September 14, 2011

extrusion of pain

     Monday morning.  Brand new week.  I took a jog in the morning sun before the thermometer had a chance to flirt with triple digits.  I don't particularly like running.  In fact, after about the first mile, I pretty much hate it.  But I need to exercise and I need something mindless.  So I go for a Monday morning run.  Exercising means music and I crank it up.  And out of the blue, a line from a song hits me like a blow to the stomach.
Suddenly, you were gone
from all the lives
you left your mark upon...
     The waves of grief and sadness have been flowing over me with greater occurrence of late.  Sometimes, they are triggered by events that warrant anticipation or expectation.  Holidays, birthdays, special occasions.  Those I can handle.  I expect it and brace myself for the emotions.  It's the little ones that creep out of nowhere, like a predator stalking a prey that is unaware of the danger lurking around a corner.  Sometimes elicited by a song, sometimes by a dream, or many times by nothing at all.  Those are the ones that hurt the worst.  And they're becoming worse.  Like running while tears come down your face.  Visions of my brother's final days flash through my mind.  Prognostications of something going horribly wrong with my dad are right behind them.  Crimeny, I'm out there trying to clear my head before going to school.  Apparently 'clearing my head' is permission for something else to take that vacancy.  And then another song shuffles through the iphone of my brother with these lyrics
For my father and my brother
It's too late
But I must help my mother
Stand up straight
     That's it.  Screw this.  I'm done with running and am actually looking forward to school by now.  Exercise has done anything but unwind me.  I drive the 33 miles down to school for my group work where for two hours every Monday, Wednesday and Friday, eight of us, under the tutelage of a doctor, unravel a case and practice how to be doctors.  Pieces of information are fed to us slowly with probing open-ended questions so that we can hone our skills at each stage of the diagnosis and treatment.  This case?  Patient comes in with fatigue and unexplained weight loss.  After identifying the "problem list", we're now free to start compiling our Differential Diagnosis.  There's a bit of a pause becomes symptoms so nondescript as this patient can be damned near anything.  But I say, "anytime there's unexplained weight loss, especially with fatigue, you have to include cancer."  As the scribe today, I write that as the first line on the dry erase board.  C--A--N--C--E--R.  I know damned well where this case is going and I bet it's not going to end well.  I can't run fast enough to escape this one.

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