February 27, 2014

A very bad case of gastroenteritis (I won't speak of the horrors of that disease) and an impending exam tomorrow have made writing rather low on the priority this week.

February 21, 2014

i've got friends in low places

     "That'll be $1.55.  How you doing?"  Every single morning for a month it was the same.  While waiting for the attending to show up for rounds, I'd run down to the cafeteria to grab the largest iced tea possible for my source of caffeine.  And every morning, I'd reply "alright, how about yourself?"
     "Good, good," was her unwavering reply. 
     For reasons that are still unclear to me, I decided to challenge her.
     "You say you're good every morning.  Nobody can have a good day, every day."
     "I wouldn't tell ya, even if I was having a bad day.  Nuh-uh.  No sir." she replied with a mischievous grin.
     "I'm going to catch you once."
     "I'd lie to ya, even if I was having a bad day," she laughed.
     I was amazed at her willingness to engage every single person.  Was it just politeness or was it real?  One morning I decided to challenge her again because I believed her to be sincere.  When she gave her usual greeting, I replied "I ain't doing so good this morning."  And I absolutely meant it.  Hell, I hadn't been doing well the whole month.
     Sure enough, she looked sad and replied, "I'm sorry honey.  Things'll get better.  Things'll get better.  You just got to be patient and have faith."
     "Yeah, but they can get worse, too."
     "You sure right.  Uh-huh.  They CAN get worse.  And that's where you just got to keep trying."
     She was so sincere and so we played this same game for the entire month.  I got to the point where I deliberately chose her checkout line, even if it was longer.  To be quite honest, it was pretty much the highlight of my day at that particular rotation.  She showed more empathy and sincerity than many of the medical staff.  And the very last day of my rotation when I kept picking at her, she said in almost a whisper, "maybe next time I'll tell ya when I'm having a bad day."
     "Ahhh, it's my last day here for this month," I said with some disappointment.  "But I'll back at the hospital another month."
     "Alright, you can get me then."

February 13, 2014


     Historical diagnosis of what afflicted a famous figure is a dicey proposition at best.  But I read of an interesting theory surrounding Ernest Hemingway's death by his own hand.  He had suffered multiple traumatic injuries leaving his body a shadow of its former self, and this from a man who was known for his daringness and bravado.  His pain left him unable to do the things he loved and that included writing.  So one theory hypothesizes, guesses really, that had medicine been able to treat pain better half a century ago, perhaps he might not have taken up that shotgun.  It's an interesting theory in that I can relate to my own life.  My physical pain has been tormenting me of late to the extent that it's limited my ability, even my desire to write.  Being in pain is exhausting.  It saps your physical energy, your emotional energy, your very will.  When I get home, my mind is not on how I want to enjoy my evening.  It's not even spent on how to make the pain go away.  It's spent on how to get the pain down to a tolerable level.  So it goes with chronic pain.  I can't remember the last time I've been pain free.  As I've said before, I have developed a very deep empathy for patients with chronic pain.  It's hard to treat and most doctors don't want to touch it or even know how to do it properly.  My family doc, fortunately, has done right by me for which I am infinitely grateful.  He tolerates a lot of my self-diagnoses (we usually agree so that helps) and experimenting with different modalities.  I can only hope that I will do the same down the road with my patients.  But it explains my lack of writing lately.