things I've learned from the ER

Tworkocet - (noun) a patient who comes to the ER with some vague non-emergent complaint who wants a turkey sandwich, a note excusing them from work for said vague complaint, and a Percocet.

the many emotions of chronic pain

the many attempts to make the pain less

These are band aids from where I had a doc stick a wire into my spine not once, but 4 times. Then went back to work. 

how many doctors does it take to screw in a light bulb?

For anyone who has been in the hospital, you know the drill. You see the doctor for maybe 5 minutes once a day. At an academic hospital, you get residents. And you're lying in bed wondering what in the hell is the doctor doing? And why hasn't he or she written that order for the new medication? What exactly is taking so long?

Just how many doctors does it take to take care of a patient? It takes 5 residents to care of 8-12 patients 24/7, 7 days a week. And these are highly complicated patients. Some of them are worthy of a Dr House episode. 

We sacrifice our families to take care of our patients. We live at the hospital. We lose sleep over the ones we are losing. We even dream about the patients as it is so all consuming. We go home and read about our patients to see if there is a new and better way to help them instead of sleeping. We are doing things far beyond what a doctor normally does. We are scheduling appointments for them when they get discharged so they don't get lost to follow up. Sometimes we see them ourselves in the clinic. We are on the phone with specialists or other hospitals. We are on the phone with the pharmacists and nurses. We walk miles during one day making rounds throughout the hospital. We age ourselves at least a year in just one month. And at the end of the month, we are left smiling and proud of the work we have done.  Believe it or not, there are doctors who truly care. I just had the privilege of spending a month (it felt like six months) working with them. 

the many colors of pain

These are lidoderm patches. They are just one weapon in my armament of living with pain. Clearly, I cannot put these on myself. So I rely on my wife who does it best as she's had a LOT of practice. Other times, I rely on the kindness of nurses.

finding beauty

Pack up all those phantoms
Shoulder that invisible load
Keep on riding North and West
Haunting that wilderness road
Like a ghost rider

Carry all those phantoms
Through bitter wind and stormy skies
From the desert to the mountain
From the lowest low to the highest high
Like a ghost riderKeep on riding North and West
Then circle South and East
Show me beauty but there is no peace
For the ghost rider
- n. peart 

During a dark night of the soul, pleasurable things often drop to the wayside. Slowly, one begins to touch those old parts to see how they feel. First, with hesitancy and a quick withdrawal. With time, one grabs the thing, flips it over in one's hands, gets the weight of it, the texture, the smell. Photography is one of those things I recently started exploring. At a time, I could capture beautiful scenes while backpacking. But as backpacking fell off, so did photography. Now, by chance I've noticed my new iPhone has quite phenomenal optics. I still could do more with my old SLR camera but I'm learning to find find beauty in that around me. Sure the framing is off, the composition and lighting could be better. But it's early on. Here is a water wall of the McGovern Center for Humanities (proud alumnus) which I pass on the way home from the hospital. 

stress

     I've never been a great sleeper. I figured working long, grueling hours would make sleep a pretty simple proposition. After all, it's one of the top three priorities of residency, along with food and showering. But I wake up with nightmares. I wake up thinking about my patients. I have trouble falling asleep despite being exhausted. So, I fall back on to what I've used ever since my brother was diagnosed. I lift heavy things and set them back down. It transforms the anger and as a consequence, I fall asleep eating. This hand is what stress looks like. Mala beads as an ever present physical reminder of where I've been, who I am, and to never lose my humanity. Chalk covering my hands to keep the bar from slipping. The spiritual and the simple physicality. 

beginning the day

At 0:dark thirty, my day begins. The heels of my boots echo off the walls as I stride down to a computer and begin assessing the patients. 

Christmas lights

I rarely saw the sun, or even daylight in December, but I loved driving by this waterwall every evening. It graces the McGovern Center for the Humanities, of which I am a proud almnus. 

Impossible boots to fill

     "That man....do you know what he would do? It didn't matter where I was. He would walk straight to the back of the cafeteria if he had to and give me a hug.  Every day. This man was BUSY. How many doctors you know do that? Most don't even look their patients in the eye." Her eyes were starting to well up with tears. She was of course, referring to Dr Red Duke. Whether the person was the president of these United States, a cafeteria lady (or a med student), he treated everybody the same. 

     "If I turn out to be a fraction of the doctor he had in the tip of his pinky finger, I'll consider myself a success."

     "Uh-uh," she shook her head no back and forth. "You got to be BETTER than that. You've got some mighty big boots to fill. And you'll fill'em. You have to. We need docs like that."

     "Well, I know I ain't him, but I'll be the one to start giving you hugs."

     And a wry smile cracked her face. "You better live up to that. Don't make promises you ain't gonna keep."

     So I hugged her like my cousin taught me to.