2017 In Review

2017 was tough.  Even setting aside the obvious travesty of Trump’s presidency, the past twelve months have battered me.  My closest friend was killed in a freak sledding accident.  My family’s cat of nearly twenty years died of renal failure.  My parents, married for 30+ years, separated.  My health suffered after months of working 100 hours a week; I developed a crippling viral pneumonia that left me wan and exhausted.  The sable talons of depression have sunk into my flesh once again.  And yet, I’m here.  Bruised, thin, quieter.  Wiser, kinder, more empathetic, more spontaneous, more appreciative of life’s precious tenuousness.  On net, a more complete person, but the transaction has been hell.  2017, I won’t miss you.

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Heroic Efforts

In the wake of the horrific Las Vegas shooting last week, there was–justifiably–a great deal of media coverage on the first responders, police, and healthcare workers whose actions saved hundreds of lives.  But there was also attention paid to the actions of ordinary citizens who risked their own safety to save others, and those stories prompted me to think about the untold heroes in our everyday world.  Contemporary society idolizes pop stars, Youtubers, Hollywood names, and sports players, but the true heroes reside among us:

The blue-collar construction worker who rises at 5 AM on a blustery January morning, sipping cheap 7-11 coffee from a thermos, frost on his beard, to pour asphalt on a new county road for $9 an hour to feed his wife and three daughters.

The fifteen-year-old, openly gay sophomore boy who faces daily jeers and abuse in the halls of his high school, routinely shoved into lockers, tripped in the cafeteria, and bullied online, to advance our social mores by an almost imperceptible margin.

The young black couple in inner-city Baltimore who determinedly raise their two sons to be upstanding, polite, scholarly men amid the crushing weight of poverty and neighborhood gang violence.

The first-generation college student from an uneducated rural Hispanic family who stays awake until 4 AM studying her pre-med coursework, sacrificing friendships and social engagements, to fulfill her dream of becoming an orthopedic surgeon.

The 85-year-old widow with crippling rheumatoid arthritis and depression who grimaces through a 1/2-mile walk every Wednesday to read to elementary school foster kids at the local library.

The heroin addict struggling to come clean, bouncing in and out of rehab centers and methadone clinics, barely holding onto her waitress job, in order to give her 3-year-old daughter a better life.

The recently graduated, debt-strapped teacher who spends hours crafting original lesson plans, buying classroom supplies with his own food budget, because he is fixedly intent on not simply instructing but inspiring his students.

Often, when I walk the streets or in public places, I watch the people around me and wonder about their stories.  After the tragedy of last week, I am more certain than ever that each of them, and each of us, is heroic.

30-hour day

I have not written much lately.  I have not done much of anything except work.

As part of my emergency medicine residency, I am required to complete two months of training at the University of Maryland Shock Trauma Center in Baltimore.  I enjoy being back in the city of my graduate school days, but the schedule at Shock is absurd: 80+ hours per week and call shifts in which I remain awake at the hospital–making critical life or death decisions about patient care–for 30 hours straight.  It is brutal.  It is unhealthy for residents.  It is unsafe for patients.  Yet, the culture is one of “It has always been this way.”  That doesn’t mean it should stay this way.

I tell every patient, and am now telling you, that I have often been awake for more than 24 hours when I am trying to figure out how to save a person’s life.  My brain is so tired, I frequently have trouble speaking clearly.  Patients are universally, and justifiably, appalled by this information.  I hope the reader need not require hospitalization, but if you do, ask your doctor for how long she or he has been working on shift.  The answer may not be a comforting one.

Upwards of 250,000 Americans die every year from medical errors.  The medieval, ridiculous, dangerous culture surrounding physician work hours surely is a part of the problem.  Physicians apparently refuse to heal themselves, so it’s up to readers and patients to demand change, to demand well-rested doctors, and to demand oversight and penalties for renegade providers and institutions that push physicians beyond all reason and margins of safety.

Sonnet for a Poetic Physician

“You ought to write,” she urged, “Speak truth in poems.”
“No thanks,” said I, “My life is at bedside.”
“But dear, you’ve got a tender soul to show’ems.”
“Ms. Prof, healed lives, not rhymes, will I provide.”

Turns out, the crazy bat gave counsel wise.
Full half a doctor’s task consists of words:
Exsanguinate, necrose, anaesthetise.
Put those in terms a patient’s mind can learn.

Take care to shun grandiloquent verbosity,
For speech alone won’t always save a life.
Inflamed appendix threatens all vivacity.
Its sole redress is surgeon’s steely knife.

Ol’ Williams might have stayed his patient’s grave
If fewer breaths to barrow red he gave.