Earlier this week I went through a phase where I radiated sex appeal like a beacon. I don't have these phases often, since I'm usually too caught up in what's going on in my head to focus energy outward. I was catching the stares of men everywhere, extricating myself from ubiquitous conversations with men behind counters and on the street who wanted to chat me up. I felt almost like Chris in that Northern Exposure 3rd season episode, Only You, who goes through an annual phase where he is ravaged by virtually all women due to his unusually potent pheromones (I recently purchased the Northern Exposure third season DVD's and have watched them voraciously, so everything in my life is referenced to those episodes right now.) I wasn't sure how it happened, and consulted with Joe for ideas. His simple suggestion: maybe you're happy with what you're doing. Hmm. Maybe I am.
I lost a patient the day before my birthday. He was the patient whose wife I have written about in past posts. He was doing really well, and we had planned to send him home in the next day or two. Then, unexpectedly, he crashed during the night I was on call. I fought so hard to get everything done for him--ABG's, ECHO, CT, and so on. I wasn't ready to let him go. But when I looked at him in the early afternoon the next day, I just knew that it was too late, that he had already edged over the line between life and death. People on the verge of death have a certain look, a certain manner about them, which I now recognize after seeing it multiple times during the last month. Before I left, I embraced his wife and whispered in her ear, "I'm so glad I met you and all your family. I just wish the circumstances could be better." And she held me tight as she replied, in that thick raspy Southern drawl, "Ah know, honey, ah know." I was devastated. After I went home, I promptly ate a pint of Ben & Jerry's while watching Sex and the City episodes. (Such a cliche!) Yet another Northern Exposure reference: the episode A Hunting We Will Go, when Dr. Joel Fleishmann falls into depression after failing to save a grouse he shot while on a hunting expedition. (You have to watch the whole episode to really get it.) There's a scene at the end where he's crying in front of the TV with multiple open cartons of ice cream. Yup. That was me a couple of weeks ago.
Despite our differences in politics, I had grown very close to his family. A few days before he passed, his wife said to me, "Elizabeth, you have a good soul, and you're going to be a wonderful doctor some day. I can just tell how much you care by the way you smile, the way you listen, the way you are with us. And I can also tell that you don't realize how good-hearted you really are. Embrace it, and treasure it." Of course I began to cry. I haven't lost my emotions yet, although I'm sure desensitization will come with time and experience.
Thursday, July 07, 2005
The previous post was written last night. I still don't know much about the bombings in London, because I was running around taking care of patients all day, but I'm horrified that it happened. Thankfully my close friend, who is finishing up grad school there, is safe. I'm not sure what to make of this, and how our government will spin it. Are they still claiming that the world is a safer place after they invaded Iraq?
I discovered the news while in a patient's room this morning. His wife was shaking her head at the TV, which was playing CNN's report of the event. She's a warm Southern lady with a smoker's raspy voice adding a gritty texture to her honeyed, elongated vowels. When I previously asked her if her husband had any allergies to meds, her response was, "Well, now, there's that Demerol...it makes him all itchy and flushed and red and miserable. I always remember that one, because it makes me think of Democrats!" Boy did I have to bite my tongue there. Anyway, this morning she was saying, "It's so sad over there. They have all those bad people who hate us, and who are teaching their kids to hate us. We've got to teach them that life can be much better. America is a great country, with a great way of life, and they should have that too. I want everyone to have that." It's not my place to argue with patients and their families about politics, but this made me sad. Do many Americans truly think that Middle Easterners don't know anything about love or goodness, and we need to export decency and morals, like we export MacDonald's and Britney Spears CD's, to those poor heathens who don't know any better? How are we going to convince them that we're good, and that they should follow our way of life, when we've killed so many of them, often without good reason? Of course they hate us! The invasion has just added gasoline to the fire.
I discovered the news while in a patient's room this morning. His wife was shaking her head at the TV, which was playing CNN's report of the event. She's a warm Southern lady with a smoker's raspy voice adding a gritty texture to her honeyed, elongated vowels. When I previously asked her if her husband had any allergies to meds, her response was, "Well, now, there's that Demerol...it makes him all itchy and flushed and red and miserable. I always remember that one, because it makes me think of Democrats!" Boy did I have to bite my tongue there. Anyway, this morning she was saying, "It's so sad over there. They have all those bad people who hate us, and who are teaching their kids to hate us. We've got to teach them that life can be much better. America is a great country, with a great way of life, and they should have that too. I want everyone to have that." It's not my place to argue with patients and their families about politics, but this made me sad. Do many Americans truly think that Middle Easterners don't know anything about love or goodness, and we need to export decency and morals, like we export MacDonald's and Britney Spears CD's, to those poor heathens who don't know any better? How are we going to convince them that we're good, and that they should follow our way of life, when we've killed so many of them, often without good reason? Of course they hate us! The invasion has just added gasoline to the fire.
Well, now I feel a bit silly. After all the whining and anguishing about medicine, I've discovered that I absolutely love what I'm doing right now, despite how depressing it can be. Then again, I'm only about 1.5 weeks into it. Give me time.
I was on call a few nights ago, and accompanied the intern as we approached the bed of a patient who was bleeding to death. His skin was ghostly paper-white, presenting a stark contrast with the thick, scarlet stream of blood gushing from his mouth, down his chin and onto his hospital gown. The room stank of iron, like the smell of the toilet paper used to wipe my bloody genitals when I'm having my period. As just a student, I was helpless, standing there as a team of doctors suctioned blood out of his mouth so he wouldn't choke, and pumped pain medications into him so he could be as "comfortable" as possible while waiting to die. His eyes were huge, round, and focused on me. I couldn't meet his gaze. I didn't know what his mental status was, I didn't know if he had thoughts, if he understood what was going on. I didn't know how long it would take for him to die, and I couldn't stare at him, or have him staring at me, while it happened. It was a truly horrific sight, to see someone suffering like that, to see someone dying in such an ugly, messy way. I have seen death before, but it had always been quiet, composed, a whisper of a breath and then none. I couldn't take it anymore, and left the room. At that point, I wondered what I was getting myself into, and whether I could do this job.
Outside the room was the man's wife. She was quietly trembling, with a few tears sliding down her cheeks. We stood outside of her husband's room, silent, listening to the sounds of suctioning, beeping, shouting of the doctors. She knew that she was moments away from losing her husband, someone she obviously loved, someone with whom she had shared a life for many years. She was moments away from being alone. I ached for her, and failed to imagine what kind of grief she must be experiencing. After several excruciating minutes, I asked her about their kids. She seemed to welcome the distraction, and told me their names, and what they were doing with their lives. She exuded a mother's pride as she spoke about them. She even smiled a few times. The intern then reappeared, and after the wife said there was nothing more we could do to help, we left her waiting outside her husband's room. I went home soon afterwards. Her husband died while I lay in bed at my apartment, unable to sleep as I was haunted by images of him staring at me--so pale, so weak, so lost.
The intern told me the next day that after he died, there was a new medicine/psychiatry resident on call who was excited to practice his counseling skills on a recently bereaved family. The intern shared this information with a bit of disgust, which I shared. Sure, we're students who are using patients to learn, but hopefully we don't forget we're dealing with people, right? Not just learning tools. During my own health crisis, my medical student friends viewed my situation as another learning opportunity, as they printed me papers and rattled statistics. I kind of hated them for it; those relationships still haven't fully recovered, and probably never will. I'm not saying that I'm above such tendencies. I have some patients right now with very rare and complicated diagnoses, and while I empathize with their suffering, there is still a part of me that is fascinated by their diseases, and is excited to learn about them. I think to do this kind of work, you have to be genuinely interested in the information, and get some kind of satisfaction from it, or else you'll burn out. I keep that part tucked away whenever I speak to patients, though. I don't think it's appropriate to act excited about someone else's health crisis in his or her presence.
Most doctors, or would-be doctors, have a weird fascination with power. I remember when a former friend, now a bona fide doctor, told me about an experience on the wards, during either our first or second year of medical school (we were just babes then). He was given the task of informing a patient that she had a new diagnosis of cancer. As he described the experience, I felt an uncomfortable twinge in my belly, because he didn't seem to be at all sensitive about the terror and pain and loss the patient must have experienced at the time. Instead, he was caught up in the incredible power he had at that moment, as the bearer of such life-changing news. He kept talking about how great and amazing it was. The hell? I don't know whether he's changed, but since he's chosen a field which doesn't require much patient contact anyway, perhaps it's moot to even consider.
I was on call a few nights ago, and accompanied the intern as we approached the bed of a patient who was bleeding to death. His skin was ghostly paper-white, presenting a stark contrast with the thick, scarlet stream of blood gushing from his mouth, down his chin and onto his hospital gown. The room stank of iron, like the smell of the toilet paper used to wipe my bloody genitals when I'm having my period. As just a student, I was helpless, standing there as a team of doctors suctioned blood out of his mouth so he wouldn't choke, and pumped pain medications into him so he could be as "comfortable" as possible while waiting to die. His eyes were huge, round, and focused on me. I couldn't meet his gaze. I didn't know what his mental status was, I didn't know if he had thoughts, if he understood what was going on. I didn't know how long it would take for him to die, and I couldn't stare at him, or have him staring at me, while it happened. It was a truly horrific sight, to see someone suffering like that, to see someone dying in such an ugly, messy way. I have seen death before, but it had always been quiet, composed, a whisper of a breath and then none. I couldn't take it anymore, and left the room. At that point, I wondered what I was getting myself into, and whether I could do this job.
Outside the room was the man's wife. She was quietly trembling, with a few tears sliding down her cheeks. We stood outside of her husband's room, silent, listening to the sounds of suctioning, beeping, shouting of the doctors. She knew that she was moments away from losing her husband, someone she obviously loved, someone with whom she had shared a life for many years. She was moments away from being alone. I ached for her, and failed to imagine what kind of grief she must be experiencing. After several excruciating minutes, I asked her about their kids. She seemed to welcome the distraction, and told me their names, and what they were doing with their lives. She exuded a mother's pride as she spoke about them. She even smiled a few times. The intern then reappeared, and after the wife said there was nothing more we could do to help, we left her waiting outside her husband's room. I went home soon afterwards. Her husband died while I lay in bed at my apartment, unable to sleep as I was haunted by images of him staring at me--so pale, so weak, so lost.
The intern told me the next day that after he died, there was a new medicine/psychiatry resident on call who was excited to practice his counseling skills on a recently bereaved family. The intern shared this information with a bit of disgust, which I shared. Sure, we're students who are using patients to learn, but hopefully we don't forget we're dealing with people, right? Not just learning tools. During my own health crisis, my medical student friends viewed my situation as another learning opportunity, as they printed me papers and rattled statistics. I kind of hated them for it; those relationships still haven't fully recovered, and probably never will. I'm not saying that I'm above such tendencies. I have some patients right now with very rare and complicated diagnoses, and while I empathize with their suffering, there is still a part of me that is fascinated by their diseases, and is excited to learn about them. I think to do this kind of work, you have to be genuinely interested in the information, and get some kind of satisfaction from it, or else you'll burn out. I keep that part tucked away whenever I speak to patients, though. I don't think it's appropriate to act excited about someone else's health crisis in his or her presence.
Most doctors, or would-be doctors, have a weird fascination with power. I remember when a former friend, now a bona fide doctor, told me about an experience on the wards, during either our first or second year of medical school (we were just babes then). He was given the task of informing a patient that she had a new diagnosis of cancer. As he described the experience, I felt an uncomfortable twinge in my belly, because he didn't seem to be at all sensitive about the terror and pain and loss the patient must have experienced at the time. Instead, he was caught up in the incredible power he had at that moment, as the bearer of such life-changing news. He kept talking about how great and amazing it was. The hell? I don't know whether he's changed, but since he's chosen a field which doesn't require much patient contact anyway, perhaps it's moot to even consider.
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