Sunday, April 18, 2010
Tailgating Coffee
She embodies every quality I have ever looked for in a woman. She is amazing to watch. She is so beautiful. Her smile, a contagious wonderment, warms my heart. Next to me on the tailgate of my truck in the middle of a D.C. neighborhood, we sip coffee together. We speak of our love and of our dreams together. The sun paints the ground, while the birds give us harmony. I find myself lost in our conversation. I love this woman before me. My life is with her. Blessed am I. Loved am I. When I am alone the mere thought of Elizabeth and how happy she makes me brings a joyful tear. I admit on quiet nights alone in my room of falling to my knees and praying that this is all not a dream.
Saturday, April 17, 2010
So, here I am...
So, here I am seven days away from completing my last rotation in the hospital as medical student. After the seventh day, my next walk down a hospital corridor while wearing a white coat will be as a physician. And although I now carry the weight of medical decisions only authorized by a physician, I do not carry the same burden. I still have that safety net in place. I am not quite yet on my own. I would be lying if I said I didn’t have fears of this impending day. There is much fear in knowing I am human and fully capable of making mistakes that may in error takes someone’s life away or hurt them. Such fear will always be a component of my life. I wear this badge; I will always wear this badge.
I am fortunate in more ways than I could ever describe within the content of this manuscript. Blessed am I. Every day on the wards of Georgetown University Hospital I am reminded. This month I have seen my fair share of death and suffering. Every little bit of it takes something from you, but if you are careful, then you realize the return has a magnitude far and above what you lose. Death has a face, an air, an ambiance. Foremost it is scary to the observer although not always to the bearer: ashen, either deafening quiet or piercingly loud, time stops, cold, completely sterile or completely messy, alone despite company. You never forget them. You learn from them. You become a better doctor because of them.
In the last week, I have taken care of four dying patients. All of which are at different stages in the process of dying let alone grieving. There is cancer. In the body’s worst way, it turns on itself, the irony of immortal cells. The body dies from its own cells. There is unrelenting infection. As physicians, we are masters of chemicals. We find a problem and throw laced candy at it. We laugh at bacteria. We laugh at fungi. We laugh at parasites. We stare hard at viruses. But, in this laugh and stare, we hide. For, it is these tiniest of organisms that we never turn our backs. Death comes by sea, a flood of overwhelming inflammatory chemicals produced by the body itself, again the irony. At times, the body is stripped of its armor. With battle, the rage of both exotic and commonplace infections easily overwhelm the defenseless body. Slowly, by means of drowning or starving, the body slides away to that deep undiscovered country of which no traveler returns.
There are those patients; the kind you know are not going to leave the hospital with a heart beat. They are prisoners to the hospital bed for months. You keep track of their stay in terms of weeks and not days or hours. They weep tearless cries. Barely able to move despite physical therapy, they rot, nearly catatonic, in an endless state suffering with emotions of frustration and anger. They are held together by a mere single remaining fiber of dwindling hope. They demand an end to the countless questions every morning before the sun comes up. They glare at the same damn ceiling, day in and day out. They have given up on fighting the needle sticks every day for the countless blood drawls only truly taken so that the doctor can check the mental box for the day. Yes, I have tried to help this patient today. In their indolent course, they lose the ability to make decisions. They fall victim to the choice of another, a surrogate, a hopeful ill-informed guardian. One day after months, their last fiber breaks, and they die. It is for these patients that today I weep in silence and solitude. It is for these patients that doctors and nurses must maintain due diligence in doing what is right and best for the patient. To the contrary of what most believe, the easiest thing to do is to throttle up and allow the system to keep these dying patients alive in a state of morbid suffering with no hope of recovery. We must always be cognizant of patient despite our own fears.
I am fortunate in more ways than I could ever describe within the content of this manuscript. Blessed am I. Every day on the wards of Georgetown University Hospital I am reminded. This month I have seen my fair share of death and suffering. Every little bit of it takes something from you, but if you are careful, then you realize the return has a magnitude far and above what you lose. Death has a face, an air, an ambiance. Foremost it is scary to the observer although not always to the bearer: ashen, either deafening quiet or piercingly loud, time stops, cold, completely sterile or completely messy, alone despite company. You never forget them. You learn from them. You become a better doctor because of them.
In the last week, I have taken care of four dying patients. All of which are at different stages in the process of dying let alone grieving. There is cancer. In the body’s worst way, it turns on itself, the irony of immortal cells. The body dies from its own cells. There is unrelenting infection. As physicians, we are masters of chemicals. We find a problem and throw laced candy at it. We laugh at bacteria. We laugh at fungi. We laugh at parasites. We stare hard at viruses. But, in this laugh and stare, we hide. For, it is these tiniest of organisms that we never turn our backs. Death comes by sea, a flood of overwhelming inflammatory chemicals produced by the body itself, again the irony. At times, the body is stripped of its armor. With battle, the rage of both exotic and commonplace infections easily overwhelm the defenseless body. Slowly, by means of drowning or starving, the body slides away to that deep undiscovered country of which no traveler returns.
There are those patients; the kind you know are not going to leave the hospital with a heart beat. They are prisoners to the hospital bed for months. You keep track of their stay in terms of weeks and not days or hours. They weep tearless cries. Barely able to move despite physical therapy, they rot, nearly catatonic, in an endless state suffering with emotions of frustration and anger. They are held together by a mere single remaining fiber of dwindling hope. They demand an end to the countless questions every morning before the sun comes up. They glare at the same damn ceiling, day in and day out. They have given up on fighting the needle sticks every day for the countless blood drawls only truly taken so that the doctor can check the mental box for the day. Yes, I have tried to help this patient today. In their indolent course, they lose the ability to make decisions. They fall victim to the choice of another, a surrogate, a hopeful ill-informed guardian. One day after months, their last fiber breaks, and they die. It is for these patients that today I weep in silence and solitude. It is for these patients that doctors and nurses must maintain due diligence in doing what is right and best for the patient. To the contrary of what most believe, the easiest thing to do is to throttle up and allow the system to keep these dying patients alive in a state of morbid suffering with no hope of recovery. We must always be cognizant of patient despite our own fears.
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