|
|
Friday, November 20th, 2009
|
|
|
|
|
Are you supposed to outgrow it, the need for a mentor, a role model? I didn't realise until I found it that I was missing it. It's been a while. For a long time, I've been purely a functional unit. All you do at work is work. Do the tasks that need to be done. Do things because you're told to, the way you're told to. It's been tough. Toe the line, as you're expected to, and that'll take up plenty of energy on its own.
Dr N, he's a ray of sunshine in the dark. He actively tries to teach, seizes on whatever opportunities turn up, whether it's stopping me at a monitor and making me explain a CVP trace, or demanding that I tell him more from an ABG than just the oxygenation and acid/base state, or getting me around to look down the scope as he's doing a bronchoscopy.. Other people get their heads down and just want to get their tasks done and that's it. He actually pushes me to be better. Tips on things like the right way to lay out your sharps in a procedure, or even reminding me about the right attitudes to have.. And he practices what he preaches. The solid confidence that comes with many years of experience, and knowledge that he has deliberately accumulated..
I want to get to that level. I want to get to his standard of practice. Rather than uncertainty, I want to be that good, be that sure of myself. I don't think it necessarily means having all the answers, because I know fully well that no one can. But being able to back up my decisions with good skills and knowledge.. It's partly about time in the field, but it's more than that as well. Other people who have been out in practice for as long aren't as good. I think it's about a deliberate choice to be better. To carry certain attitudes with you. Which I'm trying to learn.
~~~
Man: You're not this good. Nobody is this good.
Michael: I am.
-Burn Notice
|
|
|
Saturday, October 17th, 2009
|
|
|
|
|
This rotation..this rotation is destroying me. It feels like the only thing I'm getting out of this is self-doubt. It's disempowering. I've gone miles backwards from my last rotation. Yes, believe it or not, I actually miss my Psych time. There, my consultant trusted my judgement, and I was responsible for making decisions. Here, I have to run every little thing past someone else, and somehow everything I do is wrong. Man who's septic postoperatively, who's got a haemoglobin that's been progressively coming down over the last 48 hours to the latest of 69 who I want to transfuse a couple of units of blood.. For some reason that's the wrong thing to do. Woman whose serum phenytoin level has been subtherapeutic over the last couple of days whose phenytoin dose I want to increase.. Shouldn't do that either, but keep monitoring. But wait, consultants change over, and then a couple of days later I get told off for not increasing her phenytoin dose. Man's potassium level is 4.8 on morning bloods, and so I give him resonium..and then get told off because although 4.5 is taken to be the upper limit of normal in this hospital, in other hospitals it's 5.0, and I should have just let it be because now he'll probably become hypokalaemic in subsequent days. Woman's sodium is 147? Why didn't I do something about it?
Yes, there's one of me overnight for the ten patients, whereas there's three of them in the daytime for the same ten patients. And yet it's my responsibility to do everything for everyone that the day team didn't pay attention to when the lots more of them were on in the daytime.
In my last rotation, the amount of responsibility I was given..was surprising, to say the least. But my consultant always backed me up. Here, it goes between not being allowed to make any decisions independantly, and either being told that all the things I want to do are wrong, or being told off for not doing things.
I'm sick and tired of this, I really, really am. How am I supposed to go from this back to a position where I'll have to responsible for making my own decisions again, and maybe for supervising other people in theirs?
It's been a long time since I've truly dreaded work. When the thought of going back makes your heart sink. Makes you feel cold on the inside. I do now.
~~~
"Not all experiences are good for you. Some experiences hurt you."
-Leaving The Fold"
|
|
|
Thursday, October 1st, 2009
|
| Time: | 2:28 am. |
| Music: | Car Crash, Matt Nathanson. |
|
|
|
Being done with exams.. It's brilliant, but still doesn't feel real yet, though it's been weeks (I can use the plural now) since. Even with the letter to confirm it (who knows whether the stuff they put the website isn't a mistake, or a misaligned table?), it's still novel enough to mind to repeatedly turn up.
Other people tell you, and I believe too, that the exams don't tell what kind of doctor you are, or are going to be. And yet, there's a sort of validation in getting through them (or maybe it's just me), that allows the belief that you pass muster, that you are good enough (or managed to fool them into thinking so) to join the club..
The other side to that though, is that while time and effort are prerequisite sacrifices for this, they still don't guarantee the result. That's what stings. And we give up a great deal to this. I'm not sure people on the outside get just how much of our lives we give over to it. It requires about the equivalent of full-time study, while doing full-time work. At least 20 hours per week per subject is the recommendation. And as one of my consultants pointed out, this is unpaid time, that comes out of any time that work has left you. I've used it before, and the applicable word still is "sacrifice". And the toll it takes, mentally, emotionally.. We are turned into different people by it. Not necessarily better ones.
What now? It's like coming out to the light after having been underground for a long time. Your eyes get used to the dark, to the way things are, even though it's bleak and colourless. Then you're blinded by the light, too much so to take in what it means, or what's out there. I find myself a little lost as to what to do now. Almost anything is a possibility in theory, I could recover some semblance of a social life. I could learn other things, now there are neurons free.. It'll take some getting used to.
The other side though, is the strange way people now expect you to actually know things..without realising that the vast volumes of information retained for the exams have now been deleted to make room for..well, nothing much yet, but potentially useful things.
It's all barely begun, really.
~~~
Nothing worth having
Came without some kind of fight..
-Barenaked Ladies, Lovers In A Dangerous Time
|
|
|
Sunday, September 6th, 2009
|
|
|
|
|
"The stories we don't tell are as important as the ones we do," he says.
And then he falls silent again. |
|
|
Friday, August 28th, 2009
|
|
|
|
|
To not succeed.. It's an unbearable thought. After all this effort, all the life and everything else I've given up.. And yet I know that others before me have put in no less effort and come away with nothing still. You can't get there without sacrifice..but the sacrifice doesn't mean you will get there.
And then there are the times I wonder.. If I get through this..then what? I waver in my notional conviction, intermittently. Unsure if this is really the path I want. Uncertain about what it leads to. The pragmatic question of where I'm going to wind up working at the end of it.
I don't feel like I have my head together. I'm not old enough for the role I'm playing. I am random, arbitrary, the thoughts that occur come plucked from a whirlwind. I'm not sure how to impose order on that chaos. It needs order.
The days that I wonder..how I got to here.
~~~
Man: You can't build a bridge out of fear and pain, can you?
Michael: No, because that would make it structurally unsound.
-Burn Notice
|
|
|
|
|
|
"A man with no future will always run back to his past." A line well-recalled from Due South. I wonder if that is what it is. The attempt to find an anchor to something. I am in the midst of reading Oracle Bones. Another, Travellers' Tales of China, sits waiting in the wings.
I have, truthfully, never felt much calling to my ancestry. The decade of mandarin we were compelled to do in school was painful, both for me, and my multiple tuition teachers. I don't understand people who claim pride in what people generations before them did. What right do they have to lay claim to the achievements of others, or think that the aura of that glory somehow filters down to them? The past..is past. And yet I find myself seeking out things of a certain flavour.
Does it make me a disgrace, that I can barely speak my mother tongue? And if you were to be puritan about it, mandarin wouldn't be my mother tongue, and I really can't speak the dialect I have genetically inherited.. Or the fact that I have the barest inkling of the history I have descended from? I have never been to that supposed hall or temple somewhere that holds the giant book in which all our names are inscribed.. It's interesting, but not part of my reality.
My reality, instead, is mundane, mechanical. I carry on, with no sense of the past, and only uncertainty in the future. Maybe that's why a part of me wants it to be otherwise. Some people have religion to lean on. My skepticism keeps me from that as well. All I know is here and now. My bleak worldview and I.
~~~
Castiel: Our fate rests with you.
Dean: You guys are screwed.
-Supernatural
|
|
|
Saturday, July 11th, 2009
|
|
|
|
|
Somehow, I've survived the 7 months. It's the longest time I've ever spent in any rotation, and, ironically, when asked to list rotation preferences, I would have put it right at the bottom of the list. Well, maybe Ortho would go below. But other than that, it would have been right down. I did think it was some sort of giant cosmic joke, did think I would quit or something before I was halfway though.. But here I am at the end of it, done and dusted. And looking back, it now seems to have gone so very quickly. I know that's false perception though. The last few weeks were a struggle to get through.
I will miss the nice nursing staff, and supportive, easygoing consultants. Not trying to reason with psychotic patients though (somehow, I kept finding myself falling into that trap). Or being responsible for fixing peoples' entire lives (med school doesn't teach you about finding people places to live, or patching them up with their families, or keeping them from being drunk and drugged up, or keeping them out of prison..). Or the ridiculously overbooked outpatient clinics in which the only way to run vaguely on time was to not write notes on any of the 8 patients seen until clinic was over and wind up staying at least 2 hours late to fill in the details from sketchy memory. Or the essentially revolving door way of things in which the same patients would keep bouncing back, because as soon as they were discharged, they would go back to their damaging ways. The study in futility.
It still amuses me, just how many people thought I was actually on the training program. I felt like someone on that show, Faking It. It was a good term to start learning the reg role on though. It took quite some time to get used to being the person making decisions, and giving others directions. To realise that I had to step up and be leader..
Favourite lines of the term (from the consultant..to me):
"I remember, you were homeless when I first met you."
"Do whatever you want with him."
I've given up the keys of power. Over the last few months, I have to admit that I have slipped into a comfort zone (much as one can given the situation). It's about time to step out. I have been someone else for long enough.
|
|
|
|
|
|
"I want to be here."
I wish I could say that, with that much conviction. Instead, I am uncertain. Comparing apples and oranges and still unable to make a choice. I decided, and then I undecided. I am not sure what it will take to get to happy. Maybe none of the possibilities I toss up will get me there.
I am underestimated. Perhaps because I underestimate myself. After this long, I am only now adjusting to the fact that I am holding a reg job together. I've gone from the resident role to the one who has to keep the bigger picture in mind.. I always used to wonder how my regs remembered the details of our very many patients..and now I'm it. I have to admit, it is bringing the obsessive and narcissistic sides of my character out. I need to have control over what's happening with all my patients, and I keep trying to do everything myself. I suppose I haven't got the balance quite right yet. I haven't reached the stage of maturity to relax about delegating things yet. But it would seem I'm being at least credible in appearing to know what I'm doing, so I suppose that is a start..
Still unsure.
~~~
"Your feelings are right out there in the open. Stuff them back where they belong." -Bailey, Grey's Anatomy
|
|
|
|
warlike |
|
Today, I am furious and full of rants.
I am sick of this place and its racists, hooligans, and drunks. That is what my lingering impression of Queensland is. Racists, hooligans, and drunks.
"While millions of dollars are spent promoting tourism in Queensland, your residents are blithely sabotaging these efforts. Over the past couple of years, I have made holiday trips to the Gold Coast and Sunshine Coast with friends, only to be abused with racist taunts at these supposedly wonderful destinations. Not merely one-off encounters, we faced this multiple times. While dining at Brisbane's Southbank this week with other visitors, we had hooligans drive by and throw eggs at us. A truck passed me on the road today proudly displaying the bumper sticker "F--- off, we're full" on a map of this continent. Before drawing the world's attention here, perhaps some efforts should be directed to getting your citizens on the same page with the attempts to make this seem like an attractive place to visit."
That's the letter I've sent in to the papers. Because I've had enough. If I were quicker-reflexed, and in future I will be, I would have taken down the number plate of the car as it drove away. All I caught was that it was a blue sedan. And the truck, I was too incensed by that bumper sticker to note the plate of the vehicle. In future I will do better. I will hold these specific individuals accountable. They will not be allowed to go on.
Why do the people here seem so much more ignorant and stupid than elsewhere? So many more drunk people get brought in by ambulances here than in other states. The ambulances really should just leave them where they are. They can sober up in the gutter rather than clutter up the ED. I only fill them with saline so they'll get out faster. But perhaps I shouldn't. They deserve a splitting hangover. At least. The disincentive to leaving the nausea is that it will probably result in mess happening in the ED.
On to another thing, I am usually some semblance of "nice". I at least pretend to be able to get along with people. But people have been overstepping their bounds and it is getting ridiculous. Nurses do not get to decide when to discharge people. The clinical decision of when patients are fit for discharge is a medical decision. I have had enough of being pressured by nursing staff every day to discharge people who are not safe for discharge. There is a reason why doctors take out medicolegal insurance, and nurses never do. When things go wrong, the lawyers and the newspapers hold us accountable. The nurses are never accorded even part of the blame. When I have clearly said and repeatedly written in the notes that the patient is not to be discharged today, do not go and tell them that they can go home today.
I cannot wait to be done here.
~~~
Man: How many people get a second chance?
House: Too many. Half the people I save don’t deserve a second chance.
-House
|
|
|
|
|
|
Such contradictions. I think my stance is that the only person who can judge the value of a life is the person living it. And if they decide that they've had enough, if it's all too much suffering, what gives us the right to compel them to keep going? It's probably easier to say that when faced with someone who has intractable physical suffering than when it is mental/emotional. The Hippocratic oath is a rigid theoretical ideal. Making someone continue suffering can't count as "do no harm". Yes, palliative care can do a lot. But even that has its limits.
I take the Richard Dawkins stance that these lives are our own. We aren't beholden to anyone. There's no invisible, intangible essence that some other being owns. Similarly, we are not public property, not park benches for society at large to decide what to do with. If a terminally ill person, a competent adult, decides that they want to end their lives, if they are not making others do the same, why is it the business of the random public?
As I said, less clear when the suffering is not from some tangible tumour or physical disease. And yet our minds make us what we are. If we are incurably ill there, is that not something on par?
I seem to spend my days detaining people who have made that decision, that they have had enough of life. It's not logical, we say. But what of life is "logical"? All of our existence is tangled in an emotional web. The will to go on living comes from whatever joy we derive from the things in our days. What of that is logical? Happiness because of it being a good weather day. What is logical in that?
How do we come to these decisions about what is right and wrong for other people? We do things they don't want because by majority vote, other people think they shouldn't have what they want.
The more I think, the less I know.
Niles: Are you happy?
Fraser: I don’t know.
Niles: It’s a simple question. Are you happy?
Fraser: No, it isn’t. It’s very complex. Are you happy?
Niles: No, but we’re not talking about me.
-Fraser
|
|
|
|
|
|
And my natural tuning seems to be to night. Find me awake in these dark hours. Unfetter me from other peoples' routines, and I am up till dawn.
Less in others' company than my own.
Never found.
It is a charade, the playing well with others. What needs must, to pass.
Almost human.
|
|
| Time: | 11:28 pm. |
| Music: | Super Massive Black Hole, Muse. |
|
|
|
Always had a thing for vampires. The polished, surface-urbane kind, as opposed to the closer-to-primative ones. For a vast number of reasons. Sleek. Predatory. Resilient. Strong. Almost human. Dangerous. Unpredictable. Playing at the masquerade. Trying to give the impression that they belong, while always being on the outside. Trying to navigate the pull between their solitary nature and the longing for companions. Tormented. Doomed.
The latest, I have to admit, is shallower than my usual fare.
Teenage-grade fantasy, monochromed characterisations, predictable plot.. And yet something in it appeals. Probably to my teenage self. The one that wants to be watched over, swept head over heels, taken out of the world.. I know. We have to be our own heroes. But it is so very tiring. Trade the day to day drudgery of work, mundane routines of paying bills and such, for flights and running for your life? Why not?
I've always wanted a world that was different. More. I've said it before, but I wouldn't particularly want an eternity. I can barely find enough purpose to drag me through this short span of life. Living forever (or close to it from mortal human perspective) doesn't appeal. I don't understand the way the world works now. What chance would I have with the world a century from now? Then again, it might not make much difference. Don't relate now, don't relate then.. What is there to lose?
Getting old. That bothers me more. Bypassing arthritis would be grand. I don't relish the day when I can't do cartwheels or sprints any more. I can't see the point beyond that.
"I don't believe you. I've watched two-year-old humans with interest for centuries. They're miserable. They rush about, fall down, and scream almost constantly. They hate being human! They know already that it's some sort of dirty trick."
-Lestat, The Tale of the Body Thief, Anne Rice
|
|
|
|
incendiary |
|
Racism is alive and well. I could almost be persuaded to give the older ones some leeway, with the notion that that was the cloistered cultural millieu they were raised in. But the younger folk have no such excuse. They have television and the internet to tell them that there is more to the world.
What is it that makes those hooligans think they have the right to yell obscenities at us? Unlike their ilk, I do not spend my time drunk in a gutter, or damaging people/property. I can guarantee that I contribute more to their society than they do. In fact, the tax I pay, unfortunately, probably goes to supporting them. If there was ever an incentive to not pay taxes..
Before accosting us on the street, consider that some of us have better command of the language than you do. Don't you dare imagine that we don't understand what you say. Your stupidity that huddles in numbers, and leaves you still no better than neanderthal.
Someone else raised the point that perhaps these are just the people who lack the cortical capacity to filter what most people think of the minority races. In other words, most of the rest of the world we function in holds the same opinion of us, but just doesn't voice it as such. And they, in fact, are more damaging than the ones who attempt to intimidate us on the street. And that, perhaps, is what gets to me more. The reminder that we are still considered less in this society, regardless of what we achieve.
I was not raised to be a second-class citizen. I was taught to aim to soar, not be beaten down.
They will not win.
~~~
Perry: Look up idiot in the dictionary, and you know what you’ll find?
Harry: A picture of me?
Perry: No. The definition of idiot, which is a description of you.
-Kiss Kiss Bang Bang
|
|
|
|
|
|
For possibly another few hours more, I'm at that stage where, if you poke me, random information will come spilling out.
It would take at least 100ccs of an air embolus so make a young person symptomatic.
65% of people who contract Hep B go on to get a chronic infection.
Cerebral autoregulation keeps the blood supply to your brain consistent over the range of systemic bp of 65 to 140mmHg.
Cardiac output decreases by up to 40% when you stand up.
How does 10 minutes in a viva give a fair assessment of 6 months of hard slogging and sacrificing any form of a life? Or the MCQs that seemed designed more to test if you have a photographic memory of every minor point that appeared in an out-of-the-way paragraph than pertinent concepts? Not to forget that, beyond all that, the information we're forced to load has little to do with our actual practice. Does knowing what colour myocardium turns 3 days, or a week after an MI matter to us? How relevant is knowing what percentage of VLDL is triacyglycerols? When will I ever ask for, or see what anyone's CCK or secretin level is, and what would I do about them, whatever they were?
What we put into these exams, for very little return, is unjustified. On top of working full-time, we're supposed to find an equivalent amount of time a full-time university course would take to prepare for them. Not to mention the annual leave we give up to prepare in the days running up to it, and travel interstate, depending on where the exam is held in that half of the year.. It's rubbish.
I like Emergency Med for the variety of the work. You can't beat the lights-and-sirens trauma excitement. It's playing detective and fix-it all together. But the pointless obstacle of these exams might make me reconsider. I've given up well over a year of my life to them already. No matter which way this lot of exams goes, I'm facing another 6 months to do Anatomy later this year anyway. But I'm wondering now if it's all worth it.
Maggie: Who are you so angry at?
Eli: Do I have to pick just one?
-Eli Stone
|
|
|
Tuesday, March 24th, 2009
|
|
|
|
|
Another of the wonderful pitfalls of our line -- makes buying "reasonable" health insurance hard. Thinking of changing to another insurer, but I find instead of saving, I'm going to wind up spending loads more.
Yes, the young peoples' cover option is supposed to be straightforward. You're healthy, not falling apart yet, just basic cover will do. Or will it? Trauma term taught me that bad things can happen to young people. Very bad things. Sure, injuries from accidents are covered under most basic options, but if anything happens, I don't want the budget replacement parts, I want the top-of-the-line ones. After that, Rehab is what you need lots of. Guess what standard cover doesn't cover? If I get torn up, I want proper reconstructive surgery, thanks. Again, a bit beyond standard cover. Psych term tells me Bell curve aside, you're never too old to have your first psychotic episode. Potentially means quite a while as an inpatient. And only the really shiny cover covers inpatient Psychiatry treatment.
Oh, and I want annual dental checkups covered too, because I've seen what happens when teeth go bad..and it's bad.
On the other hand, why in the Universe would I pay for Extras cover covering homeopathy? Subsidising other people buying water and sugar from charlatans (because that's what it is) is no doubt contributing to why health cover is that expensive.
I can see the irony, betting large amounts of money against yourself. I'm hoping the odds are against me. I wonder if I'm the only one this paranoid..
"I’m stuck on Earth like..like an ordinary person, like a human.. How rubbish is that? No offense." -Doctor Who
|
|
|
|
|
|
The insistent thrum of fear. Rumbling in your veins. Pulsing in your head. Keeps you awake. Keeps you going. Rest is for the weak. Can't stop. More to cover. More to do. Not there yet. Not enough. Not enough time.
Forget that there's anything else but this. Let the rest of the world fall away. On and on.
Maybe this is what makes us us. The ability to give everything else up. To take the self out of yourself. To step away from family, friends, any spark of what you might have enjoyed. To not sleep.
Somehow we accept this. It's expected.
As those before you have done, so shall you.
Hours, days, months of life. Life. Excursions. Flights of fancy. The things people do.
No one said "this will be your life". Or lack thereof.
But perhaps we have ourselves to blame. For wanting more.
To get to the other side, there's a heavy price to pay. This will not be taken lightly. Cheaply.
You pay with your life. It becomes you. You become it. It is your life. It will take you. It will walk around in your skin. You forget how to be anything else. You forget how to run away.
Still it wants more. It will keep hunting. And you keep hunting, to feed it yourself.
|
|
|
|
|
|
I hate Psych. I really, really, really do. Not just the non-medicalness, or feeling out of my depth so much of the time. Or all these people I have no hope in heck of fixing. Or the forests of paperwork, documenting minutiae for no one to read. Or maybe it is. That, and never feeling quite safe because there are aggressive, or potentially aggressive and unpredictable people around you all the time. And that people don't appreciate all the effort you put in to try to make them better, that for all the overtime and ringing around you do to get things happening for them, all they do is hurl abuse at you.
It's soul-destroying. A tidal wave of futility. I am over it. Totally over it.
I'd love to be able to walk away. I still fail to see how much more time in this is going to make me better in the ED. (The same way I don't understand why it's necessary that I know about gastrin, CCK, whether things act via cAMP or IP3-DAG pathways, or the size of chylomicrons to do further training, considering these have no relevance whatsoever to our actual work.)
Grr.
Frank: There is a plan to all this.
Eli: I know. If the plan is to massively screw up my life, I'd say it's working.
-Eli Stone
|
|
|
Monday, January 12th, 2009
|
|
|
|
|
I suppose the one consolation is that I know what I want to do. If Med is it, then it's ED. Most times, it's fun. I like the ethos of it. To steal someone else's words, it's about rolling with the punches. It's pragmatism, pluripotency.. It's detective work. It's hands-on. Sometimes you get to save lives. Or something like it. I remember being asked by a consultant as I was leaving after a shift, "You're not staying to play?". That's the attitude.. I want to be able to have that, instead of being frustrated and drained and thwarted.. To have to see the same patients every day for weeks while they get better by microscopic degrees..doesn't work.
In the end, you have to come to terms with who you are. And I guess I have to concede and admit that I am the job. Work makes me tick. Some people find their adventures out there at other ends of the world. I wait for the adventures to roll through the doors, heralded by lights and sirens..
And, am so getting  this.
"When you're alone, the world is full of possibilities." -Bones
|
|
|
Wednesday, December 31st, 2008
|
| Time: | 5:30 pm. |
| Music: | This Is How It Goes Down, Pink. |
|
Hours before the new year ticks in.. This place is like a ghost town now. Partly from the people who've just been on extended holidays from Christmas, partly from people rushing off to get ready for their various festivities later..
I'm turning into my dad, I think. One year to the next means as little as one day to the next. No celebrating, no partying, no making resolutions. I'll probably be awake at midnight, but purely because..I'm awake most midnights anyway.
Looking back on the year though.. As always seems in hindsight, it's gone fast. Maybe there's been change. But I'm not sure it's been good change. I don't think I've gotten to happy. Or any semblance of it. I've painted myself into a life that lacks balance. And convinced myself that it's a Necessary Thing. I still think it is. Sort of.
I'm less and less convinced.
I would get off the track..if I had the courage to do so. But it's a form of security, I guess. The pretense of purpose. I'm reminded of Grey's Anatomy's Addison.
"You don't understand. This job is my life."
"If you need your job to get your life, you either need a new job, or a new life."
Or something along those lines.
My GP pointed me here.
I worry a little about what I'll be by the end of next year.
~~~
You could have flown away
A singing bird
In an open cage
(...Walk On, U2)
~~~
|
|
Thursday, December 4th, 2008
|
|
|
|
|
In this line, we sort people out, send them places. We should be efficient, we cut to the quick. There are others in trolleys, others in chairs, who have yet to be seen. We multitask to keep things rolling. What then, do I do about the elderly man who I've just dripped, catheterised, and art lined, who only now starts to realise just how unwell he is, who tells me the only thing he's sad about is that he won't be able to take care of his wife anymore? Who catches my hand and tells me he's lived a good life? I have no authority to offer assurances. And we don't have the time to sit and say the things people want or need to hear.
When I was a med student, I had the luxury of time. To hear stories about lives. To listen to the things everyone else, in their daily scurry, had not the time for. Now? I have the time to help myocardium, but not a heart.
I know I have much to learn yet. The balance between compassion and practicality. The hospital has no space for every eighty year-old who lives by themselves who feels acutely unable to cope because of a cold.
The rare times when people express their gratitude for what we do..are such a nice surprise. It says something, that it's something out of the ordinary for us to be told nice things, rather than hear more of the drunken cursing or psychotic profanities. When people have to wait hours to be seen, it's not because we're sitting around twiddling our thumbs behind the scenes. We're working within the limits of the returns of pathology, radiology, and the lack of beds. Elsewhere in the system, they're backed up too.
Some days we do good things for people. Some days..it's less clear.
This takes up time, absorbs all of Life. Don't sleep. Don't dream. Don't rest. It rolls on. Days upon days upon nights.. I think I used to be someone else. I forget now.
Thirteen: We can aspire to anything. We can do anything.
Woman: No we can't. We can aspire to anything, but we can't have everything just because we want to.
-House
|
|
|
|