Sunday, March 27, 2011

Anhedonic

Last call I was placing an emergent ventriculostomy into somebody with a tangerine sized hemorrhage in their brain when a transfer from an outside hospital rolled in that needed to be red-lined to the OR for subdural hematoma evacuation. Even that barely got my pulse up.

It all feels the same now. Nothing seems to excite me anymore. The only things I feel are tired or very tired. I need another vacation.

Sunday, March 20, 2011

Pain within the walls

Every patient that walks through our doors has walked a path of sorrows. The winding roads that have left scars within their skins and tears within the tapestries of their hearts start to harden into the walls they build around them. Our own fatigue simmers and smolders, forging the iron cast appearances of disinterest and coldness. Limiting transference, maintaining professionalism, they would say.

They build their walls one hospital trip at a time. "Your child is very ill" the foundation, "he may require surgery" the mortar, "he may have a brain tumor" the moat. With each surgery, each clinic visit, each MRI scan that shows possible progression of the disease they lay the bricks of their walls ever taller, ever stronger. Avoiding the compassionate, and oftentimes pitying looks of their neighbors and friends, as the constant reminder is too much to bear, has become cause to their construction. We're doing ok, they want to believe, to prove.

All the while the brutal work hours, unappetizing hospital food, empty chairs and empty tables sing the chorus of our misery. The job is painful, but our fatigue and sorrow must be left at the door. So we build our own walls to hide our souls. Inundated by neurosurgery, thoughts of quitting are commonplace. We ask ourselves if this is really what we want to do for the rest of our lives. The fatigue erodes the passion within, but our walls remain tall. We cannot show them weakness, they need us to be strong.

However, sitting there in their hospital beds, dawning hospital gowns with their backs open to the sterile air and their hearts open, thirsting for empathy, their defenses crumble. They lament the pain they've experienced, lash out with the frustration their roads have been littered with. We cannot comprehend their pain, as our dilapidated minds fail for want of reprieve and compassion themselves. We build our walls ever higher for fear that their weakness may overtake us, and in our ivory towers shiver in our own misunderstanding.

Tuesday, March 08, 2011

Reawakening

The primitive man did not fail to paint murals or script sonnets for want of creativity or ingenuity, but rather for want of shelter, sustenance and sleep. I often refer to Maslow's hierarchy of needs to explain, if not justify, my laziness in pursuing literature, art, music, love, etc., which dictates that only after man has the most basic of needs such as food, water and a roof over his head is he able to, or even arguably capable of, pursuing the more finer aspects of human living. Well in a brief moment of reprieve I was able to sleep, and finding myself rested, discover that I still have thoughts independent of the ones that are forced upon me.

The past weeks have been interesting. Notable moments include driving a Ferrari California at midnight while on call; openly reprimanding an intern for his failure to perform his duty adequately; and feeling my soul die as the year continued to draw on without end.

We're more than two-thirds of the way done now. Having worked nearly 3000 hours, with more than 75 overnight calls, the hospital has become more home to me than the apartment I live in. At night I still fumble for the light switches when I get up for work in my one bedroom apartment. In the hospital I can get from the cafeteria to the ICU without looking up once. People I don't know and likely have never met are greeting me by name, knowing that I'm basically a white coated version of Tom Hanks from that terrible movie Terminal (yes I do keep a tooth brush in the hospital). And inadvertently, I've become very accustomed to my job. So much so that it's starting to frustrate me when others can't do their own. One often forgets that other people actually have lives outside the hospital, that their existence consists of more than ventricular drains and craniotomies. But they've been there for years, shouldn't they know how to do all this? Although outwardly still patient, internally I've become less tolerant of laziness and more critical of incompetence. What used to be a list of tasks to me has become a list of individual patients, each with a system of problems that need to be addressed. Instead of simply trying to keep people alive, the small nuances come to mind so we can maximize patient recovery. With my mind set on perfection, the idle, green minds of the new recruits who still lack the experience and big picture as I did only 6 months ago perturb me when they leave tasks unfinished so they can check out of the hospital an hour or two early. Likely the small stones they left unturned won't change anything in the long run, but they lack the spirit needed to help our patients overcome their improbable diseases.

Too much soap boxing.

The chronic sleep deprivation has destroyed my hippocampus and I no longer have any ability to form long term memories. I dated this girl for a bit (I forget her name) but do recall that she was constantly mad at me because I couldn't remember her favorite fruit, her favorite color, her birthday... her name... So demanding. I could tell you the post-op days, medication lists and neurologic exam on any one of the 40 patients on our service... but ask me if you like pineapples or not and yea... fail.

Every morning I wake up wondering if I still want to do this. I don't think about quitting, but do spend a good deal of time creating interesting ways in which I could get myself fired. I'm open to suggestions...

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About Me

I'm a quixotic idealist that's readjusting to the reality of the world around him. An aesthetic at heart, willing to not shower a week at a time to go camping, exploring, hiking, etc. I love food, poker, and anything that can be turned into a competition.