Picture your shoulders thrusting forward as you slink into the nursing home or hospital at some ungodly hour in the morning. Day after day, year after year, your gait adjusts to the facade of the foreboding colossus. You become boxy, structural. Familiarity has affected you.
It's not just the hospital, but the patients of course. Being a physician is just like any other human being, just magnified. You start with a basic unadorned body of armor. Certain things penetrate: the first cry of a baby as he leaves the womb. Others splatter and stain but you don't dare let them in: the swoosh of blood as it spurts out of a ruptured a-v fistula, the screams of fear, and the ever-present sobs of the mourning. The outsides may become disorderly and unkempt, but the insides remain pristine. Or so you think.
Patients come and go. They either die or move away or decide they no longer want to receive care from you. Hospitals open and close. You move your office. There is much transience. The faces fade and the circumstances become hazy. But the detritus remains. You may forget the specifics but your exterior has been marred. Your armor adorned.
Until the day you realize that you never really had any armor in the first place. Just porous skin. Now faded and bruised, you carry these marks with you. That which you relied on for protection has inevitably become a sieve. Your insides are now also untidy.
And you may find yourself walking through the mall on occasional Saturday mornings with your family. Your children weaving through the isles and ducking under wayward clothes. Your wife leafing through the discount racks in the corner. Your phone hangs from your ear as you answer yet another phone call. You stop mid orders to look at yourself in a full length mirror. And you wonder if the reflection is really you anymore or some stranger.
The pain only lasts for a moment, and then you turn your attention back to the phone and answer-
whatever pressing question is being posed to you.
Jordan, for the last 30 years, people asked me, a radiation oncologist, "Doesn't it bother you to see death and dying all the time?" When I was young, I could cope--I would say, "No, I just think of all the good I've done." But when I turned 60, I looked in the mirror and saw the person you describe, porous, undone by the years of "coping." Thank you for putting into words what all physicians feel at some point--some sooner, some later. I am grateful for your insight.
ReplyDeleteDr. Jordan, thank you for writing such thoughtful reflections on your blog. I enjoy following your blog! This is a bit forthright, but I am hoping that you considering counseling sessions where you can just decompress and process all of your experiences in medicine, both good and bad. Writing is great for this but talking is even better!
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