Something Different

And the dam breaks  

Because it always does.  As the rebellious seas churn and the indelible cracks breach at the base, a web of infirmity spreads it's lacey tendrils unloosening the mooring of a once sturdy structure.  The cackling of unhinged cement, the prepubescent rejoinder to the whoosh as the frothy waters churn past what once was solid, absolving the absurdity of insincere firmness.  That which was an obstacle, now a conduit.  

The mark of the trainee.  The years of suffering, and sweating, and staring down disaster with a stiff upper lip and trembling twenty-four hour knees.  The abuse.  Rampant abuse.  From patients.  From colleagues. From the dumb luck of being on the opposite side of death.  A familiar foe with unbearable strength and agility.

The self effacement.  The drowning of ones own needs.  The rumpled collar, greasy hair, and lazy eyes of a night on call.  Sleep abandoned.  Needs betrayed.  Humanity unraveled into a dream laden schedule.  Every few days.

A calling.  A calling to duty.  A call to sacrifice.

And the dam breaks

Because it had to.  Patients replaced by computers.  Insurance forms and boxes to check, and minutia upon minutia.  Upon minutia.  Until the little becomes so big that you become little too.  With tiny pitiable goals and aspirations.

Far from a healer.  You are a generator of paper.  A signer of forms.  A whipping boy for an ungodly mechanical voice heard disjointedly from somewhere up above.

That drug is not formulary!
That admission is an observation!
That is not a C3, it's a C2!  Run to the fax machine.

Suggestions become commands.  Commands become dictates.  Dictates become laws.

Laws we abide while sneering.  Pitiful sneers that make us hide from the reflection in the mirror.  The reflection in the eyes of those we had sworn to serve.

I'm sorry you're having the most shitty day of your life.  But I can't seem to remember how to order that  coffin in my electronic medical record.  What's the ICD-10 for death?

And the dam breaks

Because the words stop coming.  There is simply nothing more to be said.  There are only so many eloquent ways to talk about something that is broken.  Smashed to pieces.  The whole no longer exists.