Sunday, October 27, 2013

Somebody's Doctor

You won't at first.

I mean you will try.  But eventually the poor gentleman cowering in bed will just become the homeless guy in room 114.  New admissions will cease to be opportunities to heal or learn.  You will dread the extra work.  Blood on your hands will no longer be the ephemeral pulsating evidence of life recently passed, but instead will be the muck mixed with excrement that you mercilessly scrape from your soiled hands.

And in those lonesome times when you're well rested enough to surface from the meandering haze of responsibility and fear, you'll scoff at the refection in the mirror.  A mere shadow of your premedical self, you will feel nothing but disgust.

Who am I? What have I become?

Many will scold me for saying that it is inevitable.  Am I too callus?  The soft supple character that leads us to medicine becomes quickly incompatible with the harshness of having one's hands intertwined in the bowels of the dying.  We all are mangled by the inevitable gears that grind daily on the smooth surface of our psyches.

If you are lucky, you will hold on to your humanity when it is safe.  You will cry unnervingly at the end of a movie so much so that others will look on awkwardly.  You will seek pleasures, whether carnal or gastronomic.  You may decide to exercise more, run a marathon.

In those moments when the sweat drips from your brow and the muscles in your calfs strain, you will feel alive.  Maybe more than you ever did in the hospital.  This will calm the unnerving emptiness you sometimes feel at work.

Life will not always be so smooth.  Friends will tell you that you are distant.  Lovers will say that you can be cold.

But with time the joy you so carefully cultivate outside the examining room can inch it's way inward. You may not connect with every patient, but you will learn to hold a hand, touch a shoulder, shed a tear.  You will no longer be soft or naive, however, that is gone for good.

Maybe you will be wise. Kind. An old soul.

And life will pass before your eyes.

And one day, perhaps, you'll become a husband or wife.

A parent.

Somebody's doctor.

1 comment:

Doctor Which said...

Such eloquent depression, dear doctor.
I know what you mean. I too was from a generation that had the medical ethic of absolute selflessness stamped into my deepest subconscious by medical training that qualified as psychological torture and brainwashing under the Geneva Convention. It came from earlier generations of doctors who lived in a protected environment that never required them to be come egotistical, defensive and competitive. They were left to do their job to the best of their ability. They had the morality to always go beyond the call of duty.
It was this absolute morality that shone through from their heart and soul. Their subconscious spoke volumes through subtle and nonverbal communication to create the aura of absolute trust. It allowed the doctor to sleep at night, knowing that egoism and vested interest was not a part of them. They could trust themselves deeply. They had no doubts that they had done their best. Their conscience was clear.
They had an inner silence that could hear their intuition and in that silence, they performed miracles, especially of diagnosis. I was taught to listen to the silence in a mother's eyes to make the diagnosis of meningitis before the patient had a fever or headache. I have saved a few children's lives with that one. More are those that I have saved from needless lumbar puncture.
Retro-caecl appendicitis, a notoriously difficult diagnosis, I reliably diagnose on sight whilst others who only know science, protocols and technology falter. Sometimes they have reached multisystems failure before I ahve seen them.
This is so much more than simple experience. It is a state of mind. It is to live levels of consciousness where jigsaws come together. Inspiration and certainty exist. Contextual logic that includes every subtle observation becomes effortless. And it saves lives.
What I was taught was such an advanced state of mind that only monks dare talk about it. They only experience it momentarily in meditation. I was taught to live it by some of the great masters of the clinical arts.
Of course, the academics of medicine and science do not like such mysticism or human potential so we dare not talk about it. None could defend it when the politicians, beancounters and administrators came along to devastate the medical culture and decimate a once sacred medical ethic that was the source of such inciteful clinical acumen.
I knew what I had become and refused to let go of it. I continued to live up to my indoctrinated ethics. The result was a mental breakdown and I have not worked in mainstream medicine again. I cannot and will not compromise. I have searched the world for a medical system that allows doctors to do their best and go beyond the call of duty. There are none.