Wednesday, May 17, 2017

And We Must Breathe

Ask any parent.  Having children is a supreme act of faith.  This revelation does not come easy to one who is particularly uncomfortable kneeling at unfamiliar alters.  It hurts my knees.  Yet there is no more durable truism.

It starts with birth.  The awareness of our own unique helplessness is overwhelming.  We are a slave to our children's genetics, environment, and wholly uncontrollable luck.  We skitter to command a million details to defray the constant anxiety of that which can't be governed.  We worry, lose sleep, and panic till the day we feebly shrug our shoulders and accept.  Then we defer to faith.  Because faith is air, and we must breathe.

As my daughter has grown, that faith has transferred from the intangible nebulous, to the burgeoning humanoid sprouting at my feet.  A far more comfortable leap, a sense of control sets in.  As parents, we can lead by example, teach, shape, and mold.  Destiny has temporarily released her grasp.  My daughter can learn not to climb on the hot stove, to look both ways before crossing, to stop, drop, and roll.

So you would think it is the consequential stuff that I struggle with, but often the ephemera nips just as gratingly at my heels.

A few weeks ago, my daughter informed us that she wanted to perform in the annual school talent show.  Each year, we battle to convince her to play the violin, something she actually holds a sprinkling of talent for.  Sometimes we win, others we lose.

This year she decided that she would perform a solo dance routine, and no matter how much I tried, she could not be dissuaded. My anxiety rose as I pondered our weekend dance performances in the family room.  Rhythm, it turns out, may not be at the top of my daughter's otherwise many talents.

Much discussion was had, videos were You Tubed, lists were made.  And two days before the performance, it was clear that her best option was to free style the whole routine.  My heart raced as I pondered her up on that stage in front of hundreds of people, awkward, and embarrassed.  This has been a hard year for her at school, and the last thing I wanted was for it to end in shame.

My daughter, however, was implacable.  She repeated over and over again:

I got this!

The day of the event, she pushed us out of the way and applied her own makeup.  I marveled at the mix of eye liner and lipstick (something we otherwise would never let our daughter wear).  She looked fierce.

When she took the stage at the tail end of the show after fifty other acts, I stood nervously with camera in hand.  She awaited patiently through three attempts to queue her music correctly.  I could no longer control the fluttering in my chest.

I keenly felt at that moment something, in retrospect, I have always known.  

That I will follow this girl with all my heart down whichever path she leads.  And I will have faith even though the journey will often be awkward and painful and sometimes...

Sometimes joyful and wondrous.

Friday, May 5, 2017

Changing Lanes

I drive a fast car.  Which if you know me, is quite uncharacteristic.  I would say that it is one the few possessions that generally doesn't reflect upon who I am.  How I chose this car, the make, and model, are a long story not to be discussed here.  But let's just say that it has quite a kick.

These thoughts jostled through my mind this morning as I pulled into the hospital parking lot.   A recent momentous decision, I surrendered my privileges at this hospital and started using the hospitalists.  It had all become too hard.  The inane compliance issues with the new EMR.  The ER attendings admitting my patients without calling me.  The slew of protocols, documents, and attestations at this institution recently became particularly onerous. The administration was pushing out the primary physicians with the indignation of a million not so subtle pinpricks.

I was making a courtesy visit.  I had asked the Emergency Room physician to have the hospitalist call me the night before.  I knew this patient exceedingly well over the years, and had a good impression of what had happened.  I was unable to relay this information, however, because I never got a phone call.

I didn't agree with the diagnosis or treatment plan.  The admitting hospitalist was no longer available and the nursing staff had no idea who to call.  I carefully documented my knowledge of the patients past medical history, exam, and my thoughts in a progress note.  I also left my mobile number and begged the rounding physician to call me.  I am not hopeful.  Eventually, after much searching and paging, I will likely reach the physician by the end of the day.  Que sera, sera.

This hospital is in the midst of a major rebuild, and part of the process is a new entrance to the expressway adjacent to the parking lot.  The beauty of this new pathway is that following a few careening turns, the entrance ramp is a straight shot for a few hundred feet.

This morning, I came to a full stop after those turns, and waited for the cars on the expressway to pass at 60 mph.  I put all four windows down.  Then I put the pedal to the metal.

10, 30, 50, 70mph,  I sped past all the cars ahead of me.  The wind blowing into the car and smacking me in the face.  Power, speed, freedom, joy!

Eventually I merged left and began the process of applying the brakes.  I was coming up quickly on a series of cars driving at more conventional speeds.

The fun is over.  It couldn't last forever.

It seems it's no longer our patients that we answer to.

Because I've been told, in no uncertain terms, it's time to stop bucking the system.

And get back into my appointed lane.