There were battles large and small. There were years littered with highs and lows. And there were days; dark, dark days.
Simon didn't ask for the genetic hand that he was dealt. He didn't drink, smoke, or idle about the house. He was strong and active. In fact, his first heart attack struck while on the treadmill. His second, when in bed. We forgot about what he was doing during the third and fourth.
Yet, after open heart surgery and multiple angioplasties, Simon was still having chest pain. His medication regimen was maximized. He attended cardiac rehab regularly.
Day after day, week after week, he came to my office. We fiddled with his med list. We searched for creative diets. We explored yoga, meditation, and acupuncture. Each intervention brought such high hopes that tumbled to the ground and shattered into tiny little pieces with each hospitalization. The leak of cardiac markers felt like the oozing spurt of unrequited blood vessels as the cup of life slowly emptied.
I once apologized to Simon for my own ineptitude. The current state of medicine was unable to solve the ruthless riddle that was unhinging the squeeze of his heart. As his lungs filled with frothy waves, his body began to sink in the great vast ocean.
And I was beginning sink with him. My confidence waining in the sturdiness of the concrete wall I called medicine. The cracks were large and disfiguring.
I sat one morning at his bedside and stared at the remnants of a body transformed over the last few years. The ventilator was removed and the room was still. The second hand on the clock marched forward refusing to bend to the will of misplaced hope.
Helpless.
No one ever warned me about this in medical school.
Tuesday, April 10, 2012
Monday, April 9, 2012
Stolen
If you've been there before, you know. Although a decade has passed, I remember it like it was yesterday. My wife was driving. It was a few years before car seats cluttered our vehicles. It had been a long day of errands and dinner at my parents. I yawned as we pulled into the ally. The sun had set long ago and the beams of headlights bounced up and down our poorly lit neighborhood. My wife reached for the garage door opener on the visor, and then stopped and hit the breaks.
I turned my head just in time to catch the darkly dressed figure slink out of our back door. Before I knew what was happening, we had passed the house and were in hot pursuit. I pulled out my cell phone and called the police. I described the suspect as we followed him down the street.
An hour later the police had come and gone. Even though the perpetrator was eventually arrested, we never recovered the majority of our stuff. The financial and physical damage was minimal, but the episode did take an emotional toll.
Years later our kids are forced to wander into our bedroom every morning before going downstairs to play.
They have to ask us to turn off the alarm.
*
Sheri had lost her glow. An athletic forty year old, she completed at least one marathon a year. She ate well, she meditated, and she took care of herself both outside and in. So when she felt a small lump in her breast, she originally was fairly unconcerned. A woman with such poise and control of her life couldn't help but feel a little invincible.
Sheri called her gynecologist and scheduled an appointment. Two weeks, one mammogram, and a biopsy later she was devastated to hear that she had cancer. As with every other challenge in life, Sheri faced surgery, chemo, and radiation like an expert.
A year later she sat in my office with her head hanging down. She had just received a call from her oncologist. Her latest exam and xrays showed that she was "cured". But Sheri couldn't wrap her head around the concept. She had spent so much emotional energy on fighting, she now found herself strangely lost. She stared up at me as the tears began to well in her eyes.
What do I do now?
It was a difficult question. One with many possible answers.
*
What do you do when you body has been burglarized? How do you recover that which has been stolen from your soul?
The traumas we face mark us and litter our insides with scars that are slow to heal. The threat of our own vulnerability becomes more overwhelming than the Achilles heal itself.
Sheri will eventually return to her previous life, although her uneasiness will likely remain. I have counseled many people through this type of situation. I have seen a myriad of different responses: anger, depression, denial. I have held their hands and told them that it would get better.
All the while, I still awake occasionally in the middle of the night in a cold sweat wondering if I was dreaming.
Or did I actually hear the beeping of the alarm system downstairs?
I turned my head just in time to catch the darkly dressed figure slink out of our back door. Before I knew what was happening, we had passed the house and were in hot pursuit. I pulled out my cell phone and called the police. I described the suspect as we followed him down the street.
An hour later the police had come and gone. Even though the perpetrator was eventually arrested, we never recovered the majority of our stuff. The financial and physical damage was minimal, but the episode did take an emotional toll.
Years later our kids are forced to wander into our bedroom every morning before going downstairs to play.
They have to ask us to turn off the alarm.
*
Sheri had lost her glow. An athletic forty year old, she completed at least one marathon a year. She ate well, she meditated, and she took care of herself both outside and in. So when she felt a small lump in her breast, she originally was fairly unconcerned. A woman with such poise and control of her life couldn't help but feel a little invincible.
Sheri called her gynecologist and scheduled an appointment. Two weeks, one mammogram, and a biopsy later she was devastated to hear that she had cancer. As with every other challenge in life, Sheri faced surgery, chemo, and radiation like an expert.
A year later she sat in my office with her head hanging down. She had just received a call from her oncologist. Her latest exam and xrays showed that she was "cured". But Sheri couldn't wrap her head around the concept. She had spent so much emotional energy on fighting, she now found herself strangely lost. She stared up at me as the tears began to well in her eyes.
What do I do now?
It was a difficult question. One with many possible answers.
*
What do you do when you body has been burglarized? How do you recover that which has been stolen from your soul?
The traumas we face mark us and litter our insides with scars that are slow to heal. The threat of our own vulnerability becomes more overwhelming than the Achilles heal itself.
Sheri will eventually return to her previous life, although her uneasiness will likely remain. I have counseled many people through this type of situation. I have seen a myriad of different responses: anger, depression, denial. I have held their hands and told them that it would get better.
All the while, I still awake occasionally in the middle of the night in a cold sweat wondering if I was dreaming.
Or did I actually hear the beeping of the alarm system downstairs?
Saturday, April 7, 2012
The Fulminant Scourge
Zeke had once been told that he was named after a great medical reformer. He assumed it was some figure from before the Great Automation in the early 20's. Before then, Data Entry Recorders (DER's) were called Physicians and were required to undergo a rigorous training process before being allowed to practice.
The discovery of the Automaton changed everything. Medical school was shortened from four to two years and post graduate training was abolished. This was before the great naming convention. Thousands of useless medical terms were organized into a hundred simple categories. In fact, the makers of the Automaton had long ago dropped the archaic nomenclature and replaced each disease with simple numbers.
After the great revolution, death from antiquated diseases such as heart failure and cancer became unheard of. The speed and accuracy of the Automaton was no match for such human failings. In fact, if it hadn't been for the perilous scourge of Virus Fulmentis (VF), life expectancy would have skyrocketed. Instead, most people were lucky to make it past the sixth decade. VF was a hundred percent fatal.
Zeke was proud of his medical training. His two years of medical school were arduous. He spent countless hours learning how to connect the probes in just the right fashion. During his clinicals, he read almost all hundred numbers off his Automaton's monitor. In fact, he sent quite a few fifty two's right to the micro dissector.
But no matter how many times the results flashed on the screen, Zeke would never get used to the large VF that occasionally popped up unexpectedly. The only disease not indicated by a numerical value, VF struck terror in the hearts of DERs in training. Although the presenting symptoms could be anything: cough, chest pain, a lump in the belly; the treatment was always the same. The patient was whisked away from their family and isolated in a dark, damp, holding center in the basement of the hopspital. First line therapy included trials of forced starvation which had been shown to prolong life weeks more than conventional cyanide replacement.
Occasionally, patients with VF would escape the hospital or office before security could escort them to a treatment center. Often they sought out alternative medical practitioners who trained in pre revolution doctrines in secret schools throughout Europe. Zeke refered to them as Witch Doctors (WDs). There was a WD who lived a few blocks down from him. He was an elderly gentleman who must have been a little boy at the time of The Great Automation. Although Zeke had half a mind to report him to the Health Alliance, he couldn't bare to see the poor old man carted away in hand cuffs. Like everybody else in the neighborhood, he kept his mouth shut.
Zeke would occasionally see wayward grifters entering and leaving the WD's house. There was no mistaking the look of desperation in their eyes. The comings and goings would continue all hours of the day and night. Zeke dared not get to close. He was afraid of catching the virus. Strangely, it had never occurred to him why he hadn't met a WD with VF. In fact, he hadn't seen a WD in his office or in medical school, not once!
Zeke's daily work was occasionally interrupted by sickness. Like everybody else, he would sometimes lay in bed and fight a bad thirty nine or seventy six. Once a twenty four caused him to miss work a whole week. So when his chest started to hurt one day, Zeke assumed it was something minor.
He had meant to strap himself up to the Automaton a hundred times, but he kept getting side tracked by one patient issue or another. On one particular morning when the pain became unbearable, Zeke cleared a half an hour from his schedule and locked the exam room door. He place the probes gingerly on his own body (which is no simple task when one considers the central back lead) and hit the analyze button.
After a moment of whizzing and whirring the machine became quiet. Zeke unhooked the leads and turned the monitor carefully to visualize the screen. With great shock, he glanced uncomprehendingly at the large letters flashing in front of him.
VF
He stared at the neon figures and squinted as if he could somehow transform them to numbers by cocking his head in just the right manner. A moment later he jumped off his chair and flipped the switch on the monitor. He knew he had just minutes before the internal alarm informed security that another VF patient was in the building.
Zeke grabbed his bag and charged out the room. As he sped past the nursing station and flew out the doors, he could hear the high pitched alarm screech in the background. He momentarily sprinted towards the garage, but then realized that he would never make it through security.
His only hope was to go on foot to his house before the authorities could question him. His chest pain had become severe now. He could taste the burning sensation arise from his belly and twist its way up to his throat. By the time he turned the corner to his block, he could see the sirens. The Health Authority had already staked out his house.
Zeke only had one choice. He turned away from the squad cars and paced a hundred yards to the WD's front entrance. The door slid open, and he was beckoned to come in before he had the chance to knock. The elderly WD looked him up and down.
I never thought I'd see you here!
He asked Zeke a number of questions and then took out an ancient looking piece of metal and plastic from his pocket. He placed one end in his ears and put the other on Zeke's chest and then back. The WD then pushed and prodded on his belly.
You have something we used to call gastroesophageal reflux.
He reached into his pocket and pulled out a bottle full of unmarked pills.
Take one of these now and then repeat every twenty four hours. I suggest you avoid the authorities for one full day and then turn yourself in. Repeat Automaton testing will be normal.
Zeke stumbled out of the WD's house and looked down the street. The authorities were gone. For a moment he regretted swallowing the pill that the old man had thrust upon him. Strangely, his chest pain was already feeling better. He remembered that he had an extra set of camping gear in the garage. He could hide out there if he had to.
Maybe he didn't have VF after all!
The discovery of the Automaton changed everything. Medical school was shortened from four to two years and post graduate training was abolished. This was before the great naming convention. Thousands of useless medical terms were organized into a hundred simple categories. In fact, the makers of the Automaton had long ago dropped the archaic nomenclature and replaced each disease with simple numbers.
After the great revolution, death from antiquated diseases such as heart failure and cancer became unheard of. The speed and accuracy of the Automaton was no match for such human failings. In fact, if it hadn't been for the perilous scourge of Virus Fulmentis (VF), life expectancy would have skyrocketed. Instead, most people were lucky to make it past the sixth decade. VF was a hundred percent fatal.
Zeke was proud of his medical training. His two years of medical school were arduous. He spent countless hours learning how to connect the probes in just the right fashion. During his clinicals, he read almost all hundred numbers off his Automaton's monitor. In fact, he sent quite a few fifty two's right to the micro dissector.
But no matter how many times the results flashed on the screen, Zeke would never get used to the large VF that occasionally popped up unexpectedly. The only disease not indicated by a numerical value, VF struck terror in the hearts of DERs in training. Although the presenting symptoms could be anything: cough, chest pain, a lump in the belly; the treatment was always the same. The patient was whisked away from their family and isolated in a dark, damp, holding center in the basement of the hopspital. First line therapy included trials of forced starvation which had been shown to prolong life weeks more than conventional cyanide replacement.
Occasionally, patients with VF would escape the hospital or office before security could escort them to a treatment center. Often they sought out alternative medical practitioners who trained in pre revolution doctrines in secret schools throughout Europe. Zeke refered to them as Witch Doctors (WDs). There was a WD who lived a few blocks down from him. He was an elderly gentleman who must have been a little boy at the time of The Great Automation. Although Zeke had half a mind to report him to the Health Alliance, he couldn't bare to see the poor old man carted away in hand cuffs. Like everybody else in the neighborhood, he kept his mouth shut.
Zeke would occasionally see wayward grifters entering and leaving the WD's house. There was no mistaking the look of desperation in their eyes. The comings and goings would continue all hours of the day and night. Zeke dared not get to close. He was afraid of catching the virus. Strangely, it had never occurred to him why he hadn't met a WD with VF. In fact, he hadn't seen a WD in his office or in medical school, not once!
Zeke's daily work was occasionally interrupted by sickness. Like everybody else, he would sometimes lay in bed and fight a bad thirty nine or seventy six. Once a twenty four caused him to miss work a whole week. So when his chest started to hurt one day, Zeke assumed it was something minor.
He had meant to strap himself up to the Automaton a hundred times, but he kept getting side tracked by one patient issue or another. On one particular morning when the pain became unbearable, Zeke cleared a half an hour from his schedule and locked the exam room door. He place the probes gingerly on his own body (which is no simple task when one considers the central back lead) and hit the analyze button.
After a moment of whizzing and whirring the machine became quiet. Zeke unhooked the leads and turned the monitor carefully to visualize the screen. With great shock, he glanced uncomprehendingly at the large letters flashing in front of him.
VF
He stared at the neon figures and squinted as if he could somehow transform them to numbers by cocking his head in just the right manner. A moment later he jumped off his chair and flipped the switch on the monitor. He knew he had just minutes before the internal alarm informed security that another VF patient was in the building.
Zeke grabbed his bag and charged out the room. As he sped past the nursing station and flew out the doors, he could hear the high pitched alarm screech in the background. He momentarily sprinted towards the garage, but then realized that he would never make it through security.
His only hope was to go on foot to his house before the authorities could question him. His chest pain had become severe now. He could taste the burning sensation arise from his belly and twist its way up to his throat. By the time he turned the corner to his block, he could see the sirens. The Health Authority had already staked out his house.
Zeke only had one choice. He turned away from the squad cars and paced a hundred yards to the WD's front entrance. The door slid open, and he was beckoned to come in before he had the chance to knock. The elderly WD looked him up and down.
I never thought I'd see you here!
He asked Zeke a number of questions and then took out an ancient looking piece of metal and plastic from his pocket. He placed one end in his ears and put the other on Zeke's chest and then back. The WD then pushed and prodded on his belly.
You have something we used to call gastroesophageal reflux.
He reached into his pocket and pulled out a bottle full of unmarked pills.
Take one of these now and then repeat every twenty four hours. I suggest you avoid the authorities for one full day and then turn yourself in. Repeat Automaton testing will be normal.
Zeke stumbled out of the WD's house and looked down the street. The authorities were gone. For a moment he regretted swallowing the pill that the old man had thrust upon him. Strangely, his chest pain was already feeling better. He remembered that he had an extra set of camping gear in the garage. He could hide out there if he had to.
Maybe he didn't have VF after all!
Thursday, April 5, 2012
Process vs Product
Okay, It's time to be unpopular. Mind you, I'm not trying to spit in the eye of my new found friends. But I think we're missing the boat. I read day in and day out about how physicians not involved in social media are doomed, falling behind, or will be lost in the future. As much as I'd like to pat myself on the back for becoming a utilizer, I think we're overstating our own importance.
Yes. Social media is brilliant, powerful, and can improve the delivery of our healthcare system. There's no doubt about it. But it's not a game changer. It's a process, not an end unto itself.
For some reason we keep confusing process with product. Quality healthcare is a product. It's not an electronic medical record. It's not a Twitter feed or Facebook timeline. These are tools.
I know many brilliant physicians who do not use social media. Their skills are supreme, their offices are packed, and there reputations are spotless. If their inability to adapt to todays information superhighway renders them obsolete, then only patients will lose.
I applaud those providers who are using social media to blaze new trails. I envy and imitate them.
However, when I'm unexpectedly lying on the operating table for an emergent procedure, I pray my surgeon is swift of hand, agile of mind, and well trained.
I could care less if she's on Twitter!
Yes. Social media is brilliant, powerful, and can improve the delivery of our healthcare system. There's no doubt about it. But it's not a game changer. It's a process, not an end unto itself.
For some reason we keep confusing process with product. Quality healthcare is a product. It's not an electronic medical record. It's not a Twitter feed or Facebook timeline. These are tools.
I know many brilliant physicians who do not use social media. Their skills are supreme, their offices are packed, and there reputations are spotless. If their inability to adapt to todays information superhighway renders them obsolete, then only patients will lose.
I applaud those providers who are using social media to blaze new trails. I envy and imitate them.
However, when I'm unexpectedly lying on the operating table for an emergent procedure, I pray my surgeon is swift of hand, agile of mind, and well trained.
I could care less if she's on Twitter!
Wednesday, April 4, 2012
Getting Dumped
We all lose patients. I'm not talking about death. More like the ones who leave the office cursing or call and harangue you over the phone. These cases are more clear cut. You evaluate the anger and the circumstances and then try to draw conclusions.
That guy was just crazy!
Boy she totally misunderstood me!
I could have done better!
Patients have left me for all sorts of reasons. Anything form my age, to my demeanor. Once a woman left my practice because her physical therapist didn't agree with my my diagnosis of coronary artery disease. This was a few weeks after her first heart attack.
I usually take these loses in stride. You can't please everyone after all. But I can't say it doesn't bother me. I question myself each and every time.
Sometimes the transition is more ominous. A relationship starts out intense and then suddenly disappears. Often it is only months later that I become aware of the absence. An errant pharmacy request for a medicine refill reminds me that I haven't seen a certain someone in quite along time.
With sadness, I realize that I have become a victim of the fade away. Unhappy with my services, I was dumped without even the kindness of a Dear John letter.
And as I sit at my desk and stare at the chart on the computer screen, I contemplate calling. Do I dispute the end of the relationship like a castaway lover? Or do I walk away with my tail between my legs?
Usually, I have my staff contact the patient and offer to forward the medical records. Experience has taught me that confronting the situation myself only leads to awkwardness and apologies.
When I was younger, I so badly wanted to learn from such experiences. But now, I no longer have the taste for hearing how I seemed distracted that day (I was dealing with a crises), or how I took too many calls from the ICU while I was in the examining room.
Furthermore, I admit that I am often not at my best. Some days I am cold, or distracted, or downright curmudgeonly. I still haven't mastered the trick of being open, attentive, and unhurried all the time.
Yet I do mourn these loses. Often more than the deaths. Surrendering to disease is about inevitability.
This, is about character.
That guy was just crazy!
Boy she totally misunderstood me!
I could have done better!
Patients have left me for all sorts of reasons. Anything form my age, to my demeanor. Once a woman left my practice because her physical therapist didn't agree with my my diagnosis of coronary artery disease. This was a few weeks after her first heart attack.
I usually take these loses in stride. You can't please everyone after all. But I can't say it doesn't bother me. I question myself each and every time.
Sometimes the transition is more ominous. A relationship starts out intense and then suddenly disappears. Often it is only months later that I become aware of the absence. An errant pharmacy request for a medicine refill reminds me that I haven't seen a certain someone in quite along time.
With sadness, I realize that I have become a victim of the fade away. Unhappy with my services, I was dumped without even the kindness of a Dear John letter.
And as I sit at my desk and stare at the chart on the computer screen, I contemplate calling. Do I dispute the end of the relationship like a castaway lover? Or do I walk away with my tail between my legs?
Usually, I have my staff contact the patient and offer to forward the medical records. Experience has taught me that confronting the situation myself only leads to awkwardness and apologies.
When I was younger, I so badly wanted to learn from such experiences. But now, I no longer have the taste for hearing how I seemed distracted that day (I was dealing with a crises), or how I took too many calls from the ICU while I was in the examining room.
Furthermore, I admit that I am often not at my best. Some days I am cold, or distracted, or downright curmudgeonly. I still haven't mastered the trick of being open, attentive, and unhurried all the time.
Yet I do mourn these loses. Often more than the deaths. Surrendering to disease is about inevitability.
This, is about character.
Tuesday, April 3, 2012
Social Media As Aggregator
Although a pile of clothes sits in the corner, my son is not in the bathtub. Instead, a naked body darts passed me chasing after a remote control motorcycle that skitters across the floor. In the excitement and adoration of his new play thing, he has forgotten to be embarrassed of his own nudity. He turns around and stands with his left hand by his side and his right clutching the remote.
Daddy, daddy...I'll never be bored again!
Now I imagine this is how most of my readers picture me after discovering twitter for the first time (Insert appropriate emoticon here-something that expresses eew). But in reality, I was a late adaptor. As much as I wanted to promote my writing, I was reticent to jump into social media. Facebook and twitter were interesting, but really seemed like just a little too much work.
So what changed my mind? After years of collecting journals, going to lectures, and browsing web sites, I realized that there had to be an easier way to stay up to date. Enter Facebook and Twitter.
By far the greatest power of social media is aggregation. Want to be the smartest guy on your block? Easy.
Sign up for Twitter. Find the two hundred most sophisticated people and journals related to what your interested in. Check your feed a few times a day.
And comment when appropriate.
Daddy, daddy...I'll never be bored again!
Now I imagine this is how most of my readers picture me after discovering twitter for the first time (Insert appropriate emoticon here-something that expresses eew). But in reality, I was a late adaptor. As much as I wanted to promote my writing, I was reticent to jump into social media. Facebook and twitter were interesting, but really seemed like just a little too much work.
So what changed my mind? After years of collecting journals, going to lectures, and browsing web sites, I realized that there had to be an easier way to stay up to date. Enter Facebook and Twitter.
By far the greatest power of social media is aggregation. Want to be the smartest guy on your block? Easy.
Sign up for Twitter. Find the two hundred most sophisticated people and journals related to what your interested in. Check your feed a few times a day.
And comment when appropriate.
Sunday, April 1, 2012
Fluency
Even as I write these words, I feel as if my head will split and the contents will pour out. Not exactly a migraine, but more the kind of headache that comes from concentrating too much. The neck muscles contract and the shoulders tense forming a ray of lightning that shoots up the nape and explodes just above the forehead. I am tired.
The contractor said that he couldn't quite figure out how to assemble the vanity. So my brother and I studied the mounted shell, and tried to make sense of the diagram heavy instructions. Eventually we had to wing it. After multiple failed attempts, we realized the scaffolding for the drawers was uneven. After correcting, we still struggled to angle at just the right degree till we heard the fabulous clicking sound.
We quickly realized that the back of the bottom drawer would have to be rejiggered to make space for the the sinks hardware that was jutting out of the wall. A half an hour later, my brother made the measured cuts with a hand saw and reinforced the slats with a piece of leftover scrap.
The victory dance, when the drawers were appropriately mounted, was short lived. I joined my wife in the basement and sprayed the surface mold with vinegar for awhile. Then I climbed carefully on top of garbage left over in the garage to re program the door opener.
A few more glitches were then worked out with the contractor. My wife devised a brilliant plan to shortcut a lighting problem. And finally it was time to hang up the overalls for the day.
After a quick dinner and putting the kids to sleep, I've collapsed on the couch. I'm exhausted.
*
My inexperience with home improvement is basically a fluency issue. I grew up in a female centered household where the majority of repairs were farmed out. By the time my mom remarried, I had lost interest in such things. As my step father toiled around the house devising fixes, my mind wandered, I did homework, or watched TV.
Years ago when I became a homeowner, I realized that my lack of literacy was a deficit that needed to be corrected. But trying to decipher a foreign language can be difficult. I find that it takes great amounts of time and brain power. I can get the job done, but it usually drives the gas tank down to empty.
*
On days like these, as my writing waxes philosophical, I really feel for my patients. They lie in hospital beds or await worriedly in their own homes. Each day can bring a dizzying flurry of data that can be impossible to interpret. They are harangued by various physicians, specialists, and nurses. The problems are complex and can change at the drop of a dime. And the consequences are sometimes deadly.
Unlike the problem solving involved in my remodeling follies, medicine is often unknowable. The systems are infinite and intricate. The headache I feel pails in comparison to what patients and families face every day.
I will sleep well tonight. My lack of fluency may slow me down, but I will live to fight another day.
I can only hope the same is true for my patients.
The contractor said that he couldn't quite figure out how to assemble the vanity. So my brother and I studied the mounted shell, and tried to make sense of the diagram heavy instructions. Eventually we had to wing it. After multiple failed attempts, we realized the scaffolding for the drawers was uneven. After correcting, we still struggled to angle at just the right degree till we heard the fabulous clicking sound.
We quickly realized that the back of the bottom drawer would have to be rejiggered to make space for the the sinks hardware that was jutting out of the wall. A half an hour later, my brother made the measured cuts with a hand saw and reinforced the slats with a piece of leftover scrap.
The victory dance, when the drawers were appropriately mounted, was short lived. I joined my wife in the basement and sprayed the surface mold with vinegar for awhile. Then I climbed carefully on top of garbage left over in the garage to re program the door opener.
A few more glitches were then worked out with the contractor. My wife devised a brilliant plan to shortcut a lighting problem. And finally it was time to hang up the overalls for the day.
After a quick dinner and putting the kids to sleep, I've collapsed on the couch. I'm exhausted.
*
My inexperience with home improvement is basically a fluency issue. I grew up in a female centered household where the majority of repairs were farmed out. By the time my mom remarried, I had lost interest in such things. As my step father toiled around the house devising fixes, my mind wandered, I did homework, or watched TV.
Years ago when I became a homeowner, I realized that my lack of literacy was a deficit that needed to be corrected. But trying to decipher a foreign language can be difficult. I find that it takes great amounts of time and brain power. I can get the job done, but it usually drives the gas tank down to empty.
*
On days like these, as my writing waxes philosophical, I really feel for my patients. They lie in hospital beds or await worriedly in their own homes. Each day can bring a dizzying flurry of data that can be impossible to interpret. They are harangued by various physicians, specialists, and nurses. The problems are complex and can change at the drop of a dime. And the consequences are sometimes deadly.
Unlike the problem solving involved in my remodeling follies, medicine is often unknowable. The systems are infinite and intricate. The headache I feel pails in comparison to what patients and families face every day.
I will sleep well tonight. My lack of fluency may slow me down, but I will live to fight another day.
I can only hope the same is true for my patients.
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