17 years ago, one of my closest friends put a gun to his head and pulled the trigger. Why? I have no idea. I can only assume that it was from some deep seated depression that he never discussed, never let come to the surface. Oh there were plenty of times for it to come up as we spent most of our days together studying for exams, dissecting cadavers, and peering through microscopes. He and I would talk about what life would be like after the big day when we would turn in our short white coat (traditionally worn by medical students) for the regality of the long one. Graduation was but a few short years away and man, were we ready for it.
But only one of us made it.
The thing I regret most is that I never got to say goodbye. One day he was here, the next he was not. There are still so many questions I have surrounding that time that will remain unanswered. Why did he do it? Why didn't he come to me for help? Why did he think life was so terrible that death was a better option? He was obviously tortured by some silent demon, a dark and petulant creature filling his head with falsehoods. He let these thoughts control and twist his perception of reality. That was the only way this could have happened.
At your funeral, I could not bear to have you leave. As I squeezed my eyes tighter, I thought I could keep your essence here if I just concentrated hard enough. I was so focused on the hurt, the anger, the sadness that I missed the beautiful, soft violin playing in the background. Bach's Ave Maria slowly seemed to grow louder in my consciousness forcing me to open my eyes and pay attention.
Pay attention to the fact that you were gone and you were not coming back.
Pay attention to the fact that even though you were gone, there were others that were still HERE.
Pay attention to the fact that I must go on. For both of us.
As that soft melody drifted through the church, I couldn't help but feel your spirit floating higher and higher with each note. Without care or constraint, you were free at last from whatever mental anguish you harbored.
I miss you, my friend. Always have. Always will.
Thursday, March 28, 2013
Wednesday, March 27, 2013
Tuesday, March 26, 2013
A Letter To My Father on His Retirement
A Letter To My Father On HisRetirement
Dear Dad-
As I write this letter, you are in the final days of a 50+ year medicalpractice. I have been fortunate to have viewed your career througha very interesting lens. I have been able to see it as a son, a patient,a medical student, and finally a colleague. It is this latter view thathas allowed me to fully realize what a phenomenal career you havehad.
As your son, I saw a very busy father and husband. Working mostdays of the week, you were constantly bombarded with incompletecharts and insurance forms brought home to our kitchen table. Thelast thing you wanted to do after a busy day of work was MOREmedicine. With tiny slips of paper holding the phone numbers ofpatients who had left messages, you would systematically call eachone and spend as much time as needed to answer any and allquestions.
When all you wanted to do was watch the evening news, you werealways available to examine your children's friends, even when youwere not their doctor. From your Laz-E-Boy you would dashchildren's hopes for a day off of school with nothing more than aflashlight, a spoon, and a peek at their throat. You never grumbledabout needing to make phone calls to worried patients even whenthey interrupted our baseball games or birthday parties. We weren'tupset. We knew that was just part of who you were and what yourjob demanded. We didn't have full ownership of our father, evenwhen we should have.
I never really appreciated the fact that I didn't see a pediatriciangrowing up. You were the one to decide whether I had to go toschool and more times than not I was on the bus whether I felt like itor not. I can remember only a handful of times I was ever onantibiotics because you knew that medicine usage was to bereserved for only serious cases of infections.
Of course, then there were the catastrophes. You were there for mewhen I cut open my leg in a baseball dug out requiring minorsurgery (stitching up muscle and skin after a metal bar had sliced mythigh to the bone). You did that in your office...your office! As aphysician, I can appreciate that what you did then was somethingthat wouldn't happen in this day and age. You knew you could dothe job as well as the ER and without the hassles of filling out insurance forms or sitting with a hysterical 7 year old for hours on end.
Dear Dad-
As I write this letter, you are in the final days of a 50+ year medicalpractice. I have been fortunate to have viewed your career througha very interesting lens. I have been able to see it as a son, a patient,a medical student, and finally a colleague. It is this latter view thathas allowed me to fully realize what a phenomenal career you havehad.
As your son, I saw a very busy father and husband. Working mostdays of the week, you were constantly bombarded with incompletecharts and insurance forms brought home to our kitchen table. Thelast thing you wanted to do after a busy day of work was MOREmedicine. With tiny slips of paper holding the phone numbers ofpatients who had left messages, you would systematically call eachone and spend as much time as needed to answer any and allquestions.
When all you wanted to do was watch the evening news, you werealways available to examine your children's friends, even when youwere not their doctor. From your Laz-E-Boy you would dashchildren's hopes for a day off of school with nothing more than aflashlight, a spoon, and a peek at their throat. You never grumbledabout needing to make phone calls to worried patients even whenthey interrupted our baseball games or birthday parties. We weren'tupset. We knew that was just part of who you were and what yourjob demanded. We didn't have full ownership of our father, evenwhen we should have.
I never really appreciated the fact that I didn't see a pediatriciangrowing up. You were the one to decide whether I had to go toschool and more times than not I was on the bus whether I felt like itor not. I can remember only a handful of times I was ever onantibiotics because you knew that medicine usage was to bereserved for only serious cases of infections.
Of course, then there were the catastrophes. You were there for mewhen I cut open my leg in a baseball dug out requiring minorsurgery (stitching up muscle and skin after a metal bar had sliced mythigh to the bone). You did that in your office...your office! As aphysician, I can appreciate that what you did then was somethingthat wouldn't happen in this day and age. You knew you could dothe job as well as the ER and without the hassles of filling out insurance forms or sitting with a hysterical 7 year old for hours on end.
Through the years, I was spared the late night visits to the ER andthe long doctor's office waits. I never developed the fear of goingto see the doctor because I knew that the very important man in thewhite jacket would be tucking me in my bed that night. Safe andsound.
When I told you that I wanted to go to medical school during myfreshman year of college, you appreciated the gravity of thisdecision even when I did not. You knew that I had the intelligencefor medical school but you wanted to make sure that I had the otherintangible qualities that make a proper physician, ones that wouldearn the respect and love of peers and patients alike. Patience,dedication, and above all, compassion for others were keys to asuccessful career in medicine, ones that you had cultivated so well.So what you did was unconventional but highly effective. Youarranged for me to be a nurse's aide at the local hospital whereempathy and compassion was all I could offer. I knew nothing aboutmedicine so my experience was to be of pure service to others.Bathing the patient who had just had a stroke, cleaning up after thepatient who had stooled in his diaper, sitting with the dementedpatient who was too scared to be alone. It was a stroke of genius. IfI sank, you saved me years of struggle and potential discontent withmy job. If I couldn't enjoy what I was doing when I had noknowledge, how could I enjoy it years later when I had theeducation but potentially lacked the desire to continue to care? Butif I swam....yes, if I swam, well, then you knew I was doing it for allthe right reasons and I was well on my way to not just a profession,but a life of genuine altruism.
Once I completed medical school and residency, I came to rely onyour counsel for “the learning years” of my private practice. How doI deal with a family after the death of a patient? How do I balancehome life with the ongoing pressures with my time at work? How doI remain compassionate to those patients that drive me absolutelycrazy? You have helped me through every step of my life and havebeen the consummate role model for all of my life's endeavors. Youradvice has been invaluable to me and has shaped the doctor andperson I am today.
I now want to offer you some advice. As the sun sets on your career,I want you to realize how important YOU are. Not just as aphysician, which has been your persona for so long that you may notfeel as if you can separate it from who YOU truly are. YOU are awarm, caring, sensitive person who has been freed from the bondsof servitude. Go gently into retirement and start the rediscovery ofYOU. Rediscover dreams long since put on hold. Rediscoverrelationships neglected. Rediscover life and everything in it that has passed you by these 50 years.
Congratulations, Dad. You deserve every bit of relaxation coming toyou.
I love you.
Chris
Thursday, December 8, 2011
Paging Doctor Google....Paging Doctor Google...
I have found that patients will go to great lengths to obtain this validation before coming in to see me. They will ask their friends, their neighbors, their hairdressers long before seeking my advice. This, however, is really difficult for me to deal with because I then have to go to extraordinary lengths to undo the damage that Herb the barber has done to my poor patient. Here is a small case report to illustrate my point. The names have been withheld to protect the innocent...
Patient: Doc, why is it that when I get out of the shower, my right pinky toe is more red then the left one and tingles for 2-3 seconds? Do you think that it means I am going to have a stroke?
Me: No. You are not going to have a stroke.
Patient: You sure? I asked my stylist and she says that her aunt's neighbor complained of the same thing and she was dead of a stroke a year later.
Me: I can't tell you whether you are going to have a stroke a year from now but I can tell you that the tingling in your toe after a shower is not a stroke.
Patient: Really? I was watching Dr. Oz and he said that tingling in the hands or feet could mean a stroke and that I should see my doctor.
Me: Well, you are seeing me now and I am telling you that this is not a stroke.
Patient: Well, I googled these symptoms and there is a doctor in Bangladesh that specializes in this type of thing. Do you think I need to see them?
Me: Really? I mean, really?
Maybe I need to start my own talk show for my patients and dole out little vague nuggets of medical wisdom that can be interpreted in a myriad of ways. I could be like Dr. Horoscope. Anything I say could be taken completely out of context. No, what my patients need is exactly what I give them. The ability to release their inner bugaboos in the safe environment of the exam room. I sit and listen. I don't judge. I just continue to assure them they are going to be okay. This is something that was never taught to me in medical school or in residency. When I first started in private practice, I was so concerned with getting the correct diagnosis that I was oblivious to what the patient really needed. I ordered lots of tests to assuage my need to know the diagnosis, when in actuality all my patient wanted to know was that their tingly toe was not going to kill them. Now that doesn't necessarily mean that they don't want to know the diagnosis, it just means that it is lower on their list of "needs" that they require from me. Sometimes the only medicine the patient needs is a stout dose of "listen and do nothing" than "do something and don't listen". Maybe that is what makes makes barbers and hairdressers so appealing for patients. They are a captive audience. If doctors did more listening and assuring and less talking and testing, maybe patients would come to us before going to Herb at the barber shop.
Friday, December 2, 2011
The Doctor Visits A Foreign Land...and HATES It.
As I wait for my next patient to be put back into an exam room, I just wanted to let everyone know that I would not trade my job for anything. Now it may not be for the reasons that you would think, such as the love of the science, the art of the practice of medicine, or the ability to drink coffee all day long without the repercussions of annoying my cubicle mates with my incessant jitteriness. No, I love my job because it is not YOUR job. I have had a taste of the other side and it is bitter and distasteful to my palate. I am, of course, referring to the routine "office" life. I have taken a position as a physician leader with Norton Healthcare helping them implement the new computerized medical record. It has required me to meet with the "suits" of the administration who are the drivers of this fantastic organization. It is a lifestyle that the majority of people have to deal with in their workplace, one that includes countless meetings, power point presentations, and God forbid, the dreaded Webinar. It is one of the strangest worlds that I have every been in, similar to how Alice must have felt when she fell into that hare hole so long ago.
Emails I have been inundated with emails. Emails about meetings (with follow up appointment reminders), emails about receiving an email discussing an upcoming meeting, and my favorite one of all- emails disregarding an email that I haven't received concerning a meeting that has not been scheduled yet. Geez.
Meetings I have been attending meetings once a week to discuss the ins and outs of implementation. In my practice, I am used to making a decision and that decision leads to a direct action and a consequence. However, during these meetings, we must hash and rehash the same information until I forget the point of interest that necessitated the meeting in the first place. If I hear another person say that they "understand why this could make you frustrated and I respect your position, but..." There is always a but. Always. If I hear this guilded jibberish one more time, I may just go apeshit on someone.
I have come to realize that the beauty of my job is that I get to dictate my day. I can decide how long I choose to deal with Aunt Gertie's toe nail fungus or Uncle Jim's concern that he gets "swimmy headed" when he gets up too fast. If medicine were run by the "suits" nothing would ever get done as there would be meeting after meeting to deal with why Mrs. Smith needs her CT scan or a special committee set up to discuss Mr. Jones' piles (that's a term I learned in residency. It is Eastern Kentucky speak for hemorrhoids- as in "Doc, I rode my tractor all day yesterday and got my piles all riled up..."). No, for me I work better on my little island, making decisions quickly, decisively, and without others approval. I am not saying my way is better, just more comfortable for me. God bless those who can navigate the jungle of cubicles and conference rooms, the endless emails, and the streams of meeting reminders. I know someone has to do it, but I am just glad it is not me.
Emails I have been inundated with emails. Emails about meetings (with follow up appointment reminders), emails about receiving an email discussing an upcoming meeting, and my favorite one of all- emails disregarding an email that I haven't received concerning a meeting that has not been scheduled yet. Geez.
Meetings I have been attending meetings once a week to discuss the ins and outs of implementation. In my practice, I am used to making a decision and that decision leads to a direct action and a consequence. However, during these meetings, we must hash and rehash the same information until I forget the point of interest that necessitated the meeting in the first place. If I hear another person say that they "understand why this could make you frustrated and I respect your position, but..." There is always a but. Always. If I hear this guilded jibberish one more time, I may just go apeshit on someone.
I have come to realize that the beauty of my job is that I get to dictate my day. I can decide how long I choose to deal with Aunt Gertie's toe nail fungus or Uncle Jim's concern that he gets "swimmy headed" when he gets up too fast. If medicine were run by the "suits" nothing would ever get done as there would be meeting after meeting to deal with why Mrs. Smith needs her CT scan or a special committee set up to discuss Mr. Jones' piles (that's a term I learned in residency. It is Eastern Kentucky speak for hemorrhoids- as in "Doc, I rode my tractor all day yesterday and got my piles all riled up..."). No, for me I work better on my little island, making decisions quickly, decisively, and without others approval. I am not saying my way is better, just more comfortable for me. God bless those who can navigate the jungle of cubicles and conference rooms, the endless emails, and the streams of meeting reminders. I know someone has to do it, but I am just glad it is not me.
Sunday, May 22, 2011
The Elderly and His Stomach
I have discovered something in my old age. The cast iron stomach that I once had has been replaced by a temperamental bitch who controls my every gastronomic whim. It is not like I get acid reflux all of the time but when I do it just kicks my ass. I don't remember it being this bad when I was in my 30's (the first sign of accepting your elderly-ness is rounding up on your age). After many sleepless, gas filled nights I finally had an epiphany. Not only is it the type of food but also the TIME that I eat. If I eat too late, my stomach turns into a pumpkin. If I eat food that is too spicy, heavy or creamy and combine it with eating too late, I am guaranteed to be up that night wishing only for an early death. This "Eureka" moment seemed to answer my conundrum but answered a question about the puzzling dining habits of senior citizens everywhere... What is the allure of the Early Bird special? It is not a desire but a necessity. Not only does eating early keep the intestinal bugaboo at bay but it also allows them to get home before it gets dark, obviating the need for a driver to take the wheel because their cataracts cause the headlights to produce awful halos around the lights. But this blog entry isn't about the visual problems of the elderly, it is about my belly and it's capricious behavior...
Chili is my Achilles Heel. I love it. My wife can attest to the fact that I once ate 5 bowls in a single sitting. Needless to say, my gut mistreated me and my family for a totally different reason that night.... But back to my indigestion. I used to pound chili without even thinking about the consequences. Now if I try that, my stomach seems to say "What in the HELL are you trying to do to me?! Knock that shit off!" I become a noisy windbag moaning in my chair watching my stomach bloat and distend. If you need a visual, imagine Violet Beauregarde from the movie "Charlie and the Chocolate Factory"
....each eructation is followed by a curse of my poor dietary choices. It is not a pretty sight (or sound for that matter)...
So why at age 39 do I still tempt the gastronomic gods? Because I am a man and men are stupid. We tend to forget the error in our ways whenever we are faced with something we really want to do. I admit it. I own it....this admission of guilt still doesn't cure my problem. Do I continue to abuse my body or do I call Uncle and yield to the inevitable? Aging sucks, through and through. But with aging comes a certain amount of wisdom. I now find myself picking and choosing my battles at the dinner table. For instance, if I am going to eat chili, then I am going all in- chili cheese coney or chili cheeseburger...no half assing it. Like a gambler- I am in it to win it, throwing in my chips with these belly bombs hoping that I don't crap out, literally and figuratively. Like that ageless bard Kenny Rogers once crooned in his timeless ballad "The Gambler", if I know when to hold 'em and know when to fold 'em, I may just survive another night and live to eat another day...
Chili is my Achilles Heel. I love it. My wife can attest to the fact that I once ate 5 bowls in a single sitting. Needless to say, my gut mistreated me and my family for a totally different reason that night.... But back to my indigestion. I used to pound chili without even thinking about the consequences. Now if I try that, my stomach seems to say "What in the HELL are you trying to do to me?! Knock that shit off!" I become a noisy windbag moaning in my chair watching my stomach bloat and distend. If you need a visual, imagine Violet Beauregarde from the movie "Charlie and the Chocolate Factory"
....each eructation is followed by a curse of my poor dietary choices. It is not a pretty sight (or sound for that matter)...So why at age 39 do I still tempt the gastronomic gods? Because I am a man and men are stupid. We tend to forget the error in our ways whenever we are faced with something we really want to do. I admit it. I own it....this admission of guilt still doesn't cure my problem. Do I continue to abuse my body or do I call Uncle and yield to the inevitable? Aging sucks, through and through. But with aging comes a certain amount of wisdom. I now find myself picking and choosing my battles at the dinner table. For instance, if I am going to eat chili, then I am going all in- chili cheese coney or chili cheeseburger...no half assing it. Like a gambler- I am in it to win it, throwing in my chips with these belly bombs hoping that I don't crap out, literally and figuratively. Like that ageless bard Kenny Rogers once crooned in his timeless ballad "The Gambler", if I know when to hold 'em and know when to fold 'em, I may just survive another night and live to eat another day...
Tuesday, May 17, 2011
The Elderly and His Hair
My Story
So now that I am 6 months from my 5th decade on this Earth, I have been forced to reflect on some not so pleasant issues that billions of men over the centuries had to grapple with when situated exactly where I am now. Aging. Yep, that's right-the systematic breakdown of a once believed invincible machine that from a health standpoint purred like a Lamborghini but now sputters more like a cheap Yugo bought on Craigslist. This is my story-My attempt to make peace with this cruel process that I knew was coming but felt completely unprepared for. Maybe by writing this crap down I can keep it all in perspective and avoid that midlife crisis I see so many of my XY brethren go into. I am not guaranteeing any solutions but maybe anyone that dares to read this will understand what drives their loved ones to grow their hair longer, comb it over and buy a red convertible....
Hair
Let's get something straight. Hair is supposed to be in certain places only. Hair growing from the ear, nose or God forbid on TOP of the nose is not what I would call normal. Aging has provided me with a front row seat for this gradual slide back to the time of the Neanderthal. Hair of inordinate amounts sprouting from the nose, ears, and eyebrows while simultaneously scant on the dome of the head is nature's way of telling me to get over it. Nothing short of daily manscaping is going to keep me from looking like a stand in for Dr. Zaius from The Planet of the Apes (the fact that I even know Dr. Zaius is proof enough of my age.)
Ear hair seems to be the most robust. One day, no problem. The next, a small hairy nub has developed. How in the hell did it sprout overnight? Some sort of sick Miracle Grow? What genetic advantage could this possibly serve to all of the sudden have a bird's nest in my ear? By getting older, am I more susceptible to have bugs crawl into my ear? If so, how come women don't get them? My favorite hairs are the ones that my wife manages to stop me and say "Whoa!! Hold still!" She then proceeds to reach out and pull a hair the size of a small twig off of my ear. Really? Really?!? I am amazed and awed, like a little boy who has just had a quarter pulled from his ear. I swear to her that this sucker wasn't there 6 hours prior to this embarrassing pruning but she just smiles and pats me on the arm as if to say "it's ok, it happens when you get older." I am mortified....
The eyebrow hairs I just don't get. Growing faster than their neighbors, these guys are will take over the brow line faster than you can say "Ernest Borgnine". I wear glasses and if I don't watch it, it will look like a nest of Grand Daddy Long Legs have crawled on top of my spectacles. It takes maintenance. Lord knows I have seen my share of old men who have just given up and let the hair ivy just take over. I can't ever let myself get that way. I just don't think I could live with myself.
The nose hairs are disgusting but at least I have gotten used to them as they seem to have plagued men since the dawn of time. There is even a lucrative industry focused on removing these unsightly growths from inside the nose. The "Turbo Nose Hair Trimmers" seem to apparently be at the top of every male's shopping list. Mind you, I get most of my information regarding this booming business from late night infomercials and the latest copy of SkyMall. That being said, it would seem other men deal with this problem too. The hairs I can't understand are the ones that sprout from the TOP of the nose. What possible purpose could these serve in the grand scheme of things? It is like they are some sort of arachnid antenna protruding out into the empty void, searching for something...anything...I remember seeing an old guy with one so long on his nose that I swore it was some sort of biological curb feeler, used to alert him of his impending collapse into his Bran Flakes. Now, if I am not careful, I may morph into THAT guy...I get the heebie jeebies just thinking about it.
This explosion of hirsutism and my search for the perfect depilatory is just one of the many trials and tribulations that I have begun to explore as I move one day closer to the grave. How I cope with it all is anyone's guess. Who knew that waxing in my old age would look so attractive and that I would be looking for the Fountain of Youth in a box of Nads? Just kidding about the Nads business..... I gotta stop watching so much late night TV....
So now that I am 6 months from my 5th decade on this Earth, I have been forced to reflect on some not so pleasant issues that billions of men over the centuries had to grapple with when situated exactly where I am now. Aging. Yep, that's right-the systematic breakdown of a once believed invincible machine that from a health standpoint purred like a Lamborghini but now sputters more like a cheap Yugo bought on Craigslist. This is my story-My attempt to make peace with this cruel process that I knew was coming but felt completely unprepared for. Maybe by writing this crap down I can keep it all in perspective and avoid that midlife crisis I see so many of my XY brethren go into. I am not guaranteeing any solutions but maybe anyone that dares to read this will understand what drives their loved ones to grow their hair longer, comb it over and buy a red convertible....
Hair
Let's get something straight. Hair is supposed to be in certain places only. Hair growing from the ear, nose or God forbid on TOP of the nose is not what I would call normal. Aging has provided me with a front row seat for this gradual slide back to the time of the Neanderthal. Hair of inordinate amounts sprouting from the nose, ears, and eyebrows while simultaneously scant on the dome of the head is nature's way of telling me to get over it. Nothing short of daily manscaping is going to keep me from looking like a stand in for Dr. Zaius from The Planet of the Apes (the fact that I even know Dr. Zaius is proof enough of my age.)
Ear hair seems to be the most robust. One day, no problem. The next, a small hairy nub has developed. How in the hell did it sprout overnight? Some sort of sick Miracle Grow? What genetic advantage could this possibly serve to all of the sudden have a bird's nest in my ear? By getting older, am I more susceptible to have bugs crawl into my ear? If so, how come women don't get them? My favorite hairs are the ones that my wife manages to stop me and say "Whoa!! Hold still!" She then proceeds to reach out and pull a hair the size of a small twig off of my ear. Really? Really?!? I am amazed and awed, like a little boy who has just had a quarter pulled from his ear. I swear to her that this sucker wasn't there 6 hours prior to this embarrassing pruning but she just smiles and pats me on the arm as if to say "it's ok, it happens when you get older." I am mortified....
The eyebrow hairs I just don't get. Growing faster than their neighbors, these guys are will take over the brow line faster than you can say "Ernest Borgnine". I wear glasses and if I don't watch it, it will look like a nest of Grand Daddy Long Legs have crawled on top of my spectacles. It takes maintenance. Lord knows I have seen my share of old men who have just given up and let the hair ivy just take over. I can't ever let myself get that way. I just don't think I could live with myself.
The nose hairs are disgusting but at least I have gotten used to them as they seem to have plagued men since the dawn of time. There is even a lucrative industry focused on removing these unsightly growths from inside the nose. The "Turbo Nose Hair Trimmers" seem to apparently be at the top of every male's shopping list. Mind you, I get most of my information regarding this booming business from late night infomercials and the latest copy of SkyMall. That being said, it would seem other men deal with this problem too. The hairs I can't understand are the ones that sprout from the TOP of the nose. What possible purpose could these serve in the grand scheme of things? It is like they are some sort of arachnid antenna protruding out into the empty void, searching for something...anything...I remember seeing an old guy with one so long on his nose that I swore it was some sort of biological curb feeler, used to alert him of his impending collapse into his Bran Flakes. Now, if I am not careful, I may morph into THAT guy...I get the heebie jeebies just thinking about it.
This explosion of hirsutism and my search for the perfect depilatory is just one of the many trials and tribulations that I have begun to explore as I move one day closer to the grave. How I cope with it all is anyone's guess. Who knew that waxing in my old age would look so attractive and that I would be looking for the Fountain of Youth in a box of Nads? Just kidding about the Nads business..... I gotta stop watching so much late night TV....
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