At the church I am currently attending, the organ is under construction. From the pulpit, the Rector explained that the 100 year-old blower needs a tune-up. The organ, he explained, is truly a wind instrument. The blower forces air through the network of pipes, and the keyboard simply directs that air as needed to produce sound. In this way, he explained, the organ has a sort of soul – a breath that flows through it and gives it life. Take away the breath, and you’re left with an empty shell.
This month I am rotating with a thoracic surgery team. We spend most of our time operating on lungs – the organ that is responsible for blowing our air, and distributing the oxygen throughout our bodies. Maybe this is really the seat of the surgical soul, just as the blower provides the soul of the organ. Take away the lungs and the oxygen they provide, and you’re left with a lifeless body.
When we resect part of a lung to remove cancer, the remaining lung tends to leak air into the chest. We place chest tubes so that this doesn’t compress the remaining lung and crush the heart. We call this an “air leak” – maybe now I’ll think of it as a soul leak.
I feel like my soul has been leaking out of me for some time. Maybe I need a chest tube so that my heart won’t be crushed. Then again, maybe it’s too late, and the soul that was such a part of me is forever changed because some of it has simply leaked away.
The organ repair will take at least all summer, the rector reports. How long do you think my repair will take? Is my soul easier or harder to fix than a 100 year-old organ? Certainly mine takes up less space on this planet. And given the size of the congregation, I’m sure many less people care about mine.
At about 3 AM today one of our patients died. Her cancer had just run too wild, and our surgeries were not enough. Her soul was destroyed. I had to tell her daughter.
Fortunately, the church I attended is grand enough to actually have a second organ in the back of the church. The postlude was the marvelous prelude and fugue in E by Bach. The organ – with its pipes and wind and organist – was spectacular. I knew an organist who once told me that she chose to play Bach whenever her soul was troubled, and that somehow Bach’s music had a way of helping her make sense of all that seemed wrong. Today I felt that same sense, as I sat there and let the music pour over me – a perfect manifestation of soulful music. Somehow the organ made sense. It was inspiring to literally feel the soul of the organ, and to image one day my own soul being just as grand.
I can’t wait.
Sunday, June 19, 2011
Monday, June 13, 2011
Sunshine
There is nothing quite like living in a new city. It’s exciting, challenging, but ultimately – for me – quite lonely. It exacerbates all my insecurities, and serves to emphasize my feelings of isolation. It’s a strange thing to feel alone in a city of eight million, but maybe that’s why it’s so unsettling.
It has been gray and cloudy recently. It rained much of my day off last weekend – why not?
I am working this month on a thoracic surgical oncology service. The patients could not be more different than those I encountered while serving on the trauma team. These patients are older, much more educated, and carry with them that loaded label of cancer patient. Theirs is a death that is slow, not unexpected, and usually very painful. It is an agonizing process to watch, as their bodies mutate and grow uncontrollably, killing them from the inside. One woman looked at me yesterday and said “I don’t recognize myself anymore.” It’s horrible.
Yesterday the clouds and rain continued. But the floor secretary had the antidote. She came waltzing in, with a big grin on her face. She pulled from her bag a plastic flowerpot with a single yellow plastic daisy standing in the middle. She plopped it on the counter and hit a button – and the flower sang:
You are my sunshine, my only sunshine.
You make me happy when the skies are grey.
You’ll never know, dear, how much I love you.
Please don’t take my sunshine away.
I used to be a ray of sunshine. But not anymore – not now.
Right on cue, the sun broke through the clouds. I guess I can defer the role of sunshine for the time being.
It has been gray and cloudy recently. It rained much of my day off last weekend – why not?
I am working this month on a thoracic surgical oncology service. The patients could not be more different than those I encountered while serving on the trauma team. These patients are older, much more educated, and carry with them that loaded label of cancer patient. Theirs is a death that is slow, not unexpected, and usually very painful. It is an agonizing process to watch, as their bodies mutate and grow uncontrollably, killing them from the inside. One woman looked at me yesterday and said “I don’t recognize myself anymore.” It’s horrible.
Yesterday the clouds and rain continued. But the floor secretary had the antidote. She came waltzing in, with a big grin on her face. She pulled from her bag a plastic flowerpot with a single yellow plastic daisy standing in the middle. She plopped it on the counter and hit a button – and the flower sang:
You are my sunshine, my only sunshine.
You make me happy when the skies are grey.
You’ll never know, dear, how much I love you.
Please don’t take my sunshine away.
I used to be a ray of sunshine. But not anymore – not now.
Right on cue, the sun broke through the clouds. I guess I can defer the role of sunshine for the time being.
Tuesday, June 7, 2011
Self
There are lots of ways that I could have ended up my month on trauma. I suppose this one was as appropriate as any.
She was 67, thin, and otherwise healthy. She was a week away from her 40th weeding anniversary. And late that evening she took the family gun, held it to her temple, and pulled the trigger. The bullet passed clean through her brain and out through her skull on the other side. The cops found it lodged in the wall of her house, amidst a splattering of blood.
Amazingly, she wasn’t dead. Her blood had spread all throughout her head, but the two holes left by that bullet served to decompress her skull and stave off the high intracranial pressures that are usually fatal in this sort of instance.
We worked very hard over the next two days on this lady, while her family gathered at the bedside and slowly came to grips with what had happened and what the likely future would hold.
In medicine we often end up prolonging life under dubious claims. But it struck me that there could not be a clearer instance of someone telling us that she did not want to live. If you believe the statistics, women attempt suicide much more often then men do, but because they often choose less violent methods (e.g., overdosing on pills) they are less successful than their male counterparts. Needless to say, out patient chose as violet a way as possible to try to end her life, and so sent a powerful message as to her wishes. It didn’t dampen our efforts, but I’d be lying if I said it wasn’t on my mind.
We often hear suicide described as a selfish act. And this became obvious as I stood in that room and saw a husband, a brother, and a friend gather at her side, speaking words that fell on bloodied ears – who knew if she could hear? – the only response being the methodic beeping of the monitors and the eerily empty breathing of the ventilator. The police would pull them out one by one to question them – a final insult to the torture of the whole process. Who was suffering the most at that instant?
And what could have been so bad as to bring someone to that point? How do you get there? How is that even possible? How can you be that self-absorbed?
I started to write my explanation, but I erased it. Why even pretend that I really understand? Besides using the clichés of hopelessness and alienation, I would write only from speculation. And anger. I’m not suicidal and I never have been – I don’t have it in me, and for that I am grateful.
We see a lot of horrible things in surgery. But suicide, for me, is the worst. Nothing turns my stomach or puts me more on edge than an attempt at one’s own life. We are hard-wired to survive and preserve our life against all odds. There is nothing so unnatural as self-destruction. Maybe it’s because so much of what we fight is accidental, or by fate, or at least out our hands – suicide is just the opposite. It is intentional. Deliberate and purposeful, it is precise in its perverted meaning. It messes with my emotions more than I care to admit.
Ask anyone who’s worked in a hospital, and they’ll tell you that death has a certain look. She wasn’t dead when I walked out the door, but you see that it was coming. Just as she had wanted.
And that’s how my month ended.
She was 67, thin, and otherwise healthy. She was a week away from her 40th weeding anniversary. And late that evening she took the family gun, held it to her temple, and pulled the trigger. The bullet passed clean through her brain and out through her skull on the other side. The cops found it lodged in the wall of her house, amidst a splattering of blood.
Amazingly, she wasn’t dead. Her blood had spread all throughout her head, but the two holes left by that bullet served to decompress her skull and stave off the high intracranial pressures that are usually fatal in this sort of instance.
We worked very hard over the next two days on this lady, while her family gathered at the bedside and slowly came to grips with what had happened and what the likely future would hold.
In medicine we often end up prolonging life under dubious claims. But it struck me that there could not be a clearer instance of someone telling us that she did not want to live. If you believe the statistics, women attempt suicide much more often then men do, but because they often choose less violent methods (e.g., overdosing on pills) they are less successful than their male counterparts. Needless to say, out patient chose as violet a way as possible to try to end her life, and so sent a powerful message as to her wishes. It didn’t dampen our efforts, but I’d be lying if I said it wasn’t on my mind.
We often hear suicide described as a selfish act. And this became obvious as I stood in that room and saw a husband, a brother, and a friend gather at her side, speaking words that fell on bloodied ears – who knew if she could hear? – the only response being the methodic beeping of the monitors and the eerily empty breathing of the ventilator. The police would pull them out one by one to question them – a final insult to the torture of the whole process. Who was suffering the most at that instant?
And what could have been so bad as to bring someone to that point? How do you get there? How is that even possible? How can you be that self-absorbed?
I started to write my explanation, but I erased it. Why even pretend that I really understand? Besides using the clichés of hopelessness and alienation, I would write only from speculation. And anger. I’m not suicidal and I never have been – I don’t have it in me, and for that I am grateful.
We see a lot of horrible things in surgery. But suicide, for me, is the worst. Nothing turns my stomach or puts me more on edge than an attempt at one’s own life. We are hard-wired to survive and preserve our life against all odds. There is nothing so unnatural as self-destruction. Maybe it’s because so much of what we fight is accidental, or by fate, or at least out our hands – suicide is just the opposite. It is intentional. Deliberate and purposeful, it is precise in its perverted meaning. It messes with my emotions more than I care to admit.
Ask anyone who’s worked in a hospital, and they’ll tell you that death has a certain look. She wasn’t dead when I walked out the door, but you see that it was coming. Just as she had wanted.
And that’s how my month ended.
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