Moving

Moving is miserable. In part because it just is. And because I’m a legitimate pack-rat with a vivid memory, moving becomes a long and emotional process. I have SO much that many would consider trash – receipts, ticket stubs, cards, knickknacks…and they all bring back a flood of memories that very nearly pushes me over the edge. It’s a long process.

The other day I was sitting on my couch looking at a bare corner of my apartment. And oddly enough I was transported back to the spring of 2000. I was a sophomore in college, and had just finished a difficult semester that focused around the conclusion of organic chemistry. “Orgo,” as we called it, is the ultimate weed-out class. Some huge number of first-year college students start off as pre-med, but orgo somehow manages to make a lot of students change their mind.

Chemistry didn’t come easily to me; I really had to work at it. I did alright the first semester, but the second was too much. I got a C, and I was crushed. And as I was packing up my things for summer break I remember seeing my orgo book on the floor. And I looked at that weighty book and had such an overwhelming feeling of disappointment. I felt like I hadn’t reached my potential, and that more of me was left to give. I felt genuine failure.

I had a similar feeling in high school after a disappointing loss to one of our rivals in a big lacrosse game. We could have won – should have – but somehow it got away from us. I remember driving by that field several hours later, thinking to myself that this place was full of such hope, such excitement, and such joy just a few hours ago. And yet now…emptiness. It was incomplete.

I am moving for all the right reasons. Happiness, excitement, and joy are all at the other end. And in no way do I have any regrets about that. But still, when I look specifically at my apartment I get a sense of failure. The marriage, the relationships, the hope for a family – none of the things that I wanted before I moved there happened. And while the joy I have now wouldn’t be possible save for that failure, when I stand in my living room and see the empty walls and scattered furniture, the negativity is all I feel.

It’s time to move.

Relationships

The “doctor-patient relationship” is an often-discussed paradigm. It’s one of those things that prospective applicants talk about during interviews, and that older physicians love to pontificate upon. For me, it was something I looked forward to, but have only rarely experienced in all the glory I thought it was going to be.


The other day a lady saw me in the elevator, and excitedly addressed me by my name...


Who was she again?


She went on to say how great it was to see me…



Do I know you?


And she told me how great she was doing…



Do you have me confused with someone else?


And she thanked me profusely…

And then I remembered. Of course! She came in with abdominal pain, and we saw on her CT scan something concerning for a mass. We took her to the operating room and performed a major colonic resection. She ended up having a T3 lesion, and the oncologist was considering chemo. Her post-op course was longer than expected, but otherwise fine. She should do well.


And how could I have forgotten? How could I? I spent every day for about two weeks seeing this lady, and I spent about 3 hours with my hands literally inside her abdomen operating. And I had totally forgotten.


Maybe it’s because we all, on some level, try to disconnect with patients. How could we not? I thrive on emotions, and am at my best when I am emotionally engaged, but even I distance myself at times. We build connections, establish trust with patients and their families, but then it’s helpful to turn it off when it’s time to cut.


Or maybe it’s because the relationships we form aren’t really that secure. How could they be? We see patients for a couple of minutes a day. Even if we do this for a week or two, that’s really not that much time.


Or maybe it’s because this relationship – while life-altering for my patient, was just another day at work for me. It was incredibly intense for her, and business as usual for me.


My cousin recently lost her child during a C-section. She carried him for 9+ months, and was used to feeling him move every day. And so, a day or two past her due date, when she no longer felt him, she rushed to the hospital. Some monitors were placed and quick tests were run, and soon she was in the OR where the doctors were trying to get that child out of her as quickly as possible. But it was too late. He was dead. She held him for 3 hours – the funeral is this weekend.


My cousin, along with her family, is appropriately crushed. Her life will never be the same again. And it’s all because of a most unique relationship – one that developed daily over 9 months, but one that didn’t even involve speaking or touching, only a magical sort of feeling. In one very plebian sense she had no time with him at all; and yet in another, every second of her being has been spent making him, and preparing for life with him.


I guess it’s really not time at all that defines a relationship, but rather intensity. Our challenge as physicians is to make every patient feel that we are giving to them the same sort of intensity that they are feeling within themselves.