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Monday, November 7, 2011

OB-Gyn: Day 13

A friend of mine recently read a few books which have been on my book list for months - Delivering Doctor Amelia and Moms Marijuana. Thanksgiving plans include these two books, especially after I read a little preview of them. It's made me feel validated, like I'm not the only one who feels like I'm drowning in the sea of medical knowledge. It's natural. It's expected. And it's all part of the beauty that is medical education. I will keep my smile on my face and keep doing my best, and the rest will fall perfectly in to place.
I wanted to share the excerpts of the book with you. Enjoy!


"Doctors are a strange breed. They nibble at an overwhelming amount of information in medical school. They are too bright to miss the incredible distance between what they know and what there is to know. They dedicate their waking hours to memorizing droplets from a great ocean of information. They learn trivial anatomical structures and then promptly forget them. They stand with groups of more experienced physicians and are asked questions they don't know the answers to. They shake the sleep from their eyes and walk down neon-lit halls feeling inadequate and small. The Ben Casey vision of medicine that propelled them through organic chemistry classes in college crumbles in the face of a reality which includes cureless diseases, obnoxious scut work, and constant humiliation. They wear down. Their lovers wear down and leave them at higher rates than in most professions. The one untarnishable thing they have left is their basic fascination with the human body and what can go wrong inside its miraculous design.

Inevitably, they lose their empathy for pain. The waterfall of pain they hear from countless patients wears them down to smooth rock. After all, they have had to deny themselves so much to succeed. They have endured their own painful humiliation. They have learned that pain is simply a warning mechanism, it isn't real. Is it any wonder that our painful cries empty into a vacuum when doctors are in the room? Is it any wonder that they sometimes forget that we are not our diseases, that to treat our diseases they must also treat us? Is it any wonder that they forget to treat our terror, that they forget to treat our lover's terrors, that they forget that we need soothing and a pat on the shoulder?

Oncologists are drawn to the good fight, to the opportunity to fight a monster on the front line. They are drawn to the magic of rescuing a life from the jaws of the enemy, but soon they find the faces of their patients haunting them. No one has taught them that they need to talk about their losses, that they must mourn the deaths of the patients they grew so fond of. They haven't learned that to survive they must find ways of debriefing themselves. When reaching for the peas at a family dinner, while casually looking into the rearview mirror at a stoplight, or while watching their toddler bound across the kitchen floor, intrusive snapshots of interactions with patients, now dead, sneak into their consciousness. These visions are potent warnings that they should not get too close to their new patients, that they should erect a screen.

But we patients sense these screens. We study these strange beings almost as carefully as we did our first love. Every subtle move of a hand, every nervous cough, every wrinkled brow, captivates us and we play them over and over again in obsessive ruminative detail. Oncologists are our oracles. We wonder if they have seen our futures. We try to engage them, hoping that perhaps an extra few words will help them commit more energy to our struggle.

I always feel a pang when I meet a new oncology fellow. They are new to the front. They have seen the falling shells as residents, but now it will be different. They will have more autonomy. They will make life-altering decisions. They will begin to root for the patients, as much as for their own sense of competence as for the patient's health. And when a patient dies, a piece of them will die. They'll wonder what they should have done differently, caught earlier. And they'll stand near the coffee machine muttering about incurable diseases, sounding too professional, and then sneak home and bury their faces in their pillows.

For doctors death is the ultimate enemy. Death is not the end result of all life. Death is an unnatural force that steals promising patients away in the dark of night. Death is messy and abrupt. Death is not to be talked about. (Death might show up if you call its name too loud.) Our fears of death only remind the doctor of the ocean of knowledge he never learned or long ago forgot. Death reminds him of the futility of his efforts and his own eventual demise. And isn't his work enough without being reminded of these dreadful things?"



Another gorgeous sunset to end another beautiful day! :)

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