I’m not sure how to begin this post, other than to admit that I’m exhausted.  I’m currently on rotation at an outside hospital, and although the operative experience has been incredible thus far, the long hours in the operating room and the random pages in the middle of the night while I’m at home have been taking a toll.  Rare is the day that I leave the hospital before 7pm and make it to the gym.  If it sounds like I’m complaining, I’m not – I’m greatly enjoying the amount of operating that I’m doing, but it would be a lie to say that I’m not constantly tired these days.  Needless to say, the number of thoughtful and witty posts on the blog have declined significantly.  Hopefully in the new year that will change a little.

The one thing about a crazy and hectic schedule that works well for me is the need to push aside all the extraneous things in life that don’t really matter.  Staying constantly focused on work only leaves room for the important things in life, although I’ll admit that I’ve had trouble staying engaged in the sometimes mindless chatter at holidays parties this season given my “one track” work mind.  That all changed today at work, and life caught up.

When people find out I’m a surgeon, they are often impressed and comment that I’m doing great work and “saving lives.”  I’ll be completely honest when I say my job is not an episode of ER or Grey’s Anatomy, and that there is nothing all that glamorous about repairing hernias and removing gallbladders (although to be fair one could spin that as improving a patient’s quality of life).  I’m going to say the thing that doctors should probably never admit, but on my worst days, I tend to view medicine as just a job/career and nothing more.  On the worst days, taking care of patients is the duty I’ve signed up for.  Thankfully those days are few and far between, and most of the time I find medicine and surgery incredibly rewarding.  I currently have an elderly patient in the ICU who is slowly improving after being very sick and undergoing a very large surgery.  Knowing that I’m playing a part in her care definitely makes feels good.

Sometimes, all it takes in medicine is one patient to remind you of who you are, what you are doing in life, and what you’ve given up to get to this point.  That patient was a 40-something year old man who came to the hospital with what he thought at worst was appendicitis and turned out to be a tumor that had already spread to his liver and likely his lungs.  His charming wife, three months pregnant, sat by his side this morning when the bad news was delivered.  The look on his face spoke volumes as he was clearly overwhelmed with information and grasping for some sort of understanding.  The idea of curative treatment slowly slipped out of his grasp, and his spirit was visibly crushed.

I walked out of his room knowing that we had done the right thing, giving him all the information he needed to make educated decisions about his future care.  My attending had prepped him for the worst while maintaining hope.  But I couldn’t help but feel devastated myself, the conversation and my patient’s history taking me out of “doctor mode” and forcibly throwing real life in my face.  We as physicians often forget what our patients go through, the “hula hoops” we make them jump through and the “tight ropes” we make them walk.  Our patients often put their lives on hold, at least temporarily, for the treatment they seek.  They endure pain and suffering, sometimes at our own hands, for a cure – no matter how elusive it may be.  We forget because it is easier to forget rather than dealing with the pain, suffering, and death. This man and his plight made it all too real, and it took every fiber of my physically exhausted being to hold it together.

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