Another Day at the Office

Another Day at the Office

11:30 pm.

Just getting home.

It’s muggy tonight.

I look up at the stars and and take a deep breath in of the humid air. 

First night on call.

I realize I’ve been going since 7:30 this morning.

3 trips back and forth to home between the hospital , clinic, back to the hospital.

Meeting, get home , try to get some of my life organized, chart, eat lunch. 

Back out. 

Office, Crazy afternoon.

Really 15 minutes? you want me to diagnose a rash in a woman who had breast cancer in that breast that presented with a rash 3 years ago in 15 minutes? 

Seriously. This is what’s so fucked up about healthcare.

And I feel the stress level building up in my stress-o-meter, reaching high levels. I’m feeling at 80%. 

Last patient at 5:45 pm: chest pain, turns out to be breast pain. 

Family history of breast cancer and lymphoma.

I’m worried. Is she worried? 

I don’t leave any stones unturned. Mammogram. Chest X-ray.

Time: 6:09 pm. 

Everyone is gone. Just me and the nurse and the patient.

I’m surprised I finished relatively on time. Supposed to be done at 6 pm.

That’s because I had a no show. Thank God for No shows. Otherwise I would be drowning.

And the office turned into a ghost town. 

I sit in my little office, overwhelmed by the papers surrounding me, typing away furiously. Charting. It never ends.

The lab inbox ever-growing. Plus, all the patients I was supposed to call back for one thing or another.

This job isn’t glorious

We are asked to do the impossible and to do it perfectly 100% of the time.

Otherwise, lives are at stake. And the worry of a lawsuit.

You want to have a life? Forget it. 

“That’s not a day off.” “That’s your admin time”

Thanks. I feel better now. More time to do work.

So why do I practice medicine, I ask myself? Does this sound like fun? 

No . No it’s not fun.

It’s not what I envisioned medicine to be.

It’s not what medicine is supposed to be.

I am not a healer. I am a pill pusher. I am a paper and letter writer. And I order tests. More and more tests. Because that’s what’s expected. Because somehow I think that’ll make the patient feel better.

Maybe it’ll make me feel better.

"Can I be excused from jury duty because of my back pain?”

Why have we become such complainers?

What happened to sucking it up? 

If you’re paralyzed from your back pain, Yes, Yes, then you can be excused. 

And we take care of the sickest. The Neglected. The ones that No One in Society cares about

Because they don’t have the money to contribute, to be a “productive” member of society

And then the nurse told me she thinks he’s high. 

I walk in the room. He is clearly high.

Then I see the fresh wounds on the antecubital fossa of both arms from just having shot up some narcs earlier today probably

And he wanted to hide it. He said he didn’t want his mother to know.

How am I supposed to help him? 

Suboxone. 

Yeah. Let’s just give people more drugs to help them get over the drugs they are currently using. 

But I know it’s the best and maybe only alternative. 

Maybe this way he won’t die.

Then I realize these people have no goals or ambitions. 

My alcoholics. Picked up every day off the street and taken to the ED only to go back out the next day and drink.

He says he has a mother. Does he really? Where is she?

They are forgotten. They have no one in their lives. No reason to shape up.

No reason to clean up.

No reason to get out of bed every morning.

So instead they get high.

They keep taking their drugs.

How did we get to this point anyway?

And I have decided I don’t want to be an enabler. 

You don’t want to help yourself? 

Then I CAN’T help you.

You have to find a reason to get up every morning and put your Game face on.

I CAN’T do that for you.

Why are we chronically depressed as a nation?

Chronically anxious?

What is lacking from our lives? What’s missing?

My mother calls it individualism. 

We are after all pack animals. At least we were. It’s in our nature.

It’s our instinct as a species to be together as a herd, in a pack, just like with most other species.

Because as a pack, we can protect each other from the dangers of the world, watch out for each other. Help each other.

Yet we have separated ourselves and made ourselves vulnerable to illness,

mental disease, substance abuse.

Why are we such a self-destructive species? We have lost the concept of self preservation which is still deeply ingrained, instinctive, for all other species on the planet.

And I realize I’m thankful that I have to work every day.

No matter how painful the day may be and no matter how much sometimes I want it to be over.

I’m tired. I’m tired of hearing the complaints. 

I’m tired of seeing that visit after visit , nothing has changed.

That the person in front of me didn’t change a thing I asked them to change.

Because they can’t find the motivation. Or the Inspiration. Because they are chronically depressed by the lives they lead. They have no hope. No Future.

We are no longer Inspired as a species the way we used to be.

Discovering electricity. Discovering space. Discovering cures for cancer. On and On.

Now we are just a Depressed species. Uninspired. NO spark. No Sparkle.

10 am. Tennis. Saturday.  I just keep holding on to that. 

And knowing I will smell fresh air soon. Feel the sun. Exercise. Smile. Laugh. Be with friends. Maybe some music. Oh I hope there will be music.

Then I think about my violin in the closet. I miss her. She’s been there for 2 months wondering where I’ve been. Feeling lonely.

A little more than 24 hours. Then I’ll be free.

I’ll be free from this Chain. This Chain of suffering. For at least a little while.

I feel like I have to Hold everyone’s suffering. 

I feel like everyone’s Parent.

I always have.

And maybe that’s really what Ultimately drew me to medicine.

Because I’m good at Parenting. And fixing people’s wounds. And calming down their soul often at the expense of my own.

"God, I’ve aged," I think to myself.

And I realize there is a deep price to pay for all this. This is what society doesn’t tell you. This is what Medical school doesn’t prepare you for.

The toll it takes on your mind, body and soul to care for all these sick, chronically ill people. And to have to fight with the system tooth and nail to help them in the smallest ways possible.

All this disease that could have been prevented. Prevented thru Preventive medicine and structured health care. Not Social Healthcare. I love how society twists the meaning of that word to make it sound bad.
'Oh you want socialized medicine? Gasp! How could you?!!!'

But then I ask myself, despite all this,
Despite the fact that the system is broke and Me.
Me alone, well I can’t fix it.

What else would I do? If I didn’t do this?

I know what else I would do.

Live.

But then I ask, what else would really give my life meaning?

Because despite being exhausted and delirious right now, I feel driven. 

I feel needed. I feel wanted. 

Most importantly, I feel useful. To other people.

I feel that my life has a purpose. And that’s what I need right now to keep me going. 

To get me out of bed every morning.

So I can hope for a better day.

So maybe one day I can see the sun rise again.

And I can smile. And be Happy.

And that,

Well that gives me a reason to get up in the morning.

Trista Pene - Gipsy Kings