Quirky thoughts from a simple mind

January 2005 has proven to be the most difficult month for me so far. And not because of being on call every third night. I've had to deliver more bad news than I was prepared to deal with. I've diagnosed people with liver cancer, lung cancer, and end stage liver disease. And those weren't the hardest to deal with.

The hardest by far was the first person I had to pronounce dead. I know this is a downer of a blog.....but there isn't a single minute of medical school that prepared me for that moment. The patient was DNR (do not resuscitate). In the process of preparing him to go home, his vital signs were found to be deteriorating. I didn't think he would have made it home.....and I didn't want him dying in an ambulance. So I called his family and told him the grim outlook I had. They rushed over and I described what had happened. I led them to the bedside and gave them their time. It was long after I was supposed to be there, and many of the nurses told me that I should go home. I couldn't pull myself away from what I knew was going to happen soon. So I waited. It didn't take long. I had the chaplain called. Then one of the family members came down the hall. "I think you need to check him, doc." I remember the words ringing down towards me and the look on her face. I grabbed my stethoscope and made my way down. I did everything that I technically had learned to do: sternal rub, listen for heart and lung sounds, check pupils for reaction. I looked at the peaceful look on his face. Then I looked up at the clock. 6:52 pm. I felt the words barely pass my lips. I looked at the family and offered my condolences. As I walked down the hall, my feet were heavy. And I felt alone.

It took a while for the situation to settle in. I finished up some work, then went to talk to the family one more time. They thanked me for calling. They appreciated that they were able to make it to his side before he passed. He wouldn't have wanted it any other way. Then they one-by-one gave me a hug. I don't know who those hugs helped more. I hope they were being comforted. I know I felt the heaviness from my feet lighten up with each hug.

It felt like the longest day ever. Mandy was great when I called- extremely supportive, encouraging. It took a couple of days for me to get over the funk. I still remember everything so clearly. Though I wasn't ready for it at the time, I don't think any lecture could have prepared me for that situation. You can only learn that from the experience. At least I'll be more prepared for the next time. I just hope it doesn't happen too soon.

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An excerpt:

"I have a dream that one day this nation will rise up and live out the true meaning of its creed: "We hold these truths to be self-evident: that all men are created equal." I have a dream that one day on the red hills of Georgia the sons of former slaves and the sons of former slaveowners will be able to sit down together at a table of brotherhood. I have a dream that one day even the state of Mississippi, a desert state, sweltering with the heat of injustice and oppression, will be transformed into an oasis of freedom and justice. I have a dream that my four children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character. I have a dream today.

I have a dream that one day the state of Alabama, whose governor's lips are presently dripping with the words of interposition and nullification, will be transformed into a situation where little black boys and black girls will be able to join hands with little white boys and white girls and walk together as sisters and brothers. I have a dream today. I have a dream that one day every valley shall be exalted, every hill and mountain shall be made low, the rough places will be made plain, and the crooked places will be made straight, and the glory of the Lord shall be revealed, and all flesh shall see it together. This is our hope. This is the faith with which I return to the South. With this faith we will be able to hew out of the mountain of despair a stone of hope. With this faith we will be able to transform the jangling discords of our nation into a beautiful symphony of brotherhood. With this faith we will be able to work together, to pray together, to struggle together, to go to jail together, to stand up for freedom together, knowing that we will be free one day.

This will be the day when all of God's children will be able to sing with a new meaning, "My country, 'tis of thee, sweet land of liberty, of thee I sing. Land where my fathers died, land of the pilgrim's pride, from every mountainside, let freedom ring." And if America is to be a great nation, this must become true. So let freedom ring from the prodigious hilltops of New Hampshire. Let freedom ring from the mighty mountains of New York. Let freedom ring from the heightening Alleghenies of Pennsylvania! Let freedom ring from the snowcapped Rockies of Colorado! Let freedom ring from the curvaceous peaks of California! But not only that; let freedom ring from Stone Mountain of Georgia! Let freedom ring from Lookout Mountain of Tennessee! Let freedom ring from every hill and every molehill of Mississippi. From every mountainside, let freedom ring.

When we let freedom ring, when we let it ring from every village and every hamlet, from every state and every city, we will be able to speed up that day when all of God's children, black men and white men, Jews and Gentiles, Protestants and Catholics, will be able to join hands and sing in the words of the old Negro spiritual, "Free at last! free at last! thank God Almighty, we are free at last!"

Long live the dream of Dr. Martin Luther King, Jr.

Try to outsmart this game:

http://www.smalltime.com/dictator.html

Randy Moss on getting fined $10,000 for pretending to moon the fans at Lambeau Field


Reporter: "Write the check yet, Randy?"
Moss: "When you're rich you don't write checks."
Reporter: "If you don't write checks, how do you pay these guys?"
Moss: "Straight cash, homey."

Gotta love it.

I was excited today to have a day off. After today, I am scheduled to work for 12 straight days. I was looking forward to getting all kinds of errands done, working out, sitting down for a relaxing cup of coffee.

As I get out of my door to start my day, I close the door and get ready to lock my deadbolt. I reach into my pocket and fear sets in......I can't find my keys. All of my keys are on one keychain, my car keys, my work keys, my house keys. The nearest extra set of keys to get into my place are in Ann Arbor. ARGH!

Thoughts are flying through my head. I'm not going to get anything accomplished today. Where can I go to stay warm? Who is going to be nice enough to bring me my keys from Ann Arbor? HOW STUPID AM I?

I start making phone calls, all while digging through all of my pockets to make sure I haven't stuck the keys in a different pocket. My heart is racing. I'm feeling like a moron.

It's snowing, too. I'm dragging myself through the snow to walk to the nearest coffee shop. I develop the plan to get some coffee and hang out there until someone can bring me the spare keys. And insults upon insults, I slip. Luckily, I don't fall. But, what's that noise? IT'S JINGLING!!!! and it's coming from my backpack.

At first I thought it was just some change I left in there. So I shake my backpack again. It sounds heavier than change. I dig and find those familiar keys in a pocket in my backpack, with my PDA and pager that I had shoved in there mindlessly before leaving.

A huge feeling of relief took over me. I gotta start paying more attention to my morning routine. I guess I must set myself on automatic in the mornings and go through a programmed sequence of events without even thinking about it. Luckily, I'm so automatic I put my keys somewhere before leaving.

That was enough excitement for me today. I didn't even need that cup of coffee for that morning jolt.

Happy New Year to all.

I can't believe that I'm 6 months through with residency already. Other residents told me that the time would fly by, and I didn't truly believe them. It is slowly settling in with me that I'm really taking care of people. The order of things at this time seem to be more learning first before actually taking care of medical problems. One secret you may not be aware of: sometimes when the doctor has you waiting in that paper gown in the examination room, s/he may be flipping through a book in his/her office trying to figure out what weird disease you may have.

One palpable sign of progress: patients are actually coming back to see me. They have asked for me by name. It's a really good feeling seeing a patient a second, third, even a fourth time. For one thing, it means that they trust you enough with their care to come back multiple times. Second, each subsequent visit is shorter because you don't have to go through asking all kinds of questions about their condition. You already know most of their medical problems and can just deal with updates since their last visit. It's really nice to have the pediatric patients follow up, especially the little ones. I'm actually watching a couple of kids grow up. It shocked me to think that the few newborns I've seen over the past few months will be 4 years old when I finish my residency. I'll see them through the major portion of their shots, follow their growth and development just until they are ready to start school.

This month is a bit tougher than previous months. Before, when I had a call month, I was on call every 4th night. It's pretty frequent, but having a couple of days in between call nights seemed to be enough to recover. This month, call is every 3rd night. Small change makes a lotta difference. Instead of being on call 7-8 times this month it's 10-11 times. And by the time you are barely recovered from one day of call, another one comes around. It's rough. It doesn't help that I've stayed up late a couple of nights playing poker when I probably shouldn't have been. Although, the last time I played, I earned more money playing poker than I did from working that day. Sad, but true.