A Lonely Calling

There is a place
not here
where the village meets the sky.

To walk along the water’s edge and be away from the hospital, even for a day, is relaxing. My breathing here is slower, deeper. When I look back on medical residency, I can hardly imagine how much I have changed since the beginning. The process of growing from an intern to a physician happened without my noticing. Central lines slide into the internal jugular with ease. I slip breathing tubes just below the epiglottis and curve them upwards between the vocal chords almost as often as I place a straw into a cold glass of iced tea. Puncturing the lumbar spine for dripping fluid, threading a long line into the narrow radial artery, suturing a through and through lip laceration with perfect alignment – all of these have become second nature. I can remember a time, not too long ago, when they were terrifying.

More and more, I feel like the RocketMan in Elton John’s song, a lone astronaut wandering in space, gear and all, forcibly removed from the rest of the world. Medicine is a lonely calling. As a physician, I spend so much of my time caring for patients. I am a listener, observer, sympathizer. If I were to let my own emotions intrude during the day, the results would be disastrous. As a physician, I am not expected to share. I observe. Tragedies, healing, grief, gratitude, survival. I am an onlooker in people’s lives. As such, I walk this road alone much of the time.

I often find that I am the only stranger in a room full of family members – not only that, I am a central presence in that room because I have knowledge which affects their lives. I still remember the first time that I declared one of my patients dead. In my four years of medical school, no one had ever taught me how to do this. It was close to Christmas. Heavy snow was falling outside. The coronary care unit was decorated with white lights and candy baskets. A nurse came up to me at 2AM and said, “You need to come to the room. I think Mrs. S has passed away.” It was one of the many times in medicine that my heart skipped a beat. I turned to her with what must have been a look of pale disbelief – it inspired the first warm smile I had ever seen from her. I asked her what I needed to do. She told me. And then I asked her if she would come into the room with me. She said she would.

It was one of the longest minutes of my life – 60 seconds with my stethoscope on her silent heart. I watched the clock. I watched her face, eyes closed, motionless. I watched the expressions of all of the family members who were circled around me. I watched the clock again, wondering if she might miraculously take a breath, wanting time to move quickly but simultaneously not wanting it to move at all. When the 60 seconds had passed, I announced her time of death in a shaky, uncertain voice. Her sons shook my hand, patted me on the back, thanked me – more for me than for them, I realize now.

Since then, so much has changed. The last time a patient died, I looked at my watch and wondered if I had time to get a sandwich at the cafeteria which was closing before going upstairs to meet with the family. It may sound cruel, but that is how the volume of death I have seen and my extreme fatigue have affected me. I walked quietly into the room with a clear task – to listen for 60 seconds, express my condolences to the family, request a chaplain to take over for me, and leave the room to complete the pages and pages of paperwork.

Being a physician has required building up walls upon walls in the hospital. And no matter how many colleagues surround me, I so often find myself in situations where I am the “doctor,” where I am the outsider in the midst of an entire family – trying to figure out how exactly I belong, knowing all along that I never will.

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2 Responses to A Lonely Calling

  1. Carl Smith says:

    I have met my doctor and he is different each time in regards to my needs. Over the years I was accused of faking pain, not taking my medication, over eating, and more. At the time my doctor was skinny as a rail and he exhorted me to diet, eat from a restricted diet, and exercise more. I worked 16 to 20 hours a day, had three of my six children still at home yet, used almost no sick leave, and was at least 100 lbs overweight. I, like my father and grandfather worked at physical labor for our income. Lifting and carrying heavy weights was a required part of the job. At 40 I could bench press over 400 lbs. When I was 18 I was gassed with SO2 in a paper mill when they “blew a cook”. My nose and throat were burned to where I had bleeding for the next 40 years. Something I had to work through I was told by the local doctor. In regards to diet, I became alergic to all fresh fruits by the time I was eight years old, an affliction that remains to this day 75 years later. Years of testing and the doctors telling me that it was all in the mind. I am still working and all those doctors have passed on. I am still overweight, have diabetes, high blood pressure, and a full time job. My present doctor does not discuss my problems with me except to talk of goals of weight, cholesterol, how to suppress pain (I never had any), while he punches the keys of a laptop during his role in my physical health. He looks terrible if I see him at the end of a busy day. I bring him and his staff presents of chocolates at least twice a year. Maybe donuts sometimes. He says he is happy to see me but I know the government is putting restrictions on our time together. I hope he lives a few years yet anyway, I am finding it difficult to build relationships with new doctors every few years. This man is my sixth, all the rest have passed on and all said I must watch my diet. As a side I have a paradox in that my dad who did not drink and an uncle who did. My dad was always sober, worked 16 to 20 hours a day, never abused his wife of kids while the uncle drank beer and boose till he was dead drunk, abused his wife and kids and retired a multimillionaire after working for ten years less than 8 hours a day. My dad took my uncle and hired him to help on the job to have him become sober again. My father died of severe arthuritis and my uncle of cancer. Strange world! My doctor turns a deaf ear to my pain of the moment and looks only at the socalled average for the population. If I really have a need it usually goes away in a week or so with out his help. I an ready for a comouter to do the job.

  2. EDG says:

    That was a really insightful post….very perceptive, and even moving.

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