Potpourri: WSJ, Coffee, and Why I am Still a Doctor

Greetings, ah, Wall Street Journal readers. What a happy Christmas surprise to find in today's Google Alerts:

WSJ links to Med Marg!

To my dear friends and loyal readers, no, that was not Photoshopped.

There was EVEN MORE GOOD NEWS. Dr. Latte might not ever become diabetic. This is important, because Dr. Latte loves cookies and potato chips more than life itself, but slightly less than Jeni's Ice Cream. Why? What important medical break-through has Dr. Latte so juiced? This:

Coffee, Tea may stall diabetes.

A shout out to my peeps at MedPage Today! Every cup of coffee I drink a day lowers my risk of diabetes by 7%. (Okay, yes, I left out the "may". I was too busy adding half and half to my joe.) I think that this week alone I have reduced my diabetes risk by approximately 5,683%, which means I have lowered my risk enough for everybody in the State of Ohio. You're welcome, Buckeyes.

Now, to the meat. The New York Times (where my blog has not yet been extoled on high) doesn't always get health care right. Even when they're not right, they get credit for thoughtful, by which I mean "full" of "thought" which if you watch local news for 4.3 seconds you will see if often in short supply. Today they shot me in the gut.

I have been chatting at length recently with my comrade in arms, Dr. Beardy, about how we've changed. What did medical school, residency, and years of practice do to our brains? Dr. Beardy shrugs and rolls his eyes at my endless fretfulness.

But I wonder. I kept a journal regularly before I went to medical school and for the first year. Entries became more spotty as time went on. I read them now and it's cute, and I mean to be patronizing. Pre-med and -clinical me is so earnest and exciteable. A Richard Selzer essay sends me to the moon. "Oh, noble savage, I am here to lay my healing hands upon you;" I was chomping at the bit to unleash my skills and empathy upon the needy masses.

That was before two years of rote memorization, then many years of a first row seat at some of the finest suffering the body has to offer. Before abscesses exploded at me, on me. Before I got amniotic fluid in my mouth; before I beheld a newborn before anybody else in the world, even its mother. Before stinky diabetic feet met my wrath at 3am in the emergency room. How many times did I cry in the bathroom at how helpless I was to help, really help?

My earnest yearnings were before drug addicts, alcoholics, and prostitutes introduced themselves and their STIs and kept me busy on weekend calls. Before I stuck sharp things in prisoners who promised retaliation and held the hands of felons as they died. Before I pronounced somebody dead on Christmas who had been breathing and warm moments before, then had to turn to the family and think of something not totally stupid to say. I had listened to the slow thump of their hearts. Then I listened to nothing. Silent stillness.

I've held hands, smoothed hair, listened to hearts, thumped livers, ordered blood, checked ears, smiled, cried, worried, fretted, and laughed through thousands of encounters. I've listened. I've catheterized, immunized, yearned, grieved, smiled, giggled, joked, talked, and hoped with thousands of people, most of whom, in fact, I've adored in one way or another. Not all, but most. Listen, listen, I tell myself when I'm starting to dislike somebody; you'll hear the hook. That thing that the patient will say that will reel me into their world, still, to this day, astonished to find myself a tourist in a life and a body quite alike and different from mine.

I remember, like most parents, before my daughter, my beloved, adorable, sparkly, vibrant girl was born, my husband and I worried. We were deeply, completely in love with our quirky, volatile, funny, handsome, curious, brown-haired toddler boy. Could our hearts expand to include another with the intense, physical love we had for our first? Impossible.

But then there was this.

My Lu. In labor and delivery after my semi-emergent section, on mag, exhausted, uncomfortable, worried, a nurse--such a dear woman--brought me a picture of her, so tiny, with oxygen and a giant IV. I had seen my daughter for a few seconds in the operating room before she was whisked to the NICU. Someday maybe I'll take a picture that means as much to me as this picture did, still does. In the wee hours of the night, lonely and a little afraid, I fell hard for a premie in a picture and I haven't gotten up yet. May I never rise. (Look at that face. How could I?)

So. I can't tell you all the ways I've changed because I just don't know. But I can tell you this. I'm bigger. I'm stronger. I'm quieter. My heart grew--like the Grinch's. My brain grew. (May that continue, too.) I know from my kids and from my patients that really, my ability to fret, to absorb, to hope, to love, to grow (my husband would add "to opine" and "to bitch") will go on. And that brings me back to the New York Times.

A picture is worth a thousand words. I should have started with these pictures, because what keeps me coming back, what gets me out of bed in the morning, what flips my switch to "on", what I love about being a physician is to reach out and touch, to help, to listen, to be near. I saw these pictures today of a little boy, with brown hair and eyes like my little boy, with tetanus. (Woe! This dear little fellow didn't need to be sick.) Tomorrow, for some other mother somewhere I will reach out, listen, laugh, hope, and try to help.

Pictures of the day: December 17th

Turns out, despite the agonies of call and the endless needs of the Axis II patient, the earnest little pre-medical journal-girl has survived. (She's much, much older and grayer and wider, now though.)