December 2014 archive

Taking a Breath.

Seroquel with repronex I should be preparing for my final exam right now. It is the last week of my family medicine rotation after all. But instead, I find myself sitting at my desk, staring blankly ahead, trying to thoughtfully process all that has happened.

My nephew, lovingly dubbed “Benny Boyee” by my 3-year-old, was born one day shy of 28 weeks. He weighed just 2lbs 3oz. For the past 17 weeks, he has remained in the NICU with his mother, a NICU nurse herself, by his side. His little lungs just don’t seem to want to work, not even on the oscillator or with his tracheostomy. Six days ago, he was declared a pulmonary non-survivor. So we have spent this week preparing for his death.

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I usually can figure out complex problems in the shower. During high school and undergrad, I solved many mathematical problems this way. I found that as soon as I let my mind wander, I would arrive at the answer. I have even found this to be true in med school; that’s how I finally figured out how the kidneys work. Something about the distraction allows me to identify the one detail I don’t understand and in doing so enables me to finally understand the larger, more complex whole.

I usually can work through stressful and overwhelming situations by working out; in feeling physical pain, I allow myself to feel, process, and resolve the deeper emotional pain. While studying for step one, I ran 114 miles.

That’s what I do. I process and resolve difficult situations in a thoughtful, purposeful, deliberate manner.

But I can’t process this. No shower, no amount of exercise can touch this. I have no solution; I have no fix. I don’t know why. Why them, why now, why another loss, why another heartache. I don’t know how. How to grieve the loss of someone I barely got the opportunity to know but yet wholly and completely love. How to prepare my son for the loss of his cousin and friend. My son who prays every night for boyee to be healthy, who longs for the day when he can share his love of dinosaurs with him, and who hated to let go of his little hand when he finally got to meet his beloved Benny Boyee for the first time. How to love and support someone who is experiencing a pain that runs so deep. I just don’t know.

So as I sit here, powerless, directionless, with tears streaming down my face, I say that some things cannot be thoughtfully processed – they must only be felt.

Rotation 3: Radiology – The Dark Room.

My very first thought at the end of my very first day of radiology was that if my older brother, an astroparticle physicist, were to go to med school, he would make for an amazing radiologist. That side of me – the side that loves math and kind of digs physics – was actually, quite unexpectedly, fascinated with radiology. Beyond the math- and physics-laden imaging modalities, radiology also offers an intriguing element of art analysis. Sitting in a dark room, with a systematic visual approach and a heavy reliance on the similarities between human anatomy, a radiologist must decipher the delicate difference between disease and the slight variations that make us all uniquely beautiful beings.

I honestly do enjoy looking at images, especially if I know the greater context of the patient’s story. And I value the amount of information imaging modalities can add to patient care. As a result, I have seriously considered pursuing radiology from time-to-time. But when I step back to look at the greater picture, I try to define what “practicing medicine” means to me. While I don’t yet have a complete definition, I know that radiology doesn’t quite fit, as it is not necessarily conducive to the type of impact I want to have, and have always imagined having, on my patients’ lives.