can you handle it?

Great flocks of geese are winging their way north but Old Man Winter is not ready to bow out just yet. Nor, it seems, is spring about to burst into bloom any time soon.


Ariound here March can be an oppositional defiant month…cold, wet and windy when you long to get outdoors and start the spring clean-up, to get to work in the garden, or to take a walk in the woods. This is the time of the year when I start to feel impatient, restless, and fidgety even though nothing at all has changed. I gaze out the window and soak up the gloom, take a deep breath, and try to busy myself while I wait for the ground to thaw and the robins to return.


Until then I have decided to amuse myself by launching another blog. It’s not ready to post yet…but ideas are gathering and words are aligning themselves on the page. Simply put, I think it’s time to share something about my life in medicine. Truth be known, many of the scenes you may someday read in The Bandaged Place (should it ever find a publisher) were roughly crafted from memory and experience…and I think they deserve to be re-envisioned as such—as nonfiction, as memoir, and essay.


For example, this scene from The Bandaged Place recalls the first day of medical school and our warm welcome to it:

"On the very first day of medical school Dr. John Paul Lockhart, Dean of the College of Medicine, stepped up to the podium and one hundred eager students, terraced like rice paddies on a hillside, snapped to attention.


He congratulated us on our academic achievement and our noble aspirations. He spoke about tradition and honor. He went on and on about dedication, self-sacrifice, excellence, courage, and the ethics of exhausting work. But the bottom line was, “First, do no harm.” And in the next breath he declared in no uncertain terms, “The day will come when a patient under your care will suffer or die because of something you did or something you failed to do and it will be your fault. You will have no one to blame but yourself for having been careless or hurried or ignorant or, God forbid, arrogant or indifferent. You will bear the burden of guilt for the rest of your life and you will never get over it.”


He surveyed the blank expressions arrayed in front of him and then he went on. “If for a moment you dare doubt what I am saying, you are invited right here and now to gather up your belongings and leave. Go. Depart.”


He paused, stepped away from the microphone and waited. He scanned our fresh young faces row by row as if he knew exactly who among us would be unable to bear it when—not if, but when—a patient died under our care. I remember locking eyes with the man as if he were able to judge strength of character and depth of devotion by the size of one’s pupils. He was waiting for the fainthearted among us stand up so everyone could get a good look at what it meant to be an abject coward. He might just as well have asked those of us who were dropping acid on the weekend or those of us who were engaging in unprotected sex to stand up in front of everyone so we could hang our heads in shame as we shuffled out the door. But no one left. A few of us shifted around nervously in our seats but who would admit it?


When the professor stepped back up to the microphone, he sounded incredulous. “No one?” He paused. “Then God help you.”


And with that he doffed his glasses, folded them, and tucked them into his coat pocket, snuffed out his pipe, picked up his notes, and left. One hundred fledgling medical students responded with stunned silence."


This, of course, is a fictional rendition of that first encounter but it captures the moment precisely. In truth, that day we were told it was inevitable that over the course of our careers each of us would be responsible—intentionally or unintentionally, directly or indirectly—for the death of at least one of our patients. “Can you handle it?” we were asked. And in our naiveté we answered, “Yes.” What did we know??


So…I’m going to take time over the next few weeks to re-envision some of the experiences that have shaped me as a physician and might interest you. It should help dispel the gloom. Your suggestions are welcome.


What would you like to know about a life in medicine?

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“The New England Medical Journal reports that 9 out of 10 doctors agree

that 1 out of 10 doctors is an idiot.”

--Jay Leno--

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I’ll be on retreat next week but I’ll get back up to speed after that.

jan