Wednesday, June 23, 2010

and looking for some parallel can be an endless game

It seems like a lifetime ago, especially now that there are probably no such things as library stacks. We were sitting in the basement, the smell of old, yellowed pages pervading as we sifted through an ancient German synthesis paper. It was October. He said that Ipswich was beautiful that time of year; he made a throwaway remark about us taking a motorcycle ride out there to visit the orchards.

Oh, I was young then. Everything seemed so promising. And I wanted so much to believe. In my mind's eye, I could imagine it, the wind whipping through our jackets as we rode out, the leaves exploding in vibrant colors like fireworks all around us. I could hear the crunch of the leaves and the pine needles as we trudged out, the lanes of perfectly spaced apple trees. A bucket of apples at my side, the two of us resting our heads against a tree in reverie.

Except none of it ever happened.

And it was years ago, but was it really? Strange how the littlest of things mark you. Little empty promises and small hopes that were extinguished, they just sink deeper into your fabric over the years, it seems. And so, I suppose, it's no surprise, the way my voice flattens, my brain and heart go numb, and I sound completely ambivalent when asked away. All of this has happened before and will happen again. Or maybe (maybe?) not.

Saturday, June 19, 2010

I don't want to doubt you, know everything about you

In this world where the multi-tasker is king, let me tell you that I am one lowly serf. Sometimes I think that one of the reasons I am particularly inept at juggling multiple things at once is my willingness to let go. I accept the concept of sacrifice without a lot of resistance, I find. To some extent, anyone who goes to med school gets better and better at giving things up. It starts with sleep, then it becomes vacation time, then it becomes who knows?

So when I get overwhelmed, I get the same impulse that I do when I see a messy room. I just start throwing things in the garbage, I just want to throw everything away and have a blank slate, start again. I want to do the same thing when I feel like it is simply too much work to keep all of these parallel lives going.

But, as with anything, there are two sides to this coin. Being realistic is useful- I find this whole you can have it all! gusto with which some people approach the world a recipe for disaster or disappointment. On the other hand, there is the matter of getting so accustomed to losing things, letting everything go, that nothing anchors you, nothing keeps you, and you wonder if anyone would notice if you simply floated off into the distance.

So I waged war with some demons. I avoided falling victim to melancholy, stopped driving myself batty with overanalysis, started to put some distance as a means to survival. But I didn’t let go entirely, I didn’t light a match and drop it in a pool of gasoline. It was an unusual change of pace for me.

There are still no guarantees. I might still run, I could still float away. But I am letting time control the situation, instead of rebelling as I might have done in the past. I’m otherwise quite impatient- if I can’t figure out a situation, if it doesn’t become entirely clear to me in short order, I very quickly get fed up. And then I force a decision. Which isn’t always such a winning strategy.

Anyway- here’s a song that’s not from medieval times for a change. I am trying, for a change, to be more appreciative of my friends. But at the same time, sometimes I wonder how much of fading-friends-syndrome is my doing, and how much is a function of life and the way it progresses. And that is why this beautiful song seems appropriate.

Sunday, June 13, 2010

it was mine all along, I'm going to find it

Sorry to oscillate between the hospital and the personal. It all blends into one for me. Today, I am frustrated. I don't know if it is my own special talent, getting myself entangled in complex situations just as things are finally starting to become clear, muddying my own waters. Or if it is just that fate likes to have a laugh at me frequently. Either way, I am in something of a bind and I am sick of it.

I was venting to myself earlier today, because I was irrationally angry, because I do not know how to deal with the stupidity of beginnings of relationships, not anymore (as if I ever did). But it was interesting, what wound up suddenly spilling out, a sharp truth delivered like a splash of cold water.

You are not worth more than me.

Cool, cool water. It washed over me, and everything slowed down. I was suddenly calm. Because it happens to be an important thing to remember, and yet one I most often forget. In my desire to be accommodating and make things work, make pieces fit even if their edges don't match, I forget. I always forget.

And yet it's the only thing that must be remembered. It would not do, to lose sight of that. Once that is lost, everything goes with it. And I have worked too hard, come too far, to just dissolve into nothingness again. I can rebuild, I can reclaim, sure, I can survive- but why make it so dramatic as life and death? If I just keep hold of this truth, I can be steady, I can be bond. And nothing can hurt me really.

Thursday, June 10, 2010

I used to live alone before I knew you

One of my patients is dying. This is not an uncommon occurrence in the realm of Internal Medicine. Internists tend to manage some of the sickest folks in the hospital. In fact, this is not the first patient I have encountered who is not likely to survive his hospitalization.

Yet, this one, I must admit, is getting to me. In medicine, there is an impulse to suppress these feelings, the sadness and frustration and despair that comes with seeing a patient dying. This particular patient is 66 years old, was just recently diagnosed with a bad, untreatable variant of cancer, and was admitted to the hospital because he had an infection in his abdomen. My team was consulted because of the infection, but soon thereafter, his bowel perforated and air started to leak into his abdomen. The surgeons have told him that he is not a good surgical candidate. No one wants to intervene.

So every day, I walk into his room and watch this man slowly lose his dignity and become even less comfortable. And this is a man who is clearly not prone to complaints. A retired police officer, he rode Harleys in his spare time. Every time his family is visiting, he says that his pain is not that bad. Every time I see him in the morning, when he is alone, he tells me that the pain is excruciating and he does not know how much longer he can take it. Because the infection is the least of his worries these days, I spend most of my visits with him asking about his life, the work he did, or the bewilderment he experienced on learning he had cancer less than three months ago.

Yesterday, when I left him room, I said, “it is good seeing you this morning.” It was nothing special, a fairly typical farewell.

He said, “you don’t know how good it is to hear people say that, it really means something.

I managed to tell him that I really meant it, and then stormed out of the room, knowing I was about to lose my composure. I know all the reasons I was about to lose it. This man is dying, but death is a natural part of life, in my opinion. The problem, for me, is how much he is suffering, and how little medicine can do for him, with all our talk of advances and compassion. And I hate watching patients lose their dignity; it really squeezed the life out of me to watch a stoic, previously strong man lying weakly in bed, not at all ready to die.

And there is something else too, something selfish. You see, you would think that you see things like this, and it changes how you view the world. You would think you see a patient dying, you see the love of his family and the way that people rally around him, and you would learn something from that. You want to learn something from that. You want to conclude that life is short and that you should focus on the important things in life. You want to be enlightened, and have that new knowledge translate into the way you live your life. But it doesn’t work that way. Some of that is due to you, and some of it is due to everyone else in the world. Regardless of the reason, you are stuck knowing that life continues to march on and you’re not applying any of the lessons you are supposed to be learning.

Monday, June 07, 2010

closer I am to fine

Well. So much for having far more time on my hands to devote to writing. Of course, I have had time to write though. I’ve been writing a lot, in fact, but in the form of correspondence. Lately, I have been feeling a little overexposed, a little invaded. I’ll be the first to admit that I have quite a prickly exterior, and I do not like letting that soft underbelly show.

And it’s there, but it’s also not. I think I have been afraid, but sometimes my fears are misplaced. Sometimes it is easy to forget. Sometimes I neglect to note what time and experience has taught me.

This song is a cute little thumbing-your-nose-at-your-frustration ditty. It’s a little overstated, and it’s a little angry. But it’s also a little something to keep in mind, to always recall. It’s funny. I was corresponding recently about The Goal and about it I remarked: I decided that I didn’t want an alternative plan, you know? I didn’t want to be safe. I wanted to want it, to be crushed and disappointed if it didn’t work out. I already knew by then that I could feel that way and still survive. So at the worst, it would just be another matter of picking myself up off the curb, putting myself back together, and getting on with life. I really did feel that way about it. And to tell the truth, I am still proud of that impulse, that rhythm inside of me that was so unswerving and steady.

And yet, strangely, I can not seem to apply that kind of confidence and, yes, carelessness towards relationships. But I wonder why not. I’m even more certain I could withstand any manner of fiasco in the context of relationship- I’ve got more practice at recovering from all sorts of calamities, moreso than I’ve had in my professional life most certainly. I honestly think I had partially forgotten about my capability to emerge from attempted drownings. I know how to keep my head above water. But sometimes, I need to be reminded to come up to the surface, and this song is as good a reminder as any.