Tuesday, February 10, 2015

destroy the middle, it's a waste of time

I'm having another one of those episodes.

I am not posting much these days. Work is exacting an impressive toll on me, more than I thought it would. The other day, I realized I don't have a lot of patience for drama in my social life because work is enough of an emotional rollercoaster. I almost cried in a patient's room (and for the record, in case it's not been made clear before, I usually have non-functioning lacrimal glands as a general rule. I remember one time I was upset about something personal, and tried to cry, thinking it would help to let it out, and nothing happened) because she said she felt badly about being nervous about undergoing a stem cell transplant. The woman is in her late 20s, has 5 children, had a full-time job, and developed acute myeloid leukemia, and after she managed to get a remission, she relapsed just as she was getting lined up for a stem cell transplant. It's fine to write it like that, and make it sound like it's all happening to her. After all, in the end, it is all happening to her. But she was 25 weeks pregnant when she first came into the hospital, and I was the one who got to tell her of her diagnosis. I got to explain the not-benign chemotherapy regimen and its side effects, which we administered to this woman while she was pregnant. I got to tell her that her the good news that her repeat bone marrow showed no evidence of leukemia. I waited it out with her from afar as she delivered her baby and then I'm the one who got to rip her away from that new baby to give her consolidation chemotherapy to keep her leukemia away. I'm the one who got to arrange transfusions for her when she finally got home. I'm the one who got to discover that she had an allergic reaction to transfusions and needed a special suspension of platelets to keep from having hives and rigors. And I'm the one who got to tell her that the leukemia was probably back. And now it is, and she is getting chemotherapy again, and she tells me she is nervous. I involuntarily laughed and then choked up all at once. It was highly unprofessional but she didn't mind. I  told her it was okay to be nervous- her doctors are nervous for her and we're not even the ones going through it. We had this uncomfortable moment of silence in which it was clear we just were no longer doctor and patient- it's an odd thing when you cross over like that. All of a sudden, we were in a different territory. Two people navigating a difficult journey together, different stakes, different roles, but both in it, all the way in it. And I knew, just at the same moment, that this was very dangerous. So yeah, I don't need a lot of drama with this sort of thing a natural byproduct of my career (which doesn't even feel like an appropriate way to describe my job, but it would be pompous to call it anything else).

And I find, yet, that I have capcity for so much rage still. About stupid things (like television shows, and I have since deleted that portion of this post, because after posting it, it suddenly seemed stupid and unimportant) and horrible things, like three innocent people getting shot in North Carolina, one Indian grandfather being injured in an arrest, and the disturbing fact that the man was stopped because he was mistaken for a black man (thinking about the reality of what that means enrages me on so many levels that I have to step away and take a deep breath). But all that rage gets quelled by the sad realities that I often see with this work- sudden deaths or long, drawn-out expected deaths. I treat cancer patients so they know what they're contending against, but it doesn't make it all that much easier. Life is short, and precarious. The world tends towards entropy. I wish we didn't have to contribute to that entropy but sometimes it's important to shift the focus to what you can't control. I am going to strive to do better.

1 comment:

Maitri said...

Girl, you're coming to New Orleans with me in October.