Wednesday, November 24, 2010

Working Here

I can be super-immune sometimes when it comes to illness and death - immune as in my office mate and I talk about the terrible cases we've reviewed that day, or say things like "if it was me, I'd stop treatment, go to Hawai'i with my morphine and OD on the beach." or "if it were a choice between mastectomy/prostatectomy/whatever-ectomy  or death, I'd give up the breasts/prostate/whatever." We talk about "end of life care" on a regular basis here, we debate the ethics of continuing to treat a patient's cancer when there's no chance of survival, whether it's giving a patient false hope to enroll them on a clinical trial that may not work. I see sick people every day, sick babies, bald little kids, girls my age getting chemo for breast cancer, grannies who should be at home gardening being wheeled through the sucks, but I feel immune most of the time. People see ads for the pediatric cancer charity run by my hospital and say "how do you do it?" I tell them "I'm not treating these kids, I'm not a parent to these kids. I see them in the halls and elevators and in the cafeteria and all I think is "there's some sick kids here to get better." My interactions are brief and rarely personal. I've become unphased by blood, vomit, hearing people vomit, body fluids, visible tumors, graft versus host disease, etc.

There is, however, one thing I will never get over - seeing one of our patients go down...."go down" as in just drop, wherever they were standing. It's scary, scarier to me than the people who are so sick they come here by ambulance. I mean, if you are going down, you want it to be here - the guy I just saw, middle-aged, bald, probably once a big guy but now reduced by chemo, whose knees just seem to give out right from under him - he's going to be fine. He had three construction workers, two security guards, at least three oncologists, and three or four nurses surrounding him, an admin running with an IV pole towards him as well as a couple Boston policeman who happened to be working a detail nearby. They obviously called a code because as I stepped into the elevator, another doctor was running out. It the great shuffle of people, he was actually trying to get up and into a wheelchair by himself. Obviously he's just having a lousy day, and we see people having crappy reactions to their treatment ALL THE TIME. Despite that I'm still worried about him as I sit here at my desk. Because we're an outpatient facility, having patients drop where they stand is not the norm, and I think it is a reminder of how sick most of the people really are. The brave faces they put on for us while they're here are amazing.

I guess the point of my post is that seeing all this is a reason to be thankful - it's fitting, given Thanksgiving is tomorrow, that I come up with something for which I am thankful, and that is, without a doubt, my health and the health of my husbando and family and friends. We're so lucky to be well this Thanksgiving, to be able to gather together and share a meal, watch the Pats game, take a snooze after dinner and probably play an exhausting game of Cranium because Auntie Jayne looks forward to it all year - for all those great and small things I love or love to hate about the holiday, I am grateful.

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