Friday, June 3, 2016

A Million Ways to Die in the West

I’ve been wearing the same green shirt for seven days. My life has become like some fucked up Irish Groundhog Day. When I left my apartment to rush my Mom to the hospital, I didn’t know what lay ahead, so I didn’t bring a change of clothes.

Everything is harder in a hospital- eating, showering, sleeping, studying, even using the bathroom. It’s uncomfortable at best and next to impossible at worst—and I’m not even a patient.

My mom has pancreatitis.  A blur of white coats and ugly (albeit extremely comfortable) clogs schlep in and out of the room. Our days blend into nights that turn into days again. My mascara is halfway down my face. I’m starting to look haggard.

They say a little knowledge is a dangerous thing—especially true where med students are concerned. First Aid also says that intellectualization is an immature coping mechanism. I’m not exactly sure how humor is considered mature and looking things up on PubMed isn’t—but perhaps that’s because no matter how far and wide I search, no matter how many papers I read—the article I’m looking for isn’t there.

I want to find a paper to tell me everything will be okay. But I can’t find one.

What I did find were publications with phrases like “potentially life threatening” and “hypovolemic shock,” and “mortality rate.” Once I’ve read them, I can’t get them out of my mind and the words circle through my brain on a constant loop. My stomach is a vice grip and my head a leadened sack getting more and more difficult to keep upright.

Last night I got a text message from a friend—she’s a resident at the hospital. “You need a drink,” it read. We devoured the leftovers in her fridge and cracked open a bottle of red. I was gushing about all of the data I had discovered while at the hospital. I droned on about the different levels of data and evidence and imaging and sensitivity and specificity. She sipped her wine. “You can do everything right,” she said. “You can treat a patient perfectly, according to the data and prophylaxis for DVT and infection and everything else under the sun that you can think of. And bad things still happen.”

“Um. No.” I protested. “I don’t think so.”

I spent four years in college, and then six years in graduate school earning three master’s degrees and now, halfway through medical school I am not about to admit that sometimes you can’t help. That sometimes life has other plans. The idea that bad things can happen—that they do happen, gnaws at me with a deep existential ache. Surely if we study hard enough, get up early enough, read enough—it’ll keep death at bay.

I’m slated to take Step 1 in April. My mother’s hospital room has become my new study spot--in between talking to doctors and the IV pump going off, my face is permanently attached to my books—well, just one book actually.
First Aid is full of things that can go wrong with the human body. But up until now its never really felt real. But now I find myself glued to the pages, hungry for answers, not facts. The descriptions of all of the horrible, terrible things that are part of the human condition are there—in plain text. Phrases like “outcome is poor” or “typically fatal” just hang out—often on the same page as completely benign conditions. Who gets what just doesn’t seem fair, it just doesn’t make sense.

While I can’t wrap my mind around why a person, going along, living their life should suddenly become ill—I can at least make the descriptions and findings of the various diseases and their treatments more meaningful. For example, next to the section about lead poisoning, I write Flint, MI in the margin. First Aid says that exposure to lead in children can cause mental delay. And I think of the communities of children who will now suffer life long consequences.

I write “Jen” next to the section about Multiple Sclerosis and “James” next to the section about Marfan’s.  Friend’s of mine who remind me that the words on the page don’t define them but also that life can be so brutally unfair. Making the conditions and treatments we study more personal, more human, helps me remember why I’m in medical school at all. And I think that’s the most important lesson we could ever learn from that book.

As my mom sleeps a Dilaudid induced slumber, I turn to the pages that describe coping mechanisms—both the mature and the immature alike.

And I write my name in the margin.

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