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understatedLIKEits1982
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Name: kenneth
Birthday: 1/1/1982
Gender: Male
Interests: Music composition, Poetry, Running, Rock Climbing, Flying a Jet, Other manly things...
Expertise: Medicine, Bio Research, Elementary Theology, Your Mom.
Occupation: Student
Industry: Medical
Message: message me
Member Since:
1/31/2005
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| My patient is dying. Probably as I type this. I callously went home to eat dinner and get a night's sleep because I have to go back to work at 5AM tomorrow, having struggled valiantly to learn from whatever mistakes I've been making. I know other residents that would have stuck around tonight to be with the family that I've come to know. To offer a prayer or some moral support as they lose their husband/father/brother/nephew. Actually, I only know one resident who would do that but he sets such a good example that it's hard not to compare yourself to him.
This has been a hard 3 weeks on the medicine floors. I've got 3 more months of this peculiar type of hell to go through before I emerge victorious on the other side, ready to get back to the business of learning Emergency Medicine, where people rarely have enough time to get to know you before they die. The place where I never feel bad about signing out a patient and going home to sleep, mostly because they won't be there when I show up again in the morning.
I sat with his wife today and talked to her and tried to understand what she must be going through, and after sitting in silence with her for about five minutes I really had no idea how she managed to sit with him day in and day out for the past week or so without going out of her mind. But then I guess I'm not in love, or wasn't once in love with him. And that's probably why "What Sarah Said", that Death Cab For Cutie song, has been running through my head today. "Love is watching someone die... So who's gonna watch you die?" Such a powerful thought, and much more so when you finally actually see that happening.
A couple points to make to myself before I head to bed. I think it's easy right now to be single and play the field and live like a single Christian guy lives in NYC, but being in a relationship is a lot like investing in retirement. Sure it sucks sometimes to miss out on that which you sacrifice to do it, but you really don't want to get to the end of your life and realize that you wasted it all on trivial things. Relating romantically to someone is an investment in the future.
The other thing is to point out how depressing it is to be on this rotation. I can't imagine what I would have done had I chosen to do Cardiology. I really am much happier in the Emergency Room, and I think that is amazingly obvious when I read back on my journals and my tweets from those rotations. Hard work, but generally punctuated by periods of intense fun-loving relaxation. Inpatient Medicine is like that but without any relief, and with much more associated emotional baggage, and it makes me dream about being in the hospital, and wake up feeling overwhelmed by the idea of being ultimately responsible for someone's life, and finally go to sleep feeling guilty about being so self-centered that I wouldn't hold a dying man's hand as he slipped his way back into the Lord's pleasant company.
This is going to be a long year.
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| Well, I officially started my orientation on Thursday, and officially finished it today. Two days of hellish enslavement to the whims of hospital PR people and namby-headed fools culminating in a mad push-and-shove line to get clearance that we can wear a surgical mask and not taste sugar. Seriously, 400 new interns, all trying to get this done, AT THE SAME TIME, when the other 6 hours of orientation were mind-and-butt-numbing power points about the State of the Institution.
But I won't dwell on that.
I've been struggling a bit since I moved to the city a few weeks ago with feeling like I actually belong here. Every time I embark upon a new semi-permanent adventure in learning, I've had a sense of providence and small glimpses that give me a view to the greater picture and make me feel connected to God and His plan for me. I guess I'm kind of impatient but I was waiting for that here, and felt like, amidst the CONSTANT rain, the furniture delays, the sleeping on a wooden rack for more than a week, and all the other headaches, it just wasn't coming along. Maybe I'd made a mistake. Maybe I didn't pray hard enough or listen to God enough. Maybe I should have made a different rank list. You know?
This was compounded when I went to Monte for orientation. It felt like a great big anonymous middle finger. Welcome to the dung-heap pal. There are a million of us here, and none of us like you, and you're totally barking up the wrong professional tree.
Well, I obviously wouldn't be leading up to this if there hadn't been an actual moment to give me a small amount of hope. Today, I took the bus across the Bronx from Fordham over to Jacobi for my ACLS training. I can't add up the small moments to make a cohesive whole, but I can describe them I guess. Feeling under pressure to perform for the MegaCode Test, I actually did alright, remembering drug dosages and the algorhithm well enough and actually feeling like I'll be okay in the ER for a while. Walking through the deserted hospital campus at sunrise, studying at a table in the cafeteria while drinking a black coffee and hearing the familiar cadences of Spanish in a new accent around me. Taking the bus back across the Bronx in the middle afternoon, seeing the diversity and the differences from my own upbringing and not feeling shoved away from it all or intimidated for the first time. Seeing that one dude on the bus who I'm sure is a serial killer and looked and smelled as if he'd applied lipstick made of poop to his face, but I didn't back down. No sir.
And finally, walking dead tired through the crowded streets of the Upper East Side back to my comfortable stilted loft bed, grabbing a bite of some Asian delicacy called "Sesame Chicken" from a local eatery. I finally felt like I was able to see the city through the buildings, get a glimpse of the skyline, you know? It felt good. It felt a little like home, for the first time.
And then I watched Friday Night Lights on my bigscreen TV. TEXAS FOREVER!
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| From a Salon.com reader-mail. Probably the best argument about health-care policy change in the U.S. I've ever read, and in keeping with what I've observed to be true in my time both in U.S. County hospitals with supposed charitable care and in the UK where a single-payer system is almost universally praised and at the same time lambasted for its inefficiencies.
"Single payer is only good for the people who don't have good
coverage now, or who can never pay too little because they're
greedy and want to spend their health care dollars on frivolous
amusement. It's not good for most Americans. We need to force 100%
enrollment in private (or mutual or co-op) insurance, raise rates
to cover the cost of the most advanced non-rationed care, and
subsidize those who cannot afford coverage on their own.
The last thing we need is a "single-payer" plan because single
payer means that coverage is capped for political purposes and
revenue (general taxes) is disconnected from the spending. Instead
we need private insurance with rigid rules on generous minimum
coverage.
The only single payer that would be acceptable would be one that
has its own separate tax, that is billed to each person (or their
guardian), and can go up indefinitely without cap to cover the best
care in the world. And the only relief from ever increasing
premiums (tax) is proven financial hardship." For the record, I agree that a single-payer health-care plan could never work in America, the land of the United (but really quite divided) States. What works in Texas will never work in Maine, period. The mindsets of the tax-payers and voters are different, and the general population stats are quite different, and one can't be expected to find a united position that works in both Texas and Maine.
The only really qualified solution is to adjust compensation, have a mandated national health insurance condition for all tax-payers, and to discontinue employer-funded health coverage to encourage a truly capitalist market within health insurance companies. Once individual choice enters the equation, you'll end up with the Southwest Airlines of health insurance companies, and then we can start moving on to Universal health care without Universal Government Coverage. Just my two cents anyway, and I'm sure much will be changed and argued with as time goes on. However, this is how it looks to me now, fresh from spending a month at the NHS. I hope we get a chance to move to universal coverage, but in the end, I wouldn't want the freedom of individual choice to be lost, and I wouldn't want us to stifle the innovation, ambition, and flat-out creativity that helped make America what it is today.
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| At noon today I woke up for real when Arash called to tell me where we would be going to kite-board that day. We weren't kite-boarders either of us so we went with Brooke, an EM intern at Memorial who had transferred in when UTMB closed down its residency last year. Next year he's going to Duke, which is in North Carolina and will no doubt help him to continue on with his wind-based sporting endeavors.
Brooke was mostly interested, it turned out, in having a crowd observe him, and in teaching the basics of kite-boarding theory. He was worried that we might be injured in the event of our actually participating so for an hour or so we watched the kite-boarders launch and ride and jump in the Laguna Madre from the shores of Flour Bluff. It was warm and pleasant and there was a good wind and the kiters played music at an appropriate volume from their cars so as you passed you got flavors of all different types of longing or celebration or whatever emotion it was inside the speaker. I had a Dr. Pepper and walked around and thought about how I'm bad at being friendly and outgoing except every once in a while.
At 4:30, we left Brooke and the other kiters and drove home and I slept for an hour in the drowsy afternoon way that I like. I woke up and found Kate and Dustin and Arash in the living room and we chatted for a bit and I promised to treat the lady right tonight, and then I showered and splashed cologne on my chest and shaved my face without any cream and then I got dressed carefully to make the right impression.
I picked her up right on time and we had that immediate uncomfortable intimacy that comes from sleeping in the same bed too soon. No funny stuff, just the sleeping, but that would be enough it turns out. We were playful and she was coy and we said goodbye to her friends and we left in my car for dinner. Magic hour in Corpus, driving to the Steak House and we stole ourselves away from the water and headed south to the suburbs. Her sister called and she entertained her with a few minutes of conversation and about what I don't know but she seemed embarrassed that maybe I could hear what was being said.
We had a blended red wine with our steaks and salads and potatoes and carrots, and me with my grilled shrimp that were over-seasoned by a mile. It was pleasant conversing and there were at least the beginnings of a real connection, despite the incredible variations in our outlooks and upbringings. This is what is meant by diversity as I understand it. There was jazz at the meal and it was the song "Caravan" for the last bite of my steak and I remembered playing that song for the first time but I didn't think to share that with her.
Later, we drove to the movies to see a film set in L.A. I thought about how I'm going to be working in the Bronx for the next 4 years and the excitement and fear and knowing that I'm going to be very very busy for a while. Everything is coming together in a way but right now life is all about the leavings. Scattered connections and friendships and maybe-mores all littering the landscape of the past few months, and no doubt continuing until I finally have a home for the next 4 years. It seems funny to think about The Match as an immovable object that defines so much of your hopes and fears about the future and places them neatly into context for you. The name evokes both challenges and pairings and it delivers a kind of peace in the way in which finality gives peace.
At midnight I dropped her off and headed home and I drove along the shores of Corpus Christi Bay and I looked for the moon through the hole in my roof and I couldn't find it. I turned south again and headed away from the ocean and I knew nothing as Alexis Murdoch sang but I wanted to write it and I wanted to remember today. | | |
| Is there something inherently Un-Christian about voting for a Democrat? My mom thinks so. So does my sister presumably. This has put me on the outs with my family of late. I think there's plenty of things that go against Jesus on both sides. Killing the unborn? Democrat! Prolonging a life filled with suffering and devoid of dignity and meaning? Republican! Stopping scientific research in a groundbreaking area like stem cells? Republican! Fostering a state of government dependence to take the place of the Church? Democrat! Greed in general? Republican! Absolution from fiscal responsibility? BIPARTISAN!
So I just don't see it I guess. How come we're willing to look past the sins of one party and embrace another? How come we're (most of us) willing to concede that Bush was both a True Believer Born-Again Christian and a Bad President, and yet we're continuing the battle to elect based SOLELY on a person's beliefs? I mean, the early Christians were told to render to Caeser, to pray for their leaders, that God was sovereign over everything and everyone regardless of their beliefs. And they believed and it wasn't until years later that the Emperor did too. And that was God's doing, not the will of the electorate determining their leader's faith.
I'm just disappointed right now because of the way things have panned out in my family. It's not a civil discourse like you'd imagine. It's a conversation filled with accusations of betrayal and hurt feelings and tears and even the implication that I wouldn't be welcome at my parent's table for Thanksgiving. This is not how God operates in a democracy.
So after 8 years of war and secrets and torture and executive privelege and having my liberties stripped away for the sake of "The Cause", I see the Christian candidate a little differently than just the one that votes Pro-Life. I see that candidate as the one who stands up for the meek, for the poor, for the one who values not just life's existence but its QUALITY, for the one who seeks to discuss rather than invade, to inspire and not mock, to give hope instead of terrify.
But I guess that's just me. Whatever your opinions, put them into your vote.
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UPDATE: another guy's similar situation, except instead of his family it's the Catholic church.
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