Sunday, July 22, 2007

Do not Squander this Precious Life

Said the Reverend in church today. You are a flying fish, leaving the infinite ocean for the atmosphere for this lifetime. Do not forget you are part of the ocean. Life is a gift, not a project.

Not a project.

The five delusory Ps: Power, Prestige, Possessions, Profit, Pleasure. Okay only in small doses and not as a root of meaning.

I don’t feel like I’m good at anything anymore.

We took a leadership survey thing to see what kind of leaders we will be when we team lead this year on wards. I don’t even know what kind of leader I am. If I’m a leader. If I’m effective. Who I am. What I want. Sometimes this career seems at odds with an unknown self.

Love, Serve, Remember.

It doesn’t give me any space to answer questions that I have. Or do I just blame it for that—for the disconnect?

A 16 year old patient of ours died last week. I’d worked with his mom the week before to get his seizure medicine prescription straightened out. We had to change the dosing schedule because his insurance wouldn’t cover the other med he was on. I guess his seizures weren’t very well controlled on either, though. He died in the ocean. Drowned. The medical examiner said his lungs were filled with water. He’d been playing at the ocean with his mom and little brother and sister. She lost sight of him and they found him face down in knee-deep water. He’d probably had a seizure and gone down when no one was looking. It is the most common cause of death in kids with seizure disorders: drowning. They saved his brain, but they won’t be able to tell if he had a seizure in the moments before he died. Only that he had seizures.

Another patient I saw in clinic earlier in the year ended up having Rat Bite Fever. The rash was atypical when she presented. But what if we’d thought about it? What if we’d done blood work? Would we have seen something suspicious before she’d ended up like she was now: in the hospital for weeks, vegetations on her heart valves that went to her brain, causing an aneurysm that burst and had to be repaired with neurosurgery and likely needed a heart valve replacement.

Of course I staffed these two patients with experienced senior pediatricians. And they agreed with our plan. They feel guilty now, too.

What will happen when I’m the experience senior pediatrician/internist and I miss things? How is that responsibility handled?

I feel unbalanced to the point where I can’t take one more jostle of the raft.

I dream about my bikes being stolen now. And my emotional reaction in the dream is the equivalent of, “oh well.”

Do not squander this precious life.

I’m trying. I just don’t know how sometimes. I don’t remember. Or I never truly knew.


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