Tuesday, February 26, 2008

Isn't it lucky


I'm exhausted. I got a pass off patient today who probably has a new diagnosis of lupus. Just when I think I'm getting okay with having it myself, something like that happens and I remember again that I'm not okay with it.

She has lupus nephritis. Kidney disease. The most common cause of lupus-related death. My kidneys are fine for now. Blood supply to my brain, questionable. But kidneys, fine.
The rheumatologist I consult about her case goes over the lupus criteria with me on the phone, asking about arthritis (check), rashes (check), and all the lab work we would expect to be abnormal (check, check and check). I pretend with her those aren't checks for my diagnosis, but some obscure "other" between whom we can both put professional distance. I have a vivid imagination, but I can't pretend about those checks. Denial, at least, has passed.

I didn't tell the seventeen year old patient, or the attending about my disease. I almost cried when I walked into the patient's room. Gathered myself at the doorway. Kept it together while I was in there talking to her and her family and examining her joints, then almost cried on the way out. Good thing it was dark already when I got to noon conference late after talking to her before transport whisked her off to an eye exam to see if she had lupus retinitis which would herald cerebritis.

I'm tired.

I did have a good time with the hood last night, though. With a couple new additions. Bob's best friend forever, Adam, has moved into his studio with him and it was sort of an Adam welcome dinner. Jane and I had plans to go to sushi ourselves and avoid the scene. She was hiding out at a bar when she texted me on my way home from work to scheme, but then we both felt bad ditching the boys (the group isn't nearly as fun without us--or so we are led to believe). I was, as usual, tired and almost didn't go, but then Rick called after he finished surfing and met us there. Half price sushi with a group of friends is hard to beat.

Melissa, and now Rick I guess, are always surprised that I even know my neighbors, let alone hang out with them on a regular basis. Jane came running up to my place when she got home from the bar and found me passed out on my bed; she was escaping the boys who had invaded her apartment before she even had time to get home and pee. We giggled over a few shared girl jokes and she told me about her new super soft pillows before joining the male fray downstairs.

At dinner, having Rick there, I realized again how well I have grown to know these people who live on the other sides of my apartment walls. And how comforting I find it to come home to a place where they watch my lights to see when I come and go. And care when I come and go. Yet still let me wander in and out without expectations or restrictions. Just with an interest, and companionship or concern when needed.

When Libby visited, I also had that realization; seeing my life through the eyes of relative strangers, I realize the unity which surrounds me when I let it. The beauty of the place we live. The diversity of the people I know. The closeness of my family. The communities I join. The work I am able to do. The health I have regained. The lessons that journey continues to provide. The writing I can do. The books I read. The music friends have shared. The friends I care about, near and far. Realizing the help I can provide. The smell of the fresh cut grass when I climbed the outside stairway at the hospital in the 70 degree February sun. Two perfect "champagne" lumbar punctures in one call day. Patients recovering. Cautiously growing confidence in my knowledge and skills. Working on asking questions and forgiving myself and speaking "impeccably." Nurses greeting me with warm reality. Sunsets over the ocean. And soon, bed.

"Isn't it lucky."

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