Wednesday, September 30, 2015

The Lord's Prayer

The Pope visited the east coast this week. His last stop was Philadelphia, a place that owns a piece of my heart. During his visit, I ran across this piece I had written long ago. I remember feeling so confused about religion while my team and I were tumbling through the emotions of caring for this beautiful soul. I was mad at God, yet he stood by me and did not let me falter. I doubted him, yet he brought comfort to those who needed it most. I label myself as "spiritual, sometimes religious" and was happy to learn that the Pope recognizes my faith. "Nature can be church ..." he said and I am proud to worship at the alter of the ocean. But during the time when I was involved with this story, I worshiped in the hospital chapel, and my hotel room, and the moments of solitude in the busy days. When I hear the Lord's Prayer now, I remember that last day ... and I believe. Let us pray. 

Our Father

The nervous energy is palpable the minute I walk into the room. My task is simple. I just have to clean up a wound and be on my way. From here, the antibiotics and the ICU would take care of the rest. Not a problem, I’ve been here before. It is a quick procedure. “I am just going to clean up the knee. Scrub up the wound. It won’t take long. Not much for me to do but make it prettier.” Dad wanted details, wanted as much information as possible. Wanted me to talk to some other doctor friends. I obliged and told them we had nothing more surgically to offer and the ICU was treating the infection. Patience, I asked for, just give it some time.

Who art in heaven

Dad is a pilot. I understand the personality. He is not in control here. Too many alarms he does not understand, too many variables outside of anyone’s control. I watch as this progresses and see him, frightened and grasping for answers that don’t exist in our world. The physics and the precise science of his world collide with the multifactorial variables of ours. Here, science can only rule so much, we can’t control every encounter with turbulence.

Hallowed be thy name

The hardest part of my day is stopping by the room. I have explained to dad that I am only one part of the team and that what I have to offer at this point is limited. I pray that the antibiotics work. I pray that the infection is conquered, but I know that something more is at work here.

Thy kingdom come

We put him on bypass. His lungs failed. Riddled with infection they could take no more. A strong, youthful heart, persistently pounding and we used it to power our machine. Give him some time. Let the lungs heal. Circulate the antibiotics and kill the infection. We watch him swell to disfigurement. We watch him withdraw to the point of no pain, no tears, no reactions. All the while, pictures of his healthy self stare down at us from the decorated ICU room walls. How did he come to this?

Thy will be done

2am. No choices. His abdominal pressures are too high and his kidneys have stopped working. Though he is anticoagulated, bleeding is no longer a concern, death is. We have no choice. Expecting the worst, my team rolls in for a bedside laparotomy in the ICU. We find destruction beyond our expectations but we will fight on, we won’t give up.

On earth as it is in heaven

Angels help us bring him to the OR. I have never seen such teamwork. Everyone is fully invested. Everyone is there to give all they have for one life, his life. Everyone is witness to the love in that room. Angels guide us as we bring him back to the ICU. We have done our best and cleaned up the damage. But we cannot do enough. 

Give us this day our daily bread

A reprieve. Nothing looks good but we can take a breath, have a sleep, collect ourselves.

And forgive us our trespasses

I can't help but cry. 12 years old. His room is plastered with pictures of a healthy boy. Vibrant, alive, thriving. I think of my nieces, my nephews, my friends' children and I cry. How is there a god who can do this? How is there a god who can put a family through this torture? I cannot accept it.

As we forgive those who trespass against us

Dad is mad. At me. At God. At everyone. I will let him yell. I will let him cry. I will answer every question, with a full heart and an honest soul. I will cry in front of him. I will tell him the hard stuff. I will explain the painful truth of body system after body system failing. I will tell him his son isn’t suffering because I still believe in a merciful god. I will tell him his son can hear him because I believe in a loving god. I will tell him that I will fight as long as he wants me to fight. But I will admit, I am losing.

Lead us not into temptation

Now, as dad has relented, mom is certain of a miracle. It will happen she says. I will be the vehicle, she believes. And I wish it were so, but I know too much. I will go back. I will fight one more time.

But deliver us from evil

I lose myself in the task. Break it down into its parts and just keep working. Open, clean it out, stop the bleeding, remove the dead tissue, dress the wound with the temporary closure … and then steal yourself to tell the family there is no miracle today.

For thine is the kingdom

Everyone meets in a blank conference room. Frustrated questions that hit like accusations  are thrown around. I cut to the chase and simply state the obvious “we have done everything we can do. I cannot make this better” as I admit defeat, the most courageous person in the room claims a victory. “My son is not going to make it here with you, but he will make it, in a better place, with god.”

The power and the glory

How can I stop the tears? I can’t. I cannot begin to understand this courage. I cannot begin to understand this pain. I cannot begin to imagine the emptiness in this father's heart.

Forever and ever

As I watch the family gather around his bedside, his dad says the Lord’s prayer.


Sunday, September 13, 2015

How to "Act" like a Doctor

Last year I had this cool gig as a medical consultant for a short-lived TV show. It was fun. I got to read the scripts, throw my two-cents in as to how to make things slightly more accurate, though often tragically less dramatic; and watch how it all turned out on the little screen. I liked the main character who was a doctor working outside the lines with a troubled personal life, messy in every possible way - but he was my kind of guy ... handsome, swaggering, trouble disguising deep-seated insecurities and a beautiful boyishly tender heart. 

One day i got an urgent call from the set ... "We need a line. Just a line. The doctor needs to explain to his friend, an actor auditioning for a part, how to 'play a doctor realistically'."

Oh the challenge of 'the play within the play'! I asked for five minutes and I went a bit overboard. I sent them a monologue, not 'a line'. Needless to say, they did not use it all but I got to hear the charming actor recite a few of my words on national TV and it made me smile. I still like the monologue, annoying rhymes and all. Read it with the handsome 'doctor on the fringe' in mind.

How to "act" like a doctor:

“…it’s all about confidence mixed with empathy, swagger with some sympathy. It’s a gentle hand on the shoulder when you tell them they need a biopsy; eye contact when you let them know it’s carcinoma. Make them know you’ve got this even though you’ve never seen a CT scan that bad before. Explain cardiogenic shock in terms a kindergartener can understand, and then explain it again. Listen. Really listen to their confusion and pain. Tell them what they want to hear wrapped into what they need to hear. You, the doctor are fearless in the face of their greatest fear. You are what stands between them and the reality of their mortality. Believe that. And that, well that, is how you ‘sell yourself’ as a doctor. (beat) That and great Italian shoes.”

ps. The actor, Tom Ellis, now plays Lucifer on the Fox show of the same name ... from renegade surgeon to Lucifer ... hmmmm