brave

i think it every day.
patients are so brave.
over and over i see them gritting their teeth, sucking up symptoms, taking risks for a potential benefit, fitting in treatments on their lunch hour, being patient with the phlebotomist who is having a bad day, returning to us...even though they know, at least in the short term, that it's going to hurt...that it has to get worse before it can get better.
but, somehow it's not the right word. it sounds cliche and insufficient. most patients would say they aren't brave - that they are just doing what they have to do. but it's how they do it all...with grace and focus.
it's all so scary sometimes. and they're brave. trust me. don't let them tell you otherwise.

sometimes doctors are brave too.
this one is one of my favorite species...the doctor/scientists. the ones who see patients but also run a lab... the ones who know what the most important paper is going to be this year...because they are writing it. the ones years ahead of the FDA in knowing what might work. the ones that often forego the enormous salaries of their peers, because their heart is in science...and science doesn't pay. the ones that, as a group over time, move the whole field ahead.

this one looked at a young guy whose options have run out
who has tried everything there is
who is going to die...soon
and he said, 'hey, my lab is working on something...we think it's going to work...it's nowhere near approval...i'm telling you this because it's what i would do'
and they throw up a medical hail mary.

and damned if it doesn't work.
today i looked at them, physician and patient, celebrating this most unexpected victory and felt grateful that they ended up together. another physician would have never had the knowledge to share. another physician might have covered his ass and not shared what he knew. another patient might have been too scared to try.
this patient was beaming today.
he told us today that he had canceled his trip to europe this summer, because he thought he'd be dead.
he isn't.

i felt like i was witnessing something great.
this doctor was brave...and may have saved a life.
who knows what will happen from here.
for now, though, this young guy is living and living well.
what else is there?

dad

where was i? oh right, my sanity. i have spent most of this blog examining it - the ways my work tugs at the places in me to which i feel my sanity is anchored...worrying about the potential of losing the sometimes fragile grip i have on it...questioning if, in fact, all this examining and questioning might be healthy and might be the very definition of sanity...honing my tools of the trade for preserving said sanity - learning to invest in and care for people without feeling their pain to the point that i start to think it's my pain, etc, etc.

all that, in short, gets shot to hell when your dad becomes the patient. no small part of the aforementioned storm was his new diagnosis of cancer. in your memory it's a blur of belly pain, a phone call from your mother, an ER visit, a strained attempt to understand the english as a fifth language (EFL) resident that examines your dad at Podunk Memorial in your hometown, scans, more scans, masses being measured in centimeters, nerves getting frayed, calls made to inform and placate overseas siblings, tears, worries, frustrations...all leading up to a huge surgery where the best and worst facts of it are all revealed.

people, mostly colleagues, immediately start talking to you about how it must feel to "be on the other side". you quickly learn there's no such thing. you are who you are, you know what you know, you've seen what you've seen. it doesn't turn off because it's family - if anything, it revs up. when you're seeing patients on the first floor and your dad is recovering in a bed on the fourth floor, there is no other side. the daughter/ oncology nurse /employee of same hospital trifecta benefits you all in different ways, but makes you fall asleep in a pile on the living room floor more than once.

when the trauma of the surgery wanes and physical healing begins...when the facts are all known and next-step plans are made, you exhale. you all learn that it could be so much worse - you learn that he has a diagnosis for which oncologists can't seem to help themselves from saying, "well if you have to have cancer, this is one of the ones to get" - or my favorite "you're probably going to die from something else" - reassuring facts said in ways that are not at all soothing. you resist the urge to slap any of the kind people who keep saying these things but add to your own mental list of Things Never to Say to Another Human. ever.

so he's left with some cross between a blessing and a time bomb inside and life all but returns to normal. somewhere between despair and relief you get to share that he's going to be a grandfather again and you all celebrate in the juicy cliche handed to you at this key moment - that life does go on.

you and he, arm and arm, stride out of your hospital each with radiology films under your arm - his showing a mass, yours showing a fetus- neither of you pretending to know for a minute what the future holds.

love you dad.