Thursday, August 9, 2007


Perhaps, if you have been reading these pages, you have noticed a change in the time of my posts. This has come from the fact that the flood of ideas that launched this blog has at least for now been reduced to a trickle. And I also find myself suffering from fatigue.

Fatigue comes in many forms. There is the bone deep weariness that comes from hard physical labor over long hours. I experienced some of that this past weekend on call for my group of four physicians. In our specialty some of our work always happens at night.

There is also a fatigue that comes from experiencing too much. Today is an example. Early this morning I saw a patient who is very young, early pregnant and has the heart of an eighty year old. If she continues her pregnancy her risk of death is greater than 50%. As I discussed this with her she began to comprehend what this means. She will have to make a decision to terminate her pregnancy if she wants to be able to raise her three year old daughter.

Around midday I see a patient younger than myself who is battling recurrent cancer. Many medications have worked, for a little while. Each time the disease has returned after a few months of treatment. Realization that this is a disease that she will have to live with and more than likely die from, has arrived.

The end of the day was spent with someone in whom I have just made the diagnosis of a sexually transmitted disease. Physical healing will take a matter of days. Emotional healing, well, that will be much longer in coming.

A good night's sleep has cured the fatigue resulting from my nights on call. Treatment of the spiritual and emotional fatigue requires more effort. In fact I find it is a constant battle. One of the reasons for writing is to help. Somehow putting my experiences down in black and white localizes the pain while I search for a cure.
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