Saturday, September 15, 2007

Like ...

Ever think about what salvation looks, smells or feels like? That was one assignment at a workshop I attended over the past three days. My image of salvation is a cold glass of iced tea on the hottest of summer days. Having just finished mowing the lawn and standing sweat soaked under the shade of a large oak tree, I am unexpectedly handed a glass that is all beaded up with cold moisture. After taking that first big gulp of refreshing liquid I touch the chilly glass to my forehead. There is the faint aroma of mint mixed with the taste of lemon along with a delightful sweetness in the back of my throat. Swallowing, my parched body demands that I move the cool of the glass from my forehead back to my lips as my tongue begs for more.
Like ...SocialTwist Tell-a-Friend

Tuesday, September 11, 2007

Things that unite

"This 37 year old Asian American female accountant who is a unmarried mother of two ..." And so it begins, the medical history where I record answers to all of the questions I have ask about age, race, occupation, sexual orientation, number of sexual partners, level of exercise, diet, allergies, recent travel history, family history, social history, good habits and bad. This is what a physician does, ask questions and listen carefully to the answers.

Often there is more information than I need. Occasionally I worry that some of this information will prejudice my judgement. In an effort to prevent such bias I try to remember what I hold in common with my patients. All of us wish to love and to be loved. We all become hungry when we are not fed, tired when we are over worked, cold when we are exposed without adequate protection. All of us have skin. Cut it, regardless of color, and we all bleed. Oh yes, and we all get lonely. This seems to be the case now more than ever before.

On this day, the anniversary of a cataclysmic event in history, when some would separate us in to countries, religions, cultures, and generations, may we all remember the above. It is not trite to say for the sake of peace "many more things unite us than divide."
Things that uniteSocialTwist Tell-a-Friend

Monday, September 10, 2007

Rest, part II

"If it were easy then anybody could be a doctor." Those words resonate in my mind daily even though it has been thirty years since I heard them for the first time. My neuroanatomy professor made this pronouncement after each assignment given. The neuroanatomy course was one of the most demanding of the basic sciences, the last lecture course of the first year of medical school. We never saw the professor during the lectures. The course was on closed circuit TV. His hands, the pro sections of the brain and spinal column and diagrams were all that we ever saw. His voice was like the voice of God. Meeting him I was surprised he appeared so ordinary.

I also recall the words of a colleague, a favorite endocrinologist, when I was begging him to see a patient sooner than his office schedule would allow. "I cannot create time!" he declared.

No, humans cannot create time. The Divine did, ordering it in such a way, with light and dark, winter, spring, summer and fall to give natural periods of rest. In our attempt to be like gods we have discovered electricity and harnessed it into a nonstop flow of activities, ideas and information.

So what could be more powerful than turning off the lights, unplug the appliances, even the oven, for a few hours a week? Think of it as conservation. The energy you save may be more than just your own.

Yes, if it were easy anyone would do it. Just like the words of my neuroanatomy professor pushing me to study, this is a challenge to arrange my week in such a way that there is time for a period of rest or Sabbath.
Rest, part IISocialTwist Tell-a-Friend

Saturday, September 8, 2007


On the way to work this morning at 5 AM I am overcome by the number of cars already on the freeway. Being old enough to remember when most of the world slept at night, I recall a time when there were no twenty-four hour retail stores and "7-Eleven" was a convenience store that opened at 7 AM and closed at 11 PM. My kids refuse to believe that television stations ever went off the air much less accept as a fact that the programing day ended as early as 10 PM. Many businesses now operate around the clock and if the store is not open the web site can be accessed twenty-four/seven.

In my daily life I find it difficult to escape human made sound. I miss darkness where the only light is that of the moon and the stars. I cannot feel nor do I hear the earth breathe. The result: I feel as if I am holding my own breath. The rhythm of life is interrupted by synthetic sound and artificial light.

When does humankind rest? The earth has existed for eons without constant mortal attention. Could the restlessness of the human race be exhausting all of creation?

Friends discuss keeping sabbath, a period of rest.

I have heard the lecture.

I need the lab.
RestSocialTwist Tell-a-Friend

Wednesday, September 5, 2007

In the operating room

I spend the better part of my Wednesdays in the operating room. This time of year the residents, interns, graduate nurses and nursing students are still relatively new at their assigned tasks. The operating room remains a bit intimidating to me, a seasoned practitioner. I am sure that these new individuals are terrified. I try to think back to my first day in the operating room on my surgery rotation in medical school.

I had been suturing in the emergency room regularly for almost two years, so I felt a surge of excitement when the resident I ask me to scrub for a case already in progress on my first day. No one explained to me what had happened prior to my arrival. The case was a coronary artery bypass graft requiring the big vein from the leg. While one team of surgeons readied the heart another team harvested the vein from one leg.

I was being asked to scrub so I could help the team suture the incisions in the leg from the vein harvest. There were twelve to fifteen people around the patient. Right after I pulled my gloves on I contaminated myself by going to the wrong spot around the patient. This meant that I would have to begin the process of gowning and gloving again distracting the scrub nurse even longer. She was not happy.

As one of the circulating nurses tied the second gown she whispered, "If that is the worst thing you do, you will be the best medical student we have ever had in this OR." She gave me a knowing look. This has happened before.

I went on to gown and glove a second time with no problems. All my previous suturing experience served me well and I was able to help repair the incisions on the patient's leg. The scrub nurse who had been so angry with me when I had to regown and glove had an improvement in her mood. She taught me the names of all the instruments and how to past them to the surgeons. For the next four weeks, when I was not allowed to help with the actual surgery, she let me stand in her place and pass instruments. Not only could I see what was happening, I felt useful and I never had to study the names of the instruments. I knew them.

The surgery rotation that most in my classmates dreaded, unless they wanted to become surgeons, ended up being one of my best rotations. My attending physician wrote me a wonderful letter of recommendation. Yet, the experience would not have been as rewarding for me, if two operating room nurses did not have the patience to teach me how to function there.

It is good to be reminded that none of us are born with all knowledge. One thing that makes the knowledge that we do acquire better is the ability to share it graciously.
In the operating roomSocialTwist Tell-a-Friend

Monday, September 3, 2007

Labor day

Several weeks ago I overheard a conversation between my two teenage sons. My eldest son had a summer job at a local bookstore. One evening after he explained to his brother how tired he was and how much he disliked his job the younger one replied, "Well, duh, that is why they call it work."

Despite the fact that I am often exhausted and despite the fact that there are some unsavory aspects to my job, I would rate my job satisfaction as high. Part of this comes from the fact that practicing medicine is challenging and rarely routine. Yet, much of the fulfillment from my work comes from the approval I receive from my patients. I have found a sincere "Thank you," to be a great reward.

Medicine is not just a series of diseases to overcome though battling disease is a large part of my work and I enjoy the effort involved in making a diagnosis. For me practicing medicine is to participate in healing. Often this is to diagnose diseases and prescribe appropriate treatment. At other times practicing medicine is providing comfort when all the treatments are done.
Labor daySocialTwist Tell-a-Friend

Saturday, September 1, 2007

September dawns

As September arrives I find myself thinking of change. Fall is coming. This is the final quarter of 2007. Who will be migrating as the seasons change? This picture along with many other wonderful watercolors are located at
September dawnsSocialTwist Tell-a-Friend