Here again

"Time flies," is my thought looking at the two months that have lapsed since I last wrote a line here. Possibly you thought that I had retired. I considered it. No, not from writing. I plan to do more if I ever do retire. I did spend some of this time contemplating what it would be like to leave medicine. As I have with most monumental decisions I made a list of pros and cons. What is it that I love and what is it that I hate about what I do.

I love the patients. Even the many of the annoying ones have moments of gratefulness. This still surprises and delights me.

I hate paper work. I can see that becoming paperless is more efficient and I hope I live to enjoy a day when everything is on a computer. I know, the power may go off. To let you in on a well kept secret, we lose pieces of paper too.

I love the thrill of making a diagnosis. Putting the pieces together, talking to the patient, doing the exam, ordering the tests and coming up with the answer.

I hate giving people a bill. I would welcome a single payer health system that would allow me to practice the best medicine on all who would trust me to be their physician. The problem is that this would also bring a severe rationing of care because cost.

I love seeing people get better. Better has different definitions depending on the patient and their disease. For some it is a complete recovery. For others it is acceptance of the condition that will be with them until they die.

I hate the fact that medicine takes up so much of my time. Little is left for pursuits outside of the practice of medicine. When I take the time to write I feel I am stealing from my family. Everything that I have done outside of medicine feels this way.

I love the challenge of my work, at least the part of that work that is direct patient care. As long as that is the majority of what I do, I will continue. And continue to feel blessed to have such a vocation.

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.

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."