Monday, August 15, 2011

Separate lives and split personalities

I was at church yesterday when I got a tap on the shoulder from behind me.

"I can't see exactly what's happening, but it looks like someone's not well over there."  She gestured over to the opposite side of the church, where one of the ushers was assisting an elderly man hunched over in his pew.

So, up I got.  He was ashen-faced, and I helped the usher propel him out of his pew and out the side door.  We led him into the pastor's office and laid him on the couch.

"What happened?"  With a mild shake of the hand, he pulled a neatly typed medication list out of his wallet.  Recent coronary bypass, took his beta blocker and long-acting nitrate as usual this am, but felt a some chest pain and popped a nitro and a vicodin about an hour before the service.  "Nearly passed out" as we all sat down for the sermon. I had one of the ushers get our first aid kit, and I checked his vitals.  His blood pressure was low, as was his pulse.  He probably just got presyncopal from too many blood-pressure-dropping meds, but the chest pain made me nervous.

"What should we do?" asked the small collection of ushers clustered around us.  I had them call 911, and EMS transported the gentleman to the emergency room.  (He ruled out for a heart attack and was discharged this morning.  No more mixing nitro and vicodin!)

I certainly didn't do anything yesterday in church that any other doc wouldn't have done, but I got to do it in front of people who don't know that side of me.  My church friends and acquaintances know that I am a doctor, but they don't know much about the specifics of my days at work.

Being in the medical field is almost like living two separate lives.  The people I work every day with don't really "get" the part of me that likes to write and perform musical theater.  And, my family and non-medical friends certainly don't "get" the medical stuff that I do at work.  Each group of people knows only one facet of who I am, and although I understand why it is that way, I am also a little sad that no one really knows me as a whole and complete human being.

My church friends got to see a tiny glimpse of my professional self yesterday morning, and, in so doing, maybe had the chance to know me on a deeper level.  I think that's why I find these out-of-office/hospital experiences so rejuvenating - they allow me to be my whole self, even if just for a few moments.  I suspect that this divide exists for other people in other professions as well, but I don't know how similiar it is to medicine.  Heck, I don't even know if other doctors have similar musings about medicine and life.

I just know that I wish it could be different for me.

Thursday, August 11, 2011

The same look

It's been a hectic few weeks, with no time to even think about blogging.  But, we've closed on our new house, I'm finally transitioning over work projects here, and the Singing Pen is glad to be back at the keyboard.

I spent most of my free time last week addressing letters to my patients that announce my out-of-state move and imminent departure.  I handwrote every name in the "Dear" line and signed each one individually, so it took a while.  I recognize that I performed this act entirely for myself; it was my opportunity to pause and reflect, if even for just a moment, about my relationship with each patient and family.

But the letters are starting to arrive at homes, and my patients are starting to arrive for their final appointments to say goodbye.  I care for a diverse group - poor urban dwellers and university professors, young transplants to the area and four generation families, white and African American and Iraqi and Vietnamese.  Yet, despite their many differences, each of my patients has been wearing the same expression when our eyes first meet for these appointments.

Their chins point toward the ground, slightly, and their eyes look up at me, daring me to confirm the letters' truth.  Accusations of abandonment are clearly evident in their wrinkled foreheads, and their downturned lower lips hint at the sadness of a severed bond.  The slight pinch of their noses display unease, perhaps, with the unknown regarding their next doctor.  They offer no words to me, waiting instead for me to speak first.

"So you got my letter," I usually say.  I reassure them about their new family doctor here and share my joy in our relationship and sadness in leaving.  They wish me well and thank me for my care over the years.  On and on these encounters repeat themselves , hour after hour and day after day.  I accept this process as a necessary component of my departure.

But every one rips another small piece out of my heart.