Sunday, July 28, 2013

i know what you're feeling


balancing two encyclopedias on its head,  realism walks ungracefully the dangerous line over the pit of fire, between objectivity and cynicism. i'm not sure i understand this self proclaimed statement myself. pin now, think later.

anyway.
just came back from Lebanon, an impromptu "vacation" that i spent helping out my mom. all dusty scraps of paper and invaluable antique items from a hoarder family inclusive. which explains the twenty day delay in writing a new post. i wonder if i'll ever run out of excuses?

a little-too-sweet taste in your soul of artificial self satisfaction when you've made someone happy.

all that was done out of love for someone who loves you back, cannot help but nudge a question of would-i-do-it-for-someone-i-care-just-slightly-less-about than my neat schedule of the day: my own personal charity, proceeds benefiting my social life, fitness goals and checklist of tv series to catch up on.
are you tired of hearing about my schedule? so am i. defaut de fabrication, deformation professionelle, obsession maladive et j'en passe! my ego always insults my id in french, its just something we do.
 
along with scheduling with a hand of steel, objectivity regarding palliative care is another feature that i thought was an attained goal of my profession (eternal medical trainee that is) 
they have really nothing to do with each other, but it makes for a nice transition, don't you think?

i've found myself drawn to, gifted at, and comfortable, at heart, with palliative care discussions with patients and families since early residency. my head somewhere is uncomfortable with this comfort and attempting to analyze its roots.

is it exposure to familial deaths so early on in life? i remember being surprised in college at a friend's unfamiliarity with death when her grandmother passed away. my bittersweet feeling of superiority, of 'death maturity'. i had all those feelings down, from the guilt, to the anger denying the grief, to where my spot in the line of condolences was.

is it the opportunity for blunt honesty that i crave (and i know they crave it too, after days of polite exchanges of hopeful uncertainties).  in discussions where most people don't want to be the ones saying these three raw words, the ones that answer all the unspoken doubts, the ones that liberate from excruciatingly unrealistic hope, three words can bring the liberation of answers, of closure, and let the light shine on comfort, on relieving pain, on bigger and everlasting hope.

i've bonded with daughters and prayed with wives and hugged mothers after the decision to relieve pain has been made. i've helped them make the right decision of selfless love in the face of certain odds. i've even answered the miracle question-nothing is impossible to God, He can still heal, what if we withdraw before He does. yes He can, and if this be His mighty plan, then no ventilator that i disconnect or no morphine that i order can ruin His healing plan. God's schedule will not be hindered by a timeline that i ordain in my icu kingdom.

and yet, i found myself become the patient's family, wonder if the outcome is certain beyond a shadow of a doubt, rationalize and minimize the amount of pain she was in, ask myself for a horrible second if i was deciding her fate to give myself some rest, so i could sleep again, so i would stop being terrified of what would happen and how she would die. i heard the guilty thoughts of betraying her trust, of playing god, of not searching for other solutions.
i've believed them for one brief second of "patient family" time. seconds that flipped the coin so i would truly know the fleeting thoughts in a daughter's head, after i've said my three words.

for the record i am talking about a cat. who was sick and not eating and still loving you with her (one)big green eye (under her likely heent tumor).for those of you who are or have been a pet's human, you will understand with no apologies needed.

i'm thankful for my teenage grief because i can understand theirs, i'm thankful for the years of training for giving me the ability to objectively recognize pain and certain outcomes, i'm thankful for the doubts because they convicted my intolerance of love's desperate what-ifs.
the agonizing few days' journey on a cat's palliative care blood stained couch made me a better doctor. God does really redeems everything, if you listen.
















 

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