the Great Fears: the culture of texting and crashing patients.

the culture of texting and chatting. i'm not quite old enough not to claim it as my generation but as the rebellious continent-confused nostalgic francophone Lebanese, i never quite claimed it or enjoyed it.

to be truthful, texting does appeal to me as a means of conversation, avoiding all the necessary polite tournures de phrases before addressing the issue you just wasted seven minutes of your life introducing. i find it hard to relate, empathize and love over the phone so: straight to the point and saving precious minutes here and there, minutes used to knock down other essential items on the to-do list.

saving time, using time, sparing time, for the sake of…? what am i doing with all this time? worrying about time. do i know that i sound crazy? yes, but this is how most of the great philosophical debates and spiritual revelations probably started in history. at least this is how they start for me.

they sound even crazier when God sits me down to type them, or hand write them for the sake of further time saving 

when i was still using a computer that required ten minutes in its two step start up: turn on. three minutes later: hard disk not found. press hard on turn off button. wait two minutes. turn back on. your system shut down unexpectedly, would u like to proceed. yes. 

it was the system of deliberate un-expectation. 

just like waving the image of the man you like out of your brain to trick the Lord who made your brain into giving you what you're not really asking for. because the dark twisted portion of your brain believes that God is whitholding what you want. but i digress.

in the days of the old metal square that believed itself a computer, the typing the beginnings of my great spiritual debates was done with two thumbs on the instantly gratifying screen of an iphone.

all that to say that i fully enjoy the benefits of introverted conversation through  the veil of technology. never through a computer screen surprisingly, but i haven’t had enough time yet over the past six years that this specific symptom has manifested, to elucidate that non-inclination.

back to the main doleances and the intended topic of this post.

perhaps it is my french-nurtured-endless-sentences-with minimal-punctuation-and-twelve-jumbled-thoughts-literrary leanings.

i do not understand, tolerate or forgive multiple small texts sent in a chat-type fashion, in a systematic morse-like pressing of send, like that poor soul you see in catastrophic movies, pushing on his small beeping button, sweating his brain off, in an attempt to save humanity, through the frantic pressing and beeping.

it must be the stuff torture devices are made of. and it makes me almost cry of frustration as i hear more beeping  drilling into my soul in the five seconds it takes me to reach the phone in my tiny (but extremely well-decorated) apartment.

perhaps it is the most commonly unimportant topics usually addressed in chatting-qui-se-veut-texting, i thought. maybe i should address the selfishness in my heart for wanting to love people on my own terms, in my own time, and only on topics that i deem worthy. maybe it has nothing to do with the beeping.

but really if they.were.just.written.in.one.paragraph.

read in one sitting.

one continuous thought.

one nice large blue rectangle on my screen rather that ever appearing new bubbles, making the screen flicker, my brain startle and my heart sink ever so sligthly

and only.one.beep.

yes, i DO have tried changing the ringtone, thank you very much for the suggestion. maybe the same musical note, if repeated so very often, would have driven even Haendel to eradicate it from his Hallelujah all together.

maybe if changed to a traditional ring, the way God and Alexander Graham Bell intended it. #fail

maybe its an undiagnosed lack of affection for specific people communicating. tried and tested. most are deeply cherished face-to-face. or when they send a appropriately sized cyber-communiqué. so it's not the people, it's the bip.

i pray to be someone who loves people, who is quick to repent and willing to serve.

but i really do.bip.not.bip.believe.bip. that the intellectual trauma and the emotional breakdown caused by.bip.the.bip.incessant.bip.beeping. bip.of.bip.multiple.bip.small.bip.texts. is a heart issue.

en passant on the heart issue: if life-giving communication was meant to mimic the heart beat of life, we would have all been speaking in one.word.sentences.like.the.robots.with.the.nasal.voices.in.eighties.movies.

one of the godly women i look up to whole-hearteldly hates group messages. and she loves Jesus. there you go. justification through the spiritual mentor. Jesus never had to deal with group sms and the incessant exasperating bip. nothing to learn there so i'll take the next best example to follow.

 (Although we could arguably analogize that the most certain interruptions of his frequently irritating disciples to the dreaded bip. which disciples he didn’t turn off with a mighty smack of his hand. have i ever mentioned how thankful I am for the faithfully recorded irksomeness of the same disciples who were loved and sent to make similar disciples of all nations? but I digress again)

my inner therapist truly believes this is related to The Great Fear.

Of Getting Paged, that is, about a Crashing Patient.

The Great Fear Of Getting Paged about a Crashing Patient while standing in line with other sleep-deprived people-studying-to-help-people, in the cafeteria twelve floors below, for the first meal in 10.5 hours, trying to grab the last stale salad before the grumpy lady at the cashier’s station decrees closing time.

The Great Fear Of Getting Paged about a Crashing Patient while on an excruciating elevator ride with a bored- and confused about disease and death in a fallen world- child pushing every floor button.

The Great Fear Of Getting Paged about a Crashing Patient while returning the last six pages of the last minute and the half.

The Great Fear Of Getting Paged about a Crashing Patient while trying to softly communicate your medical point of view on a landline, all your senses helplessly witnessing the sinister beeping and the flashing arrows of multiplying unreturned calls grow increasingly bright and terrifying on the tiny pager screen.

The Great Fear Of Getting Paged about a Crashing Patient while trying to phonecall a hello to your mother 3000 miles away (preaching to yourself that an eight hour time difference makes being awake at 3:49 am allright), pretending to call her to check on her while truthfully really just needing to hear a friendly loving voice on your seemingly eternal terrifying cold and eerie night.

The Great Fear Of Getting Paged about a Crashing Patient while wrapped in a plastic sterile tent, because the hospital only carries extra-large sterile gowns, trying to focus on sticking a two millimeter wide vein in someone’s father’s neck through your blurry eyes and scratched eyeglasses.

The Great Fear Of Getting Paged about a Crashing Patient while running in a reception-free hallway trying to return a page from ten minutes ago on your cell phone, while the terrifying beeping continues on the machine of death strapped on your waist, its radiations dangerously close to your ovaries-the kind of thoughts that penetrate your exhausted brain at 3:52 in the morning.

and to alleviate the drama and terror of the above descriptions for non-medical personal, The Great Fear Of Getting Paged about a Crashing Patient while trying to empty your twelve-hour-full bladder while simultaneously-and precariously- trying to hydrate for the first time in said hours.

if The Great Fear is the root trauma behind the trauma of the texting bip, la boucle est bouclée and brings us to the explosive knot in the vicious circle.

why don’t i just silence my phone. and stop complaining, and wasting analytical power and people's time. 

because The Great Fear is above all missing a text about someone crashing. in my life that is. because buried in the midst of all the blue bubbles and important-but delayable-topics may be a truly emergent message. unlikely you say, but not in my conditioned brain. not in the volatile middle east. (cf:explosive 3 lines above). not in a hospital's operating room for a last chance to say goodbye.

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.
















 

Musical envy

importing old country music cds borrowed from a friend, you know, one of those people whose dark living rooms, dusty kitchen counters, and torn down trucks carry a treasure of music legends and brilliant unknown artists, all of which you've never heard of.

maybe because you're a foreigner, and you were busy with your people's music legends. (to my Lebanese friends I will now admit, I have seen maybe two Fairuz plays, and can only hum the well known classics). none of that "b-sides for the elect" superior attitude.

maybe because you grew up without itunes or pandora.

or with overworked parents trying to raise kids and carry a household of fourteen in war time. sharing delicate Arabian notes floating on exquisite love poetry or the musical anarchist themes of the seventies would have been Ultimate Irony.

maybe because you just learned to ask when in ignorance. maybe you just reached that magic point, not of the illusion of absolute self-assurance, but of serene security in a mixture of worldly and Christ-grounded identity, where you are not terrified of other people's opinions. asking for musical recommendations is now acceptable.

i am making up for time lost in musical education by borrowing cds, stalking people's musical tastes on social media, and most importantly learning to listen. ha! because acquired deafness is probably at the root of all ignorance.

loudly turning music on, and wandering about the house pretending to do chores, or studying, just adds a layer of noise to the roaring cerebral to-do lists engines in my head.

music was not intended as an instrument to drown your thoughts or numb your co-existing experiences. for people who need "something in the background" let's just admit that this is merely where it is: in a background where the arrogant brilliance of your musical choices doesn't matter anymore.

 hey! my thoughts are dangerously tipping to bitter jealousy..

true. i envy you, respect and admire you, sometimes don't comprehend your taste at all. i don't know how you did it, how all these names and cassettes and endless spotify lists became knowledge to you.

so i will keep borrowing. and learning to listen, trying to make up for lost time.

so i have a few tunes to introduce my children to, in an era where justin bieber will likely be the classic of the time.





 

Tornadoes and M&M's

only until recently did i understand the difference between a tornado watch and warning. this issue may be a source of confusion to a multitude of people,that confusion then translating into the topic of casual conversation and the smallest of talk.

but for us foreigners, we know the cultural areas to focus on and fight to acquire, in order to prove, mainly to ourselves, that we are not FOBs (fresh off the boat) . A few years after hitting shore, after the initial self-deluded FOB-denial phase has passed, and we acknowledge our initial condition, we vow to be born again and strive to slowly shed our persistent FOBiness as we grow in visa years.

tornadoes and the weather are not covered by the doctrine of fitting in.

Acceptable initial steps after cross-cultural baptism:
acquiring an acceptable accent that makes the overworked and minimally tipped lady at starbucks understand you need waaaate'  instead of the phonetically correct wo-ter, taught to you devotedly in school,
acknowledging college sports as the gods of ever-changing and ever-returning seasons even if not endorsing them,
learning that no one will invite you twice for coffee, or offer you M&Ms more than once because you politely refused the first time, thinking you were visiting your mom's second cousin's great-uncle's widow (as the tradition is for the pope to refuse the conclave's decision twice before solemnly wearing - in my opinion that which would have made Simon-Peter cut the designer's both ears, and more than likely, delicate hands)

what a liberating realization. yes please, no thank you, how very few occasions to clearly express you desires and be on your way
this is a young country, and to catch up with the millennia of brother continents, has had to abandon, the triurne negation tradition. There are many facets of freedom. That was one of mine, gained after years of claustrophobic mathematics of convention.  

abysmal plans

it is 6: 47 pm and i sit on my couch with an overheated computer on my lap .who knows if that's normal, ever since the glittery stickers on my toddler Dell faded, i have lost interest in its therapeutic needs. a new computer has also not yet found its place on my to-do list or my budget. what's the point, i would not appreciate its marvelously intricate world of possibilities. really all i need is a half-clean screen, an internet connection faster than good ole dial up and a keyboard. I would still be using my nineteen ninety seven Lebanese twenty pound dead weight if it would fit on my lap and stream netflix.

well it is now 6:55, eight minutes spent on one paragraph only took my feelings of doom to abysmal dimensions. see i was supposed to be heading to the Roasterie between 4 and 5 pm, pretend to read about lung cancer while really copying Bible verses on orange glitter paper with a teal marker, that God ordained be brought back from a bookstore in Achrafieh Lebanon, probably for this specific design of my spiritual edification.

twelve minutes of reading would have made me feel really comfortable in my newfound knowledge of chemicals i had never heard of as risk factors for lung cancer. chloromethyl esters. so i am supposed to ask the sweet eighty year old in my clinic- with whom i have just flirted a little to soften the blow of a posterior speculated nodule in the apico-posterior aspect of his left upper lobe, if he has ever been exposed to that thing.

or am i supposed to, in addition to relocating to the first world to better learn to save lives, leaving my elderly cat and my one-eyed nounours (a plushed bear typical francophile name) in the master bedroom my parents let me have in the newly built house of my youth in the Lebanese mountains, where the breeze flows through each of the vast windows, encircling your soul.... (are you still following: we were at "am i supposed to":) learn the materials involved in every single welding, construction, naval, et j'en passé! job, to pinpoint what caused his cancer.

He has it. that's all they want to know. and how long does he have, can he still help his wife pickle the tomatoes this year. sweet old man with the aggressive daughter, we all comment, but hey guess what, if it were my dad in that tiny clinic examination room, you would bet i would be aggressive to the 24 year old looking curly haired foreigner doctor with the occasional blank stare (as she is trying to remember the name of that chemical so she can ask him if he was exposed to it.)

it is now 7:14. i meant for this to be a post about how my plans for the day got messed up. i guess my patient's abysmal news trumps my OCD (obsessive compulsive disorder) miseries.

off to the roasterie then. i seem to remember my marque-page (book mark) was stuck to a paragraph describing how most trials do not support the observed beneficial association or a role for supplemental beta-carotene in the prevention of lung cancer. 
i mean that is great news for me, i hate carrots (and claim a deadly allergy involving terrifying dimensions of tongue swelling if i cohabitate with carrots at a relative's Christmas dinner table).

my joy of living in denial and my natural tendency to laziness also cling to evidence-based medicine to avoid searching for evidence supporting nature-based medicine.

but who knows, i mean God must have had a reason for making carrots, besides me using them as ghastly entertainment at the dinner table. let the poor man eat carrots and pickle this year's batch of tomatoes.
 

at the beginning.

i've been wanting to blog for years. ok maybe not years, but i'm Lebanese, i exaggerate. its in my dna and generational legacy.

i was encouraged to actually start (blogging, are you still following?) by a group of women i met while on a baby-hugging trip in Haiti. that turned out to be a God-meeting, prayer building, identity fixing trip. but everyone has been blogging about that so i will hold off for now.
having made that decision, it probably means i will be randomly posting about Haiti as thoughts and prayers fly in my heart. im not really a decision following kind of person. but im asking God to change my heart.

first post written 2 days after being back home.... (wait, am i home, are the States home? is the hospital home? but then when i talk about my mom, i say she is back home, i.e in Lebanon, Leb for the Initiates).

donc.... 2 days after being back home, sitting in pulmonary clinic waiting for patients whose charts have been looked up yesterday to not waste time (a regular demonstration of my OCD)

Joking around with acquaintances who know nothing of the world or the God I just met (or maybe i'm judging them to be like that, i mean, do i really reflect the God of love in my life?) 

sitting in pulmonary clinic, thinking about Haiti , praying to not loose sight of the Jesus i had my first date with after a prolonged long-distance relationship.

also planning the path to the previous level of fitness i was at before leaving. kicking myself for not maintaining the resolution not to binge on the remaining cliff bars and cereal bars from the trip. (i usually don't buy cereal bars - so i wouldn't eat them- duh. )so i have to taste every single one not to miss an exceptional opportunity : prelude on my relationship with food)

 

the degree of fitness has decreased by 50% in 10 days.

no numbers (in miles or minute) since i still can't live up to full disclosure and honesty. i like to pretend Jesus doesn't know. in this case it's ok that He does since He will not be making fun of my diminished VO2max. he would tell me to press on and that He's standing by the treadmill, ready to activate the emergency response system should my historical clumsiness slide off of the treadmill.

since while running, i'm following some dumb reality tv show that i didnt know existed because i don't have cable,(the purpose being not to watch dumb  tv shows, remember?). with the advent of hulu, that resolution pretty much died off.
 

anyway, what i meant to say, is that i ignore Jesus standing by the treadmill and get mad about how people might make fun of my minute by minute running victories. (approval idol anyone??)

i believe  this flight of ideas perfectly preflects my general brain of mind. and the vision for this blog but then again, I don't know where God will take it, and take me..

ps. this paragraph was posted multiple days after la redaction.  another case of inglorious procrastination