sadness

I am okay now, but sometimes I feel that the sadness of the hospital is going to consume my life.  I had two palliative care conversations in a row and one on the phone, and I could hardly breathe afterwards.  One family - healthy, functional, and grieving.  Another family - dysfunctional beyond belief, making bad choices in death as in life.  A third - alcoholic cirrhosis, grieving brother.

We don't deliver bad news because it hurts us too.  Stripping away someone's hope and believe in improvement is simply not something that I wanted to do.  Telling someone that his liver is not going to improve does not help the picture.  Why are you having us torture you?  Why do you want us - a bunch of young doctors - to rush to your bedside to "resuscitate" you rather than having your loved ones there as you pass?

It is a gift to tell people the truth and allow them to make good choices, but it hurts us.  It hurts me, the so-called doctor, who wishes my white coat would magically protect me from all the pain and tragedy of this job.

* * *

I have eaten of the tree of the knowledge of good and evil, and I know that I - and all of us - will surely die.  Was it worth it?  I feel that maybe I will never be the same person again, as I feared.  You will never have that sunny innocence that I once had.  We declare people dead as a routine matter of course.  We see the families crying, or putting on strong faces.  We see love and dysfunction and indifference in dying as in living.

Surely I must now go and do something good for the world.  But am I so hardened now that I have no more sensitivity to the "little" problems of everyday life?  Am I going to end up with that sadness and tiredness in my eyes that comes from seeing too much?  Am I going to lose my empathy, creativity, caring?

I don't think so.  I hope I am a better person coming out of residency than going in.  It can consume you - or refine you.  I hope the latter, but I feel that many of the good things about who I was before have been consumed.

I have left behind being a scientist for now, and that is simply how it has to be.  Being a physician is too all-consuming a responsibility to dabble in.