Oh Yeah...

For potential medical students or those already in a program:

Just remembered some advice I was recently given and want to pass on before I forget. It came from a surgeon I respect very highly - one of the sharpest and kindest guys you could ever meet. He said, of the things he uses today, he wished he had studied "bugs and drugs" better. That would be microbiology and pharmacology. Sounds like these are things we will need to know in detail when we are in practice, but may not have a ton of exposure to. It makes sense that we will need to be better able to comprehend the things that are coming at us and how to employ the tools to deal with them, but he says it's easy to get lost in the minutiae. Just a heads up.

Christmas Thanks

Our lives consist of the relationships we have with one another.

Relationships by definition, I suppose, are described by the way we share things, the way we give to one another and accept things from one another. That’s how we connect. I am convinced that our lives will be measured in the sacrifices we have made for one another. To that end I am certainly thankful for where I am right now. I’ve been given much more than most.

One of my best gifts is a wonderful wife with a huge heart. She pours herself out for her children and friends, for the kids she teaches, and for me. There is a challenge with big hearts, however. They are like the large vase in the middle of the table that is easily bumped by the careless, or easily stolen by the greedy. I think most of us tend to shrink our hearts down, so they are more manageable and less fragile. We try to fit them into our chests in order to keep them well-protected. Deep inside our rib cages. Closely guarded. So, I am thankful for Hillary’s example. Lots of folks have bumped her carelessly (myself included) or intentionally taken advantage of her due to their perceived need. But, she continues to love and to be a reminder that love must be what we are made of. I hate to think of where I would be without her presence.

Unfortunately, I haven’t had much time to share with her, lately. Or with Katy. But I’m reminded of the wonderful experiences we have had together. Trips we’ve taken across the country and to beautiful places. Shared moments are the stuff of life. Even the time I had with her sons. Much of it was hard. Some of it I wish I could do over. But, some of that time was pretty darn good, and I hope I made a difference for them. Indeed, we all illustrate our lives with the brushes we choose to paint with. I hope mine can be love rather than hate, compassion rather than coldness, and joy rather than misery. I hope I add color while I’m here.

Caring for others at the most basic levels has been a humbling wonder, and I am constantly learning how to turn myself upside down and give away the things that are most precious to me. I’m reminded of parents and friends, brothers and in-laws. I entrust them to their choices and to the creator that guides them. Before you misjudge me, however, know that I am no saint. I have to confess I’m not built this way. It’s hard for me to always be a nice guy (which is why some of you have noticed I am not…). Maybe that concept resonates with some of you folks, too. Truth is, I really have to work at it. I need reminders from the good people around me. I’m surely grateful for them. There I am being thankful again.

Of course, I’m thankful for the opportunity to go to this medical school. I fall somewhere around the 99.95th percentile when it comes to age. Way out to the right on the curve. Out of over 18,000 folks I started with, you could probably count students my age or older on both hands. I’m very blessed, very fortunate. I truly hope this will be another way for me to really learn to give away both the parts of me that I already have and those I am able to create anew. Hopefully, I can leverage that capacity to create a greater effect.

It’s been quite a year. Wishing you all the best you can be and all the joy you can know.

Home for Christmas

We are on Christmas break now. Two weeks of bliss for most of us. I must confess that I am tired. The last test was challenging, maybe even more than the previous. I went into it feeling less sure about what I knew. – You must understand that in medical school we cover a great deal of difficult material in a short period of time. We are essentially reviewing everything we should have already learned, and then they add icing on top of that cake. If you haven’t even been exposed to the material, it can be an uphill climb. I would guess we cover three or four times the amount of material you are covering in your undergrad courses in the same amount of time. For example, how long did you spend on the Krebs Cycle? A week? We spend an hour. And you have to know everything about it. Of course, we don’t… Most of us only answer about ¾ of the test questions correctly. Just understand that these are very bright people and very challenging tests. The bar is always being raised.

If medical training is on your horizon, I strongly suggest you learn all you can about the human body in the greatest detail you can muster. You won’t be able to learn the detail you will gather in the four years here, but you will need the base to operate from. And, I do emphasize the term “learn”. You must have mental access to this knowledge. Your recall must be crystal clear. You must do this with intent. You must realize that your patients will be counting on you to have made this effort. Very few people are actually willing to do this. It takes a person with a wonderful combination of desire, perseverance, ability and compassion. I hope that’s you.

From the gallery, I think all of this hard work and bar raising is a good thing. I truly can’t imagine any better way to become a doctor. We all need motivation, and this can be a very useful way for us to soldier on. So, bring all of the best equipment you can pack as you head toward this, though try not to be weighed down with the things you don’t need. Many times we have been advised this is a marathon. Pay your entry fee gladly (thankfully), grab your Gatorade every mile or so, stay light, be strong, and keep your eyes focused on the next marker. In the end, you will be amazed at how far you have come and what you know. Then you get to apply it. You will be blessed beyond your wildest dreams. Do well.

On Grieving Patients

Went to my Living with Life-Threatening Illness class today. The room settled down, and a gentleman stood up. As he began to speak, I focused my attention and listened carefully as this veteran oncologist (a medical doctor) told the story of how his son had died suddenly several years ago. I listened as he told us of three years of grieving and painfully sorting emotions until his life felt livable again. His pain is not gone, and his emotions will likely never be entirely sorted, but he was present, and his story was, at that moment, ours as well.

Knowing that our interaction with patients would probably only occur over a few days or months rather than years, I asked him a question. “As future physicians, what we should be doing in those moments or days in the hospital when patients and their families receive news of fatal prognoses or watch loved ones draw their final breaths? What do we do when the wounds are raw and open?” And, this is what he said.

Just be there.

Don’t try to fix the problem. They don’t want us to try to fix the problem. Don’t tell them how things will be okay. They’re not okay. We need to take off the doctor hat for a moment because what they want is for us to open our hearts and come close. They need to know we care. We may not need to say anything. Less is probably better. Just soak up their grief and share it.

That’s right, future doctors. After 12-15 years of challenging training, the best you can do is sit there and cry. Maybe hug them. They have a lot of hard work to do, and this will help them begin to do it.

I really hope you’re listening.

Note: Permission was granted by the doctor to post his story.