Little Miracles

“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” Albert Einstein

“Miracles happen everyday; change your perception of what a miracle is, and you’ll see them all around you.” — Jon Bon Jovi

“The miracle is this: The more we share the more we have.” — Leonard Nimoy

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Sand and Sky, Summer, Ocean Park Beach, Maine

It is amazing when things in medicine work just the way they are supposed to —  it’s like a miracle.

When I take an antihistamine, I can breathe, and all the itching and sneezing stops. When I get an injection of local anesthetic, I can touch and poke and pinch to test that it is working — and it is. When I had an operation on my knee, an ACL repair, my knee stability was noticeably restored almost immediately, despite the post-op pain and swelling. I know these things work on patients, because books, observations, and experiences have shown me so. As a surgeon I get a kick out of operating on acute appendicitis, where often even in the recovery room immediately after surgery, the patient already feels better.

Yet I still marvel when I notice that this stuff is working on me.

I used to worry that as I entered the world of science, and then medicine, I would lose the ability to see beauty, to appreciate and be amazed and awed by the world around me. I worried that the more I knew about the details of how things worked, that I would not be able to see the glorious whole, the big picture, whatever that big picture might be.  Would the biology and chemistry and biochemistry and physics become like a filter on a camera lens, changing the way I would see these things? As I got deeper into this world of science and medicine, and then surgery, I was concerned that the experiences around me might overwhelm or blunt my humanity,  become mundane. Would I  become callous, detached, dispassionate? Would I still feel? Would I lose my faith, whether in people and humanity, or even more? Continue reading

In Harm’s Way, the Tradition and Legacy of Medicine

 “There isn’t any such thing as an ordinary life.” – Lucy Maud Montgomery

“Heroes are ordinary people who make themselves extraordinary.”Gerard Way

Clouds, Sunset after winter storm, Falmouth, MA

Clouds, Sunset after winter storm, Falmouth, MA

My colleague, Dr. Jesse Ehrenfeld, is currently on leave from his academic anesthesia practice as well as from his post as Speaker of the House of Delegates for the Massachusetts Medical Society to serve as Lt. Commander Jesse Ehrenfeld, Combat Anesthesiologist in Kandahar, Afghanistan. We all appreciate the sacrifice he is making, putting himself at risk and in harm’s way.

This sacrifice is part of the great tradition of medicine, a tradition that compels physicians into war zones to take care of the injured. It is the same tradition that has us traveling to help treat diseases for which we may not have a cure or even a name yet, or into areas near and far ravaged by natural disasters.

As physicians we imagine that the risks we take are contained in far-flung locations or defined by the time it takes to start the recovery from disaster. Taking these risks is part of our  commitment and calling, our responsibility. These are not every day, ordinary events and circumstances. They are extraordinary, and we rise to those challenges, to be extraordinary ourselves to take care of them. Then life returns to normal.

But what about yesterday, an ordinary crisp sunny winter day in Boston? When at about 11 a.m. a man entered the cardiothoracic clinic at the revered Brigham and Women’s Hospital and  fatally shot surgeon Dr. Michael J. Davidson  before taking his own life. The patients, the doctors, the nurses and staff in the hospital and clinics were in the throes of an ordinary day, no grand events planned in the city, no special holiday.

In short, it was — or should have been — an unremarkable day. Continue reading

Help the Doctor! When Systems & The System Fail Physicians

“Help, I need somebody! Help, not just anybody! Help, you know I need someone, help!” –Help!, The Beatles

“We are all here on earth to help each other; what on earth the others are here for I don’t know.”  W. H. Auden

After the storm, Falmouth, MA

After the storm, Falmouth, MA

Help the doctor!”

I’m sure most surgeons have heard this exasperated statement at some point in the operating room. It is said with that special mix of frustration, irritation, and sarcasm, usually when things aren’t going smoothly. When there is fumbling or bumbling, when the assistance, the systems, the help are failing, breaking down.

That same emotional mix is permeating medicine; this statement of exasperation could well be the new rallying cry for physicians.

Since I have started to write, and to post to this blog, I have also started to read even more of the blogs out there, primarily the medical writing. Part of writing is reading. As I write about the subjects and issues and events that touch my professional life, I have noticed that many of the same are on the minds of my colleagues. They likewise broadcast their thoughts to the universe. I am conflicted, I confess. I don’t know whether I feel a tinge of disappointment that my observations and epiphanies are not so singular or earth-shattering, being shared by others; or vindicated, to see so many with similar experiences leading them to similar observations and conclusions. We each are unique, though, with slightly different angles as we approach the topics, like the facets on a diamond. But, we are all on the same gemstones, and like the facets, reflecting more light, illuminating the stone. So I will claim my facet on the gem, and hope to illuminate. I add my voice to the chorus.

One thing that shines through so clearly to me as I read, as I go to medical meetings, or even attend any gathering involving two or more physicians, is the general sense of frustration. It touches all doctors, regardless of specialty, employment status, or even level of training or experience.

It comes as no news to observe that our capital-S System is broken, and that our lowercase-s systems are failing us. I think that the root of the problems with both share a common underlying cause.

These systems no longer help the doctor. Continue reading