My Fears

8/20/2013 Recently, I was on a lovely 24-hour work binge and early during the evening I got a consult for a little old lady (LOL) with a bowel obstruction. She came in with abdominal pain, nausea, and vomitting. The CT scan showed that her bowels had gotten into some pretzel-forming shenanigans so bad that you could actually palpate the knot of bowel in her abdomen on physical exam. It almost felt like a tumor. She needed an operation. STAT. DR. TINYCAT! (please see picture at the bottom) :) The problem was that she was over 90 and demented. And unfortunately, the surgeon I had to work with does not have the best reputation. Now, I had to tell the husband that she needed an operation as soon as possible, because her bowel was at risk of dying since it was so twisted it was going to cut off its own blood supply. This risk was greater given the fact that I wasn't called about the consult for 12 hours while the patient just sat in the ER. If we held off on the surgery, her bowel would become ischemic, die off and bring her along with it. But she was very old with other health problems, and the surgery itself could kill her. The look on his face... I guess that's what distraught would look like. He kept asking if we could hold off on the surgery cause he thought it would kill her. But I had to keep insisting that even though she looks okay and isn't in pain, the risk of her dying without surgery was greater. He stuttered a bit and finally agreed. You got to do what you have to to save her. We go to holding and the husband is nervous as he shuffles around with his walker. I engage in a similar conversation with multiple staff members: "You ever operate with this surgeon?" "No, this is my first time." "Oooh... well, good luck." "Yeah, I know." Even the scrub nurse, out right whispered to me, "This doctor is going to kill her. I really don't want to be here for that. Worst surgeon I've ever worked with." Oh Baby Jesus, in your little onsie, please help. But, what touched me, was this moment: The patient gets wheeled from her spot in the holding area to the doors that enter the operating suite. The husband having had his back turned while taking to someone notices she's bein wheeled away. He so nervously starts rushing forward in his walker with fear in his voicing saying "Please, let me give her a kiss goodbye." Everyone stops the anesthesiologist from taking the patient away and the husband caresses his wife's face and kisses her forehead. He tells her he loves her and that he'll be waiting till she gets back. Everyone reassures him she'll be fine.... I feel myself lying to him when I say she's going to be okay. He smiled and just shook as he stood grasping his walker, watching the love of his life be strolled away. The woman he'd been married to for 70 years, we found out. LUCKILY, the case went well, and she's okay! But it got me thinking of how scared the husband was knowing he could lose his wife that night. She wasn't healthy healthy, but she was in a good state, doing well. He brought her in because he was worried about this abdominal pain and to suddenly find out she needed life-saving surgery that could potentially kill her. He wasn't mentally or emotionally prepared for this. No one could be. And within 2 hours of meeting him, I had given him his wife's diagnosis and was wheeling her away to surgery. All a whirlwind in his mind I'm sure.And I don't know, it made me think of things I'm scared of. How I haven't been afraid to lose something or someone like that. Someone whom you built your life with. At the time I was afraid of losing someone (as in the relationship would end, not her life) who I had been dating for a couple of months. I didn't want to lose the relationship and companionship that had developed. But the moment I saw the husband kiss his wife goodbye, it made everything seem so insignificant. Most of the time, our interactions with other people can be so petty and inconsequential, yet because it is personal, they tend to be exaggerated in its importance. She was on my mind and whatever would happen, we'd remain friends. In the end no big deal. Especially compared to this couple who might have just said bye for the last time. Seeing how scared the husband was made me just think about what I'm afraid of in this life. I'm afraid that as a surgeon I won't have insight into my ability. I hate to say it, but some surgeons are not good. They shouldn't be operating. They put people's lives at risk. No one should be operating for more than 12 hours, 10, even 8 hours, ever! Unless you're some plastics guy reconstructing a person from scratch, and by scratch I mean play-doh). I don't want the residents and nursing staff to express the same opinions about me as they did about the surgeon that night. It's not that they aren't smart, or know the steps, or care about the patient. I just feel like either they either can't accept that they fail as a surgeon, or they really just have no inisght and think "Well, that was tough and anybody would've had the same problem." If that ever happens to me, I ask my collagues to just break my hand so I can't operate (but not enough that I wouldn't be able to play videogames). I'm afraid that I may not be the person I should have been. Or could be. I sometimes look at my shortcomings and think they probably just extend from my lack of committment. I love to try and do so many things but I don't finish it. Its something I've been trying to work on, but with work it interferes. I want to write stories and be published. I want to make beer and maybe have a personal recipe. I want to continue making origami. I want to start playing the flute again on a consistent basis. I want to be able to do well in my career and become a safe surgeon. I want to finish the books I bought 6 months ago. Too much... but I want to change that. I cancelled my cable so I'm less distracted! So, baby steps! I'm afraid of things with many legs, like millipeds. Why, why so many legs?!! I only need two, why do you have so many??? Trypophobia. Enough said. http://www.buzzfeed.com/daves4/trypophobia-is-a-real-terrifying-thing-and-you-definitely-ha I'm afraid that I've hurt people I cared about enough that they don't want to see or talk to me again. And not because they don't want to talk to me, but because I made someone feel that bad that they had to cut me off. I'm afraid that my mother's adoration may be underserved. That perhaps any admiration from anyone in anything may be. That I'm not living up to expectations of others, or even of myself. Like I could be some kind of fraud. I'm afraid that the world may run out of bacon... or shrimp. I'm afraid of getting old. I see so many patients that have dementia and it's scary. Losing who you are completely. No memories. No emotions are stirred when you look at loved ones. No inside jokes when you chat with friends. Or becoming so frail and weak that you become a drain of your family and friends. You end up getting stuck in a nursing home, passed out in your wheelchair along with the other gomers. I'm afraid she'll walk away. I'm afraid of killing a patient. What if I forget to order something, or follow up on something? What if I forget an important step in a procedure? What if... anything?! It happens to everyone. It'll happen to me. I just hope I don't cry too much afterwards. I'm afraid I won't get to see the Northern Lights. I don't know why, but I feel like I have to go. I'm afraid that if this life is all we get, it gets wasted away with nonsense... crappy TV (which i now cancelled), mundane paperwork, irritating interactions, sleeping, staring into space, pooping, traffic, etc. I have a huge fear of missing out, and it's annoying because, sometimes I'm not really missing out on anything. Not every night out is epic. Not ever happy hour is epic. Not every party is epic. Some times, they suck. And they are a waste of money. And a waste of time. Time I could have been using to make origami, reading a book, or making a new delicious dish since I'm a chunky monkey. And to be sappy, I'm afraid I won't know when I've found the love I'm supposed to fight for. But if some of my degenerate friends are married, I can't fuck that up too bad. I'm sure I'm afraid of other things like the kraken, veggie burgers, or mermaids not being real.