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Physician, Heal Thy Self

Mon, Jun 18, 2001 10:40AM -0800

It must be disconcerting to have 3 out of 4 of your immediate family members be in some sort of health care profession, dispassionately observing you while someone sticks a needle into your arm, letting fluids drip directly into your bloodstream.

There are reasons to be afraid about being in the hospital, but now I realize why the Truth sometimes needs to be let out in a controlled manner. It seems quite counterproductive to tell a patient about all the hazards of nosocomial infections, air bubbles in their IVs, drugs getting mixed up or the chances of the surgeon opening up the wrong knee while they are suffering an acute anxiety attack about their impending surgery. Live and learn, I guess.

So my brother is lying in a hospital bed, recovering from knee surgery, with one-click access to morphine, in terrible pain, and it's amazing how a little knowledge can sometimes make you delusional. Just because I know that pain is really all in your mind, that if they just sliced off all your dorsal roots from your spinal cord, you'd never feel physical pain again, doesn't mean that I can pretend to be immune to it, that I can force myself to be without pain. Even though your conscious mind knows that you'll be O.K. in the end, it doesn't mean that your sensation of fear and impending doom isn't valid.

But onto the subject of wounds. (It's kind of amazing how facile it is to write metaphors involving medical procedures...it's a little heavy-handed and obvious a lot of the times, but when you're as lazy as I am, it's nice to have a few shortcuts on hand...)

It's funny how all your knowledge and wisdom seems to go out the window when you're in terrible pain, mentally or physically. Like that time I thought I had meningitis because my neck was all stiff and I was extremely feverish, when in fact it was just salmonella and an ill-advised dose of anti-diarrhea medicine. (All the bad effects of opiates and none of the good.)

But I am trying to regather my scattered wits.

It's all well and good to think that someday I will recover from this mess also known as my life, that all of this will be just a memory, something to laugh about and tell my kids, but mental and emotional wounds are just as real as physical wounds. Despite heroic intervention, you will never be the same. That knee will forever bother you. (You will always know when the rain is coming, so I've heard.)

So what do you do? You have to try to get by as best you can. There are things that you won't be able to do anymore. This doesn't preclude you at all from leading a full life. You just have to adjust. No one wins against entropy anyway. You just make your best showing, play your best game with the hole cards you're dealt. Sometimes, just sometimes, you may very well be able to river a straight, pull down a flush on Fifth Street. You just better not be counting on it.

Of course, on the other hand, there are things to be said about surgical intervention. There really is nothing you can do about the initial injury... you've suffered it, it becomes a part of you physically, emotionally, and mentally. But you can surely keep it from healing badly. The hard thing to figure out is when you should just leave well enough alone, or when you should rebreak the bone, maybe reopen the wound and flood it with oxygen.

Can I live with this limp? (I'm still breathing, so there's still hope, right?) Would it really be worthwhile to bring me back to the operating room this long after the breakage, all the while emotionally terrorizing everyone around me who have so long ago moved on? Would it really be worthwhile when I know that there's no chance in heaven or hell that I'll be good as new, that everything could possibly return to how it was? I mean, yeah, there's a slight chance things might get better, but is it really worth it?

Well, medicine ain't no exact science. Like magic, the arcane art of wizards, you may know a few tricks here and there, but 90% of it is just observing, watching carefully. And being able to think on your feet when you realize your initial opinion (read: first guess) was wrong (and you will be, more often than not, wrong.) If it gets bad enough, I suppose I can always ask for help.

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