One doctor’s day: Everything comes full circle eventually

Sometimes my day is like a book.  The first chapter may begin in the darkness of a self imposed corner as a phone call is made.  A voice, full with the thickness of slumber, answers unexpectedly.

“I think today is the day.”

No matter how many years I have been discussing death I still find myself using poor euphemisms.  The bane of medical school teaching, I often struggle with the directness.  “Your mother will die today.”  So cold.  So hard to muster the courage and keep one’s voice strong and confident.  I used to shy away from such dire predictions.  I no longer do.  Better to tell prematurely than not at all.

I pick up my stethoscope and jacket and move on to the next room, the next hospital, the next home.  And the memory of the fading elderly woman falls into the recesses of my mind.  These days are so full, the plot so complex, that plans are made, thoughts are compartmentalized.  Family called (check), Roxanol and Ativan written for (check), DNR/do not hospitalize (check).  There is nothing more I can do.

The next stop may be a hospital.  Where a leg is broken, or saliva aspirated, or hearts fail.  The clicks of the computer keyboard is accompanied by the ringing of phones.  Family meetings are carried out in hush tones in corners or conference rooms.  The rise and fall of a chest, a sigh.

I have an octogenarian to visit at home.  He just returned from the hospital after a pneumonia.  He still needed a few more days but was afraid to leave his wife alone.  Her memory is not as good as it used to be.  She had never stayed by herself before.  Fifty years of marriage and she had never slept without him by her side.

Work life quickly intermingles with personal.  I pick up the kids at their grandparents as I absentmindedly squawk into the blue tooth.  Most days there is some activity.  Violin, tennis, or Spanish.  The phone calls pepper my afternoon and evening.  At some point we find time for dinner.  Maybe a short jog with the family or a long walk.  Have you ever seen a jogger talking on his mobile?  That was probably me answering a page.

I might take a quick shower before  bed or watch some TV.   My phone almost always goes off when I am in the shower.  Almost always.

Around ten, I climb the stairs to the bedroom.  After brushing my teeth and hobbling into bed the phone buzzes one last time.  It’s the nursing home.  The prophecy from the beginning of my day has come true.  I give my condolences to the daughter and turn off the lights.  I can’t sleep.

It’s like a book, you see?  There is a beginning.  Then a muddled and twisted middle that almost makes you forget.  But everything comes full circle eventually.  I put my head down and jerkily fade into sleep.

The end of one’s day.

The end of another’s days.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion.

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  • Ron Smith

    Hi, Jordan.

    Being a Pediatrician, I have similar feelings but only at the beginning and not at the end. The children I’m seeing today, will probably not know or remember me as adults. I’m 56 and in 25 years statistically I may already have passed from this life.

    Most physicians I think have the same uncomfortable feeling when they talk of or contemplate their own passing as when they are discussing it with patients.

    If only we could really say ‘Physician, heal thyself!’ and it would be so.

    So the question then is, can we really ever be whole? If from the moment we are born, née conceived, we have a date with our own passing, then why struggle at all? Why do the right things? Why contemplate anything about a better life or improved human nature?

    Surely in asking those questions, we actually confirm that there must be something before conception and beyond our passing? Why is it during our life that the accummulation of things proves only temporarily to satisfy, until of course, the next new thing comes along. We ‘swing’ from one thing to the next like monkeys swinging from vine to vine or tree to tree in a forest.

    What ever satisfaction we get from this life is a mere shadow of something else beyond it which is unfading satisfaction. I think it is for that which we truly long.

    Physicians can never heal themselves until they come to grips with what is before and after this present life. We fall into two basic camps. Those who think there is nothing before or after, and those that do.

    I couldn’t tell from your post or from the others posts on your blog site where you stand, but since you have brought this subject up, it seems appropriate to provide some comment back.

    Warmest regards,

    Ron Smith, MD
    www (adot) ronsmithmd (adot) com

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