Friends, have I told you all lately how much I love my work?

Nerding out over the science is just so fun, even more so because I don’t have to be the one doing the research. I just get to benefit from it! That we can know the chemical mechanism of how hemoglobin’s oxygen affinity changes with altitude, how sodium and calcium channels work in kidney and muscle cells, and how caffeine and adenosine affect the brain–how amazing is that? And that neuroscientists like Adrian Owen have figured out how to communicate with locked in folks by putting them in a functional MRI machine, asking them yes or no questions, and having them answer by imagining either playing tennis or walking through their house–I mean how crazy awesome is that?? And did you know the father of modern scientific surgery started out as a body snatching anatomist? 

OH the science, I just get giddy about it–pretty much daily!

And in the end, it’s still about helping people–helping the person in front of me right now. The best way to do that is to apply all of that vast knowledge and expertise to the human I’m with today, in their current circumstances, phase of life, and psychophysiologic state. I get to take all of the science I can possibly comprehend and use it to help you, the unique individual. *sigh* *gawk*

I cannot do any of this without knowing you. How do I know you? I query and observe. I attune and attend. I stay quiet, I listen, watch, feel. I try not to interrupt. I ask open, honest questions, and I wait for you, your whole self, to emerge. I look and listen to understand your experience from your own point of view. I do my best to self-regulate, and not project my own judgments and prejudices onto you. It’s so much all at once–I have to be slow and quick at the same time, hearing, seeing, retaining both your output and my own processing, holding it all to let out with appropriate filters and timing–and I love it all!

You know your body and mind (to the extent that you can). I know the body, some of the mind, and a lot of science (as well as I can). You know some of your own patterns, I know some patterns from thousands of patients seen over twenty years. We can, together, apply our collective and collaborative knowledge and awareness to your current context, in service of moving you toward your goals. Only you can decide what actions are worthy of your time, energy, and resources; only you can reassess and alter those equations.

My wish for you is to have the fewest possible regrets at the end of your life, whenever and however it happens. How can I help? How can the science help? How can it not? How can science actually make it worse? 

Medicine is the practice and discipline of lifelong learning of the science, yes. And its core is about caring for people. We make the journey together, my patients and I. What do we share? Here’s my list:
Information
Interpretation
Responsibility
Respect
Privacy
Relationship
Power
Agency
Decision making

We are humans in relationship–with ourselves, with one another, with our environments. It’s all so much, so dense and complex. And yet in the room with you, talking with you, examining you, I can usually distill to one or two central concerns and objectives, for now and the future. It’s gratifying for us both, and it keeps us connected, strengthening our relationship over time and shared experience.

I can hardly think of a better way to spend my professional life.