Category Archives: medicine

To Comfort Always

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Joseph Carey Merrick; Written by Michael Howell and Peter Ford, Narrated by Steve West

Sometimes a book affects you.

You already know parts of the story
Because it’s legend
And you know it’s sad
You just don’t know how sad
And you usually avoid such things

And then you see
That your favorite voice actor narrates the True History
And it’s also about the doctor
Who did good
By a patient, a lovely man
Whom the world had degraded and abandoned
So you decide to endure
Because you know the voice
And you trust it to shepard the account
With respect and dignity

And through the tragedy
That almost brings you to tears
Because how can people be so cruel
How can one person endure so much
And never harbor bitterness, resentment, or rage

Through all of that
The line that shines most brightly
That calls to your physician, helper, human soul
Is one you have not heard in years
When you should probably recite it yourself daily:

“To cure sometimes, to relieve often, to comfort always.”

These days people expect
Cure often if not always
Relief, when incomplete, disappoints

And Comfort, well, what does that even mean
In an age when physician-patient
Relationship is defined more and more
By transaction than by
True and deep human connection

And yet
Stories like this inspire, reassure and
Comfort us
Who do it for the connection
Because in the end
It’s worth every effort

————-

The True History of the Elephant Man: The Definitive Account of the Tragic and Extraordinary Life of Joseph Carey Merrick
Written by Michael Howell and Peter Ford
Narrated by Steve West

Due to horrible physical deformities, he spent much of his life as a fairground freak. He was hounded, persecuted, and starving, until his fortune changed and he was rescued, housed, and fed by the distinguished surgeon, Frederick Treves. The subject of several books, a Broadway hit, and a film, Joseph Merrick has become part of popular mythology. Here, in this fully revised edition containing much fresh information, are the true and un-romanticized facts of his life.

©2010 Skyhorse Publishing, Inc. (P)2012 Audible, Inc.

*I have no interests in any entities mentioned in this post


Medicine: The Science and the People

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The Quad, UChicago

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.

I Wish I Was Better For You

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Dear Person I Knew Before,

Looking back, I wish I had been better for you. When you knew me, I was young in the work. I was well trained and I understood the task in my thinking mind. But I had (still have) a lot to learn about relating to people who are different from me, people whose behavior I don’t understand easily, who rub me the wrong way at first.

I wonder if you felt disliked by me? I hope I was professional/amiable enough, but I know I wear my feelings on my face. My tone and words can be terse and even cold when I feel disconnection. I hope you still felt respected, attended to, even cared for. If not, I own it. I remember you because I knew it at the time–knew I was not my best with you, and yet I could not help it. I had only yet begun the inner work journey that has brought me to today.

I know so much better now. I am so much more self-aware, humble, honest, and accountable. I withhold most judgment now, unlike before. I engage with difference now in openness and curiosity, and take few things personally. I am so much more peaceful inside. Even when I get triggered these days, it’s much less intense and lasts minutes, maybe hours, instead of days. I am far better at asking direct questions to clarify meaning, calling out disrespect, and connecting better or amicably exiting a poor relationship. I don’t let things hang or fester like before.

If/when we meet again, I welcome the chance to reconnect and apologize. I want to show you how much I have learned and grown since you knew me, since I had my potentially negative impact on you. I was doing the best I could, with what I had, at that time. I still am. There is no substibute for experience and time.

Please know that my relationship with you, through its challenge and difficulty, has been the pebble in my shoe making me more mindful, more intentional. I thank you for crossing my path, showing me my deficits and calling me to address them. I hope my future relationships will show my progress, so that even if I cannot make direct amends to you, I can avoid doing similar harm to others. You have made me better.

Wishing you peace, and people in your life who show up better for you than I did. I will stay on my path, and if we meet again, I will smile.