My 22-year-old patient died today. He came in with what he thought was the flu-- high fever, nausea, headache. We suspected possible meningitis, ran some tests.... One morning we noticed he was talking a little funny, having a little trouble moving one side of his body. It was subtle but definitely there. Seemed like a stroke. Ran more tests. Didn't know quite what was going on. And what we found sucked. Cancer riddled throughout his body, unsure where the primary tumor was. Ran more tests, but, really, we didn't know what we were attacking, how long it had been there, how quickly it was spreading, what was going on. A week of increasing symptoms. More tests, less consciousness. Overnight the attending got some results and they decided it was lymphoma. This morning, he died.
And I complain about my hours? Jeez, it could be so much worse. I feel like we grow up thinking if you do everything right, things will be okay. And yet for so many people, it isn't. I have no idea of this patient's history-- if he was a good person, if he was a bad person, if he treated his body well or badly, although at age 22 how much can any of that matter anyway? And if I were to walk down the stairs to pediatrics it would be even worse, what did any of those kids do to deserve any of what they have? It's sad. It's crushingly sad. Which is why we're supposed to get used to it and see it as routine and move past it. But virtually every patient comes in with a family, comes in with people who care about them. For them it's not routine, it's not ordinary, and it's not something to move past. It matters. It matters more than anything.
And then the next day the families are supposed to go back to work, go about their lives, move on. Is life just about alternating between looking forward to the high points and getting past the low ones? When do you just get to *be*, without looking forward or looking back? We spend all of residency with an eye on what's next, very few people come in thinking they're here for the long haul, it doesn't feel like "adulthood," it just feels like another stage along the way-- college, med school, residency-- but maybe life is just that way, nothing ever feels permanent, you're never finished having to think about the future and having to make sure you're doing the right things to get there.
Somehow I've jumped from my patient to me, and onto an entirely different subject. I'm tired of feeling like everything in my life is temporary. This job, this city, this hospital. But at the same time, I'd be scared if I didn't think of it as temporary. If I thought I would be here forever, from intern to resident to attending, here, for the rest of my life, stuck, in this hospital, doing this day after day after day. Not that this is worse than what a lot of people do. But day to day it's kind of the same. You round, you do orders, you write notes, you respond... and then back again. There's a reason hospital shows on TV are only on once a week, for an hour. That's about the amount of time it's exciting. An hour a week. More than that, and it's a job. An endless job where there are always new problems and you can never finish. You're never really finished. There's always something else to check, and if there isn't, there's always someone new coming through the door.
Sometimes I just want to take a nap.