what has happened to the human spirit?

I walked into work today, smiling, upbeat and with a positive attitude. As I was sitting down to review the patient list on my service, my pager goes off. I read the text that stated something like, 'this is the 4th page I'm sending, the next time I am going to page the attending' all in regards to a patient's elevated BP. For the record, that was the first page I received so you can only imagine how the rebel and non-obedient inner-self within me handled such a proclamation. I calmly and promptly returned the page, letting the nurse know that it was inappropriate to greet me with such threatening remarks, which needless to say spinned into a heated dialogue or why else would I be sharing this right? Her page was wrong for many reasons, a few I'll share: #1 she was paging the wrong person #2 there were medications already in place for BP that she did not see and #3 she lied stating she paged me numerous times. It was a completely unprofessional interaction and had me fired up all day. See, in a non-teaching hospital this behavior simply would not be acceptable. Beyond that and on a deeper level, I can't seem to understand what has happened to the human spirit. I can't imagine she would treat a patient so disrespectfully, so then why me? This is clearly not an isolated experience, I've seen this repeatedly among residents, in particular the females. I just wonder have we as a society become so overworked and unfulfilled that we no longer find appreciation and meaning in the simple interaction among humans? Have we become so cold and distant that were are numb to others? See, I come from the perspective that we all are the same and one for that matter, so when you hurt another spirit you are actually hurting yourself. Perhaps this is all something limited to the hospital and residency and I'm just being dramatic, I'm not sure.

healthy.

here's a few of my creative ventures that I've come across through my detox, which is going strong. I have to say this is the healthiest I have ever felt in my life. My hope is that this becomes a lifestyle rather than just an experience.

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quinoa with zuccini & almonds

lentils with beets & herbs

chickpea, tomato & spelt soup

detox.

millet with black beans & vegetables

After a month of 'q3 call' (spending 30 hours at the hospital every 3 days), I can feel the accumulation of toxins throughout my body and fear the longterm effects it will have, which has inspired me to start a detox plan. My hope is to 'let go' of the intensity and expectations I have acquired as a result of my month in the CCU. I have found a great 28 day plan with a holistic approach aimed to cleanse the mind, body, and spirit. I cleared my apartment today of all processed foods and made this lovely dinner! I have packed my lunch, dinner & breakfast for my last call in the CCU and am interested to see how it goes...

rumi.

“Forget safety. Live where you fear to live. Destroy your reputation. Be notorious.”

I like this.

a patient's dilemma.

I took care of a patient last night who is 90 years old and pretty functional for her age. If that's not a blessing enough, she's also been married to her husband for 72 years now. Wow, right? This is something I feel we will be seeing less of as time goes on. I wonder what it must feel like to have spent that many years together.

She suffered a cardiac arrest at home, was resuscitated in the field and brought over to our CCU. She was found to have significant coronary disease (left main & 3 vessel disease) and severe aortic stenosis with bypass and valve replacement being her only option; however, given her age the surgeons were not enthusiatic in taking her to the OR--a subject I have many thoughts on. So, the patient and husband are left to make the decision of pursuing surgery despite the risks or accepting palliative care with medications. It seems for the rest of our lives at various times will be faced with difficult choices...this is something we simply cannot escape.

feel your own mortality.

For the past few days, I have seen so many young people come in with heart attacks. It's amazing how in one simple day your life can change. I had that experience myself in a different capacity several months ago when I had a needle stick at work. I watch people, some with no prior medical problems, others who are obese, smokers or alcoholics absorb their close brink with death. It's made me think a lot more about prevention than I already do. Our way of life is integral to our health.

Last night, I took care of a patient who collapsed at home after arguing with family members. She has an underlying abnormality in her cardiac conduction system, called long QT syndrome. She had a pacemaker placed several years ago and was lost to follow-up. A sudden catecholamine surge such as arguing in her case can cause a person with this underlying medical condition to go into V.fib arrest, which is exactly what happened to her. The rather sad and unfortunate circumstance in her case is that her defibrillator did not go off and that's because her 'battery' literally had no life. She was overdue for replacement of her defibrillator. In talking to the family, there was no reasonable explanation why she did not continue to follow with anyone. My thought is that she did not understand the significance of her disease. This likely could have been prevented, which is utterly disturbing and sad to me. She came to me intubated, on pressors and bradycardic...essentially very sick. She's only 56.

When we think of prevention, we typically think of preventing the onset of disease which in the medical world is called primary prevention. There is also secondary and tertiary prevention, which is aimed at treatment and preventing complications of pre-existing disease. This is something that has recently began to interest me, inspiring me to spend a lot of my time empowering patients with knowledge about their medical condition. My experience last night only confirms this need and importance. If I can impact at least one life, my efforts will have been worth it.

my current love.