Category: Reflections on Life, Being Human, and Medicine

Reflections on a variety of topics. My hope is to stir your thinking and perhaps even give you things to talk about in regards to what it means to be human, about life in general, and often times on the practice of medicine.

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Being human Reflections on Life, Being Human, and Medicine

Layers

Sometimes when I am lying in bed trying to go to sleep, I play a game in my mind. 

I imagine that I am not in the bed in which I am currently lying but am in one from my past. With my eyes closed in a quiet and dark room there are no cues to defy the times and places that I am playing out in my mind. It could be true. “I could be there and then,” I muse to myself.

I could be home in Decatur. This one I often think when there is a box fan on. The sound of the fan brings back hot summer nights in a time before air conditioning and the soothing sound of the box fan blowing the cool outside air into the house.   Once again, I am a shy little boy, the youngest of six children, living on a farm.

I could be in our apartment on Blueberry Bank, our first apartment after we were married. There we learned how to build a home and a life together. I so enjoyed being with Sarah and having things to do with her. In my mind I picture the position of the bed and the closet. Sarah hid once in the closet to scare me as I came out of the bathroom. We laughed and laughed as I jumped so high when she popped out that I fell over on the bed. I can imagine Sarah late night propped up in bed, working through our budget. We didn’t have much “wiggle room” on my Navy intern salary. I also learned that while I can fade at night and get tired, Sarah seems to pop awake with a new energy in the late evening.  She is a true night owl! Once again, I am a newlywed, discovering new and wonderful things each day.

I could be in the house we rented in Pensacola on Cayman Lane. There I was in flight surgery training and while it was only 6 months it was a wonderful time. The bedroom was large. It was so big that we were able to put my large slate top desk on my side of the room. On the other side of the bed we had a beautiful cradle for our baby daughter Dorothy. I can imagine giving her baths with Sarah in the master bathroom. As first-time parents it was a 2-person job of course. I think about trying to feed Dorothy green beans, propped in a car seat on top of the card table on our back patio. Once again, I am a young and new father learning all the wonderful things that means.

I could be in Frizzell Drive. This was our home in Virginia Beach, and we had so many adventures there. Our second daughter Margaret was born there. I picture how we had the bed arranged and the girls’ room next door. In my mind I walk through the house again thinking of different times. We had a lot of family visit, and we loved seeing the historical places when they came. I can think of the 30th birthday party I put on for Sarah complete with church friends and all our neighbors especially Doug and Bunny and Paul. Once again, I am a young physician, husband and father navigating all of what that means.

This whole process can go on and on.  Sometimes it is Everglade. There we started in the large upstairs bedroom with our girls downstairs. Later after JJ came along, we moved the 3 girls up into the large space and we moved into a smaller bedroom downstairs. In my mind I am first in the one bedroom and then second in the other. I can think of Sarah’s parents spending Sunday and Monday nights with us. I think of the movie times down in the basement covered in blankets cuddling with my daughters. Once again, I am back to a different identity, now in internal medicine practice and enjoying my young family and the support of other family members. 

Another fun one is to imagine I am in my bed on the aircraft carrier. My room was below the catapult. I would hear rumbling as the plane taxied to position. There would be a roar of engines and then the catapult would fire. When the catapult reached the end of its throw it would bang and the walls would shake. This would be followed by a clanging sound as the catapult banged back into its starting position.  I would laugh as I tried to fall asleep despite all of this. Once again, I am back in time again and in this identity I am a US Navy flight surgeon, young and trim and jaunting around an aircraft carrier.

The past few years have brought our transition from Trillium (and a lot of wonderful things to think about there) to our condo and then to Remington. People ask if we miss our old home. We tell them it is about the people not the place. That is mostly true.

But in my mind, there are a lot of treasured places. 

Understand, there have been hard times and hard things also. But as I try to go to sleep, I focus on the love and joys from each place.  Recall, my game is about trying to get to sleep so it would only make sense that I would focus my thoughts that way.

I heard a speaker on Kate Bowler’s podcast[1] (I wish I could remember who) talk about the complexity of our inner identity.  She said that as we go through life, we naturally change who we are and how we view ourselves. But she said that it is better to think of our identities as concentric circles. Like the many rings in an onion, the person or persons that we were before do not ever go away. They remain within us and each phase of life adds on new aspects and dimensions to who we are.

This means that even though my identity today is different than my identity as a child growing up in Decatur, the boy that I was then is not gone from my life. It is just buried deep inside of me. It is still a part of me. 

The high schooler or college student that I was is still me.

The young husband and then young father is still very much me and a part of me. 

The energetic man with passion and vision who had so many things he wanted to do and see is still me or at least inside of me.

This is important for a variety of reasons:

  1. It is okay to move on.  We cannot hold to the past or try to remain stuck in the past. Life changes and it is okay to change with it. Who you are today, and your life today is absolutely different from the other circles of your life that define who you are. But those prior identities are still a key part of what makes up who you are. Moving on does not betray the reality of the past. It makes today easier knowing you don’t have to sacrifice or give up who or what you were before. It is still there.
  2. It helps to understand that who you are is a complex combination of stages and stories and identities. You are multidimensional. You are not a simple character that might be depicted in a novel or movie. You’re complex with many years and many complex layers that make up who you are. How you respond today does not fit just your current identity but absolutely is due to all the complex and wonderful layers that make you up.
  3. Enjoy the layers. My game of pretending is not just silly nostalgia. It involves an appreciation and a thankfulness for all the phases of my life and the good things and times that I have been blessed with. It seems a shame to have lived something once and just have it gone. Once is not enough for the nice things in life. Recognizing that they are real and a part of who you are does not betray the present.  If I allow myself to remember and enjoy the past it frees me to enjoy the now. Yes, there were the “good old days” but there is also the good that is now. I don’t have to live in the past. I can relive it in my memory and recognize it within my person. In that I can go out and live today fully. 

I hope that I am explaining this well enough that you can see the power in it.

There are times, places, events and people that have gone or changed. It is possible to get stuck grieving the fact that they are gone. But they are not really gone. Those things were real. They were valuable. Just because they are gone or changed cannot take that away. We do not have to sacrifice those memories to move on with the future. Those things are a part of me and who I am today. Today has new times, places, events and people. Knowing that I am not losing the past makes me free to open my eyes and enjoy today. 

You might think my game is silly. That is fine. But I can tell you that you absolutely are a complex and wonderful person that is made up of all your identities and the phases of your life. Today is a grand opportunity to expand further. 

What will today add to who you are?

[1] https://katebowler.com/podcasts/

Categories
Being human Reflections on Life, Being Human, and Medicine Reflections on the Christian Life Updates on my health

A Broken Tricycle, Things We Can Fix, and Coping With Things We Can’t

This is blog post I wrote over 4 years ago now. For one reason or other I did not post it then. Perhaps it was hitting too close to home then? For whatever reason I left it sitting on my laptop but it seems like I ought to share it.

A Tricycle, an Accident, and Now

I backed the car onto her tricycle. She had left it behind my car. I just didn’t see it.

I felt terrible about it. I was able to fix it. It was fine. She was fine. But oddly, even now, 20+ years later I still feel sick every time I think about it.

JJ is our youngest child. I called our oldest Dorothy, “Princess.” Our middle daughter Margaret was “Sunshine.” Our youngest daughter Jeannette (JJ) was “Happy.”  She was (and generally is) just a happy soul. For her birthday we bought her a brand-new tricycle. She loved it. She could ride it around the driveway and sidewalks in front of our house. Her sisters would ride their bikes around, and she would ride her tricycle. It was fun to see how much she enjoyed it.

It was Saturday and I was on call. I got called back into the hospital to see a new admission. I started to back out of the driveway. I hadn’t seen that she had left her tricycle behind my car. I heard and felt it when I hit it. I got out and saw what had happened. 

“It is ok, Daddy,” sweet little JJ said.  My wife reassured us that we would fix it.

It was not ok. I had just hurt the most prized possession of this sweet little child.

I went and saw my patient, and everything was fine at the hospital. My mind was however distracted. I compartmentalized for the moment but after I was done I drove immediately to the hardware store. I found some wheels that could work for the tricycle. I was able to replace the wheels and remarkably nothing else was damaged. It looked and rode just fine.

But oddly, that emotion and that moment still disturbs me even to this day. Just thinking about it can make me feel tense and unwell inside. What is that feeling? Why does it stick with me?

Perhaps it is guilt. I had the forgiveness of my wife and my daughter very quickly. I didn’t mean to do it. I should have looked behind the car but there was no malice and certainly no desire to cause harm. But I felt the guilt, nonetheless. It is interesting how others can forgive you, but you don’t allow yourself to feel forgiven. Guilt is a complicated thing. How odd if that is the emotion and that I would still feel it all these years later.

Perhaps it is fear of any harm coming to my daughters. I never realized what sorts of emotions would come over me when I became a father. I can honestly say that I never felt a need to cry before becoming a father. I was strong and firm. But after becoming a Dad I can find myself choking up at the most inconvenient times. We worked hard to provide a safe and happy home for our girls. We would do anything to prevent harm from coming to them.

I felt this same emotion one other time.

I was working putting a window box on the front of the house. My middle daughter Margaret was home with me. She came and asked me if I could get something for her. I was buried in behind the bush with drill and screwdriver in my hand. I told her that I would, but it was going to be a few minutes.  Margaret went back into the house.

After a few minutes, I put down the tools, slid myself out from between the bushes and the house, wiped my feet off and went into the house.

No Margaret.

I called and called and called. I searched the house and then the yard and then the neighborhood. My heart was pounding. Sarah was away with JJ.  Dorothy was home and she helped me look. I called Sarah’s sister Jeannette. She came over and started combing the neighborhood.

No Margaret.

By now I was frantic. I was terrified. I felt terrible. I started getting ridiculous. I checked and rechecked areas for her. I started checking closets and the refrigerator (she couldn’t fit in the refrigerator). I went into the back-storage area of the basement. I started looking at the suitcases to look inside of them.

When I did I found her.

She was asleep on the floor, hidden under some suitcases. My sweet little Margaret had gone to get a snack from the pantry in the basement. When she did she had pulled the door closed behind her. When she went to leave she couldn’t get the door open. I was outside and couldn’t hear her calling. She was scared being alone in the basement, so she went and hid under some suitcases. She fell asleep. She never heard us calling.

She was fine.

But I have never forgotten that time. The emotions I felt have also never left me. For the sake of getting a window box put up, I risked harming this person who was (is) so precious to me. How foolish.

Now I wake with a similar emotion inside. I am waiting on bated breath for an answer from my oncologist. The CT scan showed two lymph nodes. They are in my chest. One of them was not there 3 months ago. The other one was there but has grown. In my mind that can tend to have an obsessive tract of worry running in the background I am becoming increasingly convinced that they must be from adrenocortical carcinoma.

I have read as much as I can find on the ACC group on Facebook. I know some have had chemo (EDP-M they call it). I read through the side effects and thought about what it will mean for my life and work. Some have had surgery. This time my chest. I am speculating what that can mean, the recovery time, the call schedules, and everything else.

But the worst is the tricycle feeling.

My daughters have a father. He doesn’t have to be with them every day. He doesn’t have to do as much for them anymore. But he needs to exist and be there for them.

As I head into a meeting today, it is similar to where my mind was that Saturday when I went to the hospital to see my patient who was being admitted. I am going to compartmentalize (or at least pretend to.) I will focus on my work. But in the back of my mind I am anxious that I not do anything that will hurt these people that I love so much.

I am eager to get to the hardware store to buy the new wheels to fix the tricycle. Please can I get done with this admission and just get away to get to the hardware store? Can I know what the next step is to fix this? I will do anything to keep from harming those that I love. Can I take the worried yet loving and forgiving expression off of my 3 year old’s face?

Can I take the worry away from my 23 year old’s face? Can’t I fix this?

As I wrote this an answer came to me from my oncology team.  Wait.

They are going to present my case to the tumor board in 8 days. I am going to have to wait. (We are going to have to wait.)

The tricycle is broken. I am going to have to go to the hospital before I can fix it. But then they tell me that I can’t leave to fix it for a while.

Wait.

I don’t have a choice.  We will wait.

As I noted above, I wrote this in 2020. I have not shared it in my blog until now. The rest of the story from 2020 was this: The tumor board said, “We don’t know. Wait 3 months.” So we waited 3 months and had another CT scan. The lymph nodes were still there but were no bigger. We waited another 3 months and this time the lymph nodes were smaller. Three months after that they were gone.

So much worry. In the end everything was fine.

Perhaps I didn’t share the post then because I didn’t have a nice answer or lesson. I couldn’t wrap it all up in a way that would be comforting or that would teach us (or teach me) how to cope and how to live my life.  And maybe in that there is an even more profound lesson. I don’t know why those lymph nodes appeared or why they resolved. On a spiritual sense I don’t know why the Lord would have me endure the anxiety and worry that came from them. I just had to walk through living and not having answers even when I desperately wanted answers.

My biggest fear and my biggest desire was to keep my wife and daughters from harm. But as hard as we try, we can’t always achieve this. There can be so much pain in this world. My father said once that the happiest years of his life were when we were little and all asleep upstairs and he could know that we were safe.

I sat in our sunroom alone in the early morning hours this past week. I was in prayer for the grief and pain of some recent events in one of our daughter’s life. I could know the Lord was hearing my prayer but also know that He does not give us the immediate answers or solutions that we desperately want.

Bad things happen. I backed my car over a shiny new tricycle. I got cancer and then the follow up CT scan showed abnormal lymph nodes. Since then we as a family have been through a lot of other things. As much as I want to immediately run to the hardware store and fix all of the problems, I can’t.

I can’t.

We pray. We trust. We do our level best to help, to love, to support.

We live. One breath at a time, one moment at a time and then one day at a time. We live.