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

Nostalgia

I just had a nice dream. It was warm and cozy and I woke up feeling the same way. It was really nice.

I am trying to figure out the good feeling. I think it is nostalgia.

In the dream I am with some of my favorite people. I am of course with Sarah. My college roommate John was there. The girls were of course there. They also each had several friends there. They were all just enjoying being here with us and it was nice. Eventually Sarah slipped outside. The next thing I know I heard the lawn mower and figured that she must be mowing. I stayed in the basement and started going through the book shelves. I started seeing old pictures and I was happy to be there. I was reliving things. And I wasn’t focusing too long on anything. I was just enjoying the feeling. I was trying to sustain the warm feeling.

And then I woke up. As you can tell, I am awake now and not able to go back to sleep.

Can I recapture the feeling?

I think it is nostalgia. 

This wonderful feeling of looking back and reliving and enjoying the past. Nostalgia is a little bit like sweet and sour. It is never without some wincing and remembering the pain but also you remember the good times. More than that, you remember the people. It is like a sweet indulgence. Perhaps you idealize it all a bit but it is your nostalgia. Go ahead! 

I know that we should not live in the past. But I think there is real value in nostalgia. The people and the places and times should not be so easily forgotten. We are on a journey in life. And is it really enough to only live each experience once? Isn’t it nice to re-taste, to re-experience, to re-feel good times again?

As I had to deal with my own mortality it occured to me that someday I won’t be here. I have no idea when that is going to occur.  It could be many years from now but being human I know that we all have a 100% mortality rate. I want people to be a little bit nostalgic and have scenes with me in them. I hope that they can take some time and replay some nice scenes with me and others. I think I will do so now. I am going to go to my memory bookshelf and pull out some nice ones:

  1. My daddy: One day we were walking through the fields to go get something. I don’t remember what was the purpose of the walk but it doesn’t matter. We were in the field across from the Lewandowski’s. It was just me and my Dad. And he picked me up and put me on his shoulders. That is a treasured memory for me. It is wonderful. I have replayed that old favorite a lot.
  2. My mom: I am sitting on the hump in the front of the car. I lean over and put my head against her shoulder and I know that I am safe. I rest and fall asleep.
  3. Sarah’s Dad: We are driving a rented truck to move us across the country. Sarah and her mom are in the car and Sarah’s Dad and I are in the truck. He starts telling me stories of his younger years. I can tell that he is forcing himself to talk. I suspect he was under orders to get to know me and to keep me awake while I drove. Nonetheless I loved how he was putting himself out there and pushing so that he could get to know his son-in-law. It was really nice.
  4. Sarah’s Mom: She is sitting at her desk in her kitchen. It doesn’t matter what she was doing or what we were doing. But it was clear that we would always settle in and we would end up talking about all sorts of things. It was a place to talk and analyze and think. It was such a special place. 
  5. Grandpa D: We are picking peaches in the orchard. He is talking in great detail about some events from the hospital board meeting. I can still hear his laugh as he tells my dad the details. I didn’t listen to what the story was. But I loved hearing how much it meant to him and his laugh as he told it.
  6. Grandma D: I was clever enough to be the one to drive the fruit to the market. We are driving back from Bangor and she starts pointing out all of the homes that she visited when she was campaigning for my grandfather (he was a county commissioner). There was so much depth to her. She was not just a farm wife. She was passionate and took on causes (like the cancer society) and this was just one glimpse that there was a lot to her.
  7. Grandpa H: It was time to go home from their house. He would come up and hug us. His beard was bristly but I didn’t mind. I knew that he loved all of us so much. They would stand outside at their house and wave and wave and wave until we were so far away that we could no longer see them. And we longed to turn around and go back.
  8. Grandma H: “The faster I go the behinder I get!” This was the wall plaque hanging in her kitchen on Dunbar. And she would make the most amazing foods. The house was warm with her love and I can picture each room and relive being there. Even now I get warm inside just thinking about being in her kitchen eating her goulash with pepperoni or something in it and hearing her talk. 

See. 

There is nothing wrong with nostalgia in that way. I am not saying that I don’t want to live and enjoy today. But to live each experience only once seems to be such a shame. There are so many really really good ones to replay and to relive in my mind.

I have dozens that I could replay that happened with Sarah and the girls. Or friends in college. Or whenever.

What are some of your favorites? 

Categories
Being human Medicine Reflections on Life, Being Human, and Medicine

I Want a Vernors

People from Michigan know what Vernors is. For those of you that don’t, it is a ginger ale type of soft drink. It originated in the Detroit area and still has about 80% of its sales in Michigan. I will explain later the significance of Vernors.

It was 1989. I was a 3rdyear medical student doing my general surgery rotation. I was on the trauma surgery service. It was really very intense. I learned a lot. 

One of my earliest patients was a man who was seriously injured right at the end of his 4thyear of medical school. As an inexperienced medical student, it was kind of intimidating taking care of another medical student / new physician. He was intubated (breathing tube down his throat) and on the ventilator. His sedation had been lightened enough however that he would open his eyes as I came into the room to examine him.

Every day I would go to check on him and examine him. Each time he would look at me as I was in the room. I would talk to him, explaining that I was the medical student and that I was on the service that was taking care of him. I wondered what he was thinking. I was very anxious that he was silently critiquing my technique. Did I listen carefully enough to his lungs? Did I spend enough time examining him? Was I doing everything the way I was supposed to? Each time I entered the room it felt a little bit like a practical exam from our physical diagnosis class.

The pattern continued for days on end. I continued to try to do my best. Every day I felt anxious as I went into his room. Every day I wondered what he thought of me.

The resident paged me to tell me that he was doing well enough that he could be extubated (have the breathing tube removed). This would mean that he would be able to talk to us. I went to his room. I anxiously watched and waited while the endotracheal tube was removed. What would he say? Would this be the moment when he would berate my inexperience and my incompetence? Would he criticize my performance over the past several days?

I held my breath as the tube came out. He coughed and we suctioned his throat. We waited to ask how he was doing and to see what he would say. He had gone from a full and active and healthy life to sudden severe injuries. So much had changed. This was the first time to hear from him after all of his experiences.

Here were his words: “I want a Vernors.”

Really? That was it? Nothing profound? No commentary or criticism of me and my performance?

It was indeed it. He wanted a Vernors. The nurses had to make sure his swallowing was intact and then they would work to get him a Vernors. And so our care of him continued to go on.

There are some very important lessons buried within this story, however.

First, it isn’t about us (me). How ridiculous I was to think that this story had anything to do with me or my performance. Honestly. It had nothing to do with me. This wasn’t my story. This was his story. We absolutely have to remember this in medicine. We are indeed impacted by our experiences in taking care of patients. We have to find ways to cope and deal with the stresses that we feel. But the focus in our care of the patient is on the patient. It really is not about me and how I feel. 

Rana Awdish’s[1]is a physician who survived a terrifying sudden illness. In her book she tells about a resident who was focused much more on himself than on what was happening to her as the patient. The resident even came back not to check on her, but instead to tell her how traumatized he was by her near fatal experience. Reading her well written book you become shocked by the lack of insight of the resident. When you read it from her perspective it becomes crystal clear that while we all need to learn how to process, in medicine the focus is on our patients.  

So also, in life others are going to have traumatic experiences. When we see what happens to them it can impact us also. But I would hope that we would have the maturity to look at what is happening from their perspective. It is about them, not you. 

Are we mature enough to look beyond our own needs to be true friends to those who are in need. We of course might have feelings about what is going on. But our first focus should be on what they are feeling, what their needs are and how we can help them. 

It amazes me how easy it is for me to fall into selfishness whenever I am stressed. He wanted a Vernors. Of course. His throat was dry and sore. He was sick. He wanted what he had as a child when he didn’t feel well. He wanted a Vernors. That was what was important.

The second big lesson is about our false self-consciousness. I was so focused on what he was thinking of me. Frankly, the vast majority of people are not thinking about you. They are thinking about themselves. They really are not noticing us. We obsess and worry and fret about what others are thinking about us. But instead they are fretting and worrying and thinking about themselves! I do not mean to imply that we are all selfish all the time. But what I am saying is that I think a large amount of the time when we are worried what others are thinking about us, they are not thinking about us.

Relax. Be real. Stop being so self-conscious. People may not be noticing the little spot or pull on your shirt. They may not be noticing that annoying hair that keeps falling out of place. They may not be obsessing over the mismatch between your belt and your shoes or whatever it is that is worrying you. Most of the time they are thinking about something else entirely. And really, we would all be much happier if we would just stop worrying so much about what others are thinking of us and instead would just enjoy being with them. 

Sometimes, they just want a Vernors. They are not spending all of their energy judging what I am wearing or how my hair looks or grading my physical examination technique. In fact, patients are far more concerned with what is going on with their health, whether I can help them, and what I am going to say about them and their health than about me.

He wanted a Vernors.

  • Can I be a really good friend to you and think about your needs instead of my own when life has really thrown you off? There are times that it is not my story, but it is your story. Please forgive me if I sometimes forget this.
  • Can I be a mature human being and stop obsessing about myself and instead just accept you and let you accept me? Can we just be friends and enjoy our friendship?

Maybe that could just be a secret phrase we could have. “Maybe he/she just wants a Vernors!” Then we will know – it is time to think about things from their perspective. It is time to support rather than take. And we will also stop obsessing about ourselves. The hair out of place may not matter. They might be more worried about their hair that is out of place! 

[1]“In Shock” by Rana Awdish, https://www.ranaawdishmd.com