Tuesday, March 6, 2012

The Healer's Art

On the first day of Medical School, I shaved a dead man’s scrotum.  No one else in my anatomy group would do it.  It’s not something normal people do. They were trying to tell us that we were no longer normal people.  I didn’t believe them.  I kept sneaking looks at my cadaver’s face, wondering if he liked chocolate or had grandkids or had ever studied philosophy.

In the second half of the first year, some of us took an extra class; The Healer’s Art.  We sat in a circle on the rug or lounged sideways in armchairs.  We wore jeans and chewed gum. I still brought my laundry home on holidays.  I was going to join Doctors Without Borders as soon as I got through residency.

In the middle of the circle, a physician in a bolo tie read us a poem.  An anatomy professor guided us in meditation, sounding a small chime.  Meditation and poetry were my bread and butter, but this seemed so hokey.  We giggled and squirmed on the carpet. 

They asked us what we liked about life before medical school, about who we were before medical school.  I thought they were crazy.  I was twenty-two years old; surely I was a fully formed person; surely they could not make me something less.

Two years later, I participated in the torture of an old woman. 

Mrs. Beedle had been in the hospital for 287 days.  Initially admitted for pancreatitis.  Fifty-three procedures later, she had a colostomy bag and an open abdominal wound stretching from her belly button to her sternum.  It was covered with synthetic mesh and black foam and a vacuum apparatus designed to remove pus and digestive juices.  We were waiting for tissue to grow over the mesh, like shrubbery over the wire armature for a topiary. 

Mrs. Beedle had grown delirious, and her wrists had to be tied down because she kept pulling out her IVs.  That morning, I came with the team of surgical residents to change her wound vac.  We swooped in, pulling on yellow isolation gowns over our white coats.   

Her eyes found my face.  “Help me.  Let me die,” she mouthed around the suction tube in her throat.  She was NPO again.  Nil Per Os.  Starving.

Her hair was short and wispy around her face.  She looked like a bird.  Her skin was so dry and thin it seemed made of millions of microscopic feathers.  Her daughter had signed a consent form, we were to continue treating her.

I wanted to unhook her from all these tubes, rub lotion into her dry hands, stroke her wispy hair.  I wanted to wrap her in a quilt and read to her.  But I could not. 

Mrs. Beedle was going to die, and badly.  I could not go with her.  I had to stay here and learn to change wound vacs and check electrolytes.  I had to finish this procedure and then scrub in for an appendectomy and then try to sneak downstairs to the cafeteria to eat a banana.  I had to get a good grade on this rotation.  Most of all I had to stop feeling her hole ripping through my own stomach.

I was there in that hospital room that smelled of latex and bile, and that was the last place I was. I felt my eyes glaze over and a dullness come into my limbs.

I looked away from Mrs. Beedle’s face.  I cut the new piece of black foam to the right size. I set out the saline solution.  The resident peeled back the old bandage from her belly, and when Mrs. Beedle screamed and thrashed, I helped hold her down. 

I thought about the meditation chime.  How was that pallid sound supposed to help this?

When I was a child, a man once came to our door, asking to mow the lawn.  He needed money, he said, to buy formula for his new baby.  Mom said no, that Dad would mow our lawn.  I ran after him with all forty-three dollars of my saved allowance.  When I gave it to him, he picked me up and hugged me.

Now I think people like that will probably just buy booze. 

I’m not the same person I was before, because now I’ve got this hard, cynical exoskeleton.  It keeps those holes from wheedling into me, the cancer from seeping into my bones.  My patients look different to me, they aren’t like me.  Women with chronic low back pain who just want drugs.  Men with diabetes raging out of control who won’t take insulin.  Children born with AIDS because their mothers were too irresponsible to take their medicine.  I reinforce my exoskeleton with ways it is their own fault, of reasons bad things can’t happen to me: I obey dress codes, speed limits, open container laws, I make good food choices and keep my BMI in the healthy range.

Then there is rage.  I feel it in the back of my throat and in my fingertips and behind my eyes.  I am angry at them for suffering.  How dare they bring me their grief, their pain, their sadness?  What answer do they think I have for them?  I’m just some kid who has attended two and a half years of grad school.  Yet they cling to me, their needs suffocating and insistent. 

It’s an effort to come back to the surface, to quiet the rage, to strip down the chitin from my hard shell.  I study patience.  I practice making eye contact with strangers and thinking un-cynical thoughts.  I adopt an aggressive form of mindfulness, digging my fingernails into my skin when I feel the first prickles of dissociation. I meditate on vulnerability, on filing down my exoskeleton, on really listening. 

It will never come as naturally as it did before.  I am not the same person.  But here I am, in my white coat, and patients keep coming, thrusting their cares into my hands and expecting me to help, not roll my eyes.  And so I keep trying.

1 comment:

  1. You made me cry. But that's not necessarily a bad thing.