Love and The Cardinal

Love and The Cardinal.

Hey, just cut the poor guy some slack.

The making of a doctor.  Four years of college, four years of medical school, followed by Residency (on the job training).  A project that takes 12 years to complete.  As a nurse in a teaching hospital,  I have had the privilege of watching over 70 doctors cycle through the residency process, from beginning to end.

We, as a society, expect Perfection from this doctor.  After all, it is our health we are dealing with.  Beyond that, its our health CRISES that brings us to counsel this individual.  Fear and intolerance of discomfort drive us to seek immediate relief.  The expectation placed on the physician is unrealistic and yet, persistent.  Society places a huge amount of pressure on the doctor.   They get it from all directions.

I’ve watched many of these doctors begin the journey of Residency hopeful, pleasant, sincere, kind and earnest.   Three years later (it actually starts to kick in at the end of the second year) that very same pleasant physician ends up curt, rude, disrespectful to staff and patient alike.   They’ve been utterly worn down by the process of becoming a doctor.

Now, people have many different ways of expressing insecurities.  Myself, I puff up like a grouse.  I get really big and almost psychically DARE you to challenge me.  It’s really embarrassing, even seconds after puffing up, I’m internally horrified.   It’s all smoke and mirrors designed to make you look away so you don’t see me sweat.

There are residents that start out that way as well.  One of my all time favorite doctors was just about one of the unfriendliness interns I’d ever met.  Yet,  by the time she was ready to graduate, I’d move heaven and earth for this woman, so deep was my admiration and loyalty.  She chose not to utilize her heart until her head ‘got things down’.  Pretty savvy, actually.

So, I’ve developed a reverse psychology theory:  Nice in the beginning= Rotten in the End; Not so nice in the beginning = Astounding in the end.   There HAVE been a precious few that have been consistently kind and respectful throughout.  Conversely, there have also been a few that just weren’t nice. period.   That’s the beauty of human nature, it’s widely diversified.

As a nurse, I am blissfully free to care about tenderness, compassion and kindness.   I am invested in making sure my patients are treated well.  Yes, there is also the same ‘perfection’ standards that apply to nurses.  I usually am capable of being 85-90% empathic.  Most times the remaining 15-10% plays out in a flat unengaged affect.   Yet, there are times when I too, am less than kind to a patient.

By the time they graduate residency, these doctors have seen hundreds, if not thousands of sore throats, GI upsets and chest pains.  What makes your chest pain any different from the 4 other chest pains they are treating at the same time is found in your EKG.  Heart attack or Not?  Yes or no?   Everything a physician does is determined by science.  Their decisions are not clouded by intuition, individuality or innuendo.  By the end of their residency, they’ve been successfully desensitized to most of humanity’s health crises.

However, nursing is all about compassion and caring.  It is an art form.  Decisions are influenced by science, but, mostly, we develop a sixth sense about our patients.  We spend more time with them.  We get to know what’s behind their physical complaint.  In short, our practice is based on humanity.Recently at work, we experienced the death of an infant.  This is always a heartbreaking experience and often takes a couple of days to recover from.  During one of the morning reports, one of the nurses was describing how relieved she felt to see one of the residents cry after the case was over.  “At least, now I know he is human”.  Heads nodded all around the room.  I remember thinking how awful it is that it took a tragedy like this to feel compassion for the resident.

The two disciplines could be complimentary.  Together, the nurse and doctor can be aligned to provide holistic care with the body, heart and soul all equally considered.  We, as nurses are expected to know the science of medicine and speak that language.  Physicians, it seems, can fit no more on their plate and a great many of them,disregard all things that can not be backed up by data. The language of the heart is often missing.

There is a hierarchy in medicine.  It is reflected in the education required, the training endured and the paycheck that accompanies it.  History has perpetuated the void between doctors and nurses.  Society places the doctor on a pedestal and that is a lonely place to be.  While I completely understand the stress involved with the making of a doctor, that understanding goes out the window when my practice is disregarded and disrespected.   I certainly believe that it has improved since the 1950’s.  However, we have a long way to go.  Furthermore, we tend to treat people similarly to the way we’ve been treated.  Doctors, are not treated well during their training and that disregard is passed down.  After awhile, they think it’s normal to speak sharply, not hold another’s opinion in esteem or demand rather than ask.   Case in point, were a nurse to speak disrespectfully to a physician, it becomes a performance issue in their yearly review.  Physicians, however, are allowed to speak any way they want, with no consequence.

As a society, we must take more personal responsibility for our own well being.  Placing our lives into the hands of human being is risky at best.  In a crises, we often have no choice.  However, so many of our physical concerns can be addressed within ourselves.  Patience, tolerance, personal adaptations are all methods which can be utilized to address these concerns.

As Providers of health care, we need to embrace the triad of wellness:  Mind, Body & Soul.  Together, as a team, nurses and doctors can do this.  However,  it’s kinda hard to sell the value of Mind and Soul, to an innocent group of individuals that are totally immersed in the Body for a decade or more.  Furthermore, the hierarchical system in place that exists in medicine is out dated and obstructive to collaboration.

We, as nurses, can begin by showing compassion for young doctors.  Yes, it’s very difficult to do this when there is hierarchy and disregard for our specialty.  However, being of sound mind and a receptive soul, it is clear that the integration must start somewhere.  Compassion if far more productive than aggression, disdain, and reactivity.  One alienates and the other embraces.

However, if WE, the medical community, want to make a difference in health care…. We must begin with ourselves, in our own front yard.   We must begin to embrace all aspects of wellness and provide consistency in that practice.

If we don’t practice it amongst ourselves, how can we pass it along to our patients?

Me?  I’m gonna begin by cutting that poor doctor some slack.  I’m gonna try to encourage a human connection and provide a positive experience with that.   It is only from visiting the ‘other side’ of my humanity, that I inspire to stay positive and hopeful about improving the health care that we provide.

Vitality

The first time it happened, I knew I was hooked.   The sweet taste of Vitality.

The route was Jackson Hole to Salt Lake City.  The car, a brown pinto.  It was snowing, I was 19 and on my first spur of the moment road trip.

My traveling partners were a couple of mountain chicks – Mary and Sue, from Minnesota who had migrated, as did I, to Jackson to ski for the winter.  We were all one year out of high school.  We were full of spirit, young, earnest and adventurous.  I gave birth to Kerouac in the passenger seat.

That first time, I recall being very aware that I was being defined.  A memory was being made I never wanted to forget. Tom Petty, Steely Dan and Lou Reed played to, and for, Me.  I had my first ‘born to do this’ moment.   I was far away from the small privileged New England town I had grown up in.  I felt freedom in my heart that night.  There was no fear, just possibility.

That was 35 years ago.  I’m a 52 year old woman, mother of two children with a successful career.  I own my own home, and my own car.  I live in suburbia.  Members of the PTA, its 3am… and I’ve just pulled in another road trip.

1230am.  Boston, Mass.   Frank made me a tall Starbucks with steamed milk.  Organic Sugar.  Michael Franti at top volume.  95 North and I am free.

1am.  Oh My.   Ventura Highway sounds good.  I think this is the ONLY time Ventura Highway sounds good.  Traffic is thinned out and the darkness welcomes my thoughts.  Here, is where my spirit starts to BE.  I can relax and melt into the music.  I wait for a moment to be marked, or lyrics to speak a truth that has laid hidden all these years.  I wait to be affected.  I’m a little disturbed it’s by America and Ventura Highway.

2am.  I text Miles, tell him his mama can still crank the tunes and travel the open road.  He texts back saying he doesn’t know what that means, that I’m crazy and that he loves me.  I snap him a picture of the dashboard lights.  I want this child of mine to know what dashboard lights can do for one’s soul.  Those are the lessons I want them to know.  He texts back that I should stop for gas soon.

2:30 Steely Dan.  Welcome to Maine, the way Life Should Be.  ‘Who’s to say how life “SHOULD” be’ I repeat for the 138th time.  Pfft.    I’ve switched to water and feel the caffeine zip through my veins.  Here’s where I think Keith Richards and I may have something in common.   I thank god that I opened my heart to music and that now, my memories are all backed by a kicking soundtrack.  It’s 1978 and 2012 all at the same time.  I’m just as satisfied in the youthful way that I was when I was a youth.

Joe Jackson backs a Manhattan Vignette for an excellent 10 mile stretch.  I light an American Spirit and tap into my bad ass, forgetting for the moment that I’m an emergency room nurse, A MOTHER!  Heck, I feel badder than bad.

Hey you, getting old before your time,  is it time?

Why can’t it stay?

3am, the car is trashed.  I’m chewing gum like a nut, or maybe Keith Richards. I get off the highway and  force myself to keep my speed down remembering the time I got pulled over with an 8 year old Janey asleep next to me.     That would be one of the lessons I didn’t want to pass onto my offspring, but, uh, I did.   I’m home and have a serious road buzz-on.

Tomorrow, or later today, I’ll roast the chicken, mash the potatoes and bake some brownies.  I’ll do a homework-nagging and  I’ll vacuum.   I’ll meld back into an adult, well, coz I am.

What makes you feel Vital?   You mama.  Yeah, you Mr. Guy.  Listen, being too old, being a mom or dad, being a professional,  believing in God, or driving a minivan should never stop you from keeping your spirit lit.

Get out there, crank the tunes, let it rip.  Go to a dark and skanky bar,  listen to the edgiest band you can.  Stay up past midnight.   If your body can still handle it, ski, climb, ride, bike, paddle.  You can mow the lawn, call your stockbroker or pick up the dry cleaning later.

I shut the car off; certain that whatever Rut was with me when I left home….. is now somewhere in Worcester, with Sly and his Family Stone.