Friday, October 29, 2021



Sitting in my car with the windows rolled up in the parking lot waiting for my clinic to start. A small part of me legit thinks I might run out of air, get light headed and pass out, maybe even die.  Don’t thousands of babies and pets cash out in locked cars every year?  Yeah, I know it’s mostly the heat but still.  And I’m a goddam doctor thinking nonsense like this.  People are always like, oh doctor this and doctor that and my doctor says and my doctor told me and I'm like for god's sake.  What if your doctor kept warning you about the dangers of low oxygen levels while you scarfed down Chick Fil A during your 20 minute lunch in your car at the office park?  You’d stay the hell away.  I wouldn’t let a guy like that come within 20 feet of me with a syringe.  Excuse me sir, kindly keep that cold ass flat diaphragm of a stethoscope off my bare chest.  This lady last night kept thanking me over and over.  Oh you saved him, thank you so much for saving him, I don’t know how you doctors do it.  By him, she meant her bachelor older brother who had been popping naproxen on the hour for the past week to self treat his trick knee and ended up blowing a hole in his stomach that I had to patch.  I was just calling the out of state phone number listed in his chart, just due diligence stuff.  She kept praising me and going on and on, profuse as all hell.  Lady, I just sewed it shut, ok?  I wanted to say.  Do you go this overboard for your tire guy when he plugs a flat?  Your damn dentist when he glues in another cap?  Your brother had the good sense to go to the hospital when he got tired of feeling like he’d swallowed a dozen knives.  Good on him.  He saved his own damn self. Everybody else was just checking boxes, closing tabs, showing up when called.  Lowest form of heroism, believe me. That’s the honest truth. Took me like 45 minutes and I was a total dick nearly the whole time to the guy running the camera, Andrey, this giant hulking mass of a dude from the Ukraine who plays hockey Sunday mornings in a men’s league at the rink where my kid used to play.  Andrey, Andrey, come on man.  Come on.  Keep me in the center.  Follow me out.  Come on man.  I need more from you.  This is a tough one. Andrey.  Andrey.  Like some bastardy old coach riding the ass of an insufficiently engaged backup linemen. I’m sure everyone in the OR was rolling their eyes.  Andrey never says anything. He’s got this gentle teddy bear mien like a friendly bodyguard who has to take shit all day in some Joe Pesci mob film. His eyes, though, sometimes get a little glassy with menace.  That’s when I tend to tone it down.  He’s actually ok.  Used to be a doctor in old Ukraine.  Maybe even a surgeon.  I’m sure he has moments when he imagines violence being inflicted on me.  Scrawny little Napoleonic me.  In any event, it ended up being a nice little repair.  Two layer intra-corporeal stitching.  Pretty slick.  This is like a memoir or something, I’m allowed to brag.  I’ll give myself that.  Not like I get off on it anymore, the surgery stuff, not like I used to.  A lot of people go through life without finding a single damn thing they’re decent at.  So I found one thing. I count my blessings for that at least.  I can whack out a damn gallbladder at 10pm in 20 minutes flat.  Now I'm like, big deal.  It used to wake me up, the surges of adrenalin.  Now I can do it in my sleep.  It just doesn’t light a fire for me anymore. The psychologist who runs my hospitals’ Physician Assistance Program (PAP) -- which, if we’re being honest, is a bald faced euphemism for “time out table for troubled docs who can’t come down off their assholery”--- tells me that disengagement and apathy vis a vis one’s own accomplishments is a classic sign of professional burn out.  I tell him I do, in fact, give a shit, I really do, just that it takes a bottle of 11 dollar wine and some background Chet Baker while I’m scratching out a few self pitying stanzas at night for all those old emotions and feelings to float to the surface. Like a batch of dead bodies tossed into a fetid pond the week before. It’s all still there.  That’s resurrection, my man.  Coming back to life.  In real life. All those dead feelings, all those frayed bits of human connection, every last shred of innocent self-becoming, long forgotten, drifting in slow currents deep inside you, like inky creeks trickling alongside some untended cemetery in the center of whatever the hell you want to call it, your soul, your self your spirit, the place where all your ghosts go, just waiting for circumstances to change so they can return to haunt you again.  Usually late at night, an infantry of faintly familiar zombies that you must let back in. This is the house of no locks. There they are. Populating your foyer, spilling into side rooms. Pretty soon there’s nowhere for you to sit or even stand. All the moaning and braying. You thought they had sunk too deep. That you were safe.  Well, surprise, here they are. Apparently, they get less dense the more time passes.  They physically can’t stay submerged. Most days, anymore, I see at least a few of them on the way out the door in the morning, hanging about near the coffee maker in the kitchen. It’s enough to make you feel like you're always walking three inches off the ground. I could use a little ballast.  No one ever tells you all your old ghosts come back to life.  Just like Christ Himself. Streaming in, right through that secret hole in the back of your head.  

Anyway, I’m probably being a little too harsh. It isn’t all that bad.  I won’t lie, I like the old ladies who come in after a week on the vent, half their guts in the morgue, and a long jaggedy-ass scar that I etched into them some witching hour several weeks ago, who tell me about their grandson at Brown or Dartmouth or wherever, how proud they are, who laugh at my dumb jokes.  I still get a kick out of shaking hands with the Andreys after a good case wraps up.  This realm where I am a person and not yet a ghost.  Yeah, I’m still down with it.  I’ll keep patching up holes. Reading Jim Harrison and Louise Gluck in my car at lunch with the windows up. Enjoying every last molecule of oxygen I have left.  


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