thankful

I originally meant to update about the excessive eating and shopping I did over Thanksgiving break, but then something happened today that put everything in perspective. I had to come back up to Dallas a day early yesterday to see a patient today. While I wasn't dreading having to see a patient, I wasn't exactly thrilled to cut my break 25% short for medically-related purposes.

Though I knew before walking into the room that my patient had cystic fibrosis, I was completely unprepared for what happened in the next hour or so. For as much as I knew about the damn chloride channels and the 1 in 2500 prevalence and the CFTR del. F508 mutation and the pink-staining fibrosis on the glass slide; for as much as I was prepared for the clinical findings and organ failure; for as much as my history and physical revealed an almost textbook presentation of CF: I was shocked at how much this REAL person affected me. You can read and study for hours on end (and we do), but I didn't realize until today how much the words we study are only abstractions. We throw around all kinds of words for disease manifestations and don't even bat an eye when discussing terminal illness, yet somehow in the sterile safe world of the lecture hall and the carrels it all seems so far removed from humanity.

And then this afternoon, my patient broke my heart. He is only slightly older than me, but the CF has already progressed to advanced stages with multiple organ involvement/transplant. He looked much sicker than I expected. In the next hour, we discussed everything. Everything. I wondered if any of the doctors before me had had the time to learn about him as a person, not just his disease. He hadn't been able to finish high school, work, meet people his age, or experience a normal life. He spends most of his time these days watching TV at home, waiting to succumb to a disease that, years ago, already claimed one of his younger siblings. By the time I finished the history and performed his physical exam, I wanted to cry and felt stupid that there was nothing I could say or do to make anything any better. There was nothing that medicine could do to make anything any better, other than prolong his life and maybe quality of life. We can only hope to make a difference sometimes. Today all I could do was listen to him pour out his life story.

He loves Sean-Connery-era James Bond movies and "Law and Order." I know it would be inappropriate for me to go back and visit him in the next few days and give him a DVD or two. I know he would hate the "sympathy." And yet I can't stop thinking about him and the damn DVDs.

I hope I never forget what this feels like. I hope that the next time the sleep deprivation and stress get me down, I will remember that this is why I chose to study medicine. And most of all, I hope I remember to be thankful for all the blessings in my own life.