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Thoughts on the subject from Yehuda Amichai, myself, and others... Sometimes, Yehuda Amichai just says it right.. Like Our Bodies' Imprint Like our bodies' imprint, not a sign will remain that we were in this place. The world closes behind us, the sand straightens itself. Dates are already in view in which you no longer exist, already a wind blows clouds which will not rain on us both. And your name is already on the passenger lists of ships and in the register of hotels whose names alone deaden the heart. The three languages I know, all the colors in which I see and dream: None will help me. ---------------------------------- I walked a lot, mainly to escape tiresome mental gymnastics. I walked up and down the streets, searching for a lost moment in the smell of a jasmine tree that, ironically, I could never find again. That mysterious tree had an aroma powerful enough to stop both of us in our tracks simultaneously, and now I can never seem to find i...

Title: How I came to be a Family Doctor, Again. Part 1: The Indecision "Miss, you have such a beautiful smile." 'Aw, thanks sir.' It was then I realized I was smiling like a fool and didn't even notice.. "You from here, dahlin?" 'Yeah, just south. But I lived here for years, it's home.' "You sure don't sound like you from here!" I give my standard answer to this comment... 'True, not much of an accent, but don't worry I eat and drink like I'm from here.' He responds with a hearty laugh. Thirty lazy minutes, eight dollars, and six-hundred calories later I leave entertained, stuffed, a little drunk, and completely satisfied to continue my stroll down Chartres street. I sneak out the secret back alley from the bathroom in the courtyard. "Bye, Miss Emily. You have a great day. Come see me again soon, hear." And with that, I turn around and wave bye to my flirtatious waiter at the Napolean House with an eve...

In med school, I saw this graceful old southern lady. She had lung cancer. She spent her time sitting in her beautiful mansion on St Charles Avenue dressed up hat and all, protected from it all on hospice, waiting to die by smoking tobacco with her long cigarette holder. We didn't tell her not to smoke. I also remember an old 98 year old black man who had never been to a doctor until he finally went and found he had metastatic colon cancer. This guy was slowly wasting away by a window in the slums of New Orleans, where he grew up. His neighbors and family would routinely stop in and visit him. We checked his vitals, and he was surprisingly hypoxic. When we asked him if he needed anything, he said his pain meds made him feel better. Just please make sure there are enough, ma'am. That's all. We didn't strap an oxygen mask on or watch the numbers nervously with a continuous pulse-ox. We asked him what he needed. And finally, there was this one guy who was an ex-profess...

Held captive in the bowels of my community hospital in Utah over the past two months, I've been thinking about a few things I have learned about myself in the last year or so. Here they are if you're interested: 1. I'm not nearly as altruistic, optimistic, humanistic, or idealistic as I thought I was.. either that or I've just changed. I'm much more of a skeptical realist now. 2. I don't really want to be a family doc... this one has been a tough self-realization this year. 3. I'd rather not work than work. But unlike a significant portion of my patients, I recognize that I have to. 4. Jumping out of a plane is pretty fun. 5. I hate to owe money, but I think not having enough money is a really lame excuse to miss out on something. This has become a predicament in my life. 6. Utah is a beautiful, unique place, but it's no place to live. 7. I'm more of an east-coaster than a west-coaster, and actually truthfully westerners kind of bug me in a weird way...

I don't know if it was just because I was post-call on MICU and didn't sleep 1 minute of 31 hours, if I was feeling guilty about not knowing what to do with my patients and/or not particularly caring what was done to them (as long as it was after I left), or maybe because I just finished re-reading the House of God.... but something about today's rounds made me pay attention to what was being said.. I don't think any of it was as horribly intentional as it sounds written out.. because everyone is so jaded and exhausted and drained in the ICU that I don't believe they can be blamed personally. Actually, in fact both my attending and resident in particular are brilliant, amazing dudes, but penultimate assholes, and I just felt the need to share the actual words... I honestly haven't been able to sleep today without sharing this. So thanks for the vent. All of these conversations were had with sarcastic humor. I'm ashamed to say, Everyone laughed. Before you te...

Two tourists go into a bar. They don't know each other. Both are young and of different nationalities. He speaks some Spanish and decides to approach her. He invites her for a drink. She is alone and in town for a small time. In two more days, she will continue traveling. He will be in Antigua for one month. He came to work on his Spanish. The conversations flows as everything in the city: gently. They smile without effort and have more than one drink. Both are single and have two more days to define the end of this story. Independent of the decisions they make, for each of them, Antigua will be that night, that conversation, those laughs. Even when it is possible that neither of them will return to that city, they became the city for each other. The ruins are wounds that have not stopped recovering, warnings on the skin that turned Antigua into a city in permanent construction. For this reason, she needs her visitors so much, to exist again. The tourists come to Ant...

I had another slam-dunk affirmation of my decision to get away from all of this just this week. I have it every week, but here's this one. I spent a great deal of time this week on night float with this patient I loved and his friends. They're awesome. I loved them. The patient essentially got handed (during this admission) a hand of multi-organ failure with cancer on top of a previously generally healthy life. He decided to be DNR/DNI willfullly, understandably, as I would have done. He's now intubated. It was done while he was unstable and hypoglycemic... I'm so furious about all of it. I truly can't stand this anymore. Really. I'm too mentally and emotionally exhausted to fight this stuff, but I really want nothing to do with it on an emotional level. It's breaking me down. Not like," oh maybe when I'm not a resident I'll want to deal with this." More like, "get me away from this stuff that's raping my mental world." I ...