Yesterday:
I’ve wasted a Saturday afternoon, but it won’t be the last. But now that the days are longer, there are some salvageable daylight hours that weren’t there in the winter months, and I’ve dragged myself to a café in the Neighborhood of the Arts where people sit outside, lounging, smoking cigarettes and having aimless discussions in the sun. There’s an illusion I have about productivity and what it really is, because on days I set out to read a chapter about heart failure or kidney disease, my ratio of time spent reading to time spent on social media is maybe something like 1 minute of studying for every 10 on Facebook/Youtube. Yet now, sitting here reading Jack Gilbert and having no intention of studying whatsoever, I can’t help but feel like I’m doing something good with my time. I consider all the things I’m behind on, all the paperwork and emails I could be catching up on, but do none of it. Instead, I’m content to sit, go through old books and old lines already familiar to me, and let my mind wander.
It occurs to me that if my family were home today, I would’ve taken them to the park, and maybe we would have ended the day out here at the coffee shop regardless. I imagine Kealia scampering in and out underneath the tables and between chairs, picking up leaves and dropping them in flower pots while Angie claps and cheers. It’s an amazing thing, I think, witnessing a toddler learn in real-time about the world around her, and while thinking this, I’m hit with a sudden pang of regret as I realize I’ve missed almost two months of this already.
Do I even know what I’m doing anymore? In just a few short weeks, I become an upper level resident. A while ago, I was finishing a rotation in the MICU, and spent my final afternoon there doing three family meetings in a row—all of them delivering bad news. I capped it off by telling a man and his mother that their estranged brother/son would probably never recover from the brain injury he sustained due to his heart stopping multiple times in the emergency room. And although I had only met them one day prior, I sat alone with them in a small room and talked about their rocky family relationship with my patient over the years, how they eventually stopped reaching out but never actually gave up on him, then how he proceeded to use the last months of his life drinking himself to death, unbeknownst to anyone until he showed up at our doorstep in cardiac arrest.
Then came the moment when I couldn’t delay the bad news any longer, and had to tell them that we weren’t expecting him to ever recover from this, that all of our tests were showing poor brain activity, and that he would likely die if we took him off the breathing machine. I watched the mother turn to her other, still-breathing son with a look of terror, and utter a few breathless, fragmented sentences—
“But, he—well, what kind of tests did they—I mean, what does he mean by—oh my God—”
—before breaking down in her son’s arms, filling our small room with her desperate sobs. I remember watching them across the table, and for the first time this year, I felt myself begin to unravel inside—this was the 3rd family I had destroyed that day. I took a breath, wiped a hand across my face, blinked several times to clear up my completely blurred vision, and held the mother’s hand for the next several minutes while we slowly talked about what we could do next. Then I led them out of the cramped conference room back to the dying son’s bedside, and quickly signed out, thinking I would not do another goddamned family meeting for the rest of the year.
In retrospect, I should’ve let someone else do at least one meeting. Other people did in fact offer to help, but I declined, partly out of a feeling of responsibility to my patients, and partly out of not realizing that I had reached my limit. I suppose it’s easy to think that a strong sense of obligation makes you a better doctor, but the problem is the toll that obligation can take on you. At the beginning of the road to becoming a doctor, I think we’re all driven to some extent by a feeling of wonder about what the job entails, hoping and believing that the job is more privilege than it is burden. After certain struggles, we ask how we win back that sense of wonder and privilege about what we do.
I don’t know.
But about a week ago, Alice and Hai-Long sent pictures from Hawaii, standing on Kealia beach and pointing to the lifeguard tower about half a mile up from where we were almost pulled away to our deaths four years ago. I think back to that terrifying Christmas morning, then to the day almost exactly two years later when Kealia was born, and can’t help thinking that there’s a certain element of destiny in our lives. Not destiny in a sense where we’re saying we have some ultimate fate that we can’t escape, but in a sense that there’s a real purpose in how life unfolds. Not that God (if you believe in a God) is the seer and decider of your future, but that God helps you find the possibility in your future. That seeing the death of a tragic alcoholic, and the devastating love of a mother for her estranged son, perhaps heightens the possibility for us who witnessed it to be better to each other in the future.
My mother used to tell me that love carries an element of destiny too. “If it’s meant to be, then it’s meant to be forever,” she would say. I thought it was just her corny way of consoling me through bad break-ups, but now I wonder if this kind of belief is something I’ll be teaching my daughter one day. Faith being not just how we endure the world, but how we continue to find wonder in it. Maybe when she’s older and we take her back to the beach of her namesake, and tell her again how we were meant to live, how I was meant to be her father, how Angie was meant to be her mother, and how one way or another, whether a doctor in the MICU someday or just a young girl looking off into the sea, she was meant to love, and be loved.
16 days and counting. Come home soon, loves.
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