Why am I here again?

Perhaps because I don’t blog anonymously, or maybe for other reasons, I don’t write that much about my personal life. That kind of writing can be self-important, insipid, and boring. But it can also have real power. A number of the anonymous bloggers here describe the intersection of the scientific life and family life with powerful relevance. Still, that’s not my talent, and I don’t do it much. One of my med school classmates, when I showed him one of my first pieces, said, “that’s good, Pal, but how do you feel?” That has always stuck with me (thanks, S!), and it’s in that spirit, and not the spirit of kvetching, that I’d like you to know that doctors are human. Yeah, I know, no surprise there, but still, sometimes patients forget it, and more important, sometimes doctors forget it. Besides, since no one reads the blogs on Sunday, it’s a good day for self-reflection.

I come from a family of very smart people. Very smart—sometimes I feel like the village idiot (but in the best possible way). They are intellectually active professionals, all have advanced degrees, and many of them are musicians as well. Along with smarts, my family has been endowed with some unusual medical problems, so even the non-medical folks have used their formidable intellects to learn a little medicine. These are not “google scholars”—these are the real thing.

So when my family challenges me about my skepticism, I have to take it seriously, not just because they’re my family and I love them, but because unlike some of the vacuous trolls that haunt this site, they’re very smart and well-informed.

I have a number of good friends and family members with cancer. Is my hypertrophied skeptical sense depriving me of sharing with them “other ways of healing”? My sister, who is pretty good at reminding me that I don’t actually know everything, challenged me pretty rigorously on my medical skepticism. Of course, my wife and cousin had to help her out. These aren’t garden-variety challenges to my beliefs. A random blog troll can bring up the same canards and fallacies over and over, but when the people you love use good reasoning and good knowledge to call you out, you gotta take it a little more seriously. When the people you love have nasty diseases, it’s got that much more gravitas. Those of us who devote our intellectual resources to science-based medicine are often accused of lacking compassion, a charge I try very hard to avoid, not because it’s false (and it is), but because compassion is the great immeasurable, the ars longa in the vita brevis. Without compassion, science-based medicine might as well hand over the keys to the reiki shamans, the homeopaths, and other smiling quacks, because no matter how right you are, a doctor who lacks compassion can’t be an effective healer.

So I don’t tell my friends, family, or patients that they’re crazy for going to the chiropractor. I prefer to focus on communication, compassion, and maintaining a useful rapport (and of course guiding people toward rational, science-based practices). Thankfully, no one who knows me considers me an oracle of rationality. They respect my opinion, and that’s great, but they help me keep my reasoning skills honed. We were hanging out with some old friends the other night. They have a kid my daughter’s age (and nearly as cute). The husband and I grew up together, and his sister is a colleague of mine. And the wife has stage IV ovarian cancer. They’re good folks, the kind of people who you can just hang out with and watch the kids play, which is exactly what we did. It’s pretty hard not to question your own mortality when you friends are sick, and I need to thank her, at least in part, for helping me focus on what’s important.

If you have kids, you probably understand what I’m talking about here. My daughter is everything (well, not everything, but my wife knows what I mean). I work a lot. On the clock, I have twenty hours in my office, and 32 at the hospital—on the clock. It works out to be about 60-70 hours per week away from home. When I go to the hospital on the weekend, my kiddo comes with me. It might not be the greatest idea to have her around a hospital, but I need that time with her, and she loves going to the hospital to “see all of her friends”.

My father-in-law is pretty ill right now. I arranged for him to be admitted to my hospital for what will likely be a very, very long stay (if all goes well). When the nurses heard he was my dad-in-law, they said, “Oh! You’re Little Pal’s grandpa!” She charms everyone she meets, and everyone who meets her falls for her (so I imagine). I don’t want to spend time with my daughter, I need to. I simply can’t relate to dads who don’t change diapers, don’t play, go out to the bar when they could be hanging out with the kids. Every diaper, every bedtime, every meal is a treasure. I’ll be very sad when my daughter is too old for me to help her in the bath. I’ll miss the giggles, the crying, the playing. Of course, every milestone makes you proud, but I always long for the previous stage, wanting to hang on every second in the rocking chair. When she stops wanting her songs at night, I’ll be off to my room to cry.

I’d love to cut back on my work hours. I’m very fortunate compared to my scientist colleagues, in that I’m certainly paid much better, but economic realities being what they are, the 65 hour week won’t be ending any time soon. Medical school is expensive, and paying it back is a long, slow process, especially when the rust belt economy forces your employer to cut your pay. When the hospital announced that all doctors would have their pay cut by 10%, there was one important consolation (two if you count still having a job). Our pay cut saved the jobs of 250 other employees, and all of us have family, friends, and patients who are struggling, so we know what that means. A recent New York Times article talked about how arrogant and abusive doctors are scaring away nurses and endangering patients. All of us have seen these docs, and some of us have been these docs, but it’s still the exception. My interactions with hospital workers has not, of late, been listening to complaints, but accepting their thanks; thanking us for taking a pay cut to save their jobs.

So my daughter is learning a lot this holiday season. She’s learning about giving (as there are plenty of folks in this part of the country who need the things we no longer use). She’s learning about her neighbors (we went to a Christmas tree decorating party last night, and a Channukah party today), and she’s learning about mortality, a lesson I really don’t want to have to teach her. When we visited grandpa Friday night, she brought him a little stuffed animal and tucked it in with him. Nothing gives comfort like hugs and kisses from a smiling toddler. I know it won’t heal him as such, but I know it makes him smile, and before he goes under the knife tomorrow, he needs all the comfort he can get.