According to Shiva, life is in the end about fixing holes. Shiva didn't speak in metaphors. fixing holes is precisely what he did. Still, it's an apt metaphor for our profession. But there's another kind of hole, and that is the wound that divides family. Sometimes this wound occurs at the moment of birth, sometimes it happens later. We are all fixing what is broken. It is the task of a lifetime. We'll leave much unfinished for the next generation.
There are moments as a teacher when I'm conscious that I'm trotting out the same exact phrase my professor used with me years ago. It's an eerie feeling, as if my old mentor is not just in the room, but in my shoes, using me as his mouthpiece.
Pray tell us, what's your favorite number?"... "Shiva jumped up to the board, uninvited, and wrote 10,213,223"... "And pray, why would this number interest us?" "It is the only number that describes itself when you read it, 'One zero, two ones, three twos, two threes'.
What we need in medical schools is not to teach empathy, as much as to preserve it. The process of learning huge volumes of information about disease, of learning a specialised language, can ironically make one lose sight of the patient one came to serve; empathy can be replaced by cynicism.
My sense is that the wonderful technology that we have to visualize the inside of the body often leaves physicians feeling that the exam is a waste of time and so they may shortchange the ritual.
There is that lovely feeling of one reader telling another, 'You must read this.' I've always wanted to write a book like that, with the sense that you are contributing to the discourse in middle America, a discourse that begins at a book club in a living room, but then spreads. That is meaningful to me.
I was angry with myself because I still loved her, or at least I loved that dream of our togetherness. My feelings were unreasonable, irrational, and I couldn't change them. That hurt.
My VIP patients often regret so many things on their deathbeds. They regret the bitterness they'll leave in people's hearts. They realize the no money, no church service, no eulogy, no funeral procession no matter how elaborate, can remove the legacy of a mean spirit.
I joke, but I only half joke, that if you come to one of our hospitals missing a limb, no one will believe you till they get a CAT scan, MRI, or orthopedic consult.
We're losing a ritual. We're losing a ritual that I believe is transformative, transcendent, and is at the heart of the patient-physician relationship.
Another day in paradise' was his inevitable pronouncement when he settled his head on his pillow. Now I understand what that meant: the uneventful day was a precious gift.