I still find the best way to understand a hospitalized patient is not by staring at the computer screen but by going to see the patient; it's only at the bedside that I can figure out what is important.
I was taking care of people my age who were dying. The constant feeling, hearing from them, was that life is transient and can end very quickly, so don't postpone your dreams.
Certainly when I got to medical school, I had role models of the kind of physicians I wanted to be. I had an uncle who, looking back, was probably not the most-educated physician around but he carried it off so well.
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.
Your job is to preserve yourself, not to descend into their hole. It's a relief when you arrive at this place, the point of absurdity, because then you are free, you owe them nothing.
This is my life, I thought...I have excised the cancer from my past, cut it out; I have crossed the high plains, descended into the desert, traversed oceans, and planted my feet in new soil; I have been the apprentice, paid my dues, and have just become master of my ship. But when I look down, why do I see the ancient, tarred, mud-stained slippers that I buried at the start of the journey still stuck to my feet?
In America, we have always taken it as an article of faith that we 'battle' cancer; we attack it with knives, we poison it with chemotherapy or we blast it with radiation. If we are fortunate, we 'beat' the cancer. If not, we are posthumously praised for having 'succumbed after a long battle.'
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.
The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.
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.
When I use the word 'healing', by that I mean that every disease has a physical element that we're very good at handling, but there's always a sense of the violation. 'Why me?' 'Why is my leg broken on the ski trip and not anyone else's?' And I think that medicine has done a terrible job of addressing that spiritual violation.