Juggling Brains

The always amazing bongi (I could also characterize him as shiftless, but not everyone would get it) has a post that led me to think about how doctors juggle patients in their brains, and how bizarre it is. The need to switch gears rapidly and completely among clients, customers, or patrons of one sort or another surely isn't unique to physicians. It's just that, given the stakes, with docs it might be the most jarring and otherworldly.

I've always tried to be mindful of -- and here I'm just making up a term -- "disproportionate impression." I walk into a patient's hospital room, or see someone in my office, and it may well be the most important and impactful minutes of that person's day. For me, it's one of many similar encounters, some pretty routine, others of horrendous import. I'm the only surgeon each patient has; each is but one of many for me. My words and reactions likely reverberate in each room for hours or days; but I must move on and reset my brain in a blink. Therein is the unworldly aspect of it: I can't, but I do. I mustn't, and I must.

"Minor surgery," it's said, "is surgery done on someone else." Seeing a surgeon is a big deal, whether for removing a harmless lump, fixing a hernia, or taking out half an esophagus. Everyone deserves a full measure of my attention. If I'm despondent over a patient dying in the ICU, or have a bunch of operations pending later, or am feeling like God's gift to surgery because of some tricky procedure done well, I have to attend properly to the person in front of me. To give a young woman news of her cancer, as bongi wrote, and only a moment later to see a routine post-op, or speak hernia. I guess that's what is meant by "compartmentalizing." I can't quite figure out if it's a good or a bad thing to be able to do it.

In my book, I wrote:

"There are times when I’ve thought that having been inside people’s bellies, touching them more intimately than they’ve ever been touched, knowing things about them that they’ll never know themselves—seeing their liver ferchrissakes!—I ought to stay at their bedside for every minute of every day they remain the hospital. Maybe take them home with me..."

I wasn't kidding. It's such a cataclysmic thing, operating. How can you operate on a person and just move on to the next case? It seems, to paraphrase and borrow from myself, "disproportionate attention." But it's obvious we need to; and somehow, in the process, we must not shortchange anyone. Including ourselves. I can handle it during the day. I just wish it could be turned off when pulling up the covers for the night, which is when the compartments seem to break down.


[P.S: For those of you who noticed and are wondering, I put up a video twice this weekend, and finally took it down because the video, about Barack Obama, kept becoming "unavailable." No hidden meaning to the disappearance, other than frustration.]