A Comment Worth Mentioning

aacommentDr. Culpepper writes in response to my recent post, “Thank You, Doctor.”

Dear Mr. Mulligan:

Medicine is a calling and I suspect that you would have served beautifully in this profession. A real physician does not have a job as a doctor, he or she becomes a doctor.

In the process of medical training, one takes on a new life… well, that’s the ideal. Much of the challenges of our healthcare quagmire result from medicine becoming instead a business.  It’s as if church and state combined into a disaster. So it is with healthcare becoming a business. No one begrudged a well paid physician, our community supports that concept. It is instead the focus on business: the margins, marketing, middlemen, and entrepreneurs (some of whom are doctors) that has poisoned this noble profession. Those physicians that are still true to the calling are swallowed up by the toxic agendas and often not seen except floating below the surface.

Please continue pointing to those brave souls. They need the attention and a lifeline.

Dear Dr. Culpepper:

it’s nearly impossible to practice a passionate profession be it medicine, applied sciences, mathematics, art, performing art, music or writing.. aacommentresponse While these passionate professions are often enjoyed by many, they fall far outside the gated community called business.

Your irresistible “calling” metaphor is the perfect rational as to why men and women pursue professions which require the volitional abdication of varying aspects of their human nature like sensibility, acceptance, support or reason. But it also provides a pathway to genuine propriety and inclusion in one of the most reverent and honored professions on a global scale. It is a profession which treats humanity not borders or anarchy or tyranny.

Physicians transcend the pettiness of our human condition to oversee the miracle of humanity. I myself have heard a calling; to ignore convention and weave together language inviting the curious to hear the harmony of words. To others blessed to hear their calling, I recommend you listen to its invitation; yet most discard it as folly. True Callings  never quiet; they continue to knock, disrupting whatever future you planned with doubt and obstacles.; then one day an example of the difference you could make persuades your abandonment of a false life to step off the canyon’s edge and begin your true life.

If it’s fear that stops you, consider your patient’s eyes filled with fear and the strength they see in yours; passionate eyes sparkling with compassion and the quiet strength of a truthful life.

Thank You, Doctor . . .

There was a time, oh, not so long ago that friends Michelle and Peter and Nick would remember that I sat in a chair in a public forum and wept because I never became a doctor.  Friends recommended nursing, but on my first day my instructor, wearing one of those origamitized hats mentioned the adjective caring in hundreds of examples.  By the end of the day I’d grown so weary of the word caring I returned my shiny new mules and knew I didn’t have the dedication to the lives of total strangers simply because your unyielding care and uncompromising affection for humanity seemed as close to grace as most of us will ever know.

I’ve been very lucky to have been able to continue my 20 year relationship with my primary care physician.  In 20 years we’ve both learned a lot about each other: he more so of course, especially with those physician distributed x-ray glasses (and we thought they were some manifestation of a cartoonist’s imagination) because how else could doctors have the degree of insight simply by engaging in an innocent conversation.

I’ve been thinking lately that all these men and women who voluntarily step up to education and raise their hands so strongly, so surely, and so hopefully that witnessing that depth and degree of service to strangers must be one of the most moving examples of humanity stepping into a life where their life is secondary.

Why they do this happily, proudly, compassionately in order to be in the presence when most of us aren’t gussied up for prom astonishes me and thanks God for loaning humanity a few hundred thousand angels to leave Heaven and come to earth (by way of unimaginable hours pouring over manual after manual after manual and I can’t even remember 3 things to buy at the grocer’s), then share their own type and degree and experience of the comfort they know to be true once we let go and become fine examples of colorful balloons rising higher and higher and out of sight but not out of mind.

To all those selfless and defenders of the weak or ill or mentally compromised or children or any other of the millions of disenfranchised a mere thank you will never repay your kindness. But maybe God’s set up a 401(k) for you in heaven.

 

 

When I Was A Boy, A Doctor’s Insight Was Law

 

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When I was a child and was literally dragged to Dr. What’s-His-Face for an annual check-up (less a check-up and more a ritualistic cadence of tsk, tsk, tsk’s) as he poked and kneaded and cold-handedly fiddled with my . . . which backs away from coldness . . . and shy’s away from evaluation like a cub scout whose self-built car elicits jeers from his Scout Master (who also happens to be his dad).  The snap of gloves and odor of soap which resembled anti-freeze gave the doctor time to compose his subtle and sensitive conclusion:  “He’s too fat and getting fatter and his fat is hiding his . . . which, for sanitary reasons may require the removal of . . . which was when I buckled my Indian Beaded Belt and disappeared until hours past dusk when a neighbor found me shivering beneath the front porch.

That incident was a painful secret which I’ve carried on my back for fifty years and continues to cause retreat when doctor’s or lover’s reach out.  Such a sad burden to carry because of one unsympathetic phrase from a stranger who had no right being a pediatrician.  I often wondered how he treated his dogs.

My mother’s ignorance and prostrating to figures of authority always meant that any run-in with any adult possessing even a pinch more aacopauthority than her resulted in stern and week-long pain.  Just what exactly did these arrogant and sadistic adults possess that was never crossed?  They had been appointed to their position because of educated insight which was never, ever, EVER questioned..

Which, of course, perpetuated a multi-century tradition which has continued even to this day.  Most doctor offices have a small-framed notice somewhere above their “All services must be paid TODAY!”  reminder which reads something like,  “My profession hasn’t been questioned or challenged in three hundred years, so don’t try to be the first today!”  And in you go to be examined, quizzed, and questioned only to receive a prescription scribed in ancient Egyptian and an “order” for physical therapy.

aaangryguyDo I sound somewhat angry?  Of course I am!  Doctors get paid enormous salaries yet complain about the escalating costs of malpractice insurance.  Malpractice insurance exists because professionals are trusted and believed and paid.  And for this degree of faith we get an educated guess of what might be ailing us.

But this is what I’m REALLY angry about: Two doctor’s at Froedert Hospital assured me my brother Rich did not suffer a stroke based on a CT scan.  It was 48 hours later when I insisted they perform an MRI.  Voila’!  A clot in a vein feeding the occipital lobe (responsible for eyesight).  Because of unconscionable arrogance my brother is legally blind while these two doctors suffer NO consequence.  Upon discharge from Froedert, I was told that Rich was totally blind due to A) The Stroke and B) A severe seizure two days later.  I made decisions based upon the information told to me by staff in the Stroke Unit.  And guess what?  He isn’t blind!  Albeit his eyesight has been significantly compromised, but his field of vision is approximately 17″ in diameter!  And the staff at Froedert?

And the worst example of guesstimating occurred this past weekend when Rich suffered a severe heart attack.  The errors in order of aapuzzleddocappearance: A) Someone at the acute rehab facility removed his DNR bracelet, yet never informed the paramedics that he had a DNR order in effect; B) The paramedics, unaware of the DNR order, couldn’t inform the ER staff;  C) When Rich went into arrest they performed heroic measures to yank him back to life including five minutes of chest compressions resulting in several broken ribs and the insertion of a temporary pacemaker to maintain his heart rate (why didn’t anyone call me while they repeatedly beat Rich?  They called me after!)  D) An ICU doctor called me and informed me that the ER stepped beyond Rich’s wishes and now, NOW I’ve got to decide if and when we reverse their . . . their, what . . . their adrenaline infused jump to action?  And when YOU do decide he will . . . be gone.

For nine hours I held firm to Rich’s wish: DNR. And I would honor his wish just like I’ve always honored him. And I aastoplightwouldn’t allow my own emotion, hope, or desire to shake my resolve. I spent nine hours picking up strength like a child picks dandelions. And upon my arrival at his room in the ICU he was semi-conscious, breathing on his own, and occasionally howling in pain as he coughed with broken ribs. The equivalent of The Cuban Missile Crisis was over and Rich, contrary to what the ICU doctor emphatically informed me, was alive, on his own, without my intervention. And even though he’d crossed that line, he’d come back, I think, just so we could laugh at the old, standard jokes as though it was the first time we’d heard them!

And those doctors? The heroic and uninformed professional, and the cardiac-specialized professional made two BIG mistakes and continue to work without consequence for their egregious and painful errors. Alas, that three hundred year old tradition continues.