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.

The Short Reach of 9-1-1

What does fifteen minutes mean to you?   To me, it’s a short walk with Jenni or the edgy, flinching time I endure, while sharp picks and mirrors and a fistful of rubberized fingers examine my mouth.

To a heart attack it’s pay dirt; to a stroke it’s a killing; to an overdose it’s long enough; it’s 25% of your critical hour.

It was the way he answered the phone and repeated “nauseous”  that prompted my intervention and a feeble attempt at reassurance, “I’ll call 9-1-1,” which began a 15-minute byzantine pursuit through a labyrinth of indifference, ignorance, misinformation, unyielding tenacity, irrationality, and finally the grossly delayed ringing of the fire department serving my brother‘s address.

In this age of instantaneous access to millions and millions of useless and the occasional entertaining tidbit of useless information, we assume that a federal infrastructure would be installed and activated and by dialing three simple digits you would be transferred to the emergency department serving your father’s address.

But there isn’t.  Instead you’re passed along with great indifference until, smartphone in hand, you’re barely capable of performing search after search of increasingly familiar street names and coverage maps and administrative offices which you call in desperation and quickly evaporating hope.

Fifteen minutes while your brother or sister or father or mother follow your misguided instructions based on years of same-city-9-1-1-calls.  Who would ever think that soliciting an emergency service would be impossible.  Impossible?  Really?  Impossible, while your brother or sister or mother or father sits alone in their home slowly dying.

Without question, the federal government should appropriate whatever amount of money it will cost to rebuild a one-city call center into a network of transferable calls to the exact city where emergency help is needed.  Please, spend less of our money on bombs which kill scores of innocent people in faraway countries and use it here at home for emergency call-centers purposefully designed to assure the caller that first responders are on route to your brother or sister or mother or father’s house to save their lives.

 

 

My Brother Rick (aka Dikes, Rich) Condition Post-Stroke

asstroke3Last Thursday, a few minutes past noon, I called my brother Rick in Milwaukee (it had become a ritual of sorts especially while driving), and he answered in an odd tone which gave me pause. He began to complain of escalating nausea to which I urged him to see his personal physician.  He failed to remember his physician or the terrible diabetic wound which almost led to amputation or his two-month in-patient hospital stay. I astroke1told him I’d call 9-1-1 and ask that he be taken to West Allis Memorial Hospital ( policy dictates patients be taken to the nearest hospital). However the paramedics discovered atrial fibrillation (fluttering heart beats) which alternately peaked and diminished and therefore paramedics informed me that they were headed to a critical cardiac unit at St. Luke’s Medical Center.

However, St. Luke’s didn’t have a bed open, so Rick was taken to Froedert Lutheran Medical Center. After tests and a CT scan the ER team began antibiotics to stave off a small area of pneumonia in his right lung.  Rick remained on the general medical floor until the results of an MRI showed he’d suffered a severe ischemic stroke (an obstruction within a blood vessel supplying blood to the brain) in the occipital lobe (at the rear of the skull and is responsible for vision). On Sunday afternoon he was transported to the Stroke Unit (one of just astroke2a few in the U.S.) where he was resting comfortably.

On Monday, June 18 Rick suffered a significant seizure which greatly diminished his short term memory and eliminated the peripheral vision on his right side.  I’ve visited and talked via telephone with him this past week.  The cadence of his speech has slowed, he’s practically immobile, he’s approaching clinical blindness, and finds difficulty in fundamental motor movements like holding a cup.  But as he told me earlier this week, “I ain’t going to be like this forever, you know!”

I’d like to ask that anyone reading this post to consider sending him a get well card.  I’m sure your sentiments would help replenish a hopeful spirit during difficult times.  For those of you who send cards, thank you; for those that haven’t, please reconsider.  Send your cards to:

Richard Didrickson
Froedert & Medical College of Wisconsin
5-NW Nursing Unit
9200 W. Wisconsin Avenue
Milwaukee, WI  53226

 

My Brother Once Said, “My Life Was Determined By Another’s Lie.”

A man will renounce any pleasures you like but he will not give up his suffering.

 

513Rick willfully shouldered a self-imposed burden his entire life.  Unsettled by our Dad’s violent outburst’s (routinely targeting our mother), he began to peek behind, beside, and beyond our parent’s staid alibi about their colorless and urgent courtship which usually quelled curiosities. Except for one widow that pursued, with neighborly caution, my mother’s dire dodging. “It was simple math,” he’d once said, “Simple math and the ordering of month’s to quickly calculate the truth. He was proud of his steely pursuit, wishing there was a merit badge for exposure of parental lies. “Then suddenly,” he said, “the whole enterprise soured.  The recently decoded shameful and moral secret they’d disguised as hushed urgency, longing, and the mid-fifties moral compass was, in fact, his birth which occurred  five months after their City Hall nuptials.

It was then, at that inconceivable denouement, that his conception was the root cause of bout after bout after bout of unbridled and disgusting epithets often followed by a round of brutish, physical taunts which, my mother learned too late, that if you retreat to the broom closet or the empty cranny next to the refrigerator, you raise your arms to protect your face like exhausted boxers stuck in a corner. Fear and submission killed my father‘s blood lust as though he’d been fed a syringe full of Ketamine.  Oh, but those few and far between times when her self-respect outweighed her self-preservation, her repressed anger putrified to man-slaughter.  She charged at him, disgust followed by anger followed by critical injuries helped to ignore his devastating kidney punches followed by multiple precisely aimed and explosive back-handed slaps which buckled her knees; by now, in his cold eyes she’d lost any humanity and devolved into the recipient of his fully expressed hatred for her.

My mother’s marriage, a litany of lies: loathing thinly veiled as affection; irritation disguised as intimacy; and an escalating and violent blame for Marge‘s moonless flight with their three children through thorn bush and brambles, and following her husband’s business partner who liquidated their company’s assets that afternoon.  Later that evening my father received a brief call from Marge confirming that all three children were safe and in her care.  And sternly warned my father that if he pursued them, she’d kill all three of them rather than spend another minute with you, then abruptly disconnected the line.  It was then that my father accepted that he’d been abandoned, ruined, and penniless.  My father was incapable of keeping his promises, especially when it came to monogamy whether married or single. But worse still was his continued punishment of my mother for Marge’s inconceivable disappearance into the thicket behind their home. Marge later confessed that it was his barefaced screwing of the nanny.  Who, coincidently, was our mother.

Rick witnessed just one of those bloodsheds and cursed his responsible birth as cause for these vengeful and sadistic rituals.  So he heaved the imaginary and backbreaking potato sack stuffed with the rubble of our mother’s self-esteem and character; up to his waist, hesitated, then at once swung the unbalanced sack up to his shoulder while tucking his short ageless frame beneath the load like a tire winch. From there he strained and distorted and drove the shifting load skyward until his swollen knees snapped open like a toy jack-in-the-box and steadied his load . . . for the rest of his natural life.

 

PAIN

apain

PAIN relentlessly reminds us of life;
PAIN is cruel, brutal, and inhumane;
PAIN cannot be proved nor disproved; much like many religious deity’s;
PAIN is private and personal and corporeal to you;
PAIN is isolation;
PAIN is an absent invitation and then another and another and . . . ;
PAIN strong-arms false confessions and prosecutes the innocent;
PAIN in prison is orthodox especially to insistent innocent’s;
PAIN is torturous;abodypain
PAIN is not contagious;
PAIN is in your head;
PAIN isn’t where you think it is;
PAIN is an expression;
PAIN might be masked by pills;
PAIN if unforgiving is chronic; disbelieved; every second of every minute of every hour of every day of every year of your life;
PAIN when chronic is a life sentence with little chance of freedom like the innocent suspect now inmate;
PAIN is mental, is physical, is reactive, is imagined;apainedemotion
PAIN is a taste of insanity;
PAIN is tangible unlike its abstract converse, painless, which slips by unnoticed;
PAIN alienates us from the painless and yet, PAIN censures the vague conjecture of painless;
PAIN painfully illuminates the oft overlooked pleasure of painlessness.