Tuesday, January 31, 2006

Doomed as I am

And I set my heart to know wisdom and to know madness and folly. I perceived that this also is grasping for the wind. For in much wisdom is much grief, And he who increases knowledge increases sorrow.

I sat next to a very sweet couple at dinner tonight. They were probably around 85 each, and at any other time, I would have seen in them the glow that usually surrounds older people, the halo of wisdom, perhaps, and perhaps it only exists in my mind.

But I was starkly reminded of my own mortality today, in a discussion of a patient we're following who is 22 and probably has just seroconverted with HIV. Having dealt with the uncertainty and anguish of a needlestick only last year, I know something of what must be going through her head. Of course, she has gotten herself into this situation by sleeping with "at least 50" (her words) different people and so many of those in the last year that she had to write their names down to be sure. But she is still 22, facing a disease that will kill her, if a car accident or angry lover doesn't first.

And so, seeing the grace of age in two people tonight, knowing that this girl will not probably live that long, was more saddening than enheartening. No man knows his time, but statisically speaking, I'll be lucky to get that old myself. And I'm not even sure I'd want to. I have a warped perspective, working where I do, but in my mind aging is connected with a falling apart, a loss of autonomy, a steady increase in the impositions of others upon your dignity, privacy, and liberty. And I noticed that this sweet couple were eating at this resturant with a nurse, instantly identifiable from her pink cardigan over a flower-print scrub top. I noticed also the thousand little things medical training teaches you to notice. The man's atrophic quadriceps, his cane, and his resting tremor which disappeared with intention. The woman's marked kyphosis, false teeth, and thick glasses. I saw them as patients, or potential patients, rather than as just two more faces in the resturant. Although I didn't realize I saw this until I realized I had started mentally reviewing my BCLS training, "just in case."

It saddens me to think think that, just as I can't look at a phrase written in English without reading it, I now cannot look at a person and not read them. We are told, from day one of medical school, how much the experience will change us, but like Adam before he took the fateful bite, we have no idea what that change means. And having changed, it is difficult to decide whether you would do it again.

What is more difficult is feeling heartbreak with every patient. Sometimes they are funny, sometimes they are sad, but every time I sit back and realize what I am doing, what I am saying, and that they are there because they are in pain, I stagger, mentally.

You have done well to share with me in my affliction.

It is so easy to see the evil in the world. What is hard, and what is my duty as a Christian, is to see that evil and to work for the redemption of the world anyway. Like Beowulf facing down the dragon, I know the fight may claim my life, or my ability to see the world as "normal", or my rest, or a hundred other things I may want, but the fight is required of me. Of me, this is required, because I have the skills needed to accomplish it.

...All this consoles me,
doomed as I am and sickening for death...

I had a conversation with a good friend of mine this evening on this very topic. He is headed into seminary, and possibly to the ministry, and I mentioned that it is very probably the pain we both experience when dealing with the lost and hurting that fits us so well for these professions. So, though our callings cause us pain, still we may say with Job "though He slay me, yet I will trust in Him."

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