Served

I became a doctor because I was medically underserved and wanted to be the change I wished to see in the world.

How young and naive

It seemed like a good idea at the time

I didn’t know what I was getting into, yet I took the plunge and signed up for years of poverty, anxiety, depression, and exhaustion. My childhood was excellent training for medical school and residency.

Because I was born addicted to stress, the transition was fairly smooth. Medicine proved to be a mediocre distraction from myself.

Now in my 16th year of formal education after high-school, it has been a long, hard road but my bootstraps haven’t broken yet.

With open veins, I invited all patients in need to partake.

Bring me your poor, your tired, your sick, your underserved, I called.

It would have been more appropriate for me to say:

Bring me your disability scammers, your self-serving, your manipulative, your misserved by a system that rewards dependence on the system itself- those who take no responsibility for their lives while demanding a life-long free ride.

To go into the field of medicine with good intentions, then receive lawsuits from the very same people who I was trying to help out of kindness and generosity makes me want to walk away from it all without looking back- I’m not in this for my own health.

I look for breadcrumbs, smoke signals, signs of hope that there may be protection against abuse of physicians and taxpayers. We feel the crack of the whip with every eroded paycheck.

Seeing the dependence of my ‘underserved’ patients on the system, I realize that being truly medically underserved was the best thing that ever happened to my health. Having no other option but to heal myself required that I be resilient and self-sufficient. Though I feel the crush of the medical un-system I work within, I will continue a life of service as I become ever more empowered by self-awareness. Though I put myself last and subsist on the leftover scraps of my time, I am my most important patient.

HPV

She told me that I have HPV

Human papilloma virus: the ghost of ex-partners past came back to haunt me
I want to line up my exes: the awkward horn-bag teens, the sex clients who shortchanged and stole from me, the abusive drunks, dramatic douchebags, one-night-too-long one night stands, and interrogate them whodunnit.
I will never know, of course
I may have gotten HPV from dreadful fingering, though it was probably from unprotected intercourse
Intercourse most likely undesired, as most of the sex I’ve had was unwanted by me
It could have been worse, at least it was only HPV which I contracted after riding bareback on so many dozens of dicks- I don’t know now many men have slept with me, but any one of them could have easily given me HIV, somehow I was spared
God, you were there
Kids, don’t try this at home
I tell my cervix to hang in there, I will make it up to you, treat you right
My ex-boyfriends aimed and fired at my cervix: the bullseye of my reproductive tract
Whether I got HPV long ago or from my most recent mistake, it is in me now and I may lose a piece of me in a LEEP if I don’t overcome this virus
My LEEP will be a leap of faith that I will regrow intact and complete, heal myself and still have the power to create and give my baby a better life than mine
That is the goal in all I do, even the abortions I’ve endured were to make a better future for my children than the hell I’ve lived through
So listen little virus, I am a strong, powerful giant and I will destroy you
I’ve survived too much to be taken down by the likes of you- senseless double-strand of DNA who has consumed too many of my sisters, lost to the sands of time
You won’t take me, the war is on and it got personal
There is no way I’m going to let one of those awful men leave a lasting lesion on my body
I am the supreme iron dragon goddess warrior, and my healing potential is infinite
My abilities to love and forgive and understand are among my many strengths
Watch out, virus, watch out
Instead of spreading you to someone new, I will melt you with my amazing body, take you down with my brilliant immune system
You will no longer struggle to survive, you will unite with the Spirit which flows through all things, and you will flow right out of me in peace

 

In Case I Die Early

In case I die early

From the virus which I will be in close contact with for the foreseeable future
Rest assured that I lived a full life
I was intermittently enlightened, and there is no higher bliss than that
It took nearly my whole life, but I finally found love
I enjoyed exquisite physical pleasures and the connection of sacred partnership
My mind was often filled with colorful visions and my heart overflowed with music
I wrote wild poetry which I shared only with you, and a great many other things too
If you want to remember my life, take a deep breath and know that you are loved by the universe, that you are love itself
If you want to see me, look up at the sky and trees
If you want to hear my voice, listen to the river and the birds singing
If you want to feel me, place your hand over your heart, and know that we are not far apart
If I don’t die early, I’ll keep creating my visions to promote vibrant healing
But in case I die soon, I wanted you to know that I go peacefully, though I long to see my family and turn my dreams into reality to share them with you
Take care of yourselves, and each other
Take care of Mother Earth
You are supported by spirit with every breath

Emergency Room

Emerging from the emergency room, gasping to find my breath, I weep.

I finished my last shift in that hell-hole, and I thought I would cry tears of joy, but instead I am crying tears of raw emotional release.
My patients called me an angel, but many of them were also angels to me- holding my spirit buoyantly with their sparkling eyes, a much-needed balance to my co-workers who seemed mostly dead inside.
Crushed inside the machine
Their eyes see only the screen
Their skin knows no fresh air or sunlight
As they toil day and night
In a crowded, chaotic space filled with alarms
Long ago, they replaced their charms
With rigid motions, mechanical minds
Without windows, they don’t notice the passage of time
When did they become so cold and bitter?
It must have been little by little
The fire in their hearts was starved of oxygen, their spirits wore away
I hope I keep my heartspirit intact, at the end of the day
Flashback to a line of gurneys in the ambulance bay
My attending grilling me, I didn’t know what to say
Broken bones and chronic pain
STAT CT to look for a bleed in the brain
Patients sustained on turkey sandwiches and diet ginger-ale
We wait on them, they wait for us, but we are all stuck in this jail
Trapped in a health care system which is systematically inhumane
No wonder so many of us don’t feel quite sane
My vision is blurred by tears
I’ve finished one more day in the middle of many hard years
Of sacrificing my life, enduring unfathomable strife
Just to help others survive another night
I want to get off this roller coaster, but I’m strapped in
Though I am sick to my stomach and deafened by the din
I return to my breath, breathe in new air
I have the rest of my life to move on towards
Tomorrow night, I’ll be back in the wards
With renewed gratitude, I leave this emergency beast
I walk past patients waiting to suckle the mechanical teat
Finally allowing room for my own emergency
My meltdown of tears isn’t enough to drown out the blaze
Which burnt me out long before today
I struggle to justify
Why I put myself in situations that make me cry

Pain

Pain and addiction.

I walk the line between giving too much and giving too little.

Rarely do I get it right.

Rarely do I feel right with myself when I prescribe opioids.

Knowing what lies on the other side of pain relief, knowing the train wreck waiting at the end of the line, knowing the lifelong prison sentence that opioid dependence brings- held hostage in our own skin, til death do us part.

Too many loved ones have died too young from overdosing.

How can I justify prescribing a substance that could suddenly and unapologetically kill someone I’ve never met, somebody’s beloved son or daughter, a curious teen who wanted to feel comfortable in their changing body, experimenting at a party, sampling the medicine cabinet

I want to feel comfortable too.

You complain of pain that you’ve had for years and expect me to fix in an instant.

You say there is a national opioid epidemic, but that you are not a part of the problem.

You say that tylenol and ibuprofen don’t work on you. You say that you need at least Percocet.

You say that other people have been prescribed more for lesser reasons.

You become bitterly enraged if I hesitate, and sickly saccharine if I yield to your request.

You shout that I wasted your time if you don’t get what you want. It kills my spirit to prescribe you opioids, because opioids are, in my humble opinion, the worst medicine- the most risk for the least benefit. With opioids, there is no healing, only the creation of an unnecessary problem without a solution.

It makes me want to leave medicine when I prescribe the medicine you beg for. I’m not practicing medicine for my health, so if I’m not ultimately benefitting your health, then what the hell am I here for.

Can’t you feel my pain? I’m so damn uncomfortable in this drug-dealer role.

If we reserved opioid use for more select scenarios, like only metastatic cancer or the immediate post-operative period, perhaps opioid dependence would be prevented for many who have yet to be born.

However, there are more drug profits to make and more blood to spill before change will come.

The whole scene makes me ill.

If I wanted to deal drugs, I wouldn’t have put myself through the brutality of medical school and residency. I could’ve just dropped out of high school and saved myself a lot of hassle. That might sound cold, but my pain ignites my fire. You didn’t ask about my pain.

I don’t want to be part of this system because I feel like I’m doing more harm than good.

I’m trying to do right in a world of wrong.

I swallow my words until they explode in a song.

Nobody hears my melody because I work all day long.

Sing sweet nightingale.

Our Job

Our job is to remember

As we bemoan each hard-won gray hair,

Our feet aching from pounding concrete hospital stairs

Our eyes bleary from early mornings and late nights

Our skin pale from days on end without sunlight

Our job is to remember

Behind every click, every key-stroke

Every beeper page, every flash of rage

As the patients we fight for are crushed by the system we work within

Our job is to remember

that the force behind all that we have done

and all that we will do

Is love

May reconnecting with that limitless force

Uplift us when we feel burdened

May it guide us when we drift astray

May it call us back when we don’t want to endure another day

When we struggle to see what our personal sacrifice is for

Rest assured, now and always,

Our job is love

Critical Care

In the Critical Care Unit,
Some are begging to live
Others are pleading to die
Most are just barely alive,
Dangling by a thread
Above their death bed

Under a tangle
of tubes, wires and drains
Armed with sharp needles,
We plunge deep into their veins
We listen to beeps and blips
Above the dry silence of their lips

We open their eyes
And shine lights inside
Inquiring if anyone is at home in this hide
Nobody comes to the door

This man isn’t yet 54
He’s a father of five
We’ve kept his body alive
But his brain is dead

His eyes no longer see
His lips no longer speak
His lungs will not breathe when we disconnect him from the machine
We’re told that his children arrived on the scene
with narcan in hand,
ten minutes too late

Holding the weight of this family’s tragedy in my heart
I blink back tears
I ask this man’s teenage daughter
If she has any questions
She does not

I have a question-
Why do we continue to lose our loved ones to addiction?
That’s a question with a big answer that includes all of us
Because it involves economics, politics, justice, lack of justice, pharmaceutical misrepresentation, self-medication, lies, truth, health care, being medically underserved, over- served and mis-served, greed, love, neurobiology, prevention, education, human needs, who we hung out with in high school, our shitty childhoods, and how often we were read to before the age of three, to name a few factors.

I have questions, and I have answers;
ideas to prevent future fatal overdoses, like using the Life Alert technology that has been around for decades which immediately alerts an emergency medical response team when it senses that a client has fallen, or the technology in my grandmother’s nursing home which senses lack of motion in a room, or the technology on your wrist that senses heart rate:

let’s give out fitbits like candy on Halloween, like we should be giving out narcan, and suboxone, like after-dinner mints, and let this smart technology show us how brilliant it can be: have the fitbit send out an alert when it senses things have gone astray, applying location sharing technology so that the person carrying narcan can arrive in time to prevent another loved one from dying. Let’s all carry narcan and enlist in a voluntary corps to be alerted to the overdose nearest to us, like uber-meets-amber alert.

Don’t tell me that it would be too expensive: it is already too expensive. What is a human life worth? I can’t put a price on it.

What does one day in the critical care unit cost?
$11,000.
What is one day on life support?
$4G.
The opioid crisis has cost more than a trillion dollars since 2001 and is estimated to cost another 500 million over the next 3 years- so put it on the fucking tab.
Maybe this technology is already in use,
I don’t know because I don’t keep up with the news
I’m too busy fighting on the front line between life and death
But I digress…this man’s life could have been saved, now it is too late. How long must this go on?
I have questions, I have ideas, and I have reflections

Here are some of my reflections, from Memorial Day, 2019:
May I have gratitude for all that my eyes see
May I choose wisely the words that my lips speak
May I dance to the rhythm of my heart beat
May I enjoy the gift of the present
My life is not always easy or fun,
But even on the rough days,
when I don’t want to get out of bed,
May I appreciate
That I am able to ambulate
May I savor each breath that I breathe without a tube shoved down my throat

And the next time I feel critical about my life
May I remember those who are struggling to survive
in the unit
With them in mind
May I strive to thrive
May I live my best life
This is critical

On-Call

Pagers beeping
Record keeping

Alarms blaring
Nostrils flaring

Amidst piercing bings,
The phone rings

I’m pulled up, down, left and right
Pounding stairs day and night

Juggling vitals, labs and EKGs
Uncertainty is my only certainty

Tasks crash like ocean waves upon my shore
One after the other, ever more

Sometimes I feel like I’m drowning, but I stay afloat
Every time a patient says ‘thank you’, it’s my lifeboat

I was blessed to find, while on call
A pot of coffee down a darkened hall

Cup after cup, I drank it up
Sometimes having it all still isn’t enough

I rest my eyes just before sunrise
Grateful that all my patients stayed alive