Welcome to the carnival
Resilient sphere of color
I throw you down but you only bounce back higher
I went into medicine partly due to heartbreak
I am surrounded by man’s medicine
Darling, though we’ve never met
Emerging from the emergency room, gasping to find my breath, I weep.
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.
To learn medicine, we spend years
Carefully cramming knowledge between our ears
Medicine is a hoarder’s paradise:
Constantly changing like the ocean, ever-expanding like the universe
In this shifting, growing, mass of information,
We hold dear each grain of sand and each countless star
Keeping them for future use
Welcoming new knowledge as it surfaces
There is always room for more at our table
On this long journey
between cadaver dissections and treating infections
between hand disinfections and anesthetic injections
may we pause for reflection, reconnect with our intention
may we cultivate connection, and to our loved ones, display affection
to our own needs, may we pay attention
may we vote in elections
and to injustice, voice objection
may we have predilection for self-correction,
not be afraid to change direction
may we not beat ourselves up for inevitable rejection
may we forgive ourselves our own imperfection
medicine is a practice, and we will never be perfect
but it is enough for us to be on this hero’s journey
Victory is every step