Friday, October 7, 2011


"Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart."

"Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on." 
- Steve Jobs

So, Steve Jobs died this week. I was never really an apple fanatic, but it is sad. I don't think I ever really sat down and thought about how much what he did changed the world. I mean really changed the world. Changed the way we communicate, the way we think, and the way we connect with others. All with some computers. Some people on the internet were calling him the Leonardo da Vinci of his time. I don't know if that is giving due credit to da Vinci, but only history will tell us if he is remembered like that or not. He was certainly a brilliant man. 

Working in medicine is hard sometimes. People die. Every day. Young people, old people, men, women, children, gay or straight. Everyone. Bad things happen. Sometimes to bad people and sometimes to good people. We have no control over this. You can pray all you want, but when Steve Jobs got pancreatic cancer, I knew that was a death sentence. People don't survive that. Even if you have the "good kind" all that means is that you die in several years instead of 4-6 months. 

Sigh. It's not a fun thing to think about your own mortality when you are 28 years old. I don't think a lot of 28 year olds think about that kind of stuff. But it's hard not to when you know all of the bad things that can happen to people and you've seen it play out over and over again.

100 years ago doctors were very different than they are today. We did not have antibiotics. We did not have CT scans or MRIs or ultrasound. There were no blood tests. For crying out loud they would taste people's urine (gross) to see if they had diabetes or not. Franklin D. Roosevelt had a stroke and died because we did not have medications to bring down blood pressure. Many people died. Slow and painful deaths because we did not have anything to give them. Back then we were all palliative care doctors. You just made people as comfortable as possible and said some prayers and hopefully people got better. Mostly on their own and sometimes in spite of what doctors did to them (leaches were never a good idea). 

Today we want to heal everyone. We push and we push. People die or go blind and that is defeat. But sometimes you are defeated. Sometimes you lose the battle. And when that happens we are put into the shoes of the many doctors that went before us and our job is to comfort, to listen, and to pray. Lots of doctors forget that. It is not an easy thing to do.

So even though I know that I might die tomorrow, I know that I probably won't. But for today I will be happy to be alive and part of this beautiful world. Because you never know when it will be time for you to leave. (Sorry this post was so all over the place, but it all connected in my head in some way...)

"God grant me strength to faithfully execute my work.
Let not desire for wealth or benefit blind me from seeing truth.
A person neither rich nor poor, friend or foe, show me only the man.
Grant me the desire to learn from doctors wiser than me.
Strengthen me in body and soul, and instill within me a perfect spirit."
- Blessing the Physician


Tammie said...

Beautiful, thoughtful, post Kristen. Thank you.

AE said...

I've been struggling this month, as I did on my other medicine rotation in August, with some of this too. I'm trying hard not to compartmentalize, I'd rather feel it all, but it's hard to remember that we're only seeing a small percentage of the population. This month, I've seen it much worse than I had before...I was part of the palliative care team you mentioned in your post. It was hard, really hard. Nearly all were dying, unless we were just consulted for pain management. It still weighs on my heart. I like what you've said, it's helpful to see another side of it. You mentioned three important things I definitely agree with after this rotation I had, comfort, listen and pray. It reminds me of standing in a patient's room, listening to her tell her story of how her son nearly died as a boy, how she carried him out to her car and rushed him to the hospital to be told he would die. She looked a lot like Grandma Marj, like we remember her. He didn't die, but he's dependent on her. My point, sorry, she was so wrapped up in the emotion of this story, tears ran down her face as she told it, and all the heartache she's felt. She talked to us for a long time it seemed, I had to tilt my own head back at one point to try and not let the tears run down my cheeks. It brings tears to my eyes just remembering it now. She was only there for pain management luckily she wouldn't be trying to die anytime soon.