Liver Lover

Upon returning to the Children's Hospital after a few months away, I was assigned to the Pediatric Hepatology service, where we take care of patients either waiting for a new liver or, more commonly, after they have gotten their new liver.

My first day back, I was very nervous, as I had to pick up some extremely complicated patients, some of whom had been in the hospital longer than I have been a doctor!

I studied their charts, looked up words I didn't understand and actually (oh, I am such a dork) PRACTICED giving my presentation on rounds. Like a medical student :)

That morning, on rounds, I stood up tall, looked the Attending in the eye and gave a stunning presentation, including intricate details about that baby's current medications, past imaging, social and family situation and plan for the future.

When I was done, the Attending scratched his beard. "AND?" he said.

"And? What does AND mean!?" I thought to myself. I just gave a 4 page lecture, what else is there? Did I leave something out?

"AND, Doctor, you forgot to mention that he had a liver transplant. Liver. Transplant. Liver Service. You should probably talk about the LIVER."

Ah. Good point.

Welcome back!

Now playing: Ingrid Michaelson - Maybe

Spirit Slaying

"Someone needs to tell her today," the social worker said, as I gathered my things up off the desk.

"I'm late for clinic," I replied, "and besides, this really isn't even my patient."

But the social worker was as persistent as he was right, and so, running forty minutes behind, I dropped my papers back onto the desk and went out into the hallway as the harbinger to the end of her world.

I took short, staccato steps to the room, and drug her out to the end of the hallway. Away from her husband, but by the window, and a chair. She sat, and I stood, knowing full-well that this was the worst way to do it, but not being able to help myself.

I started saying all the things I was supposed to say--all the truth we'd been holding up inside of us for weeks. The words charged out, tumbling across my lips, spilling down onto the floor, splashing around her feet and filling up the space in between us. I kept talking and didn't even take a breath. I knew, when I saw her eyes, that I had said enough, but I could not turn off the words. They just kept coming. As the tears spilled down her cheeks, the words streamed forth, creeping up to our chests, threatening to drown us.

When I was finished, she was speechless and the letters began floating dead around us, she hung her head. Shame squeaked underneath my wet shoes as I turned and walked away.


Now playing: Sandra McCracken -- Now and Then

Tree Hugger

Autumn is everywhere! Hold the phone. I am 100% sure that just yesterday it was green and sunny, and then I woke up this morning and every tree on my block had disrobed and flung its underthings about in my yard.

I know it's cliche, but cliches often bear truth. There is something warm and comforting about the fact that we glean so much beauty from dead and dying things. Green had its glory days, and we are just certain that absolutely nothing will be better or more beautiful than sticky watermelon hands and barefoot toes digging into hot, sandy beach. But now I see these bright red and orange trees set up like stage props on my street and I wonder if running up to them and wrapping my arms around their bark would be too over the top?

Please. Don't. Ever. Leave me.



Now playing: Ingrid Michaelson - When the Leaves

In Fourteen-Hundred-Ninety-Two

During a session with his speech therapists, I heard one of my patients struggling to come up with an answer. She had asked him a sort of "guess what I am thinking" question, the answer of which was "Halloween." She tried to give him clues, like "It's a holiday in October." and "You might give out candy and dress up in a costume."

But he furrowed his traumatized brown and seemed to ponder this for a while.

So she went on, "Kids really LOVE this holiday!

"Ah!" he exclaimed, as if he had just re-discovered DNA. "You must be talking about Columbus Day! Children really love Columbus Day!"

And even after she told him that the answer was "Halloween," he continued to disagree and delight in thoughts of the Nina, Pinta and Santa Maria.

For some reason, I just really, really like that.

Wish, Love.

One of the great things about being a pediatric resident is that most of your friends are also pediatrics residents. This especially comes in handy when you have kids. Get-togethers become one big carnival for the munchkins, as Pediatricians are the most fun people in the WORLD. Really.

Last night, we were celebrating Kevin's birthday. Both he and his wife are Pediatricians. Kevin had Jack, a 3-year-old mini-doctor-in-training, up on his shoulders and a baby wrapped around his leg. We lit the candles on his birthday cake, and everyone "oooohed" and "aahed." When we sang to him, Jack sang "Happy birthday dear JACK!!!"

But the lights dimmed and Kevin leaned in to blow out the candles. Jack, still atop his shoulders, gripped Kevin's hair with sticky fingers.

"Make a wish!" we all chimed. Talking to the kids, but also around them, as adults often do.

The baby dropped her pacifier in an open-mouthed smile, and Jack squeezed his eyes shut tight.

And just as Kevin took a deep breath in to blow out his (many) candles, Jack let out his wish:

"Please give Mr. Kevin a ROBOT!"

And so it might be.

:::poof!:::



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Now playing: Sondre Lerche - Let My Love Open The Door
via FoxyTunes

Sunday

I know this guy who had a heart transplant a few years ago. Now he rides a motorcycle and refuses to wear a helmet. He says that motorcycle accidents lead to organ donors, and that's the only reason he's gotten to live this long.

I think that is really stupid and lovely all at once.



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Now playing: The Arcade Fire - Wake Up
via FoxyTunes

The Crazy Life

I recently learned of a phenomenon common to many patients with severe aphasia or language impairment. Many people who have trouble speaking after a stroke or traumatic brain injury actually do very well with humming or singing. I first observed this when my attending asked a patient to say the word "pen." He said, "Can you name this?" and the man stared blankly at us. Then he said, "Say pen" and the man opened his mouth, and said "aaah." No words. Finally, my attending, with a little twinkle in his eye said, "Now, can you try singing along with me?" And he began singing Row, Row, Row Your Boat. Sure enough, the man started singing right along with my attending! He was no Blind Tenor or anything, but the words were perfectly clear. Then my attending stopped singing, and the patient finished out the song on his own. I had chills.

Later in the week, one of the speech therapists was humming a tune that I couldn't quite place.

"What are you humming?" I asked.

"Argh!" she said, exasperated. "Livin' La Vida Loca! Mr. A has been singing it all day and I can't get it out of my head!"

This completely mute, non-verbal man, whose wife hadn't heard him utter a sound in 8 weeks, was singing. You might THINK you've lost everything, and that nothing you once knew will return to you, unblemished. You might think it's impossible. You might not be able to walk or talk. You might not remember your own name. But that darn Ricky Martin. You just can't forget him.

No matter how hard you try.

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Now playing: Rilo Kiley - Breakin' Up