A family brought a Mrs. M to the ER on the last day of her life. They shouldn’t have.
Her home hospice nurse told them not to. Mrs. M was 80, with metastatic cancer and on palliative care, resting peacefully at home when she became feverish and confused. The nurse told her four adult children that she should stay at home and made comfortable to pass in the tranquility of home surrounded by loving family. Continue reading When Full Code is Wrong
On the train back down from upstate yesterday, across from me sat a mom and her son — about 6 months old. Per the suggestion of my critical care professor and because I’m rotating with pediatric neurology right now, I observed the young boy as he cried from hunger, fed a bit, then played with his mom. I thought of the thoughts and neural connections buzzing through his brain in that moment. His curious eyes darted around studying the faces of passengers, realizing that they’re faces and we’re people. He squinted when light shone through the autumn trees whistling by outside the window. He grasped at hair and clothes and with his clumsy fingers, instinctively bringing them to his mouth. As his mom lifted him by the shoulders, he pulled his legs underneath him to strengthen his hip and knee extensors. He heard his mom’s teasing voice chanting “I’m gonna get ya! I’m gonna get ya!” and his brain captured this pattern of vibrating air molecules as samples of language for future decoding. Baby brains are outright miracles. Continue reading Bad Brains
“What mazes there are in this world. The branches of trees, the filigree of roots, the matrix of crystals, the streets her father recreated in his models… None more complicated than the human brain, Etienne would say, what may be the most complex object in existence; one wet kilogram within which spin universes.”
So writes Anthony Doerr in “All the Light We Cannot See,” a brilliant novel that won the 2015 Pulitzer Prize for fiction. It’s the book I’ve been reading this week and (sadly) the only novel I’ve read all year. Between my shifts at the hospital, I crack open the covers, unfurl the pages, and fall into the universe that Doerr spins with his sharp sentences. I follow two characters, two unusual children in extraordinary circumstances: Werner, a scrawny albino orphan prodigy conscripted by the Nazis for his mastery of radios and who fights to retain his humanity; and Marie-Laure, a blind French girl hiding in a walled seaside city who becomes a vulnerable courier and a dreamer. For hours at a time, the book’s words transport me into the vividly bleak fictional realities of two children in the maelstrom of World War II. Continue reading Imagination in the Stroke Ward
Early this morning in the PICU (Pediatric Intensive Care Unit), I witnessed one of the most horrifying things that can happen in this world: a mother watched her 2-year-old daughter die. Continue reading To watch her daughter die
It took just one case for me to know: anesthesiology is a pretty cool job, and there’s no way I’ll do it. Their job, when unperturbed, is a routine of vials, syringes, lines, tubes, and making sure a digital control station doesn’t freak out. It’s delicate and complex, but it’s also a relatively unstimulating exercise of parameter control. Their job, when perturbed, is supremely stressful, situations in which they must act within seconds or permanently brain damage or kill someone. Neither of these situations sounds remotely fun to me. Continue reading Anesthesia Impressions
There were oracles in China around 1200 BC who could see the future in ox bones and turtle shells. They would inscribe them with characters, anoint them with blood, heat them up until they shattered, and “read” the fracture patterns to divinate future events. Royals would ask about rainfall, about warfare, about their own health. There were oracles everywhere in the ancient world; in Greece, Africa, and America, people sought the advice of those mystics who could see things they couldn’t. Continue reading The Hospital Oracles
I wrote this post in the style of a spoken word performance. It is Part 3 of 3 about my stance on surgery, but it is meant to stand alone. Continue reading My Hands Shake
For the past month, I have mostly played Pokémon GO standing still in the same place: in the operating room hallway during spare minutes between surgeries while I wait for patients to arrive. The ORs are right on the East River, which means all day (and I mean all day) I only get to catch water Pokémon, mostly Magikarps that are flopping around. This is pretty ironic on many levels, but it also got me thinking. Continue reading Laparoscopic Magikarp
