Saturday, May 8, 2010

The Physician

It is not in the retrospective armchair analysis of paper work that the life of a physician is spent but in the dynamic details of the daily grind. The details are present in the heady intercourse of thought and action. The practice of medicine is the constancy of intuition evoked through experience, knowledge gained from education, compassion tempered by hurt and desire based on promoting life.

There is education on a daily basis from a surgical procedure or institution of new therapy with knowledge of all its potential side effects that might hamper or enhance progress. There is constant chatter of ideas to view the future impact of the treatment rendered to the patient and there is continuous monitoring of the situation that prevents a throwback into the luxury of a comfortable armchair. The real world of medicine is fettered with grease and grime of human emotions and physical pain. All actions that are undertaken are real-time. There is very little or no time to reflect when the human suffering is on display. Knowledge, intuition and experience come into play. 

A cardiologist looks at the riot of ink on an EKG paper strip and within minutes of rustling up the exact concoction of medical devices, medicines and touch, comforts the patient and rids the resident commotion of the heart.

An Internist sees the wide eyed look of fear in her patient and differentiates from a catalogue of diseases to pick the right one to attack and win the battle for her patient.

The Pathologist peers into the binocular portals of the microscope knowing the surgeon is staring down the open wound of the abdomen with blood and guts displayed in the carefully retracted site where the tumor is lodged, trying to deliver the answer whether the mass the surgeon sees is benign or malignant.

                       Benign Adenoma                Cancer of Colon

While the Emergency Room physician who is faced with a John Doe lying in bed unconscious without a family member in tow must decide from the pallor that is cast on the patient’s face and the subtle but hidden clues that point to a myriad of diagnoses to determine what ails this unfortunate soul. His every action of every minute is tabulated on paper to be reconciled later if the outcome is poor. Any fractured thought or implied action or inaction is magnified.

All these moments of momentous change in the patient’s life that hang in the balance are weighed upon the shoulders and mind of the physician. His is a vocation to allow life to blossom. His is a need to comfort the family. His is a desire to educate his colleagues. In fact it is this very essence of any working day that embodies the relics of his time. To mend the body, to heal the wound, to calm the nerves and feed the soul are the passion of his life.

Walking in his shoes is a medley of acts, constantly juggling to understand the malady, educating the patient and family, responding to the burgeoning weight of regulatory paperwork, monitoring the duties of the personnel, managing the fiscal responsibilities of the practice of medicine, tempering the attitudes of the workers’ emotions, worrying about events that can happen and reacting to those that do happen. This is the turmoil of a physician’s much heralded, sometimes glorified, often demonized, and frequently vilified life. It remains the nebulous and elusive rainbow without the pot of gold at the end.

In the end a physician is still the same quintessence of dust, a human being replete with a baggage of his or her experience and knowledge. No more no less.

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