If you attended the inaugural UnCon in Salem, this post is an attempt to recreate a bit of its inherent magic. If you couldn’t attend, this is one explanation of why you’ll read reviews like this paraphrased quote: “What have you people done to me? I’m forever changed and so is my writing.”
Several decades ago, an excessively young, naïve, and nervous version of myself began working as a first year medical resident in the Cardiac Care Unit (CCU) of a major city hospital. It promised to be a grueling month, in part because there were only two of us to share the call schedule. I’d be working for 24 hours on as the sole resident attached to the Unit, then I’d remain long enough to transfer my patients to the other resident. In the roughly 22 hours of free time remaining, I would commute, shower, eat, sleep, study up on whatever had arisen in the previous night, whereupon I’d return to the hospital and begin the cycle anew.
My duties meant I’d be the first one called to handle admissions through the emergency room. I’d be the first on-scene “doctor” if a patient crashed in the Unit, and if a Code Blue was called anywhere in the hospital, it would be my sorry ass expected to run the resuscitation protocol. (Doesn’t that make you feel safe?) To be sure, the experienced nurses would help and if the staff cardiologists happened to be around they’d back me up, but the primary responsibility would be mine.
How did I handle this, you ask? I neither was nor am a religious person but during my first shift on the CCU, I located the hospital chapel and began to memorize the Psalms.
Your Voice in the Workplace
We have a voice in any vocation we pursue and, as with writing, it’s a critical component of our success or failure. Consider, for instance, two social studies teachers’ approach to a standardized curriculum. Were you to scramble their students – have them attend the alternate classroom for a few sessions – do you believe they could mistake one instructor for the other?
The same principle applies to doctors. Each time you meet a physician you absorb their professional voice – their way of being in the world – from minute details such as whether they invite you to address them by their first name, whether they wear a lab coat, their office’s decor. In their presence will you be permitted to laugh at your own cancer? Will you feel foolish if you cry at the birth of a baby?
At the CCU stage of my life, if you had pressed me to describe the story of my medical career, I would have said it was about the struggle to survive information overwhelm, sleep deficits, and responsibility, not to develop an independent physician-voice.
That changed the morning I met “Jim.”
A Paradigm Change
He’d arrived overnight, been admitted by my colleague for a heart attack, and in the transfer meeting was said to be recovering uneventfully. But as I began rounds on the CCU, Jim developed a known complication – intermittent heart block, meaning that he went through periods when the top and bottom parts of his hearts were not communicating. He hadn’t passed out yet, but his EKG was deteriorating.
This is not the kind of problem which can be fixed with medication. Should Jim progress to complete heart block, depriving his brain and vital organs of oxygen, his life could only be saved by the emergency placement of a pacemaker.
Now I’d never inserted a central line before, never mind a pacemaker, so it was fortunate that a new-to-me cardiologist was on the unit at the time. As we collectively wheeled Jim into the attached OR and as we donned our sterile gowns and gloves, I became Dr. H’s assistant, more bystander than participant. I watched him prep the patient’s skin, make an incision, and prepare to thread the pacemaker through a vein into Jim’s heart.
That’s when things got interesting.
If you’d been told that your life hung in the balance while a team attempted to float a delicate mechanism into your chest, do you suppose you would remain motionless when specifically asked? While I’d personally be doing my best Hans Solo impression, Jim, who was a great shaggy beast of a man, wasn’t cooperating. No sooner would we get close to stabilizing his heart than he’d shift his body and we’d have to begin anew.