“To forgive is to set a prisoner free and discover that the prisoner was you.”
– Lewis B. Smedes
I’m week 4 into my internal medicine rotation, and was speaking with one of my patients. He’d told me a lot about his life, and his experiences. A retired corporate lawyer, now working on his deteriorating health. Since he was just waiting in hospital for placement in the community, he doesn’t have any acute issues, so he was one of the last patients I saw for the day. I usually sit with him for an hour or so because we have pretty unique conversations.
We were discussing some of his experiences in law school, and practise. He told me some of the reasons why he was averse to family-practice and divorce-law, and he replied “I never want to be in the middle of two people that hate each other immensely.” So I told him how I couldn’t believe that two people that vowed for undying love would turn to hatred. I asked him whether it had to do with communication or trust. “No, its about forgiveness. People hold on to the smallest things of lttle significance, and its like a spur under a saddle. It builds resentment over time. If you can’t let go of the little things, the resentment builds and turns to hate, and when something big happens – everything falls apart. It happens because people can’t forgive. Some are just incapable of it, and hold on to things simply because they don’t know how to let go.”
Forgiveness is a lot harder for me than trust. It means not bringing up someone’s past and using it against them. It means taking a step back and appreciating why someone may have betrayed your trust. To me, that is hard to fathom. But I realize that forgiving someone is acknowledging the fact that friends and loved ones are human, and make mistakes. I think more importantly, without being able to forgive, we shut out people in our lives that could have made a world of difference, and we limit our ability to grow and expand.
However, if someone truly hurt us, in the most deepest, intimate and unimaginable of ways – is forgiveness appropriate in that situation? Because even if forgiveness takes place, betrayal changes a relationship (of any kind whether with family, friends, a partner – it changes trust. So how does true forgiveness occur in that circumstance?
Today I am week 3 into my internal medicine rotation. Our clinical teaching team just switched attending physicians. The internal medicine physician I worked with today called me over, and told me he had a good Emergency Consultation. My case:
78 year old male with history of hypertension, diabetes, renal transplant after 15 years of dialysis, severe peripheral vascular disease and gangrene of the toes, past coronary artery disease presented with 3 second periods of light-headedness which started this morning at 8:30 AM when he sat down to read the paper. This occurred six times. The paramedics found atrial fibrillation on ECG at 10:30 AM while on route to hospital. Pt has had no other symptoms other than the lightheadedness. Patient denies chest pain, shortness of breath, altered level of consciousness or mental state. Physical findings were unremarkable, however cardio exam revealed a 4th heart sound. All investigations came back normal (bloodwork, Troponin T, CK, glucose, etc.).
He told me, “this would be a good case for you, I have lots of clinical pearls to teach.”. I saw the patient on my own, wrote up my consultation note, and reviewed the case once I was ready. He listened to me as I listed what I gathered from the history and physical, investigations, as well as my assessment of the situation and plan.
“Talk me through the common causes of Atrial Fibrillation”
“What do we worry about for management of New-Onset Atrial Fibrillation?”
“What drugs would we use?”
After each point, he gave me feedback. He wasn’t condescending towards me as I expressed that I didn’t know the answer to some of his questions. He even sat down and walked me through how to read this gentleman’s ECG. Afterwards, he thanked me and acknowledged my contributions for this patient’s care at the hospital under the Internal Medicine unit.
I walked away, feeling like I had learned so much. I appreciated his patience, his time, and acknowledged the fact that medicine is not something I can learn entirely on my own.
What an end to a great day.
Ehh… I’ve been working on this project on wordpress (shhh… Its still secret and unfinished! But you can check out how its doing by clicking here). I stayed up a little late last night to work on it, then woke up extremely early. Seems like I am the kind of person that requires AMPLE sleep in order to function. So guess what? Bad day.
I felt I had very little to run off on today, and a pretty hefty workload, so I got overwhelmed pretty early in the day. Instead of powering through and being on top of all of my patient’s issues, I felt I was chasing my tail. It made me realize if you aren’t on top of your game, Internal Medicine can become overwhelming. If I have a lot of gusto and good sleep, I’m good and enjoy it so much. If I don’t, even staying awake is really difficult, and the job is less fun.
Gonna take tonight to re-energize and ensure I can tackle work so is fun again.
How exhausting. I just moved from a lucrative (for me) $840 a month apartment to a $285 room in a student house closer to the university I study at. I managed to move the majority of things within 4 hours – and the help of 3 burly young men (my two cousins and friend Alvin). With 2 cars, and shuttling back and fourth, as well as up and down 31 floors. Everything is moved.
When I arrived at the new room I was supposed to move in – a single desk, room light and lots of dust I had to sweep up. The first thing I set up was my bed. Put domo and my other plushies into one corner, plugged in the light, and set the boxes down.
A room is a lot like a sanctuary. Somewhere I may come home to be comfortable, relaxed, where I study, and spend time with my special someone. Except what usually ends up happening is that mess inevitably starts to accumulate, and without constantly cleaning – I end up with a mess by the end of the week. Its funny though, for the past 6 years, every year I have moved once – or even twice from a student residence on campus, to many rooms in student houses, to a 3 bedroom apartment, to my own apartment.
My hope is that my next “home” will be a condo or upscale apartment. Where I am not paying for it with student loans like I am right now, but my own income once I start working.