Move Along (Lani)

 Working in the medical profession can be…difficult. Any part of it, really, of course some parts are harder physically, or mentally, or emotionally, than others, but all in all it’s hard. Sometimes I regret my career choice, and specifically my specialty of choice. Today is one of those days.

“It’s far too early for it to be Monday already.” I mumble to myself, shutting off the alarm and getting out of bed. It’s a typical morning routine, get up, grumble a little, look through the laundry pile for clean clothes, eat breakfast quickly, and off to the clinic- it’s going to be a busy day…it’s always a busy day at the clinic. “Morning Lani.” The secretary says when I check in, I tell her good morning and head back to my office, looking over charts for the day, my first patient is due for a visit in an hour, and so I look over their chart first. Having reviewed blood work and other things done since the last time we saw each other I then wash my hands thoroughly, grab what I need, and begin the day's task of seeing patient after patient, with a brief break for lunch.

By the end of the day, I am exhausted, physically and emotionally. It’s not all fun and games in pediatric hematology-oncology, for the physician or especially the patient. Packing up my things for the day I send a message to Carmen asking if she wants to meet for dinner, I need to vent to someone, and shortly after hear back- she’s up for it, we’ll meet in an hour. Saying goodnight to the remaining staff I exit the hospital, go home, and head to take a shower.

Showers have an odd effect on emotions I’ve found, as they give one time to reflect. Standing in the steam and hot water I do exactly that, reflect on the events of the day. Clinic started slowly, a few routine follow up appointments, and then after lunch things took a turn. I had two patients, back to back, and witnessed a peculiar phenomena that one can only perhaps witness when working with adolescents and young adults, and it was eye opening as to how context can affect the feelings of a situation.

My first patient after lunch was an adolescent benign hematology patient, let’s call him…tommy, for now. Tommy was due for a routine postoperative check in, and had come in raving about how his double mastectomy for ‘top surgery’ was healing. I was happy for him, though we did have an honest discussion about other potential SRS that is known to have a much lower satisfaction rate- I gave him my opinion from a hematology perspective, looked at how things were scarring and making sure there was no problems with any blood counts or clotting and sent him on his way to further discuss things with more appropriate members of his team. My next patient did not have as happy a story…

Having finished with the previous patient, I reviewed my next patient's chart, let’s call her…Vivian. Before going into the exam room I steeled myself for an unfortunate situation. Unlike Tommy, whose condition is easily manageable and benign, Vivian is one of my hematologic-oncology patients, with relapsed lymphoma that had spread to her breasts. During our visit she began to cry about the double mastectomy that was needed to remove the cancer that had spread, it was entirely understandable. If I were in her shoes I would be crying too. The encounters got me thinking about the importance of context, and to a lesser degree, the importance of potential trigger warnings. After all, they’re the same scars, same procedure, the difference is the name ‘top surgery’ instead of ‘double mastectomy’ along with the context…one brings joy and comfort, while the other…the other traumatizes one for life. Out of sadness, and to a degree frustration I have a brief cry in the shower before getting dried off and getting dressed into something more casual to go meet Carmen for dinner.

I knock at the door of the Smith residence and Sarah opens the door, yelling for Carmen who is upstairs still getting ready. Maddie I find sitting looking over a catalogue that I later find is from Emma’s surgeon, and laughing at some of the results. Phalloplasty still needs to catch up on the science that other genital surgeries have already achieved. Some of them are amusing in a morbid way, I suppose, they look rather lopsided and unrealistic, oh well. You get what science can offer I guess? After a few more minutes of waiting Carmen finally comes downstairs and we head off, Sarah when we left was busy cooking dinner with the help of Emma and ‘moral support’ of Maddie. I hope they enjoy whatever they’re having.

“So, you had a rough day?” Carmen asks as we sit down “You could say that.” She leans in and rests her head on her hands with a sigh “I know that tone.” She says “Well, do you wanna talk about it- or do you want a distraction?” I think for a second “Both?” Carmen the. makes an affirmative noise as if to say “Alright then, vent away.” With a deep breath I then voice my feelings in the best way I can think of eloquently doing so. That leads to a discussion, and then another discussion, and then another discussion. Having discussed all things we possibly could on the matter, the food arrives and in between bites Carmen provides amusing stories and other distractions to lift my spirits.

When the night is through she walks me home, and I silently go upstairs, cleaning up quietly so as to not wake my sleeping parents, and fall asleep quickly. Even on the bad days with this job one has no choice but to cry a bit, talk to someone, sleep, get up the next day, and move on.

Everything is wrong but still we move along…