Will The Adults In The Room Please Stand Up

Uncertainty.  In particular, diagnostic uncertainty, would keep me awake at night, early in my career as a freshly minted critical care doctor.  Patients who deteriorated without explanation or haziness on CT Scans without an identified cause, fanned the flames of my insecurity. The scenarios would leave me edgy and uncomfortable impacting my life outside the boundaries of work. Like most doctors, over the years I learned to co-exist with this uncertainty.  Human sickness and disease can be challenging mysteries.

Recently, a new kind of uneasiness has invaded my world causing all sorts of havoc. With the politicization of health care reform and attempts at repeal and replace Obamacare, uncertainty is rearing its head with a vengeance. Twitter and Facebook give minute by minute updates on which senators are a “yes” or “no” and where public opinion currently lies. The evening television roundup details rumors that have leaked from behind closed door meetings. The background noise of it all is deafening. Most discussions are focused on the future impact potential budget cuts or regulation changes. But the uncertainty created by our polarized and tribal politics on any path forward for health care reform is having a real impact now. Every hour of every day, both in the hospital and in my office where I interact with my patients.

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How did I get here?

And you may find yourself
Behind the wheel of a large automobile
And you may find yourself in a beautiful house
With a beautiful wife
And you may ask yourself, well
How did I get here?                         -Talking Heads

 

A middle aged father, critical care physician, triathlete, water polo goalie and Bob Mould stalker wakes up one day and asks, “How did I get here?”

The answer to that is probably longer than what is appropriate for this blog, the human attention span being what it is. But that question along with its logical follow up, “where am I going?” has been on my mind quite a bit.

How did I get here? Where am I going? My past. My future. With change coming just around the corner, it’s hard not to have my headspace taken up by these questions. But with some more introspection, I find that this is my brain’s default; to be looking forwards or backwards. I can be in the middle of a long run or bike ride, but instead of seeing the countryside around me, my eyes focus on last week’s battles with the kids, wishing for a “do over”.  Or I fail to see the sunrise in front of me, on my morning drive to work, as I have already mentally dived into the ICU to deal with the overnight admissions.

My past. My future.

But what about my present?

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Ch Ch Ch Changes..

“Ch-ch-changes
Don’t want to be a richer man
Ch-ch-ch-ch-changes
Turn and face the strange
Ch-ch-changes
Just gonna have to be a different man
Time may change me
But I can’t trace time”

-David Bowie

Months have passed since I last wrote.  Thoughts, musings, topics have flittered frequently through my head. But in the general chaos and anarchy that I call my life, (we are often living hour to hour in the Topin household)  as soon as these thoughts gain some traction, something comes up and steals my head space, my bandwidth. And I get wrapped up in the whirlwind of my world.

But something of late feels a bit different.  The ebbs and flows and highs and lows that seems to be the backdrop of my life..seem to no longer feel right…The familiarity of the cyclical nature of things feels…no longer safe..or comfortable…but constricting, and obstructing.

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Dissonance

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It is September 2012, a bit chilly out, a mist of rain that night, and I find myself a few feet from the stage, packed amongst several hundred others at the Metro. Bob Mould comes out with his new band and promptly starts playing the first song from Copper Blue, “The Act We Act”. Even if the 15 foot speakers were not 10 feet from my ears, the music is felt more so than heard. I am there at the Metro, but I’m also 21, just graduating college. I’m at my desk plodding thru organic chemistry and physics questions with Copper Blue playing on repeat in the background. It’s a warm summer night, but cool in my car with the top down and the stars dancing above, on the road to Michigan City or Fond Du Lac or Madison, with “Changes” on the CD setting the tone. The album is played that night start to finish at a frenetic but absolutely familiar pace. My heart pounding a half-tick ahead of the tempo as I am here, 42 years old, at the Metro, but also 22 years of age with my life ahead of me.

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