Quiet voices from the heart

 “Why don’t people’s hearts tell them to continue to follow their dreams?” the boy asked the alchemist.
  “Because that’s what makes the heart suffer most, and hearts don’t like to suffer.”

                                                                                                           -Paul Coelho, The Alchemist

If you clicked on this to read a medical vignette, my apologies. This piece is going to be a bit more existential. Or metaphysical. Or something less concrete. But I’d love to have you come along for this ride. For months I have written and talked about changes that were coming. I have shared the angst and discomfort I felt as I approached July and the change in my work status to part-time. And I have commented on the parallels to other moments of change in my life.  Change Redux,  How did I get hereCh Ch Ch Changes.

And now it is here.

It’s interesting how the best laid plans can change in an instant.  For more than a year, I have planned to hit the ground running by lining up some part time and consulting opportunities. Writing daily as the sun rises, working on projects and pieces.  All aimed at opening new doors in the near future.

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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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Change Redux

It started almost as a little hum… a vibration in my head, felt more than heard.  A connection between some deep part of my brain straight to inside my chest. In the days leading up to my college graduation I mostly ignored it. Easy enough in the midst of goodbye parties, long nights at the Terrace drinking pitchers of beer while the sun set over Lake Mendota. Graduation parties, visiting family to entertain… there was plenty to be distracted by. But the hum turned to an ache. A growing uneasiness. An angst. I tried to drown it. Alcohol, music, sleep. But graduation came, and as day turned to night, and evening settled in, I saw Liza, my friend, forged on those first few nights in the dorm freshman year, across the street from my apartment on her porch. I walked over and sat next to her and buried my head on her shoulder and just cried. Tears flowed with the pressure and force of the angst that had been percolating inside me now at a full boil. She held me as I just let go. And for a few moments at least I had relief from the discomfort that had entered my perfect world.

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