What Could We Have Done Better….Part 2

Life’s Hard-learned Lessons

“If people bring so much courage to this world the world has to kill them to break them, so of course it kills them. The world breaks every one and afterward many are strong at the broken places. But those that will not break it kills. It kills the very good and the very gentle and the very brave impartially. If you are none of these you can be sure it will kill you too but there will be no special hurry.”

-Ernest Hemingway, A Farewell to Arms

After reading my first post, if you did,  you probably felt the anger, and there is anger.  However, anger is not the only thing left.  I have found a lot of a lot of comfort in literature and art over the last year.  Art has the ability to make the very sad also very beautiful, which is at times  is all we have to hang onto as we wander through the wilderness of grief – the beauty of life.

And in those wanderings, you learn a great deal.  You learn about yourself, about your spouse, your family, your friends, and the world at large.  If approached in a certain way, it can be a great gift.  Do I wish my daughter could have lived independently?  Absolutely.  Do I wish I could go back to being the person I was before?  No.

I am so much more rich and human than I was before.  Yet, I have been broken by a double grief.  The grief for a life with a child that is not here, but also the grief for a medicine that supports and heals – both patients and their community of healers.  I am comminuted, displaced.

By Bill Rhodes from Asheville – mid-shaft humeral compound comminuted fx lat, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=5784840

My anger is actually not all that personal.  I certainly would not count my former partners as friends, or even colleagues.  I have come to understand how deeply medical training unmakes and then remakes a person.  After 4 years of premed, 4 years of medical school, and 3-5 of residency with possible fellowships thereafter, you have been destroyed and remade in the image of Medicine.

It is often not for the best.  I do not think my former partners or administration were particularly good people, nor do I think they were particularly bad people.  I think they were products of the system, which it takes amazing strength and courage to fight day in and day out.  The system never rests, doesn’t take breaks.  It has no humanity.  Who is strong enough to confront that?

And there is the problem, if I just thought that I fell in with a bad group of people, then I could just find another practice and feel like everything would be okay.  However, increasingly, I think that what I experienced is the natural outgrowth of our current Culture of Medicine.  Over at the Happy MD he refers to it, in part, as the “Lone Ranger on a Gerbil Wheel Syndrome.” How can you save anyone else if you are drowning yourself?

Now, I find myself a nomad doctor on the High Plains, too wounded to try and commit to another organization, community, or practice.  Seeing patients I can do, but I have to use shiftwork to protect myself.  I am too vulnerable, I had grown to love primary care and find purpose in healing.  I cannot take another heartbreak right now.  With time, I may become strong again at the broken places, but the callous around the bone is fresh.

I am still “non-weightbearing.”

2 thoughts on “What Could We Have Done Better….Part 2”

  1. HPMD,

    I am so profoundly sorry for what you are going through, the righteous hurt you feel, the callous response you received at your most wounded moment.

    I hope that by doing less medicine, more humanely, you can be for your patients what your colleagues were unable to be for you: present and empathetic, instead of absent and pathetic.

    With sincere wishes that you and your wife experience healing,


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