Medicine

“Now, in my fiftieth year, I venerate the sight of the abdomen or chest laid open. I’m ashamed of our human capacity to hurt and maim one another, to desecrate the body. Yet it allows me to see the cabalistic harmony of the heart peeking out behind the lung, of liver and spleen consulting each other under the dome of the diaphragm—these things leave me speechless. My fingers ‘run the bowel’ looking for holes that a blade or bullet might have created, coil after glistening coil, twenty-three feet of it compacted into such a small space. The gut that has slithered past my fingers like this in the African night would by now reach the Cape of Good Hope, and I have yet to see the serpent’s head. But I do see the ordinary miracles under skin and rib and muscle, visions concealed from their owner. Is there a greater privilege on earth?” - prologue, Cutting for Stone, Abraham Verghese

D and I entertain ourselves by talking about getting venous access, mostly because it’s the procedure we can both relate to the most. The other things he does as a medicine resident—lumbar punctures, tapping the lungs or abdomen—are only things I’ve done overseas, without anesthesia and with the barest of instruments; I wouldn’t even know how to set up for those things here. The other procedures I did as a surgical intern he obviously doesn’t have to bother with, to his relief. He proverbially rolls his eyes when I recall the glory days of chest tubes and emergency appendectomies.

And so we discuss lines. I talk about the time I practiced by putting an intravenous line in every patient that walked into the MGH emergency room. He talks about the central line he threaded blindly into the neck of a bleeding and hysterical young girl. We talk about quadruple jugular lines and femoral lines. I talk about a procedure more familiar to surgeons than internists—the saphenous vein cut-down—which he scoffs at. Do people really do those? So I had to smile when I read about it in Verghese’s novel. Ha ha! They did in the 1900’s on cargo ships going to Africa!

It feels good to read good writing. And it feels good to read about medicine. It’s a way to return to myself, to remember part of who I was before I turned into a milk-making machine governed by feeding cycles. D has gone back to work now, thankfully at a relatively normal schedule, and I see that it makes him a better parent. He has greater perspective, more love and patience to lavish upon the baby at the end of the day.

This is the longest I have been away from clinical medicine for three years. Seeing medicine through its absence in my life and influence upon D’s tempers the exhausted and increasingly cynical view that came from its taking so much of my earlier life. It’s good to remember again, why I do this, what it can mean for a balanced life and future ministry.