HOW I FOUND MY RHYTHM WHEN THE MUSIC STOPPED

At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.

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THE MAN IN A BLUE SARONG

I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.

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PATIENT “OWNERSHIP”

I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.

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in West Virginia going 70 miles an hour.  She called me when she was at the hospital and I could feel my heart drop in my chest.  I had done several rotations on trauma by this point and all of the victims I had seen rolling through the trauma bay kept flashing in my mind.  Thankfully, she underwent a workup and was, on the whole, uninjured.  As the oldest sister, it is my job to look out for my younger siblings and my instinct was to get into my car and head east on I-64 to the small hospital in which she was hospitalized.  But I was on call that night and for the rest of the week and could not do that.  I ensured my sister had arrangements to get home to Virginia and called numerously during the next week, but what I really wanted to do was to just be with her.


These missed moments certainly do stand out for me, but other, considerably powerful moments also surface.  I remember a veteran with metastatic pancreatic cancer leaving from the VA to die just weeks later, surrounded by his family.  He only wanted to spend as much time as he could with his loved ones and we were able to do that for him so he could leave this earth on his terms.  I remember the fiancé of a man I felt certain would die inpatient begging us to save him.  He eventually left Chandler Hospital and walked down the aisle with that fiancé.  I remember performing a pleurodesis on a teenaged patient who went home to her family and went on to live her life, unimpeded because we had helped her.  I felt we had given these patients that most valuable, irreplaceable thing:  time.  Time to seize what remained of their precious lives.  Time to be married.  Time to play and time to grow; time to love and be with those who loved them.  More often than not, the patients themselves would not thank me, but their families would.  Mothers and husbands, siblings, grandparents, best friends, walking up to me and mouthing “thank you so much” silently.  A quick embrace from a grateful wife after we had resected her husband’s colon cancer.  A tight grasp on my hand from a grateful daughter because we had given her more time with her mother.


To sacrifice is to surrender something precious, of value to you, for the sake of something or someone else.  Sacrifice sometimes evokes an image of a single great loss or offering, but in medicine, it does not always look like that.  I believe that I have surrendered many irreplaceable moments of my life for the sake of medicine and my patients.  As demanding as this job is, as much as you give up for it, there must be a part of me and many others that feel it is a sacrifice worth making so that others in the world can live to enjoy the same kinds of precious moments we ourselves have given up.  With all that I have seen and all that I have missed out on, I cannot say that it is an easy choice.  I do believe it is a choice I would make again because while it appears to be a sacrifice of time on my part, it transforms into something more like a gift of time when I think of my patients.       

I have a small black planner from Japan that has chronicled my life for the past year.  It is a compact and sturdy little book I carry back and forth to work.  Since the beginning of my residency, I have had several of these, archived in a striped banker’s box once the year is up.   If someone were going to be nosey and read one of these books, they would see a rather humdrum list of appointments, tasks, deadlines, and days of call written down in my indecipherable cursive.  They may also, however, note several events that I have recorded – events which have an “x” marked through them or furiously scribbled out.  Events that I either cancelled or missed due to residency, whether it was because I was on call or a case ran much longer than anticipated.  Those planners stand as a record of all the valuable time with my family and friends that I have sacrificed to do the work I came here to do.


I do not presume to be unique in this regard.  I believe many of my colleagues would agree that time with our loved ones is one of the biggest sacrifices we have made in our pursuit of medicine.  As I flip through the pages of the book, I can recall many such events.  My best friend from college, whom I cherish as a sister, delivered her first child two years ago and I could not be there for her delivery.  I attempted to schedule a vacation around her due date but the stubborn little baby remained in her mother’s womb until after I had returned back to Lexington.  In addition, I have missed two weddings (both scheduled rather impetuously by all involved), and my baby sister’s graduation from both college and graduate school.     

BY ANH-THU LE, MD

Although the occasions I mentioned above were all joyous, I have also missed several crucial incidents with my family.  In some ways, these events seem more critical than the happy ones.  Several years ago, my father was hospitalized with acute chest pain and altered mental status.  I answered my mother’s frantic phone call in between cases.  I wanted to catch a plane home, to fly south several hundreds of miles, to comfort my mother while she waited for my father’s doctors to find out what was wrong.  I wanted to be able to see for myself how my father was doing, to determine if he was having a stroke, and to meet his doctors.  Instead, I texted and called my mother and sisters furtively, when I could, for the next two days, trying to decipher what the doctors had told my mother; an endeavor made more difficult by the fact that her knowledge of medical English was much less robust than her conversational English.  What did his MRI show?  His Echocardiogram?  His EKG?    Eventually, I understood my father had been hospitalized for a hypertensive crisis and I was finally able to hear his voice on the phone the day he was discharged.  The entire ordeal was extremely frustrating.  I felt like a negligent daughter who had left my parents to navigate the medical world with its many consultants, bills, and jargons by themselves.


One night, last winter, my younger sister flipped her car over the side of a highway

ANH-THU LE, MD

Anh-Thu Le grew up in Florida and attended college and medical school at the University of Florida.  She will be pursuing a cardiothoracic surgery fellowship after completing residency.