"I have pain...." Mrs. Robinson said as I took a seat on the stool in the corner. "Ok", I thought. Somehow, I knew where this one was headed. Before making my way into the room, I had informed myself. The patient, Mr. Robinson, had a long and well, painful history with pain. Fibromyalgia, fibroids, endometriosis, restless leg syndrome, and on and on and on. Turns out she had pain with intercourse (dyspareunia) with recent onset. Her symptoms had come and gone over the past several years, with periods of time that offered relief, quickly followed by more pain. I, unfortunately, had little to offer. Nevermind the real issues at hand, probably an overweight, insensitive husband that had been married to a withdrawl, super-sensitive woman for 20 years, and a shell of a marriage that existed in terms of a few minutes of sex once every few weeks. How was I supposed to address this with a woman I hardly knew, with only 15 minutes?!?
She got an ultrasound, an exam, and some lortab.
My pager beeped as I slowly began to rouse in bed. Not that this was a comfortable bed, but more one designed to make sleep as painful as possible. Maybe, that way, it was easier to get up to the sound of this damned pager. Because medical students are the last one to get the most important trauma pages, I rolled around the corner just as the patient rolled into the bay. A 25 year old male, drunk and high, had a not-so-pleasant meeting with a mailbox. Unfortunately, it met his head while he was on a motorcycle at 45 mph. And what a meeting it was....
There was little we could do, and the last memory I will ever remember of this man is his father running down the hall screaming "Mi nino! Mi nino! Mi nino!" all the while, falling and getting up repeatedly, while wailing and mourning like few have ever seen. As he saw his son die before his eyes, the look in his eyes was such that I will never forget. I have never seen such sorrow in a mans face, all the while, we were the doctors, and we were supposed to do something. Something--anything.....and we did. But it didn't matter. We let that father down that day. To this day, I can see that man in my mind's eye like I am still there, and it brings me to tears to even think about it 2 years later.
There is something about the white coat that is reassuring, and arrogant. It says to everyone that sees it, "I have all the answers." (and believe me, I like to think that I do.) The truth though, is shamefully different. While doctors have saved millions of people from diseases like cancers, heart attacks, TB, appendicitis (yes, people died of that); we are only what we are. The man in the motorcycle accident was drunk and high, and the woman was ignorant of her real problems, but medical school taught doctors that we heal. Unfortunately, we can't always do that and although its easy to say, its hard to do.
Life isn't simple or straightforward. That man, did he deserve to die for being smashed out of his mind (quite literally)? No. Its all life and death decisions that are made without knowing the severity of the consequences, and its a bit much for one human being to see unfold in front of his sleepy eyes at 3am on a Tuesday morning. Mrs. Robinson may never find relief, probably because medicine doesn't have time to deal with a problem that has no quick fix. If it isn't ugly, I don't know what to call it.
