The "Arte Y Pico" ... My First Blog Award ... and I got 2

If thou desire the love of God and man, be humble, for the proud heart, as it loves none but itself, is beloved of none but itself. Humility enforces where neither virtue, nor strength, nor reason can prevail.
~Francis Quarles

This year I have been honored with 2 awards that I don't know if I deserve, but have received them none the less. Every time I am given a compliment or an award, my first instinct is to say, "I am not worthy," or "so and so is better." A wise person once told me, instead of trying to be humble, just say thank you. So, Thank you.

I thank the residents for awarding me the Resident Teaching Award for 2008. I am particularly proud of this award.

I also thank my 2 blog friends, Make Mine Trauma and Chrysalis Angel, for awarding me the Arte Y Pico blog award.

Make Mine Trauma

Someonetc at Orthopaedic Residency. He cleverly incorporates everyday challenges and situations as a mirror into the challenges of training ortho residents as their attending. He is constantly striving for more creative, motivating and successful methods of teaching.

Chrysalis Angel

Orthopedic Residency – This blogger actually found me one day, and I’ve been the one reading him ever since. Occasionally he disappears and then reappears out from behind his work and home life, balance is essential you know. I hope he comes back to write more often, I’m going to be especially interested in what he has to say now.

The rules of this award are as follows:

1. You have to pick five blogs that you consider deserve this award in terms of creativity, design, interesting material, and general contributions to the blogger community, no matter what language.
2. Each award has to have the name of the author and also a link to his or her blog to be visited by everyone.
3. Each winner has to show the award and give the name and link to the blog that has given him or her the award itself.
4. Each winner and each giver of the prize has to show the link of “Arte y pico” blog, so everyone will know the origin of this award.
5. To show these rules.

So as part of the rules, here are my chosen blogs:

1. Midwife with a Knife - This OB/GYN who specializes in maternal fetal medicine bring her insight about medicine, teaching, and life. Through her blog, she shares her personal struggles.
2. Musings of a Dinosaur - This is a well written blog by #1 Dinosaur, a family practice physician. His wisdom and experience in both medicine and life permeates his writings.
3. Medical School of Hard Knocks - This is a relatively new blog started this year. It is written by a medical student, CSTEW. He bring his humorous insight in tho the medical student mind.
4. Hurricane Jill - This former general surgery resident, future neurosurgeon, and now pharmacist consistently writes her humorously honest prose about her day to day life and struggles.
5. Crzegrl, Flight nurse - Crazygirl or Emily is an awesome flight nurse with a wicked sleeve. Her blog continues to evolve. She is a little crazy and maybe even zany. Her blog is no different. She is also military, Hooah.

Humility is the embarrassment you feel when you tell people how wonderful you are.
~Laurence J. Peter

"Sorry about Michigan" ...

Do not dwell in the past, do not dream of the future, concentrate the mind on the present moment.
~Buddha

Life is always throwing us curve balls. In medicine, it is easy to get caught up in work. Medicine consumes. As I have said before, I am a grunt. I work. I teach. I mentor. It is my work persona. Outside of work, I am a husband, father, friend, and blogger. Balancing these roles is very difficult. Often, one overshadows the other.

Over the last few months, I have been engrossed in medicine. My long days at work brought on by emergent surgeries, OR delays, and over booked clinics. Mentoring keeps me in the office answering the questions and concerns of residents and medical students. Administrative meetings for the residency, medical school, or hospital, fill my lunch hours and evenings with bad coffee and cookies. Mentally fatigued, I come home to a family starved for attention. The dog needs to be walked. My daughter needs to tell me about her day. My son needs to be read a story and put to bed. Then there is my wife who wants to share with me what the kids are doing, changes she wants to make on the house, vacation plans she has for the future, and things friends and family are doing. There were days that I don't think I had anytime for myself.

Last week started like every other week. Monday was a long clinic day. Tuesday was a long OR day because of OR delays. Wednesday kept my head spinning with OR, clinic, OR, Clinic, and then a consult that changed my week and probably helped to bring me back to humanity. I was consulted on a patient that is well known to me and the hospital. His disease is chronic and likely fatal. Studies were ordered. I reviewed them and realize that he needs surgery, a big surgery. I sit down with the patient and his father. We discussed the options and our goals. Mom was not present because of another family emergency. After going through the options and expectations, they elected for surgery.

Wednesday night, I was on call at the adult hospital. I was up all night. Thursday long OR day and I was on call at my little hospital, luckily did not have to go in. Friday, surgery day, we had a pre-, post- op spine conference, I gave Grand Rounds to rheumatology, and then went to clinic. The case was in the afternoon. OR was ready. All of the implants were available. Anesthesia was informed of all of the problems and they wereready. Pre-operative plan was done. I was ready.

I walked out to talk to the patient and his parents. Mom was there apologizing for being out of town dealing with a family tragedy. I explained the planned procedure to the mother and she understood. At the end of my discussion, my patient said to me, "dude, I am sorry about Michigan." He is a Notre Dame fan. Although he struggles to be like other kids, he was at ease here. He has been in the hospital more than he has been in school. He knows that he has a disease that is likely fatal. He and his family have come to terms with this. Now, it is about quality of life.

We went back to the OR and anesthesia places lines. I visualized my plan. My mind's eye showed me the procedure, step by step. I was ready. After lines were placed, we positioned the patient. At that moment, a wave of emotion came over me. Tears filled my eyes. I didn't want to make a mistake. I questioned whether I was doing the right thing. I didn't want to be the person that shortened young man's life. He trusted me. His family trusted me. Never before have I doubted my own skill. So, I composed myself, re-centered. I said a prayer and ask for guidance.

In the end, the case went flawlessly. My breathing became easier. I spoke with the family. They were sitting comfortably smiling and joking. I explained that everything went well. They were at ease. They were dealing with this big surgery and a family tragedy, yet they were comfortable. Their family was centered.

There are times when I feel sorry for myself. Whether I am working too hard or have too much family responsibility, my life is never as hard as my patients life. Dealing with death and dying requires strength of character and is by far more emotionally draining than anything I ever encounter. I wish I had the spirit of my patient. Today, I am going to follow his lead. It is time to re-balance. It is time to get out of myself and back to life. To my friend, I say thank you for your wisdom and GO BLUE.

The price of anything is the amount of life you exchange for it.

~Henry David Thoreau