First, know thyself

Even though I am in the business of knowing a lot about others, it has been confirmed to me over and over the importance I should reserve for the opinions of people about themselves.
You may wonder why this is something I waste time to inform you about when I could be telling you about the heat of the sun, the humidity of rain, or the spiciness of chiles. I have thought a lot about this, and last night while I was on call, I had an interesting interaction with one of my patients.
My patient was an elderly woman who had arterial disease in her legs and is waiting for a bypass operation tomorrow. She hadn't been up out of bed, so I offered to take her myself and we toured the unit together at a pace I have never considered in that environment. My laundry list of duties had been nearly cleared by 11:30 last night, so I decided to gamble on the chance that I would be called out for a trauma halfway back from the nurses' station and have to leave her stranded in the hallway next to the soiled utility room. We had a good walk, and she was the reflective type last night so I chatted with her. We discussed life, and death and her grandkids and great-grandkids.
She was widowed about 7 years ago, and she asked me about my family. Somehow the topic of my mom's departure came up and her husband's fight with cancer. She described the amazing fact that her husband had lasted just long enough to see his newborn first greatgrandson, as well as his 75th birthday, which were a week apart. Someone had told her that he would somehow last long enough for them both and she was considering how it was that he actually did.

This had me thinking about another patient I have had that has kept me up the past few nights on call. He is a guy who reminds me of my step-grandfather, who was a hardened old vet with more swearing than legitimate words in his spoken vocabulary. He claimed he had been a part of that company in Vietnam that was reenacted by Tom Hanks in that movie "We Were Soldiers." He had become quite anxious during the course of his admission here and was in jeopardy of losing his other leg to diabetes-related vascular disease. He constantly accuses all of the hospital staff of trying to kill him, kill his last good leg, and a bunch of other stuff I suppose doesn't bear repeating.
He had worked himself up into such a state that he began refusing the treatments that were keeping his leg alive, and his anxiety and paranoia were such that he refused treatments and then blamed the symptoms on the treatments. He finally confirmed my hope that he was going to stress his heart to the point that cardiology would have to take possession of him for more close monitoring, and bless his soul he finally started damaging his heart by being so worked up about everything.
My point is, I keep coming back to that observation that as much as I think I understand human physiology, there is this thing called emotions that also affects physiology in mysterious ways. I remember reading a couple of articles around the time my mother died. These articles discussed the observed affect someone's personality and emotional state has on their ability to overcome terminal diagnoses. They profiled lots of people who were diagnosed with the same kind of cancer and then followed them all to see who died and who didn't. As you may expect, the people who were resigned to whatever was in store for them, wishing not to fight the process did not survive nearly as well as those "nasty old birds" who always fight through everything.
Through this, I have learned two things: what you think about and how you approach things mentally and emotionally does have bearing upon your immune system and physiology, and if everyone in the room is randomly chosen to have a specific diagnosis, the meanest and most undeserving person gets the best prognosis, and the nicest of the group always gets the inoperable 100% fatal with a painful death prognosis.
Take it however you want to, but I think it is about time to stop being so nice and resigning myself to what is perceived to be inevitable. From now on I am going to wear a Livestrong bracelet and think mean, low thoughts for a few minutes every day, just to ensure I am not the nicest person in the room. That is if living here for the longest time possible is the ultimate goal, however, which brings me back to "First, know thyself."

Parting Quote:

Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind. - Dr. Seuss

I would amend it to say "say what you should as a child of God" vs "what you feel."

David