I met Death yesterday.

He was nothing like you see in the movies. He did not wear a hood or carry a seive. Nor did he wear the face of an aged man gasping for air. No, yesterday he chose to meet me in a baseball cap and high tops. As if embracing the irony he laughed. I breathed it in, tried to cleanse my soul of the truth that was coming.

He was taken for a walk "so he doesn't have to listen." I watched his parents hand the doctor his living will. She read it out loud: "Do not resuscitate, do not intubate, no antibiotics . . . " And then the questions. Will he be able to start swallowing better? Will he be get out of his wheelchair? Are there any more tests? Any more medicines?

And as I stood and listened to talk about comfort care and autopsies his father looked at me, the black fly in the corner, as if to plead for some sense of doubt. I closed my eyes, trying to pretend he wasn't calling out for something, anything to save him from this nightmare. Because I didn't want my eyes to lie.

Death doesn't come to torture the dying. We have medicines to treat pain, nausea, breathlessness. Death comes to torture the living. And as I watched this man pound his fist against the wall and sob, all I could think of was the silence that would fill his 6 AM breakfast when it was no longer interupted by a child's desire to spend a few minutes with Dad.

Toe Tales

So I'm sitting there minding my own business when this 11 year old toe-head boy comes up to me and says:

"Excuse me Maam, but did you know your toes are stuck together?"

Now apart from the fact that I resent being old enough to be called "Maam," there was the potential for so many ridiculous responses:

1. You know, thanks for pointing that out, I'd never noticed that I my toes are fused together.
2. Yup, I had the doctor do that so that I could swim better. I almost swam in the Olympics, but they disqualified me based on the operation.
3. I know I'm a freak, just leave me alone!

But instead I smiled politely and said, "Why yes, I did know that."

The smile spread to his face as his mom explained that he had the same thing and was starting to feel self-conscious about it. So I had him bust off his shoes and show me. Sure enough, we matched.

I explained to him that it is called incomplete simple/soft-tissue syndactyly and that about 1 in 200 people have it. Many people in my family bear these toes and it has become a source of "Mead pride." At the age of 4, my twin sister and I were shocked to learn, after arguing with our friend, that we were the "freaks" and not she. I learned at about his age that I could have an operation to separate them, but couldn't understand why I would want to.

Most importantly, I counseled him to severely mock anybody who thinks they were the first person witty enough to ask "Can you swim better?" to which he sincerely and quickly replied, "But I can! I swim so much better!"

That's fine. Whatever helps you embrace your identity, Kid. In the mean time, I'll keep embracing mine, even if I do sometimes wonder what it would feel like to spread my toes out wide.

Fun in the rain.

This has been the wettest summer of my life. There have been only rare days where we haven't gotten at least some rain here in Rochester. By some rain, I mean sudden-onset thunder with a blanket of water. It is exhilarating.

Round 1: Today, after spending 1/2 an hour changing out of my work clothes, getting the kids to put on their shoes, coaxing them out of the sandbox, away from the swings, across the road and out of a puddle, I finally made it to the vegetable garden . . . just as the first drops of rain began to fall. Ashton climbed into my arms and tucked his face into my shirt saying "It's getting on me."
In defiance I retorted, "It's getting better, see it's going to go away." just as the rain drops grew to the size of pistachio nuts. Fine. "Isaac, take your brother over to the playground and hang out under the bridge." I began weeding around our sorry, yellow tomato plants until I realized that with all the water spilling over my back I might as well be weeding in a swimming pool. I picked a few woody turnips and conceded this round to the rain.

Round 2: I ran to the playground, only to find that the kids had NOT decided to take shelter under the bridge and now looked like happy drowned rats. I hesitated, set down the turnips, and climbed up the slide with them, plummeting down into a fat, juicy mud puddle. Isaac and Ashton got some serious air, landing full-body into the sloppy mess. After the kids' faces were caked with mud and I had no clean area of clothing left to wipe their eyes, we finally came home. Luckily, the rain washed most of the mud off before Aukai laughed at us.
I win round 2.

Final score: Rain 1, Heather 1. There will be a tie-breaker later this weekend.

Twinkled

I was tucking Isaac into bed when he turned to me and said, "Mom, I don't want you to die."

Me: "I don't want to die either, but it is a normal part of life. Besides, I don't think it will happen for a very, very long time."

Isaac: "I hope Jesus comes and twinkles us soon."

M: "Are you talking about the millenium?"

I: "Ya, I hope Jesus comes and twinkles us so you will be alive again and Grandma will be young again."

M: "Where did you learn about that?"

I: "In Primary."

M: "You learn a lot of things in primary, don't you."

I: "Ya, but only good stuff."

M: "Well, Isaac, I don't expect I will die until you are old and have children of your own. But if I do, you need to know that even though you can't see or hear me, there is part of me that will always be with you."

I: "You will be my guardian angel, right Mom."

M: "Right."

I: "Will you be Daddy and Ashton's guardian angel too?"

M: "Yes."

I: "I guess you can be Ashton's guardian angel as well, if you want to be."

Favorites

My family is sitting on the bench waiting for our airplane.

Isaac turns to me and says, "This is so cool, I am next to Daddy and Asthon is next to you, Mommy."

"Well would it still be cool if you were next to me and Ashton were next to Daddy?"

"Ya, I am starting to like you and Dad the same now."

"Oh really. Why is that?"

"Well, you used to be my favorite, but Daddy was gone for while, so now I like you and him the same."

Flying Home

There are two ways to fly into Salt Lake City.

The first is to fly North to Idaho and then fly South over the Wasatch Front. All you can see are mountains.

The second way is to come from the South and fly North, following the path of Highway 89. The stewardess had said she thought we were coming in over Idaho, so I was surprised when I saw a big, intrusive "Y" pasted to the side of the mountain.

This way is always a little strange to me because, in a literal and figurative way, you see your past from an aerial view: Brigham Young University, what I assume to be Mount Timpanogos (but I'm not quite sure because I have never been able to see the "woman" on top), the point of the mountain, the eerily well-organized Salt Lake City, the Capital Building, the Great Salt Lake, the oil refinery, the beautiful rose sunset colored by pollution from the oil refinery, the Bountiful Temple. It gives me a chance to reflect about where I was, where I am now, and if I am anywhere near where I expected to be.

It's a bit nostalgic and uncomfortable.

My New Favorite Blog

My husband recently came across a blog called 6yearmed. It is written by a clever and insightful 2nd year resident in pediatrics. Like a drug, I can’t stop reading it, even though it makes me cry.

I cry because the tales she tells are heart-wrenching and honest.

I cry because I’ve watched my own patients through similar journeys.

I cry because I am angry. Angry at her for having something that I am desperately afraid of loosing. This past year has been wonderful, but it has also been somewhat akin to breathing polluted air. The greater part of it keeps you alive, but there is a part of it that slowly poisons you, and I am frightened that I will some day turn around to find some fumigating lung cancer stealing my breath away.

There is something very painful about this journey. Sometimes it feels like the harder you try the harder things get. Because you are exhausted. And you say or do something that your peer misinterprets to mean that you are trying to screw him. Or a resident accuses you of being a bad parent and your husband is so tired and frustrated that you are convinced she must be right. Or you stay late with a patient only to be griped at the next morning for not spending more time because you slept in. Or you accidentally say something that makes a mother cry for 5 minutes and you cry for 5 days.

I cry because I am hate myself for being so human.

But most of all I cry because it offers hope. Hope that, even as this resident struggles with these same questions, there is a chance to retain one’s humanity amongst all the noise and bureaucracy that is medicine. And that maybe, if I don’t give up and if I turn to my patients, I can remember why I came to medical school and, with some luck, become the kind of doctor and person I want to be.