"Do over"

I delayed today's dose for the last hour or so but now I'm plugged in and will soon know how I'm going to do on 2 grams of Rocephin daily. This kind of procrastination is unusual for me. I'm the type who sizes up a difficult situation and then proceeds to conquer it. I'm more inclined to jump than stand at the edge and fret about the fall. I don't mean to imply that this is the only way to approach such problems, it just happens to be my method of operation. That I've hesitated about the Rocephin says a great deal about my ambivalence. I want to get well but wish the price wasn't this high. Yesterday a friend said she hoped that my gains would be worth feeling lousy from the antibiotic. Well, there isn't much of a choice here; without the meds I would certainly get worse and there's no hope in that pathway. So I've jumped.
Right now I'm tempted to ask God for a "do over". I have always said that I haven't met a person that I would wish this ordeal on but lately I've been looking around for one. Lacking that fiend I wish this illness would be lifted from my shoulders. I'm sure other people have wished away their medical problems; doesn't work that way, bummer. As kids, my friends and I took our games seriously. Someone might get bad breaks but we reasoned that is simply how things go- tough luck. Rarely, someone would ask for a "do over". When that happened we would mentally weigh all of the variables and issue a decision. We were stern judges but not heartless and occasionally a "do over" was granted. If that happened to me now I would consider it a miracle. I believe in miracles but am not counting on one.
Lyme is making me tougher but not colder. When I return to my patients I'll have more compassion to offer an fewer medical absolutes. I will seek medical methods to grant more "do overs".

Listening

This is my last day at the 1 gram dose of Rocephin. Tomorrow I increase to 2 grams daily. I had been at that dose before and did not function or feel well, which frustrated me. I have always been a "doer". My leisure activities involved either physical endeavors or mental exercises. I am not one to "veg out". At 2 grams I had days where my only accomplishment was that I made it through the day. My son once asked how I spent my time. I was embarrassed to admit how little I did; my daily routine seemed so insignificant. From the outside it might have appeared that I was being lazy when, in reality, every day required all the energy I could muster. Impressions do not always reflect the truth.
Most people have an innate tendency to judge others yet those judgments are often based on incomplete facts and limited understanding. We would all be better served if we judged less and listened more.
This is especially true in medicine. As I searched for a diagnosis my medical records began to overshadow my oral history. Consultants were spending more time gathering information from my chart than from me. When I met Dr. Smith for the first time I was careful to bring only a few notes and the majority were from nonneurologists. This meant he had to listen to my telling of the story and not work from a second hand account. Having met him I feel sure that he would have done that anyway. Doctors tend to be "doers" and few view listening as an active process. Thus many rush through the history and move to the exam where the patient is passive and the physician is driving the process. Yet the best diagnosticians through the ages repeatedly stressed that a carefully gathered history more often leads to the correct diagnosis than an exam or battery of tests. Tests are meant to confirm diagnostic impressions, not to make the diagnosis. Yet contemporary medicine places undue emphasis on tests and technology and the public has bought into this philosophy (what work up is complete without a CT scan or MRI?). While both have lead to advances in medical evaluation and therapy they have not altered the fundamental problems that propel patients into physician offices. Illness and death persist despite our efforts. We should focus more energy on building relationships with our patients and to do that we need to listen more. True healing will flow from that bond even when cures are unattainable.
Here sits the "doer" extolling the virtues of listening and claiming it as a truly useful activity. I hope that tomorrow finds me able to listen to the lessons offered by my journey. I might gain insights that are worth passing on.