The art of medicine

I've wanted to be a doctor since before I can remember. It's just been something I've felt an overwhelming calling to do and, for the seemingly hundreds of applications over the years asking me why, I've waxed eloquently about healing and helping the sick and dying. But honestly, until tonight, I never really could put my finger on what it was the drew me so inexplicably to the art of medicine.

I got a call tonight to come down to the emergency department for "an old man who is a No Code who arrived after getting CPR three times at the nursing home. The family is here and I need your help with them." I walk into (let's call him) John's room expecting to see a dead man and a grieving family only to find a pleasantly demented non-dead man on a stretcher talking to his daughter. The family was very clearly and understandably shaken and as I walked into the room, they all looked directly at me for guidance.

That is why I went into medicine.

There is only one certainty in life and that is that we all will die. It's just a matter of timing. Some of us are likely closer to it than others but in the end, we'll all have to face it. I've seen it done poorly over and over and over again. But, thanks to my God given abilities, I've also seen it and even helped it be done well. With the vast arsenal that we have now in modern medicine, there is just no reason for death to be anything other than peaceful, painless, and dignified.

I had the luxury of spending a long time with John's family tonight and the majority of it was spent helping his youngest daughter come to terms with her father's No Code status. She felt like the fact that we were talking about his death in front of him was "cutting holes into his soul." It took time explaining that simply by the family gathering to have such an open and honest conversation directed at honoring John's goals and wishes, they were actually pouring out their love all over him. But, by the end of the conversation, she said to me, "Thank you. I never thought about it like that." And then, in the middle of the cold bustling ED, on top of my germ-filled white coat and without any warning, she hugged me.

That is why I went into medicine. To be the Shepherd. To hold the hand. To open my magical black bag and pull out sanity and common sense and pain relief and humor and reality and hope and understanding and knowledge and confidence and comfort. So much of what I do every day has nothing to do with healing and everything to do with buying people time and giving them the tools to come to terms with their own mortality.

Don't get me wrong, given the option I'd much rather deliver a baby than turn off the life support machine, but there is nobility in both and I am truly in awe that I have the opportunity to be, for all intents and purposes, a tour guide on this big adventure called life.

New annoucement from the food industry.

Thumb. It's what's for dinner.

They start so young these days...

"So...uh...you come here often?"

When Daddy dresses the baby for school...

...we get a frog man...

Oh yes, those are flippers on my son's feet...at daycare...as if to say, "We haven't done laundry in 2 weeks and had nothing else to wear..."

Our Hero, Mark Sanford

Apparently I'm not the only one who went hiking for Father's Day...

Late Monday, spokesman Joel Sawyer said the chief executive is hiking the Appalachian Trail, which explains his perplexing absence. A statement issued by Sawyer didn't make clear what part of the trail he was on.

Sawyer had said earlier in the day he wasn't aware that anyone on staff had spoken to the governor since Thursday. Sanford's wife said she hasn't heard from him in several days, including Father's Day.

... but at least I went with my wife and son. What a dumb arse.

After going AWOL for seven days, Gov. Mark Sanford admitted Wednesday that he'd secretly flown to Argentina to visit a woman with whom he'd been having an affair as steamy e-mail exchanges with his mistress emerged.

Wiping away tears, he apologized to his wife and four sons and said he will resign as head of the Republican Governors Association.

Don't Cry For Me, Argentina, indeed. I have to say, I will always love my home state of South Carolina but this is ridiculous. I guess that's why Mark didn't need that stimulus package - he was clearly getting all the stimulus he needed.

Dumb, and Proud of It.

Update I:

My wife sagely noted that if you can start an affair over email, you can certainly end one that way. "We all know why you went to Argentina."

'nuff said.

Hanging Rock

For Father's Day, we took Dad on his first Daddy Leads The Way hiking trip.



We had a great time humping our way to to the top of hanging rock.



We packed a picnic lunch...at least for Jack.

It's the small things in life...

...like an evening with my mother and my son, that recharge me. Thanks, Momma, for being the example of what I'm trying to become. I love you.

Wagon Wheel

Not to be debbie-double-downer, but stories like this are why I love public radio. Not to mention, this is a fantastic song:

Brother John

Four years ago tonight, I carried the body of a dear friend from the battlefield, stood watch as he was identified, watched a company of Marines file through to pay their last respects, and said goodbye.

Our loss of John came in the context of two days of unit-wide suffering - his was just the death the struck me most personally. June 15th was a hot night, and at 1am the boys of 2nd Platoon, Weapons Company 1/5 stood up as QRF to assist an Alpha Company platoon that had suffered a catastrophic vehicle strike. This was a tragedy the likes of which I hoped to never see again: a double stacked anti-tank mine exploded directly beneath an up-armored M1114 HMMWV in a dirt alley. The doors blew off the vehicle in both directions, knocking down cinder block walls, and the 800-pound gun turret was flung up over a 10-foot wall into an adjacent courtyard. We found the truck's windshield, over 200 pounds of laminated glass, almost 50 yards away, a dogtag embedded in its shattered crystal. The recovery operation took almost 8 hours to ensure nothing was left behind. Tyler Trovillion, Jesse Jaime, Jonathan Flores, Chad Maynard and Dion Whitley were killed in the explosion; 4th Platoon took them home while 2nd finished the cleanup and retrograde.

Later in the same day, Marines from the command element were surveying the blast site when Doc Baez was shot by a remain-behind enemy sniper. That next afternoon, 2nd Platoon deployed to screen an Alpha Company operation in the souk, the heart of Ramadi's market district. As the sun reddened the dust of the western sky, a distant explosion rumbled in the distance like summer thunder. Alpha had almost wrapped up their op, and as the explosion echoed through the city 2nd Platoon peeled off from a final turn through the souk and headed south without order or encouragement, almost of its own mind. Over the radio I let Capt Thompson know we were already moving, and heard Charlie break in calling troops-in-contact. After the previous night, not one of us wanted to drive on a dirt road again, but there weren't many other options to get down to Shit Creek.

We sped out of the souk and cartwheeled through a maze of one-lane residential streets until we popped out on a large southbound road. As we neared the southern part of town, an ominous pillar of black smoke stood silent on the horizon, peppered by the static of small arms fire. Our vehicles spread out on the dirt alleys, and as we emerged from the density of the city a single upturned humvee brought our column to a standstill. There was but a second to watch the flames pillaging the vehicle, to remember the sickly sweet smell of burning diesel and rubber from the night before. With their lead vehicle struck and stranded, Charlie had dug in and was returning fire, but our arrival just to their north blocked their shot at the enemy. My guys took up the fight, Gunny directing the dismounts into buildings and the Mark-19s opening up on open windows and suspect alleyways.

Initially, we did not know the scope of the damage, only that wounded Marines needed immediate evac. After linking up with Lt. Fell, now leading the company under fire, we determined that two of the wounded were already loaded in a cargo vehicle, and two others were being treated in the courtyard of nearby residence. Later, I heard Marines speak quietly of men aflame, running to the safety of the nearest building. Oddly, for some reason I chose to run across the same open field to find the Marines in the courtyard - Fell didn't know which building they were in. The sight of one man sprinting across this dump of trash-choked land was enough to catch the attention of the wounded Marines, who quickly flagged me down. Even more odd, my failure to communicate my recon to the platoon resulted in several dismounts and two vehicles following my haphazard quest. While that worked out in the end, someone could've gotten hurt.

Gunny had the suppression and room-clearing well in hand, and I was operating under the assumption that a speedy evac was more important at this point than chasing a presumably long-gone triggerman. Once we loaded the stretcher cases into the cargo vehicle, my truck and one other escorted the WIAs back to the field hospital at Camp Ramadi. Cpl Ramirez, the Charlie radio operator and a comm Marine by training, drove solo through the city in the highback containing the casualties. Radioing ahead to coordinate helo support for the burn victims, I became aware that there were still two Marines unaccounted for. It wasn't until we got to Camp Ramadi that the Ramirez asked me if they had gotten the CO out. I'll never forget the chill as I realized he meant John, and "out" meant the upturned humvee that greeted our arrival. With that thought on my mind, we headed back to Shit Creek.

Once again in two days, an IED buried in soft dirt roads had taken its toll. How often have I looked back and regretted failing to go to the humvee first thing? I am assured that a rescue had already been attempted, and that the damage was complete, but you can't help but wonder what good you might have done by trying one more time.

It took three more hours to recover John and Erik from the the vehicle - our unfortunate practice from the night before paid off. Complete, we loaded up our revered cargo and stood fast to cover the retrograde of Charlie Company. Like many leaders before and after, John was the last of his men to leave the field. Looking back, I should have taken the time afterwards to sit down with every one of my Marines to talk about all they saw and did. I didn't - missions wait for no man - but I hope in their actions that they bore the same honored witness that I did.

John Maloney was as fine a human being as I've known, and the *finest* Marine Officer I have ever served with. The stirring final stanza of the Marine's Hymn sings of the Marines that guard the Streets of Heaven - if that is true, then certainly John must be the Captain of the Guard.

Are you sleeping, Brother John? I hope so. You earned it.


In memoriam: Capt. John W. Maloney, USMC (1970-2006)

Would you like fries with that?

New life

What a full 48 hours I've had.

I got a call from the Women's Hospital right as I was walking off a 24 hour shift that my patient was in labor. I was deflated. All I wanted was to get home to my little one and my beautiful husband and my wonderful in-laws who were visiting and have a full big jazz breakfast. But, grumpily, off I went to see her. As soon as I walked into her birthing room, she lit up and clamored up despite her numb lower body to hug me and thank me for being there. All the fatigue and annoyance instantly melted away and she went on to push out a beautiful little girl, my first delivery since my son was born. I was flooded with all the emotions of motherhood all over again as I watched her snuggle her daughter. As I finished up the paperwork and listened to the new little family get to know each other, I was yet again struck by the miracle of how we bring others into this world.

I was still able to spend a large part of my day with my family including Jackson's first real pool trip.

What a blessed life I live.

This is ZOOLANDER

My boy's got some serious moves. We've got some work to do to get to "Magnum," but this is definitely a "Blue Steel"-quality expression:

What am I going to do if he ends up a male model?!?

Good Buddy

Thanks to the excellent scrounging abilities of Uncle Matt, Jack is now the proud owner of a baby-sized t-shirt emblazoned with a life-like picture of an M18A1 Claymore mine on the front. Now, I'll know exactly which way to point him after feedings.

Thanks, dude.

Sweet Innocence

Family Reunion

We came. We reunioned.
We ate.
We ate some more.

Vive les Américains de la Normandie!

Just a coupla-sixty-five years ago, an intrepid bunch of lads came ashore at Utah, Omaha, Sword, Juno, and Gold. Take a minute to remember that. And while doing so, consider the attitude of General George S. Patton, Jr. on the eve of battle:

We want to get the hell over there." The quicker we clean up this god***ned mess, the quicker we can take a little jaunt

against the purple pissing Japs and clean out their nest, too. Before the god***ned Marines get all of the credit.

***

I don't want to get any messages saying, 'I am holding my position.' We are not holding a god***ned thing. Let the Germans do that. We are advancing constantly and we are not interested in holding onto anything, except the enemy's balls. We are going to twist his balls and kick the living sh*t out of him all of the time. Our basic plan of operation is to advance and to keep on advancing regardless of whether we have to go over, under, or through the enemy. We are going to go through him like crap through a goose; like shit through a tin horn!

***

There is one great thing that you men will all be able to say after this war is over and you are home once again. You may be thankful that twenty years from now when you are sitting by the fireplace with your grandson on your knee and he asks you what you did in the great World War II, you WON'T have to cough, shift him to the other knee and say, 'Well, your Granddaddy shoveled sh*t in Louisiana.' No, Sir, you can look him straight in the eye and say, 'Son, your Granddaddy rode with the Great Third Army and a Son-of-a-god***ned-B**ch named Georgie Patton!"

Full text of Patton's speech can be found here.

My Boy's On A Roll...

See more videos here. 

Front Towards Enemy

Some days - especially this summer when I've been wearing a suit every day - Jackson reminds me of every one's favorite anti-personnel mine, the M18A1 "Claymore."

It is not enough to just have a devastating weapon that will wipe out anything you aim at. The US military goes so far as to instruct young warriors to point the "Front Towards Enemy" by printing those words on the front of the mine. Actually, I found the raised letters to be *quite* helpful during night-time emplacements when you can only 'see' with your fingertips. Don't want that thing going off back towards your foxhole when you hit the clacker.

I got nailed with projectile vomit today, courtesy of my four month old. I should have known better. Do you think anyone sells Claymore Logo t-shirts that come in baby sizes?