Here's something you won't here your physician say everyday.....I hate hospitals!. I hate emergency rooms! I hate when my patients are sick enough to need emergency care. I hate when they get admitted.
Why...because hospitals are dangerous places where bad things can potentially happen and bad bugs hang out. It's a place for sick people...really sick people...deathly ill people. And I don't want to ever let my pateints get that way.
As I am fond of saying in my office...If you find yourself in a hospital you better be one of a few things....either really ill, visiting a friend, or at work. Because it's not the place for the kinda ill or sorta ill. Only bad things can happen to these people.
So if you call me in the middle of the night and expect that I'll tell you to go the the emergency room for your cold...you got another thing coming. Or if your an emergency room doctor and you want to admit my 50 year old patient with bronchitis....I'll probably give you a hard time.
It is my responsibility to protect my patients from the harms that they don't recognize. And let me repeat this to make it clear....the hospital is a great place if your on the cusp of dying.....but incredibly risky for everybody else.
Tuesday, November 18, 2008
Monday, November 17, 2008
My First Medical Blog Post (classic post)
This is a little bit long...but this is what started my medical blogging (around 2005?):
We tell ourselves the stories about our lives that make it bearable….our better yet magical, mystical.
When my father died unexpectedly, when I was seven, I had no words or stories that made sense. How could I explain how this loving father of three and devoted husband could be taken from this earth so quickly and with so little warning. It was a question that puzzled me throughout childhood.
As I grew older I unconsciously formulated the answer to this question. You see…my father died when I was seven years old. At this age, he was my idol. I wanted to be just like him. I copied his movements, his words, and of course I wanted to be a doctor too. My father was a highly respected oncologist and often treated the sickest people. He had received many accolades as well as the love and respect of his patients.
I figure, if he had lived longer, I may have outgrown this period. Maybe I would have reached an age where we fought more or I might have become disillusioned with him. Maybe I would have changed my mind and wanted to be a sports star or a policeman. Who knows? The point is this idea of being a doctor stuck with me. And it carried me.
It carried me through a learning disability; it carried me through a move. It carried me through successes and failures. It created a confidence that never questioned if…only questioned when.
That story made sense. My father’s death, tragic as it was, made concrete in me the idea of becoming a physician. And by doing this I would carry on the tradition and touch countless lives. From his death would come rebirth and renewal. I would help people….I would save lives. I would turn my sadness into good and beauty.
It almost pains me to read this last line. If I had known then how far this was from the truth………………………………
2
When I started residency training in July of 1999 I felt relatively confident. After all, this is what I was meant to do! I showed up to work early the first day. As luck would have it, I was on call. What this meant is that my first day of work would last 36 hours with very little sleep. The chief physician brought me to the third year resident who was handing over his patient’s to me. This was his last day of residency. I will never forget the phrase my chief used when introducing him. He said, “This is John, your taking over his patient’s. Today is his last day of residency. He can’t be hurt anymore!” My thoughts raced…what do you mean “can’t be hurt”? Who was hurting him? It took me about year before I understood what this meant.
In the second year of residency you learn what it feels like to be independent. You do a minimum of 2 months in the ICU where you function without direct supervision. Of course, during the day there are ICU attendings and fellows to help but at night you are on your own.
One night early in my ICU month I was faced with a situation that changed my life. One of my patients had severe respiratory problems and required to be placed on a ventilator. He was an elderly man and we weren’t completely sure of what was wrong with him. I paged the anesthesia person on call to help me intubate him in case I had problems and then I got started.
But things went terribly wrong. I couldn’t get the endotracheal tube in! I kept trying but it was useless. Furthermore, the anesthesiologist never came. We paged and paged but he didn’t show up. My anxiety started to rise. As I placed the mask on the patient’s face and delivered life saving breadths, I felt out of control. I could feel the confidence leaving. I struggled for a few minutes and finally another resident was walking by the ICU and came in and helped. After flailing for about 15 minutes we finally got the patient intubated. Within in seconds his blood pressure dropped. We started CPR and injected epinephrine without benefit. The heart monitor went flat…..and within minutes he was gone. I held back the tears and rehashed every moment. Had I moved to fast to intubate him? Had I deprived him of to much oxygen while fumbling to get him on the ventilator? Did I over sedate him? I will never know the answer to any of these questions.
3
The rest of the night was a blur. I didn’t sleep a wink because I was so busy with my other patients. The man’s wife and family came and went. They didn’t seem to have many questions. It wasn’t till the next morning that the phone calls started to come in.
You see…the family was his new wife and step family, he also had three daughters who were unaware of what had happened. I took three calls that morning. I told three young women over the phone that they lost their father. I listened patiently as all three broke down on the phone. I listened to their moaning and wailing. I remembered what it felt like to lose my father. Each call lasted less then 5 minutes. I never met these women in person. I never spoke to any of them again. Each one of them has left an indelible mark on my soul. I have never experienced grief so pure or innocent. And I will always feel responsible for that grief.
And this is what that resident meant by being “hurt”. If you practice medicine long enough you will make mistakes. You may accidentally hurt people. You will work long hours and deal with the bassist human emotions. At some point you either learn to sublimate, learn to move on, or get crushed. When you say that someone can’t be hurt what you are saying is that they can work 36 hours in a row without sleep, deal with not only the annoyances of hospital life, but also the shear fear and sadness, and still at the drop of a dime make critical decisions involving peoples lives. It also means that you learn how to be hard, learn how not to cry. Your drop your emotions and sentimentality to survive. You change who you are.
When I became a physician I unwittingly made this sacrifice for the possibility of the shear good that I could accomplish. I could deal with the stress, the sadness, even the culpability for people’s lives, as long as there was a pot of gold at the end of the rainbow. I could give up the tenderest side of myself, in order to carry on as a physician and not get squashed by my experiences. During residency there really was no place for tenderness!
So that day, in the ICU, amidst the phone calls and the grief I stood at the abyss. I could either let momentum and sadness carry me down or I could step away. At the time, I thought I was choosing life. At that point I didn’t realize that I was lost and that I wouldn’t feel like myself for many years. In fact, I found myself again October 25th, 2004. The day my son was born……..
4
The rest of my career has been rather mundane. I left residency and joined an internal medicine practice. My days are straight forward. I cram as many patients into as few hours as possible to stay afloat. The malpractice crises is a constant worry. Malpractice prices go up. Physicians are forced to see more patients in less time to cover overhead. The quality of care goes down. There are more law suits…..and the circular trend continues.
People are less happy with their doctors. I often find my patients to be angry and distrustful before they even meet me. There is a constant barrage of paperwork for what seems to be useless reasons. I am constantly being questioned by insurance companies on why I am ordering certain tests and whether I am making the right decision. I so rarely feel like I am helping people!
Physicians are also changing. Because of the poorer income, decreased respect in the community, and family obligations…..they are becoming less responsible for their patient’s well being. The days of your physician meeting you at the emergency late at night in times of need is gone. Most young physicians believe that after the work day is over….their patients are someone else’s concern.
And I believe I would have been okay with this except my world radically changed on Oct 25th, 2004. When my son was born I became a different person. When I looked into his eyes all the barriers that I had erected since that horrible day in the ICU came down. I had found myself again. After years I could feel the warmth return. I could cry again. I could love again. I didn’t have to protect myself any more.
So why was I staying in medicine? It clearly wasn’t making me happy! Why did I give up an important part of myself for a profession that promised so much and delivered so little? Where had I gone wrong?
And what does this say about the state of healthcare today? I had come into this profession with the hopes of helping humanity. I had trained at some of the top institutions in the world. I had received various awards both for academic rigor as well as patient care. I was considered bright, caring, and hardworking. These are qualities you would suspect would make a great physician. But they don’t! And that is the problem.
The story that I told myself about my life had changed. My father’s death had brought me to a profession which I eventually would not like. As my son was born I would come to this conclusion and leave medicine. I could change in time to teach him what is really important. And change I surely had.
But in my heart of hearts, I really tell myself a whole different story. Maybe I truly was meant to be a physician and help humanity and that it wasn’t me at all but medicine……. medicine that had changed.
Either way I realize it is time to change my way of thinking. Who I am and who I will be was neither a result of my father dyeing nor that horrible night in the ICU. It’s time I stopped looking for a cosmic truth in my father’s death and accepted it for what it was….A sad tragedy that will neither define me nor hold me back. It’s time for me to take responsibility and embrace….
Who I have become.
We tell ourselves the stories about our lives that make it bearable….our better yet magical, mystical.
When my father died unexpectedly, when I was seven, I had no words or stories that made sense. How could I explain how this loving father of three and devoted husband could be taken from this earth so quickly and with so little warning. It was a question that puzzled me throughout childhood.
As I grew older I unconsciously formulated the answer to this question. You see…my father died when I was seven years old. At this age, he was my idol. I wanted to be just like him. I copied his movements, his words, and of course I wanted to be a doctor too. My father was a highly respected oncologist and often treated the sickest people. He had received many accolades as well as the love and respect of his patients.
I figure, if he had lived longer, I may have outgrown this period. Maybe I would have reached an age where we fought more or I might have become disillusioned with him. Maybe I would have changed my mind and wanted to be a sports star or a policeman. Who knows? The point is this idea of being a doctor stuck with me. And it carried me.
It carried me through a learning disability; it carried me through a move. It carried me through successes and failures. It created a confidence that never questioned if…only questioned when.
That story made sense. My father’s death, tragic as it was, made concrete in me the idea of becoming a physician. And by doing this I would carry on the tradition and touch countless lives. From his death would come rebirth and renewal. I would help people….I would save lives. I would turn my sadness into good and beauty.
It almost pains me to read this last line. If I had known then how far this was from the truth………………………………
2
When I started residency training in July of 1999 I felt relatively confident. After all, this is what I was meant to do! I showed up to work early the first day. As luck would have it, I was on call. What this meant is that my first day of work would last 36 hours with very little sleep. The chief physician brought me to the third year resident who was handing over his patient’s to me. This was his last day of residency. I will never forget the phrase my chief used when introducing him. He said, “This is John, your taking over his patient’s. Today is his last day of residency. He can’t be hurt anymore!” My thoughts raced…what do you mean “can’t be hurt”? Who was hurting him? It took me about year before I understood what this meant.
In the second year of residency you learn what it feels like to be independent. You do a minimum of 2 months in the ICU where you function without direct supervision. Of course, during the day there are ICU attendings and fellows to help but at night you are on your own.
One night early in my ICU month I was faced with a situation that changed my life. One of my patients had severe respiratory problems and required to be placed on a ventilator. He was an elderly man and we weren’t completely sure of what was wrong with him. I paged the anesthesia person on call to help me intubate him in case I had problems and then I got started.
But things went terribly wrong. I couldn’t get the endotracheal tube in! I kept trying but it was useless. Furthermore, the anesthesiologist never came. We paged and paged but he didn’t show up. My anxiety started to rise. As I placed the mask on the patient’s face and delivered life saving breadths, I felt out of control. I could feel the confidence leaving. I struggled for a few minutes and finally another resident was walking by the ICU and came in and helped. After flailing for about 15 minutes we finally got the patient intubated. Within in seconds his blood pressure dropped. We started CPR and injected epinephrine without benefit. The heart monitor went flat…..and within minutes he was gone. I held back the tears and rehashed every moment. Had I moved to fast to intubate him? Had I deprived him of to much oxygen while fumbling to get him on the ventilator? Did I over sedate him? I will never know the answer to any of these questions.
3
The rest of the night was a blur. I didn’t sleep a wink because I was so busy with my other patients. The man’s wife and family came and went. They didn’t seem to have many questions. It wasn’t till the next morning that the phone calls started to come in.
You see…the family was his new wife and step family, he also had three daughters who were unaware of what had happened. I took three calls that morning. I told three young women over the phone that they lost their father. I listened patiently as all three broke down on the phone. I listened to their moaning and wailing. I remembered what it felt like to lose my father. Each call lasted less then 5 minutes. I never met these women in person. I never spoke to any of them again. Each one of them has left an indelible mark on my soul. I have never experienced grief so pure or innocent. And I will always feel responsible for that grief.
And this is what that resident meant by being “hurt”. If you practice medicine long enough you will make mistakes. You may accidentally hurt people. You will work long hours and deal with the bassist human emotions. At some point you either learn to sublimate, learn to move on, or get crushed. When you say that someone can’t be hurt what you are saying is that they can work 36 hours in a row without sleep, deal with not only the annoyances of hospital life, but also the shear fear and sadness, and still at the drop of a dime make critical decisions involving peoples lives. It also means that you learn how to be hard, learn how not to cry. Your drop your emotions and sentimentality to survive. You change who you are.
When I became a physician I unwittingly made this sacrifice for the possibility of the shear good that I could accomplish. I could deal with the stress, the sadness, even the culpability for people’s lives, as long as there was a pot of gold at the end of the rainbow. I could give up the tenderest side of myself, in order to carry on as a physician and not get squashed by my experiences. During residency there really was no place for tenderness!
So that day, in the ICU, amidst the phone calls and the grief I stood at the abyss. I could either let momentum and sadness carry me down or I could step away. At the time, I thought I was choosing life. At that point I didn’t realize that I was lost and that I wouldn’t feel like myself for many years. In fact, I found myself again October 25th, 2004. The day my son was born……..
4
The rest of my career has been rather mundane. I left residency and joined an internal medicine practice. My days are straight forward. I cram as many patients into as few hours as possible to stay afloat. The malpractice crises is a constant worry. Malpractice prices go up. Physicians are forced to see more patients in less time to cover overhead. The quality of care goes down. There are more law suits…..and the circular trend continues.
People are less happy with their doctors. I often find my patients to be angry and distrustful before they even meet me. There is a constant barrage of paperwork for what seems to be useless reasons. I am constantly being questioned by insurance companies on why I am ordering certain tests and whether I am making the right decision. I so rarely feel like I am helping people!
Physicians are also changing. Because of the poorer income, decreased respect in the community, and family obligations…..they are becoming less responsible for their patient’s well being. The days of your physician meeting you at the emergency late at night in times of need is gone. Most young physicians believe that after the work day is over….their patients are someone else’s concern.
And I believe I would have been okay with this except my world radically changed on Oct 25th, 2004. When my son was born I became a different person. When I looked into his eyes all the barriers that I had erected since that horrible day in the ICU came down. I had found myself again. After years I could feel the warmth return. I could cry again. I could love again. I didn’t have to protect myself any more.
So why was I staying in medicine? It clearly wasn’t making me happy! Why did I give up an important part of myself for a profession that promised so much and delivered so little? Where had I gone wrong?
And what does this say about the state of healthcare today? I had come into this profession with the hopes of helping humanity. I had trained at some of the top institutions in the world. I had received various awards both for academic rigor as well as patient care. I was considered bright, caring, and hardworking. These are qualities you would suspect would make a great physician. But they don’t! And that is the problem.
The story that I told myself about my life had changed. My father’s death had brought me to a profession which I eventually would not like. As my son was born I would come to this conclusion and leave medicine. I could change in time to teach him what is really important. And change I surely had.
But in my heart of hearts, I really tell myself a whole different story. Maybe I truly was meant to be a physician and help humanity and that it wasn’t me at all but medicine……. medicine that had changed.
Either way I realize it is time to change my way of thinking. Who I am and who I will be was neither a result of my father dyeing nor that horrible night in the ICU. It’s time I stopped looking for a cosmic truth in my father’s death and accepted it for what it was….A sad tragedy that will neither define me nor hold me back. It’s time for me to take responsibility and embrace….
Who I have become.
Saturday, November 15, 2008
Dyspnea
Buoyed
by
urgency
Diving into the
human
abyss
The bodies
traitorious
conspiritor
A return
to
primordium
Yearning
for
atlantis
Alveoli
float
helplessy
In the deep
pneumatic
ocean
From the chapbook Primary Care, The Lives You Touch Publications
Friday, November 14, 2008
Our World
So I'm watching TV in my family room when I here my 4 year old son crying in his bedroom. I bound up the stairs and walk into his room to see he is clearly upset.
"Cameron....what's the matter?"
"I can't sleep Daddy....everytime I close my eyes I dream a wolf is coming to eat me!"
"We read Peter the Wolf in class today and now I can't stop thinking about it!"
I try to convince him that it's just a dream. That it's not real. That he is safe at home in bed. But to no avail. So I try a different tact.
"Just imagine that right before the wolf gets you that your daddy is there and jumps in front and saves you at the last minute!"
"Daddy....that won't work...what if you are not fast enought?....I want Mommy"
By that time my wife walks into the room.
"Honey...what's the matter?"
Cameron Speaks up, "we read Peter the Wolf in class today and now I keep dreaming that a wolf is coming to eat me!"
"Oh that..." she replies, "I forgot to tell you that I talked to your teacher about this exact subject today."
"You did?"
"Yes...and after I picked you up from school, while at work, I wrote an email to the wolf and told him not to bother you tonight.....that there are much tastier kids down the block and to leave our house alone!"
"You did...thanks Mommy...I thin I can go to sleep now."
I, forever the smart ass, to my wife, " I hope you cc'ed evil spiderman and the boogeyman also!"
Cameron turns to his mother quizically with eyes wide, "the boogeyman?"
"Cameron....what's the matter?"
"I can't sleep Daddy....everytime I close my eyes I dream a wolf is coming to eat me!"
"We read Peter the Wolf in class today and now I can't stop thinking about it!"
I try to convince him that it's just a dream. That it's not real. That he is safe at home in bed. But to no avail. So I try a different tact.
"Just imagine that right before the wolf gets you that your daddy is there and jumps in front and saves you at the last minute!"
"Daddy....that won't work...what if you are not fast enought?....I want Mommy"
By that time my wife walks into the room.
"Honey...what's the matter?"
Cameron Speaks up, "we read Peter the Wolf in class today and now I keep dreaming that a wolf is coming to eat me!"
"Oh that..." she replies, "I forgot to tell you that I talked to your teacher about this exact subject today."
"You did?"
"Yes...and after I picked you up from school, while at work, I wrote an email to the wolf and told him not to bother you tonight.....that there are much tastier kids down the block and to leave our house alone!"
"You did...thanks Mommy...I thin I can go to sleep now."
I, forever the smart ass, to my wife, " I hope you cc'ed evil spiderman and the boogeyman also!"
Cameron turns to his mother quizically with eyes wide, "the boogeyman?"
Thursday, November 13, 2008
Stroke of Genius (Conclusions)
1
As Scott mixed the vials together he knew that this could change everything. His left hand was shaking as he lifted the flask to his mouth. He was alone in the lab. Cecilia droped him off at lunch and wouldn't be back till after work. His mind raced as he felt the cool concoction wash past his lips and down his throat. It had a gentle taste. Neither sweet nor bitter. Rather pleasent. As he consumed the last ounce he dropped the flask onto the lab top where it smashed into a thousand little pieces.
Scott was feeling weak and dizzy. The blood rushed into his face. His right arm and leg started to tingle and then burn. Oh no! This is going to kill me like the rabbits. I miscalculated! His mind quickly replayed the formula in his head. But his brain was working slower now. He couldn't quite remember how he had arrived at the master formulation he just consumed. As he drifted off into unconsciousness he felt his body falling and finally thud onto the ground. Oh Cecilia....Cecilia...would I have not suffered this fate for you?
2
Scott felt someone gently pulling his arms. He opened his eyes to see his beautiful Cecilia towering above him. He struggled to explain but he couldn't. His mind was moving at what seemed to be a snail's pace. But then he realzied that he wasn't slow at all....he was back to himself. Back to how things were before the stroke. Before his thoughts began to race and his ideas began to quicken.
Scott grabbed onto Cecilia's hands and pulled himself upward. They stared at eachother dumbfoundedly. He had used his right arm. It was no longer disabled. Then he walked around the desk. His leg was working perfectly. He was cured! He looked down at the flask..it was empty. Now what was that formula?
3
For month's Scott tried to piece together his frantic notes. He would sit for hours at night thinking in his dark bedroom. But it was all gone. His mind could no longer make the mental leaps it had before he cured the stroke.
He returned to the lab convinced he would eventually recreate his success. But he never would. His life work would have meaning....he would win many awards...help many people. But he would never remember the formula. He would never cure the epidemic.
Scott eventually came to terms with the fact that his genius was short lived. That It came with the stroke and left with the cure. But he was always keenly aware of how slow his mind now worked. He felt like a turtle. He may eventually win the race but he would do it at his own tortured, humble pace.
And then there was Cecilia. The magic potion that cured his stroke did nothing to diminish his feelings for her. He still was sensitive to her needs and emotions. He could still read the expression on her face before she said a word.
The fact was that even before his illness he always had the ability to love and be loved......and maybe that...that....
was Scott's true stroke of genius.
As Scott mixed the vials together he knew that this could change everything. His left hand was shaking as he lifted the flask to his mouth. He was alone in the lab. Cecilia droped him off at lunch and wouldn't be back till after work. His mind raced as he felt the cool concoction wash past his lips and down his throat. It had a gentle taste. Neither sweet nor bitter. Rather pleasent. As he consumed the last ounce he dropped the flask onto the lab top where it smashed into a thousand little pieces.
Scott was feeling weak and dizzy. The blood rushed into his face. His right arm and leg started to tingle and then burn. Oh no! This is going to kill me like the rabbits. I miscalculated! His mind quickly replayed the formula in his head. But his brain was working slower now. He couldn't quite remember how he had arrived at the master formulation he just consumed. As he drifted off into unconsciousness he felt his body falling and finally thud onto the ground. Oh Cecilia....Cecilia...would I have not suffered this fate for you?
2
Scott felt someone gently pulling his arms. He opened his eyes to see his beautiful Cecilia towering above him. He struggled to explain but he couldn't. His mind was moving at what seemed to be a snail's pace. But then he realzied that he wasn't slow at all....he was back to himself. Back to how things were before the stroke. Before his thoughts began to race and his ideas began to quicken.
Scott grabbed onto Cecilia's hands and pulled himself upward. They stared at eachother dumbfoundedly. He had used his right arm. It was no longer disabled. Then he walked around the desk. His leg was working perfectly. He was cured! He looked down at the flask..it was empty. Now what was that formula?
3
For month's Scott tried to piece together his frantic notes. He would sit for hours at night thinking in his dark bedroom. But it was all gone. His mind could no longer make the mental leaps it had before he cured the stroke.
He returned to the lab convinced he would eventually recreate his success. But he never would. His life work would have meaning....he would win many awards...help many people. But he would never remember the formula. He would never cure the epidemic.
Scott eventually came to terms with the fact that his genius was short lived. That It came with the stroke and left with the cure. But he was always keenly aware of how slow his mind now worked. He felt like a turtle. He may eventually win the race but he would do it at his own tortured, humble pace.
And then there was Cecilia. The magic potion that cured his stroke did nothing to diminish his feelings for her. He still was sensitive to her needs and emotions. He could still read the expression on her face before she said a word.
The fact was that even before his illness he always had the ability to love and be loved......and maybe that...that....
was Scott's true stroke of genius.
Tuesday, November 11, 2008
Stroke of Genius (4)
Scott's pace was becoming frenetic. He abandoned physcial therapy in order to spend more time with his research. Cecilia begrudgingly dropped him off at the lab every morning and picked him up every night. Often he would bring his notebooks home to work further after Cecilia went to sleep. His lab assistants and students had been reassigned so he worked alone. As his pace quickened his organiztional skills started to fail. His once neat and clean notes were now scattered about the lab and apartment. At some point his thoughts were coming so quickly he abandoned keeping formal accounts of his activities. He used any piece of paper he could find around the house for quick calculations.
And Scott was energized. Never had he felt so capable. Never had his ideas been so vibrant. He was getting closer and closer to the answer. The unique solution that would bypass the damage to the oxygen starved, seemingly dead cells and bring them back to life. He visualized the compound entering the infarcted area of the rabbits brain. He saw the alterations occuring at a cellular level. But the compound was a loose cannon. An unguided missile. Its effects spread to other parts of the body. Sensitive parts. Parts that eventually led to the rabbits death.
It was as clear as day. He needed to modify the compound. Allow it to hone in on the incapacitated tissue in the brain but ignore the rest of the body. A coating to keep it centered and not allow it to cross back over the blood brain barrier. He again went over the chemical formula. How could it be modified. What component changed such that it would get stuck in just the right place.
The answer came to Scott in a dream. He had fallen asleep in his chair while studying the numbers. The chemical he had been using to treat the rabbits was flawed. Although it erased the damage from the stroke it eventually led to toxic metabolites that killed the rabbit prematurely. But now...now in the subconscious depths of sleep he stumbled upon the answer. It was a simple adjustment. A basic organic reaction.
He fell back asleep with his mind made up. Tomarrow after Cecilia dropped him off he would alter the compound. And then....then....
He would try it on himself.
And Scott was energized. Never had he felt so capable. Never had his ideas been so vibrant. He was getting closer and closer to the answer. The unique solution that would bypass the damage to the oxygen starved, seemingly dead cells and bring them back to life. He visualized the compound entering the infarcted area of the rabbits brain. He saw the alterations occuring at a cellular level. But the compound was a loose cannon. An unguided missile. Its effects spread to other parts of the body. Sensitive parts. Parts that eventually led to the rabbits death.
It was as clear as day. He needed to modify the compound. Allow it to hone in on the incapacitated tissue in the brain but ignore the rest of the body. A coating to keep it centered and not allow it to cross back over the blood brain barrier. He again went over the chemical formula. How could it be modified. What component changed such that it would get stuck in just the right place.
The answer came to Scott in a dream. He had fallen asleep in his chair while studying the numbers. The chemical he had been using to treat the rabbits was flawed. Although it erased the damage from the stroke it eventually led to toxic metabolites that killed the rabbit prematurely. But now...now in the subconscious depths of sleep he stumbled upon the answer. It was a simple adjustment. A basic organic reaction.
He fell back asleep with his mind made up. Tomarrow after Cecilia dropped him off he would alter the compound. And then....then....
He would try it on himself.
Monday, November 10, 2008
Stroke of Genius (3)
If Scott's brain had been an abacus before it now worked more like a supercomputer. Ideas would bounce from neuron to neuron. Becoming form and substance, changing, taking on new meaning. Inverting to show a previously incomprehensible view. His mind took off like a rocket. Craving complexity and embracing the abstract. He became keenly aware of the intricate.
And his body...his body languished under the austere framework of physical therapy. While his brain could move mountains his muscles were powerless. It took supreme concentration to wiggle the fingers on his right hand. He spent hour after agonizing hour in bed, in the wheel chair, sitting on the couch. And Cecilia patiently attended to him. She was a godsend.
After the hospitalization she came obediently after work each day to prepare him dinner. He never asked. But he dare not refuse. She kept him up to date with the comings and goings of the hospital. She checked on the lab and brought his mail. She even wheeled him over to the office a few times.
She was beautiful and sweet. Smart and caring. So many things Scott had never taken the time to notice. And he loved her for it. Loved her like he had never loved before. The stroke had rendered him so physically weak....but had opened up other forms of strength. The strength to see that which made another person so wonderful. It had been years since he let someone into his life.
It started rather innocently. She would stop by to help, run some errands. But then the visits became longer. And eventually she began to stay over. All with Scott's tacit consent. He wouldn't have had it any other way.
And late at night while Cecilia was sleaping Scott would pour over his data from the lab. He no longer could sleep. When the lights were out and the apartment was quiet his mind would start to race again. Keeping him up. Driving him back to the numbers scrawled meticulously in his notebook. Turning them over and over agian in his mind until they became characters dancing through his brain. Pausing briefly over the damaged tissue and studying that which was out of place.
Scott had become like the rabbits in his experiments. He had studied them and reversed the defects from their strokes. But they were dying to quickly. Now he turned an inner eye on his own damaged tissues.
How would he fix it?
And his body...his body languished under the austere framework of physical therapy. While his brain could move mountains his muscles were powerless. It took supreme concentration to wiggle the fingers on his right hand. He spent hour after agonizing hour in bed, in the wheel chair, sitting on the couch. And Cecilia patiently attended to him. She was a godsend.
After the hospitalization she came obediently after work each day to prepare him dinner. He never asked. But he dare not refuse. She kept him up to date with the comings and goings of the hospital. She checked on the lab and brought his mail. She even wheeled him over to the office a few times.
She was beautiful and sweet. Smart and caring. So many things Scott had never taken the time to notice. And he loved her for it. Loved her like he had never loved before. The stroke had rendered him so physically weak....but had opened up other forms of strength. The strength to see that which made another person so wonderful. It had been years since he let someone into his life.
It started rather innocently. She would stop by to help, run some errands. But then the visits became longer. And eventually she began to stay over. All with Scott's tacit consent. He wouldn't have had it any other way.
And late at night while Cecilia was sleaping Scott would pour over his data from the lab. He no longer could sleep. When the lights were out and the apartment was quiet his mind would start to race again. Keeping him up. Driving him back to the numbers scrawled meticulously in his notebook. Turning them over and over agian in his mind until they became characters dancing through his brain. Pausing briefly over the damaged tissue and studying that which was out of place.
Scott had become like the rabbits in his experiments. He had studied them and reversed the defects from their strokes. But they were dying to quickly. Now he turned an inner eye on his own damaged tissues.
How would he fix it?
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