She was like....Superwoman. A strapping medical visionary probably in her forties. Gray long coat falling below the knees. She strode confidently down the hallway towards the elevator, a father hurrying beside her with his young lanky daughter cradled in his arms. The girl's head nuzzled into her father's shoulder. She was old enough to walk by herself...but clearly she was sick. Unable.
Undoubtedly they were headed from the medical complex to the ER which was a few hundred feet away. As I walked past them towards my own office door one clear thought leaped into mind. Boy....I wish I was a doctor. Then I froze. Wait...I am...I am a doctor. But maybe I no longer feel like that kind of Doctor. You know, the one with a capital D. As in MD. The one who throws caution to the wind and runs out of a full office of patients to escort an ailing person and family member to the ER. The one who rushes out of a crowd to perform CPR on the elderly lady who collapses in the shopping mall.
Unfortunately most of us in Internal Medicine have found our jobs and lives deranged to the extent that we no longer feel the strength and surge of emotion that brought us into the profession in the first place. Most of us have lost our inner Superman. And our patients have grown tired of waiting.
It's been going on for years now. The devaluation of primary care and especially Internal Medicine. It started with the loss of technical abilities. Over the years Internists have given up most of the manual labor. We no longer perform biopsies, place central lines, lumbar punctures, or manage ventilators. We have ceded these skills to specialists.
This loss of technical prowess has had far reaching implications. For one...our patients, as well as our specialist colleagues, no longer see us as doers....they only see us as thinkers.
And this by itself is no big deal. If you need your car fixed you go to a mechanic. And we don't want to be mechanics. So we embrace our new vision as thinkers. We are warm, kind physicians, who a patient can talk to. We use manual dexterity through physical exam and pure wit to solve medical problems.
Except....that over the years physical exam has been undervalued. Medical training has moved to lab and radiology based evaluations. The Internist no longer prides himself on exam skills. Who needs to know the ins and outs of heart murmurs when you are going to order an echo anyway.
So Internal Medicine lost its concentration on manual dexterity...and turned towards mental gymnastics. I am reminded of Rodin's Thinking Man sculpture. We are now the astronomers and philosophers. Physicists and scientists. We can live with that!
Now take the Thinking Man and remove hand from chin and place squarely on mouse. Take other hand from knee and fill with preprinted checklists and practice guidelines. Tell Thinking Man he has 7.5 minutes till his next patient appears and he will have to strike the same pose in the next exam room with a new patient.
What you get is a thoughtless, hurried physician, who feels impotent. He is isolated from his patients emotionally. He is boxed in by a computer that doesn't allow eye contact. He is isolated physically by a loss of manual dexterity and an overwhelmingly belief by both patient and physician that tests are more important than human touch. And lastly he is isolated mentally by rules and regulations, check lists, and inadequate time to fulfill his role as a thinking man.
Our patients are figuring this out. They are leaving our practices and going to minute clinics, specialists, emergency rooms, and alternative medicine practitioners. They are taking on cute names and becoming epatients and creating their own empowerment movement.
They are sick and tired and frustrated by us supposed supermen who are enslaved in straight jackets of cryptonite. They have been here before.
Our patients know what happens when you're waiting for Godot....
You sit around an awful long time....
But ultimately...ultimately..
no one comes!
Friday, November 5, 2010
Thursday, November 4, 2010
Portraits of the CIty
Head down.
Feet forward.
Hands Up.
On Michigan Ave.
Where the rich people shop.
Hat in the air.
Catchin quarters.
Head down.
Feet Forward.
Hands Up.
Squattin like a boy.
Curled in a ball
To escape the blows.
Of his father.
Head down.
Feet Forward.
Hands Up.
Watchin shoes.
The more beat up
The more they leave.
Head down.
Feet Forward.
Hands up.
Makin a few bucks.
For the long...cold
winter.
Feet forward.
Hands Up.
On Michigan Ave.
Where the rich people shop.
Hat in the air.
Catchin quarters.
Head down.
Feet Forward.
Hands Up.
Squattin like a boy.
Curled in a ball
To escape the blows.
Of his father.
Head down.
Feet Forward.
Hands Up.
Watchin shoes.
The more beat up
The more they leave.
Head down.
Feet Forward.
Hands up.
Makin a few bucks.
For the long...cold
winter.
Wednesday, November 3, 2010
In Memorium-Snap Shots
My son is standing in the Principal's office. Or actually it's not my son...it's me. That's just how I picture myself in my minds eye when I think back to when I was his age. I am struggling with a large winter coat. I lay it on the floor upside down. Thrust my arms into the sleeves and flip it over my head. I pull on my hat. At first covering my eyes and then giggling...push it back upward.
It's the middle of the school day. While I am aware that it is highly unusual for the teacher to have taken me out of class and told me to bring my coat, my young mind has not yet been poisoned by fear of the unexpected.
The Principal's office is drab. Old stained linoleum on the floor and off gray popcorn ceiling. I have a pair of gloves which are tied together by a string and looped through my coat sleeves. I pull them on and hop around the room on one foot making monkey sounds. The secretary raises an eyebrow but remains quiet.
I am expecting my mom to come through the door at any moment but instead her best friend enters briskly. She barely notices me and walks to the secretary's desk. The secretary nods gently in my direction. The friend walks over and grabs my hand....come on honey, we have to go.
I agree willingly but now even in my seven year old brain I know something is wrong.
As we walk out the front door of the school the wind hits my face. It's a cold winter day and I have to concentrate on the steps to avoid slipping on the ice. I stop and look up into my mom's friends face. Where's my mom?
She pauses, takes a deep breath, and then responds coldly...at the hospital. Then a single tear drops down from her eye onto her cheek. Only my adult mind understands the look of pity on her face as she prepares to tell me, a little boy, that my life will never be the same.
Something has happened to your father.
It's the middle of the school day. While I am aware that it is highly unusual for the teacher to have taken me out of class and told me to bring my coat, my young mind has not yet been poisoned by fear of the unexpected.
The Principal's office is drab. Old stained linoleum on the floor and off gray popcorn ceiling. I have a pair of gloves which are tied together by a string and looped through my coat sleeves. I pull them on and hop around the room on one foot making monkey sounds. The secretary raises an eyebrow but remains quiet.
I am expecting my mom to come through the door at any moment but instead her best friend enters briskly. She barely notices me and walks to the secretary's desk. The secretary nods gently in my direction. The friend walks over and grabs my hand....come on honey, we have to go.
I agree willingly but now even in my seven year old brain I know something is wrong.
As we walk out the front door of the school the wind hits my face. It's a cold winter day and I have to concentrate on the steps to avoid slipping on the ice. I stop and look up into my mom's friends face. Where's my mom?
She pauses, takes a deep breath, and then responds coldly...at the hospital. Then a single tear drops down from her eye onto her cheek. Only my adult mind understands the look of pity on her face as she prepares to tell me, a little boy, that my life will never be the same.
Something has happened to your father.
Tuesday, January 12, 2010
I Wish They Would Just Leave Me Alone
I wish I knew how to express myself. I wish I knew how to put this into words. How the direction of things has just become depressing. How each day makes me wonder how we got to where we are today. And I think back. Back to the beginning.
I think back to my childhood. And how I looked up to my father...the physician. How he died when I was so young. His last gift to me was his profession. How an eight year old somehow made a decision about what he would do with his life. It didn't matter that I had a learning disability.
My thoughts were pure. My intentions the best. Money was the farthest thing from my mind. I studied hard. Tackling the first years of medical school with vigor. Scoring among the highest in my class. Only to be whacked by the reality of my clinicals. Abused by some of my teachers, undercut by fellow students.
I entered residency a little less naive but no less excited. I married. I matured. I held my patients well being in my hands as best as I could. The weight of responsibility sometimes crushed me. There was that night in the ICU when the elderly man in respiratory distress crashed. Where I botched the code. And then had to tell his family over the phone. And the guilt ate my insides out. And I clammed up. The night I dropped my applications to fellowship.
I became cold...but no less dedicated. I lost my self in a protectionalist shell. I replaced joy with calm. I replaced tenderness with cold clinical aassessments. And I became the doctor that I despised. Maybe not to my patients or to my colleagues but I knew the difference. I felt so much rage against the system...against the medical group that I worked for....against the government who wouldn't let me practice the way I wanted to....and sometimes against the patients themselves.
But then my first child was born. And I started to blog. And my heart opened up. I learned how to feel with my patients. How to cry with them. I took their stories home with me each night. And my skills grew. I learned how to read into not only what a patient said but how they said things. I watched the way they walked into the exam room. The way they held their head.
I became a better physician. I learned how to help my patients live with disease....I helped them learn how to die with dignity. I started to catch things that others didn't. Things I had only read about...the guy who was traveling and got erhlichia, the lupus patient with csf rhinorhea who got methemoglobinemia from dapsone,the diffuse lewy body disease missed by the neurologist, the conns syndrome, and the young guy with acromegaly.
And I learned how to be economically as well as medically efficient. Only consulting specialists when absolutely necessary, eschewing antibiotics for watchful waiting, managing patients in the office or nursing home when my colleagues would have put them in the hospital, billing the same yearly totals as my piers but seeing hundreds more patients in the same time period.
I make a nice living. Much better then I ever thought I would. My office is full. The nursing homes are always calling. I see my own patients in the hospital. I am efficient but thorough. I may only spend 10 minutes in the room with the ninety year old with chf,diabetes,and copd. but I also spend 10 minutes reviewing her chart. And 15 minutes on two separate occasions with her on the phone. And 30 minutes calling her cardiologist discussing my plan for her.
But things are changing in medicine. Overwhelmed by a system that costs too much the government is forced to make changes. And the debate roles on about who is at fault. Is it the insurance industry...pharma.....or doctors. We all know that the doctors pen is the most expensive technology in health care.
We all say that primary care doctors are not paid enough. But in the same breath we say that they inefficiently manage their patients, order to many tests, consult too many specialists, and miss to many diagnosis. We talk about quality as if it is something that anyone really knows how to measure.
And I see such change coming. Medical homes...pay for performance....bundled payments....employed physicians.....the endless jargon of health care reform. And my anxiety grows. For those who practice ineffectively some of these government intrusions will undoubtedly bring them in line. But for some of us....those who have prided themselves on cost effective, efficient care...these changes will just slow us down. They will make it harder to get reimbursed at our current level. They will produce more silly administrative hoops to jump through. More useless pain. Eventually many of us will leave. Why not work for an insurance or drug company. Even if we are happier practicing...at least our type of medicine.
It makes me sad. And makes me think....the reformers...the government....I wish they would just leave me alone.
I think back to my childhood. And how I looked up to my father...the physician. How he died when I was so young. His last gift to me was his profession. How an eight year old somehow made a decision about what he would do with his life. It didn't matter that I had a learning disability.
My thoughts were pure. My intentions the best. Money was the farthest thing from my mind. I studied hard. Tackling the first years of medical school with vigor. Scoring among the highest in my class. Only to be whacked by the reality of my clinicals. Abused by some of my teachers, undercut by fellow students.
I entered residency a little less naive but no less excited. I married. I matured. I held my patients well being in my hands as best as I could. The weight of responsibility sometimes crushed me. There was that night in the ICU when the elderly man in respiratory distress crashed. Where I botched the code. And then had to tell his family over the phone. And the guilt ate my insides out. And I clammed up. The night I dropped my applications to fellowship.
I became cold...but no less dedicated. I lost my self in a protectionalist shell. I replaced joy with calm. I replaced tenderness with cold clinical aassessments. And I became the doctor that I despised. Maybe not to my patients or to my colleagues but I knew the difference. I felt so much rage against the system...against the medical group that I worked for....against the government who wouldn't let me practice the way I wanted to....and sometimes against the patients themselves.
But then my first child was born. And I started to blog. And my heart opened up. I learned how to feel with my patients. How to cry with them. I took their stories home with me each night. And my skills grew. I learned how to read into not only what a patient said but how they said things. I watched the way they walked into the exam room. The way they held their head.
I became a better physician. I learned how to help my patients live with disease....I helped them learn how to die with dignity. I started to catch things that others didn't. Things I had only read about...the guy who was traveling and got erhlichia, the lupus patient with csf rhinorhea who got methemoglobinemia from dapsone,the diffuse lewy body disease missed by the neurologist, the conns syndrome, and the young guy with acromegaly.
And I learned how to be economically as well as medically efficient. Only consulting specialists when absolutely necessary, eschewing antibiotics for watchful waiting, managing patients in the office or nursing home when my colleagues would have put them in the hospital, billing the same yearly totals as my piers but seeing hundreds more patients in the same time period.
I make a nice living. Much better then I ever thought I would. My office is full. The nursing homes are always calling. I see my own patients in the hospital. I am efficient but thorough. I may only spend 10 minutes in the room with the ninety year old with chf,diabetes,and copd. but I also spend 10 minutes reviewing her chart. And 15 minutes on two separate occasions with her on the phone. And 30 minutes calling her cardiologist discussing my plan for her.
But things are changing in medicine. Overwhelmed by a system that costs too much the government is forced to make changes. And the debate roles on about who is at fault. Is it the insurance industry...pharma.....or doctors. We all know that the doctors pen is the most expensive technology in health care.
We all say that primary care doctors are not paid enough. But in the same breath we say that they inefficiently manage their patients, order to many tests, consult too many specialists, and miss to many diagnosis. We talk about quality as if it is something that anyone really knows how to measure.
And I see such change coming. Medical homes...pay for performance....bundled payments....employed physicians.....the endless jargon of health care reform. And my anxiety grows. For those who practice ineffectively some of these government intrusions will undoubtedly bring them in line. But for some of us....those who have prided themselves on cost effective, efficient care...these changes will just slow us down. They will make it harder to get reimbursed at our current level. They will produce more silly administrative hoops to jump through. More useless pain. Eventually many of us will leave. Why not work for an insurance or drug company. Even if we are happier practicing...at least our type of medicine.
It makes me sad. And makes me think....the reformers...the government....I wish they would just leave me alone.
Tuesday, February 17, 2009
Some More Thoughts On Physician Extenders
I made the mistake here of posting on my thoughts of PA's and Nurse practitioners. Predictably I received a number of not so happy comments. Most of them came from people who had googled phrases such as "physician opinions of nurse practitioners" and fortuitously landed on my blog. I can understand their venom. And maybe I deserve it. Maybe I am a little defensive. A little jealous even.
I mean.... why did I spend so much time and money learning how to be a primary care practitioner? Why did I endure medical school and residency? Why didn't I take the faster route? I could have become a PA or Nurse Practitioner with much less training. I wouldn't have had to spend nearly as much on education. And I would still be able to take care of people and pretty much fill the same role I do today. Right?
I mean you can understand that. Why I would be a little bitter. I guess I do have a jealousy problem. But its not the training or the cost of education that gets me. It something else completely.....
You see I find practicing primary care inexpressibly difficult. Every day I struggle endlessly to balance physiology and psychology, ordinary and uncommon, health and illness. And most days I feel like I do a miserable job. Many nights I sit up worrying that I made the wrong decisions.
I can chart the maturity process of my education. It started early. My first patient.....during gross anatomy. I watched as my cohorts were crass and cocky. How they made fun of the cadavers. In retrospect we were sublimating to protect ourselves. And then we dissected the genitals. And emotionally I fell down. I faced a very sad and scary reality. This was a person that I was cutting open. A human being who had willingly donated their secrets to me.
And then there was medical school. When every patient was a room number or a disease. Until you realized they were people. People who had lives and family. And that was tragic.
Next came residency. After hours of being on call. When no matter what you did your patients got more and more sick anyway. And then there was the day when you sit next to a patient and hold their hand. And watch them die and accept that sometimes even when you can't help by being a physician you can help by being a human being.
With time my attitude towards knowledge also changed. From thinking I knew nothing...to thinking I knew everything....to learning my limitations.
And my knowledge. From anatomy and physiology to disease. To use my senses to evaluate a patient. The visual....the smells...the sounds. To learn to become quiet and listen to myself. To pay attention to what each patient evoked inside and use that to help guide judgement. Seeing sickness over and over again until one could recognize it by the most subtle clues in a half awake state after working 24 hours in a row. Until the gravity of illness was not only a series of lab results and exam signs but an innate feeling that pinches you in the chest before death rears its ugly head.
And overtime I got better. My diagnostic acumen improved. I was better able to wade through the morass of anger, denial, oversimplification, and the useless complexity of the human condition to feel a small level of competence. To appropriately recognize the chest pain that smacked of imminent coronary disaster and direct to the ER as well as comforting the chest pain from anxiety and starting appropriate meds.
But everyday I learn something new. Everyday I return to the literature. Everyday I confront my own inadequacies to imperfectly perform this task that has become my life work. A task that leaves me in awe and humble.
And everyday I wonder if my training has been enough....and I probably will till the day I retire.
So yes I am jealousof you....of anyone who feels that they can do my job with less training. I bow my head to the PA's and Nurse Practitioners who are vying to take my job. I find being a primary care practitioner extremely difficult and wish I could be smart enough to arrive at your level of expertise...
so quickly.
I mean.... why did I spend so much time and money learning how to be a primary care practitioner? Why did I endure medical school and residency? Why didn't I take the faster route? I could have become a PA or Nurse Practitioner with much less training. I wouldn't have had to spend nearly as much on education. And I would still be able to take care of people and pretty much fill the same role I do today. Right?
I mean you can understand that. Why I would be a little bitter. I guess I do have a jealousy problem. But its not the training or the cost of education that gets me. It something else completely.....
You see I find practicing primary care inexpressibly difficult. Every day I struggle endlessly to balance physiology and psychology, ordinary and uncommon, health and illness. And most days I feel like I do a miserable job. Many nights I sit up worrying that I made the wrong decisions.
I can chart the maturity process of my education. It started early. My first patient.....during gross anatomy. I watched as my cohorts were crass and cocky. How they made fun of the cadavers. In retrospect we were sublimating to protect ourselves. And then we dissected the genitals. And emotionally I fell down. I faced a very sad and scary reality. This was a person that I was cutting open. A human being who had willingly donated their secrets to me.
And then there was medical school. When every patient was a room number or a disease. Until you realized they were people. People who had lives and family. And that was tragic.
Next came residency. After hours of being on call. When no matter what you did your patients got more and more sick anyway. And then there was the day when you sit next to a patient and hold their hand. And watch them die and accept that sometimes even when you can't help by being a physician you can help by being a human being.
With time my attitude towards knowledge also changed. From thinking I knew nothing...to thinking I knew everything....to learning my limitations.
And my knowledge. From anatomy and physiology to disease. To use my senses to evaluate a patient. The visual....the smells...the sounds. To learn to become quiet and listen to myself. To pay attention to what each patient evoked inside and use that to help guide judgement. Seeing sickness over and over again until one could recognize it by the most subtle clues in a half awake state after working 24 hours in a row. Until the gravity of illness was not only a series of lab results and exam signs but an innate feeling that pinches you in the chest before death rears its ugly head.
And overtime I got better. My diagnostic acumen improved. I was better able to wade through the morass of anger, denial, oversimplification, and the useless complexity of the human condition to feel a small level of competence. To appropriately recognize the chest pain that smacked of imminent coronary disaster and direct to the ER as well as comforting the chest pain from anxiety and starting appropriate meds.
But everyday I learn something new. Everyday I return to the literature. Everyday I confront my own inadequacies to imperfectly perform this task that has become my life work. A task that leaves me in awe and humble.
And everyday I wonder if my training has been enough....and I probably will till the day I retire.
So yes I am jealousof you....of anyone who feels that they can do my job with less training. I bow my head to the PA's and Nurse Practitioners who are vying to take my job. I find being a primary care practitioner extremely difficult and wish I could be smart enough to arrive at your level of expertise...
so quickly.
Sunday, February 8, 2009
In Memorium
It was a beautiful cool day much like this morning. I pulled into the parking spot recklessly. I was running late but if I hurried I might just make it. I grabbed my backpack and slammed the door shut without a second thought. And then my stomach sank. I heard the calm hum of the motor as I reached back for the door. Locked.
I felt the panic swell inside. My sixteen years of experience hadn't yet taught me how to deal with such things. Overwhelming embarrassment. How could I have locked the keys in the car with the motor still running? As I stood frozen trying to find a way out of the situation I heard footsteps behind me.
The women stood momentarily and gently placed her arm on my shoulder. A little bit of a predicament...huh? She had known me since birth. Her eldest child was my age. She was friends with my parents. And she had been kind enough to allow me to park at her house because I wasn't old enough to get a parking permit from my high school.
I remember her..... growing up. At that time we lived on the same block. Her smile was always comforting. Motherly. And her kitchen usually smelled of something good. Her son and I were best friends once. But time and distance had taken its tole. And now we only ran into each other occasionally.
But here we were again. I may have no longer been a child but I felt again like a five year old parked in her kitchen waiting for my mom to come pick me up. I was helpless. So she called the police to have my car door opened. And she made me hot chocolate while we waited. And she neither teased nor chided. As I left she offered to write a note for my teacher. But I relented. I had at least a little pride.
And over the next 15 years our paths crossed occasionally. Family events. My mom would update me on what was going on with them.
And I was busy with college, then medical school, then residency. I finished my training and returned to be a hospitalist at a local hospital. I was feeling young an important. Competent. Ready to tackle the world.
I had known that she was diagnosed with lung cancer. Never a smoker she was one of the unlucky ones. And I would stop into her room to chat when she was admitted for chemotherapy. We discussed her fears and anxieties. We talked about old times. Just a friendly visitor to pass the hours.
The last time she was admitted I made a point of visiting early. She was in the hospice program and was dying quickly. I knocked gently on the door and let myself in. I expected to find a room full of people but instead it was empty. Her family had stepped out briefly for a cup of coffee. She was resting quietly. Unconscious. Breathing deeply. She had a look that I recognized. The look of someone who was walking their lasts steps through life's unexpected maze. I knew she had hours at most.
So I sat quietly next to her bed and let her know that I was there. I spoke softly but leaned forward towards her. I told her that I was sorry for what she was going through. I told her that it was a pleasure knowing her. And then I said goodbye. I placed her hand in mine. Then I promised that I would always remember.
I left the room before the family returned. And she died later that day. Inexplicably I did not go to the funeral.
I run into her son every now and then. Our lives have taken such different paths but we still share history. Unlike the peolple he now meets today I knew his mom. And this means something.
I don't know why these thoughts came to me this morning as I got out of my car. Why such randomness pops into my head. But I am thankful for them nonetheless. And no matter what...
I will keep the promise I made that day...
I will always remember.
I felt the panic swell inside. My sixteen years of experience hadn't yet taught me how to deal with such things. Overwhelming embarrassment. How could I have locked the keys in the car with the motor still running? As I stood frozen trying to find a way out of the situation I heard footsteps behind me.
The women stood momentarily and gently placed her arm on my shoulder. A little bit of a predicament...huh? She had known me since birth. Her eldest child was my age. She was friends with my parents. And she had been kind enough to allow me to park at her house because I wasn't old enough to get a parking permit from my high school.
I remember her..... growing up. At that time we lived on the same block. Her smile was always comforting. Motherly. And her kitchen usually smelled of something good. Her son and I were best friends once. But time and distance had taken its tole. And now we only ran into each other occasionally.
But here we were again. I may have no longer been a child but I felt again like a five year old parked in her kitchen waiting for my mom to come pick me up. I was helpless. So she called the police to have my car door opened. And she made me hot chocolate while we waited. And she neither teased nor chided. As I left she offered to write a note for my teacher. But I relented. I had at least a little pride.
And over the next 15 years our paths crossed occasionally. Family events. My mom would update me on what was going on with them.
And I was busy with college, then medical school, then residency. I finished my training and returned to be a hospitalist at a local hospital. I was feeling young an important. Competent. Ready to tackle the world.
I had known that she was diagnosed with lung cancer. Never a smoker she was one of the unlucky ones. And I would stop into her room to chat when she was admitted for chemotherapy. We discussed her fears and anxieties. We talked about old times. Just a friendly visitor to pass the hours.
The last time she was admitted I made a point of visiting early. She was in the hospice program and was dying quickly. I knocked gently on the door and let myself in. I expected to find a room full of people but instead it was empty. Her family had stepped out briefly for a cup of coffee. She was resting quietly. Unconscious. Breathing deeply. She had a look that I recognized. The look of someone who was walking their lasts steps through life's unexpected maze. I knew she had hours at most.
So I sat quietly next to her bed and let her know that I was there. I spoke softly but leaned forward towards her. I told her that I was sorry for what she was going through. I told her that it was a pleasure knowing her. And then I said goodbye. I placed her hand in mine. Then I promised that I would always remember.
I left the room before the family returned. And she died later that day. Inexplicably I did not go to the funeral.
I run into her son every now and then. Our lives have taken such different paths but we still share history. Unlike the peolple he now meets today I knew his mom. And this means something.
I don't know why these thoughts came to me this morning as I got out of my car. Why such randomness pops into my head. But I am thankful for them nonetheless. And no matter what...
I will keep the promise I made that day...
I will always remember.
Monday, February 2, 2009
Jumped
We were young. Arrogant. Silly enough to believe that affluence had left a a chip on our shoulder. So we kept trying to knock it off. Or at least to appear that way. In reality we had as little common sense as street smarts. We weren't tough at all. We were just kids. Unschooled in life's bleak realities. Unaware of the danger that lurked around corners. But there were appearances to keep up. So we walked tall. Strutted even. But rarely dealt with the consequences.
I was nineteen. Inebriated. And home from college. My buddies and I had left the apartment at midnight for fast food. It was a quick walk. Ten minutes through empty downtown streets. We arrived just before closing. We scarfed down our burgers even though there was no particular rush. We loitered until they eventually kicked us out of the empty restaurant.
As we walked back we entered a particularly isolated area where lighting was sparse. My two buddies were carrying on as I listened closely. Behind me in the distance I could here a car screech to a stop. Then doors slammed as multiple feet hit the pavement. I crossed the street as my friends obliviously followed. I didn't dare turn around.
Then as I heard the footsteps gaining rapidly I zig-zagged back to the other side of the street. My friend at my side looked up towards me. Where the hell are you going?. But there was no time. The foot steps were coming too quickly. I broke into a sprint and turned only after putting a few hundred yards between us.
One of my friends was wise to what was happening and ran in the other direction. But our third buddy hadn't quite figured it out. I say "buddy" loosely because actually I barely knew the guy. I met him for the first time earlier that night.
But there he was alone. Surrounded by three tall men who were starting to grab at him. Give me your money...give me your money. They kept yelling but he didn't respond. His genteel upbringing and sheltered existence were crashing in around him. He stared blankly with the look of a lost puppy dog.
As I slowly walked back towards the group I felt none of the toughness I had tried so hard to portray at my suburban high school with my suburban friends. I was just a typical rich snot head. Inexperienced and weak! Wearing a beat up brown leather bomber jacket hoping that others would think that I too was gritty and tough and bruised but durable on the inside.
Wordlessly I pushed my way into the center of the fray as the men grabbed my jacket. I clipped there arms under my shoulder and broke my friend loose. The shortest of the bunch reached into his coat pocket and held his hand in place. I have a gun...Don't make me use it....give me all your money. My buddy had awoken from his reverie and I pushed him towards freedom. Yah...well if you have a gun pull it out and I'll give you everything!.
No gun appeared. I wrestled myself free and we all ran to safety. There wasn't any pursuit.
As we returned to the apartment and rejoined the rest of our group my two friends told a tall tale barely resembling what had actually occured. They left out the fact that our three pursuers weighed in total about 200 pounds and that they were likely cracked up and harmless. They forgot to mention that at precisely the most important moment they both froze.
But I didn't correct them. After all was I any better. Hadn't I struggled with the same chip on my shoulder? Let them have there moment.
Maybe toughness was overrated. Maybe what I was really looking for all those years was something that is much more important. Something that I'm still struggling with today:
Wisdom.
I was nineteen. Inebriated. And home from college. My buddies and I had left the apartment at midnight for fast food. It was a quick walk. Ten minutes through empty downtown streets. We arrived just before closing. We scarfed down our burgers even though there was no particular rush. We loitered until they eventually kicked us out of the empty restaurant.
As we walked back we entered a particularly isolated area where lighting was sparse. My two buddies were carrying on as I listened closely. Behind me in the distance I could here a car screech to a stop. Then doors slammed as multiple feet hit the pavement. I crossed the street as my friends obliviously followed. I didn't dare turn around.
Then as I heard the footsteps gaining rapidly I zig-zagged back to the other side of the street. My friend at my side looked up towards me. Where the hell are you going?. But there was no time. The foot steps were coming too quickly. I broke into a sprint and turned only after putting a few hundred yards between us.
One of my friends was wise to what was happening and ran in the other direction. But our third buddy hadn't quite figured it out. I say "buddy" loosely because actually I barely knew the guy. I met him for the first time earlier that night.
But there he was alone. Surrounded by three tall men who were starting to grab at him. Give me your money...give me your money. They kept yelling but he didn't respond. His genteel upbringing and sheltered existence were crashing in around him. He stared blankly with the look of a lost puppy dog.
As I slowly walked back towards the group I felt none of the toughness I had tried so hard to portray at my suburban high school with my suburban friends. I was just a typical rich snot head. Inexperienced and weak! Wearing a beat up brown leather bomber jacket hoping that others would think that I too was gritty and tough and bruised but durable on the inside.
Wordlessly I pushed my way into the center of the fray as the men grabbed my jacket. I clipped there arms under my shoulder and broke my friend loose. The shortest of the bunch reached into his coat pocket and held his hand in place. I have a gun...Don't make me use it....give me all your money. My buddy had awoken from his reverie and I pushed him towards freedom. Yah...well if you have a gun pull it out and I'll give you everything!.
No gun appeared. I wrestled myself free and we all ran to safety. There wasn't any pursuit.
As we returned to the apartment and rejoined the rest of our group my two friends told a tall tale barely resembling what had actually occured. They left out the fact that our three pursuers weighed in total about 200 pounds and that they were likely cracked up and harmless. They forgot to mention that at precisely the most important moment they both froze.
But I didn't correct them. After all was I any better. Hadn't I struggled with the same chip on my shoulder? Let them have there moment.
Maybe toughness was overrated. Maybe what I was really looking for all those years was something that is much more important. Something that I'm still struggling with today:
Wisdom.
Subscribe to:
Posts (Atom)