Disguise

What are the goals for my recovery? The obvious answer is to return to some semblance of ‘normalcy’. Before the surgery my trajectory was becoming a self-sufficient family physician in my career and a loving husband and father in my family life. I enjoyed going to the gym (my routine would include going to our local gym, the Michigan Athletic Club, or MAC as it’s known here, one of the biggest gyms in the country. I would try to go once per day, usually before heading to Sparrow). A return to my pre-surgery habits and appearance is a superficial response. I have to delve deeper. What is ‘normal’? Was my life, routine, and career ‘normal’? If I hope to return to my pre-surgery days, is the goal a disguise of what I’ve been through? I have to come to terms with the fact that this ordeal is going to change my life forever. For me, accepting this drastic change is easier to come to terms with when thinking of inner change (my psyche and perspective on life), than surface change (i.e. the way I walk and talk).

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—- Jenny Allen —-

I recently heard a great talk by Jenny Allen on the Moth Hour on NPR[1]. During her talk she brought up a very interesting topic: she went through cancer, chemotherapy, and resulting hair loss. She then spoke about preparing for this—she had to make the decision if she wanted to become a “wig or scarf person”. She decided that she would be a ‘scarf person’ stating that, “a wig would be dishonest and I wasn’t ashamed of my disease,” and that if she wore a wig “I would be saying ‘please, just let me blend in’.” That made me think, my goal throughout this whole ordeal has been to return to the way things were as if this never happened, like a speed bump in the road. But why was this my hope? Was I ashamed of my condition? Was I a ‘wig’ person? People go through life altering events all the time, from something seemingly innocuous like a speeding ticket to something as serious as the death of a loved one. Now, these are called ‘life altering events’ because they alter your life: for a speeding ticket maybe you decide to drive under the speed limit, or for the death of a loved one maybe your outlook on life is changed. The reason these two points are connected is that when it comes to our health, why must a life changing condition end with a return to ‘normalcy’? Is the hope just a disguise of what we’ve been through? Are we saying that we’re all ‘wig’ people?

—- My Hopes —-

Let me be clear, in no way am I saying that all people who lose their hair due to chemotherapy and wear wigs are trying to hide their condition—my take, and Jenny Allen’s take, is simply one point of view on the topic, perhaps only one reason why someone might wear a wig. I constantly attempt to hide or disguise my condition; I have come up with certain maneuvers that might put off a titubation episode. My only point here is that some people do try to disguise their medical conditions. As I mentioned in “Holding On” former president Franklin Delano Roosevelt would only very rarely allow photos of him in his wheelchair, in fact back then most of the American public did not know that he required a wheelchair for mobility. Whether big or small, we all try to hide what we perceive as imperfection, from someone wearing (a lot of) cologne to someone who wears long sleeves to cover up skin conditions like psoriasis. There is nothing wrong with these practices (although your opinion may differ in the ‘cologne’ example), but with my tumor and resulting condition I have to reexamine what my hopes are; am I hoping to run a 4 minute mile? Of course not, I’ve come to realize that my ultimate goal in my recovery is to be true to myself. Even if this means that for the rest of my life I’ll have an odd, slowed gait and delayed speech I have to come to terms with this and remind myself what I’ve been through. To go through an ordeal like this and not expect it to change my life forever is simply not realistic. My coming to this realization does not mean I’ve ‘given up’. I will continue put all my efforts into physical therapy, and will continue doing at home speech exercises; however after pondering this idea of disguises, I am now aware that my goal is to gain functionality, not to hide my afflictions.

Shakespeare once said “to thine own self be true”.[2] Be true to yourself no matter what you’ve endured. Think of these imperfections a ‘battle wound’ and wear it like a badge of honor.

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[1] Listen to it at https://www.youtube.com/watch?v=rBjPXTrfBc8

[2] http://www.enotes.com/shakespeare-quotes/thine-own-self-true

Teaching

This is dedicated to everyone who works at the Sparrow Central Clinic and all of the incredible clinicians who allowed me to shadow them.

This post comes with a little update on my recovery: after review of my neuropsychological report, it has been deemed that I require an independent neuropsychological evaluation with the neuropsychologist of Sparrow’s choosing. I am slated to undergo this testing in early February. In the meantime, I have been allowed to return to the clinic in an observership role. Even though this simply entails me following either the supervising physician or resident, just being back in the clinic is a significant step in my recovery. The importance of this may be more nominal than tangible, however, being able to be with patients again, seeing the smiling warm faces (of people like Marcie Powers and Liz Cholakis, two of our fantastic program coordinators), bantering with the staff nurses, medical assistants, and front staff, or even seeing my colleagues at work, has all been truly cathartic for me. I mentioned this in an earlier post, but it’s worth mentioning again: Seeing patients puts me at peace. I had so many questions and apprehensions about seeing patients: how would they perceive me? What if a titubation episode occurred during our encounter? What would they think of my slower speech? Would too much focus be taken away from the patient?[1]  But when I met with Dr. Osuch (see the earlier post), who also had a brain tumor removed, she reassured me, “Chris, patients are incredibly understanding,” she went on, “they can handle more than we realize.” In my two weeks back in the clinic, my fears have been quelled, and Dr. Osuch’s words have been validated: I have not suffered a titubation episode while with a patient and thus far none of our visits have been spent explaining my condition. Dr. Osuch was right, the patients just seem to understand. Even though they arrive at the clinic with a myriad of their own medical issues, they somehow find a way to process and understand the situation.

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Much of my time in the clinic is spent shadowing other clinicians. I have been fortunate in that I’ve had the opportunity to shadow many of the resident physicians who were interns when I had my surgery. I had spent 10 months as their senior, and now the tables had turned and they were my superiors. Seeing each of them work brought out so many emotions in me, the main one was pride. I had played (albeit small) a part in their development, and seeing their progression from lowly intern to fully functioning senior residents evoked a sense of pride. I had been granted this rare opportunity to see firsthand the minor role I had in their development. This made me think, how has the role of teaching played out in my recovery? And have my views changed as my perspective has changed?

—- Stinky —-

In medicine, many of the lessons learned only come with time. There is a certain art of medicine that cannot be acquired through reading. The purpose of residency is to prepare future physicians; this creates the constant battle in residency between learning through words (this includes lectures, articles, and textbooks) and ‘trial by fire’.[2] The residents I was now shadowing had only just gone through this struggle, and I was the lucky one to be their senior when they went through it. Before my surgery, I remember speaking to an intern in distress: the stresses common to internship were getting to him. I told him, “Being an intern stinks. You’re given this responsibility of managing patients but really don’t know how to do it. It’d be like being given keys to a brand new car before knowing how to drive. What makes it worse is that everyone somehow knows you’re an intern, it’s almost as if you walk around with a sign around your neck labeling you as such. People in medicine know that interns don’t really have much experience, in fact it’s assumed,” I went on (besides trying to convey to him that I understood his struggle, I was also trying to convince him of the light at the end of the tunnel), “but it gets better. Besides adding to your medical and clinical knowledge, you learn the ropes of the hospital. You figure out how to drive so you can enjoy that new car.” This group of people that were fresh out of medical school before my surgery were now ready to become practicing, self-sufficient physicians. I had always loved teaching before my surgery, but being able to see the metamorphosis of my colleagues only reinforced this notion. The joy I get from being in the clinic came from this unexpected source: the knowledge and expertise of my colleagues and the fact that I played a role in their development as physicians.

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[1] If too much of the visit’s attention was diverted to me, the purpose of the visit would be lost.

[2] The idea here is that the more time spent in the hospital with patients, the better prepared you will be.