Mediocrity

What the hell am I doing with my life?

Here I am, babysitting anxious suburbanites afraid they're having heart attacks or dying of Lyme disease when all they have is muscle pains and achy joints from overdoing their version of "exercise." Trying to talk overweight forty- and fifty-somethings into taking statins to lower their LDL cholesterol of 165 after three years of "trying" diet and exercise, because there are guidelines that say it lowers their risks of MI and stroke. Explaining to diabetics why a blood pressure of 120/80 isn't good enough, again, according to all the latest that evidence-based medicine has to offer. Feeling pretty good when I diagnose a basal cell carcinoma instead of the ringworm the patient has been treating for two months. I spend an entire day doing nothing but giving flu shots.

And so on...and so on...and so on.

Then I come home and log on to my computer, where I read things like this:

People who hunt because they have to. (My version of stocking up on meat is going to Costco.) Villages who gather for funerals. Places where life and death seem more real than the Philadelphia burbs, where folks folks carry on about Flyers and Eagles as if putting a small piece of rubber into a net or getting a leather balloon over a line really means a damn thing at all.

People who tend caringly to a woman who has just lost her baby -- not because it's actually their job, but because there's no one else to do it. People to whom HIV "post-test counseling" is the emotional equivalent of a diagnosis of cancer -- not quite a death sentence, but just about. (Do you know how often I've seen a positive HIV test? Never. The only HIV patients I have came to me already diagnosed.) And these are medical students breaking this kind of news.

People who work 19 days straight; twice, with only a weekend in between. After surviving two strokes; who also have children and families and friends and all the other things I struggle with (never having had even one stroke; nor arthritis; nor anything worse than a fractured metatarsal that took a year to heal.)

I've never really saved anyone's life. The closest I've come to that was picking up ITP from a purpuric rash on a little girl and finding that her platelet count was 3. I sent her down to Children's for IVIG, where she did great. It's now 10 years later and I just signed her driver's permit. But to this day, her mother swears I saved her life.

I bitch and moan about how hard it is to make a living doing...what is it I do?

• I called a lady back today to tell her she doesn't have mono.
  
• I saw a man yesterday who was worried because the left side of his face felt hot -- as he was undergoing a work-up for transient blindness in his right eye several weeks before. His MRI was scheduled next week back home in the UK, and he wanted to know if it was ok to wait. I did a careful history and exam, found nothing, and told him it was.
• A lady was worried because a mole on her leg was changing; it wasn't even an actual nevus.

I make people feel better.

What a crock.

And yet...

When I counsel and console people in pain who insist that they're not so bad off -- so many other people are suffering so much more than they are -- I validate their pain for them. I point out that pain is absolute; not relative. If you have a broken leg, it doesn't hurt any less just because the guy down the hall has two broken legs.

I suppose nervous suburbanites have as much right to reassurance and health maintenance as Yupik villagers have to basic (and not so basic) health care from amazing paramedics who also hunt, mush and mourn with them. I guess encouraging women to go for mammograms is a form of caring, even if it doesn't seem as profound as being the one to tell them it wasn't their fault their baby died.

So yeah, I'm a wonderful doctor. But oh, what a mediocre person I feel like today.