At the Still Point of the Turning World
Residency is over, NOW what? (While I'm waiting for the answer, I'll get some spinning done....)

Thursday, August 29, 2002

All I have tonight are a few random thoughts to share....


I am thinking of Tracy tonight, and wishing her strength as she helps Astro with his last earthly transition. It is so hard to say goodbye to an old friend. Over time I have had to share in the grief of losing many pets, and the longing to see them again still pierces my heart unexpectedly when I am feeling vulnerable. Why do cats and dogs (and other animals who share our lives) live shorter lives than humans? Is it to teach us essential lessons while we share their wonderful lives?

Thankfully, just as I find myself on the verge of tears at the thought of Astro and my many departed friends, I also find myself smiling at the thought of Izzy, who is 16 years old and still a FABlog supermodel!


These thoughts about animal friends is somehow connected to my latest struggles on the job. Right now I'm covering the Family Practice inpatient service, taking care of the patients whose primary doctors are family docs at our clinic or one of the outside FP clinics in town. Last week I admitted my own clinic patient, a very sick 80 year-old man with an unusual bone cancer. (As always, I've changed some details about this patient to protect confidentiality.) The cancer makes him more prone to fractures, and indeed he broke his left hip two months ago and had to undergo surgery. Sadly, this time he has broken his right hip and had to have another surgery yesterday. It was a success, but he is very frail and, I'm afraid, going to require more full-time care than his family can provide. I was hoping to transfer him to our convalescent ward, where he could undergo rehab for a few weeks, but this morning he said "I don't want to go. I feel sad over there, and the beds a terrible. I want to go home."

Part of me--the good part of me--understands this desire completely. I think he knows that he is at the end of his life and wants to be at home during these last months. Who wouldn't? The other part of me wants him to go to the convalescent ward where I can keep an eye on him and assure myself that he's strong enough to go home. I had to stop myself today, and remind myself to let go of my own grasping nature, and allow myself to be guided by what I know is right. So, with a great deal of help from the case managers and social workers, we're going to discharge him home tomorrow, with visiting nurses and home physical therapists. I'm still afraid for him, I have to admit, but I believe he'll feel better at home, and maybe this is the most important thing all of us can do for him at this point in his life.


I'm still dithering about the pattern for the SOAR vest project. In the meantime, I cast on a sweater for my father in Jo Sharp 8-ply yarn. And of course I have a couple of socks going at the same time. I usually knit about an inch every morning during our Morning Report. Tonight, I spun some more tussah from The Silkworker in beautiful purples and blues. Photos of everything to come soon, but not tomorrow. (I'm on call again! Will this ever end?)