Cancer

I spend more time than I would like having to tell patients they have cancer. On good days, it starts with "you have lung cancer", but finishes with "but it looks as if we found it early enough to help". Today was not one of the good days. I am sure there has to be a way to tell a 50 year old person and their family that they have an incurable, terminal disease without devastating them, but I haven't found it yet.

My least favorite question - how long do I have? I expend a great deal of energy dodging that question. For starters, people don't come with expiration dates. I can quote literature about what the average life expectancy is for someone with certain stages of lung cancer, but we, despite all our wisdom and tests, have absolutely no idea how that number pertains to the individual patient in front of us. Secondly, navigating the tight rope between hope and false hope is difficulty enough. Putting a time limit on the situation never helps.

Obviously not having a good day professionally. Ironically, personally I found out today that my own biopsy results are benign. At least I saved one of my colleagues "the talk".

Time Out

The "Time Out" technique wasn't around when I was a kid. My mom had her own version - it was called my room. However, I think this was more to get me out of her hair than anything. It wasn't truly punishment - I would always go there and read. As usually, I am getting side-tracked. Back to the point . . .

I am putting myself in Time Out for bad attitude. For reasons that I won't even bother to go into, I haven't been in the chippiest of moods lately (and I am inventing words). Today, I seemed to reach my breaking point. It occurred shortly after the second Latino male in as many hours couldn't help but tell the poor helpless "mamasita" how to do her job. Thankfully, for the sake of my employment, when I get TRULY angry, I get REALLY quiet. Let's just say that you can hear a pin drop.

If you need me, I will be sitting on the naughty mat. What's the rule - one minute per year of age? I don't think 36 minutes will be long enough.

End in sight

I know that I get no sympathy when I complain about how cold it is here, so forgive me this post. It has been cold here. Reportedly this is the coldest winter in 75 years. At the risk of making it all about me - why does that statement seem to follow me wherever I move? Is mother nature trying to toughen me up?

Yes, I remember living in Philly. Yes, I remember needing six layers of clothes to walk out the door. Is it that cold here? No. The difference - I was expecting it there. A lot should be said for expectations. Two days before it "turned cold" here, I was wearing flip-flops on the beach. Sorry, but I am old, my brain can't adjust that fast.

Thankfully our long cold winter is almost over. Weather forecast for this weekend - 80 degrees and sunny.

High score - Bad

I have never been good at games where the object was to score low. It just seems contrary to me. Therefore, I long ago wrote off golf and Hearts as fun games for me. I am now officially writing off mammograms also. Turns out, I don't score low enough to play them well either.

Explanation: Mammograms are scored on a scale of 0 to 6. Zero shouldn't really count - basically it means we screwed up and didn't get good enough pictures. One is normal and 6 is breast cancer. My score - a four. Long story short, they see something on X-ray and ultrasound that none of us can feel. My only risk factor is the fact that I have never put my uterus to "good use". Sure I can go out to dinner whenever I want without worrying about a babysitter , and I don't have to put anyone through college, but I have increased my risk of cancer. I guess everything does come with drawbacks.

They think it is probably benign, but feel there are two too many qualifiers in that statement and wanted a biopsy which I had done this morning. The kicker - it takes over a week to get the results back. I'm going to go run up the score on a game of Spades or tennis.

Need a new vice

So I am currently in search of a new vice. Why you might ask. Simple really - I have been forced to give all of mine up. As I wrote earlier, my doctor has forced me to give up caffeine. My trainer has forced me to give up sugar, refined carbs and sluggishness. My job prevents me from taking up smoking or drugs. My moral center prevents my becoming a slut. What else is left?

Isn 't at least one vice needed? Necessary even? The dictionary defines a vice as a moral weakness. Isn't a little weakness okay. Being strong all the time has to be exhausting. Vices keep you grounded. They remind you that you are human. (I am a surgeon - a Thoracic surgeon - we occasionally need reminding that we are not The Higher Power.) Vices remind you that you are a work in progress, and never a finished product. Vices give you a place to turn when you are stressed, anxious, depressed or even happy.

I have been thinking a lot about vices today. Mostly missing mine.

Oh no she didn't

In my ongoing effort to improve my longevity, I saw the doctor today for a "check-up". I was initially quite smug. I was able to brag that I am working out with a trainer, and have restarted running. I wasn't thrilled with the number on the scales, but it was a perfectly acceptable number.

We discussed the blood work that she wanted to order, scheduling a mammogram and the gyn that she recommends. I thought I was going to get a nice pat on the back about how well I have cared for myself. Then, she does the physical. I have fibrocystic changes in my breasts. This was not news to me, I have always had them. Medically, it is not that huge of a deal. My doctor however, thinks that we should try to "fix" them. Her prescription - give up caffeine.

Yep, you heard me correctly. She recommended that I give up all caffeine. I am not a big fan of patients who come to see me, and then ignore everything I tell them, but surely asking me to give up caffeine crossed the line. My face must have said what I was biting my tongue to hold. She looked at me after her "announcement", smiled, and said initially just cut it down to 1 cup a day. I'll try. (Since Diet Coke comes in a bottle, it shouldn't count for my total right?)

Good Riddance 2009

I can't say that I was all that sorry to bid adieu to 2009. I can only hope that 2010 is less stressful. In the spirit of the Season, I decided to make my New Year's resolutions. Here's hoping I can keep them past Friday.

#1 - Time management - Fact: I work a lot of hours. However, so do lots of people. They still make time to have a life. It is time that I stop blaming my job, and learn how to better manage it.

#2 - Patience - I have never in my life possessed patience, and as I get older I only seem to get worse. I don't want it now - I want it yesterday. This holds for all aspects of my life. Poets write that anticipation has its own reward. It is time for me to find out.

#3 - Quitting - I tend not to stick to things in which I don't excel. Be it tennis, painting, speaking Spanish, dating or running, if I don't immediately conquer it, I abandon it. It is past time for me to recognize that some things come through hard work and multiple failures - not natural ability.

#4 - Accepting praise - For someone with such a sizable ego, I accept praise very poorly. I usually make excuses or give credit to someone else. Time to learn to say a heartfelt thank you and move on.

#5 - Venturing out of my box - I tend to avoid things that make me uncomfortable or that are not familiar. I like to stay firmly in my comfort zone. I am such an adrenaline junky at work - time to take a little of that on the road.

As you have probably deduced, my resolutions have a general theme. It all goes back to learning to embrace my life where it currently exists, and stop waiting to live it until some future perfect date.