The Spark*

"The Spark" happened about 6 week ago when I first met Sergeant Major B****** from an Armored Cavalry Regiment at a nearby Army base.  It was a day like any other, clock in at 6AM, take report from the exhausted night shift, prioritize tasks, decide, act (after my morning snack of cereal, of course).  Mentally prepared to throw Albuterol darts at our health systems' gaping wounds.

My usual patient population consists of:

1) Overweight diabetics that will do NOTHING to reverse their disease (yes, it's reversible in its early stages)
2) Overweight heart disease patients recovering from their heart bypass operations.  This is where your arteries supplying life sustaining, oxygen-rich blood to your heart, are clogged with plaque from untreated hypertension, smoking, overeating, inactivity.  But this is not their first parade through my hospital. They have been coming in to have Angioplasties and stents for up to 10 years before they need this bypass.  You know you are one of these when you know your ENTIRE health care team by their first names!! "Welcome back you SOB:)"  This means:

  A) They have no interest in taking responsibility for their own health.
  B) They want to stay disabled to continue collecting their disability payments and Medicaid/Medicare.
  C) They want to really say "Fuck You" and pay up April 15th, tax day, whip out your wallets so I can pimp my ride.

3) Smokers**  I have a special bond with smokers.  I smoked heavily for 10 years.  I started in high school, not because i wanted to but because my friend wanted to but didn't want to smoke alone.  My parents both smoked and I really didn't want to go down that road, oh well....  I had a really hard time quitting,  it took about a dozen tries.  You know you are hard core when you develop bronchitis and cough up tar, thanks Marlboro Reds!  Anyways, by the time the smokers meet me, they are in dire need of relief and most of them can't kick the habit.  I try to educated them on my own personal experience knowing their doctors have already given them the tsk tsk speech.  I don't even go there.  For the die hard smokers i just tell them "Light em up, job security for me".  Ironically, smokers are my favority patient population.  Now, to my least favorite...ARGGGG!!!

4) Drug Addicts!  They are a unique breed.  They are usually between the ages of 20-40, led underproductive lives, sometimes collect disability and Medicaid for their "disability", ruin my Saturday mornings.  Apparently the big 'party night' is Friday so when the sun comes up, the bodies are found, half-way dead.  EMS called, fire department dispatched, arrive at my hospital and a team of 20 medical professionals swoop in to save them, just so they can be discharged 3 days later in time for the next RAVE! This is my highly esteemed professional life.  ENABLER: > (

Because of my usual population, my professional feelings of self worth are in the toilet.  It's not like the beginning of my medical career at all.  In the beginning, all was well.  I felt like I was a part of something great, important, non-enabling.  In fact, whining was not allowed, drugs were not aloud, incompetence was not tolerated, ambition was rewarded, leadership was exemplified and pride was pervasive.

In the beginning, I was a soldier.........