In A Heartbeat

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This was my life, just a few years ago.  It was a turning point, a moment to inspire change.  I submitted this essay to Medical Economics, but it was not accepted.  It still meant the world to me. 
In A Heartbeat
January 2017
There is nothing quite like a health crisis to make you reassess your priorities. A few years ago, I was a newly minted attending physician. I joined a busy Neurology practice, and I was also the wife of a Hospitalist and mother of a young son. My husband and I were like two ships in the night; we passed off parental duties to whoever was not currently on call. We typically had one weekend per month to spend as a family, and it quickly filled with activities. 
After a few months at this pace, my 33 year old husband came home one evening complaining of paresthesias, and he had splinter hemorrhages in his nailbeds.  After many diagnostic tests, it was discovered that he had an unusual congenital heart malformation: two Atrial Septal Defects and an anomalous pulmonary circulation. It was suggested that he had been able to compensate, perhaps, until we moved to the higher altitude. He needed open heart surgery, and if he didn’t, he would be in heart failure by 35 years old. As physicians, we are trained to remain stoic and detached when delivering difficult news, but it is a different matter to receive it. To say that this came as a shock is an understatement; we were balancing the feeling of finally having “made it,” with an immediate and concerning health crisis.
Suddenly, our lives came to a screeching halt. All of the carefully juggled tasks and painstakingly balanced schedules crashed down around us in the midst of this unprecedented and unnatural role reversal. We discussed our options: should we postpone the surgery?  What would we do about our patients? What about our call shifts?  I have never felt so torn and, truthfully, scared. I looked into the eyes of my child and saw innocence. What would I tell him? He was too young to understand what was happening. In a moment, it flitted across my mind: what if his father doesn’t make it? Shutting my eyes hard, I forced the thought to the back of my mind and held my child. I breathed in the sweet smell of his shampoo. When was the last time I had simply held him like this? Would his Daddy be able to hold him this way much longer? We decided to have the surgery as soon as possible; admittedly, I was worried he might have a stroke the longer we waited. 
His surgery was scheduled only days before Christmas. Before long, it was time. I took one last look at my husband’s chest; it would never again be this smooth, this flawless. I kissed it and tears fell from my eyes. He was my everything. He rolled away into the OR. As I watched him go, I regretted having only seen him a handful of weekends since we started our new jobs. I could have lost him that day- a very real risk that was not lost on me; would I be satisfied with how our lives had played out to this point? I promised to love him in times of sickness and in health; and yet, we had not seen each other often enough for me to love and cherish him the way I had vowed on our wedding day.
Then, I waited.  I sat alone in this cold room. It was humbling to be sitting in these chairs, rather than in the physician’s lounge or at my desk. I watched as the snow drifted peacefully down, in sharp contrast to how I felt.  Being that it was painfully quiet in this room, my thoughts became deafeningly loud. Why had I allowed my career to be prioritized above my family? The pervasive habit of prioritizing our careers above our personal desires and needs is not uncommon in medicine; in many cases, it is how we manifested our dreams of becoming physicians. Sacrifices had been made, but at what cost? 
Finally, his surgeon materialized at the door and called my name.  “He did fine,” he said, and relief flooded my mind; I could breathe again. 
He was intubated when I’d been able to see him. How many patients had I seen this way? Too many to count; and yet, it was different seeing my husband this way. His eyes fluttered open. His eyes searched for mine; when he found me, he mouthed “I love you” with the ET tube still in place. His chest now had a long incision, a beautiful battle scar. 
We spent Christmas in the hospital. Machines were beeping incessantly, the couch was uncomfortable, and the food was awful. And yet, none of it mattered. I couldn’t be more thankful for the blessing I’d been given. My husband was alive, and his surgery was successful! Within a couple days, he was discharged to begin the long process of healing both body and mind. 
We had two possible realities facing us: by 35, my husband could have been in fulminant heart failure. Instead, at 35 years old, he is snowboarding, mountain biking, and hiking trails in the Rocky Mountains- he had a second chance. It was at this point we both realized that we had to make changes to find balance in our lives.  First, we both got new jobs, focusing on a better lifestyle: a new position for my husband closer to home, and one affording me weekends free with family. Shifting our focus to improve our lifestyle served as the foundation upon which we built growth and balance to enjoy life and its pleasures again.
I knew, from my background in Neurosciences, that people are state-dependent learners; for example, a whiff of cologne can bring back memories of sitting on grandpa’s lap. Further, one could potentially exploit this principle by meditating on a sensory experience that was perceived as peaceful, thereby inducing calmness.  Thus, I find reprieve in meditating on the sound of the waves crashing against the shore as I paint them on a canvas. I savor the smell of baking vanilla when I make cookies, and feel comforted. I realize that though our existence is fleeting, we find significance within a community, as I observe nature on a hike. I take a minute to tickle my kids’ feet and luxuriate in the sound of their laughter, savoring the beauty and innocence of childhood. Life is more than a finish line; it’s about the journey.
As physicians, we prioritize our studies, careers, and patients above all else. We sacrifice our minds, bodies, time and youth for this endeavor. Our lives are focused solely in medicine. And as a result, we are burning out at an alarming rate. Like my husband before surgery, we (physicians) are on the precipice of crisis- many physicians are unhappy; some are even leaving medicine altogether.

The surgeon fixed my husband’s heart; he took something dysfunctional and made it work. We have a responsibility to ourselves to do the same. As physicians, we need to find the parts of our careers that are dysfunctional and rethink them. If we do not, we may find ourselves in metaphorical “heart failure:” inefficient, dysfunctional, and suffocating.   

-L 
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