michael michael michael

Hot Lights, Cold Steel HOT LIGHTS, COLD STEEL

"We start here, and we go there. But it's not that simple, is it? Our paths may be circuitous or direct. We may gaze excitedly ahead, or cast our eyes regretfully behind. Until we reach our destination it exists only in our minds. It is what we have imagined it to be. And yet we tend to neglect the journey, which is real, in favor of the destination, which is not. For too long I neglected this journey. It was an obstacle to be overcome, an ordeal to be endured; for I had never chosen the journey, I had chosen the destination. But now that the journey has ended, I have discovered that here isn't so important after all. I find myself looking back with particular fondness for how I got here."

"We had been training for years to become surgeons. We had excelled in college. We had excelled in medical school. Our lives had been one success after another until we woke up one day, and there we were, surgical residents at the world famous Mayo Clinic. It was all so perfect. But before we could congratulate ourselves, scarcely before we learned where the surgeons' locker room was, we discovered this was a profession that, like no other, quickly and ruthlessly and uncaringly proclaimed we were not perfect. People came to us with head injuries—and we couldn't help them. People came to us with gunshot wounds—and we couldn't heal them. People came to us with ruptured arteries—and we couldn't save them.

We kept confronting these terrible problems, and we kept failing, again and again and again—we, who had always succeeded, who had always known what to do, who had always been so sure of ourselves. Never before had we attempted anything so important, and never before had we failed so miserably."

"The sheets and gray woolen blanket were tucked tight and crisp under the mattress. The doors, the walls, the desk, the square metal ends of the bed all rose and intersected at their perfect right angles. Everything was so symmetric, so defined. Sometimes, coming back to this room late at night, the cleanliness, the order, the symmetry would comfort me. But not tonight. Tonight the incongruity of it all overwhelmed me.

Everything inside me seemed to have been beaten away. I wasn't tired. I wasn't depressed. I wasn't sad, or outraged, or horrified. I was just empty. I kept seeing the gaping hole where Ben's shoulder should have been. I kept feeling guilty that Ben's death was another step on my learning curve, another item on my resume. I needed things like that to become a surgeon. They brought me a step closer to my goal.

The whole thing made me sick. I wondered if any goal could be worth all this. It wasn't that I minded the work. In some ways the mind-numbing drudgery was my salvation. It was a crutch, a shield. I got tied up in it and it insulated me, protected me. It used me, but I used it, too; and I had drifted into a comfortable marriage with it. I immersed myself in work in order to distort and disguise what I did."

"Two hours later, when the code was over and the death certificate filled out, when the janitors had mopped the floor and the nurses had re-stocked the crash cart, when the PM shift had gone home and the coroner had come to claim the body, I was still slouched in a chair at the desk. I kept going over the code in my mind, asking myself what I could have done differently. I couldn't think of a single thing. I ran a perfect code. But I kept seeing the look in the eyes of the kid with the letter jacket, and the fact that I ran a perfect code did nothing for me.

Death, suffering, failure. They were the enemy, but they didn't play by the rules. Sometimes, even when I did everything right, they still won. I couldn't give up the childish notion that things ought to be fair. When I ran a perfect code, when I did everything right, the patient ought to live. What more could be asked of me? What more could I give? Day in and day out I did the best I could, the best anyone could—and so often it wasn't enough."

"I had let my work become automatic, forgetting the essence of what a doctor is called to do. I had let pragmatism take me too far, take me to where I had lost sight of my calling. I was all wrapped in the technical aspects of what I was doing while ignoring the fact that my vocation wasn't approximating collagen bundles or correcting angulations, it was helping people—living, breathing, hurting people. How could I have forgotten that? Why, even the X-ray tech knew it intuitively, knew enough to show an injured little kid that someone cared about him—and all I could think of was hurrying him up, straightening his arm, and getting on to the next order of business."

"I rolled down the windows, unbuttoned my shirt, turned up the radio and headed east, into the rising sun, going back to Rochester one last time. In a dream-like, sleep-deprived state I drifted along, flooded with memories. Eagle Lake, Smith's Mill, Janesville, there wasn't a town along the way that didn't have someone I had stitched up or casted or repaired or resuscitated. I felt a fondness for them all, and a sense of gratitude that I had been able to help them. It had been a lot work. At times it felt like I was killing myself. And yet the only thing I could recall at that moment was how much fun it had been, and how wonderful it was to do this for a living."

Michael J. Collins ©