Monday morning arrives, bringing with it two more large windows next to my desk smashed into splintered crystal patterns. We've spent hundreds of dollars in glass replacement this calendar year alone. Ironically, the kids who are doing this probably have parents or grandparents who receive care from our health center. Do we need bars on the windows, or no windows at all?
The next shock of the morning reveals that one of the residents involved in the community medicine program at our clinic died this weekend from consequences of a very minor outpatient surgery. The clinic is reeling from this sudden and unexpected death of someone so young and vibrant. The group of residents cancelled their clinic hours and are huddled en masse for an impromptu memorial service while they await the arrival of the young woman's family from a distant state. There are many ashen faces today.
At the hospital, I visit with my patient with relapsing rectal cancer of whom I have written previously. He weeps as I lean over his bed, saying that he might as well die as face one more week stuck in the hospital, a further stay in a rehab facility looming on the horizon. His usual stoic demeanor has cracked and he expresses some deep feelings which are plaguing his soul. The ambulance drivers pack him off to radiation on a stretcher, and I watch his emaciated face fade down the hall. We wave to each other wanly.
I also learn that a troubled and addicted patient has landed in the ICU with an esophageal rupture. His avid cocaine abuse, uncontrolled diabetes, and very poor self-care are coming home to roost. The prognosis is poor, since large amounts of vomitus leaked directly into the pleural space around his lungs before he made it to the ER. I knew he was time-bomb, but I thought I might have lengthened the fuse a bit. I know it's not a failure on my part, but there's a little ache in the heart when these tragedies occur on one's watch.
A call on my cell-phone brings the welcome news that my wife has landed a job as director of a senior center just across the park from my office. I'm thrilled, and visions of summer lunches in the park grace my mind's eye.
The happiness from this welcome announcement is then subdued by a message from someone at the community college that there has been a complaint against me which needs addressing. In that moment, I realize that my plan to let go of my adjunct teaching position in May is an excellent decision to which I will adhere enthusiastically with a bittersweet tinge. I feel crestfallen.
The day ends by bringing my wife flowers---yellow roses---and meeting for a quick meal to celebrate her success. The dogs, music, the cozy house, the roaring fire, all assuage the troubled and somewhat heavy heart that accompanied me home this evening.