I'm Suffused

I’ve been thinking a lot lately about the Higgs Boson, which is great, because then I don’t waste my time thinking about less important things. Like electronic medical records. And how everyone is angry at work because of the implementation thereof. Or how I’m an hour late going home because I’m on the committee for said medical record.  And there is lightning and I’m on my bike.

According to Time magazine, which may or may not be an authority on quantum physics, the universe is a field of energy suffused with Higgs bosons, which allow the greater energy particles to turn into the mass form of energy.

I don’t know what “suffused” means, but it reminds me of when they sell olive oil that has a certain flavor to it.

Also I thought particles by definition already had mass, but I could be confusing them with Doritos.

So all we are is energy, bundled up and stored, with lots of empty space between. Somehow that energy stays in a constant form, a constancy of being, of life. But life is ever changing. Cells constantly remodeling, dying, dividing. Pieces used up by another process. Waste recycled. Air and water exchanged. Where do I end and the world begin? Or you?

My legs connect to the bicycle which grounds to the street. I’m here and moving and the trees are whirring and it could be all in my mind or I could be everything.

As I ride my bike up the last hill home I have that euphoric sensation that I’m peeking through a tiny window into the mind of the universe. My own mind is splitting open and I could almost, maybe, barely grasp the meaning. And know, by virtue of being that energy itself, hurtling down the last corner on a bike, pure kinetic and potential and mass times the speed of light squared. Barely held together at any moment by bosons.

And then I passed a mailbox. And I thought, that mailbox, too, is pure energy.

Huh.

Implements

We’re “Implementing” an “Electronic Medical Record.” An electronic medical record is an exciting new way of storing your patient’s medical information in a brightly colored and incoherent and less efficient fashion. Basically it’s like hiring people who are high to do your filing.

And you aren’t high, you just wish you were because you are working 50% more hours than previously with the same pay.

Having an Electronic Medical Record is important because it is The Future. Also, because the government will pay you to have one. Also because “Meaningful Use.” Meaningful use is where you have a password and you have to try to guess it on a website and then you have to call a lady during work hours and wait for 30 minutes on hold and then authorize her to give your company $10,000 for you to use a computer, meanwhile your patients are piling up in the waiting room like so many angry ranchers in a stockyard.

If you don’t have an EMR, all of the patients will look at you like you’re incompetent dinosaurs applying leeches to wounds and diagnosing “Hysteria” and performing exorcism on patients with cirrhosis. The lab will use chisels to draw bone fragments out for analysis.

If you do have one, all of the patients will look at you like you’re a robot who cares not to look at them during the patient visit and spends most of the time in communion with the wall-mounted machine. Which communion sounds something like this: “I’d rather have a cystoscopy than use this fucking computer program!” To quote Dr. DDx.

After hours, you and your colleagues will continue to labor, bent over the keyboard, brows furrowed.

And you might take comfort, because previously you were the only one there after six.

But then it’s seven, then eight.

You overhear your colleague on the phone. “I know you need your prescription for Norco, but we’re closed. So I’m going to send it to the pharmacy using this computer…..”

Pause for 4 minutes.

“Okay, actually that didn’t work. Now I’m going to try to fax it using this computer….”

Dramatic pause for another 3.

“Okay. Screw this. You at home? I’m coming over on my bike. Be there in ten.”

And that, my friends is the Future.

I'm on a boat

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“You’re on a lifeboat. You only have so much space. Are you going to pull in the ones who are waving their hands at you, calling for help? Or the ones who are swimming away from you?”

Huh.

The communist PA and I look after each others’ patients sometimes. While I was away he saw Yellow Eyes. Who, while not wanting to die, is still drinking himself to death. His legs and belly have grown. We have to see him once or twice a week these days. The story is always the same.

“Yeah, I’m still drinking, but I’ve cut back, a LOT.”

“I don’t drink hard liquor anymore.”

“You know, no one quits unless they are ready. You have to want to,” he tells me.

And I want, so badly, for this to work out for him. But he’s drowning. Can’t really breathe. I don’t think there’s water in his lungs, but the twins-gestation-sized belly he’s grown doesn’t leave a lot of room for the air in the top half of the torso.

The communist asks me about him. I admit I don’t know what else I can do. In fact, I’m not really doing anything, just adding water pills and running out of time.

So he gives me this cryptic advice about boats.

I used to be a lifeguard. (Now the card is expired. I can’t use my CME money to renew it. Apparently.)  Anyway, in training we learned that people who are drowning will grab hold of a rescuer and push you under. Nothing you can do, it’s just their instinct to survive. And you shouldn’t fight it, just go down, away, then up. But in practice, you should try not to let it get to that point. So, always carry that floaty thing, and put it between the drowner and yourself.

168 pounds, Yellow used to weigh, when we first met. Last month he crept up to 180. Now he’s 210, 212, 214. Taking his meds only when it rains or something. Definitely not as directed.

I call a few days after our visit for an update. His daughter tells me he’s in the hospital. They took the water off and he’s decided to detox. That’s good.  Early the next morning I was there to deliver a baby, then stopped by his room after. His belly looked a little more post-partum than gestating. He was, as ever, full of smiles.

“I think I’m really going to do it this time, doc. No drink for 5 days, now. The priest came by.”

And I want to believe it, I really do. But I’m not going to paddle after him.

am

Early morning is the prize for those who labor all night

And its slanted golden light and stillness

And all the memories of summers gone 

(and the smell of breakfast cooking)

And things that might yet be just dreams

And all that promises to be

My tired eyes face unblinking