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.

Back

Years ago I worked in the woods every summer, next to a lake. The days were endless in North Idaho, and it was light from 4am until after 10.  The water, chilled in early June as though the ice just barely cleared, was 75 degrees by August as it rolled over our golden skin. At the end of the day, we’d clear the swimming area of kids, and send them to shower. Then we’d backflip off the lifeguard tower, or jump into the boat for a quick ski around the lake.

In those days there was so much to believe in. My legs were strong and there was God and night would always fall slowly like the way my Midwest relatives say goodbye. Most of all there were all of us, working 18 hour days together under the sun, to make people, kids, happy. There was this common goal, so there was community. I was never alone.

A world later, I found it again, in the place you’d least expect it, residency. In the hardest months of my life I found them. Earnest folks who know who I am and what I am capable of, and somehow still believe. In me, in medicine, in the joy that is working together.

It was hard, sure. The work took everything I had and more. And I’ve said before the toll it took on my family nearly broke us. But in those days, there was so much to believe in, even when I didn’t believe in myself.

Where I live now it’s different. There’s less cohesion, less inspiration. Belief in anything is optional.

I’d been gone a year. I feared I’d been forgotten, that I’d forgotten everything I learned.

And then I went back to the place where I became the doctor I am today. I visited all the familiar haunts: the hospital, the sacred sign-out place that is the Falcon’s office, the call room, the clinic.

I must have looked weary to the Dragon when I met him for lunch. “What’s wrong?”

“I’m just tired,” I said, and ordered a pizza. Later I mumbled that I might be less than excited about my job.

“Tell me a story about a patient,” he said. An attempt, I think, to inspire me, remind me of what I do love.

I told him about Potter.

Which of course is the worst patient story from the last 8 months, but it was the only one I could think of.

It’s unfair to blame this dysthymia on external forces. There’s something I need to learn here, some way I need to grow.  But I miss these people, like I miss the Idaho summers of my youth. Not for the work itself, but that it was made bearable by a community. These people give me something to believe in.

It’s a crutch. I need to believe in things myself. I need to inspire, not just to be inspired. Maybe I need to be without my people right now so I have something to offer when I move back and establish the commune.

See, I want to work with these people again, share practices and overseas projects with them. We should all buy a piece of land with yurts around the periphery, a garden ringed with daisies, and Shaman will create a series of baths. The Visionary will inspire me and Haiyan will stretch open my mind to the world, and my kids will be raised by a village. We’ll call it Yurt Village. We’ll have matching tattoos.

It’s sort of a joke. Except I mean it. It would be neat.

A half hour later I somehow found myself in Vasectomy clinic, a syringe and a Li clamp in my gloved hands. Ceci, a year behind me in training, invited me to do her surgeries for her; she doesn’t want to learn them. My clinic needs me to. She handed us instruments. The Dragon stood across from me.

I operated successfully on two men. It had been a year, but I remembered the techniques, and learned the updates. Plus, I was a visitor, but I was home.

And something had changed. I don’t think Ceci saw it, I don’t even think the Dragon noticed. But I was no longer a resident, across from my mentor. I was an attending. I was thinking each step out for myself. I didn’t wait for the instrument to be selected for me, I asked for it or took it off the table. When there was bleeding I moved to control it.

It was an unexpected boost to my faltering ego. I got to see, for a moment, how far I’ve come.

Huh. And most of that came out of being mostly alone.

And then I went to the woods, which was the real reason I was in town. The Visionary was getting married, after all, next to a lake. We swam and canoed, and slept late under the trees.

Intake

Based on several new patient encounters over the last few weeks, I’m making an intake form for all new patients requesting narcotics.  It will look something like this:

1.   Are you taking cocaine right now?

2.   No? Good. Okay.

3.   Why have you fired your last 3 doctors or been fired from their practice?

4.   Are you expecting narcotics today, as in, right now?

5.   Because I am not going to give them to you without a little more information.

6.   What exactly is your pain?

7.   What, besides Vicodin, are you doing for your pain?

8.   Ok, what, besides medications, are you doing for your pain?

9.   Are you taking methamphetamine right now?

10. No? Good. Okay.

11. Are you willing to submit to a drug test?

12. Why aren’t you able to pee today?

13. If you had to choose among the Percocet, the Xanax, and the Soma you currently want to take all at once, which would you pick?

14a. Is it cool if I call your previous doctor before our next visit?

14b. Please list the names of the doctors you have received prescriptions from in the last 2 months:

1)_________________________

2)_________________________

3)_________________________

4)_________________________

5)_________________________

6)_________________________

15. Many people seem to have nicknames for their medications. What do you like to call your pain pills? (e.g. oxies, vikes, etc.)

16. After leaving jail last month and having been off narcotics for a year, why did you then immediately resume taking 8 oxycodone 30’s a day? Are you sure you’re taking them? Because you do not appear to be dead.

17. In the past month, how many times has your cat knocked your Vicodin into the toilet? (0-5) (5-10) (>10)

18. In the past month, how many times has your cat knocked your Ciprofloxacin into the toilet? (For statistical purposes only)

It will be printed on pleasing pink paper with a marbled background and smell like candy canes.  I’m super excited.

Dreamy

Last night I was on call with a resident. She told me she had a dream in which she was evaluating a woman in OB triage when all of a sudden the patient’s baby came out without any warning.

Here is the sort of dream I have.

I am running through a maze of doors, under a dark sky with trees. Several rabid deer are chasing me. The doors are crumbling, so when I close them behind me the deer can still get through. Finally, a room seems safe, and there is a piñata. I stand next to it and it breaks open and millions of tiny chainsaws fall out.

The good news is neither of those things happened last night.

Dangerously Close

The first few months of medical school are consumed with anatomy, biochemistry, and cell biology. Histology, maybe, and the physical exam. Most of those classes are a hazy, pleasant-ish memory to me now. For example, the elderly pathologist who lulled everyone to sleep by reading directly from his overhead slides in an unruffled voice until one day he exclaimed “What’s this? Well by golly it’s a Howell-Jolly Body!” At which point I woke up for 5 minutes.

But somehow no one ever forgets the anatomy lab. It’s recalled with perfect distilled clarity every now and again when I catch a whiff of formaldehyde or phenol. Like, just the other day as I was ablating a portion of my patient’s toenail bed.

I turned my head away from him for a moment. “Es que este olor… bueno, nada mas que no me gusta mucho.”

Before my oblivious patient I was suddenly 22 again, in a room of dead bodies, drenched in repulsive sickly sweet preservatives. Immersion. Handed a scalpel. Told to cut. Against every instinct in my naïve little heart. White as the sheet that used to cover this respected elder who gave her body to science, to us, now lying naked.

Suddenly with a clipboard staring bewildered in the mid-term at tags tied to tendons. Rotating after each “ding” to the next cadaver, longing for my own, whom at least I knew. Willing, teleporting myself outdoors into the blinding heat and late-summer stillness just outside the window. Lost in the last dying days of my childhood. The days when I knew enough and knowing wasn’t everything, anyway.

Wishing there was some sort of mid-term that might test my knowledge of kitchen implements, or garage tools, so I might feel like I knew something at all. Then confidently I could write “This, Dr. Professor Sir, is a measuring cup. 1/3 cup to be exact. Exhibit #35 by contrast is a sieve.”

Staring into the abyss of What I Need to Know. At the crossroads of earnest interest and imperative mastery, the fear of failure gives you the courage to don a white coat and with it delude yourself into believing you’re impervious to pain and death.

I made it through the class.

Several months later we started Neuroscience. After a few lectures we were sent back to the lab. Nothing, not the white coat, not the desensitization of anatomy class, could have prepared us to see our lady’s brain lying neatly on a cutting board. A single serrated bread knife was on hand.

We were told to cut. Sagittal sections, about a centimeter apart.

Nervous laughter.

“So, who wants to cut open the brain?” I offered. No one took me up on it. “I’m not doing it myself.” The holy grail of humanity, the sacred seat of the soul, the great mystery of consciousness. We’d been told the consistency was like tofu, the extra firm variety.

Years ago on an ornithology field trip in the middle of a 30-mile salt flat a group of girls had to pee. Wordlessly we spread into a circle about 15 yards across. We faced in, and all went together.

Somehow subverting our instincts is easier when we do it as one.

I made the first cut. Then I passed the brain to the left, and my partners, in sequence, took their turn.

That weekend I went camping in the desert. We took a guided tour of some caves. In the dark among strangers, it was all I could do not to blurt out “Say, on Thursday I cut up a human brain.”

Why? It felt like a confession I needed to make. Like it might absolve me of the crime. Also I wondered a little what they all might think if they knew.

All I was trying to be was a doctor. I felt like a monster.

I said nothing.

Now there are a million moments like this that set me apart. Horrors we see and do every day that give us an air of mystery and a privileged place in society.

My landlady works with veterans, as a psychologist. She’s busy at the moment with the returning Iraq and Afghanistan troops.

She sat opposite me on the couch. “They are all suffering so much. So many of them have anxiety, panic, PTSD. They’ve seen such terrible things, it’s like they can’t be normal again.”

“Is it all of them?” I asked. “Do you think some will turn out to be okay?”

“Well, I worry more about the ones who seem unaffected. Those are the ones who do worse. Humans can’t see that kind of devastation and be unaffected. If you’re numb to it something’s wrong. Those are the sociopaths, the killers.”

The ones who can mutilate a brain and then casually go on a cave tour. The ones who can pump on a teenage chest for 30 minutes and then give up and have a sandwich. The ones who can look into the eyes of a heart that’s breaking and feel nothing, and glance up at the clock.

My God, what sort of “healers” might we be at the end of all this? To stay alive in this profession we’re strategically deadened. Afraid for our own survival, we jump through all these hoops. Some drop out. They’re “weak.” We’re worn down to exhaustion working night after night, so we never complain. Worn down to the point we’re relieved to see that the struggling cirrhotic has died overnight and we have one less patient to round on in the morning.

Did I just say that out loud?

Outsource the empathy to the nurses, folks, because there’s nothing left here. Nothing but an empty, encyclopedic brain and beating, mindless heart.

Can it be true? Has it all been bled out of me?

See the patients faster, Doctor, that’s not fast enough. They might cry, they might beg, but you’ve got others waiting. Give them a piece of paper, they’ll be fine.

You’re just trying to take on too many things. Set a reasonable agenda. Tell them to save the other 8 items for next time.

That baby just died? Here’s another one on the way. This one needs to be removed surgically. And the answering service has someone on the line who’d like to know what flavor of pudding to mix with ciprofloxacin.

She has cancer. He’s suicidal. She’s had her foot removed. Talk to them, sure, but no more than 10 minutes apiece.  She’s been kicked. He’s addicted. She doesn’t understand her diagnosis. His cat just died.

I’m neck-deep in charts and urinalyses. What the cadaver horrors didn’t drain from me the endless ticking clock will. This is primary care. This is the trenches. I’m dangerously close to numb.

Fortunately, so is his toe. It took a bit of extra lidocaine but the digital block worked. He’s smiling. The ingrown toenail was a pain. He’d tried to remove it himself with pliers. Apparently I did a slightly better job.

I believe I’ve killed the nail bed with phenol. My soul may yet survive. Maybe.

*Note: the suffering and death seen by most physicians pales in comparison to the trauma experienced by many veterans. I don’t equate our lot with theirs, and I give them the credit they are due. This was written merely to make an interesting comparison. And, mostly, to hold out hope that humanity and empathy can be reborn, even when all seems to be lost.

Day of Women

Today is March 8, 2012.

It is my dad’s 54^th birthday. When I called him this morning he told me it was also International Women’s Day, and that for his birthday he wanted me to do something for the Women of the World.

Kind of a large task if you ask me but I remembered there was something I wanted to try to write. And I’ve been wanting to write it for a while.

I’m angry at a yogurt company. It might not be yogurt, actually, it could be tampons. I wasn’t really paying attention to WHAT they were advertising. It was just that the advertisement riled me up.

And I know I shouldn’t be wasting my time with Glamour magazine anyway, but, whatever. Guilty pleasures when your flight is delayed at the airport.

This yogurt/tampon advertisement I found showed a cute young woman’s face looking thoughtful. Above her head was a bubble of all the thoughts she was having. And the advertisement was about how you shouldn’t have to worry your pretty little head about ______________________, when you’ve got so much else you’re busy thinking about. (Yeah, yogurt doesn’t fit well in that blank. Probably it was something to do with leak protection. Tampons it is.)

Here are the sorts of important things this woman was thinking about instead of her tampons.

Gaah! Bad hair day!

Do I have something stuck in my teeth?

Elevator with the boss-man. Be witty.

Holy shmoley this research project is like ultra-boring.

MMMM! Fro-yo!

Ooh. Yoga. I likey.

At bar with the girls. Super-cute guy at 11 o’clock. Wink wink.

Listen, ladies. Either we are actually incredibly vapid, or we’ve been completely undersold and are somehow totally cool with it.

Where’s the outcry? I mean, probably I shouldn’t have started yelling at the magazine in the actual airport. I get it. We’ve all learned to ignore stupid advertisements/bosses/politicians because anger doesn’t get us anywhere and we’ve got bigger fish to fry. But. Are we frying those fish? I don’t even know how to fry fish. I’m a vegetarian. I’m a weakling.

I do little things to promote egalitarianism, attempting to balance out various injustices in the world. Little things like providing discounted health care to folks without insurance. And teaching my kids to respect others regardless of race/gender/orientation/religion/BMI. And not honking at drivers who cut me off. Because maybe they were in a hurry. Because I like to be understanding. And also because my horn doesn’t work.

Yeah. It’s not enough. Because those tampon people think they’ve pinned me. They think I’m going to sit in my suburban track-home all my life and contentedly buy things, my mind consumed with major concerns like whether I’m paying too much for cable television. I think maybe they’re in cahoots with major politicians.

Now, I don’t follow politics, in the gossip-column sense. I know what I believe about the world, and I research the candidates, and I vote.

But something has managed to catch even my attention recently. Women are seriously being attacked. We’re being used as scapegoats, as political ammunition. We’re left out of congressional committees whose purpose is to determine the right of companies to decline insurance coverage for one of our most rights: the right to family planning. Abortion issues aside: folks want to pretend birth control is not a basic health care necessity. Like access to birth control has not been one of the most important determinants of a woman’s health and happiness in the past 100 years. It’s right up there with antibiotics and vaccines, people. And political pundits think they can get away with calling women prostitites who ask to have that medication covered by their insurance, like antibiotics are, and vaccines. And insulin and dialysis and colonoscopies and Viagra.

What the hell, America? It’s 2012. I was supposed to have my personal space ship by now.

Many of the women I know are quietly ignoring this. And that includes me. Why? Are we afraid to speak up, to be labeled something *gasp* unladylike? Or do we just think that if we ignore them they’ll go away? And what’s up with our men, too? Are they cool with their wives and girlfriends being treated this way?

Here’s the thing, too. We womenfolk make up 51% of the population in this country. Sure, a few ladies are out there with signs. They’re applauded in some circles, ripped apart in others. I’m not going to tell people not to make signs about what they believe in, or to stand outside and protest and demand change.

But it seems that on the whole most of us are “too busy” to do something about this trend. In perhaps the most progressive century in history, in perhaps the most powerful nation on earth, we’re accepting outright 1890’s behavior in our leaders (political, media, and otherwise.)

I’ll put it another way to try to ruffle a few feminist feathers: we’re too busy taking care of everyone else to demand what we need for ourselves.

I don’t have any posterboard and I can’t find any markers. I’m asking us to consider something simpler. We make up over half of the voting populace. We’re fortunate enough in this country to have a representative-ish government. Sure, your congressperson may not look like you, but they’re paid to represent you. When was the last time you told him or her what you think?

Because we do think.

And despite what my tampon advertisement nemeses believe, here’s what we think about:

The kids need to let go of my legs so I can go to work.

Let. Go. Now.

Where are my keys?

I’m leaving for work. I hope my kids know how much I love them, even though I have to leave every day. I hope they know I do it for them.

Maybe when they start school that will distract them.

I hope the school cares about my kids almost as much as I do. I hope they teach them things. I hope it gets better before they start school.

And when they learn stuff and graduate, it would be nice if they had jobs, too.

I hope they can get jobs.

I hope they like their jobs.

Do I like my job? Yes. I do. Mostly. It’s just hard. Not just the thinking part. It’s hard that so many people are sick right now, without insurance, without jobs, without homes, without hope.

How come I never change the oil in this car? It’s been… 3 years? Can that be right?

I totally forgot to bring a lunch.

At least I have food at home. I’m lucky I have a job, too.

If things are this bad in America, how awful must they be in other places?

Imagine if I didn’t have food for my kids.

I hope it gets better for those folks, too.

I hope. I still have it. Do you? Good. But hope is completely actionless. It’s waiting, passively, for the world to change. It’s like waiting in a castle for your prince charming to rescue you. Not gonna happen. Sounds boring, anyway.

Instead of hoping I’d be a doctor one day, I studied. I took way too many tests. I went to school for a lot of years. I stayed up all night, heart racing, feet running up and down halls to codes, deliveries, surgeries, patients requesting dilaudid. I helped people be born, and watched others die, and everything in between. I did all that. And now I’m a doctor.

We ladies know how to get things done. We start with hope, but then we do something about it. We’re good at that, as long as it’s within the realm of home, self, and work. But what about everything else that affects us? The schools, the city, the country, the world? This world needs to get some things done, folks. This world needs us.

It’s not going to happen without us.

So I’m taking all my thoughts, all my hopes. And I’m doing everything I can to make them real. Starting today.

Starting with:

I’m telling my kids how much I love them. I’m showing them I care by working for something I’m passionate about, something that matters. Something that’s bigger than I. I’m going to actively make a difference in the world, try to make it a better place for them. I’ll start by fighting for the rights of women. When the kids are old enough, I’ll explain this to them, so they know. They are the reason I need to do this, and why I need to leave them every day. One day it will be worth it for all of us.

I’m taking charge of my kids’ education. I’ll learn alongside them while they’re little, and I won’t accept mediocrity in the school system. What I can do there to make a difference, I will.

I’m changing the oil in my car. Probably.

I’m letting my government know I’m not happy. With all the focus on me keeping an aspirin between my knees I’m pretty sure more important things are being left by the wayside. Like my kids’ education. And other kids’ hunger. And lack of adequate health care. And jobs, and war crimes, and famine and rape and subjugation of women the world-over. Not cool, government. Let us fill you in on what matters. I’m not voting for you if you don’t care about what matters.

And if they don’t listen, then we need to take over. Let’s be elected officials. Let’s be presidents. Let’s get this done. We know what we need, ladies, and there’s no dragon keeping us from stepping outside this castle. Let’s go out into the world, and make it the place it needs to be. For our children. For our sisters’ children. For our men. For us.

Just as soon as I find my keys.

Love and Blood

I went in early to work today. I needed to look at as many diseased cervices as I could find in a textbook before 8am. At 8 procedure clinic would start and I’d be supervising the Superstar. On the docket were 2 lipoma removals, 2 colposcopies, and a punch biopsy.

I wasn’t sure if I remembered how to do any of these things, let alone supervise them.

See, a colposcopy, for example, is about two things. Thing 1 is sheer awkwardness: setting up cameras and screens in front of a nervous, half-naked woman. Then you spend another grueling 20 minutes finding a speculum and adjusting the camera and adding a filter and zooming in and clumsily knocking the camera over and contaminating the biopsy tray and asking for another and adjusting the light and the camera again, between the mortified woman’s legs.

“Oh, sure, just like at home,” our nurse JHot said when I explained this to her (she lamented never having watched one. For reals.)

Thing 2 is pure pattern recognition. Mosaicism, leukoplakia, bridging. Immature metaplasia. Punctation, nabothian cysts, papilloma. Decreased uptake. Ulcerations. Algorithms.

I’m better at thing 1.

Thing 1 is all about finesse. Thing 2 takes frequent, repeated exposure. Hard work, at that one thing. Studying with your eyes, as much as with your mind. But I’m willing to put in the work.

The good news is, it went well. In an hour I brushed up just enough to know what to biopsy.

Also, I’m good at surgery. Relatively, I mean. I had forgotten this about myself. I’m not a surgeon because instead I trained to be a family doctor. I just mean I have the aptitude. I know how to handle the tissues. My fingers know what to do.

If I’d done surgery maybe I’d be a better surgeon than the family doctor I am today. Maybe I’ll try not to think about that too much.

I watched the Superstar cut through the epidermis overlying the lipoma. I told her to hold the knife a little different. She obliged. Dermis. Connective tissue. Fat. She dissected. I dissected. We got out fancy instruments. We uncovered the fatty tumor, used a clamp to lift it and found the tissue plane between it and the fascia below. 

Then it was out in a satisfying glump. We closed the wound with two layers of stitches. I showed her ways to hold the skin, to produce better tissue eversion.

Blood and tissue equals gore, but surgery is heady. How many nights did assisting on a c-section awaken me from half-sleep? Blood means business. It narrows the focus to the present, life and death, meanings therein. It’s messy and euphoric. Once I even got cut in surgery with a scalpel, and I didn’t notice. Only when the Dragon asked “did you just punch me in the scalpel?” did I realize I was bleeding into my glove.

I like it, and I have something to offer in teaching it. Relatively speaking, of course.

That felt good.

I finished clinic early (for me) and stopped by the hospital on my way home. My  patient had delivered the day before.

She’s the one I worried about, with possible cholestasis, then liver issues, then renal insufficiency vs atypical preeclampsia. I wanted her delivered sooner, but couldn’t pin a diagnosis on her. Plus she was going to try a VBAC.

She didn’t make it. When her bag of waters broke, there was meconium and the baby’s heart rate went down for a while.

The love of her life had left her when she became pregnant. “I guess he wasn’t ready for the responsibility,” she told me. When she was about to have her baby, though, her mother drug him to her bedside as she writhed in pain without an epidural and people ran in and out of the room. He went into the c-section that ensued, watching the blood that poured onto the floor. “Mom thought he deserved a front-row seat,” she told me.

Her baby rests now, on her chest. He doesn’t want to leave her, not for a moment.

Last year in the worst of times G.B. told me I didn’t know how to love anymore. I spouted off something angry and doubted myself for days. He was wrong. I do know how. But love is not what we’d believed it to be, maybe. Love is blood. Love is war. Love is backbreaking, work in the trenches, elbows deep in carnage, debt, dirty diapers. Love is a clear blue sky torn through with screaming missiles, fire sweeping the fields, children cowering in tents. Why else does cupid shoot you in the heart, but that you may bleed?

Blood is love. It is not all of love. But what else but love and blood, rushing through our veins, keeps us alive?

Fatty tumors. Blood-stained babies resting over Mother’s heart. I’m going home now, to all those I’ve bled for.

If I Couldn't Be

Sometimes I think about what I might do if I couldn’t be a doctor.  You know, were I to become incapacitated for medical work, or lose my license due to a lawsuit or clerical error by the Medical Board (not inconceivable), or were the apocalypse to be nigh, for example on Dec. 21, 2012.

Here are some ideas I’ve thought of.

·      Physics instructor

·      Actor

·      At-home parent (GB laughs at this idea, but maybe I could do it, right?)

·      Faxer of Things (see The Other Shoe Dropping 12/15/11)

·      Forest ranger

This morning as I pulled in to the hospital parking lot I realized ALL OF THESE THINGS ARE INSANELY BORING.

Obviously I would be a helicopter pilot for Life Flight (or similar.)

Probably I have never thought of this before because I have never parked directly next to a helicopter before.  It is a lovely beast.

It would be fantastic.  Not only would I be rescuing folks from remote hospitals with mediocre specialty access and possibly SAVING LIVES but more importantly I would be FLYING A HELICOPTER.

Probably I’ve never been in a helicopter before but I don’t think that matters too much.  How hard could it be?  Ask me a troubleshooting question.

What happens when there is a storm approaching?

·      Fly away from the storm.

What happens when the helicopter turns upside down?

·      Obviously you reverse the direction of the blades.

See?  Easy.

What if all the power goes out on the helicopter?

·      You should have brought your battery.  I would always bring a back-up battery.

What if there was a mutiny on board the helicopter mid-flight?

·      Obviously I would start singing Kum-Bay-Ah or a made-up song about helicopters.  Works for my kids.

What if a velociraptor appears from the sky and tackles you?

·      Consult Up-To-Date for Helicopter Pilots.  (They have that, right?)

I am so excited about my alternate career I might even see if they will allow me to ride in a helicopter one day so I can subtly talk them into letting me fly it, such that they will not even realize my pretext until it is too late.

I will grasp the steering wheel (Console? Handlebars?) with my pasty-white, overly-dry hands and conjure up reflexes and dexterity long-held dormant to guide the lovely beast safely through the air.  I will push buttons (lights?) and talk on the radio with a headset (is it called CB or CV?)  “Roger, 40, what’s your 20?  I’ll have a number 17 with Ranch Vinaigrette.  Will be landing shortly if that’s ok.  Do I land on the X or next to it?”

After we land I’ll take a moment to relax and drink some lemonade while reading a little bit about Helicopter Piloting Terminology.  Probably I’ll be considered a prodigy and earn a medal.

But first I guess I will round on a few patients.