Weaver's Web

My NP student just left after her final day here with me.

Ana is now in her later 20's. She was born in Mexico and came to the US in early childhood. She's the first in her family to finish college. She's the first in her family to get a professional license. In three weeks, she'll be the first in her family to have a graduate degree.

She's a sharp cookie, fluently bilingual, with a very caring heart. I see a bright future ahead of her and for her family and it has been my privilege to serve as her preceptor for the past 18 months. I only hope I've been able to teach her enough.

It's sobering to realize that she'll likely be practicing 30-40 years from now, maybe mentoring a new provider as I've done for her, learning the art and science of medicine. She'll be doing this long after I have hung my stethoscope up. Today for the first time, as she departed, it's hit me that my time to lay this burden down will come all too soon. Not tomorrow, not next year, maybe not for another decade, but it will come. My schooling, my residency is so long ago, it's no longer in my rear view mirror, not that the details of the learning process ever ends in this profession. Continuing education is a way of life to be able to do this job.

Mid-day we hit grand rounds over at the hospital. Really a fascinating presentation on bariatric medicine - the medicine of weight loss/weight management. (Not that this one doesn't hit way close to home!) Hearing a bariatric surgeon from the practice I went to in consultation 6 months and 85 lbs ago, was quite fascinating, particularly when it came to the endocrinology and microbiology of obesity.

I spoke with my colleague after he finished his lecture. He seemed truly happy to see me, asking for my details. The phrase "You look fabulous" is always music to my ears. I wanted to know what exercise does to leptin, and peptide YY. He didn't know. We did spend a bunch of time taking about the probiotics they're pushing at people and the research papers about it. The statistics of how many kids hit with large doses of antibiotics in early childhood wind up with weight problems. That one hit close to home as well. I was on tetracycline from the just past 2 to almost 3. The mouse studies they quoted with adjusting the gut flora and finding the mice's weight shifting from normal to obese and back to normal just with manipulating the gut flora is both fascinating and confusing. More questions than answers as of yet.

Enough gazing at my navel for now; I have too much to do. Time to head for home and hearth. Tomorrow it's back to the gym in the morning, and then here again to do battle with paperwork, trying not to feel like Sysiphus rolling the boulder up the hill.

I left for home last night, nearly in tears. It's been a long time since I felt THAT validated.

I'd gone to the hospital after way too long a day at the office, to see a rather difficult patient. He's both medically complicated and not much with the program for taking responsibility for his care. Shall we say he doesn't accept direction well? Routinely, he won't tell me the truth about what he does, that is if I'm to believe his children.

In any event, I had to call in a colleague of mine to consult on this gent. My colleague's a specialist, someone whom I have the utmost respect for; he's got to be one of the brightest physicians I know. Frankly, I think the world of him.

After chatting 'bout the details of the consult I needed, we spent a couple of minutes just catching up with one another. He mentioned he'd just seen my office manager earlier in the day (translating for her mother, whom I'd referred to him for a routine colonoscopy) and what a gem he thought she was. I reminded him of the biblical quote about a virtuous woman being more valuable than rubies (and that Oana is not just my employee, but my friend). Then, I mentioned I'd seen one of his staff people in my office the day before, and what an absolute sweetheart she was. He told me that when she'd asked him for a reference on someone to go see, he'd suggested me, that I was who he would see himself. This raised my eyebrows. He went on to say, he feels I'm a healer, a 'gifted intuitive', "something no residency can train you to be." "You either are, or you're not," he continued.

I was nearly speechless; I'm not sure just how deeply I blushed, but one of the nurses commented about my color, after I got off the phone. All too often, I feel like the 'brain-dead' generalist, and this is one of the specialists to whom I turn when I'm in waters over my head medically. To have him pay me a complement this huge, was one of the biggest professional rewards I've had in I cannot remember how long. He called me a 'gifted intuitive'....

As I drove home, I thought about the things I seem to hear and recognize, that often surprise me, as mulled over what had been said to me. After a bit, I thought, "Alright, enough positive strokes for now, your head is quite big enough!" and I turned on the radio. Instead the CD player kicked in. I had "Wicked" in and the song that started, interestingly enough was rather ironic.

"Wicked" is a re-telling of the "Wizard of Oz", from the viewpoint of the Wicked Witch of the West. It starts with Elphaba (the Witch) and Glinda (Good Witch of the North) as freshman college roommates. The particular song that started was "When I'm With the Wizard". The lyric starts with the college teacher singing, "Oh, Miss Elphaba, many years I have waited, for a gift like yours to appear........." The witch responds a minute or so later, "Did that really just happen? Have I actually understood? This wierd quirk I've tried, to suppress or hide, is a talent(?!?), that could help me meet the Wizard, if I do good? So, I'll make good!"