Monday, June 25, 2007

"I could never do your job!"

I get this a lot.
From the Starbucks barista, the cashier at the department store, people I meet at barbeques, at church, or my son's preschool...It's slightly insulting, slightly admiring, and slightly funny. I guess if your work is of the kind that deals with paper, or material goods, or coffee, it would seem rather foreign to think about a job where you see people's guts or blood or whatever it is people think we see! I'm generally not up to my elbows in guts when I'm at work, but still people think it's gross. I think we are scared of things unknown, and, as much as we live in our bodies and never get away from them, what's inside is unseen and thus unknown, and we don't like to see it.
I like to see it.
I've had this fascination with theatre since I was little. I loved being onstage myself, with everyone watching me, especially if they thought I was great, but I also loved backstage. I was curious about the tech booth, the lighting, the catwalks, the backstage hallway that connects stage right from stage left, the wings--everything. I was fascinated with the mystery behind the magic that happens onstage to transport an audience to another time, another place, and another set of circumstances. In high school I got very involved in theatre, onstage and backstage, acting, dancing, and being a techie, so by university it wasn't such a mystery to me anymore. But it was still magic.
It is this same quality that I love about medicine. Human anatomy is the inside, backstage, secret universe that makes the outside walk, talk, cry, love, and eat. It is beautiful! And amazing. The amount of intricate steps involved in digestion, for example, can take days to describe, and there are still aspects of digestion we don't understand. We don't usually get to see our muscles work, or the bones articulate, or our nerves fire. Not that I've seen nerves firing, but it is magic to see a person's hand move despite a nearly severed arm, which is the next best thing.
Blood is supposed to be 'so gross.' Blood is amazing! It is the only fluid tissue in the body. Changes in the colour of your blood change the colour of your urine, breastmilk, sweat, and skin. Blood is the great intersection of the body. Gas exchange, nutrient exchange, waste exchange, hormone transportation, massive battles against foreign invaders, body repairs, histamine release--all of these events happen in the bloodstream. At work we alternately refer to blood as 'the red sticky stuff' and 'motor oil' (this one I query with raised eyebrow? I work with a lot of men) and surprisingly, don't see a lot of it. Even when people have been smashed into hard objects at high speeds (ie, the windshield of a vehicle, for instance), there is not really a lot of blood most of the time. I guess any blood is more blood than most people see at work, but you would think that a body designed to absorb the trauma involved in impacting the ground or trees at full running speed, which then travels in motorized vehicles at speeds many times that of a full run and frequently crashes, would bleed more.
Guts are also supposed to be 'gross.' Fascinating! We never get to see those! So mysterious. It is amazing to see someone's muscles at work through a deep wound, or peristalsis still travelling down the digestive tract despite a big gouge in the skin of the abdomen.
Now, I think the 'grossest' thing people think of when they tell me they could never do my job, is death. Granted, death is frightening for all of us. It is the ultimate unknown, unknowable, unavoidable black shadow, and it sits in everyone's future. It lurks. We can hear it sometimes. When people around us die we can often even smell it, and we hate it. Some people leap right into the shadow, choosing at least to control when, if not if, they have to face death.
I think sometimes that here in human-ness, with our vast capacity for denial coupled with the depth of our fear of that shadow, we manage to sanitize ourselves from death. This is interesting, since most people would likely consider themselves desensitized to tragedy and violence through movies and television (do we like to watch it on a screen because we've sanitized our lives of it, but are curious? Is it easier to deny it will happen to us if we watch it on a screen?). I would argue that most of us don't see death or tragedy in our lives often, if ever. We all feel it. No one goes through life without losing someone, and grieving it. I don't deny the visceral pain we all feel when someone we love dies, is ill, or is injured. I mean actual visual seeing. Seeing changes you.
Although I fear death as much as anyone, I'm not afraid of seeing it. Death is a big event, a frightening leap, and it brings out a lot of visceral emotions in those left behind. It is an honour to be a part of people's lives during tragedy, when their emotions are cracked wide open like glacial fissures, when denial is gone for awhile and we face the shadow and all our fears. No one should have to face this alone.
Some deaths are expected (it always surprises me when expected deaths elicit surprise in the family members who are left behind...I guess perhaps it is the shock of the actual after the fear of the possible, and shock and surprise at the loved one's absence, and not their death itself which surprises them), and some are 'sudden.' I saw a woman who died of anorexia. Does this qualify as expected, or sudden? I would be surprised if she weighed 60 lbs when she died. It is grievous to me that people die of starvation in apartments above grocery stores in Vancouver, Canada, a place affluent and full of resources. It is a testament to the strength of the human will that this is even possible. What would happen if we put the strength of this will towards resolving world conflict, or the surplus of orphans? Or creating great art? Or amnesty?
I saw another woman who died of a drug overdose two days after the birth of her baby. What makes us so lonely that we would rather get high? Over and over until we quietly disappear? How much closer can you get to another human being than growing one in you and giving birth to it? Yet she still was too lonely to stop using. It hurt too much. I speculate, of course. It has to hurt to make someone start using, and once hooked, there is an addiction on top of the original pain, plus the knowledge that you are now a junkie and the suspicion that you don't deserve better...
This seems insurmountable. But some people surmount addicition! Another testament to the strength of human will. We have our lazy or mundane moments, but as a whole I think we are fascinating and miraculous. That's why I do the work that I do.

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