Karma

On my neurology service I have seen many examples that life is just not fair. A woman in her 30s who had been trying to get pregnant for several years finally does, only to experience a seizure; we scan her head and find that she has metastatic lung cancer. She was a smoker when she was a teenager. Now she is faced with the decision to aggressively treat her cancer and live an extra few months or give her future child a chance even though it will mean that her child will never have a mother.

I have also seen an example of how sometimes the bad things that you have done to others can catch up with you. We had a world famous neurosurgeon on our neurology service as a patient this week. Neurosurgeons are notorious for bragging about the very worst residency lifestyle- on call overnight at the hospital every 2nd or 3rd night, bragging about working 120 hours a week, excited that they were only home for 8 total hours this week. The long years of sleep deprivation and the surgical culture bred throughout training makes many of these surgeons unpleasant to say the least. Our patient this week was a neurosurgeon who suffered a traumatic brain injury after driving intoxicated on his way to a surgical conference. Last week, he was doing life or death procedures on brains and making nurses/residents/students cry on a daily basis on the side. His life as a neurosurgeon was mean- he was well-known for being one of the meanest humiliating surgeons around. This week, he is a patient and is slowly starting to realize how humbling it really is. The patient maintained his bossy cruel demanding personality at first. As he realized the extend of his injury, the long road to rehabilitation ahead, and that he would never operate again despite those long years of training, he became a different man or at least tried to.

I met a neurosurgery resident this week and recognized the name. This neurosurgeon in training had paged me late on a Friday night after I had gone home to yell at me for an inconvenience that my staff physician had made. It was totally uncalled for (I was just a medical student, it wasn't my mistake, it wasn't a big deal) but I remember his name. After I met the patient-former neurosurgeon on our floor I thought of this resident again. Sure, he was tired and it wasn't fair that he was working so late... but how quickly it all can change and you can be at the mercy of your colleagues.

These experiences remind me- life isn't fair sometimes, but sometimes it is. I hope to work hard at being the best person I can be as well as the best physician- after all, they are not mutually exclusive.