How to Save a Life

And I would have stayed up with you all night–Had I known how to save a life.

The Fray, “How to Save a Life”

The tenth season of Grey’s Anatomy premieres tomorrow night.   For the cognoscenti, this means we will find out what happened after the cliff hanger of last season:  Will April really leave Matthew at the altar, for her first love plastic surgeon Jackson?  Or will the handsome paramedic who loves the doctor unconditionally and quite unbelievably without ego issues, win his lovely bride?  After all, he organized a flash mob for his proposal to her.  He deserves his beautiful red headed pig farming sweetheart.  And why do I watch these things?  Is it because the women wear makeup and heels and do their hair and the men are so very handsome and no one looks tired, and lives are saved quickly, with great valor. As Hemingway’s Jake says at the end of The Sun Also Rises, “Isn’t it pretty to think so?”

The song, “How to Save a Life” by the Fray, was used in an episode of Grey’s second season, and afterwards became an anthem for the show itself.  My favorite rendition is a home video with a hand held camera, of the actual cast singing the song at a benefit—you can view it here:  http://www.youtube.com/watch?v=KX3AjiqFA1s   Yes, I know they aren’t “real” doctors. But I suspect that if you act like a doctor for ten years of your life, it might be hard in the end to tell the difference.  The emotions are all right out there, in the video and in the show.  And that’s the real answer to why I watch Grey’s Anatomy—I get it all out in front of my own television set so I don’t have to do it in front of my patients.   I don’t think it’s helpful to have your doctor cry while she is giving you bad news.

Friday, February 28 will be my last day at work.  I am officially retiring, at age sixty. My staff and my patients have been asking me why for several weeks now.  They make very complimentary proclamations like, “But you look so young!” and “But you’re so GOOD at what you do” and “How can we replace you?”  The answers to these questions are “thank you,” “thank you,” and “No one is irreplaceable.”  The truth is that I feel like time is running out.  I have had some extremely joyful experiences over my last thirty two years in Radiation Oncology and I have witnessed some incredible success stories, many of which I have told here.  I know that miracles DO happen.  But I have also seen some terrible things, and there is not a doctor alive who would say that we don’t take our failures personally.  We do.  What I have come to realize, at least for me, is that the sad times are not getting easier as I am getting older.  Facing the deaths of loved ones this past year–patients, relatives, friends and pets—has left me with an acute sense that the clock ticking in the belly of the crocodile is ticking for me, and  I am no Peter Pan.

So I will leave my practice in the best of hands, and I will read and I will write and I will travel and see more of my children and all the other people I care about.  There is a line in “How to Save a Life” which goes, “And you’ll begin to wonder why you came.”  There is one thing that I am certain of, when it comes to my career.  I will never ever wonder why I came.

Sara Beth Closes Her Eyes

Just when I think that I have escaped my work world for the day, here I am lying on my couch weeping while watching Dancing With The Stars.  Apolo Anton Ono, Olympic speed skater and his partner Karina Smirnoff have just danced to the Rascal Flatts song “Sara Beth”.  For those of you who don’t know the song, here’s a little sample for you:

“Six chances in ten it won’t come back again
But with the therapy we’re gonna try
It’s just been approved it’s the strongest there is
But I think we caught it in time
Sara Beth closes her eyes

And she dreams she’s dancin’ around and around
Without any cares
And her very first love
Is holding her close
And the soft wind is blowing her hair.”

The dance starts with Karina on the floor, her gauzy blue gown puddled around her on a dimly lit stage.  Apolo lifts her up and they begin a slow waltz.  As I watch, I am overcome with sadness as this thin slip of a girl dances away her cancer, her long hair about to be lost. And then, the lights go on and the crowd cheers and I am reminded of a conversation that I heard on Saturday night.

My husband and I had gone downtown to see a play at the San Diego Repertory Theater about the protest music of the 1960’s.  We went early because there was a lecture and discussion between the director of the play, Todd Salovey, and his brother Peter Salovey, who just before Thanksgiving had been named the new President of Yale University.  Professor Peter Salovey had given the opening address to my daughter’s incoming freshman class at Yale in September of 2002.  The talk was quite memorable because he had just described and written a book about a concept called “emotional intelligence”, roughly defined as the ability to recognize, empathize with and respond correctly to emotions exhibited by others.   In the world of psychology, this was BIG, because it explained that IQ, or intelligence quotient, is only one ingredient to successfully navigating life, career and relationships.  Emotional intelligence, or EQ is the other essential.  If you lack it, you are in trouble.

In the discussion Saturday night, Professor Salovey was asked two questions:  first, is it possible to quantitatively measure emotional intelligence.  The answer was “yes, it is.” The measurement device is a validated 45 minute test called the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), administered to persons over 17 years old.  The second question was even more important, and relevant to the practice of medicine:  is it possible to IMPROVE one’s emotional intelligence, and if so, how?  The answer was surprising.  One way, and perhaps the best way, to improve emotional intelligence is to practice “feeling” through art.  Listening to music, going to plays, watching a comedy on television, seeing an exhibit—all of these things are designed to elicit powerful emotions.  Apparently, the older we become (unlike the IQ test where sadly, we peak out in our early twenties), the more life experience we have, and the more just plain practice we get, the better we become at expressing and interpreting emotion.

Our cancer center takes a very holistic approach to curing cancer and I can take no credit for that—the medical oncologists who started the practice there have long been committed to offering complementary therapies such as massage therapy, acupuncture and art therapy.  One of my patients told me on Monday just how much she is enjoying these ancillary services, especially the art classes.  She told me that they help her deal with the emotional trauma of being diagnosed with cancer.  As it turns out, if you want your children to be empathetic and able to read the signals of others, you might want to hand them paint, brushes and an empty canvas, or a camera, or clay to model or a musical instrument or a pencil and a blank book to write in. And of course, get them a puppy to love.  As for me, I got a good dose of emotion tonight on DWTS.  And if I find myself lacking, there’s always “Grey’s Anatomy” on Thursday!

My Doctor Shows

This week is a big week for me: my doctor shows finally return to primetime television!  I have been waiting a long time since the plane crash cliff hanger finale of last season’s “Grey’s Anatomy” for my tv counterparts to return.  Last night I was taken by surprise– just after the first elimination round of “Dancing With the Stars” I had walked outside to answer a friend’s phone call on my cell, when my husband appeared and whispered, “I’m going to bed, but I’m recording the season premier of “Private Practice” for you.”  Needless to say, the phone call ended very quickly, for I have been a doctor show junkie practically since birth, or at least since the handsome Dr.Kildare first picked up a scapel on primetime.

When “Grey’s Anatomy” appeared as a mid season replacement in 2005, I was barraged with phone calls from several of my friends, not physicians, who reported it as a “must see.” I was a bit slow to respond, having missed the first several shows.  When I finally turned it on, I was neither impressed nor amused.  George, one of the interns, was tasked with the unpleasant business of telling his own father that dear old Dad had, as George put it, “The Big C”.  I was indignant.  I called my best friend, who was by then the show’s biggest fan.  I told her emphatically, “THAT WOULD NOT HAPPEN!”  Medical students and interns do not tell their own family members that their worst fears have been realized.  That is a job for a senior resident!  And besides, I harrumphed, “NO ONE CALLS IT THE BIG C ANYMORE!”  I was astounded by the inaccuracy of the medical writing, not to even mention the mispronunciation of medical terms by the befuddled cast.

So how was it, that sometime later, between the third and the fifth season, that I found myself irrevocably sucked in by the story line, not only of “Grey’s Anatomy”, but also its spin-off show “Private Practice”?  I think it was when I finally suspended my own experiences and reality and started to believe in the characters.  Meredith and Derek, Izzy and Alex, and of course, the ever endearing Lexie, aka “Little Grey” were no longer just actors, stumbling over medical words they had never previously had reason to utter.  They were people, who laughed and loved and lived and cried, and died.  When George, the most inept of all the interns, was hit by a bus while shoving a stranger out of the way and maimed beyond recognition, he signaled his identity to his peers by signing 007 (“licensed to kill” as dubbed by his fellow interns) on Lexie’s hand.  I wept for hours.  Really, I did.

When Addison left for Santa Monica and “Private Practice,”  I followed.  “House” may have seen its last season, but that’s okay by me, because Addy and Jake are finally going to be happy.  Why do I love these shows so much?  I will tell you why.  When I see these beautiful young women and men, dressed to the nines in their form fitting clothes, sporting sparkling make up and very good hair, and better shoes, having even better sex, I can pretend, just for a moment, that that’s the way it really truly was. It is a very good fantasy indeed.