Thoughts at the end of a long year

"For it must needs be there is an opposition in all things. If it were not so...righteousness could not be brought to pass, nor wickedness...neither corruption nor incorruption, happiness nor misery, neither sense nor insensibility."

Somehow, inconceivably, 2010 is almost over. Of all the lessons I've learned in the past year (and especially during the last 6 months), it is that life is defined by opposites. In every experience, one end of the spectrum gives meaning to the other end of the spectrum.

On an overnight shift a few weeks ago, I was called to come pronounce a man dead. He had been a healthy 91 year old, then he fell at home and caused bleeding in his brain which the neurosurgeons couldn't repair. He was still in the hospital doing poorly weeks after it happened, so his family met together, decided he wouldn't have wanted to live that way, and he was put on palliative comfort care. That night, he drew one deep breath then quietly died as the nurse was changing his bedding.

It was the first death I have had to pronounce. I had never met him; never known who he was or what he was like as a living person. I stood there alone in his room, like the world was on pause, hit by the clarity of the fact that his body was still there but he definitely was not. Taking up a corner of the room, there was a big custom blanket printed with a life-sized picture of his children and grandchildren, which made it look like he was surrounded by loved ones even though the room was actually chilly and empty, full of death.

Just a few days later, I was taking care of a new patient: a young woman who was 6 months pregnant and having abdominal pain. Her OB was worried she might have an infected gallbladder which would need surgery. While I listened to her abdomen, I had a hand on my stethoscope and the other on her belly. Suddenly, there was one strong, perfectly-aimed kick from a tiny foot against my hand. Full of life.

About a week after that, a little old man came to collect a bag of his wife's clothes that had been accidentally left at the hospital when she was transferred to a nursing home. He wanted to tell me they have been married 68 years. He's had a stroke and she had been taking care of him at home until she got sick. He wanted to ask me whether she would ever completely recover. He wanted to tell me that he's afraid she will die and leave him alone here without her. He wanted to know if she'll be okay and if he'll be okay. Full of fear, seeking hope.

Every day in that hospital, people are being born and others are dying. People are struggling and suffering, but others are healing and recovering. One family in the waiting room is sobbing and a kid is coming to terms with how real death is when it happens to someone you know. One family in the waiting room is crying tears of joy that their son walked away from a triple-rollover car accident with only a few stitches. People dealing with stress or with relief. They're relying on faith or losing their faith. They're praying or they're cursing God or they're not sure He even exists. They're feeling joy because it could have been pain. They're heartbroken because they had hoped for happy news that never came. They're overwhelmed and feeling nothing at all yet. And I'm there for long hours and late nights and anxious questions and whichever end of the spectrum happens to be occurring.

I don't tend to write much about the hospital or work because things that strike me deeply tend to come across sounding overwrought and cliche in writing, but I do feel humbled and blessed to be here as a part of this. The whole messy soup of opposites and contradictions and joy and pain is an elegant place to be. Full of lessons.