A Series of Unfortunate Events

No one wants to hear good news.

Take the wild popularity of Daniel Handler’s A Series of Unfortunate Events, the commercial and critical success of Modest Mouse’s Good News for People Who Love Bad News, or the voracity with which we consume any television or newspaper reporting of tragedy—which is to say, most of the reporting. It might seem that we are genetically encoded to seek out suffering.

If such is the case, I’m happy to recount that this past week was Miserable with a capital M. On Monday I am in the hospital until 11 PM after transferring one critically ill patient. Her O2 sat drops from 98% to 60% and her systolic blood pressure goes from the110’s to the 60’s. We rush to give fluids and maintain oxygenation. Tuesday I stay again until 10 PM to help with a second emergency transfer, a man whose blood refuses to clot and we cannot wake up from breathing assistance. On the occasions I am able to make it to my own outpatient clinic, I feel overwhelmed trying to manage medically what I so often see as failures of society: failure to prioritize grade-school education over tax breaks for the super-rich, failure to protect local farmers from having to compete with an influx of cheap packaged food products, failure of insurance to cover basic, proven therapies that would not only improve health but also save money by keeping people out of the hospital.

Yet if tragedy is our daily bread, we also seek out humor, hope, good-ness. We marvel at the story of the 4-month old baby pulled from the wreckage, alive, a full 96 hours after the tsunami hit the coast of Japan. We celebrate the pilot and crew who manage to land a plane with 259 people on board after both engines fail (LL and I just finished listening to Atul Gawande’s The Checklist Manifesto on CD.) We laugh with relief when Jackie Chan uses a chair and a ping-pong net to defeat an attacker twice his size.

In my series of unfortunate events this past week, there is a moment that I hold on to for hope. It is not the phone call I receive on Thursday that the man we transferred is awake and doing quite well, though that is unbelievably good news. It is not the patient who presents with a stroke and recovers quickly. Nor is it the small times when I get to go home and sleep.

Rather it is the moment of calm in the middle of Tuesday’s transfer when, with the indispensable help of our anesthesiologist, we have stabilized the patient enough to wait for the flight crew. For a few minutes, I get to talk with the son about his dad. I get to hear about his move out to this tiny town and his years working as a diesel mechanic. I get to hear about the time up in Alaska when he pulled in five halibut—and then that night couldn’t lift a drink up to his lips because his arms were shaking. How he was a simple, hard worker who spent too much of his life standing on hard concrete lifting heavy objects.

Then the flight crew arrives and it is all medical again: how much fresh frozen plasma was given over what time frame, the exact lab values measuring bleeding time, the results of the chest xray.

But for those few minutes, waiting there with the patient’s son and my colleagues, we are able to know that we have done everything that we can do, that there is nothing else that we can do, except talk to each other, connect, as humans.

That is good news indeed. Even for people who love bad news.