Choosing Life

Choosing life is the title subject as the alternative can be a scary thought - Dying. It's been a while since I last penned down my thoughts.

A lot has happed since I was last here.

In summary:
1. I became a father to 2 very adorable kids - greatest joy
2. I finally graduated from my formal training in Cardiology
3. Started working as an attending


Last night I was on call covering all cardiology related issues for the hospital. I received a call from the ED about a patient who was having chest pain. This is not unusual and often questions and directions can easily be answered over the phone. However, this case was different. The data was not very concerning, however, I felt compelled to go see the gentleman myself. This part was unusual especially if the patient is stable. In fact, the ED doc was surprised that I was ok leaving my home and my family to attend to what seemed like a routine case.
I saw the gentleman and his wife. They were both very appreciative that I was there to explain what was going on.

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The subject of death is a difficult one. As a doctor, I was introduced to the idea during my first year in medical school while learning gross anatomy on cadavers donated by people who wanted to give back to science. I always thought that was a noble gesture.
The second instance was during my internal medicine rotation while on call, my intern had to declare a patient dead. I was amazed at how much responsibility was placed on this young man who was my age. You don't want to get it wrong!
Another memorable instance was my very first code blue. This was at Baylor while on my IM rotation, again on call. I saw my upper level and interns run ACLS. I had the opportunity to perform chest compressions. Eventually our efforts were futile. It was a very intense experience, for those who've had the opportunity to be involved in a code blue.
I have since been involved in several code blues and even had the opportunity to develop educational videos to assist others. Experiencing death is never easy and in every instance I've felt a deep sadness.

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We recently took a trip to Kenya and South Africa with the kids. It was a pleasant experience as it was the very first time for my dad and father in-law to see their grandchildren. It was also the very first time the kids to be in the continent of our birth. Everything went smoothly except our flight back from Amsterdam to Atlanta.
We lost an engine 3/4 way over the Atlantic. The plane dropped (gradually) from 32000ft to 22000ft. During this process, there was no communication from the cockpit or flight attendants. My wife and I were seated on opposite sides in the middle ail with our children in-between. We locked eyes and non-verbally seemed to ask: "is this it?"
 ...is this it?
I idea of losing everyone that's so dear to my heart was scary, painful and... what seemed unreal. But it was real! We were over the Atlantic and 90 minutes from the closest safe landing spot.
The pilot eventually came on the PA system and explained what was going on. 90 minutes later, we safely landed with one engine at a military airbase in Goosebay Canada.

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I eventually left the hospital and returned home to my family. Knowing that call can be unpredictable, I decided to jump straight into bed and get as much sleep as possible before my pager went off again. I quickly drifted into dream land and began experiencing my subconscious. It involved friends from high school, my days at Strathmore college, my job as a cardiologist, family members... the usual mix that doesn't happen in real life (dreams can be surreal).
Interesting, in one instance while learning to relax at a swimming pool, I had an out of body experience. I literally saw myself floating above my relaxed body in the pool. Scary stuff!
What was even more scary was the higher I floated up, the harder it was to get back (explains the concept of being a spiritual being). Is that what dying feels like?
I wanted to live! The only way I was able to get back down was focusing on serving others.
That's correct, focusing selflessness and that saved my life.
Interesting, the person teaching the relaxation class was by good friend from high school (AB).
After choosing life, he pulled out a a powerpoint presentation to illustrate how to stay alive.

The hierachy was:
1. Everything one does should be to serve God - bring glory to His name
2. Everything after that should be service to fellow man
3. Choosing life mean self-denial.

I woke up and realized this was a divine message and most importantly, the world needed to know. I decided to pen it down while still fresh in my mind.
It is really not a new idea. It is the core to most religious and non-religious beliefs.  We are all going to die someday. The gap between then and now is... Life.
Choosing life means living everyday positively impacting the lives of others around you. This begins by acknowledging that life is a gift from the creator and we supposed to bring glory to His name by following his commandments.

Luke 10:27 and 28 summaries it best.
27: You shall love the Lord your God with all your heart, with all your soul, with all your strength, and with all your mind, and Your Neighbor as yourself
28: ... Do this and YOU WILL LIVE.

Now what?

It's been awhile since I last blogged/wrote. A lot has happened since. Two weeks ago I completed my Cardiology fellowship training. This was in addition to my internal medicine residency. The past 3 years have had their ups and downs. It was especially trying in the beginning. My wife has been very supportive and has been my number 1 cheerleader.
Yes, I got married to an amazing woman in 2014 and have also been blessed with 2 wonderful children. My family has been my bedrock during this period and I am truly thankful for them.

I decided to take 1 month off to spend more time with the kids and wife. This decision was supported by my mentors (older experienced cardiologists). So far, I believe it was the right choice. I've had the opportunity to reflect on the future and I enjoy the present by spending time with the kids.

The new assistant pastor recently preached about philosophical questions that have plagued man since King Solomon's time. Who am I, What am I doing here and Where am I going?
As I begin my career, I also wonder what contributions can I make for the betterment of others. Seems like an obvious answer being a physician. Afterall, our profession is about helping others. I feel, however, like there is more to it than applying my skills and knowledge in treating maladies.

I have proposed focusing on preventative cardiology (primary and secondary) by focussing on the health message which is in line with what the SDA church teaches. Seems very doable ministry and I had the opportunity to discuss with Dr. James Marcum who runs Heartwise ministries. He seemed to enjoy what he does and gave a stellar talk during the Eat Healthy Knoxville day in the fall of last year. I am not sure, however, if that is what I have in mind for the rest of my productive life.

The truth is I do not know what God intended for me during my limited time in this place. I have always had a knack for business and teaching. I incorporate teaching during all my patient encouters and I really enjoy it. I like doing short procedures like diagnostic caths and not longer structural problems . I also recently began placing permanent pacemaker which is "real surgery." I enjoy it, hower, wearing lead for several hours at a time is not exactly what I would like to do long haul.

For now, the future still remains and adventure. I do not know where this road leads. I begin seeing my patients in less than two weeks and my hope is that I can be the best cardiologist who can positively impact their lives through teaching, healing and love.

Kemmy, Joshua and Michelle still take number 1 priority. My creator is encompassed in every aspect of my life. For he is the only one who knows why he gifted me with life.

Amen!

Left Behind

I had been up all night working with a new intern, his first night shift. We got slammed with ER admits, transfers from OSH and floor consults. I triaged the straight forward cases to the intern to allow me to stabilize the sickest.

He arrived in the ED in PEA arrest and the trauma team began resuscitation. I joined the team and took control of resuscitative measures. I informed the attending on call of my clinical assessment and transferred him to the unit. We worked on him some more and kept his heart beating although we all knew he was already brain dead.

Then you walked in and broke down into tears... You called his name and cried some more. You spoke to him about your 2 daughters and how they needed their father. You spoke of the camping trip and how the family vacation had turned into a nightmare. You spoke of how God had found a perfect mate for you and how much you loved him. All the medical explanation and treatment plan didn't seem to matter... and it shouldn't have. I was lost for words. The RNs, RTs and everyone else in team continued working... with teary eyes.

You wanted to be left alone with him, and we all complied. I had 2 admits waiting in the ED, and continued working. The call came around 0550. He's heart had stopped. No resuscitation as per your wishes. You had already witnessed it 3 times and couldn't handle a 4th.
I examined the body and pronounced him dead. We sat there is silence. "He was a brilliant man", you said. "An electrical engineer. It is now too late. He is gone."

...a step at a time

Today marks another milestone in my journey. Nothing special like graduation or moving to a new grade or passing a major test. Today I got inspired by a few things I've observed around me. As I type this, game 7 of the NBA championship between the Spurs and the Heat is yet to be played. I watched most of game 6 and it was very close. The spurs were very impressive and appeared seasoned (some people call it "old"). The heat on the other hand, is full on talent... however, mostly bought talent. I was very impressed to learn Tim, Manu and Tony have been together for almost 16 years with Popovich as the head coach. That is a championship team that was built-up. It took steps to recruit and patience to reach that level. Even though the popular thing is to root for a big name team like Miami, I feel that San Antonio deserves this one. Looking forward to tonight's game!
Related to the basketball finals, is a short clip from an interview with Russell Crowe about his latest movie "man of steel". Apparently Henry Cavill met Russell years ago while he was a teenager in high school. He candidly approached him for advice about acting and Russell's reply was interesting. It's a cliche phrase, but yet; so true... "a journey of a thousand miles begins with one step" ...today, Henry stars as superman alongside Russell in Man of Steel. Can't wait to see the movie this weekend!

Unit 2.0

The past 24 hours were one of the most trying moments in my career as a physician. Without delving into details, I saw life end right before my eyes. Don't get me wrong, I've seen a lot of death between med school human gross anatomy and my intern year in residency.
But there was something last night that hit me especially hard. Even though everyone on the team, ER doc, intern, nurses, attending, consultants did everything they could possibly do, I feel like I lost a fight. Even worse was breaking the news to the family. Never have I felt so bad...
Today, I mourn. Even though I did not know you personally, I lost a part of me when you left. You will truly be missed by your family.

Closing

In 3 days, I will be done with med school. I will no longer have the word student attached to my description even though I am a life long learner. Somehow, the word student has a naivety feel to it. Sort of offers some security from the real world.

It's been a journey alright. As I look back and reflect on my experiences I really cannot come to any conclusions. I must admit there were pretty low points and some highs as well. I made some close friends who I hope to keep in contact with through-out my career. I tried not to make any enemies, but like in any large group, there will be people whose personalities don't match-up. I feel pretty burnt-out not necessarily from the course work, but from the constant worrying of what the future entails. I chose not to worry (doc's advice).

I learnt a lot from my Parkland patients whom I will forever be grateful. I tried my best to be an advocate for the sick and poor. Some of my attendings were very inspirational, especially the older folks who still know what it means to be a physician. They could have chosen a lucrative career taking care of the "whose who" in dfw but they chose Parkland. They get the word: "And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done [it] unto one of the least of these my brethren, ye have done [it] unto me."

Med school was not a walk in the park. It required a lot of sacrifice from a lot of people. I don't feel like a hero who just survived 4 grueling years. Instead, I am truly humbled. Becoming a doctor isn't just about adding the initials MD to my name. It comes with great responsibility that I will bear to my grave. I pray the Lord to guide me through this new journey I'm about to embark.

Amen.

almost there... really?

In 4 days, ill be taking my last exam. Wow! Well i'm not really that excited. I've taken so many tests, gotten used to studying all the time and to be honest, its really an anti-climax. So, how was the past year?
Started off well with pediatrics. Lots of ear infections, URIs etc. New born nursery was fun. Then off to Neuro. Neuro Peds was really sad esp kids born with devastating neuro deficits... Stroke service was cool, esp reading MRIs. Always nailed the anatomy! Its all about localizing the lesion. Then off to family which was ok, except it was at the height of H1N1 and we hadn't gotten immunizations! Then surgery, which was truly an eye opener. Working 33 hours straight is possible but literally sucks the life out of you. My R3 seemed really depressed and I felt really sad for her. Took a much needed christmas break, then back for OB/Gyn. Started off with Gyn which was awesome. I actually got more OR time than I did during Surg. My last day on the team I got to do a myomectomy (literally yanking out fibroids). I realized I liked doing procedures. OB was ok. Deliveries can be really messy, but its still a miracle of life. Motherhood is a beautiful thing. Psych followed shortly with a stint at Presby. 3 weeks of consults followed by 3 weeks of eating disorder (ED). Ladies and gentlemen, ED is a true disease that can be devastating. Please don't brush it off and encourage people you know to seek help. Parkland psych ER was interesting! Nuff said.
Finally, internal medicine. First month at parklands, 2nd month at BUMC and now doing ambulatory rotations at various clinics. Medicine is very broad and requires a lot of intellect. The more you read, the more you know. I feel that I have a lot more to learn and wouldn't mind doing that for another 3 more years. An ideal program would be one that is not too busy such that one has time to read.
And so, the journey continues. As I wrap-up my year, I now must decide on my future... Reading through my past posts I hope to remember why I even went to med school in the first place...
I'll keep you posted.