2.01 Raindrops Keep Falling On My Head
To be a good surgeon you have to think like a surgeon. Emotions are messy. Tuck them neatly away and step into a clean sterile room where the procedure is simple. Cut, suture, and close. But sometimes you're faced with a cut that won't heal. A cut that rips its stitches wide open. They say that practice makes perfect.
The say practice makes perfect. Theory is, the more you think like a surgeon, the more you become one. The better you get at remaining neutral, clinical. Cut, suture, close. And the harder it becomes to turn it off... to stop thinking like a surgeon. And remember what it means to think like a human being.
2.02 Enough Is Enough (No More Tears)
I have an aunt who whenever she poured anything for you she would say 'Say when.' My aunt would say 'say when', and of course, we never did. We don't say when because there's something about the possibility, of more. More tequila, more love. More anything. More is better.
There's something to be said about a glass half full, about knowing when to say when. I think it's more of a floating line, a barometer of need. Of desire. It's entirely up to the individual, and it depends what's being poured. Sometimes all we want is a taste. Other times there's no such thing as enough, the glass is bottomless... all we want is more.
2.03 Make Me Lose Control
Surgeons are control freaks. With a scalpel in your hand, you feel unstoppable. There's no fear, there's no pain. You're 10 feet tall and bulletproof. And then you leave the O.R. All that perfection, that beautiful control, just falls to crap.
Nobody likes to lose control, but as a surgeon there's nothing worse. It's a sign of weakness, of not being up to the task. Still there are times when it just gets away from you, when the world stops spinning, when you realize your shiny little scalpel isn't gonna save you. No matter how hard you fight it, you fall. It's scary as hell. Except there's an upside to the free fall. It's the chance you give your friends to catch you.
2.04 Deny, Deny, Deny
The key to surviving a surgical internship is denial. We deny we're tired, we deny that we're scared, we deny how badly we want to succeed. And most importantly, we deny that we're in denial. We only see what we want to see and believe what we want to believe, and it works. We lie to ourselves so much that after a while the lies start to seem like the truth. We deny so much that we can't recognize the truth... right in front of our faces.
Sometimes reality has a way of sneaking up and biting us in the ass. And when the dam bursts, all you can do is swim. The world of pretend is a cage, not a cocoon. We can only lie to ourselves for so long. We are tired, we are scared, and denying it doesn't change the truth. Sooner or later we have to put aside our denial and face the world, head on, guns blazing... Denial. It's not just a river in Egypt. It's a freakin' ocean. So how do you keep from drowning in it?
2.05 Bring The Pain
Pain comes in all forms. A small twinge, a bit of soreness, the random pain, the normal pains we live with every day. Then there's the kind of pain you can't ignore. A level of pain so great that it blocks out everything else. Makes the rest of the world fade away. Until all we can think about is how much we hurt. How we manage our pain, is up to us. Pain- we anaesthetize, ride it out, embrace it, ignore it... And for some of us, the best way to manage the pain is to just push through it.
Pain. You just have to ride it out. Hope it goes away on its own. Hope the wound that caused it, heals. There are no solutions. No easy answers. You just breathe deep, and wait for it to subside. Most of the time, pain can be managed. But sometimes, the pain gets you when you least expect it. Hits way below the belt, and doesn't let up. Pain. You just have to fight through, because the truth is, you can't out-run it. And life always makes more.
2.06 Into You Like A Train
In general, people can be categorized in one of two ways. Those who love surprises and those who don't. I don't. I've never met a surgeon that enjoys a surprise, because as surgeons, we like to be in the know. We have to be in the know, because when we aren't, people die and lawsuits happen. Okay, I think I'm rambling. My point, actually, and I do have one, has nothing to do with surprises or death or lawsuits, or even surgeons. My point is that whoever said 'What you don't know can't hurt you,' was a complete and total moron. Because for most people I know, not knowing is the worst feeling in the world.
As surgeons, there are so many things we have to know. We have to know we have what it takes. We have to know how to take care of our patients... and each other. Eventually, we have to figure out how to take care of ourselves. As surgeons we have to be in the know, but as human beings, sometimes it's better to stay in the dark. In the dark there may be fear, but there's also hope.
2.07 Something To Talk About
Communication. It's the first thing we really learn in life. The funny thing is, once we grow up, learn our words and really start talking, the harder it becomes to know what to say. Or how to ask for what we really need.
At the end of the day, there are some things you just can't help but talk about. Some things we just don't want to hear, and some things we say because we can't be silent any longer. Some things are more than what you say. They're what you do. Some things you say because you have no other choice. Some things you keep to yourself. And not too often, but every now and then, some things simply speak for themselves.
2.08 Let It Be
For extra credit, Mrs. Snyder used to make us act out all the parts. Sal Scafarillo was Romeo. As fate would have it, I was Juliet. Most of the girls were green with envy. I wasn't. I told Ms. Snyder that Juliet was an idiot. For one thing, she falls for the one guy she knows she can't have... Everyone thinks it's so romantic: Romeo and Juliet, true love... how sad. If Juliet was stupid enough to fall for the enemy, drink a bottle of poison, and go to sleep in a mausoleum, then she deserved everything she got.
Mrs. Snyder explained to me that when fate comes into play, choice sometimes goes out the window. Maybe Romeo and Juliet were fated to be together, but just for a while, and then their time passed. If they could have known that beforehand, maybe it all would have been okay. I told Mrs. Snyder that when I was grown up, I'd take fate into my own hands. I wouldn't let some guy drag me down. Mrs. Snyder said that I'd be lucky if I ever had that kind of passion with someone, and if I did, we'd be together forever. Even now, I believe that for the most part, love is about choices. It's about putting down the poison and the dagger and making your own happy ending... most of the time. And sometimes, despite all your best intentions, fate wins anyway.
2.09 Thanks For The Memories
Gratitude, appreciation, giving thanks. No matter what words you use it all means the same thing. Happy. We're supposed to be happy. Grateful for friends, family. Happy just to be alive. Whether we like it or not.
Maybe we're not supposed to be happy. Maybe gratitude has nothing to do with joy. Maybe being grateful means recognizing what you have for what it is. Appreciating small victories. Admiring the struggle it takes simply to be human. Maybe we're thankful for the familiar things we know. And maybe we're thankful for the things we'll never know. At the end of the day, the fact that we have the courage to still be standing is reason enough to celebrate.
2.10 Much Too Much
When you're a kid, it's Halloween candy. You hide it from your parents and you eat it until you get sick. In college, it's the heavy combo of youth, tequila and well... you know. As a surgeon, you take as much of the good as you can get because it doesn't come around nearly as often as it should. Because good things aren't always what they seem. Too much of anything, even love, is not always a good thing.
How do you know how much is too much? Too much too soon. Too much information. Too much fun. Too much love, or too much to ask of someone? When is it all just too much for us to bear?
2.11 Owner Of A Lonely Heart
Forty years ago, the Beatles asked the world a question. They wanted to know where all the lonely people came from. My theory is that a great many of the lonely people come from hospitals. More precisely, the surgical wing of hospitals. As surgeons, we ignore our own needs so we can meet our patients' needs. We ignore our friends and families so we can save other people's friends and families. Which means that, at the end of the day, all we really have is ourselves. And nothing in this world can make you feel more alone than that.
Four hundred years ago, another English guy had an opinion on being alone. John Donne. He thought we were never alone. Of course it was fancier when he said it. No man is an island entire onto himself. Boil down that island talk and he just means that all anyone needs is someone to step in and let us know we're not alone. And who's to say that someone can't have four legs. Someone to play with, or run around with, or just hang out.
2.12 Grandma Got Run Over By A Reindeer
It's an urban myth that suicide rates spike at the holidays. Turns out they actually go down. Experts think it's because people are less inclined to off themselves when surrounded by friends and family. Ironically, that same family togetherness is thought to be the reason that depression rates actually do spike at the holidays... Okay. Izzie doesn't count.
There's an old proverb that says you can't choose your family. You take what fate hands you. And like them or not, love them or not, understand them or not, you cope. Then there's the school of thought that says the family you're born into is simply a starting point. They feed you, clothe you, and take care of you until you're ready to go out into the world. There you find your own tribe.
2.13 Begin The Begin
Fresh starts thanks to the calendar they happen every year. Just set your watch to January, our reward for surviving the holiday season. Bringing on the great tradition of new years resolutions, put your past behind you and start over. It's hard to resist the chance for a new beginning, a chance to put the problems of last year to bed.
Who gets to determine when the old ends and the new begins? It's not on the calendar, it's not a birthday, it's not a new year. It's an event, big or small, something that changes us. Ideally, that gives us hope, a new way of living and looking at the world, a way of letting go of old habits, old memories. What's important is that we never stop believing we can have a new beginning, but it's also important to remember that, amid all the crap, there are a few things worth holding on to.
2.14 Tell Me Sweet Little Lies
As doctors, we're trained to be skeptical, because patients lie to us all the time. The rule is, every patient is a liar until proven honest. Lying is bad. Or so we are told constantly from birth. Honesty is the best policy, the truth shall set you free, I chopped down the cherry tree. Whatever. The fact is, lying is a necessity. We lie to ourselves because the truth... the truth freaking hurts.
No matter how hard we try to ignore or deny it, eventually the lies fall away, like it or not. But here's the truth about the truth. It hurts. So we lie.
2.15 Break On Through
In surgery there is a red line on the floor that marks the point where the hospital goes from being accessible to being off limits to all but a special few. Crossing the line, unauthorized is not tolerated. In general, lines are there for a reason. For security, for clarity. If you choose to cross the line, you pretty much do so at your own risk. So why is it that the bigger the line, the greater the temptation to cross it?
We cant help ourselves. When we see a line we want to cross it. Maybe it's the thrill of the unfamiliar, a sort of personal dare. The only problem is once that you've crossed, it's almost impossible to go back. But, if you do manage to make it back across the line, you find safety in numbers.
2.16|17 It's The End Of The World & As We Know It
It's a look patients get in their eyes... Some kind of sixth sense, when the great beyond is headed for you, you feel it coming. What's the one thing you've always dreamed of doing before you died?
In hospitals, they say you know when you're going to die. Some doctors say it's a look patients get in their eyes. Some say there's a scent, a certain smell. Some say it's some kind of sixth sense. When the great beyond is headed for you, you feel it coming. If today were your last day on Earth? How would you spend it?
After careful consideration and many sleepless nights, here's what I've decided. There's no such thing as a grown-up. We move out, we move away from our families. But the basic insecurities, the fears and all the old wounds just grow up with us. Just when you think life has forced you to truly become an adult, your mother says something like that. We get bigger, taller, older. But, for the most part, we're still a bunch of kids, running around the playground, trying desperately to fit in.
I've heard that it's possible to grow up, I've just never met anyone who's actually done it. Without parents to defy, we break the rules we make for ourselves. We throw tantrums when things don't go our way. We whisper secrets with our best friend, in the dark. We look for comfort where we can find it. And we hope against all logic, against all experience, like children, we never give up hope.
2.19 What Have I Done To Deserve This?
George: Okay so sometimes even the best of us make rash decisions. Bad decisions. Decisions we pretty much know we're gonna regret the moment, the minute, especially the morning after. I mean maybe not regret, regret because at least you know we put ourselves out there. But still something inside us decides to do a crazy thing. A thing we know that'll probably turn around and bite us in the ass. Yet, we do it anyway. What I'm saying is - we reap what we sow. What comes around goes around. It's karma and any way you slice it - karma sucks.
George: Karma. One way or another it will leave us to face ourselves. We can look our karma in the eye or we can wait for it to sneak up from behind. But karma will always find us.
2.20 Band-Aid Covers The Bullet Hole
As doctors, patients are always telling us how they'd do our jobs. Just stitch me up, slap a band-aid on it and send me home. It's easy to suggest a quick solution, when you don't know much about the problem or you don't understand the underlying cause or just how deep the wound is. The first step toward a real cure is to know exactly what the disease is to begin with. But that's not what people want to hear... We're supposed to forget the past that led us here, ignore the future complications that might arise and go for the quick fix.
As doctors, as friends, as human beings, we all try to do the best we can. But the world is full of unexpected twists and turns. Just when you've gotten the lay of the land, the ground underneath you shifts. It knocks you off your feet. If you're lucky, you end up with nothing more than a flesh wound, something a band-aid will cover. But some wounds are deeper than they first appear, and require more than just a quick fix. With some wounds, you have to rip of the band-aid, let them breathe and give them time to heal.
My college campus has a magic statue. It's a tradition for students to rub its nose for good luck. My freshman roommate really believed in it and insisted on rubbing its nose before every exam. Studying might have been a better idea. She flunked out her sophomore year. But we all have little superstitious things that we do. If it's not believing in magic statues, it's avoiding sidewalk cracks or always putting our left shoe on first. Knock on wood. Step on a crack, break your mother's back. The last thing we want to do is offend the gods.
Superstition lies in the space between what we can control and what we can't. Find a penny, pick it up, all day long you'll have good luck. No one wants to pass up a chance for good luck. But does saying it 33 times really help? Is anyone actually listening? Why do we bother doing those strange things? We rely on superstitions because we're smart enough to know we don't have all the answers.. and that life works in mysterious ways. Don't diss the juju, from wherever it comes.
2.22 The Name Of The Game
A good basketball game can have us all on the edge of our seats. Games are all about the glory, pain and the play-by-play. Then there are the more solitary games. The ones we play all by ourselves. The social games, the mind games. We use them to pass the time to make life more interesting... to distract us from what's really going on. There are those of us who love to play games, any games. And there are those of us who love to play a little too much.
So go ahead. Argue with the ref, change the rules. Cheat a little, take a break and tend to your wounds. But play. Play. Play hard, play fast... play loose and free. Play as if there were no tomorrow. It's not whether you win or lose, it's how you play the game... right?
2.23 Blues For Sister Someone
The key to being a successful intern is what we give up. Sleep, friends, a normal life. We sacrifice it all for that one amazing moment, that moment when you can legally call yourself a surgeon. There are days that make the sacrifices seem worthwhile. Then there are the days where everything feels like a sacrifice. And then there are the sacrifices that you cant even figure out why you're making.
A wise man once said you can have anything in life if you will sacrifice everything else for it. What he meant is nothing comes without a price. So before you go into battle, you better decide how much you're willing to lose. Too often, going after what feels good means letting go of what you know is right, and letting someone in means abandoning the walls you've spent a lifetime building. Of course, the toughest sacrifices are the ones we don't see coming, when we don't have time to come up with a strategy to pick a side or to measure the potential loss. When that happens, when the battle chooses us and not the other way around, that's when the sacrifice can turn out to be more than we can bear.
2.24 Damage Case
We all go through life like bulls in a china shop. A chip here, a crack there. Doing damage to ourselves, to other people. The problem is trying to control the damage we've done, or that's been done to us. Sometimes the damage catches us by surprise. Sometimes we think we can fix the damage.
We're all damaged, it seems. Some of us more than others. We carry the damage with us from childhood, then as grown-ups, we give as good as we get. Ultimately, we all do damage. And then, we set about the business of fixing whatever we can.
2.25 17 Seconds
In life we're taught that there are seven deadly sins. We all know the big ones... gluttony, pride, lust. But the thing you don't hear much about is anger. Maybe it's because we think anger is not that dangerous, that you can control it. My point is, maybe we don't give anger enough credit. Maybe it can be a lot more dangerous than we think. After all, when it comes to destructive behavior, it did make the top seven.
So what makes anger different from the six other deadly sins? It's pretty simple really. You give in to a sin like envy or pride, and you only hurt yourself. Try lust or coveting and you'll only hurt yourself and one or two others. But anger is the worst... the mother of all sins... Not only can anger drive you over the edge, when it does, you can take an awful lot of people with you.
2.26|27 Deterioration Of The Fight Or Flight Response & Losing My Religion
Meredith, George, Cristina, Izzie, Derek, Richard, Addison, Alex, Bailey: Human beings need a lot of things to feel alive. Family. Love. Sex. But we only need one thing to actually be alive. We need a beating heart. When our heart is threatened, we respond in one of two ways. We either run or- we attack. There's a scientific term for this. Fight or flight. It's instinct. We can't control it. Or can we?