7.01 With You I'm Born Again
Every cell in a human body regenerates on average every seven years. Like snakes, in our own way, we shed our skin. Biologically we are brand new people. We may look the same, we probably do. The change isn't visible at least in most of us. But we are all changed. Completely. Forever.
When we say things like "people don't change" it drives scientist crazy because change is literally the only constant in all of science. Energy. Matter. It's always changing, morphing, merging, growing, dying. It's the way people try not to change that's unnatural. The way we cling to what things were instead of letting things be what they are. The way we cling to old memories instead of forming new ones. The way we insist on believing despite every scientific indication that anything in this lifetime is permanent. Change is constant. How we experience change that's up to us. It can feel like death or it can feel like a second chance at life. If we open our fingers, loosen our grips, go with it, it can feel like pure adrenaline. Like at any moment we can have another chance at life. Like at any moment, we can be born all over again.
7.02 Shock To The System
They say lightning never strikes twice. But that's a myth. It doesn't happen often. Lightning usually gets it first time. When you're hit with 30 thousand of amps of electricity, you feel it. It can make you forget who you are. It can burn you, blind you, stop your heart and cause massive internal injuries. But for something that happens only in a millisecond, it can change your life forever.
Lighting doesn't often strike twice – it's a once in a lifetime thing. Even if it feels like the shock is coming over and over again. Eventually, the pain will go away. The shock will wear off. And you start to heal yourself. To recover from something you never saw it coming. But sometimes the odds are in your favour. If you're in just the right place, at just the right time, you can take a hell of a hit. And still have a shot in surviving.
Most surgeons grew up being freaks. While other kids played outside, we hold up in our rooms, memorizing the periodic table, hovering for hour over our genuine microscopes, dissecting our first frogs. Imagine how surprised and relieved we were when we grew up and found out that others out there are just as freaky as we were. Same microscopes, same dead frogs, same inexplicable urge to take human beings apart.
Nobody chooses to be a freak. Most people don't even realize they're freak until it's too late to change it. But no matter how much of a freak you end up being, chances are there's still someone out there for you. Unless of course they've already moved on. Because when it comes to love, even freaks can't wait forever.
7.04 Can't Fight Biology
Biology determines much of the way we live. From the moment we're born we know how to breathe and eat. As we grow older, new instincts kick in. We become territorial, we seek shelter... And most important of all, we reproduce. Sometimes biology can turn on us though. Yeah, biology sucks sometimes.
Biology says that we are who we are from birth. That our DNA is set in stone. Unchangeable. Our DNA doesn't account for all of us though. Life changes us. We develop new trades. Become less territorial. We stop competing. We learn from our mistakes. We face our greatest fears. For better or worse. We find ways to change our biology. The risk, of course is that we can change to much, to the point we don't recognize ourselves. Finding a way back can be difficult. There is no compass, no map. We just have to close our eyes, take a step and hope to God we'll get there.
7.05 Almost Grown
They train doctors slowly. They watch us practice on frogs, and pigs, and dead people, and then live people. They drill us relentlessly. They raise us like children. And eventually, they take a cold, hard boot, and they kick us out of the nest.
We all want to grow up. We're desperate to get there,to grab all the opportunities we can... to live. We're so busy trying to get out of that nest... We don't think about the fact that it's going to be cold out there... really freakin' cold. Because growing up sometimes means leaving people behind. And by the time we stand on our own two feet... we're standing there alone.
7.07 That's Me Trying
Question: when was the last time a complete stranger took off her clothes in front of you, pointed to a big purple splotch on her back and asked: 'What the hell is this thing?' If you're normal person, the answer is, hopefully – never. If you are a doctor, the answer is probably – about five minutes ago. People expect doctors to have all of the answers. The truth is: we love to think that we have all of the answers. Basically – the doctors are 'know-it-alls'. Until something comes along that reminds us we're not.
We're all looking for answers. In medicine, in life, in everything. Sometimes, the answers we're looking for have been hiding just below the surface. Other times, we find answers when we didn't ever realize we were asking the question. Sometimes, the answers can catch us completely by surprise. And sometimes, even when we find the answer we've been looking for, we are still left with a whole hell of a lot of questions.
7.08 Something's Gotta Give
The human body is a highly pressurised system. The blood pressure measures the force of blood pulsating through the arteries. It's important to keep this pressure regulated. Low or inadequate pressure can cause weakness or failure. It's when the pressure gets too high that problems really occur. Because it's the best indicator that something is going terribly wrong.
Every pressurised system need a relief valve. There has to be a way to reduce the stress, the tension. There has to be a way to find relief. Because if the pressure doesn't find a way out, it will make one. It will explode. It's the pressure we put on ourselves that's the hardest to bear. The pressure to be better than we are. The pressure to be better than we think we can be. It never, ever lets up. It just builds, builds and builds.
7.09 Slow Night, So Long
We doctors, take pride in the fact that we can basically sleep standing up. Anytime, anywhere. But it's a false pride because the truth is, after about 20 hours without sleep, you might as well just come to work drunk, doctor, or not. So, it's no wonder that fatal medical errors increase at night. When we doctors are, proudly, sleeping on our feet. Recently, our communal pride has been shattered, and our egos have been wounded by new laws that require that we sleep all day before we work all night. We're not happy about it. But as someone who might one day need medical care, you really should be.
Under the cover of darkness, people do things they'd never do under the harsh glare of day. Decisions feel wiser, people feel bolder. But when the sun rises, you have to take responsibility for what you did in the dark and face yourself under the cold, harsh light of day.
7.10 Adrift and at Peace
The first 24 hours after surgery are critical. Every breath you take, every fluid you make is meticulously reported and analyzed, celebrated or mourned. But, what about the next 24 hours? What happens when that first day turns to two, and we extern into months? What happens when the immediate danger has passed, when the machines are disconnected, and the teams of doctors and nurses are gone? Surgery is when you get saved, but post-op after surgery is when you heal. But, what if you don't?
The goal of any surgery is total recovery. To come out better than you were before. Some patients heal quickly and feel immediate relief. For others, the healing happens gradually, and it's not until months or even years later that you realize you don't hurt anymore. So the challenge after any surgery is to be patient. But if you can make it through the first weeks and months, if you believe that healing is possible, then you can get your life back. But that's a big if.
To a degree, medicine is a science. The doctors who see medicine as science only, you don't want them by your side when your bleeding won't stop. Or when your child is screaming in pain. The clinicians go by the book. The artists follow their guts. The artists feel your pain. And they go to extremes to make it stop. Extreme measures, that's where science ends, and arts begins.
Surgery is extreme. We cut into your body, take out pieces and put what's left back together. It's a good time life doesn't come with a scalpel. Because if it did, when things started to hurt, we would just cut and cut. The thing is, what we take away with a scalpel, we can't ever get back. So, like I said, good thing.
7.12 Start Me Up
People are really romantic about the beginnings of things. Fresh start, clean slate, a world of possibility. But no matter what new adventure you're embarking on, you're still you. You bring you into every new beginning in your life. So how different can it possibly be?
It's all everybody wants, right? Clean slate, a new beginning. Like that's gonna be any easier. Ask the guy pushing the boulder up the hill. Nothing is easy about starting over. Nothing at all.
7.13 Don't Deceive Me
Doctors practise deception all the time. We give vague answers to hard questions. We don't talk about post-op pain. We say you'll experience some discomfort. If you didn't die, we tell you that surgery went well. But the placebo has to be the doctors greatest deception. Half of our patients we tell the truth, the other half, we pray that the placebo effect is real. And we tell ourselves that they'll feel better anyhow. Believing help is on the way, when in fact, we're leaving them to die.
Doctors practise deception every day. On our patients, on their families... But the worst deception we practise is on ourselves. Which is why sometimes it takes us a while to realize that the truth has been in front of us the whole time.
7.14 Pretty Young Thing
One of the hardest lessons as a doctor is learning to prioritize. We're trained to do all we can to save life and limb. But if cutting of a limb means saving a life, we learn to do it. Without hesitation. It's not an easy lesson to learn. And it always comes down to one question: what are the stakes? What do we stand to gain or lose? At the end of the day we're just gamblers, trying not to bet the farm.
No matter how high the stakes, sooner or later you're just gonna have to go with your gut. And maybe, just maybe that will take you right where you were meant to be in the first place.
7.15 Golden Hour
How much can you actually accomplish in a hour? Run an errand maybe, sit in traffic, get an oil change... when you think about it, an hour isn't very long. 60 minutes. 3600 seconds. That's it. In medicine though, an hour is often everything.
One hour can change everything. Forever. An hour can save your life. An hour can change your mind. Sometimes an hour is just a gift we gave ourselves. For some, an hour can mean almost nothing. For others, an hour makes all the difference in the world. But in the end, it's still just an hour. One of many, many more to come. 60 minutes, 3600 seconds. That's it. And it starts all over again.
7.16 Not Responsible
Everyone figures doctors are the most responsible people they know. They hold lives in their hands. They're not flakes, they don't loose track of the important details or make stunningly bad judgement calls. Because that would be bad, right?
We're all responsible with our patients. The problem is, we blow it all out at work. In our own lives, we can't think things through. We don't make the sound choice. We did that all day at the hospital. When it comes to ourselves, we've got nothing left. And is it worth it, being responsible? Cause if you take your vitamins, and pay your taxes, and never cut the line the universe still gives you the people you love. And then lets them slip through your fingers like water. And then what have you got? Vitamins and nothing.
7.17 This Is How We Do It
Renegades. Rule-breakers. Gagsters with scalpels. This is the way we like to think of ourselves. And makes us feel badass. Sexy. The problem is, it's not exactly true. At heart, we are rule followers. We don't break protocol, we follow it to a tee. Because if we don't follow protocol, our patients die. And then we are no longer badass. We're just bad.
It's every doctor's dilemma. Do you play it safe and follow protocol, or take a risk and invent a new one... There can be rewarding risk, there can also be fallout. And when you get the results you want, there's no better feeling in the world. But when you don't...
7.19 It's A Long Way Back
After a trauma, your body is at it's most vulnerable. Response time is critical. So you're suddenly surrounded by people, doctors, nurses, specialists, technicians. Surgery is a team sport. Everyone pushing for the finish line, putting you back together again. But surgery is a trauma in it of itself. And once it's over, the real healing begins. We call it recovery. Recovery is not a team sport. It's a solitary distance run. It's long, it's exhausting. And it's lonely as hell.
The length of your recovery is determined by extent of your injury. And it's not always successful. No matter how hard we work at it. Some wounds might never fully heal. You might have to adjust to a whole new way of living. Things may have changed too radically to ever go back to what they were. You might not even recognize yourself. It's like you haven't recovered, anything at all. You're a whole new person, with a whole new life.
7.20 White Wedding
Germs, disease, toxins. Our bodies encounter dangers all the time. Just beneath the surface. Hidden. Whether you realize it or not, your body is constantly protecting itself. Every time you blink your eye, you wash away a thousands of unwanted microbes, breathe in too much unwanted pollen, and you sneeze. The body knows when it's encountered something that doesn't belong. The body detects the invader, it releases it's white blood cells, and it attacks.
Just when we think we have figured things out, the universe throws us a curve ball. So we have to improvise. We find happiness in unexpected places. We find our way back to things that matter the most. The universe is funny that way. Sometimes, it just has a way of making sure we wind up exactly where we belong.
7.21 I Will Survive
We've all heard the same. It's one of those things we learn in the seventh grade's science class. Adapt or die. Adapting isn't easy though. You have to fight your competition. Defend of their attacks. And sometimes, you have to kill. You do what you need to do to survive.
Adapt or die. As many times as we've heard it, the lesson doesn't get any easier. The problem is, we're human. We want more than just to survive. We want love, we want success. We wanna be the best that we can be. So we fight like hell to get those things. Anything else feels... like death.
7.22 Unaccompanied Minor
I always said I'd be happier alone. I'd have my work, my friends... But someone in your life all the time? More trouble than it's worth. Apparently, I got over it.
There's a reason I said I'd be happy alone. It wasn't cause I thought because I'd be happy alone. It was because I thought if I loved someone, and then it fell apart, I might not make it. It's easier to be alone. Because what if you learn that you need love. And then you don't have it. What if you like it? And lean on it? What if you shape your life around it? And then... it falls apart. Can you even survive that kind of pain? Loosing love is like organ damage. It's like dying. The only difference is – death ends. This? It could go on forever.