MEDICAL SURFARI: HOW TO BUILD A DOOR

Thursday morning 4:00 AM: I kissed my wife and kids goodbye as they lay asleep. My night's rest was short but I knew that I must begin early to get the days work done. Sleepily, I crept out of the house trying not to make a sound so I wouldn't awaken the dogs. The night air was cool but invigorating and I paused for a moment to enjoy it. I don't know what triggered it but for a fleeting moment I thought to myself "I'm alive!" Philosophically, I pondered that briefly and felt thankful that I could, because the alternative on such a beautiful spring morning didn't seem nearly as appealing.

During the drive to my office I reminisced a little about some of the patients that I have been fortunate to know. As I was driving east on Jackson Boulevard I noticed that not even the penumbra of the morning sun could yet be seen. It made me think of a patient who I took care of and operated on several years ago. He had a pituitary brain tumor. The tumor had caused his vision to be particularly poor.

So, on the first morning after his surgery I asked, "How's your vision this morning?" He turned toward me and with confidence, he looked me right in the eye and said, "Doc, every day above ground is a blessed day. I woke up early this morning and looked out the window and I saw the sun come up and that's 93 million miles away!"

Almost powerfully as the morning that he said that to me, I felt a wave of optimism pass through me and it made me smile. Then I thought of several of my other patients who have shown a similar attitude:

* A 39-year-old single mother who developed blood clots that caused her to have a stroke, paralyzing her left side and blocking blood flow to her right arm and hand.

She developed dry gangrene of her arm and hand and it had to be amputated.

To this day I have never heard her complain

* A 77-year-old man with ankylosing spondylitis whose spine is fused from the base of his skull to the tip of his tailbone. He has broken his neck twice and his neck is fused with his chin on his chest. He works 16-hour days on his farm and he recently fell mowing his lawn. He fractured his lower back and consequently he will have to rest in bed for 12 weeks. I have never heard him complain.

In fact, he is just the type of person who would not complain that roses have thorns but he would rejoice that thorn bushes have roses.

I am a caregiver who ministers to the injured, diseased and dying but I'm not yet one of them. In the continuum of time I know that my career and life will be but a short breath among the stars of our galaxy and this often causes me to think carefully about how I should use my time for what I am to accomplish.

As a physician, I can tell you that people often forget what you say but they never forget how you make them feel. That is perhaps our greatest value.

For me, it is the patients that I must give unending thanks, for the courage, optimism and dignity is contagious and it often has emerged from their pain and suffering.

A positive attitude is a form of kindness to oneself and to those who witness it. And, I believe that it is evolutionarily adaptive for the survival of our species.

Don't wait for an opportunity to knock, build a door.