into the light

This is (completely unrelated to the rest of this post) a photo of me and my grandma when my grandparents came to visit me in Florida! We went to an awesome state park where we saw sting rays and lots of fish, as well as tons of flowers and trees that we had been missing - SO MUCH COLOR! Then we had delicious fresh fish at a little Italian restaurant we found. Later we discovered a sculpture garden to wander through where we saw more exotic plants as well as sculptures ranging from Theodore Roosevelt sitting on a bench to modernist art of forms walking up steps. It was pretty perfect.

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I think I've figured out the hardest thing to treat in medicine.

At one point I thought it was PAIN -

because pain pathways continue to send signals even after limbs are amputated and ends of nerves destroyed.

Another time I though it was DELUSIONS -

because how do you convince someone that their reality is false?

Now I think it's HOPELESSNESS.

A man came in today to our inpatient psychiatric unit and in a complete defeated, but not flat (devoid of emotion) voice, told us that his life was to the point where it just wasn't worth anything anymore. He made a bunch of bad decisions, ended up on the street, found out that he was a pretty good thief while simultaneously learning that certain drugs can take away not just all your pain but all feeling altogether. So his life has slipped even further into not caring about anyone, not caring about himself, just stealing for dealers in exchange for pain pills day in and day out. I wouldn't even say he was depressed, he just felt completely depleted of hope, and clearly had felt that way for a while. He then told us that while he would "contract for safety" on the unit, meaning that he would enter a contract where he would ask for help if he thought he might hurt himself, he would most certainly kill himself when he left.

what do you say when someone says that to you?

I asked one of the nurses and we talked about how it's possible that once we help him get medication for depression, find a place to live, and connect him with other people in the unit, he'll feel like perhaps he has something to live for.

So that's the hardest task in medicine: helping someone find something to live for. as the quakers would say, helping them find the light.

I'm still hopeful.

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"there'll be no more hiding in the shadows of fear

there'll be no more chains to hold you

the future is yours - you hold the key

and there are no walls with freedom

side by side we are not afraid

because the train is coming to carry you home

come dance with me

come on and dance into the light"

-phil collins

also, for fun: easy peanut sauce