Category: Inspirational

It’s strange to think that we usually are not aware of the last time that we will ever do something. The last time I saw a patient as a physician, I was not aware that she was my last patient at the time that I saw her. Most of us have friends who have died… and the last time we ever saw them or talked to them was probably nothing special. We will someday eat our last meal and watch our last sunset. We will probably all have a “last time” that we kiss our spouse goodbye or give our kids a hug. Will we know at the time that it will be for the very last time? Probably not. The chaotic nature of human life dictates that you can usually only discover the most significant moments in retrospect. Given that, we should all make a concerted effort to appreciate what we still have today.

Janet and I have been married for exactly seventeen years today. People refer to this milestone as our anniversary. My wife and I don’t really talk about our wedding day very often. Janet and I drove to the local justice of the peace on the morning of our “wedding” and he married us in his backyard. We had no fuss and no witnesses. I paid the exact same amount for our wedding as I paid for my golden retriever. Each cost exactly one hundred dollars.

Janet forgets our anniversary most of the time. I have to remind her of the actual date on a regular basis. This date does not mean very much to either of us. You see, Janet and I both failed at our first marriages. We both made promises to other people in front of God, friends, and family… then failed spectacularly. We both learned the hard way that an aging promise and a marriage license are not enough to keep two people together for the rest of their lives. Janet and I were keenly aware the second time around that our marriage together was not crossing a finish line but was simply a starting line. We knew early on that a real marriage requires a constant recommitment to one another.

In the seventeen years that my wife and I have been together, I have repeatedly asked her if she will marry me. I have probably asked her this over one thousand times throughout our relationship. I need to know that if she started over today knowing everything she knows now that she would still choose me. Each time she tells me the same answer. She always smiles at me and says, “Over and over again”. Each time it lights up my heart. I try to make sure that I go out every day and earn this response that I need.

My wife and I have learned to never take each other for granted. We are best friends in every definition of the word. If Janet and I have a problem between the two of us, we attack that problem wholeheartedly. We don’t leave things unsaid. We never use our words as a weapon against one another. We are careful with each other’s heart. We are both acutely aware that our legal binding is fragile and does not serve to keep our relationship safe.

Janet and I didn’t need any wedding dresses or tuxedos. We didn’t need wedding guests or a reception. We did not have a ring bearer and we do not have a wedding photo album. At the end of the day, all of those things mean absolutely nothing to a marriage. So go ahead and wish us a happy anniversary if you see us and in all likelihood we will politely smile and nod. But I will not be telling my wife to have a “Happy Anniversary” today. The only thing I have to say to my wife in front of God, friends, and family is the same question I plan to ask her repeatedly for the remainder of my life: “Janet, will you marry me?”

regret

for that stock you never bought

for that friend you never called

for that life you didn’t choose

for that person you never kissed

for that trip you never made

for those feelings that you hurt

for those words you didn’t say

for that effort you didn’t give

for that chance you never took

for that time you didn’t spend

one chance

one path

make it count

I have no other explanation for what happened early that summer morning. The only thing that I can point to in order to explain my actions that day is the invisible Hand of God. I was a 27 year old medical resident just coming off a sixty hour shift in a tiny emergency room in Paris, Arkansas. I would moonlight extensively in emergency rooms over the weekends to help pay my bills during my training. Each shift would begin at 6:00 PM on Friday and would end at exactly 6:00 AM on Monday morning. It was understood that I could just walk away at exactly six o’clock and the local physicians would then start taking call from home until the regular staff arrived at seven.

I almost always left the hospital at exactly six in the morning because I had about a 45 minute drive back to Fort Smith and my work at the residency started at 7:00 AM. I was a little late getting out of the hospital one morning and was walking out the door with my bag of clothes in hand when I heard an ER nurse talking with an EMT. “Dr. Guyer”, she shouted down the hall. “We just had a lady deliver her baby at home. EMT says that both the mom and baby are doing fine. Do you want them to head on over to Fort Smith?” Without even thinking I answered, “No, have them come by here so that I can see them first.”

“What the hell?” I immediately thought to myself. “Why the hell would I say that? My shift ended fifteen minutes ago. I am already exhausted and now I am going to be late for work”. I opened my mouth to divert the patients back to Fort Smith when I started second guessing myself. “I am going to look stupid if I change my mind and reverse my decision”. I don’t know many doctors that would wait for a complete stranger (who was reportedly in stable condition) to arrive in the ER after their shift had already ended. Ninety nine times out of one hundred, I would not wait for this patient myself. For some reason, this morning was different.

Less than five minutes later, the EMT arrived with the mother sitting in a wheelchair covered in a blanket. “Where is the baby?” I asked. “I let the mom hold her”, the EMT replied. I pulled back the blanket to discover a slightly blue 27 week premature female infant still attached to the umbilical cord. This baby was mere seconds away from death. I immediately jumped into action. The medical rotation that I had been on the past month in my residency program just happened to include extensive neonatal intensive care. I had to quickly get the newborn much lower than the mother in order to get more blood back into her tiny system. I then clamped the cord and then started bagging her little lungs. I had to do chest compressions with just one finger to keep blood circulating through her body.  The infant was very cold and I had to get creative to warm her little body as much as possible. We called Children’s Hospital and had the child transported by helicopter to Little Rock.

The nurses in this small emergency room were extremely competent but were completely flustered because they had never dealt with anything like this before. Everyone in the emergency room agreed that this baby would have died within minutes if I had left for work at the end of my shift as usual. The EMT was placed on probation and was sent to get further training. My residency director told me that he was never more proud to have one of his residents arrive so very late for work. To my astonishment, this baby not only survived this incident but suffered no longer term consequences. She is now about to graduate from high school and is reportedly doing very well.  To this day, I can’t believe those words which caused me to remain in that ER left my mouth.  I know it sounds crazy, but I believe that God made me say those words and kept me from taking them back.  If you don’t believe in miracles, I am writing this to inform all of you that we all have one walking around us right here in Arkansas.  I don’t know what God has planned for the rest of her life… but I know without a doubt that this little girl is here for a reason.

It is often in the deepest depths of our despair where we find our inner strength. In a world where we often times feel like everything is upside down and nothing makes sense, sometimes it is best to admit that you don’t even have a plan but that you are willing to trust God’s plan. Trust in your heart and the goodness in yourself, even as you are bitterly disappointed by the world around you. The older I get, the more I am convinced that the world is truly separated by good people and bad people. The obligation that we have to our creator and to the rest of humanity is to make sure that the people on the good side never give up.

I once had a 30-year-old patient that was in a severe car accident that left him with a traumatic brain injury. The patient was permanently wheelchair bound but completely oriented and able to communicate. He was brought to my clinic by his home health provider and multiple family members. They were all arguing loudly as I entered the room. The conflict was due to the fact that they had stopped buying him cigarettes when they would go out shopping for him and they would not allow him to buy any when he was out with them.

I think the whole room was shocked to discover how quickly I sided with the patient. I told the caretakers, “You are not taking care of an eight year old child, this is a thirty year old man. If the man wants cigarettes, it is not your place to stop him”.

As the man smiled at his family with vindication, I turned to him and said “Their job is help you provide for your needs, my job is to explain to you how idiotic it is to continue smoking in your current condition”. I spent the next fifteen minutes describing the physiological effects of smoking. I explained the increased risk of stroke and how his life would be negatively effected if his condition deteriorated even slightly further. I basically frightened the living hell out of him.

Over the course of the next few months, the patient weaned himself down and eventually completely off of cigarettes. He did this on his own terms and was filled with a sense of pride. Both he and his caretakers thanked me for the unusual way that I handled their conflict.

As a society, we have become too paternalistic. We have reached a point where we feel justified in forcing our own opinions on other adults because we think that we know what is good for them. We rob others of their autonomy. Regardless of our intentions, it is morally wrong. If you want someone else to change their behavior, then all you should really have to do is present a convincing argument.

Growing old in this strange new world
A single gray hair in a bed of dark strands
Isolated and different
Just waiting to be plucked and discarded
Still so much to offer a world that I no longer recognize
Unappreciated and misunderstood
Longing for a day that is long past gone
And wanting to make sense of it all
Never say that I quit and walked away
The tide simply eroded the place where I stood
The principles instilled in me
About hard work and decency
And how far these things can take you
They are now just faint echoes of my ancestors
And I wonder if anyone else can still hear them
Strange new world, indeed

I once knew a surgeon who drove around a 120,000 dollar sports car. This did not impress me. I once met a mother of four who kept an amazingly positive attitude after losing her job and living for a short period of time in the back of her van. That impressed the hell out of me. I have come to the realization that the people who impress me the most in life are the ones whom aren’t even trying to do so.

As a family practice doctor, I often get insight into people’s darkest secrets. People are suffering. They are struggling with their finances and having trouble paying their bills. The cost of feeding themselves and their family is going up while their pay has stagnated or gone down. They are having conflict with their spouses. They are struggling to pay their rent. Some feel trapped in loveless marriages. Life is not turning out anything like they had planned. Many are struggling with this privately while trying to show the rest of the world that everything is just fine. They usually isolate themselves and feel all alone in this world. It is time for all of us to end all of this suffering in silence. Turn to those around you. People that seem to “have it all together” may be in the exact same boat that you are. Turn to God. You just might find out that you are really not “all alone” after all.