Living the Dream?






I ran into an old acquaintance recently and we spent some time catching up. She told me what was happening in her life and business, in her kids’ lives, with her husband. She asked about my girls. I told her about their graduate school programs, about their boyfriends. Because we met in Michigan near my cottage, she asked if I got there every weekend. I said No, as I worked irregular hours and days. But I visited as often as I could. I usually spent vacation time in Michigan.

She asked if I was still writing. I said Yes, I was working on a new book.

And then she smiled and nodded and said, “So you’re living the dream.”

I leaned in, peered at her closely to see if she was serious. She seemed dead serious.

I even asked. “Are you kidding?”

She shook her head. She looked confused.

I couldn’t decide if she was clueless, prone to meaningless aphorisms, or had no idea what working in healthcare is like today. I suspected all of the above.

“Aren’t you doing exactly what you want?” she asked.

I shook my head in wonder. I thought, I work ridiculously hard and earn a good living. I have found a way to make it okay. Because what are the options?  I changed the subject.

But here’s the real question: Is anyone in healthcare living the dream?

Patients are sicker than ever. They are older than ever. They are bigger than ever. And their insurance covers less, which makes them worry more. I work in a trauma center in the county with the worst legal climate probably in the entire country. Cook County, Illinois. We do some surgery here just for the lawyers. No kidding. We wrap our communications in legalese. And now we have the oxymoronic, CMS-mandated Meaningful Use obligation to further increase our workload. We are to generate a form for every outpatient with information that gets faxed to the billing company within twenty-four hours of that patient’s procedure, then is collated and sent on for use by the government. Patients’ names, health information, height and weight, vital signs, medications, allergies, etc. They want their email addresses too, but I don’t go there. The NSA can figure it out. Or they already have. We will receive incentive payments for this info. It’s downright creepy.

When I was a little girl, I wanted to grow up to have a job that would give me the chance to do something different every day, to tackle a new problem every day. And I have that. God help me. Just last week I placed a routine endotracheal tube in an uninsured patient who’d gone too long without healthcare. I found an enormous laryngeal cancer instead of a normal larynx. So I guess you could say that I’ve grown to realize my dream. I feel very privileged to do what I do. I am lucky to have the skills and experience I have, to be able to provide the care that I provide. I still see something new most days. In that respect, my acquaintance was correct. I suppose I am living a dream. But it is a child’s dream, the fantasy of someone who can’t anticipate the real impact of stress and responsibility over decades. As an adult, I know better. Working in healthcare evokes a grim reality and a profound empathy. It is tiring in every conceivable way. Intermittently, I recover from the privilege of having lived my dream too long by escaping to a cottage in the woods near the southwestern shore of Lake Michigan, where it’s quiet and peaceful and I can catch up on my sleep.