Living the Dream

“Living the Dream”

This is a phrase that is often stated by people who work in health care. There may be other professional arenas that say this too, but this is where I hear it, this is where I know it.

So, what does it mean? This phrase we use.

I think most people who start out on a career path in health care have an idea, a concept, a dream that positions them in such a way to be the hero, the savior. We dream of being in unbelievable situations and coming out heroic after encountering almost unconquerable circumstances. We dream of saving the day, saving the life. Maybe I really mean I, and not we.

After awhile reality overtakes the dream. More often than not, I hear “seasoned” (or jaded) health care workers saying this phrase in a more sarcastic, indifferent, more humorous way. Almost to laugh, as if to say that it’s no dream at all.

Events have occurred in my professional life as of late that makes me stop and think about this phrase.

I went to Duke recently and assisted in the OR on a neurosurgical case (this is brain surgery). As I drove in my car that morning and arrived at that colossal place, I said to myself “I’m living the dream!” and I found a smile in my heart. Assisting with brain surgery, it sounds quite intense, exciting, awing, powerful. But the truth is, I just did some preoperative work and then I left before the actually surgery got underway. I was invited to stay. The neurosurgeon was more than hospitable. But the truth is, I didn’t want to stay; brain surgery is boring, it’s hard to see, OR’s are cold, and I was just plain tired. So I did my part and left.

We idealize something sometimes and when the reality of the situation is fully embraced, it is at times not quite as gratifying as we had imagined. We find that we are left wanting and dissatisfied.

When I work, I respond to Code Blues. A Code Blue is called when a patient becomes unresponsive, their heart stops, they’re no longer breathing. I was in the call room the other night, had my shoes off, my pager on the night stand; a Code Blue was paged from overhead. “I’m living the dream!” I thought as I gathered myself and ran down the hall. The patient was the typical floor patient, a patient that I have seen so many times, not breathing, no heartbeat. We started compressions, we gave life saving drugs, we intubated, we did a lot of things. I knew we would not get them back. You can almost always tell by the eyes. As I stood at the head of the bed, with the laryngoscope in my hand, I stared into those eyes. After multiple rounds of resuscitation, two shocks, and some last resorts, we called it, the Time of Death.

Most the time there is no saving the day, no saving the life. When I walked into the Duke OR there was no cape on my back, I did not fly down the hall to the code. There is nothing heroic about it.

I spent some time tonight with the child of a patient. The patient is very close to death. Decisions need to be made very soon regarding the end of life choices. We talked about different options, different avenues of support, positives and negatives. We talked about how joyful the patient had been the other night after visiting with all the children and grandchildren that day. We talked about how proud the patient was of the family and how encouraged they were.

I don’t know when that patient will die or the avenues they will choose for the end of life treatment.

What I do know though is this, “living the dream” isn’t exactly what I thought it would be. I thought “living the dream” involved intense, exciting experiences, like assisting in the OR and running a Code. But what I’m finding is that this is not the case at all. “Living the dream” is making small differences, taking advantages of obscure opportunities, being real, being true. Finding a family member who has flown in from across the country, sitting in the parent’s ICU room, alone, in the dark, watching as the parent takes deep long breaths and engaging in meaningful conversation at 0130 in the morning, making a small differences to that child, that, that is “living the dream”.

I will have worked 78 hours for the week by the time I go home today. I’m living the dream.