Branch

Bin Laden was killed today, almost ten years after the tow­ers fell. I won­der how impor­tant he still is to the net­work that he is con­nected to. Did the root get pulled today or was it a prun­ing? In any case, I felt relieved that he is gone.

In med­i­cine it is often true that we think we have done the right thing, made a good deci­sion or dis­cov­ered a great treat­ment, but later, after all the con­se­quences are known, we find that we did not know enough and that we couldn‘t know enough. I think some­times our premise is off to begin with. West­ern med­i­cine, which is what I prac­tice, does not take a sys­tems view of our bod­ies. Even say­ing the word body does not take in to account that a per­son is more than her body. The sys­tem runs infi­nitely deeper and wider. We are more than our bod­ies. We are more than our thoughts. Our thoughts are not really even our mind. My self looks at itself and knows the thoughts I think are run­ning through me the way the Deschutes River runs through town. My friend Jodi says that her mind is sim­ply some­thing that thinks. Think­ing is what it does, but it is not her – and she can­not quiet the mind, any more than she can stop the river from flow­ing. The med­i­cine I prac­tice does not take any of this in to account most of the time. It can‘t. We are not smart enough.

After much long expe­ri­ence we have learned some things that are usu­ally use­ful. It is good to tie off a blood ves­sel that is bleed­ing, for instance. But even that can be tricky. If that blood ves­sel hap­pens to be one of the ves­sels that feeds the lungs (there are two) and you sud­denly make all the blood go to other lung, it cre­ates a flood to the remain­ing lung and the patient can drown. Stop­ping the bleed­ing (good) was poten­tially fatal (not so good). This is an extreme exam­ple, but I was involved in a case in which it almost happened.

A young woman was shot in the chest by her hus­band and the ves­sel to her right lung was gap­ing. Our only choice was to tie off the ves­sel. She mirac­u­lously sur­vived, and a decade later sent me an amaz­ing let­ter of what her life had become. She went in to the crim­i­nal jus­tice sys­tem and was work­ing to pro­tect women from abu­sive part­ners. The treat­ment for the near-fatal shoot­ing should also have been fatal, but it wasn‘t. Some­times, try­ing to the right thing to treat a prob­lem, doesn‘t turn out well. That is a com­pli­ca­tion, and they are com­pli­cated, and hum­bling. Noth­ing points out the lim­its of what I know as a doc­tor as quickly as a complication does.

I can‘t see the for­est con­nected to the trees that I oper­ate on. I strain my eyes and still can only see this lit­tle, injured branch. About the best I can do is to remem­ber that every per­son is con­nected to innu­mer­able peo­ple and, in fact, con­nected to me.