When I started typing this blog post, I originally began it with some incredibly lamerz opening sentence about being a "translational" and "integrative" physiologist. Then I chuckled at myself and deleted the fuckwittery I had written because, really, if you're going to be an internet sensation, you have to keep the douchewigglery off of the blog. And trust me, nothing is more of a yawner than having to listen to some blowhard go on and on about what an integrative physiologist he is.
So, I'm an integrative physiologist. I work with what is essentially the Axis of Awesome - cells, humans, and animals.
Video 1: All of the most awesome science is done with basically four chords.
But, my real expertise is in human clinical research. We currently work with healthy human controls and patient populations, studying normal physiological function and disease. In many of our experiments, research participants undergo (IRB approved) medical procedures that they would only receive if they were seriously ill in order to measure cardiopulmonary and vascular function. I have no ethical problem with any of the procedures, but that doesn't mean that sometimes this doesn't all get inside my head.
I recently finished a study where patients visited the lab eight times over a several month period for what amounts to be ~40 total hours. When you spend ~40 hours with someone, you get to know them a bit. But, it's really getting to know them under these conditions that gets inside my head. In a lot of people, there is something about having something invasive and potentially painful done to them (even though we use all of the pain relieving medication that we can) that makes them form an attachment. I don't know if the appropriate word for it is "trust", but many of the people I have studied have formed these bonds with me in ways that I would not have predicted at the beginning of my career. They share things that you know they would never have shared with you in any other situation.
Early in the research career I began 11 years ago, I worked with a population of Vietnam War veterans with terminal lung disease. They were incredibly sick, although still ambulatory and living independently, and we were trying a new medication to try to relieve some of their symptoms. They visited my office every month for a year and would stay for 18 hours at a time. None of them ever wanted to sit alone in our patient room with the comfortable couch, television, and fridge full of water and juice and snacks. They wanted to sit with me in my office in the small wooden chair in the corner, and I accommodated them. Usually they would sit quietly, sipping decaf coffee and reading the paper or a book while I worked on my charts and entered my data. Sometimes they would want to make small talk - tell me about the town's latest gossip, their children and grandchildren, or discuss the weather, And sometimes, late at night, at the end of our time together, they would tell me about the things they had seen. Things so sad and so horrific that those stories are blistered permanently inside of my mind. Knowing these things changed me. I don't know that they made me better, but I know that they made me different inside. I know now that there are things you can never forget. But I also know that what are even more horrific, are the stories they couldn't bring themselves to tell me.
One of the men came to see me every month, wearing the same black and red flannel shirt , green sweatpants, and house slippers each time. He had been a big, strapping army major, discharged with honors, but now breathed so laboriously as he shuffled down the hallway that I knew he was coming long before he could see my office door. Because of the protocol he was in, I had to draw blood from him every four hours and I wasn't allowed to take it from an indwelling catheter. He had to be repoked with a needle each time. His veins were so poor and his arms and hands so atrophied that every blood collection was like a little war in itself. Yet, he sat quietly and stoically and each time. After I withdrew the needle, he reached out to pat my gloved hand with his, nodded and smiled, and said, "Thank you, ma'am" as though we had just finished dancing a waltz.
One day we had an especially hard time and we tried at least 10 times before we found a site on his feet to draw blood from. At the end, just as he had done before, he reached out to pat my gloved hand with his, nodded and smiled, and said, "Thank you, ma'am". I looked up at him while I was putting a dressing on his foot and said "Why do you always thank me? This can't be pleasant for you." He reached down, cupped my face in his hands, and just smiled. I knew this was going to be another one of those things he wasn't going to tell me and I wasn't supposed to press him. It was up to him to determine what he was willing to share. That Christmas I received a Christmas card from him that was signed, "Thank you, ma'am" and then his name. I received a similar card every year for several years and then the cards stopped. I knew what had happened and I knew that I wasn't supposed to ask. Like all the others, he set the boundaries of our relationship and I had to be satisfied that I had done something for him that he felt grateful for. I think of him often.
Last week a patient in one of my current studies finished his series of visits at the lab. Afterward, I helped him collect his things and handed him his payment. He reached out, put his arms around me, lifted me up, squeezed me tight and said "thank you." He put me down and said, "I am really going to miss coming here to see you all." I replied, "I'll miss you too" and I meant it.
He said, "I'll keep in touch and I'd like to come and visit." I said, "Whatever you'd like. I wish you all the best." He hugged me again and then shook my hand.
I may see him again. That may be the last I'll ever see of him. Like every other, he will determine what he wants to share with me. And although he formed a bond with me during his study participation and felt some amount of gratitude, the challenge is not to form the bond back. The gratitude has to be enough.
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