I have so many dreams about still practicing medicine. They almost never have anything to do with how I really practiced. Still I see them as nostalgia, though sometimes there are qualities to them that must have meaning beyond mere nostalgia. Elevators pop up in them frequently, a symbol of change I think, maybe even rebirth, where one is confined to this narrow canal. Then the doors open up, and voila, here’s a new world. Usually there’s something bizarre about the elevators in my dream. They might be 8-sided instead of rectangular. They might be twisted or offset from the world beyond where the doors open and close. There are so many ways my dreams say, “We’re not in Kansas any more, Dorothy” Hmmm, I recognize that voice. I recognize Her very well. But this dream wasn’t about Her. She says it actually was, but we’re not going there right now. I do have some say so over this.
This morning I awoke from one of these dreams. This time the patient was a woman with bleeding in her head. It’s urgent to get to the OR quickly in that situation, but it’s somewhat different from when someone is bleeding out from a bodily injury where blood is pouring out like a spigot. Then the bleeding is like a clock, where you only have so much time before someone runs out of blood. Bleeding in the head is different, unless someone has been shot through a venous sinus and a unit of blood pours out each time you take the pressure off to see if there’s something that can be fixed, but that’s very rare. Because the skull is a confined space, there is a lot of pressure right away to stop the bleeding, but one’s brain doesn’t tolerate the pressure well. That’s the emergency in head trauma, not turning off the spigot. It's not the same clock as when a patient is bleeding out. It can easily be that the situation is already irreversible and hopeless. It may even be that the situation is fine without doing anything. It's hard to know when the cause is more obscure than a spigot. Strange that I should be in charge of that this time, since I’m a neurologist, not a neurosurgeon, but I’m often in over my head in these dreams.
So there we were, taking this woman to the OR. Strange that in this hospital the elevator went down to go from the ER to the OR. I don’t think I’ve ever been in a hospital like that, though I can imagine a hospital on a hill where that could be. I also think of Stargate SG1 where one goes down to level 28 to get to the gate to go to another world. Who knows, maybe that’s relevant.
Anyway, even with the override key, it’s taking time for the elevator. Who can understand the limitations of machinery? One who knows every nook and cranny of the machine does, but for so many of us the machine is just what it is. Either way things can only go so fast, but one way one knows exactly why, while the other way one has to wait and wonder. I’d rather go the first way, but it’s not always practical. Even God doesn’t know everything. He proves that to me frequently. Still the elevator comes eventually, either way.
There wasn’t more to this dream before I woke up. Often after whatever issues there are with the elevator, I encounter equipment which is definitely not anything of this world. What to do with this? It’s always the same answer. I do what I know how to do, even if I don’t know how I know. I am that I am. Even though I’m not God, does even God do it better than that? We all do what we know to do, sometimes proving that we know very little indeed, sometimes proving that we know so much, it’s a mystery to everyone to know how we know that much. How did you do that? I don’t know. I just did.
I help people because I know how. There are other reasons about how much of my life I give to helping people, how much help I give to any one person, exactly what help I give or forget to give. Forget, right, how easily one can remember at a time other than when one was supposed to forget. Often that’s so innocent, but sometimes it’s so odd what one forgot that the Wizard’s handiwork is showing.
There’s this joke where the punch line is that God likes to play doctor. The punch line is better than the joke, any of the jokes that can get you to that punch line. One can easily miss a greater truth in this, one that God does like to play healer, not just the opposite of doctors playing God. God says there are many good things about healing, not just the end result of whether or not someone can be saved. Save someone today, and he or she may just die tomorrow. Eventually he or she definitely will die, but it’s still usually a good thing to prevent premature death. Beyond that, though, there are so many aspects of this to teach everyone involved about love, to draw love out of someone, from the patient, from everyone else. God loves a love story. Both He and She can be such softies. That’s not how They are all the time.
Nostalgia, right. Well, OK, that’s a cover story. You see, there are labels for those who don’t know much about what’s going on. Then there is something deeper for those who can see past the most superficial interpretation. Then there’s another layer just for someone who may have thought there are only two. Then there are more. Hey, there are more than enough. Eventually the elevator comes, no matter how slow it is. We have things to do, places to go. Some people manage to talk about such things forever with vague and abstract words. If that’s how they want to spend their time, they can, but eventually the elevator comes. Helping people is better training than talking about it and especially better than excusing oneself from it. God says so, right here, right now. He’ll say it again for anyone who wants to listen.