2012-03-13 - 11:19 p.m.

Eric

My first recollection of Eric is during residency. I was an intern and needed to put in a central line. In those days we called the on-call perfusionist to assist with line placement and Eric was the guy on. I'm sure I had met him before but my first real recollection was during that central line when I was sweating, dressed in a surgeons gown with sterile gloves and not hitting the vein.

I remember Eric didn't say a word at that point he just moved my hand to a different angle and when I pushed the blood flowed. I finished placing the line and he complimented me on a good job. I knew full well that he could have placed that line in half the time with half the risk to the patient. But he never looked like he was thinking anything like that. He was just that kind of guy.

As it turns out, he remembers me much earlier. As he told me today, he remembers me from when Dr. Pat Moore took me into the OR. Now that was a rare story.

I was in my first year of medical school and one of the rotations we had was called.....Well I'm not sure what it was called but it was something like 'the art of medicine'. It was a rotation where early medical students got to tag along with a real doctor for a couple days. Most got to shadow an FP and watch a few physicals. I got Dr. Patrick Moore.

Dr. Moore was a cardiothoracic surgeon. An old MASH surgeon. On my first day I was told to go to Mount Carmel Medical Center (that's what is was called then, not Mount Carmel West). I was to page Denise Kniesly, his nurse.

I did that and she met me in the ER waiting area. She took me to meet Dr. Moore and he had a bypass to do. He had me change into scrubs and taught me how to scrub for surgery.

I'm now sure they were all laughing behind their masks but at the time all I knew was that a scrub nurse was holding up a gown for me to put on and then showing me how to put on sterile gloves without contaminating the field.

I stood on a couple of stools and watched as Dr. Moore and Dr. Brahos worked together and harvested veins from the leg for the bypass. After the veins were harvested, Dr. Brahos showed me how to close the leg incision and, as I continued to close the leg, they did the bypass. When I was done Dr. Brahos said..."You have now done more suturing than I did in my entire time in medical school." As it turned out, it was the most I would do in the rest of medical school also.

Eric was the perfusionist that day and he told me today that he remembered me being there.

Eric has a brother who is a doctor. Greg is an FP and we did some time in residency together. Now he is the Chief Medical officer of MediGold and I am the Medical Director of Health Partners. It is interesting how things go.

Greg called me early last week while I was in Vegas. I got back with him on Wednesday and surprisingly he did not have a question about MediGold, Health Partners nor CI, he called to ask if I would be willing to see Eric as a patient. He was worried because Eric was losing weight and have abdominal pain. Of course I was honored at the request and said yes.

Eric came to see me the next day. Still the nicest guy ever. No past medical history but had lost 10 pounds since January. He was really tender in the epigastrum and right upper quadrant.

I ordered a GB ultrasound. I hoped he had gall stones. I knew he didn't have gall stones. Eric knew he didn't have gall stone. Greg knew he didn't have gall stones. We all knew but we hoped.

His ultrasound showed no gallstones but a 'possible' mass in the pancreas. I ordered a cat scan.

Have you ever heard of the Whipple procedure. It is the most awful procedure in surgery. It involves removal of the head of the pancreas, the first part of the intestines, the gallbladder, part of the liver and some of the omentum. It is a 5-6 hour procedures followed by months of recovery.

I hoped Eric would qualify for that.

To have a Whipple one must have an isolated pancreatic tumor in the head of the pancreas. It is a terrible, awful procedure but it is the only chance for survival in pancreatic cancer.

Eric did not qualify.

His cat scan showed a tumor in the mid pancreas and metastatic disease in the liver.

When we ordered the scan we asked for a 'wet read'. The radiologist never called but I pulled it up on the computer.

I called Greg for advise. I told him it was the worst possible result and asked him if he thought Eric would want to know right away or wait until Monday.

He said he would go over and tell him.

I knew he would say that. I knew he would relieve me of the burden and so I used him. That was a whimpy thing to do but it is what I did.

So, today I saw Eric in follow up. Would you like to know what his concern was? He wondered how I was doing. He was concerned that giving that kind of news might be hard on ME.

My eyes burned as he left (and now). He is SUCH a nice guy. I told him that there is nothing fair about this. It just is not fair. It is nothing that he did or didn't do, it just IS. And that is just not fucking fair.

I have tried to rekindle my positive feelings for God in the last couple years but something like this really, REALLY tests my faith. Why would a caring God do this to such a nice guy.

I know I'm not supposed to question God but I have to say....."God, WHAT THE HELL??"

But enough of that. I gave Eric a card today. It has by cell number and my email. He can contact me anytime, day or night.

But he won't. He won't because he won't want to bother ME.

Goodbye diaryland. I needed to write this and now it late and I need to cry in my wine for awhile before I go to bed. Goodnight