“…face to face for the last time in history with something commensurate to his capacity for wonder…” – F. Scott Fitzgerald

My patient today stood, riveted, steaming up the window with each breath as I tried to get him to show me his PICC line. He was seven, and a helicopter had just landed on the pad some 20 stories below his room. This was, by far, the most exciting thing that he had seen since he came to our hospital. In true Hotel California fashion, he has been checked out but hasn’t been able to leave due to some scheduling snafus that kept delaying his line placement (it has been a pretty busy week in IR, from what I gather).

I had forgotten that anyone could look out a window with such rapt intensity. He was eagerly awaiting the return of this fascinating creature, which was sure to rise any moment now (especially if he took his eyes off the pad to pay attention to me). I knew from the page we had received from the ED that the helicopter would not be leaving until another new guest, a boy not much older than my patient, had been checked in by our concierge downstairs.

Watching him watch the helicopter reminded me of my own dreams of becoming a pilot (although nature did me no favors when it provided me genetic material from parents whose combined vision scores were 20 / 20,000, nuture didn’t help me much in that department either). Before I knew about such limitations, there was nothing I wanted more than to have an airplane at my fingertips. I would practice landing flight simulators over and over again while most of my friends would fly around and shoot things. There was one particularly challenging section which required landing on an aircraft carrier at night in inclement weather and high seas that I must have played hundreds of times. I know that I once had his capacity for absolute enthrallment. I’m just not sure where it has gone.

I used to sit and watch helicopters for hours, too. When we lived near one of the big bases, they would fly sometimes over the water near our house in pairs and triplets. Sometimes I would sit with binoculars and sometimes they would be close enough to touch. Now the coming of a helicopter makes me sick to my stomach since I am conditioned to the 911 INBOUND TRAUMA PEDIATRIC MVC ETA 15 MIN that will inevitably arrive on my doorstep.

Now, needless to say that the first thing I wanted to do was run downstairs and grab an a-line – but I’m on the pediatric floor now, and so I went back to my new buddy and told him that I wanted to be a pilot once too before my eyes went bad just like his but that there were a lot of other cool things to do and someday he could ride in a helicopter too and yes it was pretty cool we got to fly.

I haven’t found that sense of wonder on the floors – occasionally you get a really cool exam finding but for the most part everyone is busy and there’s just so much paperwork. Delivering good patient care isn’t necessarily exciting (calling to get outside lab results so we can discharge our patient earlier, following up to get Ortho attending reads on an equivocal MRI, triple re-checking the vitals, always going to the bedside whenever in doubt, and so on). There are moments when you get to think – and when you get stumped, but not humiliated – and those moments are really cool, but they don’t make me run up to the window and smush my grubby nose right on it.

But I guess that’s why I want to be a surgeon. When I saw my first lap chole, I was glued to the TV screen like that little kid to his helicopter view. I probably drove the camera into the cystic duct trying to get closer to the action, and I probably made the attending reach for his dramamine, and I probably was told that I had cerebellar ataxia or some other neurological disorder. Of course I have my doubts. No, I’m not sure. But once you’ve come face to face with something commensurate with your capacity for wonder, how could you ever do anything else?


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