Reflections

The kids are finally asleep.  So is Lily.  We'd hoped to be able to watch Disneyland's nightly fireworks from our hotel room but pea soup fog rolled in and teased us with just sounds minus the fiery display.  It's been an amazing 2 week vacation w/my parents, wife & kids, both relaxing & stressful.  Yes, stressful, as I'm one of those physicians who find it difficult to let go even though I know that I have tremendous colleagues back home who can handle any situation they come upon.  Yet, I feel it's my responsibility to care for my patients.

But in the quiet of the night, between the basso profundo explosions of fireworks unseen, as I listen over & over to Israel "IZ" Kamakawiwo'ole's famous medley of "Somewhere Over the Rainbow/What a Wonderful World", I wonder if physicians are fully responsible for their patients' health & outcomes.  After all, we can't monitor each movement of the fork, each (sub)conscious decision to remain inert & enact Newton's First Law of Motion nor each inhalation of illicit chemical by our panel of patients.  At some point, don't our patients have to take (some) responsibility for their health (outcome)?

Why then, are physicians held accountable for their patients?  Sure, if we don't get antibiotics or thrombolytics started in a timely manner, we're responsible.  That makes sense.  But if our patients choose not to eat responsibly and not to engage in regular physical activity despite our repeated & persistent exhortation, why are we penalized?

And as we reflect on what resolutions to make for this new year, let's consider starting small.  Just like taking a few steps rather than one giant leap, it'll be easier to keep up momentum brought about by our good intentions if we give ourselves small achievable goals rather than fantastic dreams.  Remember that it takes more effort to turn an aircraft carrier than a small speed boat.

Here's to your best year ever!

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