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Private Thoughts: Scars

2006-10-13T08:45:44Z

There are some cases that you know you'll never forget. Even if it's a standard procedure-- one you've done a thousand times, things, events, names, faces stand out in your mind.

Today it was Mr. Sullivan.

Even if human attachments make things messy and you try to keep your professional distance and usual aloofness, medicine's more than just the instruments and the drugs. Medicine's about the people: the people you operate one, their families, the people you work with.

The people you care about. The people you love. The people that love you back-- if you're lucky enough to have such things.

Patients usually heal faster and make a stronger recovery with friends and family at their side. Those who struggle alone are forced to rally their own strength to save themselves, rather than drawing on the support and love of those around them. It's one of those things you can't see with your eye or even a microscope, but it makes all the difference in the world. Even just one visitor can turn the tide in the favor of the patient.

Because it's never a good thing to be alone.

The thing with plastics is that it's mostly on the surface, which makes other specialties like cardiology or neuro think that it's somehow less important-- that' it's superficial. Because no one looks at someone walking down the road and thinks that person has a subdural hematoma or an anurysm about to burst, but you can look at a burn victim and see the scars.

Sometimes I wonder if people can see my scars.

You can perform surgery. You can prescribe treatments, but it's still there. Scars never completely go away. But eventually you become less aware of it's-- or at least try to be.

Some scars never fade.

And some scars never heal.

So you do the best you can to survive any way you can.

Private Thoughts: Is it ending or beginning?

2006-09-23T05:43:48Z

I've never considered myself to be the kind of person that throws all self-respect away. Maybe it's the surgeon thing-- the idea of putting yourself through med school on nothing but sheer determination and a pile of student loans. Maybe it's more specific than being just a surgeon-- maybe it's being in plastics.

Nurses talk. Doctors talk. Hell, even patients talk. I hear the gossip. I know the stereotypes.

We're cocky, arrogant doctors running around with scalpels. Worse than Cardiologists and Neurologists-- plastics are akin to your high school jocks. I know the role, and I know I fit it well. A stranger on the subway would look at me and think: "that bastard is real full of himself." Nothing would give you any indication that I am the kind of person who revels loosing all sense of self-respect. The tough exterior? Apparently it's all just an act.

Whatever it is, there's something about pretending to be self-assured and self-confident that screams "liar." The kind of pretending that drives you to lie down on a leather sofa twice a week for the past six months and shell out $400 for 54 minutes of discussing childhood traumas and the hidden meaning of dreams and where my place sits in the damn cosmos.

I thought my place in the cosmos was with her. I saw her when he didn't. I listened to her cry when he ditched her for a surgery, cancelled dinner reservations, or forgot their anniversary. I'm the one that brought her Chinese take-out from the restaurant across town just because it reminded her of what we ate during finals in med school. I'm the one that held her when she cried and picked up all the pieces when he ran across the country just to get away.

And if my place in the universe was by her side, then a gesture like sacrificing my dignity would surely be viewed as a grand romantic gesture. A huge 'I'm in it for the long haul' act. Dropping everything in Manhattan just because she was broken and needed me wouldn't be pathetic, it would be considerate. And taking her back to a hotel and kissing her back wouldn't scream 'rebound,' it would sing 'romance.'

Because ultimately-- I was there to pick up the pieces before, and she loved me. She loved me, but she had to work on her marriage, because it was her marriage. But the entire time she loved me.

Or at least I thought she did.

But if she loved me, then why is the speech about her marriage ending so forced and rehearsed? Why do her eyes look empty and lifeless? Why is it Derek sitting on my bed in my room with my Addison telling her that it's over?

AU Summer: Private Thoughts

2006-08-27T06:17:28Z

There's this rational part of my mind that screams to think rationally and not jump to conclusions. Unfortunately, this is also the part of my mind that told me not to jump into bed with my best friend's wife, so of course it's the voice I listen to the least.

Who is this guy? And why has Addie never mentioned him before?

I feel like there's this horrible double standard at work here.

I'm supposed to open up and talk about my friends-- who I go get coffee with, but she doesn't feel obligated to tell me she's been running around Seattle with some strange man that I've never heard of. I'm expected to tell her everything about how I'm feeling, yet it's perfectly acceptable for her to clam up and not share.

This is driving me insane. This woman is seriously driving me up the wall.

What is it about her that makes my world turn on it's head and nothing make sense?

I keep telling myself not to form such a low opinion of Addie-- sure, she and I began as an affair, but that was after years of flirtation and friendship and unrequited love... at least on my end. But that doesn't mean she's a repeat offender-- that doesn't mean that when she's not satisfied, she'll go looking for what she wants elsewhere... right?

Is this why when I mentioned moving in together that she didn't want to talk about it? Because of this guy?

I didn't want to tell her that the reason I wouldn't answer her question about wanting children and a family is because after she refused to consider moving in together, she got me so scared that this isn't going to work out. Why would I admit to something that would get my heart trampled on a second time?

I never understood those guys that would propose to a girl and not already know the answer. Why would you do something so stupid as to throw yourself out there if there's the possiblity of it being thrown in your face? So, yes, I have considered marriage and a family, but that is such a long way off, because at this point, I don't know the answer-- and I'd never ask a question unless I knew, or at least had a strong inkling what the answer would be.

And right now, I don't know a damned thing.

AU Summer: Just What I've Always Wanted...

2006-07-22T07:58:10Z

My life has seriously been lacking in the drama department. What, with my ever changing relationship with Addision; the death glares, and the sympathy talks from my best friend (or is he my ex best friend, I'm very unclear on it at this point); the unbelivable amount of shit one has to put up with when running the Plastics department; and having to relocate to a new city--my life has just needed that extra amount of excitment to make it all worth waking up in the morning.

You get that I'm being sarcastic, right?

So against my better judgement, I met Derek for drinks at a bar. Sounds like the beginning of some sort of joke, doesn't it? "A plastic surgeon and a neurosurgeon walk into a bar..."

And a fight breaks out.

I'm being serious this time.

And I get the stereotypes that go with all the surgical specialties-- hell, I helped cultivate my own rep during my residency. The brain surgeons are the... well, the smart ones. While your plastics are the beefy jock-types that say "dude" every other sentence. So if a plastic surgeon and a brain surgeon walk into a bar, and a fight breaks out, with all medical truths holding equal, you assume the plastic surgeon was the one who started it. Well, dude, you couldn't be more mistaken.

So possibly-ex-best-friend Derek starts a fight. The wierd part is that it's not me he's taking the swings at, but some random guy who--I don't know, I wasn't really listening to that part.

Funny how even when Derek's not punching me, I still end up getting a CT to check for head injury.

AU Summer: Private Thoughts...

2006-07-06T07:08:16Z

I honestly don't know what it is about her that makes the world stand on it's head. When she smiles at me it feels like I can do anything and when she frowns I know I'd do anything to see her smile again.

All I want is to be the good guy, to do things properly, but when there's no right or wrong, what do you do?

Do you ask forgiveness or charge ahead without absolution?

Do you look to the past for lessons to learn or look to the future, charting your own territory without fear of failure or guilt holding you back?

What is it about her that makes me lose it? I can't focus or think or breathe and sometimes it feels like I'm drowning.

But this time there's not guilt. Well... that's not completely true. There's guilt, but it's more from the past than from the present. And when I look at the future now, I'm hopeful instead of devestated.

If only I could kick the addiction-- because I'm hopelessly fixated on her and I can't do a damned thing about it.

AU Summer: Private Thoughts...

2006-06-24T05:38:43Z

Impulse control...

It's never been something I've been very good at.

Some people have a gift of processing all the possible consequences of their actions before they speak, before they act... I don't. As a surgeon-- sure, I can stay disconnected and calm and can chart out all the complications and actions. Surgery's structured, surgery's clean.

Life sucks. Because in life there are emotions. And when emotions get involved it opens the door to impulse. And I don't have good impulse control.

When my best friend's wife kisses me, I kiss back. When I see a pretty girl, I flirt. When I get angry, I yell.

I've never had good impulse control.

AU Summer: Back Again...

2006-06-20T01:59:12Z

I really do hate flying.

Being back in New York was wierd-- only because it made Seattle feel like a dream. It almost seemed like I hadn't been there at all.

Packing everything was... also wierd. New York's been my home since my own residency, and fitting my life into a pile of brown, cardboard boxes is... wierd. Mom helped pack-- I'm worried about her. She doesn't look so good, and it almost made me reconsider moving out to Seattle.

I need to go apartment hunting soon-- get a new apartment, maybe a condo. Realestate is cheaper here, so maybe even a house, but then that would include a lawn and I'm way to much of a workaholic to mess with mowing and watering.

My flight was originally suppose to get into Seattle this morning around 9, but the hospital called-- despite me having turned in all of my badges and filled out all my paperwork, a former patient of mine had contracted an infection post-op, and they wanted me to go in a check him out.

Now how Parker-- a fifth year resident-- can neglect a patient and their meds so much that they contract an infection in their third day post-op is completely beyond me. I swear, I've been saying for the past eight weeks since Parker has been moved to under me, that he is going to kill someone one of these days. I told McColme to email me as soon as it happens-- apparently the nurses have a pool on how long it will be until he does. I put $150 on August.

I ended up taking a later flight, but first class was booked-- I ended up sitting next to a mother with a screaming toddler. Reason one that I hate planes. Then the flight was delayed on the runway-- apparently another plane had a mechanical problem prior to take off-- another reason I hate flying. We sat there for two hours waiting for them to clear the runway and finally take-off. The child screamed almost the entire flight and as soon as we landed I downed a fistful of Advil.

So here I am, back in Seattle. Starting the next chapter of my life with no idea what to do.

AU Summer: Confused...

2006-06-09T23:34:23Z

The craniofacial surgery today went well-- morning surgeries always get my adrenaline going. It reminds me why I went into this in the first place-- the rush, the thrill, the way the world can seem so simple when all you have to worry about is fixing the person on the table in front of you. I had a late lunch afterwards-- I never eat breakfast when I have a major morning surgery scheduled. After lunch I went to go check on some pre and post-op patients. Seriously, how this place managed this long without a crippling liability lawsuit is beyond me. When I get back from New York there are going to be major changes in op-notes and how they monitor patients.

Speaking of patience: I'm not a patient person, I never was. I graduated a year early just to get out of high school. The monthly auto-insurance payments remind me constantly of how impatient I am when driving from all the traffic tickets. Hell, I didn't even have the patience for a marriage to properly end before I moved in. And all of this impatience will probably make me a very ineffective teacher. Probably not a good thing since I will be teaching: teaching this place how to run a department with the efficiency and professionalism of an East Coast practice, teaching residents how to be real surgeons, teaching people how to trust me again... This is either the best thing I've ever done, or the stupidest.

Some intern named Karev has been hanging around me a lot, sucking up, but not flat out asking to scrub in. He's cocky and arrogant and full of himself and considering how everyone else around here seems to walk on eggshells all the time-- I like that. I remember him from my last trip here-- he wants into plastics, so I'll probably will have in scrub in on a surgery or two when I get back.

I had a brief (awkward) conversation with Addie yesterday, but I didn't know what to say to her. I haven't spoken with Derek yet. I've seen him briefly from a distance, but honestly, I'm not even sure that he knows I'm here.

Chief Webber met with me again today. I was right: he is hiring me to head up the plastics department. I tried to act surprised and grateful, but I don't do well with deception. Which means my returning flight to New York will actually be for me to pack up my apartment and make the move to Seattle.

So what am I doing?

I'm moving away from almost all of my friends, my family, my job, my freaking life(!) to a place where the woman I love ignores me, my best friend still hates me, and I am essentially alone.

At times like this, I'd typically ask my best friend what to do. Unfortunately I haven't been able to do that for some time.

I'm going to call mom later tonight and let her know my plans. She'll most likely drive down to Manhattan for lunch or something before I move back. Part of me feels like a horrible son for not visiting her more often when she lives less than 100 miles away. One hundred miles from New York seems like a world away, but soon I'll be on the other side of the country and it really will be.

Maybe mom will help me pack-- I've never been good at that organizing stuff. I have no idea where I'll have everything shipped to since I'm living out of a hotel at the moment. I doubt Derek would appreciate FedEx leaving all my belongings in boxes outside of his trailer.

But I'll worry about that later. I've got to call back home. Then I'm headed to Joe's. Addison may not like seedy bars, but I certainly do.

AU Summer: First Day...

2006-06-09T05:31:46Z

Well any hopes I'd held that Chief Webber would have put the past behind him since the last time I visited SGH have been effectively killed. The man hates me, and he makes no effort to hide it. Too bad he's torn between professional and personal loyalties. Speaking of people who hold grudges, I wonder how much Derek will flip when he learns his dear mentor was the one to call me out here.

Officially I'm only here until Monday, but yesterday I took every opportunity to mention to Webber that for a world-class hospital, their plastics department is, at best, par for the course. The equipment is in relatively good shape, but there are so many newer products that would open up the doors for a wider variety of procedures. Their reference material for plastics is at least three years old--shameful. I told him I'd be more than willing to move out here and spend the new few years revamping the department, provided he also invests...

He said he'd think about it. I'll have the answer by the end of the week.

There's no way he'll say 'no.' You don't refuse one of the best plastic surgeons in the nation offering to move out to fix up your slacking plastics department.

I never thought I'd find a place with more excitement than New York, but every day there are sparks flying in this place. Should be fun.

The two interns and resident that were on my cases yesterday are completely incompetent. Maybe I'll request for Derek's lusty intern to be assigned to me for the day, just to piss him off.

Addison's still been avoiding me like the plague. Neonatal and plastics aren't in the same wing, but still-- I've been here for over 48 hours, and she knows I'm here. A 'hello' or a phone call would be nice. I didn't fly 3000 miles to be ignored.

One of the nurses accidentally called me "McSteamy," and then turned bright red before she rushed off. Apparently the interns call Derek "McDreamy." If only they knew the stories from med school that I know... haha!

Maybe Seattle is alright after all.

AU Summer: Red eye to Seattle

2006-06-07T06:35:12Z

I've never been much of a plane person. I'm not a fan of flying thousands of feet in the air, confined to a metal cage full of screaming children, unattentive parents, and rude business travelers. Give me a cab or the subway or a long car trip, and I'm just fine.

Planes are small metal cages with no escape, messy, dirty cages. Mom says I feel like this because I'm addicted to the control surgery gives me. I really can't disagree with that.

So the fact that I'm flying across the country again for this woman should say something.

I thought about stopping at that little bar by Addison's hospital, just on the off-chance that I'd see her, but I once I got to the hotel I knew there was no chance I'd be leaving here until tomorrow. Addison wouldn't be in a seedy little bar like that anyway, at least New York-Addison wouldn't. Seattle-Addison, I don't know. I still can't believe she's out here. Of course, I can't believe I'm sitting in a hotel in Seattle when I'd normally be asleep in my apartment by now.

Technically, I am here for work, but what's a few details between friends? A family wants one of the best plastic surgeon in the States for craniofacial surgery, and here I am. It's amazing that the best plastic surgeons are now concentrated on the East Coast rather than the West. It really tells you something about shifting demographics, but it's way too late to go into that.

I guess if we're going by Seattle time it's not that late, but the jet-lag is hell. It's after 2:00 am in New York and it's a struggle to just keep typing, but I need to finish checking the emails for updates on my post-op patients back home. It'll be a miracle if any of the residents or other attendings don't kill someone or mangle their face before I get back.

Time to shut this computer down, I've got an early start tomorrow, and I need to find a diner that serves scrambled eggs before I check in with the Chief. Now that should be fun.