What Have I Done to Deserve This? (Season 2, Episode 19)

Ok, so sometimes, even the best of us make rash decisions.  Bad decisions.  Decisions we pretty much know we're going to regret the moment, the minute especially...the morning after.  I mean, maybe not "regret" regret because at least, you know, we put ourselves out there, but still, something inside us decides to do a crazy thing, a thing we know will probably turn around and bite us in the ass. Yet, we do it anyway.  What I'm saying is, we reap what we sow. What comes around, goes around.  It's karma.  And any way you slice it, karma sucks.

One way or another, our karma will always find us.   And the truth is, as surgeons, we have more chances than most to set the balance in our favor.  No matter how hard we try, we can't escape our karma.  It follows us home. I guess we can't really complain about karma.  It's not unfair.  It's not unexpected.  It just...evens the score.  And even when we're about to do something we know will tempt karma to bite us in the ass... well, it goes without saying... we do it anyway.

Yesterday (Season 2, Episode 18)

After careful consideration and many sleepless nights, here's what I've decided.  There's no such thing as a grown-up.  We move on.  We move out. We move away from our families and form our own.  But the basic insecurities, the basic fears and all those old wounds just grow up with us.  And just when we think that life and circumstance have forced to truly, once and for all, become an adult, your mother says something like that. Or worse, something like that.  We get bigger.  We get taller.  We get older.  But, for the most part, we're still a bunch of kids, running around the playground, trying desperately to fit in.

I've heard that it's possible to grow up.  I've just never met anyone who's actually done it.  Without parents to defy, we break the rules we make for ourselves.  We throw tantrums when things don't go our way.  We whisper secrets with our best friends in the dark.  We look for comfort where we can find it.  And we hope against all logic, against all experience. Like children, we never give up hope. 

As We Know It (Season 2, Episode 17)

In hospitals they say you know.  You know when you're going to die.  Some doctors say it's a look patients get in their eyes.  Some say there's a scent, the smell of death.  Some think there's just some kind of sixth sense.  When the great beyond is heading for you, you feel it coming.  Whatever it is, it's creepy.  Because if you know, what do you do about it?  Forget about the fact that you're scared out of your mind.  If you knew this was your last day on Earth, how would you want to spend it?

If you knew this was your last day on earth, how would you want to spend it?

It's the End of the World (Season 2, Episode 16)

It's a look patients get in their eyes.  There's a scent.  The smell of death.  Some kind of sixth sense.  When the great beyond is headed for you, you feel it coming.

What's the one thing you've always dreamed of doing before you die?

Break on Through (Season 2, Episode 15)

In surgery, there's a red line on the floor that marks the point where the hospital goes from being accessible to being off-limits to all but a special few.  Crossing the line unauthorized is not tolerated. 

In general, lines are there for a reason.  For safety.  For security.  For clarity. 

If you choose to cross the line, you pretty much do so at your own risk. 

So why is it that, the bigger the line, the greater the temptation to cross it?

We can't help ourselves.  We see a line, we want to cross it.

Maybe it's the thrill of trading the familiar for the unfamiliar.  A sort of personal dare. Only problem is, once you've crossed, it's almost impossible to go back.  But, if you do manage to make it back across that line, you find safety in numbers.

Tell Me Sweet Little Lies (Season 2, Episode 14)

As doctors we're trained to be skeptical because our patients lie to us all the time.  The rule is: every patient is a liar until proven honest.  Lying is bad.  Or so we're told.  Constantly, from birth.  "Honesty is the best policy."  "The truth shall set you free."  "I chopped down the cherry tree."  Whatever.  The fact is, lying is a necessity.  We lie to ourselves because the truth freaking hurts.

No matter how hard we try to ignore it or deny it, eventually the lies fall away, whether we like it or not.  But here's the truth about the truth: It hurts.  So... we lie.

Begin the Begin (Season 2, Episode 13)

Fresh starts.  Thanks to the calendar, they happen every year.  Just set your watch to January.  Our reward for surviving the holiday season is a new year, bringing on the great tradition of New Year's resolutions.  Put your past behind you and start over.  It's hard to resist the chance at a new beginning.  A chance to put the problems of last year to bed. 

Who gets to determine when the old ends and the new begins?  It's not a day on a calendar, not a birthday, not a new year.  It's an event.  Big or small.  Something that changes us.  Ideally, it gives us hope.  A new way of living and looking at the world.  Letting go of old habits, old memories.  What's important is that we never stop believing we can have a new beginning.  But it's also important to remember that amid all the crap are a few things really worth holding on to. 

Grandma Got Run Over by a Reindeer (Season 2, Episode 12)

It's an urban myth that suicide rates spike at the holidays.  Turns out, they actually go down.  Experts think it's because people are less inclined to off themselves when surrounded by family.  Ironically, that same family togetherness is thought to be the reason that depression rates actually do spike at the holidays.

There's an old proverb that says you can't choose your family.  You take what the fates hand you.  And like them or not, love them or not, understand them or not, you cope.  Then there's the school of thought that says the family you're born into is simply a starting point.  They feed you and clothe you and take care of you until you're ready to go out into the world and find your tribe.

Owner of a Lonely Heart (Season 2, Episode 11)

Forty years ago the The Beatles asked the world a simple question.  They wanted to know where all the lonely people came from.  My latest theory is that a great many of the lonely people come from hospitals.  More precisely, the surgical wing of hospitals.  As surgeons, we ignore our own needs so we can meet our patient's needs.  We ignore our friends and families so we can save other people's friends and families.  Which means that at the end of the day, all we really have is ourselves.  And nothing in this world can make you feel more alone than that.

Four hundred years ago, another well-known English guy had an opinion about being alone.  John Donne.  He thought we were never alone.  Of course, it was fancier when he said it.  "No man is an island entire unto himself."  Boil down that island talk, and he just meant that all anyone needs is someone to step in and let us know we're not alone.  And who's to say that someone can't have four legs?  Someone to play with, or run around with, or just hang out.

Much Too Much (Season 2, Episode 10)

When you were a kid, it was Halloween candy.  You hid it from your parents and ate it until you got sick.  In college, it was the heady combo of youth, tequila, and well, you know.  As a surgeon, you take as much of the good as you can get, because it doesn't come around nearly as often as it should.  Good things aren't always what they seem.  Too much of anything, even love, is not always a good thing. 

How do you know how much is too much?  Too much, too soon?  Too much information? Too much fun?  Too much love?  Too much to ask? And when is it all just too much to bear? 

Thanks for the Memories (Season 2, Episode 9)

Gratitude.  Appreciation.  Giving thanks.  No matter what words you use, it all means the same thing.  Happy.  We're supposed to be happy.  Grateful for friends, family, happy to just be alive, whether we like it or not.

Maybe we're not supposed to be happy.  Maybe gratitude has nothing to do with joy.  Maybe being grateful means recognizing what you have for what it is.  Appreciating small victories.  Admiring the struggle it takes simply to be human.  Maybe we're thankful for the familiar things we know.  And maybe we're thankful for the things we'll never know.  At the end of the day, the fact that we have the courage to still be standing is reason enough to celebrate.

Let it Be (Season 2, Episode 8)

In the eighth grade, my English class had to read Romeo and Juliet. Then, for extra credit, Mrs. Snyder made us act out all the parts.  Sal Scararillo was Romeo.  As fate would have it, I was Juliet.  All the other girls were jealous.  But I had a slightly different take.  I told Mrs. Snyder that Juliet was an idiot.  For starters, she falls for the one guy she knows she can't have.  Then she blames fate for her own bad decision.  Mrs. Snyder explained to me that when fate comes into play, choice sometimes goes out the window.  At the ripe old age of 13, I was very clear that love, like life, is about making choices.  And fate has nothing to do with it.  Everyone thinks it's so romantic.  Romeo and Juliet.  True love.  How sad.  If Juliet was stupid enough to fall for the enemy, drink a bottle of poison, and go to sleep in a mausoleum, she deserved whatever she got.

Maybe Romeo and Juliet were fated to be together, but just for a while.  And then their time passed.  If they could have known that beforehand, maybe it all would have been ok.  I told Mrs. Snyder that when I was grown up, I'd take fate into my own hands.  I wouldn't let some guy drag me down.  Mrs. Snyder said I'd be lucky if I ever had that kind of passion with someone.  And that if I did, we'd be together forever.  Even now, I believe that for the most part, love is about choices.  It's about putting down the poison and the dagger and making your own happy ending, most of the time.  And that sometimes, despite all your best choices and all your best intentions, fate wins anyway.

Something to Talk About (Season 2, Episode 7)

Communication.  It's the first thing we really learn in life.  Funny thing is, once we grow up, learn our words, and really start talking, the harder it becomes to know what to say.  Or how to ask for what we really need.

At the end of the day, there are some things you just can't help but talk about.  Some things we just don't want to hear.  And some things we say because we can't be silent any longer.  Some things are more than what you say.  They're what you do.  Some things you say because there's no other choice.  Some things you keep to yourself.  And not too often, but every now and then, some things simply speak for themselves.

Into You Like a Train (Season 2, Episode 6)

People can be categorized in one of two ways: those who love surprises, and those who don't.  I don't.

I've never met a surgeon that enjoys a surprise, because, as surgeons, we like to be in the know.  We have to be in the know, because when we aren't, people die and lawsuits happen.  Am I rambling?  I think I'm rambling?   Ok, so my point actually, and I do have one, has nothing to do with surprises or death or lawsuits or even surgeons.  My point is this: whoever said, "What you don't know can't hurt you," was a complete and total moron.  Because, for most people I know, not knowing is the worst feeling in the world.  Ok, fine, maybe it's the second worst.

As surgeons, there are so many things we have to know.  We have to know we have what it takes.  We have to know how to take care of our patients.  And how to take care of each other.  Eventually we even have to figure out how to take care of ourselves.  As surgeons, we have to be in the know.  But, as human beings, sometimes it's better to stay in the dark.  Because in the dark, there may be fear, but there's also hope.

Bring the Pain (Season 2, Episode 5)

Pain comes in all forms. The small twinge, a bit of soreness, the random pain.  The normal pains we live with every day.  Then there's the kind of pain we can't ignore.  A level of pain so great that is blocks out everything else.  Makes the rest of the world fade away.  Until all we an think about is how much we hurt.  How we manage our pain is up to us. 

Pain.  We anesthetize, ride it out, embrace it, ignore it.  And for some of us, the best way to manage pain is to just push through it. 

Pain.  You just have to ride it out.  Hope it goes away on its own.  Hope the wound that caused it heals.  There are no solutions.  No easy answers.  You just breathe deep and wait for it to subside.

Most of the time, pain can be managed.  But sometimes, the pain gets you when you least expect it.  Hits way below the belt and doesn't let up. 

Pain.  You just have to fight through.  Because the truth is, you can't outrun it.  And life always makes more

Deny, Deny, Deny (Season 2, Episode 4)

The key to surviving a surgical internship is denial.  We deny that we're tired, we deny that we're scared, we deny how badly we want to succeed, and most importantly, we deny that we're in denial.  We only see what we want to see, and believe what we want to believe.  And it works.  We lie to ourselves so much that, after a while, the lies start to seem like the truth.  We deny so much that we can't recognize the truth, right in front of our faces.

Sometimes reality has a way of sneaking up and biting us in the ass.  And when the dam bursts all you can do is swim.  The world of pretend is a cage, not a cocoon.  We can only lie to ourselves for so long.  We are tired.  We are scared.  Denying it doesn't change the truth.  Sooner or later, we have to put aside our denial and face the world head-on, guns blazing.  Denial.  It's not just a river in Egypt.  It's a freaking ocean.  So how do you keep from drowning in it?  

Make Me Lose Control (Season 2, Episode 3)

Surgeons are control freaks.  With a scalpel in your hand you feel unstoppable.  There's no fear.  There's no pain.  You're ten feet tall and bulletproof.  And then you leave the OR.  And all that perfection, all that beautiful control, just falls to crap.

No one likes to lose control, but, as a surgeon, there's nothing worse.  It's a sign of weakness.  Of not being up to the task.  And still, there are times when it just gets away from you.  When the world stops spinning and you realize that your shiny little scalpel isn't gonna save you.  No matter how hard you fight it, you fall.  And it's scary as hell.  Except, if there's an upside to free falling, it's the chance you give your friends to catch you. 

Enough is Enough (Season 2, Episode 2)

I have an aunt, who, whenever she poured anything for you, would say, "say when!"  My aunt would say, "Say when," and of course we never did.  We don't say "when" because there's something about the possibility of more.  More tequila.  More love.  More anything.  More is better. 

There's something to be said about a glass half-full.  About knowing when to say "when."  I think it's a floating line.  A barometer of need and desire.  It's entirely up to the individual and depends on what's being poured.  Sometimes, all we want is a taste. Other times, there's no such thing as enough.  The glass is bottomless.  And all we want is more.

Raindrops Keep Falling On My Head (Season 2, Episode 1)

To be a good surgeon, you have to think like a surgeon.  Emotions are messy.  Tuck them neatly away and step into a clean sterile room where the procedure is simple.  Cut, suture and close.  But sometimes, you're faced with a cut that won't heal.  A cut that rips its stitches wide open. 

They say practice makes perfect.  Theory is, the more you think like a surgeon, the more you become one.  The better you get at remaining neutral, clinical. Cut, suture, close.  And the harder it becomes to turn it off... to stop thinking like a surgeon and remember what it means to think like a human being.