The Unsung Hero

I would write this as a personal letter, but as I thought about it, there are so many of you that might need a "shot in the arm" I decided to dedicate this blog to the performer.  All of you.  Big household names, names on the inside back cover of a CD, those of you slumped over composition books, those panicking tonight about "juries", contest , scholarship auditions, a Friday night gig, that solo that you landed last week for Church that you now dread, and everyone else along the spectrum.

I want to say thank you.

Many who read this blog would be dumbfounded that I would spend more than a sentence or two thanking those of you who over the last week, month and many years have heard thunderous applause, seen endless standing ovations, and endure people taking endless pictures of you. I also want those of you who are still waiting in the wings, those of you that stayed up all night last night rearranging a piece for the 10,000th time because one person couldn't hang on, the person who is back stage frantically changing a broken string with hands shaking, I want you to know how grateful I am for your sacrifice.

I've even watched some of you grow since junior high contests, I've seen the exhilaration of a perfect senior recital.  I've watched you crumble with letters of rejection.  I've heard the criticism directed at you from your colleagues, your teachers, your parents, your spouse and especially - you.  I've seen you running into the corner drug store in a long tail tuxedo.  I've shopped with you as you're trying on another black blouse.

I understand what it takes to do what you love, and when what you love to do takes all you have.  I've seen you miss an entire month of your life preparing, practicing and performing, running frantically from one gig to another.  I know you forgot to eat breakfast, snagged a lukewarm plate from the wedding you just finished and are trying to remember if you even brought the music for your next gig.  I know you are going to fall into bed at 1 or 2 am exhausted and have to be at a church at 9am to do it again.

I know that everyone expects to see you fresh-faced, smiling and excited to play or sing.  I love how you can inject new life into a work created centuries ago.  I love that you love what you do,  it makes us love you more.  I know how you dread a mistake and I marvel at your recovery.

I am a physician. I started down the road you travel every day. What I discovered on a dismal rainy day while soaked, and walking back to my dorm after my 5th hour that week, alone, in a grey practice room was that your road was too hard for me.  Breaking up with my dream was one of the most gut wrenching decisions I ever made.  I called a college back in Ohio, declined a scholarship and chose a path that would lead to healing bodies, instead of souls.

I too, work long hours and have to put on a smile every day, in every room. I spend some weekends and evenings away from my family as well, I've spent endless hours practicing my skills.  I don a white coat, instead of performance black.  I have moments of exhilaration, moments of disgust, panic, and devastation.

Only recently have I dipped my toe in the great ocean in which you all get to swim daily.  And, oddly, not even with the instrument that I had trained in, but the one I dreamt of.  I have had to, as an adult, face some of the obstacles that made me quit music the first time and do this with a new instrument. Interestingly enough, it's made me want to sing again, and I've recently jumped both feet into a venue that I would have never dreamt I would do.

This morning, for the first time in more than 15 years, the black pants came back, and I found myself sight singing, acappella.  I was leaning on instruction from vocal teachers from 30 years ago, the names my director wouldn't know.  The foundation solid as a rock.  On a part of me that I've abandoned for nearly 20 years, that I'm finishing, finally.

To all of you who feed our souls with the beauty of music, applause just isn't enough.  The world can be a very dark place.  This road that you have chosen can be exhausting, yet exhilarating.  I see both anxiety and confidence in your eyes.  I can feel anguish, and then peaceful resolution within minutes while you play.  The color of our lives is given to us by music. I stand in awe of you. You teaching our children ensures that the language of our soul will never be lost.

I took the kids and their friends to a Oklahoma City Philharmonic "Discovery" concert this afternoon. Those musicians were there Friday afternoon, played Friday night, most of them taught lessons all day Saturday and gave another fantastic performance Saturday night, then turned around to play their hearts out today to a bunch of little kids.  Many of them probably came from playing at Church straight to today's venue.

After the show, while talking to my friend, the kids were invited on stage.  She led me to the back and eventually on stage to go collect my crew.  She started talking to me about the Civic Hall, I think.  I was trying to act as though I was present, but I was long gone.  I was at Packard Music Hall, my heart was pounding...

...and I was still in my performance black.  In fact, I just took it off a few minutes ago.

Room 21

Dear patient in room 21,

I know you've dreaded this visit for years.  I see the 6 foot man walking ahead of you, assessing the room, looking for his seat.  He is not nervous.  In fact, he is quite talkative, inquiring about my training, where I came from. How long I've been doing this, and that we have some issues to address. What you don't know is that I have him pegged, and have since he marched into the room. The less I say, the more I can observe.  The nurse comes in, asks you a series of questions answered by him.   She then presents you with a gown and a paper towel and you wait.

What you don't know, dear patient, is that I am outside the door.  I'm listening to you interact when no one is watching because I fear that the family I am about to meet is not the family that you experience.

I enter with an outstretched hand and a warm smile to him.  "He's got her snowed", you think, and I see your shoulders slightly slump in defeat.  I sit down, put my feet up and ask what brings you in, to which he answered "decreased libido, too tired and having a hard time keeping up (with what?), she's cranky and she just doesn't listen very well."

I instantly notice him jump out of his seat to watch me perform a routine breast exam.  I say nothing about the bite marks on your chest. I see the bruises on your forearms, in the exact area you would use to protect your face.  Not bruises around the wrists consistent with creative sexual exploration. He's quick to tell me about your fall last week, except these are fresh bruises.

I ask you to follow my pen. Not because I am concerned about your cranial nerve function, but I need to look in your eyes.  Vacant.  Looking at the floor.  And your husband is quick to tell me that he's just started a church.  You smile right on cue, with a nervous laugh. "Yeah, she has NO idea what kind of man he his...", you think.

What I notice first is your pounding heart, anxious breathing pattern ..."Oh she hates these things!", he exclaims.  I lighten the mood talking about your children and that surely a routine gynecological exam can't be worse than an 8 pound baby, right? "Oh, they weren't  mine," I hear your husband say.

Then, I have him breathing at the back of my neck... Your legs clamp tightly, a barely audible sob fell out completely out of your control.  Your breathing is fast, uncontrolled, and tears roll down your checks.  It's fairly obvious at this point that someone, somewhere, has violated you, emptying you of your dignity and self worth leaving a void now filled with a controlling and  potentially abusive  husband.

"I can't see in there!  Do you see anything?  Does she have anything?"  I smile politely and state that her gynecological exam appears normal.  Except for the fact that he had to mark his territory immediately prior to the visit today, like a tomcat.  What I didn't tell him is that while her pelvic area is perfectly groomed,  her legs have yet to see the 3 minutes of attention they have deserved this month.  I also notice her $700 Coach bag, but 6 month old pedicure.  I see the big bruise on her knee... From the fall "last week" I assume.  I see him aggressively trying to look over my shoulder, and I'm doing my best to preserve what's left of your dignity.  Why won't he leave you alone for 90 minutes for a pedicure?

I continue to engage him, attempting to earn his trust.  Offer to draw labs as a biochemical explanation for your perceived shortcomings.  I believe none of it, but I want to have him think he's got me fooled.  Fooled enough that he will let you come alone next time, so I can really look into the window of your soul and extend my hand as a safe rope .

My student emerges and I ask her what she noticed about you.  "Pretty, thin, quiet and very polite."

"Why is she here today?", I ask.

"Just for an annual. No issues."

"None?", I inquire?
"Tell me about her hands, her forearms.  Did she wear nail polish?  What does she do for a living?
Where was that dysplastic looking mole?"

"Well...I was typing her info. She's v70.0 and 627.2, needs screening Mammogram."

I ask, "What color is her hair?  Tell me something about her husband."

Awkward silence...

And, so now, I spend the next 20 minutes teaching a medical student how to look at her patient, and how to manage controlling husbands, identify signs of abuse, and how to delicately document these observations in a computer medical record that will be eventually accessed by the world at whim.

My patient did come back. He stayed in the lobby on wifi.  She said, "It's not happily ever after, but it's what I signed up, for." I then gently asked if he was always that protective when she went to the doctor. I told her that I knew her bruises were recent and not a result of last week's ice storm. Through tears, she said, "I thought he had you fooled.  He set you up to never believe some of the crazy stuff I could tell you."

I assured her we will check in once a month to address her "hormones".  I also assured her that violence only breeds more violence.   And, that maybe it was time for her 16 year old to come in for a visit as well.

She needed her pap done, but it was about much more than that.  I know that I can't save anyone that doesn't think they are worthy of a better life, but I pray as we build a relationship, she will slowly learn that not only is she worthy of respect, but that her children are learning by their examples how to treat others and what kind of behavior is acceptable.  The cycle of violence and control has to stop, and I will fight it as long as God gives me the grace and the guts to do what it takes so that no one else ever has to experience the gut wrenching anxiety every time they turn the knob at the back door.

I had an attending tell me more than a few times, "God gave you 2 eyes, 2 ears, 2 legs to get to 'em and 2 arms to hold them, you've only got 1 mouth, so listen more, hug more, do more and talk less."  What you give to your patients daily is your vocation, their trust in your care is your salary.