Heartfelt with Dr Melissa Walton-ShirleyView all posts »
Contemplating the New Year: A private cardiology practitioner's resolve to stay the courseJan 3, 2012 10:33 EST
A few fleeting hours are all that separate the peace of a winter respite from the insanity of my daily work routine. I sit just outside the shadow of my family's temporarily abandoned beach tent, grasping at the sound of ocean waves, collecting them as they gently, rhythmically caress the beach. I try in vain to record the soothing sea song and the warmth of the December Florida sun so I can later conjure them on a cold damp day in Kentucky. I close my eyes and drink in the sun, happily recalling why I have always felt such love for the beach.
Cocoa Beach, FL is our favorite respite, where time melts like Salvador Dali's clocks, draping itself over palms and boardwalks. It spreads itself over gritty powder-white sand and lingers on comfortable worn flip-flops. The ocean, blue as the sky, gives up mounds of shells and is my constant companion on long morning walks and nighttime excursions. I love this beach. I long for it at times, but there has been no other time that I have been needier of this refuge than the last two years of my practice.
Like an old sea captain who reflects backward on his career, I took inventory this weekend of my time on the high seas of private practice. Although challenging, the first two decades of my career were smooth sailing and most rewarding, but there is truth in the saying "there is nothing more deceptive than the calm before the storm." An able and wise cocaptain stood beside me through rough waters and celebrated victory upon victory. He still stands beside me today. We still rise to every challenge but are both a bit battle-worn, not from physical demands so much as from the politics and change in our local medical climate.
We have learned much from two years of turmoil. We have toughened up with assaults from our own government, which has locked in private practitioners at the other end of the spyglass, cannons at the ready, to dismantle old practices that have served the multitudes. Private practitioners are scapegoats, with threats to decrease our reimbursement by one-quarter, a misguided attempt to correct the sins of mismanagement and waste, and for that portion of the population who drink, smoke, and eat us into financial oblivion, individuals who are always expecting the treasure chest of government funding to be ever at the ready. They have no thought of the efforts and sacrifices required to fill it. Our income and those in our employ who have also entrusted their future to us are ever vulnerable. Add to this the pain of loss of consortium of our former colleagues who have fallen victim to the more attractive cousin of socialized medicine, hospital acquisition, and the sting of abandonment by the very institutions we have helped to build and sustain. With the weight of disappointment of the immediate past and the reality of the consequences of the temporary definition of legal collusion, another year of disappointment of last year's magnitude is at first difficult to contemplate.
Despite my clothing heavy from the water coming into our ship, I am miraculously now more optimistic. In part, I owe it to the lessons I have learned from nature on how best to cope with the adversities of a hostile practice environment. I have learned that sharks do not adapt to their environment but rather adapt all that is around them to theirs. I either must steer clear or outsmart their tiny brains, which understand only pain and hungry greed. I will sustain by being as reliable as the ocean tides and as truthful as the promise of a rising moon. I will give up the dead yearnings of yesteryear much like the sea spits out its dead each morning on every shoreline that edges its mother earth. I will accept the need to endure occasional raging winds but will still enjoy the warmth and comfort of calm waters. I will be a survivor and will hang onto whatever driftwood, plank, or passing ship that might lend itself in times when there is need of rescue, as long as it is a vessel with honorable intention. If the intentions are ever otherwise, I would rather let go and sink slowly to where the waters become murky and dark. For a brief moment, interrupted only by the sounds of sea birds, I once again, and hopefully for the last time, allow myself to sink, free falling into that small corner of my imagination to that unthinkable place. My toes first sense the cool depths of resignation, then my legs and my face, immersed and though hungry and panicking for air, a comfort compared to a life of piracy chosen by a few and a life fully mapped with few choices for others. I see in the distance other ships passing above me and contemplate their offers of assistance but stay submerged until that dreadful chapter of my imagination is finished.
I open my eyes and step back into reality. I feel the sand beneath my feet, the sounds of children playing in the waves. I stand to walk back toward home accompanied by a hint of dread at the thought of the beginning of another year. It will be a year of strategy, some certain disappointments, surviving . . . but then I abandon those negative feelings for a ship that passes with flags flying, sails full of wind, the ocean spray peeling off the bow as it parts whatever waters that lay before it. I am the proud captain of my ship. I author the manifest, the ports of call, and with the help of God, the destination. I realize that I have a beautiful family, a warm home, and a great life partner that welcome me at the end of every day's journey. I have tens of thousands of patients who are treading those murky waters of uncertainty who view me as their life preserver, their anchor, and their guide. They are adrift in a far more unsettling sea than what we as medical professionals will ever perceive.
As I reach my destination, I realize the sun that so gently caressed my skin this last hour, while now setting on a crimson horizon with the fingers of night dangling toward earth will rise over a glorious first new day of 2012. The subconscious scales that weighed my future are now tipped toward the positive. I have willed myself in the space of this hour to believe with every fiber of my being that right will triumph over might. I am resolved that I will be productive and happy. I will approach the year with a clear focus on each patient and each decision before me. My calm resolve perceived as weakness by some will be my navigation tool and my greatest strength.
My New Year's wish for all of you is that 2012 will bring you prosperity, happiness, health, and, most of all, peace in a future that often times is what we make it. May you always be your own captain.