Stayin’ Alive When You’re Eastbound and Down
When I was working in Alaska this summer, I was able to be still and smell the roses for the first time ever possibly. My life and routines, both at work and at home, are all about action, productivity and seeing how much can be crammed into a day. I love work. It gives a sense of purpose.
Work and employment are sometimes seen as synonymous, but they actually aren’t. Employment is one vehicle for accomplishing tasks, or work. An employee trades their time for money. This purchased time is spent accomplishing agreed upon tasks for the employer. The arrangement can sometimes be mutually beneficial, but it also has the potential to be very lopsided depending on the circumstances.
While I have long been open-minded to the possibility of working differently than I do now, it hasn’t been real to me. More of a nebulous, theoretical concept. The fast pace and long hours of a trauma and emergency general surgeon has essentially been all that I’ve ever known. It’s a mental and physical trap that can be exceedingly difficult to liberate yourself from. You become intensely focused on the present moment. Perform the task at hand then move on to the next. Constantly re-prioritizing tasks that need to be completed in the back of your mind. You are functioning in survival mode and are in a perpetual state of fight or flight.
Experiencing the contrast between what has been my hectic work life up to this point and the pace at a remote critical access hospital was just what the doctor ordered. It was like exploring a new world. And I actually had time to sit down and think. At that moment, it was exactly what I needed. My entrepreneurial flames were stoked and I actually had time to take action. I had started filing the necessary paperwork for a new business with my accountant just before heading to Alaska. Elite Acute Care Surgery was conceived in Tennessee, but it was born in Alaska. I knew that it was something that I needed to do, but the vision wasn’t crystal clear. I needed to be able to understand the why of my business so that I could better develop my what, when, where and how. My time in Alaska brought clarity.
There has been a shift in medicine from a symbiotic relationship between administration and physicians to an ownership model dubbed employment. As a whole, we have been so focused on one aspect of our work, providing care to our patients, that we have relinquished the rights to another important aspect of our work, managing our business. In the process, we have abdicated our birthrights and have assumed the role of highly vulnerable serfs. Part of my vision involves a paradigm shift. A restoration from serfdom to symbiosis.
The new website discusses some of the basics. The goal is to provide relief coverage for trauma and emergency general surgery providers in remote and difficult to cover areas. I am able to provide a valuable service to the communities that I am invited to temporarily become a part of and the opportunity to adapt to new circumstances and personalities keeps me from becoming stir crazy.
Sometimes the adventure is in the destination and other times it is in the journey.
A few weeks ago I was working in Jackson, TN. It was my first assignment there and it was a great experience. The physician assistants and nurse practitioners kept things running as smooth as silk. My last shift ended at 2300 on a Sunday night, and I was eager to get home because we were going on a road trip the next day to celebrate my grandfather’s 90th birthday.
Most of the commute home is eastbound on I-40 and the drive takes around six hours. On this particular night, it seemed that I was in the good graces of the traffic gods. I had the pedal to the metal and was making great time. That is, until I got to the other side of Nashville. My sensors started going nuts and it was clear that I was losing tire pressure. I got to a gas station as quickly as I could, and fortunately I ended up at one with an air compressor. I should be back on the road in no time. Or so I thought.
I hopped out and took a survey of the situation. Have you ever seen The Walking Dead? Night of the Living Dead? Zombieland? Michael Jackson’s Thriller video? I’m not even bullshitting you. It was as if I had been dropped in the middle of ground zero of the zombie apocalypse. No one ever looked directly at me. They kind of kept their heads down and limped towards me like it was a choreographed routine. When they got close enough I could tell that the leader of the pack had a wicked case of atchaforya. One of the minions set up shop about 10 meters away from me. He crouched down like Gollum and raised his head slightly. He weighed about 135 pounds, had wiry braids and had blood shot eyes. He just crouched, watched and mumbled.
I proceeded to try to fill the tire so that I could get the f^<% out of Dodge lickety split. When I began trying to re-inflate the tire, I found a blowing hole on the thickest part of the tread.
Now it’s time to take a poll…
What would you do in this situation?
A. Call your insurance company and request roadside assistance
B. Call AAA
C. Call the police to see if they could lend a helping hand
D. Pull out the spare and change the tire
E. Wander through the homeless colony to try to find a tire repair kit
F. Drive away on the smoking rim as fast as humanly possible
G. Curl up in the fetal position on the passenger-side floor board and call your spouse to say your goodbyes
Please record your answers…
I locked the truck up, ran into the store and looked for a tire repair kit. I found the spot where they used to be, but they were sold out. No big deal. There was another gas station a few buildings down. Another strike out, but the clerk said that there was another gas station “up the road a little bit”. Hell, I couldn’t even see lights “up the road a little bit”. But at this point, I had my mind set on fixing the tire. So I started plodding.
I don’t know if you’ve done much wandering through homeless colonies in the middle of the night in strange cities, but here are a few tips. Never let them smell your fear. Put on your best crazy face and pretend that you’re either strung out on something or that you’re schizophrenic and in a full blown crisis. Occasional outbursts of animal noises and flailing limbs can add to the effect. If you can’t sell the act and you feel like you’re in danger, piss your pants and start approaching the perceived aggressor. If all else fails, consider the nuclear option. Even the most desperate, despicable, dastardly derelicts tend not to rob or rape folks covered in excrement.
“Up the road a little bit” ended up being about a mile. The lights were on, but I’ll be damned if the place wasn’t locked up tighter than Fort Knox. I looked in the window and saw two tire repair kits on the rack staring back at me. They were taunting me. I saw a large rock on the ground. I stepped back, looked further up the road and considered my options.
About that time, a man who appeared to be in his early twenties pulled up to get some gas. What a relief! I’m not the only survivor after all. I explained my situation and he asked why I didn’t just call for roadside assistance. Touché! He did let me know that there were a few more gas stations further up the road.
So, back to pounding the pavement I went. Another mile up the road it was as if I re-emerged into civilization. I made the transition from black and white to the world of color. The atmosphere was raucous compared to the darkness from which I had just left behind.
I went into the gas station with low expectations. Hallelujah! One tire repair kit left. For good measure, I grabbed a can of some Fix-A-Fat knock-off. No way I was going to make this hike again if I could help it.
When I got back to the truck, I honestly didn’t know what to expect. Would it still be there? Would it be vandalized? Would it be on fire and the center-piece for an epic Vienna sausage roast? Fortunately, it appeared to be unmolested. Under the watchful, wonderous wandering eyes of my new friends, I patched the tire up in less than 2 minutes. I tossed Gollum a five and peeled out. Finally, after my two hour long adventure, I was back on the road again.
I’m already looking forward to my next adventure!
