This post is a bit all-over-the-place. I know it already, only after writing the first few words. Noo and I are in Ashland, OR, to see a few plays at the beginning of the season, before Interferon robs us of any opportunities for pleasure. I drove us up here yesterday, after completing a truly awful week of hospitalist rounds, the kind of week that raises disparate literary allusions in my mind. At one time, I wanted to be a writer and a scholar, so I'm afflicted with disparate literary allusions from time to time. I think these allusions are the primary occupational hazard of literary scholars. Believe me, I prefer to examine infected wounds and gangrenous feet than wrestle with renegade literary allusions.
I conjure you, by that which you profess,
Howe'er you come to know it, answer me:
Though you untie the winds and let them fight
Against the churches; though the yesty waves
Confound and swallow navigation up;
Though bladed corn be lodged and trees blown down;
Though castles topple on their warders' heads;
Though palaces and pyramids do slope
Their heads to their foundations; though the treasure
Of nature's germens tumble all together,
Even till destruction sicken; answer me
To what I ask you.
I think the image of a person who is both provoked and self-motivated to abandon all human goodness has preoccupied me recently, and I think this is because I see a lot of human failings when I'm at work. Last week I averaged eighteen or nineteen patient encounters per day, and although most of them were old people in frail health, a significant minority were younger people whose own bad habits--IV heroin abuse, smoking, disregard for the basics of diabetic self-care--landed them in the hospital. I spent hours working up a 50ish man with uncontrolled diabetes and an infected foot who derailed every conversation I tried to have with him about taking care of his diabetes by insisting "I'm STARVING to death on the food you give me." This from a man with a BMI of, oh, thirty-seven and blood glucoses in the 200s despite the same amount in insulin every day.