All my life I have been catapulting towards this moment ...

This was the jist of a statement made in a recent movie I watched called 127 Hours about the life of Aaron Ralston.

Two weeks ago on Friday, February 17th my attending, mentor and the Pediatric Department Chair Dr. Don Lewis died.

That Thursday, as I was driving down to Norfolk from DC, where I had been for my friend Leila's birthday, Dr. Lewis intermittently entered my thoughts. I wanted to make an appointment with him to discuss my rank order list, which was due in a few short days. I thought of buying him the book "Proust was a Neuroscientist" as a thank you gift for writing a letter of recommendation and always making the time to provide his input about residency programs whenever I had a question.

That evening I was working the 3PM to 11PM ER shift in the Norfolk General Hospital. Towards the latter part of my shift I overheard the resident I was working with talking to an attending about a "child neurologist ... it's like when a cardiologist gets a heart attack." I did not like what I heard. There are only a few child neurologists in the area, and I was pretty sure I knew them all. Before I got a chance to inquire, I was whisked away to see a patient on the South ED. At some point, I went to the North ED to check on another patient. That's when I saw Dr. Toor, then Dr. White and I knew something was not right. Dr. Toor greeted me with a hug and relayed the news that Dr. Lewis was in the ER after suffering an intracerebral hemorrhage. I was stupefied. Intracerebral hemorrhage? The prognosis for that was usually not good. My thoughts began racing and I could no longer pay attention to our motor vehicle collision guy who, for the most part, was stable. The neurosurgeon came out of Dr. Lewis' room after having performed a ventriculostomy and my resident chatted with him about our patient's possible fractured vertebrae. I vacillated about whether or not to go into his ER room and decided it would be too much. I would be an uninvited intruder. Soon after, my shift ended and as I was leaving the ER I thought that Dr. Lewis may not be 100%, but that he would probably be OK. The thought of death never even occurred to me. I planned on getting flowers and dropping by the ICU the next day.

That never happened.

The next day he deteriorated rapidly. The prognosis was poor and his family opted for DNR. He was pronounced "brain dead" in the morning and the LifeNet folks came by to evaluate him. Of course, he was an organ donor. He was Dr. Lewis after all: giving, caring and healing even at the precipice of death. At that moment, I knew, but didn't or couldn't accept that it was over. Really!? No! How could this happen? How was this happening? He was perfectly healthy and only 60! He had known about the AV malformation. It was a ticking time bomb in his brain. Why this sick irony?

It made me queasy to envision the doctors testing his brainstem reflexes, those tests that we learned about in neuroscience. Corneal reflex, gag reflex ... ugh ... they even did a caloric test on him. They were no longer lifeless factoids like 2+2=4 in our neuroanatomy notes, they were real and ominous, a harbinger of an unwelcome reality. I had to stop torturing myself with these haunting images. That Friday I was somber and zombie-like throughout my shift at Sentara Leigh. Dr. Lewis and his family occupied my thoughts all day.

The next few days were better, but I remained in a state of quasi disbelief. Had this all really happened? Was this beautiful human being no longer enjoying the sunlight that was pouring into my car? No longer hearing the news about political slander?

He touched so many lives in so many ways: children, parents, students, residents, colleagues, friends, and family. It was, therefore, no surprise to see hundreds at his memorial service.

There are moments when we cease to be the choreographers of our lives, when a higher power takes the helm. Each and every one of us walks step by step towards our respective destinies. Since the moment of its conception, the AVM in Dr. Lewis' brain was destined to give in at the very moment that it did. It was his time, then and there. It is with this awareness of our unrehearsed and enigmatic role in this life that we can accept each and every moment with gratitude, love, and humility.

Dr. Donald Lewis no longer occupies the corporeal world. He does remain alive in the spiritual realm of all our hearts and our memories. Amin.

http://www.wavy.com/dpp/news/local_news/norfolk/neurologist-dies-of-brain-hemorhrage

Happenings

It's 2012. Not only is it 2012, it's almost March. Fourth year of medical school has quite literally "flown by". It started with studying for the USMLE2, then taking the USMLE2, then waiting for the results while writing my personal statement and preparing the rest of my residency application, applying to residency programs, waiting for invitations to interview, receiving interview invitations, scheduling them, going to them ... many of them, spending a lot of money I do not have, learning, meeting, talking, lots and lots of talking, New Years, more interviews, rank order list, nervousness, excitement, ruminating over and sometimes dreaming about whether I made the "right choices?", and now waiting ...

Amidst all this, some incredible things have happened. My best friend form medical school got married in Seattle, my best friend from college got married in New York. I went on my first mother-daughter vacation. An incredible 10 days driving around the breathtaking Southwest with my beautiful mother. Unforgettable. Two professors, one of whom was very influential on my path, passed away. One a slower progressive death, another a sudden, unexpected death. Both a surprise. In a few months I will be a real doctor with real responsibility, to people, to children and the people who love them. I will be employed and earning money. I will be making decisions and working hard. All this change in one year. It's a lot. It's beautiful. I love all of it. I can't believe I'm here. I know I am blessed through and through again for my life, health, family and friends and the gift of love and gratitude.