"You should probably brace yourself for some light vomiting followed by life altering hallucinations."

Grace and Frankie makes me happy.  As I look around at my fairy lights and my paper lampshade globes and my crystal bowls and my strings of garlic and collections of essential oils, I also clearly need a labyrinth. Of course I need all that emotionally in addition to my deep appreciation for and dependence upon the scientific method. I work in a field that is based in real science, albeit imbued by lots of lovely fuzzy stuff like compassion and love. We save lives with science and passion, both.

50 years ago, I was 14, and attending a really nice little prep school in a tiny town in Maine. Even there, we knew  that things were changing, and many of us have gone on to make changes in our world, inspired by the chaos of that time.

But now, at 64 years old, I find myself wondering when and how our kind and compassionate hippy approach to the world somehow destroyed logical thought and respect for research and scientific thought. Yes, my generation made huge changes  in the world and in global consciousness. But it feels to me right now that somehow many of us may have fallen down on the job...even as we made huge changes in our personal lives, good changes, that we believed manifested in the greater world.
Individually, we meditate, we do yoga, we respect others no matter who they are, how they manifest; we donate to humanitarian causes; we recycle and have compost heaps; we eat clean because we actually  kinda invented co-ops and organic foods . We foster kids, we adopt kids, we give money and time to our transgender and gay kids and friends, we celebrate diversity in our schools. We practice compassion.

But somehow, we seem to have become complacent over the decades, and we stopped being outraged and effectively effective  about things that were happening in the political and judicial sphere.  We didn't rise up and protest when the automatic weapons ban expired in 2004. We forgot to rise up and protest when the Supreme Court narrowly allowed Citizens United to let corporations donate money as though they were equal to individual voter. We didn't rise up when congress allowed our rights to privacy to be devastated post 9-11.
We have allowed education to elide over real history, and to allow kids to graduate from high school unable to differentiate between the National Enquirer and actual science. I'm sorry. I am honestly very sorry. i thought my personal satoris were enough. Somehow we've missed the piece that radical compassion ALSO requires action in the real world, commitment to change. We all need to be obnoxious in telling our stories, and sharing our beliefs. There is a caveat: we need to make sure that our opinions are backed up by fact, not just nifty memes. It may well piss people off; it will undoubtedly trim down our nice friends lists on Facebook. No biggie, I can live with that. And I am planning to support the newest entrants into our great tradition of protestors against the big money that is working against all of us who are not billionaires. The teen survivors of Parkland are the ones who are saying, loud and clear, "the Emperor has no clothes!" The system is corrupt. We need their energy. It behooves us to support them in every way we can. They are our future, our hope and our chance to keep on doing the things we have always believed in. https://www.theatlantic.com/photo/2018/01/50-years-ago-in-photos-a-look-back-at-1968/550208/

I seriously don't want to be one of those old farts talking about how much harder it was in 'my day" of nursing, critical care. I don't want to bore the crap out of people I share with, yet at the same time , I do believe I have some perspective to offer, both personally and historically.

I'm going to park this Face book post here until I work on it and deepen the historical parts.

There are some interesting things about having been in healthcare for a few decades+ .
I'll skip my frustrations and anger about the politics and finance of caring for humans, and look at positives.

The things we can do to save lives are far more effective and nuanced than they were even in the 80's. We have better equipment...better monitors , better ventilators, more specific testing modalities, better understanding of many diseases, even though it is surely a work in progress. There is so much we are only now barely beginning to discover about autoimmune diseases, for instance, about how to tailor care very specifically to individual genomes.

I no longer need to carry my own tiny screwdriver to adjust the gain on a cardiac monitor. The advances in imaging and digital manipulation are extraordinary...(I honest to god remember crying when I took a patient into our first MRI and saw the gorgeous pictures of his tumor....and what we can see now is hundreds of iterations more accurate and clear)
it is possible to develop 3d pictures that allow surgeons to visualize up front what they will encounter in real life. Very soon, we'll be able to grow body parts. Really.

But perspective:
One of my (many) grandfathers was an obstetrical surgeon. He graduated from Johns Hopkins Medical School in 1902, and went on to a very distinguished career including being an editor of the New England Journal of Medicine for a time.
(I think I might have learned to read by a combination of the NEJM and the obituaries from Henry Illinois, but that's a whole other story :) )

My step-grandfather Stephen was trained in a very different time: when one was expected to be able to read medical literature in different languages...in his case, Latin, Greek, Hebrew, German and French. A time when surgery was just developing and expanding ,when so often one could only offer comfort and common sense.

I can only imagine now how elated he must have been when antibiotics were discovered and made available in the 1930's, how his practice must have changed...how many women's lives were saved. Let's just think about that paradigm shift ...suddenly people no longer inevitably die from bacterial infections, but are miraculously saved with an injection of penicillin.
Hell, when he was in training, blood types were only just being discovered in1901!

Thanks to Abraar Quraishi for letting me meander around and reminisce while we were talking this evening.

I am reminded about why I keep working in critical care...it's so fascinating, and so much in flux. There is always something to learn. There are always resonances of the past, recognitions of how lucky we are, how recent our innovations and understandings, how hopeful we are for more paradigm shifts.

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55Catherine Mc Mahon, Quynh Truong and 53 others

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