The death of the doctor who’s not a doctor

The cancer had metastasized before I even knew it had hit me. In hindsight there were symptoms, I just didn’t feel them in time. I didn’t understand what they were. They were quiet whispers behind the scenes. Flitting motion in the shadows. Dark wings flapping in the night, assassins stalking.

Oh, don’t panic. This cancer isn’t in my body. It is in my work place.

But just as human cancer starts in one organ of our bodies, then spreads to others; so too can work cancer start with one bad apple and then infect another in a work place, and then another, and then another.

In medicine we know that the best way to survive cancer is to catch it where it starts. Cut it out. Remove it from the body. The poison the site with toxic chemicals and radiation so that it can never come back. You have to strike quickly to win against cancer. But organizations rarely recognize the source of a work cancer and cut that person out in time; before the spread starts. Decent people who want to communicate and work together in teams are no match for a human tumor.

The cancer that got me was a relatively new employee. One of those people who believes that the only path to knowledge and wisdom are credentials.

When I started building the diabetes program at my clinic I barely made minimum wage, I was in a small place in one of the poorest parts of the country. No one gave a shit about credentials, talented warm bodies were in short supply.

Don’t get me wrong. There was nothing shoddy. Nothing careless going on. We had to earn the right to do the things we were allowed to do. It was not simply granted because a certain chain of letters followed your name.

But no good deed goes unpunished in medicine. We grew from 30 diabetes patients to 260; the growth for other types of patients followed the same path. We grew from one nurse to eight nurses. From one doc to three. Then four.

And number four was the cancer. I was a marked man before I even knew it. I was too busy doing my job to realize the well was being poisoned when I wasn’t looking. It is amazing how one person with ill intent can so quickly destroy what took years to build. It is amazing how one vicious soul can so quickly devastate more gentle ones. Some of us just don’t have the skills for a knife fight.

I’m still too shell shocked by lies, twisted truths, half-truths, and the lack of support from people I worked side-by-side with for years to even fully understand, much less relate to all of you, all that has happened over the last months, weeks, and days—accelerating to a terminal velocity today. My soul is too bruised to tell the story in the detail that you all deserve. Maybe in time. But not today.

I tried to stand up, to fight this cancer, but I was not quick enough, nor powerful enough, nor sneaky enough to win. I was mowed down. Now instead of bruised, I’m bloodied and the cancer is that much bolder and stronger.

Back spasms from stress cripple me for days on end and riddle me with pain. Insulin has no more effect than water. Sleep is a stranger to me. The daily stress of the last three months has rocketed my A1C from 6.9 to 9.2 making my blood toxic to my tissues. My kidneys are at risk. My eyes.

I dread getting out of bed in the morning. My joy at driving to work has been replaced by anxiety and fear. My stomach churns. I’ve become paranoid, not knowing where the cancer has spread. Who is still my friend. Who is my enemy. My safe and warm nest is now cold barbed wire.

I eat lunch alone in my tiny postage-stamp office; the laughing and chattering of my coworkers a distant echo down a long hallway.

It sucks but I am too tired to take care of my diabetes, two hundred and sixty other people’s diabetes, a ten hour day with a two hour commute, plus get into a virtual daily knife fight with a coworker. For months I ignored the growing slights. The increasing nasty little side comments. The petty changing of meds just because I thought they were a good idea. But then this person, this demon, this cancer, did something that risked a patient’s health just to get back at me.

But in medicine, credentials always win the day.

I’m not strong enough, wicked enough, clever enough for this fight. Good does not always triumph. Sometimes the folks with the back hats have the last laugh.

So I’m walking away. It kills me. It rips my very soul from me. I would cry, but I have no strength left to generate the tears. Just yesterday an old woman told me “I thank God every day that he called you to our village.” I used to believe that. I used to believe I was on some sort of mission. That I was called to help our kind to thrive despite of our disease.

Now I don’t know what to believe.

I cut my hours to the bone to keep my insurance for now. I have to work a little while I figure out what to do next. It is the worst economy ever, at least in my lifetime, to look for work. But I can’t stand another day like the ones I’ve been living through . . . well, I guess dying through would be more accurate.

The cancer has infected the work place. It is moving from person to person. Teamwork is dying before my eyes. I’ve become bitter and disillusioned. To try to save myself I am removing myself from the source of the disease; but it may be too late. When I’m with my patients I feel full of life and wisdom; love and understanding. I can help, teach, guide. But then I have to interact with the tumor, and all that good feeling is erased and I feel not joy, but sick at heart.

With bitter sadness beyond describing I know I have to leave. And even if I had the opportunity to do this job somewhere else, I don’t know if I have what it takes anymore. The cancer has infected my soul. As I couldn’t cut the cancer out, I should have tried to escape sooner, before it made me sick.

And what is the next act? What will I do now?

I do not know.

But I think I need to find a field far from medicine. A field with no licenses. No credentials.

A field where it is your name that matters, not the letters that follow it.