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The Post Traumatic Stress New Order

You’re not going to find the answer you seek anywhere on this page, other than “Iceman X” by Robert Longo above, and the original music video for New Order’s Bizarre Love Triangle, also by Robert Longo.

Full disclosure, I do not own any Robert Longo pieces, though I wish I did. I’ll wager that I could have dug through a trash can at Hunter College back when I was tripping on LSD in the back of the storage closet with Amanda Reane, and probably found a sketch that he tossed in there. Longo was a force in that school back in the 1990s in a way that I’m not sure he really even cared. Hunter and Voorhees were probably the two cheapest art BFAs in the tri-state area. And here comes Longo, content to fulfill his Academic Torture Requirements (ATRs) with a bunch of broke-ass immigrants and children of immigrants from the top of some coin-op laundry in Flushing. I can’t guess to know what Longo was actually thinking there, maybe he was pissed? Maybe he loved it? Maybe he didn’t care much one way or another, because he already found the the combination lock on the contraband locker had been set to open quickly at a touch by its previous user?

But you see, Longo was, is and will be an artist. And that’s a position that physicians will likely see as useless to their practices. Not all physicians, but a sufficient number that when the shit hits the fan, they have such poorly developed skills of Nihilism, that they can’t … cope.

Longo was, is and will be an artist. If artists are blessed, they will rarely feel pain. If artists are lucky, they will feel pain in the sufficient amount.

Physicians aren’t built to these specifications. You’ve been trained as some kind of superhero, so when the structure fails, you will most likely adopt a retroactive position recenterizer that retroactively changes your past actions to your current opinions. It’s a remarkable tool, the recenterizer, ex-post facto or not. As convenient as the recenterizer is, it will do you no good. You may want to think like a physician in your failures, but in your successes, think like an artist. Take what little goodwill, money, tinned tunafish or nickle bag of Mexican pot, and put it aside. Because when we succeed, failure is around the corner. It’s the nature of entropy itself. That little bag of provisions might be what gets you through the next failure.

When you fail, keep those good thoughts near; you do good work, you help to save lives, you are paid well for your skill and knowledge. If you don’t know how to nurse yourself, watch the way one of the nurses or assistants in the ward, nurses someone who is in pain. Look at how they use their voice, their hands, their pace. If you notice the patient visibly calm, then the nurse has done to the patient what you will need to self-administer. Sometimes just a gentle touch can take away pain, it often takes very little. You’ll figure it out.

And then when you fail, you acknowledge the failure and build on that. Eugene Hutz said, “lack of failure is lack of talent.” Fail, and fart proudly. Other than your luxuries, it’s one of the few things for which you have to take credit, good or bad, to build something for which the world cannot move forward, due to its lack.

You failed, some people died. That happens. Next time you won’t fail and fewer people will die. You do need to understand this luxury however, this class to which you have ascended through your hard work and competitiveness. You have this position because we have become so sentimental over the remnants of this pointless life we collectively lead; we’re willing to let you be our gods for the promise to have our loved ones near for a little bit longer.

But this isn’t about us.

It’s about you. So, do you let this become your reality? Simply because we worship you as gods, do you believe that you are in fact gods, rather than someone with a modicum of hard work and competitiveness? When you mark the death certificate do you think to yourself, without fail, “how long would that old goat have lived if I hadn’t given the lot of them my powers of extended life”? If you believe you are without fail and error as a physician, you would be something like the minor league goalie who learned to fixate on the twitch of a wrist more than the eyes or the puck itself and then kill your career with a punch to the wall with your bare glove hand because your significant other pushed you to the edge of insanity and you blew up a contract that probably would have taken you to the Ottawa Civics.

Here’s the math …

There are about 500,000 physicians in the country. We have some average of accidental or unintended deaths in the U.S. Healthcare industry of about 250,000 per year. Something like 1/4 of all caregiver accidents are non-fatal. It may be something as simple as 100 milligrams of Prednisone instead of the correct dosage of 10 milligrams, and a little buzz in the ears, but nothing more too traceable to the mistake itself. And it can go all the way up to “Please tell me we didn’t almost kill a kidney donor, that was a close one.”

Say we double the 500,000 physicians to also include the other people in the line of fire who can screw up, like some nurses, or a pharmacist, or the physicians assistant who wrote the scrip with a 100 instead of a 10. So say we have 1,000,000 people in the USA who CAN make a major mistake versus (250,000 * 4) = 1,000,000 medial screw ups per year, with a quarter million of those actual deaths, and the rest not-deaths. That suggests that every average provider has about one screw up per year, with a 25% chance that it will be fatal. It suggests that in 6 years of practice, the physician will have a very low probability of never screwing up, assuming a relatively even distribution of skill in the industry.

There. So for the most part, there are two kinds of physicians;
A. Those who screw-up sometimes,
B. Those who fail sometimes.

You don’t have the artist’s training to work while in failure mode or screw-up mode. Art teaches how to work in failure mode, music teaches you operate in screw-up mode. But medicine sees failure and screw-up as things that can be engineered out of the system, rather than as an inevitable launching point of something incrementally necessary.

So, no answers here. You have done well, and the failures are part of the process. You can’t work without some failure. To learn from the failure, the first step is always to acknowledge that it is in fact a failure, and not some glistening mountain of peach and strawberry Jell-O.