I guess like all of you who blog, there are always posts swirling around in my mind. Then I come here and nothing comes out (surprised?). But I'm going to make an attempt to write about a few things that I have learned on the job that have nothing to do with lipids and heart disease.
Some of my patients I have been seeing for nearly four years. I help manage the complex dyslipidemias at my practice, which means I see the folks who had their first heart attack as a supposedly healthy 35 year old, or the person who has an LDL cholesterol level of 300+ despite being on six different medications. You get to know these people over time, over the years. But patients always seem to want to know a little bit about me and, well, I'm guilty of oversharing (I know--shocker.)
As unprofessional as it may have been in the past, I've told some of my patients that we were trying to start a family.
Obviously they've seen me every six months for four years they're going to notice I've never been pregnant. Some of them gently ask "How is that going?"
I say it, I don't tear up, the words are out there, and saying it every time makes it more real, more concrete, more fact.
"We cannot have children."
"We cannot have children." It's a hard thing for people to hear. But it's getting easier to say.
On a different but related note, I also gingerly ask people about their family histories, which has led to me to hear some delightful, some sad, and some just plain heartbreaking accounts of adoption.
"I finally connected with my twelve brothers and sisters. I was the baby, the one they couldn't afford to raise." I remained quiet to see if he would continue. "But it was nice to finally meet someone who looked like me, to get a sense of where I came from, to get a small sense of who I am."
"My parents are absolutely the people who raised and loved me, no ifs ands or buts. I adore them and they are wonderful people." And then laughing, continuing "But they both have heart disease so I'm glad they didn't give me any genes!"
But yet I haven't met myself yet. I haven't had a mid-30s vegetarian with high cholesterol, a thyroid disorder, a wicked family history of heart disease come in, sit down in my office and tell me she can go on medication without also having to take birth control because, come on, she's NOT going to get pregnant. She did, after all, fail five in vitro cycles with nary more than a chemical pregnancy.
Thanks for hanging in for the mindless ramble.