There are lives in the balance

A painful truism in the practice of medicine is that nothing is ever casual.

No off the cuff remarks or comments are allowed. Non-medical people don't always get it. When a doctor says something, whether it is the clinic or the hospital or on the phone or in an email or during a meal or a hockey game, it has the potential to alter lives and can lead to actions that simply can't be undone. There are lives in the balance.

This is not the familiar G-d delusion that afflicts too many in my chosen field. It is the recognition of the awesome responsibility that comes with a little knowledge.

I don't for a minute believe what I say alone determines what others do, but I would be naive and self deceiving if I said I don't think I influence choices.

Today I was touched to the wick of my soul by a post from my friend Wanda on her Caring Bridge site by her thanks for nudging her towards her courageous choice of an "experimental" transplant protocol at Stanford.

I am simultaneously blessed and challenged by this burden with its mix of joys and sorrows.

This is not a burden that I can or would want to put down. A doctor is always taking a risk with someone else's health when he or she is less than thoughtful with a medical comment.

So my dear friends, please understand how hard I have worked to lighten up, to be comic force in the dark world of leukemia and all the existential decisions that diagnosis engenders. It doesn't come naturally. I am just fighting to balance both my innate and professional tendency to lead with all that possibly can go wrong.

I love what I can do and the world that my leukemia has opened to me.

I just get tired at times.

Heck, I am no G-d.

I am not even a specialist.