Getting better is not supposed to be easy.  The whole reason why better is better is because it is more.  More of what you ask? Well, as I remember the lesson well from John Travolta, everything we are and everything that is, we are all made of the same stuff. Energy.  Better is better because it has more energy.  A $5 Starbucks care is good, but a $50 Starbucks card is better because it is able to do more.  For any of us to become better, fundamentally we must put more into it.  

Tonight my patient was determined to not invest in their success.  And as I saw this play out I couldn't help but think about how I also cry and complain and feel sorry for myself when I have to try and make something better.  The level of difficulty is, in my patient's case, and in my personal case. negligible.  The mountain ahead of me is a lie I tell myself to make me feel better about not trying.  The scowl that took up permanent residence on my patients face years ago had already left its mark.  And the impact that worldview is having on their ability to get out of the ICU is now becoming a serious detriment. 

Imagine having a life threatening situation that only 50 years ago killed pretty much everyone who had it. Now through the wonderful advance of technology and technique, you can spend 6 days in a hospital eating crappy food and having all your family and friends finally take an interest in you before you are back at home enjoying your life again. It's a great deal, I say the only place that delivers more second chances than a hospital is a church.  Why would anyone want to derail that success or make it less likely that you do get home?  But so many do. It's hard work to walk when you feel sick.  Physical Therapy is very hard, in fact my patient at the Children's hospital would playfully call PT "Patient Torture".  Therapy is hard, getting better is hard and requires work on the part of the person getting better for any of the work done by the medical community to last.  Disengagement, depression, manipulative behavior...These probably cause just as many nosocomial (Hospital acquired) complications as anything.  And today with the pressure to be paid by insurance company's based on the patient's experience puts even more pressure on us to cajole and plead, and eventually aqueous and accommodate what the patient wants despite the risks and danger is enormous.  "It's a walk, ONE walk, not that big of a deal."

Instead of going home, you start to have complication after complication.  You just can't breathe right, you are not peeing off all the fluid, the invasive lines and tubes are still in place, long overdue to come out because you are just not progressing well.  Medicine is like high school, it's only great if you get involved, and it doesn't take too long.  Medicine, (and here I mean hospitalization and advanced care, not taking your blood pressure meds) is intended to swoop in and over the course of a few days or a few months depending on what's going on, return you to your normal life.  Let me put this plainly: If your normal life involves you trying to avoid things, or if you normally get what you want by manipulating others to get it for you, you will not successfully recover.  Your healing, like your health and your life. is yours alone.

No one can take your meds for you, go to Physical Therapy for you, eat right for you or live your life for you.  Please understand what I mean.  Our world today uses digital technology to augment our human experience. We communicate with black letters on white light (it's not even paper).  I sent a picture of a walk and thanks to filters and color "correction", which is more like color "deception", I make the whole experience seem magical.  Ordinary isn't good enough.  We want to be seen and thought of as extraordinary.  So we lie, all the time.  It's not a big deal and not worth further unpacking at this time but understand this; when it comes to the reality of you and your body and your health...There is no app for that.