Black warmth and cold white hands
My father was fond of breasts and guns. I wasn't either, so he wasn't very fond of me. That might explain why last night I had a dream in which I held hands with a somewhat older middle-aged black man whose hands were huge, beefy, and as warm as a cozy fireplace with glowing embers.
In real life, not a dream, I'm bothered by hands that are cold even on summer days. In winter, exposure to moderately cold temperatures triggers vasospasm that makes my fingers white, numb, and painful, even while wearing thick mittens. Frequent snowfalls this year necessitated clearing my driveway up to five hours per day, so I've been outside a lot, suffering, and longing for warm hands.
Presto! One wish-fulfillment dream later, I finally had them, and they felt sooooooo good! But what felt even better was the warmth oozing from the man. He and I really connected—not romantically (I'm heterosexual), but in a very close, avuncular or parental way: something I've never had. In fact, it wasn't until last night that I had any inkling of what it feels like to have a loving relationship with a father figure. And oh, did it feel great as my right hand held his left as we smiled and gazed adoringly into each other's eyes and his deep, raspy voice made my heart melt. Pure love, zero romance. (Yes, I realize this is a bit much for a father-son relationship, but this was a dream, after all, and a doozy!)
When asked about my ancestry, I often jokingly say I'm a mongrel. I'm part Native American, Italian, English, Spanish, French, German, and Irish. And who knows what else. But not black, as far as I know, so why did I dream of having a black father figure?
My girlfriend, a psychologist, thought the dream went well beyond warming my hands (a hand warmer could do that) to warming my heart. During my career as an ER doctor primarily in Detroit and Flint, I met thousands of black folks and found that many of them possessed an indescribable warmth not present in most others. I've discussed that over the years with my girlfriend, who also noticed the same thing while training in Detroit. Neither of us can verbalize the exact source of that warmth we find so appealing, but their straightforwardness, lack of ostentation, and down-to-earthness made it easy to form a mutual emotional connection. Perhaps that's why my sleeping brain chose a black man for that role, creating one of the best feelings in my life.
Most dreams are quickly forgotten unless written down. Hence this blog posting so I can revisit the dream and bask in the pleasure it provided.
Perhaps that dream was a belated gift for going out of my way to save the life of a young black man years ago. During an uncharacteristically slow shift in the ER, I left it to run upstairs for a code being botched by the resident physicians, who were responsible for in-patient codes at night. I took over and successfully resuscitated someone I couldn't bill. I knew the dismal odds (85% of in-hospital cardiopulmonary resuscitations fail), and my malpractice insurance at that facility covered me in the ER only.
Thus I risked my future for no potential gain to save his life, but I'm glad I did. As I exited his room I spotted his mother approaching. I was happy that she would take a few more steps and find him alive, instead of dead, which is what would have happened if the residents hadn't recognized the mistake they made.
“You can easily judge the character of a man by how he treats those who can do nothing for him.”
— Malcolm Forbes
I was also pleased to teach the resident physicians a valuable lesson. This was a teaching hospital and the presumption is that doctors-in-training must learn by doing, but what they do too often is kill people they code and learn little if anything from their mistakes. I'd once been in their shoes, not really knowing what the hell I was doing, but I eventually improved enough so I went over 18 months without losing a single patient in a busy, high-acuity emergency department in which I often managed several critically ill or injured patients at the same time.
Related article: How Your Big Ego Can Actually Help Your Coworkers: “Egos are necessary and, believe it or not, they don't have to be obnoxious and productivity-killing. They can actually make you, and everyone around you, better.”
Comment: Ego does more than help coworkers: it incentivizes people to work harder and better — or even take risks, as in the above example — to justify that positive self-assessment. Earlier in my medical career, I had no self-confidence (and hence no ego) in dealing with critically ill patients, such as those in cardiac arrest. Had I had an ego then, it wouldn't have been justified because I wasn't particularly good at saving lives. Then something clicked in my brain and I finally got it, so to speak. Of every 100 out-patient cardiac arrest codes treated by average ER doctors, 95% of patients go to their graves, yet I saved almost everyone. As my ability grew, my self-confidence/ego grew, too.
Is that bad? No, it's good. Had I not been brimming with self-confidence/ego, I would not have left the ER (and hence my malpractice insurance coverage) to treat an in-patient in cardiac arrest I had no responsibility to treat. Treated by average doctors, 85% of in-patient codes fail, so if I had average skill in coding cardiac arrest patients, it would have been too legally risky to intervene. Since the residents were not properly coding the patient, he likely would have died. But thanks to my ego thinking I could save almost everyone, I gave him a chance to live and hence have children, and for those children to have kids of their own. Hence, centuries from now, hundreds of people may have lived thanks to what I did in saving the life of their ancestor: without him, none of them could exist.
In hospitals without residents, I was called to run codes and treat critically ill people in the ICU, CCU, and other units during evening and night shifts, which is what I usually worked. I saved everyone I treated, so I never thought about my malpractice insurance coverage, but at the first hospital I mentioned, I knew I had none outside the ER. Hence when I saw his Mom I was happy for her but I also realized that she likely would have been the one initiating a lawsuit if her son died.
That's enough to scare most doctors into running away from such patients. A friend who works as a cardiac nurse told me about a recent in-patient who desperately needed a cardiologist but the two who saw him were so frightened by the challenge of his case that both refused to treat him. This is a trick some doctors use to make themselves seem better than they really are: rejecting patients with a higher risk of death so they don't degrade their batting average, so to speak.
In a similar case, a cardiothoracic surgeon at that supposedly top hospital refused to operate on a patient who clearly needed surgery. The spineless doc turfed the patient to a smaller hospital, where he was treated by a surgeon with less impressive stats. But stats in medicine can be very misleading. I couldn't reject anyone who walked (or rolled) into the ER, but some docs cherry-pick their patients to minimize their risk and maximize their profits.
More than cold hands need warming
Perhaps I've been on a quest for warmth after receiving a Christmas card a week ago from a relative that seemed intentionally cruel and cold.
I ate a heap of turkey last night, hoping it would lull me into sweet dreams filled with nurturing and warmth—both kinds. No such luck. In my first dream, I visited the hospital cafeteria five minutes before they were scheduled to open. The food was ready for serving, so I asked if I could eat now, but the answer was a stern, steely cold NO. I waited a couple minutes but was paged to return to the ER stat, so I went hungry that shift.
I encountered another unfriendly white person in my second dream. This one slowly walked up my driveway as my girlfriend and I were horrified by what we saw: a man who looked like a cross between a Neanderthal and a crazed bodybuilder in a 'roid rage. His face grimaced with hate as if he either wanted to kill us or eat us, or both, so I decided to run for my gun instead of the door. If he came in, he'd meet Smith & Wesson and hopefully the same fate as Lester Moore, killed in the Wild West and buried in Boothill Graveyard in Tombstone, Arizona (appropriately enough) with an epitaph that read, “Here lies Lester Moore, four slugs from a .44, no Les, no more.” (Update: Moore wasn't a gunslinger as I presumed; he was a Wells Fargo Station Agent killed by a customer who arrived to pick up a package and was enraged by its battered condition.)
The roots of all this
I had an unusual childhood. My Dad abandoned us when I was young and my Mom usually worked multiple jobs for men who flat-out told her she was paid less because she was a woman; their curt advice was marry a man to get more money. We were episodically poor, especially after one of her bosses was shotgunned to death, as I discussed in articles about Adam Lanza's Newtown massacre and welfare recipients. Children define normal based on what's normal in their families, so I never felt unloved or deprived even when I developed diseases such as scurvy and phrynoderma that resulted from malnutrition rarely seen in developed countries.
Growing up in a vacuum of supervision left me free to do my own thing. One day I traveled on my bicycle, equipped with training wheels, to a distant city by myself. It seemed like a good idea in my 5-year-old brain, and there were no adults around to say no, so I did it.
Another day I cashed in my coin collection to eat hamburgers in a restaurant that strangely never asked why a kid not yet in kindergarten was eating without an adult. I was starving, so eating was the logical thing to do.
In sixth grade, I camped in a distant state park with a friend during the winter, woke up freezing and hungry (we didn't bring food), and walked ten miles to the nearest restaurant and struggled to figure out what I could order with the little money I had.
I sometimes encouraged my Mom to leave us because I thought kids were dead weight that limited her dating appeal. When she drove off and left us a few times, I cried, worrying how to support myself at age 9. She dated various men who seemed to desire something other than marriage, including a powerful Mafia don who, I later learned from his obituary and various articles about him, parlayed his criminal beginnings into countless legitimate businesses and connections.
He was a philanthropist and Chairman and/or CEO of several corporations and a member of the Board of Directors of so many corporations, hospitals, colleges, banks, organizations, and charities I wonder how he had time for even 5% of them. He was an appointee of several presidents and Governors. He was decorated by a foreign government (that I won't name, along with other details to protect his identity). He was the former chair of a major metropolitan Chamber of Commerce. He received numerous honorary degrees and awards. His birthday celebrations drew unbelievably huge crowds, including hot women young enough to be his great-granddaughter. (Now what kind of old codger has birthday parties that draw many yummy young babes and countless ritzy people? A very powerful one.) In his younger days, he rose to an impressive rank in the U.S. military. His funeral Mass included Cardinals and numerous priests.
He was obviously supremely accomplished and very devoted to religion, yet he dated my Mom while married to someone else. The rest of the story, as Paul Harvey would say.
If you've seen or read The Godfather, you might think the connections between organized crime and politicians were merely a product of Mario Puzo's mind, but my Mom dated a real-life Godfather who visited our home. She seemed to know only a few pieces of his remarkably intricate puzzle and likely only told a fraction of that to me, yet I knew that while our government fights organized crime, they don't fight all of it.
Besides food, the one thing missing from my childhood was warm, unconditional love. My Mom taught me that I was worthless unless I was working, so even now that she's gone, I work 365 days per year, but money doesn't buy love or even acceptance. I should have learned that lesson years ago when I dated women as cold as ice. I'd love to adopt a parent or sister now—but how?
Back to my cold hands: I recently used an infrared (non-contact) thermometer to measure my hand temperature and then a stuffed animal. It was warmer, which has since been something of a joke as I kid about being colder than a dead object. What caused my problem is a cautionary tale for others: I spent many hours using vibrating equipment, from lawn mowers and post-hole diggers to chainsaws and sanders—the latter primarily used to make cupolas and hand-carved doors, the first one for a shed I built for my Mom. Here's the door:
Equipment manufacturers were remiss for not adequately warning users of the risk posed by vibration: once the hands are so injured that cold elicits intense vasospasm, there's no way to reverse the damage. Prevention is key, but manufacturers typically ignore the problem even though there are simple, low-cost ways to reduce vibration they could sell as optional accessories. In a future posting, I'll describe easy ways to dampen vibration and protect your hands and potentially other body parts—the tractor I'm now using vibrates primarily in its seat: use your imagination to think what problem that might cause!
- I described the case of the young man's life I saved in more detail in one of my ER sites.