As those who have heard my story well know, medical error is rampant. The CBC recently reported that over 70,000 Ontario patients are avoidably harmed during medical care each year. In November I and Patients for Patient Safety Canada met with the Minister of Health and Wellness of Nova Scotia. The meeting was one in a series of roundtables being held in each province. We wanted to propose better post-error policy.
Minister Doherty was very personable, introducing himself to us as "Randy." (He even asked for an autographed copy of The Cancer Olympics!) He listened attentively to our ask: that if a patient is harmed in hospital, and an investigation into the error ensues, the patient/family will be informed of the outcome in writing. Also, we recommended patient presence on committees tasked with investigating an adverse incident. Hopefully, having a patient at the table will help shift the culture from one that protects clinicians and organizations to one that protects patients.
But other big things went down last month. When I saw my surgeon a month ago, I was looking forward to telling him that I was planning to return to work in January. I had thought I could postpone my ostomy reversal surgery until my retirement. He surprised me by saying that I should have the correction as soon as possible. Apparently, organs get used to being dysfunctional if they are offline too long, making adjustment worse. I will need many things first: imaging by PET-CT to ensure I am not having another recurrence, endoscopy and balloon treatments to address a stricture, and a pelvic MRI to guide any intervention.
It will take months to move through that checklist, provided I am even good to do so. This sudden change of plan is very welcome to me, as I would dearly love to say goodbye to Flipper Number Two. But there is another consequence of the change. I am back to work NOW! I will work, gradually getting to full time, until I must go off for the surgery. I know from experience, having had a reversal before, that I will be very disabled for many months afterwards. So I am back at it until my next big disjuncture. My first full day was last week.
Why go back at all, people ask. Why not just retire? There are many reasons for my desire to go back beyond the obvious financial advantages. For many of us, work is an identity. Because cancer strips us of everything, taking back this aspect of personhood seems like a victory of sorts. So even a brief sojourn into the working world is like a reclamation. Socially, it will diversify my restricted existence. Because I am stage IV, I know well that disability and decline await me one day. I want another kick at the “normal life” can before they descend.
So what is today’s song? The Indigo Girls’ song “Watershed” from their 1990 album Nomads Indians Saints is about decision in the face of uncertainty. A watershed is an area of land that catches precipitation and drains or seeps into groundwater or another body of water. It is a place of change. The Indigo Girls’ clever harmonies capture the courage and curiosity it takes to tackle life choices. Life is capricious – our plans go awry, our way is confounded, our destiny indeterminate. And yet, we go on because we choose to. We transform, as the rain does.
Thought I knew my mind
Like the back of my hand
The gold and the rainbow
But nothing panned out as I planned
And they say only milk and honey's
Gonna make your soul satisfied
Well I better learn how to swim
'Cause the crossing is chilly and wide
Twisted guardrails on the highway
Broken glass on the cement
A ghost of someone's tragedy
How recklessly my time has been spent
They say that it's never too late
But you don't, you don't get any younger
Well I better learn how to starve the emptiness
And feed the hunger
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
And there's always retrospect (when you're looking back)
To light a clearer path
Every five years or so I look back on my life
And I have a good laugh
You start at the top (start at the top)
Go full circle round
Catch a breeze
Take a spill
But ending up where I started again
Makes me want to stand still
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
Stepping on a crack (stepping on a crack)
Breaking up and looking back
'Til every tree limb overhead just seems to sit and wait
'Til every step you take becomes a twist of fate (twist of fate)
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
And when you're learning to face
The path at your pace
Every choice is worth your while
Minister Doherty was very personable, introducing himself to us as "Randy." (He even asked for an autographed copy of The Cancer Olympics!) He listened attentively to our ask: that if a patient is harmed in hospital, and an investigation into the error ensues, the patient/family will be informed of the outcome in writing. Also, we recommended patient presence on committees tasked with investigating an adverse incident. Hopefully, having a patient at the table will help shift the culture from one that protects clinicians and organizations to one that protects patients.
But other big things went down last month. When I saw my surgeon a month ago, I was looking forward to telling him that I was planning to return to work in January. I had thought I could postpone my ostomy reversal surgery until my retirement. He surprised me by saying that I should have the correction as soon as possible. Apparently, organs get used to being dysfunctional if they are offline too long, making adjustment worse. I will need many things first: imaging by PET-CT to ensure I am not having another recurrence, endoscopy and balloon treatments to address a stricture, and a pelvic MRI to guide any intervention.
It will take months to move through that checklist, provided I am even good to do so. This sudden change of plan is very welcome to me, as I would dearly love to say goodbye to Flipper Number Two. But there is another consequence of the change. I am back to work NOW! I will work, gradually getting to full time, until I must go off for the surgery. I know from experience, having had a reversal before, that I will be very disabled for many months afterwards. So I am back at it until my next big disjuncture. My first full day was last week.
Why go back at all, people ask. Why not just retire? There are many reasons for my desire to go back beyond the obvious financial advantages. For many of us, work is an identity. Because cancer strips us of everything, taking back this aspect of personhood seems like a victory of sorts. So even a brief sojourn into the working world is like a reclamation. Socially, it will diversify my restricted existence. Because I am stage IV, I know well that disability and decline await me one day. I want another kick at the “normal life” can before they descend.
So what is today’s song? The Indigo Girls’ song “Watershed” from their 1990 album Nomads Indians Saints is about decision in the face of uncertainty. A watershed is an area of land that catches precipitation and drains or seeps into groundwater or another body of water. It is a place of change. The Indigo Girls’ clever harmonies capture the courage and curiosity it takes to tackle life choices. Life is capricious – our plans go awry, our way is confounded, our destiny indeterminate. And yet, we go on because we choose to. We transform, as the rain does.
Thought I knew my mind
Like the back of my hand
The gold and the rainbow
But nothing panned out as I planned
And they say only milk and honey's
Gonna make your soul satisfied
Well I better learn how to swim
'Cause the crossing is chilly and wide
Twisted guardrails on the highway
Broken glass on the cement
A ghost of someone's tragedy
How recklessly my time has been spent
They say that it's never too late
But you don't, you don't get any younger
Well I better learn how to starve the emptiness
And feed the hunger
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
And there's always retrospect (when you're looking back)
To light a clearer path
Every five years or so I look back on my life
And I have a good laugh
You start at the top (start at the top)
Go full circle round
Catch a breeze
Take a spill
But ending up where I started again
Makes me want to stand still
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
Stepping on a crack (stepping on a crack)
Breaking up and looking back
'Til every tree limb overhead just seems to sit and wait
'Til every step you take becomes a twist of fate (twist of fate)
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
Up on the watershed
Standing at the fork in the road
You can stand there and agonize
'Til your agony's your heaviest load
You'll never fly as the crow flies
Get used to a country mile
When you're learning to face
The path at your pace
Every choice is worth your while
And when you're learning to face
The path at your pace
Every choice is worth your while
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