less than one in a million

Maybe the other reason the perseverance comment is getting to me is I feel unworthy of it on of top finding it non-productive.  I am trying to make big, big, big health decisions right now that will alter my life and my career. I am no longer a minor so its me myself and I making these big decisions.

The truth is I have to be realistic.  I’m like a football player with a torn ACL that refuses to quit playing football. I will be an intern in T minus 16 months inless I want to be in debt 50,000 for nothing. I want it. I do. Even though I know what it will cost me in cartilage. I want to be a doctor.  So hip surgery is my best shot of internship not becoming a death march for the rest of my joints and my sanity.

When I was a kid I am sure there was ambiguity about what was right in terms of surgery or no surgery. In fact I even remember the conversations especially around the first big one. But I was a kid and I believed in Santa Claus, the Easter Bunny and the Tooth Fairy and medicine. Oh how I believed in medicine.  Now I have become a priest of medicine of sorts and I realize that the magical, all powerful healing wizard behind the curtain is actually an army of humans who make mistakes, have bad days and never eat or sleep but still cut on people’s babies.

I also grew up thinking less than one in a million diseases are way more common than you think because I was less than one in a million and so were my friends.  I could name 20 people who were less than one in a million.  I also was a military dependent which means I got to go see the big shot orthos for free (and by free I mean thank you US Tax payers!). Sure my pediatrician and all the residents had never heard of Kniest or operated on any one with it but my orthos knew about it and had experience with it. I lived in a happy world where I had faith in people who were bigger, smarter and more  magical than me.

Now I am an adult. An adult in medicine no less. Who knows that while less than one in a million is common in my life, in adult medicine you are as prevalent as aliens from Pluto who are protesting its deprivation of planet hood.   Adult Orthos look at me with fear in their eyes. FEAR. from orthopods who have egos the sizes of small european countries.  They look at my flims and audibly gasp (really I watched this…I will dig of the post from 4 yrs ago and link it later) and say bad words which I shall not type.

I do somewhat like the dude in Baltimore that my peds ortho sent me to because he treated me mostly like a human and not as an alien. But he is famous and in demand because he pioneered hip resurfacing in the US.  He doesn’t answer my phone calls or e-mails. This is the procedure I need. He agrees I need it. One small detail he left out when we dicussed this 4 yrs ago (we were dicussing as a future proceddure in the next 3-5 years), he has never, NO ONE has ever does this procedure in a person with Kniest or SED or any related disease. I spent weeks looking everywhere, talking to everyone I know. The truth is out. Cong. hip dysplasia yes.  Chondroplasia (beyond early OA) NO.  Its a new procedure (FDA approved in 2006, in clinical trials since 2000, been in England for a while). And the truth I am tall, so tall.  A LP would be at higher risk for this.  Thats why I am the lucky millionith customer.

Um, wtf? How do people make these decisions? I mean I want the procedure really i do. It buys 10 years of Romania or Kenya or whatever. I want it. But I am also terrified about it.  Because I don’t believe in the magic. I know the raw, carefully calculated and learned skills of medicine.  I know that there are no sure things and God knows that I know that less than one in a million odds happens. And he also  knows that I am good at doubt.