Crash Team Racing Quotes

I lost my first patient on a Tuesday. She was an eighty-two-year-old woman, small and trim, the healthiest person on the general surgery service, where I spent a month as an intern. (At her autopsy, the pathologist would be shocked to learn her age: “She has the organs of a fifty-year-old!”) She had been admitted for constipation from a mild bowel obstruction. After six days of hoping her bowels would untangle themselves, we did a minor operation to help sort things out. Around eight P.M. Monday night, I stopped by to check on her, and she was alert, doing fine. As we talked, I pulled from my pocket my list of the day’s work and crossed off the last item (post-op check, Mrs. Harvey). It was time to go home and get some rest. Sometime after midnight, the phone rang. The patient was crashing. With the complacency of bureaucratic work suddenly torn away, I sat up in bed and spat out orders: “One liter bolus of LR, EKG, chest X-ray, stat—I’m on my way in.” I called my chief, and she told me to add labs and to call her back when I had a better sense of things. I sped to the hospital and found Mrs. Harvey struggling for air, her heart racing, her blood pressure collapsing. She wasn’t getting better no matter what I did; and as I was the only general surgery intern on call, my pager was buzzing relentlessly, with calls I could dispense with (patients needing sleep medication) and ones I couldn’t (a rupturing aortic aneurysm in the ER). I was drowning, out of my depth, pulled in a thousand directions, and Mrs. Harvey was still not improving. I arranged a transfer to the ICU, where we blasted her with drugs and fluids to keep her from dying, and I spent the next few hours running between my patient threatening to die in the ER and my patient actively dying in the ICU. By 5:45 A.M., the patient in the ER was on his way to the OR, and Mrs. Harvey was relatively stable. She’d needed twelve liters of fluid, two units of blood, a ventilator, and three different pressors to stay alive. When I finally left the hospital, at five P.M. on Tuesday evening, Mrs. Harvey wasn’t getting better—or worse. At seven P.M., the phone rang: Mrs. Harvey had coded, and the ICU team was attempting CPR. I raced back to the hospital, and once again, she pulled through. Barely. This time, instead of going home, I grabbed dinner near the hospital, just in case. At eight P.M., my phone rang: Mrs. Harvey had died. I went home to sleep.

the ancients were fond of the metaphor of a charioteer. To win the race, one must not only get their horses to run quickly—but also keep the team under control, calm their nerves and jitters, have such a firm grasp on the reins that they can steer with pinpoint precision in even the most difficult of circumstances. The charioteer must figure out how to balance strictness and kindness, the light and the heavy touch. They have to pace themselves and their animals, and find every ounce of speed when it counts. A driver without control will go fast . . . but they will inevitably crash. Especially around the hairpin turns of the arena and the winding, pockmarked road of life. Especially when the crowd and the competition are rooting for exactly that. It is through discipline that not only are all things possible, but also that all things are enhanced.

So there we were before breakfast in the hotel garden beneath palm trees, all wearing our matching conference T-shirts. The sound of waves crashing into the hotel beach was drowned out by a boom box playing loud electro workout music to pump us up: exuberant, high-octane tunes with pulsating rhythms that keep building to new crescendos. After dividing into teams, we spent the next forty-five minutes racing from one exercise to the next—planks, squats, sit-ups, sprints, and burpees (a combined squat, push-up, and vertical jump)—constantly high-fiving each other and shouting encouragements. At the end, everyone was exhausted, and we all congratulated each other for our efforts, agreeing vociferously how much fun it was. I enjoyed myself, but was it fun? I did the exercises as best I could, but what I actually enjoyed was the camaraderie, the beautiful setting, the high-fiving, and even the music. Afterward, I also enjoyed the feeling of having exercised intensely. But frankly, the planks, squats, sit-ups, sprints, and burpees were hard. The routine brought to mind the running guru George Sheehan’s observation that “exercise is done against one’s wishes and maintained only because the alternative is worse.