Writing Center
Spring 2007 Edition

Fear, Loathing and the Pursuit of Happiness

Robert Elster
Expressive 2010 2nd Place
Professor: Dr. Bryce Christensen

July 11, 2003 what a picturesque summer day in the quaint town of Enterprise, Utah.  The mountains that shelter the rural farming community I still consider home, basked in the midday sun. A gentle breeze blew from the south, over the vast expanse of alfalfa fields that sprawl across the valley, causing them to take the appearance of a dark green ocean with swells rolling toward the north. My wife had left in the late morning to tend to some errands and left me at home to tend our six-month-old son Hunter. I spent most of the afternoon wrestling and playing hide-and-go-seek with him, hoping to expend what sometimes seemed like an infinite supply of energy before his afternoon nap. As I prepared a bottle of formula I placed several phone calls attempting to reach my wife and make plans for the evening. Before leaving she said that she would be back in an hour, and when I began rocking my son to sleep it had been five hours since anyone had seen or heard from her. I began to get concerned. Hunter finished his bottle and, angered that I was no longer on the floor playing with him, began to cry. Knowing that the gentle jostling of a car in motion almost always lulled him to sleep, and concerned about my wife, I clipped Hunter into his car seat, and we began meandering path through town. His cries gave way to whimpers, and then to silence as we made our way through the grid of streets, passing every conceivable place my wife could be. After returning home and carefully placing Hunter in his crib, concern for my wife turned to worry. This was not like her. I sat down on our couch, and, peering out our bay window onto Flat Top Mountain, I began pondering the recent problems my wife and I were having. I sat there, thinking, looking superficially at the issues we were having, naive to the root of the problems until my then wife came home. 

I remember the scene vividly. A large cloud passed in front of the sun. Shadows that, seconds before, danced across my family room floor disappeared, and an ominous darkness enveloped the room. The door opened. My wife, without saying a word or casting a glance in my direction, walked through the room and into the kitchen. In silence she filled a glass of water from the faucet. Forcefully pressing the glass to her lips she swallowed two large gulps, as if trying to harness from the water she drank the courage to tell me what had just transpired.  Leaning over the sink she broke the silence. “I have betrayed you.”  The moment those words left her mouth it felt as if the room had instantly decompressed, like the air that once filled my lungs had been sucked out. She continued, “I have never loved you; you don’t make me happy; marrying you and having a child with you was the biggest mistake of my life!” As she stormed out the house, slamming the door behind her, I stood there in the kitchen in a catatonic state, knowing what just had happened was in fact reality, yet somehow feeling as though it was all a dream. I was shattered from my daze of contemplation by the cries of my son. Carrying him to the rocking chair, I laid him on my lap and tried to comfort his cries. As the sun subsided behind the western horizon, I looked into my son’s eyes and began to weep. I knew that from that moment forward our lives would never be the same again. But how would they change?  Should I continue down the path I was on? Or should I use this tragedy as an opportunity to deviate from my current course and peruse the aspirations that were building inside of me?  Both paths could lead to disaster.

I was young, twenty-two years old at the time of my divorce and content with the life I was living. I owned a 2500 square foot home on three acres, had three cars, and held down a steady job. Many people would be happy to carve out that kind of existence for themselves. I was not. I learned many important lessons during the summer of 2003, one of which is that physical possessions will never substitute for love or fulfillment. Another is to never take anything for granted.  My divorce was devastating physically, mentally, and emotionally.  But it was also an opportunity, a chance to pursue the dream that, before my divorce, I lacked the opportunity and the ambition to pursue. That dream was to practice medicine. The opportunity came when I signed two documents: my divorce decree and the closing papers on the sale of my house. The ambition was derived from two events that made me question what I wanted to pursue in life. 

As a child I had only minor interest in the sciences. This interest was always trumped by my love of sports. I was a jock. Since shortly after my birth, through my first two years of college when an injury ended my baseball carrier, sports were always my first priority (and I have the report cards to prove it). However, shortly after my injury I had a paradigm shift.  It occurred when I accepted a job as an orthopedic representative. The Job entailed selling orthopedic implants and products to surgeons, and then assisting the physicians that used my products in surgery. The knowledge base required to become a successful rep is enormous, and I lacked all of it. Upon accepting the job I was given an anatomy and physiology book, a book on bio-mechanics, a catalog of all the implants the total joint company I now represented offered, step-by-step instructions on how to implant each device, and a plane ticket for a flight to San Diego that left in five days. Attached to the ticket was a single page of paper that contained the instructions “Please report to corporate headquarters November 11 at 7:00 AM with a working knowledge of the information contained in this packet.”  I did the best I could with the mountain of information I was given and the time frame I was faced with. However, I arrived in San Diego a wide-eyed twenty-year-old, wholly unprepared for what I faced.

The training was a week of sixteen-hour days, a crash course in bio-mechanics, anatomy, physiology, histology, and organic chemistry. It was as if they expected me to learn in one week what physicians spend four years in medical school learning, and I struggled.  For the first half of the week I lagged behind the rest of my peers, but by the fourth day I turned the corner. Information they shoved down my throat the first part of the week began to make sense, neurons in my brain began making connections, and on the dawn of the final day I was confident in my abilities. That confidence, however, did not last long.  In fact, it lasted the amount of time it took me to finish my breakfast, for it was after breakfast we learned that we would be applying our newfound knowledge on cadavers, and our performance during the procedure would determine if we passed or failed the training session. 

Taking my seat in the van that served as our transportation to the University of California, San Diego School of Medicine, the confidence that had emboldened me earlier that morning had been replaced by the fear and trepidation of earlier in the week.  I was shuttled into the first room I came to while the rest of peers continued down the hall.  My eyes scanned the room quickly coming to rest upon a large stainless steel table with a black body bag resting on top of it.  The regional sales manager for my territory entered the room and explained that, for my final exam, I would be performing a total hip arthoplasty on the cadaver which lay inside the body bag before me. I was petrified. I have never in my life, until the birth of my son, felt so unprepared and inadequate. We unzipped the body bag, and a putrid smell enveloped the room, so dank I could almost chew it. After positioning our patient, I slipped a surgical gown on and was handed a scalpel. I took deep breath through my mouth, hoping that the infusion of oxygen would steady my trembling hand. It didn’t. Clear fluid began to ooze from the body’s pale, lifeless tissue, as my scalpel traced the line I had drawn earlier in black ink. But as I made my incision and began dissecting the deeper layers of tissues, something strange happened.  The fear that had nearly paralyzed me just moments earlier vanished, and I became enthralled by the procedure I was performing and what I was seeing. What I had been poring over in anatomy books was now before my very eyes: the muscles, nerves, bones, and how they interact with each other was right in front of me, and I was amazed.  As I prepared to implant the hip stem, a new voice entered the room.  It was that of Dr. Santori, the Dean of Surgery at UCSD School of Medicine and a world-renowned orthopedic surgeon.  He walked over to the table and we introduced ourselves. After surveying my work, Dr. Santori complimented me on my resection of the joint and shared some pearls of wisdom. He then instructed me on how to properly suture the joint capsule and congratulated me on a successful surgery. As I tore off my gown and mask Dr. Santori came over to me again and asked me a question that has stuck with me to this day.  He asked, “Son, you’re young enough, why are you here and not in med school somewhere?”  I did not have a good answer. I was fascinated with medicine, but I was also completely content with my role in the medical community. I did not see the need to dedicate over a decade of my life to it. But that changed with the premature birth of my son.

My son did not come into this world with a loud cry, kicking and screaming like healthy babies do. Instead, he was born without a sound, blue and limp, seven weeks premature.  He was rushed out of the delivery room and into the neo-natal intensive care unit where he was placed under an oxygen hood to supplement his breathing.  I stood there at his side while a whirlwind of nurses, respiratory therapists, and doctors quickly tended to his needs.  I have never been more terrified in my life.  It became apparent that the oxygen hood would not be enough to sustain Hunter’s life and a respirator would be needed to breathe for him while his lungs still developed.  Our pediatrician, Dr. Bart, informed me of this and I gave him the consent he needed to continue.  The commotion around my son’s crib subsided until the only people left were Dr. Bart and I.  He explained in detail what he intended to do to save Hunter’s life and clearly stated the risks and what my wife and I might expect over the next few days. My son’s health gradually improved. Dr. Bart’s prescribed treatment worked, and, three weeks after his birth, Hunter was finally able to be brought home. Dr. Bart, a complete stranger before the ordeal, bestowed upon me the greatest gift of my life: my son. The love and admiration I feel for that man will never dissipate, but this was not an isolated event.  Thousands of times a day, all over the world, families entrust the lives of their loved ones to doctors, trusting that their physician’s ability and training will facilitate their family member’s recovery, or lessen their agony.  It is this trust that affords physicians a unique opportunity to touch the lives of people in their communities, in a way no one else can. I was oblivious to this “personal” side of medicine until the birth of my son; but after witnessing it first hand, after seeing the impact Dr. Bart had on my life, my goal of becoming a physician was solidified. 

Looking back upon the events that have transpired over the past five years of my life fosters no bitterness, and renders no regrets. I do not look upon my ex-wife with angst, for without her I would not have my son. And while her affair caused me much pain and sorrow, if it had not occurred, the opportunity to fulfill my dream would have eluded me. Also, it taught me the most important lesson of my life: never take anything for granted. With the advantage of hindsight, I see my divorce as the final chapter in a chain of events that began with the accepting of a job offer and have lead me to where I am today. I have since remarried to a beautiful and understanding wife and witnessed the miracle of my second child’s birth. And as I begin the application process to medical school, I look back upon the tumultuous path I have traveled to the crossroads I stood at in the summer of 2003. I have no regrets.