Sometimes the stars are aligned a certain way and good things happen. Sometimes they line up another way and #@$% happens. I seem to be in the latter phase right now. Among the bad things that have happened, a low point was my Monday this week. After being on call over the weekend, I assisted in an 8 hour atrial fibrillation ablation, and then proceeded with a 4 hour supraventricular tachycardia ablation that turned out to be an atrial tachycardia that was in a very difficult to ablate location. This procedure was then complicated by cardiac tamponade, which required emergency pericardiocentesis. After getting home after midnight, I then got up at 4:30 the next morning, did hospital rounds, a half day of office and then 3 procedures. At age 59 I don’t think I have quite as much energy for this sort of thing as I used to. I ended up canceling today’s office and taking the day off to recharge. After some AM coffee at Panera’s, and a run through Iroquois Park I am feeling a little bit better.
I think in general the good and bad parts of life balance out. It does seem though that bad things, like earthquakes, seem to cluster — what is known as stochastic clustering. When in one of these valleys it is difficult to look up and see the peaks above us. In doing procedures one complication can negate hundreds of good outcomes. It’s interesting that I can remember every major complication that has occurred in my patients, but I tend to forget the really good results I have had with the vast majority of procedures. I did my first EP study back in Philadelphia in 1979. If you believe in the 10,000 hour rule of proficiency then I can certainly consider myself an expert in Cardiac Electrophysiology. But the Law of Averages (it’s not just a Good Idea, it’s the Law!) is not to be denied, and sometimes there is Trouble in River City (with a capital T). If it is tough for me, who has been doing this for a long time, to withstand adversity, I know it is even harder for someone just starting out in the field. So I offer this advice for the younger generation of electrophysiologists: Stop, Take a deep breath, Do something non-medical, Turn off your cellphone/pager, and Move on. It will get better. Time heals all wounds.