I thought I had a low-pressure, fun New Year’s intention: the idea of going slowly through the alphabet and posting reflections on a new letter every two weeks or so.

Leave it to me to get stuck on D.

I’ve spent the better part of seven weeks on desperation, distress, desolation, devastation, and my personal favorite, dysanapsis ( a word which tries to describe part of the difficulty in bronchopulmonary dysplasia, one of our common NICU problems.)  “Dysnapsis” comes from “bad, malicious, hard” and “fastening, hanging”. The word specifically refers to “physical incongruence between growth of lung parenchyma and airway caliber”: in short, airways that don’t keep up with the lung tissue, growth-wise, and so can’t deliver enough breath. Lungs with dysanapsis are literally badly fastened, under-branched, poorly hung in the chest cavity.  The small, floppy airways don’t stay open long enough to let breath in and out; the air gets trapped in the lung tissue, over-expanding some areas while others collapse. Managing ventilators for babies with BPD is a challenge; the settings we used in the first few weeks to keep premature babies alive don’t help any more in the subsequent months as they and their lungs are trying to grow.  

Being stuck on a blog post isn’t at all like being stuck on a ventilator. But both of these situations take more patience than I can muster up on my own. 

I want to move on to delight.   But the connection isn’t there. There’s a gap that I can’t bridge on my own. 

Different is another ”D” word.  And doctor and distance.  And dictionary.  

More often than not, I feel as though there’s something terribly wrong with me for dwelling in dictionaries when I’m supposed to be devoted to being a doctor. And also as though there’s something wrong with the distance that seems to be demanded (or expected) in surviving while practicing medicine.  We’ve been disciplined to be detached, to decree diagnoses and then depart.  But rather than distancing us from disease and death, that detachment definitely feeds the desperation and devastation. 

Thanks be to God Who seeks and establishes connection.  And brings His breath and life — and delight — into our deadness. 

If this is an abrupt end and an incomplete argument, so be it.  I’m done!