A Dream: Small Boat in a Gale

I am in a place like Ketchikan, but unlike the Gastineau Channel, this inside passage has access to the open sea. I am in a skiff on the channel, and a strong wind is blowing, waves are big. I am worried about losing control of the boat, trying to steady my mind and my hand to be firm on the rudder, but I realize that even with the engine at full throttle running into the wind, I am being blown backward, downwind, up the channel. I am afraid and realize my boat doesn’t have the power for this. I wonder if there is a port, someplace I can nip in and get shelter. I successfully dock the boat in a tiny harbor even though it’s still pretty rough seas there. Then I am back at the main port where two surgeons, one a man I have worked for and the other a woman I have mentored, are in rain gear on the deck of a much larger fishing boat than the boat I was on. The wind is blowing the rain sideways, and the big chop of the waves is churning the fishing boat. These two people are fishing for a living in the dream, not being doctors. They are also very seasick. Every few minutes they run to the side of the deck to throw up over the railing and then return to their work, to the next fishing task—tending the lines or nets. They are methodical and persistent. This is just part of the arduous work—struggle with the conditions (the “weather”), do the work, throw up. It is a harder day but not unusual at all. Back and forth. I am standing on the dock and call out to the man that I found the wind too strong for the boat I was in and that I hope it’s secure in the tiny port I managed to get into. He calls back that a boat has never been blown out to sea from here and he doesn’t think there’s reason for alarm. But I know the boat was pushed backward despite running at full throttle. Even so, his words reassure me somewhat that the boat is unlikely to tear loose its mooring in the port or be damaged by crashing against the dock. I go to check the boat in the little harbor, and it’s still there, snug and undamaged. It hasn’t been torn free and been carried out to sea.

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Beyond Dishabituation: Dealing with Moral Distress in Medicine, Elusive Alignment

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Dishabituation to Healthcare’s New “Normal”