Methodist Journal



The Burgeoning Field of Cardio-Oncology

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Barry H. Trachtenberg Leads Issue on Cardio-Oncology

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Heart Failure in Relation to Anthracyclines and Other Chemotherapies

Heart Failure in Relation to Tumor-Targeted Therapies and Immunotherapies

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity

Cardiovascular Toxicities of Radiation Therapy

Electrophysiologic Complications in Cancer Patients

Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment?

Future Directions in Cardio-Oncology


A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure


Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention



Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg


Onconephrology: An Evolving Field


Herbal Nephropathy


Rolling the Dice on Red Yeast Rice


Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 9, Issue 3 (2013)

Humanities Full Text


Conducting in Chaos

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Article Citation:

Jeffrey Van Eps. Conducting in Chaos. Methodist DeBakey Cardiovascular Journal: July 2013, Vol. 9, No. 3, pp. 184.

Through the generosity of Charles R. Millikan, D. Min., vice president for Spiritual Care and Values Integration, an annual award competition was established at Houston Methodist Hospital among the resident staff. To enter the writing competition, residents submitted a poem or essay of 1,000 words or less on the topic, “On Being a Doctor.” A committee of seven was selected from Houston Methodist Hospital Education Institute to establish the judging criteria and to select the winning entries. The following is the second-place winning entry; the third-place winning entry will be published in the next issue of this journal.

Jeffrey Van Eps, M.D., PGY3 General Surgery Resident


The brightness of surrounding artificial lights seems to fade a bit, and the bustling sounds that come with a busy hospital dampen as their eyes meet down the long corridor. Her little blonde curls bounce more with each step as she breaks into a run, arms outstretched and yelling, “Daddy!” Her little brother does the same as he struggles to keep pace, until they all explode in an embrace long overdue. And for a moment, all is right once again in the world. In this moment, he is not the exhausted, stressed-out junior surgical resident, and they are not toddlers deprived of their father, nor she a wife deprived of her husband. Right now, they feel whole again. Between his recent above-average work schedule and their need for both sleep and some semblance of routine, it has been 3 days since they last saw each other—and the coming days would not afford much further opportunity, as he stood on the doorstep of the dreaded Friday/Sunday call. The perfection of their reunion was suddenly rocked by reality, though, when his young daughter turned innocently to her mom and asked, “Mommy…is this where Daddy lives?” Looking to his wife, both of them caught off guard, the sting of innocent truth caused tears to begin forming in both of their eyes. They tried desperately to explain—more for themselves now than anyone—“No, Daddy has just been really busy lately trying to help the sick people, and …. he’ll be home again soon.” The two little ones were already off to something else, mesmerized by this big place, as he stood still trying to digest it all. “What have I done?” he wondered to himself aloud. But before he can think of exactly how to fix this (the knee-jerk response of all those destined for surgical disciplines), the Great Equalizer cuts life short with its repetitive chirp and buzz from its home on his hip. It is the first of many calls from the E.R. … and a life of balance slips further from his grasp.

In times like this he dreams of a simpler life, maybe as a flyfishing guide near home in the Rockies, or perhaps the family business of carpentry, or a simple plumber, stuck in a different sort of daily muck and mire. The idealistic boy who long ago started this hectic pursuit of surgical prowess after seeing true poverty and health disparities in the heart of South Africa seems but a distant memory to him in these cynical moments. If this life is indeed a calling rather than mere employment, he wonders why it must be such a struggle. He knew there would be sacrifices, but he didn’t realize that there would be times when the job at hand asked for an outright trade for the ones he holds most dear. He thinks often of his attending physician mentors, who truly defined what being a “resident” means with their work ethic and sacrifices almost beyond imagination. It is them he tries to emulate, but he fears the cost at home for his diligence in training, and he is lost in circumstances he cannot change.

These were some of my honest struggles as I began my surgical residency with two toddlers and no family within 1,000 miles. Little did I know, however, that the very ones I so worried about disappointing would be my saving grace.

I, like many of you, suffer from the deadly combination of a type A personality, happiness found only in perfection, a love for seeing something to its completion, and being my own worst critic. Countless times I’ve returned home utterly exhausted, apologizing for falling asleep mid-sentence or while playing with my kids on the floor. We exist in a symphony of chaos, waving our wand frantically as the conductor, hoping the melody is played clearly. It’s not a matter of if you will burnout, but when. Like you, I’ve watched my hobbies, several friendships, and my own health at times fall by the wayside while trying to juggle my different lives. And I would utterly fail without the people under my own roof and the faith that binds us.

I have a wife who believes in my calling to become a surgeon as much as I do, and sometimes even more. She has the courage to function essentially as a single parent and the grace to not make me feel guilty for it. She is everything I’m not—strong when I’m weak, grounded when I’m drowning in circumstance. She returns my world to balance. I don’t get to see my children every day, but when I do, I have two kids who race to greet me at the door like a rock star. I have a daughter who sweetly hums to herself while she colors. She leaves me notes stuck to my wallet, her name signed with a heart next to a stick figure drawing of us. I have a son who tells strangers that his dad is stronger than the Hulk and faster than Superman. He tells me he loves me “bigger than the whole universe” and wants only to spend time hitting baseballs in the backyard with me. I have a faith that restores my perspective when I think that I’m in total control of my life, and it gives me strength to be a physician worthy of caring for the helpless and a father worthy of leading my family. For me, balance is restored in an understanding glance from my wife, telling me I’m understood. My empty tank is refilled watching my daughter dance in her tutu, falling asleep on the couch next to them as the “big spoon,” or hearing my son’s unabashed laugh. My flailing faith is restored in a whispered prayer that I know is heard. Some look at my life and say they don’t know how I do it … but I look at it and wonder what I would do without it.