Sunday, February 22, 2009
M Fact - Cretinism
The term "cretin" may etymologically stem from the meaning Christ-like, indicating that these individuals are so severely mentally impaired that they are unable to sin.
Friday, January 16, 2009
Help cope.
In learning the art and science of medicine, we are privileged with countless "Aha!" moments - when embryology explains a congenital defect, when etymology helps decipher conditions and anatomy, when biochemistry demystifies the symptoms of a disease.
But, with each "Eureka!" comes at least as many "You’ve got to be kidding me’s" and "Oh no’s.”
Today’s was: "I have to bisect and clean the rectum in order to dismember my cadaver? You have got to be kidding." After a momentary freak out, I suppressed my gag reflex, came back to my tank, told myself to suck it up and got the job done. Yuck!
Last week it was worse. It was an "Oh no."
I’m sure many of you saw Barbara Walters' interview with Patrick Swayze, who was diagnosed with pancreatic cancer, the same terrible disease that killed the man whose body I’ve learned so much from this year. This is one disease I have seen with my own eyes, and the understanding that comes with seeing something so destructive first hand is incredible heavy.
As Swayze spoke of hope, my heart sunk, and so many questions rushed to mind. Does he understand how pernicious, rapid and incurable this disease is? Does he know how advanced it must be to be diagnosed? Does his family? Does he really think there will be a cure before his time is up?
I recalled the sutures throughout my cadaver’s abdomen combining portions of the bowel that were never meant to be together, his cirrhotic liver, the cancer’s penetration of organ after organ, and I imagined the pain he must have endured. For the first time in my life, I felt that hope was a waste. I momentarily equated hope with denial.
Then I caught myself. My perspective was perfectly incorrect.
The future looks grim for him, however, right now, Patrick Swayze is alive. And, I realize now that the extent of his medical understanding may be irrelevant, especially if hope is driving him to really live the rest of his life.
In a terminal case a physician’s role is to help manage pain and disease progression, to provide support and to maintain quality of the patient’s life to the best of their means. Yes, physicians must deliver the truth to patients and their loved ones, but that does not mean we should be a constant negative reminder of impending doom.
But, with each "Eureka!" comes at least as many "You’ve got to be kidding me’s" and "Oh no’s.”
Today’s was: "I have to bisect and clean the rectum in order to dismember my cadaver? You have got to be kidding." After a momentary freak out, I suppressed my gag reflex, came back to my tank, told myself to suck it up and got the job done. Yuck!
Last week it was worse. It was an "Oh no."
I’m sure many of you saw Barbara Walters' interview with Patrick Swayze, who was diagnosed with pancreatic cancer, the same terrible disease that killed the man whose body I’ve learned so much from this year. This is one disease I have seen with my own eyes, and the understanding that comes with seeing something so destructive first hand is incredible heavy.
As Swayze spoke of hope, my heart sunk, and so many questions rushed to mind. Does he understand how pernicious, rapid and incurable this disease is? Does he know how advanced it must be to be diagnosed? Does his family? Does he really think there will be a cure before his time is up?
I recalled the sutures throughout my cadaver’s abdomen combining portions of the bowel that were never meant to be together, his cirrhotic liver, the cancer’s penetration of organ after organ, and I imagined the pain he must have endured. For the first time in my life, I felt that hope was a waste. I momentarily equated hope with denial.
Then I caught myself. My perspective was perfectly incorrect.
The future looks grim for him, however, right now, Patrick Swayze is alive. And, I realize now that the extent of his medical understanding may be irrelevant, especially if hope is driving him to really live the rest of his life.
In a terminal case a physician’s role is to help manage pain and disease progression, to provide support and to maintain quality of the patient’s life to the best of their means. Yes, physicians must deliver the truth to patients and their loved ones, but that does not mean we should be a constant negative reminder of impending doom.
Thursday, December 4, 2008
Personify.
11:06 PM me: umm hi
Rebecca: hiiii
me: how do you feel about the kidney?
Rebecca: ummm not that great.
11:07 PM me: i know...i'm kinda mad at her
it has to be a her
Rebecca: its a her
me: b/c it is so smart
Rebecca: yeah
me: and adjusts
Rebecca: "if you were an organ, you'd be the kidney"
i actually love that analogy!
so true!
11:08 PMRebecca: and you have to be really careful
i mean, she's really strong but also really sensitive!
me: yea
she is
Rebecca: and she's ALWAYS taking care of EVERY OTHER ORGAN, making sure they have osmolites
me: and she is better as a pair but does just fine on her own
11:09 PM Rebecca: if it weren't for her, none of the other organs would even be there. but do they EVER thank her? no
me: of course not, but she keeps on trucking
and saves the day every time
Sunday, November 23, 2008
Educate.
Today I, along with a group of first and second year medical students, set up a free diabetes screening booth at a nearby Wal-Mart. The constant stream of people coming to us, willingly getting themselves pricked on a leisurely Sunday afternoon shopping trip, was heartwarming. I realized that these individuals are curious about health and truly want to maintain their own and their family’s as they listened intently to advice on healthy lifestyle changes and took information on diabetes and regular doctor’s visits seriously.
While uplifting, their receptiveness was saddening. It demonstrated that their lack of education about a disease so prevalent and destructive, especially in the Hispanic population, was not their fault. It was because nobody had taught them.
Ignorance is not a choice for most. Our privileged lives with education at our fingertips (literally, how hard is it to type “diabetes” into Wikipedia?), oftentimes makes us forget that our world is not the whole world. This discrepancy can lead us to blame others for their plight instead of understanding the disparities in healthcare and education.
As we grow and excel in our careers we should never take our abilities and facilities for granted. They are not deserved. Instead they are opportunities to make a difference in the lives of others by being the bridge between our worlds.
While uplifting, their receptiveness was saddening. It demonstrated that their lack of education about a disease so prevalent and destructive, especially in the Hispanic population, was not their fault. It was because nobody had taught them.
Ignorance is not a choice for most. Our privileged lives with education at our fingertips (literally, how hard is it to type “diabetes” into Wikipedia?), oftentimes makes us forget that our world is not the whole world. This discrepancy can lead us to blame others for their plight instead of understanding the disparities in healthcare and education.
As we grow and excel in our careers we should never take our abilities and facilities for granted. They are not deserved. Instead they are opportunities to make a difference in the lives of others by being the bridge between our worlds.
Tuesday, October 21, 2008
Battle burnout.
With a dozen medical school exams under my belt barely three months into school, I suffered the same fate as many of my classmates who have been treading hard to stay afloat - BURNOUT.
After exams I took a week off from school. And myself.
Relaxing getaway? Not so much.
A few days into my “vacation,” I noticed I was neither acting nor feeling like myself. I was cranky, lazy and my normal enthusiasm for life was dampened. I was accomplishing nothing.
I realized that I thrive on personal and academic discipline, organization and routine. Doing, excelling, working – these are the things that make me feel good about myself and excited about what each day may bring.
Clearly, I needed to find an alternate therapy for academic burnout.
I re-read my personal statement where I say, “Healing as a physician is a threefold process involving knowledge, medical care and emotional support.…and I’m inspired to pursue this process further with a career in medicine.”
My own words motivated me to get out from under biochemistry and to reconnect with why I am here.
Today I met with a professor of anesthesiology to discuss my career aspirations, and he gave me advice, told me I could shadow in the OR and set me up with a mentor. I also attended a workshop where I learned suturing techniques and methods to obtain samples for biopsy. On Thursday, I get to see the heart. Next week I’m going to an intubation workshop.
I’m not seeing patients yet, but now I remember that I will.
I’m re-inspired to prepare myself.
After exams I took a week off from school. And myself.
Relaxing getaway? Not so much.
A few days into my “vacation,” I noticed I was neither acting nor feeling like myself. I was cranky, lazy and my normal enthusiasm for life was dampened. I was accomplishing nothing.
I realized that I thrive on personal and academic discipline, organization and routine. Doing, excelling, working – these are the things that make me feel good about myself and excited about what each day may bring.
Clearly, I needed to find an alternate therapy for academic burnout.
I re-read my personal statement where I say, “Healing as a physician is a threefold process involving knowledge, medical care and emotional support.…and I’m inspired to pursue this process further with a career in medicine.”
My own words motivated me to get out from under biochemistry and to reconnect with why I am here.
Today I met with a professor of anesthesiology to discuss my career aspirations, and he gave me advice, told me I could shadow in the OR and set me up with a mentor. I also attended a workshop where I learned suturing techniques and methods to obtain samples for biopsy. On Thursday, I get to see the heart. Next week I’m going to an intubation workshop.
I’m not seeing patients yet, but now I remember that I will.
I’m re-inspired to prepare myself.
Wednesday, September 10, 2008
Trust yourself.
My life, blessed with a myriad of opportunities and an incredible support system, devoid of failure and hardship, has delayed my introspection on personal limitations until, well, now. I’m just learning the fact that I will not be good at everything, or even be interested in everything. I cannot help everyone. My greatest effort may not always be enough. And, even I (gasp!) can be wrong.
Alas, I’m a member of this human race.
With an increasingly demanding academic world and exposure to more and more individuals with varied perspectives, I have learned that accepting myself - strengths, weaknesses, preferences, values and all - will be and should be important to each of my decisions, personal and professional. More than anyone else, I must believe that the choices I make are the right ones, because my conscience is the greatest bearer of their consequences.
Self-acceptance does not mean giving in to failure. In fact, to me, it means just the opposite – it means playing up your strengths. Contradictory to what I’ve believed for so long, letting go does not equal giving up. It means moving forward with a new approach and perspective. It means trusting yourself.
Alas, I’m a member of this human race.
With an increasingly demanding academic world and exposure to more and more individuals with varied perspectives, I have learned that accepting myself - strengths, weaknesses, preferences, values and all - will be and should be important to each of my decisions, personal and professional. More than anyone else, I must believe that the choices I make are the right ones, because my conscience is the greatest bearer of their consequences.
Self-acceptance does not mean giving in to failure. In fact, to me, it means just the opposite – it means playing up your strengths. Contradictory to what I’ve believed for so long, letting go does not equal giving up. It means moving forward with a new approach and perspective. It means trusting yourself.
Tuesday, August 5, 2008
The human body is complex.
And, as I found today, the body can invoke complex emotions. Today was my second anatomy lab, and surprisingly it went much less smoothly than the first. I suppose I was feeling especially human, or maybe my cadaver was, because today we were connected. This connection forced my mind to scream with every contact of the scalpel and each hammering of the chisel.
I have no doubt that in future labs I will be able to disconnect myself and keep my emotional response at bay, but I hope that I will never completely lose this sensitivity that comes with the naivety of being a beginner medical student. Remembering that “our cadavers” belonged to individuals brave enough and selfless enough to concretely teach us about the human body should teach us a lesson about respect not only for the dead, but also for the living.
If we can connect with a nonliving human, making a connection to a living patient should be easy. I think this human connection with our patients will make us more compassionate, caring, sensitive, thorough doctors who can keep from viewing common ailments as monotonous and who remember that each patient is a whole human being more than merely a disease.
In the words of Dr. Francis W. Peabody in his lecture, The Care of the Patient, “The secret of the care of the patient is caring for the patient.” Let’s practice on our cadavers.
I have no doubt that in future labs I will be able to disconnect myself and keep my emotional response at bay, but I hope that I will never completely lose this sensitivity that comes with the naivety of being a beginner medical student. Remembering that “our cadavers” belonged to individuals brave enough and selfless enough to concretely teach us about the human body should teach us a lesson about respect not only for the dead, but also for the living.
If we can connect with a nonliving human, making a connection to a living patient should be easy. I think this human connection with our patients will make us more compassionate, caring, sensitive, thorough doctors who can keep from viewing common ailments as monotonous and who remember that each patient is a whole human being more than merely a disease.
In the words of Dr. Francis W. Peabody in his lecture, The Care of the Patient, “The secret of the care of the patient is caring for the patient.” Let’s practice on our cadavers.
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