From Dr. Val:
Monday, July 6, 2009
Sunday, July 5, 2009
A neat food website
full of random articles on cooking. Enjoy.
In other news, I start my last firm of Medicine tomorrow; GI. In three more weeks, I will have a week off! I can't wait. Going 18 weeks in a row is pretty intense, not that I should be complaining, because it's all down hill from here...
In other news, I start my last firm of Medicine tomorrow; GI. In three more weeks, I will have a week off! I can't wait. Going 18 weeks in a row is pretty intense, not that I should be complaining, because it's all down hill from here...
Thursday, July 2, 2009
Wednesday, July 1, 2009
Happy Canada Day
My parents fly in today for a few days. And like the slightly befuddled moron that I sometimes am, I was convinced they were coming next week. Oh well, this week works better for me anyway. :)
And for a few those of you who are old enough to remember this era, I give you: Яolcats. Enjoy!
And for a few those of you who are old enough to remember this era, I give you: Яolcats. Enjoy!
Monday, June 29, 2009
Sunday, June 28, 2009
Friday, June 26, 2009
Check out the side menus
I've added some stuff (sorry about the adds), including a place for you to see some of my photos, and purchase copies of them if you're interested. It'll take me a while to upload the one's I want, so do keep checking back for more photos.
Thursday, June 25, 2009
Wednesday, June 24, 2009
Tuesday, June 23, 2009
Monday, June 22, 2009
Sunday, June 21, 2009
We are the dead
When I first started this blog, way back in my first semester, I wrote and even waxed poetic about my experience with the dead in anatomy lab.
And while I was a TA in anatomy lab and tutored (somewhat haphazardly) anatomy during my last semester, and even though I was around the cadavers quite a bit, I found I had made an uneasy peace with their (and my) mortality.
I find that now I am on the wards, I am having to revisit these thoughts and emotions. I have seen a patient pronounced three times now (once doing the tests; it's a little strange listening to someone's chest and hoping to NOT hear anything), been to the morgue, and broken a patient's ribs doing ultimately unsuccessful CPR.
What has struck me as a difference between the anatomy lab and the hospital is the business-like approach. When I'mtagging along behind and generally being a nuisance working with the House Officer on call, pronouncing a patient or examining them in the morgue before writing the death certificate is just one stop they have to make between putting a canula in bed 14 and writing up PRN meds for the demented lady in bed 5. In the anatomy lab, we were all a little conscious of a sense of purpose. Some of us in an over-intellectual, naval-gazing isn't-life-a-profound-journey sort of way; others with a sense of how-cool-they-were-and-what-great-orthopods-they-were-going-to-be-and-didn't-they-have-an-enormous-penis?
But on the wards, with too few nurses, and too few junior doctors, and too many patients, the sense of purpose is replaced by a sense of something I can't really define. It's not haste, or unconcern. It's not denial, or boredom. Or maybe it's a combination of all these things. It's mostly a fleeting sense that something profound has just happened tantilizingly out of our reach; a feeling of faintly gnawing dissastisfaction. One lady who my HO pronounced had been left in her room, the sheets drawn up over her thin hospital gown and a plastic rose placed on her breast (I assume by one of the nurses, or by family?). I remember feeling a mingled sense of warmth and impatience at this act of humanity; warmth that in this often terrible place someone had recognized the journey this person had been on and was marking its end, and impatience that I was being forced to confront her humanity when I didn't have time to deal with the emotional implications of what we were about to do to her. Although it's not really about not having time. It's about the demands of the evening shift that require that I don't confront her humanity in any meaningful way; a few minutes later, I will be sticking sharp metal objects into another patient, as he flinches in pain and begs me to stop. I will never forget the pain in his eyes and the warmth of his hand as I tried (and failed) to get the cannula into his vein.
I've written before about the need to maintain connected to our emotions, while not being mastered by them, and I'm still working that out now that I'm in actual contact with real patients. It's not an easy balance to strike. Susan, over at Rickety Contrivances of Doing Good writes about her interest in Narrative Medicine and how writing about their experiences allows health care professionals the space and the time to work through what they have seen and done in the name of "health care." And I suspect this is one reason I write on this blog, however infrequently. It gives me a place to try and come to terms with the emotions I am feeling. The guilt especially.
I feel guilt fortorturing performing CPR on the patient whose heart had stopped beating. I feel guilt for feeling a smug sense of satisfaction that I got to do CPR on an actual patient while most of my colleagues haven't gotten past Annie, and for being the keener who stayed late to do it. And I feel guilt for the high fives and back-slapping (and the sense of pleasure and belonging) that came from my colleagues with my admission of breaking a rib. I feel guilt for poking needles into people who are already in pain, knowing that in my inexperience I will probably miss their vein; all in the pursuit of more experience. I feel guilt for my inexperience and lack of knowledge, and I feel like a fraud when I stammer some plattitude to a relative or patient because I don't have any answers or the courage to give those answers I do have.
I feel enormous guilt for the patient, who in the intimacy of my taking blood from him whispered to me, "Tell me the truth, doctor, am I going to make it?" And I, who had only seen him once on rounds and only knew about his history of poor self-care, could only mutter something about not really knowing his case and not being sure. If only. If only I had cared enough to check on how he was doing before I'd headed blithely into his room to take his blood, if only...but then we were off again to write up those meds for the demented lady in bed 5, who was getting increasingly more agitated.
I feel guilt for my impatience when confronted with death and a white plastic rose.
After we had performed the indignities of death certification and replaced the sheet over the thin hospital gown, I put the rose back on her chest. It was the only thing I could do for her.
And while I was a TA in anatomy lab and tutored (somewhat haphazardly) anatomy during my last semester, and even though I was around the cadavers quite a bit, I found I had made an uneasy peace with their (and my) mortality.
I find that now I am on the wards, I am having to revisit these thoughts and emotions. I have seen a patient pronounced three times now (once doing the tests; it's a little strange listening to someone's chest and hoping to NOT hear anything), been to the morgue, and broken a patient's ribs doing ultimately unsuccessful CPR.
What has struck me as a difference between the anatomy lab and the hospital is the business-like approach. When I'm
But on the wards, with too few nurses, and too few junior doctors, and too many patients, the sense of purpose is replaced by a sense of something I can't really define. It's not haste, or unconcern. It's not denial, or boredom. Or maybe it's a combination of all these things. It's mostly a fleeting sense that something profound has just happened tantilizingly out of our reach; a feeling of faintly gnawing dissastisfaction. One lady who my HO pronounced had been left in her room, the sheets drawn up over her thin hospital gown and a plastic rose placed on her breast (I assume by one of the nurses, or by family?). I remember feeling a mingled sense of warmth and impatience at this act of humanity; warmth that in this often terrible place someone had recognized the journey this person had been on and was marking its end, and impatience that I was being forced to confront her humanity when I didn't have time to deal with the emotional implications of what we were about to do to her. Although it's not really about not having time. It's about the demands of the evening shift that require that I don't confront her humanity in any meaningful way; a few minutes later, I will be sticking sharp metal objects into another patient, as he flinches in pain and begs me to stop. I will never forget the pain in his eyes and the warmth of his hand as I tried (and failed) to get the cannula into his vein.
I've written before about the need to maintain connected to our emotions, while not being mastered by them, and I'm still working that out now that I'm in actual contact with real patients. It's not an easy balance to strike. Susan, over at Rickety Contrivances of Doing Good writes about her interest in Narrative Medicine and how writing about their experiences allows health care professionals the space and the time to work through what they have seen and done in the name of "health care." And I suspect this is one reason I write on this blog, however infrequently. It gives me a place to try and come to terms with the emotions I am feeling. The guilt especially.
I feel guilt for
I feel enormous guilt for the patient, who in the intimacy of my taking blood from him whispered to me, "Tell me the truth, doctor, am I going to make it?" And I, who had only seen him once on rounds and only knew about his history of poor self-care, could only mutter something about not really knowing his case and not being sure. If only. If only I had cared enough to check on how he was doing before I'd headed blithely into his room to take his blood, if only...but then we were off again to write up those meds for the demented lady in bed 5, who was getting increasingly more agitated.
I feel guilt for my impatience when confronted with death and a white plastic rose.
After we had performed the indignities of death certification and replaced the sheet over the thin hospital gown, I put the rose back on her chest. It was the only thing I could do for her.
Saturday, June 20, 2009
"Pity is not in my repertoire"
From A Day In The Life Of An Ambulance Driver comes this very moving post that captures many of my feelings about seeing patients who choose not to care for themselves.
Two of my favorite expressions are, Life is hard, and then you die. and Suffering is optional.
It takes courage to live a good life; to make decisions that honour oneself and others. It's far easier to give in to the myth that life is supposed to be easy, and that we're supposed to be happy all the time.
But life is hard, shitty things happen, pain and disappointment happen every day, and the only power we have is how we react and the choices we make. But that's the most powerful thing of all.
Edited to correct stupid linkage error.
Two of my favorite expressions are, Life is hard, and then you die. and Suffering is optional.
It takes courage to live a good life; to make decisions that honour oneself and others. It's far easier to give in to the myth that life is supposed to be easy, and that we're supposed to be happy all the time.
But life is hard, shitty things happen, pain and disappointment happen every day, and the only power we have is how we react and the choices we make. But that's the most powerful thing of all.
Edited to correct stupid linkage error.
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