Posts tagged narrative medicine
Why Physicians Need to Write
I would argue that one cannot be a good doctor without being able to communicate one’s thoughts, knowledge, opinions, and analyses in writing.
I write for many reasons. One of them is to reflect on my day, to debrief on the moments that my colleagues and seniors impart on me. Another reason I continue to write is to keep the passion of medicine alive.
It is no secret that most of us lose our ability to empathize in third year, a year where we are exposed to the real world of medicine for the first time. We are young and impressionable and bad habits can quickly form if one is not careful. Our passion for medicine, as it turns out, is a fragile and easily corruptible entity; I try not to lose sight of that.
I write for these two reasons and many more personal ones as well. Why do you write?
First Breath
The patient was going to have a C-section.
“Let’s go see the patients together,” said the nurse. I followed, coming to the realization that it was a two-patient case; for now, we could only speak to one.
I had spent very little time in surgery beforehand. Initially, the trouble was not about knowing how to scrub - this was further down the list. Rather, the initially worry was finding my way to what I needed to do. I scurried down halls, asked directions, and walked through the same halls again.
This morning, barely past seven, I worried about keeping pace. The nursing station was gathering a crowd as nurses and doctors checked in with the morning schedule. We walked into the holding area and found an obvious match: the only patient there with a round belly, anxious but excited.
Personal Best by Atul Gawande
Dr. Atul Gawande, a endocrine surgeon, reflects on the art of coaching in this piece for the New Yorker. An excerpt:
I watched Rafael Nadal play a tournament match on the Tennis Channel. The camera flashed to his coach, and the obvious struck me as interesting: even Rafael Nadal has a coach. Nearly every élite tennis player in the world does. Professional athletes use coaches to make sure they are as good as they can be.
But doctors don’t. I’d paid to have a kid just out of college look at my serve. So why did I find it inconceivable to pay someone to come into my operating room and coach me on my surgical technique?
Within medical school, there is a very distinctive transition: we begin first in the lecture theatre and end our training in the clinical ward. Our learning switches from lecturers giving us information to coaches critiquing and assessing our performance. It is through that engagement whereupon we offer up ourselves and our work to their judgment that we learn from our mistakes, our shortcomings, and improve upon them. It is also perhaps the time often quote by my seniors as being both the most arduous but also the most rewarding years of their education.
Admittedly, part of that stems from the excitement of finally practicing medicine in a real setting. We often itch to dive into the thick of it, after years of accumulating the foundational knowledge to practice. But yet another part is perhaps the growth we know we will find ourselves in. My seniors always reflect on how much they have learned and how fast they have improved. “You’re better almost every day,” I remember one clerk said. It is an amazing time to be a student. It is an amazing time of coaching.
Though I have yet to advance that far, I look forward to the next few years of learning, and the experiences that will shape and define my growth, but the question of course remains: how do I keep up with continual learning? How do I continue to improve myself as I move through my careers? Every doctor I know spends some time reading on the latest clinical guidelines, familiarizing themselves with the latest studies, and understanding new breakthroughs in medicine. But can we do more?
Night by Tony Judt
In a deeply personal and vivid account, Tony Judt describes what it is like to live with Amyotrophic Lateral Sclerosis or Lou Gehrig’s disease, a degenerative condition of the brain and spinal cord nerve cells that control voluntary muscle movement. He delves into the toll of living with the condition and the things we take for granted during our health. As he summarizes, “there is no saving grace in being confined to an iron suit, cold and unforgiving.”
Heart Stop Beating by Jeremiah Zagar of Focus Forward Films.
Back in July of 2011, a reader asked me about my opinion on a pulseless pump. At the time, I had never heard of such a technology but was excited and intrigued. Drs. Billy Cohn and Bud Frazier saved the life of Craig Lewis with a pump design that was so far out of the box, that by all conventional metrics the patient was dead.
And yet he lives.
This is the story behind that amazing radiograph.
I have heard of it from professors and classmates but I have not read it.
As part of my new years resolution of finding some balance to my daily life, my significant other has suggested that leisure reading would be a good way for me to unwind from studying. I’m trying to get into two books at the moment, one of which is Complications: A Surgeon’s Notes on an Imperfect Science by Atul Gawande. It was one she highly recommended and so far it has been a great read.
I will give House of God a try sometime in the future. If anyone else has recommendations for books, feel free to share your suggestions with everyone below.
