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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?
The Biopsy: Medical School Essay Edits
I was recently contacted by Roheet from the Biopsy. A prospective medical student who has been maintaining a beautiful blog that reflects on the process of medicine in the digital age, he is offering to help anyone who is applying to medicine with reviewing their personal essays.
The deadline for submissions is May 20th, 2013. Submit here.
Many thanks to Roheet for his kindness and generosity in offering this service to other student hopefuls.
The Impossible Workload for Doctors in Training
I remember reading about these new regulations when I was in first year. It was all that everyone could talk about: the days will be better.
Being exposed to clinical teaching this year, I can tell you that this restriction often times exists as a formality on paper only. By mandate of the university, we are only supposed to work up sixteen hours excluding call shifts. At that point, we are mandated to work only until handover and latest until noon.
I can count on one hand how often I have gone by the rules. I have almost always worked the whole day following call. Thirty-plus-hour days are not uncommon. Partly, the issue is one of manpower to meet the requirements and objectives of a day; partly, it is still the expectation of the team that you do not clock out until the job is done.
Is restricting the hours the solution? It would appear not. However, we struggle to find the answer. No one denies that it is unhealthy and the outcomes suffer, but simply restricting hours is most definitely not the solution.
I Do Not Fear Death by Roger Ebert
“I will pass away sooner than most people who read this, but that doesn’t shake my sense of wonder and joy.”
The essay is from Roger Ebert’s Life Itself: A Memoir and was published to Salon as a memorial of sorts for a recently deceased critic and friend. It is a beautifully written essay about that final threshold to which we all find at the end of our days.
Visualizing Birth and Death
Hospitals are the crossroads to life and death.
In three short months, I have seen my share of new lives start on this earth and seen a few of the patients I have worked with pass into memory. The cycle of life is conveyed through these two intertwined moments. Enter stage left. Exit stage right.
The following link simulates the births and deaths in the United States in real time. Where one life ends, another begins.
Beautiful Cervix Project
One of the residents I did call with told me about this website she had come across that might be of use to me, given my string of patient refusals. The Beautiful Cervix Project describes itself as a grassroots movement celebrating the beauty and intricacies of women’s bodies and fertility.
The centrepiece of the website, that which the resident thought I could use as a resource was the gallery, a small collection of both normal and abnormal cervixes on speculum exam. (Not safe for work)
For the female readers of this blog who might be curious or interested in what it is that we inspect and examine during these exams, you might learn from this website as well.
Or maybe it is just too much information.
Life, Interrupted: Five Days of Chemo
“Every month, I go to the hospital to receive outpatient chemotherapy injections for five days in a row. My doctors say this will be my routine for the next year.”
I remember when my father underwent chemotherapy. “Experimental combination,” the oncologist would say. The cancer was aggressive and advanced. A standard treatment protocol was out of consideration. There was not much they could do about his mets, but they were hopeful that chemo would prolong his life beyond the months they could foresee.
Sadly, that never came to pass, but what did pass was the terrible after effects of chemotherapy. My father was a strong man, and even in his last days following chemo, the misery of it was plainly obvious. It is such a strange and horrible dilemma to suffer at the hands of either cancer unchecked or of the potent and toxic chemo.
To not have undergone chemo would have most likely made his last days easier, but then again, at that point, we were willing to take any chance.
Follow the link to read the first person account of Suleika Jaouad as she writes about her experiences as a young adult with cancer in the series: Life, Interrupted.
The Bullying Culture of Medical School
Powerfully built and with the face of a boxer, he cast a bone-chilling shadow wherever he went in the hospital.
At least that is what my medical school classmates and I thought whenever we passed by a certain resident, or doctor-in-training, just a few years older than we were.
This is an unspoken truth of medical school. While there are great teachers and role models everywhere, there are too few of them to shift the entrenched culture of medical education on their own.
Even as the expectations mounted leading up to third year, there was a growing sense of urgency for me to meet the challenge. Certainly, growing thick skin is part of learning. Mistakes happen and accepting them and learning from them is a part of the process. Having said that, there are limits.
And those limits can be crossed.
I have heard my fair share of third year horror stories over the last two years involving verbal and physical abuses. While I have no doubt that the staff and team I will be working with are excellent teachers, I am cautiously aware that I might hear and see more in the coming year. From berating to ‘sterile slaps,’ the culture of teaching is a vicious cycle, where the good in people is eroded away. If we are to continue like this in this modern age, what legacy will we leave for a new generation of doctors?
Perhaps as much as we focus on changing the paternalism of medicine to become more patient-centred, maybe it is time for us to work towards a better environment for healthy learning.
Medical Student Problems by Lakshmi Krishnan
I lost my pager a few weeks ago…Imagine a flamingo without the pink, an elephant without its trunk, or a toilet without toilet paper. That’s a medical student without its pager.
At first, I was resigned. I informed all and sundry, “dude, I lost my pager.” At first, it was refreshing. But soon, I became persona non grata on my team… the annoying person who had to be contacted through email or patchy 4G. I felt like a puppy without a leash.
The Moments That Define the Job of a Physician
Written by Allison Overmon, a medical student.
One of the most intense moments of my third-year of medical school was during my internal medicine clerkship when a code blue was called.
It was our responsibility as medical students on the inpatient service to report to every code blue while we were on our calls every 4th night. This time was no different, and my call partner and I ran to the code. When we arrived, I recognized the patient as someone I had admitted a few days prior myself. I witnessed my team of residents running the code with a cardiologist supervising, The designated ICU resident was ordering epinephrine, the patient was being defibrillated, and no matter what was tried, our patient wasn’t coming back. Aggressive chest compressions had been ongoing and were still continuing.
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