Giuliana Guarna is a medical student in the Class of 2019 at McMaster University
I pulled back the large door and stepped into the room. It was early in the morning — just after 6 am. She was lying in bed, awake, with a smile on her face despite the fact that she was post-op. The evidence of surviving rounds of chemo were borne out in front of me. Her hair was peach fuzz, peeking through a silk turban wrapped around her head. Her cheeks were like little Timbits, but her frame was swallowed by her hospital gown.
“Oh, hi. Come in. Let me turn on the light.”
I walk to the foot of the bed. The sun had not yet peeked out from under the shades. The room was illuminated by a yellowish-white hospital glow as she pressed the switch.
The 10th annual White Coat Warm heART exhibit, which celebrates and showcases the creative talents of medical trainees and practitioners from across Canada, will be held in conjunction with the Canadian Conference on Medical education (CCME) in Niagara Falls from April 13th to 16th, 2019.
Submission is via teachingmedicine.com — in order to have your art considered by the jury, you must register (it's free!) Entries can include, oils, watercolours, photographs, pastels, etchings, pen and ink, etc. Limited space will also be available for the display of small sculptures.
The deadline for submission is Sunday, January 27th by 5 PM PST.
Serena Arora is a medical student in the Class of 2019 at McMaster University
I love puzzles.
I love looking at the picture on the box, seeing what the completed version will look like and then pouring out all the little pieces — knowing that, somehow, they all come together to create something.
In some ways, practicing medicine is like doing a puzzle. It’s complex, intersecting, and incredibly rewarding when done right. At the same time, medicine is fractured into a thousand different components. As physicians, we look at our patients and we piece them apart into organs and body systems and tissues. We rip the details we think are important from the fabric of their narrative to focus on specific complaints. We take their words and distill them into our jargon, often so much so that their original story would be unrecognizable. Medicine is often an act of reductionism.
Once an elastic band is stretched beyond its limits, it is difficult for it to return it to its unstretched state. Burnout represents a similar phenomenon: an erosion of one’s sense of self and a reflection of emotional over-exhaustion, leading to disinvestment and depersonalization. Years of intensive training, long working hours, increased managerial responsibilities, resource limitations, emotionally-involved patient and family encounters, fear of limited job prospects and litigation, and mounting clinical and non-clinical responsibilities, among other demands: physicians and other health care professionals represent a highly vulnerable group susceptible to burnout, with some estimates suggesting close to 50% of physicians being affected. Evidence suggests that physicians experiencing burnout are more likely to make poor medical decisions, share more tenuous relationships with co-workers, experience more individual and personal relationship challenges, and suffer higher risks of anxiety, depression, and suicidality. Physician burnout has also been associated with differences in overall quality of care, system-level costs, and rates of staff turnover and absenteeism.
This piece focuses on the compromise some residents and physicians make in placing themselves second while dedicating themselves to the care of others, and the silence that some encounter while struggling with burnout. It is encouraging to observe that dialogue around burnout and mental health is growing at individual, institutional, and systemic levels over time. This piece is part of that conversation....continue reading →
Matthew Lee is a medical student in the Class of 2019 at Dalhousie University
I was totally unsure. Meeting a patient who knows they are going to die... wouldn’t it be intrusive, at the end? A student coming into your life: asking questions, getting signatures, asking you to share your precious time. In the same position, I don’t know if I would say yes. That thought makes me feel a bit uncomfortable. Checking in on the floor, with information hurriedly scribbled into the margins of a notebook. A brief run-in with her mother in the crowded room, then twenty minutes spent in the hallway — trying not to be obtrusive while staff hurry by. There are visitors every day, and I doubt I looked out of place.
In some ways, I chose to take on this project in order to become more comfortable with death. It’s something I have faced before, and it took years to move past my friend dying from lymphoma. He quickly stepped away to take a phone call at our convocation. It was a biopsy result. Nearly six months to the day and it was all over. It took nearly everything I had. ...continue reading →
Shubham Shan is a medical student in the Class of 2019 at the University of Toronto
She arrived on an inclined stretcher, grasping her Venturi mask like a child holding on to her favourite toy. Flanked on both sides by paramedics, her eyes were splinted wide open by shock and her chest heaved up and down rapidly. She was a queer shade of purple — like spoilt red wine diluted with water — and her gaze flitted around the emergency department as if looking for someone familiar. The paramedics passed her off to the doctor then left, shaking their heads. I remember watching the doctor take the patient’s puffers. The patient swore loudly and snatched them from his hands; first the orange, then the blue. She cocked the puffers like guns, inserted them into her mouth, shot the mist deep, and inhaled. She coughed for what seemed like an eternity. She was what we called a “blue bloater.”
When I saw her again, she was lying on a tattered mattress with bright blue sheets in a freshly bleached acute care room in the emergency department. Her condition had gotten much worse. Her abdomen caved in paradoxically whenever she breathed in. Her eyes were bloodshot. Every time she exhaled, it sounded like an infant's rattle. ...continue reading →
Beatrice Preti is an Internal Medicine Resident (R2) at Queen's University
The list is long, but I know your name
Each day before, its spot was the same
Second from the top, the second room on the right
The one with three windows and a broken bathroom light
But today something’s different; the list I have’s bare
I looked for your name, but it wasn’t there
Something has happened, and, in my heart, I know
That though I fought to keep you here, you found a way to go ...continue reading →
"First of all," he said, "if you can learn a simple trick, Scout, you'll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view […] until you climb into his skin and walk around in it." — Harper Lee,To Kill a Mockingbird
This piece reflects a daughter’s internal struggle as she comes to terms with her mother’s suffering through delirium and terminal illness. Touching on the sensitive balance between seeking care and doing no harm, this piece provides an intimate perspective on the challenges many family members encounter in letting go of their loved ones during trying times of declining health, as well as on the difficulties involved in recognizing that ‘more’ is not always better — that, sometimes, less is more....continue reading →
Rebecca Lauwers is a medical student in the Class of 2019 at McMaster University
Empathy as invited, first. Still it knocks. Waits. Empathy sees the fogged glass but drags no fingertip across it. There is a grey field; can you, too, see suffering like a red coat in the distance, walking? Do not go charging. What is imposed is not empathy. Set the kettle on the stove. Stoke the fire.
Empathy as unattached. As tracking a runaway bride, who knows what it’s like to be in one moment Ready and the next hijacked by fear. Empathy as the lover who will follow anywhere... yet as fluid as the crowd that will part to allow for what must happen. Empathy as the veil acknowledging the ground it grazes, feeling out the terrain as it follows.
Empathy as seeing it all, somehow, at once. Guided by someone whose vision will narrow and widen and narrow, and — somehow — letting each momentary glimpse be the only thing it sees while watching still over shoulders, overhead. ...continue reading →