Courtney Bercan is community health nurse at a clinic in the Downtown Eastside of Vancouver
Years later, I still don’t want to think about it, let alone type it out. Three children, babies practically, dead before me. Their parents, dead beside them.
It has now been two years since I was on a Doctors Without Borders search and rescue vessel in the Mediterranean and it’s been a slow path, at times, to finding healing and peace for the things I saw and experienced there. As my life settled into a predictable rhythm, the memories started coming out of the blue and with intensity. They demanded attention. Normally, in Canada, the process of finding closure for a patient’s death, while not always easy, is not usually this difficult. There are mitigating thoughts and phrases to help you along the way:
Sarah Tulk is a family physician in Hamilton, Ontario
Despite earnestly advocating for physician mental health, my own story has remained cloaked in secrecy. As a medical student, I felt far too junior to risk such a revelation. I watched as stigma, perpetuated by the hidden curriculum, kept my peers from seeking mental health care. Still, I kept my head tucked safely in the sand, and swore to break my silence in residency. However, as a resident the fear of jeopardizing job prospects maintained my mutism. I vowed to speak up when I was staff. Unfortunately, early in my staff career my advocacy efforts were smothered by fierce judgment and harsh consequences. I wholeheartedly renewed my vows with the ostrich approach and reconciled to start talking about mental health when I was protected by more seniority. I hated the secrecy and hypocrisy, but at least I was safe. Then I heard of another resident suicide. Then a medical student. Another resident. A staff physician. ...continue reading →
Sarina Lalla is a medical student in the Class of 2020 at McMaster University
When McMaster medical students learn about medical conditions in a problem-based setting, we frequently use the mnemonic “DEEPICT” (Definition, Epidemiology, Etiology, Prognosis, Investigations, Clinical presentations, Treatment) to approach them. Medical schools focus on teaching students about these important aspects of diseases; with time and practice, this information can be retained and applied by students to make them better clinicians.
However, there is also value in understanding a disease through the eyes of patients. More specifically, it is critical to recognize how facing an illness and navigating the healthcare system impacts their lives. Patients are the experts on their own experiences, and the knowledge they can present in the form of stories can teach us a lot. While we learn how to interpret information in the form of bloodwork and imaging, patients present first and foremost with a story. ...continue reading →
Prasham Dave is a medical student in the Class of 2018 at the University of Ottawa
Sunken eyes my burden and a blazing smile my shield,
My patient burned under baleful fluorescence—purified en blanc.
My breaths were shallow. His shallower still.
I was haggard and he was in shambles,
I was shuffling and he was frozen,
I was ash and he was a husk. ...continue reading →
“Medical professionals concentrate on repair of health, not sustenance of the soul”.
Atul Gawande’s recently published book, Being Mortal, discusses the treatment of our elderly population and the various flaws of our health care system. One important point from the book is that health care providers such as physicians and nurses are too focused on physical well-being while forgetting about the less tangible necessities of life.
When an elderly individual is sent to a nursing home, safety is the highest priority. Residents are provided with call bells, ramps, elevators, nurses, and physicians who come directly to their rooms. This seems beneficial, as physical health is maintained. With 24 hour nursing surveillance and living in single rooms, residents are less prone to injuring themselves. It is a situation that seems optimal for both the caregivers and seniors. Why, then, is the rate of depression and sadness so high among the elderly population in nursing homes?
I’m tired. I’ve worked just under 17 hours today, but I can’t sleep.
Too bad. I will start at 8 am again tomorrow for another 8 to 9 hour day.
I can’t sleep because I’m thinking about my patient with the declining oxygen saturation. I worry that I may have missed something in the history, in the investigations… did the on call physician and I make the right decision?
Upon being accepted to medical school in 2012, I received a special edition of “Oh, the Places You’ll Go” from a personal mentor; reminding me to not just look ahead, but to remember and cherish the distant memories that shape who we are. I recently stumbled upon this memorabilia when I returned home over the March Break, and sat down to write this poem.
Jonathan Tomlinson is a general practitioner in London, UK, and a NIHR In Practice Research Fellow at the Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry
Kate Granger, a young doctor with cancer, recently wrote a book called 'The Other side'. It's a book for doctors ‘to be better able to understand exactly what being the patient is really like …” Other medical writers have also been motivated by the shocking realisation that medical education and clinical practice had taught them so little about what it’s like to be a patient, the particular problems that doctors themselves have in coping with illness and the health risks associated with their profession; loss of identity, shame and stigma, the need to be treated as a person and an acute awareness of mistakes were common themes of narratives.
Inspired by their stories, I have been leading teaching seminars with medical students, GP trainees, GP trainers, GP retainers, medical humanities students and the public and learned a few more lessons along the way.
“We just don't know.” It's not exactly what most people want to hear from medicine's top minds. We want our healers to be certain. And with rapid improvements in genetic research, Big Data, diagnostic imaging, and personalized, predictive medicine, there's more information than ever about what makes us tick.
“We've made stunning progress,” Dr. Elizabeth Nabel, former director of the US National Heart, Lung and Blood Institute, told participants at #TEDMED2014 yesterday. “But the simple truth is what we have is not knowledge; it's information that is going to morph and shift into something else next week, next year or in 50 years.”
The more we know, the more we should realize the limits of what we know, she said. “We are desperately in the dark about how most things work. Humility is the secret ingredient that unveils truth and brings about change.”