Sahil Sharma is a medical student in the Class of 2020 at Western University
It was my first week on service for internal medicine as a third-year clerk. I had finally begun to figure out the labyrinth of charts, forms, and computer apps that went into my interactions with patients. I still had four of the eight pens I’d started with and had managed to misplace my sacred “pocket guide” only twice — so, all in all, I was off to a good start.
I was told by my senior to go see a patient who was in ICU step-down and had recently been transferred to our care. I hurriedly went to the computers and started reading up on the patient’s history.
Mr. C had a long and complicated history. He had initially presented to the hospital with signs of cholecystitis but later developed multiple complications landing him in the ICU. After a flurry of resuscitative measures and close monitoring, Mr. C was finally deemed stable enough to be transferred to the ward. ...continue reading →
Shaun Mehta is an Emergency Medicine Resident (R4) at the University of Toronto
In elementary school, I always dreaded bringing my report card home. My grades were good, but the teachers’ comments that followed could go either way — and were unfortunately of much more interest to my parents. I was often described as “disruptive,” and it seemed that relinquishing this quality was the key to making something of myself.
Two decades later, I’m finding out that being disruptive is one of my most valuable assets.
To clarify, we probably shouldn’t praise students for being disruptive in the classroom. But outside of the classroom... now, that’s an entirely different story. The health care industry is ripe for disruption; strapped for cash and bursting at the seams, we need better ways to manage today’s volume and complexity of patients. Forward-looking individuals and organizations have heeded the call and are making huge strides in health care innovation, yet patients continue to suffer as a result of systems-level issues.
By shifting our paradigm of innovation, creating an environment to foster disruption, and educating future leaders to drive change, we stand a chance at driving maleficent creatures (like hallway medicine and eternal wait times) to extinction. ...continue reading →
Kacper Niburski is a medical student in the Class of 2021 at McGill University
There are only a few bodies that I have touched fully and fumblingly: my mother’s, as a baby drawn to a life that spills kindness; my twin’s, as a faulty scanner realizing that meaning is not found in mirrors; my lovers’, who have known that fingers loiter like summer horizons when undressing the lightness of being. I’ve hugged big bodies, mountains of men and women. I’ve stretched to bodies that have slipped away, that have asked for my palms to leave. And I have felt the bodies that whispered into a night that saw everything that this is what it was all about — to hold and be held, to love and be loved.
Sometimes, in the steep silence after these uneven affairs, there are heartbeats. Tiny, repetitive things that almost seem too quiet to be, but are. There, under your nail. There, in my own now. They bumble braveness. They tickle familiar muscles and call like sunlit laughter. Against the unseen quiet, their sacredness spools out in a language older than language itself. ...continue reading →
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.
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 →
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 →
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 →
Austin Lam is a medical student at the University of Toronto
We often hear and use the term “patient-centred care” without having a precise definition in mind. In order to elucidate the meaning of this term, it is important to analyze the concept lying at its centre: the patient. What does it mean to be a patient? What is the core, essential definition of patient?
Some have argued for patient to be replaced with a different term. As someone who has undergone surgeries myself, I have reflected on the meaning of this word and its associated implications. My hope is that this preliminary analysis can help provide directions for future questions, emphasizing an open exploration rather than closing off areas of discussion. ...continue reading →
Arnav Agarwal, CC3. I starkly recall etching those three words as I signed off on my first clinical note on a warm September morning. I wish this could be in pencil, I remember thinking. The idea of permanently associating my identity with a patient’s story and offering a proposed impression and plan felt outlandish — I barely had my own impression and plan figured out. How was I going to help patients and make a difference when I could hardly find my way to the right area of the hospital for my first day? And, a more weighted question: could I really practice medicine?
Indeed, the two years that followed were defined by gruelling academic intensity unparalleled by the prior two years of pre-clerkship. A rigorous clinical schedule was now paired with the expectation to prove theoretical capabilities every six to eight weeks. Uncountable sleepless overnight shifts on-call were matched by long days and weekend shifts. The unwavering anticipation of new learning experiences was paralleled by the uncomfortable sense of needing to constantly impress those around us and hold our own in a seemingly foreign environment. ...continue reading →
Sabrina Slade is a medical student in the Class of 2019 at Queen's University
Let me preface this by saying I am the kind of person who uses sarcasm and humour as a form of coping, and these opinions are my own.
You I have cancer.
A phrase I never could have dreamt would come out of my mouth, yet something I see or speak about almost every day in my so far short-lived medical career.
It’s the last week of June; I’ve just started my internal medicine rotation in Toronto and am rushing to get ready as I have slept through all seven of my alarms. I glance at my phone, noticing three missed calls and a voicemail with a little urgent symbol beside it. It’s my family doctor’s office; I listen to the voicemail half-heartedly as I struggle to pull on my nylons. She says something about biopsy results, and the words “neoplasia” and “urgent referral” stop me cold. I shimmy over to my phone, my nylons awkwardly half on, and hit replay. ...continue reading →