Reflections

 Sarah Silverberg is an R1 in OBGYN at UBC and an intern at St. Paul's Hospital.

 

 


Please let me take your history.

I know the triage nurse and the emergency physician already asked you many of these same questions. But humor me -- let me ask them too. After all, I was asked to see you by the emergency doctor who saw you. They knew I would ask you these questions, and felt it was necessary. They referred you to me, and like it or not, you’re now under my care.

I am the resident that was asked to see you. You ask me if you could see the real doctor. Unfortunately, I am the real doctor. At least, I am a doctor; one of the country’s medical institutions has granted me an MD. And while I know what you mean – that you don’t want to see the resident, and that you want to skip ahead directly to the attending – at this moment I can’t make that happen. My attending sent me down to see you because I’m the one on consult service. My staff is in the operating room, or managing the ward, or reviewing the three other consults we’ve been asked to see this evening with other residents and students. You’d be waiting a while longer if I didn’t see you.

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 Ashleigh Frayne is a Family Medicine (R1) at the University of British Columbia.”

 

 


The pavement darkens as the chill of the night settles

Stretched across the lap of the day, a shadow cat

Moving swiftly down the street, between pools of light

Cast by warm windows, freeing the damp of evening

To reach long fingers down my spine, the sigh of today.

I rub my eyes, crusted with the dread of tomorrow.

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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:

“They were elderly and had had a good life.”

“We did everything we could.”

“At least now they are out of pain.”

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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

Kacper Niburski is a medical student in the Class of 2021 at McGill University. He is also the CMAJ student humanities blog editor.

 

 


murphy’s sign

yellow on the horizon

with a dark more total than

fingers moving in small steps

and smaller spaces

an ambulance is in the distance

your breathe is on my neck

what is this gall

how do you hold me

with all your living

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Abhishek Gupta is a medical sub-intern with CAMH, who graduated from Windsor University School of Medicine.

 

 


Hear Ye, Hear Ye

A song of mental health for all,

In dark times and vanishing grace,

Give light and cushion a fall,

Where suffering is hidden,

And discourse forbidden,

Now, to change rules unwritten,

I pray, lend your ears to listen!

 

Where actions and mood were once controlled,

Now, fits of mania, blues, highs and lows, ...continue reading

In a first "Med Life with Dr. Horton" podcast, Dr. Jillian Horton discusses CaRMS, the Canadian Resident Matching Service. In this episode, she is joined by Dr. Moneeza Walji.

They answer these questions:

  • What are some strategies for choosing and ranking programs?
  • Should I have a back-up program in my ranking?
  • What should I do about conflicting interviews?
  • What are interviewers looking for in a candidate?
  • What should I do when I can't think of an answer to an interview question?
  • Should I change my strategy when being interviewed by a resident versus a program director?
  • How does the panel score the interview?
  • Should I disclose a mental health diagnosis or personal struggles?
  • Should I talk about my partner, kids, or family?
  • How do I handle the stress related to CaRMS?
  • And more.

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1 Comment

Pat Rich is an Ottawa based medical writer and editor.

 

Cometh the hour, cometh the man.

It would be the very height of pretentiousness to apply this phrase to Dr. Liam Farrell, an author and former family physician from Rostrevor, Co. Down, Ireland and I am sure he would be the last person to do so.

But at a time when family medicine seems to be at its lowest ebb, if not globally then very much here in Canada, there is much to be said for having a physician who can so eloquently write about both the rigors and the ...continue reading

Hillel M. Finestone is a Physiatrist at the Elisabeth Bruyere Hospital and Professor, Division of Physical Medicine and Rehabilitation, University of Ottawa.

 

My 52-year-old patient took his BP at a pharmacy on 6 separate occasions.  Systolic BP values were high, ranging from 150-177. When I take his BP in the office it’s 168/98.  Yup, he has high BP.  He’s 10 pounds overweight, doesn’t have diabetes, doesn’t smoke and thinks that he was told that his BP was “probably high” 5 years ago, but he didn’t feel that medications would make a difference.

We talk about weight loss, healthy eating and reducing high sodium foods, that we don’t know why BP elevates but that medications really work and help stop strokes and heart attacks from occurring.  He agrees to my prescription of one medication and we discuss its side effects.  A drug information sheet is provided. ...continue reading

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Keegan Guidolin is a General Surgery resident at the University of Toronto

Han Yan is a Neurosurgery resident at the University of Toronto

 

 

Much attention has been paid of late to the phenomenon of social echo chambers - situations in which people’s beliefs are amplified and repeated in a closed system as no dissenting opinion originates from within the group. Echo chambers on social networking platforms such as Facebook and Twitter were identified as a factor contributing to the outcome of the 2017 US Presidential Election. We believe that social echo chambers exist in the real (non-digital) world as well, within social groups whose members may interact outside the group in general, but who discuss particular subjects only within the group. ...continue reading