Sarah Chauvin is a medical student in the Class of 2018 at the University of Toronto
Collateral. Collateral. Collateral. Three weeks in a psychiatric Emergency Department, and I have more than a mere appreciation for collateral: I’ve come to understand it as a key diagnostic investigation.
Toward the end of my weekend call shift, my young patient with severe alcohol use disorder and borderline personality disorder — who had been discharged the week prior with an addictions referral — was back in the ED for alcohol intoxication. Though I had been cautioned that the patient would likely return, I was disappointed to see her name back on the patient-tracking list. ...continue reading →
Amy Gajaria is a third year resident in the Department of Psychiatry at the University of Toronto
Last week was the first snowfall of the season in Toronto. Usually, the first sight of fluffy white flakes collecting on city streets would have me dreaming of strapping on my cross-country skis. This, year, however, the first snow left me huddled inside, frightened of slipping on ice.
Towards the end of September I badly damaged my ankle when attending a charity event. In a few moments I went from an active 30-something to someone unable to stand independently. After the paramedics got me to the nearest hospital, the first thing that popped out of my mouth was not “pain medication STAT” (that was the second thing), but instead “I’m a doctor. I hate being a patient.”
I later told myself that this was because I wanted to speed up communication and avoid unnecessary explanations. ...continue reading →
Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
Energised, refreshed, and inspired. The National Institute of Health Research, School for Primary Care Research annual research showcase meeting in Oxford brought together senior academics, key opinion leaders and young researchers from the Universities of Birmingham, Bristol, Keele, Manchester, Nottingham, Oxford, Southampton and UCL. But, unlike many academic conferences, the focus wasn’t just on scholarly content alone, but under the wider theme of “Promoting excellence and impact”.
Trisha Greenhalgh, currently professor of primary care at Barts and the London School of Medicine and Dentistry but soon to move to Oxford, gave the keynote address, entirely appropriate given her academic title as Dean for Research Impact. Her main message was that research must make a difference and that assessing the impact of one’s work is important at both ends of the research process from grant acquisition to dissemination and evaluation. ...continue reading →
Some would say it is strange to remind physicians or health care workers of the humanity of medicine, I would argue with the onslaught of new drugs, new research, and new technology to make medicine a faster evolving machine… we have sometimes forgotten the art of interacting as humans. So when Dr. Abraham Verghese gave a talk at TEDMED 2014 on metaphor and medicine (and language and medicine more broadly) it struck a chord.
During my medical school training I had often heard (sometimes from older and wiser physicians) that the art of the physical exam was dying with the increase in tests that allowed us, at times, to not touch or even see patients before making a diagnosis, let alone speak with them. One physician said we were losing the intimacy in medicine that allowed us to really listen to what was needed from those in our care. Much of what I gleaned from Dr. Verghese’s TEDMED speech was similar, we needed those moments of communication.
Dr. Verghese is Professor of the Theory and Practice of Medicine and Senior Associate Chair of the Department of Internal Medicine, at Stanford University Medical School. He is also a best-selling author, having written fiction and non-fiction throughout his career. So when he asked “What is a metaphor?” I found I really wanted to hear his answer. ...continue reading →