- Did I do everything I knew how to do to care for this person?
- Was there something I missed, something I should have changed?
- What will happen now? Will the family blame me for the consequences of their loved one's frailty? Will I lose everything I worked for even though I did the best I could?
- If the hospital or the family wants me punished, how much punishment will be enough, since no punishment could possibly bring their loved one back?
- If someone else had been taking care of her, would things have been different?
- Even if I am a good physician, will this forever color people's ability to recognize that and their willingness to hear my opinions and advice?
- Whom can I talk to who would actually understand?
- Even if losing this patient wasn't my fault, will this churning of thoughts ever heal, this ache ever go away?
Saturday, August 30, 2008
Wednesday, August 27, 2008
Stoneheart by Charlie Fletcher - wherein a 12-year-old boy named George goes to the National History Museum in London and gets much more than he bargained for, like gargoyles and other statues coming to life, chases through the streets of an alternate London universe, a battle of good against evil...
The Battle of the Labyrinth by Rick Riordan - book four in the engaging Olympians series (he raced through books 1-3 about as fast as he got through all 7 Harry Potter books...)
Warriors by James Harpur, to feed his fascination for ancient civilizations.
and A Child's Introduction to the Night Sky by Michael Gifford, which is beautifully put together.
2. Each award has to have the name of the author and also a link to his or her blog to be visited by everyone.
3. Each winner has to show the award and give the name and link to the blog that has given him or her the award itself.
4. Each winner and each giver of the prize has to show the link of “Arte y pico” blog, so everyone will know the origin of this award.
5. To show these rules.
Saturday, August 23, 2008
I can only hope that despite my training and my job, they didn't feel neglected. I hope they felt I was there for them anyway. I hope they feel some of what this child-of-a-doctor wrote - that time spent with her parent was memorable and precious, and that some missed award ceremonies and school plays were forgive-able. I hope. I hope they know I wanted to be there, tried to be there, for everything, and that they were always, always present, front and center, in my mind and heart.
Do I regret choosing this career? No.
Friday, August 22, 2008
Tuesday, August 19, 2008
I am away from work for a week, and that's a good thing. Work has been stormy; even with time and space away, in sunny, breezy weather near mountains and a gorgeous lake, it's been hard not to be affected by the malignant energy churning around lately. But I'm here now, with the people I love most in the world; I'm going to try to take a real rest.
We admired artifacts that showed the Shakers' inventiveness and ability to unite beauty with usefulness.
Saturday, August 16, 2008
Zipoli: Adagio for Oboe, Cello, & Strings
Marcello: Concerto in C minor, 3rd movement
Bach: Concerto for Oboe and Violin in D minor
Schumann: Romance No. 2, Op. 94
Vaughan Williams: Concerto for Oboe and Strings
Saint-Saens: Oboe Sonata in D major
Fauré: Pavane, Op. 50
Poulenc: Sonata for Oboe and Piano, 2nd movement
Menotti: Shepherds’ Dance
Friday, August 15, 2008
Wednesday, August 13, 2008
"Hit the Road, Jack, and Dontcha Come Back No More, No More, No More, No More..." (just kidding, of course)
Friday, August 8, 2008
O.R. Nurse: Of course there is! The anesthesiologists document it on their record! They sign the blood sheet!
Anesthesiologist (from the sidelines): Remind him that life-threatening transfusion reactions occur in, like, 1 out of about 250- to 600,000 patients REGARDLESS of who orders the blood transfusion, so creating a measure for the purpose of assigning blame is an ignorant and asinine thing to do.
DICAS (on phone, to O.R. nurse): What is your name, exactly?
O.R. Nurse: An order to whom? To self?
Monday, August 4, 2008
- I know I am not truly an anonymous blogger - no one is.
- I know I need to protect people's privacy and am committed to doing so.
- But I also know that STORY MATTERS. Ultimately, for me, story is the whole POINT of writing, and, arguably, the very way in which we define ourselves and forge our connections with one another - even in medicine, where taking a good history, learning a patient's story, is one of the most important steps in the healing process.
The authors of the article "Online medical blogging: don't do it!" (published in the journal of the Canadian Medical Association) assert, "Telling personal stories about individual patients poses the risk of eroding the public's trust in the particular physician involved, as well as in the relevant department, hospital and university, and in physicians in general." What a limited and limiting understanding of the powerful positive role writing about one's experiences can play in medicine. So many visitors who have been kind enough to leave comments here on this blog have described just the opposite phenomenon: an increased trust in, and understanding of, physicians due in part to a particular story related here. Who better than the surgeon himself to describe what it's like to be feel almost inexpressible sorrow over an outcome, or to convey, as this surgeon did, the momentary intimacy of an office visit in which compassion for a patient's physical and emotional lesions, and the willingness to become part of another's story, transform a mere "encounter" into something much greater?
To the authors of that journal article, I must say that perhaps five or ten years ago a discussion of whether or not doctors should blog might have made sense, but considering the plethora of truly remarkable, valuable, fruitful, and praiseworthy blogs out there by now - open your eyes and take a look, please - I think the horse has left the barn.
I'd like to thank Melissa Healy of the L.A. times for featuring Notes of an Anesthesioboist on today's roundup of "Medical Blogs For Doctors and Patients Alike."
Other medical blogs included on her list were
Emergiblog - "The Life and & Times of an ER Nurse"
GruntDoc by former Marine infantryman and physician Allen Roberts, an ER doc in Fort Worth
Blogborygmi by Dr. Nicholas Genes, an ER doc from Mount Sinai Hospital in New York
Edwinleap.com - "husband, father, physician, writer"
DB’s Medical Rants maintained by Dr. Robert M. Centor, an internist at the University of Alabama School of Medicine
Dr. Val and the Voice of Reason
Kevin, M.D. by Nashua, N.H., internist Kevin Pho
California Medicine Man, by Dr. John S. Ford, assistant UCLA professor and an internist at Harbor-UCLA Medical Center
Fingers and Tubes in Every Orifice.
Mothers in medicine
Musings of a Distractible Mind by Dr. Rob, a primary care physician in the Southeastern U.S.
Clinical Cases and Images
Medical Jokes, Cartoons, Videos
Placebo Journal Blog -"Medical Humor With a Purpose," by family practitioner Dr. Douglas Farrago of Auburn, Maine. (Thanks to you, Dr. Farrago, my husband will never look at a cast iron stove the same way again...)
Addendum August 25, 2008:
Here's an article on the website of the American Medical Association on physician blogs: http://www.ama-assn.org/amednews/2008/09/01/prca0901.htm#1 . There seems to be an underlying assumption about what blogs should be - tools for dissemination of information by "professionals" with proper "citations" only, whereas blogs are clearly different things to different writers, including journals, art exhibits, family albums, etc. The genre is fluid and undefined; it can be personal, not professional. Not all physicians who write blogs are writing in their professional capacity as physicians. I think Dr. Rob stated it brilliantly: "Physician blogs should not be seen as an attempt to replace other sources of information, but instead as a new kind of medium -- a view into the minds of the rank-and-file members of medicine."
And via KevinMD on August 26, 2008:
Here's another site that expresses my view pretty well, which is that in this country that glorifies the First Amendmet, my right to write whatever I want should be respected, not abrogated: http://www.medrants.com/index.php/archives/3718
More links on the subject here - specifically, on the story of a Scottish doctor suspended for something he wrote on a doctors-only blog forum - found on September 2, 2008: http://thebrownstuff.blogspot.com/2008/08/story-here.html
Sunday, August 3, 2008
How a Plate of Broccoli Got Me Thinking About God and the Whole Evolution v. Intelligent Design Debate
Right now I certainly can't claim to be an atheist or a strict materialist either. Some of the most arrogant, obnoxious, disrespectful fundamentalists I have ever read or heard speak have been atheists. I do, however, accept the Theory of Evolution as the best explanation we have for our observations of living things.
I sometimes enjoy the debate between rational empiricists and people of faith. It can be like watching that last tournament between Nadal and Federer. Whether you were rooting for one or the other, watching the volleys was fun.
- There's a watch here, so there must be a watchmaker somewhere.
- God must exist because there's so much beauty and goodness in the world.
- God must not exist, or must not be a loving God, because a loving God wouldn't allow so much pain and suffering in the world, especially by innocent people.
- God must be an UN-intelligent designer, or there must be no designer, because so many "designs" in nature are suboptimal - a perfect God would design a perfect world.
Saturday, August 2, 2008
Finally, and most importantly...HAPPY BIRTHDAY, MOM! :)