I was tagged a couple of times in the last month with the random things meme, but given the sporadic nature of my posting lately and the uninspired state of my muse, I'm not sure I can reach eight facts. We'll see.
1. I'll start with the fact that I am now a homeowner. It's a surreal state, to be sure, but a regular paycheck with the promise of relatively certain financial solvency in the future makes me a fairly good candidate for lending money to, apparently. This new purchase actually accounts for much of my silence on the blogging front lately, since there are a myriad little things to be done in a house which can be (and were) safely forgotten in an apartment. My concerns over how to afford a house are somewhat assuaged by the fact that it is an investment, and additionally I won't be around enough to spend any money these next three years anyway.
2. As a continuation of #1, I am inordinately proud of the fact that I managed to put up a respectable set of shelves in my garage, without instructions, manuals, or advice.
3. I meet most of the criteria for obsessive compulsive disorder. Go figure.
4. Despite #3, I still have difficulty closing cabinet doors. I figure, I'm going to open them again anyway, so...
5. This vacation thing is getting old. I may rue the day I said that eventually, but I haven't done anything really taxing in three months. Once residency starts, I plan to work until the day I die.
6. Despite what my mother says, having a good stereo system is more important than having a good dining table.
7. Ditto a TV.
8. I write about two blog posts for every one that ends up being posted lately. Mostly because the lack of inspiration keeps the quality down, and the beautiful weather outside keeps the volume down. Here's hoping I can get back into regular posting despite residency starting (at least the orientation) in about two weeks.
Wednesday, May 30, 2007
Saturday, May 19, 2007
Tuesday, May 08, 2007
Pleasant diversion
In this, our penultimate week of medical school, the administration has planned for us a variety of classes. Nothing serious or stressful, just refreshers on medical-legal ethics, lectures on how to give appropriate feedback as interns teaching med students, cap and gown distribution, etc. Everything is done by noon, and I think it's mostly a way for our faculty to pull everyone together for one last moment of bonding before we scatter to the winds.
The highlight of the morning came from the feedback/basic educator lecture, in which our learned teacher put up the following slide regarding learning environments, which he called the Starling curve of learning climate as it affects medical students, particularly in lecture:
Then this evening a group of us went to a local pro baseball game, and I was struck with how odd it is to have a classmate from California tell you, gesturing with one hand while the other holds a beer, in between cheers as he tells a story in his very relaxed, almost surfer-dude accent that "this lady had like a lymphogranulomatous vasculitis or something." I realized, again, that all of us are just human, and though we've crammed a ridiculous amount of information into ourselves over four years, and we've changed a great deal in some ways while doing so, we still take that information and apply it with the humanity we brought here, accents and all.
The highlight of the morning came from the feedback/basic educator lecture, in which our learned teacher put up the following slide regarding learning environments, which he called the Starling curve of learning climate as it affects medical students, particularly in lecture:
Then this evening a group of us went to a local pro baseball game, and I was struck with how odd it is to have a classmate from California tell you, gesturing with one hand while the other holds a beer, in between cheers as he tells a story in his very relaxed, almost surfer-dude accent that "this lady had like a lymphogranulomatous vasculitis or something." I realized, again, that all of us are just human, and though we've crammed a ridiculous amount of information into ourselves over four years, and we've changed a great deal in some ways while doing so, we still take that information and apply it with the humanity we brought here, accents and all.
Thursday, May 03, 2007
Little to do, little to say
I'm shockingly unproductive in the blogging sense lately. I think Medstudentitis put the reason quite succinctly in her latest post. If you don't do anything, you haven't got much to say. This is obviously even more true when your blog is ostensibly about one topic and you haven't had anything to do with the topic in weeks.
I have managed to do a lot of reading though, getting through all twenty of Patrick O'Brian's Aubrey/Maturin novels in the past three weeks. When I think how many pages that is, I stop wondering why my eyes have seemed to burn at times lately. But they are absolutely some of the best books I've ever read. I got to the end and wanted to start over. I think I'll read the rest of O'Brian's books first.
And I found a new band, called "A Fine Frenzy", and since they haven't come out with a complete album yet, I'll postpone writing a real review. I'll just mention that going to her website and listening to a few tracks is worthwhile. And if you have iTunes, she has four songs available for download. I have them all.
So that's all for now, hopefully with my last two weeks of classes and graduation coming up I'll have something to write about soon. 15 days to go.
I have managed to do a lot of reading though, getting through all twenty of Patrick O'Brian's Aubrey/Maturin novels in the past three weeks. When I think how many pages that is, I stop wondering why my eyes have seemed to burn at times lately. But they are absolutely some of the best books I've ever read. I got to the end and wanted to start over. I think I'll read the rest of O'Brian's books first.
And I found a new band, called "A Fine Frenzy", and since they haven't come out with a complete album yet, I'll postpone writing a real review. I'll just mention that going to her website and listening to a few tracks is worthwhile. And if you have iTunes, she has four songs available for download. I have them all.
So that's all for now, hopefully with my last two weeks of classes and graduation coming up I'll have something to write about soon. 15 days to go.
Friday, April 27, 2007
Last Class
The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not a college course,not a medical course, but a life course, for which the work of a few years under teachers is but a preparation.
Today was the last academic requirement of my medical school career. It wasn't particularly taxing, simply my final meeting with the professor guiding my last month of reading, but it was rewarding. I had finished reading the two biographies of Osler, along with a volume of his essays and speeches, and then I closed this month of Osler-mania by reading the man's favorite book, Religio Medici, by Sir Thomas Browne.
Much of Osler's writing is directed towards medical students, so in reading his works, I regretted not discovering him sooner. (And if you're a medical student or about to be one, you should drop everything and read Aequanimitas and The Student Life today.) But Thomas Browne is not writing to anyone at all, the work is a sort of confession, as he explores his thoughts on God and life. It is also highly worth reading, and though some parts of it are quite dated, the charitable reader will find much to learn from. Browne was a physician in England, who wrote his book in 1635 (though it wasn't published until later) just before he turned 30. At this point in his life, he had learned 6 languages and studied medicine in all the great schools of Europe. But the book is much more about his relations with God and man than with his profession.
Returning from Browne to Osler, it is easy to see the echoes of the great 15th century doctor in his protege 300 years later. Many of the same thoughts, much of the same style. It is easy, reading him, to see why Osler would state "No other profession can boast of the same unbroken continuity of methods and of ideals. We may indeed be justly proud of our apostolic succession." If the profession is deep, it is also broad, and Osler would say in another place "medicine is the only world-wise profession, following everywhere the samee methods, actuated by the same ambitions, and purpusing the same ends." Both these ideas can been seen, nascently, in Browne.
My question after finishing this three thousand odd pages of reading (two biographies, two collections of essays, and Religio Medici) was "where to now?" Osler brought the "Jovian and God-like" image of the physician in antiquity into the modern era, demonstrating its continuance in a scientific world. But he finished his practice before antibiotics, before most diseases could be cured, and before the era of "informed consent." How does a physician today take the lessons of Osler and transfer them to a modern world? I have reached the end of a class, but not the end of my learning.
My professor's answer was straightforward. Francis Peabody, MD was a member of the generation of medical students growing up under Osler's influence, and he lived long enough to see the new ideas and conflicts start to arise. He wrote an essay called "The Care of the Patient" which at least framed these questions, taking the philosophy of Oslerian medicine and working it into the new world. It is, apparently, worth much more than the famous closing line "for the secret of the care of the patient is in caring for the patient." So I haven't run out of reading material.
Today was the last academic requirement of my medical school career. It wasn't particularly taxing, simply my final meeting with the professor guiding my last month of reading, but it was rewarding. I had finished reading the two biographies of Osler, along with a volume of his essays and speeches, and then I closed this month of Osler-mania by reading the man's favorite book, Religio Medici, by Sir Thomas Browne.
Much of Osler's writing is directed towards medical students, so in reading his works, I regretted not discovering him sooner. (And if you're a medical student or about to be one, you should drop everything and read Aequanimitas and The Student Life today.) But Thomas Browne is not writing to anyone at all, the work is a sort of confession, as he explores his thoughts on God and life. It is also highly worth reading, and though some parts of it are quite dated, the charitable reader will find much to learn from. Browne was a physician in England, who wrote his book in 1635 (though it wasn't published until later) just before he turned 30. At this point in his life, he had learned 6 languages and studied medicine in all the great schools of Europe. But the book is much more about his relations with God and man than with his profession.
Returning from Browne to Osler, it is easy to see the echoes of the great 15th century doctor in his protege 300 years later. Many of the same thoughts, much of the same style. It is easy, reading him, to see why Osler would state "No other profession can boast of the same unbroken continuity of methods and of ideals. We may indeed be justly proud of our apostolic succession." If the profession is deep, it is also broad, and Osler would say in another place "medicine is the only world-wise profession, following everywhere the samee methods, actuated by the same ambitions, and purpusing the same ends." Both these ideas can been seen, nascently, in Browne.
My question after finishing this three thousand odd pages of reading (two biographies, two collections of essays, and Religio Medici) was "where to now?" Osler brought the "Jovian and God-like" image of the physician in antiquity into the modern era, demonstrating its continuance in a scientific world. But he finished his practice before antibiotics, before most diseases could be cured, and before the era of "informed consent." How does a physician today take the lessons of Osler and transfer them to a modern world? I have reached the end of a class, but not the end of my learning.
My professor's answer was straightforward. Francis Peabody, MD was a member of the generation of medical students growing up under Osler's influence, and he lived long enough to see the new ideas and conflicts start to arise. He wrote an essay called "The Care of the Patient" which at least framed these questions, taking the philosophy of Oslerian medicine and working it into the new world. It is, apparently, worth much more than the famous closing line "for the secret of the care of the patient is in caring for the patient." So I haven't run out of reading material.
Thursday, April 26, 2007
5 reasons
I've been tagged with "5 reasons I blog" by Medstudentitis, so here goes.
1. I started this blog to tell stories. At the time it began, I was discovering that even the most indulgent of friends and family tire of graphic descriptions of hospital life. This was a great way to share.
2. In many ways, sharing the odd and amazing stories that form life in a hospital can seem like showing off. It certainly is an enthralling lifestyle at times, and that exultation can be wearisome to those who do not share it. Here, since I know only the smallest fraction of my readers personally, they cannot think less of me for exulting. And most of you know exactly what I mean anyway.
3. Working in a psychiatry ward, as I was back when this started, can make anyone feel they ought to be a storyteller. However, telling the same story fifty times can be trying, and this was a great way to let all my interested friends get the story without exhausting the teller.
4. As I progressed in blogging, I decided to work through some more difficult issues for me, as a developing physician, through this medium. I certainly learned a lot through writing here, especially the three posts "in sickness and in health," "as long as you both shall live" and "Parenthood" which are linked in the sidebar under "Key Posts". Probably others were just as good, but those are the ones that come to mind.
5. Less of a reason why I blog, and more of what's been going through my mind lately: I've been away from the hospital, in the legendary lull of fourth year medical students, cramming what enjoyment they can into the last few weeks of freedom before we all start actually working for a living, and so I haven't been blogging a whole lot in the last month. I've questioned whether I will start again once residency begins July 1, and if I do, what shape that will take. A commenter here a while ago took exception with one of my posts, believing that I was laughing at a patient's expense. Though I wasn't, it caused me to more closely consider the Hippocratic Oath, specifically the line "All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal." I'm not sure how much of what I do, and how much physicians do in general, "ought not be spread abroad." Certainly, there is a rather considerable precedent for blogging about the hospital, but precedent does not make ethics. If there are any medical bloggers out there who have actually made it this far, I would truly appreciate your input on the subject. I'm not worried about HIPAA, as I've very clearly stated multiple times that all names here are invented, but I do think law is a poor substitute for societal moral pressure, and I'm trying to determine where that lies here.
1. I started this blog to tell stories. At the time it began, I was discovering that even the most indulgent of friends and family tire of graphic descriptions of hospital life. This was a great way to share.
2. In many ways, sharing the odd and amazing stories that form life in a hospital can seem like showing off. It certainly is an enthralling lifestyle at times, and that exultation can be wearisome to those who do not share it. Here, since I know only the smallest fraction of my readers personally, they cannot think less of me for exulting. And most of you know exactly what I mean anyway.
3. Working in a psychiatry ward, as I was back when this started, can make anyone feel they ought to be a storyteller. However, telling the same story fifty times can be trying, and this was a great way to let all my interested friends get the story without exhausting the teller.
4. As I progressed in blogging, I decided to work through some more difficult issues for me, as a developing physician, through this medium. I certainly learned a lot through writing here, especially the three posts "in sickness and in health," "as long as you both shall live" and "Parenthood" which are linked in the sidebar under "Key Posts". Probably others were just as good, but those are the ones that come to mind.
5. Less of a reason why I blog, and more of what's been going through my mind lately: I've been away from the hospital, in the legendary lull of fourth year medical students, cramming what enjoyment they can into the last few weeks of freedom before we all start actually working for a living, and so I haven't been blogging a whole lot in the last month. I've questioned whether I will start again once residency begins July 1, and if I do, what shape that will take. A commenter here a while ago took exception with one of my posts, believing that I was laughing at a patient's expense. Though I wasn't, it caused me to more closely consider the Hippocratic Oath, specifically the line "All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal." I'm not sure how much of what I do, and how much physicians do in general, "ought not be spread abroad." Certainly, there is a rather considerable precedent for blogging about the hospital, but precedent does not make ethics. If there are any medical bloggers out there who have actually made it this far, I would truly appreciate your input on the subject. I'm not worried about HIPAA, as I've very clearly stated multiple times that all names here are invented, but I do think law is a poor substitute for societal moral pressure, and I'm trying to determine where that lies here.
Monday, April 23, 2007
Slowing down
Osler was a bit of a bore, truly. I got about 300 pages into the 1200 page behemoth of Cushing's work and decided to switch to Michael Bliss's bio, which at 700 something pages seemed more manageable. Cushing wrote to an audience already familiar with Osler, in an atmosphere of hero-worship. Bliss, though certainly not as accomplished a writer, had the advantage of distance in time from his subject, and gave a perspective I could more easily understand. Still portraying a medical hero, surely, but without assuming I already knew why he was heroic.
But as heroes go, I found Osler more demotivating than otherwise. He certainly had an incredible amount of energy and a singular drive to learn everything he could about medicine. And he balanced his pursuits with reading classics and modern literature, so what's not to love? But I think, upon reaching the end of four years of toil towards an almost mythical end, with "MD" on a paper after my name, that I'm a bit demotivated. Certainly, the end is exciting, but I have to re-examine my motivations for coming to medical school. Most of my friends through high school and beyond wanted to go into medicine, or at least we all said we did. I often point to that as the reason I got here at all: peer pressure. Is that going to be enough to sustain me in residency? Time will tell. But reading about Osler, who published over 700 articles in his lifetime, while writing a textbook that would become the standard work for some 50 years, leaves this particular audience feeling inadequate.
But more than just Osler, my motivation for work has been pretty slim. Given the freedom of a month almost entirely without responsibility, I've been desperately visiting all the museums and restaurants the metropolis has to offer that I've missed in the past years while studying. I've been catching up on reading for fun, sometimes combining the two pursuits, sitting outside some particularly interesting animal's cage at the zoo while poring over the Patrick O'Brian novel I'm finishing. (and as an aside, I find that the higher the animal, the more disheartening the sight of them in a zoo. Fish are fine, and the smaller birds seem to enjoy their large faux-jungle enclosure, but I could see in the eyes of an orangutan the same look I've noticed in depressed patients.) All of this has left little time or inclination towards medical reflection.
I have, however, found a place to live at my residency site, begun packing my things, and started the process of saying goodbye to friends, beginning indolently the next step in this journey. 25 days to go till graduation.
But as heroes go, I found Osler more demotivating than otherwise. He certainly had an incredible amount of energy and a singular drive to learn everything he could about medicine. And he balanced his pursuits with reading classics and modern literature, so what's not to love? But I think, upon reaching the end of four years of toil towards an almost mythical end, with "MD" on a paper after my name, that I'm a bit demotivated. Certainly, the end is exciting, but I have to re-examine my motivations for coming to medical school. Most of my friends through high school and beyond wanted to go into medicine, or at least we all said we did. I often point to that as the reason I got here at all: peer pressure. Is that going to be enough to sustain me in residency? Time will tell. But reading about Osler, who published over 700 articles in his lifetime, while writing a textbook that would become the standard work for some 50 years, leaves this particular audience feeling inadequate.
But more than just Osler, my motivation for work has been pretty slim. Given the freedom of a month almost entirely without responsibility, I've been desperately visiting all the museums and restaurants the metropolis has to offer that I've missed in the past years while studying. I've been catching up on reading for fun, sometimes combining the two pursuits, sitting outside some particularly interesting animal's cage at the zoo while poring over the Patrick O'Brian novel I'm finishing. (and as an aside, I find that the higher the animal, the more disheartening the sight of them in a zoo. Fish are fine, and the smaller birds seem to enjoy their large faux-jungle enclosure, but I could see in the eyes of an orangutan the same look I've noticed in depressed patients.) All of this has left little time or inclination towards medical reflection.
I have, however, found a place to live at my residency site, begun packing my things, and started the process of saying goodbye to friends, beginning indolently the next step in this journey. 25 days to go till graduation.
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