Shubham Shan is a medical student in the Class of 2019 at the University of Toronto
She arrived on an inclined stretcher, grasping her Venturi mask like a child holding on to her favourite toy. Flanked on both sides by paramedics, her eyes were splinted wide open by shock and her chest heaved up and down rapidly. She was a queer shade of purple — like spoilt red wine diluted with water — and her gaze flitted around the emergency department as if looking for someone familiar. The paramedics passed her off to the doctor then left, shaking their heads. I remember watching the doctor take the patient’s puffers. The patient swore loudly and snatched them from his hands; first the orange, then the blue. She cocked the puffers like guns, inserted them into her mouth, shot the mist deep, and inhaled. She coughed for what seemed like an eternity. She was what we called a “blue bloater.”
When I saw her again, she was lying on a tattered mattress with bright blue sheets in a freshly bleached acute care room in the emergency department. Her condition had gotten much worse. Her abdomen caved in paradoxically whenever she breathed in. Her eyes were bloodshot. Every time she exhaled, it sounded like an infant's rattle. ...continue reading
Hilary Drake is a medical student in the Class of 2021 at the University of British Columbia
On my first day in a new family practice, my preceptor asked me to take a history from a patient who had listed their “reason for visit” as a sore throat. I stood in the hallway and made a mental checklist of questions to ask and observations to make. Have they had any sick contacts? Does their voice sound hoarse?
When I opened the door and asked them if they could tell me what brought them in today, they responded as expected: “My throat is sore.” When I asked what they thought might be causing the pain, they unwrapped a scarf from their neck and stated, “I think it’s because the noose didn’t work.” At that point they started crying.
They had tried to come in before. They had recognized their pain and wanted to reach out for help, but they were unable to out of fear that their physician would not believe the pain if they could not see it.
That was the day that I learned how stigma can kill someone. ...continue reading
Mitchell Elliott is a medical student in the Class of 2019 at the University of Toronto
Doctors are amongst the intellectual elite of society. In many cases, with decades of training and continuing education in clinical practice, our expertise grants us the opportunity to do things that would be deemed invasive and inhumane if performed outside of the context of medicine. Selectively poisoning people with chemotherapy; carefully dissecting fascial planes and removing organs; asking invasive and personal questions... all in the name of symptom management, remission of disease, and prolonging the inevitable: death. For physicians, these daily rituals become almost routine. In many cases, we have spent the majority of our lives training for the uncertainty of each day, rigorously memorizing each disease presentation and management principle, habituating to these processes and procedures. With the heavy clinical demands on physicians, it may be difficult to fully realize the impact of our actions on each patient. ...continue reading
Yipeng Ge is a medical student in the Class of 2020 at the University of Ottawa
Humbled. I am so truly humbled that I get to work with and learn from so many passionate medical students with such strong and refined values, morals, and dedication to their causes.
I am specifically speaking about the shift in the medical learner community to respond more attentively and compassionately; to acknowledge the importance of health and social inequities as they affect and inform our medical education and profession, and — more importantly — how they ultimately affect our current and future patients. Patients do not experience the health system not as an isolated entity (though for many of us in the healthcare field, it can certainly feel as though our assistance is limited to clinic rooms); instead, they are affected by the many determinants of health and wellbeing beyond the direct control and impact of clinicians in the healthcare setting. ...continue reading
Welcome to this week's edition of Dear Dr. Horton! Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment. Submit your questions anonymously through , and if your question is appropriate for the column, expect an answer within a few weeks!
Dear Dr. Horton,
With CaRMS applications open, the pressure is definitely piling on... yet no matter how much I tell myself I need to get started on preparing personal letters for the different programs I'm applying to, I just keep putting it off.
I know a great letter isn't going to pop into existence the night before applications are due, but I'm also at a loss in terms of where to even start... any advice would be much appreciated.
Noren Khamis is a Family Medicine Resident (R1) at the University of Toronto
Early morning: the student comes by in a daze
Disoriented in the hospital maze
He’s frantic and sweating, the hallways all crossed
But one look at me and he’s no longer lost
The happy father and toddler walk by
One look at me, and yikes, what a cry!
Dad lifts his daughter up from the ground
And smiles in relief when she calms down ...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
is an Internal Medicine Resident (R1) at the University of Toronto. Check back the last Thursday of each month for a new featured piece as part of his series (Doc Talks: Reflections to Reality)!
"First of all," he said, "if you can learn a simple trick, Scout, you'll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view […] until you climb into his skin and walk around in it." — Harper Lee,To Kill a Mockingbird
This piece reflects a daughter’s internal struggle as she comes to terms with her mother’s suffering through delirium and terminal illness. Touching on the sensitive balance between seeking care and doing no harm, this piece provides an intimate perspective on the challenges many family members encounter in letting go of their loved ones during trying times of declining health, as well as on the difficulties involved in recognizing that ‘more’ is not always better — that, sometimes, less is more. ...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
Ever wish you could ask a wise, kind, approachable Student Affairs Dean something without having to admit the question was yours? Maybe you think it’s cringe-worthy; maybe you feel like you should know the answer already; maybe you think you will be judged; maybe you’re sure you are the only medical trainee on the planet ever to have felt this way, and you need confirmation now.
Enter Dear Dr. Horton, a new feature on the CMAJ Blog. Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment (rest assured, though — Student Affairs Deans in Canada are all really great people, and not only have they heard it all, but they take on these decidedly unglamorous, 24-hour call jobs because they really, really care about learners).
Submit your questions anonymously through , and if your question is appropriate for the column, expect an answer within a few weeks! ...continue reading