Tag Archives: medicine

Sarina Lalla is a medical student in the Class of 2020 at McMaster University

 

When McMaster medical students learn about medical conditions in a problem-based setting, we frequently use the mnemonic “DEEPICT” (Definition, Epidemiology, Etiology, Prognosis, Investigations, Clinical presentations, Treatment) to approach them. Medical schools focus on teaching students about these important aspects of diseases; with time and practice, this information can be retained and applied by students to make them better clinicians.

However, there is also value in understanding a disease through the eyes of patients. More specifically, it is critical to recognize how facing an illness and navigating the healthcare system impacts their lives. Patients are the experts on their own experiences, and the knowledge they can present in the form of stories can teach us a lot. While we learn how to interpret information in the form of bloodwork and imaging, patients present first and foremost with a story. ...continue reading

Prasham Dave is a medical student in the Class of 2018 at the University of Ottawa

 

 

 

Sunken eyes my burden and a blazing smile my shield,
My patient burned under baleful fluorescence—purified en blanc.
My breaths were shallow. His shallower still.
I was haggard and he was in shambles,
I was shuffling and he was frozen,
I was ash and he was a husk. ...continue reading

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author-pictureJeremy Zung

University of Toronto

Class of 2016


Taut sheets as cotton fetters

In curtained cloister bare

Enshroud the shrivelled limbs

Whose fingers flex in fetal curl

'Round liquid sleep.

---

Masked messenger in priestly white,

Hath divined th'encircling doom?

My fallen airways, Medusa's veins spell

Agonies untold.

 

Lips pursed, throat tight, and orbits sunk,

You scrabble to set me free

Of serpent tubes and catheter lines

Ensnaring, strangling me.

 

But stenotic hours, austerities

Have hemmed you in too far.

I fault you not, dear Hermes, but quick--

Prescribe your closing mercy:

 

The noose which crowns your chiselled neck can't

Auscultate mute screams.

I pray: release these sesame pupils to

Spelunk Elysian dreams.

author-picture-jpeg

Daniel (Yiqiao) Wang

University of Ottawa

Class of 2019

“Medical professionals concentrate on repair of health, not sustenance of the soul”.

Atul Gawande’s recently published book, Being Mortal, discusses the treatment of our elderly population and the various flaws of our health care system. One important point from the book is that health care providers such as physicians and nurses are too focused on physical well-being while forgetting about the less tangible necessities of life.

When an elderly individual is sent to a nursing home, safety is the highest priority. Residents are provided with call bells, ramps, elevators, nurses, and physicians who come directly to their rooms. This seems beneficial, as physical health is maintained. With 24 hour nursing surveillance and living in single rooms, residents are less prone to injuring themselves. It is a situation that seems optimal for both the caregivers and seniors. Why, then, is the rate of depression and sadness so high among the elderly population in nursing homes?

...continue reading

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Anonymous


It’s 1:15 am as I write this.

I’m tired. I’ve worked just under 17 hours today, but I can’t sleep.

Too bad. I will start at 8 am again tomorrow for another 8 to 9 hour day.

I can’t sleep because I’m thinking about my patient with the declining oxygen saturation. I worry that I may have missed something in the history, in the investigations… did the on call physician and I make the right decision?

...continue reading

2 Comments

Kayla Simms
University of Ottawa
Class of 2016

Upon being accepted to medical school in 2012, I received a special edition of “Oh, the Places You’ll Go” from a personal mentor; reminding me to not just look ahead, but to remember and cherish the distant memories that shape who we are. I recently stumbled upon this memorabilia when I returned home over the March Break, and sat down to write this poem.

This poem is a testament to the physician’s inner-child and the ‘art’ of medicine. ...continue reading

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is a general practitioner in London, UK, and a NIHR In Practice Research Fellow at the Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry

, a young doctor with cancer, recently wrote a book called ''. It's a book for doctors ‘to be better able to understand exactly what being the patient is really like …” Other medical writers have also been motivated by the shocking realisation that medical education and clinical practice had taught them so little about what it’s like to be a patient, the particular problems that doctors themselves have in coping with illness and the health risks associated with their profession; loss of identity, shame and stigma, the need to be treated as a person and an acute awareness of mistakes were common themes of narratives.

Inspired by their stories, I have been leading teaching seminars with medical students, GP trainees, GP trainers, GP retainers, medical humanities students and and learned a few more lessons along the way.

Doctors’ illness narratives have a particular power ...continue reading

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Lauren Vogel is a news editor at CMAJ

“We just don't know.” It's not exactly what most people want to hear from medicine's top minds. We want our healers to be certain. And with rapid improvements in genetic research, Big Data, diagnostic imaging, and personalized, predictive medicine, there's more information than ever about what makes us tick.

“We've made stunning progress,” , former director of the US National Heart, Lung and Blood Institute, told participants at #TEDMED2014 yesterday. “But the simple truth is what we have is not knowledge; it's information that is going to morph and shift into something else next week, next year or in 50 years.”

The more we know, the more we should realize the limits of what we know, she said. “We are desperately in the dark about how most things work. Humility is the secret ingredient that unveils truth and brings about change.”

It will also help us roll with the punches as rapid change becomes the norm, said ...continue reading

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Andrew and Akshay - Hacking Health

photo credit: Victor Panlilio

Dr. Akshay Shetty (centre right) is an Internal Medicine Resident at the University of Calgary Dr. Won Hyung A. Ryu (centre left) is a Neurosurgery Resident at the University of Calgary
Dr Aleem Bharwani is Director for the Medical Teaching Unit, Internist, and assistant prof at the University of Calgary

For budding young physicians, it’s almost a rite of passage: you finish your residency, accrue research along the way and then enter the clinical workforce. But a small wrinkle has crept into this tried and tested formula. More than ever, physicians in training are disrupting their medical education to foster innovation and improve the field of health care through non-conventional means, but often at the expense of their own traditional careers. ...continue reading

is Deputy Editor, clinical, at CMAJ, and Editor of CMAJ Open

 

As clinicians, we are taught about patient-centred care, where the needs and desires of the patient are foremost. For those of us who work as medical teachers, we are told to focus on the goals of our students in a learner-centred curriculum. We work in multi-disciplinary teams in hospitals and clinics, where it seems, at the very least, paternalistic for the leader to be a physician.

Some of our traditional roles have been taken over by other health professionals—and we are often told that they provide the same or better service at a lower cost. Administrators and other health professionals run the hospitals and clinics we work in. Few doctors are in leadership at the government level, even for decision-making related to health care.

We are frequently blamed for rising health costs, and some of us are not welcome at the bargaining table where our own remuneration is discussed. People may view us as greedy or, increasingly, as lazy and not willing to sacrifice for the greater good.

Somehow over the years, things changed from the physician as “god” to the physician as No Good.

Why did this change happen? Could it have been a reaction to our casual assumption of money, control and entitlement? Or maybe our failure to play well with others? Did we destroy the mystique around our profession when we abandoned our white coats in favour of casual clothes? Perhaps it was when women entered the profession in large numbers? Or was it simply that health costs began to spiral out of control and a scapegoat was needed?

Few of us would wish to go back to the times when a patient may have been kept ignorant of a cancer diagnosis for “his good”, a nurse had to step back to allow a doctor to go ahead through a door, or throwing surgical instruments across the operating room was condoned.

But surely there must be room for us—a physician-centred place—in the health care system.

There is such a place. That place is Medicine. And we are the experts, the only experts, in this millennia-old discipline. From its early days in ancient Egypt to the heady promise of gene and molecular therapy, the medical profession has advanced—and society has benefited.

Because of the life’s work of physicians over the centuries, we have a greater understanding of the human body and mind; what can go wrong and how to fix it. We now know that that cancer or diabetes or an infection does not have to be a death sentence. Indeed, the blind may see and the lame walk; some may even be raised from the dead.

To be able to do this work, we study for years (in some specialties for more than a decade)—and then we keep on studying to maintain our skills in the discipline where we are the experts, the only experts. There is no one else.

Because when patients are sick - really sick - they need a doctor. Yes, the doctor needs to be part of a health care team that works together. And yes, the doctor needs to respect the contributions of others and recognize the importance of involving the patient in his or her own health care. But a health care team without a doctor is missing expertise, expertise that can literally mean the difference between life and death, between illness and health.

But even when patients are not at death’s door, we bring our expertise to bear in addressing their current health concerns—major and minor—and work with them, in conjunction with our colleagues, towards a healthier future. We can listen, we can examine, we can diagnose, we can treat—and perhaps even heal.

Sure, we have made mistakes (big ones, on occasion) but, for the most part, we have tried to make the lives of our many, many patients better. People live better for longer, and are healthier.

And as such, we have earned the right to be key players in our health care system. At all levels.

We need to be included at decision-making tables—to participate as essential contributors. From the individual clinic to the hospital to government. Locally, provincially and nationally.

If health is the issue, we have the right to be there. To speak, to share our expertise—and to have our contribution respected. We need to be heard, along with the voices of our patients, our fellow health professionals and others.

To improve the health care of all Canadians, we, as doctors, need to be in our rightful place.