"Nobody asks [us] dragon parents for advice; we’re too scary. Our grief is primal and unwieldy and embarrassing. The certainties that most parents face are irrelevant to us, and frankly, kind of silly. Our narratives are grisly, the stakes impossibly high." So writes, Emily Rapp in an Opinion piece about her child with Tay-Sacks disease.
Wilh all the fanfare about Tiger Moms -- Ms. Rapp's essay is an important glimpse of reality, far from the ivied halls of the Academe.
A young Vietnamese immigrant wandered into the inner city clinic where I trained as a student and subsequently worked for several years. Although he spoke little English, his chief complaint was obvious: an unsightly mass protruded from the right side of his face along the jaw. He had been to a number of medical facilities for treatment, but no one wanted to excise the cluster of bumps just beneath the skin. In retrospect, the reason was obvious—he had no medical insurance.
Several of my classmates in PA school elected to pursue careers in surgery. I opted for a track in general medicine instead. Even so, I found myself standing over this young Vietnamese man that afternoon, excising a mass that other clinicians more experienced than I had refused to touch. >>more
Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years. His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."
Daniella Lamas was an intern when she met a young man with terminal heart failure on I.C.U. rounds. Through Facebook she learned "[h]e was 'single,' and he liked Radiohead
and Tom Clancy.
He’d been sending upbeat status updates from the I.C.U.; to read them,
you’d never know he was so sick, but to me they were missives from a
dying man"
Her essay, Friend Request, is as moving as any I've read. I know you will appreciate it.
Osler wrote: "The pupil and the teacher working together on the same lines, only one a little ahead of the other. This is the ideal towards which we should move." Daniela Lamas, medical intern, with this essay is the professor for all of us: her colleagues, professionals and laypeople alike.
.
Henri Nouwen coined the phrase the wounded healer in reference to individuals who have developed the ability to empathize with the sufferings of others through sufferings that they have experienced themselves. >>more
Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years. His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."
Hertenstein MJ, Holmes R, McCullough M, Keltner D. The communication of emotion via touch. Emotion. 2009 Aug;9(4):566-73.
Abstract
The study of emotional communication has focused predominantly on the facial and Evelyn Coke, Home Health Aide, dead at 74. (NY Times, August 10, 2009)
"Year in and year out, Evelyn Coke left her Queens house early to go to the homes of elderly, sick, often dying people. She
bathed them, cooked for them, helped them dress and monitored their
medications. She sometimes worked three consecutive 24-hour shifts.
She loved the work, but she
earned only around $7 an hour and got no overtime pay.
For years Ms. Coke, a single mother of five, quietly grumbled, and then, quite uncharacteristically, rebelled. Ina case that reached the U.S. Supreme Court in 2007, Ms. Coke sued to reverse federal labor regulations that exempt home care agencies from having to pay overtime."This is an important, and sad Obit.
"God doth not needLet not Ambition mock their useful toil,
Their homely joys, and destiny obscure;
Nor Grandeur hear with a disdainful smile
The short and simple annals of the poor.
There's a Yiddish proverb: "If the rich could pay the poor to die for then, the poor would make a very good living." Sadly, this is happening.
Rembrandt's "Return of the Prodigal Son" Although we e-mail one another several times a week, my friend and I see each other but once a year. Once a year he travels from the southwest to visit his boyhood home and reconnect with his eastern roots. Once a year during his week-long stay we plan an afternoon rendezvous in a small town nestled in the mountains of eastern Pennsylvania.
Brian T. Maurer has practiced pediatrics as a Physician Assistant for thirty years. His "Marginal Notes" column appears periodically in the Cell2Soul Blog. The title "Marginal Notes" is taken from a quote by Henry David Thoreau: "I love a broad margin to my life."
Nell Burger Kirst, a 4th year medical student at the University of Michigan, tells a memorable and important story in the March 31st New York Times: Comforter and Comforted relates the story of a person who is called to be a "care giver." Little is written about this important human subspecies, yet they are the substructure of the entire health care system. Some are unlikely candidates.
Please read Nell's vignette. It's a keeper!
Image pilfered from New York Magazine
There is a short disturbing article in the NY Times summarizing a recently published study which found that "hospital patients are rarely able to identify their doctors by name or to describe their roles in the patients’ care."
To me, shockingly, Dr. Ernest Moy, medical officer at the federal Agency for Healthcare Research and Quality said “Do you really need to know who your doctor is, or is it more important to know some processes that will help you get at the information you need?” He added, "In some ways, ignorance is bliss."
Read the Times article and come to your own conclusions: Download Hospitalist Anonymity
The article in the medical literature the Times piece summarizes is:
Ability of hospitalized patients to identify their in-hospital physicians. Arora V, Gangireddy S, Mehrotra A, Ginde R, Tormey M, Meltzer D. Arch Intern Med. 2009 Jan 26;169(2):199-201. Your thoughts will be welcome.
