Tuesday, March 26, 2013

FFT

I love family medicine

I hate family medicine because I can't cure my patients.
I love family medicine because I can listen.
I hate being a family doctor because my patients die.
I love being a family doctor because I become part of the family.
I hate being a family doctor because I am late for dinner with my family.
I love being a family doctor because my kids run and hug me when I get home.
I hate being a family doctor because some days I am exhausted mentally and physically and have nothing left for my family.
I love being a family doctor because it makes me appreciate my family more.
I hate being a family doctor because people complain most of the day.
I love being a family doctor because I know these patients are not my family.
I hate being a family doctor because people show me all sorts of disgusting body fluids like sputum and stool.
I love being a family doctor because I have funny stories about what people show me at work.
I hate being a family doctor because it is so frustrating trying to access specialty care and diagnostic imaging for my patients.
I love being a family doctor because it is an amazing feeling when I can get my patients into medical services that they need quickly.
I love being a family doctor because of the collegiality I have with my office colleagues and staff.
I hate being a family doctor because I see so many patients in my nursing home suffer from severe dementia.
I love working in my nursing home because I focus on quality of life with my patients.
I hate being a family doctor because I spend more time with my patients than with my kids and wife.
I love being a family doctor when my five-year-old son asks me to take him on a house call.
I love being a family doctor because my five- and six-year-old children already know the words: axilla and patella.
I hate being a family doctor because I spend only 10 or 15 minutes with my patients.
I love being a family doctor because there are some patients I want to spend only 10 minutes with.
I hate being a family doctor because I am expected to know everything.
I love being a family doctor because my patients appreciate my honesty when I tell them I do not know the answer.
I hate being a family doctor when I have to tell bad news.
I love being a family doctor because I can support and help my patients when there is bad news.
I hate being a family doctor because I can't motivate or change my patients' behaviour.
I love being a family doctor because occasionally a patient makes a lifestyle and behavioural change and becomes healthier.
I hate being a family doctor when all I can offer is a medication prescription.
I love being a family doctor when I tell someone they no longer need that medication.
I hate being a family doctor when I worry I may have missed a significant diagnosis.
I love being a family doctor when I make a diagnosis that has a significant impact.
I love being a family doctor because it affords endless opportunities for work and lifelong learning.
I love being a family doctor because I can be a leader in my community.
I love being a family doctor because it makes me appreciate life, myself and my family.

- Daniel Dodek

Monday, November 12, 2012

FFT

Glass

A visit by the Pope to families in two small shacks of wood and corrugated iron occupied by 10 and 14 people respectively in a squalid, muddy back alley without sewage was cancelled at the last minute for unexplained security reasons.                         UPI/Reuter

That world will come like a thief
and steal all we possess
Poor and naked, we will be transparent as glass
that both cuts and reflects.                               Karol Wojtyla

Nothing else was cancelled

The glittering ceremony
in the Presidential palace
The carefully orchestrated
motorcade across the city

Nothing else was cancelled

The solemn meeting
with the august Cardinal
The Mass for massess
in the majestic cathedral

Nothing else was cancelled

For neither chandelier
nor stained glass
nor pointed mitre
nor rear-view mirror
can cut and reflect
cut and reflect like
the naked and the poor

And their squalid
back alley shacks
their open latrines
their armies of flies
bugs and cockroaches
the sharply pointed
ribs of their children
will ever pose the greater
threat to the security
of thieves who have stolen
their birthright and
rooted themselves in power

The poor have nothing
to lose but their poverty.


-Cecil Rajendra, Songs for the Unsung

Tuesday, October 09, 2012

Vows, deeply knotted and embedded tightly

I suspect it's probably a bit normal to get a bit of the jitters before the big day, wondering if it's the right decision, and whether you have the constitution to persevere and work and love, even when it's really hard and you don't feel like it, for multiple decades. And this is even if, deep in your heart of hearts, you already know it to be true. And this is even when you know that the big day is just the beginning of a long and adventurous journey, that it hardly registers as a blip on the rollicking, rolling waves of life.
I suppose also that God is kind of funny in how He'll give you a smack upside the head every once in a while to remind you of things that you know to be fundamentally true, but just so that He brings it right back up to the surface again, to remind you. And not too hard, just barely enough for you to handle, but definitely obvious enough that it is hard to miss.
Kind of like this trip to the ICU. I'm thankful that it was a medical smack upside the head; I could speak their language, and gauge better the severity of the calamity, and weigh it more rationally than if it was, say, a hostage-taking scenario (Christ have mercy upon us). I am thankful that it happened here and not there. I am thankful that there was no need for intubation and ventilation; I'm not sure how I could have handled intubation. I am thankful that mostly peripheral lines were sufficient for what needed to be done, and I could not perceive the central line. I am thankful for being able to interpret, and have interpreters walking alongside me, as to what was happening. I am thankful for the homecoming and the slow recuperation.
What it did, though, was bring into stark relief some of the cliches that we speak of: the reality of 'in sickness and in health', the ephemeral nature of life itself, that love can conquer all, even beyond the grave. Some of this helped alleviate my fears, though not totally. But it helped confirm for me, yes, I can. Yes, I will. Yes, I do.

Tuesday, September 11, 2012

FFT - love songs II

Forever

Forever is a holy word
I've stolen from God's vocabulary
that I dare to utter when speaking of my love for you.

From the ten thousand names of God
with lips trembling in fear,
I have chosen Forever
to sing of my love for you.

Idolatry - to make human love divine
and put it on par with God
no, not idolatry, but identity
for love and God are one
when love longs to be Forever.

O You who never created love,
but are Love and Love-Forever,
gift me with your sacred heart
to love You and my beloved,
Forever, Forever.

-Psalms for Zero Gravity

FFT - love songs I

This is just a series of poems that a friend of mine had shared with me, many years ago. They're so beautiful, but, wanting to save a bit of space, I'm going to post them here:

Love Sonnet II

Love, what a long way to arrive at a kiss,
What loneliness-in-motion, toward your company!
Rolling with the rain we follow the tracks alone.
In Taltal there is neither daybreak nor spring.

But you and I, love, we are together
From our clothes down to our roots:
Together in the autumn, in water, in hips, until
We can be alone together - only you, only me.

To think of the effort, that the current carried
So many stones, the delta of Boroa water;
To think that you and I, divided by trains and nations,

We had only to love one another:
With all the confusions, the men and the women,
The earth that makes carnations rise, and makes them bloom!

- Pablo Neruda

Friday, September 07, 2012

Goodness gracious!

I am terribly bad at keeping up with this blog. I think I've mentioned this before, with the rise of Facebook, that it makes it a bit harder to write something slightly more substantial than a status update. In many ways, it's easier to just post a sentence of what one is thinking about and getting immediate feedback, rather than this format, where it goes off into the ether, and I have no idea where it goes, or who sees.
At any rate, nothing really much to say since. So that is my non-status update :) .

Friday, August 03, 2012

The Dark Knight critiqued

So I know I'm not the most avid pop-culture consumer, but went with some friends to go watch the newest Batman flick. Now, I have no idea what has been happening prior to this one; I haven't seen a Batman movie back since Michael Keaton was the Batman (yes, I know some people will think that is lame, but that's just the way it is).
However, the film disturbed me in the way it critiqued worldview. We all know Batman is this brooding, independent, reluctant to cooperate with government and authority structures, ridiculously wealthy gazillionaire because of his vast holdings. In short, a libertarian, capitalistic, wealthy hero. He wins, in part because of his wealth, but also because of his subversion and general avoidance of working with authority and rules. Hm.
The villain in this movie decides what should function instead is a more horizontally economic system, with democracy handed back to the 'people'. Admittedly, he is a bit psycho with the nuclear bomb, and you do have to wonder how he manages to eat in order to keep his strength up, but his concept is to raze the power structures entirely, allowing a horizontal governance system, where the rich are no longer allowed to oppress the poor and marginalized.
And this is one of the great clashes in this story: The Occupy Movement, characterized as chaotic and terrible, vs. the Dark Knight, with hints of aristocracy in knighthood, coming to re-establish the status quo of the power structures already in place.
It's interesting in looking at the movie from that angle; clearly Hollywood would be one of the first to be demolished if the ideas of the Occupy movement could take hold - the power structures and clear class discrepancy is rampant. No wonder why they would demonize the idea of the marginalized taking back power and taking back wealth.

Wednesday, June 20, 2012

Switzerland Part II Episode V

Man, today did it. Quantitative scientific research, purely for the sake of its own existence, was utterly denigrated for me. I used to believe that good, solid research could inform policy, make positive changes for people, and could be used for good. Now, I realize, though it may tangentially serve those purposes, it's really to provide means for researchers to continue to fund themselves and their livelihoods.
Case in point: Here's a common sense notion - poverty profoundly affects many lifestyle outcomes. It affects smoking rates, it affects employment prospects in that people are corralled into jobs that are more hazardous, it affects housing quality and materials, as well as geographical location (such as closer to highways, industrial zones, petrochemical plants, etc).
So, I attended a talk today re: respiratory outcomes in children and environmental factors that impact lung function. Though the speaker was very nice, he's interested in doing a massive study to try to measure environmental factors that may impact pediatric lung development. When I asked explicitly about the socio-economic factors and poverty that would inevitably impact disproportionately on those who are lower-income as well as from lower-income countries, they had not really taken that into consideration. When asking about how this, then, could impact policy in countries where issues such as housing quality and placement, etc. could be affected if such factors were not taken into account, there was no answer. The 'scientific' approach was to determine and quantify the environmental factors (specifically pollutants, not environmental factors such as class or income) could affect pediatric lung development.
However, without disaggregating the data, and how it would disproportionately impact the poor, perhaps no significant findings will be found. Perhaps in aggregating the data, less aggressive targets and measures to decrease air pollutants would be made.
Sigh. What is the point of research if it is simply a fatuous exercise?