As venus turns around the sun in this "one in 150 years" eclipse I find myself moving away from the place I called home for the past 5 years. I came here with one suitcase, single and ready for adventure and I am leaving with a treasure full of spoils; wife, daughter, dog, cat and of course a title "Doctor" that will forever be mine, for better and for worse, if I choose it as my occupation or move on to another adventure, it will always be there, I have earned it.
As I try to enjoy these final moments between my last exam and my graduation I am finding it hard to feel happy in this moment of triumph, I am busy with packing and planning my way back to the mother land that I have hardly noticed that I am finished. This blog will try to identify this moment and help my busy mind set into the joy and fulfillment that is rightfully felt.
Organizing my life into boxes makes me think about the amount of STUFF I gathered throughout the years, it is a good opportunity to hand out things that are of no use for me but are worth plenty to others. Until I get settled down in my new place these boxes will be my home. My safe place will be the road and the feeling of peace and quite that accompany the safety of ones home will not be felt until the boxes are unpacked and placed away.
This entry took 3 weeks to be written, not because the english is fabulous or the idea is revolutionary, just because I had no time to write and no time to dwell on my accomplishment.
Sunday, June 24, 2012
Wednesday, May 16, 2012
Starting to walk
My daughter is starting to walk by her own. Other then being a great achievement it is really her first steps toward independence. The freedom she experiences when starting to walk is a lesson I wish I could take with me on my day-2-day life. She is one year old now and she is just waddling all over the house.
Something in me wishes to go back to the feeling of accomplishment like that fist step, first word, first anything. It's like magic seeing her face when she "gets it". I wish her great travels and even greater adventures in the future.
I want to try and imagine that every day should be the start of something big, a real achievement. When I wake in the morning I want to feel like today will be the day that I start to walk. Starting to walk can symbolize any new beginning, even things that I do everyday can be looked upon as if they were done for the first time, with all the awe and gratitude that comes with the first step.
I wish I could remember these wishes during the day, they seem so clear to me when I write them down but after I leave the PC to go on with my life I forget, I get caught up in life and I can't bring myself to focus on the important moments. Well that is not exactly true...I find the moments...and they are magical.
Something in me wishes to go back to the feeling of accomplishment like that fist step, first word, first anything. It's like magic seeing her face when she "gets it". I wish her great travels and even greater adventures in the future.
I want to try and imagine that every day should be the start of something big, a real achievement. When I wake in the morning I want to feel like today will be the day that I start to walk. Starting to walk can symbolize any new beginning, even things that I do everyday can be looked upon as if they were done for the first time, with all the awe and gratitude that comes with the first step.
I wish I could remember these wishes during the day, they seem so clear to me when I write them down but after I leave the PC to go on with my life I forget, I get caught up in life and I can't bring myself to focus on the important moments. Well that is not exactly true...I find the moments...and they are magical.
Thursday, May 10, 2012
Last day of university
It has happened, today was my last day in the university as a student. The beginning of the end has started, I still have one exam left at the end of this month, but until then I have no obligation to come in to study - I have this time to study at home and prepare for the exam - so I consider this to be my last day in university. I can count down the days I will be visiting the walls of my faculty on one hand. Mostly to finish up some academic bureaucracy - return all the books to the library and hand in my locker key to the janitors.
I haven't really seen any interesting cases that are worth my opinion lately, that is way I haven't shared any ideas for the past week or two.
I am just getting used to the idea that I have finished something big. Until now it was mostly a vague idea in the mist, but today it suddenly became real. I am going to be a doctor. Its kinda freaky to realize it, the responsibility that comes with the job can debilitate me and cause me to freeze, but I choose to stand strong and hold my head up high towards what the future will bring. The responsibility. The hard work. The challenges. The long shifts with low pay. The fulfilling feeling of maybe saving life. It all starts with the last day of university.
The journey has begun...I'm sure it will be a great film...I can't wait to see the end but I'm really interested to find out how everything will unfold.
I am just getting used to the idea that I have finished something big. Until now it was mostly a vague idea in the mist, but today it suddenly became real. I am going to be a doctor. Its kinda freaky to realize it, the responsibility that comes with the job can debilitate me and cause me to freeze, but I choose to stand strong and hold my head up high towards what the future will bring. The responsibility. The hard work. The challenges. The long shifts with low pay. The fulfilling feeling of maybe saving life. It all starts with the last day of university.
The journey has begun...I'm sure it will be a great film...I can't wait to see the end but I'm really interested to find out how everything will unfold.
Tuesday, May 1, 2012
Practical Medicine???
I wonder how practical the use of medicine really is? If this question is a little unclear let me try to clear it up before I add my opinions on the topic.
I studied chinese medicine and acupuncture for 2.5 years before I started my journey into modern medicine. Back then I thought I was not getting enough information from my classes and I searched to understand the human body better, so I went to learn medicine. One thing I can say for sure is that I do understand much more of the biology and chemistry and physics and molecular processes in the body, but do I really understand the body more? That question is still not answered to me.
While I was learning acupuncture I felt I had the power to "heal", I could always poke a friend with a needle and treat his headache, stomach ache or just get him to clam down. Of course this was not always successful due to my human errors in finding the right acupuncture point or just due to the fact that acupuncture is not an exact science and not always the results are clear and immediate but at least I could treat, I wasn't afraid to try, whats the worst that could happen???? That is what I call a practical medicine. Medicine that can be used on a day-to-day basis and give results.
Today after 6 long years and even longer nights of studying and remembering all kinds of crazy syndromes and pharmaceutical names I can't even treat my wife when she wakes up in the middle of the night to vomit and has a diarrhea from hell. I forgot the acupuncture points for vomiting and nausea, I don't have any needles left for treating...all I could do was tell her to hold on tight its probably a virus and tomorrow she would feel better.
I was right, it was a virus, a 24 hour flu, but what about the practical part of my studies what about the practical medicine??? I felt useless. Yes I could have gave her a prescription for some anti emetics or open an IV fluid line, but I could do nothing to help her symptoms make her feel better right there and then. "We'll go to the doctor in the morning" "I'll find an open pharmacy maybe they can help". Modern medicine heals and prolongs life but in order to fully treat we need the equipment and the computers and the microscopes and the chemicals...we forgot how to heal using nature, we forgot how to look at a human body and not only at the numbers of a blood test.
I believe the combination between the two worlds is the future, and I hope one day to find a way to implicate both worlds into my practice and to be able to truly heal. Am I naive? Am I innocent? Time will tell....time will tell.
I studied chinese medicine and acupuncture for 2.5 years before I started my journey into modern medicine. Back then I thought I was not getting enough information from my classes and I searched to understand the human body better, so I went to learn medicine. One thing I can say for sure is that I do understand much more of the biology and chemistry and physics and molecular processes in the body, but do I really understand the body more? That question is still not answered to me.
While I was learning acupuncture I felt I had the power to "heal", I could always poke a friend with a needle and treat his headache, stomach ache or just get him to clam down. Of course this was not always successful due to my human errors in finding the right acupuncture point or just due to the fact that acupuncture is not an exact science and not always the results are clear and immediate but at least I could treat, I wasn't afraid to try, whats the worst that could happen???? That is what I call a practical medicine. Medicine that can be used on a day-to-day basis and give results.
Today after 6 long years and even longer nights of studying and remembering all kinds of crazy syndromes and pharmaceutical names I can't even treat my wife when she wakes up in the middle of the night to vomit and has a diarrhea from hell. I forgot the acupuncture points for vomiting and nausea, I don't have any needles left for treating...all I could do was tell her to hold on tight its probably a virus and tomorrow she would feel better.
I was right, it was a virus, a 24 hour flu, but what about the practical part of my studies what about the practical medicine??? I felt useless. Yes I could have gave her a prescription for some anti emetics or open an IV fluid line, but I could do nothing to help her symptoms make her feel better right there and then. "We'll go to the doctor in the morning" "I'll find an open pharmacy maybe they can help". Modern medicine heals and prolongs life but in order to fully treat we need the equipment and the computers and the microscopes and the chemicals...we forgot how to heal using nature, we forgot how to look at a human body and not only at the numbers of a blood test.
I believe the combination between the two worlds is the future, and I hope one day to find a way to implicate both worlds into my practice and to be able to truly heal. Am I naive? Am I innocent? Time will tell....time will tell.
Thursday, April 26, 2012
C-section or vaginal delivery - the need to control
There is a big debate, in our gynecology department, about the "trendy" rise in c-sections vs vaginal delivery**. It seems that when given a choice between c-section and vaginal delivery a lot of woman prefer the surgical procedure upon the natural birth. I am not regarding the cases where c-section is indicated to save the life of the baby or the mother, but rather in the absence of medical indications the mother chooses the "quick and painless" approach.
As a doctor I can understand the comfort of a c-section, the procedure is scheduled to a convenient time (most commonly in the morning after a nice coffee and breakfast) and I have the control over what is going on. As a patient I think everyone acknowledges that there is no pain like labor pain (not that I know it for a fact but I believe my wife) and the comfort of painless labor is very appealing. While picturing the birth of a baby in the eyes of a mother I'm sure that there is always the fear of pain that comes with it. When given the choice, by the physician, c-section or vaginal - painless vs painful the decision is not really a fair one.
On the other hand I see the underlying need here is what pushes most people today in this world regarding their decision making and actions. The need for CONTROL. " I want to have control over this terrifying and overwhelming event" "This is nothing I can fully prepare for and I rather be in control then face the consequences".
The act of giving birth is one that requires the most trust, in the body, and the will to just LET GO. I think this is the one place that if a woman does not let go of her control the labor cannot continue or even slows down. It's an important lesson to realize that our body is just a vessel through which LIFE is taking place. Creation is stronger then our will to control it.
Try and ask yourself: "Are you willing to let go and trust yourself or do you need to be in control?" "Do you rather have a c-section or vaginal delivery?
The facts are that c-sections carry a higher risk then spontaneous labor, for the baby and the mother. The risks are not only immediate risks due to the surgery but also future risks concerning the well being of the baby and further pregnancies (click here to see a list of these risks), all these risk are of minor importance, of course, if the need for medical intervention is essential.
There are also risks in spontaneous vaginal labor, I'm not denying that, but remember, this is what your body is intended to do, this is what women have done thousands of years before you - YOU CAN DO IT! Believe in yourself and in your body's ability. You have the ability to give life, it is a gift that not everyone gets a chance to fulfill, take advantage of it, LIFE.
**There is a rising trend favoring cesarean section. In the UK during 1953, 2% of births were c-section while in 2001 that number got to 21%. The nation average in the USA stands on 24% and the differences between private sectors and public are large. (numbers taken from: Lavender T, Hofmeyr GJ, Neilson JP, Kingdon C, Gyte GML. Caesarean section for non-medical reasons at term. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004660. DOI: 10.1002/14651858.CD004660.pub2.)
As a doctor I can understand the comfort of a c-section, the procedure is scheduled to a convenient time (most commonly in the morning after a nice coffee and breakfast) and I have the control over what is going on. As a patient I think everyone acknowledges that there is no pain like labor pain (not that I know it for a fact but I believe my wife) and the comfort of painless labor is very appealing. While picturing the birth of a baby in the eyes of a mother I'm sure that there is always the fear of pain that comes with it. When given the choice, by the physician, c-section or vaginal - painless vs painful the decision is not really a fair one.
On the other hand I see the underlying need here is what pushes most people today in this world regarding their decision making and actions. The need for CONTROL. " I want to have control over this terrifying and overwhelming event" "This is nothing I can fully prepare for and I rather be in control then face the consequences".
The act of giving birth is one that requires the most trust, in the body, and the will to just LET GO. I think this is the one place that if a woman does not let go of her control the labor cannot continue or even slows down. It's an important lesson to realize that our body is just a vessel through which LIFE is taking place. Creation is stronger then our will to control it.
Try and ask yourself: "Are you willing to let go and trust yourself or do you need to be in control?" "Do you rather have a c-section or vaginal delivery?
The facts are that c-sections carry a higher risk then spontaneous labor, for the baby and the mother. The risks are not only immediate risks due to the surgery but also future risks concerning the well being of the baby and further pregnancies (click here to see a list of these risks), all these risk are of minor importance, of course, if the need for medical intervention is essential.
There are also risks in spontaneous vaginal labor, I'm not denying that, but remember, this is what your body is intended to do, this is what women have done thousands of years before you - YOU CAN DO IT! Believe in yourself and in your body's ability. You have the ability to give life, it is a gift that not everyone gets a chance to fulfill, take advantage of it, LIFE.
**There is a rising trend favoring cesarean section. In the UK during 1953, 2% of births were c-section while in 2001 that number got to 21%. The nation average in the USA stands on 24% and the differences between private sectors and public are large. (numbers taken from: Lavender T, Hofmeyr GJ, Neilson JP, Kingdon C, Gyte GML. Caesarean section for non-medical reasons at term. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004660. DOI: 10.1002/14651858.CD004660.pub2.)
Monday, April 23, 2012
Hospital discrimination and fair treatment
I always had a feeling that there is some kind of hospital discrimination but I never saw it happening as obvious as today. I believe unfair treatment happens all over the world but to be able to look at things from the eyes of an outsider helps give perspective and objectivity about a fairly common situation.
A 32 year old patient arrived to the delivery room today after giving birth in the ambulance bringing her to the hospital. I first saw the baby, he seemed healthy enough and was going through the Apgar scoring and initial check ups / screening. The mother arrived shortly after with the umbilical cord dangling between her legs, waiting for the last stage of labor - the delivery of the placenta. As expected in a few minutes and a little push on the belly from a midwife the placenta came out completely.
The woman was suffering from some lacerations due to the delivery and needed stitches, I was shocked when the doctor started stitching without any local anesthesia. At first I thought its probably going to be one or two stitches and that they decided to spare the needle poke. I was wrong. Lets just say that it was a lot more then one or two.
I could tell that the lady was simple minded and belonged to a minority group. She was very poorly dressed and her hygiene was the dictionary definition for the word "dirty", non the less she was in pain and yelled out in agony but the "professionals" just told her to relax and that it should be over soon. There was not much I could do as a student, but I knew this was hospital discrimination. If she were a bit cleaner and a bit "whiter" the attitude would be different I'm sure. I asked the doctor afterwards why she didn't use any anesthesia, and she told me that in her opinion the patient didn't need any anesthesia.
I regret not asking the doctor there and then why she didn't use any anesthesia. Maybe I should have insisted.
This story is really shocking but discrimination doesn't have to be so obvious, it can be a attitude towards a patient or even just a face not in place. I just want to use this blog to address any doctors / future doctors that may be reading, we are in a profession that people trust us, trust our opinions and believe in our words and actions, even when life is on the line. We cannot take advantage of this trust, we must be true to our profession even when the patients is not aware of his simple rights, like getting anesthesia when being sutured.
I pray for the ability to always see each patient as the human he is and the miracle that he is. I hope I will not be institutionalized by the day to day practice and forget my humanity.
A 32 year old patient arrived to the delivery room today after giving birth in the ambulance bringing her to the hospital. I first saw the baby, he seemed healthy enough and was going through the Apgar scoring and initial check ups / screening. The mother arrived shortly after with the umbilical cord dangling between her legs, waiting for the last stage of labor - the delivery of the placenta. As expected in a few minutes and a little push on the belly from a midwife the placenta came out completely.
The woman was suffering from some lacerations due to the delivery and needed stitches, I was shocked when the doctor started stitching without any local anesthesia. At first I thought its probably going to be one or two stitches and that they decided to spare the needle poke. I was wrong. Lets just say that it was a lot more then one or two.
I could tell that the lady was simple minded and belonged to a minority group. She was very poorly dressed and her hygiene was the dictionary definition for the word "dirty", non the less she was in pain and yelled out in agony but the "professionals" just told her to relax and that it should be over soon. There was not much I could do as a student, but I knew this was hospital discrimination. If she were a bit cleaner and a bit "whiter" the attitude would be different I'm sure. I asked the doctor afterwards why she didn't use any anesthesia, and she told me that in her opinion the patient didn't need any anesthesia.
I regret not asking the doctor there and then why she didn't use any anesthesia. Maybe I should have insisted.
This story is really shocking but discrimination doesn't have to be so obvious, it can be a attitude towards a patient or even just a face not in place. I just want to use this blog to address any doctors / future doctors that may be reading, we are in a profession that people trust us, trust our opinions and believe in our words and actions, even when life is on the line. We cannot take advantage of this trust, we must be true to our profession even when the patients is not aware of his simple rights, like getting anesthesia when being sutured.
I pray for the ability to always see each patient as the human he is and the miracle that he is. I hope I will not be institutionalized by the day to day practice and forget my humanity.
Wednesday, April 18, 2012
Opinion on abortion
There are many opinions on abortions, but I think most will agree that it is a difficult procedure for both mother and physician. I don't think it matters what's the indication. Today I saw an 18th week pregnancy being terminated. It was the first time I witnessed an abortion.
The indication was clear: multiple genetic abnormalities were confirmed by amniocentesis and USG. According to the doctors opinion the fetus was not compatible for life and an abortion had to take place.
The procedure was technically simple: The patient was placed under general anesthesia. The cervix was dilated and evacuation took place. It only took 10-15 minutes to preform yet I believe no one in the room was left untouched, even the most experienced doctor in the room admitted that this was the worst part of being a gynecologist "I never get used to it" she said.
The debate over legalizing abortions is one with no definite answer, I believe that both opinions "pro life" or "pro choice"can be understood and have a righteous background. I can just say that observing the abortion left me with many questions.
I have not yet established my opinion on abortion and I have a feeling that I will never have a definite one. I can only hope that as a doctor I will do what I think to be the best thing at that moment for my patient. Hopefully those would be the thoughts that guides my actions.
If anyone is interested here is a link about facts collected on abortions and their outcomes that were published in well known journals.
The indication was clear: multiple genetic abnormalities were confirmed by amniocentesis and USG. According to the doctors opinion the fetus was not compatible for life and an abortion had to take place.
The procedure was technically simple: The patient was placed under general anesthesia. The cervix was dilated and evacuation took place. It only took 10-15 minutes to preform yet I believe no one in the room was left untouched, even the most experienced doctor in the room admitted that this was the worst part of being a gynecologist "I never get used to it" she said.
The debate over legalizing abortions is one with no definite answer, I believe that both opinions "pro life" or "pro choice"can be understood and have a righteous background. I can just say that observing the abortion left me with many questions.
 |
| Drowning in thought and emotion |
- Questions regarding our medical opinion and the weight it carries.
- Ethical grey areas that no one really knows what is right or wrong and how to act.
- Moments in life where our actions as medical doctors can come into conflict with our beliefs.
- A practice that combines life and death so clearly but can be regarded as nothing more then a "medical procedure".
I have not yet established my opinion on abortion and I have a feeling that I will never have a definite one. I can only hope that as a doctor I will do what I think to be the best thing at that moment for my patient. Hopefully those would be the thoughts that guides my actions.
If anyone is interested here is a link about facts collected on abortions and their outcomes that were published in well known journals.
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