Thanksgiving

I have just completed two teaching assignments at my medical school, Columbia P&S. I was a preceptor for four second year students learning to take a medical history and examine a patient. Separately I taught a seminar regarding cancer, also for second year students.

The experiences were refreshing for me and a reminder about how earnest young people develop important skills to become bedside clinicians. All of the students at this medical school are very accomplished, bright and well motivated. What is striking is the transition from hard working student to empathetic clinician. The skill set is subtle. It is amazing to watch. I could see their beginning recognition that all of their book knowledge was only a fragment of what is required to be an excellent physician. Although compassion probably cannot be taught, I do think that when a student recognizes the unique position in to which they are placed in the intimacy of the patient – physician relationship, a change occurs. I can see a student develop a new respect for the complexities of human life and a discernment that he/she can make an important impact on another person’s health and well being. There are few other relationships as potent as this. It is striking how a stranger will present him/herself to a physician and open the windows into a unique life with all that is good and bad. The trust is palpable and requires great respect. The interaction is amazing and so fulfilling.

So, the students have gotten a glimpse of what is to come for them. I can see changes developing in them. I sense they are beginning to finally get to where they want to be as clinicians and not students and for them this time in school is truly transforming.

Last night, I received a phone call from my niece Emily, a nursing student who is also at the beginning stages of trying to understand the opportunity offered to her to become a clinician with its unique look into the lives of strangers. For now, for her, just coping with some of the awful insults to humanity now being presented to her is challenging enough. But, again, I got a sense of a budding clinician who will relish her opportunity to intercede and make a positive difference in the lives of her patients.

There is a wonderment about the process of becoming a clinician that I still find so stimulating. And for this opportunity to transmit what I have garnered from the practice of medicine to another generation, I give great Thanks today.

Transfiguration

When I walked into Edith’s room on the fancy floor of the hospital, she was sitting in a chair near the window overlooking the Hudson. The sun was low on the horizon and its rays reflected off her craggy face providing an unusual glow as if she were transfigured.

We are old friends as she has been a regular patient in my practice for many years dealing with recurrent iron deficiency anemia from blood loss from a longstanding rectal prolapse. There has always been a lingering worry that something more sinister was causing the blood loss and iron deficiency  but there were mechanical limitations to examining her colon and she was 90 years old with severe aortic stenosis that would have made any operation prohibitively risky.

I was paying a visit soon after she was told she had a widespread cancer problem that could not be treated. She had always been stoic about her life and her illnesses. At this visit, her impending death from cancer was not spoken about. Instead we discussed her good fortune in having a wonderful loving family and we reviewed a recent photo from the bris of a great grandson in which she was surrounded by a large and loving family.

She was proud and the reflected glow from the sun made her appear regal. Her immediate concern was her worry about leaving her family and the fear of that departure. She asked if I had a pill to deal with the anxiety that she was facing. I thought for a bit about this request. Not spoken was her fear of death and the loss of her conscious presence among her family. Of course this is a universal concern in my experience and one where no pill can fully alleviate the worry. My quick answer was of course, we have medicines that will make your passing easy and worry free. We looked at each other and she again told me how much she respected me as one of her physicians and that she was so grateful that she had been honored to know me. Left unsaid was her certain knowledge that I in reality did not have a pill to ease her transition. We kissed each other and promised to see each other in my office in the near future. This promise is also not likely to be fulfilled.

Later that night, I went to Zagura, a wine bar in the neighborhood where on a previous visit I had enjoyed an excellent pear martini. This time I ordered one hoping that it was still as good as the first time and to remind myself of Edith’s holiday gifts to me of bottles of vodka. It was excellent and the memories of her many gifts to me were equally luscious.

Remembrance Day

What do you mean you thought I was kidding?

Dear Dr. Oh You:

First, put your phone down for once and view this with your laptop or desktop. I’m sorry for the delay, but my laptop died, plus I was vivisected last week.

You have to pick a name for the blog!

Once you send me the (anonymous?) email account you want to use, you can get to the dashboard to see how it all works to change/add things/delete my nonsense. I think it’s a little frustrating at first (wordpress, not my nonsense).

By the way, I was very happy to learn about all this through trial and error, even if you don’t use it. Maybe I’ll have a blog one day and the knowledge will come in handy.

for the millions who will read this:

video trial

 Why would those spiffy men in this scene from Shame put olives in their pear martinis?