Archive for April, 2008

Psychosis

Psychiatry is fascinating in that people who are psychotic are not that different from normal people.  The difference is the degree of impairment from psychotic thoughts that bring people to A-2.  I get depressed, wish to die, get angry and somtimes I’ve even had minor psychotic, delusional breakdowns, but somehow I manage to maintain control and perspective that keeps me functioning in the normal world.  This is a terrific insight into psychiatric illness because I used to be scared of psychotic people.  I’m starting to understand them a little more.  Although I will always be wisely cautious around “crazy” people, they have some rationale for their behavior and ultimately want what everyone wants: self-respect and respect from others.

Advertisements

Real?

For all my ranting about the medical community/school, etc, I wonder how my analytical side would have faired in a more rigorous environment, challenged to hone my skills and answer pimping questions.  Today I sat through almost 4 hours of touchy-feel-ly discussion between the residents (mostly the international medical graduates-IMGs) and the faculty of the Maine Darthmouth Family Medicine Residency.  The program has become known for its laid-back, open-minded program.  The IMGs were concerned that people were excited next year’s intern class had no IMGs, which turned into this huge discussion on ethnic diversity, benefits of IMGs and disadvantages, blah, blah, blah.  Some points were valid and interesting, but I was not interested in sob stories.  I feel like such a hard-ass.  I greatly admire the IMGs for coming to the US for their training despite being away from their home culture and familiarity, but why are they so upset if the patients can’t understand them or ask where they’re from?  I wonder what it would be like in a place that doesn’t allow this kind of belly-aching.  Where the goal is teaching/learning and patient care.  Would I feel just as alienated because of the lack of human relating or would I be more comfortable?

Last thought (has to include Osteopathy, right?): there was some discussion about the prejudice against DO’s and I was wondering if ANY of the DO’s or OMS’s feel discriminated against because they want to treat a patient (regardless of disease) with manipulation.  To be honest, I feel like my education has discriminated me against Osteopathy because we have to behave and think like medical students.  And yet one of UNECOM’s goals is innovation in health care.  Did they ever consider that returning to our roots would be an innovation at this point???  It kind of makes me laugh and cry and go insane, but I have to be careful because I’m on my psychiatry rotation and they might not let me go home!!!

It is completely ironic that I have to “get through” my education without getting the education I really want.  Although, maybe next year…maybe I’ll find people who treat all diseases with manipulation and can talk to me about the anatomy…maybe next year…

All I want

Truth, honesty and integrity.  That’s what attracted me to Osteopathy, that is why I am constantly searching for a spiritual home, that’s why I want Obama to win the election.  Even science is a search for the truth.  However, he truth is obscured when people let their egos get involved, when pharmaceuticals fund the research and when the AMA has the largest influence on societal beliefs.  People and finances do the worst damage as far as messing up something that is good and divine.  This has been happening since the bible was written and will probably continue until people finally kill each other or go extinct for some other reason.

A surgeon’s perspective

It is so interesting to get different people’s opinions of me.  I was evaluated today by the surgeons I’ve been working with.  They labeled me as quiet, reserved, passive, even mousy.  They were concerned I would not make an impression on people where I rotate or do my residency.  This is interesting for 2 reasons: first, they are surgeons and by definition they have to fairly out-going and aggressive.  For goodness sake, they are cutting people up!!  Therefore, they don’t understand introverts.  I am an excellent listener, thoughtful and compassionate.  I wasn’t able to show them these qualities in the OR other than listening to people yak, in which case they don’t notice anyone is listening as long as no one else is talking!!  Plus, they didn’t see me in lectures where I regularly answer questions or ask questions of the instructor while most other students sit passively through the lectures.

Secondly, the OR was an extremely intimidating place for me, so I naturally shut down until I became comfortable and understood my position.  Once I became comfortable, I didn’t have many questions because surgery became rather boring to me.  Once patients are scheduled for surgery, or yet, as soon as they are referred to a surgeon, the course of action is fairly straight forward.  I asked a few questions that I thought were intelligent, but I didn’t ask the questions like, “Do you think OMT instead of surgery could help facilitate the healing of this [fill in the blank]?”  “Should we do soft issue OMT to the thoracic and lumbar paraspinal muscles to help this patient regain bowel function?”  “How about suboccipital release for all the patients who are intubated?”  What’s really ironic is that Inland Hospital is the only Osteopathic hospital left in Maine, but you’d never know this by the way it is run…

Medicine…

I was reminded after my last post that allopathic medicine has quite a bit to offer patients.  I do believe that, especially in the case of emergency situations.  Today I saw a woman prepared to be air lifted to Bangor from Waterville because she had a rupture thoracic aortic aneurysm with right hemothorax.  It was an intense experience and I was the official glove provider.  🙂  My emphasis on this blog is in regards to all that allopathic medicine cannot do or does not understand: assisting the body heal a diabetic foot ulcer by stimulating circulation or alleviating an asthma attack by putting your hands on the patient’s ribs.  Natural, common sense approaches to patient care.  I’m learning about fluid management, electrolyte disturbances, surgical patient perioperative care, which is useful.  The constant question in the back of my mind is how many of these procedures are actually preventable given appropriate Osteopathic management?  Breast biopsies, cyst/abscess removals, I even wonder about appendectomies.  The key word here is WONDER.  Until I get significant experience, I plan to practice as expected.  My constant curiosity, analytical ability and faith in the body to heal itself given the right circumstances will continue to gnaw at the back of my mind.

Fear of…

Fear is the basis of so many problems, possibly all the social problems of the world.  I have dealt with a significant amount of fear during my time as an Osteopathic medical student, however, my fear is rarely that of other students (passing tests, getting into a “good” residency, remembering a lot of useless facts so I can stand around and tell patients that nothing can be done, etc), so I often feel alone.

My fear and deep sadness is that Osteopathy will be lost in the US.  I also have personal fear of treating people because I’m afraid they won’t get better or I’ll make them worse (counter-argument: just touching is helpful).  I am getting better with this fear, but it still exists.  I have fear of treating patients in the hospital because I worry about liability issues.

Regarding the politics of Osteopathy, fear also plays a role in a subtle and sometimes not so subtle way.  The allopaths obviously feared Osteopathy and what it could accomplish where their skills were lacking.  In the adversity the early Osteopaths faced, they found strength to defend what is true.  The concept of finding health was emphasized in Dr. Still’s writings, which is why he was so successful.  He studied anatomy until it was literally pouring out of his hands.  Health created all the bones, blood vessels, nerves, muscles  and restriction in these tangible structures cause tangible disease.  So simple and elegant that many DOs feared they were not living up to their obligations as physicians compared to MDs who studied more, therefore they must know more.  My reply would be, “Yes, they know more bullshit”.  This basic fear is what eventually lead to the development of DO schools being just like MD schools with manipulation.

Yoga and Brits

One of the general surgeons I work for is one of the nicest people I know.  He is so gracious and polite, even to the obnoxious nurse that everyone else ignores.  He recently moved to the States from Britain and that may partially explain his congeniality, but he speaks of some of the surgeons in England who are complete asses, as one would expect from a surgeon.  He makes me feel guilty for being judgmental/critical.  Unfortunately this a is a part of who I am and although I know it is not something to be proud of, it is what has helped me in my pursuit of various scientific degrees.  However, I see the healing effect that this surgeon has on the patients, nurses, students and other doctors and it is humbling.

I started reading a book dissecting the different types of yogas.  The yoga we are most familiar with is Hatha yoga, where people use exercise to separate soul from mind/matter and connect with the greater Oversoul.  However, all forms of yoga are various ways to attain this goal and they just use different means to get there.  I’ll write more as I learn more.  I’m learning a lot of new vocabulary, so the information is not sticking as well as I would like, hence I will write interesting tidbits as they come up.

“The Audacity of Hope” by Barack Obama

I know that the democratic nomination is getting out of hand with Hillary and Barack jockeying for the upper hand. As far as I’m concerned Barack Obama is the most amazing presidential candidate I can remember. I’ve never liked politics or history. I was inspired to buy his book last summer and read about half of it. I was impressed with his knowledge of history and his admiration for the constitution. He really is a beacon of hope. I often feel so despaired by our country’s lack of integrity that I forget to see what an amazing place it is. Barack is able to kindle hope in people.

I put down his book once I started rotations because I was busy adjusting to my new life on the wards, and I was also a bit discourage by people who didn’t believe he would be a viable candidate due to his color, age and lack of political experience. Now that he is technically in the lead, I picked up his book again. It brings me to tears to see how intelligent he is, seeing the trees as well as the forest, understanding individual struggles and how government policies affect people, corporations and foreign alliances. He has the humility to admit his own faults while striving to do his best. He is an inspiration and I pray he becomes our democratic nominate and wins the general election. He could change this country and how other countries view us.

Assassination Aniversary

Once again, I am struck by the spiritual strength of people when fighting for a common good.  Today is the 40th year anniversary of Martin Luther King Jr’s assassination.  Black Entertainment TV showed the movie “Boycott” starting with Rosa Parks in 1955, leading into the boycott of the Montgomery buses for 381 days until the federal court’s decision to uplift the segregation laws on the buses in 1956.  One and a half years later Martin Luther King Jr was shot after changing a nation.  The Civil Rights Movement, at least how it is depicted, was beautiful, full of amazing courage and non-violence it makes me cry.

As in my last entry, I am still looking for my cause.  I know that Osteopathy is a part of it.  Another interesting correlation is this.  A famous quote of AT Still’s is, “It is the job of the Osteopath to find health, anyone can find disease.”  Perhaps my cause is to find health in society (love, flourishing individuals, laughter) instead of disease (injustice, hatred, violence).  In reality that is really all anyone can do. We often start with a disease and in the process of figuring out how to cure it, we have to find the health.  On the other hand if we go straight to the health, disease will no longer manifest itself.  Sigh…if it were only that easy…

« Previous entries