September 13, 2014

Living: It’s Parents’ Weekend at Vanderbilt and Neil and I are visiting our eldest. Seems early in the year, but it was time for an “Erin fix”. Last night we saw The Giver, which I’ve not yet read. It was a nice story, sort of addressing the age old “If God is benevolent, why is there pain in the world?” Answer: “You can’t have good if you don’t have bad” or something like that. We’re going to watch the Gators with the Music City Gator Club this evening. Poor Erin, raised during the Tebow era at Florida, she doesn’t know what to do with the Commodores.

Working: Here’s a conundrum: if a resident (doctor-in-training), age ~26-30+, has not yet developed compassion, what are the odds we can teach it to them now? My answer after 15 years of trying…pretty dang small. Compassion (per Wikipedia, that bastion of knowledge): “More than simple empathy, compassion gives rise to an active desire to alleviate another’s suffering.” We do a lot of labor epidurals. The residents are delighted to perform the procedure – believe it or not it’s rewarding to put a needle into a hard to find space and provide almost immediate pain relief. Instant gratification – not something we get a lot of…except maybe doing yard work. What is less gratifying is when the nurse calls because the pain relief has waned. No matter how many times I admonish, “You are not being called to push more drugs through the epidural, you are being called to relieve the patient’s pain,” still I find the occasional resident outside the patient’s room mere moments after entering…”I gave her more medicine, they’ll call again if it wasn’t enough” or “She just has unrealistic expectations, I told her pressure was normal,” the last part hard to hear above the patient’s screams. And so I take the resident back into the room and try to role model the appropriate response – talking to the patient, expressing concern for her discomfort, evaluating the situation, and often replacing a non-functioning epidural – but not leaving until the patient is satisfied, even if it takes a half hour or more. None of this is rocket surgery. And then a week later we go through the same thing again. By no means is this the majority of residents, but there are a few who just seem to be missing the compassion gene. For years I thought I was failing them, unable to instill a “commitment to patient care above self-interest.” Now I think you either got it or you don’t, and the weeding out must occur before medical school admission. How you ask? Not a clue, but the head of UF’s med school admissions has some great ideas and has revamped our admissions process. My fingers are crossed!

Reading: I’m on a British mystery kick, started before traveling to London last summer, and I just haven’t stopped. Since I listen to most as .mp3 downloads from the library, I really enjoy the accent. After finishing Deborah Crombie’s series, I’m on one set in the 1930’s starring Maisie Dobbs. London after World War I was an fascinating place. There is much discussion of Adolph Hilter and the appeal to many of his ideas on governing. Scary in hindsight! I also just started The Art Forger for book club, and a book on mindfulness for myself. Me, silent? That’ll be interesting.

Writing: Struggling a bit here. I need to re-work the plot a bit and that takes continuous free time. Getting organized is more of a challenge than I expected. I’m using yWriter which is designed for this, and tried to make a mind map with FreeMind, but there are so many characters and clues and I’ve already edited the first half so many times I can’t keep track of what has happened and what I’ve cut. I’ll get the hang of it eventually. I’m hoping to plow through to the end, then go back and fix things. Volunteer readers who will be critical???

Have a great week and Go Gators!!

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