. . that I overheard the other day went something like this:
"Just remember, you never know when you are going to have your last first kiss."
Monday, September 15, 2008
Friday, September 12, 2008
Priests and Layfolk
I can’t believe I am actually saying this, but it may be that the thing that I find unsettling about family medicine is the emphasis placed on patient centered care and preventative medicine. It’s not that I don’t believe in those things, I absolutely do. The only way we as a population can become healthier is by preventing ourselves from doing those things that make us unhealthy. And of course, the patient should always be at the center of health care.
The problem with preventative medicine in its current incarnation is that we have made basic common sense seem like something you need an MD to understand. Preventative medicine is not rocket science: don’t smoke, don’t drink too much, eat fresh stuff, exercise, don’t get too fat, don’t get too stressed. It is possible that by naming these topics medical we have actually done a disservice to our patients. Once something is medical, it is seen as inaccessible to anyone other than a health professional. Practitioners have become the priests required to access common sense; we are the intermediaries between laypeople and their own health.
Along those lines, with patient centered care, the patient is always right and every concern they have is equally valid and important. Of course a patient’s worries should be addressed, but I’m not sure it’s to their benefit to come in for every 2-second pain or unusual sensation they experience. This is linked to the sequestration of common sense to the medical elite. People don’t trust themselves anymore. They have no connection to their bodies and so they doubt every feeling they have. Normal body processes are now seen as death knells. The medical field reinforces this ignorance of self by giving a visit to every preoccupation. And we validate every anxiety by solving it with medical advice. Instead of saying. “well, sometimes that just happens,” we prescribe opiates or anti-anxiety medicine. And our latest trend response to non-issues issues? Yup, you guessed it. . preventative medicine, which means that people only do preventative medicine when they are told to as a curative measure (and is that really preventative anymore??). (And on a side note, of course there are forms of preventative care that should never be abandoned - cervical cancer screening, for example).
I'm not 100% sure if I agree what I wrote above. Since I believe in holistic medicine and I believe in treating the entire person rather than the illness, there is something to be said for being able to prescribe things like "eat better," and "exercise," and "meditation." And I never want the medical pendulum to swing back in the direction where doctors are patriarchal figures - telling their patients what is best without any input from the patients. That said, I do think that we these 2 concepts aren't sitting quite right. There is work to be done there, because I'm not sure that, at this point, we are doing the best by our patients.
The problem with preventative medicine in its current incarnation is that we have made basic common sense seem like something you need an MD to understand. Preventative medicine is not rocket science: don’t smoke, don’t drink too much, eat fresh stuff, exercise, don’t get too fat, don’t get too stressed. It is possible that by naming these topics medical we have actually done a disservice to our patients. Once something is medical, it is seen as inaccessible to anyone other than a health professional. Practitioners have become the priests required to access common sense; we are the intermediaries between laypeople and their own health.
Along those lines, with patient centered care, the patient is always right and every concern they have is equally valid and important. Of course a patient’s worries should be addressed, but I’m not sure it’s to their benefit to come in for every 2-second pain or unusual sensation they experience. This is linked to the sequestration of common sense to the medical elite. People don’t trust themselves anymore. They have no connection to their bodies and so they doubt every feeling they have. Normal body processes are now seen as death knells. The medical field reinforces this ignorance of self by giving a visit to every preoccupation. And we validate every anxiety by solving it with medical advice. Instead of saying. “well, sometimes that just happens,” we prescribe opiates or anti-anxiety medicine. And our latest trend response to non-issues issues? Yup, you guessed it. . preventative medicine, which means that people only do preventative medicine when they are told to as a curative measure (and is that really preventative anymore??). (And on a side note, of course there are forms of preventative care that should never be abandoned - cervical cancer screening, for example).
I'm not 100% sure if I agree what I wrote above. Since I believe in holistic medicine and I believe in treating the entire person rather than the illness, there is something to be said for being able to prescribe things like "eat better," and "exercise," and "meditation." And I never want the medical pendulum to swing back in the direction where doctors are patriarchal figures - telling their patients what is best without any input from the patients. That said, I do think that we these 2 concepts aren't sitting quite right. There is work to be done there, because I'm not sure that, at this point, we are doing the best by our patients.
28
I’ve been neglectful lately. Somewhat willfully, since I have been gifted late mornings and a job that I leave behind when I go home. But somehow I have not had the drive to write. And I have suffered for it, I think. Like exercise or yoga, reflection is one of those activities that makes us feel so good that they are the first thing to go when we get anxious or restless.
So I am nearing the end of my 2nd rotation. Family Medicine. Experiences continue to occur, although I feel less engaged by them this 6 weeks around. I’m not sure if it’s the place I’m learning or the field itself, but I certainly don’t feel the light me up sort of passion I felt during my OB/GYN rotation. That may not be a bad thing. In fact, if my goal is to wind up living a balanced life where medicine is a job rather than a lifestyle, family medicine is the simplest answer. For sure it is lackluster, but I like to think that it would inspire me to seek passion elsewhere. That said I have some concern that dullness is catching – leaving me with an overall subdued existence. The dying adolescent in me shudders at the thought of such complacency (the horror, oh the horror). Of course I also am worried that an uninspired medical career would swing the pendulum in some warped direction where I forget to fill my time with things like outdoors, music, food, art, politics, thought, people, etc, etc. Instead, in search of more intensity, I would resort to old habits of poking at my relationships till I create some purposeless drama and find myself in a familiar mess I had sworn off years ago. Luckily no decisions have to be made yet. This year is just for observation and information gathering.
In truth, the last 4 weeks have brought out strong examples of both responses. Instead of writing and reading and playing and exercising, I have slept and complained, and (oh the shame of admitting this) watched T.V. And when I wasn’t doing that, I was regressing to my late teens and foolishly getting caught up in ridiculous drama. I behaved poorly towards others and towards myself and almost cost myself a friendship or two (the outcome may still be uncertain). Suddenly old tapes were playing and I lost the clarifying breath of perspective; I became a person I like to think I no longer am, but obviously still have the capability of becoming. I suppose we are never rid of our lessons learned.
But on the eve of the start of my 28th year, I figure I get to clear a slate. Birthdays, like New Years, are good times to kick start the drive to grow and improve. Resolutions (that will always be broken, and set again) abound. As Emily would say, it’s probably a good time to build that bridge (yet again) and get over it (thanks lady).
Well, sentimentality is getting the best of me, but it’s almost my birthday, so I can give in to it tonight. I just want to say thank you to all the folks in my life (those who read this and those who don’t). I am damn lucky to know such incredible people. When I look around, I see crazy beauty and passionate commitment and so much laughter. It’s a good reminder to breathe and live it up, all purty like.
I love y’all.
So I am nearing the end of my 2nd rotation. Family Medicine. Experiences continue to occur, although I feel less engaged by them this 6 weeks around. I’m not sure if it’s the place I’m learning or the field itself, but I certainly don’t feel the light me up sort of passion I felt during my OB/GYN rotation. That may not be a bad thing. In fact, if my goal is to wind up living a balanced life where medicine is a job rather than a lifestyle, family medicine is the simplest answer. For sure it is lackluster, but I like to think that it would inspire me to seek passion elsewhere. That said I have some concern that dullness is catching – leaving me with an overall subdued existence. The dying adolescent in me shudders at the thought of such complacency (the horror, oh the horror). Of course I also am worried that an uninspired medical career would swing the pendulum in some warped direction where I forget to fill my time with things like outdoors, music, food, art, politics, thought, people, etc, etc. Instead, in search of more intensity, I would resort to old habits of poking at my relationships till I create some purposeless drama and find myself in a familiar mess I had sworn off years ago. Luckily no decisions have to be made yet. This year is just for observation and information gathering.
In truth, the last 4 weeks have brought out strong examples of both responses. Instead of writing and reading and playing and exercising, I have slept and complained, and (oh the shame of admitting this) watched T.V. And when I wasn’t doing that, I was regressing to my late teens and foolishly getting caught up in ridiculous drama. I behaved poorly towards others and towards myself and almost cost myself a friendship or two (the outcome may still be uncertain). Suddenly old tapes were playing and I lost the clarifying breath of perspective; I became a person I like to think I no longer am, but obviously still have the capability of becoming. I suppose we are never rid of our lessons learned.
But on the eve of the start of my 28th year, I figure I get to clear a slate. Birthdays, like New Years, are good times to kick start the drive to grow and improve. Resolutions (that will always be broken, and set again) abound. As Emily would say, it’s probably a good time to build that bridge (yet again) and get over it (thanks lady).
Well, sentimentality is getting the best of me, but it’s almost my birthday, so I can give in to it tonight. I just want to say thank you to all the folks in my life (those who read this and those who don’t). I am damn lucky to know such incredible people. When I look around, I see crazy beauty and passionate commitment and so much laughter. It’s a good reminder to breathe and live it up, all purty like.
I love y’all.
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