What do you think they need to hear?

Hello, Friend to Yourself Community!

Please let me know what you think these fine folk need to hear from us?  It is our chance to talk to college pre-med students!

English: red apple

This is the caption of our invite-letter:

Dear Dr. Quijada,

Thank you for participating in MDCN 204: Introduction to Medicine at —-University. It is my pleasure to have you join our lecture series this year. 

Students are very excited about the prospect of meeting a physician and learning more about medicine. For many of them this is a firm choice and they would like to add to their knowledge base, while others are simply exploring medicine as a possible health career. Many students in the class are freshman, but several are sophomores, and juniors; a few of them are seniors.

I am really looking forward to hearing your thoughts, questions, if you were them, and recommendations.

Thank you friends.  Keep on.

Getting Yourself Healthy Protects The Freedoms of Others

hey if you are too stinky we will ask you to l...

hey if you are too stinky we will ask you to leave not really sorry (Photo credit: stevendepolo)

Some of our most difficult cases are when we, the medical care-givers, think we know better how to take care of someone than we do take care of ourselves.

When a person maintains decision making capacity, but whose brain health disables them, if we care, we care.

Monty was one of these.  He was ill!  He was ill on so many tectonic plates, no one near him could keep their footing.  His quality of life wasn’t what he wanted.  He was disconnected from meaningful relationships.  He was suffering.  However, he couldn’t decide to engage in therapy.

Monty wanted to go “natural” but couldn’t name any natural therapies he’d be willing to try.  He didn’t want to continue suffering, but couldn’t accept medications “just yet.”  We went into one option after another, invested time together learning about brain illness and coming to terms with the biological involvement in where emotions and behaviors come from, and we did it many times.  Monty had a full informed consent.

Deciding not to treat or to treat is not easy for any of us.  Watching Monty step away into the foggy chaos of sex abuse and obsessive compulsive rituals was really hard.

We fight for our freedoms when we fight brain illness.  I suppose we fight for the freedoms of others as well, simply by taking care of our own selves.  Letting Monty choose even when his choices are affected by his illness is still his right and I defend him.  We all who take care of ourselves have more to offer Monty than if we didn’t, including a defense against the losses that brain disease brings – like processing information.

I’m not sure yet how to explain how taking care of ourselves influences the freedoms of those around us who are less inherently free by brain illness.  I suppose like anything good, freedom is contagious, a little bit of light in any room, Love being stronger than death and the Gettysburg address – this is along those lines.  It makes a difference to the Monty’s out there that we all take care of ourselves.

Self-Care Tip:  When frustrated that you can’t help others, get yourself healthy.  It’s contagious.

Question:  Have you been in the place where you thought you knew what was better for someone else then that person’s own choices?  How did you deal with that?  Please tell us your story.

Recommended Reading:

Why not skip medication And Go Natural?

Mistaken Expressions of Freedom and Medication Compliance

How to Trust Whom You Serve and Whom is Serving You

Michael E. DeBakey, world-famous cardiothoraci...

Much of what we do in medicine is elementary. I wouldn’t know how to quantify the amount of plainness involved with our goings-on. Behind the writing of controlled substances on pricey government controlled paper, behind our, “Hmm’s”, our flow of learning and teaching, and more (or less) than the laying on of professional hands, we are… we are common.

To say it simply, physicians are dealing with themselves. In medical practice, separating the self out, effectively breaking the emulsion of the physician from their personal journey leaves many of us suspiciously grouped into the numbers of old and lonely but practically excellent. Some medical specialties are infrequently bested by anything other than 80+ hour work-weeks, knowledge retention and steady hands. The imminent peril and the literal moment by moment of life-saving interventions helps the rest of us understand.

Even so, I’ve known some who have been “the best” and still managed to be connected to their personal. I imagine some other dimension is forced open by all the space that that kind of nearly fictional human occupies: Cardiothoracic surgeon, Anees J Razzouk, M.D., at Loma Linda University, for one; Gisella Sandy, M.D., critical care specialist, general surgeon and medical missionary in Peru, for another. We are all happy to say that the list is long here. We think of the ordinary physicians planted around our planet who are heroic enough to do the simple. After all, how much can a physician offer to her patient if she hasn’t taken care of herself first?

Those of us who seek medical care from a physician will be interested to know that the physician as well as the patient can only carry so much before things start to fall out of their arms. Before a sack tears on our way from the car to the kitchen, before there is spillage and things go unnoticed, we want to know that they thought about it. We want for them what they want for their patients in other words. Accountability to Me.

Wanting this for others, because we are afraid, is understandable. But it’s not at the aorta where life pumps and freedom flows. Each of us, regardless of fancy prescription pad or paper gown, to trust the other, we must have their own wanting. Wanting this for themselves. For Me. That is the pulse on trusting each other.

Questions: How has being a better friend to yourself improved your trust in those who are serving you? How has being a better friend to yourself improved your ability to trust those you hope to serve? Please tell us your story.

Self-Care Tip – Follow the thoughts that bring you back to Me where you will healthily grow your accountability, wanting and trust. Be a friend to yourself

Seeing Your Brain As The Place Emotions and Behaviors Come from is Terrifying

Terror

Image by pablokdc via Flickr

Where do emotions and behaviors come from?

Now think about it and answer your true beliefs.

I was speaking with a wonderful physician the other day to whom I asked this question, (let’s call her Doctora.)

I respect Doctora for her character, personality, standard of medical practice and interpersonal beauty. She is a bulldog in the operating room. When patients need studies done that insurances won’t pay for, she tears barriers to treatment apart with vicious tools of rightness. And she cares.  She sits.  She asks.  And she cares.  She sees the person in the paper gown, each one for the person she knows them to be and the person yet unknown.

I admire Doctora greatly not only for these qualities but also because it gets personal.  I, who have my own special practice of medicine, cannot do her’s.

When just a green bumbler in medical school, there was a fateful day when I shadowed another great artist of medical care into a locker room.  I suited up in that blue sack they call scrubs.  I put little blue sacks over my tennis shoes too.

Do you know why there are blue sacks on the surgeon’s shoes?  So that when wet things come out of the human body and fall onto their feet, their toes won’t feel squishy. Yep. That’s what was going through my mind as I scrubbed my hands, each finger and each finger nail the ten minutes it takes to reach what is considered clean.

Surgery in progress, the color red mixed with a smell and monstrous sensual force that clobbered me to the ground.  I swooned, gagged and promptly ended my surgical career.

There is nothing more irritating to a surgeon than someone who doesn’t appreciate the “fun” of “cutting.” Yes. I irritated this mentor and others too I’m afraid.

This doesn’t keep me unfortunately from pleasuring in telling people, “I am licensed to do surgery.”  I am you know.  Any Jane with a medical license can pick a scalpel up and bring back the dark ages, or contemporary, depending on who holds the license.  I’m irritating to my mentors, remember.  It reminds me how anyone can go online and pay to become a marriage registrar, i.e. perform a marriage ceremony for couples.  My brother did that twenty years ago and has yet to perform the marriage ceremony for a willing couple.  For real judges and clergy, this might be irritating too and that makes me a little happy as well.

Anywho, Doctora and I were rolling with the injustices haranguing us in the practice of medicine, both from the angle of the physician and the patient. I was pumping her up for being the cutting-wonder who she was and she was dutifully marveling at my jabber-mouth work that she would, “never be able to do in a million years.”  Somehow this brought us round to how our culture avoids embracing the biological paradigm of anything inside our skull but is so willing to celebrate it for any other part of our human bodies.

Where do emotions and behaviors come from?

Doctora answered me with a frozen breath. Then after I soiled the air with a lot of jabbering and she was finally able to speak, she said,

I would just be horrified if my brain got sick!

I wondered if it was scary enough to clobber her to the ground, but I do agree.  Terrifying.  Don’t you think?

Question:  Is that why hardly anyone can speak about the brain being human and largely responsible for where our emotions and behaviors come from? How has this played into your experience of self-care?  Please tell me your story.

Self-Care Tip – Go to the fear that keeps you from embracing your biology to gain more freedom.

What Makes A Doctor-Patient Relationship

Power

Image by JAS_photo via Flickr

In our last post, The Struggle in A Doctor-Patient Relationship To Not Get Personal, your comments were critical to bringing it all together.  So much so, that I think it’s worth our time to review the main points about the doctor-patient relationship.

1.  People wonder about how to relate or conduct themselves.  It’s not clear and there are no directions.  In fact, for something so objective, why isn’t it?

  • a subject I have often wondered about – Cindy Taylor
  • when I see the new Doc, I just tell my story and describe symptoms????  – Sekan Blogger
  • hope that those professionals would be much more upfront with their patients – Nancy

2.  The professional distance itself between doctor and patient lends to the healing process

  • The doctor patient relationship is one thing that makes healing possible – Pattyann
  • if friends could help me I wouldn’t need to see a professional… – Patricia
  • distance …is such a strength – Kate Shrewsday
  • something far more greater than what a friend could provide and if I knew the intimate details of her life, that would have changed – S Sanquist

3.  The exchange of money for service is generally part of its constitution and brings motives into question.  Is there a price for the value of a patient’s health or even life?

  • You better keep me alive or there will be less money for you to make – Carl D’Agostino

4.  Power Imbalance

  • health professionals and I are not on the same social level when I am the patient and they are my health provider – Val
  • It (is) a loss to move from friend to patient. That is just how it has to go in the self-care process. Then there is the anxiety of the Dr. discovering who you really are and perhaps being disappointed. – M
  • same fine line in the teaching profession – Sarah McGaugh
  • most of my relationships have some sort of power imbalance – Shout Abyss

In truth, all relationships have an imbalance of power.  In healthy personal relationships, there is a flux in power, back and forth.  It’s a problem if they don’t pulse and is possibly one of the signs of an abusive relationship.

However, this doesn’t hold true in doctor-patient combos.  They are imbalanced by design and stay that way.  It feels counterintuitive at times to those involved.  But a good physician is like a good book – he/she/it is there for Me.  It is a unidirectional relationship.  There aren’t many good unidirectional relationships otherwise, …except for all those others.  You’ve heard of police, cashier’s, housekeepers, entertainers or, for example as Sarah reminded us, teachers.  But these are professional relationships and none of these are personal either, are they?  Unless you’re human, and then they are.  Oh bother!

Self-Care Tip – Find out what pleases you and what bothers you about your doctor-patient relationships.

Question:  What does please you and what does bother you about your doctor-patient relationships?  How do you imagine it would be if it were even better for your needs?  Please tell us your story.

No One is Choosing For You – Know Your Choices For Health

Yesterday we asked some pithy questions re: Why Psychiatry?  Your responses were received with gratitude and humility.  It takes courage to understand our connection with psychiatry considering ongoing stigma.  Today we’re reviewing that some and taking it one bit further.

When referred to a psychiatrist for medical care, we can feel confused.

Why is my physician sending me away?  Does this mean I’m at my last resort?  Does this mean I’m that sick?, or,

Does he think I’m crazy?  I’m not insane!, or personalizing with,

Does my physician not want to work with me?  I’m that bad of a patient?  Cast off?

Our expectations when we first see our psychiatrist are often also similarly reactive.  Maybe,

I’ll give this one chance but if she doesn’t fix whatever it is that’s going on, I’m out of here. 

I am not going to be dependent on medications!

I do not want to be made into a zombie!

Are we looking for a cure?

Also, we might be confused by the amount of time that she spent with us the first appointment as compared to our follow-up appointments.

I need to talk about my problems!  I need time!

There’s a lot to take in.

Unfortunately, when we are referred to a specialist, often our referring physician hasn’t effectively communicated as to why we are being sent there.  This is for many possible reasons, including Me not hearing him.  Many other reasons are also understandable with insight but we aren’t always given the opportunity to hear the inside story of why our physician does what he does.  That doesn’t mean we have to accept it.  But if we do, we did and it’s our choice.

Choice

Image by Scarygami via Flickr

We have choices.  Before accepting the referral, we can ask, Why?  Keep asking why until we are satisfied with our level of understanding.  Schedule a follow-up appointment with the referring physician if necessary to gain more time if we think we need it.  Sometimes, despite our physicians best efforts, we won’t understand as well as we’d like and we have to make our choice with the information we have.  We can read up on our symptoms ourselves.  I read in Twitter from @NathanBransford,

The 11th Commandment: Thou shalt not ask someone a question thy could easily Google thyself.

That’s ridiculous although I cracked up.  The World Wide Web comprehensively and including Google or any other source within that World Wide Web are not designed to practice medicine.  When we read something, we need to ask for qualifications behind the author of the print, references and so forth.  The Internet is a tool worth our attention but you decide how far you are willing to take what you read before you consult with your own physician.  I think if Doctor Seuss were alive today, he’d write a book (or many) about health care; Oh The Tools We Can Use!  (Maybe Carl and Thysleroux will do a series or a post on this?  Should be fun.  – Asking, “Why?”  Becoming our own friend.  Connection.  Going towards shame, pain, anxiety.  Growing bank – and more.)

And so that brings us to today’s questions:  What choices do you perceive you have in referrals like these?  In your continuing medical care?  In your ability to collaborate with your physician?  In obtaining an understanding of your illness(es)?  Please tell me your story.

Self-Care Tip – Grow your understanding of your choices for your health and medical care.

Related Articles:

  1. Stay Connected For Your Sake and For Theirs
  2. Connecting To Others Is a Condition of Freedom
  3. Safety in Connections

Why Psychiatry?

An American Lady butterfly against a cloud-fil...

Image via Wikipedia

If we have ever seen a psychiatrist, then there has been some point in our lives when someone told us to go or we told ourselves.  I have some questions for you.

How did you hear about psychiatry?

What are your thoughts?

What did/do you understand?

Please tell me your story!

Self-Care Tip – Explore your connection with psychiatry.