Sunday, March 23, 2008

Expectations

It's time for another rant. I'm in a terrible head space right now because my mother laid a wicked guilt trip on me last night. The family came to town for Easter Vigil Mass and I chose to go with them rather than skip it or go to a much closer (and as it turns out, 2 hour shorter) service. But I went. And I went to communion. Then in front of the church, she told me that I shouldn't have gone to communion, that living with my partner means that I'm not allowed to go to communion. She loves me, but needs me to know that it's not OK that I think that I'm eligible to go to communion. She wants me to annul my previous marriage and get married and make everything legal and perfect. Since weddings are so cheap, and med school is practically paying me to attend, of course I'll do that. I'll do it tomorrow. And then everything will be absolutely perfect and she'll love me.

But wait. I don't want to have children. Oh, well, you can't be a good Catholic and not procreate like little bunnies. Ok, so what if I'm biologically incapable? Well that's fine then.

But wait. You're willing to counsel women in making their own choices? You will help a person through their last moments on earth with pain relief that may hasten their death as a side effect of alleviating their pain?

I don't know why I'm trying so hard to be a good child. She's already picked the perfect one. It's the one that drinks almost every night, always assumes she can have the car, lies to both my parents, isn't planning on a future education and will likely be married and pregnant and married by the time she's 25. That's the perfect daughter.

The one who never drank through high school, worked her ass off at home and outside of home to provide for herself and family, who got into effing medical school but lives with her boyfriend...well that one's just plain evil.

I'm so incredibly jealous of friends and class mates who have a safe home and haven with their families. It's hard to imagine a place where you know that everyone will love you, even if you decide you want to be a doctor.

Sunday, March 16, 2008

Oops.


I've gotten myself so far behind with 6 projects that I can barely breath. How did I let this happen? Too much T.V. probably. Stupid T.V. Plus I've definitely stretched myself beyond the real capacity I have for working.

Very little real work got done this weekend, but I did get into the habit of going to the gym every day, so I suppose that's something. I ended up counselling a couple people too - how is that possible? I'm on break fer cryin' out loud!

After doing 2 years residency in Family Medicine, we have the option of adding on a third year in whatever we'd like. I spent quite a bit of time looking at my options this week and am quite confused about what to do. Palliative care has been calling to me, so has psychotherapy, obstetrics and paeds.

Thank goodness I've got another 5 years before I need to make that decision.

Palliative care seems a bit out there right? It's not. One of the things that really drew me to medicine was the way my uncle was treated by the docs caring for him during end stage pancreatic cancer. They were patient and compassionate with his family as they explained the options and what quality of life he could expect if they continued treatment. They allowed us to have a mini - family reunion/going away party for him in his hospital room. To me, they gave him a good death. There's something really noble about giving people a good death.

To me a good death is on the terms of the patient. They deserve to spend their last days in the way that their well - self would have liked. Their family also deserves to spend time with their loved one in a way that is hopefully not entirely clouded by pain meds/end of life delerium. The family and patient need to be heard. This is a pivotal moment in their lives and they deserve to be able to talk about it and celebrate/mourn.

I was lucky enough to get to hang out with a palliative care doc a month ago. In the hospitals here, there's a palliative team working with the docs to provide a comfortable end of life experience. Social workers in particular are available to the patients and their family as they work through what will be happening next. Tests and medications that don't have short term effects are discontinued so that the last moments aren't spent being poked and prodded.

Maybe when I hang out with a psychotherapist though, I'll feel just as passionate.

Saturday, March 8, 2008

So much snow!


We're into March Break now - so great. And well timed since I'm 4 weeks behind in classes and have 3 extra curricular projects that need to be wrapped up, not to mention that I still don't have summer plans....I can do all that in a week right?

There's something about snow though that makes me want to not do any work. We can barely see the houses across the street right now. I tried to get out and make it to an even earlier today but it literally took me 20 minutes to get around the block. Safety first boys and girls! So rather than catching up on my Cases of the Week, I'm watching TV. In particular In Treatment.

I was turned onto by someone in my clinical methods group since it mimics some of the problems we go through in our advanced interviewing skills classes. Yikes.

In case I get the "patient who hits on you", I thought I should know if they're nuts or not. Apparently not.

bedroom toys