Compassion trumps all…

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Healthcare and Humanity thinks this piece reflects the essence of healthcare.  Compassion. Kindness. Respect.

Congratulations Dr. Hacker for not only being such a wonderful doctor to your patients, but an inspiration for your colleagues.

“The first time I met Dr. Paul Hacker, I was working as a shift nurse in the community with a palliative patient who had ALS (Lou Gehrig’s Disease). Dr. Hacker sees a lot of patients  but he was able to remember almost every detail about this woman’s story as he sat on her couch talking with her. I recall thinking about how respectful he was by sitting by her side.  I remember admiring how thorough he was and how he didn’t refer to his notes when asking her detailed questions about how her mobility.  I remember that when he left, the family all started talking about how wonderful he was.

The next time I met Dr. Hacker, I was working as a nurse with Maycourt hospice. This is a hospice that deals specifically with end-of-life care (the last weeks or days of life) and Dr. Hacker would have patients  transferred there from their homes at the end. Every time he came to see one of them, he would make their days better– whether by reassuring family or talked realistically with the patient. As a nurse, working in the hospice was hard emotionally– I can’t say enough about how many times he would go out of his way to sit with us and make us laugh. He made volunteers laugh. He could even make his patients laugh. Every time he visited, we all got that reassurance. Families have even told us that when Dr. Hacker first visited them in their homes, he was the only person to have made the patient “truly laugh” since their diagnoses.

I think one of the best qualities your doctor can have is compassion. Being empathetic, patient and understanding toward people who are suffering is not something I see every day. Honestly, we all did a little celebratory dance of joy whenever Dr. Hacker was assigned to a patient in our care. We knew how well they would be looked after, and that meant a lot.

To one of the kindest, funniest doctor I know; who is 1000 times more amazing for bringing his dog to patients homes as well: thank you for looking after one of my friends’ dad recently. I got that same reassured and comforted feeling in my heart when I was told you were the doctor looking after him.

Thank you.

You are one of a kind and I am so blessed to have met you, learned from you, and worked with you.

Courtesy of  a colleague of Dr. Hacker who feels that it’s important to highlight a friend/colleague monthly that deserves a compliment.

 

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Here comes the sun..

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It’s May.  A nice, sunny day today amid the dreary rains, winds, and ever changing temperatures. Spring… in Canada. An awakening of sorts. The tulips are out, the lawns in Southern Ontario are being tended, and the goal of getting outside seems laudable, even if it’s just a patio. For some with seasonal affective disorder, or SAD, it can be a lifesaver.

Doctors have a variety of options for treatment of patients with SAD. Full-spectrum lights in the patient’s office or home. Antidepressant medications. Increased vitamin D supplementation. Trips to sunny destinations if feasible. Outdoor exposure. Exercise. Talk therapy. Group therapy. All of these options have their pluses and minuses, so options are tailored to the patient’s needs.
But what if the patient is a physician?
I know at least three close colleagues who will admit to SAD. One is a surgeon, stuck inside an interior office, often rounding in the winter before the sun is up, and leaving after dark. They are operating in a windowless room with screens to watch the cameras for minimally invasive surgery so patients can go home sooner.
Doctors are supposed to be altruistic, and put the best interests of their patients first. But I admit, there are times on a sunny day where staring out the window or even nipping outside for 5 minutes makes the day a whole lot better. And it’s better for patients if their doctor feels better. We try to get patients rooms with windows when they are admitted, so they see daylight and a daily rhythm; it reduces the risk of delirium. We need to do the same where possible for ourselves and our colleagues. As George Harrison said, Here comes the sun. Here comes the sun, and I say. It’s alright.

I promise…

I know.

I know what it feels like to suffocate. To see the dawn and wish your eyes hadn’t opened.
To dive under the covers and will your brain to bring you back into unconsciousness.

I know what it feels like to drown. To feel like a tsunami is hovering right over you, waiting
to crash into you and drag you down deep into its undertow.

I see.

I see how you plaster that almost-smile when you walk into the room. The one that doesn’t quite reach your eyes that are already half-filled with tears.

I see you dragging your feet, avoiding eye contact with people as you walk by so you don’t have to pretend for yet one more person that you’re okay.

I feel.

I feel your pain. I feel your heart race. Ache. The anger that is masking the pain. The irritability, the confusion, the defensiveness–all to hide what you’re
really feeling.

Because I was there.

I know what it’s like to lose your sense of self. I know what it’s like to dunk your head in
the bathtub and wonder if you can drown yourself willingly. I know what it’s
like to envision your own funeral and wish there was a way it would happen, but feeling guilty at the same time for the suffering you would cause others

I know what it’s like to feel like you’ve fallen off the precipice. And you keep falling…falling. Wondering when it will stop.

I promise.

I promise it will get better. I can’t make it go away. But I can help.
I can be there for you. I can help you find a light at the end of tunnel. I can remind you of
what is going right. I can help you find yourself.

And when it lifts?
I can remind you that you are stronger than you have ever imagined.

 

PHYSICIAN BURNOUT is a real entity and a significant under recognized risk in those that work so hard to help the physical and mental health of their patients.

http://blogs.bmj.com/bmj/2017/04/10/working-under-pressure-in-an-increasingly-under-resourced-nhs/

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Poetry as a Cadence of the Spoken Word..

                                                                                             

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Poetry is something that I have never indulged much in, and although I appreciate the written and spoken word.. I am an amateur at best when it comes to having an opinion.  I happened upon “Ancestral Worship”  a poetic journal quite accidentally. The book literally fell in my lap.  Mr David McKirdy, the poet, is a transplanted Briton with the soul of Hong Kong racing through his blood, faster than the bikes he rides.  He starts our journey with the title poem  “Ancestral Worship” where we feel his infusion/transfusion of the old Blood of China in a clinical and factual report..  That brings us to fragments of his life, put to verse from early childhood to the rebirth of the man that made Hong Kong his home.

Words make you feel.  And see.  And maybe not understand but somehow have something imparted in the soul.

Such is David McKirdy’s work.

Although I suspect if we were to ask  him, he would not consider it work.

David describes himself and his relationship with Hong Kong in a very modest manner that is in keeping with his demeanour.  ” I consider myself an Asian writer.  Hong Kong has always been a city of immigrants and I am simply one more that has been welcomed and made the city my home”  Having said that .. the depth of his verse belies but also celebrates that simplicity.

Healthcare and Humanity is fortunate to have the opportunity to share some of David’s work, both in his first anthology “Accidental Occidental” from 2011 and more recently “Ancestral Worship” published in 2014.  In both he expresses his experience with cancer with candor, sensitivity in an a manner that both belies and embodies reality. Poet, vintage car mechanic, dirt bike racer, ambassador, friend, sage, patient.

Please enjoy David McKirdy’s work and remember the Art of Medicine also is embodied in the patient.

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Journey to New Life

baby-408262_1920I walked trembling and tearful into one of my mentors office interrupting him at his work. His initial smile turned to a look of alarm.  “What’s wrong Chief?” was his response. I had just come from the ultrasound department with the bad news.

Again no fetal heartbeat.  No baby. I was to be admitted later that day for a D and C.

So he let me cry for a few minutes, and before I asked him if I could become a patient, he reassured me that he could help me.  Of course he could help me, he was and is the Guru of Fetal Loss.  He specialized in helping women through high risk pregnancies including repeated miscarriages.  He would joke about how he just sprinkled pixie dust to get results, but we both knew that his expertise and interventions were scientific, sometimes complicated and always carried out with the greatest compassion and knowledge.

So started my “Journey to New Life”.  That was my 3rd miscarriage over a period of about 14 months.  The first felt like a normal happenstance,  the second upsetting,  the third desperate.

I became a patient with little control over my situation.

I relinquished that control and allowed myself to follow the advice given to me.  The pregnancy “stuck” with low dose Aspirin and Progesterone.  I required bedrest for most of the second and third trimesters.  It was my own journey  but my doctors accompanied me with the most detailed maps.  I am not sure I would have reached my destination without them.

And then I remember looking at my baby,  3 weeks early and screaming like a madman. He was the greatest gift then and still is today.

Sometimes it takes an entire team to make a baby.  Sometime it takes an entire team to become a mother.  For this, I am eternally grateful.

Confronting myself…

I knew I had PCOS (polycystic ovarian syndrome) so as soon as I got married, we started trying for a baby. After 1 year of trying on our own didn’t get us anywhere, we sought out infertility treatment. 10 months after that, we got our first positive pregnancy test.

I was on call one weekend early into the pregnancy.   I started spotting during my anaesthesia shift but I covertly used a mini ultrasound in the operating room I was working in, to check that the baby’s heart was still beating.

Two days later, the spotting was worse and when I again checked for the heartbeat, it had stopped.

 I stopped.

I hadn’t told anyone yet that I was pregnant, but I had to share it with the staff now so I could see my doctor.

An ultrasound through my family doctor confirmed the loss.  I took a day off work, and then went back.

Waiting to miscarry.

It took a year to get another positive pregnancy test.  A year of endless trying-ultrasounds, blood tests and injections to try to get pregnant.  I did this in the very early mornings before the operating rooms started at 7:45 a.m.

This one ended a few days later, even before it really began.

I couldn’t keep it private.  I was immediately sent home and soon, the entire department knew about it as they tried to cover my shifts.  I was an anaesthesia resident and our on-call schedules didn’t really leave room for anyone to be missing shifts.

It took 4.5 years.  4.5 years of heartache and tears.  We finally did IVF just at the end of my residency and were blessed with our beautiful daughter.

Those were hard years–I spent my days doing epidurals and anaesthesia for expectant mothers, while dealing with failed cycle after failed cycle myself.  Occasionally I would be giving pain medication to a mom terminating a pregnancy in her second trimester for reasons I struggled with, or giving sedation for abortions of unwanted pregnancies.

Each time a baby was born,  I was confronted with my own infertility.  Each time a termination happened, I couldn’t help but think of how I would have loved to adopt.

Even since I became a mother myself, I’ve still had these feelings.  My heart aches a little each time I’m present at a caesarian section and see new parents overjoyed at meeting their baby, something that I’ll never get to experience again myself.  But I know that my experiences have also made me more compassionate towards those going through the same struggles and who are dealing with losses of their own.

Being a doctor makes me confront my infertility daily.  I do sometimes wish I wasn’t constantly exposed to things that still wrench at my heart. And then I put my chin down, buck up, and care for my patients as I was trained to do, relieving their pain and seeing them safely through procedures.

And at the end of the day (or sometimes at the end of the next working day if I’ve been on call), I go home and hug my daughter just a little bit tighter, eternally thankful that she’s ours.

Kate Ryan baby

Letter from a Mom of a Young Man with Autism

city-person-relaxing-sittingHere are some things that I would like to tell parents of children on the spectrum:
Try to not be totally devastated by the diagnosis.  Your child is still the same lovable, adorable child that you had before the diagnosis.  The diagnosis has not changed your child.  He/she is still the same wonderful person and you can still have the same dreams for that child that you had before.  The only difference is that there are going to be a lot more challenges for you and it is going to be a lot more work in the beginning.  But in the end it will be worth every ounce of effort.  Parents always love their children unconditionally and they always love their children for who they are.  That is never in question.  But have faith, there will also come a time, and it may take years and years, but there will come a time when you tell yourself that if you had to do it over again, you wouldn’t even want the path to change.  Even though it is tons and tons and tons of work, (and costs tons of money), it is totally worth it.  It is such a true high to be a parent of a 16 year old autistic young man and look at him and know that you totally have it made.  It is the best high on earth.
Don’t ever let other people put limits or ceilings on what your child can do.  Trust your gut.  Trust that inner brilliance that you see and work like hell to find people to help you pull it out.
A diagnosis is truly a double-edged sword.  I tried, in the first few years to keep it a secret.  I took my son to all the therapists and ABA and everything else, but I fought like hell to keep it a secret from the neighbours or the dentists or anyone else.  Honestly, it was a complete disaster.  People would think my son was being “bad” instead of having sensory challenges or receptive language challenges or a lack of awareness of social skills.  Once I started to share the diagnosis, the perspective of others, and their attitudes to him totally changed.  It went from judgement to  compassion.  Where there was frustration and dislike came patience and understanding.  If I can give you one piece of advice, don’t share this burden alone.  Give others a chance to step up and help you lighten the load.  Some won’t step up … they just don’t get it.  But you would be amazed at how others do … including children.
When sharing the diagnosis or telling people, the number one thing is to ensure that you never talk about your child in third person in front of him.  Maintaining your child’s high self esteem should be your number one priority at all times.  I made up a “Passport” that I would give to the optometrist and dentist and others before they met Stephen.  When the optometrist called my son in, I went to him and said, I have something for you to read first.  It had a photo of my son on the front and it said:
“Hi!  My name is Stephen!  I have autism.  I’m a really smart kid, but I need your help sometimes.  Please make sure that I am looking you in the eye when you talk to me to make sure that I hear what you say.  If I’m not, please say ‘Stephen, can you look at me?’  I have a hard time with new places and new situations, so if you tell me first about what is going to happen, it really helps me a lot.  I’m also really afraid of loud noises, so if you could tell me before there is a loud noise, it will help me to not be so frightened.  If you take your time, be calm and explain everything to me, things will be just fine and you will find out that I am a really awesome kid to meet!  Thank you so much for helping me!”  I cannot tell you what a difference that the passport made in the way that other people treated my son and I .

Be Brave

How do I use this space; my time and yours—best? What do we have to say, you and I?

Together.

And that’s what it is, isn’t? Like a train on a track in a needle—running. Time. Understanding. This place and love. We all have this and we all want this. And no, there are not exceptions.

Here, look: she ran a razor blade through her skin—hundreds of times. For relief. Open your stomach wall for relief. How do I hide that from you and do this? Write about what I have not been able to before – mental health. Not from the point of view of someone who suffers from it, but as someone who loved and lived next to it.

There are hospitals with psych wards and there is your family, if you have one, and that’s it. That’s what we have. One is tolerant, at best, and let’s make this clear from the onset, it is a temporary space, a sanctuary of sorts, a lockup with glass and buzzers. Sympathetic? Maybe. And the other one? Unequivocally unqualified.

Science is a wonderful thing. Technology can be a wonderful thing. And yet, in the field of mental health, we are living in the dark ages, still. Fine. But can we acknowledge this please? At least this? That despite the best efforts of so many well trained, talented and educated individuals, we are a multitude of decades away from understanding the brain, if then. Because if we did, at least did this, we might just force ourselves to elevate the other side of the health care equation – the care side; the functioning, compassionate and merciful side, one that can be sustainable for patients, their families, and to a much larger degree, society.

In other words, it is not an acceptable solution to put the responsibility of care for a mental health patient on that patient and their families, should they have one. It is not acceptable for young children to have to watch a parent experience this level of pain and suffering, this—killing. And it is not reasonable to expect them not to be affected by it.

Major depressive disorder (MDD) affects approximately 121 million people worldwide. Treatment-resistant depression (TRD), an often more severe, or more chronic, subset of MDD, affects 5 – 10 % of people living with MDD, and for these people, nothing helps. No combination of meds, ECT – nada. They are naked to their illness. They will continue to suffer. In many of these cases, they will continue to try and kill themselves until they are successful, or – “successfully treated”

Here’s the protocol.

You’re in crisis—go to your local hospital, the first, last and only line of defense, before you pull the trigger, light the match, tighten the rope—ingest anti-freeze. You’re admitted to the psych ward—sometimes. Other times, no, not today, the inn is full, and home you go.

You’re taken to the emergency ward after you have done something. Your physical state addressed, according to whatever you have done, you are admitted to the psych ward. For how long? Three days—a form 1? Three weeks? It doesn’t matter, back home you will go.

And this can go on for years, in our case, six, over twenty attempts. Desperation and helplessness. An unrelenting death repetitiveness that you or your children, in my case, five, cannot stop.

And this, this is not protocol.

You are locked in a room with restraints, for days.

ICU nurse: I can show you how to kill yourself if you really want to die. Why? You’re taking up a bed someone who wants to live could use.

You escape triage, breakout, barefoot, and you run, picked up in the night, and it does not matter if it was the hospital you fled, because you needed to be there, you are charged and arrested. You are set free in the morning to the world, barefoot. And home you go.

And I don’t care how old you are – go fuck your bootstraps.

I could go on, but the point is not that, those experiences above, it is—care. Health Care. It is all of us, together, mental health, and we must find working solutions and re-examine systems when they are not working, and not just say, this is what we have, there are budget, staffing, facility restraints. That is not good enough. We need to motivate solutions through care, because if we can’t, or won’t, together, please stop calling it that.

By Christian Fennell.

Christian

Christian is currently working on his novel, The Monkey King. His short stories have appeared in a number of literary magazines and collected works, including: Wilderness House Literary

Review, Spark: A Creative Anthology, Carnival Magazine, Liars’ League London, Liquid Imagination, Tincture and Kingston University of London: Words, Pauses, Noises, among others. His short story, "Under the Midnight Sun", was an Eric Hoffer Award, 2015 Best New Writing finalist. Christian was a columnist and the Fiction Editor at the Prague Revue.

A Hero A Day….

Happy Doctor’s Day!!!! 

We at Heathcare and Humanity would like to share this piece from The Belleville General Hospital Foundation. We are once again honoured to celebrate the dedication of our colleagues.

http://bghf.ca/stories/dr-trevor-bardell/

Dr.-Trevor-Bardell

 

March 8th the high winds caused a tragedy to unfold in our neighbourhood. Trevor and I are neighbours on Bridge St. E and can see each other’s homes from our respective dwellings.

Yesterday afternoon the winds came up and I went outside to secure some of my furniture as the wind was blowing it around. I was on my stone terrace and I heard a large crack. I turned around and saw one of the huge trees on the corner of Bridge St. and William break in half and comedown hitting the transformer across the street (with a huge flash and explosion) and then a huge crash as it hit the roadway. It took power lines down with it.

Next thing I know I see someone on top of the fallen tree blocking Bridge St. E amongst the downed power lines which I though was weird until I recognized it was Trevor and knew something bad had happened. I quickly went over to see it I could help and as I exited my yard and saw it had crushed a passing car. Trevor was trying to manage the situation since he was first on the scene when I got there. I came to help and he instructed me to stay within talking distance of him as he wanted me to stay safe. He then told me to make sure no one came near the downed power lines.

Trevor quickly tried to assess the lady that was struck, and due to the destruction of the car there was limited clinical exam, but Trevor relayed as much info as he could and I called my ER physician colleague in Belleville to give him heads up on the horrible situation so the department could prep.

The Belleville Police responded incredibly quick followed soon by Belleville Fire and EMS. Trevor helped coordinate the situation with the Fire, Police and EMS, both to keep them safe and update them as to what had happened.

The part that really sticks out to me is how Trevor took charge, but it was his calm and caring attitude towards the horribly injured lady in the car that kept her from panicking.

Once Police, Fire and EMS had the situation in hand Trevor came to chat with me and asked to borrow my truck as one of the power lines was blocking his driveway and he was on-call for General Surgery and had to go in and assess another patient at the hospital. However, Veridian showed up and made it safe for Trevor to take his own vehicle.

Trevor will say he was just doing what he was trained to do as a physician, it it is that attitude that makes him a physician and a Hospital Hero!

Sincerely,

Dr. Robert W. Webster