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jakeelko

Alaska Highway. September 2017

@jakeelko

Check out my instagram! => @jakeelko

buzzfeed

This Artist (@sparklyfawn) Started An Important Hashtag So Black Artists Can Get The Recognition They Deserve

“I just want the black artist[s] to know that they are just as worthy. Black artist[s] have to work twice as hard as their white peers just to be seen,” Hayford said.

Hayford said they are so grateful for everyone who participated in the hashtag: “I feel warm inside. People were sharing their experiences under the hashtag. It’s nice to know that I am not alone, and I love the sense of togetherness that the hashtag has created.”

adayinthelesbianlife-deactivate

NYC Pride March, 1980s Lesbian Herstory Archives

vir-adahlen

this joke is gay and lesbian solidarity

weloveshortvideos

with-grace-and-guts

nomehablen2

when your mom calls you by all your siblings’ names before she remembers who you are

goblinkind

So my mom likes to dictate her texts instead of typing them.

The thing is, my mom swears a lot, and she’s often at home with my impressionable little brothers. So she programmed her phone to type “bitch” whenever she said “B” and “f**k” whenever she said “F.” For a while, we all thought this was a pretty clever idea. Yesterday, she sent me a picture of my brother sitting in his car seat and crying. The caption was, “he got stung by a bumblebitch!!! ”

wingolight

no you DON’T UNDERSTAND THIS IS GOLD

dollgirllandsknecht

Oh my god

wayfaringmd

What do you think is the biggest misconception people have when entering the medical field, not just MD's, but any medical professional?

I think people glamorize medicine too much. They seriously underestimate the amount of boring and frustrating crap we deal with. Especially paperwork.

boluscoffeestat-deactivated2020

People don’t always understand the shear amount of literal and figurative poop that we all have to deal with. And just how gross the body can get (aside from the poop factor).

wnq-anonymous

The human heart beats approximately 4,000 times per hour and each pulse, each throb, each palpitation is a trophy engraved with the words ‘you are still alive.’ You are still alive. Act like it.

Rudy Francisco (via nakeaud)

umbillicus

goodtypography

Work by trianglethree Follow our Twitter: @goodtypography

amanda-future-doctor

We need more resources available to physicians and health care employees to ensure that the ones giving treatment are being treated themselves.

I have a confession to make: I sometimes look forward to my trips to the bathroom at work. Being a busy pediatrician, it can be the only alone time I get to myself; and on occasion you just need a quiet place where babies aren’t crying, and phones aren’t ringing. The other day as I was leaving the bathroom and returning to the bustling clinic, I did something strange. I knocked on the door before I exited the bathroom. It has become so much a part of my routine to knock on doors as I enter rooms that my brain apparently now knocks on doors as a reflex of sort. Luckily, no one saw me do this, and I left the bathroom pretending to have done nothing abnormal.While the story above is obviously light-hearted, much of health care is not. Practicing medicine is rigorous; it consumes the person that you are in many ways. What is often overlooked in medicine is the emotional heft of dealing with hardship that the doctor himself or herself experiences. A doctor, nurse, or anyone involved in the health care of people is often at the eye of the proverbial storm.I remember a blistery winter day while I was in medical school in Ohio. The snow covered the streets, and I felt lucky to be on my obstetrics rotation in the warmth of the hospital, where I wasn’t paying the heating bill. Suddenly the senior resident said we had to run down to the ER for an emergency. The moments that followed have never left my memory. A pregnant mother had gotten in an automobile accident, and her car flipped several times. She was rushed to the ER and in front of my anxious eyes and racing heart, the medical team tried to resuscitate her and her baby. Neither of them made it past that ill-fated day. An hour later I was there to witness the moment that the father of the baby learned of the tragic news in the trauma bay. I will never forget the sound of his scream as his body went limp and fell to the hospital floor.

Unfortunately, there are many more of these memories that haunt me. My journey in pediatrics has been lit by the laughter of children, but the moments where they cry or suffer bear a turbulent burden on my soul. Nobody teaches a physician how to deal with the emotional consequences of being involved in such poignant moments. I know that personally my emotional gas tank only holds so much fuel. There are days after work where I seem like a zombie to my friends and family. Occasionally in the midst of my day, I find myself being warm and friendly with my patients and their families, but rather cold and removed in my relations with the office staff.

I certainly don’t mean to treat anyone poorly in my personal life. However, trying to calm everyone’s worries is more draining than I would have imagined. Some days I have 40 to 50 different patient encounters of various kinds, and each of these requires me to be emotionally available. In the process of training to become a physician we are rigorously instructed to have the tools to weather the storm (i.e., diagnose and treat conditions). Sadly, we are poorly taught on how to keep ourselves afloat after the storm has passed.

Medicine is a grind on the heart. We need more resources available to physicians and health care employees to ensure that the ones giving treatment are being treated themselves. It is also vital to create a culture where seeking help in dealing with the emotional toll of medicine is encouraged, and not looked down upon. Many doctors (myself included) are too stubborn to seek out such therapy, because we are trained to see ourselves in the provider role, and don’t quite understand how to be patients.

I don’t want to suggest that I have some kind of privileged understanding of all the moments I have encountered as a doctor. In fact, I don’t know if I ever will fully comprehend the seemingly random events that make up our lives. I do know however that I am not ashamed to admit that these encounters affect me. They lead me to laugh at myself when I knock on a bathroom door, and to shed a tear when tragedy unfolds. Hopefully, they will also lead me to a better understanding of myself and everyone else who touches my life in one way or another.

Ahmad Bailony is a pediatrician who blogs at A Bunch of Bologna: Life Lessons in Pediatrics.

cranquis

So much truth in this, including the sanctity of “quiet work-bathroom time”.

lamentations44

It should have never happened

I had the strangest feeling Your world’s not all it seems So tired of misconceiving What else this could’ve been - Mumford & Sons

It should have never happened. I guess that is what torments me the most.

I walked onto my unit and raised my eyebrows quizzically. Two code carts were open, the contents spread asunder. The tele strips lay in piles on the floor and the red light on the printer blinked to show it needed refilled. I glanced at one of the night shift nurses on the unit and murmured a good morning.

“I’m ready to go.” She said blankly, her hair mussed and eyes weary.

“Who was it?” I said nodding my head in the direction of the code carts.

“200.”She said tiredly. “It was awful. She coded twice. The compressions… it made her surgical incision open up during CPR…So we were doing compressions on an open chest.” She cringed and shook her head at the memory.

I looked up startled and then a seething anger filled me.

“200? She coded? They didn’t make her comfortable?” My frustration was barely contained as I fired off questions. “What happened?”

“Respiratory arrest and then cardiac arrest,” she said rubbing a hand over her face.

Our chat was interrupted by the start of report but my mind was distracted as the nurse rattled off the details of my new patient.

200 was an frail 82 year old who had been on our unit for at least a month and a half. She had been intubated 3 times because of respiratory failure and had been on and off continuous dialysis. Her blood pressure was labile and she would go from being hypertensive to being on 3 pressors. She had been a heart surgery for a valve that was supposed to help her feel better… instead she never recovered. Every day was a new challenge. It had been a roller coaster for her devoted husband. He stayed with her every day. He was constantly talking about their life. I had been in and out of the room so many times troubleshooting her lines, drips, issues with other nurses- I felt like I knew them well.

I only took care of her once- 4 days before she died. I got report and shook my head. I wrote the word “Plan??” on my report sheet in big letters. We had been patching holes in vain and needed to face that our interventions were not working.

The ICU doctor strolled up to chat about weaning the sedation and ventilator and I nodded along. I waited till he was done and then asked bluntly.

“What is the long term plan? Palliative needs to be involved and at the very least she should be a DNR. Can we consult them?” I asked hopefully.

The ICU doctor actually stuttered at my words.

“No… No… I don’t think the husband is ready.” He said trying to dismiss my thoughts.

“Not ready? When WILL he be ready? She has been tubed 3 times, on CRRT for the 3rd time and we are getting nowhere. She has been in the ICU for over a month now and no progress. I’m not trying to be pessimistic…but, we aren’t going to win this one.” I said as forcefully as I could while keeping my voice even.

He stared at me and repeated what he said about weaning the ventilator. I shook my head in frustration as he left the unit. I repeated the same discussion with the cardiac surgeon and PA’s that rounded. I asked for the discussion to be started…to make her a DNR at least. They all refused to listen.

Today, 4 days later, I stood in the unit listening to a nurse tell me about the patient I would care for that day. I listened but my eyes were glued to the demolished code carts in the hallway. The code carts that had been broken open to shock, jam medications, and run fluids into her desperately sick body. The code carts that were powerless against the havoc we had already wreaked on her. I watched the nurse who had cared for her walk dejectedly to sit and chart the tragedy. I watched her husband, eyes red and rimmed with tears hug a few nurses and walk out of the unit with his shoulders slumped. I looked back at the words I was scribbling down and I felt my anger and frustration flare up again.

She died a horrific, disturbing death…and it could have been prevented. Instead of being surrounded by whirring machines, blood smears and the scream of alarms- she should have died peacefully, painlessly with her loved ones. Her ribs should never have been broken, her chest never split and bleeding. The scream of the alarms should have been silenced and a comforting hand holding hers should have been felt.

I shook my head. It should have never happened.

Sometimes, I wish ICU’s were as good at letting people die with dignity as we are keeping the dead alive.