Medical State of Mind

A glimpse into the daily life of a family medicine resident, chronicling the journey both within and without work. Follow me on Twitter or Mix by FiftyThree.

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Chapter Close

It has been a long time since I have been on Tumblr and a lot has changed. My long absence came without much explanation and for that I owe everyone an apology.

The past few months have seen a paradigm shift in the work that I do. No longer am I a resident or a student bound to the obligations of a rotation, a team, or a superior. I now have the exciting but scary prospect of being the captain of my own ship. When it comes to decision making, I answer only to myself and my patients without a third party, and now must do right by both parties. It has been a lot of responsibility to shoulder.

In that adjustment period, I have travelled across the province and locumed for a number of clinics and physicians and gained confidence in my skills. It has also exposed some of my inadequacies and shown me areas to improve in the coming years.

The entire time the focus has been on righting this ship and plotting a course forward. The tides have eased and the winds steadied. And thus it was time to direct my attention elsewhere, to here.

I have had some time to reflect about this blog and my experience here. It is an encapsulation of six years of my life, a chapter forged in medicine, in humanity, in relationships. It has involved both on the page and off, successes and failures of my life. Lives saved and lives lost.

I honestly do not believe I would be the same person without having this outlet for myself.

Yet as I continue onward, I am not sure what to do with this part of my life. Can it continue to be an outlet where I can express myself honestly about my work and my life? Or would it encroach upon what is professionally acceptable?

I have always tried to be honest and true to myself while walking that fine line, seeking balance in what I say and what I portray on the Medical State of Mind. As a staff, this task could become more difficult.

I would very much value your opinion on this matter. I appreciate all of the love and support you all have given me all of these years.

I have not yet made up my mind about this blog’s future. It may continue to exist in some for or another or I may start anew with a fresh face or under a new name. But one way or another this chapter has come to a close.

Thank you again for your continued readership and support through thick and thin. Here or there, I will see you when I see you.

Sincerely, Tom of the Medical State of Mind

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I passed! I have noting further to add. For the time being this is pretty much the best thing since sliced bread.

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We have seen imitators and duplicators but now here we see the originator. Dr Heimlich helped this lady when she was in distressed and demonstrates yet again why this is such a simple, effective, and important skill to learn for any person.

[medicalstate]

Crocheted Wire Anatomy by Anne Mondro.

[medicalstate]

Consult Warhorse

I am currently on service again in the hospital and have found myself in the midst of a busy couple of days with very few other learners to assist. Thus far, it has been myself and my preceptor tackling quite the flood of consult requests. 

It has been a while since I have had to work in the hospital (a different one at that) and I am quickly finding my legs again and shaking off a bit of that rust. Thus far, I have managed to keep my head above the water and churn out some decent work for the service. 

Tomorrow is shaping up to be another steady day again, but I am ready to meet the challenge.

[medicalstate]

Action Packed Weekend

This weekend was a flurry of activity. Not only was it Mother’s Day weekend, but it was also my friend and mine’s birthday. 

I celebrated my friend’s big day, Tammy and I ended up going out for a nice dinner, and we had a chance to watch Captain America: Civil War, which was fantastic. Sprinkle on top of that some hiking in the wilderness, shopping therapy and a Mother’s Day night out and there you have a nice, condensed space of awesome.

While certainly exhausting, the key thing is that we all had a great time together.

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Surgical instruments for amputation. Tome 6. Pl. 55 from Traité complet de l'anatomie de l'homme by Marc Jean Bourgery and artist Nicolas Henri Jacob (1831).

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I'm currently in high school and interested in a medical career. I really love art and I had the opportunity to take it this year (I'm a freshman). The problem, while planning my classes, I don't have enough space to take art again during my next three years. The majority of the classes I'm planning to take are science/medicine related. How did you balance other interests with career oriented classes?

If it is not possible to add classes in your spare blocks or do an early morning class, then I would suggest taking art classes outside of school. If this is something you know you are passionate about and are interested in pursuing then I think investing in it would be a reasonable choice. Depending on what programs you are applying to the in the future, you do need to cover a lot of ground with your school courses but the other angle to that is to hone in on what career paths you would like to take and then shed what other courses may not be necessary. Good luck!

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Hello Tom, I'm a new reader of this blog and this little space has been quite a motivation source for me :) May I ask what good books about anatomy and histology can you recommend? Thank you very much!

Thanks for your feedback and support. I used Gray’s Anatomy when I went through medical school but there are other choices out there like Frank Netter’s Atlas of Human Anatomy, or Grant’s Dissector. I used Netter’s Histology when I went through histology class.

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Am I worthy?

One of the new objectives I need to address is locum work. For those who do not know what this is, it essentially is coverage work for other physicians when they are on leave. The locum can be short like in the span of days, or even longer, in the span of weeks to months.

For most new graduates, the rite of passage into a practicing career is through locum work. One, it is an opportunity to explore a region and travel. Two, it is a chance to gain exposure to different practices and models of care. Three, it can be a way to continue to learn on the job, and network with other physicians. Four, it is a way to bridge responsibilities as you gain more confidence and continuity in your care.

When I first left my rural placement at the end of last year, I was offered a position to return for a month after I graduated. Since then, I have put the search for locums on the back burner in order to focus on my studies. 

Gnawing in the back of my mind however was the sense of unease. My regular preceptor had yet to ask me about this subject. I had been with my current clinic for nearly 9 months and nothing had been mentioned. In all honesty, I worried: was I not worthy? 

But yesterday, I had a chance to finally sit down with my preceptor after a long day of work and we talked about the future, when the question came up.

“So are you doing anything in September?” I shook my head. 

“Well, I’ll be away for a bit, so if you are interested, we could have you back for a bit.”

For me, to be acknowledged for a locum by my preceptors is a milestone. It signals to me that they would be comfortable with me seeing their patients, that they are comfortable with my management plans, that they can see themselves working with me in the future. It is a validation of my skills, and a validation to that age-old question that has plagued medical students more than once since getting our admission letters: am I worthy?

Yes, I am worthy.

[medicalstate]

Naji - Fallen by Fête.

This song really helped me relax after a long day at work for the last few weeks. Also, it would make a great song for a rainy day. 

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Hey! I'm planing on pursuing medicine but I deal with anxiety. I'm not sure I'll be able to get through it all but at the same time, medicine is my passion, it's the only thing I ever see myself doing. Any thoughts?

I think if it is the only thing you see yourself doing then you owe it to yourself to give it a try. I don’t think anxiety should be something that should hold you back. You can always consider working out your anxiety or at least learn various methods of coping with stress and anxiety. These will become useful skills in the medical profession but also in your personal life. I hope that helps you and good luck!

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I just wanted to say to the anon asking about epidemiology that epi offer so many great opportunities to work alongside other healthcare professionals and make real changes in people's lives. I'm getting my MPH in epi right now and my focus is in field epi/infectious disease/global health. There's plenty of contact with patients, plus investigation into disease causation, and lots of coding/computer work. If that's what you like (I do!) then go for it!

Thanks for your answer and your show of support!

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Views on epidemiology as a profession?

It is a good field and important in the field of medicine. We rely on a lot of the information they provide to better understand diseases and our patient populations.

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Spring Skiing.

We all need some R&R time. This is what my wife and I decided on after my CCFP exam. The snow condition was nice enough that we still managed a solid day of skiing before the weather deteriorated. It was a great way to finish the season off. 

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I am a recent graduate, parent, husband. Im glad to read what you have written on the subject of burn out and depression. I have recently battled with both. It is important to take a minute and understand that you are not alone and it will pass.

Absolutely. It is paramount to recognize that you are not alone in all of this. It can be hard to see the forest when you are in the trees. Being in the thick of things can narrow your perspective and make it even harder to reach out. Having great supports is an important part of helping you cope and recognize when you need help. Being able to take a moment every day to check in with yourself is even better.

It sounds like you were able to get through that difficult time and I am happy to hear that from you. I wish you all the best going forward. Take care of yourself. 

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On Mental Health

I think it is important to take a moment to address the issues of mental health and burnout. Recently, I learned of a medical student who succumbed to the effects of depression. They left this world far too soon.

In many studies, stress and burnout occur in the medical field at rate disproportionate to the general population. The high demands and constant stressors coupled with the standards and responsibilities we put on ourselves puts individuals at risk of emotional and mental health problems. It is important to recognize that we are not alone in this and there is help available to us.

Remember to take a moment. Find time to catch up on sleep. Talk to someone. Remember it is okay to make mistakes. Believe in yourself.

I would encourage anyone who is struggling with distress or burnout or who knows someone who is, to reach out and find help and support. There are always people willing to listen, through your family and friends, or through the faculty and staff. 

My sincerest condolences to those affected by this tragic loss.