Tag Archives: medicine

12 Years in a Coma, With Just Your Thoughts

From NPR: What would you do if you were locked in your body, your brain intact but with no way to communicate? How do you survive emotionally when you are invisible to everyone you know and love? That’s the first question asked by NPR’s new program on human behavior, Invisibilia. The first show tells the story of Martin Pistorius, who fell into a mysterious coma as a young boy. He had only one thing left as his mind began to function again — his own thoughts. Here’s a glimpse into his story.

Full audio program http://www.npr.org/blogs/health/2015/01/09/376084137/trapped-in-his-body-for-12-years-a-man-breaks-free

An Oncology Nurse on the Barbarity of the ‘Culture of Life’

From a thread on Reddit about medical care:

“So I went back to school and became a nurse, recently, and now I work on an oncology unit in a hospital. I used to love what I did, in hospice. It jived well with me to do what I did in every way. Now I feel barbaric. The whole setup feels barbaric, and I feel gross about what I do. The whole system feels primitive to me and I hate going to work each and every day. I don’t say that to complain, I don’t say that because I have an agenda, I just say that because it’s the truth and it kills me.

When I worked in hospice there really was a ‘culture of life’. Even though it was about dealing with death. This author’s description of palliative care professionals being implacably positive is my experience, too, and I think that has a lot to do with the type of person who gravitates towards that profession and the perspective they hold.

Now my job is about doing things to patients. I do things to people, and I keep them moving along, and if I talk to a patient for too long I’m too “touchy-feely” and not managing my time well, even if that patient is opening up to me, a stranger, about being close to death, and the spectrum of conflicts that accompany, even if that patient is opening up to me, a stranger, when s/he hasn’t been able to talk to anyone else about it, including family and spouse, as has happened, I am expected to keep the conversation politely brief and remember my role is task oriented. And this is the “normal” culture I’m now spending my workdays in, and I feel very alone there.

This is probably not the fault of the hospital I work for. It’s the nature of healthcare here. But it’s something I have no idea how I’ll reconcile. I feel my job involves taking care of people in such a limited scope that I can hardly say I’m promoting anyone’s well being. I realize I’m coming to this position where I work now in a backwards kind of way.

I learned to treat the psychological and emotional needs of patients early in my career and later learned how to treat medical needs, whereas most of healthcare is oriented in the opposite direction, medical first, psychological well being secondary. I just have to say that I’m severely conflicted about my current position, and am so grateful to read this article and this thread, to know I’m not alone these days in my perspective.”

Full thread on Reddit http://www.reddit.com/r/TrueReddit/comments/220re9/who_by_very_slow_decay_a_freshlyminted_doctor/cgimgxt?context=3

Image from http://www.franklinjoseph.com/assets/images/Medical_Symbol.jpg

Another quote from the article the writer is talking about:

“I work in a Catholic hospital. People here say the phrase “culture of life” a lot, as in “we need to cultivate a culture of life.” They say it almost as often as they say “patient-centered”. At my hospital orientation, a whole bunch of nuns and executives and people like that got up and told us how we had to do our part to “cultivate a culture of life.”

And now every time I hear that phrase I want to scream. 21st century American hospitals do not need to “cultivate a culture of life”. We have enough life. We have life up the wazoo. We have more life than we know what to do with. We have life far beyond the point where it becomes a sick caricature of itself. We prolong life until it becomes a sickness, an abomination, a miserable and pathetic flight from death that saps out and mocks everything that made life desirable in the first place. 21st century American hospitals need to cultivate a culture of life the same way that Newcastle needs to cultivate a culture of coal, the same way a man who is burning to death needs to cultivate a culture of fire.”

The Economics of Med School Debt

From a Reddit thread about med school and student loans:

“400k for a medical education is a crippling, unconscionable amount of debt. That amount will capitalize upon graduation, and then you’ll hardly be able to touch the loan during residency. Here’s four years of $100k/year expenses with 5.4% interest. Holy shit.

medschool-1

(it’s slightly off because the interest does not capitalize until graduation but too lazy to do the calculation otherwise.)

What does that mean? So you will be left with 440-450k of principle right at graduation. Now here’s what happens after 3 years of residency:

Double holy shit.

medschool-2

So you’ve got $537k in debt after residency! You have no house. You’ve got no savings for your kids to go to college. You have no retirement funds. Each kid will probably need at least $100k for college, and you need roughly $1.5M to retire comfortably. Now you get to start over from scratch with a massive debt burden in your mid to late 30’s. Congrats – doctor.

To pay off $537k at 5.4%, you would have to pay $5000 per month for over 12 years! Think about that – writing a check for $5000, every month, for 12 years.”

Full discussion and graphs from http://www.reddit.com/r/medicalschool/comments/20t3yn/how_can_i_possibly_afford_this/cg6um2f