Week Six

Hi guys!

Hopefully everyone had some great learning opportunities this week, I know I did! On Monday, I attended one of the most inspiring lectures titled "Burning Shield: The Jason Schechterle Story". Since the keynote speaker was Jason Schechterle himself, the lecture was considered a patient panel in discussing Schechterle's story as a patient and victim of a fire. 

A former Phoenix cop, Schechterle was hit by a taxi going 115mph on a 30mph speed limit. Because of the speed and impact, Schechterle's car immediately went up in flames, and due to a "series of miracles" he survived 4th degree burns. He started the patient panel by addressing anatomical and technical components of medicine: removal of burned and disfigured tissue, pain from physical therapy, plastic surgeries worth over 4 million dollars, and transplants to cure his acquired blindness and deafness. But the significance in the telling of his story was how his health improved through a growing emotional strength. He discussed his experience with being disfigured and the toll that took on his wife and young children. Most insightful to me as a future clinician was his anecdotes of interactions with doctors because I learned that empathy is different for everyone. While some patients like to be nurtured throughout the process, others prefer to be given brutal honesty and find strength through that. This gave my understanding of narrative medicine some more depth because it's one thing to know that medicine needs humanity and empathy, but it's another to know that every patient has a different interpretation so as doctors, we must adjust our care accordingly. 

At the end of the week, I shadowed at the same pediatric urgent care, and even though it was only my second visit, it already felt like home! I took some time to discuss with the head pediatrician there, and she made me realize that because the setting of an urgent care calls for the quickest clinical visits, the system almost forces a limit on the patient-doctor relationship. Keeping this in mind, I noticed that in one visit a cultural belief prevented a mom from giving her child anything cold during a fever. The pediatrician was able to make a connection and explain that a popsicle or any other frozen product might actually be the best solution for instant relief. I admired that she was able to take into account the traditional belief and simply suggest, but not force, an alternative explanation. At the end of my shift, I even got to watch a kid getting stitches! It was amazing to witness the procedure of anesthetic numbing and suturing from so close up. 

Having experience in the clinic and in lectures preparing for clinic was remarkable and I'm excited to start collecting data from surveys soon, so check back in next week! Thank you for reading! 

Anivarya

Week Five

Hey everyone!

I hope all of you had a great week! At the beginning of my week, I attended the "Film and Medicine Series: Being Mortal" at UofA's downtown campus. During the session, we watched a documentary adaptation of Atul Gawande's Being Mortal, which is easily the most well-known book in the medical world. (Which is also why I read the book twice to try and level up to the physicians and doctoral professors on campus) At the completion of the documentary, the auditorium was opened up to a Socratic Seminar on physician experiences related to those discussed in the documentary as well as advice for practicing medical students on humanistic approaches to patient care.

For me, the big takeaway from the Film and Medicine Series was that, in the paradox of medicine being both extraordinary and less than ordinary, you can't always count on the doctor to lead the way, sometimes the patient has to do it. Gawande detailed a series of questions that allows the patient to take the lead and, as a result, feel more valued throughout their care. Although this documentary focused on more long-term relationships with cancer patients, these individualized questions allow patients to use the clinical environment for emotional and physical therapy. To give you a more concrete idea of this, here are the four major questions:

1. As a patient, what do you think of your illness? What do you think it is and what do you feel will be its effects?
2. What are your priorities and goals for these last months of your life?
3. What are you worries? What are your fears?
4. What are you willing to sacrifice and what are you not?

I later shadowed an urgent care pediatrician, where I observed patient doctor relationships and attempts, or lack thereof, of an empathetic approach to medicine. After meeting with patients suffering from conjunctivitis, a reaction to a spider bite, an ear infection, and strep throat, I noticed that because it was in an urgent care setting, there wasn't any interaction besides discussing a quick fix from a prescription. Each clinical visit was about 5 minutes and, although the tone of the doctor was very warm and amicable, no one was taking the time to understand where the patient was coming from and what exactly the patient or parents were dealing with. I think this was a really important learning experience for me because in order for me to know what narrative medicine, it's vital for me to know what it is not. This way I can build a foundation of humanism in medicine off of this differentiation.

Thank you for reading and check back in next week!

Anivarya

Week Four

Welcome back from Spring Break!

I hope everyone enjoyed their time off! Last Saturday was my first day as a member of the Humans of SHOW program in the SHOW Clinic, and I had such a heartwarming experience interacting with homeless patients. For the rest of this week, I dedicated my time to analyzing works of the renowned physician-writer, Atul Gawande.

At the SHOW Clinic, I was welcomed by UofA, ASU, and NAU medical students and immediately became a part of the community there. After partnering with a student photographer, I interviewed four of the patients experiencing homelessness, in which the questions were geared towards an open and comfortable narration of their story - their path towards homelessness, their emotions and understanding of their current situation, and what they hope to fulfill in the future. In interacting with them, we uncovered that even within the category of "homeless", each individual was unique because of their background and goals, and this drew ties with the purpose of narrative medicine in that each patient is unique even if the illness is categorized under one.

I was intrigued by the stories of each of the four patients and humbled by their optimistic perspective on life despite their struggles. Due to patient confidentiality, I'm not allowed to release names of the patients I interviewed, but fortunately they did sign a consent for me to share their story in hopes to change people's misconceptions of homelessness. The first I interviewed was a woman suffering from epilepsy and domestic violence from her former husband. She pointed out that her loving husband getting a brain tumor, and as a result, becoming violent towards her and her daughter, in complement with her epileptic episodes, was all truly unexpected. After opening up to us, she began crying and even hugged us because her goal is to help others understand that homelessness isn't the result of unstable backgrounds or misconduct in actions. Her words showed us that homelessness is a temporary situation that happens to the person affected, and each person has tried and will continue to try their hardest to come out of the situation. I then interviewed a Navajo man who had been in and out of jail three times due to misconceptions regarding his ethnicity, and when asked about his daughters, began crying in hopes to use the resources at SHOW to stabilize and provide for his children. After a short snack break, (although we really weren't able to eat anything after listening to their stories of suffering) we interviewed a man who was relatively hesitant to speak as well as a religiously devout woman who stated that she wasn't homeless because she had a permanent home in heaven and that she was simply in a "transition state here at SHOW".

Although each individual's background and future outlook was unique, the one thing that was consistent was that they were truly thankful for the care they were receiving at the clinic. What seemed to us as almost an impossible style of living was one they cherished and wanted to utilize as a foundation for their dedication towards a future purpose.

Somehow, this one day was much more substantial than the six days of reading I did, but why not lighten the mood with a brief description of Atul Gawande's work. Gawande sheds a new light on medicine by introducing its paradox of being both extraordinary and less than ordinary. By tying in the importance of humanities and patient stories, he discusses that as much as medicine is advancing and saves life after life, medicine is essentially a trial and error process because physicians can't know the right way to treat a person since each is so physiologically and psychologically different.

In my next blog, I will talk more about this complex analysis of the practice of medicine because turns out Atul Gawande even has a movie!

Thank you so much for reading!

Anivarya