Love, and looking ahead.

I know, this is probably too mushy for most of you (so you've received your warning here) but you know sometimes when you listen to a particular song you're just overcome by emotion, and can't stop yourself shedding a few tears? I know, it's not something a guy will normally (willingly) admit to, but tonight, whilst watching this video, I couldn't stop thinking of the academic year ahead, without her (relatively) close by.

But no, I'm not going to induce some involuntary reflux of your last meal by elaborating any further, of course.

Patients With Cancer.

I met a patient, a few months back now, who suffered from Hodgkin's Lymphoma, a type of cancer, obviously. He was at home, receiving palliative care, and was given a prognosis of a few months.

Now what struck me most was that although his skin, on his lower extremities, was covered in horrible ulcers (the sight of which scars you for life), and he was obviously in pain, having to change the dressings (I was with the district nurse, who does it for him), he seemed remarkably upbeat. His wife was there too, and they were telling us the holiday they had booked with some grant they had received, and that they were going to enjoy themselves while they could, together.

The patient seemed more worried about his wife not being able to cope after his passing, and in fact had penned down a diary detailing each and every thing he wanted to do, with his wife, before the eventuality came.

And a few weeks back, I met an elderly lady, this time whilst with the GP, who had presented again with a carcinoma a few years after she had achieved remission from Non-Hodgkin's. Basically another form of cancer. Besides the obvious cliche that came to mind, "Cancer is the ideal state every cell aspires to", what struck me was that she, too, appeared calm, stoic and composed.

It is patient contact, like this, that makes you appreciate life for what it is, and steers you towards a certain complicated branch of medicine.

I bet this is gory reading for most of you, and we don't normally think of our own mortality at such a tender young age where our aspirations and ambitions take precedence over our health - but please, my friends, please take care of your health. Enjoy life, responsibly.

On Words.

What, do you think, is more effective - an essay on living, or a movie on the purpose of life?

As you know, I'm currently doing an SSC (student selected component, ie report on some topic you've chosen) on Tolstoy and the Art of General Practice, and have been asked to read a book called . Now as the book only arrived today I had a free day yesterday, which I utilised effectively to watch random movies and ponder on the role of general practitioners as artists in society. And I managed to watch "I am Legend" (don't ask why, because I don't condone illegal downloading of movies, which I didn't, obviously.)

So you may ask how and why an action/thriller/horror movie starring Will Smith toting an M16 (or is it an M4?) poses such an intellectually challenging question. Well watch the first hour of the movie (on DVD, obviously) and although you might have to extrapolate a little (considering the fact that it is a Hollywood movie) you should get my point.

And read the book, of course, if you have the time. And the article. I promise they're worth the time.

Tolstoy and the Art of General Practice.

Yup that's my SSC for the first semester this year, anybody have any insights on that, other than the 'we are all small but significant parts of society/history, just like the cells/organs of our bodies, and general practice is all but keeping it going (not making drastic changes) and letting it roll along' concept that I have three weeks to refine (greatly, of course) on?
Other than the belief that we should be vegetarians and live full spiritual lives, of course.
Philosophical and arty people out there, help me!

Professionalism in Medical Students.

We've a discussion we have to do as part of a portfolio, and the current one's on (as the title suggests) professionalism medical students are supposed to exhibit. I'd appreciate some comments about my post below, thanks!

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OK I think we've plunged straight into the murky depths of
professionalism in our medical education straightaway haven't we?
Seriously though, I believe Louisa and Sri have both made very valid and
important points in our discussion - in fact, if we look closely at the
GMC guidelines on Tomorrow's
Doctors, you have both mentioned certain outcomes we should have
attained by the end of our undergraduate education!
Further to the points you've made, however, I do feel there are certain
areas we can expand upon, namely
1. What is the 'professional' behaviour required of a medical
student? By that I mean not just what we think we should exhibit
(as Louisa has mentioned), or what our educators, or other doctors, show
(as Sri has noted), but perhaps also think about what patients expect of us.
2. What are the ways in which we can develop a professional relationship
(albeit as a medical student) with not just our patients, but also our
peers and educators?

With regards to the first point, am I the only one to find the symbiotic
relationship between patients and us medical students fascinating? Is it
not such a complex, and sublime one, where they have a vested interest
in our education, helping us (in our vain ventures into history-taking,
and clumsy attempts at clinical examinations), in the hope of moulding
us in their expectations? As such privileged confidantes, where do we
draw the line between passing on valuable medical or social information
for good use, and keeping certain facts confidential; how do we present
ourselves to patients, being too much 'on their side', not just as a
healthcare professional, or risk appearing too detached, and seem
concerned only with our own learning objectives?

I'm sure we can all congratulate ourselves on the fact that we have
demonstrated the former reasonably well through our actions, if we have
not explicitly stated so, in our presentations to senior staff and
discussions amongst ourselves (Mr X, etc), but regarding the latter,
what do you think we should, or should not do, to show our empathy for
patients, yet achieve our learning aims at the same time? Gaining
consent properly, and introducing ourselves are obvious points; perhaps
making them feel at ease, as well as appropriating shared
objectives, I feel, are areas we should improve on (at least for me!)
What do you think?

As for the second point, there is an interesting article about role
models in the medical profession and how professional behaviour should
be taught1, perhaps you'd find it an interesting post-PBL
read! An interesting point it makes is that professional behaviour
should be taught not just through group discussions (like this), but
also by people of other professions. I personally think it is an
interesting idea - remember the ethics lectures by Prof Harris? What do
you think?



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1How important
are role models in making good doctors? Paice et al. BMJ
2002;325:707-710