Wednesday, February 20, 2008
My trip down to Vegas yesterday went very well. The medical students in the seminar were terrific, and did excellent work: they wrote very movingly in response to the prompt. I used the same case I did last time, about a pediatric death. I asked the students to write a letter from one character in the case to another, explaining how that person felt about what was happening. Then they traded letters with a partner, who wrote a response to the first letter.
It was a satisfying session, especially since after the class, one of the students came up to ask me a question and to tell me how much she'd gotten out of the exercise. It turns out that we share a passion for psychiatric and homeless patients, so we swapped stories about our favorite encounters. She's concerned about the fact that psychiatry has become mostly about medication management; psychiatrists don't spend much time talking to their patients anymore (that's the realm of psychologists). She's also interested in international medicine, and shares my admiration for Paul Farmer. I really enjoyed the conversation, and I think she's going to be a great doctor.
The only downsides of Vegas were a) the fact that I'd woken up at 4 a.m., which meant I was pretty wiggy by late afternoon, and b) the serious knitting error I made on the plane flight down, which means that I have to frog at least three rows. Ack!
Our plane back was delayed forty-five minutes. I got home at 8:00 and was in bed at 9:00. My alarm went off at 7:00. I turned off the alarm, intending to get up momentarily. At 8:00, Gary shook me and said, "Don't you have a meeting at 9:00?"
"Oh, #@&%!" I said, and raced into the shower, into my study to print out materials I needed for my 11:00 presentation, and into the car. I got to the med school a few minutes early for the meeting: turned out I was the first one there. Only two other people came, and they were both sick. (My partner for the 11:00 presentation had already canceled because she's sick, too.) We had a nice chat and ended early. I went to find my friend Marin, who photocopied the presentation stuff for me; then I checked my e-mail in the med-school library and went to give the presentation.
I was presenting under the aegis of a group with a grant to study spirituality and medicine. We've been finding that this subject is a somewhat tough sell to residents, who are working seventy hours a week and exhausted. My topic today was "Woundology, Or Why Patients Don't Heal," and my partner and I had put together a couple of real-life cases about patients who derived their meaning in life (and therefore, implicitly, their spirituality) from their illness. One of these cases was a man I met in the ER who'd developed a complicated cardiac history after the death of both of his daughters: his interpretation was that his physical pain was God's way of telling him that his daughters were better off dead than they would be on Earth, "where everything hurts."
The residents' first response to all of the cases was "call in a psychology consult." They don't have time to deal with these issues; they only get to see patients for fifteen minutes, which is really more like seven, and they don't get reimbursed for depression diagnoses, and this stuff isn't their area of expertise, anyway. I think they were sympathetic to the cases, but the urge to refer to another specialist was overwhelming (note: these are family practice residents).
So I felt like the presentation fell flat, although Marin thinks that it went well and that I gave them something new to think about. At any rate, after that session ended at 12:00, I raced down to lower campus to gobble lunch and teach my 1:00 fiction class. When I got back to my office at 2:15, I had e-mail from my mother saying that one of my cousins was in the hospital after having an intestinal tumor removed, and was waiting for biopsy results.
A graduate student whose MA committee I'm chairing came to talk to me about her thesis plans. While we were talking, the phone rang. It was Gary. "Your mother just called. They got the biopsy results. It's malignant, and two lymph nodes were involved."
"Oh, #(@&!" I said. "#@(#&, #@&*#(O, @#*#%&!"
When I got off the phone, I apologized to my student for cursing. She was very sympathetic and supportive. I had about half an hour to collect myself before my 5:30 Tolkien class; luckily, my lesson plan involved a fairly extended small-group exercise for the students, which gave me a long stretch when I didn't have to be coherent.
I also got my first batch of papers in the Tolkien class, and because of various scheduling issues, I have more grading than usual for my fiction workshop, too. So it's going to be an extremely busy weekend. I hope I manage to regenerate some brain cells over the next few days!
Please pray for my cousin and his wife in Arizona, and for my uncle in New Jersey, who lost his wife not long ago and is now facing the serious illness of a child. And for my cousin's two brothers and their families.