悄悄 是别离的笙箫
沉默 是今晚的康桥
Wednesday, December 31, 2014
Sunday, December 21, 2014
"...Neither of us bemoaned what I could not do; instead we always marveled at what I could do. My mother's favourite saying during moments of trauma had always been, "It could be worse!" And we both agreed, as bleak as my situation appeared on the surface, it could have been a lot worse... We were caught up in the process of recovery and every moment brought new hope and new possibilities...
...A lot of stroke survivors complain that they are no longer recovering. I often wonder if the real problem is that no one is paying attention to the little accomplishments that are being made. If the boundary between hat you can do and what you cannot do is not clearly defined, then you don't know what to try next. Recovery can be derailed by hopelessness."
...A lot of stroke survivors complain that they are no longer recovering. I often wonder if the real problem is that no one is paying attention to the little accomplishments that are being made. If the boundary between hat you can do and what you cannot do is not clearly defined, then you don't know what to try next. Recovery can be derailed by hopelessness."
- My Stoke of Insight
Friday, December 19, 2014
"...Faith, a well-recognised source of solace, of strength to endure, can also give people the courage to recognise uncertainty, acknowledge not only their own fallibility but also their physicians', and thereby contribute to the search for solutions. Of course, individuals for whom faith is not a cornerstone can find the resilience to endure and sustain the presence of mind to search for information and parse the logic of their doctors...
...Does acknowledging uncertainty undermine a patient's sense of hope and confidence in his physician and the proposed therapy? Paradoxically, taking uncertainty into account can enhance a physician's therapeutic effectiveness, because it demonstrates his honesty, his willingness to be more engaged with his patients, his commitment to the reality of the situation rather than resorting to evasion, half-truth, and even lies. And it makes it easier for the doctor to change course if the first strategy fails, to keep trying. Uncertainty sometimes is essential for success."
...Does acknowledging uncertainty undermine a patient's sense of hope and confidence in his physician and the proposed therapy? Paradoxically, taking uncertainty into account can enhance a physician's therapeutic effectiveness, because it demonstrates his honesty, his willingness to be more engaged with his patients, his commitment to the reality of the situation rather than resorting to evasion, half-truth, and even lies. And it makes it easier for the doctor to change course if the first strategy fails, to keep trying. Uncertainty sometimes is essential for success."
- How Doctors Think
Thursday, December 18, 2014
"Imagine watching a train go by. You are looking for one face in the window. Car after car passes. If you become distracted or inattentive, you risk missing the person. Or, if the train picks up too much speed, the faces begin to blur and you can't see the one you are seeking.
...It can become rote, and you stop observing closely. Then you have the endless number of kids who are cranky and have a fever, and it's almost always a virus or a strep throat. They can all blur. But then there is that one time it's meningitis.
...A blessing, of course, that the kids are fine, but a curse because you can become lulled by the monotony of the mundane.
..., and not to be lulled into complacency despite her expertise.
...There were time when I was so spent, and yet still pulled in so many directions by patients in need and nurses demanding action, that all I wanted to do was deflect their requests. Subconsciously, I found myself minimising the severity of a symptom or assuming that an aberrant laboratory result was an artifact rather than a sign of a serious problem... The danger is to stop caring. The goal of each day and each night was simply to move everyone through, to clear the decks, rather than to deliberately and expertly care for those who needed care and reassure those who did not...
...But both McEvoy and Bigby emphasised to me that in the hurly-burly of primary care, a physician must not lose sight of the fact that what may seem mundane to the doctor can strike the patient as tragic."
...It can become rote, and you stop observing closely. Then you have the endless number of kids who are cranky and have a fever, and it's almost always a virus or a strep throat. They can all blur. But then there is that one time it's meningitis.
...A blessing, of course, that the kids are fine, but a curse because you can become lulled by the monotony of the mundane.
..., and not to be lulled into complacency despite her expertise.
...There were time when I was so spent, and yet still pulled in so many directions by patients in need and nurses demanding action, that all I wanted to do was deflect their requests. Subconsciously, I found myself minimising the severity of a symptom or assuming that an aberrant laboratory result was an artifact rather than a sign of a serious problem... The danger is to stop caring. The goal of each day and each night was simply to move everyone through, to clear the decks, rather than to deliberately and expertly care for those who needed care and reassure those who did not...
...But both McEvoy and Bigby emphasised to me that in the hurly-burly of primary care, a physician must not lose sight of the fact that what may seem mundane to the doctor can strike the patient as tragic."
Sunday, December 14, 2014
"...Joe had his bearings about him. Joe knew when to fight and how to fight and when to quit fighting. He knew just how much of himself he could afford to pour into each case.
...We went into medicine because we cared. But caring kept bringing us pain and frustration and anguish.
...we tried to let conventional wisdom shield us.
...And afterward we'd sit on the bench int he doctors' locker room, and take a deep breath and slowly let it out - but we couldn't exhale everything. We'd sit there, hands folded and heads bent, too lethargic to pull out of our bloody scrubs, too tired to go to bed, too dispirited to start that IV the nurses had called for two hours ago; our minds slowly going out of focus, slowly retreating from the horrors of the past few hours."
...We went into medicine because we cared. But caring kept bringing us pain and frustration and anguish.
...we tried to let conventional wisdom shield us.
...And afterward we'd sit on the bench int he doctors' locker room, and take a deep breath and slowly let it out - but we couldn't exhale everything. We'd sit there, hands folded and heads bent, too lethargic to pull out of our bloody scrubs, too tired to go to bed, too dispirited to start that IV the nurses had called for two hours ago; our minds slowly going out of focus, slowly retreating from the horrors of the past few hours."
"...We did the best we could, but for the 100th time I realised that doing the best we could wasn't enough. There was something in me that wanted results not just effort. Don't tell me how hard you tried, tell me whether or not you succeeded..."
"...but it can be a moral dilemma for a younger surgeon. If they do not take on difficult cases, how will they ever get any better? But what if they have a colleague who is more experienced?"
"...but it can be a moral dilemma for a younger surgeon. If they do not take on difficult cases, how will they ever get any better? But what if they have a colleague who is more experienced?"
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