Walking down this cold lonely path home, I wondered if my efforts counted.
I recall ventilated patients struggling with their own breath.
I saw healthcare workers struggle to prone patients, frantically adjusting pressures and giving medicines. Paradoxically, I heard their fear, and saw their thoughts- “it’s about to get real”!
Codes running, expiration time recorded and heads bowed for moments of silence and respect… The procession continued.
Alas, it’s sunset. We tried.
Destiny saved most but Heaven called the rest.
Our efforts perhaps still counted.
It’s time to unwind.
Although we drop the stethoscopes, out comes the cell phones for nocturnal advocacy on mask wearing compliance.
No time to rest. We will conquer this malady called Covid-TOGETHER.
Suddenly the beautiful fall leaves hurry off the road in a whirlwind.
Choppers’ chuff cry broke the silence, bringing in our rescue SEALs: vaccines.
COVID no longer can stop us. Let’s go save more lives!
There is so much around us and so much to take in.
We see vibrant ads pop up on our computer screens or out our windows. We hear our neighbor’s tasteless music.
We are badgered by the incessant alerts on our smart phones all while craving just one more dopamine hit.
I ask you. I urge you.
Find your focus.
Right now, I’m constantly thinking about all the things I have to do.
There’s definitely an email or two I’ve forgotten to send, and I’ve put off a paper to write day after day. There are notes to write and patients to see. There are things to read and presentations to prepare for.
Dinner? Dishes? Also, my room is a complete mess. As things pile up outside, we forget they pile up inside as well. Everything takes it toll.
I ask you. I urge you. Find your focus.
Some people get lost in a world of imagination.
Others breathe deeply and hum or become a downward dog and sometimes practically resemble a pretzel.
I’ve even seen people sew or knit for hours on end. I’ve even witnessed people telling themselves they want to go someplace else, and then proceed to get there fast, on their own two feet.
Occasionally, people take a stick and hit a small ball into a faraway hole.
I ask you. I urge you. Find your focus.
It could be a goal. It could be a simple task. It’s your way to get away.
Your way to escape the hustle and bustle of your surroundings and the world.
It’s your way to leave the ads, alerts, papers, patients, dinner, dishes, and messes behind.
It’s your passion.
It’s about discovering clarity and breaking free from the chains of your mind. Even if it’s just for a few minutes.
Sudoku? Do it. Everyday. A mountain? Climb it.
I ask you.
I urge you.
Find your focus.
Let us know what YOU do to empty your mind and focus on the NOW
I see you. I hear you. I am here for you. Thank you for trusting me. Thank you for being vulnerable. Everything you share, no matter how small, is invaluable. It helps me become a better listener, a better healer, a better person. My journey may be long, but with each and every one of you, I get a little closer. I stand a little taller. You see, I am still a medical student. I am still in training. But with each of your encounters, I feel myself leveling up. So, if you are willing, tell me your story. Show me your scars. Let’s face your fears. Slowly and steadily, I trek forward. I am nothing without you, but with you, I am everything. So dear patients, thank you. Thank you to each and every one of you.
I have been reflecting of late on the many teachers and mentors who I am grateful for. I have taken to recontacting (by phone or letter) some of these special and generous people.
Here is a letter I wrote to one of them. It shows how even a brief “teaching moment” can have valuable impact throughout a career.
Make each moment,
each encounter (with students, patients, and colleagues)
count.
Dear XXX,
This is a letter of thanks and gratitude that I have been meaning to write for several decades.
This story is about my encounter with you one night while I was on call as an intern and you were the attending physician. It is very likely that you have no recollection of this brief encounter but it was one that, as it turns out, had a great impact on my life and career.
Let me explain. One night as an intern on call at PMC I admitted a patient with a GI bleed. We called the attending to come in to consult that night, and it happened to be you. You came in and after hearing the history of the patient, you turned to me and said, “What would you do to manage the patient?” I replied that I would summon the gastroenterologist on call and get their advice on management.
You replied, “What if I were not here, what would you do?” I was somewhat taken back by this, and responded, I would call another gastroenterologist. “Well,” you said. “I want you to analyze the situation and give it your best shot. What would you do? I won’t let you harm a patient with over or under treatment, but I really want you to think through the problem as though I was not here. And, I don’t care if I have to stay all night while we figure this out.”
I was stunned. Most attending physicians and teachers wanted to swoop in, demonstrate how much they knew, impress the interns, and get back home as quickly as possible. You were different. You created a safe environment in which no patient would be harmed. But you wanted me to grow-up as a physician and think through decisions in advance of asking for help. Your insight and generosity as a teacher has stuck with me for many years. I cannot tell you how many times I have shared this story with others as an example of effective teaching.
I have applied what I learned that night to my interactions with patients. I have found that my questions can be more powerful than answers. I have often found it more effective to elicit patient-generated solutions by asking “What do you think might help or work for you?” rather than flooding them with advice.
Similarly, when managing co-workers I will often ask them, “If I were not here, what would you recommend doing or deciding?” I have found this often builds their competence, confidence and leadership ability.
So you see, your night of teaching me at PMC has had happy repercussions throughout my career and I am very grateful to you.
My inspiration for this poem was truly my love for teaching Family Medicine Residents and medical students.
However, I realized that my passion for teaching was also due in part to the Family Medicine Faculty, Residents, Specialists, Nurses, Hospital Staff and last but not least the patients I care for, ALL of whom were instrumental in training me.
I have become, in many ways, the Physician and Teacher I am because of them.
Teacher
Teacher, teacher what can I say
You chose me to stretch beyond any normal boring day
With thoughts of scalpels and sutures and retractors swimming around in my head
You chose me for a different journey than that for which I had been led
To what do I owe you
Can you or will you ever know
How much you have done for me there is so much to say
How much I have learned each and every day
Oh teacher, teacher what am I to do
When this beautiful journey ends
I will most certainly miss you
How can I say it, where will I begin
But as a sorority, of which I am a member for life
You too are with me forever
I cannot tell you how much I went through to meet you
As much as I can, I will leave you never
Here I am teaching those as you have taught me
The biopsychosocial model swims lovingly in my head
Differential diagnoses are where the learners are led
In this journey planned out for me, more incredible discovery
So now that I have told you all that you need to know
How much I truly have grown because you have loved me so
Thank you for stretching me beyond where I thought that I could never go
An incredible teacher I have become, to you I know I owe
1. There’s no cure for the virus that can be killed by sanitizer and hand soap.
2. Is it too early to put up the Christmas tree yet? I have run out of things to do.
3.When this virus thing is over with, I still want some of you to stay away from me!
4. If these last few months have taught us anything, it’s that stupidity travels faster than any virus on the planet , particularly among politicians and bureaucrats.
5. Just wait a second- so what you’re telling me is that my chance of surviving all this is directly linked to the common sense of others? You’re kidding right?
6. People are scared of getting fined or arrested for congregating in crowds, as if catching a deadly disease and dying a horrible death wasn’t deterrent enough!
7. If you believe all this will end and we will get back to normal just because we we reopen everything , raise your hand. Now slap yourself with it.
8. Another Saturday night in the house and I just realized the trash goes out more than me.
9. Whoever decided a liquor store is more essential than a hair salon is obviously a bald-headed alcoholic.
10. Remember when you were little and all your underwear had the days of the week on them . Those will be helpful right now!!
11. The spread of COVID-19 is based on two factors 1. How dense the Population is and 2. How dense the population is.
12. Remember all those times when you wishes the weekend would last forever ? Well wish granted . Happy now?
13. It may take a village to raise a child, but I swear it’s going to take a whole vineyard to home school one.
14. Did a big load of pajamas so I would have enough clean clothes for this week!
“It’s fascinating and powerful to think that music, something that has been floating around in our environment forever – that this natural, omnipresent human activity has demonstrable benefit as treatment.”
Sarah Hoover., D.M.A., co-director of the Center for Music and Medicine
There is one universal language that unites us all – music.
Music is all around us. It’s not just the repetitive pop songs on the radio or your fine-tuned Spotify playlists that fit your every mood. Open your ears to the world around you – and you soon realize that music is everywhere.
The singing of the birds in the morning; the mechanical synchrony of your car starting up in the morning; the symphony of alarms, call lights, bed alarms, telephones, yelling of agitated patients during rounds; the calmness, wind, and quiet whirring of your bike’s pedals and chain during an afternoon ride; or the subtle humming of the fan as you study in the evening.
For me, making music is a way of creative expressiveness – something to keep my mind off medicine just for a little bit. However, you can’t deny the healing powers of music. Researchers have studied music interventions and the application of clinical music strategies in medicine. Music can balance the autonomic system by toning down sympathetic activity, allowing patients to relax; it can influence how the mind, body, and spirit interact with one other. Check out the videos below to see some examples how music can bring joy and better health to people.
95yo Julian Lee plays the piano
Henry’s transformation after listening to his favorite music
My quick cover of Stevie Wonder’s Isn’t She Lovely on melodica and piano
For more on my musical endeavors, follow me on Instagram: @jorvicjustinmusic
Oh so complicated. I realized this when controversy over the identity of the tooth fairy plagued my colleagues. Were magical beings actually invading everyone’s homes or was it simply everyone’s parents? Their conspiracies never swayed me from the truth: my parents were fairies and one day I’d awaken the same powers of dental thievery.
Just kidding. I knew right away the tooth fairy was just a story to help kids not freak out about losing baby teeth, but it always bothered me that the fable even existed – that we had to make this up. It wasn’t until I was older that I fully appreciated the tooth fairy. This story transformed a potentially painful process to an event that kids looked forward to.
After dispelling other noble characters of childhood (like Santa Claus), I took it upon myself to create a personal “tooth fairy story” to reframe my perspective on life.
Life is a movie
Movie (noun): a sequence of consecutive still images recorded in a series to be viewed on a screen in such rapid succession as to give the illusion of natural movement.
The movie of life starts with birth and ends with death. Every moment in the present is a screenshot of the film, and when these images are connected together, the passage of time that you and I experience is created.
Recall the last movie you watched. Pause it at a random spot. If you had never seen the movie, would you be able to determine if the characters on screen were good or bad? Could you deduce that Darth Vader was Luke’s father all along? Would Darth Vader remain evil or would he go on to a redeem himself? You just can’t know from a singular moment.
Movie is life
I like to think everyone stars in their own movie and every encounter with others is an intersection of plotlines. When you meet someone new, you can’t rewind their tape and learn their entire backstory. Nor you can fast forward and see what will happen to them. Because I don’t know who they’ve been or who they will become, I shouldn’t pass judgement or assume anything about others.
Applying the same rationale to ourselves, we only know our own past and have no idea what crazy plot twists lay ahead. With the same open mindedness towards others, we should embrace our own future and all the possibilities in life.
Time is a finite resource for movies. Everything in the film is intentional. Those long pauses in dialogue, subtle changes in the musical score as tensions heighten, hidden pop culture references, and so much more. Movies don’t waste a second and nor should we.
When I feel overwhelmed and unsure of what to do, I take a step back, breathe, and imagine myself on set. Megaphone in hand, the director reassures me:
A research study found that “patients spoke, uninterrupted, an average of 12 seconds after the resident entered the room.
One fourth of the time, residents interrupted patients before they finished speaking.
Residents averaged interrupting patients twice during a visit.”
–Rhoades DR, McFarland KF, Finch WH, Johnson AO. Speaking and interruptions during primary care office visits. Fam Med. 2001;33(7):528-532.
As a medical student on my second month of clinical rotations, I’ve found that it is crucial for healthcare professionals to take the time to truly listen to their patients. The patients know themselves best and when we take the time listen to their stories, it is our best chance at really making a difference in their lives. I found a quote from Rachel Remen, the Healer’s Art curriculum creator, that aligns with this.
Rachel Remen writes,
“the most basic and powerful way to connect to another person is to listen.
Just listen. Perhaps the most important thing we ever give each other is our attention…a loving silence often has far more power to heal and to connect than the most well-intentioned words”.
Two roads diverged in a yellow wood, And sorry I could not travel both And be one traveler, long I stood And looked down one as far as I could To where it bent in the undergrowth;
Then took the other, just as fair, And having perhaps the better claim, Because it was grassy and wanted wear; Though as for that the passing there Had worn them really about the same,
And both that morning equally lay In leaves, no step had trodden black. Oh, I kept the first for another day! Yet knowing how way leads on to way, I doubted if I should ever come back.
I shall be telling this with a sigh Somewhere ages and ages hence: Two roads diverged in a wood, and I— I took the one less traveled by, And that has made all the difference.
Daily Dose of Humanities 