Speaking of Addiction…

By Meaghan P. Ruddy

When we speak of addiction, there is a lot we can say. We can talk about stigmatization, how stigma is a mark, a signifier of something often associated with shame and disgrace, which in turn are responses to things deemed problematic by dominant cultural narratives. We could focus on historical usages of stigmatizing practices, how we come to know disgrace and feel shame by observing how others, particularly those who are in helper roles, respond to our marks, and how all of this negatively impacts healthcare. And we could, as we often do, speak about it from the safe, professional distance of the theoretical.

But there is a simpler truth here.

It is the truth expressed by the civil rights movement, the equity in marriage movement, and women’s suffrage. It is the truth that fuels both political correctness and the fight against it. It is the truth that language matters.

Think about it. If it didn’t matter, we would never take offense, never laugh at a joke, never tear up at a well-delivered line in a film or speech. No one would bristle at terms with historically racist or fascist overtones.

Yet, we do.

Healthcare has made some progress but our work is far from over. The person-first language movement has done a lot of good; even the CDC-recommended terms of use for people with disabilities. Even the word healthcare is a relatively new and welcome reframing away from the silos implied by medical care, rehabilitation, nursing care, etc. The harsh terminology that was once part and parcel of “clinical-speak,” handicapped, gomer, diabetic, depressive, has largely been abated or is at least on the way out. There has been wide-spread recognition that these are people first, conditions second.

Except. Except for one challenging, and unfortunately swiftly growing population.

Addict.

Drug-seeker.

Yeah, but c’mon, someone might say. They are seeking drugs. They’re a huge problem! They should know better.Read More »

“Pobrecito” – The Fine Line between Compassion and Infantilization

By Fabiana Juan Martinuzzi

“Pobrecito”– she said as we discussed the patient’s pneumonia course before entering his room.

Pobrecito” – she repeated as we donned our gloves.

Pobrecito”- she mouthed to us in front of our patient.

Pobrecito”- she whispered in my ear as we left the room.

That day, “pobrecito” became a word I eliminated from my vocabulary. In Spanish “Pobrecito” translates roughly to “poor thing” or “poor baby” and it is an appropriate word to use to show empathy with an endearing connotation. However, when one of the healthcare providers in the team used it incessantly to show pity in front of my 60 year old patient with cerebral palsy and dementia I began to cringe every time I heard her say it.Read More »

Sharing at the Free Clinic

By Megan Masten

I recently had the opportunity to spend a month at a free health-care clinic in Flint, Michigan as part of my third year Internal Medicine clerkship.

I am in an underserved medicine program and I have a deep interest in working with people who have characteristically been left out of healthcare.  I loved working with the population who receive their healthcare services at the free clinic – I have mostly been impressed with patient’s willingness to feel vulnerable.  I have spent my third year of medical school in a variety of medical settings, and my favorite type of patient interactions are the ones where patients are willing to be completely honest with me and share things about their life that they might be ashamed of or have complicated feelings about.  I feel like I am doing what I’m called to do when I get to have difficult discussions with people about medical and non-medical issues that affect their lives, and my ability to have these discussions has been strengthened by my time at the clinic.

I spent time with a patient at the Free Clinic who opened up to me about his mental health issues.  He was recently started on a new antidepressant medication for depression and anxiety, and he was open and honest about his challenging feelings.  He shared with me that he was feeling really depressed and had frequent suicidal ideations – and he was quick to say, “I’m sure you don’t struggle with depression, I’m sure your life is really good.”  It was such an important and unexpected conversation to be had; although I don’t personally struggle with depression at this point in my life, I can’t say that I never will, and I can’t say that I don’t understand how he feels.  I shared this with him, and I shared with him the fact that I have family members with depression and bipolar disorder who have been suicidal in the past.Read More »

The Past Today: A Southern Physician Visits the Mississippi Civil Rights Museum

By Suzanne Minor

At this year’s Southern Group on Educational Affairs conference, the University of Mississippi hosted an outing at the Two Mississippi Museums, consisting of the Museum of Mississippi History and the Mississippi Civil Rights Museum.

I focused my visit on the Mississippi Civil Rights Museum.  It was exhausting, difficult, heart-wrenching, and, in the end, hopeful.  Growing up in rural Georgia and Jacksonville, Florida, I witnessed legalized segregation through small private schools and experienced rampant racism as the norm. Thankfully, college and medical school broadened my perspective, particularly gross anatomy.  Once without skin, all of those black and white cadavers looked so similar.  Not better than or less than, but equal in skinless death.  I dove into former slave narratives, reading Frederick Douglas and trying to reconcile the message from my upbringing – that I was better than because I was white – with my new learning in gross anatomy and in my direct experience with people who looked different than me.  I was learning that we were all just human, no better and no worse than each other.  My professional career has been dedicated to attending to the medical and holistic needs of the underserved communities of Miami, Florida, a diverse area in which I’m in the minority.

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New Year’s Resolutions – Walking the Talk with Compassion

By Hedy S. Wald

Take two Tootsie Rolls and call me in the morning. Self-prescribed for sweet tooth me. Not such a blasphemous “drug of choice” (I’m not even using caffeine!) but it’s New Year’s, that infamous time of resolutions. And I’d like to “kick the habit,” do all that stuff the nutritionist advised and ramp up the gym visits. Jogged 2 miles and took a 1/2 mile swim today to start the new year “right” – hopefully burned off the chocolate high. Fueled by endorphins and feeling oh so optimistic, I’m writing this blog. The question is – what happens on January 2?

The ongoing effort to implement and sustain behavior change has given me a profound appreciation for some of the struggles our patients (and even our colleagues and students) endure. Harnessing motivation can be tough and self-flagellation for not following through can make it tougher . . .  this is where some self-compassion with an attitude of kindness and acceptance toward ourselves may make a difference (1). Self-compassion can promote self-improvement motivation given that it encourages us to confront mistakes or weaknesses without either self-deprecation or defensive self-enhancement. (2) According to Breines and Chen, “resolving to make changes can be scary, as roadblocks and setbacks are inevitable along the way. From a self-compassionate perspective, however, there is less to fear.” (2)

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What do Advent and Christmas Have to do with Medical Education, Anyway?

By Virginia McCarthy

As a Jesuit, Catholic medical school, we have had several preparations for Christmas that may not be as “front-and-center” in other institutions.  These traditions are deeply engrained in our culture and expected by our students.  With the flurry of academic activity in the final weeks of the semester, the true miracle of Christmas might lie in the simple fact that anyone shows up to spend time together at all.  In the busy-ness, we pause, but what exactly is it that we are trying to remember about ourselves, the community, the world?
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“There’s a Person in There”

By Joe Burns

The elderly female patient was a frequent visitor of the dermatology clinic.  Her physician had provided routine care for her, removing suspicious spots for decades.  Today she was presenting for an exacerbation of her psoriasis.  We entered the room and the patient was visibly distraught.  She was wearing a wrinkled t-shirt and old jeans, a stark contrast to her usual Southern Lilly Pulitzer dresses.  As we began taking her history, she broke down, bawling over her psoriasis…
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