The Aftergift

“… and maybe then you’ll hear the words I’ve been singing;
Funny, when you’re dead how people start listen’n…”
If I Die Young (2010), The Band Perry

By Michael Dauzvardis

It was in the fall of 2015 that I received a call from a Mrs. Jones.  She went on to detail how her husband, Robert, had died from cancer and donated his body to our anatomy lab in 2006.  She further explained that she and her children had finally come to terms with his passing and now, 9 years later, were finally ready to spread his ashes at the family cemetery plot.  She stated that she wanted to hold a ceremony and perhaps have the students that worked on her husband write something about their experience that could be read at the service…
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Loss: The Hidden Barrier to Professional Identity Formation

By Meaghan P. Ruddy

Paying attention to the wider trends in medical education recently makes it difficult to miss the growing voice of Pamela Wible, MD and her crusade to end physician, resident and medical student suicides.  One premise of her argument is that all the language around burnout and resilience misses the point.  The point it misses? This demographic is suffering from abuse.

I tend to agree.  To this I would add that the result is not burnout but the closely related state of grief…
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DACA Medical Students- Making America Great Again!

By Kimrey Van Perre

My friends have been called “courageous” for sharing their plight as undocumented students with the US Congress.  They have been called “DREAMers” due to the Dream Act that has been repeatedly introduced in Congress but never passed.  I call them “selfless” and “unrelenting” in their commitment to the medically underserved despite their uncertain legal status.

I am a 3rd year medical student at the Loyola University Chicago Stritch School of Medicine (SSOM).  I am not a DACA (Deferred Action for Childhood Arrivals) student.  I was born a US citizen.  But many of my friends at SSOM are DACA students.  Their families, like mine generations ago, immigrated to this country.  They wanted their children to have opportunities and to grow up in a safe and stable country…
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Stories from the Border: Hearing the Voice of All Community Members

By Audrey Hertenstein

We shuffled through the metal detector and were directed to stand with our backs against a wall – the final step in an hour long process to enter the Florence, AZ Detention Center to visit with detainees the organization Mariposas sin Fronteras had been communicating with to offer assistances such as letters of community support and a friendly voice to reach out to.  The guards ushered me and the other Loyola students through several locked doors and into a visitation room where we were only allowed one hour to meet, rules which seemed much too strict for a person whose only crime had been seeking asylum within our borders…
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ICYMI: The Best of Reflective MedEd 2016

With the holidays upon us, we are taking this opportunity to showcase a few excellent posts from the year gone by.  We invite you to check out these highly popular posts.

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Darrell G. Kirch, MD, “Educating for Resilience and Humanism in an Uncertain Time.”

https://reflectivemeded.org/2016/09/27/educating-for-resilience-and-humanism-in-an-uncertain-time/

 

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Hedy Wald, PhD, “Becoming Zusha: Reflecting on Potential in Medical Education and Practice.”

https://reflectivemeded.org/2016/03/09/becoming-zusha-reflecting/

 

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Sunny Nakae, PhD, “Presence and Vulnerability in Medical Education.” 

https://reflectivemeded.org/2016/02/02/presence-and-vulnerability-in-medical-education/

 

Lessons Learned from a Beatbox Heart

By Tim Lahey

Two days ago, Jimmy stuck a used needle into the soft skin of his forearm, and released 20 milligrams of black tar heroin and a bolus of bacteria into his blood.

The bacteria floated from vein to artery as he nodded, eventually sticking themselves to the ragged edge of his aortic valve.  There they multiplied and burrowed until each systole whipped a two-centimeters of snot back and forth in his atrium.

Fevers came first, which Jimmy ignored while buying more black tar at a rest stop on I-91.  A day later, little red stigmata appeared on the palms of his hands as plugs of snot lodged in small vessels there.

When he couldn’t breathe, Jimmy went to the ER.  My medical student and I met him there as he shook in bed.  A snarl of IV lines snaked under the covers.

Jimmy gave one-word answers to my questions, and did not open his eyes…
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Our Devices, Our Selves: How to Avoid Practicing Distracted Doctoring

By Laura Vearrier

Americans check their phones an average of 46 times per day, (Eadicicco 2015) and they do so no matter what they are doing, including while driving, while at church, during sex, or out to dinner. (Rodriguez 2013) Are healthcare providers any different?  In a survey of medical students, 46 % reported texting, checking email, or making a call on their personal devices during a patient encounter, and 93% had seen a senior resident or attending do so. (Tran et al. 2014)  The answer to this problem is not as simple as turning off the device.  Improvements to medical care afforded by personal devices include efficient access to electronic text books, up-to-date literature, medical apps such as dosing calculators, and improved provider connectedness, among others.  The flip side is that the inevitable distraction created by smartphones creates a threat to professionalism in healthcare…
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Memento Mori- Reflecting on my Death and the Education of Medical Students

By Laura Creel

As part of their undergraduate medical education, students discuss end-of-life care; they hear lectures about valuing the lives and deaths of future patients; they are instructed in the legal issues surrounding advance directives and care planning.  They see death, too—see it in the cadavers that they incise, see it in patients who die surrounded by family members and in patients who die alone.  Sometimes these experiences with death are personal; many times the experiences are stripped of emotion because they occur in clinical environments.  But although students see death in medical school, some recent research shows that approximately half of residents do not feel well-prepared to deal with the deaths of patients.[i]

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Educating for Resilience and Humanism in an Uncertain Time

By Darrell G. Kirch

We face a crisis of well-being in medicine. From the acceleration of science to the implementation of the Affordable Care Act, rapid change has become the “new normal” for our profession.  While many of the changes have the potential to revolutionize health care, they also create stress and uncertainty within our community about our personal futures and the future of academic medicine.  At its worst, this stress contributes to the high levels of burnout, depression, and even suicide we are seeing in health care professionals.  As a psychiatrist who has treated physician colleagues, I have seen depression interrupt promising careers in medicine and science.  As dean of two medical schools, I saw the impact of burnout along the entire continuum, from students to senior clinicians…
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The Value of Reflection in Clinical Teaching

By Patricia Stubenberg

“No words are ofterner on our lips than thinking and thought.”  – John Dewey

The teaching physician has opportunities for personal and professional growth through reflection and revisiting not only their own experiences in training and practice, but also their role as clinical teachers with medical students and residents.  Studies on reflection in teaching are abundant including, Freese’s work on Reframing One’s Teaching1, Dewey’s Art of Reflection2, and the theoretical underpinnings of reflective engagement, metacognition, and transformative learning.  The literature on reflection in clinical teaching is expanding through scholars including, Irby et al.3 and Sanders4.  This essay offers perspective on the value of reflective activity to advance medical education in training the next generation of physicians…
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