What’s Laremy Tunsil Got To Do With It? Professionalism, Social Media, and Medical Education

By Mark Kuczewski

On April 28, 2016, ten minutes before the NFL draft of college players was to begin, the Twitter account of Laremy Tunsil of the University of Mississippi, displayed a video of him wearing a gas mask and smoking from a bong.  Mr. Tunsil was a talented prospect widely believed about to become the second player drafted.  He had done an imprudent action at some point and, allegedly, a hacker made the video record available to the world.  A panic swept through the NFL executives making selections for their teams.  Mr. Tunsil was not selected second as predicted but was passed over until the Miami Dolphins took him with the number thirteen pick in the draft.  Because higher draft picks receive larger contracts than those drafted later, commentators estimate that the drop in draft rank likely cost Mr. Tunsil at least $8,000,000…

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What is a Doctor and What is a Nurse? As Patients, We Have the Answer

By Aaron Michelfelder and Fran Vlasses

As the health care professions struggle with defining a “doctor,” a “nurse,” and all of the other remarkable people comprising the health-care team, it is clear to us that the most important perspective is that of the patient.  Who better to contribute to the conversation than a physician and a nurse who are patients themselves?

The Patient (a physician) on “What is a Nurse?”

It was the outpatient nurse whom I nervously called for an appointment with the surgeon, and who compassionately found a reasonably soon appointment time. At the visit, it was her gentle voice that immediately calmed me, and she who corrected the medication errors in my electronic chart. Later, as I lay on the hospital gurney awaiting surgery, it was the pre-op nurse who recognized the fear on my stoic face. She was the one who squeezed my hand and whispered, “Everything will be alright.” In the operating room through a haze of machines, bright lights, sedatives, and scattered voices, it was the pacemaker nurse, whom I have come to know well over many years, who triggered in me a wave of relief as she deactivated my defibrillator in preparation for surgery.  Before the anesthesia, her face was the last I remember seeing, and hers was the first I saw when groggily recovering as she reactivated my defibrillator She who first relayed the good news of the successful surgery. It was the shaking hands of the student nurse, who attempted to change the IV bag, and his confident nurse professor who together, did everything right. At home, it was the surgical nurse practitioner who called to check on my recovery, and whose compassion and support bubbled through the phone.  All of these extraordinary individuals have different training, duties, and approaches to health care; and yet as a patient, I recognize each of them as a nurse…
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Illness As An Opportunity for Reflection: Enabling the Unseen To Be Seen

By David Leach

On March 1st my aortic valve was replaced. I received extraordinary care, was discharged on the third postoperative day, and am doing very well. When I arrived from the operating room to the intensive care unit I had an endotracheal tube, two chest tubes, an arterial line, a jugular vein Swan-Ganz catheter, two 14 gauge intravenous lines, a urinary catheter, various chest leads monitoring my heart rhythm, a pulse oxygen monitor and I have rarely felt better. In fact I was filled with joy. The Society of Thoracic Surgeons rates the 1300 plus cardiovascular surgery programs in the U.S. and I was happy to discover that my local thoracic surgery program was highly rated. I was grateful to have a disease that was fixable and a surgeon who knew how to fix it. I was also terrified at what I would have to go through to get it fixed. I did not anticipate joy…
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Awareness Creation in Healthcare Should be a Priority in the Developing World

By Calvince Owiti

I was born about two decades ago in a small village in Western parts of Kenya.  I grew up in a humble background, learning all that was relevant that time.  My grandparents were herbal medical practitioners.  I lived with them most of my early life even though my parents were still alive. My grandfather kept on calling me ‘ajuoga’(meaning doctor).  Before he became a herbalist, he had been to a seminary where he was training as a father but left before finishing for a driving job in Tanzania.  He could urge me every morning to study hard in class to become a modern doctor.  They could treat all conditions, including malaria, curses as well as a number of obstetric/gynecological conditions.  However; there was one practice that kept me wondering…

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Social determinants: Why are they so difficult to address?

“He who knows only his own side of the case knows little of that.”
John Stuart Mill, On Liberty. 1869

By Greg Gruener

At a lecture I recently attended with our students, the guest speaker’s topic was on health disparities and the data presented was, as most of us in the healthcare field know, pretty conclusive.  I have to admit that I knew and had seen this same information in prior lectures, articles, and had gone over it in small group discussions.  I also knew that health disparities existed because of various social determinants.  While the subsequent discussion moved along, I was left at the reflective starting line since I finally grasped the fact that being caused by social determinants, health disparities could only be completely addressed by changing those same determinants.  This is not news for most people in healthcare as their organizations and schools, unlike business, law, etc., have been charged (and are accredited) with addressing those determinants.  So, despite being immersed in the data, why had it taken me so long to have this aha moment?  Here is my explanation for a cognitive lapse, as informed by Donald Rumsfeld…

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Promoting Social Justice in Medical Education

A profile of Dean Linda Brubaker, MD, MS, Dean and Chief Diversity Officer, Loyola University Chicago Stritch School of Medicine

Professor Linda Brubaker brings an enthusiasm for medical education, social justice, and her medical specialty fields of female pelvic medicine and reconstructive surgery (urogynecology) to her several roles at Loyola’s Stritch School of Medicine (SSOM). As a medical scholar, researcher, educator, journal editor, and clinician who sees patients every week, author of nearly 300 journal articles and book chapters, and principal investigator on five federally-funded research grants, she is uniquely suited to leading a medical school in the application of Jesuit educational values…

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Contemplation in Action: Reflective Habits in Clinical Care

By Karen Spear-Ellinwood

I began professional life as a lawyer, representing people accused of violent crimes, most having failed to graduate high school, if they made it there at all. I realized that while a lack of education accounted for a great deal of crime, the more dangerous affliction was a failure to reflect before acting.

After 13 years, I became an educator. I started in middle school. I constructed debates on history, legal and social issues, on weighing the potential harm of perceived ills and their perceived remedies. The sorts of subjects that forced reflection and self-awareness.

I told my eighth graders that lawyers never make decisions without reflecting on what’s likely to happen and what might happen. Lawyers had to know the law and they had to figure out how to apply it, sometimes while encountering unanticipated circumstances. I assigned these eighth graders to argue the side of the debate with which they vehemently disagreed. They had to stretch their perspective, I told them. See this issue from someone else’s perspective to reconsider their own position. They might not change their mind but they would understand the issue and themselves better…

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Becoming Zusha: Reflecting on Potential in Medical Education and Practice

By Hedy Wald

Reb Zusha* used to say: “When I die and come before the heavenly court, if they ask me, ‘Zusha, why were you not Abraham?’ I’ll say that I didn’t have Abraham’s intellectual abilities. If they say, ‘Why were you not Moses?’ I’ll say I didn’t have Moses’ leadership abilities. For every such question, I’ll have an answer. But if they say, ‘Zusha, why were you not Zusha?’ for that, I’ll have no answer.”   

*Rabbi Meshulam Zusha of Hanipol (Anipoli), pious great Hassidic Rabbi (1718-1800)

What is our answer when faced with the challenge of helping our “Zushas,” our learners and educators, be all the “Zushas” they can be?

Developing a “reflective culture” within medical schools and teaching hospitals can encourage and guide learners, educators, and practitioners to recognize and take steps toward realizing untapped potential in self and in health care teams. Within a longitudinal, developmental reflective process starting in year one of medical school, extending into residency  and beyond,1 reflection-fostered awareness of self, other, and situation facilitates purposeful, self-directed learning, more effective use of feedback, and development of new habits of mind, heart, and practice.2  Meaning is created from experience and newly illuminated capabilities may be actualized…

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A Doctor’s Personal, Religious, and Professional Struggle to Wear the Niqab

By Claudio Violato

As a professor and researcher studying the experiences of physicians, including international medical doctors (IMDs), I have interviewed and studied many hundreds of doctors.  These doctors have come from over 35 countries from every continent in the world speaking more than 50 languages. I have heard their stories, why they left their home countries and faced many challenges trying to enter the medical profession in Canada or the United States…

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