Tuesday, April 29, 2008

Bad news

Yesterday was a bad news day. Every now and then the stars align to allow me to ruin more than one day at a time. It is not my favorite part of the job. I see some of the best and sweetest and most genuine patients with life threatening issues and my heart hurts to tell them the news. Somehow, it almost seems as if I could protect them from their cancer by just not telling them and letting them live their happy life.

The first case was a woman 12 years out from her bad breast cancer who had been having back pain. When she wasn't getting better with the care of her chiropractor, he sent her to me to get further testing. We did a CT and found numerous cancer spots in the bones of her pelvis and spine. BAD BAD BAD......She didn't cry. Her husband held her hand and she asked the right questions about where to go next and if her oncologist could be alerted. Amazingly, she was most concerned about how long she could wait to tell her daughters. The younger is graduating from high school in a few weeks and has prom coming up and she didn't want to ruin those experiences for her. I know in her head she is thinking " I may not be there for her wedding or to see her graduate from college, at least I can enjoy one more prom and high school graduation before I become the center of the world of worry in my family."

We decide she may be able to wait a while but her daughters will likely know that something is wrong.

After lunch another cancer, this one new. Too many cancers. Too many nice people, young people. Non smokers, good helpful people. It challenges me to keep any optimism that there is something or someone watching out for us when these people are in pain who certainly did nothing to deserve it.

I walk out of the room and one of our new nurses sees my face. She didn't know which patient I had just seen or that I had ruined a prom and a graduation and put a family into a depressed state. "Not now" I said and walked to the bathroom to gather myself. The cold in the next room just seems really pointless and unimportant all of a sudden, but I have to take care of them too. They are hurting in their own way.

Tomorrow maybe I can escape without too much hurt to others.

Some people wonder how you can become a hardened doc, able to look at people and not feel. I don't know that it really ever happens but I do know that if I got too caught up in this empathy/sympathy, I wouldn't be able to do my job. I have learned not to put aside my empathy but to let it only live in the moment and my end of the day stories with my husband (and apparently this blog), to give my hand of support and then package it away to think about later (never maybe).

And I have my own medical tragedies to deal with. Sometimes that interferes more than it should as well. I will be blogging on a different site for a while detailing my own adventure in the medical realm. Nothing life threatening but hopefully life producing. My own struggle. Hopefully, I will be more diligent with this blog than I have been here!

You can check it out over here http://carrfamilygrows.blogspot.com.......

Tuesday, August 7, 2007

Give yourself a break!

This is more of a public service announcement than a blog. I feel motivated to write to anyone who may listen and actually follow my advice (including me). GIVE YOURSELF A BREAK! This is, of course, motivated by my long list of patients today who felt anxious, stressed, overwhelmed and fat. This is a reasonable feeling since most people I know, save my husband who is almost a pure hedonist, go go go go go go go go go. I include myself in this group but am trying to work on it for the betterment of my future self and my present patients.

Your body does not know the difference between a person chasing you with a knife and your boss yelling at you, a deadline you may or may not meet, your kids yelling, or the bills needing to be paid without money in the bank. IT IS ALL THE SAME TO THE BRAIN!

So, why are we surpised that we feel tired, don't sleep well, gain weight, and generally feel like a big pile of poo. Every now and then, we all need to remember that we were not meant to live like this and put ourselves first for once.
Be good to yourself. Actually treat yourself as you would like to be treated and as you would treat others. Give yourself a minute or a day or a month off and do that thing you wanted to do. Do it for yourself and for all the other people who wish they could. Just don't expect to develop superhuman abilties to go back to your day to day grind.

Play and have fun and do silly things.

I'll see you in Hawaii or at the Oregon Coast.

Read a book, throw away the book you will never ever finish.

Tell yourself YES! Tell another person no (politely of course)

Good luck !!

Thursday, July 19, 2007


It is always amazing to me what a little piece of sticky paper can do to help make someone feel better. In my office we give many stickers away for kids who are brave (or not) during their shots. Kids who are good while their siblings are being seen. Occasionally, I have given stickers to my favorite Down Syndrome patient because she likes them almost as much as chocolate which I don't always have on hand.

I have denied stickers as well. For the kid whose mom wanted him to have a sticker even though he refused to listen or follow through on any of her requests, I said "no".

I like stickers myself and actually had many a sticker book in elementary and even middle school of various shapes, color, puffiness and smell. We had to stop getting the scratch and sniff ones because my staff and I would scratch all the smell out of them before they were a day old.

I am often looking through our collection commenting on the stickers we should be purchasing. "We need some princess stickers", I would say and be more excited than the kids when they arrived.

But by far my favorite sticker memory will be today.

An 80 year old man cut his forearm with a rusty nail on a birdhouse. Not much damage done but who knows when the last tetanus shot was so he came in to satisfy his wife. He didn't move an inch and complimented my medical assistant on her injection savvy. "You did great! I didn't feel a thing!"

I was telling his wife that earlier that day a mom had promised ice cream to her child when he only barely jerked his arm completely out of the way when he was getting his shot. I suggested maybe her husband could use an ice cream on the way home and we giggled.

Then I turned to the husband and asked if he would like a sticker. "Oh, sure!"

Let's see what we have........Superman, Madagascar, Shark Tales, Horses, Dogs, My Little Ponies.....

"Yup, that's the one!"

And he walked away with a beautiful purple My Little Pony sticker - his badge of honor for his tetanus shot and bird house adventure.

Sunday, July 8, 2007

Virtual Interaction

I am beginning to realize that I am terribly out of touch with the way that communication occurs these days. I have no my space page but I DO have a few blogs that I posted for the sole purpose of having an easy place to share pics with my family without them having to join shutterfly or snapfish and an email account. I talk with my sister-in-law Jen more than often than not over the text messaging feature on my Treo. I am sitting here with my husband on a lazy Sunday afternoon after we have been off doing different things all weekend and we are both glued to our laptops in a house where we have more computers than people.

It is a bit disturbing to me that we have become a nation that interacts through electronic media preferentially to visiting with our neighbors next door. We virtual date rather than go out looking for people in person. We text all day long instead of talking with or meeting face to face. And now the My Space Age. My large extended family has become more easily accessible by computer than by visit I have discovered recently. Family I haven't seen or had the chance to talk any more than a couple of sentences to at family reunions are now openly and personally available for scrutiny and review any time of the day or night. It is a bit upsetting that my next door neighbor could actually become better acquainted with my cousins in Washington than I am.

And so, I am forced to enter the virtual interaction as well.

I have been impressed by my cousin Allyson's blog site and her amazing ability to capture her family moments and personal musings in writing so compelling that I read every word that she wrote and every comment to every word and wanted to read more. I found myself thinking that it was more like reading the work of a stranger than someone I knew. On her blog they all called her "Ally" a name I have never heard anyone in our family use. She even refers to herself as Ally and her screenname is Ally. Perhaps this is the real her, hidden from my point of view from inside the box of her role in our family.

I have learned about my Judd cousins and Winn cousins on their myspace pages through their self descriptions, choice of music, pics and comments from their "friends". All of a sudden, I feel that I am looking at these people whom I have literally known since birth in a new light. I can see who they are better outside of our weekend family gatherings when their hair is let down and their behavior is more normal. Maybe this interface takes away the awkwardness of not being able to find a place to start with a person you have known forever but never really talked to in a meaningful way.

So if this is this only way I am able to meet my family in a way that lets me really see them and find out what makes them tick, then so be it. Maybe it will make the real interactions a little more meaningful in the end. And, at least when it comes to the family parts of their back stories, I will at least know the players.

I am not a gifted writer, I ramble and like run-on sentences. I am better at talking one on one which is important since I spend most of my day listening (or trying to at least) to people and help them find a way to heal themselves. So, I may not write something as poignant or interesting as you may find on the links I have listed to my cousins and siblings and aunties, but I will try to make a place where those who know me can keep up - check out the other blogs - some are just pics from our family, the baseball trip is by far the most exciting, but again a little lacking in completeness and maybe I will finish it someday.