Pneumonochrome

This one didn’t turn out quite as well as I’d have liked, I bumped my focus off of the drop of sap there just as I took the picture, apparently. That said, I still like it.

Today’s random photo is of a tree near my home.  I really like the way the leaves arc across the trunk there.

I found some old photos I took, and have no idea why I took some of them, other than that I might have been playing with my camera. This is one of them.

In the May 28th issue of JAMA the “A Piece of My Mind” feature is titled “In Defense of Phobias“. Rosenbaum concludes with the following:

I hope that you all experience many times the opportunity to participate in an action or a decision that could do harm to a patient. These activities are an unavoidable component of medical care. And if you fear that participation, do not lose your fear. Instead, remember that our profession seeks to extend the quality and quantity of life, but the effort to conquer illness will always bear inherent risk. Be afraid, because that fear makes you more human, and greater humanity makes you a better physician. Be not so afraid that you cannot take action, but not so confident that you forget the potential consequences of that action.

This really rang true for me. I’ve commented before on the awe that I believe a physician should maintain for the trust extended to him by his patients, but I really don’t think enough can be said about it. At least, I never feel like I’ve completely come to terms with it myself.

Rosenberg uses as an example in the article the unease, or fear, that a physician may feel just before inserting a needle into a patient’s eye to administer treatment. Even if that treatment is the best hope of saving the patient’s vision, even if it is the two-thousandth time the physician has done it, doing this should give a person pause. The fear should be felt by the physician because it is likely being felt in a much greater degree by his patient. The ability to sense that fear, to feel it a little with the patient helps us to keep proper perspective as we attempt to help our patients solve the problems they bring to us.

That fear will help us avoid arrogance. It will help us maintain humanism in our relationship to our patients. That discomfort that we feel when considering if the potential benefits of a treatment justify the risks will help us remember that our patients are considering the same balance, though usually without the specific education and experience the physician will have to inform that decision.

I understand that not every patient we see will need a treatment that is really risky, most of them won’t. Not feeling fear when working with those patients is fine, because the patient probably isn’t feeling much fear.

I have no delusions that every decision I make as a physician will be earth-shattering in some way, but I hope I never forget that some decisions I make will be earth shattering, and that I’ll feel a little of the shudder.

I began reading “The Curious Incident of the Dog in the Night-time” for my psychiatry class today. It is a novel narrated by a 15-year-old autistic boy named Christopher. I’m enjoying the book, which is enjoyable, insightful, and poignant all at once, and sometimes I come across a quote that is just awesome. Like the following:

Prime numbers are what is left when you have taken all the patterns away. I think prime numbers are like life. They are very logical but you could never work out the rules, even if you spent all your time thinking about them.

There have been many, many times in my life where I have felt exactly this way. I get the feeling that everything that happen in my life makes sense on some level, but if I were to try to sit down and explain why it makes sense, I could never adequately do it. I think, perhaps, the same realization is at least partially behind expressions of inevitability, like the many so-called Murphy’s Laws.

I also think that when you get the opportunity to get inside Christopher’s mind in this book, you (or at least I) begin to realize that his way of experiencing the world is not completely foreign to you. There are aspects of his personality and thought process that I very much identify with, and though someone else may not identify with the same parts, I think most people probably identify with him at least a little bit.

Anyway, I’m enjoying the book, and I wanted to share that quote and my thoughts on it, now it’s time for me to hit my texts again.