It’s been a busy few weeks on inpatient services, and I haven’t gotten to sit and write for a while. The hospital is busy, and people are tired: both providers and patients. The war in Ukraine is horrifying; I’m particularly impacted by the stories of mothers with young children, pregnant women, hospitalized babies, finding shelter in this attack.
Last year, Philadelphia welcomed a number of Afghan refugees, many of whom we saw in the hospital and in clinic for medical evaluation, and their stories—the vast chasm between their life before and their life now—stuck with me.
One of the things that confuses me about medical culture is, even though we’re so close to so many things in the news—COVID, refugee crises, school closures—we rarely talk about politics or the news in the hospital. I noticed this as a medical student on clerkships, and now as a resident. One of my distinct memories of the 2020 election was the fact that on election day, it was one of the few times we paused rounds to discuss a polls update, since we all had the election page open in the background. People care about the news, and the work we do is often reflective of what is happening in the world and in our local communities, but it also makes sense that we live in that bubble. Patient care is demanding, in time and in energy. Adding the weight of the world to our day-to-day is another mental load. But it’s also limiting, because in not having the time to stay fully informed, and in not talking about what’s happening in the world at work, it can feel like we are not listening. And that’s a common complaint of patients, about doctors.
I’m not sure what I’m rambling about, and what I want to change. It’s not the individual people. The people I train with are incredibly bright, compassionate, knowledgeable people who are constantly advocating for social justice. It’s not the patients and families; they are often the ones who tell us things we don’t know about the way things work in our current system, for them. Maybe, I think, it’s time. It’s the systemic burden on our time. We are all pressured for time, constantly. Especially now, when pediatric hospitals are experiencing high volume.
I think I’ve been fascinated by time and medicine for a while now. I was reading through old writing recently and dug up a piece about how part of learning medicine felt like “learning to rush.” Maybe I’ll share that piece another time, but I wanted to share my more recent article below, which is about time and the clinical encounter. It’s a blog post for Columbia’s Narrative Medicine program’s literary journal.
https://www.theintima.org/blog/reflectingonbedsidemannerisms-intima
My ask: I would love to hear from you, if you’re comfortable sharing, about experiences you’ve had in medicine (either as doctor or patient) where you felt rushed.
Thanks for reading!
Some odds and ends:
I’m very excited for this book coming out March 29. The author, Dr. Grace Farris, is a doctor and comic artist and she mainly makes comics about parenting (her instagram, @coupdegracefarris, is great). Her observations are often so spot-on!
My new favorite Pixar movie is Turning Red - I laughed and cried so much. Also, seeing an Asian auntie squad in a Pixar movie is something young me would never have imagined
I was asked to write an article about breastfeeding for the Philadelphia Inquirer, after my JAMA piece came out on the subject. It’s hard to write something on the same subject that is fresh and not repetitive—but it was a great writing exercise for me! It was also really amazing to see it in print.
I’ve worked a night shift on “Fall Back” clock change for the last two years, so getting to work the “Spring Forward” Daylight Savings shift (on a 28-hour call) was special for me—one less hour!
Thanks for reading. Yes, I woke up early to write this, and apparently I am just as rambling at 6:30am as at nighttime. Oops.
-VV