Showing posts with label Grace. Show all posts
Showing posts with label Grace. Show all posts

Wednesday, February 8, 2012

The Heart of Inspiration


Below is the combination of several pieces that I've written about my granddad and the story of his lectures which were given to me this past summer. I wanted to post this version, which I recently submitted for a school project. I think that (finally) this tells the whole story in the way that I wanted. Apologies to my frequent readers who are probably tired of hearing me harp on about all of this. 

I thought the timing was interesting, as this is another week where I've needed some major inspiration to keep my head up. 

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My Beginning

I remember the exact moment that I decided to become a doctor. I was seven years old and standing in the front pew at my granddad’s funeral. I had been listening, really listening, to what the mourners in that packed church had to say. Granddad was a doctor. The eulogists spoke of his wisdom, generosity, and kindness. I heard references to his medical innovation, his skill as a physician, and his dedication to patients. Throughout the speeches there were murmurs and nodding of heads, dabbing of eyes. I was mesmerized by the sea of stricken faces behind me, feeling the powerful impact his life had had on all of these people. I saw very clearly a glimpse of what a meaningful life looked like, the legacy that was left behind. I knew I wanted to leave a similar mark on the world and I remember determining, in my seven-year-old mind, that like my grandfather, I would be a doctor.

Long Before That

My granddad, Russ Taylor, fought in WWII. For his service as a navigator in the Royal Canadian Air Force, he was granted free tuition in the university and program of his choice.  As a fifteen-year-old Russ had heard Norman Bethune, famous humanitarian and champion of universal medicine, speak at his high school.  From that time on Russ had wanted to study medicine. But the Taylors were a farm family with six children so Russ had attended normal school to become a teacher. And as well, in a part-time job his hand had been deformed in a printing press.  He never imagined that because of the war his dream would be realized.

For his post-war training Russ chose biochemistry and medicine at McGill and went on to become, first, a legendary rural family doctor and eventually a polio expert. He was on the team of physicians who brought the first iron lung to Canada. In his forties Russ studied internal medicine and then specialized in cardiology.  After further training at McGill he returned to set up the first Cardiac Care Unit (CCU) in Alberta.

Even after being diagnosed with cancer Russ Taylor continued to work in cardiology, still visiting his long-surviving polio patients.  In his last months he wrote an account of the polio epidemic for the university and he was working on a cardiology textbook when he died. The cardiac ICU at the University of Alberta hospital is named the Russell F. Taylor ward in his honor.

It almost feels wrong to extol the virtues and accomplishments of this truly humble man who was never comfortable with praise. Because I was a child when he died most of my knowledge of him is second-hand. I have only a handful of my own memories… watching  him play the piano, sitting with my head on his chest listening to his mechanical heart valve (consequence of childhood rheumatic fever), sharing scrambled eggs with him in the morning before he left for ward rounds.  I also remember clearly that he was one of the few adults who spoke and listened to me with genuine interest and delight… with respect for my personhood.

 All of my life I've been steeped in stories of his astounding medical career, his profound love of medicine, his intelligence, insatiable curiosity, and his interest in the world around him. Each of these stories is locked in my memory coupled with the sadness that I was never able to know him as a health care practitioner, myself. Sad that I could never hear his opinions on certain procedures, ethical dilemmas, learn what he loved about medicine, or find out what frustrated him. Ultimately, I feel cheated that I never was able to have him as a mentor. Others have often described him to me as the 'greatest teacher and mentor' and yet I never had the opportunity to learn from him.

My Granddad’s Voice

In the spring of 2011 my mother woke up one night thinking about a couple who been good friends of my Granddad’s, Dora and Richard Lam.  Dora had arrived in Canada as a young Chinese woman, to study at the Southern Alberta Institute of Technology in Calgary. After finishing her secretarial program she became my Granddad's medical secretary. Over time she and her husband, Richard, developed a close friendship with Granddad.  At that time Richard was a masters student trying to gain entry into medical school.

Knowing how much I valued learning more about my grandfather’s life, my mother set about trying to find the Lams in the hope I could someday meet them.  And I did meet them.

It was the week before my writing of the USMLE. I was feeling guilty for taking a day off from cramming for the exam, but at the same time I was looking forward with delight to meeting them and gleaning a few more details to add to the mental portrait I have of Granddad.  It makes me feel somehow closer to him when I hear about him from people whose lives he touched.

According to Richard, it was my Granddad's letter of reference that got him into medical school. His interviewer commented on the weight that a recommendation from Dr. Russ Taylor carried. Dora claims my Granddad was very much like a father to her, and that she would never have become a "damn good lawyer" if it hadn't been for his continuous support and encouragement. When people with tears welling up in their eyes tell you things, you simply have to believe that they are telling the truth.

At one point during our lunch, Dora pulled out a small bag that she had brought in with her.  She told me it was something that she'd kept for the past 30 years, through three residential moves…something she wanted me to have. Even before she pulled out the contents I felt my pulse quicken. "This is going to be a treasure," I thought. It didn't matter what it was...whether it was going to be an old pager, or a chart he had signed, a fountain pen...anything. I couldn't wait to see what the gift was.

Dora handed me a collection of audio tapes. All the hours of my Granddad's cardiology lectures to 3rd year medical students.

She had been the one who typed up the manuscripts for him, and she had kept the old reel-to-reel tapes in a box in her basement. "These are his lectures on cardiology and his notes for the cardiology textbook that he was working on. I could never bring myself to throw them away. And now I know why,” she told me.

I was overcome with emotion.

All my life, all my adult life I have wished that I could hear my granddad speak to me about medicine.  And now that would happen. I couldn't contain myself. The tears poured down my cheeks. There in the trendy restaurant with a handful of photographs on the table and an empty coffee cup to stare into, I could not wrap my head around it. There in the final week of a very challenging year, studying for a terrifying exam, feeling completely over my head, second guessing myself at every turn…at that moment my Granddad's actual voice was given to me.

It was the boost I needed. Granddad speaking to me across the years, reaching me through people whom he loved. Talking with the Lams about their careers and about Dr. Taylor’s vocation for medicine gave me an immeasurable dose of determination and renewed my understanding of why I chose this path. It was not only because he was great physician, but because I could see how his example and his legacy continues to move and inspire others to meet challenges and make contributions.

I have finally been able to listen to my grandfather’s voice, the sound of which I had forgotten. I hear him talk about his passion, about something that inspired awe in him…Medicine.   

CBC

The radio show, White Coat, Black Art is a national program hosted by Dr. Brian Goldman, which airs on the Canadian Broadcast Corporation (CBC) twice weekly. Dr. Goldman is an emergency physician and best-selling author, and one of my medical heroes. I was thrilled when he contacted me last summer and asked me to appear on the show, for a piece they were doing on nurse and physician communication styles. When his producer asked me if I’d like to contribute again to the show I knew what I wanted to do. I wanted to bring the story of these tapes to life and create a radio piece with excerpts from the lectures.

When the show entitled Inspiration aired on Christmas Eve, it was very well received. A former RN who had worked with Dr. Taylor heard the show and emailed the host to say how much she had enjoyed being a colleague of Russ Taylor’s for years on the CCU. It was also a delight for our family to hear him over the radio waves after all these years… the sound of his voice rousing memories.

My Granddad loved listening to CBC, often sitting in his car in front of the house to hear the end of a program before coming in from a house call, or in later years retreating to his study to listen to a program on his old radio. It was a strange and wonderful gift exchanged between us…these tapes with his voice and my voice responding to them through the radio show. But the lasting gift was to me from him…a reminder of who set me on this path, why I chose it, and how I’ll carry on. Rededicated to my childhood ambition of twenty-five years ago… I will be a doctor.


Thursday, February 2, 2012

Life One Liner

(I know this is supposed to be a medically related blog but lately it is more like a this is what I am eating and doing in my free time blog. Apologies. The heart-wrenching and hilarious moments of my emergency nursing days are long gone and I am starting to feel like a broken record of worn-out anecdotes. Also, I'm working like a fiend to finish up my research project and special study module as I hope to do an elective in March. I want to be able to leave the country knowing all my little scholastic ducks are in a row and life is organized. A very non-ABB behavior pattern. Usually when I leave the country there is a dizzying storm of clothes, textbooks, toothbrushes, running shoes, papers, granola bars, open luggage, garbage bags, and USB cables around me for 2-3 days...and then *POOF* I disappear. I swear this time, that shall not be. As a result I fear Asystole is not getting the attention it deserves. Hence, blogger guilt. It's like mommy guilt without the cereal in the hair and spit-up on the shoulder.)

Dr. Joe is on annual leave this week so I sat in with one of the other GP's in the practice, I thought I should branch out in his absence. Everyone here is lovely, though I must admit that I miss Dr. Joe's Prairie Home Companion version of social histories. During one of the consults the patient was talking about the age ranges of her four children, aged 6 - 13.  I thought she summarized things so brilliantly, "Ah sure, in my house there is everything from Santa Claus to maxi-pads". What a perfect slice of life. That is one of the things I miss about bedside nursing, the little glimpses into people's lives, scenes I could collect in a shift.

It got me thinking, what would my one-liner of life be right now?

It's all...tupperware and textbooks?

...Band-aids and backpacks?


...practice tests and data tables?


...scones and stethoscopes?


...residency worries and vitamin D supplements?


...bad skype connections and emotional eating? 


Dunno. All of the above I suppose. What is your one-liner these days?




Sunday, November 27, 2011

No Pressure

"So the patient has been temporarily paralyzed by the drugs, and you're the one keeping them alive by squeezing air into their lungs...but...no pressure".

Gulp. 

I was holding the mask as tightly against her face as I could, sealing the rubber to her cheeks in the effort to keep highly oxygenated air from leaking out. Looking down at her from the head of the bed I saw the patient from a different vantage point, a place that made her look so vulnerable.

And she was vulnerable.

A few minutes prior to closing her eyes she had been nervously chatting and laughing away as we prepared her for surgery. The dose of propofol and the inhaled sedatives smoothed her face and left her body limp. Now we had injected medication into her intravenous line to paralyze her. Once her muscles were relaxed we could slide a tube down her throat and into the trachea, providing the means to ensure that her airway would remain open and her lungs could be well ventilated with oxygen during the surgery.

I removed the mask to prepare for the intubation. Her skin was pale, the freckles standing out now that the nervous blush had faded from her cheeks and neck. She was perfectly still and we were moving into action. 

It struck me then how explicitly patients trust their doctors and nurses. Of course I have always understood this as a general concept in healthcare but this was suddenly a much more concrete example. Patients literally put their lives in our hands on a daily basis.

Why have I never said to a patient, "Thank you for trusting me with your most precious possession"? Why has a patient never said to me, "Please do not be hurried, or harried, distracted or inattentive, because today you are responsible for my survival"?

I suppose these are silent agreements and understandings that we have in all of our patient interactions. Yet the fact that we don't outwardly acknowledge these understandings means that maybe we've forgotten that at the core, it is an honor to be in this role. I'm not so unrealistic to think that one is thankful when the bleep goes off for the 47th time on a Christmas eve night shift...but I hope that at the end of the day when I am bone tired and flopped-out on the couch in the call room I'll remember this, and take even just a tiny measure of satisfaction from the honor of responsibility. 

No pressure.

Wednesday, November 24, 2010

Engage with Grace

Things we are grateful for this year

For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important -- and believe it or not, most people find they actually enjoy discussing their answers with loved ones. The key is having the conversation before it’s too late.

This past year has done so much to support our mission to get more and more people talking about their end-of-life wishes. We’ve heard stories with happy endings … and stories with endings that could’ve (and should’ve) been better. We’ve stared down political opposition. We’ve supported each other’s efforts. And we’ve helped make this a topic of national importance.


So in the spirit of the upcoming Thanksgiving weekend, we’d like to highlight some things for which we’re grateful.


Thank you to Atul Gawande for writing such a fiercely intelligent and compelling piece on “letting go”– it is a work of art, and a must read.


Thank you to whomever perpetuated the myth of “death panels” for putting a fine point on all the things we don’t stand for, and in the process, shining a light on the right we all have to live our lives with intent – right through to the end.


Thank you to TEDMED for letting us share our story and our vision.


And of course, thank you to everyone who has taken this topic so seriously, and to all who have done so much to spread the word, including sharing The One Slide.



theoneslide




We share our thanks with you, and we ask that you share this slide with your family, friends, and followers. Know the answers for yourself, know the answers for your loved ones, and appoint an advocate who can make sure those wishes get honored – it’s something we think you’ll be thankful for when it matters most.


Here’s to a holiday filled with joy – and as we engage in conversation with the ones we love, we engage with grace.


To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team.