Got home early.
Jamie and I had x-mas last night. Opening presents, thoughs of family, feeling loved but missing the tradition of being home.
Good food from friends.
Sad for people spending the holidays sick.
Greatful I can bring joy to them.
All is not right in the world, but doing my part.
Merry Xmas!
So I am working tommorow. And the next day. Sigh......
At least on holidays the hospiltal is quiet. Only trully sick people come in on the holidays, b/c who wants to be there on x-mas.
Submitted my first abstract to a national conferance.
Wrapped my present to Jamie, think she will love it.
She already opened her nano.
Hope you all out there are doing well.
Much love!
Signed,
Santa Sandy
I have become addicted to Cheese popcorn.
Such a strange thing to be eating this regularly.
I am bleeding . Lots. There is blood on the floor.
Kind of funny how I can look at my own life blood pouring out on the floor,
and find myself thinking, How much blood am I loosing, would I transfuse?
The blood looks striking on the wood floor.
It's color so shocking to the eye.
Some how, a singlke spot of blood gives me the willies much more then being elbow deep in it.
Mabye it is the fact that when it is all over you it is very sureal.
When it is just in a single drop, it is chilling.
I have to get this problem fixed.......
A new day has dawned
Scattering light on High
Awake and reborn
I belive I know who you are, or at least who you live with..........
Guess you did not have to declare yourself. Your computer did it for you.
I have always perfered to think of myself as Gorgias, not Socrates.
Hmmmmm....
Hmmm.....
Baltimore.
Are you a johnny?
I am gonna let out a big sigh now.
You have a nack for missing the fundemetal point.
It is possible to be more them one thing at once.
That is the last i will say on the subject because though fun, it is to big of a waste of time to keep posting in return, instead of venting and using this forum to share with my loved ones as I normally do.
You also seemed to have missed my comment about my using these as venting, and seem to not relize there are different levles of "Identifying" with someone.
You have declared your nature, though knowing people are more then just electronic words, I would be willing to give you the benifit of the doubt.
You have brought so much energy to writting here, why not spend some of it working on yourself, or have you found that you are "perfect"?
Anyway.
Todays post:
Had a pretty good day. Worked around the house on my one day off this week, got a lot of shopping done, and cleaned. The wife is away, so I got a chance to play some games with ryan and watch CU get housed.
Reading the new Dan simmons book, which I like quite a lot. It is a strange combination of LGM, the Illiad, and SciFI. You should check it out if you get a chance.
On call tommorow. Have to say feel very spoiled. Community hospitles are not as efficent, and you just can't do what every you want. I ask the nurses to push 5 of Lopressor for me and they do @ home base, but if you ask them at where I am now they will not do it. In part b/c they are not allowed and inpart b/c they are just not as skilled i think.
Kim, Ryan and I are trying to plan a trip, interested in coming?
Meno, Have you ever read any doctorly oaths? Do you know how many of them there are? Do you actually have a clue what they say?
Try looking up wht modified Declaration of Geneva. Thats my favorite.
More to come. More patients to see......
Fool's sonata plays
vanity, shortsightedness
One is foresaken
So this will not be a finished entry. At least not until tonight. I am typing this in between my clinic patients, so you will have to be "patient".
I have decided that I cannot call my unknown interlocular "Jackass" and since they will not identify themselves I have decided I will call them "Meno."
(Pause for a second so you can look up who and what that person was...)
I will not however be doing this "dialogue" in the Socratic style, but I will help my little Meno thinks this through.
So starting with, your underlying definition of compassion and thoughts about compassion. They are simplistic and flawed. It is always amazing to me how often people mistake what is and is not compassion, how narrow and uninsightful they are when they speak about it. Despite popular opinion and your underlying subtext, compassion is not about always doing the nice thing, always thinking the nice thought, or always giving someone what they want or ask for. Compassion is not always about alleviating someone’s immediate suffering, especially when an action is taken that may cause immediate suffering but may prevent long-term suffering. (Like not treating the "worried well" in the ED) Compassion is not black and white as you suggest in your arrogant tone. Compassion is, as found in the following definitions (and more importantly in my experience) something more and not limited to immediate suffering
1.Compassion is a deep awareness of and sympathy for another's suffering and
The humane quality of understanding the suffering of others and wanting to do something about it
2.Compassion is a sense of shared suffering, most often combined with a desire to alleviate or reduce such suffering
Compassion says nothing about not being able to feel other emotions about the situation. Compassion says nothing about the "actions" you must take on those feelings.
Compassion is most simply the state of being in which you "feel" (to some degree or another) what another is feeling and a wanting to help.
I do that every day, all day. My work, my actions, my emotions are all based around that, that is why I do the Job I do. This is not incompatible with the feeling that these people are acting like idiots. This is not incompatible with the feeling that these people who are suffering, would be better allived (better helped and my actions more compassionate) if the just got hooked up with a Primary doctor and took care of themselves. In fact I could argue (and is indeed is true) that these people are worse off for having visited the ED and received a quick fix. I could say that it is in fact not a compassionate act (or a very short sighted one) to treat them in the ED since from the ED they do not (and thus will not) receive all sorts of necessary care which they would have received if they had handled there ills more appropriately (with a primary doctor.). And I can state this on all levels, not just the physical one. (If they get a Primary doctor they can form a relationship, and thus if it is emotional stuff they need, they have someone who understands.) Thus I educated them as they come to me. I meet them at their level as best as I can. I let them know someone hears their pain.
I do not let them dodge personal responsibility for their actions, because to let someone be irresponsible, is in fact not compassionate. I am not here just to "make them feel better." I am here to help them. Big difference, and one that may be too subtle for you Meno, you who makes judgments without basis, you who makes sweepingly false statements.
You have an idea in your mind, that the only way to be compassionate, is to "like" people and play nice all the time and to think nice happy thoughts about them. Human beings do not work this way; they are not just "one" thing. Sometimes you can feel more then one thing at once ie: understand and sympathize with what someone feels and want to help, but also think they are doing the wrong thing for the wrong reasons and would be better served in other ways........
But in the end people have to come to that conclusion, and choose actions on their own and of there own free will. I don't deem to teach people the "right" way or they most "effective" way to live their lives. I don't claim special knowledge. What I do do is educate them the best I know how, try to protect the resources so other who need them more may have them, and I try to stay sane doing it. And I make these judgments out of the solid experience I have in working in those things, and that is the most foundation any one can hope for.
You are as great of a fool as Meno if you think that people are anything but full of contradictions and paradoxes.
To borrow from your electronic drivel, read my entries again dear Meno, look at them with new eyes.....
More tonight I think. I am enjoying this.
Will address oath in part two......
Anger in my Belly
Awash in in the sour flux, bile.
Breath, and let fly free
Just an FYI whoever wrote that. I would not have been pissed if you had just identified yourself. If any of my close friends said what was said (or written I guess) what was said WITH their name attached, I would not have responded in the same way. Though I would still think the comment of the person was not worth the space in the digital world that it is taking up, I would respect the person for stating things the way they see it no matter how missguided it my be.
But I must say, if it was a friend of mine, they don't seem to know me very well.........
I have to re-post this. I want to make sure who ever this is directed at will see this:
First I would like to say, it is absolutly gutless of you to not post your name with this. Take responsibility if you are going to make statments like this. I do.
Second. Most of these people do have insurance. Most of these people do have a PCP. Trust me, I look at there charts every day. Additionally you dont have to have insurance to see a PCP @ MGH. You can set up an appointment with me, and I will in-fact, young or old, fat or slow, help you get insurance and even have you see me (or another doctor) without having to pay a dime. I have set up many of my pts who came to see me with the same complaints as the ones in the ed, and not only been able to help them with them, but have gotten them insurance to boot AND regular follow up. As for some of your other points, I am not bitching about the people who are "sick" as you put it. I am not talking about the 103 fever and the person with an MI or SAH, I am talking about the person who has had a headache for 4 months, AND NOTHING HAS CHANGED AND THEY HAVE NOT SEEN A DOCTOR AT ALL, and they choose, even thought they feel no different from the month before, call EMS at three in the morning to be seen by a doctor NOW! I have a fundemental problem with that. PERIOD.
You can argue that yes, I should care about these people, and yes I should do my best to help them because they are "sick." I in fact I do. Ask them if you don't belive me. But, the problem is, and the thing I am upset about is that this is, a fundemental misallocation of not only time, but resources due to a total lack of of personal responsibility on their part. It comes down to two things. That they do not take care of them selves, and by not doing so take medical dollers and resources away from sicker people ( and cost the system a lot more then if they just went to the PCP.), and that they are irresponsible by not addressing things as they should and then they expect immediate answers and cures with no effort on there part. That is my problem.
To rehash: 1. The resources are there if you make ANY EFFORT to get them, and GUESS WHAT? THEY ARE FREE!!!!!! My patients on free care HAVE BETTER BENIFITS THEN I DO! and did I mention, IT IS FREE? (to anyone who cannot afford health insurance. If you don't get it b/c you don't want to spend the money and can afford it that is your problem)
2. Lazyness does not deserve to be rewarded
3.Take some responsibility for your health you idiot.
4.Emergancy rooms should be used for what there name sake is, EMERGANCY!
This list includes but is not limited to, suspected heart attacks, PE's, PNA, Dissections, Trauma, Stroke, GI Bleed, Gyn Bleed, ectopic preg, SZ and many more.
It does not include: anything you have had going on longer then a 2 weeks and have not been evaluated by your PCP for, Migrain headaches, urinary trac infections, sprains,One day of nausea and vomiting (unless you are over 75yo), muscle cramps, body aches and so on.
IF THERE IS NO OTHER OPTION I UNDERSTAND when the "worried well" go to the ED, but in 99.9% of the cases this IS NOT THE CASE!
Third: Don't you think I have already heard (and thought of) everything you said, and guess what, none of it really applies?
And finaly
Fourth: Don't you EVER, EVER DARE doubt my commitment to taking care of people or remind me of what my oath says and means. I do it EVERY day of my life in every aspect of my life, wiether or not I think the person deserves care or did it to themselves through there own destructive choices. How many pages have you answered in your off time for your patients? How many extra hours of your life have you given to make things happen for the helpless sick people who depend on you.
Jackass.
SMG