My Doctor Reading List

Monday, July 23, 2012

Shameful


My grandmother is in her early 80's and has really declined in health over the past couple of years. Her health  has never been great (largely due to her very sedentary life-style combined with a smoking addiction) and as she aged and moved less, took more pain killers and continued to smoke, got worse. Recently she developed some nasty bedsores and my mother (who is her daughter-in-law) was so shocked when she saw them, she immediately rushed my grandmother to her family doctor. 


My mother told me that what happened next, and over the next few days, has left her livid and speechless with disappointment.

At the visit to the family doctor, she said that when the doctor came in, instead of greeting her and my grandmother, he asked "Why on earth isn't she in a nursing home?" My mother, totally caught off guard, didn't even have time to answer that my grandmother is wealthy enough to afford two full-time caretakers to care for and help her in her own, comfortable home and did not WANT to be in a nursing home, a decision that her children (my dad and aunt) respected. The doctor just marched over to my grandmother, and with a totally disgusted look on his face, gingerly lifted the edge of the bandage covering the bedsore, glanced at it for a second and dropped it. He told her there is nothing he can do and she should take my grandmother to the ER - but then added "Though I don't know why you'd bother...they usually die a few months after developing them anyway." My mother told me she was horrified, that firstly he grouped my grandmother into this group of "they" - meaning the elderly (who for some reason don't deserve to have treatment) and to do so in front of my grandmother!

My mom didn't want to drag my grandmother to the ER (knowing what the wait times in Ontario ERs are like and didn't want to subject my grandmother to that unless absolutely necessary) just because the doctor clearly just couldn't be bothered with her, she took my grandmother to a walk-in clinic to get a second opinion. She said this doctor, was much nicer, examined my grandmother and prescribed an antibiotic.

However, after two days my mother thought that the sores looked worse, so she decided she would take my grandmother to the hospital and called an ambulance (because doing so cuts down on the waiting time a little).

What happened at the hospital she said furthered her anger. My grandmother was left on the stretcher for hours and no one would come to check on her. She said when she finally was given a "room" (i.e. a bed with a curtains on both sides for privacy) she again waited for hours until the doctor would come. Finally she said a young doctor entered and she was relieved. She said she went over to my grandmother to help turn her over, and was surprised the doctor didn't budge to help her. Without introducing himself, acknowledging my mother or my grandmother, grabbed a swab and, just like the first doctor, lifted the bandage, swabbed the wound and went out. Without saying a WORD to my mother. My mother said she was baffled and thought that he'd come back. But then when the nurse came in and started to hook my grandmother up to an IV, my she asked if the doctor would come back and was told "No." and that he just said to start my grandmother on antibiotics. Now, my mom said "Ok, but wait a minute, she is already ON antibiotics - can she be on two? Is it safe?" The nurse looked surprised and said he wasn't sure - he wasn't aware that my grandmother was on antibiotics. This set my mom off. She had had enough. She told him she was just so frustrated because she didn't know what was going on. First of all, she was insulted that the doctor wouldn't speak to or acknowledge her or my grandmother. That he recklessly ordered antibiotics before even checking to see if she was on anything. That he disappeared before my mother had a chance to ask any questions about the treatment, next steps, how long my grandmother would have to be there...She said the nurses heard her annoyance and stepped it up, being extra attentive to my grandmother (and my mom said that they were great) and who finally she managed to persuade to find the doctor.

Finally he came, looking annoyed. But my mother pulled him aside and kindly and calmly said "Thank you for taking the time to come back a second time. I know you are busy." Then she went on to tell him everything from her perspective. That when he  first came in, how he ignored them and didn't help even turn my grandmother over.  She pointed to a sign above the nurses station that read "Introduce - Acknowledge - Explain" and was wondering if that is supposed to be a practice of the hospital, because NONE of those things were done with her. That he just seemed so annoyed to be there. She told him how he can't treat people like this - that she is NOT a doctor, she didn't know what was going on but that she WAS worried and just wanted some answers. Her mother-in-law is in pain. And no one seems to care. She asked him why he became a doctor, because she thought doctors become doctors because they want to HELP people? She also reminded him that a doctor is a civil servant - and his job was to serve his patients.

This "I'm disappointed" speech resonated with him, she said, and he had the decency to look ashamed. He stammered out a half apology, explaining that he was just so busy but that she was right. Then he gave my grandmother a proper and thorough examination and explained to my mother why he took the swab, what they were looking for and next steps. All that she wanted in the first place. She said that when the doctor left, one of the nurses (who had overheard the conversation, even though my mother told me she intentionally spoke softly because she didn't want to chastise the doctor in front of other staff) gave her a grin and thumbs up and said "Good for you for standing up for yourself - they need to hear it sometimes!"

I was so sad to hear this, though I know this must happen all the time. Its shameful.

I understand that being a doctor, especially in a specialty like ER where they are over-worked and often exhausted, is hard. But most jobs are hard and no one forces people, at least here in Canada, to become a doctor. This is a choice, a choice made with free will.

I hope that if I ever do get the privilege to be a doctor and practice medicine I will remember that. On those days and nights where I'm tired and possibly will hate my job, I need to remember that this is my JOB and that no-one forced me to do it and to remember why I did it in the first place.

One thing that bothers me sometimes, when people discuss these types of stories, is that they excuse the manner or attitude of the doctors away and say they don't care, as long as they are smart and good doctors and ask, "well, wouldn't you rather have a smart doctor who is rude over someone who is nice but dumb?"

Obviously, I'd *rather* have a very smart and competent doctor who is an asshole over a nice but stupid one, however I also think that its possible to be both. I really hate when people use that argument, as if somehow being kind/compassionate and intelligent are mutually exclusive. Or that being an asshole is a sign of intelligence.There are smart people in every industry and let me tell you, no matter how smart you are, if you spoke to your client the way some doctors speak to their patients, you'd be fired faster than you can roll your eyes. 

My husband thinks that its inevitable that most doctors will be assholes because they are witness to so many awful things and they are over worked etc. But I disagree. Sure, most will become a bit desensitized to a lot of these things, but that doesn't mean they can't at least pretend to care and be polite to their patients. Like I said, in other industries, people do it all the time, why shouldn't doctors be held to the same standard?

Thursday, July 19, 2012

Forums

In my prep for applying to medical school, one of the resources that have been the mostly helpful are premed forums. Members can assess your chances, they can give you advice on everything from best courses to take to informing you on changes to med school policies, their personal success stories (I especially like reading the stories of other non-traditional applicants such as myself) and they often even post their stats (GPA, MCAT score, what extracurricular activities they had etc) and whether they got rejected or accepted to med school with those stats. Its definitely useful because med schools usually post averages and highs/lows only so its hard to tell what individual accepted candidates really looked like. I even found a great Organic Chemistry tutor via a forum.

To be honest, though you really have to take EVERYTHING said on the forums with a grain of salt. There are trolls, people who just don't know what they are talking about (like high school students) and people who are just speculating. At the end of the day, NONE of them are on admissions committees and really don't know for sure what the admissions committees are going to be looking for and prioritizing.

And forums can be a MAJOR time suck. Its hard not to get involved in debates that sometimes spring up and hard not to be very judgmental (i.e people with a terrible GPA in their first 2 years announcing that they will for SURE get a 4.0 for their last two years, or worse, people who compare themselves to Einstein or other exceptional individuals) and just telling people to get a reality check.

I often need to take a break from the forums because I find when I've been spending too much time on them, I end up anxious and just negatively affects everything from my motivation to my mood.

But all in all, they are very useful and I'd recommend them to anyone pursuing medicine, whether they are high school hopefuls or other old non-trads like me.

Tuesday, July 17, 2012

Ugh. So confused!

So I was reading the OMSAS instruction booklet today and I realized that one university that I had written off as a potential to apply to was University of Toronto. U of T requires 2 full year credits of Life Sciences (among others requirements, which I have met) and at this point in time, I only have 0.5. So I thought U of T was out this application cycle.

But - in the booklet it said that you can still apply if you are ENROLLED in the course at the time of application. And since applications aren't due until the beginning of October, I can still enroll into my remaining 1.5 credits worth of Life Science pre-requisites. Which would be great, because MCAT wise, U of T is the most forgiving, only using the MCAT as a flag instead of a hard cut off.

Another thing I learned is that Western won't post their MCAT cut-offs until AFTER applications are due - in fact, probably after they select people for interviews. And Queens just doesn't post their stats for MCAT at all (though word is that they are high)! Not only that but I won't even know what my MCAT score will be until after the applications are due anyway.

Ugh  - so here I am wondering whether gunning for a great VR score is in fact the best approach. I think it still might be, because the minimums required for U of T are still 9,9,N,9 and at the moment, the highest I've ever gotten on either PS and BS is 8 (and its only happened once, I usually range between 6-7 on those in practice tests). And Mac is still my first choice, so I really should focus on that this application cycle - especially since I'm convinced that I won't get in anywhere this time anyway, and am kind of treating this like a practice run for the "real" thing next year.

But then again, I definitely won't get an interview to U of T, Queens or Western if I don't apply and I keep reading about people getting invited for interviews at those schools who didn't expect it...

Sigh. Its all so confusing.

Monday, July 16, 2012

Signed up for my OMSAS account today!

Today I created an account for OMSAS! It's exciting because it means that I'm officially applying to medical school this year.

I was really excited to fill out the whole thing but I decided to just start with the easy stuff (name, address etc) and added the info for all the universities that I've attended in Ontario, which unfortunately is 3, since I had to take courses at a bunch of places while getting my pre-requisites for my CA designation in addition to the university I did my degree in. I wish I didn't have to add them (well, I don't mind one, that I got an 3.8 in but all others are 3.3's and they bring down my average). This took surprisingly long since I had to dig up all my old student numbers.

I'm still debating how to best study for the MCAT. I want to sign up for a verbal only prep course to help me  ace verbal, but I think I'll keep practicing the other subjects in my spare (read: rare) time. I might focus on just high yield areas like genetics in BS and try to memorize as many formulas for PS as I can.

I'm going to spend the rest of the afternoon reading the OMSAS booklet and then doing some verbal passages.

Saturday, July 14, 2012

MCAT study dilemma

My second attempt at the MCAT is just over a month away and again, I'm not at the stage of being really ready. I think I'll do better this time, but not well enough to get a great score or balanced score.

So I'm facing a bit of a dilemma - do I just give it my best and study like mad for all the sections to MAYBE (by some miracle) get a good enough score to apply to 3 universities that I'm eligible to apply to (based on my GPA, prerequisites and location) OR do I just skim over the sciences and really focus on the verbal reasoning section, to increase my chances at the one university that only looks at the verbal score (which I got average for on my first attempt without really studying)?

I'm starting to lean towards option #2 - why? Because this school is my first choice anyway, its the closest to where I live now and because I really like that its a 3 year program. Also, because I think that I really COULD nail the verbal with a lot of practice.

However, the idea of not studying the other sections makes me a bit uneasy...it just goes against my nature to completely abandon studying certain sections of the exam. I want to do well on it all! But realistically, for the other two universities, I have to do exceptionally well on the other sections too, since unfortunately, these two schools have high MCAT cut-offs.

Sigh.

Thursday, July 12, 2012

Be back soon!

Sorry for being MIA lately. My in-laws from New Zealand have been staying with us for the past 3 weeks and we've been busy doing fun stuff with them. Any spare time I've had I have been trying to squeeze in some studying in, so just haven't had time to update the blog. But I'll be back soon!