Uninvited Gift

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It’s been five years since she was told she was “cancer free”. Today she was told it was back, and the future was quite grim.

My job was to make sure she understood how to properly take the medication that would reduce the swelling around the tumour so radiation could start as soon as possible.

That was my job. Clinically speaking it wasn’t the most challenging or difficult issue of the day as I scanned her file. Then I went to speak with her.

It took mere minutes to make sure she understood how the new medication worked, how to fit it into her day with her other medications, how she might feel taking it. We reviewed her other drugs and medical conditions and I assessed her level of understanding to be high. Job done.

But what about the other part of my job? When she told me about the cancer returning, I looked into her eyes and could see the shock… and the fear. What she needed in that moment was human connection; a hand on hers and someone to listen to her.

When I looked around for the time I needed all I saw was the impossibility. At least a dozen patients waiting for me to sign off on their medications, one waiting to learn how to use their new inhaler, and two patients nervously waiting for me to administer their injections. At the same moment I heard one of my technicians say I was wanted on the phone by a physician.

Time…..I didn’t have it. I couldn’t take her into my office and be that presence for her.  So I spoke medication, touched briefly on the agony of the diagnosis, and resisted going too deep.  I know too well the fragility of emotion, and without the privacy to truly be present to her situation, she needed to keep from falling apart and make her way home.

But somehow I feel I have failed. There have been times when I have taken patients into the office who have been grief stricken, going through withdrawal, requiring in-depth discussion of an issue…. But today, I was stretched too thin.

And so…I take it home with me.

I have had colleagues tell me to leave the job at the door. Walk away to my family and rest assured there will be more patients and problems tomorrow. I have learned that at times I can and must do it, and at other times I simply can’t. But perhaps it’s the “can’t” moments that make me a better professional…..a better person. There are times when I experience humanity laid bare….a rawness of emotion, a fragility to life. These experiences become a part of me whether I invite them in or not. In the end they are an univited gift.

Dr. Oz and the Ruby Slippers

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I really wish Dr Oz would just put on his ruby slippers and go home. Just click those heels three times and retire.

That may sound harsh, and I usually don’t make such blanket statements, but honestly, he’s starting to do some real damage.

Like Oprah, when Dr. Oz speaks, millions of people listen. His level of influence in the average North American household has become almost iconic. Millions turn to him for advice. That would be a good thing if he was a health professional with integrity and his advice was backed by science. The reality is quite the opposite. Here’s my beef with Oz.

Dr. Oz puts profit before people.

When Dr. Oz first started out on Oprah, his information and health recommendations were fairly standard, typical of your family doctor with some Hollywood spin. Over the years, however, he has become more “Hollywood”and less “doctor”. He sensationalizes medicine, often offering quick fixes with unproven therapy. It makes for great sound bites (like the un-workout workout) and it sells, but it’s not based on science. In fact, coming soon is his own product line of unproven supplements. It doesn’t matter that he lacks the science to back up his claims. His name sells and so will his unproven products.

His advice can be dangerous

Diabetes can be prevented with vinegar and coffee. Really? If that were true, I know many of my patients would be reaching for more pie; just add a cup of coffee and it’s all good. Instead, what is proven by science is that weight management and good nutrition can delay Type 2 Diabetes.
If a person needs to lose weight to reduce their risk of having a heart attack or stroke and Dr. Oz says all they have to do is take white kidney bean pills and they can eat all the cake they want…that’s dangerous.
How about having a doctor on his show that believes cancer can be cured with baking soda? Not kidding.

Dr. Oz presents “Pseudo-Science” as fact

Pseudo-science is presenting a claim or belief as scientifically valid without having the scientific supporting evidence. Here’s what we mean by science:

What we mean by “science” is simply rigorous methods of observation. Good science looks at all the evidence (rather than cherry picking only favorable evidence), controls for variables so we can identify what is actually working, uses blinded observations so as to minimize the effects of bias, and uses internally consistent logic. Steven Novella, MD

Are there some studies showing coffee has an effect on diabetes risk? Yes. Can we use these studies to make sweeping statements that affect people’s health? No. That would be irresponsible. All that is proven by a few small studies is that more studies in that area need to be done.

Dr.Oz takes “bad science” or limited science and presents it as fact. That’s irresponsible.

I’ve been in health care long enough to see really good studies point to facts that we incorporate into our practices as health care professionals. But 10 years later (after more studies with larger numbers of people, going on for a longer time), the original studies are proven to be misleading or even point to the opposite conclusion. Studies need to be examined with the eye of a sceptic and there is a science in itself to evaluating the strength and validity of scientific studies.

When people come to me with health concerns looking for advice, they are in essence sharing a trust. Patients expect me to be honest and to have their best interest at heart. They expect that my advice will be based on scientific evidence, not on anecdotes, popularity or profit. Patients should expect that from all their health providers.

Dr. Oz fails on all fronts. So, Dr. Oz, if the ruby slippers don’t fit, perhaps you can take the job of the original Oz behind the curtain. After all, he was a charlatan too.

Beautiful Boy

Last night my eleven year old son asked me to sing to him while he was going to sleep.  Singing him to sleep was something I did when he was very young and not the best sleeper.  Today, he has already acquired the sleeping habits of an adolescent, so his request caught me by surprise.

When I asked him what he would like to hear he chose “Beautiful Boy” by John Lennon.  So, I sat down on his bed and rubbed his back while I sang to him.   And as I sat there in the moment, I realized my oldest son was teaching me the value of presence.  Being entirely present to someone is a gift, and that is in essence what he was asking for.  My complete focus
was on him with my mind, my voice and my touch.

It struck me today that there are only so many bed times in a child’s life.  Already he is 11.  There won’t be many more years of snuggling up in bed to read a book together, back rubs and singing.  How many bed times have I rushed through over the years?

If you are a parent I’m sure you can relate to the exhaustion, frustration and the “just being done” at the end of a day with children.  Some days, it would be all I could do to just make it to bedtime and I would rush the routine to get them to sleep.  My thoughts would be not on my child but on the dishes that needed doing before I could go to bed, or the problem at work, or what I needed to prepare for the next day.

As I sang to my son again tonight (I can see this will be a routine for awhile), Mr. Lennon’s words rang true for me:

“Life is what happens to you while you’re busy making other plans.”

How much life has gone by while I have been too “busy” to be present in the moment?