doctor heal thyself

Lately, I have been getting a bit of teasing about my competence in dealing with my own self-care. Of course the dialog goes a bit like this: "Shouldn't you take better care of yourself? After all,  you are a doctor."    I thought I might look into this  and when I did, I realized I wasn't the only one this is a problem for.  Here is an excerpt from the British Medical Journal (1994:309:557-558):

It has long been recognised that doctors, as an occupational group, experience excess mortality from some causes, particularly suicide and self injury, poisoning, and cirrhosis of the liver.1 Reviews of morbidity among doctors have suggested a relatively high occurrence of psychiatric and stress related disorders as well as drug and alcohol misuse.2,3

A study carried out under the auspices of the Nuffield Provincial Hospitals Trust set out to explore perceptions of and attitudes to sick doctors as well as the provision of services for them in eight health service localities (p 561).4,5 The messages from the interviewees (senior and junior doctors, health service managers, industrial relations officers, and representatives of community health councils) were that doctors' health problems are poorly dealt with, interventions come too late, and appreciable attitudinal and organisational barriers exist to the uptake of services. Respondents' views on why help is not sought encompassed the stigmatising nature of illness for doctors (and consequent denial), misguided professional loyalty, attitudes formed during medical training, the perceived irrelevance of services (particularly occupational health services), and a tradition of self treatment and direct self referral to hospital consultants.

1. Office of Population Censuses and Surveys. Occupational mortality 1979-80, 1982-83. London: HMSO, 1986.
   
2. Pilowski L, O'Sullivan G. Mental illness in doctors. BMJ 1989;298:269-70.
   
3. BMA Board of Science and Education. The morbidity and mortality of the medical profession. London: BMA, 1993.
   
4. Nuffield Provincial Hospitals Trust. The provision of medical services to sick doctors: a conspiracy of friendliness? London: NPHT, 1994.

So....  I just want everyone to know that it isn't my fault that I have a hard time with routine medical care fore myself.  It is a profession thing.  And,  just so everyone knows, my blood pressure today was 110/60, sats 97%,  heart rate 100 (which is normal for me), and blood sugar of 110 (after a big breakfast). Why would I want to live to be a hundred anyway??  Why would I want to live past 50 for that matter? 

Things that make me happy.

The hospital I work for has several contracts with the local mental health care services.  This allows me to see and try to help many people in crisis.   Evaluating patients who are having mental health issues is something you learn in medical school but as with most difficult things, you don't really learn it until you do it a couple of hundred times.  Even after this,  I am still often surprised and amazed at the experiences that I have each time I walk into work.  I know you want a surprising or amazing story right now but, alas, that old HIPPA looms ever present and unless I want to go to jail or be fired, I better stay with my own thoughts and feelings. 

One of the text book questions that medical students are taught to ask to assess for severe depression is "Is there anything in your life that makes you happy?"  As I was taught in my psychiatry rotation, profoundly depressed people are unable to find joy or happiness in their lives.  I was thinking this morning in the shower as I blearily got up at 6:30 for another long day at work and asked myself this question as a reality check.  (Kinda of like the self breast exam that you'all should be doing in the shower each morning, only for mental health!!)

So,  here was some of the things that have made me happy recently (not in any order):  

1. Playing golf with Vicki and winning a game against Steph and Marylyn
   
2. Watching BYU slaughter UCLA
3. Morning boat rides on Lake Powell
4. Watching Skye on the trail
   
5. Naps
   
6. Dinner with Denice
   
7. Personal scapbooks made by your sister
   
8. Birthday parties on the houseboat
   
9. Skye wanting to sleep on my lap
   
10. Dry Canyon
    
11. New hiking shoes
    
12. Weekend visits to Illinois

Have you asked yourself this question lately? (You don't have to be in the shower to do it)

Linear thinking

This is a test, this is only a test....

I have shoulder pain.  Pick the appropriate answer:

• a.  Make an appointment with my primary care provider.
  
• b.  Go to the ER.
  
• c.  Go to the ER over and over again to get pain medication and pay 5 times the price of a primary care provider, all because you don't have enough money to pay for your cigarettes and go to the doctor and you are too busy to make an appointment. 
  

Yep you guessed it!  The answer is c.  

What...  You have concerns about this test?    Answer c is not logical or practical?  Welcome to my world!!!

Hiking alone

So last night I decided to go for a hike and take poor Skye out with me.  Skye loves to run and swim and smell everything there is to smell.  Unfortunately with my schedule and Salt Lake Cities leash laws, I am often unable to get her out to do some real running and exploring.  In Cache Valley, Utah where I live half the week, there is no such things as leash laws and there are some great trails only 5-10 minutes from my house.  I have been exploring them slowly.  I am strolling hiker not a "reach your goal at all cost" hiker.

Yesterday we went up Green Canyon.  It is in the Cache Forrest just East of North Logan.  It is a pretty canyon that, as I found out after Skye and I were nearly run over a couple of times, is used fairly heavily by mountain bikers.  It was beautiful though, and between the whir of Mtn bike tires was peaceful and quiet.  The temperature was perfect as we walked up the trail and the old campfires gave it just the slight whiff of campfire smell that made you feel like you were 50 miles into the forested wilderness instead of 10 minutes from the city.   I sat contemplating life and its mysteries for a good 5 minutes at the apex of my strenuous outing, then started back down the canyon.  On the way down, I strolled along the trail appreciating natures beauties.  I even turned off my ipod to listen to the crickets chirp in their near-dusk rhythm.  Ok,  I will admit it really was to listen for the mtn bike tires so that I could jump out of the way quickly to avoid tire marks across my back. 

Skye is a little to be desired as a hiking companion.  She likes to run ahead and sniff the trail leaving me in the dust behind.  Occasionally she runs back to check on her slower companion and make sure I haven't been playing with any other dogs (she is very possessive).  So, as Skye is 30 yards ahead, I hike alone thinking a great deal.  My thoughts wander, wondering when the next mtn bike will come by, how I might stop one of them if I fall and break an ankle, how I can exercise Skye without putting on hiking shoes, etc.  

Skye

Ode to the best dog ever!!

As a child raised in a dogless world, I was unaware that there existed a force of nature that could raise the most intractable of dark moods, soften the hardest of hearts and melt the coldest of natures.  How a being considered and "animal" can become so ingrained in the heart of a human is beyond my understanding.  But, I do know that in my life, my dog has become my friend, my companion, and my family.   Skye became part of my life almost as a whim.  She was a incredibly cute, yellow fuzzball that Denice (my sister) and I stopped to see in Meadow, Utah on the way back from a funeral.  Her mother was an old yellow hunting Lab and her dad was a black wirey hunting Labrador as well.  No papers for this family of farm dogs.  I got the distinct impression that it was beneath them.  Skye had 2 sisters bounding around the farm with her, tumbling over a clump in the grass and chasing a chicken or two.  These were not pampered indoor pets but good old country dogs.  Skye's blaze on her nose and paw made her distinctive and she permanently stole my heart!  As a life long cat person, it took some time and a few frustrating

 months to figure out the dog persona.  Now that I have some understanding of the loyalty and love that one of these 4 legged canines can give, I am forever converted.  Don't get me wrong, I will always love my cats and will value their unique personalities and the traits that make them cats.  But, there is just something about coming home after a long hard day and witnessing the joy that a dog can express just because you walked in the door.  How can you not but love something that makes you feel so completely wanted and needed?

I'm trying this out!

So...  I thought I would finally join the technologic main stream and start a blog.  I have tried to decide if anything I might write would be at all interesting or useful to someone reading it.  I concluded that no, probably not.  However,  then I decided that,  so  what!  How many people actually blog in a completely altruistic and self-less state.  The vast majority of writing on the internet is purely self interested rhetoric, put out into cyber space in an attempt to either self-inflate or self-promote, or trash on others self promotion.  With that said, I am joining the self promoters  and trashers!

Recently returned from a great birthday trip with friends and family.   It was expensive, a lot of work but very fun!  Lake Powell is one of those places on Earth where you just have to stand there for a minute and go.... "wow."   There are few places that are so awe inspiring that you can't take it all in and I feel that I under appreciate this rare beauty.   Occasionally, I feel discouraged about the way this world runs and then, when I have an experience like I had recently at Lake Powell, I am refreshed and my faith in the world is renewed.  I can't imagine that a political speech or even a religious talk or speech could ever inspire me like a few hours appreciating the beauty of the natural environment!

Well...  I look back at what I have written and I can't find any profound information but, as they say in UTAH, "what the heck!"  I am doing it anyway!!