Journal Club on June 5

This is a special announcement that I will be moderating the first Twitter Journal Club for the Journal of General Internal Medicine (JGIM) on June 5 at 9:00 PM (EST).  This event will be a guest appearance on the #meded Twitter chat, which occurs weekly on Thursdays.  Details of how to join the chat are available here, including an abstract of the article we will be discussing.  I hope you can join us!

The impact of cost displays on primary care physician laboratory test ordering. Horn DM, Koplan KE, Senese MD, Orav EJ, Sequist TD. J Gen Intern Med. 2014 May;29(5):708-14. - See more at: http://sgim.org/about-jgim/from-the-web-editors-desk/jgim-twitter-journal-club#sthash.NCdLFmqs.dpuf

The impact of cost displays on primary care physician laboratory test ordering. Horn DM, Koplan KE, Senese MD, Orav EJ, Sequist TD. J Gen Intern Med. 2014 May;29(5):708-14. - See more at: http://sgim.org/about-jgim/from-the-web-editors-desk/jgim-twitter-journal-club#sthash.NCdLFmqs.dpuf

The impact of cost displays on primary care physician laboratory test ordering. Horn DM, Koplan KE, Senese MD, Orav EJ, Sequist TD. J Gen Intern Med. 2014 May;29(5):708-14. - See more at: http://sgim.org/about-jgim/from-the-web-editors-desk/jgim-twitter-journal-club#sthash.NCdLFmqs.dpuf

The impact of cost displays on primary care physician laboratory test ordering. Horn DM, Koplan KE, Senese MD, Orav EJ, Sequist TD. J Gen Intern Med. 2014 May;29(5):708-14. - See more at: http://sgim.org/about-jgim/from-the-web-editors-desk/jgim-twitter-journal-club#sthash.NCdLFmqs.dpuf

The impact of cost displays on primary care physician laboratory test ordering. Horn DM, Koplan KE, Senese MD, Orav EJ, Sequist TD. J Gen Intern Med. 2014 May;29(5):708-14. - See more at: http://sgim.org/about-jgim/from-the-web-editors-desk/jgim-twitter-journal-club#sthash.NCdLFmqs.dpuf

Poem Link

You can check out my new poem in the Yale Journal for Humanities in Medicine! 

SoMe and Me

In addition to returning to my blog after a recent break, I have also resumed my activity in other forms of social media (or SoMe for short).  In particular, I am back on Twitter (@TaborF).  Twitter has a reputation for being rather superficial, and there certainly is plenty of inane celebrity-related tweeting going on.  However, it can be used for more productive pursuits.  My primary involvement with it is the weekly #meded chat on Thursday evenings, which allows me to meet others all over the world, who share my interest in medical education.  If you would also enjoy a lively discussion of current issues in the meded field, you are welcome to check it out.

I have also joined Linked In, as a relatively late arrival.  I had been putting it off, mostly because of time constraints.  Enough of my colleagues have invited me to join them that I finally gave in.  I am still very new to it (not even a profile picture up yet), so it is too soon to say how I will like it.  I do have a multitude of professional contacts to maintain though, and it does seem useful for this purpose.

My use of Facebook is purely personal, rather than professional.  Even though mine is the cutest baby in the history of babies, I do not necessarily want to share our photos with the entire world.  So I restrict this to family and friends.  It is also my main means of keeping up with their weddings/babies/special events and a great way to rediscover people from my well-traveled past who could be in any time zone.

The one form of SoMe that I obstinately avoid participating in is Pinterest.  I regard it as a conspiracy against working mothers.  I will never decorate the baby’s room (or any room in our home) in a coordinated manner.  His Star Wars/dinosaurs/miscellaneous animals theme is perfectly fine, thank you.  I will never make any homemade crafts or baked goods for his class functions.  It’s just not going to happen and that is okay.

My blog is a mix of several identities.  I reflect on my professional work as a doctor and also my personal interests in literature and creative writing.  It also provides an opportunity to reflect on this intersection of personal and professional selves.  Any doctor who is active on SoMe needs to be vigilant about standards of professionalism.  Even when “off duty”, we are still a part of the medical community and invested with the public’s trust.  My friends in the clergy face a similar challenge, never able to truly separate their private lives from their vocation’s ethics of appropriate behavior. 

Despite these strictures, it remains important for us to be part of the public conversations about medical education and healthcare, especially in times of great change.  Our voices, as advocates for our profession and the welfare of our patients, should be heard.   

Endurance

I have been sadly neglecting this blog.  With a new job and new baby, this is not very surprising.  However, I am finally starting to feel that I am through the major transition for now and settling into new patterns.  I have time to read again, during the hour or two in between baby’s bedtime and mine.  And a limited-but-still-appreciated time to write during his weekend naps.

Although my theme has been literature and medicine, I have actually been on a non-fiction run recently.  Reading Shackleton’s South has helped put my problems in perspective.  I may have some challenges to deal with, but I am not trying to traverse Antarctica.  I am not struggling to rescue my crew after our ship is crushed by ice.  I am not living on seal and penguin blubber, constantly cold and wet, going months without sunlight, always in danger.

When I start to complain, I should remember: I don’t have scurvy. 

Though not as extreme, medical training does bear some resemblance to the Endurance Expedition and similar ventures.  It includes physical deprivation, lack of sunlight, and some danger.  It is more psychological than physical risk most of the time, but I will never forget the nurse disarming a patient who smuggled a knife into the ER or the resident who saved me from being bitten by a demented patient.

Like Shackleton’s crew, we bring our troubles on ourselves.  They all decided to go to Antarctica.  Many had been before on other expeditions and had no illusions about what might await them.  We may be less accurately aware of what medical school and residency will be like, but it should not come as a shock to find it an intense and rigorous journey. 

What impressed me most about reading Shackleton’s account was not the adventure or survival against all odds but the leadership that made it possible.  Both Shackleton and Wild, his second-in-command, had to make tough decisions to keep their men alive.  They had to keep everyone motivated, hopeful, and ready.  If they had given up, they would have perished.  They set the tone for the entire group. 

Now that I am in charge of residents and medical students, it is important to keep in mind that their motivation, hope, and readiness are under my influence, to some degree.  When I feel cynical or worn out, I can think of Wild packing up camp every morning, looking out to sea, and projecting unfailing optimism that today help would arrive. 

Let’s also raise a glass of orange juice to Frank Hurley (the intrepid photographer) and each crew member who kept a journal on the expedition, despite the burden of carrying equipment and books across the ice floes.  They not only survived the experience but preserved it, reflected on it, and shared it.