Resilience – from within or without?

  I have been confused about resilience. To me, it always seemed very sensible to focus on it, this ability to 'bounce back from tough times, or even triumph in the face of adversity'. It surely is part of the ‘hidden curriculum’, as Horne and Peters refer to it in their BMJ article, ‘Ensuring our... Continue Reading →

Wrecker

On this blog I have explored the challenges involved for doctors who engage patients in conversations about resuscitation. I have written about the emotional energy consumed in initiating them, and in The Hill, a series of 7 episodes, I described the spectrum of reactions seen in patients and relatives. Recently I gave a lecture that... Continue Reading →

Asymptote: answering the dreadful question

Working in a specialty that is almost overwhelmed by '2 week wait' referrals (patients who are sent by their GPs with a suspicion of cancer), I am often asked, 'How long?' For some patients, inevitably, are found to have incurable disease. It is the job of me and my colleagues to provide an answer. Frequently,... Continue Reading →

The problem of late-stage consent in Assisted Dying

Assisted-dying law in Canada requires the person to be alert and able to provide consent just before their death. The Government of Canada website on Medical Assistance in Dying (MAiD) says, You must be able to give informed consent both: at the time of your request immediately before medical assistance in dying is provided This seemingly... Continue Reading →

Fear and medicine – friend, foe, natural bedfellow?

Juliet entered the ward expecting a normal, busy day. But the face of her colleague Nethmi who met her by the nurses’ station told her that something was up. “What?” asked Juliet, responding to Nethmi's wordless warning. “Mr Peterson. Bed 19. They took his vascath out last night.” “So?” “Did you tell the nurse to... Continue Reading →

Evidence for evidence

At a recent patient safety meeting the subject of the ‘theatre cap challenge’ came up. This is an initiative that encourages all operating room (OR) staff to write their name in pen on the front of their disposable theatre cap so their identity is clear, which is especially important in an emergency. There have been... Continue Reading →

Caring and disdain: emotional juxtapositions in Adam Kay’s This Is Going to Hurt

  Adam Kay’s book really made me think. Among the gags and orifice-centred humour, examples of disdain for patients coexist with expressions of deep caring. I wasn’t sure who the real Kay was. But then I realised, he is probably all of us. In our fatigue we have all simultaneously despised patients who (we perceive) are... Continue Reading →

Get real: a conversation about alcohol

Moderate alcohol drinking is recognised as a major health issue. Although end-stage cirrhosis and liver failure are the most visible and tragic results of alcohol dependence/addiction, there are many more people out there who drink regularly to excess but who have no physical or mental problems with it... until an abnormal blood test or a... Continue Reading →

Death eclipsed

  Finding the right balance between active treatment, which may include surgical or semi-surgical interventions, and palliative care, can be difficult. The two can go on in parallel, of course, but often a full palliative care assessment and plan takes place when the primary medical or surgical team have drawn a line under their management.... Continue Reading →

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