Thursday, May 31, 2018

Sick (2018)

by Porochista Khakpour

“Sick, A Memoir” appears to be an illness narrative of the chaos variety.  There are three types of illness narratives and they have been extensively dissected and discussed by Arthur Frank in “The Wounded Storyteller.”  Often, there are overlaps between the chaos, quest and restitution stories.  Chaos is the most disturbing and difficult story, because it can not be well articulated and leaves the witness uneasy.  We all prefer hearing about someone who overcame adversity and triumphed.  Hamlet asks. “Whether ‘tis nobler in the mind to suffer/The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles, And by opposing end them?”  The chaos actor is adrift on the “sea of troubles” and can not make sense of what is happening.

I have not read the book yet.  It will come out on Audible on 7/10/2018.

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Wednesday, May 23, 2018

p53 and Me

by Shekinah N.C. Elmore, MD
NEJM May 24, 2018

This is an extraordinary Perspective  piece in the New England Journal by a young oncology resident who has the p53  mutation. This is seen in people with Li-Fraumani syndrome.

" A mutation like mine threatens to consume your whole imagination, especially with regards to the future. You start making crazy calculations..."

" Genetic knowledge is power only if both clinician and patient are equipped to move beyond a result and toward action, even if that merely means living well with what we know."

 She feels that people like her need to be studied not just for the data of their genomics but to help build programs for learning to teach people how to live with the uncertainties that their mutations will engender. 

This short essay is has many valuable teaching moments. She says, "I want as many of my days as possible to be untethered to the scans, biopsies and long waiting room sojourns. This is a cry from one who has been there for minimally disruptive medicine.


Sunday, May 20, 2018

Portraits of Resilience

by Daniel Jackson
MIT Press 2017

This is an important book. The students, faculty, and staff who are portrayed are bravely candid. 

The impetus for the book likely derived from and attempt to understand and impact on the high suicide rate of MIT students.  There are many reasons for this and it is not the purport of the book to delve into them.  Suicide rate is the tip of the iceberg of depression, anxiety and burnout and sometimes just bad luck that patients experience; and MIT with its rigorous curriculum may be a more stressful venue for students than most, if not all, other institutions of higher learning.

Portraits in Resilience is a must read for any in the caring or teaching professions.