Don’t judge me! Reflections on reflection

A very good article….

A Better NHS

Few things seem to irritate doctors and medical students so much as mandatory reflection. Compared to bullying bosses, the lack of sleep and an unstoppable tide of human suffering, the amount of bitterness harboured at being forced to write down ‘reflections’ may seem crazily out of proportion, but I share their frustration. I say this because I am enthusiastic about reflection, but dismayed by the ways it has been handled in medical education and clinical practice.

The assumptions underlying medicine and reflection

To justify any kind of reflection we need to begin with questions like, ‘What is medicine (for)?’ The philosophical foundations of our practice are rarely examined in the formal medical curriculum, but in the hidden curriculum of real-life experience we learn that medicine is a moral practice, guided by science and shaped by culture. It is impossible to escape from the inherent moral ambiguity, scientific uncertainty and cultural…

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Fatigue

One of the most difficult adjustments is In finding myself so fatigues after simple things. For someone previously so fit and active, I am now jiggered after a half hour walk! Or a meal out. Or if it’s anything after eight o’clock at night, pretty much! And so today I have rested for the afternoon. Now I shall read – resting my body if not my brain! I remember vividly arriving home from hospital to my book-lined house and the frustration of not being able to read! Luckily, that did not last too long.

Pain relief

For the past two weeks I have had dreadful pain, going from one dose of co-codamol to the next and timing it absolutely. I have last night started a neuropathic pain killer and, as well as a good night of sleep, have had a more comfortable day!! Alleluia. I hope and think I was always sympathetic to patients’ pain. It certainly affects everything adversely!! 

The c word

I finished the book and it’s a very good read. Knowing the millions of people affected by cancer daily, it is an IMPORTANT book. BUT I also make the point that not every serious diagnosis is cancer. “Life changing” diagnoses happen on a daily basis too. I won’t even start a list as I am bound to miss out something devastating to someone. As a GP, it was very hard to go from a cancer diagnosis to something seemingly trivial. BUT it may be devastating to that patient and there is the skill of general practice- giving the patient time to explain their worries and YOU time to explain your conclusion. Have I ever mentioned that there is not enough TIME in general practice? That’s another blog in itself.

Election

Well, the world has changed overnight! The unexpected has happened and I wonder if this marks the beginning of the end of the NHS? In the run up to the election, there were all kinds of promises about more GPs and improvements to services. I am not sure that this is answer at all!? Ever since my illness began, I feel to have watched general practice decline and, indeed, the NHS itself. In this “brave new world” I wonder what will happen next? 

Polyarteritis nodosa

so that’s my diagnosis. Can you even say it? 

Formerly I was a GP. I had two weeks in hospital in the autumn of 2012 and then a brain haemorrhage which scuppered all normal life as I knew it! I was 40 when it happened…. They say life begins then. Well, it marked a new beginning in many ways! 

Pain

And so, the problem now is pain….pain in the neck, and left arm and numb fingers. Yes, I’ve heard all the jokes and made them too. But this is MY pain. I do appreciate how much my condition impacts on other people: friends and family. More anon…