Boredom

Just read a post from my friend, Tazzy...inspired me to write down what I've been feeling for probably the last year or so.

So three years ago, I get into medical school...that had been the biggest priority in my life during undergrad. First year was spent really making friends, getting over the homesickness and figuring out what it's like to live on ur own (and putting up with that god awful appartment! ARGH the horror!)

Second year ws spent having fun with my friends here in Kingston, missing home less

Third year...what can I say about third year. A very hectic year...finished pre-clerskhip, left the classroom forever and starting working in the hospitals. Never doubted myself more than I did in the beginning but thankfully, things have worked out well. Residency application time is here and as usual I'm procrastinating. I really don't care...part of me wonders if this is due to over confidence (which is a dangerous thing to develop this early on in my career) or that I've become so blazay (??sp) about it?

All this aside, these are things that have been on my mind over the past year.

The first being, while I love living on my own, living in Kingston along with having to work terrible hours really is getting to me. People tend to forget about you when you are out of sight. Isn't there a saying that goes: out of sight, out of mind? Many who treated me as if I was one of their closest friends have not kept in touch and often do not share important news personally. Ive realized that although I value friendship tremendously and feel my friends are a very important part of my life, for some people friendship is simply a momentary thing...something that happens when the circumstances are right. When the situation changes and the friendship dies...no matter how close you were to the person or how much you like the person. Friendships of convenience.

The second being, is the whole routineness of everything (is that even a word). I'm in the prime of my life (supposedly) and I'm so utterly bored. Things don't excite me as much as they used to. The things that do, I really have nobody to share with. My friends in Kingston are just as busy as I am and don't have time to get excited. My friends in Toronto are so far away...calling is such an effort (and I am a very lazy person when it comes to calling people). It is during the times I get great feedback from attendings or see something wierd or take a walk along Kingston's waterfront or go away on a trip or whatever that I really realize how alone I am. I've tried sharing with my parents but I've realized that half the time they are not really listening and the times they have, they don't get it. People who know me, know I get excited by not only the big things in life, but the small things as well...only now my excitement is extremely short lived because just as quickly that ache starts that I feel in the middle of the night when I can't fall asleep, or when I feel sad by what I've seen in the hospital, or when I watch a cheezy Indian movie and the guy woes the girl in a sappy but romantic way. I guess I never thought that I'd end up alone...a part of me always figured, hey, i'm not such a bad gal...a little chubby but cute, easy to get along with, it should be pretty easy. The simple things in life, I don't enjoy anymore b/c they almost inevitably bring on that ache...which I wish would just go away. I, who always preaches that a woman should not reduce herself to the point where having a man in her life becomes an all encompassing thing...where she can't define herself unless she has a man...where she can't do a nything without a man...I now wonder if I should just keep my mouth shut.

Why do I feel that having someone will complete me? I can't forget how fortunate I am...I'm doing something in my life that I want to do...I've been given an opportunity that others only dream about. I'm successful, I'm intelligent, I can look good when I make the effort, I'm easy to talk to, my patients love me and yet...it's still not enough.

Is this a biological/physiological need that we have been ingrained with to ensure the propagation of mankind? (No i'm not talking about being horny. that's another topic alltogether). The need to have companionship, without which we feel imcomplete no matter what else is perfect in our lives. Or is this just something that grows out of our environment, our upbringing and being bombarded by the media that this is what is expected of us as women? I wonder even after (that is IF) I find someone, will I still feel empty and incomplete. Will I still long for something more? Will I still be bored with the routine. Why can't I be satisfied with all that I have. Maybe it's because I expected life to be this melodramatic soap opera where fireworks are always exploding whenever something important happens in our lives and where things are never routine.

Aite, enough babbling. As always I need to clean my house (I can't wait to be able to afford a cleaning lady!)

The Marginalized of Society

I just finished watching an episode of ER where in the beginning it shows a man trying to break into a poor woman's house. She has her three young children with her, the oldest being 9. She is absolutely terrified that it is her ex-husband who has come back to kill her. A gun shot fires through the door. She takes her two youngest daughters and in a desparate attempt to save them from their abusive, violent father, tells them to jump from their three story appartment. Her son freezes on the spot and is unable to jump.

One of her daughters ends up dying and the other is seriously injured.

As the show proceeds, you realize that the father actually died a year ago in a robbery. She has been depressed ever since and seeking help from an outpatient psychiatric service. She was on benzodiazepines and recently had to stop taking them suddenly b/c she could no longer afford them. What actually happened was that she was undergoing benzo withdrawl and suffering from hallucinations and an acute psychosis.

The show got me thinking and I really wish many health care professionals would watch and learn a big lesson from this.

Over the last three years, I've often noticed and pointed out to my friends that there are many people in my medical school class who lack true compassion. In addition, they do not realize that an treating an illness is so much more than just figuring out the diagnosis and writing a prescription. This is best demonstrated by what happens to people who are marginalized in society and become ill. Let me explain.

Drug addicts, patients with mental illness, the working poor and those on social assistance, the native population, those without a post secondary education, etc. are all people whom our society pushes to the margin or periphery. When these people become ill, I find our health care system has a very difficult time dealing with them. Part of this is due to discomfort on our part dealing with these people. Part of this is ignorance on our part. Many people do not realize that there are people out there who often have to make the choice of feeding their kids or buying expensive medication. In fact, this is not something that even crosses their mind. And sometimes, it's just plain arrogance and a judgemental attitude. People form an opinion immediately in their minds and this affects their interaction with their patients. Talking down to a person is one of the most effective ways of alienating them...and in alienating them, you are almost guaranteeing that a patient will not listen to your reccomendations or advice.

I mentioned earlier that I feel many people in I work with lack compassion towards many patients. I find this often stems from the fact that many people have not had to deal with sick people in their families. Or even when there were illnesses, the best possible care was utilized because they had all the resources available to them. Many of them come from middle to upper class families. Money to buy medication, drug plans to cover rehab/physio/etc are present. Time off work is often paid and even if it is not paid, there is often enough money to fall back on. Their sheltered lives make them ignorant of most of the population's hardships. The marginalized do not have these luxuries. Most are on social assistant barely making ends meet or have jobs that even if they can get sick leave, they will not be paid. Those few days/weeks of lost pay is often detrimental to them and their families because every single penny counts. Their jobs do not provide insurance plans which cover for medication, physio etc. Hence people will go to the doctor, take the prescriptions, listen to the advice and then go home and go about their daily lives. As much as they would like to get better, they often have to struggle and work through their illness. In essence this means that despite our abilities to provide excellent health care, the unfortunate souls are unable to utilize all the options available to them. The lack of compassion does not necessarily stem from a consious effort. Often it is simply that the realization is not there that there are many more issues surrounding a person's illness than just the disease itself. A person's ability to take time off work, a person's ability to pay for meds/physio, a person's capability to understand the effects of the disease and the importance of treatment. And with addiction and/or mental illnesses, the addiction/illness often plays such a huge role in disabling a person's ability to make informed choices that it takes over their lives. Feeding the addiction at all costs or a mental illness impairing's one's ability to make proper choices are often factors that push everything else back on the back burner.

Now going back to today's episode of ER. A classic example of a poor woman, who was in an abusive and violent relationship becomes ill. In her case, clinically depressed. She's coping so long as she is taking her medication. However, when she can no longer afford the medication, she abruptly stops it. Anyone who has been on benzos for any significant period of time, cannot abruptly stop the medication; it needs to be tapered over time to avoid withdrawl. Unfortunately for her, she does not have that luxury and hence suffers from withdrawl. In her case, this results in the tragic, yet avoidable death of her daughter. Her fear during her psychosis stems from longstanding physical and emotional abuse. Extremely heartbreaking as all of this was avoidable.

It is extremely frustrating that there is not a system in place whereby people who are marginalized have programs/options available to them whereby they at the very least get the standard of medical care that is everyone's right. Living in a rich society like North America (rich in comparison to the rest of the world), there is no excuse why anyone should be receiving suboptimal medical care. But then again, those in power are from the same middle to upper class group that many in medical school come from and hence have led the same sheltered lives.

I know this is a long post. I mainly wrote it as a reminder to myself that despite not having lived a sheltered life, knowing what it is like not to have money for medication, etc. I too forget and lose my compassion. Especially with patients who have difficult personalities, who have addiction issues etc. I forget that I promised myself I would never do that. I forget that it is very difficult to leave an abusive relationship. I forget that with poverty comes anger, furstration and depression...all of which impact a person's well being. And most importantly, I forget that it is not my place to judge...it is simply my place to do my best to help people with the gift Allah has given me and the knowledge I have been provided with.

Matchmaker

So on the last long weekend when I was home in TO, my dad calls me to the living room and says, "I don't want you to get mad but I want to ask you something. Have you joined a matchmaking service? Because if you have, you know I can't do anything about it, it's your choice."

WHAT??!!?? I was shocked! I said, "No but did someone tell you that?" He's like "no".

Now that came out of nowhere. I mean if he wants me to do that, he should just ask me (I'm not sure I would be comfortable doing that though)...I hate how he always gets things done in a round about way so that it seems like me, my mom or my sister wanted to do something when in actuality he wanted it. Stupid man!

Interesting Quote

I heard this on TV by Tarek Fateh (he's a prominent member of the Cdn. Muslim Congress, a group which prides itself on being progressive)

" Muslims are pre-occupied with two things: sexuality and hair--how much hair a man has on his face and how much hair a woman is covering on her head."

SO SO SO true...I could not stop laughing. I love how all of our debates can be reduced to two things...sexuality and hair. If people moved past this, maybe then we can actually come up with solutions to our numerous problems as muslims!