Friday, February 19, 2016

What Medical School Looks Like XXIX: I'm not a doctor, but...

Friday I participated in a group project about "Medicine on T.V." My job was to lead our classmates in charades of popular doctor shows and to discuss the portrayal of medicine and physicians in them. The skits (we let them talk) were hilarious. After each one, I played a clip from the show and invited reaction. Some people shared how watching the show had shaped their desire to go into medicine, or how their views changed about another after they got into medical school. We debated whether depicting doctors as anti-heroes was more realistic than the classic "tv doctors," or whether the episodes were too "soapy" to convey anything about the characters as physicians or surgeons.

The original tv doctors were Ben Casey (5 seasons, 1961-1966) [Primal metaphysics] and Dr. Kildare (5 seasons, 1961-1966) [mashup]; Marcus Welby, M.D. (7 seasons, 1969-1976) [Episode intro] came along at the end of the decade. All three were white, heterosexual, able-bodied men who were beloved by American TV viewers for being compassionate, principled healers who did the best for their patients, even if it was unconventional or required standing up to "the system," narrow-minded specialists, greedy medical malpractice lawyers, etc. Casey was a neurosurgeon, Kildare an idealistic young surgical intern, and Welby--interestingly enough--a general practitioner. It occurs to me that surgery (and emergency medicine) appear flashier and more exciting than internal medicine, which may be why House, MD had to have such exaggerated differentials to make diagnosis look interesting. It is probably why the cases on Mercy Street tend toward the surgical, even though 2/3 of casualties during the American Civil War were from disease.

Handsome intern Dr. Kildaire
in "hospital whites."
The skit for M*A*S*H (11 seasons, 1972-1983) [War is war, Hell is Hell] depended on the audience understanding a reference to at-first unheard "choppers." All of the doctor tv shows address social issues, this one perhaps more than most. I pointed out that the creators had borrowed a page from Gene Roddenberry's book: just as Star Trek was set in the future in space to make commentary about the present possible, so M*A*S*H was set in the recent past during the Korean War, even though it was pretty obviously about the Vietnam War. One person mentioned how foreign the idea of military medicine is, particularly the fact that working and living happen in the same place--the medical staff never really leave the "hospital," which was also true of the original hospital "residents."

Doogie Howser, MD (4 seasons, 1989-1993) [VHS trailer] and House, M.D. (8 seasons, 2004-2012) [tensions on the team] provided examples of socially inept medical geniuses. Doogie made it look like anyone could practice medicine, but no one practices the kind of shot-gun testing, treat-before-the-results-come-back medicine that House did. These doctors have a lot of privilege and were forgiven many things (being too young, being a misanthropic drug addict with no bedside manner) because they got results.

I included Dr. Quinn, Medicine Woman (6 seasons, 1993-1998) [Season 1 opening] as a positive portrayal of a female physician. Set in Colorado Springs in 1867, the show is at least as much about family and community as it is about historical and rural medicine. Someone pointed out that male doctors' families are rarely thematized as often as female practitioners' are.

Starting just a year later but running three times as long, E.R. (15 seasons, 1994-2009) [I think I'm going to be sick] introduced the era of modern doctor dramas, with complicated, often faulty characters. I thought this clip from the opening of the very first episode was an excellent introduction for soon-to-be interns looking for their own wise Dr. Greene mentors.

Scrubs (9 seasons, 2001-2010) [Double secret decoder ring-wearing doctors!] brought comedy back to the genre. Episodes combined J.D.'s surreal daydreams, spontaneous musical numbers, and slapstick comedy with pointed commentary on adulthood, relationships, and work-life balance that ranged from the wry to the melancholy. Somebody mentioned that for all his sarcastic comments, Dr. Cox does in fact mold the interns into better doctors, who turn around and teach the next generation.

Alas, my classmates were not as excited as I was about the clip from Grey’s Anatomy (12 seasons, 2005- ) [surgeon vs researcher] I showed. There were plenty more representative--and salacious--scenes, but I was curious to hear how fellow MD/PhDs balance their dual identities as confident clinicians and researchers uncertain about what they will find. Mostly we talked about the unethical basis for the show (superior physician pursues an intern) and how it is such a soap opera that viewers never get to see the characters mature as surgeons.

Finally, we didn't have time to discuss The Knick (2 seasons, 2014, 2015)  [Surgery 101] on Friday, but I have led a discussion about the first episode for (mostly) medical students about the kind of medicine it portrayed: another unstable, drug-addicted genius who's forgiven because of his heroics in the operating theater; racism and sexism in American medicine c. 1900; and I think a really touching exchange after a surgery goes badly about the difference between taking responsibility for patients and identifying one's work as one's worth. The clip nicely encapsulates the stereotype of "I'm not a doctor, but I play one on tv," as the actors describe gaining the confidence they had to portray on screen. It was a good segue into the next part of the session, looking at the performance of medical authority by real doctors on tv (e.g. Dr. Oz), celebrity spokespersons (Jenny McCarthy, Angelina Jolie), and direct-to-consumer advertisements (click here for a word from our sponsors).

With thanks to E.D., A.J.M., A.L., I.N., and J.S. for being such good team members!


Saturday, February 13, 2016

What Medical School Looks Like XXVIII

Sometimes medical school looks like my and Dear Husband's collective knowledge weighing down the threshold to my study while the wood glue dries for the next 24 hours. That's 10 of the 11 Durant volumes, a Shakespeare anthology, and textbooks on genetics, anatomy, and physiology.


Thursday, February 11, 2016

Let's Go on a Book Tour!

I noticed the other day that there are books *all over* our house. So I decided to go on a little "book tour" with my camera. These are the books Dear Husband and I are currently reading.

On the sideboard:

Shifting Boundaries of Public Health (2008) is a collection of essays edited by Susan Gross Solomon, Lion Murard & Patrick Zylberman. I am particularly interested in doyen of public health history Dorothy Porter's chapter on "The Social Contract of Health."

Susanne Michl's Im Dienste des Volkskörpers. Deutsche und französische Ärzte im Ersten Weltkrieg (2007) continues the discussion about individual versus collective identity and responsibility for health.

On the living room coffee table:

In Medizin und Krieg. Deutschland 1914-1924 (2014), Wolfgang Eckart compiles a career's worth of secondary literature on medicine before, during, and after World War I. I've stalled in the first chapter.

The other one is a PreTest question book in Pediatrics. I have not been "reading" it as much as I maybe should be.

On my bureau:

I've actually already read Mary Fissell, Vernacular Bodies (2005) and Clio in the Clinic: History in Medical Practice (2004), edited by Jacalyn Duffin; click to read my book review on this blog. On my to-read list is Duffin's Medical Miracles: Doctors, Saints and Healing the Modern World (2008).

On my bedside table:

A friend loaned me Far From The Tree: Parents, Children and the Search for Identity (2012), Andrew Solomon's 700-page award-winning meditation on the joys but mostly the difficulties of raising children who are in some way different from their parents: gay, Deaf, multiply disabled.

For Christmas, my father found me a neat little book edited by Harold Elk Straubing, In Hospital and Camp: The Civil War through the Eyes of its Doctors and Nurses (1993), with letters from medical personnel on both sides of the conflict.

On Dear Husband's nightstand:

Also for Christmas, I gave DH a copy of William Goldman's "abridged" version of The Princess Bride: S. Morgenstern's Classic Tale of True Love and High Adventure (1973). We take turns reading it to each other before (sometimes while) falling asleep at night.

DH has also set himself the task of reading all 11 volumes of Will Durant and Ariel Durant's The Story of Civilization in 11 years. He's got 3 months to read the last 300 pages of Volume XI: The Age of Napoleon (1975).

Tuesday, February 9, 2016

What is the Opposite of Nostalgia?

As graduation and moving approach, I am trying to divest myself of old paper journals, unloved knickknacks, and the detritus of sixteen years of college, graduate, and medical school. Next to my desk I found a thick stack of lined index cards, a handwritten bibliography of figures from German medical history that I compiled from microfiche (microfiche!) about a decade ago, before my first laptop, before the Deutsche Biografie went online, and before the Sächsische Biografie was compiled. Reliant as I am on my computer's search function, I have no nostalgia for the way I would have written my dissertation in the pre-internet age.

Sunday, February 7, 2016

Children's Sermon: Mountaintop Experiences

I traveled so much last semester that I couldn't join the children's sermon roster, so I was pleased to get back in the swing of things on Transfiguration Sunday. I knew the pastor wanted to talk about how mountaintop experiences prepare us for the valleys of life, so I wrote this little message about a one such moment in my life.

Dear Husband was recording the hymns during the service, and he captured the children's sermon too, so you can hear it live by clicking here.

Editor's Note: Other children's sermons have considered the Pentecost/the Tower of Babel and Holy Week.

~ * ~ * ~ * ~ * ~

All right young mountaineers, are you ready for a challenge? I know this mountain looks tall and dangerous, but if we stick together and try our hardest, we can make it to the top. Are you ready to climb this mountain with me? Let’s go! [Have each child hold onto a length of rope, then throw the other end to a helper at the top of the mountain. Huff and puff and struggle to the top.] Phew, that was hard! But we made it! [DH played a triumphant fanfare on the organ here.] The view from the top of this mountain is so beautiful! And look--if you squint, you can see all the way to Indiana from here! [DH told me after the service that we had actually been facing the wrong direction to see Indiana. Oops! Guess the clouds got in my eyes.] Let’s sit down and rest.

There’s a story in the Bible about the time that Jesus took three of his disciples (Peter, James, and John) up to the top of a mountain, where he was “transfigured.” Can you say that? [“Transfigured.”] It’s a fancy word that means changed from within. The Bible says that Jesus’ face “shone like the sun” and that his clothes became pure white. Then Moses and Elijah appeared and talked with Jesus. God’s voice said, “This is my Son the Beloved, with whom I am well pleased. Listen to him!”*

Isn’t that amazing? There was Jesus with two of the Prophets, and God was speaking directly to the disciples! It was such a perfect moment that Peter wanted to just stay there forever. But they couldn’t stay there forever.  If the disciples just sat on the mountaintop and listened to Jesus, then they would never get around to actually doing what Jesus told them to do. What kinds of things do you think Jesus was telling them to do? [Love your neighbor, be kind, help the poor.]

Sometimes we have mountaintop moments, too. Maybe it’s going on retreat to the lakeside, or a time when God’s voice was particularly clear during prayer. Have you ever had a mountaintop experience? [Answers.] Here is a photograph from one of my mountaintop experiences. It was taken at the beginning of my second year of medical school, when I received my white coat. It was a very proud moment and symbolized the responsibility I had to my future patients. Just like the disciples, we can’t stop time and stay on the mountaintop forever. If I had tried to relive this moment over and over again, I never would have gotten around to seeing any patients! We have to get on with our lives. But mountaintop moments refresh our spirits so that we can continue our faith journeys. Photographs like this one remind us of how wonderful the mountaintop experience was and give us renewed energy toward the goal, whether that is creating God’s Kingdom on earth or graduating from medical school.

Sound like a plan? Let’s pray about it: Loving God, thank you for mountaintop moments. Refresh our spirits, so we can serve you. Amen!

Be careful going back down the mountain!

*I used Matthew 17:1-9; the voice says something slightly different in Mark 9:2-8 and Luke 9:28-36, but all agree the disciples were told, "Listen to him!"

Saturday, February 6, 2016

So you're going to a Canada-themed party, eh?

Time for another episode of Cooking with the Doctors! Despite the fact that we have 22 years of post-graduate training, 2.75 masters degrees, and 2.75 doctoral degrees between us, every foray into the kitchen is liable to turn into an adventure, so we advise you to please buckle your seatbelts, keep your arms and legs inside the car, and enjoy the ride!

As I mentioned in an earlier post, at last year's potluck holiday party, I brought store-bought Swedish meatballs. This year's party was "Canada themed" in honor of one of our deans. Googling around for some ideas, I hit upon a kind of Quebecois pork pie called tourtière. It's pronounced something like "tawr-tyehr" with rolled "r"s. It is definitely not pronounced like this automatic pronunciation. (Warning, do not drink anything while listening!) I decided to make one for the party, one for us to eat the next week, and one for a friend who had just had a baby. This is the recipe I used, and these are the steps it took to produce lovely, steaming meat pies.

Step 1--Research ingredients. Unfortunately, our grocery store does not sell green ketchup--they didn't even have canned green tomatoes so I could make my own condiment. I also couldn't find dried savory, which Dear Husband found incredible. "Look next to the ground delicious," he said.

Step 2--Ask the home inspector to please, please, please fix the wiring to the oven that he tripped because the previous owner's father "the electrician" mixed up the line and load so that we can actually bake with it today.

Step 3--The recipe has no instructions for making the crust, so set DH to researching and then preparing three. When he is two cups of flour short of a pie crust, send him to the grocery store.

Step 4--Chop onions finely and celery chunkily. (Narrowly) avoid amputating distal ends of any digits.

Step 5--Run interference with the carpet installers, who still haven't finished the job they supposedly did two days ago.

Step 6--Start heating the oven. Smell the juices in the broiler. Remove broiler pan, spilling the juices. At least both the inspector and the carpet guys have left.

Step 7--Realize the recipe lists the cooking time incorrectly as 55 minutes instead of 1 HOUR and 55 minutes. Turn off the oven.

Step 8--Cook meat, water, veggies, and spices in three large pots on the stove. (Make sure you break the bay leaves in half; I think that activates them.) When tasting the supernatant halfway through after salting, realize they are too peppery. Make mental note for next time to halve the amount of pepper. If there even is a next time.

Step 9--Discover that the recipe as written already suffices for TWO pies. Having tripled the recipe, we made enough filling for SIX pies. Implore DH to make another pie crust. The last batch of meat will have to be divided and frozen since we only "have" four pie plates. (Hi, MIL!)

Step 11--Skip "Step 10--Cool meat mixture," because otherwise will be late to party. Retrieve bay leaves, strain mixture, and fill four pie crusts. Cut appropriate vents in top crust (maple leaf, hockey sticks, shirtless lumberjack). Brush with beaten egg.

Step 12--Bake the first two pies as instructed. Well, almost. Adjust temperature down when you remember. Realize too late that you forgot to stir in the oats during the last 2 minutes of stovetop cooking. Add oats to the pot still on the stove and the two as-yet-topless pies. Top pies and divide extra meat for freezing.

Step 13--Change into your best flannel or hockey jersey, grab the winter hat with the ear flaps, and practice being excruciatingly nice to everyone.

Bon appétite!

There was LOTS of good food at the party. This is my first plate, clockwise from 12 o'clock: tourtière, poutine, cold bean salad, and "Moose Moss in Sauce," a hot broccoli and fried onion dish. There was also nanaimo (aka "Canadian crack," a decadent chocolate brownie thing), maple-glazed bacon, peppermint bark, maple sugar candy, venison guisado, pumpkin cookies, ginger snaps, madeleines, and Tater Tot Hot Dish from Minnesota, which is basically like South Canada, roight?

The tourtière certainly looked impressive, and the crust was lovely and flaky, but I felt that the innards were dry and crumbly, most likely a result of not having been allowed to cool and congeal in a snow bank. (Seriously, that was the recipe writer's instruction!) But surprisingly not too peppery. So it's leaner and maybe healthier but doesn't hang together well. You know what would have helped that? Green ketchup. Sorry aboot that.

Friday, February 5, 2016

What Are You Reading?

Today my guest post on the Illinois Program for Research in the Humanities (IPRH) blog Reading Matters went live. You can find it here. It's a distillation of my reviews of four of the audiobooks I listened to while driving around the eastern United States for residency interviews. You can find the originals below; more are coming!

Terry Pratchett, Going Postal (2004)

Shannon Hale, Austenland (2007)

Walter Mosley, Fortunate Son (2006)

Jon Stewart, Democracy Inaction (2004)

Wednesday, February 3, 2016

We Get By With A Little Help From Our Friends

When Dear Husband and I purchased our house eight years ago, we knew we would have to replace the carpet before we sold it again. It came with a dated, bluish-gray diamond pattern in the front room and hallway, thin brown shag in the two corner bedrooms, and a thin, dirty blue carpet in the middle bedroom that had been the dog's room. We pulled up the blue carpet ourselves and installed a locking hardwood floor for my study and left the rest. This was just as well, because our dearly departed cat Erasmus had a bad habit of retching his orange-colored food (always on the carpet, never on the hard floor). Well, now that we're preparing to sell and move, we went ahead and got the carpet replaced in the front room, hallway, and master bedroom. The carpet place doesn't want to take the responsibility of moving a grand piano, so we had to leave the music room as is.

Very kind friends P.S., B.B., and R.W. helped us pack up and move all the "belongings" from the furniture: the china in the cabinet; the DVDs, VHS tapes, and records; the TV and lamps; the drawers out of the bureaus; and no fewer than 25 books from our bedroom (natch).

Although our realtor had recommended a variegated shag named "Snow Peak" that we thought looked like "wild rice mix" and my mother proclaimed "dirty snow," we opted for a soft, solid shag called "Tassel." It's the middle of three tans that the carpet shop owner dubbed "renting" (darkest), "selling," and "owning" (lightest). We love it--and the new pad underneath--and wish we could have done this sooner.

It hasn't been without its aggravations, however, as it took Dear Husband half an hour to fix the furniture after the subcontracted carpet layers had finished; they forgot to cut the vent in the bedroom (left); and we are still in negotiations with them about putting down the loose threshold from the hallway into the study.

Monday, February 1, 2016

Herdy Gerdy Foomty Boom! [Trans.: I love Swedish Meatballs!]

Last year for a holiday party, I brought store-bought Swedish meatballs: hot and tasty with a minimum of prep. With their creamy gravy sauce, they were a big hit!

Dear Husband craved some this winter, but all he could find at the grocery store were frozen Italian meatballs. We decided to jerry rig the meal, so he got those, and I found a recipe for the appropriate sauce. I did buy a jar of lingonberries just for this purpose, but as for noodles, I simply used what we had in the cupboard, which was bow ties.

Pros: the meal took "just" a busy half an hour to prepare, what with baking the meatballs, boiling the noodles, stirring the sauce, and even throwing together a green salad.

Cons: although I had followed the recipe, the sauce was just too thin for our tastes (even after adding the last 1/4 cup of sour cream in a vain effort to thicken it up a bit). DH suggested adding more flour next time, which I think I'll do.

Børk, børk, børk!
(Click for some original Chef clips "subtitled" in Swedish.)