Hello Classmates
Most of you know today is Veterans Day. We don’t make much noise about it here, so I wanted to raise some awareness and make a request.
At OHSU we have a large, blue building filled with 303 beds just for veterans, and the main road that courses through our campus is a reminder of these special persons in our midst. They come from all walks of life. For the last forty years or so, they have all been volunteers. They almost all begin their service as young, idealistic women and men who desire to serve their fellow citizens in a deeply personal manner. They literally sign their lives away and stand ready to place themselves in harm’s way believing it may be the only means by which we might protect our freedoms, our families, and the ideals that bind us together. They then carry these experiences of sacrifice in their hearts and minds until they lay themselves down for a final rest. They are worthy of our thanks.
Indeed, they are not unlike all of you. They choose to serve others. They hope that they will make a difference in the lives they touch. They press on with courage and honor and a sense of duty knowing that giving our best for the people around us is what makes us unique on this earth. They put hands and bodies into motion for the sake of persons who are weak or hurting, fearful or oppressed.
In that we are all the product of the intentions of those who come before us, and we are currently in a relative state of safety, free to speak our minds, provide well for our loved ones, and gather as good people, please take a moment today to remember the best intentions of our veterans. If you know one, give them a call. If you see one, say ‘thanks’. I’m headed to the VA today to do just that. Maybe I’ll see you there.
Thanks for your thoughts and service,
Paul Reynolds
SOM MS1
Friday, November 12, 2010
Saturday, November 6, 2010
Lifeline
My oldest and best friend has been watching his mother die slowly over the last few years. His Mom has been obese most of her life. Diabetes has stolen her energy, freedom, and eyesight. Each year she is carried to the hospital one more time than the year before. She really didn’t think she would make it to last Christmas. Now she is approaching another.
She has refused all meds but comfort care meds. No more insulin, heart pills, or drugs for hypertension. Just the fentanyl, an antiemetic, and something for acid reflux. She lies in bed and mostly sleeps. She has a bowel movement once a week, or they induce with a suppository. She doesn’t want my friend to clean the mess it makes because she says it affords her some dignity.
I talked to my friend last night. He said he was exhausted. He said he was more tired than he can ever remember being. He said he knew what it was going to be like when she died, but I wondered how anyone could know. He hoped for the best goodbye possible and some quality moments in her final days. I wondered how he would live in the vacuum that would exist after she is gone. He seemed to distract himself with the busy-ness and final details of death. I wondered when the moment would come for him to stop and come to grips with what was happening, ask himself how he fit into two lives that were such a part of one another.
He worried about her when she was in the assisted living apartment and spent most of his time there when she was ill with an infection or a complication of her condition. His sister died a few years back from an overdose. His brother is in town but has only dropped by once last week to see his Mom because they thought it was the end. His Mom and Dad have been divorced for over 20 years. His Dad is in town, but he doesn’t come by to see the grand-kids much.
She got out of the hospital a couple of weeks ago for a drug-resistant infection. The doctors thought she was going to die because she had stopped her meds, so they allowed her to move into a hospice facility. A day or so after she got there, her condition improved. The pain meds seem to lower her blood pressure, and she began to be more alert for more hours of the day. The doctors said she would have to move out of the hospice facility. In the state where they live, you only have five days to die.
If she doesn’t die fast enough, my friend will have to move her from hospice to his one-bedroom apartment. She will stay in the living room. He will have to get her hospital bed back out of storage and get it over to his place. He says at least he can sleep at night because he can check on her easily and not have to travel to her old place and spend the night in a chair.
The way we live affects the way we die. Our culture and society, the choices we make, and the hand we were first dealt all impact our dying. My friend hasn’t been a saint by any means, but he keeps trying to be the best person he can. He has been obese for many years and wants to get his weight down to something manageable. His wife is divorcing him after 20 years. It should be finalized this month. He’s in between jobs. He has three daughters. The oldest will be out of high school next year. I wonder how he will die, and who will be there to take care of him. I hope it’s me.
Before our parents die, we grieve knowing we will miss them. When they die, we have to experience it. We remember how we’ve lived our lives. We ponder what these people who’ve cared so much about us may have wanted for us - and maybe from us. We realize that in the same way we hope for our children, they hoped for us. Death certainly provides perspective.
She has refused all meds but comfort care meds. No more insulin, heart pills, or drugs for hypertension. Just the fentanyl, an antiemetic, and something for acid reflux. She lies in bed and mostly sleeps. She has a bowel movement once a week, or they induce with a suppository. She doesn’t want my friend to clean the mess it makes because she says it affords her some dignity.
I talked to my friend last night. He said he was exhausted. He said he was more tired than he can ever remember being. He said he knew what it was going to be like when she died, but I wondered how anyone could know. He hoped for the best goodbye possible and some quality moments in her final days. I wondered how he would live in the vacuum that would exist after she is gone. He seemed to distract himself with the busy-ness and final details of death. I wondered when the moment would come for him to stop and come to grips with what was happening, ask himself how he fit into two lives that were such a part of one another.
He worried about her when she was in the assisted living apartment and spent most of his time there when she was ill with an infection or a complication of her condition. His sister died a few years back from an overdose. His brother is in town but has only dropped by once last week to see his Mom because they thought it was the end. His Mom and Dad have been divorced for over 20 years. His Dad is in town, but he doesn’t come by to see the grand-kids much.
She got out of the hospital a couple of weeks ago for a drug-resistant infection. The doctors thought she was going to die because she had stopped her meds, so they allowed her to move into a hospice facility. A day or so after she got there, her condition improved. The pain meds seem to lower her blood pressure, and she began to be more alert for more hours of the day. The doctors said she would have to move out of the hospice facility. In the state where they live, you only have five days to die.
If she doesn’t die fast enough, my friend will have to move her from hospice to his one-bedroom apartment. She will stay in the living room. He will have to get her hospital bed back out of storage and get it over to his place. He says at least he can sleep at night because he can check on her easily and not have to travel to her old place and spend the night in a chair.
The way we live affects the way we die. Our culture and society, the choices we make, and the hand we were first dealt all impact our dying. My friend hasn’t been a saint by any means, but he keeps trying to be the best person he can. He has been obese for many years and wants to get his weight down to something manageable. His wife is divorcing him after 20 years. It should be finalized this month. He’s in between jobs. He has three daughters. The oldest will be out of high school next year. I wonder how he will die, and who will be there to take care of him. I hope it’s me.
Before our parents die, we grieve knowing we will miss them. When they die, we have to experience it. We remember how we’ve lived our lives. We ponder what these people who’ve cared so much about us may have wanted for us - and maybe from us. We realize that in the same way we hope for our children, they hoped for us. Death certainly provides perspective.
Saturday, October 30, 2010
Time machine dream
Oooo, I'm a bit groggy. Just got up. I woke up this morning thinking abut the advances medicine has made over the last 40 or 50 years. I imagined what it would have been like to treat a small boy my age when I was growing up in the early sixties and what it will be like to treat a small boy like me 50 years later. I will soon be tending to someone like me.
I think of research I've recently read and the things we knew back in the day. Every once in a while I'll come across articles from the 70's and the 80's and the 90's and then the post-century mark. And, of course, even after I'm out of school, I'll be studying articles in 2014 and beyond. I remember even in high school - in the advanced biology class I took - how we really didn't even understand mitosis, and now every molecule has a function and a name. We understand how alkylation affects genetic outcomes, and the entire genome has been sequenced. We know which parts of that genome are common to us all and which parts contain the variation that makes us so unique. We're beginning to home in on the genetic source of so many differences between us and so many causes of disruption in our phenotypic lives.
So, I'm reminded again of the incredible gift of being able to have this second life, if it's not a second chance at this life. With new clear sinuses, good sleep, exercise, and good food, I feel like I can live this long again. It feels like it might just be glorious.
I think of research I've recently read and the things we knew back in the day. Every once in a while I'll come across articles from the 70's and the 80's and the 90's and then the post-century mark. And, of course, even after I'm out of school, I'll be studying articles in 2014 and beyond. I remember even in high school - in the advanced biology class I took - how we really didn't even understand mitosis, and now every molecule has a function and a name. We understand how alkylation affects genetic outcomes, and the entire genome has been sequenced. We know which parts of that genome are common to us all and which parts contain the variation that makes us so unique. We're beginning to home in on the genetic source of so many differences between us and so many causes of disruption in our phenotypic lives.
So, I'm reminded again of the incredible gift of being able to have this second life, if it's not a second chance at this life. With new clear sinuses, good sleep, exercise, and good food, I feel like I can live this long again. It feels like it might just be glorious.
Thursday, October 28, 2010
Hey... great idea! Except...
Got an email today advising students that a new blog forum had been created on OHSU's website. It will record the experiences, ideas, and opinions of 5 selected, representative students at the med school and in a couple of PhD programs. Figured it was worthy of a post here.
All I can say is, "Nice job."
For all of the reasons I've written and about and many more, I think this is a great way to chronicle med student life and lend insight to inquiring prospects. I look forward to posts they create and wish them all great success.
Currently, there's a bit of a problem, however... You have to have an OHSU username and password to access the site. No access for outside folks who would like to see what student life at OHSU is like... The email says it will be opened up "externally" at some point. I think that will make it much more useful. Hope it happens.
If you have the login codes, you can access it here.
All I can say is, "Nice job."
For all of the reasons I've written and about and many more, I think this is a great way to chronicle med student life and lend insight to inquiring prospects. I look forward to posts they create and wish them all great success.
Currently, there's a bit of a problem, however... You have to have an OHSU username and password to access the site. No access for outside folks who would like to see what student life at OHSU is like... The email says it will be opened up "externally" at some point. I think that will make it much more useful. Hope it happens.
If you have the login codes, you can access it here.
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