It is the duty of a doctor to prolong life. It is not his duty to prolong the act of dying.
Linda Alterwitz - While I Am Still: In-Sight, 2012
“In these photographs, images of the human body derived from medical PET scans are woven with landscapes and with images of fabrics, revealing ethereal figures in a raw and vulnerable state. The mind, wrestling with sadness, fear, and hope, retreats to a safe refuge. Alterwitz brings insight and awareness to the struggle and the resulting withdrawal of the inner mind. What remains is the unearthed soul desperately searching for a place of sanctuary.”
While medicine is to be your vocation or calling, see to it that you have also an avocation—some intellectual pastime which may serve to keep you in touch with the world of art, of science, or of letters […] No matter what it is, have an outside hobby.
ADHD is a fictitious disease
Remember, there are two ways drug companies can make money:
- Invent new drugs
- Invent new diseases already invented drugs can treat
In the past decade or so, Big Pharma has created less than 10 new novel drugs per year.
As an example of Big Pharma inventing diseases is “short, normal” children. We can treat “short, normal” kids with human growth hormone and make them “normal.” For parents who want tall or “normal-sized” children, they can inject their kids with growth hormone on a regular basis. When I worked with Nader at his group, Public Citizen, in 2006, I wrote a petition to the FDA to ban human growth hormone on the newly approved disease, “short, normal” children because we identified about 10 reported cases of “short, normal” children who had died from complications of receiving human growth hormone.
Too many people tell me that they suffer from ADHD when, to me, they suffer from the consequence of bad design. Are you familiar with the Social construct theory of ADHD?:
Psychiatrists Peter Breggin and Sami Timimi oppose pathologizing the symptoms of ADHD. Sami Timimi, who is an NHS child and adolescent psychiatrist, explains ADHD as a social construct rather than an objective ‘disorder’. Timimi argues that western society creates stress on families which in turn suggests environmental causes for children expressing the symptoms of ADHD. They also believe that parents who feel they have failed in their parenting responsibilities can use the ADHD label to absolve guilt and self-blame. A common argument against the medical model of ADHD asserts that while the traits that define ADHD exist and may be measurable, they lie within the spectrum of normal healthy human behaviour and are not dysfunctional. However, by definition, in order to diagnose with a mental disorder, symptoms must be interpreted as causing a person distress / espec. maladaptive. In America, the Diagnostic and Statistical Manual (DSM-IV) requires that “some impairment from the symptoms is present in two or more settings” and that “there must be clear evidence of significant impairment in social, school, or work functioning” for a diagnosis of ADHD to be made.
So doc, be honest with me. Can I make a long or short bucket list?
The way I see it, the standards and recommendations of practice change from year to year, decade to decade. What does not change is the art of medicine, the ability to build a relationship with your patients.
If you can take away that from your training, you will do fine. The rest you can look up and read.
The challenge of creating a palliative care program
- It’s not like I saved his life.
- No, you did something most doctors have forgotten how to do. You saved his death.
The fact that you are willing to admit that you do not know and that the amount of knowledge you still do not have scares you already shows me that you will make a great doctor. It is not a weakness.