Stages of Dying

I recently came across the following poem by Dr Tim Metcalf (Poet and Part-Time GP from Australia) and thought I should share it with you guys. It is taken from 'Verbal Medicine: 21 Contemporary Clinician-Poets of Australia and New Zealand'; Ginninderra Press Canberra; Metcalf T (ed.) (2006) which earned him an 'ACT Writing and Publishing Award (Poetry)' in 2007:

STAGES OF DYING (after Elisabeth Kubler-Ross)
Tim Metcalf

Denial

In anatomy class
we cut textbook lines
into the dull clay of our body.
We shook dismembered hands,
and bragged of cricket with arms and balls
for a joke.
We washed the formalin from our hands
for the next two days.

Shock

A pregnant girl collapsed.
The scalpel cut quick and deep.
Her grey belly peeled apart.
The monitors ticked:
a mechanical requiem.
White gloves pulled out the baby
cold and dead like the streets
I wandered half that night.

Guilt

As an intern
I was anxious, and obedient.
To cure at all costs
was the boss’ creed.
I had no time for the old woman
we made betray her faith.
Soon after the transfusion
she died of cancer.

Anger

Some drunken bastard
hit this woman with his car.
Her young breasts quivered
each time we thumped her chest.
Over half an hour
her face, burned alive,
set cold, branding for life
the mind of her child.

Sorrow

Was it happy, his final memory?
This poor bloke, purple-faced
and next in line for death?
I was naive, yesterday,
regarding his broken heart.
Today it wouldn’t go anymore.
Tonight I was drunk.
There were tears, briefly.

Acceptance

I went to see an elder on his beach up north.
He didn’t say much.
There was this sky-blue dreaming;
the ocean its lucent mirror,
flawless like an egg.
I heard he died around sunset.
That night a warm breeze blew
the soothing tune of the sea

Posted with the kind permission of Dr Tim Metcalf. You can read more of Dr Metcalf's work at http://www.softblow.com/timmetcalf.html

Social networking meets health care

New Scientist has picked up on the popularity of a networking site called patientslikeme. This is more than an information-sharing site, it encourages patients to record their symptoms and responses to treatment regimes on a regular basis. There is a star-based incentive programme for patients to keep their information up to date. The site makes money, not from advertising revenue, but from aggregating, anonymising and selling on the data to 'life science companies for treatments' (is that a euphemism for pharmaceutical companies?).

For the site to work, it means that patients have to forgo their privacy. The site encourages 'an openness philosophy'. Of course, you can still use a 'handle' instead of your real name, but many members upload photographs and make an extraordinary amount of information available. A bot like Facebook's live streaming, members with mood disorders can record 'instant mood', as well as a detailed breakdown of symptoms which are all plotted graphically. Check out Zephyr_Marie's profile as an example of how much information is available.

With rumours that DIPEx (a UK based website of interviews with patients) is going to become subscription-only, patientslikeme is potentially groundbreaking. It challenges a longstanding assumption that people are less likely to be 'honest' on the web. The site currently has 11850 members and covers ALS/Motor Neuron Disease, Anxiety, Bipolar, Depression, HIV/AIDS, Multiple Sclerosis, OCD (Obsessive-Compulsive Disorder), Parkinson's disease, and PTSD (Post-Traumatic Stress Disorder).

Although the numerical data is publicly available, but you have to be a member to access the patients' stories (on the forums). By foregrounding the data aspects, it tells only one, very medicalised, version of the patient experience. It's an interesting experiment though, and worth watching to see if it does herald a seachange in the attitude to patient confidentiality and medical data.

Do the arts make you a better doctor?

There is a great discussion going on the BMJ blog on the value of the arts to medicine.

Art and Medicine event

The Royal Society of Medicine is hosting a talk on Art and Medicine directed at Students and Trainees this coming Friday 9th of May. It looks like a really interesting programme.

Entry is 5 pounds for non-members and includes 3 short talks, tea and coffee, a wine reception and art exhibition.