Bambi Syndrome

Life changes in a heartbeat.

In the “Events of the Cardiac Cycle” lab, four students are assigned to each dog. Instructions: Inject the live dog with epinephrine and study the EKG. Sever cardiac nerves. Carve open the chest and shock the heart. As the dog’s blood pressure drops, remove the heart. Now, stab the aorta with a scissor blade and slice open the ventricle. Check for heartworms. Bag the carcass, and clean your instruments and work station.

To be a healer, I’m being forced to kill. But murder is not part of my curriculum. So I sign the papers to drop out of medical school. But I can’t leave. With an apartment full of pets, no money for a U-Haul, and no clear destination, I’m unable to garner sympathy—even from my parents. My anatomy partner advises, “Just keep taking tests until you figure out what you want to do.”

At age twenty-two, I decide to fight for my life. In a petition, I state my personal intention not to kill, and circulate the petition to classmates. From among the 189 students, three share my moral objections and sign on. I circulate a second petition for others to support our right to opt out of animal labs, but no classmates sign due to “fear of being blacklisted from residencies.”

Then I send a letter to the physiology director stating that “I will not participate in animal experiments.”

“These are not animal experiments,” he responds. “They are experiences. Attendance is mandatory. You are assigned to Team 11B. An unexcused absence will compromise your teammates’ education and prevent your matriculation into the clinical core.”

So I forward my petition to the dean of medicine, who requires that I meet with him. I enter his office and sit in a large mahogany chair across from the sixty-year-old physician.

I begin with a personal statement of my values and priorities: “I am vegan. I do not eat or wear animal products. I am morally opposed to injur- ing animals and will not participate in these labs.”

He stares at me quizzically. Then—with an authoritarian, yet paternal, even loving tone—he diagnoses me with “Bambi Syndrome” and grants my exemption. I’m relieved that I will not have to kill a dog to become a doctor.

My relief is short-lived. The next week, while studying, I see a cart full of dogs wagging their tails. As they pass by my classroom, I panic. My vision narrows and blurs. My heart is racing and I feel like I’m going to faint.

An hour later, classmates emerge splattered with blood. Men boast of their conquests. Bags overflow with carcasses—man’s best friend slaughtered in cold blood.

Walking home, I’m crying not only for the loss of our innocent, ever- faithful friends, but also for my classmates, methodically dehumanized right in front of me.

I cry myself to sleep holding my dog, Happy. The next morning, it’s impossible to return to class. With swollen eyelids, completely sealed shut, I can no longer bear to see the brutality.

Nearing graduation, we’re all so excited. While completing residency applications, fellow classmates beg me to write their personal statements for them.

“But a personal statement is personal,” I say. “How could I possibly write your personal statement?” In the end, my classmates are blacklisted, not from their residencies, but from their own identities. Medical education too often robs us of our souls, ourselves—our very humanity.

Bambi Syndrome saved my life. I’ve never been so happy to be diagnosed with a disease.

HappyMe eBook6in copy

Pamela Wible, M.D., is a family physician and founder of the ideal medical care movement. Watch her TEDx talk on ideal care. Excerpt from chapter 41 of Pet Goats & Pap Smears.

8 Comments

***

The *Surprise* Birthday Party Physical :)

I love my patients. And I love surprises. Most patients fear unexpected medical events, but medical surprises don’t always have to be bad news.

I’m a neighborhood family doc. My patients are friends. They celebrate my milestones and I celebrate theirs. A few like to surprise me for my birthday. So when Rachel scheduled her physical a few days before her birthday, I didn’t miss the opportunity.

I called her friends and family (most are patients) and told them to arrive with gifts by 3:30 and hide in the exam room.  At 4:00 pm Rachel sat unsuspecting in the waiting room. I brought her back for the usual pre-physical interval history and girlfriend chat (yes, I DO need to know everyone she’s been dating in the last year!). Before she revealed all her romantic escapades, I guided her back to the exam room where everyone jumped up from behind the exam table, screamed, blew bubbles and party horns, and basically scared the crap out of her!

_GVE7277_GVE7285_GVE7280_GVE7289_GVE7313_GVE7314_GVE7271

And if you still don’t believe it’s possible for a doctor to throw a surprise birthday during a physical exam -> WATCH THIS!

So did she allow all of us in on her physical? Nope. She cut her appointment short and asked us to take her out for drinks.

Just another day in the life of a family doctor. :)

Pamela Wible, M.D., is a family physician in Oregon. She pioneered the first medical clinic designed by patients. Watch her TEDx talk “How to get naked with your doctor.” Photos and video by GeVe.

Leave a comment

***

Doctors not allowed to ask patients, “How are you?”

Medical Insanity

Another indication that health care is sick—doctors are being told to stop asking patients open-ended questions like:

“How are you feeling?”

“What worries you?”

“What’s on your mind?”

Today a physician just e-mailed me:

“I am really, really overwhelmed right now.  What happened to me at work this week was grim, even before our dreaded production meeting.  I can feel tears welling up. Reason:  Many times I have tried to incorporate friendly pick-me-ups like a smile, a handshake, a ‘thank you for coming in to see me today,’ an ‘it was wonderful to see you today’ at the end of patient visits. My standard opening line has always been some version of ‘What brings you in today?’ I’ve always felt a source of pride that I can ask open-ended questions and still get to the bottom of most issues in a short visit. My production meeting yesterday pretty much squashed all those niceties out the door.

We are now to be double-booked [two patients per appointment slot] to ‘make our production quotas.’ Our regional director (not a doctor) reinforced the decision by our medical director (an MD under the thumb of the regional director) that we are NOT to ask open-ended questions in our visits but to let the medical assistants who room the patients identify the SINGLE issue that they are coming in for and THAT’S IT.  So we basically need to shut down to whisk them through the door.

You know as well as I do how ridiculous and futile that is and how fast care like this destroys what’s left of the therapeutic relationship. I now have to figure out a way to work even faster while still being caring and compassionate.  I am in a really shitty position.”

My plea to doctors: please stop taking this shit.

Pamela Wible, M.D., is a family physician and founder of the ideal medical care movement. Watch her TEDx talk on ideal care. If you’re a doctor, join the physician teleseminar and learn how you can stop suffering and start practicing real medicine. Photo by GeVe.

19 Comments

***

Top 10 ways to know it’s time to quit your job

QUIT

Attention all doctors: The first three are mine. The rest are from miserable colleagues. All true. And common. If you’re a doctor and you recognize anything on this list, please quit your job.

10. You feel nauseated when you see your clinic logo; you alter your commute to avoid streets with your clinic’s billboard.

9. Discouraged by the general despair among staff, you try to be joyful. Then you’re reprimanded by the clinic manager for being “excessively happy.”

8. You dream of leaving medicine to work as a waitress.

7. You envy your sickest patients and/or you develop a perverse pleasure in your patients’ pain.

6. You pray you will be diagnosed with cancer so you can get some time to sleep.

5. You spend your nights trying to keep patients alive while you imagine ways to die by suicide.

4. You work 16-24-hour shifts and have not had sex with your spouse in months.

3. You’re a top-rated doctor, yet you daydream about walking into traffic, jumping through the window, or just dying in the course of a normal day.

2. You are counting down the days until retirement during patient appointments.

1. You change your computer password to “fuck [name of hospital where you work]!!!”

Pamela Wible, M.D., is a family physician and founder of the ideal medical care movement. Watch her TEDx talk on ideal care. If you’re a doctor, join the physician teleseminar and learn how you can stop suffering and start practicing real medicine. Photo by GeVe.

32 Comments

***

Drop doctorspeak & get real with patients

If you’re a doctor, I bet you speak doctorly. You act doctorly. And dress doctorly. And spend your days in clinic with other doctorly doctors.

But life is what happens while you’re busy staring at computerized flow sheets, algorithms, and billing codes.

Real life happens outside of man-made medical institutions. Patients live in the real world. And I always wanted be a real doctor—a doctor who specializes in being real with real people meeting them where they really live and work and play.

So last week, I left my office to treat people on the streets. Over 6000 patients. For free.

Beside a row of port-o-potties, I volunteered my services to those in need. Some required medical care. Others just psychological support. All received a smile. Many left laughing.

I live in Eugene, Oregon—The birthplace of running. TrackTown USA. America’s premier summer marathon runs right in front of my house.

Unfortunately being too healthy can be hazardous to your health. There are medical ailments unique to long-distance runners. Chiefly: chafing. Thighs, armpits, and yes, nipples. After miles of shirt friction, even the toughest nipples get torn up. Bras protect women. But look at these bloody nipples on men.

The proper medical term: marathoners thelorrhagia. But medical jargon often creates fear and confusion, so I use normal words anyone can understand. Plus I made a sign:

_GVE5996-YES-2

How should guys protect their nips?  Some use duct tape or bandaids. Others go topless. A few wear sports bras. Here’s another solution:

_GVE5998-YES-3

I got out on the streets at 5:00 am.  Even brought my boyfriend’s daughter—an avid athletic supporter:

_GVE6034-MAYBE-4

And recruited a man on the sidelines to cheer with me:

_GVE6938-YES-5

I know what you’re thinking: “Did anyone really take her up on this?”

_GVE6583-YES-6

Well, one guy yelled, “Too early. It’s only mile 3.”

“I got bandaids,” another dude announced as he pounded his chest.

A husband said, “No thanks,” until his wife interjected, “Yes, we’ll take some!” I squirted a glop on her palm; she applied the goo to his nips as he ran away from me.

When I posted these pics on Facebook, a friend replied, “You’ve out-weirded me, Pamela.”

“Hey, I didn’t make this nipple thing up just to be rubbing runners’ nipples.”

Doctor means teacher. The best teachers make learning fun. Mission accomplished.

Watch how one doctor can prevent 12,000 bloody nipples from 17 countries in one hour:

Pamela Wible, M.D., is a family physician in Oregon. She pioneered the first medical clinic designed by patients. Watch her TEDx talk “How to get naked with your doctor.” Photos and video by GeVe.

5 Comments

***

Wow! Man discovers simple way to prevent suicide

While I struggle to prevent physician suicide. I discover a man who didn’t seem to struggle at all. With no training in suicide prevention, no training in mental heath, and no medical background, one man saved hundreds of souls from suicide.

Meet Don Ritchie.

He lived beside a popular suicide spot. A life insurance salesman by day, Don sold life to the suffering by night. For 50 years, he coaxed 100s from the cliff’s edge.

How?

He gently asked: “Can I help you in some way?” With a warm smile, he’d offer a cup of hot tea. And invite them over for a chat. Before he died, Don urged others: “Never be afraid to speak to those in most need.”

I have a huge collection of teas. If anyone wants to hang out, call me: 541-345-2437.

A cup of hot tea = the solution to suicide.

Thanks to this man:

dNM201G

Watch video of Don Ritchie. Watch another video of Don Ritchie. Photo credit by Salute to Don Ritchie.

Pamela Wible, M.D., is a family physician obsessed with preventing despair, depression, and suicide among medical students and physicians. She’s so inspired by Don Ritchie!

3 Comments

***