Published by Jennifer Lycette, MD on May 18, 2021

Recently, one of my clinic patients asked me to administer his intramuscular medication injection. I appreciated the vote of confidence but had to tell him he was mistaken in thinking that my skill would surpass that of our nurses’.

“Trust me,” I told him. “You’re in better hands with them.”

It reminded me of the time, some years back, when I inadvertently found myself “impersonating” a nurse for a school field trip. And soon found myself in way over my head.

Years ago, our family was new in town. When my child’s teacher found out I worked in health care, she asked if I would help out on the three-day, out-of-town, multi-class field trip. …

Before COVID-19, I left the practice of medicine for what would turn out to become an entire year. Then, the pandemic happened, and I found my way back to clinical practice. During that time away from medicine, I discovered five things that transformed my life and practice. With the guidance of a life coach, intensive reading, and exploration of literature, I found a new way of seeing our hearts and bodies as humans in the medical profession. Here are five lessons I learned, in the hope that they might help others.

Perfectionism Doesn’t Make You Perfect

If perfectionism isn’t an unwritten rule in our profession…

Here’s my curated list of top 5 articles on burnout for this week, with a theme: the EHR (electronic health record).

1. Physician Burnout: Are Too Many Patients Making Doctors Sick?

by Joe Harpaz

In this Forbes article, the author explains the burden of administrative (non-clinical) tasks that contribute to burnout. “Physicians don’t hate technology … what they hate is bad technology. “

One example: many (if not most) EHR (electronic health record) systems were designed for primary care. But a specialist using an EHR designed “for a primary care physician would be akin to a server at a restaurant attempting to place a food order on a system meant for retail applications. Screens and questions might be out of order and fields for documenting patient responses may be missing or require shorthand when a symptom or billing code…

Spoiler Alert: Contains minor spoilers for the memoir “Educated” by Tara Westover

“You seem very angry,” I say to my patient.

It’s a basic technique in our physician tool chest, but I’d forgotten to try it — reflection.

He hesitates. Surprise crosses his face. “I am,” he says. “But not at you.”

I allow the space of silence, not sure which direction the conversation will go next.

After a moment, he elaborates further. He talks more than he has at any other visit.

He shares his deep-seated mistrust of doctors. His belief of Internet rumors — including the ones about governments and pharmaceutical companies that have the cure for cancer, hidden away, but will never share it with the common man.

“But I don’t think that about you,” he says.

Well, thanks, I guess.

But how should I…

In a recent talk I gave for colleagues, I ventured outside the box.

I searched for a metaphor to make cancer treatments easy to understand. Around the same time, it so happened my kids decided we needed to re-watch all of The Avengers movies at home. (in order — of course).

Here’s where you get some insight into an oncologist-mom’s brain. While we watched the movies, another part of my brain cogitated on my upcoming talk, and a light-bulb went off.

I could use an Avengers’ character to illustrate each type of cancer treatment.

I was super excited about this idea.

Well…I’m not sure academic medicine was ready for “Oncology 101” given Avengers-style…

Happy week of International Women’s Day 2019 (IWD2019)!

In the spirit of this year’s IWD2019 theme, #BalanceforBetter, I pulled together this collection of posts from and about women in medicine. I hope you will draw inspiration from them for your own lives and practices.

1. Being a Woman, by Dr. Anne Malatt

An uplifting reflection on our lives as women and physicians.

Excerpt:

In medicine, I am seen as a woman at times when it suits some agendas, and not seen as a woman when it does not suit. But no matter what veils I am seen through, I am and remain a woman. Being a woman does not define me, any more than being a wife, a mother, or a doctor does. But being a woman has affected me.

excerpt from Being a Woman, by Dr. …

In celebration of Valentine’s Day this week, it seemed fitting to put together a post on the concept of love in medicine. Only…there’s not many of us out there writing on the topic. After a google search of “love in medicine” and “love and doctoring”, I found the following three posts, and have included one of my own at the end. I included an excerpt from each piece, but encourage you to link back to each original piece and read it in its entirety. I hope they will inspire you to celebrate, and re-discover, the importance of love in medicine.

1. The Foundation of Medicine is Love

I came across this tool, the 55-word story, when I researched my recent post on narrative medicine. I liked it so much, I made this blog post all about it.

In From Doctors’ Stories to Doctors’ Stories, and Back Again by Marcia Day Childress, PhD, in the AMA Journal of Ethics, the author explains how we can all accomplish and benefit from writing a “55-word story,” as follows:

…the 55-word story is a powerful tool for busy clinicians’ reflective writing… As a literary form, it is simple. As an assignment, it may or may not be written to a prompt…

There are small moments of reflection that pop up in any given day that can affect how we approach our practice of medicine.

Something at home affecting us at work, or vice versa.

Like a Venn diagram, the two circles overlapping by just that slight amount at the center. One such recent intersection for me occurred during an unexpected moment — the mundane household task of doing the laundry.

It was a weekend, of course, or I wouldn’t have been home. I loaded the dirty clothes into the washer and reached up to the shelf for the detergent, when something new drew my focus.

Something that didn’t belong.

A sentence, written on the front…

When I first turned to writing, I had no knowledge of the field of Narrative Medicine.

It took 4 years of medical school, 3 years of residency, 3 years of subspecialty fellowship, and over a decade in practice before I learned of it. (that’s 20-plus years for those counting).

Throughout, I’ve struggled to hold fast to my core belief that the key to patient care is to allow the telling of, and make the space to listen to, the stories underlying the disease.

Turns out, that’s what narrative medicine is all about.

As stated on the Columbia University Narrative Medicine website,

“The care of the sick unfolds in stories…Medicine…

Jennifer Lycette, M.D.

Physician/writer. Essayist, published in NEJM, JAMA, JAMA Oncology, Journal of Clinical Oncology, and The ASCO Post. Doximity Op-Med Fellow.

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