Confessions of a Ballerunner

Essays on Sports, Arts, Culture, and Life

Archive for the tag “healthcare”

Cartoon: Health messaging is all around us

Crowded subway screening messages cartoon_color2

Everywhere we look, we are bombarded with health messages, usually across a variety of media platforms. How to prevent disease. How to treat disease. These days, a person has to be able to think critically not just about the message being transmitted (i.e., Is it credible? Does it apply to my personal circumstances?), but also about the messenger transmitting the message (i.e., Is the information from a trusted source? Are there any conflicts of interest or external motivations that may be influencing the message?). In an age of such complexity, it has never been more important to educate ourselves about health and healthy living. We need to become critical thinkers, so that we can appraise the messages and the messengers. There’s a lot of health information out there – too much to stay on top of by ourselves. That’s why we also need to identify trusted curators of health information, who can help us sort through all the noise to find the signal.

An excellent, plain language resource to start educating oneself about health messages is the free, open-source book by Woloshin, Schwartz, and Welch called Know Your Chances.

The Great Re-Set: Part 2 – A brand new job in a brand new city…

Moving to Ottawa wasn’t exactly love at first sight for me. It was definitely no Montreal (downtown Ottawa practically becomes a ghost town after 5:00 pm) and as for being a national capital, it felt more like a small town masquerading as a big city. But my initial reasons for moving to Ottawa were more strategic than the job for which I was recruited: I was conveniently located between Montreal and Toronto, where friends and family resided and where some of the most innovative medical/health research in Canada takes place…

I was also on a high from having just returned from one of the best trips I’d ever done to this point: a weeklong visit with my little sister who was living in Calgary at the time. It was my first visit to Calgary, and we ended up doing this fabulous road trip through Banff, Lake Louise, and Jasper. I was just in awe of the Rockie Mountains, glaciers, pristine emerald lakes, and lush forests. This was the type of scenery of my imagination — what I had always idealized as distinctly Canadian. On a par with the Canadian Shield. Both landscapes immortalized by members of the Group of Seven.

[Photo taken near Moraine Lake in Banff National Park, October 2008.]

Speaking of the Group of Seven, if you’re a fan — particularly of Tom Thomson — you must see the Canadian film, West Wind – The Vision of Tom Thomson. I saw it a couple of weeks ago and loved it. I found it particularly (and unexpectedly) moving seeing and hearing about Thomson’s singular focus, his passion — his creative calling or vocation — to paint (in this case, nature in all its colorful, seasonal splendor in Algonquin Park). There are even some previously unseen paintings on display. Lots of great commentary by various curators and experts in art history, too. (I first fell in love with the Group of Seven at the 2003 exhibit held at the National Gallery of Canada. After that, I just couldn’t understand why my grade 12 art teacher always used to diss these guys’ works… What resonates as great art can be so subjective, I guess.) Another more contemporary Canadian landscape artist, whose works could be thought of as a modern take on the Group of Seven style (as seen through stained glass), is Tim Packer (a former cop turned full-time artist, which is a pretty cool and interesting career change). I tried to pick up a small, limited edition framed giclée print downtown last month, but I missed out 😦  — I’m sure because of a story that ran in the Ottawa Citizen promoting an upcoming exhibition of his work.

Getting back to my move to Ottawa…

I had to initially live in a downtown hotel for about a month and a half, which sounds posh, but it wasn’t really. (It wasn’t that kind of hotel.) It may be hard to believe, but hotel living can actually get pretty frustrating and tiresome after a while. It’s not really your home; you’re just squatting there temporarily. Finding an apartment in Ottawa was tough, though, especially in late fall. The housing/rental market was and continues to be very tight, and I refuse to live in a condo box. I need my space and connection with the outdoors — just not in suburbia. Eventually, I found a first-floor flat in a triplex in a vibrant, eclectic, urban neighborhood close to the canal and to the downtown. I moved in to my new digs on a snowy day in December, which would herald the start of the coldest winter I can ever remember experiencing — and I generally like winter with all its snow and cold (just not regular temps of -30 C!?)… I had seriously thought I’d been dropped off in Nunavut, not Ottawa. Ottawa is apparently one of the world’s coldest national capitals. I suspect that infamous distinction could be changing, however, with the milder winters of late along with the sizzling summers we regularly get. Ottawa is definitely a city of extremes, including of extreme athletes…

[Picture of typical architectural style of many triplexes in my neighborhood with wild, often overgrown gardens, Summer 2009]

So my new job… Let’s just say it was an adjustment, having never worked in government and not being a willing conformist by nature. I also had to learn Bureaucratese, a language with which I was previously unfamiliar. (Check out this playful video for a sample of the third most common language spoken in Ottawa: http://www.youtube.com/embed/OtLL7pLM-yE) I wouldn’t say I’m fluent or a regular speaker of the lingo now, but I have developed conversational proficiency (out of need).

The work I do is far from a perfect fit, but I wouldn’t have necessarily known that going in. I’ve learned that, like my entrepreneurial dad, I don’t like to be told what to do and how to do it. Nor do I like a lot of rules or meetings for rules’ or meetings’ sake. Or hierarchy. I was also somewhat surprised to find out that I don’t love technical writing or sifting through ginormous amounts of data either… And, I’ve discovered, I actually prefer not to multi-task, at least on things that require a lot of thinking; it just takes too long to refocus when you’re constantly interrupted and having to shift gears…

So, I guess as much as I enjoyed working in a hospital emergency department in a previous job a few months before, I probably wouldn’t have made the best ER doc, had I pursued a career in Medicine. I don’t have high idea productivity (I have quality but not quantity) and I like to stay focused on the task at hand (where the ER can be Grand Central Station) — unless it’s mindless stuff and then I can develop situational ADHD. I can’t picture things in 3-D very well (definitely a problem for performing invasive procedures), and my biggest shortcoming, arguably making someone like me incompatible with ER medicine, aside from my strong aversion to the smell of vomit — I am the most unmechanical person you’ll ever meet. IKEA furniture assembly — except for maybe the most uncomplicated of tables — all but stymie me. I’ve screwed up the simple installation of a Brita filter on my kitchen tap. I’ve even destroyed some sections of wall trying to hang up framed pictures without first trying to locate the stud (that’s of the non-human variety). A couple of days ago, my toilet stopped working. I thought, ‘oh maybe I can just find a good Youtube video to guide me on how to fix it’, but me playing plumber would be akin to an SNL Bad Idea Jeans commercial!? (Fortunately, good sense prevailed and I called an expert instead.)

All this tangential prose to make the point, rather emphatically: don’t count on me to be able to figure out how to do a bronchoscope insertion without severing vocal chords or anything else that gets in the way… But, could I ever give a master class on parallel-parking! 🙂 (Stall-parking? Maybe not. I know, I don’t get it either…)

[Picture of Bank Street Bridge – familiar landmark to the running community of Ottawa, Summer 2009]

Aside from the work in Ottawa not panning out as I had hoped (despite some internal lateral movement – can you say, bureaucratese-speak?), I’m persisting with it for now while I figure out my next move. (I know, slippery slope to a relapse of inertia. Duly noted.) On the personal side — and to compensate for the professional side — I did hook up with an amazing, hard-core, mixed running group. The people were wonderful, and it was such a nice change to run in the company of fast, fun, fit athletes and to enjoy some variation in my work-outs. I would run with the group twice a week and by myself two more times during the week, including running the equivalent of a half-marathon (~ 21-k) every Sunday. OK, admittedly, running a half-marathon distance every weekend was an insane ritual on my part, and I would eventually pay for that excessive mileage (without benefit of cross-training) that I’d been stubbornly logging for 5 years. It certainly was not a part of the group’s approach to training and the coach had actually repeatedly warned me that I needed to periodize my training or risk an injury sidelining me. (He was right, of course.)

In the meantime, working as a square policy peg in a round hole + intensive training (running) was my initial dance rhythm in this new city of Ottawa back in 2008-2009, but this relative comfort and routine would soon be upended again by a life event so profound as to make me question or re-evaluate almost every aspect of my life. The construct of existentialism, and my own life’s purpose. I would never again view life the same way after this event…

More cartoons from the artistic time capsule…

Here are a few more oldie but goodie health-related cartoons from the artistic vault… (I was doing everything from sketch to colorization at this point since I had learned how to do some basic stuff in PhotoShop and Illustrator.)

The 2004 cartoon below tries to illustrate the frustrations from a patient’s perspective of getting to a clinic appointment in a big city. Often, the buses are packed with people, and if the weather’s bad, these buses can be late arriving and be even more crowded than normal. Sometimes, they don’t even show up at all. Not a pleasant experience when someone is elderly or unwell, trying to get in to see their doctor or health professional…

These next two cartoons (from 2006) showcase my attempts at creating some birthday cards that our clinical team could potentially give out to patients in our clinic. I think I only ended up using the one of the artist at her easel (kind of a self-portrait, I’m told) once to wish a friend Happy Birthday, however… The other ‘group’ illustration (immediately below) was meant to be a ‘from all of us’ type of birthday card with the whole clinical team represented — and some patients mixed in — wishing one a Happy Birthday… This ended up on the cutting room floor, too. (I had lots of ideas back in those days for patient education tools and other fun things to give out, but understandably not all ideas fly, especially when there are significant dollars or time involved. Oh well, it was still fun pursuing these different ideas.)

This last cartoon (from 2002) was inspired by a clinical trial in diabetes in which I was a study coordinator. During the trial, patients had to get periodic ECGs done to monitor their heart health and screen for any rhythm disturbances. I can remember having to stick electrodes (which were really sticky!) on some pretty hairy, obese men. Sometimes, the electrodes just wouldn’t stick at all, though, so I was faced with having to shave some of their precious chest hair off. I felt so bad having to do this. (I don’t think they minded, however.) I was also a newbie coordinator, so I wasn’t exactly practised in the fine art of esthetics & barbering…

It is far from elementary, my dear Watson

I had an interesting – both funny and disturbing – what-if discussion with a colleague at work the other day. I was lamenting how so many previously desirable, secure jobs were at risk of being rendered obsolete or nearly so by the rise of increasingly efficient and sophisticated automation. My colleague, who has a deep appreciation for standardization of process, maximizing efficiency and quality control assurance (and the famed “Watson” robot), could nonetheless not help but also feel a bit vulnerable, himself, as a knowledge worker.

We both began musing about what jobs might be left in the future, which would remain viable and not easily susceptible to automation. We could only come up with two: being a musician or being an artist (e.g., visual arts). I’m sure there are many others in the creative arts, but that’s the point. Isn’t it interesting how as kids we were purposefully steered clear of the arts and instead encouraged to follow the tried and true, safe path to what was ostensibly viewed as predictable, stable employment (usually, something in the applied sciences) only to find out years later – largely unforeseen by most – that the technological revolution would totally upend what constitutes secure employment. Imagine telling your kids today to focus on developing their creativity because that’s how they will land interesting, stable employment. Sounds strange, doesn’t it?

Consider the work of a pharmacist, for example. Traditionally, pharmacy work focused on the provision of a product (i.e., a medication), which usually implied some sort of physical preparation (“compounding”) – think pastry class, but instead of making chocolates, you’re making suppositories, which like chocolate, melt at body temperature, but are not so melt-in-your-mouth delicious… All this to say that pharmacists of yesteryear (perhaps your grandfather or even your father) spent most of their time as pharmaceutical iron chefs toiling away behind the counter in their dispensary kitchens engaging in a sort of small-scale manufacturing prior to dispensing the finished medicinal product to the patient or customer. Nowadays, most medications are mass-produced almost exclusively by large pharmaceutical companies in various formats and volumes, all but obviating the need for the comparatively more expensive, boutique-style “local” production that typified pharmacy practice for a good part of the last century. As the profession slowly evolved from a primary manufacturing role to one in which practising pharmacists would position themselves as the go-to information resource for all things medication-related, the internet age had dawned, arguably signalling the biggest gamechanger for the profession yet. Nowadays, with the ease of access to the internet and sophisticated software support systems, drug information is increasingly being accessed like a commodity at the user’s fingertips without the involvement of the pharmacist. So, just what is the role of the pharmacist today? While we still need pharmacies as a medication distribution channel, how essential are pharmacists anymore? Does it make sense for them to preside over drug distribution when there are now less costly alternatives available, such as regulated pharmacy technicians or ATM-like machines? Are there better ways to leverage or apply pharmacists’ specialized technical skills and knowledge?

What I see happening to the profession of pharmacy is just one example of a steady erosion of formerly stable professions. To me, a sure sign that employees sense trouble within their field is when you start seeing more and more climbing for higher ground – in this case, higher academic ground. More nurses pursuing Master’s to become higher-level Nurse Practitioners with prescribing authority. More pharmacists pursuing hospital residencies or a Doctorate in Pharmacy, with resultant opportunities for more advanced clinical work including collaborative prescribing agreements. In the crowded alphabet soup that typifies primary health care with its MDs, PAs, RNs, NPs, RDs, RPhs, SWs, etc, one can start to see increasing instances of overlapping scopes of practice. The more similar the various professions appear, however, the more suspeptible I think they are to having their unique contribution to patient care questioned. Are they so unique afterall? Is their salary justified by their skills? If everyone can prescribe, should they? Is it safer and more effective to have multiple prescribers or a Watson-like super-computer doing all of the prescribing based on best available evidence? How are a patient’s health outcomes affected by multiple (human) prescribers?..

As someone with a background in the health professions, myself, I look ahead to what the future may hold for me personally as a practising health professional, and feel more than a twinge of anxiety. It is really hard to say for certain how these various helping professions will tranform under the dizzying pace of technological innovation, and as such, how to anticipate change and still remain viable – and most importantly, be passionate about your work. I think my initial childhood whim of running away and becoming an artist (or cartoonist with Disney – ok, maybe change that to Pixar) might not have been so impractical afterall…

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