A Blockbuster First Novel
Stephen Jackson, MD, editor of the CSA Bulletin, reviews a book in the Fall 2008 issue: OXYGEN, by Carol Wiley Cassella, MD, an anesthesiologist in private practice with the Virginia Mason group in Seattle.
…I strongly urge each of you to read Oxygen, especially because it examines in great depth the gamut of the important and too-often-neglected topic of physician wellbeing. Indeed, while engaging the reader with a mesmerizing plot that has full relevance to the art and science of the practice of anesthesiology, she explores life’s personal and professional choices as we progress through our careers as physicians and anesthesiologists. In fact, from a wellness point of view, I will be bold enough to suggest that Oxygen be required reading for all of us…
So, with the author’s blessing, we reprint (with Simon and Schuster’s permission) the first chapter of Oxygen for your enjoyment.
People feel so strong, so durable. I anesthetize airline pilots, corporate executives, high school principals, mothers of well-brought-up children, judges and janitors, psychiatrists and salespeople, mountain climbers and musicians. People who have strutted and struggled and breathed on this planet for twenty, thirty, seventy years defying the inexorable, entropic decay of all living things. All of them clinging to existence by one molecule: oxygen.
The entire complex human machine pivots on the pinnacle of oxygen. The bucket brigade of energy metabolism that keeps us all alive ends with oxygen as the final electron acceptor. Take it away, and the cascade clogs up in minutes, backing up the whole precisely tuned engine until it collapses, choked, cold and blue.
Two portals connect us to oxygen — the mouth and the nose — appreciated more for all their other uses: tasting, smelling, smiling, whistling, blowing smoke and blowing kisses, supporting sunglasses and lipstick designers, perfumeries and plastic surgeons. Seal them for the duration of the morning weather report and everything you had planned for the rest of your life evaporates in a puff of imagination…
The entire review and book’s first chapter are at www.csahq.org/pdf/bulletin/casella_57_4.pdf.
A Grandmother’s Wisdom
In the Winter issue of Sonoma Medicine, the magazine of the Sonoma County Medical Association, Sanjay Dhar, MD, asks the question, “Are you smarter than my grandmother?”
My grandmother passed away several years ago, but I am reminded of her almost every day. My memories of her are more relevant than ever in these times of financial crisis, cost-cutting, global warming, overuse of natural resources, limited health care, lack of trust in government, lack of jobs, and uncertainty about our future and that of our kids.
My grandmother used to be looked down upon by her neighbors because she grew “misshapen” tomatoes in her backyard. Today I pay a lot of money to buy these misshapen heirloom organic tomatoes that she grew. She also grew herbs in her kitchen garden and would always sing to them. Today some scientists claim that music can make plants more productive. She always said that we should eat food the way it is produced in nature: raw. Today a growing subculture promotes the consumption of uncooked, unprocessed, organic foods…
My grandmother would always buy things only after she was sure she had the money to spend. Today with the credit crunch, we may want to follow her example. Her slogan was, “If you don’t have the money, you don’t need it.”
Everything got recycled in my grandmother’s house. Newspaper was used for packaging, stuffing and wrapping; old clothes were stuffed into pillows, bedding and insulation; vegetable and garden waste was given to the animals. Today we pay to send our waste to the local garbage companies for recycling and pay even more to buy it back (as 100% consumer recycled paper). How about using newspaper to wrap your gifts this winter holiday season?
My grandmother objected to moving into our larger new home. She always said that she could only sleep in one bedroom. Today, after a few decades of growth in home sizes, we are considering how we can reduce our carbon footprint by building smaller and more energy efficient homes…
My grandmother taught me values and habits that are so needed in our current era: the importance of “being a family”; the importance of an education; the importance of respect, of self-reliance, of being ethical and conscientious, and of sharing with people less fortunate than me. But I know that even now I am not as smart as my grandmother.
To read the entire article, go to at http://scma.org/magazine/articles/?articleid=317.
Destruction and Beauty in Pakistan
The San Mateo County Medical Association Bulletin devoted its November-December issue to medical volunteerism. In “Living the Dream, and More,” Naveen Mahmood, MD, told of her October 2005 trip to Pakistan.
Ever since I can remember I wanted to become a doctor who could travel all over the world to help people. During medical school and residency I was involved with patient education and basic health care in rural Pakistan. However, three years ago, the ultimate experience came unexpectedly. In October 2005, a 7.6 magnitude earthquake hit northern Pakistan. By December my family and I traveled to Pakistan, at our own expense, to volunteer at remote locales.
We collected 700 pounds of medications and supplies in the U.S. In Pakistan we rented a van and drove for a day to get to Abbotabad, one of the northern cities hit hard by the earthquake. We visited the local university hospital that had been turned into an outdoor trauma center. Volunteers from all over the world were present, working tirelessly; large tents were converted into operating suites and temporary wards to accommodate the large post-operative patient population.
The scene was surreal. In Balakot, not a single building was left standing. All we could see were piles of rubble and debris, a sea of innumerable tents and the sheered mountains in the background. This was all juxtaposed against a magnificent background of clear blue skies, beautiful snow covered mountain peaks, and the famous River Neelam flowing through the destroyed city.
Despite so much destruction, life continued — people cooking in their tents, classrooms being held outdoors, children playing among the ruins, and the predictable five daily prayer calls heard over the speakers. The local people were so calm and so friendly. As we began our daily routine of setting up our “mobile clinic”, everyone came by to offer their help. As soon as the local people heard that there was a medical team available they came down with their remaining families in tow. We saw over 200–300 patients per day and worked without a break.
We were there as a pediatric team but essentially saw whole families. In fact we ended up seeing a large number of female patients since by cultural norms, they only go to female doctors.
Apart from the usual acute care issues such as bronchitis, ear infections, pneumonias and urinary tract infections, we also had to deal with depressed, anxious and traumatized patients. Every patient had a story to tell—children losing parents, parents losing children, young wives losing their husbands and caretakers, now having to figure how to survive on their own… However, at the same time, we witnessed this cohesive sense of community and camaraderie amongst the locals — everyone watched over the local orphans, and over each other.
To read the entire article, go to www.smcma.org/Bulletin/BulletinIssues/Nov-Dec08issue_copy(1)/BULLETIN-08NovDecR6.pdf.