Category: Medicine and Science

My thoughts/inputs/essays about anything and everything, science and medicine!

  • How to Ignore Chronic Pain and Hack your brain to beat it. A step-by-step guide.

    I wrote this up for a friend recently. And as some of you who follow me know, I’m writing a book about my experiences through cancer, and the science behind the mentality which kept me going. But I realised recently that I hadn’t written up what I wished I did have when I was suffering most from chronic pain… A step-by-step guide which showed HOW you could beat this back.

    The thing is – when you have something like chronic pain… everyone around you has suggestions. Eeryone suddenly becomes an expert. When you’re already so drained, physically and emotionally, from the condition itself – being told about miracle cures and being sold things that ‘WILL CURE IT ALL’ is not only heartbreaking, when you find measure after measure fails, but also depressing, in and of itself.

    So I’m telling you straight up – this isn’t a miracle cure. I still have issues dealing with the sleep and fatigue I get from this chronic pain/cramping/fibromyalgic-like condition that I have. I still do get frustrated by how it limits me, at time (though I can ignore the fatigue as well, I know it’s healthy to respond to REAL signs it needs rest). With this system, I still feel pain. But my suffering because of it has decreased significantly. It wasn’t even hard to do this. It didn’t require an ounce or bravery, courage or willpower. It did take time. But today, I can, and do ignore pain as it comes on, automatically. Without willpower, or effort, or, as I talked about above, an ounce of bravery or courage. I hope it helps you do the same too.

     

     

    It took a few weeks to get there. But the key to this is that I had this long term goal in mind – of getting to a point where my mind would automatically ignore the pain when it came on.

    I knew I could do this because I was on duloxetine – an antidepressant – for a while 2 years ago, and that helped me, despite it not actually stopping the cramps which initiated my pain. While I was on it… the pain still happened, but it didn’t affect me as much. This powerful evidence of this working –  of me being able to ignore pain – in the past, really helped get through my head that I could indeed accomplish this. That I COULD ignore chronic pain, which really helped me stay on track.

    But it was also reading about the science of chronic pain that solidified this belief and gave it backing. I looked at how greater connections between attentional centres and emotional ones, amongst others sensitizes us to, and enhances the impact of pain via neuroplasticity. I also read about neuroplasticity in general (the science of habit formation in particular), and the effects of positive reinforcement on strengthening mesolimbic (aka reward) pathways – which has numerous effects that makes a thought process or behaviour addictive, and hence, easier to maintain  – from our amygdala (emotional centre), to the pre-frontal cortex (responsible for planning and attention) to our hippocampus (a vital part of memory) –

    By learning everything I could about these things, and combining my findings, I figured out how I could hack this process, via positive reinforcement, to make the journey to get to a stage where neuroplasticity would change my reaction to pain, easier. Below, I go into this process, step by step, in a manner that could help you out too!

     

    I’ll be talking more about this, and referencing hundreds of articles which helped me ‘hack my brain’ in my book – do sign up to my email list and I’ll keep you updated on its progress! But, these steps I keep talking about are not only simple and replicable, but makes this process easy too!


    1) Take a step back and look at the pain I was facing – when it was worst, when it was best etc. and wrote that down.

    2) I saw that I could, and did ignore pain when I was feeling happy, when I was on that antidepressant (it didn’t reduce the cramps themselves, but did help me ignore them). When I was able to attach less importance to a burst. I then latched on to that.

    3) I knew that I could ignore it, and could focus on stuff that made me happy – and make that an automatic response, in a matter of weeks, as neuroplasticity could rewire my responses to pain.

    Almost mantra like, nstead of focusing on the pain once it occurred, I told myself “This is an aberrant, faulty signal that I shouldn’t be attaching significance to,” that “it would be over in seconds – minutes” that “getting annoyed by it, fretting over it happening again was only gonna make it worse” and told myself that “focusing on something else was more constructive – why not do that instead?”

    and

    4) I rewarded myself every time I ignored the pain. And I allowed myself to be human – acknowledge there would be times I’d fail along the way – but that in the long run, I would get there.

    After a week, as I got better at this, I even started looking forward to cramps coming on as an opportunity to show myself I could do it. I’d addicted myself to getting better at doing this. It became easier to do.

    After a month, my reward pathways kicked in and I didn’t have to keep rewarding myself – exponentially growing hits of dopamine surged through me as I got closer to my long term goal (another observed phenomenon that my research assured me would kick in).

    In 5-6 weeks, I didn’t have to tell myself any of this at all. I was automatically ignoring chronic pain when it struck. IT DIDN’T EVEN TAKE WILLPOWER – or me reminding myself of those ‘mantras’-cum-realisations I did in step 1 and 2. Neuroplasticity made this a habit. One I maintain to this day.



    Maybe this could help some of you guys out too.

    It isn’t perfect. When I cramp these days, I do still cry out and it does still stop me from doing things as it physically takes a lot more effort to do things when you do have issues like what I have.

    But I have been able to ignore the pain more often than not.

     

    My psychologist told me “you have to accept the pain”. But doing that was REALLY HARD – accepting that and saying “I may suffer like this all the time…” was impossible for me to just jump straight into. CBT and all that, I mean it could have helped, maybe… but again, that was hard to maintain.

    It was the preparation of this mindset – the manipulation of my reward pathways and neuroplasticity – and the knowledge it could – that helped me stay on track. The acknowledgement that it’d take time, and knowing I’d fail and feel crappy some days – but that in the long run, I’d get there – prepared me. When failure did come, when I felt pain overcome me (I knew I inevitably would in my journey),  I’d grit my teeth and bear it, but found myself focusing on the long run, and taking solace in that I would get there, instead of trying to be this ‘brave, strong dude who had to ignore everything’ which I could not. That helped me persist with this and get to this stage I’m at now, where I do ignore the pain, as an automatic response, when it comes on.

     

    I think it could possibly help some of you. I wrote this out for a friend, and realised I didn’t have a ‘lay-over’, something to help people as I kept working on that full sized book (don’t worry, it’s only going to be 30-40 pages). So I thought I’d share this with you guys too. Again – sign up to my email list (I only email people once a month or so, don’t worry), and you’ll know when that books’s finally out. I’m gonna try and make it free too!



    I know how much is sucked being told “It’s all in your head” when I was really in the dumps because of all this, that’s why I don’t wanna kid you and let you know that it’s not perfect. You can ignore fatigue as well, I’ve found, but my recent health run-ins made me realise that ignoring legitimate signs your body is suffering (something pain is not) is not exactly healthy.

    But I hope my getting there can help some of you. Feel free to hit me up if you wanna talk it through – info at nikhilautar.com will ensure you reach me. I’m also decently active on my Facebook page and have a startup – Get To Sleep Easy – I run (we won Australian Student Startup of the Year actually! Check out our GoFundme.) which I’m always working on.

     

    But ultimately – the thing that helped me most was the realisation that this life can be very long. Why make my suffering worse by lingering on it? Why let it take anything more than me than it should? That’s what really got me thinking about this.

    Let me know your thoughts – good or bad (Please… ROAST ME if you hate this post. I wanna make sure what I’m saying helps the most people possible. I won’t mind at all if you completely hate this).

     

    More about my pain condition –

    So I’m an ex leukaemia patient, current graft versus host disease sufferer and get chronic cramps. This is sort of common post transplant, but doctors aren’t too sure about what it is, how it happens, and have no clue about treating it in general. You can read more about my journey here. 

    I’ve got motor and some sensory neuropathy, and there’s definitely fibromyalgic elements to it too – it was looking at fibromyalgia that got me to ask my doc about duloxetine, actually. Something that had changed my life for the better for a long time. If your suffering is because of something similar, and have found something that helps… let me know!

     

  • Why and How are Doctors and Medical Students so Depressed? And What Can WE Do About it?

    Why and How are Doctors and Medical Students so Depressed? And What Can WE Do About it?

    The day I got into medicine, was the greatest day of my
    life. 

    I’m sure many medical students and doctors would tell you the exact same
    thing…

    For me it was personal. 

    I’d always wanted to study medicine. What better job was there? You could save lives
    and live in relative comfort your entire life. I’d get to emulate my childhood
    hero growing up, Captain Hawkeye Pierce from M.A.S.H. 

    But after leukaemia struck my life… it became personal. 

    I wanted to help people as I’d been helped. It was my doctor’s words; that
    “The Good News Is You’re 17 and You Have Leukaemia, but the Bad News is
    You’re 17, And You Have Leukaemia…” and his actions that got me to
    believe that I actually had a chance in this… It was another patients’ words
    the day before my transplant that really sunk in, and changed my life. Imagine
    being in a position to do that for people everyday!

    My first day in medicine was one of the most joyful of my life. 

    I was so excited to finally be in a position to give back, and so delighted to
    be alongside so many other people who cared just as me. 

    But as time went on… things changed. 

    For me, and for many of my classmates too. 
     
     

    As I progressed through the course, I got more and more burdened with work, and
    more and more dissatisfied, and indoctrinated (pardon the pun) into the collective Group-Think of
    modern medicine. One which emphasised speed over accuracy, marks over
    competence. One which measured success through KPIs such as reduced wait times
    and greater efficiency rather than reduced morbility and morbidity, and higher
    patient satisfaction and involvement. As I feel many in this profession feel at some point. 
    And this in a population who are most educated about
    mental illness, and the fact that they are illnesses, not just an abstract
    constructs or “excuses,” as many still widely suggest and believe.
    Somehow still, amongst those with depression or severe symptoms of
    depression, 
    only 15% of medical students actually get help… For doctors… the rates are even lower

    Why is this happening though? 

    Aren’t these people being paid heaps? 

    How I imagined life would be after med.
     
    Aren’t they close to services? 
     


    Don’t they know the risks of the disease, and how altered biochemistry can
    alter your very mental state – your very person? 


    Well, there are many reasons why. 

    Various personality traits and attitudes make doctors more likely to suffer
    from depression. 

    Perfectionism, hints of narcissism in some, compulsiveness in others, martyrism in most, and disparaging views of
    vulnerability are all commonplace. 
    Facing death, watching good people suffer, and losing
    the battle over and over again
     also burdens doctors. Burnout from stress affects 45%
    of doctors
    , ladies and senior physicians in particular. And as this article puts so poignantly, Osler, the founder of the
    first American residency program, advocating for equanimity in physicians, was
    perhaps the largest contributor to all this… 
    Many doctors feel that showing
    weakness is a failure on their part. A failure.
    If they’re not steady under pressure,
    how can they serve their patients? 
    And that can be a tough burden
    to bear…
    400 doctors take their own
    lives in America alone.
    An entire medical school’s
    worth…

    Junior doctors and medical students have similarly sky-high rates of depression
    and suicide ideation (the 10% figure is a conservative estimate; studies in my
    nation show , but have the added pressure of exams and the weight of
    expectations on their shoulders too. 
    Furthermore, other factors, such as living on their own for the
    first time, often overseas for many students (where the added pressure of
    maintaining a steady income is another burden), high levels of student debt,
    and the sheer pressure of the course and succeeding itself plagues many
    students. 
    Many of my medical student and junior doctors friends
    complain about many of the above stresses. Many feel medicine takes over their
    lives. In a time where they should be out and enjoying their life, many
    students, as well as doctors, regret not enjoying life more. 
    And many feel disillusioned too. They feel they were misled
    about what medicine actually was. About the impact they have. About the
    difference they make. So many of my friends express this in particular. 
    But the toxic, competitive hospital environment, where specialty spots are
    limited, the medical heirachy is emphasised (
    and perpetuated by older doctors in an “If I went
    through it, they should too” manner
    ) and bullying is rife, also pushes many
    young meddies over the edge. 

    Very recently, in my country, Australia, 
    3 junior doctors took their lives within one week

    One of those young doctors, a passionate advocate for medical students took her own life. 

     

    THREE. YOUNG. LIVES…
    With so much to look forward
    to.
    In. One. Week. 
    2 people I knew took their own
    life last year. 
    1 was an old school mate of
    mine. 
    What can we do about it then? I guess that’s the question
    that remains. 
    Well, dealing with how doctors perceive themselves and
    mental illness is one step in the right direction. 
    This great TED Talk, one of the highest rated of all time I
    believe, discusses the expectation of doctor perfection, and how this
    counter-intuitively actually worsens patient outcomes. 




    When doctors feel they have to be perfect, that their
    mistakes are their fault, a great burden is placed on their head. 
    It’s important to be competent, don’t get me wrong. But
    this unreal expectation of perfection is what, as Brian Goldman points out
    here, is only harming doctors more. 
    We’re not learning from it right now. There’s no mandatory
    reporting of issues or near misses in hospitals. More recently, at a quality
    and safety lecture I attended, I learned there was one in our hospitals in my
    state in Australia, but that it was under-utilized, and something feared by
    doctors, as opposed to the learning tool it was intended to be. 
    Something as simple as a place for doctors to confess
    mistakes, and seek sympathy from other doctors, could change the lives of
    hundreds of thousands of silently suffering, perfection seeking, burned out
    medicos. And it could improve patient outcomes too. 
    Of course, it needs to be a done in a sensitive manner.
    Perhaps confidentially, with identification being made impossible. Though it’s
    horrible that some die due to lapses in doctors’ concentration, as pointed out
    in this article, 
    overworked doctors, facing physical and emotional
    stress, are less competent ones
    . Hundreds of thousands will die due to medical error this year alone –
    medical error is estimated to be the third highest killer
     in the American medical
    system. 
    The numbers are alarming, to be sure. But not learning from
    mistakes, not making diagnostic/prescribing/treatment processes better, and not
    giving doctors a place to vent, and relax, is only going to increase this
    number if anything. 




    A great TED talk by a very
    interesting man – Atul Gawande (highly recommend his books on medicine and how
    to fix it), discussing a simple process which reduced mortality in surgeries by
    as much as 40% – a checklist. These little innovations and improvements are
    necessary to accomplish the end goal of saving more lives and reducing
    suffering!  
    But reducing medical error
    alone isn’t the only way we can ease doctors’ strife. 
     
    Loss is something many doctors
    have to face too. 
     
     
    I can only imagine how going to
    work everyday, knowing that you’re going to witness suffering, pain and death
    can be soul-wrenching. I certainly do feel disillusioned when walking through
    wards and seeing the same story, of a seemingly nice person, suddenly finding
    their health deteriorating, and then, in most cases, having some scars from all
    this tail them for life. 
     
     
    It wasn’t easy. It never is at
    first. Especially when it’s someone you’ve really connected with.
     
    I can’t imagine how you doctors
    can deal with it. This is how I dealt, and deal with mine though…
     
    When George passed… I was
    devastated. It shouldn’t have happened. Not just because he was so young, not just
    because he’d left a baby behind, but because it was so sudden. So unexpected.
    Just so unfair.
     
    And I was bereaved.
    Inconsolable. But silently suffering. For weeks.
     
    I didn’t realise it at the
    time, but I was going through depression. That was the first time I did. That
    someone so young, innocent, someone who I’d helped grow to overcome so many
    battles and someone who I thought would make it could go so soon made me
    question why bother at all? In the face of so much struggle, so much of which
    that we couldn’t resolve… Why bother facing anything at all? It didn’t make
    sense.


     

     
    I stayed that way for weeks.
    Scrolling down Facebook, watching Youtube video after Youtube video… unfeeling,
    uncaring. Questioning why continue at all? Until one day, I talked to someone
    about it. My father. He came up and hugged me from behind, and just held me.
     
    And I asked him, “why do we
    bother?” He’d sensed I was going through something. He didn’t know why. But he
    did. A parent’s intuition maybe.
     
    He said, “Nikhil. Look.
    Everyone in this world will die someday.” An abrupt start to what I’d expected
    would be an inspiring, or inappropriate joke, something frequently gushing from
    his mouth to be sure. But he continued, “We can’t control that. What we can
    control, is what we do in our lives. We focus on doing our responsibility, and
    that’s all, as best as we can. And where we can, we leave this place a better
    state than we found it in.”
     
    I saw then, something I believe
    is a fundamental truth of humanity.
     
    The feeling of helping someone,
    of being an active member of a community, in the essential sense of the connection
    that humans need to survive. 



    I’d always wanted to help people. It was just the right thing to do, it seemed. It’s why I’d wanted to do medicine. Cancer just cemented that. But I realised that it also is the best thing you can do, not just for others, but also yourself. 


    Because that feeling of putting a smile on someone’s face, or easing someone’s struggles… unlike things like fame, money, power, men or women – all those things we seem to desire most in life, that can never be taken away from you. That will never seem meaningless. That’s something you can always do.

    And I want to share 1 unwaverable truth to all the doctors, medical staff, and regular people out there reading this…



    No matter how dire things seem, no matter how much you feel like you’re just a cog in this machine which keeps churning out pain and death, no matter how much you feel hope, and powerless – YOU CAN, and DO, ALWAYS MAKE A DIFFERENCE.

    No matter what the outcome.


    Because what made my doctors special wasn’t the medical calls they made or their knowledge and prowess, what made my doctors REALLY special to me was the times they’d talk about my biking progress or my basketball before an appointment (that alone mitigated the 1 – 2 hour wait to see them)… the time one doctor walked alongside me and chatted on the way to a lung plural biopsy which I knew was gonna hurt. It was the time my doctor decided to write in to the medical entrance board and allow me to sit the exams that would allow me to become a med student. THAT’S WHAT MADE THEM SPECIAL… to ME.




    I’ve sat down with men who were dying’s families and held their hands as they knew they were about to go, and been told by their family that that night we played snakes and ladders a few days before he passed was something he remembered on his deathbed itself. That the barbecue one friend had on father’s day, when a companion of mine in hospital had finally gotten gate-leave on Father’s day was the best barbecue and one of the best meals he’d had in his life.

    But to those reading this, I also want you to know also that you don’t have to go this far to create change. Because the little things are Huge. They not only give fleeting happiness to your patients, your small gestures, and make you feel HUGELY cared for too as a patient… something that I realised I hadn’t felt when I had severe, suicidal depression for a year until I visited my old doctor, who’d treated me first (thank God I didn’t take that jump on that day.)… They also make you realise, at a doctor, that YOU ARE making a difference.That YOU DO matter… Those little acts of kindness reinvigorate you.


    And if you take that opportunity to be the light in peoples’ darkest day, instead of going into work everyday thinking “Oh here we go, another 12 hour shift where I’m looking after people I can’t even listen to me, yet alone help or save”, “you’ll be thinking, “whose day can I make… whose pain can I ease… whose LIFE can I change?”

    And that’s huge. It’s the difference between this being a job and a profession. It’s the difference between being run down or turning to alcohol or drugs to get by, and feeling fulfilled. It’s the difference between life and death.

    So go out there and take every opportunity you can to do it. When you have a spare few minutes, take a few moments to see what allied health services around you can do to help improve quality of life for your patients and refer people to social workers to see how you can improve their lifestyles. They’ve made huge changes to my life, and so many others. It takes a median of 15 years for people to go see a pain clinic, for instance. Let’s fix that.


    A reason why people won’t come in when they need to – “Oh why wait that long for something that won’t help anyway”



    And if you still feel sometimes down despite it all, please, do get help. The biggest reasons doctors don’t seek help is fear for their career, or what their peers will think about them.

    If that’s you, let me tell you this. I’m a man who used his mind to find a way of smiling, despite his cancer, 3 days after being told he’d had it at 17. I’m a man who’s ridden 200km 2 months after chemo for cancer charity. I’m a man one who’s running 2 social enterprises, one of which will save HUNDREDS OF THOUSANDS and BILLIONS in healthcare expenditure and most importantly… I’m man who found a way to smile after he’d been told he’d relapsed and that palliative care was a very good option in JUST 10 MINUTES…



    But I still couldn’t outthink depression.
    I still was miserable, despite my fighting against it and willing myself on, again and again. I still went into that deep dark place of wondering what’s my point in my mind when the pain I face struck.

    If others think are thinking you’re weak… then they’d better have done more than me. Otherwise, whoever is or would, is someone who doesn’t understand something that should be basic knowledge. Someone judgemental and incapable of thinking outside the tiny little box that guides their life experience. Someone beneath your concern, someone who you wouldn’t want to befriend anyway.

    Someone you shouldn’t worry about, or let get into your way to becoming the most content version of yourself – something you do deserve, no matter what depression makes you feel otherwise. I say this because one of the other biggest reasons we don’t get help is because we’re embarrassed.



    Sometimes that person is yourself. Most of us are strong people. We power on. We’ve gotten through gruelling pre-med studies, then through medical schools and internship and everything that comes with the job, or in the struggle to get there. We can beat this. Or we can’t be one of those losers or sadsacks or whiners who suffers. We just get on with it. Scraping by, as some of us always have.

    But getting help isn’t the “weak” option. You don’t get anything out of beating it. Why risk proving it to yourself, or put it off, or dismiss it as unnecessary, or just chinning up, and putting on a facade when you can get help to get you through it.

    And I can tell you that when I got help, this all changed. Instead of walking in front of a train that day, I decided to walk across the street from the lab I worked in to see my old doctor, tired, cramping and feeling so alone. And thankfully, he was there. He just sat there, talked, and acted as any person would for another. He did what any doctor should do. He cared for me. As well as took care of me. He sent me to emergency, something you guys reading on mostly likely wouldn’t have to do, and I saw a psychiatrist. When I saw her, she said I wasn’t despondent, and didn’t need admitting, but would require therapy, for some time. When I asked about an SSRI (I’d noticed something was wrong for weeks), I remembered tbere was a drug I’d looked up for my unexplainable, untreatable cramping called duloxetine. I suggested it instead of the one she’d prescribed… and on day 2 of it… I not only lost this fog that was clouding my brain for a year every single day that I now know was depression, I also stopped feeling the pain. I’d felt as good as I had for years! Since before cancer. But it wasn’t just a drug that got me there, and got me to stay there.

    It was talking to someone about it. My psychiatrist, he mainly does psychotherapy. Indeed, his goal is to minimise drugs (indeed, I’ve eliminated all of my psychiatric;neurological ones for that depression currently), and I recommend seeing someone who does too – maybe a psychologist, perhaps your nations’ doctor – doctor help line or mental health service (something I found out at that national doctors’ conference that we did for the first time). It seems confronting to do – open yourself up and admit things that you’ve never admitted before – to others or yourself – but the very things that make it seem confronting are the very reasons why it’s great.

    What you say, can never leave his or her office. You’ll never see them in day to day life, or even have to see them again if you don’t want to. They are literally professionals at their jobs. And whatever you say to them, they legally can’t disclose to anyone! I encourage you to take that first step of reaching out to one, if you haven’t before, and think you may benefit.

    And finally, I’d like to say thanks. You may not hear it a lot as doctors. It seems we patients are becoming less and less grateful over the years, but you guys really to matter to us. You see 20, 30, some of you, even 50 or 60 (in India, that’s common according to my Uncle), but we only see 1. It seems like a huge burden when you put it that way. But it’s also a huge opportunity. I hope what I’ve said convinces you to seize it with all your heart.

    Nikhil



    If you’d like to talk. I’m always here.
    Suicide hotlines: 13 11 14 – Lifeline Australia. Add a +61 after your international dialing requirement and punch this number if you don’t have an alternative.

    American: https://suicidepreventionlifeline.org

    A 24/7 hotline where you can talk to another doctor anytime –

    https://www.drs4drs.com.au/contact-us/


    And I’d like to announce what I’m doing for the first time on this blog. I’ve started up a social enterprise that’ll, as said above, save hundreds of thousands and billions of dollars a year! Check it out at www.gettosleepeasy.org – here’s what it is.

     

  • An Open Letter to Doctors from a Scared Patient in Scared Times.The Best Doctors I’ve had. And the Worst.

    Last post:                                     My Story:                                         Next One

    Being a patient isn’t easy. Especially when you’re in hospital in an emergency situation, as I was last week… For those who didn’t know – I presented to emergency last week, midway through chemo, with shortness of breath and they ended up finding a new cancer on my fourth rib on the right. Don’t worry though – I’m fine! 


    They removed the lesion that was there and the worst case scenario – a relapse of my very aggressive original leukaemia has essentially been ruled out. Whatever the tumour is, that’ll likely be all that’s required in terms of treatment. 


    During that tumultuous week, my first where I’d gotten major surgery come to think of it, I probably met as many doctors as I had since being diagnosed 4 years ago. I definitely would have if you took out med students, interns and residents from the equation and just left the specialists. I met 12 anesthetists alone. By the time you’re reading this… I’d probably have met 14.

    And over this last pressure-filled week, I’ve had some of the best and worst experiences with my doctors. 

    But let’s save the best for last… 

    I’d like to say, first off, these doctors I’ve been under – I don’t believe are bad doctors. Skill and knowledge wise, they’re far from deficient. Indeed, one is apparently one of the best in his field; one of three who even performs the surgery I needed last week in my nation. And they’re not horrible people either – I’ve come across worse, more abrasive doctors in my time, heard of many more horrible experiences, and circumstances. Rebukes from doctors and regular people to young cancer patients in particular commonly degrade patients. I probably came across these guys at bad times, in time-constrained circumstances or something of the like. 

    But that still doesn’t ease the pain, or worry I felt because of them…



    Luckily, I’m a person who can cope with that anxiety well. But not everyone can. So at the very least… for those doctors, future doctors, nurses or other healthcare staff reading on – this can serve as a lesson. 

     

    Words that were said to me, just last year. In truth, there were things out there that could, and indeed, have helped. Check out an entire album, asking what the best and worst things patients’ doctors have told them. 


    When I was told I had a lesion on my fourth rib – one that may be cancerous, as you can imagine, I wanted to see exactly what it was. Or at least learn more about it. 


    I was admitted to hospital on Tuesday morning, and found out about this lesion that afternoon. Immediately on hearing this, and learning that there was a spot in that same area last year – I wanted to see the scans or reports myself. I struggled (I was still cramping and short of breath) and limped my way to the nurses and doctors station and demanded to see my reports or my doctors as soon as possible. 


    After a while, the resident on my medical team walked in and told me the bad news. He confirmed that there was some kind of lesion, but when it came time to seeing the report… he couldn’t give it, as “Only a specialist could give such reports to patients, according to New South Wales Policy.” I was pissed. Angry,,, beyond words… They were my scans… my reports… about my body. Why was I not allowed to see them, and someone else was in the first place? Shouldn’t it be the other way around?


    But I guess it wasn’t his fault. And I guess I could see a potential reason for such a policy. You wouldn’t want a patient to worry themselves too much, or be disclosed information without knowledgeable guidance…. Fair enough. 


    “Could you call or page my specialist so I could see them?” 


    No. That was for some reason or the other impossible too… He was probably scared of bothering him for this tiny thing. The systemic bullying, and even sexual harassment that come with the doctor hierarchy may have had something to do with this. If the consultant on call was such a bully, he may have had to cop a huge tongue-lashing from him, at the very least. Perhaps the laws were extremely restrictive. In any case, it wasn’t him I was angry at. I got where he was coming from, and saw that he had no power to change things here. So I tried everything; calling my own specialist on his line (he wasn’t in the office and couldn’t answer), calling my GP (who’s amazing and has helped me often in crisis situations in the past) and even calling and asking other doctors, including specialists at other hospitals, to see if there was something I could do. 


    Eventually, I resigned myself to waiting ’til tomorrow, for my consultants’ usual Wednesday “Grand Round”, where he and those under him would review all patients under their care for the report. 


    And the next morning, I got an absolute ‘Yes. Of course you can see your reports” from him. 

    Great, right?!



    That’s when I met annoying doctor number 1. The senior registrar (the level just under consultant) under my consultant was busy. I could understand that. She may have had a few long cases, or emergencies under her belt. 


    But for two whole days, two painstaking days of me asking her, the residents under her, my nurses, my doctors and my consultant again on the phone again and again, I didn’t get to see that report. I didn’t know for 2 days how large the lesion was. What caused them to suspect what they suspected it was. How much of my body would be deformed; cut away in this surgery that was being planned!


    All I had to work off in this time were off remarks from my haematologist about a “lesion on the anterolateral aspect of the fourth rib” that radiologists suspected was a “chondrosarcoma” that the orthopedists (bone surgeons) recommended required me to go straight to “a rib resection” rather than a biopsy first. Words I could luckily grasp and understand, with my medical knowledge, but ones that would have left most other already anxious, suffering patients even more distressed. 

     

    Surgeons huh?

    A shocking statement from a chronic illness patient, from a survey we conducted of chronic pain, cancer and chronic illness patients on patient-doctor relationships.  Click here to check out the entire album.

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    When we asked her why the reports hadn’t been disclosed thus far, by anyone else, including the anaesthetists, orthopedists or the pain team who’d all been by by that point on her own rounds (which can happen at anytime in the day by the way – they often catch you when you least expect it, one after the other) later that day, she responded, brashly, dismissively even, to my obviously anxious mother, that “It’s because we’re the haem team.” before brushing on to the next question, failing to even acknowledge our plight. 


     After a rushed consultation (we were her last patient of the day, and we’d seen her laughing alongside colleagues later on; so she wasn’t rushed by other patients), a non-commital “Yeah, we’ll get on to it,” and a “hmph” and a small turn, she was out of the room, leaving us even more confused than when she entered.


    The next day, early, before 7am (breakfast is served at absurdly early hours at St Vincent’s), we had more of the same. And it was only after cornering my haematology consultant onthe phone that we finally had the original resident, who’d initially been the one to refuse our seeing the reports, come in, show and explain the results of that CT scan to us. A mere hour before 5am Friday, the hour at which hospitals, for all intents and purposes, close. 


    Now I understand that doctors are busy. I understand that they don’t always have time, that they may have emergency situations and that they have a LOT of work to do. I understand that some patients are placed on higher priorities than others; indeed, rather than get angry, I’m a patient who’s grateful if he’s seen last, as that means I’m probably most well off, medically.


    But though these things may seem like little, pestering requests peppering your busy schedules as doctors, they mean EVERYTHING to a patient going through tough times. Especially those newer to hospital experiences. But as you can probably gather… veterans like me get scared and anxious too. Even a quick explanation as to WHY you couldn’t get to me would have saved me heaps of pain.


    The sad thing is, teams often have these informal priority lists assigned to patients to get procedures and scans during in-patient stays done, but the little requests, and sometimes even the less likely, yet all-too-possibly correct tests aren’t done. Because in addition to my not getting these reports, my echocardiogram (an ultrasound of the heart) was put to the back of the list so often, after they ruled out most of my major causes of shortness of breath, that it wasn’t even done until I specifically reminded the team about it. They’d simply forgotten. 
    The chances of there being a pericardial effusion causing that (they ultimately ended up pinning that initial shortness of breath that brought me in to my cramping as all the other tests came back negative) initial haggard breathing was unlikely, the chances of it being severe minimal considering my lack of the Beck’s triad of dangerous clinical signs. But it was still something that could have played a part in my initial presentation. Something that could have blown up in my face considering the fact I was getting major surgery in the chest later that week. 


    I understand there may not be time to answer everyone’s tiny little questions, or to grant every little request. I understand that there are days where you may be overwhelmed, where the concerns of a pushy family whose child has what’s likely a slightly cold seem irrelevant next to your failure to resuscitate a young man after an accident. I know you’re human, and can’t do everything…


    But you don’t need to. Delegating the less necessary concerns, the less-likely-to-be-severe complaints of patients and their requests, to those below you in the medical team, those secretaries or clerks assigned to you, or to a colleague with more time on his hands is one way you can make the lives of both you and your patient better without impacting your own. If it does require a little effort on your behalf, then do document those “less urgent” concerns somewhere – maybe even design a symbol or mark to distinguish them from the rest of your notes – and try to get back to them later when you get a chance because believe me – it’s not just your patients who benefit from this – it’s you too. The small things can make the biggest difference to a patient going through what’s often the worst days of their lives, and if you can resolve those problems for people every ordinary day of your life… then your own life will be the richest of anyone’s in the world. 

    Making your job your profession as a doctor is vital not just for job satisfaction, it could have huge mental and physical impacts on YOUR life too.
    I’ve dished out a lot of dirt now… and this is just annoying Doctor #1. I could go into Doctor Annoying Number 2 into extravagent detail; and some of the words, some of the things I’ve faced from doctors in the past, I could go on for pages about; but I feel I’ve done enough of that for now.  something else very alarming today…. but I understand how he can be very busy too. 
     
    Though I’ve had many bad experiences with doctors at various stages, in various circumstances, in the past, I’ve been blessed to have most of my experiences with doctors positive, even life-changing in nature. 
     
    The words that changed my life were uttered from my first haematology doctor’s mouth, the conversations we’ve had over things ranging from life-and-death decisions, the future of medicine and treatments, to exchanges of fishing tales and adventures tantalisingly human in nature. The confidence my transplant specialist had in me to choose the medication that’s kept me alive today and then fight for my right to get it completely subsidized came down to an email exchange between him and I that he was happy to facilitate in his own time. 
     
    I’ve been blessed with not only the best parents, siblings, nurses, staff and friends in the word, but also some of the best doctors too. 
     

    But by far the most human of these has been my opthalmologist; my eye doctor, and my first doctor, who’ll always have a special place in my heart. 

    That ophthalmologist though, she showed just how amazing she was in this last tumultuous week too. 

     
    My eyes, as most of you regular readers would know, have gone through a lot in the last half year or so. I’ve lost almost all my vision in my left eye permanently to a “central retinal venous occlusion“, whose cause we still don’t know and then, just over 3 months after that, almost lost my right eye as well to the same reason
     

    My reflections… my feelings as I went through what I felt may well have been the last time I saw anything.
    During this second time in particular, as I was rushed to the hospital, experiencing the same things as I did the first time, seeing the same results from the same tests coming back, I was in one of the most sullen moods of my life. I knew what was coming. And I knew that there wasn’t must we could do to change the results of it. All I could do was sit there and wait for what could have been the last flashes of lights I’d ever see go by in this alien, dreary waiting room. 
     
    Yet when I called Claire during that time… she showed nothing but concern and care for my welfare. Me. Just one of who knows how many patients she had she showed love and concern for where she had every right to be peeved, pissed off and even violated for being called up at 5am with information of this going on. 
     
    During that crisis itself, and in the weeks following up, she was her usual amazing self. Luckily, the vein blockage that caused my left eye to go blind had cleared for some unknown reason and I hadn’t lost both my eyes. And in the weeks following, she was happy to see me every week during this time, and even offered and decided to see me for free in this period. 
     
    Every appointment, as usual, we’d discuss the findings as she saw them, and she did more than explain the goings-ons of my eye to me as the details emerged on the screen, she made sure mum and I both could see the differences; the changes in the scans, actively involving us in the process and making us feel like we had control of the situation. Something many, if not most patients, wish they had in their interactions with doctors. Something that’s indeed, been linked with better outcomes and survival times in diseases ranging from colds to kidney failure to advanced cancers
     
    We couldn’t thank her enough for what she’d done for us in those last few weeks/months. She’d transformed this tragedy that would have stayed with me for life into one of the most inspirational experiences of my life. And we thanked her in kind by giving her a pair of gold bauble-style ear-rings; a wedding present to her (she’d recently been engaged we found out from another patient of hers), as during her eye examinations, she always had me look at her earrings, and I always made sure to point out the style she’d chosen to wear on the day (she always picked quirky and extravagent ones to “give her patients something to look at). 
     
    We gave that to her a month ago, looking forward to my next 6 weekly appointment. 
     
    But somehow, during the crisis that was last week, she got wind that I had yet another cancer. And when I saw her face in my window the day I’d gotten my bone scans (indeed, she was the one who deciphered them for me, and let me know that they confirmed it was another cancer I had), I was shocked. I couldn’t believe it at first. But there she was, the earrings we’d gotten her glimmering in the light, smile bright as ever, beaming at me, with flowers in hand. 
     
    “How come you’re here? How did you know what was up?”
     
    “I’d heard about this happen, and I wasn’t far away. I live right in the middle of Sydney, really, so it wasn’t that hard to pop in.” she exclaimed cheerily, handing me a set of fake flowers and then taking them from my hands, still limp from disbelief and organising them on my noticeboard of cards and encouragement with my similarly awed mother. 
     
    I was astounded. I know personally the amount my doctors, my two haematologists leading my treatment, cared for me, as they cared for any of their patients from deep conversations with them about treatment and just life. But even THEY hadn’t gone this far to show their concern. Now that I think of it though… I do remember my first doctor, the one who’d told me those words, “The Good news is you’re 17 and you have leukaemia, but the bad news is… you’re 17… and you have leukaemia,” walking in shyly to see me and wish me well before one of my procedures at a completely different hospital, on his day off, one day. He played it off cool… but he was there to specifically see and talk to me…
     
    The generousity of these souls… their sheer care for the people who’d been thrust into their hands damaged and sick and their nurturing huamnity to bring us back to health… was just staggering. 
    That sort of care these 2 amazing souls had didn’t just extend to me though. My first Haematologist told me his code one day in a candid moment. He treats “Every single person as if they’re his father, brother, son, or uncle”. And the way he treats them backs this up. He goes to every extent, doesn’t care if he steps on toes or upsets people; he’s renowned for giving tongue-lashings to clerical staff who wouldn’t budge on red tape, and every time you’re in serious trouble, you’re glad to have him there because, if you needed it most, he’d ensure you got that CT scan, MRI or procedure done, no matter what others would say. 
     
    People call him eccentric, difficult to work with, rude even. But my Dad saw him immediately for what he really is. “The other day, before your first chemo, I came across him in the hallway and asked ‘Doing anything this weekend, doctor?’ attempting to make small talk. He just stared off into the distance and walked off the other way. And I wasn’t offended at all.” 
    “Why,” I asked. I’d only just met him for the first time the other week. To me, in the days after being told the bad news so ‘brashly,’ he was an eccentric, off-putting doctor who had, in my own words, “No people skills.”
    “Because I know that the reason he did that was because he was busy thinking about a problem he had with another patient. And that patient in his mind may have well been you. With that in mind… Who do you want treating you?” 
    Claire, my opthalmologist, displays the same level of compassion and care for ALL of her patients too, I know, through this enlightening chat we had with another of her patients at during last visit. She was carrying a bunch of flowers, the same variety, I’m realising now, as the one’s hanging on my noticeboard in this room, and my father made a remark on the arrangement. 
     
    “Yes, they are pretty aren’t they?” the old lady smiled. “Claire got them for me, bless her. My son had died this month 20 years ago, and I mentioned that I was planning on visiting his grave to her during my last check-up last year. The dear soul remembered… Bless her.” she sighed, wiping off a tear…
     
    It’s no wonder she always talks about being blessed and having the most adorable patients ever, “a veritable gang of second grandmas” as she puts it… 
     
    The humanity of that action… the sheer compassion and thought it showed… goddamnit… 
     
    THAT’S the kind of doctor I wanna be. 
    Hell… that’s the kind of PERSON I want to be!
     
    Random acts of kindness have the power to change lives. I’ve said it many times before… but these guys transcend that and make every action as good as possible. It’s bloody amazing, and I’m honoured to be affiliated with souls like this, and one day, aspire to be someone just like this.
     
     
    I know it’s hard to display this level of care and compassion everyday, for everyone during every circumstance too. But I know one thing as well… it’s bloody worth it. And I’ll definitely try to be as good a person, as well as a doctor, as I can be for everyone… forever. 
     
    But for you doctors, medical professionals; just ANYONE reading this, you don’t have to feel the pain, or the worry of getting a cancer to understand this. You don’t have to experience it first hand, as many doctors, such as these, end up doing before they themselves decide to write an inspiring article and change the way they practice. Hopefully reading this will make sure you try and do these little gestures of kindness without having to go through something yourself to get there. You don’t have to examine or read through textbooks and journal articles to find out how you should deal with your patients. All you’ve gotta do is Just Be Human.
    Just be nice… wherever you can.
    This profession can be tough. It can drain you. Make you feel like you’re not making a difference after years of seeing the same patients with these same issues come to you over and over again. But take it from someone who knows, from someone who’s been there. You will ALWAYS be able to make a difference in others’ lives. No matter what the circumstances. 
    It wasn’t the medical decisions that made my doctors special… no, what made my doctors special to me – were those tiny little things they did, which combined have changed… even saved my life.
    At one point, at my lowest, it was only knowing that there was a doctor out there who cared for me that stopped me from doing something I couldn’t take back.
    You could know everything there is to know about medicine and biology. You could be the GOD of medicine, but you still wouldn’t have been able to save me that day. Only that man could. And I think this goes to show that making someone feel cared for is the most powerful weapon you have on your side.
    And if you can spread that humanity in a place, at a time at someone’s life where there doesn’t seem to be much going around – you WILL Change Lives. You WILL make a difference. And if you’re ever struggling to find meaning in your life – be you a doctor or not – these acts will change YOUR life too.
    I hope this helps you see that.
     
     
     
  • 7 Great UCAT Tips You Probably Haven’t Heard Before

    This was pretty much a copy-pasted conversation I had with a friend asking for UCAT tips, so sorry if it’s not that well worded. In the time I did it – the UCAT was called the UCAT! But the principles, time sensitive nature of the test, and test taking skills are essentially the same. I figured I’d put up one of these so I wouldn’t have to do them individually any more and to help you guys out =P


    For those who don’t know, the UMAT – now known as UCAT – is a challenging pre-medical test every prospective doctor needs to sit in Australia and New Zealand. In most universities, it is a major consideration for gaining an interview and a seat in medicine. Unlike other requirements, such as good performance in final-year-school or university exams, it’s not necessarily based so much on knowledge as it is on non verbal and verbal problem solving skills and empathy. This is the official site which outlines the exam and basic preparation for them: https://www.ucat.edu.au/ucat-anz/practice-tests/-strategy . 
    Basically – there are 3 styles of questions. Previously – they were divided into ‘sections.’ You could only do section 1 type questions in the first 60 or so minutes. AFter that time was up, only then could you go onto Section 2 – with everyone else starting that section at the same time.
    Now, all these questions are jumbled up.
    “Section 1” questions give a passage of writing on a random topic or a logical assumption and then ask you to make logical assertions of it. It could be on anything – and though some of it is medical, most of the time it’s not. Indeed, in some years, they didn’t have ANY medical sections – so don’t feel you have to study biology at all.
    Section 2″ questions give passages about a few characters and ask you to make judgements on people’s  character, emotions and responses.
    And “Section 3” questions test your non-verbal reasoning and give you patterns and ask you to pick the option most likely to be next in the pattern, which one should be in the middle or which one is missing. Think puzzles. The hardest thing about the exam though is arguably the time factor. It’s a 3 hour test but filled with long passages and challenging questions.
     
    This post will not be focused on the best tips to tackle individual questions; there are many programs and blogs designed to help you on that topic, but rather on general tips, exam taking strategy and techniques that will help you in the exam. So here you go. The 7 best tips I give to people who do this test. 
    In long passages, which come up heaps in section 1 and 2:
     

    1) Read the Questions, before ANYTHING, and PLAN accordingly.

    1) – Have a look at the questions before you read the passage so you understand what you need for and then underline bits that will be, or seem important as you go along (so you can refer back to them later on). This is one of the best tips I can give, because it saves you so much time when compared to you effectively having to re-read the whole passage as you look for one or two key points.  People say that you should skim read and stuff like that – me – I make sure I understand EVERYTHING that needs to be understood before moving on.
    Instead of skimming through and having to reread a passage, 2 or 3 times, it makes more sense to just do it once and do it well. 
    By reading the questions first – you know what you can skim, and what you need to focus on to understand this.
     

    2) You can’t be perfect. Time is a huge factor! So don’t be worried to skip it!

    Don’t be afraid to skip or make educated guesses on questions. The UMAT is time intensive – so once you get a good guess or narrow it down to 1 that seems likely, don’t spend too long worrying about if it’s wrong or right – just move on.
     

    3) Practice previous papers for Section 3 puzzles, and get a grasp of how to answer the main puzzle types!

    With section 3 style questions – there’re different questions with patterns. Narrow it down systematically, as you can for most of them, then it becomes easy. For eg – “pick the middle” or “pick
    the ‘x’th”  ones where they give you 5 options, 3 will have a similar pattern, meaning 1 of those is the end, 1 is the beginning and 1 must be the middle. Narrow it down from there, pick the
    most likely of them after that and move on. You can check if they’re right if you have time at the end of the exam.
     

    4) Get some vocabulary down pat for section 2 – and understand them!

    For section 2 type questions – know the key vocab vocab. That was my worst, not because I couldn’t empathise with the characters’ feelings and situations, but because for some of them, I just didn’t know what a word like “indignant” or “beatific” really meant haha. So get delectable, despondent, those kinds of words through your head and make sure you understand some of the common words that come up.
     

    5) For the empathy questions – think about WHY they’re asking you these questions.

    Think like a doctor would think. Think about WHY they have section 2 style questions. They set questions that try and judge how you respond to the world, and they want doctors who are empathetic, who understand, who aren’t judgmental. Good people see good in others.
    So if there’s 2 options which seem similar but one is a more severe, or more evil reaction to a situation, pick the one which makes the persons actions seem somewhat reasonable. So don’t pick “jealous” or “angry” or “contempt” pick “reluctant gratitude”, “despondent” or “disappointed.” unless it really seems like it is just that for the character or subject they’re talking about. For eg if the
    question was”how did I feel after the fish came off the line” you wouldn’t say “Pissed the f*#* off” or “angry” you’d say something less severe like “disappointed”. A bit of an extreme example and one that may seem ludicrous (’cause if you know me, you know I get really, REALLY MAD when I miss a fish), but the message is the same.
     
    Those are the major “test taking skills” I used when I sat them. Remember, the tests aren’t the same as when I did them – the “section” style questions are mixed around, but that’s okay – it
    means you won’t be as pressured for time and that if you’re good at one section compared to another, you’ll get more time to focus on your weaker styles of questions or more time to go back and
    check!
     

    6) Even better than ‘studying’ or doing ‘drills,’ is just to READ

    But the best thing I did – I didn’t really do that much practice or that many practice papers – was I read in my spare time. A LOT. And I read widely too. And that made my reading speed, empathy and basic comprehension pretty damn good – perfect for a test like this. Section 1 type questions ask for you to interpret anything from some kind of scientific scrap of knowledge (it usually has nothing to do with medicine), to instructions on how to play table tennis. By reading articles from newspapers, as well as science journals, and indeed – other posts on my blog –  you’ll gain speed in comprehension. And learn more. By reading novels, or even better – short stories – you grasp what kind of things section 2 style questions ask. 
    I’d always be reading a good novel before I slept – it was a habit, I needed to before I slept. On top of that, I read things like TIME magazine, science/technical journals. it’s even easier to do it nowadays, and it’s not a chore at all – a lot of the things you can read are really interesting.
    Rig the algorithm, and fill your news feeds with stuff that makes you learn passively. The I Fucking LoveScience FacebookWeb page is a good place to start – it has a great science blog where it
    talks about recent advancements, which are all interesting and fun to read. All of this makes comprehension/ reading speed go up, and also gives random pieces of knowledge to you, which who knows, may just get you more marks. That’s exactly what you want in this kind of test!
     
    I guess those are some of my best tips for the actual UMAT – that’s what I did and ended up doing pretty well, even though I really didn’t prepare for it too well (I was in the 98th percentile, with an overall score of around 200, though I can’t remember exactly). 
     

    7) It’s not the be all and end all. Remember that.

    But the best tip I can give is a simple one. Don’t stress or panic. I talk about it in detail in this blog post I wrote not too long ago. I talked about stress and how it makes you perform worse… not just for tests like this, but for life in general – and – more importantly – I talked about how to deal with it. Stress, worry and panic won’t help you on the day.
    If you go in thinking “OMG this is life or death!”, “what if I forget stuff?” or “I’m not gonna do well!” you doom yourself to panicking, having mini-breakdowns in the test, a confused overworked mind and just feeling bad about yourself, which all lead to you being more likely to fail. If you instead go in on the day thinking “well, I’ve done what I can, all I gotta do is give that damn test” you’ll do yourself a great service. If it’s hard to see that in the day, the best advice I can give is to take a step back and look at the second, more constructive attitude you can take going into the exam.
     
    Instead of thinking about what there is to lose, think about what you have to GAIN. 
    The chance to make your career one where you spend every day of your life helping others, while doing well for yourself too. THAT’S how you’ll give yourself the best chance of making it.
     

     

    GOOD LUCK! Feel free to ask for more tips, advice, or your own tips. And feel free to splurge or vent and I’ll try and help you feel better about yourself!
    Sign up to my newsletter, and I’ll keep you up to date, and probably send a few sciencey articles that’ll help with your UCAT on the way 😉
    But no seriously – if you ever wanna talk – email me at info.at.nikhilautar.com
  • Vaccinations aren’t necessary??

    Last post:                                      My Story:                                         Next One:
    Anti-vaccination groups have pushed a scare campaign on the public for years now, claiming that vaccines harm, not help kids.

    But the truth is, this whole scare campaign really caught fire, after a literally fraudulent, made up paper, was published years ago. This video explains it well. Check it out. 
    Anti-vaccination movements have been around for a while, but this whole idea that vaccinations cause autism really started in 1998, after a paper was released looking at only 8 kids who’d ‘developed autism after having the measles vaccination’. But the fact was, that 8/12 of those kids had another disease at the time. Subjects were hired by an anti-vaccination group. Data was completely falsified – in fact NO children were found to even HAVE AUTISM in the study – yet alone 8/12. Since then. multiple studies, ranging from 5,000 to as many as 5 MILLION kids – have shown no association between the MMR (or any other) vaccine and autism. Hell – anti-vaxers even funded a $250,000 study to prove, once and for all, whether this was the case – and lo and behold… THEY FOUND THAT VACCINES DON’T CAUSE AUTISM!
    The article was retracted by the journal that published it. 11/12 of the original authors have retracted their statement – something never seen in medical articles before. Only 1, the person who wrote the initial article, a person who makes millions off this campaign, a person who had his medical licence revoked prior to this article being written, still backs his claim.

    At the time of publishing this paper, which has been confirmed to be fraudulent, Wakefield himself submitted a business prospectus for a new autism testing kit (of a strain of autism that he actually created) which would earn him $44 million A YEAR! He didn’t claim this conflict of interest, nor others that he had (including being paid £435,000 by lawyers to falsify the study – they were trying to win a lawsuit against vaccine companies and resorted to bribery, risking millions of lives in doing so) and now, he charges tens of thousands (some have claimed hundreds of thousands as he’s seen a resurgence in support, largely thanks to Trump’s anti-vaccine sentiments) in speaking fees. 

     
    It’s stupid.
    It’s FRAUD
    But the idea of not vaccinating still goes strong.
    And it’s already killed millions. 
     

    Prior to that vaccinations were seen as a godsend. Probably because before that we actually had children dying in large numbers in front of us, unlike the thousands who die every year without having an organisation that makes MILLIONS in donations behind them, due to their kids, or other kids, NOT BEING VACCINATED. Anti-vaccination/Pro-Disease movements have actually been listed in the top 10 threats to humanity by the World Health Organisation. 

    The question comes to mind.
    Why do people not know this information??
    Well it’s either: 
     

    1) Anti-vax campaigns and groups, though they may have arisen from actual concern, are now powerful. They keep providing funding to enhance their agenda, making people think those who support them are doing good, when in truth they’re unknowingly being led by people who know this information to KILL thousands of dollars a year. 
    Now they, either by accident or, more likely, purposefully, have created a whole conspiracy theory around the idea that the government is trying to cover something up or make people sick on purpose. They invest millions into this and are making millions off it too… while 30,000 adults in America alone –  a developed nation – die of diseases that would never had affected them had they been vaccinated.

    OR



    2) There is not enough conversation between scientists and ordinary people about why things are necessary and what different studies mean (or the studies don’t get publicised enough) because doctors/scientists don’t communicate well enough with the wider public and the public can’t get access of easy to process information.

    Likely, it’s a combination of both.




    The question now becomes:
    How do we fix it?

    Well, to stop the anti-vac campaigns, we need to raise awareness. 
    Make videos like this, blog posts like mine that expose these campaigns as the frauds they are go viral to the people who don’t know better and the people who question the necessity.



    To do this, we need to EDUCATE PEOPLE on why vaccinations are necessary. What the REAL side effects and chances of those happening are. Research has shown that explaining to them the risks as opposed to trying to hide them, and conversing with people, with effective, respectful communication strategies, as opposed to making memes about them or calling them idiots is more effective.
    And we have to communicate this information to the public, with as little jargon as possible, at levels that ANYONE WHO CAN READ CAN UNDERSTAND.
    Interestingly, evidence also shows that trying to persuade people is less effective than reminders for people to vaccinate.

    Vaccinations are why we, in the developed world, don’t have to worry about diseases like polio, smallpox and measles. 2 of those 3 still plague the developing world, by the way, and kill MILLIONS of people, a lot of them kids, every year. 
    To make sure they’re effective, a certain percentage of the entire population needs to be vaccinated. This level, which we call “herd immunity” will ensure that the population can’t spread the disease that’s being vaccinated against easily. The number varies among different diseases depending on how easily it spreads and other factors, but for the flu vaccine in Australia this year, that number was 95%.


    And if you’re skeptical about the effectiveness of these programs, a few of these stats should indicate how important they are. 

    Reduction in vaccine preventable diseases after 5 years of vaccination in Croatia:
    Bernard Keich, “Impact of Vaccination on Vaccine Preventable Disease in Croatia”, Periodicum Biologorum Vol 114, No 2, 141 – 147
     
     





    So they are necessary. And you can see from that video and my data above, they DON’T cause autism, like some groups would have you believe. 
    They do have side effects in some patients (less than 1%), but most of them are minor, and they save more than they harm. 

    Without them, we’d still have millions of people, most of them KIDS dying every year.
    Millions of kids die every year in the developing world from diseases that could have been vaccinated against. 
    We are privileged to not have our kids torn away from us. 
     
    But this may soon be changing… with incidences occuring more and more in developed countries due to the influences of the Anti-Vac movement. 
    You and I can stop this trend where it stands.
     
    If We Vaccinate Our Kids. 


    You can do your part by sharing that video, or this blog post with those less aware than you so that you can save your kids’ lives, as well as THEIR KIDS’ LIVES.


    My facebook page:
    https://www.facebook.com/musingsofamedstudentpatient

    An addition to the original post – A guide to educating those who think vaccinating isn’t safe:

    One question to pose to all anti-vaccers next time you debate them – what’s the harm of vaccinating? The only evidence of it having some conceivable harm was the fraudulent Wakefield studies shown above. No heavy metals are added to vaccines any more by law, indeed, they never exceeded the amount you get in a serve of tuna. Risks of things like Gullian Baree Syndrome are 3/1,000,000. For the Flu vaccine, these rates are 1/1,000,000. The Flu itself has a 17/1,000,000 risk of causing GBS!. Risks of febrile seizure are present, at 30/100,000 children vaccinated, but they cause no long term harm. Indeed, reducing incidence of severe diseases like measels, or the flu, which cause febrile seizures at much higher rates than vaccines ever could, actually leads to LESS overall febrile seizures from occurring than vaccinating. 
     
    Common Arguments They Make. Why they’re wrong:
     
    They often argue “It’s good to have some diseases early in life!” – well vaccines work on that same principle.
    Except instead of giving you one that can leave you sterile, brain damaged or dead, it gives you a weaker/dead version of the disease so that your immune system is prepped for later encounters with disease. This video outlines the immune processes that occur in vaccination and the dangers of not vaccinating really effectively!

     
    “They don’t work in all people! Why should I get mine?”
    That’s true – they don’t always cause the intended effect, and vaccinated people can still get sick. However, if enough people in a population are vaccinated (and evenly so – as in, there aren’t pockets where people have very low vaccination rates where diseases can spread) the disease can’t spread in the first place, so everyone’s gotta do it for it to be effective. Many people (pregnant ladies and immunocompromised people for eg) can’t get them – so you’re protecting not only yourself and your kids, but also them. That’s the concept of herd immunity!

    “But what about the toxins and insets on vaccinations which outline worst case scenarios and the vaccination court? Doesn’t that PROVE vaccines do cause harm?”

    In preparing vaccinations to ensure they’re safe, some chemicals are added to some vaccines. The most common ones espoused by anti-vaxers are things like formaldehyde and mercury. However, you get 10-60x more formaldehyde when eating an apple as compared to the traces of formaldehyde left in vaccines after their preparation. Similarly, the use of thimerosal has also been criticized, but most modern vaccines no longer have ANY mercury or mercury derivatives (indeed, many of these mercury derivatives are passe through via stool as well) – and you get a higher dose of mercury in an 85g serve of tinned tuna than you do from any vaccine too.

    “But can’t vaccination make me sick?”

    Most vaccines out in the market are inactivated ones. The flu vaccine is the most famous, common example. Viruses are killed and there is literally no way that they can cause you to catch the disease. Live vaccines are out there too. But they utilise a severely weakened version of the pathogen they’re immunising for, or even, in some cases, use similar viruses or pathogens which are nowhere near as dangerous as the actual vaccine, but confer good rates of protection nontheless.

    I understand. You’re concerned. But hopefully I shown you why vaccinating is so crucial. Do let me know if you are still concerned – you can reach me at info [a.t.] nikhilautar.com
  • 5 Reasons Why You Can’t Afford NOT To Give Blood, and Join the Bone Marrow Donor Registry.

    And Join the Bone Marrow Donor Registry

    Through my journey to recovery, I’ve said thanks countless times; to my doctors, my nurses, my parents and my bone marrow donors. But the other day, I realised that I must have had at least a hundred bags of blood pushed into my veins at some point in my treatment. That’s on top of the two very vital bone marrow transplants I had.

     
    It’s staggering the lengths our health system will go to in order to save a life.
     
    I guess only after getting sick and really needing those bags of blood did I understand the importance of blood donation. After volunteering at the blood bank, I realised how much goes into just maintaining proper stocks.
     
    Most blood products have to be collected on a regular basis, as they can’t be frozen. In fact, all of them can’t, except for plasma. And, as you’ll learn by the end of this… some common treatments require literally THOUSANDS of plasma donations per patient. 
     
    I’d been brought up with the idea, the common misconception, that giving blood is a painful, time consuming process. But in truth – it was anything but.
     
    I watched people walk in out within twenty minutes, smiling the whole time. Only 6 of which was actually spent giving blood. But despite all the great work that thousands of Australians, and those in other countries of course, do every day in donating blood – there is still a critical shortage. In fact Australia, as a country, still has to import blood to keep up with demand. 


    Only 1/30 people donate. These guys often donate regularly and are the reason we don’t have to import huge amounts of blood. People don’t give because they’re afraid of the procedure, because they don’t think it’s needed, or because they don’t care.     
     
    But what if it I told you that the only pain involved was the initial needle prick… pain no more than a blood test? That it only took 6 minutes. That there is indeed shortages in giving blood, and in the bone marrow donor registry, particularly in the minorities, and during winter when regular donors get sick. And what if I told you that there are pretty awesome benefits of giving blood too – you get paid, you reducing your risk of major diseases like cancer and heart attacks and you even lose quite a bit of weight losing weight. So you’re not only saving 3 lives every time you donate… you’re helping yourself too.


    Well – all of these are true. And I hope these ideas will make you see that you can’t afford NOT to give blood.

    1) It’s needed – and demand for it is always increasing.
    2) It’s an easy, almost painless procedure.
    3) It’s a free health check-up every 3 months and there are HUGE health benefits to boot!
    4) There are financial benefits and free stuff that you could
    be missing out on!

    5) It’s a great way to lose weight and you get a guilt free meal each time you do it!

    Here’s a video I made outlining the benefits of giving blood – and why you can’t afford NOT to do it!

     
    1) The necessity is
    ever present and ever increasing.
     
    Everyone’s heard this stat. 1/3 people will need blood in their lifetime. But only 1/30 donate regularly. As an Australian, as citizens of a developed country, we will never have a shortage of blood as we are rich enough to buy blood in times of shortages. Health systems suffer and people literally die when they don’t get access to the blood they need and to boot… that money doesn’t come from nowhere. We pay for it. Through our taxes. 
     
    Blood donations have to be constant. As I said before, you can’t freeze whole blood or platelets. And during cold and flu season in particular, regular donors are often sick and can’t donate – so it’s needed even more then!
    So make sure you donate. The procedure takes, in most cases, 5-15 minutes. And almost all of the pain you feel comes in the first few seconds. They’re often less painful than even a blood test, because staff there do this every day, and because they have access to ultrasounds and other tech which makes the process less painful, and extremely accurate.  
    And the increase in the amount of bone marrow transplant procedures done, as doctors realise it is a viable method for treating a variety of autoimmune conditions, such as diabetes, scleroderma and even AIDS, as well as blood cancers like mine, means that demand for bone marrow donors is higher than ever before. But the registry, where your ’tissue type,’ (your immune profile – which has to match, or nearly match, a patients’ own profile to be able to do a stem cell transplant) still remains sparse.  This means many people will not get a second chance at life like I had. In Australia, you need to donate blood to join the registry. And you need to actively ask them in the pre-donation interview to join it! So do that! In many countries, you only need a swab of the cheek!  
    But did you know, despite the scary name, over 95% of people who get called up to donate marrow (a 1/400 chance of that even happening) never actually have their marrow invaded at all? They need your STEM cells, which they can collect peripherally, from veins in your arms. I’ll explain how the stem cell donation process works more in the next section.

     
    Sadly, some cultures in particular lag behind others when it comes to joining a stem cell donor registry, and giving blood. People of Indian, Asian, Black or Middle-Eastern descent in particular have much lower rates of participation on this front. This pie chart above, based on the American Bone Marrow Donor Registry, demonstrates this shortage for Asian and African-Americans in particular. 


    A lot of this is due to cultural beliefs that blood is related to male virility, but a much larger part of this is due to lack of awareness, or being afraid of the actual procedure. Well, hopefully, the next point will change your mind about that.
     
    2) It’s easier than you think and involves little risk to the giver.
     
    Many people relate the process of giving blood to intense pain and a lot of sacrifice on behalf of the donor. While it is a very noble thing to do, it’s not nearly as scary as it seems…
     
    Did you know, whole blood donations are done in 6 – 10
    minutes?
    Did you know that the only pain involved is the initial jab
    from the needle, not from the blood leaving the arm?
    And did you know that a vast majority (over 95%!) have absolutely no side effects from giving blood?
     
    I won’t kid you, the needle is larger than most. But the fact that you’re required to drink a litre of water before donating, and the fact that you’ve got the best phlebotomists (the fancy word for blood takers) working on you means your chances of having severe pain from a blood donation are very small. In fact, in his greater than 20 years experience in donating blood, my father has only had one “two-arm-specials,” where they had to jab him twice. IN OVER 200 DONATIONS! I’ve had a MUCH higher rate of blood takers missing veins in my 12-13 years of treatment, that’s for sure…
    That alone is a true testament to the skill these guys have. As a doctor, I wish I had this kind of skill. 
     
     
    Here’s a picture to put it in perspective. The one they use in blood samples is the blue or purple one standing up. The one they use in taking blood donations is the light blue or black one lying down. Yeah, it’s a little bigger, but when you know that the pain only lasts an instant, not throughout the whole donation, it doesn’t make much of a difference.

    Relaxing during a blood donation. Over 200 (300 now since I wrote this) done by this man – my father – alone. 
    Joining the bone marrow donor registry doesn’t involve extra
    pain. In fact – they NEVER need a sample of your bone marrow to join!


    To join the registry in Australia, historically, you’d have to donate blood and be under the age of 45, so that if a match is found, you don’t get the unfortunate situation of a person refusing to donate their stem cells due to fear of the procedure. 
    Even then, joining the registry only involves the taking of an extra 20mL of blood, which they use to figure out your “tissue type,” which is used to match the recipient to a donor. You may as well, while you’re donating blood anyways, right?
    When you consider you’re giving 475mL of blood at the time anyways, that isn’t too much. Make sure to ASK to join the blood donor registry, as they may not bring it up with you otherwise, and someone will hand you a form to do just that.
     
    In America though – it’s even simpler. It only involves buying a $5 kit and sending in a sample of your DNA taken from a cheek swab to join. Right now – in Australia – you can do the swab method too!
     
    Once you’re on the list – you’re on there forever. 
    And
    there’s only a 1/400 chance of being a match for someone in your lifetime.
     
    And the procedure of donating marrow is nowhere near as painful as it sounds! In 95% of cases, it’s actually STEM CELLS that you donate. The process takes 3 hours and basically involves taking blood from one arm, siphoning off the stem cells they need, and pumping it back into your other arm. They may give you medications a few days to weeks before to ensure your stem cells exit your marrow, and circulate in your blood.
    But even if they need to take it from your marrow, you’re under general anaesthetic, so it’s nowhere near as painful as it sounds. In fact, that 5% of people who do give via that means, often do so because they’d prefer to not feel anything and take a while to recover than choosing the other option. 

     

     
    For more info on how to join the registry, click here:
     
    America/International:
    3) It’s healthy for you! You get a free health check-up. And it may reduce your risk of heart disease, cancer and diabetes too!
     
    Every time you give blood, they need to assess whether your blood is healthy. So giving blood every 3 months is essentially a free, quick health check-up, at least for your blood counts (though I wouldn’t recommend not getting physicals/check-ups done just because you’ve given blood). It’s a great way to catch diseases early.
     
    Indeed, in my case, I would’ve known I had myelodysplasia syndrome (MDS) a long time before it developed into its deadly form, acute myeloid leukemia (AML). And MDS is much easier to treat than AML, which I found out the hard way.
     
    I’m not saying that you’re at risk of getting such diseases if you don’t give blood, but you will definitely pick up on any abnormalities you may have earlier, making any conditions you may develop much more easily treatable if you do.


    But early detection isn’t the only benefit. Giving blood regularly has been shown to reduce the risk of heart attacks in men, as well as the ability to slow insulin resistance which leads to diabetes.  A study of nearly 3000 men in Finland showed those who did give blood regularly had an 88% lower risk of heart attack than those who didn’t! That’s HUGE! Donating blood has been known to reduce the buildup of toxic elements in your blood, including iron, making it not only a free detox, but a good way to reduce your risk of cancer!

    4) You’re missing out on a lot of benefits – including time off, and money.
     
    While talking to a few donators at the marrow centre, I realised that a lot of them were there not only to give others a second chance at life, but also to help themselves fiscally.
     
    A lot of the donors were actually school kids. I wondered why. Apparently, they came as often as they could over the year in order to miss a few periods of class.
    But it’s not just school kids who benefit. A good chunk of people donating were actually being paid to do so, or given a half day, or day off by their employers. There are many schemes and benefits out there where you can donate blood and actually be paid for the time it’s taken out of your day by your employer. And I’m sure sitting in a chair for 10 minutes is much more preferable to slugging it out at work! Depending on where you live, there may be tax benefits eligible for donating.
    Indeed, in some countries, including the US, they even pay you for donating blood!
     
    Here’s a link to a video of how you can do this in America:

    The ethics and implications of a system which compensates everyone for donating is interesting. But if you can cash in AND save lives, there’s nothing wrong with doing both!



    5) You lose weight donating blood!
     
    When you donate blood, your body needs to replace what was lost. In fact, it takes at least 650 calories to replace a pint donation ofblood. That’s the equivalent of going on a 5mile run!
    Feel a split second of pain in your arm and sit on a chair for under 10 minutes or run 4-5 miles? You decide.

    I know which one I’d choose…

     

     
    Not only that – but after giving blood, you’re given a chance to go crazy over a veritable buffet. At the centre where I volunteer (Liverpool) there are sausage rolls, pies, soups, milkshakes, coffees, toast and more – and it’s served by chirpy, good looking volunteers (well, at least when I’m on duty).
    When I’m feeling too lazy to cook one day, or needed a break while stressing over exams,  this would be where I’d be going to get a free meal. Indeed, the fact that you know your body will have to work to make up for what you’ve lost will mean you can have a guilt free meal. Be warned though – too much donating can result in a figure like this:

    Dad going to TOWN on some freebies. Remember – this is only the COLD food they provide. Add to this sausage rolls, pies and milkshakes, and that’s what’s on offer every time you donate! Some centers have other meals on offer too, including lasagna, pies, and even give out additional meal vouchers for restaurants.

     
     
    So – now that you’re convinced that you’ve got to go out and give blood – remember these things:
     
    Before giving blood, make sure you have a meal and drink a litre of water within 3 hours of donating. It’s a requirement and you don’t wanna be turned back on the day!
    Try and include high iron foods and things like orange juice (which increases iron absorption) to ensure your iron and haemoglobin levels are sufficient. A tip from the nurses there – spinach and orange juice in the meal before you donate increases iron levels into the healthy range for those who find themselves turned back for being too low. My mum had low haemoglobin levels, and was turned back many times when trying to donate. But after eating that spinach with orange juice (she’s a vegetarian, so red meat wasn’t an option) religiously for a few weeks, she managed to donate blood for the first time during COVID-19 lockdowns – when it was needed most!
    Make sure you haven’t travelled to areas with infectious diseases in the past 3 months and make sure that you can prove any recent tattoos you’ve had were done in sterile situations.
     
    After you’re done giving blood – make sure you drink a glass of water before eating or drinking anything hot, just in case, as it reduces the already small chance of vaso-vagal syncope.
     
    To find and make an appointment to give blood at your local blood donation centre, click here:
      [email-subscribers namefield=”YES” desc=”” group=”Public”]
    How can you help if you can’t donate blood?
     
    Unfortunately, a small chunk of women, and some men, can’t donate blood as their iron levels are not high enough. And there are other reasons why people can’t donate too.
     
    But if you can’t give blood and join the bone marrow donor registry, you can still spread the word and encourage others to do so! Whether you mention it next time you catch up with friends or just post it on your Facebook wall – these things all count and if it helps 1 extra person get into donating blood, well, you’ve already saved 3 lives!
     
    If you are donating – make sure you “check in” on social media each time you give blood. Letting people know what you’re doing is not boasting (even though it’s definitely something you should be proud of) when it gets others to donate too!

    You can also volunteer at the Red Cross like I do, either by helping out and giving snacks to the donors, or by driving a car or van that picks up donors. It looks great on your CV and you’re just as vital a cog in the great machine as the donors themselves. Click here for more info.



    Participating or donating to people in the World’s Greatest Shave or events like the Leukaemia Foundation’s “Light the Night Walks” also helps in a similar way.

    Here’s a speech I gave at the most recent Light the Night event about how I stayed happy during my treatment, and how the Foundation helped me during my treatment:

     
     
    Other things you can do include donating to the Red Cross or
    to the Leukemia Foundation, which can be done through the links below. These organisations are trying to find a cure and save people from having to go through this pain in the
    first place! 

     

    And make sure you share this with others and on your Facebook Walls so as many people as possible join up and so more lives can be saved.

    Another way you can donate – PLASMA! And why it’s so necessary!
    The name of a treatment I used to get – Intragam. Not Instagram. #INTRAGAM.
    This was a blood product I used to get once a month to help with the chronic inflammatory disease process and nerve damage my#bonemarrowtransplant gave me. Though it wasn’t fun, coming in every month to be plugged into an IV pump for over 2 years, it likely did delay further damage and was one of many blood products which have kept me here.Every 200mL bottle takes 7.5 ENTIRE Plasma donations to create, if we’re strictly speaking numbers of immunoglobulins, aka antibodies, specifically IgGs (antibodies essentially confer immunity to people who can’t produce antibodies on their own, and mitigate some autoimmune disease processes by triggering suppressive pathways of your immune system) per mL, dosage wise. I used to get around 750mL of this stuff. Every month.But each of these bottles contains a mix of 1000 individuals’ IgGs. It took a literal village to keep me going for a time there! And plasma, like blood, is not only easy to donate – it can be done every 2 weeks, and, as you can clearly see, is really needed.More info on that process, on how easy it is to donate blood, how it actually is healthy to do so (each plasma donation burns 450 calories – whole blood, 600!), and how joining the list to donate bone marrow (and even donating bone marrow itself) doesn’t require, at any point, a needle in your bones at nikhilautar.com/donateblood
    #redcross #vampirecup #blooddonation #intragam#notinstagram #everydonationcounts #doit!#spoonies #spoonie #chronicillness #chronicpain#nervedamage #peripheralneuropathy



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  • Nurses. True Angels in our Wards.

    Last post:                                      My Story:                                         Next One:

    You see it all the time on those medical shows on TV. 
    You see a doctor, who could probably earn millions modelling
    on the side, running through hallways and corridors, hanging IV drips, getting patients
    food, finding time to sit down and talk patients through all their fears and
    concerns – basically doing anything and everything to help the patients through
    all of their troubles. 
    I guess that’s what I’d expected would happen when I was told I had cancer.
    My first week in hospital, however, would turn out to be a shock to my system. Even on the
    day I was diagnosed, I saw my doctors for no more than thirty minutes. 30
    minutes! And that would turn out to be the longest single session I’d see a doctor in
    a day, outside of emergencies… well… ever. 
    In the end, it was the nurses who did the REAL work.
    I’d been brought up, maybe through the media, maybe through cultural
    perceptions – probably through ignorance – thinking that a nurse was just an
    over-hyped house-maid. 
    As it turned out, it was a nurse who placed my first canula
    in emergency. A nurse who took my bloods every morning. A nurse who’d be in
    charge of injecting chemotherapy through my central line – a long plastic tube
    that pumps medicines from the veins in your neck to your heart. Hell, it was a nurse who
    put that in too!  
    If it wasn’t for their badges and uniforms, I wouldn’t have known the difference between them and the doctors. 
    In fact, I would’ve thought that they were the doctors. 
    Because the thing I found most astounding was that despite all their work on top of these vital responsibilites, despite taking care of, at times, half a ward-full of critical patients… despite their unreasonable shifts and rosters, they still managed to find the time to do all those I thought doctors would be doing.
    Yeah, it was a doctor first gave me the bad news. Yeah, he was the one who prescribed all my medications. Yeah, he was the one whose knowledge and experience I could trust.
    But it was a nurse who sat down and hugged me with my parents that day after I’d been told I had leukemia. A nurse who told me that my journey would be hard, but reminded me that I could survive nonetheless. A nurse who would sit down and just chat when I just couldn’t find it in me to sleep for the pain and worry. 
    And no matter how many cards we gave them in thanks, no matter how many chocolates or donuts we brought in – the true testament to their generous, giving souls, was the fact that they ALWAYS shared them with all the staff on duty. 
    Personally, for me, they’ve always been the balm that eased the sore of treatment. The girls and guys who’d go beyond their strict professional duty and hold my hand in emergencies, keep me calm during procedures and just keep me cheerful through their words and their, at times, crazy antics.
    And if it wasn’t for them, I wouldn’t be the man I am today.
    I remember the day I came back in for my second round of chemotherapy. My heart was racing, pulse rising from my usual 60 beats per minute to well over double that, and it stayed that way for most of the day. 
    I was back in that damn place, stuck in the tiny confines of that room for what would end up being fifty-six consecutive, bed-ridden days. And the crazy thing was, I didn’t even realise I was in trouble. I hadn’t felt apprehensive or anxious about all this… I’d unconsciously bottled it all up. 
    But then, as I walked around the corridors and glimpsed the door of my last room, I saw this. 
    They’d known that I was a fishing tragic and that that was exactly what I’d be doing in my 2 week break. No matter how tiring, risky and stupid.
    And, just realising that the next few weeks of pain and torture would be eased by these people, these amazing souls who made their job a profession dropped my heart rate back down to normal. 
    They’re angels, all of them. The humblest, most devoted, most under-appreciated, yet most vital aspect of hospital life. And in my eyes, they’re the lynchpin of our medical system.
    So I hope after reading this, that next time a nurse tells you that you’ll have to wait another half-hour in emergency, you’ll understand it’s probably because there’s somebody who’s going through haemolytic shock due to
    blood loss just behind that ED door. Next time a nurse insists that you leave a friend or family members bedside, after initially getting upset, you’ll see that it’s because if they didn’t, other patients’ rest may be in jeopardy. Next
    time you’re about to berate a nurse for getting the bloods done a little late that morning, it’s probably because they had six other patients to medicate before they’d even gotten the chance to pull bloods out of a line.
    And I hope that you’ll forgive them. If not for their compassion, dedication or graciousness, for the fact that you’d expect the same of them if you were the one on that bed.
    Don’t worry – I know there are many roles in healthcare that
    do just as amazing work – social workers, dieticians and the hospitality to give a few examples. I’ll be doing them justice in later posts, don’t worry about that. 
    As for doctors, I do believe they have to up their game in helping the people they care for beyond just their physical condition. Read more about that here
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