Featured Read: Finding Chicka

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“Bestselling author Mitch Albom returns to nonfiction for the first time in more than a decade in this poignant memoir that celebrates Chika, a young Haitian orphan whose short life would forever change his heart.

Chika Jeune was born three days before the devastating earthquake that decimated Haiti in 2010. She spent her infancy in a landscape of extreme poverty, and when her mother died giving birth to a baby brother, Chika was brought to The Have Faith Haiti Orphanage that Albom operates in Port Au Prince.

With no children of their own, the forty-plus children who live, play, and go to school at the orphanage have become family to Mitch and his wife, Janine. Chika’s arrival makes a quick impression. Brave and self-assured, even as a three-year-old, she delights the other kids and teachers. But at age five, Chika is suddenly diagnosed with something a doctor there says, “No one in Haiti can help you with.”

Mitch and Janine bring Chika to Detroit, hopeful that American medical care can soon return her to her homeland. Instead, Chika becomes a permanent part of their household, and their lives, as they embark on a two-year, around-the-world journey to find a cure. As Chika’s boundless optimism and humor teach Mitch the joys of caring for a child, he learns that a relationship built on love, no matter what blows it takes, can never be lost.

Told in hindsight, and through illuminating conversations with Chika herself, this is Albom at his most poignant and vulnerable. Finding Chika is a celebration of a girl, her adoptive guardians, and the incredible bond they formed—a devastatingly beautiful portrait of what it means to be a family, regardless of how it is made.” (1)

  1. Amazon. Finding Chicka. Amazon. https://www.amazon.com/gp/product/B07NWR1JRW?ref=dbs_p2d_P_R_popup_yes_pony_T1. Published 2010. Accessed October 18, 2019.
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Featured Book: Compassionomics

Check out this recommended read, I’ve provided the electronic equivalent of a back cover blurb curtesy of Amazon.

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” A 34-year-old man fighting for his life in the Intensive Care Unit is on an artificial respirator for over a month. Could it be that his chance of getting off the respirator is not how much his nurses know, but rather how much they care?

A 75-year-old woman is heroically saved by a major trauma center only to be discharged and fatally struck by a car while walking home from the hospital. Could a lack of compassion from the hospital staff have been a factor in her death?

Compelling new research shows that health care is in the midst of a compassion crisis.
But the pivotal question is this: Does compassion really matter?

In Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, physician scientists Stephen Trzeciak and Anthony Mazzarelli uncover the eye-opening data that compassion could be a wonder drug for the 21st century.

Now, for the first time ever, a rigorous review of the science – coupled with captivating stories from the front lines of medicine – demonstrates that human connection in health care matters in astonishing ways. Never before has all the evidence been synthesized together in one place.

You will see compelling evidence that:
– Compassion has vast benefits for patients across a wide variety of conditions
– Missed opportunities for compassion can have devastating health effects
– Compassion can help reverse the cost crisis in health care
– Compassion can be an antidote for burnout among health care providers
– 40 seconds of compassion can save a life

After seeing all the evidence, the answer is crystal clear: Compassion matters…in not only meaningful but measurable ways.” (1)

  1. Trzeciak S, Booker C, Mazzarelli A. Compassionomics: the revolutionary scientific evidence that caring makes a difference. Amazon. https://www.amazon.com/Compassionomics-Revolutionary-Scientific-Evidence-Difference/dp/1622181069. Published 2019. Accessed October 18, 2019.

When healthcare “happens” to patients

Recently I’ve had several patients that shared a similarity.  They seemed to be content with allowing their life, or at least their healthcare to “happen.”

What do I mean by “patients who allow healthcare happen to them?”  The very first thing I notice when I’m working with a patient who exercises no agency is that the work is hard and slow.  The work that the patient abdicates to the provider often feels heavier.  As the healthcare worker you’re not only now interfacing with someone who has a health problem and is consuming medical care, you are working with someone who has a problem that they think you can solve.  Many times providers will work with patients to understand what patients really want, to make most effective time of the patient encounter.  But have you ever come across those patients that don’t know what they want? Consider the screaming child in the middle of tantrum who can’t remember what the issue was to begin with and yet they will pout until something magical happens when they feel better. Do every feel like you’re negotiating with a child in a tantrum? Sometimes I come across patients that want you to help with EVERYTHING.  They can’t articulate it but deep down they want you to divine their purpose, so you cant fit a perfect intervention into their life, that is if they understood what their goals of care were.

I take my example to the extreme, but everyone has had a patient where life continues to ‘happen’ directly to the patient.  Many times the patient quite literally had a string of unexpected, uncontrolled things happen in their lives.  Some patients have been seriously disenfranchised by their circumstances such that learned helplessness has taken hold.  This type of patient reminds me of Santiago in the foreign market place.  He has just sold all of his worldly belongings and crossed into a brand new world when he is robbed and lost. Do you ever see a little bit of Santiago in your patients?  A lot of times these patient will get mad at you. I find this most frustrating.  The patient who cannot articulate what he or she wants is insistent that you fix “it,” what ever it is, RIGHT NOW.   I think in many ways Santiago had already made the grand gesture of embarking on a journey and now, robbed and lost, the world wants even more of him.  His adventure, which appeared to be “happening to” poor Santiago was cruel and unforgiving and left him feeling like he had no agency.

Now comes the question.  Santiago’s adventure didn’t stop in the market place, so what was the special sauce that move him forward? What do you offer your patients who act as though life is “happening to” them? How do you continue on the journey with those difficult patients but share the load?

Finding Inspiration in Purpose, Part I

One of the resounding themes of The Alchemist is Santiago’s journey, that in the end, leads him on a search for purpose.  Santiago has the benefit of reflection, of long hours in the fields with his sheep, or later in long expanses of time traveling the desert contemplating the meaning of his life’s events.  That’s a luxury that many residents, heck anyone who works in a busy emergency room might forego.

Being the quintessential emergency physician I was drawn to a quick top 10 list, pared town to 5 list, words of wisdom while on your journey to your purpose. They echo many of the lessons Santiago encounters over the course of the novel.

 

1. Letting discouragement overwhelm you.

Santiago took risk after risk by leaving his home town, selling his flock and traveling to a new country only to be robbed on arrival.  He didn’t let it stop his transformative journey and neither should you let failure dissuade you from your purpose.

2. Denying your current situation.

Santiago knew that he couldn’t stay at the Oasis without pursuing his purpose, even if that meant leaving Fatima.  Take stock, and honor your present.

3. Dwelling on the past.

Maybe if Santiago had fixated on the life set out for him by his family maybe he would have never lead to his adventures. Life takes courage folks. 

4. Procrastinating.

If Santiago had not realized his vision for the crystal merchant, he would have never made it to the caravan. Don’t let time be your enemy.

5.  Trying to get approval for your dream.

The Englishman was blinded by his end goal of transforming lesser elements to gold, his only validation came from accomplishing the seemingly impossible task.  What if he had taken a moment to enjoy the trek across the desert, enjoyed the stars.   Residency definitely feels like a trek across the desert, so maybe we should take a few moments to enjoy the stars.

  1. Davis A. 10 Mistakes To Avoid When Chasing Your Dream. Tiny Buddha. https://tinybuddha.com/blog/10-mistakes-to-avoid-when-chasing-your-dream/. Published January 21, 2016. Accessed September 7, 2019.

 

Adventure Reading

Do you ever feel like Santigo of the Alchemist, needing direction during the daily drudge?  Yearning for more adventure in your life?  Living that low budget resident life?   Outside magazine asked readers what inspired their “athletic, artistic, and environmental feats,”  many highlighting insight which might come in handy in the emergency department. Check out these summer reads, and even more, found at:

https://www.outsideonline.com/2176152/adventurers-books-changed-their-lives?utm_source=facebook&utm_campaign=facebookpost&utm_medium=social&fbclid=IwAR1ew3J5vGF7UXXmi1nVkhbMpu5nMhGkmvwoTMm8nff4UVM4bwMk4cvc4MM.

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‘Willpower: Rediscovering the Greatest Human Strength’ by Roy F. Baumeister

“When distance runner Alexi Pappas was assigned psychologist Baumeister’s book about self-control as summer reading in college, it changed the way she thought about her limits as an athlete. “The book gave me the words to identify some of the things I was feeling,” Pappas says. “It taught me that I have a certain amount of willpower that can be depleted but can also be replenished, which are both such important things to know and realize as an athlete trying to push boundaries and improve yet also have longevity. It also told me that it is okay and super important to sleep.”” (1)

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‘Thinking Fast and Slow’ by Daniel Kahneman

 

“In his job as host of the Dirtbag Diaries podcastFitz Cahall breaks down a lot of the one-dimensional conventions we have about the outdoors, from weekend warriors to environmental activism. The book that Cahall says colored a lot of his thinking, Thinking Fast and Slow, does the same, just on a different scale. “I think for me it basically comes down to this: there are a lot of obvious ways of looking at the world and at people, but they aren’t always the correct ones,” he says. “We are really good at tricking ourselves into following others and our own deep biases. Right now, I think it’s worth examining how we think, how we engage, and how we empathize with others. There are a lot of ideas in that book, but I think what’s important is that questioning our assumptions is more imperative than ever.”

Our Favorite Quote: “Our comforting conviction that the world makes sense rests on a secure foundation: our almost unlimited ability to ignore our ignorance.”” (1)

 

  1. Hansman H. 10 Adventurers on the Books that Changed Their Lives. Outside Online. https://www.outsideonline.com/2176152/adventurers-books-changed-their-lives?utm_source=facebook&utm_campaign=facebookpost&utm_medium=social&fbclid=IwAR1ew3J5vGF7UXXmi1nVkhbMpu5nMhGkmvwoTMm8nff4UVM4bwMk4cvc4MM. Published July 10, 2019. Accessed August 21, 2019.

 

Fall 2019 Selection

The Alchemist by Pablo Coelho

Check out this review, if you’re feeling luke-warm about the selection, this youtuber will get you pscyhed! (1)

Bonus: No joke on the graphic novel version of this book!  https://www.amazon.com/Alchemist-Paulo-Translated-Clarke-Coelho/dp/0007435185

  1. Entertainment MD. This is why you should read the Alchemist! (Review). YouTube. https://www.youtube.com/watch?v=dH0IVh5YOLY. Published September 1, 2014. Accessed July 28, 2019.

Copa Book Club Fall Selections

A Long Way Gone

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A Long Way Gone: Memoirs of a Boy Soldier (2007) is a memoir written by Ishmael Beah, an author from Sierra Leone. The book is a firsthand account of Beah’s time as a child soldier during the civil war in Sierra Leone (1990s).[1] Beah ran away from his village at the age of 12 after it was attacked by rebels, and he became forever separated from his immediate family. He wandered the war-filled country and was forced to join an army unit who brainwashed him into using guns and drugs. By 13, he had perpetrated and witnessed a great deal of violence. At the age of 16, however, UNICEF removed him from the unit and put him into a rehabilitation program. There he was able to find his uncle that would adopt him. With the help of some of the staff he was able to return to a civilian life and get off drugs. He was then given an opportunity to teach others about child soldiers. He traveled the United States recounting his story.”  (1)

 

One Few Over the Cuckoo’s Nest

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“One Flew Over the Cuckoo’s Nest (1962) is a novel written by Ken Kesey. Set in an Oregon psychiatric hospital, the narrative serves as a study of institutional processes and the human mind as well as a critique of behaviorism and a tribute to individualistic principles.[3]  (3)

The Alchemist 

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“Paulo Coelho’s masterpiece tells the magical story of Santiago, an Andalusian shepherd boy who yearns to travel in search of a worldly treasure as extravagant as any ever found.

The story of the treasures Santiago finds along the way teaches us, as only a few stories can, about the essential wisdom of listening to our hearts, learning to read the omens strewn along life’s path, and, above all, following our dreams.” (2)

 

  1. A Long Way Gone. Wikipedia. https://en.wikipedia.org/wiki/A_Long_Way_Gone. Published March 6, 2019. Accessed July 22, 2019.
  2. Coelho P. The Alchemist. Amazon. https://www.amazon.com/Alchemist-Paulo-Coelho/dp/0061122416. Published April 25, 2006. Accessed July 22, 2019
  3.  One Flew Over the Cuckoo’s Nest (novel). Wikipedia. https://en.wikipedia.org/wiki/One_Flew_Over_the_Cuckoo’s_Nest_(novel). Published June 22, 2019. Accessed July 22, 2019.

Dream Land, Summarized

We hope you can make it to the July 23rd Summer Edition Copa book club. A quick summary for reference from Book Rags.

“Working as a crime reporter with a focus on Mexican drug trafficking, Sam Quinones found himself at the nexus of Ohio’s Rust Belt and Appalachian Kentucky, investigating how heroin from a small village from a small state in Mexico found its way to the eastern United States in alarming numbers. “I grew consumed by this story,” he admits the book’s introduction, “it was a story about America and Mexico, about addiction and marketing, about wealth and poverty, about happiness and how to achieve it” (8). The story, which he retells in the pages of Dreamland, follows the progression of opiate abuse and dependence throughout history with a hyper-critical lens on the years leading up the current opiate epidemic. Combining his investigative and storytelling prowess, Quinones paints a dynamic and moving picture of the opiate epidemic from every possible perspective, from dealers and addicts, to doctors and clinicians, to football players and wrestlers. With a swiftly-moving structure, dramatic flair, and a genuinely insatiable appetite for his subject matter, Quinones manages to maintain several fluent narratives within his rapid pace; the product is an equally captivating and informative investigation into one of the largest social issues of the modern United States – opiate addiction.

Quinones begins by investigating the roots of pain and pain management, a history plagued at every turn by the morphine molecule. Though the “Holy Grail” of modern medicine, a non-addictive opiate painkiller, continues to elude researchers, pain remains a far-reaching and serious problem (76). Combined with Americans’ proclivity for fast and convenient fixes, those suffering from pain and the doctors ethically bound to treat them initiated what Quinones calls the pain revolution, a hugely successful campaign to destigmatize the use of opiates for a wide array of pain patients. On this newly destigmatized turf, pharmaceutical behemoth Purdue introduced OxyContin with a direct and aggressive marketing campaign driven by profit as opposed to pain management. Alongside his story of the pain revolution and the spread of OxyContin use and abuse, Quinones weaves in the narrative of the book’s primary cast of characters: a vast but loosely connected network of Mexican heroin traffickers called the Xalisco Boys. The Boys’ efficiency, scope, their humble roots from the same small state of sugarcane farmers, and their reluctance to engage in territorial violence and drug use like most trafficking networks intrigued Quinones and law enforcement alike. Within the pages of Dreamland, Quinones details these two powerful waves of opiate abuse, one stemming from prescription pads and the other from Mexican black tar heroin, and their convergence to create the opiate epidemic.

In studying the convergence of these two waves, Quinones found himself at the same frustrating and confusing crossroads as the parents of overdose victims: how can someone grow addicted to doctor-prescribed drugs? Why did black tar heroin ravage middle class suburbia? Why wasn’t rehab enough? By the end of his investigation, he realized that “the history of heroin was best told by addicts,” as their relatable stories of human suffering and failed attempts at redemption re-painted them as humans affected by a disease rather than desolate junkies (71). In this light, Quinones works to humanize addicts by offering their stories in their own words as well as the stories of family members who have lost a loved one to addiction. Support groups and activist organizations run by parents of young overdose victims offer a beacon of hope that a “drug scourge so ably abetted by silence” may be defeated by speaking out (289). While most of his text is dedicated to the investigation of the roots and progression of the opiate epidemic, Quinones naturally finds himself searching for the same answers as those in the throes of the epidemic. Instead of wallowing in these difficult questions, however, Quinones looks to the future to find hope; “perhaps heroin is the most important force for positive change in our country today,” because, as he believes “more strongly than ever,” “the antidote to heroin is community”” (1)

  1. Dreamland: The True Tale of America’s Opiate Epidemic Summary & Study Guide. http://www.bookrags.com/studyguide-dreamland-the-true-tale-of-americas-opiate-epidemic/#gsc.tab=0. Accessed July 22, 2019.