So, my little brother, Devan, does stand up comedy. He performs with the BYU group Humor U. Some of my loyal readers (yeah I don’t have any of those, but I like to pretend I do) may remember that I posted one of his first shows on my blog a couple years ago. Now he is much better! So for your enjoyment here are a couple of his shows. Hope you like them as much as I do. And ladies, he’s single and I need a new sister-in-law ;).
I just finished reading The House of God by Samuel Shem, MD. The House of God is a medical satire about a group of interns’ experience during their first year of residency. The book follows Dr. Roy Basch, a ‘red-hot’ medical doctor fresh out the the ‘Best Medical School’ and starting his residency at The House of God, a prestigious hospital in Boston affiliated with the Best Medical School (Harvard, I assume). The book was referred to me by a friend in medical school who said it’s the most popular medical novel written to date. Expecting to get some fresh insight into what life is like as an intern, I approached this book with anticipation and excitement. In fact, Mel would tell you I looked at every used-book store in Nepal hoping to find this book. My enthusiasm quickly turned to confusion and even distress as the author paints a very cynical picture of medical education. Roy and his fellow interns are tortured with being on call every third night (and at times every second night), working 100+ hour weeks, being tortured by GOMERs and LOL in NADs, and slowly realizing the idealized physician’s life they all desire is turning out to look more like a nightmare than a dream. As these young doctors become disillusioned they lose their humanness, break down (one jumping to his death from a hospital window), and at one time or another become despicable.
I want to focus on one of the terms this book introduces, the GOMER. This derogatory term is defined by The Fat Man to mean “Get Out of My Emergency Room, a human being who has lost—often through age—what goes into being a human being.” It describes elderly people suffering from diseases such as dementia, whom the interns must care for in unflattering ways such as disimpacting hard stools. They can’t die, and are constantly abused by the medical staff. For example, one the the rules in The House Of God is GOMERS GO TO GROUND, meaning they fall out of bed. The interns use this rule in order to TURF their GOMERs to ORTHO or NEURO by setting the hospital beds up at dangerous heights. The treatment of these people portrayed by this satire is disturbing.
During my undergraduate education, I worked part-time as a certified nursing aide at two different nursing homes. One man for whom I provided care (I will call him James) was a WWII veteran, learned Chinese, and taught Chinese literature at Brigham Young University. In his old age dementia had left him miserable. He relied on CNAs for everything, and many CNAs resented him. James’ dementia made him violent, especially at night and he would punch, kick, spit, and do anything he could to prevent the aides from helping him. I remember one aide who even resorted to hitting James back. She lost her job. Whenever James’ call light went off, the aides would do their best to ignore him, or try and persuade another aide to go see what he wanted. Shem would call James a GOMER.
I became a ‘go-to guy’ when it came to James’ care. James liked me. I think he started to like me the first summer I grew a beard. A gruff man himself, James would say “you and I need a shave” with the biggest grin on his face. I found that James was rarely resistant towards care if I sat down and talked with him for a few moments before attempting anything. An avid reader, James enjoyed showing me what he was reading, and I would occasionally show him what I was reading. I would sometimes greet him with a ‘nee hau’ or begin by throwing his boot, which he hated, across the room to which he would applaud. He loved to tell me about his travels, about his family, and other such things. While his mind was ill, his soul was not. One day when I was struggling with my faith, James bore his testimony to me of the Book of Mormon and of the Restoration. James’ testimony is one of the most powerful spiritual experiences I have had in my life. James became a dear friend of mine.
The purpose in sharing this is to help encourage better understanding. James was treated as less than human because of his dementia. I discovered that James is a beautiful person who enriched my life greatly. People yearn to feel loved and respected. Treating people like GOMERs or GOMEREs (the feminine version of GOMER) is not acceptable. A lot of people have inherited a tough situation in life. I think one of our duties as human beings is to help each other out and encourage better understanding. Let’s think again about how we and others treat people like James.
Leia Mais…I received wonderful news this week. I will be attending the University of Rochester School of Medicine and Dentistry in August as a first-year medical student! As Melanie and I research activities and sights in New York, where we are going to live, how we are going to pay for tuition, and other logistical necessities, I continue to find my mind wandering and worrying about what lies up ahead. In an effort to demystify my future I decided to watch a PBS NOVA special called Doctors’ Diaries. This program follows seven doctors starting from their first day of medical school at Harvard. The program does a fantastic job at showing the different students’ personalities, and allows the viewer to get a glimpse of what it takes to become a doctor and what being a doctor entails.
Some aspects of the documentary are disturbing. As an intern, talking about the stressfulness of being a physician, one doctor says he’s “become this person that [he] doesn’t particularly like.” Another says “I’m gradually just getting more and more tired.” Several of the doctors go through a divorce or two (or three). A wife describes the time her husband is able to give her as a “shell” of the man she married. I also watched an intern connect with her patient before heart surgery and then, after six hours in the OR, pronounce that patient dead. These are some of the things I fear.
One doctor says, “In my years of practice now I’ve seen all the range of extreme tragedy, extreme joy. I can’t think of anything that’s grounded me so much in my life as being a doctor.”
There are also many uplifting aspects to the documentary. My favorite aspect is the film subjects’ interaction with patients and other doctors. These students and interns genuinely care for the people they are helping. One doctor develops a way to get eyeglasses distributed to rural areas of China. It is refreshing to see genuine care provided by all the physicians documented since this type of care is the reason many (including myself) go into medicine to begin with.
“You’re going to be okay. We’re going to take care of you and you’re going to be alright.” Being able to say (and mean) this is what satisfies one physician in the documentary. “I wouldn’t trade that for the world.”
Leia Mais…I am now back in Bangkok (which feels like home… strange). For the past month I have been in Nepal spending time in the Himalayas. Here are some notes on my trip:
We arrived at Kathmandu airport on Tuesday, March 29. The airport was a worn-down dust box. Guards stood around holding automatic firearms, employees begged for money after helping lift baggage onto a cart, and the line for immigration seemed to drag as slowly as it possibly could. Not a good first impression. We arrived later that day at our hotel in Thamel (a tourist area inside Kathmandu). The trip didn’t start out well. One easily gets a headache in Kathmandu from the incessant beeping of cars and motorbikes warning pedestrians of their whereabouts on the absurdly narrow roads. Dust seeps into every physical space possible, a nightmare for your lungs. By the second day I found myself clinging to a toilet, puking in the dark after unwisely eating a cold pizza from the local bakery. The symptoms of food poisoning lasted the next three days including a ten hour van ride across the winding road that leads to Pokhara. We stayed an extra day in Pokhara to allow my symptoms to subside before we started our trek.
The first day of the trek was fantastic. We left the dust, blaring horns, bad hygiene, and unsafe food in the city and replaced it with good exercise and gorgeous scenery. The trek was great for our physical well being--our party being in dire need of conditioning. The first day we walked for 8 hours and ascended about 1000 meters of steeps stairs. At the end of the day we were utterly exhausted. This was the first of many physically taxing days. We spend our nights in tea houses. The tea houses were great, they include a room with a light, food available for order (we got used to eating primarily potatoes and eggs), and even a hot shower. Far from roughing it, we enjoyed each others company, read, played cards, washed clothes, and made friends from all over the world. I feel closer to every one of my family members thanks to these wonderful places.
Eventually, after over a week of grueling effort, we made it to our destination: Annapurna Base Camp! I immediately found a cozy place to sit high above the moraine where I watched Annapurna 1 for over an hour. Here, I experienced relaxation beyond anything I had ever felt before. I sat listening to the ambient noise. Just in front of me I could hear the occasional sound of a rock tumbling down the cliff. High above me I watched the slow, hypnotic movement of avalanches thundering down the mountain. I was reminded of nature’s subtle power. Mel and I read a chapter of the Book of Mormon together. Sitting Indian-style on a patch of grass I watched birds playing in the strong winds rushing up the cliff. Their grace translated to my peace. To me, that spot is sacred ground.
We stayed a couple days at the top and then slowly descended back down to Pokhara, ending our two week trek. We then spend another week in Pokhara and Kathmandu where I found that if you don’t eat cold pizza you can find delicious food that is inexpensive. I now sit here in Bangkok feeling utterly refreshed. What a great get-away!
Leia Mais…
