Less whiny

This blog is now three years old, more or less.

And I made it through the first month of residency without making a complete fool of myself. Barely.

Not the ones dead

It's not that we become used to death, it's that there's no halfway point where we have to struggle with it. We never learn how to express our horrors and hopes. We sit in the call room, most of us just out of college, not even knowing which questions to ask, or whom.

Shabbat and the residency: a rabbi advises

One posek I asked (I'm not going to say who it is, but you can probably narrow down the alternatives) said this:

If it were possible for all observant Jews to work in a shomer shabbos medical facility, it would surely be nice. I, however, do not believe that it is forbidden to work in a non-shomer shabbos facility. Do your best to avoid hillul shabbat, but when it must be done, do it be-shinui unless it is a case of pikuah nefesh or safek pikuah nefesh.

Irregulars of the Lost Ark

Newish: my review of Cecil Helman's book of prose poetry. (And if you don't like my review, here's another.)

The earth will be devoured by the sun

Ten billion years from now. That’s what they say.
Come on! Let’s think about what can be done.

It’s true, we’ve had an enviable run
Although it might not always seem that way.
Have you read how the ancients saw the sun

As a capricious god? You wanted none
Of that in school – now bend your knees and pray.
Surely there’s something more that can be done!

I guess that you could take a loaded gun,
Abduct professors of astronomy,
Demand solutions to the giant sun

That’s engulfing all our neighbors, first one
Then anoth – Look, the moon’s been swept away
By fire’s tides. Before destruction’s done

Let’s clutch our sides and laugh: It sure was fun
To be alive in those few heady days
Between the core of earth and molten sun,
Between our wishes and what can be done.

Do Not Reconsider

I signed my first DNR order today. I did not refuse, but I can't say I'm proud of it. The philosophical conumdrums that come into play are weighty enough not to talk about at length.
(And what follows, it should go without saying, is not a religious or halachic treatment.)

What confused me in this instance was that I, as one of the treating physicians, was asked to confirm that resuscitation of the patient in this case would be "medically futile."

I don't know what the phrase means. Of course, I could look it up, but it seems to me on first glance -- and what is a blog after all but a displaycase for first glances and uninformed impressions? -- that most possible understandings would be either truisms or impossibilities. Does medically futile mean that resuscitation would not return a patient to his baseline functioning (i.e. before the illness)? Or that it would not cure the diseases which originally caused the cardiopulmonary problems in this patient?

Perhaps the most likely meaning is that it would condemn the participants - patient, family, and doctor alike - to a process which renders medical decision making futile, since all end points are the same.

More Agriprocessors

For what it's worth to those not in my kehilah, the rabbi of our synagogue said today that Agriprocessors meat should not be eaten, though it is still kosher -- i.e. one can eat at another's house, or in a kosher restaurant, without inquiring into the provenance of their steak. He made the point that the slaughterhouse's current techniques, while receiving the qualified approval of Temple Grandin, still do not make the cut according to the Conservative movement's Committee on Jewish Law and Standards.