jenniferhawke.com

We have so much to be thankful for.

This holiday season, take the time to talk to family about important (and too often avoided) end-of-life care plans. Sound like a morbid way to celebrate? I can’t think of a better way to show love than to know the answers to these 5 little questions.

Clear the fog. Engage with grace.

1 month and 1 week
2 months and 2 weeks

about a month before our wedding, i got a sparkly card in the mail from my grandma. the front was a picture of a Super Bride-to-Be swinging on a star. it was awesome.

she also sent three photocopies of our Saskatoon Star Phoenix engagement announcement and her wishes that i enjoy this time now because soon it will be all “us” and “we”. i have been compiling a little post about all the marriage advice i have received through congratulations, well-wishes and well-meaning wishes since we announced our pending nuptials.

“Congratulations! We never thought this day would come for you!”
~ Auntie Joni

“Try to do the things for him that you know mean the most to him, because you can’t do everything all the time.”
~ Tiffany

“Marriage has 3 key components: fierce loyalty, a profound sense of destiny, and hot sex.”
~ Dawn

“Marriage isn’t 50-50. It’s 100% and 100%.”
~ Grandpa Hawke

and one of my all-time favourites…

“My mother Mary — who is still ticking along at 91 — always told my sisters to marry younger men: ‘They don’t last as well, so get a young one.’

You two seem to have the Mary W formula for a successful marriage about right.”
~ Brian W

what’s your advice for a successful marriage?

it’s always sad when two of my favourite subjects come together in a negative way.

Two neuropathologists are prominently spotlighted in an article by Malcolm Gladwell in the October 19 issue of The New Yorker. The article explores a provocative question raised by autopsy results on football players: namely, should football be illegal?

Featured are Dr. Ann McKee, neuropathologist at the Veterans Hospital in Bedford, Massachusetts and Dr. Bennet Omalu, forensic neuropathologist and San Joaquin Valley (CA) chief medical examiner. Drs. McKee and Omalu have done some interesting autopsy work which suggests that chronic traumatic brain injury leading to dementia suffered by football players is much more common, even among high school players, than previously realized.

What’s alarming is the presence of abnormal collections of a protein known as tau, one of the proteins one sees in cases of Alzheimer disease, in brains of young ex-football players. As an example, McKee provides photomicrographs from a case of an 18-year-old high school football player and says: “He’s got all this tau. This is frontal and this is insular…. This is completely inappropriate. You don’t see tau like this in an 18-year-old. You don’t see tau like this in a fifty year old.”

You might counter that this is simply the result of a few bad-luck hits on the field, but research involving the University of North Carolina football team suggests otherwise. Players at UNC wear impact sensors in their helmets throughout the season. Results from these investigations suggests that even routine hits during practice can add up to cause concussions and, theoretically, set the stage for chronic traumatic encephalopathy. (On the first day of training camp one UNC lineman was recorded as having been hit in the head thirty-one times!)

Back in 1905, Gladwell reports, the question of whether football should be played in our nation’s schools was raised to the level of the White House, when President Theodore Roosevelt called an emergency summit to discuss the issue. At the time, a professor at the University of Chicago called football a “boy-killing, man-mutilating, money-making, education-prostituting, gladiatorial sport.” And in December of 1905, presidents of twelve prominent colleges met in New York and came within one vote of abolishing the sport at their institutions.

What does this mean for football in America? Nothing. Fans are willing to spend a lot of money to see men slam into each other’s heads on the field. But, as a parent, you can do something.

You can forbid your son from playing football.

~ Brian E. Moore, MD (via KevinMD.com)

“Like a band of gypsies we go down the highway
We’re the best of friends
Insisting that the world keep turning our way”
~ Willie Nelson

have i mentioned that Brandon’s dad is a truck driver too?

i love it when they send us pictures from the road on their phones. new-fangled technology is so coool.

this post and these photos are dedicated to the roadtrip genes we obviously inherited paternally and the gods of good gas prices as we hit the highway again tonight.

i was just going to come here to tell you that i’m busy and don’t have time to write.

how annoying.

i may neglect email and bathing, but i make time for you.

it’s dark and rainy and thundering. which means Maddy is cozying up on the bathroom tile under the sink and i’m tired of getting up before dawn. i mentioned to Brandon this morning that we haven’t slept-in together in this house even once since we moved in. sad, no?

i am pleasantly surprised at how much i’m enjoying Internal Medicine. the patients are sick and it’s hard to keep track of 5 or 6 conditions and 20 or 30 medications in one person, but it’s a lot like solving a puzzle. i’m currently learning how to gather the pieces. my pockets are literally bulging and you should see the inside of my head. index cards are falling out of my ears.

Brandon is considering taking a job for a few days a week. i’ll let him talk more about it on his site, but suffice it to say, we are poor med students that like to spend money on expensive gas so we can drive around to Husker games and i can’t legally work in this country yet. plus, i’m sure he’ll enjoy getting out of the house and talking to someone other than our dogs. i’m actually pretty excited for him. yes, his Big Important Exam is still coming up and yes he’s still studying his little butt off, but the job he interviewed for yesterday sounds pretty cool and may actually relate to the kind of thing he wants to do long-term.

speaking of driving around! Husker games! and dogs! tomorrow we’re dropping the kids dogs off at the babysitter vet and skipping town to pick up a couple of friends in Dallas. then it’s on to Waco for the Nebraksa-Baylor game. i met a neurologist from Lincoln yesterday and, upon hearing i married into the Husker lifestyle, he said “i hear Bo says the entire team is getting the H1N1 shot, except the wide receivers. they can’t catch anything anyway.”

if i’m not posting from the road, i’ll be back sometime Sunday.

happy Halloween, kids! stay safe and stay spooky.

————
photo: me not cutting my fingers off. taken by Brandon.

i started Internal Medicine. everyone says they learn a lot on this rotation and, after only one day, i can see why. we saw 18 patients today and that gave me about 1800 things to look up tonight.

this is going to be a mind-numbing and grueling rotation, with long days and work straight through Thanksgiving and Christmas and New Year’s (oh boohoo, i know!). our (10? 11? hour) days start at 7am and i’m on a team with 4 residents and 3 other students. yes, that makes 8! i’ve suddenly become part of the white-coat pack that shuffles behind the doctor and moves from room to room in an albino herd-like fashion. it’s a little different than the solo flying and co-piloting i did on OB and at the Family Medicine outpatient clinic.

speaking of Family Medicine, it’s done!

after each rotation we get mini performance reviews from the supervising resident or attending. some of them are even nice enough to take the time to give you concrete feedback (you know, other than just “you did good”) with advice for how to fix things as you move forward.

during the the performance review i got from the Family Resident attending on Friday, he said something along the lines of: “i know students are told it’s okay to say ‘i don’t know’, but your — and i’m assuming it’s the Canadian in you — mild mannered and non-confrontational personality makes ‘i don’t know’ sort of a sucky answer for you.” he also said nice things like how i’m highly motivated, great with patients and staff, insightful, bright, articulate, and read more than any other student he’s had rotate through.

but even the most articulate “i don’t know” is worse than a theory or blind guess in the dark.

so, if you’ll excuse me, i’m off to read. i need to be able to come up with some big girl words if i’m put on the spot tomorrow.

“If u get a swine flu shot ur an idiot.”
~ Bill Maher

“Hail, Zeus. The Greek god of timely pharmaceutical research! But… Is the H1N1 vaccine a deadly poison? … and are we running out of it??!”
~ John Stewart

i decided to include a little about H1N1 here after an extensive texting conversation with my worried mother this morning. sometimes i take working in a healthcare environment for granted and forget that there are a lot of people who only know what they see on the news.

all questions are from my mom and all answers are from from the Center for Disease Control (retrieved October 20th, 2009).

wow! aren’t you worried? it’s dangerous for people your age!
yes, it does seem to be hitting my age group (25-49) pretty hard. but most of those hospital admissions and deaths are people with comorbid conditions such as heart disease, kidney disorders, asthma, weakened immune systems and pregnancy. i don’t have any of those. nope, not even the last one.

how do you know it’s H1N1 and not the flu?
last week, 2,505 out of 2,520 flu viruses were tested and found to be 2009 H1N1 influenza A. that’s 99.4%. it’s everywhere. i like to think i’m one in a million, but i doubt i’m in that 0.6% bracket. i’m pretty sure i have the same ol’ flu everyone else does.

where did you catch it?
we saw a TON of people with flu-like illness at the clinic over the last couple of weeks.

how can i tell if i have it?
it looks just like the “regular” flu: fever, nausea, aches, etc. it sorta sucks, but doesn’t seem to last as long as regular seasonal flu.

i don’t think i want to get the shot. it’s not here till November.
it’s true that many places will get the vaccine too late. and working from home in Canada probably lowers my mom’s risk, but there isn’t much risk to just getting the vaccine. the shot (different than the nasal spray) is a killed viral particle that can’t actually give you the flu. please check out the CDC website for more information on who should get the H1N1 vaccine and how safe it is.

i hope this post either answers a few of your questions or empowers you to use trustworthy resources like the CDC website to find out information that your local news coverage may be missing. thousands of old people and young kids die from the flu every year. H1N1 is no different. arm yourself with reliable and scientific information.

“The effort wasn’t good enough. There wasn’t any phase of what we did that was good enough today.”
~ Bo Pelini

i’ve had days like that too. thankfully, they aren’t in front of 80,000+ people.

“More dancing, less killing. Please.”
~ my dad

i don’t often share videos. and here i am: 2 in a week.

my sister posted this on her Facebook page. it made me smile and gave me goosebumps and even brought tears to my eyes.

so, of course, i had to share.

(i’m sighing on the inside)

concerned reader is worried that i thought i was linking a legitimate bit of information about the H1N1 vaccine and the government’s plot to take over the world. she is rightfully concerned that our medical system is training up a series of doctors that would offer online medical advice without justification or consideration of the repercussions of our words. she feels that we forget there are lives at stake. children.

as a doctor, do you really believe in the h1n1 conspiracy theory? i read the BLOG to which you linked. it is preposterous. firstly, it is outdated. secondly, the questions it proposes you ask yourself have been answered.

i am a mother of 4 who is kept abreast of the h1n1 virus. i have not yet decided whether or not to vaccinate my children.

but, for crying out loudly, you are in the medical profession. please do not tell your readers NOT to do something based on a blog that is pure speculation.

as far as your readers are concerned, you are the closest they have to a knowledgeable “authority”. if you really feel that blog is correct, you need to justify it yourself.

you need to take a look at your actions and ask yourself what the repercussions are to your advice.

please. that is just wrong coming from someone like you. remember there are lives at stake. children.

currently, the numbers in the flu death is above normal.

http://www.cdc.gov/flu/weekly/index.htm#MS

“Seventy-six of the 147 deaths were due to 2009 influenza A (H1N1) virus infections, and 29 of these have occurred since August 30, 2009.”

hello, concerned reader.

if this is a true email address that you commented from, then i hope this note reaches you.

i guess you are probably new to my blog. there are two things that may or may not come across in online blog writing unless you are familiar with the author:

1) i can be sarcastic and prefer tongue-in-cheek commentary to flat-out calling someone an idiot. i think parents that believe the H1N1 vaccine is a conspiracy are idiots. i figured linking to such a ridiculous (“preposterous”, as you say) webpage would make my point for me.

2) i have absolutely no medical advice to give anyone at any time anywhere on this weblog. the decision about whether or not to vaccinate your 4 children should be between you and your doctor.

thank you for stopping by and sharing your concern.

have a wonderful day.

sincerely,
`Jennifer