What Travelling the World Taught Me About Patient Care

i read this blog regularly for its insightful and acute observations. the barefoot medical student almost runs a kind of small press here, putting much work and time into well researched blog articles. have a look at this article, for example, really regarding the way health care provider’s attitude towards their patients.

i couldn’t agree more with her. physicians need a patient’s cooperative consent in order for a successful treatment especially where chronic or vague complaints of ill-being are involved. I am convinced that most illnesses are not separable from complex environmental factors and the way a person is linked to it.

the regard other do or don’t have for a person’s value contributes greatly to their sense of well-being and will contribute to their quality of life and health. physicians without regard for the basic individual integrity reinforce feelings of helplessness. illness and the way we treat patients and people in general are often symptomatic of what is wrong with the environment in the first place and a hint at where to make some maybe small but none-the-less vital changes to treat a patient successfully and with a chance to make long term changes.

not touching a patient without their expressed consent in that sense might just be the first step to demonstrate that the patient is held in high regard by his or her physicians and the first step to her or his willingness to regain health.

Barefoot Whispers

sas pt care

When I heard about Semester at Sea for the first time, I admit it was the idea of travelling the world that attracted me. I knew from a little bit of experience that travelling would enrich my perspectives and teach me more than any classroom, but really I was just thinking about all the places I had always dreamed of visiting, that could now become a reality.

Justifying such a long absence from campus meant that I had to identify teachable moments the program could provide. I came up with a whole report which I presented to my faculty (and which they miraculously accepted). I mentioned the virtues of travelling, and the work I would have to put in to carry a double course load, and then I mentioned the research I wanted to do: experiencing first-hand the public healthcare facilities in the various countries, as well as visiting…

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Portfolio of an amazing photographer and friend, Kristina Steiner, presenting CIRCUS UTOPIA PAINTINGS

Circua_Utopia_Kristina_Steiner-1

Photos were taken during the 2012 exhibition of my work in an old barn … Enjoy! A great WOW and thank you to Kristina Steiner who recreated the Circus in these pictures perfectly!

Infinite Jest …

IMG_5726It only occurred to me some years after first meeting him that his brain had been on fire probably day and night, during waking moments and during sleep. He was, I could see that right away, back then, high wired, hyper intelligent, super sensitive, coy, cornered, cynical. In was apparent in the first conversation one would have with him that he was constantly computing any kind of informational offering of his environment for bits and pieces of useful knowledge, useful in his own sense, not ruling out the value of overheard conversations of strangers, visual clues of bill board advertisement, the color scheme of the dioxin polluted NJ marsh lands, conspiracy theories and their opposites, math, astronomy, information technology, Shakespeare, even the CNN news ticker. He was reading, forever reading, and then reading some more, his brain was speed feeding itself knowledge, and he could recover this knowledge with the casual speed of a trained illusionist. When I knew him better he showed me the encyclopedic if highly individual work he was dedicated to, a work in many volumes bound in blue linen as soon as a new one was considered completed. A friend who worked at a university library did this for him volume by volume, one for the shelf in his den, and a twin one that he archived openly secretely in said library, for everyone to see and no one to find in maybe another century. It was a work so biased and yet so beautiful that it was unquestionable that I had been admitted to a unique work of art though he preferred to call it a scientific study of random code.

And still, it was only years later when in the course of an increase of my English language skills I could not only read but  also hear all the different voices merging in “Infinite Jest” by David Foster Wallace that I realized I had actually met a man who is – if that is at all possible considered who Wallace was – the dark twin of David Foster Wallace, sharing his semantics, his obsession, his socioeconomic circumstances, his despair, his addiction, his near autistic ingenuity to gain access to ever deeper layers of information and information encoded within this information,and that he was the man who had to be expected to exist in the margins of literary history, never to be found, as we know that there is never just one genius at any given time, but often just one to emerge to public consciousness , maybe to his own destruction. so that, with other words, i know there to be one other living madman, or genius, or whatever you’d like to call a man with a brain on fire, to weave the net still, to still find the words, to write the chronic of what is and was and will be in all its Borgean implications, thereby freely accepting the responsibility of calling the world into existence.

moonflower

Canis Major as depicted in Urania's Mirror, a ...

Canis Major as depicted in Urania’s Mirror, a set of constellation cards published in London c.1825. Next to it are Lepus and Columba (partly cut off). (Photo credit: Wikipedia)

“Your fist like this”, she said, “covers about 10 degrees of the night sky.”  She moved my hand slowly over the dark water and spoke in her methodical way, no use to interrupt her. “20 degrees south-east of the belt of Orion, you see, there is the brightest star in the night sky, right in the constellation of Canis Major.” She waited for a moment for me to catch up with her. Our entwined hands travelled over the night sky and stopped. And there it was, deep underneath us, the brightest star of the night sky, as far as I could see. “Do you see this star?” she asked. “It is called Sirius. It is 23 times more luminous than our sun, twice the mass and the diameter of the sun. It is only 8.5 light years away.” The way she said “only 8.5 light years”, it sounded as if she was talking about a Sunday picnic destination. It sounded like: We could take the bike. It’s only 8.5 light years away. Before I had a chance to point that out to her, however, she had started talking again, and almost without warning, though in answer of my question, switched from her facts, from degrees between two points of light in the celestial sphere, luminosity and brightness, and mass of celestial objects, to a startling revelation.

 

artist statement (mine)

this knowing “you are on to something good” is exactly where the artist meets the scientist. only that in general the scientist will be patient and disciplined enough to acquire the skills necessary to actually explore and eventually understand that unfounded suspicion and the artist will just take a cursory inventory of the idea’s implications and then take to the type writer (or the canvas) like the monkey, ready to blindly shell out the sequence of letters to actually and surprisingly eloquently prove that “it” was always known.Bild

huis clos

Jean-Paul Sartre (um 1950)

Jean-Paul Sartre (um 1950) (Photo credit: Wikipedia)

walking up some flights of stairs in the morning, taking one step at a time, my thoughts start drifting, and i continue walking, and i keep thinking, and my feet continue climbing up the first flight of stairs, one step at a time, one step at a time, and i continue dreaming pleasantly, and my feet continue walking until i grow aware that it is taking a rather long time to climb that one flight of stairs, 13 stairs at most, and while my feet are still climbing i see that i have reached the second to last step and still i climb and my feet continue to move obediently, my thoughts retracing my steps, until finally, and i can measure that time span of the last step, i have reached the first landing.

time perception of course, by its nature is subjective, but how long a dream can one dream climbing up one flight of stairs, i wonder. on the landing the grey light filtering through the milky hall way window does not admit to time passing and i almost dread climbing the next flight of stairs.

but, of course, i do, what else is there to do, but to continue. so i focus on the steps this time, 13 at most, and i am resolved not to allow my thoughts to drift.

i focus while i am walking, and i focus on my focus, and i see myself walking up that flight of stairs, 13 steps at most, while i am concentrating so hard on not dreaming, not drifting, on almost not thinking that my brain starts feeling cold.

and my feet keep moving, climbing up the steps, and i am carefully keeping my focus, and yet when i have mastered not even half the flight of stairs, i realize that once again the time it takes to climb these steps does not correspond to the number of steps i have been climbing and i freeze in the midst of climbing, one foot on the seventh step, one still on the sixth, and i have a hard look at that staircase but there is nothing out of the ordinary to be observed.

and yet i am sure of it, it takes too long to climb these stairs, and ideas start forming, offering themselves with deceptive playfulness, but i reject them because now all i want is to  be done with climbing that staircase and so i continue.

trying to regain that coveted state of unconsciousness with with which one climbs a step of stairs, not observing the act of climbing, not synchronizing mind time with physical time, i pitifully fail.

again i step up and step up and step up as if climbing that staircase was a specific task to fulfill, as if i was not mastering some flights of stairs but was struggling up a mountain to reach a monastery carved out of the mountain side, as if i was following a pilgrim’s path to enlightening. i couldn’t be more aware of every single neuron firing to accomplish this complex daily task though all i crave is unawareness towards it. and i continue climbing.

on the next landing i hardly pause to contemplate what i must do as there is no alternative to walking, and i simply walk up the next flight of stairs, i walk and  i walk, and by now i am not struggling against the perception of the walk that does not correspond to the space though i am not accepting it either.

on to the next. i know by now that this is and is not an ordinary staircase, that i will resume life once i reach the top but as of now my life is suspended and all that is asked of me is to walk up those steps, so i keep walking.

my unimaginative mind gets bored of this existential task, even slightly amused, rather than to be terrified, never mind that for all i know this stairway might be sartre’s huis clos and gabriel, ines and estelle might be right behind me, or i might be ines or estelle, but still my mind gets bored of this task of climbing some flights of stairs as if that was all there was to do for eternity.

when i am bored of being slightly amused by my own superior outlook on the terror of eternity i start swearing silently under my breath, but still  i am climbing, and at some point i am done swearing, too, or rather i run out of entertaining curses.

so when i am done swearing , i start wondering who is going to study my briefs today, or tomorrow for that matter, who is going to review my documents, conduct my research, draft my pleadings. and after climbing another flight of stairs, i start feeling pity for myself and i  sadly ask myself who is going to comfort my children and read my books and paint my paintings while i am climbing this endless staircase. and still i am climbing.

and this i do every morning. i tell you this just because you asked me whether i believe in eternity (or anything, really). sure i do.

every morning, rejecting the elevator, i do repent of my choices by climbing that eternal staircase and, for all i know, i never leave it, for all i know, i am forever walking up one flight of stairs after the other, because i do not remember ever reaching the top of it, i do not remember opening the door to exit the hallway and entering my office even though i won’t deny either that i am indeed sitting here, at my desk, drafting my briefs, conducting my research, writing my pleadings and trying to convince you if not myself that i am more than a speck of transient dust.

 

 

tesselation with 5-fold symmetry

My head still throbbed lightly and the smell of the new scrubby grey floor tiles did not help to improve it. I concentrated on the unusual pattern of the otherwise ordinary floor covering. The tiles were light and dark grey and laid out in an unexpectedly complex arrangement. Areas can be filled completely and symmetrically with tiles of 3, 4 and 6 sides, but it was long believed that it was impossible to fill an area with 5-fold symmetry though Kepler played with the idea. I knew this because my mother loved the work of M.C. Escher who was intrigued by mathematic patterns and used them in his illustrations. It did perplex me that the library floor tiles were cut out of so called kite and dart shapes which actually allow a surface to be completely tiled in an asymmetrical, non-repeating manner in five-fold symmetry with just two shapes based on phi. As a result the tessellation of the dense felt tiles in the lobby made it impossible to arrange my thoughts according to the floor pattern – a technique I had used since childhood to soothe anxiety. Instead I began to draw shifting lines through the pentagrid in my mind, preferably coming up with glowing triangle shapes. The forms danced in front of my eyes. I felt faint.