Feb 5: Musings on lecturing
Getting into the time of year where cardiology is taught in the PA programs in the area, so back to lecturing, which I enjoy immensely. Today was CAD (coronary artery disease), particularly appropriate as it fell on "Go Red for Women", increasing awareness of women and heart disease.
One of my 'standard' lectures is on valvular heart disease (VHD), which I had done for many years even prior to my diagnosis. My typical presentation is going through all the various different valve problems, exam findings and treatments, then showing echoes for a few interesting patients, saving mine for last. At the beginning of the echoes I explain to the students that there is no way to get the name of the patient off the tape, so to please just ignore them as it's breaking several privacy acts for them to see the images plus names. So most students really don't notice on the last one that it's my name on the study. This gives me a chance to announce "And this last echo is, in my opinion, the worst one of all because it's mine." This leads to a satisfying number of gasps in the room (usually between 40-60 students), fulfilling my need to create a little drama every once in a while. Part of this exercise is to reinforce that women and heart disease can be very difficult to discover, with me being the perfect example. By personalizing the message I hope the students remember when they become practitioners to dig a little deeper, that anyone can have a bizarre and unusual problem.
There have been several polls that show many people's fear of public speaking is on par with their fear of death--no, I'm not kidding! It took me a few years to get really comfortable with speaking in front of groups, get used to the questions often asked, not feel like the dark recesses of my ignorance would be brought to light. Maybe all the theater I did as a child/teen has paid off by increasing my level of comfort.
My least favorite thing, however, is going over complications of valve prosthetics. One book has my type of valve listed with the comment (paraphrased) "St Jude valves have excellent long term results, with 68% of patients not experiencing any significant problems 20 years out." Gulp. Most of the time medicine does not refer to statistics as 'excellent' when there are negative outcomes in 32% of patients.
During the two hour lecture I get up and point at things on the screen occasionally, but mostly remain seated. It is disconcerting to notice how short of breath I get during these lectures. When you are in conversation, you pause while listening to the other person. Lecturing doesn't give that option, and I notice my speaking pattern change. I can't speak an entire sentence without pausing, so try and phrase things as if with commas. This was something I was doing when my breathing was bad all the time, most people don't notice. But taking a break after an hour so that everyone can stretch their legs also gives me a chance to, literally, catch my breath. There is lung damage from all the surgeries, my right lung in particular has lost volume. My heart rate speeds up while lecturing, only natural, but the blood is pumping through a comparatively small opening. These two factors are why even speaking affects me, despite the sitting position.
While trying to breath as naturally as possible, the experience always takes a toll on me afterwards. I'm fatigued, and my chest hurts from the change in breathing pattern and taking deeper breaths.
I tell you these things not to complain, but as a statement in how my regular life is affected and inhibited, even though everyone tells me how wonderful I look. It's sometimes frustrating that everyone assumes that there isn't anything wrong any more because I'm not as obviously ill. And over the years coping mechanisms, such as changing phrases, have become very natural and unobtrusive. But life is still quite different and painful.
I'm up in NY now with John, Lyle and Emma. The last visit was already a month ago, for the memorial service. Jane left to go back to New Zealand 2 weeks ago. The next two weekends the kids are on winter break; Lyle is going on a school trip to England, John and Emma will go skiing. The weekend after that I'm on call, so it was important to come up now. A few practical things that my help has been requested for, and good to be here with them.
Thanks for checking in, Laurie
One of my 'standard' lectures is on valvular heart disease (VHD), which I had done for many years even prior to my diagnosis. My typical presentation is going through all the various different valve problems, exam findings and treatments, then showing echoes for a few interesting patients, saving mine for last. At the beginning of the echoes I explain to the students that there is no way to get the name of the patient off the tape, so to please just ignore them as it's breaking several privacy acts for them to see the images plus names. So most students really don't notice on the last one that it's my name on the study. This gives me a chance to announce "And this last echo is, in my opinion, the worst one of all because it's mine." This leads to a satisfying number of gasps in the room (usually between 40-60 students), fulfilling my need to create a little drama every once in a while. Part of this exercise is to reinforce that women and heart disease can be very difficult to discover, with me being the perfect example. By personalizing the message I hope the students remember when they become practitioners to dig a little deeper, that anyone can have a bizarre and unusual problem.
There have been several polls that show many people's fear of public speaking is on par with their fear of death--no, I'm not kidding! It took me a few years to get really comfortable with speaking in front of groups, get used to the questions often asked, not feel like the dark recesses of my ignorance would be brought to light. Maybe all the theater I did as a child/teen has paid off by increasing my level of comfort.
My least favorite thing, however, is going over complications of valve prosthetics. One book has my type of valve listed with the comment (paraphrased) "St Jude valves have excellent long term results, with 68% of patients not experiencing any significant problems 20 years out." Gulp. Most of the time medicine does not refer to statistics as 'excellent' when there are negative outcomes in 32% of patients.
During the two hour lecture I get up and point at things on the screen occasionally, but mostly remain seated. It is disconcerting to notice how short of breath I get during these lectures. When you are in conversation, you pause while listening to the other person. Lecturing doesn't give that option, and I notice my speaking pattern change. I can't speak an entire sentence without pausing, so try and phrase things as if with commas. This was something I was doing when my breathing was bad all the time, most people don't notice. But taking a break after an hour so that everyone can stretch their legs also gives me a chance to, literally, catch my breath. There is lung damage from all the surgeries, my right lung in particular has lost volume. My heart rate speeds up while lecturing, only natural, but the blood is pumping through a comparatively small opening. These two factors are why even speaking affects me, despite the sitting position.
While trying to breath as naturally as possible, the experience always takes a toll on me afterwards. I'm fatigued, and my chest hurts from the change in breathing pattern and taking deeper breaths.
I tell you these things not to complain, but as a statement in how my regular life is affected and inhibited, even though everyone tells me how wonderful I look. It's sometimes frustrating that everyone assumes that there isn't anything wrong any more because I'm not as obviously ill. And over the years coping mechanisms, such as changing phrases, have become very natural and unobtrusive. But life is still quite different and painful.
I'm up in NY now with John, Lyle and Emma. The last visit was already a month ago, for the memorial service. Jane left to go back to New Zealand 2 weeks ago. The next two weekends the kids are on winter break; Lyle is going on a school trip to England, John and Emma will go skiing. The weekend after that I'm on call, so it was important to come up now. A few practical things that my help has been requested for, and good to be here with them.
Thanks for checking in, Laurie
posted by Laurie @ 10:26 PM
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