Dr. Julia Shaw – The Memory Illusion

Why you may not be who you think you are

Blurb: Think you have a good memory? Think again. Memories are our most cherished possesions. We rely on them every day of our lives. They make us who we are. True, we can all admit to having suffered occasional memory lapses, such as entering a room and immediately forgetting why or suddenly being unable to recall the name of someone we’ve met dozens of times. But what if we have the potential for more profound errors of memory?

The fragility of our identity and why nostalgia is better than our past

I listened to this audiobook, read by Siri Steinmo, at the right time – while I was back in the town I grew up in for a part of my medical “electives”. Growing up here wasn’t easy, at least not for me, but coming back there were many beautiful feelings and also a longing to go back in time. I guess it’s just bitter-sweet to remember the good things and dream what could have been or to see who we (probably) were and who we became. Memory was already something I discussed a lot with friends and siblings. It fascinates me how different memories can be and Dr. Shaw explains how those disparities come to be.

Combined with the interesting topic of medical errors the book opened up so many possible research questions too. How much of the presentation of a resident or intern to higher up doctors is actually the information the patient shared with them and how much is a completion of a picture with information we’ve experienced before in similar situations. How much of that which the patient remembers actually happened and how does it impact our treatment of a certain situation?

I guess this will be one of those books I’ll get as a hard copy for my library since it’s a well researched book on an interesting and important topic. Also I’m really interested in the footnotes and references which I missed out on with this (very nicely read) audiobook.


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Belle du Jour – Intimate Adventures of a London Call Girl

Belle De Jour Bookcover with a picture of Billie Piper in red lingerie, lying on a white bedsheet, holding a riding crop.Reading this book I feel like there is a certain type of person who’s perfect for sex work (as there is for most jobs).
Someone who doesn’t like human touch, doing menial tasks for people while balancing emotional involvement and managing complex therapeutical procedures probably shouldn’t be a nurse. And someone who doesn’t love themselves, doesn’t like people and isn’t curious about their intimate proclivities, but rather gets attached quickly, probably isn’t cut out for being a callgirl. Of course one should like sex – in many varieties – too.
Appart from the sex, being curious about the intimate lives of people and how they work, while not getting attached also seems perfect for the field the author studied: forensic science.

I got the book because I loved the Secret Diary of a Callgirl with Billie Piper. I was curious how much the production invented and how much was based on the blogposts of the author. To be honest I felt Billie Pipers character was more accepting of the different kinks than Belle du Jour in the books. Actually I liked the TV-series’ character better than the one in the book. It’s possible that something got lost in translation, because blogposts were made into a book and the mediums don’t work in the same way.

The book reads like an entertaining first draft that could or should be arranged in one or more story arcs for a satisfying read. There are some nice thoughts in it, some glimpses into an interesting but yet shallow or egocentric character. Some reviews show how little the book was able to convey that different forms of sex are just that – sex; “…she’s willing to be degraded for money.” For me the character never felt degraded and while some acts may look degrading from a subjectives perspective, they might not be at all. They might be empowering from the perspective of the people involved. But the authors offhand accounts just don’t communicate the joy or even uncaring nature she has in such situations. There’s no reflection about most things or the things she does (especially to her ex-boyfriends) and therefore everything feels shallow, as if there’s some depth missing.
That’s okay for a blog (although I probably wouldn’t read it), but it lacks in a book.
As for the critique that she’s glamourising sex-work, I don’t think this sentence does nothing of that kind:

There are downsides to unpaid casual sex, of course. Aren’t there always? By engaging in truly random, one-night attachments, you open yourself up to stalking, relationships and all other manner of sexually transmitted ills.

And sometimes there are even “good” sentences as inspiration from the readers. Take it from a sex-expert, she must know:

Sexy is the result of being pulled together and comfortable in your skin. Holding your stomach in when your clothes are off is not fuckable. Slapping your ample behind and inviting him to ride the wobble is.

3/5 Bücherratten

Pathologie-Monat

In diesem Post geht es auch um den Tod und tote Menschen.

Mein 4. Wahlstudienjahr-Monat habe ich in der Pathologie verbracht. Die medizinisch inklinierte Person weiss, dass diese nicht mit der Rechtsmedizin zu verwechseln ist. Dieser Weg einer Leiche scheidet sich beim Kreuz “natürlicher Tod” oder “agT – aussergewöhnlicher Todesfall” und alles, was aussergewöhnlich ist, landet in einem anderen Autopsiesaal.
Interessanterweise verbringt man in der Pathologie weniger Zeit am Schreibtisch, als in der Inneren Medizin (Notfall ausgenommen).

Die Pathologen sind der Krankheit auf der Spur, sei das bei lebenden oder toten Menschen. Der Grossteil der Zeit ist den lebenden Menschen gewidmet. Alles was die Chirurgen, Dermatologen und Mediziner schicken wird in Formalin fixiert, zugeschnitten, eingebettet und gefärbt, damit man sich die interessanten Stellen unter dem Mikroskop anschauen kann. Zwischendurch gibt es einen Schnellschnitt, bei dem die Chirurgin im OP wartet, ob alles bösartige rausgeschnitten ist.
Natürlich dauert das Fixieren, Zuschneiden, Färben und Beurteilen eine Weile (2-3 Tage in der Regel). Denkt daran, wenn ihr mal auf einen pathologischen Bericht wartet 😉
Noch länger dauern die Berichte einer Autopsie. Als Vertröstung gibt es gleich nach der Autopsie jeweils eine Demo für die Kliniker, wobei auch die Patholog*innen dabei nicht immer die Todesursache nennen können. Dafür muss das Gewebe meistens auch mikroskopisch untersucht werden.

Die Autopsien fand ich besonders interessant, wenn auch irgendwie absurd, dass ein Mensch in einem Moment noch ganz ist, nach zwei Stunden mit hohlem Oberkörper auf dem Metall liegt und die Organe säuberlich aufgeschnitten und untersucht auf einem anderen Tisch. Es ist anders als das Sezieren im Sektionssaal. Es ist schneller, klarer, weniger darstellend – und die Arbeit direkt am Menschen machen Präparator*innen, die Assistenzärzt*innen präparieren die verschiedenen Organpakete, um die Todesursache zu finden. Oft findet sich etwas anderes als das was die Kliniker vermuten oder andere Dinge als sie diagnostiziert haben. Autopsien sind deshalb wichtig für die Weiterentwicklung der Medizin, sie sind eine Kontrollinstanz der klinischen Diagnostik, zeigen uns die Häufigkeit von unentdeckten Krankheiten. Alles wird gewogen und aufgeschrieben, also lernen wir auch mehr über das “normal” der Menschen, wenn auch tendentiell in den höheren Altersklassen.

Die Molekular-Pathologie und Big Data sind die Kontrollinstanz der Histologischen Pathologie. Über Jahre waren Pathologen die Ärzt*innen der Ärzt*innen. Nun werden sie korrigiert. Es scheint als würden viele Zellen oder Tumoren, die einander ähnlich sehen, wohl doch etwas anderes zu sein als ihr Bild. Die Pathologie ist demnach ein sehr klassisches Fach mit den Autopsien, einer der Grundlagen der Medizin, und ein Fach im Umbruch mit neuen wissenschaftlichen Schritten mithilfe der DNA und Computern.

So oder so habe ich die Zeit in der Pathologie genossen, auch wenn es nicht mein Fach ist. Bisher hab ich noch nie in einem so sozialen und rücksichtsvollen Team gearbeitet, dass ehrlich ist zueinander, sich den Rücken stärkt aber dauernd konstruktive Rückmeldungen gibt. Ich glaube wenn mir der Patientenkontakt nicht so wichtig wäre, hätte ich mich dort beworben.

Von Bluterguss bis Exitus – Florian Teeg

tl;dr: Ist es das deutsche House of God? Nein!

Buchcover

Klappentext Bleiben Sie ruhig, ich werde Arzt. Gestern noch an der Uni, heute allein vor einem Patienten, der vor Schmerz halb ohnmächtig ist. Und man hat keine Ahnung, was ihm helfen könnte: Wie ist das, wenn man ein halbes Blutbad anrichtet und dann plötzlich der Chefarzt ins Zimmer platzt? Oder wenn man einem Patienten sagen muss, das er eine tödliche Krankheit hat? Sehr ehrlich, selbstkritisch, aber auch höchst komisch berichtet Florian Teeg von seinem ersten Jahr an der Klinik: von störrischen Patienten, Fehldiagnosen und ihren Folgen, Flirts im Schwesternzimmer und den Grenzen der Medizin.

Meinung Laut Goodreads war ich im Dezember 2014 in der Mitte des Buches. Dass ich bis jetzt gebraucht habe, um es zu beenden, sagt einiges. Immerhin ist es medizinische Lektüre für die Freizeit. Eigentlich mag ich sowas. Leider scheint der Autor an Apex homo albus angekommen zu sein, mit seinem Ego, wenn man ihn in seinem Humor beschreiben will. Ganz nach dem Motto, sieht er die Pflege meist als inkompetent. Ausser er hat ein sexuelles Interesse. Wenn er eine “dicke Schwester”, und ja, das schien durchaus abwertend gemeint, aus Versehen dann doch Kompetenz zuspricht, nimmt er das selbstverständlich einige Seiten später wieder zurück. Allgemein haben alle ausser ihm sehr offensichtliche Fehler. Wenn er Fehler macht, beginnt manchmal eine Selbstreflexion aber die endet nach einem Satz, ohne zu einem Schluss zu kommen. Wie zum Beispiel, als er eine der “Schwestern” stalkt, bis sie ihm unter Tränen eröffnet, dass sie gekündigt hat, weil sie es nicht mehr aushielt. Er selbst wurde auch von einer Frau verfolgt, von der er eigentlich nichts wollte. Eine Parallele, dass er vielleicht ebenso unangenehm und uneinsichtig war, wie seine Stalkerin, brachte er nicht hin.
Wie gesagt, von “Schwestern” hält er nicht viel:
Zwischenzeitlich hatte ich fast das Gefühl gehabt, dass sie Spass daran hatten, mal etwas Spannenderes zu machen, als immer nur Popos abzuwischen und Tabletten auszuteilen.
Das A und O der Patientenkommunikation schien auch noch nicht angekommen zu sein, als er abschloss:
Um den Patienten zu beruhigen, benutzte ich das kumpelhafte “Wir”. […] Vielleicht war es auch ein Pluralis Majestatis.
So realistisch wie der Klinikalltag dargestellt sein mag und wie gut der Herr die medizinischen Sachen auch für Laien erklärt, ich würde Ihn, zumindest als Assistenzarzt, nicht als meinen Arzt wollen. Vielleicht hat er auf seinem Weg zum Facharzt ja noch etwas Empathie und gesunde Selbstkritik gelernt. Lustig fand ich das Buch jedenfalls selten und bei seiner Sicht auf Patienten und Frauen wollte ich teilweise fast kotzen. Zu dem Punkt auch folgendes Beispiel:
Das […] sei mit ein Grund für den Ärztemangel: Eigentlich gibt es mehr Ärzte als je zuvor. Da diese jedoch zunehmend weiblich sind und neben der Arbeit noch andere Dinge im Kopf haben, sinkt die effektive Arbeitszeit der Mediziner.
“effektiv” meint er wohl das Total. Ob ein*e Ärzt*in nach 24 Stunden Dienst allerdings tatsächlich noch “effektiv” ist, behaupte ich sehr zu bezweifeln. Es wirkt fast so als würde er nicht viel davon halten, dass Frauen den Arztberuf wählen.
Bezüglich Patienten und deren Angehörigen scheint er eine eher undifferenzierte Meinung zu haben, was Suchterkrankungen angeht. Ja es wirkt fast so, als könnte er nicht sehen, dass Menschen mit Suchterkrankungen mehr sind als ihre Sucht und vielleicht auch mal nicht gesoffen haben. Ich behaupte mal er würde aber auch nicht verstehen, wenn seine Partnerin in verliesse, wenn er in einem Burnout anfangen würde irgendwelche Drogen zu konsumieren.
Vielleicht hatten die Schwestern ja recht. Schliesslich waren sie mit dem Schmerz der Angehörigen besser vertraut und reagierten oft einfühlsamer auf deren Ängste als wir Ärzte, die wir häufig nur die medizinische Seite sahen. Auch wenn ich nicht verstehen konnte, wie man einem Leben an der Seite eines üblen Trunkenbolds auch noch hinterhertrauern konnte.

Ich jedenfalls trauere diesem üblen Buch nicht hinterher.

/5

The Psychopath Test: A Journey Through the Madness Industry by Jon Ronson

The Psychopath Test: A Journey Through the Madness Industry

My rating: 5 of 5 stars
Certainly a book that shows the ambivalence, problems and challenges of psychology, especially today.
We need to protect us, but also not at every cost, there are some people, that just won’t fit into society and others that fit charmingly well, but are dangerous. Jon Ronson went on a journey from denialists of psychologic illnesses to people who overdiagnose children who are simply reacting to a sick world.
I think this book is very important, especially for people working in medicine, child care, law or media. Esentially it’s interesting for everyone and I enjoyed it thorougly.
If you’re unsure, check out Jon Ronsons Ted Talk on the subject. That’s where I got hooked.

Them: Adventures with Extremists by Jon Ronson

Them: Adventures with ExtremistsThem: Adventures with Extremists by Jon Ronson
My rating: 5 of 5 stars

Entertaining and thoughtprovoking. Also reminds you of the fact that most enigmatic and mystical things are just as boring, shallow and potentially dangerous, as you never hoped they are. People just seem to search a meaning for their tedious unconsequential lives, spice it up with conspirancies, to give reasons to the seemingly random things that happen to them. And the easiest way is to have tangible culprits. Other people. Them!

View all my reviews

Borderless – Eliot Peper

Book cover of Borderless, Borderless written in bold letters in the middle and shadows of the same text repeated over and under it. The picture looks like a very colorful, neon map of a city by night or a computer chip glowing, looks very futuresque.
I got this book as an uncorrected proof from NetGalley in exchange for an honest review. I did not read the first issue of the Analog Novels, Bandwith, but I will check it out after I’ve read Borderless.

ISBN 9781503904729

Blurb

Brenna Thummler – Sheets

I had the opportunity to read and review this through Netgalley and chose to do it Cover of the Comic Sheets. Drawing of a washing machine from the front with a sheet with two holes, looks like a ghost, looking out through the glass door of the machine.
since I really liked the cover.  Also her name is Thummler^^ Sounds like a bad tumbler pun. =)

Blurb

Marjorie Glatt feels like a ghost. A practical thirteen year old in charge of the family laundry business, her daily routine features unforgiving customers, unbearable P.E. classes, and the fastidious Mr. Saubertuck who is committed to destroying everything she’s worked for.

Wendell is a ghost. A boy who lost his life much too young, his daily routine features ineffective death therapy, a sheet-dependent identity, and a dangerous need to seek purpose in the forbidden human world.

When their worlds collide, Marjorie is confronted by unexplainable disasters as Wendell transforms Glatt’s Laundry into his midnight playground, appearing as a mere sheet during the day. While Wendell attempts to create a new afterlife for himself, he unknowingly sabotages the life that Marjorie is struggling to maintain.

Sheets illustrates the determination of a young girl to fight, even when all parts of her world seem to be conspiring against her. It proves that second chances are possible whether life feels over or life is over. But above all, it is a story of the forgiveness and unlikely friendship that can only transpire inside a haunted laundromat.

Opinion

Have you ever seen a sad ghost? Because I have and it breaks my heart that someone forgot him. I read this graphic novel in one go, I was so captivated. Brenna uses beautiful colors and still the panels can show you the depressing boredom, the sad day to day life, making it palpable without words. A skill of show don’t tell that many movie directors don’t have. The main character seems to be multi-dimensional, although there isn’t much description and is unpretentious, but still a fighter. There’s a lot of subtext and room for wonderful interpretations as well as some puns. A simple, heart-warming and tear-inducing story that seems a wonderful fantasy.

Quotes

She died this past spring, and then Dad sort of did, too. He’s still 100% opaque, but slightly less visible.

Kevin will probably get new shoes, right? ‘Cause he has a mom.

Grown-ups are skilled at making terrible things seem great.

Anthony O’Neill – Lamplighter

Red book cover with the skyline of edinburgh. Over it there is a huge eye and in its iris there's the silhouette of a lamplighter on his ladder, lighting a lamp.

I picked up this book after enjoying a newer novel by Anthony O’Neill: The Dark Side, which I thoroughly enjoyed. Somehow I “get” his characters, they feel real and flawed in realistic ways. So I looked up what else he wrote and stumbled upon The Lamplighter. Since it’s set a) in Edinburgh and b) in the Victorian age I had to read it.

Blurb An atmospheric thriller set in nineteenth-century Edinburgh, Anthony O’Neill’s elegant, darkly masterful novel is full of psychological suspense and first-rate horror. Evelyn is a clever orphan at the Fountainbridge Institute for Destitute Girls. Enchanted by a cheerful lamplighter who fires the streetlamp outside her window each evening, she mesmerizes the other girls with flights of fancy. In a time before Freudian awareness of sexuality and the subconscious mind, such tales are forbidden by the institute’s governor, who warns Evelyn to cease her nocturnal storytelling. Evelyn defies him — and is cast out of the orphanage and sacrificed to a shadowy figure claiming to be her long-lost father. Who is this man, and why does he lock Evelyn away in a hunting lodge? Years later, the mutilated body of a professor of ecclesiastical law turns up on one of Edinburgh’s finest streets; the grave of a famous colonel is ravaged; a shady entrepreneur is slaughtered while dashing for a train; and a retired lighthouse keeper is ripped to shreds while walking his dog — all this after Evelyn, now a young woman, has reappeared in the city. What connects the victims? And what of Evelyn, anguished and appealing, who repeatedly claims to have dreamed the murders in great detail — each time blaming a mysterious “lamplighter”? Leading the official investigation is Carus Groves, a conceited yet effective police inspector desperate to cap his unremarkable career with a sensational case. Heading up the unofficial investigation is a disillusioned professor of logic and metaphysics, Thomas McKnight, and his assistant, Joseph Canavan, a strapping young gravedigger. Using reason, intuition, philosophy, and luck, these men race to solve the murders and unveil the source of Evelyn’s torment, and in so doing penetrate the very gates of Hell.

Opinion The writing is different that in the Dark Side, because it seems adapted to the time in which the novel is set. There are many! words I haven’t encountered yet, because I’m not a native english speaker and also O’Neil seems to have used quite a lot of “old timey” and Scottland specific language. But using my eReaders dictionary that was no problem and I actually enjoyed learning new stuff (although I suspect I won’t be remembering much of it). The novel feels like a bunch of loose threads getting woven together and then totally change direction. There’s a sense of mystery and wonder to the way he tells the story. And I was often on the verge of being pulled in, into pre-enlightenment superstitions for the sake of the book, as well as doubting if that really was, where the story was going and expecting a scientific twist.
The characters although not described in much detail, feel realistic and three-dimensional. Looking back there was a good mix between the thoughts of the characters and their actions, that made them palpable.
There are quite a few philosophic discussions in the book, dealing with the difference between medieval and enlightenment times, woven in between the crime story that takes one to many different places. Having been to Edinburgh certainly helped with my imagination, knowing which streets the characters, and especially Evelyn wandered.

There is no romance (which I was happy about), there’s only one female character and three main male characters and one female sidecharacter, but it works, especially in that time. I didn’t find it especially horrific or horrific at all, being honest, so I would not categorise it as a thriller. It’s a very special crime story somehow, in my opinion.

Quotes There are soooo many good quotes, but most of them hint at some things that happen or are in the twists themselves, so I just selected a few that I hope won’t spoil anything.

It was a terrible and exquisite thing, to have a heart that was not a muscle but a wound.

Such men, riven with self-doubt, were of course vulnerable to fantastic theories and fabulous missions, and equally at risk of driving deeper into self-destruction.

Blood is like French perfume to the Edinburgh hussy, Carus.

Have you ever stopped to consider how much time even the most unimaginative man each day spends, neither willingly nor unwillingly, in the world of his imagination?

It could well be the case that the last thing a man sees is not that which his eyes settle upon, but that which his imagination furnishes for him. It could be argued quite reasonably, in any case, that this imagination is what really constitutes a man’s soul.

We consciously impose limits on our own thoughts and settle into an expedient system of simplifications and archetypes. We willingly stamp archetypes even upon ourselves, to fall into the world we have constructed out of easy recognitions and the disinclination for complexity. The unconscious, however, remains unsated and frequently rebellious.

“And of the orphanage? What do you think of when I mention it now?”
She considered. “I think of a parcel tightly bound.”
“A parcel? Not a cage?”
“Cages,” Evelyn said, “have air.”

Atul Gawande – Better

Plain petrol book cover with "Atul Gawande + Better" in silver and subtitle a surgeon's notes on performance

What does it take to be good at something in which failure is so easy, so effortless?

I bought this ebook some time ago and I should have read it sooner. Being someone who often doubts themselves and the path I’ve chosen – not for lacking love for medicine, but rather second guessing if I’m the right person for the job – I was quite familiar with many questions Atul Gawande raised.

In this book, he points out three points one could and should observe if one wants to do better.

DILIGENCE – DOING RIGHT – INGENUITY

Blurb The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande’s gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labour and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practising surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande’s investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavour.
– via @goodreads

Opinion I’ve enjoyed the book quite a lot and read it in three days. It’s filled with stories about the three things that help us to do better. Two of them, the one about the polio vaccination efforts of the WHO and the one about the MRSA hygiene problem were particularly interesting to me. It reminded me of good hand hygiene and makes me take our hygiene experts even more seriously, which – if we’re being honest – most doctors don’t do.
But some doctors believe in homoeopathy, without knowing what it’s really all about – too. Of course, these stories are uplifting and devastating at the same time. It reminds you that medicine is a permanent struggle. It’s never done. Unless of course, we adjust our goals.
Adjusting your goals, away from perfection and to more effective and realistic ends can actually push us. This was shown in the story about war surgeons. And it reminded me for one about that great documentary Frontline Medicine with Michael Mosley – as well as something a palliative doctor once said:

If your goal is to defeat the illness, you’ll often lose – if you change your view and make it your goal to give your patient the best care possible, you often win.

By the best care, he meant taking reality and a persons wishes into account. You’ll probably lose the fight against death with a polydrug using patient who has a GI bleed and doesn’t want to live anymore. But if you take him and the situation into account you might just give him some dignity and a good death.

All in all the book was exhilarating and giving me strength, reminding me that not seeing everything rosy isn’t necessarily bad, but can actually make you a better person, because you strive for more.

Quotes

In medicine, our task is to cope with illness and to enable every human being to lead a life as long and free of frailty as science will allow. The steps are often uncertain. The knowledge to be mastered is both vast and incomplete.

As a doctor, you go into this work thinking it is all a matter of canny diagnosis, technical prowess, and some ability to empathize with people. But it is not, you soon find out. In medicine, as in any profession, we must grapple with systems, resources, circumstances, people—and our own shortcomings, as well.

The second challenge is to do right. Medicine is a fundamentally human profession.

Betterment is a perpetual labor. The world is chaotic, disorganized, and vexing, and medicine is nowhere spared that reality.

At times, in medicine, you feel you are inside a colossal and impossibly complex machine whose gears will turn for you only according to their own arbitrary rhythm. The notion that human caring, the effort to do better for people, might make a difference can seem hopelessly naïve. But it isn’t.