Showing posts with label mary fernando. Show all posts
Showing posts with label mary fernando. Show all posts

12 November 2017

Breathing

by Mary Fernando

I still remember standing there, in that hospital room, decades ago. We had news to tell the patient and her family. Although at first it didn't look like it was going to be a bad diagnosis, it was indeed, very bad. That is medicine in a nutshell: we see behind and beneath and in the end the news is ours to tell, but not to craft.

As we told them the news the patient and the family held their breath. A whole room not breathing. Me too.

Afterwards, my supervisor, not fooled by my tough exterior - which I have found fools no one at all- gently said to me ‘When patients tell us their stories and let us help them, it is a privilege. Never forget that. Even if the story ends in tragedy, it is a privilege. Honour it by serving those who trust you.” Sometimes you are lucky enough to find people who define you, who are in your life and shape you to be better. This was the man and he shaped my approach to patients for the decades. It taught me to serve. To know it is a privilege. And that patients don't breathe when the news is bad.
I scuba dive. In the boat, at the dive site, the ocean stretches out, and there is a sense of glass and ripples. Diving in, there is coral, turtles and fish. I love that there is another world under the water. I love the beauty of it and how hidden it is. Most of all I love being able to breathe underwater as I move forward deep in the ocean.
Back to patients. There is nothing that prepares you for what medicine is either. What the surface of medicine looks like is nothing like the truth of the practice. Yes, you help. Yes there are medicines to offer but the reality is the stories. The ability and privilege to immerse yourself in the lives of patients where you see their hopes, their loves, their fears and finally, even their deaths. And this brings me back to breathing.

In many books, authors will say that, in response to bad news, people feel ‘punched in the gut’ or ‘their world collapsed’ In reality, what I have seen is that patients, and the people that love them, hold their breath. And I recently learned why.

I have had many people who have shaped me, made me better, because goodness knows, I have needed that, perhaps more than most people.

The person who shaped me most, I met when I was about 6 or 7. She had a blond pixie cut and bright blue eyes. We were the same age but she was much smaller than me. When the large school bully kicked the cello she was carrying, she grabbed his arm and twirled him around and around and sent him flying into a wall. She would wander streams, ride her bike in the woods, and strangely, at the corner store while the rest of us bought chocolate, she would buy a carton of milk. An original from start to finish. I did what any sane person would do: loved her for life.

In our teens she grew and became a 5’10” blond beauty, who towered over me. Which was fitting because she was built for the life she wanted to lead - bold and strong.

Over the last fifty years, she and I have talked every few days. When she headed off to Europe at 18, with a backpack and panache, I stayed in university and worried about her. When she wandered into the woods for long camping trips on her own, I would worry while writing my exams. She got a PhD and turned into a crack research scientists who still takes off for lone camping trips that worry the crap out of me. The real truth of who she is to me is that she was the first person who came when my children were born and the first to come every time I needed her. If she detected a tremor in my voice, I would find her on my doorstep even if we lived in different cities and she had to travel for miles.

This summer, while we sat sipping coffee on a patio of a restaurant, she gently told me that she had breast cancer. I stopped breathing. I looked at her, blond hair now darker and longer, lines around her eyes, and I finally took a breath. Because the not breathing was wanting to stop the world, to go back to before, when illness wasn't real. And the breathing part was because I knew that I had to breathe and move forward. Because she needed me. Because I needed to be there. Every step.

And I was. The mastectomy was hard, and I was there for that. I was there at the hospital, and when she was home, we laughed in our zany way about all things cancer related. Then after she had eaten the food I had made for her, she gently told me that that cancer had spread to her bones. I couldn't breathe. This time, my lungs simply refused to take in any air. Then I did. Because I had to be there for that too.

When tragedy hits, and in books it must, I think it is important to dive in and write about breathing. Because that tells the story. Of wanting to stop time, and go back. Of breathing and moving forward.

08 October 2017

Hospitals and Murder in One Step or Two

by Mary Fernando
“Hospitals are a great place to kill people” said MC, during our interview, “You can kill people in one-step or two.”
I would like to reintroduce MC – Mystery Cardiologist. He is a doctor who opens up blocked heart vessels with stents, puts in new heart valves and uses defibrillators to bring people back from the brink of death. He is also a voracious reader of mystery novels. What can be more delicious than a man who saves lives and ponders how to kill people? After he read my last blog, he felt it made him sound a bit ghoulish. So I would say, unequivocally, that he is a great guy. A wonderful husband, father, puppy owner who has never murdered anyone. He is safe to have over for dinner and introduce to your children.

Although his one-step and two-step murders are worth hearing about, what is equally as interesting is the character of a hospital murderer.
“There is nothing more creepy than someone like a nurse, doctor or paramedic who kills.” said MC. “That is the person with the most access to the patient, the knowledge to kill and the person everyone trusts.”
MC is right. The best person to know what drugs could kill and at what dosages, is a person who is medically trained. Further, they would know, for example, that in death, all cells break down, release sugar, and make an insulin overdose difficult to detect. However, a sample of the vitreous humour (fluid in the eye) could be a perfect way to catch this murderer.

Setting a murder in a hospital opens up avenues of murder but also allows for the creation of a complex character. What makes someone who has devoted a great deal of time educating themselves on how to save lives, who has a career of service to patients, turn themselves into a killer?  It could be a latent aggression finally coming to the fore, or it could be a character up against hard times who changes and becomes embittered. Or it could be a character who becomes a doctor or nurse to compensate for a sense of helplessness but gradually develops a sense of arrogance and invincibility, coupled with the a distain for those who are helpless like they once were.

One-step murders in hospitals can involve numerous methods. If someone is admitted to hospital for routine surgery such as an appendectomy or even for a heart attack that they survived, then finishing them off in hospital is an interesting option.

In hospital, people have IVs that provide a portal to inject them with something deadly. An overdose, of insulin, epinephrine, or potassium are some of MC’s suggestions.

A two-step murder is another intriguing option. Perhaps a murder attempt - a car accident, or bludgeoning on the head - has failed to completely kill off the victim. Bringing them to hospital provides an opportunity to try to kill them again.

Here a principle of reversing medical treatment is key. For example, if the victim has brain swelling after a thump on the head, in hospital they will give drugs to reduce swelling. They will also raise the head, using gravity to get rid of excess fluid in the brain. A visit during which the hospital bed is positioned to lower their head will send enough fluid into their brain to kill them. It is a gruesome way to die as the brain swells and pushes into your skull and again, it takes a certain twist of character to make a person trained to save lives, now take them.

Killing via an IV line is of course an option when a murder is botched and someone wants to complete the kill. Insulin injected could bottom out their glucose and put them into a deadly coma. Adrenaline could cause a fatal heart attack. And someone who has survived a murder attempt would be frailer and more susceptible to most drugs. Air injected into an IV is a perfect way to kill someone.

Once you have decided to set up a hospital murder, either in one or two steps, there is a wealth of internet info to look at. For example, if you are set on killing someone with air injected into an IV, I would like to recommend the blog by James J Murray, Prescription for Murder, as a great starting point. Another intriguing find is a book about murder by insulin.

For me, the intriguing part of my interview with MC was the hospital setting as an opportunity for murder with a necessity of developing the kind of complex character who would murder in a hospital. I truly think this hospital killer allows a writer to develop a character that embodies the saying: ‘As we get older, we just get more so.'

All our vulnerabilities, our fears and frailties, can be hidden under work and purpose. However, in the end we all become ourselves and more so. What haunts us eventually will consume us and that, in essence, is the making of a murderer.

22 August 2017

Mystery #1: How to Balance Motherhood, Work, and Writing

by Melissa YiPatreon

Hi everyone, I want to tread lightly as we mourn the great writer and friend, BK Stevens. I'd written this post three years ago, and tucked it away for an emergency day that didn't come, although I came close many a time.

Sleuthsayers have been very kind to me, but I've struggled to balance my 'big three': medicine, writing, and my children. This summer, I realized it would be best for my family and my sanity if I gave someone else the opportunity.

Next month, you will meet Dr. Mary Fernando. I first met her through Capital Crime Writers, the Ottawa writers' association. Her first novel, An Absence of Empathy, was nominated for the Unhanged Arthur for Best Unpublished First Crime Novel, sponsored by Dundurn Press. In addition to her obvious talents as a physician and a writer, Mary likes to laugh, and I think you'll have fun together.
Shoot. Her face is cut off (perhaps fitting in a crime blog?), but that's Mary Fernando, me, a skull, and Elizabeth Hosang.

Best wishes, everyone. Perhaps it's fitting that my last column is about family. Yesterday, my eleven-year-old son, Max, turned toward me. "You said you weren't working in August."

"I said I wasn't working [at the hospital] as much. But that means I'm writing more. You know that."


"I hate your writing. I hate it. It takes you away from us."


So I'll work on getting our family back on track. Today, we watched the partial solar eclipse. Tonight was their last, despised swimming lesson. Tomorrow they'll revel at a barbecue before I start back at the hospital again.

See you online, and at Bouchercon in Toronto!
Cheers,
Melissa
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Original post:
When I was in med school and residency, I knew I wanted kids, but I had no idea how I’d make time for them AND emergency medicine AND writing. So I used to corner parent-writers at parties and say, “How do you do it?”

Dr. Ilsa Bick, a writer and a psychiatrist, said, “You have an advantage. You started writing young.”

“What does that have to do with anything?” I shook my head, genuinely confused. Writing in my twenties wouldn’t help me stay up all night with a colicky baby.

But now I see a few advantages, like before I procreated, I’d already written my million words of garbage, I’d published a handful of short stories and won a few awards (including Writers of the Future, where I met Ilsa), I’d written a few novels, and I’d perhaps most importantly, I’d learned iron-clad self discipline.
From the Kobo office. Cool place.

Still, since this spring, I’ve been wrestling with the question of how to become a more attentive mom.

Over the past two years, I’ve doubled my emergency room shifts per month. I still need to write. So motherhood was sliding on to the back burner. Now that my daughter has enough of an attention span longer than a few minutes, it’s all too easy to foist both kids off on the electronic babysitter (Netflix and/or YouTube).

So I tried a few different tactics.

I read about how other people prioritize their family life.

I wrote about balancing medicine and my family for the Medical Post.

And I started doing video diaries/vlogs (video blogs), walking my dog with my kids while talking about writing.




Last year, the fearless fantasy writer, Michael La Ronn, introduced me to #walkcasts. Those are podcasts you record while walking. Walking is a good idea for writers, who tend to be sedentary. And podcasts are fun, as you can hear on Michael's podcasts here. So I recorded ten of them, but I never got around to putting them in order, labeling them, etc.
On impulse, at the end of August, I started recording videos instead. Just a minute or two. Just long enough to say a few words about writing and show people the neighbourhood and our dog Roxy’s hind end as she trots in front of me.


I can’t say my videos are blowing up YouTube. My son Max laughed and said, “Why do you only have two views?” But you know, for once I’m not as worried how many likes or views I get. This is my way to combine two of the big loves of my life, and if the rest of the planet doesn’t see it, well, it’s probably just as well for my kids’ Internet privacy.

No matter what happens, or how many trolls give us the thumbs down, I will love my kids. And I will love writing. This feels like a win to me. It makes me more present if I’m recording my walks instead of just getting lost in my own thoughts.



If a young’un were to ask me now, “O Great and Wise Melissa, how do you do it?” I’d say supportive partner is priceless. A tight circle of family and friends will keep you afloat. But it takes ferocious will to make time for multiple serious interests. Do you let the kids weep for a few minutes while you finish your word quota for the day, or do you let the words slip away because kids come first? 

Medicine waits for no one. Are you willing to scale back your career now for the sake of your writing, or go all-out doctor and pick the pen back up in twenty years? You decide.

You can see how writing can easily drop off the to-do list. That’s why I encourage you to keep writing no matter what. Even one line, one word a day. Just keep at it, and it will add up to a song lyric, a poem, a short story, or a novel. Something beautiful for you, and maybe for the world.