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drmjansen

Oct 01
2

Inspired, grateful, and a little star-struck.

By | Ethics | No Comments

I found out that I had been awarded a Churchill Fellowship while I was on holidays in Japan. My husband and I were on a train from Tokyo to Yamanashi (one of Japan’s wine regions) when I checked my email on my phone and saw the congratulatory email from the Churchill Trust. I had to suppress a cheer (etiquette on Japanese trains not really allowing for a victory dance) and be content with poking my husband in the ribs, carving my face in half with my smile, and indulging in some attenuated fist pumps.

The Churchill Trust https://www.churchilltrust.com.au/ is an Australian trust that was established in 1965 to honour and perpetuate the memory of Sir Winston Churchill. Apparently, Sir Winston Churchill preferred the idea of a travelling scholarships scheme as his memorial, rather than having a fancy statue built. After Churchill’s death, countries around the world set up trusts in honour of him. In Australia, a huge public appeal was launched and had a spectacular response, in particular from a doorknock appeal run by the Returned Services League. You can read more about the history of the Trust here.

What this means is that since 1966, the Churchill Trust has awarded over 4100 Australians with Fellowships. To be awarded a Churchill Fellowship, people with particular expertise propose a project through which they will develop this expertise, and return to contribute to Australian society. If awarded, the Churchill Trust funds their travel and expenses for up to 8 weeks so that the Fellow can pursue their project. One of the many things I love about the Churchill Fellowships is that they are open to people from all walks of life. My cohort from 2016 included an optometrist, a panel beater, a sound recording artist, a radiation scientist and a chef to name just a few. Even before setting out on my Fellowship, meeting this group of people made my world bigger. I’m fascinated by all their projects and can’t wait to see the outcomes of their fellowships.

The one-liner to describe my project is: To enrich and inform development of paediatric clinical ethics services in Australia. Clinical Ethics Services (CES) are a funny thing. Ethics is relevant to all healthcare professionals in all specialties and ethical, or moral, dilemmas happen everywhere in healthcare. CES are increasingly common in hospitals and exist to give advice or help clinical staff to deal with these difficult moral problems.  However, no one really knows what the best way to run CES is (there are probably many), we haven’t decided who should be allowed to call themselves a clinical ethicist, and we don’t know exactly how to measure whether a service is good quality or not. You can read more about CES in general, and in paediatric hospitals in particular, in a recent study done by our centre in Brisbane and published in BMJ Open Paediatrics.

During my Churchill Fellowship, I will visit several CES around the world to see how they function and how they think about and measure their outcomes. I am particularly interested in the best ways to teach robust moral reasoning to those working in CES, and so I am also visiting several universities with excellence in teaching ethics. Through my work in both clinical ethics and clinical medicine in Australia I am increasingly aware of the need to foster openness and compassion in healthcare workers. Being able to make good ethical decisions is uniquely dependent on understanding the narratives of all involved. There is some literature describing that engagement with the arts is one way to foster these skills, and so another thread running through my project is to explore these techniques.

So, I’m off – to Europe, Canada, the United Kingdom and the United States! I’m feeling grateful, inspired, and a little star struck by all the wonderful people I will have the opportunity to meet and learn from.

I’ll be chronicling my Churchill Fellowship adventure on this blog and will also be active on my Facebook page and Twitter @DrMJansen. Follow me if you’d like the updates!

Sep 29
1

A collection

By | Uncategorized | No Comments

The content on this blog may seem like a random collection of stuff. It is a collection, however it’s not random, but an honest collection of things that interest me. I feel a little bit weird about blogging. Maybe I’m too close to the X end of Gen Y for it to feel like a natural thing to do, or maybe, like many people, I’m not convinced anyone will be that interested in what I write. Despite this slightly weird feeling, I decided to go ahead and start a blog because my reasons for starting it are not focused on necessarily developing a following, but rather that I have a few interests and pursuits that I think it would be helpful (definitely for me and maybe for others) to write about and collate, and a blog seemed like a good way to do that.

The catalyst for creating this blog was my Churchill Fellowship. I’m travelling around the world to research ways to enrich and inform paediatric clinical ethics services and thought a blog would be a good way to document my experience, and also to post about ethics issues more generally. After the Churchill Fellowship, I’ll be studying for my ICU fellowship exam, and I’d like to share some of my notes/podcasts. Throughout my medical career, I’ve been exquisitely grateful for blogs such as Deranged Physiology and Anaesthesia MCQ, but I’ve noticed there is a little gap in online information available that is specific to paediatric ICU, and so I thought if I posted up some of my study stuff, it might be helpful to others. I’m also planning to post about travel and, in particular, wine. I haven’t been on a holiday to a place without a wine region either at the destination or en route to it in about a decade. Writing about wine will help me remember what wineries I’ve been to, what wines I liked, and might even be useful to refer to for future WSET study. You’ll also eventually find posts reflecting on the human experience of illness and caregiving. I’ve always been drawn to the arts, and have been writing poems and stories my whole life. I think reflective writing and interaction with the medical humanities can add immeasurably to the practice of medicine.

Lots of people told me I should have lots of separate blogs. One for wine, one for poetry, one for ICU, and one for ethics. Some people said to combine ethics and ICU into one (my ‘professional’ blog) and put the other ‘fun’ things in another blog. I was warned about the need for a ‘professional profile’ quite separate to my ‘personal life’. To craft a ‘wine persona’ and an ‘ICU persona’ and an ‘arts persona’.

I listened to all this advice and then chose not to take it. The first reason is pragmatic – there is no chance I will have time to run more than one blog in any meaningful way. The second is that it felt disingenuous to create different blogs with their accompanying “personas”. I am only one person. I do not become a different person when I leave my home and arrive at work, nor when I leave at the conclusion of a medical journal club to go to a poetry workshop. Like most people, I behave in different ways depending on what is appropriate to the setting, but I am not a different person. I don’t have separate personae for each activity that I do. Occasionally, maybe a parent of a child I have cared for in ICU will stumble across my blog. Maybe future employers will find it. I have no problem with them knowing I am interested in ethics, wine, travel and the arts as well as intensive care medicine. None of these things make me less of a committed and professional doctor. All of them make me a fun dinner party guest 

I can’t promise I’ll be posting at a particular frequency – it’s likely I’ll post in fits and starts depending on a host of factors. As my content increases, I’ll arrange things under headings so that people can find what they are interested in. Comments are welcome, particularly on factual content related to ICU stuff – the closer we can get to peer review the better! However, I will moderate comments, and some may not be published. I love robust discussion but not all of my posts will be intended for this purpose.

If you’d like to contact me directly, details are on the blog front page.

Salute!