Pamela Q. Fernandes's Blog, page 29

Q 18 Political Correctness in Doctor Patient Conversations

“Do I always have to be politically correct?”

Do I have to be politically correct?

Dr PS sent in this question last week. Of late I’ve realized with younger generations of patients communication seems to be misunderstood. My patient’s are offended if I tell them they’re fat or if they’re smokers or addicts. My question is why can’t I be honest? Do I have to be politically correct?

I won’t mince words. The current climate has become extremely negative. People complain about everything because they can and have an audience that will listen. So, my answer is, yes. You have to be politically correct. Here’s the trick to doing it.

Try more Tact

Being tactful can go a long way. Using medical terms could probably help. Instead of fat, there’s no harm in saying overweight, stage 1 obesity or stage 2 obesity. Instead of addiction, say dependence. Clinical terms are correct and if you could be tactful, no one’s feeling will be hurt

Be Honest

You shouldn’t have to lie. I think the worst thing you can do is lie or sugar coat things for patients. Even at the risk of losing patients, it’s in the best interest of the patient to be honest. Honesty is correct.

Check your Tone

If you’re being condescending then patients will resent you. No one enjoys being talked down to. You may want to sound strict or straightforward but listen to yourself while you’re talking. How do you sound?

I’m sorry if I don’t have a more politically “correct” answer but with the shape our world is in right now, people don’t want to hear the truth and while we have to have the courage to call things as they are, we also need to make sure patients are encouraged to take the advice offered to heart by changing their health for the better. You can read this book by Micheal Williams on how it all started.

 

 

 

 

 

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Songs from Under A Scottish Sky

Songs. Music and Melodies. For some reason, my readers have been especially interested in the music included in Under A Scottish Sky. There wasn’t much but yes it was an integral part of the book. I even thanked the musicians in my acknowledgements because the songs were a very important part of my writing process that fueled my imagination.

Under A Scottish Sky

Come to think of it, without those moments of music and song the book would be incomplete. For instance when Rory sings in a pub full of patrons for Michelle when she’s having a hard day. He actually sings “Hard Times, Come Again no More” to cheer her up. This was an American Parlor song that became an anthem during the war and was covered by so many artists including Dolly Parton and Johnny Cash.

Lyrics

Let us pause in life’s pleasures and count its many tears,

While we all sup sorrow with the poor;

There’s a song that will linger forever in our ears;

Oh! Hard times come again no more.

‘Tis the song, the sigh of the weary,

Hard Times, hard times, come again no more.

Many days you have lingered around my cabin door;

Oh! Hard times come again no more.

While we seek mirth and beauty and music light and gay,

There are frail forms fainting at the door;

Though their voices are silent, their pleading looks will say

Oh! Hard times come again no more.

There’s a pale drooping maiden who toils her life away,

With a worn heart whose better days are o’er:

Though her voice would be merry, ’tis sighing all the day,

Oh! Hard times come again no more.

‘Tis a sigh that is wafted across the troubled wave,

‘Tis a wail that is heard upon the shore

‘Tis a dirge that is murmured around the lowly grave

Oh! Hard times come again no more.

Then, there’s Rhona’a funeral where the bagpipes play and the old church hymn, Amazing Grace is belted out as the Scots file out in their kilts and tartans for her last goodbye. Bagpipes can really pierce your soul. It’s the most beautiful strain and Amazing grace is a very common hymn at Catholic funerals and wakes.

Amazing grace! How sweet the sound

That saved a wretch like me!

I once was lost, but now am found;

Was blind, but now I see.

’Twas grace that taught my heart to fear,

And grace my fears relieved;

How precious did that grace appear

The hour I first believed.

Through many dangers, toils and snares,

I have already come;

’Tis grace hath brought me safe thus far,

And grace will lead me home.

The Lord has promised good to me,

His Word my hope secures;

He will my Shield and Portion be,

As long as life endures.

Yea, when this flesh and heart shall fail,

And mortal life shall cease,

I shall possess, within the veil,

A life of joy and peace.

The earth shall soon dissolve like snow,

The sun forbear to shine;

But God, who called me here below,

Will be forever mine.

When we’ve been there ten thousand years,

Bright shining as the sun,

We’ve no less days to sing God’s praise

Than when we’d first begun.

Then there’s this song by Cherish the Ladies that I was listening to while I wrote this book in mourning. And of the many songs out there,  it filled me with a background to write this book.  Erin Gra Ma Chroi’s lyrics aren’t particularly Scottish as you can tell by the lyrics.

Oh Erin grá mo chroí, you’re the dear old land to me

You’re the fairest that my eyes did e’er behold

You’re the land St. Patrick blessed, you’re the bright star of the west

You’re that dear little isle so far away

At the setting of the sun, when my long day’s work was done

I rambled down the seashore for a walk

And I being all alone I sat down upon a stone

For to gaze upon the scenes of New York

Oh Erin grá mo chroí, you’re the dear old land to me

You’re the fairest that my eyes have ever seen

And if ever I go home, it’s from you I never will roam

You’re my own native land so far away

With the turf fire burning bright on a cold dark winter’s night

And the snowflakes falling gently to the ground

When St. Patrick’s Day has come, my thoughts will carry me home

To that dear little isle so far away

Oh and Erin grá mo chroí, you’re the dear old land to me

You’re the fairest that my eyes have ever seen

You’re the land St. Patrick blessed, you’re the bright star of the west

You’re that dear little isle so far away

On the day that I did part, well, it broke my mother’s heart

Will I ever see my dear ones anymore?

Not until my bones are laid in the cold and silent grave

In my own native land so far away

Oh Erin grá mo chroí, you’re the dear old land to me

You’re the fairest that my eyes have ever seen

And if ever I go home, it’s from you I never will roam

You’re my own native land so far away

You’re my own native land so far away

The music is haunting and I daresay I wrote with this sad lingering tune in my heart. If ever this book becomes something more, (I know big dreams) this is the song for it. A song for Adrian and Michelle’s love story.

What do you think about the songs? Like them? Hate them? All of us have songs in us. That’s why we use songs instead of words for what’s happening in our life and these are what I used for Under a Scottish Sky.

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Q 17 – Talking to Patients about a Living Will

How to talk to patients about a living will?

Talking to Patients about a Living Will

So this week’s post is in response to the flood of emails I received on the Supreme Court petition filed by the Government of India and it’s ruling. Everyone kept texting and writing saying, “have you see this?” And I had to take time to read the entire petition which allows people to seek passive euthanasia. Well, I’m Catholic and my stand on this is clear. And if people already had advanced health care directives, none of this would be required.

So how do you handle these discussions with patients?

Start at the very First Visit

We all know this is something people are uncomfortable talking about. Nobody wants to admit they’re going to die at some point. We delude ourselves thinking we’ll be here forever. And then no doctor wants to upset patients especially if they do not like admitting they’re old. We’re all like that. Which is why this is something that should be discussed during the first walk-in.  You have a new patient, you get the complete history, do the physical, don’t simply ask them whose your emergency contact. Talk to them about the living will.

Make it Mandatory

I’ve worked with certain institutions that have made it mandatory to do this. After all, if we’re your emergency care provider we need to know what advance directives or the living will state, whose the decision maker, who knows and represents your wishes, who calls the shots. Without this, the further appointments won’t be scheduled. Although the ruling of the SC does say in the end the team of doctors decides if brain function is present or not and if life support can be maintained, but in cases where there is function and relatives want to do otherwise, a living will would be great.

Give People Time

Don’t expect it to happen overnight or in the same visit. Get the conversation started. Offer patients time to think about their living will. Let them process this and get back to you.

Meet with the Representatives

If patients tell you that their wife or husband is their representative named in the will, then try and meet with them. Get to know them, just to make sure no one is being coerced. This is also so that it’s no surprise to you if and when it’s required. Talk to these people, discuss the will, and address all their queries.

Explain the Will

This is the most important thing of all. I bet lot’s of patients are going to ask this question of their GP’s after this ruling, especially if they haven’t had a family doctor or GP for their annual health needs. Explain what a living will is, explain end of life care, decisions, machines, protocols, procedures and what is required. Repeat if necessary, till the can explain it well to other people. Don’t instill fear but let them know how and why a will helps.

If you’re a doctor who would like to send in a question, you can DM me on twitter @PamelaQFerns or even message me on LinkedIn or simply use the contact form or email me.

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Authors Be Careful with your Money

Money issues, all authors have them. Especially when you’re just starting out. Everyone thinks you’re making bank when you put out a book without realizing how hard it can be to get all the stuff behind the scenes done, cover work, editing, and then marketing.

Be Careful with your Money

I recently received an email from a book reviewer raving about my book. Now I give myself the benefit of the doubt, but the novella is 80 pages long and only been out for three weeks, so I was wary already.

The email was about twenty lines long saying they would love to review my book (red flag 1) and said they were writing a short email to tell me about the “review process.” They would be happy to give me a stats of their website and whatnot. So I clicked on the website, seemed quite legit. Nice high resolution pictures. I see reviews of books like “Gone Girl”and I’m  thinking, “does she really think my book’s all that?” (red flag 2)

So I shoot her my standard reply thanking her, asking what format she will prefer and there’s no talk of money so far. I know for a fact that most reviewers do this for free. Amazon has a strict policy of not paying people for reviews. If you do pay money and get caught, Amazon can kick you off their program altogether.

The next morning I receive a long email, like 50 lines long, with a number of spelling errors, then the reviewer mentions she is running a business, she likes to read, is a mom, and charges 75$ for a review. Holy moly Batman!

75$??? For an 80 page novella?????? She also rambles on about she loves to help indie authors and then sends me stats of her website and how many readers she has and how she can help me sell more books.

I send a reply that I’ll pass because my publisher does not have that kind of budget for a novella that’s available for 1$ and I haven’t made 75 bucks yet, on my own book to spend it.

So why am I writing this? Because authors, I want you to be careful with your money. I understand Bookbub and book blast sites charge money, but reviewers? Don’t be gullible and fall prey to these people.

The emails maybe heart-wrenching and  a convincing sales pitch. But if you were spending money it would be better on ads than on a single review.

Have you had this experience?

 

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What to do when you don’t feel like writing?

Don’t feel like writing?

Many writers feel this way at some point. I know I do, occasionally.  In between work, going out to see Chicago, eating at all the possible restaurants to review on Trip Advisor and writing, the latter has taken a back seat. Add to it all the promotion and marketing for Under A Scottish Sky, it’s been a full week but not a writing week.

Recently, I started a short story and I have two R & R’s along with WIP’s that have to be completed. I’ve gotten behind the ball completely simply because I don’t ‘feel’ like writing.

So what do we do when we feel like not writing? Here’s what I did:

Read a Similar Work

I started reading East of Eden by John Steinbeck, although my work is nowhere like his. (hahah) But I started reading as a writer, searching the trope, the mechanisms, the editing, the vocabulary he’s used, as a way to learn my craft and get a feel of his fiction.

Created a More Detailed Outline

I figured if I was wasting my time not putting down the words, I might as well draw a map of how the writing should flow.  With a more detailed outline I can jump right in and follow the lines I already drew out when I get out of my funk.

Search Potential for the Project

Since I was surfing the net anyway, I figured why not look at some agents and publishing houses looking for books like my WIP. It’s part of the process and instead of doing it later why not do it now, since I don’t feel like writing.

Organized my writing plans 

I revisited all my writing plans. I hit most of the deadlines half yearly and then fell out of steam by September so my projects all hit the wall with new releases. I spent a lot of time sending books for reviews and all that stuff. Since I didn’t feel like getting back into writing I redid my targets and set new daily word-counts.

Sought Inspiration

Since I couldn’t get into the feel of it, I went on walks, visited parks, and with fall, you cannot help but get inspired. Since my book is set in summer, it didn’t help, but it did give me plenty to fill up my journal with ideas.

All in all, you can tell I never really stepped away from the writing process. It’s at the back of my mind and I did all the other writerly things I had to do but didn’t have to do now. But that’s the thing when you don’t feel like writing, take on editing, researching, reading, studying, organizing, anything so that you you don’t feel like you’ve wasted time. I know I do feel guilty about it but I’m hoping taking care of those other tasks have been helpful. Pretty soon I’ll be fed up of all those “other” things and I’ll get into the writing seat again.

What do you do when you don’t feel like writing?

 

 

 

 

 

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EPISODE 13 – Can I Answer the Call to Martyrdom like Maximilian Kolbe?

“The most deadly poison of our times is indifference.” Maximilian Kolbe  

Answering the call to Martyrdom

Charles Johnston is a father and husband in Phoenix, Arizona. His conversion journey has taken years, as he felt God pulling him toward His Church but he resisted until he couldn’t take it anymore. He gave in and fell in love with His Church.  He blogs for ‘Now that I’m catholic.wordpress.com’. In this episode, I talk to Charles, about the Apostle Peter, his ministry and transformation from a fisherman to fisher of men.

 

In this episode, I talk to Charles about saying yes to die for Christ like Christ. He talks about St. Maximilian Kolbe’s life and his choice to say yes to dying for a stranger during his imprisonment in Auschwitz.

He also explains how this priest accepted his call right from his childhood up to his death, following in the footsteps of Christ. Kolbe is a great example for suffering Christians all around the world today.

He teaches us how to make the ultimate sacrifice? Can you?

Tell us what you think.

Here’s the podcast. We don’t have a transcript this week. Let me know if you’d prefer reading.

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Q 16- Why do I have to teach medical students?

Why do I have to teach medical students?

Dr JI asks this question. “Recently our practice has signed up as a preceptor for students as a way of increasing revenue. We have to take on a number of students, and teach them. I don’t see the point to this and I’m wondering why should we do this in a busy practice.”

Why teach medical students?

Well here are a few things you need to consider:

We’re all students

As doctors we’re constantly learning. We take courses, learn procedures, we get accustomed to new surroundings, we study new guidelines and always there’s someone more experienced than us and there’s never any hesitation on their part to teach.

Teaching is learning

When you teach your learn twice. Whether it’s students or otherwise repetition is learning. When we teach others we reinforce the subject in ourselves. I for one find certain core subjects ingrained in me because I repeat it to other people, whether my nurses or patients. So consider teaching as a way for you to learn.

Revision of old concepts

One big advantage of teaching is revisiting old concepts that you don’t see in real life. Just the other day we had a teaching session on fetal health and precocious puberty. Let’s be honest we hardly ever see precocious puberty in real clinics, but I realized there was so much I had forgotten about the subject. And yes a very senior gynecologist, taught us this subject. With the teaching session, I brushed up and revisited the subject.

Getting up to speed with Research

If you’re a busy practitioner there’s not much time to read all the papers that come out in your field. In Neurology alone, there are fifty different new discoveries and findings every week. If you’re an internist, imagine how many papers you’d have to read to find out the latest research on the human body. But when you teach, students make an effort to bring the latest research to the fore. Current generations of med students are interested in all the chip and technology driven medicine. You can learn from them.

Division of Labor

This may sound mean, but you can delegate some of the “lesser” work to students as you teach them. Taking vitals, getting pertinent history, height and weight (if you have to do that kind of stuff.)

Pass on what you know

You didn’t one day wake up and learn how to do a Whiff test or suture a patient. An intern, resident, consultant, attending, took the time to teach you and now it’s your turn to pass on what you have learned. You owe them. Thank your stars you’re at that stage and have to teach the little ones what you know. It’s how medicine works. It’s how we thrive. It’s how we train the doctors who will one day treat us and our children.

If you’re a doctor who would like to send in a question, you can DM me on twitter @PamelaQFerns or even message me on LinkedIn or simply use the contact form or email me.

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Romance Reviewers List

Since I’m gearing up for the pub date of UNDER A SCOTTISH SKY on Sep 26th, 2017 I’m reaching out to reviewers. I’m also spreading the word that it’s 90 cents or 60INR until pub date.

Most authors write to people and reach out to readers. Over the past few days, I’ve scoured the net to get a reviewers list and I have to say sites valid a year ago are not anymore.

Romance Reviewers

Some reviewers have been overwhelmed by requests, some have given it up and some are closed to requests. Others have a waiting period of two months. Needless to say I tried to compile a list so that the next time  it won’t be such a hassle locating them. See if this starter list can help you. If you do enjoy reading books and free books (I must say) then sign up as a reviewer on these sites. The one thing I noticed is that many big reviewer sites are always looking for readers.

If you know of a reviewer specifically for romance, then let me know. I’d be happy to add them to this list. If you are a reviewer and would like to be added to this list then leave a comment and I’ll be more than happy to add you.

This list is in no way exhaustive.  It is a starter list.

http://smartbitchestrashybooks.com/contact/review-requests/

http://www.theromancereviews.com/requestreview.php

http://aestasbookblog.com/

https://natashaisabookjunkie.com/review-requests/

http://redhotbooks.com/review-requests

http://smexybooks.com/review-policygiveaway-info

http://harlequinjunkie.com/about-me/request-review/

http://fictionvixen.com/request-book-review/

http://anasattic.com/review-policy-and-contact-info/

http://steamyreads.net/review-request/

http://dirtygirlromance.com/review-policies-requests/

http://coffeetimeromance.com/authors-book-review-request/

http://www.thereadingcafe.com/review-other-policies/

http://bookthingo.com.au/contact-us/

http://romancejunkies.com/contact/

http://www.inspyromance.com/contact/

http://www.truestorybookblog.com/review-requests/

http://romancebetweenthesheets.com/contact/

https://geybie.co/review-requests/

http://www.theromancedish.com/

https://romance4thebeach.wordpress.com/review-policy/

http://typicaldistractions.com/review-policy-past-reviews/#comment-1626

http://www.cleanromancereviews.com/p/review-requests.

htmlhttp://www.bffbookblog.com/review-requests/

https://australianromancereaders.wordpress.com/rd-guidelines/

Also each of the sites listed here takes you to the policy page or the page where you can see the policy. Read it first. It’s important. I know many other sites where they wanted dark romances, paranormal romances or something very sub-genre or niche. This list is more wholesome. These sites are for a blanket of romances. Period.

Steps for Review Acceptance

– Write a Template Email

– Include Name of author, book, genre, word count, book links, book blurb, ASIN, Publisher’s name, date of publication

-Some have additional questions: Is it HEA? Is there cheating or death? Is it a series or standalone. Answer all these questions. Reviewers are busy people. Make it as easy as possible for them to pick up your book for review.

-Tell them what format you can send them, epub, mobi, pdf? Check what format they like to read. And try as much as possible to give them that format.

-Thank them. They don’t get paid for it. It’s a service they provide for free.

– Follow their feeds. Many will not inform you if they’re done with the review. You will just see it on social media.

-Don’t argue. If they will not put up a review on Smashwords, Kobo and Instagram and Snapchat or the gazillion other places don’t argue. It’s time consuming. Check the sites they do use and accept it.

-Accept the review. No matter what. Don’t defend yourself or blame them. Different people have different tastes. It won’t kill you.

-Please review other people’s books too at as many places as you can. Do unto others as you would have done unto you.

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Pre-order Under A Scottish Sky for .90 cents until Sep 26th

Under A Scottish Sky is now available for Pre-Order.

My publisher has allowed a special price of just .90 cents till Sep 26th which is my Pub date.

How Travel Sparks Writing Ideas

Chicago Travel

I’m late with posts because my travel to Chicago has gotten me busy. Jet lag and settling in the Windy City has taken much of my time. But today I want to tell you how travel can spark new writing ideas.

New Landscape

Every time you start a new book, you need a new landscape. You need a fresh picture on the canvas of  your page. It provides the flora, architecture, roads and landmarks you wouldn’t get from a picture or from using Google.  Travel can give you the backdrop, the kind of trees that grow there, the style of home you will find, the network of roads, etc.

New People

It provides new characters. Let’s face it, if you don’t meet people, you can still watch and hear them. You hear their conversations, the way they pronounce their words or say things. It can add another dimension to you characters.

Activities 

You can’t possibly know what the locals enjoy doing unless you travel to that place. Just to explain, I for one would never peg Chicago as a cyclist’s dream. But it is. Here in my neighborhood alone, I’ve seen more than a dozen people cycling and it’s amazing because I’d never pick this up from google.

Cuisine

Food is an integral part of a story. No matter what you write I bet there must be mention of food in your book. In the book, In search of Lost time, Proust uses Madeleines which made the biscuit popular. Similarly in your book, food and cuisine can play a major role in adding a layer to the story. On a separate note, I haven’t sampled the deep dish pizza yet, but I’m dying to try.