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Kevin Holly
Kevin Holly

When Things Go Wrong In Urology: Reflections To... UPD



"You just don't know where they're going to be from day to day. 'Cause one day they're one way, and the next day they're in a different mood and the next day...this is bothering them and that was where I wasn't prepared. I just...I knew we had to get through but I think you go through that big trauma period and then you hit a point where you go, 'okay, now we've got that sort of under control. We're not sure where we're going with it yet but it's kind of under control,' and that's when things sometimes get out of control. And you're their back at home, and they're going through all these different things emotionally. Well you're sucked into all that stuff. I mean, you don't know from day to day how they're going to handle it."




When Things Go Wrong In Urology: Reflections to...



Kala Sridhar: Sure. So this was my first APCCC meeting and I've really enjoyed it. I thought the talks were very focused, were very interesting. The debates, in particular, were nice because there was no right or wrong, but it was just learning two sides of the issue. So I really liked that. In terms of my key thoughts, I have a couple of them. So, the first is in the area of metastatic hormone-sensitive prostate cancer, which is an area that we both treat. I think the things that were really interesting or came out of this was the fact that there's a fair amount of heterogeneity within this setting. So we talk about low volume life expectancy, about eight years, high volume life expectancy, about three years. But within these categories there is indolent low volume, there's more aggressive high volume. So I think we have to be cautious about painting everybody with metastatic hormone-sensitive prostate cancer with the same brush. And I think we really have to consider the patient in front of us and how they fit into this. So I think that's one of the first things that was very evident from the presentations today.


Flash forward 3 years: I'm now one of the internal medicine chief residents and I just finished my first week as an attending on the chief service. I'm still figuring things out, but it's hard to explain just how transformative residency has been for me. Sure, I was nervous on my first day as an attending, but I knew I could handle it. I even live-tweeted it! Residency changed me for the better. Here are a few things I wish I understood when I started.


I loved residency. It was difficult, but after spending so much time and effort to get there, I was finally able to function as a doctor for the first time. I made decisions that saved people's lives. I got to comfort patients and their families when things didn't go well. I learned a lot about myself -- my resiliency and my limits. I have stories to tell for years, and I made good friends to share them with. I really couldn't have asked for much more.


Practicing being grateful, for little or big things in daily life helps us to see that every day has some good. We don't want to miss out on these day to day moments that comprise our lifetimes. There are Mindfulness reflections one can do daily which boosts positivity and appreciation, learn how here.


We all get stuck at times. We can beat ourselves up, judge ourselves harshly and get hooked on a story about what is wrong that becomes a repetitive loop in our brain. Notice when you have one of those stories going through your mind, and try this practice. Self compassion is essential to rebounding and building resilience. With practice, you can rewire your brain and help yourself.


I knew something was wrong with the waterworks, and naturally feared the worst. Initial tests suggested that it was BPH rather than anything more serious. However until, under the care of Richard Hindley, this was confirmed by an MRI scan, it was a tense period. Mr Hindley had talked about Rezum, but because it was still early days he had, quite properly, not pushed this treatment too hard and in fact, when the diagnosis was clear, initially suggested green light laser. On reflection this may have been because I had a significantly enlarged prostate. 041b061a72


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