I recently started a note on my phone entitled ‘Musings,’ as inspired by a staff doctor in Goose Bay who has sent us several emails with this as the subject line. I love the word musing ‐ it is reflective, creative, and offers a window into someone’s inner psyche. It also makes me think of a small creature that I imagine would look somewhere between a lemming and a badger. A musing.

Etymology‐wise, musing in English is to be absorbed in thought. In Old French it was closer to the meaning of to meditate or to waste time. It actually wasn’t directly related to a muse (source of inspiration) and no, amusing is not a…musing (I was disappointed by that, come ON etymology!)

Wasting time was the definition that struck me. An emphasis on productivity, efficiency, and effectiveness is supreme in medicine. How many patients were you able to see during your Emergency shift? Did you stay on time in clinic? Being busy is glorified and accepted. What does that then mean for the act of musing if we are not wasting any time? Is medicine an anti‐musing profession? How could a job so centred on humanity not be full of musing and reflection? For me, it is typically in the middle of a long stare at a blank wall that I start to appreciate the nuances of a difficult day. Perhaps it is that musing is too easily pushed aside by our daily to do lists. We need to choose to muse, like we actively choose to do everything else in our lives. With that choice, we go against the grain of productivity. We accept, and cherish, that some of our time will not have an immediate tangible output.

There’s a man in the UK who started to count his sneezes in 2007 *1  as a way of documenting the mundane moments in life. All those moments in between the big ones. He thought sneezes were a good choice because they were banal, unremarkable, and often unwelcome. I was so taken by this idea when I learned about it that I started to count the times I spilled on myself – another (fairly frequent) involuntary act – and have noticed that it is a phenomenal way of remembering moments that are otherwise entirely forgettable.

I think this can be applied to our jobs and can certainly be applied to my experience as a resident so far. There are the big landmark moments: the first time you run a code, the first time you help deliver a baby, the first time (and every time) you have to tell someone their loved one has unexpectedly passed away. There are also a lot of forgotten moments in between that make up our days, and ultimately, will make up our careers. The man that counts sneezes says on his website that “the act of counting…..gives him a more profound understanding of the simple joy in the passing of  time.” *2 Maybe it is an act of preservation to ascribe value to the in‐between moments. Not the ones that you make you smile all day. Just the ones that pass without you noticing. Or, maybe, ascribing value to the in‐between moments means that no moment is really in‐between at all. << Musing.

(*1) Fletcher, Peter. “Sneeze count – counting sneezes since July 2007” Retrieved from: http://sneezecount.joyfeed.com/
(*2) Fletcher, Peter. Date published unknown. “Reflections on the Counting of Sneezes.” Retrieved from: http://sneezecount.joyfeed.com/reflections‐on‐the‐counting‐of‐ sneezes/

Below are some excerpts from my ‘Musing’ note, recorded during the first few months of residency in Goose Bay and St. John’s. Some are quotes from other people that affected me and others are random thoughts from hour #15 of the drive between Labrador and Newfoundland. All were written down while I was wasting time:

Invention: A spray that will protect my clothing from all the pens that explode on me. Buying better pens honestly seems like a less realistic alternative.

“Be kind. Everyone has a story.” – C.E.

I feel insecure about the fact that I am playing a key role in people’s lives at the ripe age of 27. But I don’t think that insecurity is useful to anyone. Time to rise up to the responsibility?

Do I even like Tim Hortons? Why do I eat 3 times a week at a place I might not even like? Why don’t I know if I like it or not?

Always shocked by the things that make me cry at/after work. It’s not consistent and it’s not logical. Being present for the privacy of other people’s tragedies will probably never make sense.

Why do people only drink spicy clamato on airplanes? I have literally never had a spicy clamato juice on land.

“There’s no better reason to be late than a good laugh.” – Woman in St. John’s when I said I had to run for ward rounds. We had just finished having a hearty giggle about an older patient who had passed some gas in our elevator.

I’ve spent the majority of my life in big cities, until 6 months ago when I took a left turn and landed in Goose Bay (okay, it was a sharp left turn.) I’ve noticed that it is a self‐ selecting group that opts to challenge themselves in the way that rural medicine demands. Despite the reality that there is always more to learn and do, I have never met a group more willing to muse. I guess it logically makes sense that a profession in rural medicine, requiring unanticipated creativity and adaptability, would be well suited to people who take unconventional pause. From what I’ve witnessed, the patience to indulge in the odd thought experiment translates, quite directly, into the patience required for sustainable compassion.

Everyone has their own way of working through the truths and contradictions of medicine. For me, it helps to have a note on my phone to record some in‐between thoughts – absurd or otherwise. Cheers to our own personal sneeze counts, whatever they may be.

By: Dr. Caroline Patterson