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Secondary Intention

~ Living life from the inside out

Secondary Intention

Monthly Archives: August 2012

Picking a metaphor

23 Thursday Aug 2012

Posted by J M Herr in Uncategorized

≈ 2 Comments

When I was a family medicine resident (oh so many years ago!), a large part of autumn was spent interviewing candidates for the next year’s residency class. The applicants met with the program director, a faculty member and a current resident. We residents were pretty much given free rein to ask whatever we felt was important to assess whether the interviewee was a good fit for our program.

One of my pet questions was “If you were to describe yourself as a fruit or vegetable, which one would you pick and why?” (I don’t recall whether I made up this question myself or borrowed it from one of the interviews I suffered through on my way to residency. If it sounds like a ridiculous question to you, then I borrowed it.) I gave them the example that I might describe myself as a potato: many eyes (observant) and a staple of people’s diets (dependable, useful). I can’t really remember any of the answers I got from the candidates, but I know that I received some quizzical looks. Still, the question made them think and express themselves in a different way than their usual recitation of accomplishments. It also was a better question than the “How’s your love life?” I was asked by one residency director (who shall remain nameless but forever scorned) when I was in the hot seat. I don’t recollect my answer to that one, and I wish I could have seen the look on my face.

I’m not sure which fruit I would choose to describe myself now: a peach, a bit fuzzy about what I’m supposed to be doing–not sure whether I would be clingstone or freestone; a tomato, firm on the outside but spills a lot of guck when cut; a nut (no, not that kind), smooth on the outside and hard to crack but worth it to get at the meat inside? Or what vegetable: a carrot, growing down while looking healthy and lush on the surface; corn, tightly packed with so many kernels of possibility, some of which have come to fruition and others which never developed; a green bean–no, I’m not long and skinny, unfortunately.

What do you make of yourself, how do you describe yourself–as the positive qualities or the negative of your chosen fruit or vegetable? Why? Do you see yourself as needed to enrich and vitalize people’s lives?

Healing by secondary intention

18 Saturday Aug 2012

Posted by J M Herr in Uncategorized

≈ 13 Comments

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secondary intention, starting over

I am a family medicine physician. I have treated many patients who suffered lacerations. Most times I stitched them together, but some injuries were better left open to heal by secondary intention. This means that the edges of the wound were not brought together by sutures or staples; the body mended by filling in the gash slowly with scar tissue. Often this method is employed when the wound is especially dirty or contaminated, or if hours have elapsed between the injury and the time the patient sought treatment. It takes a lot longer for the wound to close this way than if it had been sewn up. The result is usually not pretty, either. Scar tissue is not always easy to hide.

All of us have been wounded. Sometimes we can stitch ourselves up and bury the unsightliness underneath with hardly a scar showing. Sometimes we have to heal slowly, and the nastiness is out there for all to see until eventually we get our protective skin back again. We are afraid that others will see our ugliness, and we try to cover it up. We will always be more vulnerable to reinjury in that area.

I intend for this blog to be about secondary intention: the slow process of learning to live again, learning to live a different life than what we first expected, learning how to live with vulnerability, learning to live life from the inside out.

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