Saturday, February 2, 2019

February 2019: Your Heart is the Size of Your Fist by Martina Scholtens

Your Heart Is the Size of Your Fist: A Doctor Reflects on Ten Years at a Refugee Clinic

Your Heart is the Size as Your Fist
Feby Martina Scholtens

The annual Couple's Book Club!!
Saturday, Feb 9. 20197:30pmAt Karen's house

1. Did you enjoy this book? Why or why not? 2. The opening chapters describe Scholtens’ “drift” into refugee medicine. She describes growing up in a community where she was “expected” to be a teacher or a homemaker. Do you think this a fair assessment, or more her interpretation?
3.She describes her first clinic as where the “worried well” came, the “anxious professionals” and it didn’t sit well with her. Who do you imagine this to be? Is it us? Do you think this a fair statement of people visiting a doctor clinic, or is it more a reflection after 10 years of working with the poorest, lowest element of society? 4. Scholtens advocates not cultural knowledge, but cultural humility - recognizing that we cannot fully understand another culture without having lived it, but that people are willing to forgive ignorance if there is humble curiosity. She also advocates not focusing on differences, but what makes us common, human and alive.Do you agree? Does this work also with popular culture rather than racial culture?
5. In the chapter dealing with the struggle/conflict of reconciling a career with motherhood, were you able to identify with this if you are a working Mom. If you are a stay-at-home Mom, were you able to identify? She lists several things as key in making the dual life work...are they specific to working moms or more universal in nature? (pg 43ff) 6. In chapter 8, we hear how Scholten hears Yusef’s horrific story, and how she deals with stories of suffering from her patients. She describes various stages of dealing with this part of her job...voyeuristic fascination; avoidance; shame; detachment and ending with bearing witness - just listening. When we hear of others struggles, do we show some/any of these responses? 7. Scholtens attributes people asking about stories she's heard to a desire for titillation and is enraged. (pg 58) Do you think this is accurate/fair (especially considering her admittance of having been voyeuristically fascinated herself) or is this a result of sensitivity to the years of horrors she's heard? 8. In chapter 14, she describes her gardening habits, and those of her patients. She describes feeling somewhat guilty at first, as if these are not really worthy of her time, but comes to see them as mental health medicine. Similarly, she later reduces her patient load to preserve her mental health. Do you consider this in your own life? Do you have something that provides you with mental break/mental health? 9. Why do you think Scholtens chose to tell her story parallel to the story of the Hadad’s? Do you think this is the story of one family, or are they an amalgamation - a family created in her mind to highlight the refugee story? 10. She is very reflective in her career and life, so much that she almost pursued a career in liberal arts. Do you think she’s right when she says on page 14/15 that “the truest answers lie in the arts”? Do you think this reflective nature hindered or helped her in her medical career? When dealing with refugees in particular? In her life as a wife and mother? 11. Reading about things that refugees are moved by, or that they struggle with, highlighted many things that we take for granted growing up in Canada. (Healthcare, education, freedom to disagree with authority, the ability to “blend in”, peace...etc.) Was there something in this book that moved you to realize how blessed we are here? 12. In the last chapter, Scholtens reflects that “the magic always seemed to be where two things brushed against each other...beach, conversation, and dusk. In the exam room, too, the patient and I were two eternal spheres that rubbed up against each other, making a little spark to see by. Most was left unknown. It was that thin line where we met that was beautiful.” What does this mean to you? 13. The bio at the back of the book recognizes an award that Scholtens received for “History and Narrative in Family Medicine” and also cites her ongoing interest in narrative medicine. A google search will give you a form of definition like: “The care of the sick unfolds in stories. The effective practice of healthcare requires the ability to recognize, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence is a model for humane and effective medical practice.” (attributed to Rita Charon and Columbia University) How does this differ from “regular” medicine, and how do you see it reflected in this book? 14. Often, this book seems to show two contrasts in its’ chapters. Poverty and wealth, peace and war, inhumanity and decency, joy at birth and missing an old life etc…at the end of the book, were you left feeling unsettled or hopeful, or something else? 15. Did this book change the way you felt our thought about refugees or the refugee situation in Canada? 16. To whom would you recommend this book?
Menu: the Multicultural Plate We are introduced to so many people and cultures in the book! In honour of the refugee clinic and the multicultural country that we are, it would be fun to sample from several places. So, rather than a specific menu, let’s everyone pick a different country and bring a dish from there! Here is a list of countries represented by refugees that Scholtens encounters... Iraq, Iran, Pakistan, Somalia, Syria, Myanmar, Kenya, Afghanistan, Congo, Ethiopia, Vietnamese, Nepal, Burundi, Bhutan, Colombian, China, Eritrea There are tons of websites online that you can search for recipes, but if you are stuck, here is a website from a lady who is cooking entire meals from as many countries as she can. (And she includes background for each country…) Pick a country and a dish, and sign up below. If you know the dish you are bringing, add the name or description so that we don’t all bring chicken stew (or something!) Appetizers: 1 or 2 people
Nepal - red lentil soup (Karen)
Afghanistan - meatball appetizer (Tessa) Entrees: 2 or 3 people
Pakistan - chicken curry with rice (Karen) Dessert: 1 or 2 people Colombia (Tamara)
Vietnam - fruit and rice pudding (Tessa) Drinks: Tamara


Tell us what you think!