Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Why I went to medical school at a later age.

Since I am far away from my home base and living the life of a sailor, my thoughts have turned to why I entered medicine. This post was one of my earliest posts on this blog and long after my decision to enter medicine. Note the reference to a “Walkman”. Do they even exist anymore?  It was my father’s dream (he was an Internal Medicine specialist) that I follow in his footsteps. My uncle was my mentor (he was a Cardiologist). I was a scientist and entered medical school a bit later because I took the time to complete a Ph.D. I have no regrets because medicine/surgery is one of the most amazing things that I do, when I am not sailing.

Medicine From The Trenches

Back in 1993 when I was a busy graduate student, I was happily contemplating my future career as a college professor. Even as a child, I knew that I wanted to be a research scientist. I had excelled in math and science in the English school that my Mum had so carefully chosen for my education. My Mum was very pro-active when it came to the education and enrichment of her children. She was my first and best teacher. She had taught me the value of an education and the value of observation. While directing the growth of her children on a self-sustaining farm, she made our 90-acre horse farm, a living laboratory for our education. Armed with this background, we were expected to excell at all things academic. The “buzz” around our evening meal was not about sports but about Einstein’s Theory of Relativity and higher mathmatics in addition…

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29 July, 2015 Posted by | medical school | 7 Comments

Starting the New Academic Year

Introduction

As many of you head back to school (or begin medical school or university), the time is great for considering some small changes that may make a large difference in your health and academic success. I wanted to list a few things since I am on an extended vacation/adventure and now have a little time to tend to my neglected blog.

Head Check

This is a great time to “let go” of anything negative from past academic endeavors. This is a new start, a new year and a new time to reinvent yourself. Why not spend a few minutes each morning with some positive thoughts (for heaven’s sake, this can be as simple as smiling at yourself or a positive affirmation). When students begin to become overwhelmed, negativity creeps in first and threatens to magnify any problems into significant issues. I have found that my first actions when I start each day are to meditate and begin the day positive with my spiritual thoughts. This places me in the proper frame of mind to meet each challenge as they come.

Consider that in this era of expensive education and limited funds/opportunities, the fact that you are a student is a great advantage. You have a body of knowledge to master and build upon. Keep your mind open and positive so that you take the greatest advantage of your present academic challenges and events. Nothing can limit a determined individual who calmly prepares themselves for anything to come and adapts to changes when they occur. Resist the urge to see your academics as a battle with your professor or fellow students. Your only competition is with yourself to do your best honestly and constantly.

Do not neglect your spiritual needs. Find some form of spiritual outlet, be it something creative or religious (even better do both). If you are in a new location, find a church that speaks to you even if you wind up exploring another religion or belief. Allow yourself the freedom and openness to learn about other religions and beliefs. These explorations can serve to strengthen your own beliefs or widen your spirituality. The fellowship and connection with others, preferably outside of medicine or school is great for your heart and soul. Yoga is a wonderful activity to explore with its calming and peaceful effect on both mind and body.

Body Check

Plan your meals for the week and plan healthy. The pizza and beer may be a wonderful treat but one can’t eat high fat foods and consume alcohol on a regular basis. Good academic performance takes a strong body to nurture sound thinking. Packing snack-sized bags of apple slices, a few almonds, cucumber slices, baby carrots and grape tomatoes are healthier, easy and cheaper than grabbing a high sugar candy bar from a vending machine. High sugar may give one a quick energy boost but in the long run, that boost doesn’t last. Ease up on the caffeine (dehydrating) and go for water rather than fruit juice. If you must have fruit juice, make it within the context of eating the fruit whole such as a whole orange or grapefruit rather than drinking bottled or canned juice.

Perform some type of aerobic exercise where you get your heart pumping for at least 30 or more minutes daily. You don’t have to run for long periods of time as you can break your aerobic work into 10-minute sessions. My favorite trick from residency was to run the steps (up and down) in between my surgical cases or run jog the length of the subway platform several times as I waited for the train. I used climb to the top of the parking garage and just enjoy the air and the birds from the heights (I used to wave at the train engineers from the garage too). You can even park your car far away from the building and hike in for some much-needed aerobic work. Let your aerobic work be relaxation and not competition or stress.

Pumping iron in the gym is also great for stress relief. I will admit that I use my iron work to give myself positive reinforcement. With each rep, I am grateful and thankful that I can perform those reps. I generally don’t have loads of time for the gym but I take advantage of every moment when I am able to get into the gym and get a good weight-lifting work out completed. I also follow-up with a dip in the pool as a means of keeping myself flexible (vitally important in surgery).

Sleep Check

You have to figure out how much sleep you need for peak performance. Trying to “train yourself” to get by on less sleep rather than more sleep is not a sound idea for optimal learning. There are plenty of fitness devices on the market that will give you an idea of how much sleep you actually are getting and the quality of that sleep. Figure out what is optimal and get proper rest.

Anxiety can often cut into sleep and can cause your quality of sleep to deteriorate. This can cause chronic tiredness and can make your study time far less efficient. Find healthy ways to reduce anxiety (not drugs or alcohol) so that you can sleep well. Even herbal supplements can erode the quality of your sleep thus you need to make sure that you are getting proper rest without chemicals unless properly prescribed by a physician for a diagnoses where an anxiolytic is indicated.

Unplug from your electronics

I have been guilty of keeping the smart phone next to the bed on most days. Now that I am on vacation, I started to turn off the phone and rely on my natural clock to awaken me. I have discovered that I don’t over sleep and I am more peaceful. My phone is in my purse which is across the room so that I am not tempted to grab it first thing when I awaken. I plan to carry this practice into my work life when I return home.

I have many wonderful connections with my friends on social media and enjoy those connections very much. I have learned to treat my social media times as part of my recreation time. Social media is a means for me to connect with colleagues and friends and not to iron out political problems. More times than I would love to admit, I have “UN-friended” someone because they are bent on berating me for my beliefs. I just don’t have time for that much stress these days.

Consider that during this time of emphasis on academics and school, you have a limited amount of energy which should be spent on your studies rather than being outraged about things that you may not be able to affect. Yes, you need to be aware and informed but gossip, shaming and bullying take too much energy and produce negativity. Support causes that you believe in but not to the point that you are consumed by your causes.

Finally, these are a few things that I am “tweaking” as I go along. As an attending physician, I take myself far less seriously than I did as a resident physician. I have come to embrace my humanity and to embrace the wonder that is the humanity in others.  There is tremendous joy in medicine and patient interaction especially when your patients begin to see that you care about solving their problems and you connect with them. At this point in my life and career, my patients, my students and the residents me teach me so much. For that I am eternally grateful.

24 July, 2015 Posted by | academics | , | 8 Comments

Patients that you might not “like” for whatever reason.

I am away from most of my writing tools. I thought I would reblog this because it’s timely. Enjoy.

Medicine From The Trenches

I received a call about a consult for placement of a temporary dialysis catheter in the Medical Intensive Care Unit. When I arrived I quickly scanned the chart (coagulation profile, patient’s medical information etc.) and entered the room of the patient who needed the temporary dialysis catheter. Just before I entered the room, one of the resident physicians pulled me aside and said, “This guy weighs 500 pounds and let himself get to this point. On top of that, he smells. I just want to warn you to have your gas mask ready”. He laughed and I “thanked” him for the information and entered the room.

Lying in the bed was a 500+ pound gentleman who was restrained and mechanically ventilated. In one hand was an intravenous line which was leaking intravenous fluid. He had a very large abdominal pannus (apron of adipose tissue), multiple scars on both arms and…

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11 July, 2015 Posted by | medical school | Leave a comment