Medicine From The Trenches

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

Crisis Averted

I try to meet my challenges in academics, my religious studies, medical practice and physical conditioning as they come. Recently, my academic work, specifically my teaching style, came under sharp criticism (very negative) and increased scrutiny. Now, I don’t mind criticism and will listen with an ear for what might be worthwhile but none of what I faced was even worthwhile; directed as a personal attack upon me. This scrutiny forced me to question everything and forced me into a position of vulnerability that I couldn’t help. I was in a tailspin; looking for anything of validation.

Couple my largely “mental tailspin” with my loss of my friendship of one of my most valued friends. I had retreated back to a point of reliving the death of Gene and my almost catatonic reaction post. I was feeling most of the same types of issues that I faced when I thought my world had come to an end. These were feelings that I couldn’t control but now I have learned that I can feel them and use them to force me to meet challenges with renewed strength.

My spiritual challenges are there but with my renewed strength, I allow myself to serve and feel without apology. I make mistakes in performing my duties at the cathedral during Sunday mass but I learn from my mistakes and from my very generous mentors. I know that they question me but by questioning me, I am forced to question myself too.

My friend who has been quite generous in advising me in my academic work is back in my life which gives me renewed hope that I can learn more from him. I should have listened to him in the first place but my extreme fears would not allow me to benefit from his wisdom. I am blessed and grateful that he spends even two minutes with me and I appreciate all the wise counsel that he has shared with me.

I have watched him interact with his students, his infinite patience and critiques. His student population is more vulnerable and more difficult to teach but he is kind and had great insight into where each student lies in their learning. I learned patience and kindness from him. One day, I watched him answer questions as he walked with his students into the parking lot; surrounded by those who truly appreciated what he had to say. Whenever I see him, I know that I am in the presence of someone who is far greater than myself.

I headed off to interview for another academic job challenging in that I had to deliver a grand rounds presentation and interact with some of the greatest surgeons in this country. I more than passed that test; surprising myself with how wonderful it was to assist on cases that I haven’t performed in years. Sometimes a skills check with master surgeons is good for the soul too. It also helped that a couple of my former professors from residency affirmed that they were proud of how I have made my way in practice.

My physical conditioning continues to be a source of challenges and growth. My trainer balances weight training with running so that I will conquer the marathon distance and I will continue to enjoy vigorous good health. I am getting faster and stronger; finally seeing some of the definition that I sought but with a smaller muscle mass. I am enjoying my increased running mileage while meditating; keeping my head together. I observe the world as it moves past me.

My spiritual growth comes in the form of reaching inside myself for affirmation these days. I am alone with my thoughts and examine each one carefully. I am happy with my solitude, enjoying exploration of my creative side (not very creative at all) and some of the artistic resources in my city. The creative resources of our local artists, musicians and actors have brought a kind of renewal of spirit for me. I seek to interact with humanity and I am acquiring the tools to do so. In that acquisition of tools of spirit, I know that I am not alone and that I am quite happy with the spiritual state of my life.

I don’t focus on material objects much as they have always had little meaning for me. My connections with my patients, my students and my colleagues have been most important. I read the writings and poetry of my like-minded physician colleagues always surprised by the insight and the richness that they bring to my world. One in particular, posts a daily affirmation that moves my meditations quite often. I am truly blessed to know this extraordinary individual who gives so much to the world.

I know that happiness in life comes from the “good stuff” and I have the “good stuff” in abundance these days. My crisis of spirit is no longer a crisis but an acceptance that while I am not good enough for some people; not valued by most, I value and accept myself. I am made by my creator and I seek to be kind, generous and accepting of those around me; no longer a crisis.

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30 July, 2016 Posted by | academics, life in medicine, practice of medicine | | 2 Comments

Getting Closer to the Start of Medical School!

This is a great post by a medical student. So much wisdom here.

Potential Doctor

As the start of medical school approaches, I can feel the excitement continuing to rise! This is going to be such an amazing journey! I know it will be very challenging and will stretch me in many ways. I am going to give it my very best effort, knowing that my family, friends and God’s strength will help to sustain me through the upcoming long journey!

Since my last medical school update, we have managed to get a lot done:

  • Take Basic Life Support class (CPR and AED): Done! Very useful course that I think everyone should learn!
  • Update immunizations: mostly completed. Pending 2 reports following a chicken-pox titre test and chest X-Ray. Two more tetanus shots will be done in August and February.
  • Financing my medical education: meet with the bank (done, credit-line approved!), apply for government financial aid (done, waiting for my application to be processed) and scholarships (done…

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29 July, 2016 Posted by | medical school | Leave a comment

In Today’s Climate…

Over the past couple of weeks, I have listened to the speeches at both political conventions along with the news reports of law enforcement officer killings/GSW injuries and civilian killings/injuries. Watching and reading new media reports have to be taken within the context of one’s experiences. My experiences have been as the daughter of immigrants, a biracial woman, a physician and a theological student. My heart breaks for those who are suffering and those who suffer. My oath, the Hippocratic Oath, that I swore many times as a medical student and now physician compels me to alleviate suffering wherever I find it.

The suffering may be physical or mental as many seek out our help in getting and keep them healthy. We, by our training, have to find, by any means necessary, a method of navigating the health care systems under which we practice as well as the political/social climate that we encounter. Sometimes that navigation can be as simple as a touch, a connection and sometimes that navigation involves working with every resource at our disposal to give the best care that we can achieve. My hope, my prayers, my experiences and my training have giving me insight.

I want to recount an experience that happened to me as a fourth-year medical student. I was returning home, driving a small red Mazda hatchback automobile, from a shift at one of the large city hospitals of my medical school affiliations. It was late at night, I was exhausted, ran out to my car in scrubs throwing my short white consultation jacket with hospital identification card and my stethoscope on the front seat along with my purse and overnight bag. As I drove through the rain-soaked city streets of this depressed neighborhood, I saw the reflection of police lights in my rearview mirror. I immediately pulled over to the side (I wasn’t speeding because of the weather) and stopped as required by law.

The police car pulled in behind me with two young officers getting out of the car quickly with their weapons drawn. For a split second, it took me in my exhaustion fog, I couldn’t believe that the weapons were aimed at me. I sat very still, keeping both of my hands on the steering wheel as one of the officers shined a flashlight on me; the other pointing his gun through the open window on the passenger side. “Get out of the car and put your hands on the roof.” one of them shouted.

I slowly opened the door, tears beginning to form in my eyes and shaking quickly overtaking me. I complied with his request stating the my identification and automobile registration were in my purse on the passenger side. I said that I was a medical student on my way home but the officer kept yelling at me to spread my legs and “shut up”. I couldn’t stop shaking (I even shake now as I remember how frightened I was). “This car is reported stolen,” he kept shouting in my ear. He began to pat me down. “This is a huge mistake,” I said in a shaky voice. “Please check my identification and look at my hospital cards,”I said.

It seemed like hours but in a few minutes, another police car pulled up with another older officer getting out. “What are you doing?” he asked. “We have the car and suspect in custody”. I was crying from fear and exhaustion. The officers immediately put their weapons back into their holsters as the other policeman said that I was free to go. I was so petrified that I couldn’t put the car in gear for a couple of seconds. I finally drove off slowly weeping uncontrollably.

What would have happened if one of those guns had discharged by accident? I would be dead by mistake. What would have happened if the other police car had not arrived? I would have been arrested most likely. It was a mistake but the first two policemen didn’t show any indication that they would check my identification. It was my first experience of being stopped by the police and not given the benefit of just being treated as a fellow human being.

As I read and hear of stories of any persons being stopped by the police, I still feel that fear from so long ago. I haven’t been stopped since then and I interact with police on a daily basis as I perform my job in surgery. Those interactions are always professional and quite polite but when I see their service weapons, I always remember that stop. I react to police officers through the lens of my experiences as I suspect all people do.

I have infinite respect for police officers as they have very difficult jobs under very dangerous circumstances. I have spent many hours with two detectives in the gang-violence division of my local police precinct learning about gang symbols and gang culture, rampant in the city that I practice in. I want to understand and stem this violence, treat its victims as they frequently end up in the trauma bay. Largely the street gangs in my city are involved in turf wars and drugs. The motorcycle gangs run in the suburbs dealing in drugs and human trafficking, another scourge of city and suburban living.

So today, I end up on the roof of my hospital, being thankful for my life and all I encounter in my practice of medicine/surgery. I always pray for insight, guidance and the ability to give the best to every patient/family member/loved one that I can give. I meditate during my distance runs, post-call in the bright sunshine of the early afternoons, as we are living in a climate of increased polarization by community leaders and populations today. I pray that I continue to live in the “gray areas” and not become jaded or polarized to the violence. I pray to continue to seek insight and solutions to the troubles of those I serve and treat; always remembering that the practice of medicine is my greatest privilege.

Yes, I swore that Hippocratic Oath as a medical student, as a graduate physician and I keep remembering it. I didn’t know back as a medical student, what I was swearing to but I know now, how difficult this profession can be. There are times of despair, depression for me as the hours tick past 30 and hope in humanity as I move thorough my theological studies. As the years have gone by, I am more of a “believer” and more spiritual than when I began this journey. I learn each day and I am grateful for the learning. When I look back, I would not change a single experience, even those that have frightened me.

 

29 July, 2016 Posted by | medical school, medicine, practice of medicine | | 2 Comments

Make Your Life Simple

As many are starting medical school, the most important task to master is getting your life under control. You are starting a journey of study that will absorb most of your waking hours in the next couple of years. Because of this, you have to take more than a few moments of time and figure out your basic needs. Starting medical school without taking a bit of life inventory is asking for problems that may cut into your precious study time. You have to figure out what you need and separate your absolute needs from the things that you want.

All of us who sit in that first lecture; open that first syllabus or textbook want to do well. We didn’t come to medical school to do poorly in our coursework. We seek out the wisdom of those who are a year in front of us and we start with the intention of “learning it all”. This drive for mastery comes largely from our premedical coursework where we always knew that in order to get into medical school, we had to have high grades and scholarship. Once in medical school, staying there and doing well becomes our next tasks as we adjust to the volume of information that will be presented in our pre-clinical coursework.

Making your life simple means that your living arrangements have to stable and comfortable. I largely used my apartment for showering, eating and sleeping. Much of my eating was done as I poured over my lecture notes and textbooks. I quickly found that doing much of my study at school was less distracting at first but I also found that heading off to bed early, getting up around 1AM and studying at home was also good for me. There were fewer interruptions from the phone and others as I was getting up when many were heading to bed.

My bed and bedroom were quiet, dark and restful. I refused to have any study materials in my bedroom; using my bed only for sleep. I also found that breaking my study time into 50-minute chunks worked well for me as I would often pace and recite my coursework, as a review, into a tape recorder so that I could listen to my study tapes on the subway as I made my way to class each day.

Making my life simple also meant that I bought my food for the week, on the weekends; making grocery shopping a break from studying. I had a great study group that like to meet on Saturday afternoon which meant that Saturday morning was great for food shopping. I also cleaned my house on that precious Saturday morning; getting rid of clutter that made me tired and less efficient.

Making my life simple meant that I planned each of my study sessions carefully. I made a list of what I needed to accomplish and marked off tasks as I completed them . Seeing those check marks gave my brain a sense of accomplishment that helped make the volume of material seem less intimidating. Still, I never felt completely ready for an exam but I always felt that I had a chance to do well because I studied for mastery (took no shortcuts during first and second year). “You can’t review what you haven’t learned in the first place.” was a favorite quote from one of my professors.

I always attended class prepared for the upcoming lecture by putting the previous lecture in perspective. This task helped me to see the “big picture” which can be neglected if one focuses solely on memorization. I sought understanding and perspective; organizing my studies around mastery rather than memorization.

If I have one regret in terms of my medical school work, it is that my physical conditioning suffered. As a graduate student, I was a middle-distance runner. My running helped manage stress and kept my weight down. I gained weight in medical school because the fastest foods were the ones that were unhealthy (high fat, high sugar). When I finally lost my medical school weight, it was my distance running that brought calm and organization to my life. Find a way to incorporate a minimum of 30 minutes of aerobic exercise in your schedule. Trust me, your grades will improve; your sleep will be more sound and efficient; your life will be simpler but more effective.

At the first sign of trouble, see your faculty instructors for help. They are the experts on the curriculum and should be your first and best resources if you need assistance. Your classmates are great but you should do a knowledge check with your instructor long before the exam comes up. Your instructor can also help you with organization should you become overwhelmed (very easy with the volume of material to master).

Finally, don’t forget family and friends. These people keep you sane but they can take up time if you don’t plan your interactions carefully. I often stated at the outset, “I have a couple of hours, let’s have a quick cup of coffee or breakfast”. I would set a timer on my watch so that I didn’t go overtime. It may seem rude but they adjusted to my general absence and helped my stay on task.

28 July, 2016 Posted by | academics, medical school | | 2 Comments