Medicine From The Trenches

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

Heading into Residency!

It’s that time of the year when many recent medical school graduates are in the heat of getting things organized for the beginning of residency. Residency is the next phase of medical education in the United States and as such, is a period of rapid change and learning. You will be fairly independent in your care of patients; studying in a different manner from your medical school coursework but definitely getting your style of learning and practice honed.

This is a time to drop any pretenses of being the perfect “intern” and let yourself learn and absorb as much knowledge from those in your program who are more experienced. If you have traveled to a position that is different from your fourth-year medical school hospital, you have to learn how the place works as well as how you will work within your locale. When your ward work starts formally, you want to have your organizational system in place, know your way around and have your most important home location settled and ready.

For example, you should have made sure that all of your training licensure materials have been taken care of. You need to make sure you have your paperwork completed long before your program starts “New Resident Orientation”. There will be many details that need to be presented thus you don’t want to add to things by not having your paperwork completed.

For many, USMLE Step 3 will come into play rapidly. For this exam which becomes something of a nuisance for many, myself included, you have to have a date in mind to complete this test. For my residency, which was in General Surgery, I knew that my in-training exam was in January, thus I set a goal of taking Step 3 within the next two months after my in-training exam. I knew that I wanted to place most of my emphasis on my surgery exam, thus I dedicated about 30 minutes per day on reviewing my medicine for Step 3. I set this schedule into my schedule of reading so that it became a habit.

In terms of reading, I asked my second-year residents which books and papers would be best to start my reading for both my in-training exam and Step 3. Again, I wanted to rely on the experience of those who were immediately above me in my program. I also sought the wisdom of my faculty adviser in my baseline reading too. If there was anything that I didn’t count on, it was that I wasn’t able to set up a regular physical conditioning program, something that would have made my PYG-1 year more efficient.

In other posts, I have emphasized the importance of taking care of your physical conditioning. Not only is being in good shape helpful for stress-reduction, good conditioning is most helpful on those very long nights when call seems to go on forever. If you are in good aerobic condition, you perform better even when you are exhausted. Figure out a way to eat well, low fat and low sugar foods along with doing at least 30 minutes of aerobic exercise five to six days per week. Your rest and your brain with be grateful.

If you haven’t figured out how you will keep track of your patients, look into any system that might work for you. At this time, you can do a little experimentation and make adjustments when you begin seeing patients. I had to alter my patient tracking system from the one I used as a fourth-year medical student because my residency hospital patient tracking/health record system was different. It’s easier to make adjustments than find yourself overwhelmed because you didn’t have a system to begin with.

Make your home your sanctuary of solitude in any way you can. For me, my solitude involved investing in dark curtains in my bedroom that I could close on a bright sunny day post call. I found that I needed the darkness and cool for rest and relaxation. I also found that I functioned best post call when I didn’t encounter another human being for a few hours. Figure what works best for you and stick to it.

I made a schedule for my post call days so that I could do routine chores such as laundry and grocery shopping as part of my relaxation. Grocery stores that were open all night became wonderful for me. I planned my menus for the week, cooked on weekends that I wasn’t on call and kept my freezer stocked with meals that I could pop into the microwave rather than hitting the fast-food establishments. I have continued this practice even today because as I have aged, good nutrition is very important.

I used one of my spare bedrooms as an office. In my home office, I kept my textbooks, computers and study materials, much as I had done in medical school. Since I kept a regular reading schedule, I checked off book chapters and topics as I completed them. Even with a regular reading schedule, I always felt that my fellow residents were better read than I was, even though it probably wasn’t the case.

Finally, I had to schedule in time for my friends and family. Residency is a very hectic time but family/friend time is as important as reading and study time. Most Sundays, if I was able, I attended church if for no other reason, to thank my Higher Power for giving me the strength to stay on top of my work. Find a religious institution in your location and attend once in awhile if you don’t belong to any particular religion. It’s just another outlook and fellowship with people who are likely not hospital folk-good for your brain.

My favorite hobby, outside of sleeping on my rare days off, was going to the movies. My restless brain needed to enjoy some pure entertainment. While television can be tempting at home, especially since you can be in your “jammies”, it was better for me to get out of the house for a couple of hours and watch a movie or attend a concert. Football, lacrosse and soccer were also great getaways for me too.

In conclusion, residency is going to be a time of learning, reading and stress. Most of the stress will be self-imposed because any new situations are stressful for most humans. You will be learning about your patients in depth, trying to anticipate their needs and keeping your senior residents/attendings up to date on how you are caring for the patients on the services.

Again, try not to take yourself too seriously in terms of forgiving yourself for making mistakes but learn from those mistakes. The people who are more experienced on your team only expect that you do your share of the work and that you learn from your mistakes. It turns out that this is a great way to learn what you need and sets you up for getting the best experience for your program.

17 June, 2017 Posted by | intern, life in medicine, relaxation, residency | | Leave a comment

Hospital Haiku

“hospital moonlight

cacophony of machines

teardrops cascading”

As we come to the end of National Physician’s Week and today, National Physician’s Day, I related this haiku from one of my most gifted and amazing friends. Some years back, he suffered a  critical and life-threatening illness that resulted in profound changes in his life with some time in the intensive care unit. This illness changed a man who is talented beyond belief, a brilliant creative genius and professor in ways that few of us can relate or even imagine. Still today, he’s affected by his illness and the events that surrounded it.

I share this haiku because it brings to mind, something that we as physicians must always remember about our patients. They place their health, their trust and many of the most intimate aspects of their lives in our hands. With our hands, we have to care for them; relate to them, in many ways hold them, and be mindful of the honor and privilege of having them place their lives in our care.

As such, we also have to be mindful that illness changes their reality and in many cases their lives profoundly especially when they are critically ill. We have to reach out and extend more comfort over the “cacophony of machines” that becomes the background of their intensive care and sometimes hospital care experience. We have to block that “cacophony” whenever and wherever we can.

I remember watching a tear roll down the side of the face of one of my ICU patients who appeared comatose. The nurses were bathing him and chatting with each other as they turned him. I saw the tear; asked them to speak with him over the ICU noise background. I asked them to play music in his room and I always held his hand when I entered the room to examine him. I am sure that my soul could feel his soul even though he didn’t ever speak to me. I never saw that tear again, after we began speaking and focusing on him, holding his hand, touching his face, and playing his favorite music even though he did not recover from his illness.

I seek to connect with my patients without exception as that is my honor as a physician/surgeon. I spent years learning the science and techniques of medicine and surgery but in these, the later years of my clinical practice, my focus is on the art of medical practice. Within that art is my chance to give some of my heart to those who have placed their trust in me (and my training). I strive to be more human and more comforting. To do less of the science and more of the art is great joy for me. My joy is in the connections; kind of strange for a surgeon.

On this National Doctor’s Day, I am honored to be a physician and grateful for all that this profession has given me. This profession has given me far more than I can give back but I will spend as much time as possible giving as much as I can to those who are in my care.

30 March, 2017 Posted by | medical school, medicine, practice of medicine | , , | 2 Comments

Great Post from “Life of a Med Student”

“Beyond the H&P” A Guest post by Jessica Morgan It’s 4:00 pm on a Thursday: time to present at teaching attending rounds. I have prepared my presentation and know about the patient’s pathology, but I can never help myself from being incredibly anxious for these moments. I gather my papers and begin…

via Beyond the H&P — #Lifeofamedstudent

24 March, 2017 Posted by | medical school, residency | | Leave a comment

You Have Matched!

A hearty “Congratulations” to all who matched! This is the next step in your medical career no matter where you matched. On Friday, you will find out where you matched; some taking the news with tears and fears. Make no mistake, if you didn’t match, the future becomes more uncertain but certainly not bleak. As I have stated in other posts, those who didn’t match should be aware of the current S.O.A.P process and should be working on getting a training position for next year.

If you have matched, some things to work on as soon as you can:

  • As soon as you know where you will be training, get in contact with one or two of the senior residents to find out which textbook(s) is (are) the major reading material for your program. Purchase the book(s)(electronic or paper) and start reading.
  • Make a list of the sentinel journals for your specialty and start reviewing articles. You need to practice evidence-based medicine. Getting a head start on your journal reading helps to make journal reading a habit.
  • Start a physical conditioning program if you have been relatively sedentary during medical school. Aerobic exercise (30 minutes per day) can help reduce stress, help with stress and keep you healthy. Make physical exercise a habit along with journal reading. Even on your on-call days, you can walk/run the steps for a quick work out which will keep you more efficient in the long run. You will also sleep better if you are in good condition. Add some strength training too.
  • Find a place to live if you are moving. Don’t put this off because you need to be comfortably in your residence before orientation week in your new hospital. Your home should be simple, convenient for commuting to the hospital, restful and useful for your lifestyle. Though you won’t be spending tons of time at home, you need for your home to be your haven in your off hours. Make sure you have a washer and drying in your residence. You don’t want to be heading to a laundry room when you need to be sleeping.
  • Get your paperwork done for your training license as soon as you get information from your program. Some states have many tasks for you to complete before you can be licensed for training purposes. The sooner you get this done, the better.
  • Take a week or so off but do this long before you start your program. You need to have a bit of fun but using too much time in vacation before you start your PGY-1 year can be a problem too. Complete off time is great but not an escape.
  • When you get your residence, scout out several routes to the hospital so that you know how to get in even if there is a problem with weather, roads and other mishaps. Make sure your car or bicycle is in good repair with a good back-up plan.
  • Learn how to cook and take your meals into the hospital. Trust me, hospital food in most cases, is not great for keeping you healthy. I cooked on my days off, put a week’s worth of meals in the freezer and carried them in for my call days and nights. Good nutrition is key to good learning and training.
  • Learn a good organizational system for your ward work. I used an Excel program complete with dropdown menus for my sign-outs; still use this system. Learn to make check-off sheets to stay on top of your patients and their needs (lab tests, radiographic studies).
  • If you can, arrive a couple of days early to get familiar with your hospital’s physical layout, systems for dictation and record-keeping. Do a recon mission that will save you time in the long run.

Finally, this is a great time of learning and professional development. Having some organization is key to keeping your head in the right place. Enjoy the experience so that you can take advantage of every minute of residency with a positive attitude. Don’t underestimate the value of a smile on your face because you are learning the tools that will make you a good physician.

14 March, 2017 Posted by | medical school, organization, residency | | 5 Comments

The Rosary

I stood there at her bedside seeing the white rosary clasped in her small thin hands. In my church, we don’t have objects such as a rosary as symbols of our faith. Perhaps the Book of Common Prayer comes closest to a rosary as it’s ever present. In the cathedral where I serve, we seldom use the actual books as our services are printed each week for worship along with our hymns. Everything one would need for service is in one’s hand along with instructions as to standing and sitting ease for the many visitors each week. Still, having a rosary in my hand would be wonderful.

As I stood next to her bed, I watched her breathing slow down and become shallow; tangible evidence that her body was dying. On my late evening run, my thoughts were of where one “goes” at death. Perhaps one stays around those loved in life or perhaps one goes. My childhood visions of death, rising souls that are ghostlike but where does that essence of humanness go? As I settled into a chair, I touched her cool hand and touched the white rosary. I always sit with patients who have no family as they become my family. It is my honor as a physician to do so.

She wasn’t even my patient though I did serve in a consulting role in her care. I looked in on her only to be told by the nurse that “they” decided to do nothing. Well, I never decide to “do nothing” because there is always “something” to be done in patient care. I guess, I needed to care for this patient thus there I sat in a familiar role, caring for one who is dying and would die.

When I saw the rosary, I questioned how many times she had said the rosary. I wondered if the rosary brought comfort to this elegant woman. I wondered what the moment of my death would be like? Where would I go? Would I even go? Would I stay? My heart in tears but not sad. My tears are for the people who loved this woman; not here with her in her last hours and minutes of life as we know it. Still, her long fingers, draped by the rosary and her beautiful white hair brushed neatly from her thin face; still the rosary. I made sure that it stayed with her, in her hands as the nurses prepared her body for the morgue.

14 February, 2017 Posted by | life in medicine, practice of medicine | | Leave a comment

If I could change one thing in the lives of those around me…

I would ask them to stop comparing themselves to others. Don’t compare your grades, your scores, your running times or anything else to anyone except you. Strive to be the best you that you can be looking at the past for experience and to the future for achieving goals. In these days of social media, when everyone is busy scanning what others are doing on sites such as Instagram, Snapchat and Facebook, look only into the mirror and be content with the miraculous person that you see staring back at you.

Your wiles and abilities have enabled you to navigate your life so far. Your experiences can allow you to toss what doesn’t work and hold onto what does work. Your goals can give you a reason not to hit the “Snooze” button in the morning but they also give you a heading for progress. If you express gratitude for what you have learned/mastered and keep you eyes on your goals, there is little time for envy, jealousy and other negatives that can hinder your progress.

I always know that there will be others who are faster, richer, thinner, smarter and more beautiful that me. I applaud them, celebrate them but I am so grateful for being able to breathe air, run my race and figure out my “stuff” these days. I am healthy, happy and blissfully loving life as I touch my students and patients lives. In short, I connect with humanity and love every second of those connections as they come.

A great and free gift to all of us is the ability to look around and lend a helping hand to anyone in need. The greatest joys come from helping others without the expectation of receiving something in return. On any day and at any time, one can choose to change one’s thinking about any situation; reach out and just connect with those in need. In today’s world, the needs are great and dire.

So in the early days of this new year, look at yourself and be thankful/grateful while looking around to see who you might help at any moment. Wear a smile (cheap accessory) and savor every moment of life as they move by. These are free gifts!

3 January, 2017 Posted by | medical school, medicine | | 1 Comment

We Do This

Last evening I was visiting with my classmates in one of the ministry classes that I am taking. As we moved through our discussion of our readings, my classmates nibbled on German Chocolate brownies that I had baked the morning before. I love to bake, therapy for this surgeon, as it is very nice to create something and watch other enjoy it. One of my mates produced a bottle of Benedictine with a supply of glassware; brownies and Benedictine!

One of our discussions in class centered around meeting Jesus. Quite an interesting discussion for a couple of physicians; two of us in the class. I related a story about one of my first patients that I treated as a medical student. This wonderful little patient was affectionately named “Ratso” by my supervising resident at the time. He was a patient in our Veterans Hospital coming in when his lung disease would get out of control.

“Doc, I was holding hands with Jesus”, he exclaimed to me as he began to respond to our treatments. He had been quite disoriented when his blood carbon dioxide level had achieved values that would be incompatible with life for most people. This patient not only had high levels, he turned the corner pretty quickly. “Yes, I will believe you saw Jesus”, I said to him as he clearly recognized me at last. I was seeing Jesus too.

So this is why I do this. For Ratso and the hundreds of others that I treat with care and love. Remember that what we do is like no other profession out there.

9 December, 2016 Posted by | medical school | , | Leave a comment

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.

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

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

Back to training for the marathon

If you have read my previous posts, you will know that I trained for my first marathon but was unable to complete the distance because of freak extreme conditions. In short, I had prepared for everything except cold and snow which fell and stopped me short of my 26.2-mile goal. I ended up with extreme hypothermia but determined to climb back into my training routine after an overseas trip.

This trip was one of my longest to date; required a 13-hour flight but worth every second the journey. I was transported to a land where I was very different from the crowds of people who live there. I found hills to run, markets and temples to explore but even better, I found connection with those who differ in culture from me. In short, the world became smaller for me but I became more aware of how similiar all human beings are. We are definitely brothers and sisters though we may look different, worship differently and have different professions/lives.

When I entered medicine, many years ago, I was determined to master the science that I knew I would need. Years later, I realize that the science is the tool that allows me to see the wonder of humanity. If I am going to take on the privledge of taking care of the health of those who trust me to have their best interests, then I must take on the connection of spirit with those who seek my care.

On my trip, I was able to explore markets and shops where those who sold herbs, used for thousands of years, explained how their medicines worked. I was able to tour modern surgical centers with those who explained how their medicine worked with equal pride and care. The simularities was the whether the physician was well-trained at some of the great universities or passing on the knowledge gleaned from previous ancestors, each took pride and care in the treatment of those who sought them out.

I also spend some time running the streets of the city that I visited. This city had hills that reminded me of San Francisco which enabled me to keep my training schedule. My marathon training is something that has allowed me to center my thoughts, improve and keep my physical conditioning and work out problems that might need careful consideration. I always allow my mind to go where it seems to want to lead my thoughts moving from something as simple as a song or careful consideration of other sides of a problem that might be present.

Long distance running is far from a chore but an exercise that can bring order to an otherwise chaotic life. As a middle-distance runner in university, I thought that the longer distances (more than 10 miles) would not be enjoyable but I have found a calmness and a serenity in covering those longer distances. I run for myself and for my selfish enjoyment. I have also discovered that with the longer distances, I can enjoy the microbrew beers that I have come to appreciate without thought of calorie intake or weight gain. For the first time in my life, I have to work to maintain my weight rather than weight loss. I am thinner than I have ever been in my life (adult or childhood).

With my marathon training and weight loss, I have found that people who haven’t seen me for six months or even six weeks, hardly recognize me. I remember one of my colleagues stating that he remembered my voice but didn’t recognize how thin I had become. For me, because I had always struggled with weight gain, especially when I am under stress, this new world of weight loss and thiness is uncharted territory. I should also that sleep has become more efficient and restful.  I use what I am learning about my new body to explore my new world. Running the streets of a foreign country was part of that new exploration.

Thus, as I move back into training for my first marathon, I have made it a point to focus on mental, spiritual and physical conditioning. I have also decided to add a healthy dose of weight training with my running. As I trained before, I find that I had lost a bit of muscle mass along with fat but now I need to see how I can work of being a more rounded and strong individual. I know that my physical conditioning is good and excellent for a person of my age but I want to be stronger, healthier and more mentally resilient.My training spilling over into every aspect of my life. This is the best marathon training that I can achieve.

30 May, 2016 Posted by | age, medical school | | 2 Comments