Categories
Poetry

For Med17: Thank you.

I find a glimmer of light.
It is the shape of a keyhole
and wavers. I crawl
blindly in a sudden desperate desire
to find the lock
and the source of light that is behind it.
The keys in my pocket jangle.

When I am in the hospital I am a stranger
amongst other strangers. Only
because I am wearing a white coat
I am supposed to know where
to go. The hallways bustle with white noise.
I hug myself and move quickly so no one
can see me shaking.

There are several keys in my pocket.
Keys made to open to secure
to keep safe to rescue.
Keys that are purposeful and always always
come with a lock. But there
one key is still being formed
is new and raw
is lockless.

The streets are full of ice
and wherever I step
the dark glimmer cracks.
I feel that if I am not careful
I may miscalculate a step and then
the crystal surface of my confidence
hair-thin
will collapse, will bring me ankle-deep
in barely frozen water rushing unintuitively upwards
rising into my socks past my white coat
soaking my barely used scrubs
ice-water surging towards my knees
femur gasping in its acetabulum
thoracic spine shaking
like a suffocating fish.
I am drowning in the thought that
I am not enough.
The snowbanks drip in the sunlight
and sparkle.

I sit amidst all my past and present identities
and begin to make out a new one ahead.
It is mirrored in the M4s: knowledgeable mature
scruffy in a responsible doctor-like way.
Will I too become like them?
I am not afraid of how I might change but rather
what I will lose after a year in the hospital.
The lock to my growing key remains unknown.
And yet, I sense its existence—
a path of light filtering through the darkness
towards me…

…and you too. Your light
your key
your lock
our journey.

Med17: thank you
for the past two years
and for the years to come.
I have my key in one hand
and your hands in the other
as we search for our hidden locks together. We walk
and look and celebrate when one of us finds a lock that fits
that opens up a bright new world of excitement.
Where will you be?
Where will I? Only time and walking and sharing together will tell.
And the doors one day will open
leading to new rooms and new doors
and our keys will jangle
like the sound of clapping hands
like the sound of many smiles
breaking ice.

 

Featured image courtesy of Stephanie Wang Zuo

Categories
Lifestyle Mentorship

Getting the Most out of a Mentoring Relationship

In November, I had a sobering moment with one of my research mentors in medical school. My mentoring relationships had till then been smooth-sailing– throughout my high school and college career, I found that my role models and teachers were readily available and more than willing to play a catalytic role in my learning and growing. Thus, when I began to struggle in my mentoring relationship with Dr. C, I was surprised. Uncertain whether I should approach Dr. C about it, I kept my concerns to myself.

It wasn’t until November that we had a much-needed conversation in Dr. C’s office. I became aware of how a wrong first impression, unclear expectations from the get-go, and several instances of miscommunication had caused our relationship to falter rather than flourish. I am thankful for the way that both Dr. C and I were able to honestly discuss these faults as learning points and have a renewed sense of optimism for our future interactions. Moreover, the experience of falling short in this mentoring relationship has allowed for an incredible amount of reflection and maturing on my end. Through my experiences, I have compiled several lists of tips and pointers that will be helpful not only in your current mentoring relationships, but also in finding new mentors and determining whether a potential role model is right for you. I hope this article will help enhance your interactions with past, current, and future mentors!

 

How to Find a Mentor:  

  1. Sometimes, when we are lucky, mentors are assigned to us (such as in the case with my mentor, Dr. R). These mentors are people who we may or may not click with, but either way, make an effort to be on good terms with them!
  2.  In most cases, networking is key. Interested in primary care? Get involved with the Primary Care interest group, which will have connections to faculty and residents. Go to a Family Medicine conference and meet faculty from other institutions. Be bold in asking potential mentors whether they would be free to meet, reaching out in person or over email.
  3. Ask existing mentors whether they might know someone who could give you advice on an issue or interest you might have. They will often be able to point you towards the right person.

 

Characteristics of a Good Mentor:

  1. Make sure your mentor is someone you admire and can look up to, whether personally, professionally or both.
  2. Don’t pretend to be someone you aren’t just to have connections with a hopeful mentor. The right type of mentor is someone you can be yourself with. This will allow your mentor to tailor advice to you, making their words all the more influential and trustworthy.
  3. A good mentor has enough time to mentor you. If a potential mentor is too busy to answer your emails or acknowledge your concerns, the mentor-mentee relationship will likely fizzle out in the long run.
  4. A good mentor is a great listener. He/she will listen actively and provide thoughtful responses to your questions and concerns.
  5. Your prospective mentor should be willing to actively help you in developing your academic and/or personal life. Ideally, he/she should be excited to help you in both areas.

 

Tips on How to Get the Most out of a Mentoring Relationship:

  1. The best type of mentor cares enough to give you constructive feedback to help you on your journey in medicine. Be humble and listen carefully.
  2. Be clear about your expectations for the relationship from the very beginning. Make sure to discuss with your mentor why you want or need a mentor in a certain area of your life and what you hope they will add to your learning/career in your first meeting. Don’t be afraid to bring up any changes with your mentor in order to make sure that you are both on the same page.
  3. Reach out when you need help—that’s what your mentor is for! Sometimes, you may need to be persistent; you’ll know which of your mentors are better at responding to emails/texts than others.
  4. Be persistent but know how busy your mentor is. Respect his/her time.
  5. Have more than one mentor. Don’t limit yourself as there are various people who can help you grow in different parts of your life.
  6. Be thankful. Mentors want to make a change in their mentees’ lives and nudge them towards successful futures. Make sure you let them know when they are doing a good job! In the same vein, reach out to past mentors every once in a while to send updates and maintain your relationship. You’ll never know when you may need help or advice from past mentors, and it is a wonderful way to show that you still appreciate them.
  7. Lastly, make a note about the characteristics and skills of a good mentor from your current mentoring relationships. One day, you will find yourself in your mentor’s shoes, sitting across from a slightly nervous but eager medical student. A good mentor-mentee relationship will prepare you for that day!

 

I highly recommend the following article and presentation if you are interested in learning more about making the most of a mentoring relationship!

http://dgsomdiversity.ucla.edu/workfiles/lectures/Making%20the%20Most%20of%20Mentors.pdf
https://go.dmacc.edu/witrg/Documents/WITRG_Getting_the_most_out_of_your_mentor.pdf

 

Featured Image:
“One Person’s Mentoring Experience” by Natalie Henrich by NASA APPEL

Categories
Lifestyle Mentorship Reflection

The Importance of Mentorship

One of the most influential and uplifting things that can happen during medical school is finding someone older, wiser, and more mature than you and being blessed with the opportunity to be mentored by that person.

“I don’t think I can do this anymore.” As the words left my lips, I felt a slight twinge, a burning feeling. Shame. I was one month into medical school and I was already giving up. We were in a 7-week crash-course version of anatomy with lectures, Team Based Learning (TBL) sessions, and dissection in an overwhelming whirl that spun us ever more rapidly as the course progressed.  I wasn’t made to memorize the flexors and extensors of the leg and the nerves and vessels of the pelvis.  My brain wasn’t wired to take in this much information and properly spit it all back out. If this was medicine, I didn’t think it was for me.

There was a moment of silence on the other line. I sniffed and blew my nose. Dr. R finally spoke.

“Stephanie, tell me more about what you’ve been thinking about.”

Over the next half-hour, I shared with Dr. R my frustrations with the rote memorization of anatomy and the feelings of burn-out I was already experiencing, having come straight from college to medical school. She was patient and understanding, encouraging me with her own experiences. She acknowledged my perspective and in her gentle way, validated it. Suddenly, I did not feel so alone. To my surprise, I found myself filling with hope that I could find success in medical school. I wiped away my tears and ventured a small smile as she made me promise to update her in the next few weeks. When I hung up the phone, I glanced at the time— it was nearly 10:00pm. I had texted Dr. R that I hoped to talk to her sometime soon about something urgent, and she had texted me back immediately. I was so grateful that she didn’t hesitate to approach me during my moment of panic and self-doubt.


 If medical school is a marathon, then having a good mentor in medical school is like having a personal coach. He/she is on the sidewalks, cheering you on, letting you know about the hill up ahead, and reminding you of your goals during the long, empty stretches of road. You look over your shoulder and at times notice that your mentor is covered in sweat and dirt and Gatorade too. In fact, your mentor has another race, but he/she is taking time off to watch you run. From sharing about previous mistakes to being an example for how to run a race successfully, your personal coach and mentor becomes a role model throughout your marathon and beyond. 


 

How did I meet Dr. R?  In fact, I was assigned to Dr. R’s mentoring group on the very first day of medical school.  As part of the Colleges program at Johns Hopkins, the mentoring group (known fondly as a “molecule”) is composed of one faculty member and five medical students in the same year.  The faculty member checks in with his/her molecule throughout their four years of medical school and provides guidance, assists with planning, and teaches clinical skills. Dr. R has walked with me through both personal and professional issues—from work-life balance to dealing with poor study habits to encouraging me to embrace my passions.  Moreover, I was absolutely touched that she managed to make it out to my wedding last summer.  In inviting me to shadow her in the hospital to having my molecule over at her house to meet her husband and children, Dr. R has generously opened her life up as an example of how one might pursue a career in medicine.  In doing so, she has become a true life mentor to me.

It is well-known that medical school isn’t easy. Thus, having a guide and avid supporter is invaluable. Mentoring programs are becoming more common nationally, as research has found that having mentorship is an important component of success in academic medicine (Cho et al, 2011). However, the importance of seeking mentorship from the start of medical school isn’t always properly emphasized. Do you currently have an influential mentor? In what ways have he/she supported you? How would you define a “good mentor”?

If you don’t yet have a mentor or your current mentoring relationship isn’t going as you hoped, not to worry! In my next blogpost, I will share some suggestions about how to get started with finding a mentor as well as how to make the most of a mentoring relationship.

 

Coming up…

“How to Approach a Potential Mentor and Get the Most out of a Mentoring Relationship”

Featured image:
Friends by Hartwig HKD

Categories
General

The Value of Medicine, Amidst all That Debt

“It’s so unfair that you have to pay for your flights for residency interviews!” George, my fiancé, was indignant.  “In addition to hotels, applications, and everything else!” I looked over, surprised at his outburst.  It was justice, not stinginess that lit the fire in his eyes.

“Dear, we pay for everything when it comes to medical education.” I said. It made sense to me—that’s the way medical training worked after all.  Debt, debt, debt, and years later, a paying job.

“But why? It doesn’t seem right that corporations pay for potential employees’ travel fare and hotel on their interview days and universities arrange for PhD candidates to come and see their programs, but medical schools and residency programs won’t. The way I see it, that’s unprofessional.”

Unprofessional? Medicine is all about professionalism. And tradition.

“That’s just the way things are,” I told George.

From what I can see, medicine leans heavily on prestige and people to entice candidates to its programs. It can’t afford (and perhaps doesn’t need) perks to do the job for them.  But George has a point.  In a world where money is valued so highly, the medical field remains a privileged one.  Why is that so?  The answer is complicated.

My first year of medical school concluded less than a week ago.  I think back to the $70,000+ spent on my one-quarter-MD and part of me cringes a bit.  It is a well-known (and well-accepted) struggle that enormous loans are often necessary to make it through the four years of medical school.  Yet, even with the MD in our hands, at least one year of internship and, more likely than not, another two to five years of residency is needed to practice.  Often, physicians-in-training will continue on to do a fellowship and subspecialize in their field, which can take another one to three years.  And the cost of applying to residency?  It is not unheard of for medical students to take out additional loans during their fourth year for the sole purpose of “residency and relocation.”

Beyond the monetary expenses of medical education, there is often an underlying complaint of lost time in medical school, something that is a mix of lost sleep and lost opportunities for making money, exploring the world, and even, of developing relationships.  Somehow, it seems that there is the notion that medical education has a way of sucking the marrow out of life.  The best years, prime years often in one’s 20s, are spent studying in libraries or wrapped up in cases in the hospital.

Still, a large part of me is idealistic.  I see the pursuit of medicine as inherently sacrificial.  Student doctors spend their time buckled down in books or the wards, learning how to bring others into health and wellness.  I admit to oftentimes believing that it should be so—that in this field of caring and healing, our focus should always be on the other, the sick patient, and not on ourselves and our own sacrifice and debt.

I told this to my friend Arnav and he laughed at me. “You know, it would be way easier to get into medical school if being a doctor wasn’t a high-paying job.”

I thought about it and after a while, I nodded.  I guess it’s true.

“Plus, there are no poor doctors; only doctors in debt.”

Hmm.  True again.  Indeed, it seemed an oxymoron to imagine a starving doctor.  The idealist in me heaved a sigh. Arnav, as always, was deeply practical about his decision to go into medicine.

Like Arnav, many of my classmates have reasoned away the burden of their loans. Being a doctor is a secure and respectable job.  Their debt pushes them to pursue fields that reimburse well.  As one of my medical school friends shared with me, no one wants to stay in debt forever.  The less time needed to pay it all off, the better.

Nevertheless, I believe that most of my classmates would agree that in the end, all those numbers fading away from our bank accounts will be forgotten.  Already, the payments to AMCAS for applying to medical school are long-gone, lost amidst the moving process of dissecting a human body, the willingness of busy physicians to be my mentors, the privilege of being so trusted by another in clinic.  Many years from now, I believe that my exorbitant tuition will be long-gone too, forgotten amidst the incredible experiences I have had, the colleagues I have met, the patients I have walked with on their journeys.  These opportunities are indeed worth so much more than the entry fee that is medical school.

My first year blew by.  The end was jerky—I performed badly on the final exam for neurology.  Yet, even in feeling unable to remember any information, I told myself this: medicine is not about numbers. Medicine is about listening, caring, healing— things that are so human and valuable.

And so, neither will I judge myself by numbers.
Featured image:
Student Loan by Simon Cunningham

Categories
Clinical General Poetry Reflection

Poem about Pain

My sophomore year of college, I had the incredible fortune of taking a course entitled “Literature and Medicine,” taught by a professor who inspired me in more ways than she ever will know.  Professor Karen Thornber introduced me to the language of medicine and illness, and her course even now deeply affects the way I perceive the dialogue around, about, and in the clinic.

In particular, after reading Susan Sontag’s Illness as Metaphor and Elaine Scarry’s The Body in Pain as part of the course (both of which I highly recommend—especially Scarry’s work), I was intrigued by the notion of the resistance of physical pain to language.  Even when describing the pain of a paper cut, we resort to using metaphors and adjectives, comparing it to other sensations in an effort to fully encompass the experience.  Is the paper cut actually “stinging” as a bee would?  How would you differentiate describing the pain of a paper cut to a more severe pain?  In fact, the adjectives we use to describe pain directly are quite limited.  And unlike other sensations that can be carried from one person to another with words, pain is perhaps too heavy, too dense to be transformed into language.  Rather, we use cries, moans, and tears to transmit the experience of pain.

Now, more than ever, I find Elaine Scarry’s perspective to be enlightening.  For if she is correct in saying that pain is one of the few feelings too big to be molded into language, we can never truly express our pain to others through words.  We can never fully describe pain or share it.  Pain is therefore deeply isolating.

Three years ago, at the end of my Literature and Medicine course, I decided to delve into the relationship between language and pain by interviewing eleven individuals of different genders, ethnicities, and stages of life.  I created a survey for them composed of a total of ten questions that included prompts such as: “Can you describe a physically painful experience?” and “Use one or two words to describe pain.” From these interviews, I produced a poem that attempted to convey the complexity of people’s reactions to and views of pain and illness.

Photo courtesy of Alex Abian
Photo courtesy of Alex Abian

Now, as I read this poem, I think about all the times I’ve asked patients to describe their pain, to rate it in severity from 1 to 10, to talk about its onset and relieving factors. How easy it was for me to write that information down and jump from one differential diagnosis to another without truly understanding their experience.  And yet, even if I can’t truly know their pain, at least I can play a role in providing hope for healing and for relief.  At least, I can listen and acknowledge the experience of their hurt.  That is, to me, one of the greatest honors of being part of the medical profession.

Below is the product of my investigation of the “unsharability” of physical pain and an attempt to better understand how difficult it is to give it a voice (Scarry, The Body in Pain).  What is your experience with listening to others try to express their pain in words?  Have you found any insight into making it easier for others to talk about their pain?  Or do you find that your experiences differ from mine?  Feel free to comment or email me at stephanie.wang@jhmi.edu.  I would love to hear more!

*Note: Italics indicate quotes taken directly from interviewees. The majority of the content of this poem is based upon the interviews.

Here and There

We alternate between here
and there. You see,
there is a line, crooked and cracked,
an emaciated demarcation,
a highlight in air, breathlessly coughing
and smelling of phlegm.

It would be very painful
to cross it, this line.

Unable to be broken,
we wax in and out.
How to describe such a thing?
Mind-numbing and distracting,
distasteful, unpleasant, depressing and miserable.
Regret, helplessness, extreme
sadness. Sick,
like you’re sick.

What pulls us along is an anti-happiness,
it drags us past the line,
it is an anger and an envy, a struggle for
God knows how long.
It nests in suicidal thoughts,
family problems, rolled-up eyes, severe
shock, pain.

Pain, it’s like,
it’s a…

A scar, a feeling I couldn’t recognize,
a breaking of the arm, a finger cut off,
a scrape of the knee,
a ball to the head, hurt jaw, appendicitis, unbearable
distress, tears, a scream, almost
dying. Well,
I don’t like pain.

You can’t think, can’t do anything. Panic,
confusion. There is a leaving behind,
a change of identity—

you lend a hand
because you have to. You are supposed to do that.
To help. The pity, the obligatory sad eyes.
I wanted to stay away, I was really
annoyed at the hack of her cough,
her eyes, feverish.
I actually wanted to avoid her, avoid
crossing the line.

The millionth tripping from one side
to another sounds like fish scales,
feels like rain, the starting
and stopping, the forgetting and remembering
of hoarse throat, runny nose,
seasonal allergies, itchy and flushed.

Forget about it,
concentrate on something else, calm down,
try to ignore it for
telling people won’t change anything,
screaming and shouting won’t do anything,
It’s like no one understands, I deal with it
myself, I can kinda block it out.
Everyone does things to alleviate it.
I’ll pray, but the only thing
that really makes it go away is time.

Halos of stars plaster the sky
and the constellations only appear
when a story is made for them. Let us figure then
a way to line everything up against this thin mark
between two vast caverns.  The body flung
from here to there
is yours and mine. As it will always be
your body, our pain.
Our pain, my body.

Featured image:
Pain by trying2

 

Categories
Lifestyle Narrative Reflection

Time | The Balancing Act of Medical School

Not too long ago, I was rushing from one informational meeting to the next, trying to gather the scoop on medicine, medical school, and what exactly it meant to be a pre-med (I found it strange that these three rungs on the medical ladder were not necessarily complementary with each other… Did acing a nit-picky orgo exam really hold any bearing on my future abilities as a physician?). During my data-gathering in college, I soon saw a common theme emerging from all of the advice I accumulated.

Regarding the medical school experience: Medical school is tough.

Courtesy of Dalya Munves: http://thehealthscout.blogspot.com/
Courtesy of Dalya Munves: http://thehealthscout.blogspot.com/

I was told that the material would be overwhelmingly vast, that I would spend most of my spare time with my nose in the books, memorizing, and that I should not even think about third year yet, because that was a whole ‘nother story. I was not deterred—I had found medicine (or rather, medicine had found me) and I could not imagine myself pursuing any other field.  I was a little afraid because I knew I was not much of a memorizer.  But, I would try my best.  This all happened after my sophomore year of college, when I finally decided to “go pre-med.” (My path to choosing medicine will have to wait for a future blog post… stay tuned!).

I couldn’t imagine being busier than I already was. I was already heavily involved with three extracurricular activities, was starting to go into a lab to do research, and had a full course load. Yes, medical school was probably going to be busy—everyone said it would be—but somehow, I couldn’t wrap my mind around a life busier than what I was experiencing in undergrad.  If I had been a more pro-active of a pre-med, I might have planned for the time-suck that I heard medical school was going to be. Maybe I would have started studying anatomy on my own, flipping through an atlas over the summer and starting to put down to memory muscles and nerves. Maybe I would have freshened up on my biochemistry or genetics.

Either way, I don’t think it would have prepared me at all for the balancing act that attending medical school has been. (In any case, I’m glad I didn’t fritter away my summer with a Grant’s Dissector.) It’s true that I’ve never been expected to memorize so much material in such a short period of time ever before. And that my attending lecture, small groups, and mandatory clinic sessions have resulted in much more class time (and hence, less free time) than in undergrad. Yet, these challenges are singular, and I have come to accept them as essential parts of the path I have chosen to take. The real challenge arches over other aspects of my life.  It is the challenge of prioritization.

Most, if not all, doctors would agree that in order to keep sane, they’ve had to prioritize activities other than studying during their medical career. Often, it’s working out, cooking, sleeping, watching TV, or spending time with friends and family. It’s ultimately all about balance.

Being a medical student is like this: a teetering balancing act that may lean or sway more towards one activity or another on a day-to-day basis, but ultimately, in the big scope of things, stays firmly upright. This dynamic, rocking state of being is what balance truly is.  I’m still awful at memorizing, and binder-loads of lecture material still catch me off guard. Yet, the biggest challenge of medical school has been learning how to best use the limited time I have in the most fulfilling way for me.  It’s about learning to promote balance in my life.

In C. Dale Young’s poem, “Gross Anatomy: The First Day,” he begins the poem with an anatomy dissection instructor telling his students to:

“Begin with bone and muscle to discern exactly what you need to memorize. Each region has so many things to learn.”

He ends the poem with a snapshot of a sentiment too often felt by medical students:

“…You have many things to learn:
procedures, facts, new words at every turn.”
His introductory words elicit sighs.
Begin with bone and muscle to discern?
There is no time—too many things to learn.”

If I were to give advice to my naïve, pre-med self, I would sit her down and look her in the eye. I would tell her with confidence that she will be able to handle the course load of medical school just fine, that she will one day wield a stethoscope and call herself student-doctor without a second thought. But I would add, after motioning her to listen carefully, that she should make sure to pay particular attention to what is important to her. I would urge her to not let those things wither and to make finding balance a priority during medical school.  Then I would share some sage advice I have gotten from fourth years past, “The extra hour you spend studying may not help you become that much of a better doctor in the long-run, but the extra hour you spend with your friends/your significant other/your family/your hobbies can make all the difference for your current and future happiness. Either way, you are going to get that MD. How you get there is yours to choose.”