Author: Mica Esquenazi

Mica is a member of the University of Rochester School of Medicine Class of 2017. She graduated with honors from Stanford University with a B.S. in Science, Technology, and Society, and a B.A. in Medical Anthropology. She works as a clinical researcher within the University of Rochester Medical Center's Department of Otolaryngology and Burn Surgery Division. She previously served on AMWA's National Student Executive Board as Secretary and as a clinical researcher for VisualDx. She also served as local president of her school's AMA and AMWA chapters. Mica is pursuing a career in otolaryngology.

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Clinical General Lifestyle MSPress Announcements

“The Real Challenge: Balance” Dr. Richard D. Krugman, 2014 Commencement Address at the University of Colorado School of Medicine

Page 1This week, Dr. Richard D. Krugman’s 2014 commencement speech at the University of Colorado School of Medicine entitled, “The Real Challenge: Balance” debuts via the Medical Commencement Archive. This piece is my personal favorite within this year’s archive.

Dr. Krugman is a respected educator and leader in the medical field. Dr. Krugman received his bachelor’s degree from Princeton University, and earned his medical degree at New York University School of Medicine. He went on to complete his residency in Pediatrics at the University of Colorado School of Medicine. He currently serves as the Vice Chancellor for Health Affairs for the University of Colorado, Denver, where he oversees all five hospitals of the university in addition to providing support for deans and faculty. Among many esteemed positions, Dr. Krugman has served as a member of the Institute of Medicine and the board of University of Colorado Hospital. Dr. Krugman is internationally recognized as an authority on child abuse prevention.

Dr. Krugman begins his speech by discussing his desire to hold the title of spouse of the President of the United States.

“I have watched for years as each Presidential spouse came to the White House, starting with Jacqueline Kennedy, and each took as a cause some area of public policy that instantly got attention and, over the next four to eight years had billions of dollars appropriated toward resolving the issue.” He goes on to discuss his future endeavors.

With a humble nature, Dr. Krugman comments on the common nature of forgetting commencement speeches. He focuses his speech on what he believes will be the single most important piece of advice that the novel physicians ought to remember,

“it is probably easier to learn the facts and the technical skills you will need to practice medicine than it is to learn how to balance lives that are relentlessly crammed with the demands of your families and friends, your patients, your supervising residents and attending physicians, your students…”

Take some time to read Dr. Krugman’s recommendations for maintaining balance alongside a career in medicine.

Read Dr. Krugman’s 2014 Commencement Speech at the University of Colorado School of Medicine:  https://www.themspress.org/index.php/commencement/article/view/69

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Clinical General Innovation Lifestyle MSPress Announcements Reflection

“The Five C’s” Dr. Georgette A. Dent, 2014 Commencement Address at the University of North Carolina School of Medicine

Page 1This week, Dr. Georgette A. Dent, Associate Dean for Student Affairs at the University of North Carolina School of Medicine joins the list of spectacular commencement speeches in the Medical Commencement Archive.

Dr. Dent is an esteemed educator, writer, and innovator in the medical field. She received her Bachelor’s of Sciences from Duke University where she graduated magna cum laude. Dr. Dent went on to earn her M.D. from Duke University School of Medicine, where she also completed her residency in Anatomic and Clinical Pathology. Dr. Dent completed a fellowship in Hematopathology at the University of North Carolina School of Medicine, where she now serves and inspires students as the Associate Dean for Student Affairs. Among Dr. Dent’s many accomplishments, she has served as a member of the AAMC Electronic Residency Application System Advisory Committee, the Liaison Committee on Medical Education (LCME), and the American Society of Hematology Committee on Promoting Diversity.

“Going forward, when you have an “on” weekend, it will not mean you have a Monday exam, it will mean that you are on call.”

“The Five C’s”, provides a succinct and intimate view of the UNC SOM Class of 2014. Dr. Dent encourages her students to go forward as physicians while staying true to their caring natures, abilities to connect with others, competence, character, and engagement with cutting edge technology. Read Dr. Dent’s 2014 Commencement Speech at the University of North Carolina School of Medicine.

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Clinical General Innovation Lifestyle MSPress Announcements Narrative Reflection

“Timelessness in the Ever-Changing Medical Field” Dr. Abraham Verghese, 2014 Commencement Address at the Stanford University School of Medicine

Dr. Abraham Verghese, critically acclaimed author and widely respected clinician, is now featured in the Medical Commencement Archive. Dr. Verghese’s commitment to medical humanities, teaching, and the art of medicine is one that students have the pleasure and honor of learning from through various platforms.

In his speech, Timelessness in the Ever-Changing Medical Field, Dr. Verghese calls upon the Stanford University School of Medicine graduates to find the connection between their technology-laden careers and the careers of their predecessors.

“I hope that sense of history will make you conscious that when you are there with the patient, you are also participating in a timeless ritual. Rituals, like this one today, with all its ceremony and tradition are about transformation, about crossing a threshold — indeed the ritual of our graduation ceremony is self-evident. When you examine a patient, if you think about it, it is also a timeless ritual, a crossing of a threshold.”

In his speech, Dr. Verghese discusses the graduation speech boycotts of 2014, patients from his past, memories of medical school examinations, and opinions about medical licensing techniques. Dr. Verghese currently serves as Vice Chair for the Theory and Practice of Medicine at Stanford University, among many other appointments. Ending his speech, Dr. Verghese leaves the graduates with words that resemble a blessing:

 

“May you celebrate the rituals of medicine, recognizing their importance to both you and the patient. May you find courage to face your own personal trials by learning from your patients’ courage. May you minister to your patients even as they minister to you. When there is nothing more medically you can do for patients, remember it is just the beginning of everything you can do for your patients; you can still give them the best of you, which is your presence at their bedside. You can heal even when you cannot cure by that simple human act of being at the bedside — your presence. May you discover as generations before you have, the great happiness and satisfaction inherent in the practice of medicine, despite everything”

Page 1Interested in reading about Dr. Verghese’s work with infectious diseases? Check out My Own Country which features stories of the rise of AIDs in rural Tennessee. Interested in reading about mental health and creating balance within the medical field? Check out The Tennis Partner which explores the drug addiction and familial struggles of medical professionals. Fancy yourself a great fiction read in medical drama? Take a look through Cutting for Stone.

Further, Dr. Verghese writes on a variety of other interesting topics through New York Times, Newsweek, and Washington Post articles. Expounding upon the importance of the patient-physician relationship, Dr. Verghese has had a number of talks and interviews including TED talks.

Incredibly popular amongst medical students is, “Stanford 25: An Initiative to Revive the Culture of Bedside Manner” which features videos of Dr. Verghese’s physical examination methods.

Dr. Verghese is a champion of medical writing and a fantastic advocate of the importance of the healing arts. Enjoy this wonderful new addition to the Medical Commencement Archive.

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General

“Your Leap of Faith Has Paid Off” Dr. John Hitt, 2014 Commencement Address at the University of Central Florida College of Medicine

Page 1This week’s Medical Commencement Archive speech comes from Dr. John C. Hitt at the University of Central Florida College of Medicine. In his speech, he congratulations the newest UCF COM graduates on choosing to attend the new medical school. What goes into establishing a new medical school? Read Dr. Hitt’s speech for an inside look. Addressing the successful UCF COM graduates, Dr. Hitt states,
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“The biggest game changers in life dare to envision a better society, and then go about creating it.”
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Dr. Hitt is an accomplished educator and leader in higher education. He graduated cum laude from Austin College where he received his Bachelor’s in Psychology. He earned both his Master’s degree and Doctoral degree in Physiological Psychology from Tulane University. Dr. Hitt has served as the president of University of Central Florida for over 18 years, during which he has achieved such remarkable accomplishments as planning and winning approval for a new college of medicine, and expanding research funding by over $114 million a year. Among his many notable positions of service, he has served as Chair of the State University Presidents Association and a member of the Florida Council of 100, and is the founder of the Florida High Tech Corridor Council.

Read Dr. Hitt’s speech through the Medical Commencement Archive. Stay tuned for more speeches each Friday.

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Clinical General Lifestyle MSPress Announcements Reflection

Medical Commencement Archive Debut with Dr. Timothy E. Quill, University of Rochester School of Medicine

Today the Medical Student Press kicks off Volume 1 of the Medical Commencement Archive. The Archive will now release a new speech each Friday. Stay tuned for spectacular reads which speak directly to the future of medicine with wise reflections from the past. The inaugural speech entitled, Who is Your Doctor?, comes from Dr. Timothy E. Quill, M.D., at the University of Rochester School of Medicine and Dentistry. Read Dr. Quill’s full speech and bookmark the Medical Commencement Archive here.

dr quill copy 2Dr. Quill is an accomplished physician and author in the field of Palliative Care. He earned his undergraduate degree at Amherst College, and received his M.D. at the University of Rochester. He completed his residency in Internal Medicine and a Fellowship in Medicine/Psychiatry Liaison at the University of Rochester. Dr.Quill is now Professor of Medicine, Psychiatry, and Medical Humanities at the University of Rochester School of Medicine and Dentistry. He is also the Director of the URMC Palliative Care Program. Dr. Quill has published extensively on the doctor-patient relationship, with an emphasis on the difficult decision-making processes toward the end of life. He was the lead physician plaintiff in the 1997 Supreme Court case Quill v. Vacco challenging the law prohibiting physician-assisted death.

In his speech, Dr. Quill spoke to the class about the need for competent and personal medical care in this complex and fast-paced world of biomedicine with all its specialties and subspecialties. He drew upon his extensive clinical experience in palliative care to illustrate how a deep understanding of the patient and their family can help physicians not only guide patients through the plethora of medical options, but also make,

“…clear recommendations among those options based on their medical knowledge and their knowledge of the patient as a person.” Dr. Quill believes, “that kind of guidance and engagement, which is both medically competent but also very person, is what will make [one] a really exemplary doctor.”

Dr. Quill’s speech is indeed very touching and inspirational. His personal clinical anecdotes are moving, as  they illustrate how competent and personal medicine improves patient care. His focus and dedication to understanding and treating patients as opposed to diseases is evident and serves as a role model to all, including medical students. His words inspire medical student to,

“become one of those doctors who is not only technically very competent, but also very willing to engage with patients and families in difficult decision-making.”

The MSPress encourages you to read his commencement speech to not only gain insight into Dr. Quill’s wisdom, filled with powerful anecdotes, but to learn from an accomplished and very thoughtful physician. Read Dr. Quill’s full speech and bookmark the Medical Commencement Archive here.

Thanks to Stephen Kwak, MSPress Editor, for his contribution to this blog post.

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General

The Doctor’s 12-Bar Blues

photoOccasionally between lectures, some instructors will play music through the lecture hall sound system. As I sat waiting for the next lecture to begin, the Blues Brothers’ version of “Sweet Home Chicago” played. The Blues Brothers is one of my favorite films. I have a poster I purchased in high school that has traveled with me throughout my cross-country moves and still graces my bedroom wall today.

Once the song ended, the class quieted down and the lecturer, Dr. Stephen Lurie, began. “How do you know this is blues?” He asked. Silence fell upon the class. “Blaring horns!” I said, breaking the silence with  my excitement to be talking about the Blues Brothers in a medical school lecture.

Soon others piped in: “There’s a progression?” “Well the history of blues being connected to jazz…”

Soon, Dr. Lurie walked over to the lecture’s sound system and stated, “Well… let me play the song without any lyrics.” As the tune played on, he moved over to the board and drew a typical 12-bar blues progression:

blues brothers

Next, he played Louis Prima’s “Jump, Jive an’ Wail.“

The Wildest copy

“In this next song, you’ll see that if you bend the notes, put the melodies in different places, it’s jazzy” Cue: Gene Ammons’ “Red Top“.

gene-ammons-argo

Pointing to the same notes on the board- he moved as each song progressed. “People really couldn’t get away from this!” Cue: Nat King Cole’s “Route 66“

the_king_cole_trio-(get_your_kicks_on)_route_66_s

Cue: The Beatles “A Hard Day’s Night“

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“Slow it down and you get…” Cue: The Clash’s “Should I Stay or Should I Go“

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“You can also frame it and make people wait for it…” Cue: Dixie Chicks “Some Days You Gotta Dance”  As soon as the lyrics “some days you gotta dance” began- he continued his routine of pointing to the different notes on the board.

Chicksfly

Bringing this musical exploration to a close, Dr. Lurie urged us to see the power in the structure of the 12-bar blues. The journey that each song takes its listener on includes 4 bars establishing the root chord, a 9th bar with the climax, and a finale with the 11th and 12th bars of resolution. This format accommodates Gene Ammons’ jazz saxophone melody, Paul McCartney’s rock n’ roll vocals, and Mick Jones’ punk guitar riffs. Further, the very first note of a song has the very last note in mind and the song as a whole seeks to reach and entertain listeners through a collaboration with tools of the music industry. This structure enables listeners to focus on the uniqueness of each song which is highlighted by the forum of the 12-bar blues.

Bringing the lessons of these tunes into the wards, the structure of the oral patient presentation serves as clinicians’ 12-bar blues. The journey that each oral presentation takes its listener on includes a chief complaint, history of present illness, past medical history, and so on. This format accommodates the story of a patient with a simple otitis media to a patient suffering from Ebola virus. Just as with the tunes, the very first sentence of an oral patient presentation has the very last sentence in mind and the presentation as a whole seeks to provide proper patient care through collaboration with other healthcare professionals. This format enables any presenter and any listener to focus on the unique facts of each patient’s case, rather than different structural choices. As such, clinicians need not focus on creating a structure for their oral patient presentation, as it is already set in place. Rather, clinicians aught to focus on properly including the details of their patient’s story within the widely understood presentation structure. 

One study that highlights the importance of the format of one’s oral patient presentation is “Expectations for Oral Case Presentations for Clinical Clerks: Opinions of Internal Medicine Clerkship Directors“. This article rates “organized systematically according to usual standards” as the most important component of an oral presentation and, “includes full review of systems” as the least important. Use the presentation structure and be efficient when including the information your patient has shared with you.

Lastly, Dr. Lurie urged the class full of medical students to remember that written presentations are short stories while oral presentations are live songs. With performance elements at our disposal, we must properly cater to our listener and create a masterful oral patient presentation should we wish to refine the art of healing- beginning with a well-tailored introduction. Reflecting upon his lecture, Dr. Lurie wrote, “I once had a saxophone teacher who was always after me to play fewer notes when improvising. ‘Anyone can play a lot of notes,’ he used to say, ‘but if you want to make music you should play only the good ones.’ Michelangelo was reputed to have said that his method of sculpting was to see the form hidden inside the block of marble, and then to carve away everything that was not part of that form. Of course, as a first-year student you are not always able to see that form, but as you practice giving oral presentations, that is the method I think you should be aiming at.” 

Dr. Stephen Lurie now serves as a faculty advisor for the Medical Student Press. He served as Senior Editor for JAMA for four years. Read more about Dr. Lurie here.

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General Innovation MSPress Announcements

Welcome to the Medical Student Press: Letter from the Editor-in-Chief

Photo by: Anirudh Rao

Dear Readers,

I am delighted to welcome you all to the Medical Student Press through the launching of the MSPress Blog. In merely five months, the MSPress has grown to have an international team of medical students serving as editors, peer reviewers, graphic designers, and writers. Our journal has had countless submissions and our diverse blog writers are eager to share their experiences with the medical student community at large. We have made incredible strides and welcome all of those interested in supporting the scholarly expression of medical students to join our team (see application: here).

Beginnings

This project was inspired by of one of my dearest professors at Stanford University, Professor John Willinsky. In my junior year, I decided to take a course entitled “Learning, Sharing, Publishing, and Intellectual Property” through the School of Education. I found myself in a beautiful turret providing a beautiful view of the sunset. In this course, Professor Willinsky taught about the classical and current debates within the publishing world. He explored modern methods of sharing educational resources, and taught us the specifics of John Locke’s theories concerning the commons (Professor Willinsky’s book on this topic is currently in the making). I stayed in the course for the rest of the semester, enjoyed the sunset, and gleaned as much as I could from this publishing giant.

Soon, I began working closely with Professor Willinsky and one of his projects: Open Journal Systems. This open-access software enables editorial teams to collaborate within a seamless online platform. Further, it publishes content that is widely-indexed, thereby providing journal submissions with the opportunity to be widely read and cited. I worked with OJS during my Stanford years as EIC of Intersect: the Stanford Journal of Science, Technology and Society. After the journal was live for three years, it became international and was strongly cited by other scholars (see the Intersect citation line-up here).

The Medical Student Press

The Library of Babel Illustration by Erik Desmazieres
The Library of Babel Illustration by Erik Desmazieres

An MS1 at the University of Rochester School of Medicine and Dentistry, I was determined to find a way to continue working with publishing. The MSPress began as a collaboration between myself and Gabriel Glaun, an MS1 at the University of Central Florida College of Medicine. We were both involved with scholarly publishing in our undergraduate years and sought out an opportunity to continue this involvement as medical students; a search I assumed would be similar to bumbling through Jorge Luis Borges’ Library of Babel. While we easily found well-established medical publishers, we surprisingly did not find any large-scale projects that were exclusively for and by medical students. Further, the collaboration between international medical students was one that was seldom seen. A well-indexed, organized, easily accessible, international, and approachable medical student publishing organization was clearly needed, and so our work on the MSPress began.

After a great deal of work and support from other medical students, I am elated to make our medical student publishing organization live. We operate using Open Journal Systems and support open-access publishing through our use of a Creative Commons license for all of our content. Currently under our auspices are The MSPress Journal and The MSPress Blog.

The MSPress Journal accepts research essays, theses excerpts, interviews, scientific papers, medical ethics essays, creative writing, sound pieces, and visual art pieces.  This platform runs directly through the Open Journal System, ensuring our articles are widely disseminated and strongly published.

The MSPress Blog supports those students interested in long term writing, as well as those interested in occasional writing. This platform accepts informal pieces, narratives, sound pieces, visual art pieces, news articles, and pilot studies.

Recognizing that medicine is dynamic, we aim to support the ideas of all students. Get in touch with our team to share your creative ideas. The education of medical students continues far after class and clinic sessions are over. Remain engaged, expressive, and innovative by contributing to the MSPress. We are proud to support the scholarly expression of medical students and welcome all readers, contributors, and creative minds.

We are a versatile team with an exciting new project that is full of potential, so to stay up to date with us, follow our blog, our Facebook page, and our website.

 

Cheers to the scholarly expression of medical students,

Mica Esquenazi

The MSPress, Editor-in-Chief