Categories
General Reflection

Scholarly Pursuits

Growing up, my father didn’t get home from work until nearly 10:30 pm.  He worked full-time at Allstate Insurance while also working part time as a realtor. There were days I didn’t see my father because he had been working all day. He told me to be grateful for what I had and where I was in life. I didn’t fully understand him, until now.

My father was unable to complete his education. He had planned to become an engineer, but his dad fell ill and the responsibility for the family fell entirely upon him. My father had to pay for his sister’s wedding and his younger brother’s education. In order to do this, he quit college and started working full-time.

I look at myself now and see how dramatically different my life is compared to his. I have everything I could dream of and more. My father is willing to work hard so that I can, today, pursue my education at the best of institutions. In fact, since preschool, I have studied in private institutions and grown up in a world that is in diametric opposition, in terms of the opportunities and expectations placed upon me, to the world that my father grew up in. He has tried to prevent me from even getting a glimpse of the hardships he endured when he gave up his dreams to serve his family. I am humbled by and grateful for the opportunities my dad’s efforts have allowed me to pursue. I know that my father did not have many of the same opportunities. As the timeless and enduring quote goes, “with great power, comes great responsibility”- I know that having the access and opportunity to seek and find knowledge comes with expectations- to serve the community which has so selflessly flung all its needs and desires to serve the needs and desires of my generation. I have had the opportunity to attend both engineering and medical school. The knowledge I have gained by attending both these schools has not only empowered me, but has also reminded me of what I owe to my community and my family- the responsibility to give back.

Whenever my father sees me with a calculus or physics book, a smile comes across his face. He begins chanting the trigonometric functions and formulas he remembers. But that smile often fades as he remembers the past. My father has never talked openly about the hardships he endured while he was young, but his eyes convey it all. There was this silence that followed that chanting and smile. I knew that my father was thinking back to his past and the educational endeavors he never had the opportunity to pursue. Despite this, my father is able to provide more than enough for our family on many levels, financial and emotional.

However, despite my dad’s success, there is still a part of him that wishes he could finish his education. I have grown so much from my father’s experiences. Although he did not have the opportunity to finish his education and pursue the engineering career he had dreamt of, his sacrifices came to yield. Family has always been incredibly important to him, and the efforts and sacrifices he has made on his family’s behalf have added immeasurable value to his life.

As I tread through my final months of medical school I’ve come to realize more and more just how fortunate I am. Every day is a reminder of the advantage and opportunities I was granted due to my father’s sacrifices. I am now the same age that my father was when he left school, and I am fully aware of the advantages I have over him. But with these advantages come additional responsibilities. I will forever remember his efforts and sacrifices and do my best to honor them.   It is this passion that is the driving force of my life and my scholastic pursuits.

Featured image:
Opportunity by Susan Frasier

Categories
Narrative Reflection

Little Flickers: How Medicine Truly Connects Us

“See the little flicker?” the doctor asked, as she tilted the ultrasound screen and pointed to the tiny movement. The patient leaned forward, squinting, trying to decipher the gray and black pixels that showed she was now a mother. “That’s the heartbeat,” her doctor explained. “Right there,” she pointed again, this time zooming in even further. The patient nodded as she tried to contain her excitement. She smiled with one of those tight-lipped grins as her eyes widened, as if joy was actually bursting out of her. Her husband chuckled at her wild expression and squeezed her hand. “It’s okay,” her doctor said. “Be excited! This is exciting!” And with that word of permission, the expecting mother squealed, just a little, and calmed herself again. “It’s our first, you know, and my sister just had a girl and I wanted our kids to be able to grow up together and we just didn’t know if it would happen this fast, and,” she paused to catch her breath. “Sorry, I just can’t believe we get to start buying baby stuff!”

I looked at the screen again, at the little flicker of light, at the little piece of white against black that would someday have a lot of “baby stuff” foisted upon it. It was one of the earliest pregnancies I had seen on ultrasound – in fact, I had only seen one other scan done at the same gestational age. It was striking how identical this scan was to the first one I had seen, months earlier. The screen had looked exactly the same, with the crown-rump length of the tiny embryo measuring the same, with the same shape of black fluid around white tissue. I thought back to that day, to the tiny portable ultrasound screen so far from home. Instead of an antiseptic outpatient OB/GYN clinic in temperate California, the first scan had been done on the dirt floor of a little hut in Central America.

It was a typical clinic day in rural Panama – humid, muddy, with lines of patients waiting to be seen. Working over the summer with the non-profit organization Floating Doctors, I saw many pregnant women come to clinic for prenatal care. Traveling to indigenous island communities, where most patients have no other access to health care, we would set up makeshift clinics and see as many patients as possible. It is common for women in the Ngobe communities to have as many as ten kids; oftentimes they start having children when they are teenagers themselves. Unsurprisingly, there was a lot of prenatal ultrasound scanning to be done.

When I saw this particular patient, whose ultrasound was done so early in the pregnancy, the crown-rump length was the same as the patient’s I would see months later at home. This woman was 32 and had five children. Her youngest, a two-year-old girl, leaned on her mother’s chest as I scanned, taking a pause in her whining to stare at the screen. She didn’t understand what it was, but her mother squeezed her excitedly anyway as I pointed at the little flicker, the unmistakable heartbeat. Even though they already had a big family, even though it was miserably sweaty sitting on the floor in our little ultrasound hut, and even though the toddler was getting fussy, this woman had the unmistakable grin of sheer excitement.

Talking to the pregnant women in Panama, either during the scan or translating during the physician checkup, I imagined the lives these babies would have. It was an easy thing to think about, seeing so many children running around and playing as their parents waited in line. The kids were a handful to organize; it was no easy feat keeping them far enough away from the clinic to avoid distractions, but close enough to organize whole family visits when it was their turn. They played muddy games of soccer or baseball, chasing each other around and asking us for highly coveted stickers. They were so full of energy, so happy and so free. The mothers usually didn’t find these games as amusing as I did; they were exhausted, overwhelmed, and just trying to get the visits done so they could go home. I can’t begin to imagine the strength and resilience it takes for those mothers to care for so many children, and oftentimes other family members, with such limited resources and support.

There was a mural painted on the side of a school in one of the communities we visited. The mural was a giant world map, not particularly accurate in terms of scale or geography, but vibrantly colored and decorated. When I saw it, I thought it was quite fitting, as I was working in a team with students and doctors from all over the world, living in a country I had never been to before, speaking a foreign language every day. When I thought about its place in the community, however, I began to wonder what it meant to them. These villages are isolated, by geography and lack of transportation and resources. The children who seemed so free to me would most likely find it difficult to leave their small village, if they ever wanted to. I wondered what they thought of that colorful map on the wall, whether it was an abstract concept of the world beyond their borders, or whether they dreamed of a truly unrestricted future. The child back home in Orange County, of course, might dream of just the opposite – wishing the world were not so vast and intimidating, wishing the world stretched just to the end of the block, where everything in between was familiar and safe.

These are the things I wonder about, the things that keep me thinking about certain patients long after they’ve left. These are the things that connect patients, at least in my mind, despite the vast differences in their lives. Ultimately, the job in medicine is to focus on the patient, or the ultrasound image, but it’s not always easy, or in the patient’s best interest, to tune out the context.

We are trained to look at that little flicker of a heartbeat, measure its rhythm and pace, and watch as the baby grows and the flicker gets stronger. We are trained to look at every patient, every heartbeat, the same – without bias, without judgment, without assumptions. At the same time, we can’t ignore the world around us, the world that we are working in and the world that our patients live in. We can’t ignore the fact that differences between two patients’ cultures, communities and access to resources may make them seem worlds apart. But mostly, we can’t ignore how strikingly similar we all are at the start – just little flickers of black and white, so simply alive. Maybe if we try to remember that, all the differences we see every day will become just parts of the mural – not terribly accurate, certainly open to interpretation, but mostly just a beautiful mess of color.

 

Featured image:
Panama Clinic, courtesy of Leigh Goodrich

Categories
General Lifestyle

Semper Fi

In early medical practices, the translating of ailments into Latin and Greek amalgams created a language that set doctors apart from the general society. This boundary signified the value that doctors provided and created a group that could identify with each other because they held similar values and had comparable educations.

The use of the phrase “Semper Fidelis” in the Marine Corps serves a similar purpose.  More than just a slogan, it is a way of life for a select population. United States Marines are admired for their dedication to each other, their service, and their country. Marines are a group that is separate and unique from any other. “Semper Fi” translates to “Always Faithful.” This statement symbolizes the ability of common people to become part of a brotherhood that demands more of its members than any other comparable group.

We don’t have to be Marines to achieve the same discipline. As medical students, we can make this a practice as we transition into our careers. Marines are trusted to make significant, split-second decisions in an environment more dangerous and confusing than those in which most doctors operate. The battlefield is chaotic and information often unreliable. In a medical environment it is important to develop effective means of communication balanced with ongoing decision-making. In practice, however, this standard of communication is rare. Empowering front-line practitioners is vital to the success of the medical system. This is parallel to what Marines do. The Marines have standards; a reputation of excellence. There is a sense of being part of something much bigger than simply an organization. What the Marines understand is the same thing that the best doctors understand- success happens through failure. There is a sacrifice that comes with joining the Corps or becoming a physician. Not only must we surrender our weekend plans and sleep to meet the physical and mental demands of our chosen paths, but we are weighted with the notion that our everyday activities affect the lives of others. No matter how good our intentions, as doctors or Marines, we will not be able to overcome the problems caused by poverty, war, the spread of infectious disease, famine, or climate change. That doesn’t mean we can’t try to help people afflicted by these events. 

Why do we do all of this? Because we take pride in what we do.  Moreover, Marines and doctors alike truly care for the welfare of the human race. Veterans Day was November 11, a celebration to honor America’s veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good (Dept. of Veterans Affairs). 

 

Featured image: Marine Week Boston, 2010: A Bell UH-1N SuperCobra attack helicopter flies by in front of pinkish cloudy blue skies by Chris Devers

Categories
Disability Issues Lifestyle Reflection

Personality Disorders

In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule.
– Friedrich Nietzsche

Personality Disorders (PDs) are defined by the DSM-V as significant impairments in the self and interpersonal functioning across time, which cannot be explained by socio-cultural environment or substance abuse (American Psychiatric Association 2012). These disorders are unique within psychiatry because, unlike many of the Axis I disorders, they did not begin to take form until the 19th century. They also tend to create controversy around their definitions, as they are molded by the behavioural standards within a society, and are therefore quite subjective. This subjectivity may be the reason why personality disorders have the lowest levels of reliability and validity among all psychiatric disorders (Alarcon et al. 1995).

There is an important difference between personality styles and disorders, and clinicians must be able to make this distinction. As society changes, roles and values are transformed, leading to the creation of new disorders. One example of this is  internet gaming disorder.

Perhaps we should start by clarifying our terms: what is personality? Is it something that is inherent and unchangeable? Or is it a malleable entity, a wisp of smoke that can never be grasped; a question to hang above the philosophers’ heads? In 1995, Alarcon et al. suggest that personality implies a way of reacting to stimuli, coping with stress and acting on one’s beliefs about oneself and the world. It has been suggested that a personality disorder is almost a caricature of the normal personality, and that it can reflect the distorted aspects of a person’s time and culture.

Society plays a very powerful role when it comes to psychological disorders. It has been suggested that prejudice can distort societies’ perceptions towards those from disadvantaged backgrounds and inflate the rates of personality disorders in these groups. For example, it has been suggested that almost half of inner city youth who have been diagnosed with antisocial personality disorder have been misdiagnosed, because their behaviors are occurring in a unique cultural context; a context which includes the prevalence of behavioral systems which value violent behavior as an acceptable survival strategy (Alarcon et al. 1995). Furthermore, antisocial behaviour could be seen as an adaptation to the excessive demands of our modern world. With the increasing expectations placed upon our youth, not only for wealth and success, but also for a ‘happy’ life with a spouse and child, a fast car and a big house, is it any wonder that many kids rebel against such idealistic expectations? Perhaps it is society that is towing the soil, encouraging the growth of such ‘pathological behaviour’ in our culture. Are we simply pushing humanity too far?

Borderline Personality Disorder (BPD) is another example of a personality disorder that has become increasingly common in the modern world (Grant et al. 2008). Those who have ever set foot on a psychiatric ward will be familiar with the label, as it is the most prevalent category of personality disorder within the mental health services (National Collaborating Centre for Mental Health, 2009).

BPD is a relatively new diagnostic entity, first described in the 20th century. Although people committed suicide in the past, self-harm in the form of wrist cutting is relatively new, only appearing on psychiatry’s radar since the 1960s (Favazza, A.R. 2011). As societies evolve, symptom banks change, and in today’s world there appears to be an increasing acceptance of self-harm as a signal of distress– a phenomenon termed ‘social contagion’ (Jarvi, et al. 2013). Traits underlying BPD are impulsivity and affective instability. In today’s world, these impulsive symptoms are one of the most common forms of expressing distress among the young. Indeed, it has been suggested that BPD risk factors are associated with modern life (Paris and Lis 2013).

Do we as a society place such high expectations on those around us that we must fall back upon psychological labels to explain away those who do not fit into our idea of perfection? I suggest that perhaps this sudden surge in personality disorders does not merely reflect our increasing awareness of such pathologies, but also a deeper issue within modern society. Perhaps we have become so obsessed with success, with money, with beauty, that we have forgotten what it means to be human. To love, to feel, to belong.

And if this is true, then the answer lies not within the leaves of a doctor’s prescription pad, nor within the four walls of a hospital ward, but in the society that we have created for ourselves. Perhaps this rise in personality disorders, this explosion of emotional distress, is a signal that the world we have created for ourselves may be doing more harm than good. The increasing emphasis on achievements, success, wealth, and fame may indeed be turning into a poison. And if this is the case, then the antidote lies beyond the physicians’ hands; it is a task that is placed on all of us, to encourage our children to create a world for themselves that is filled with love and belonging, rather than goals and desires. It is only through an increasing emphasis upon our own humanity that we can begin to combat this psychological plague.

References

  1. Alarcon, R., Foulks, E.F. 1995. Personality Disorders and Culture: Contemporary Clinical Views (Part A). Cultural Diversity and Mental Health. 1:3-17
  2. American Psychiatric Association. 2012. DSM-IV and DSM-5 Criteria for the Personality Disorders.
  3. Chavira, D.A. et al. 2003. Ethnicity and four personality disorders. Comprehensive Psychiatry. 44:483-491
  4. Favazza, A.R. 2011. Bodies under Siege: Self-mutilation, Nonsuicidal Self-injury, and Body Modification in Culture and Psychiatry. 3rd Ed. JHU Press.
  5. Grant, B. Stinson, F.S., Saha, T.D., Smith, S.M., Dawson, D.A., Pulay, A.J., Pickering, R.P., Ruan, W.J. 2008. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiological Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry. 69:522-545
  6. Jarvi, S., Jackson, B., Swenson, L., Crawford, H. 2013. The impact of social contagion on non-suicidal self-injury: a review of the literature. Archives of Suicidal Research. 17:1-19
  7. National Collaborating Centre for Mental Health. 2009. Borderline Personality Disorder, The NICE Guideline on Treatment and Management. The British Psychological Society, The Royal College of Psychiatrists.
  8. Paris, J., Lis, E. Can sociocultural and historical mechanisms influence the development of borderline personality disorder? 2013. Transcultural Psychiatry. 50:140-151

Featured image:
Female Warrior # 14 “Extinction” by CHRISTIAAN TONNIS

 

Categories
General Literature

A farewell to Oliver Sacks

In my life, I haven’t had many heroes. Yes, I have been fascinated with some athletes, scientists, artists, and people around me, but I cannot say that I have had many true role models. In terms of science and medicine, one soul in particular stands out – Oliver Sacks.

In my introductory histology & embryology course, a professor mentioned a funny story during a rather uneventful lecture concerning ocular histology. The story told of an interesting “optical illusion”, and the lecture suddenly became much more engaging. He briefly mentioned that the clinical tale presented was described by Sacks in “The Man Who Mistook His Wife for a Hat”[1]. I often leave many off-side notes, and in this instance I scribbled: do check this guy out. While revising my histology notes for the exam, I spotted this side-note in my “trademark” hieroglyphic handwriting and decided to follow up on it. With that, a new influence in my life began.

Most articles will state that Sacks was a British neurologist, physician, scientist, and prolific author. Although he was born in London, he spent most of his life in New York City. Sacks was a meticulous examiner and analyst of neurological disorders, and he devoted his life to patients who suffered from these debilitating conditions. Many of his works became classics and best-sellers in the arena of popular medicine.

Sacks’ book “Awakenings” was used as a scenario for a major Hollywood motion picture [2] . In this true story, Sacks used a new experimental drug, L-DOPA, to treat patients in a state of total paralysis due to “encephalitis lethargica”. The treatment looked promising, as patients seemed to be resurrected and displayed dramatic improvements over their original condition. Unfortunately, the patients eventually regressed, once again falling into despair; once again drifting through the abyss of mere existence, which is what they had been enduring for years before the L-DOPA treatment briefly brought them out of it (the infamous “on-off” pharmacological feature of L-DOPA/Levodopa [3]). This was only one of many adventures that Oliver Sacks embarked upon and described in his novels. He was an intelligent, witty, compassionate, and truly unique writer and clinician who knew how to transpose the emotions, atmosphere, and feelings he encountered during his medical career.

In medical education, we explore different avenues – from basic to clinical sciences, bench to applied medicine, bedside to operating room, small rural ambulances to comprehensive medical centers. We try to reach a correct diagnosis. We try to adjust and find a sweet spot in our therapeutic modalities. We do our best to cut out what is sick and preserve what is still functional. Likewise, we are all attracted to different things. My “thing” is the nervous system and it has been for quite some time. If I was ever in doubt about such a choice, people like Sacks were there to remind me of my passion. Sacks’ stories of neurology and intricate brain puzzles consumed my attention on a daily basis. A few of his books, in particular, made a profound impression on me.

In “Musicophilia”, Sacks writes about the relationship of music and neurological disorders [4]. I was impressed when I learned how different clinical neurologic entities like stroke, cerebral hemorrhage, or head trauma can modify the processing of the sound and even alter someone’s musical inclinations. Likewise, in his book “Hallucinations” he talks extensively about how hallucinations can be generated as a consequence of trauma, drugs, or other physiological alterations [5]. Reading through Sacks’ books, I am continuously re-fascinated by his scholarly capacities alongside his humble and gentle nature. If the equation of human ego equals 1/knowledge, then Sacks had a miniscule, irrelevant amount of ego within himself. I rarely encounter such a trait these days, especially on the wards in daily clinical routines.

The last day of the August was humid and I had just returned home from a beautifully refreshing swim. I was soon struck with the news that Sacks had passed away. I was overwhelmed by the feeling of sadness. The world lost an outstanding individual, a soul that will be dearly missed by many. A few months earlier, in his New York Times column, Sacks wrote that he was diagnosed with metastases originating from his ocular melanoma. In this farewell piece, Sacks sensed his end was near and reflected on his life, which was well lived by any standard [6]. He announced that his final work, an autobiographical sketch of his life entitled “On the Move: A Life”, would soon become available [7]. His life was one of compassion and dedication; he was a source of warmth and kindness for those who were in need. He genuinely understood human suffering and worked to alleviate it to the best of his ability. Although I lived in New York City during my college days, I did not have the privilege of meeting Sacks. Regardless, I can find some consolation in the fact that he only departed physically – his writings, works, and grand opus will continue to inspire generations of minds to come. Goodbye, dear Dr. Oliver Sacks and thank you!

References

  1. Sacks O. The Man Who Mistook His Wife For A Hat: And Other Clinical Tales: Odyssey Editions; 2010.
  2. Sacks O. Awakenings: Knopf Doubleday Publishing Group; 2013.
  3. Lloyd K, Davidson L, Hornykiewicz O. The neurochemistry of Parkinson’s disease: effect of L-dopa therapy. Journal of Pharmacology and Experimental Therapeutics. 1975;195(3):453-64.
  4. Sacks O. Musicophilia: Knopf Doubleday Publishing Group; 2008.
  5. Sacks O. Hallucinations: Pan Macmillan; 2012.
  6. Sacks O. My Own Life New York, NY: The New York Times; 2015 [cited 2015 02/19/2015]. Available from: http://www.nytimes.com/2015/02/19/opinion/oliver-sacks-on-learning-he-has-terminal-cancer.html.
  7. Sacks O. On the Move: A Life: Knopf Doubleday Publishing Group; 2015.
Featured image:
oliver_sacks by Mars Hill Church Seattle
Categories
Clinical Emotion Lifestyle Narrative

A letter from a patient with anorexia nervosa

Dear Doctor,

What I need from you is validation that what I am experiencing is real; recognize this is more than just a burden for me.

At first it was a rush. The best feeling I’d ever had. I was getting compliments, attention, and my jeans felt wonderfully loose.  But it didn’t take long until it became everything; an obsession.  My eating disorder (ED) has become all I think about.  Every second of every day is consumed with what I eat, what I avoid, how I can avoid it, when I will exercise and for how long. I can’t escape.  Even if I actually wanted to gain weight back, it’s not that easy.

I know you might understand, but at least acknowledge that it’s not about the food. The truth is, when you say it’s about the food, it’s more tangible, easier to categorize, like a patient with a broken wrist.  People think that if I “just eat a sandwich” I will be fine, but this is far from accurate.

Sometimes ED hints at me, other times it screams. Either way, ED is a part of my life; it is a part of who I am right now. I have a deep connection to this diagnosis. Because of this, I will defend and validate ED, and conjure any excuse to hold on to this relationship just a little longer. For patients like me, ED becomes another member of the family, the third wheel in a relationship, or even another personality who needs attention.

I still struggle often, but I have good days too.  I am not just another girl with anorexia.  I’m a young woman who never takes life too seriously, loves road trips and playing the piano, and who fights back against anorexia every single day.  I know it’s your mission, but you cannot fix me. Only I can do that and I am going to need your support.

So right now, take a seat on my rollercoaster, listen to me, and let’s get to the end of this ride.

Sincerely,

Your ED patient

 

* Inspired by a loved one

Featured image:
Anorexia. by Mary Lock

 

Categories
General MSPress Announcements Public Health Reflection

“Fulfillment in Practice”: Dr. Howard K. Koh, 2015 Commencement Address of the Yale School of Medicine

We are excited to publish the final contributor to this year’s Commencement Archive, Dr. Koh’s 2015 commencement speech to the Yale School of Medicine, “Finding your calling.”

Howard Kyongju Koh is the former United States Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS).  

Screen Shot 2015-10-06 at 8.08.49 PMDr. Koh oversaw the HHS Office of Public Health and Science, the Commissioned Corps of the U.S. Public Health Service, and the Office of the Surgeon General. At the Office of Public Health and Science, he spearheaded programs related to disease prevention, health promotion, the reduction of health disparities, women’s and minority health, HIV/AIDS, vaccine programs, physical fitness and sports, bioethics, population affairs, blood supply, research integrity and human research protections.

Dr. Koh graduated from Yale College and earned his medical degree from Yale University School of Medicine. He has earned board certification in four medical fields: internal medicine, hematology, medical oncology, and dermatology, as well as a Master of Public Health degree from Boston University. 

Dr. Koh previously served as the Harvey V. Fineberg Professor of the Practice of Public Health, Associate Dean for Public Health Practice, and Director of the Division of Public Health Practice at the Harvard School of Public Health.  

Dr. Koh begins his speech by advising students to find meaning and fulfillment in medicine, regardless of external expectations,

“Please listen carefully to your inner soul so that you can discover your own sacred calling.  Doing so will help you express yourself, not just prove yourself. Doing so will help you determine in your life what is ultimate versus what is merely important.”

He continues by reminding students that patients will be teachers as well, and may be key factors in finding that calling,

“One way to learn more about meaning through your journey is to respect how your patients find meaning in their own. They can teach you in unexpected and profound ways. Sometimes the patients who will educate you the most will be the ones you couldn’t cure, no matter how hard you tried.”

He concludes and advises students to enjoy every step of the way,

“So please pay great attention to how you live your lives, not just as doctors, but as individual human beings.”

Visit the Medical Commencement Archive to read Dr. Koh’s full speech here

Categories
Lifestyle

Just Give Me Ten Minutes

As medical students, we are undoubtedly busy. Between studying and trying to maintain some semblance of a normal life, we don’t pause. Sometimes the only quiet we get is the car ride to class, or the few minutes before we fall asleep. A recent experience showed me that we might need a little more of this “quiet.”

When I was volunteering at Hope Lodge, a place for cancer patients and their families, I led a few short segments on meditation. Each segment was only ten minutes, but its benefits lasted much longer. After only ten minutes of focusing on my breathing and my body, I felt rejuvenated. We are often told that thirty minutes of moderate exercise, five times a week, will help us feel awake and alive. While this is correct, it’s still hard to find time to go to the gym regularly (especially during exam week). For meditation, you don’t have to get sweaty, leave your room, or change your clothes. Don’t get me wrong—I still love and encourage regular exercise. Yet if you feel too overwhelmed, stressed, or tired to exercise at the gym, give yourself ten minutes of meditation. These ten minutes will give you the clarity your body is craving.

So, what exactly do you do?

You can go about meditating in three ways:

  1. Complete silence
  2. Soothing music or sounds (such as a steady waterfall, a running stream, or nature’s lovely birds)
  3. Guided mediation with a voice accompaniment
    Both (1) and (2) can be found on YouTube. One of my favorites for (c) is this 15 minute video.

Once you have made your choice, give yourself at least five minutes to reap the benefits. You’ll find that even five minutes of focused breathing can do wonders for your mind and body.

Sit down in a comfortable position, close your eyes, and start breathing. Breathe in through your nose and exhale through your mouth.

When you are done, get up, and enjoy your renewed alertness!

There is no right or wrong way to meditate, and I am far from an expert. I only ask that you try it.

Further strengthening the therapeutic value of meditation, an article by the Huffington Post discusses the role of meditation in cancer patients. We all know about telomeres—telomeres shorten as we age, and shortened telomeres increase one’s risk for cancer. This article discusses a study where patients who participated in a mindfulness intervention had longer telomeres.

So give yourself ten minutes. You won’t regret it.

 

Featured image:
Meditation Transcendence by Hartwig HTG

Categories
General Reflection

Medical Conferences: Are they worth it?

Each year there are many medical conferences held around the world. These could be conferences about new research, medical education or, perhaps, a gathering of those in a specific specialty. Last year I was lucky enough to attend the American Medical Women’s Association (AMWA) Centennial Conference in Chicago, IL. After attending my first medical conference, I have made it a personal goal to attend at least one each year.

So, was it worth it? In my opinion, it is a definitive yes. I’ll break down some of the pros and cons based on my experience so you can decide for yourself if you’ll be attending a conference (or two) within your medical school years.

Pros

  1. Connections. I can’t go on long enough about how many new connections I made. I met physicians from around the nation in different specialties. I heard from speakers who had written books, gotten double board certified while raising a family of four, and even travelled to the moon (I’m not kidding, Mae Jemison was in attendance). An easy way to stay in touch with the new colleagues you’ve met is LinkedIn. After hearing from them at the conference I connected with them on LinkedIn, which allows me to see what they are doing professionally and keep them in my network for any future communications.
  2. Relationship growth within my organization. The AMWA chapter at my medical school has always been a tight-knit group, but this trip made many of us even closer. It was a great way to get the entire group motivated for an awesome upcoming year. We were able to bond over our favorite speakers and chat about some of the important issues being discussed on the women’s rights front.
  3. Stepping outside of your comfort zone. In advance, the conference paired student attendees with physicians and asked students to meet with and interview the physician. I ended up getting paired with an internal medicine physician coming from the renowned Tuft’s University. I was intimidated at first because she came from such a prestigious university, but she turned out to be incredibly down to earth and friendly. I had the opportunity to talk to her about her personal journey and how being a woman in a once male-dominated field affected her.  She told me a story of when she was involved in a patient’s care when they began coding. As if this weren’t stressful enough, she was seven and a half months pregnant and started having contractions. Womanhood presents unique obstacles, but this physician was able to overcome them with flying colors.
  4. Exploring a city! The conference allowed me to experience Chicago in a new way. We stayed right in the heart of downtown and went on quite a few sight-seeing adventures. Next year the AMWA conference is in Miami, which would be so much fun to visit! Heading out of town for a conference can feel like a mini vacation from the hectic life of a medical student.
  5. Intellectual growth. The AMWA conference placed a strong emphasis on the advancement of women in medicine. We heard from numerous female physicians about their experiences within the field and how they got onto their current path. It was empowering to listen to women who had written numerous books, founded various organizations and impacted society so greatly. Additionally, I was able to hear from numerous female physicians about raising a family and having their dream career. It gave me hope that the life I want is doable. I think this conference truly revitalized my energy after a long first year in medical school. It allowed me to see past the current grueling coursework to what my career could potentially blossom into.
Cons
  1. Money. Okay, to be honest, this AMWA conference was actually affordable, but I know many are super pricey. My advice is to seek funding from various sources. This year I’d really like to go to the conference again, so I plan to set up a Go Fund Me account that will allow my relatives to donate some money to help me attend. Last year, I was fortunate enough to get some money to support my travel. Most student organizations can get some funding from their school, which is what our AMWA group was able to do. In addition, many conferences have grants or scholarships to help students attend. I recommend looking at a few different conferences you find interesting and pick one that is the most economical. Another option is to create a poster (or research) to present and most likely you can get a grant from your school to present it at a conference.
  2. Time. The conference I went to was an entire weekend event, so I wasn’t able to study at all. In the little down time we did get, I wanted to explore the city or just relax for a few minutes. Plan ahead and study during the car (or plane) ride. Check your schedule and make sure the conference falls during a time that isn’t incredibly hectic for you. Even though conferences are a large commitment, the time “lost” I think ends up being an overall gain when you consider the benefits.
I think medical students should look further into the idea of attending a conference. Many of us are hesitant because we think it will just cost extra money we don’t have. I urge each of you to look deeper than the price tag and make a plan to go to a conference at least once during your four years of medical school. To find out more information about the AMWA Centennial conference click here.

Featured image:
Conférence NWX2012 by Frédéric BISSON


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“The Three Ingredients of Medicine” Dr. Myron Cohen, 2015 Commencement Address of UNC Chapel Hill Medical School

This week, Dr. Myron  Cohen’s 2015 Commencement Speech at the UNC School of Medicine entitled, “Becoming a Citizen of the World” debuts via the Medical Student Press.

Screen Shot 2015-10-01 at 9.25.18 PMDr. Myron Cohen is known for his invaluable contributions to the construction of the HIV Prevention Trials Network 052, which established that treating an HIV patient with antivirals makes them less contagious to their sexual partners.

Dr. Cohen earned his medical degree from Rush Medical College, completed his residency in internal medicine at the University of Michigan, and did his infectious disease fellowship at Yale University.

Dr. Cohen is the Associate Vice Chancellor for Global Health, the Yeargan-Bate Distinguished Professor of Medicine, Microbiology and Immunology and Epidemiology, Chief of Division of Infectious Diseases and Director of the Institute for Global Health and Infectious Diseases.

Dr. Cohen’s research work focuses on the transmission and prevention of transmission of STD pathogens. Dr. Cohen and his coworkers have identified the concentration of HIV in genital secretions required for transmission of HIV, and the effects of genital tract inflammation on HIV.

Dr. Cohen structured his speech based on three “ingredients” of medicine that are essential to identify: change, being a citizen of the world and humanity.

“Diseases do not respect borders… Tomorrow -wherever you go- you might well be asked to deal with a patient from West Africa at risk for Ebola, or to make recommendations about measles vaccination.”

He continues by advising graduates to remain compulsive and balanced or the pleasure and significance of medicine may be harder to appreciate. He then concludes with reminding graduates of the privilege they now have of being physicians:

“And with this privilege and recognition comes responsibility: the responsibility to do your very best for your patients; the responsibility to contribute to the health of people in your community; and the opportunity for leadership for the graduates of UNC who will move to communities all over this great state.”

Read Dr. Myron Cohen’s full commencement address.