Have you met... Ted?

"I FIGURED IF I HAD ANYWHERE TO PRESENT

FAR-FETCHED IDEAS...

ITS HERE AT TED."

I get random links from random people at different times. They fit into one of three categories:

1. Sometimes they're funny (Nik sends to me one just about every day)

2. Sometimes they're important (like the new blogs my friends Neal and Don have set up)

3. Sometimes, they just strike you in ways that you've never imagined.

Yesterday, Shraddha introduced me to TED, through a video that was demonstrating technology that might give us the sixth sense. No, TED is not a person (not a Ted Mosby, or a Ted Dansen, nor is it a hot 3 letter name appropriate for a 80s toy robot). TED is an annual conference that spreads ideas in Technology, Education, and Design. Previous speakers at the conference have included Bill Clinton, Al Gore, Bono and even Bill Gates. However don't think that any Average Joe can attend their conferences live (which requires an invitation or application with annual membership fee of about $6000) What caught my eye was the subheader on the front page of their site demonstrates its effect on the world:

Inspired talks by the world's leading thinkers and doers.

I started scanning the site left and right, seeing if there were any links toward medicine or any videos, and that's when I was introduced to a girl named Eva Vertes. Her talk was called Eva Vertes Looks to the Future of Medicine. When she was 19 years old, she gave this talk about her visions of where Cancer research should be directed. When she was 17, she had discovered important links towards a drug cure for Alzheimer's. For your viewing pleasure, I have a streaming link to the 18 minute talk, above.

It was quite an engaging 18 minutes to watch for several reasons. I was particularly impressed in the way that she drove herself to start researching and seeing how the different molecules of the body interact to cause tumors to move and to spread. If you listen to her lecture, she is able to compress major medical concepts (such as what us medical students have been studying for hours under fluorescent lights & piles of textbooks) in layman's terms. However, what inspired me the most about Ms. Vertes, a Princeton student, was the way that her passion about the material and what she learned earned her a standing ovation at the end. The way that she delivered that speech, really inspired me to get into my lecture notes and study medicine not for sake of memorization or performing clinical tasks, but to understand how the human body works.

To be honest, this site was exactly what I needed. There's more videos from other aspiring leaders, just like the one that Ms. Vertes presented. Like I say... the freedom of thought idea is just so amazing. With that freedom (and the respective motivation), its able to drive people's passions to move further and to things that were so not imaginable before (Ms. Vertes is a clear example). The power of questioning allowed her to find new lines of thought and see problems like one's never seen before. Like Descartes said, Cogito ergo sum: "I think therefore I am." And it seems more and more that thinking more about what I'm studying means I can take my skills so much further. Now, that's what I call motivation for progress.

To me: We aren't in medical school just to be doctors... We're here to move medicine forward.

Oh yeah... Thanks, Shraddha. :P

Riverside Restaurant & Bar

Above: Sahil and myself devouring at the Spring 2009 Fourth Semester Banquet.

KENNY G IS THE

EPITOME OF MUSAK.

I'm a service-nazi at restaurants back in the States. So much to the point where I almost wanted to pull off the trick set on one sitcom...

WAITRESS: "Good morning, I'm ______, and I'll be your server for today."

PATRON: "Oh, hi. I'd like to tell you, I have $10 in my hands today, and I'll lay it out on the table, and if you do a good job, you can have it. However, if you don't do well, I'll deduct a specific amount from the $10 tip for every error you make."

I'm picky... if I don't get good service from a place where I expect service, I might as well end up getting my food from a fast-food restaurant down the street. Well, it's cheaper and I won't feel satisfied (even with good food) if I'm expected to pay a tip for lackluster service. Don't get me wrong... I'm not a dollar-tipper (no matter how good the service, I pay a dollar... I know people like that). I reward quite well for good service. For instance, one time when heading down the interstate to my alma mater, we walked into a Wendy's, and there was a guy at the register who was literally abounding with good energy. He threw out a few good jokes and gave us a good time as we put our order in for Frosties and Jr. Bacon Cheeseburgers. After noticing that speed of service wasn't affected, we decided to hand him a large tip (I think larger than 20% of that meal's value). I'll admit, working at a fast food joint might be tough... BUT, its even tougher to give out good service under the pressure of Dave Thomas & his managerial brigade.

In Dominica, its hard to find ample, satisfactory table service restaurants. There's a lot of counter-service food-court like restaurants (i.e. our shacks), a slowly growing amount of fast-food name brands (i.e. KFC, Subway, and Rituals), and loads of Chinese run operations (good on food, but service, other than being good with speed, isn't much more than that). However, nothing like the good old sit-down American flare. That was until Riverside Restaurant & Bar was open last Wednesday in Picard, Dominica.

You really don't understand.

My friends Jo (Miss Chicken Dinner) and Sahil hit up the joint this past Saturday (and yes, again today, with our missing in action friend Zenny). However, the first time that Sahil, Jo and myself went, the moment we walked into the "orange gates" and right into a reservation table, all three of our jaws felt right at home with the floor.

It was literally a welcome miracle.

We walked in, saw exquisite, fancy furniture, along with universal table settings and center pieces for all the tables, the most professional we've seen in Dominica. And yes, the name of the restaurant tells the truth... its a riverside view that looks quite elegant from riverbank. What sealed the deal was what was coming out of the outdoor speakers... they were playing my favorite Kenny G LP, Breathless. Instead of hearing the car on the street blasting its Soca or Reggae for ambient music, it was the right musak for the dining experience: soothing, but provided enough distraction to provide privacy for everyone's table.

We had to shake our heads to believe it was true.

The service was exceptional (although there was a bug at the end with the lack of the card machine, but because they just opened, it was forgiveable). It felt good to say the words, "Table for three, please." They refilled our water quite, quite frequently (which is usually unheard of around here), and we had four or five people come to our table to check on how we were doing.

We really wished we had this restaurant much earlier in our Ross careers.

Ah yes, I haven't talked about the food yet. So far, I've had the New York Sirloin Steak, Sushi Combo, and Fried Calamari for an appetizer. Each one of these things were quite on par with United States quality food, the steak being juicy and cooked evenly to order, the sushi was as good as it can get in Dominica (pretty well prepared), and the calamari was definitely crunchy and breaded lightly for taste. I have been averaging about $120 EC (~$45 US, with a drink) for my meals, including the 10% service charge (which by American standards is cutting themselves short for the service quality provided). It sounds expensive, but for getting this experience away from home was definitely worth it (they also have some more everyday items available, such as a Spaghetti marinara for $25 EC, almost $10 US).

It really made me miss home more...

I applaud Riverside for setting up that American-like ambience with what they have here in Dominica. The service and the quality of food are definitely up there. Although the pricing prevents the restaurant from being an everyday affair, it is definitely highly recommended for a post-exam night or birthday night out. If there isn't a review yet for this restaurant... let this be the first good review, and hopefully not the last.

Green Yarn

AT PMH, ALL YOU

NEED TO KNOW

IS THE

RAINBOW.

My very good friend Neal, from Champaign, IL asks:

"I'd love to hear about the medical gadgets and technology you're using [in Dominica]. Which do you think are cool? Are there old fashioned devices/new ones?"

On Friday of this week, President Obama named a Harvard professor (Dr. David Blumenthal) to take over the modernization of information technology (IT) record keeping (from the days of paper-domination) in the United States (with a price of about $20 billion dollars). For everyone, I'm sure you've seen those tabular sheets that your doctor probably carries around in a light manila folder whenever you're in the office. When you're talking to him or her, it won't seem like he's trying to actually fill it in properly: He's not circling all the items, using handwriting that's not much better than the output of a seismograph during an earthquake, and not following his mother's advice by writing outside of the lines. That's the issue with record keeping: it's hard to keep it uniform so that when another doctor that gets a hold of the records, he or she can understand your situation.

Well, Neal, you probably are still wondering if I'm ever am going to answer your question, but I mentioned the above to create a dramatic contrast of the level of technology simply based on organizing critical patient information.

Like I said above, it's all about the rainbow. At PMH, record keeping is definitely old-fashioned. When handed a patient's records, I don't get a manila folder here. I end up with a pink (or sometimes blue, or sometimes tan-ish) colored folder that's seemingly constructed out of (go figure) construction paper. Holding together the massive amounts of colored paper that are inside are pieces of green yarn. Inside, the paper forms are definitely consolidated to a small set: Green is usually for doctor's notes, Yellow is for blood tests, Manila is for admission information, and Red (I think) seems to be more admission information. The best part is that there's no standardized chart on the Doctor's / Nurse's Notes. So, aggravated by the seismograph-like handwriting, it makes it more tough figuring out abbreviations or organization of critical information when trying to report back on the patient. As you can tell, Neal, to me, record keeping is one of my biggest concerns with technology for the Dominican Hospital (and to me, probably the easiest to set up: get together and IT department and wire up the hospital).

With that out of the way (and knowing you're an engineer), I think one of the best pieces of technology actually is something I carry everyday. You've probably noted your doctor ask you for permission to look into your eyes during a general check up and he'll flash a light into your eye and look through an instrument right into your eyes. This baby is called an ophthalmoscope. Looking into your eye and visualizing the rear wall of your inner eye (the retina) can be very diagnostic of signs of conditions that plague many of us (i.e. Diabetes or Hypertension). However, the ophthalmoscope I carry around (the WelchAllyn PanOptic, with a more detailed link below), is about 3 times as large as a standard ophthalmoscope you see in a typical Doctor's office. Using refractory technology, it actually gives a Doctor 5 times the viewing field of the rear of your retina than the standard opthalmoscope, allowing someone like myself to catch abnormal changes in your retina more easily.

Otherwise, PMH isn't really fully featured with technology, to be honest to ya. You'll find good, up-to date standards in the operating room (i.e. finger-placed optical detectors for vital signs such as blood pressure and oxygen saturation), also there's standard tech such as X-Rays and (I think a CT machine), but its hard to find even computers to organize patient data or records of who has been admitted in some of the wards. Another stark contrast occurs when noticing that there's no TVs to keep patients occupied as they lay in the wards.

It sounds like technology acts as a detractor to the whole experience, but I totally believe that technology can only be as good as the doctor that uses it him/herself, and the hands-on experience with patients (the people who truly matter) is something I can take with me in the future. Trust me, when I say that the doctors at PMH are absolutely amazing as clinicians and also as teachers, because it's amazing what they can do even without the big-bucks technology we find in U.S. hospitals today. With T-19 days left until I return home, I'll say it before I forget: Thanks for Everything, Princess Margaret.

Hope this answers your question. I'm looking forward to another good prompt (it keeps me occupied). :D

Sources: RedOrbit, WelchAllyn

A Matter of Trust

Above: A view of Dominica just from above the Justin Fadipe center, one of our training sites.

"THIS TIME YOU'VE GOT

NOTHING TO LOSE." - Billy Joel, A Matter of Trust, 1986.

I'm tired. It's 4;25 pm and I'm riding back on a local bus from Roseau to campus. (I'm going to blame Jamina for us taking the bus we never vowed to take again). But the tired that's going through me comes after a day of the ER... it's one of those "motivated tired" episodes. It's only day 2 and I'm already finding myself blogging about my episodes in the ER.

What makes the ER (I mean... A&E) so great? First, as simple as it seems to an experienced doctor, having the ability to do sutures or putting on a plaster of paris (layman's terms: a cast) can be quite amusing to a naive medical student such as myself. From the doctors we've had, we've learned a lot about practicality (i.e. how to make use of what you have). And they've utilized a quality that makes the hospital environment work efficiently... It's called... Trust.

[ Go figure, I'm talking about A&E and there's an ambulance viewable in my rear-view monitor (remember what I said: the bus I'm on won't move for it at all... so it just passed). Okay, gotta quit the addiction to watching ambulances... ]

Yep... TRUST. And the coolest part is that it came in three dimensions today:

1. TRUSTING MYSELF.

Within 30 minutes of arriving at the ward, I already had found myself in gloves with a pair of forceps in one hand, and a suture needle in the other. Mind you, I have had only practiced suturing once in my life (about 5 weeks ago). Our doctor had placed us with a patient with a deep slice on his finger, and with an urgent case coming in, he told us to get started with the patient as he handled this new case. One of my colleagues, Jamina, decided to take help us and say, "He knows what he's doing." Shivers were sent down my spine. However, it was at that moment that I said to myself, I needed to use the knowledge I already had...

In, Out, Loop... Loop... In, Out, Loop... Loop... In, Out, Loop... Loop...

Before you know it... the doctor was in the room approving of my sutures and we had sent off our patient. If I hadn't trusted myself, I don't think I would have made it all the way through, mind you making some pretty hot sutures, if I don't say so myself... :P

2. TRUSTING TEAMMATES

It can be tough sometime, especially if in you're group, you're neck-to-neck vying to perform the next procedure. However, it was done. With one person in the lead of the next procedure, we put our trust in the other person (i.e. Jamina and my suturing, above), it's supportive for the student and not to mention, definitely reassures the patient that everyone's on the same page. Another way that the trust came into play is using them as your "assistants", as Robert took on another incident of drainage of pus from the knee (we get a lot of these... the Dominicans love their cricket and basketball). Before you know it, we all were working on assisting him based on his direction due this previous experience working as a Nurse. With that trust, we learned we could all work as a team effectively to provide proper procedures in addition to making the patient comfortable (I'll admit, I loved giving out my hand to the patient who needed to squeeze to take on the pain of a brutal procedure).

3. TRUSTING STUDENTS

What our attending doctor did was pretty gutsy. Just leaving a bunch of medical students at the start of their career in front of a patient. However, you don't see me complaining or saying that our doctor didn't care. In fact, doing so, I respected him so much more. Why? His trust gave the ER the best learning environment that I have had learning medicine not only at PMH, but also in Dominica. We acted like real doctors, and mind you, doing the history, the physical exam... then writing up the referrals and prescriptions, before having our attending come in and verify our work along with our impressions completed. With that trust, I learned a lot of practicality, because there wasn't guidance around most of the time, but our doctor would always recap the case with us afterwards, so any of our mistakes or issues, would be addressed.

I'll admit, with those three degrees of trust, I felt completely engaged in the hospital environment, and not another one of those silly medical students left to do random, kinda pointless work.

[ Did I tell you about this darn bus... at this point I think that the springs in the back of my seat have gathered a liking for my lower back (and I think they're getting involved in a one-way relationship)... ]

Anyway, you'll hear at least one more day about A&E... this day sets a pretty high standard for the remaining days in rotations at PMH. So far, it's been absolutely rewarding.

---

NOTE: ENTRY EDITED FOR CONTENT & FORMATTING AFTER THE BUS RIDE.

Accident Prone

"YOU HAVE ONE OF THE

NICEST ABDOMENS

I HAVE EVER SEEN."

I've been wondering if I really need to be "up close and personal" on this blog. However, with me trying to be truly honest, I guess I'll have to break through my "comfort barrier." I'm screaming it from the inside... but I'll go ahead and be brave and brute... admitting that I have a horrible habit...

I like to stare at ambulances. :P

I don't know... its something I picked up here in Dominica. Dominican ambulances get so much different treatment than the ambulances found in the U.S. Back in the states, as soon as an ambulance puts on its sirens and lights... everything stops and the red carpet is laid out: The cars move over. The lights turn green. The street is all theirs. However, in Dominica, while staring at ambulances, I've seen the opposite. They sometimes get passed. Cars don't move over for them. And yes, if a traffic jam occurs, its over for the ambulance to get to the hospital.

And then after all that hassle (and time), the patient makes it to the hospital, and that's where I was today :P. Today began my Accident & Emergency (A&E) rotation at Princess Margaret Hospital. A&E is the Dominican equivalent of the ER in the States (along with other lingo differences such as Operating Theatre over Operating Room). Our overseeing doctor had us playing the game of "doctor" from the beginning. We were making out prescription forms, requests for specific labs we wanted, examining the patient and taking histories at our (and okay, somewhat his accord). Think of it basically being in a serious version of Microsoft Doctor Simulator.

Have you ever watched either ER on TV or one of those cheesy disaster films (i.e. Volcano or Earthquake) where a bunch of patients were rushed to the hospital ER after an accident or disaster? Well, I gotta say, we felt a rush just like that, as people started to come in from a bus accident on the main road, and we had some pediatric patients come in with musculoskeletal and internal injuries. Our doctor just kept pushing us forward by saying, "Come on, let's go." Luckily it wasn't anything too serious today... I don't know how I would have handled my first day with the group with many patients walk in.

Today was also pretty sweet, such as learning how to deal more efficiently with getting compliance & accurate information from patients. For instance, there was a pediatric patient with a stomachache that walked in. We questioned if that was really the case... However, using both the mom and supporting the answers from the patients answers with physical exam findings, we took the chief complaint pretty darn seriously. We ended up giving a clean bill of health and declared that that patient's abdomen was "one of the nicest abdomens" we have ever seen. But still we had given some anti-parasitic mediation, just in case.

Other cool things we got to do today were draining of hematomas, pus removing from a football player's knee, and flushing a foreign object out of a bus driver's eye. However, at the end, our overseeing doctor said to us, "Today wasn't the most exciting of days." All of our cases were pretty much straight forward today. So, here's to a week of A&E... our most amazing rotation yet.

The adventures continue...

----

I'd like to thank all of you who've been reading this blog. To those of you who've commented and said good things about it to me... extreme thanks for your support and feedback. You guys are my supporters (and participating) on this, my great medical adventure. If you have a prompt I should discuss on my blog, let me know. I'm always looking for something new to write about or address... prompts are fun. :P

Countrified - The Sequel

Above: March 2007 in St. Louis, running one of my highlights as a RA... The St. Louis Trip.

"TED, WHAT IS THE FIRST SYLLABLE IN

RUT-TINE?"

So here we go again... the question of whether or not the country life is right for me. This time, a debate on living life is something that has been on my mind. Where did I leave off with the last entry?

OH YEAH... being adventurous.

Those desires to do things new... do things differently... explore things all I possibly can... for me, seem to be most associated with urban life. And not to mention, going out and finding adventurous people to do things usually comes associated with city life. Everything from clubbing, to sightseeing, to seeing shows, watching sports (some of these things I've never done if not only once or twice in my life)... things associated with genuine American life.

YOU'RE RIGHT... I can travel. However, there's something about living in the daily aura of active lifestyle that keeps me going. The thrill of not knowing what's behind the corner when driving into the city or even throwing darts at a dartboard to choose a new restaurant to eat at every night. I really appreciate having the desire and the ability to try something new, something different. This is a reason I love the suburbs of my hometown, Chicago (there's always something new, I haven't done yet).

Examining one of the thoughts in my previous entry: It's really not Dominica that's really having me get this urge. And also, don't get me wrong: Dominica has things to do. Okay, you lack a lot of options because yes, it is a third world country, but I've done a lot of firsts down here (everything from jumping off a rock cliff graced with a waterfall right next to it, to yes... eating conch). Sometimes I think its just everyone's dedication into studying that "ruts" my plans to do more adventurous things away while in med school. Sometimes it makes things seem like med school is more like a routine than anything... or like Barney said on How I Met Your Mother, a "rut-tine."

It seems that the country, at least initially, seems However, like I said, everything does come with a price, and I do value very highly the community lifestyle of the country. It also powers me to keep moving and do what I'm doing. However, I want to find a way where I can combine both the aura of excitement with the community of appreciation.

... and the debate continues.

Reality TV

Above: Marshall, Lily, Robyn, Barney & Ted at MacLaren's hanging out on How I Met Your Mother on CBS.

SMART GUYS ALWAYS INVOLVE

THE LIBERTY BELL.

Here's a good question for you... Have you ever just started watching at TV show and found that one of the characters who is on that show is just exactly - with a rare exception - like you? And what drives you along the show isn't just the character (that's a pretty good selling point, I'd say), is that the other characters seem like people you've actually see on an everyday basis in real life?

I think I found that show. (I'm living it right now).

No, it's pretty bad. Not my life... I'm referring to how badly addicting this show truly is. The show is the hit comedy sitcom on CBS called How I Met Your Mother. The Premise: In 2030, a 52 year old man, Ted Mosby, is telling his son and his daughter on how he met their mother back in 2005. You watch Ted's story unfold with every incident with his friends, his family, and his ways of following (assuming that you're starting from Season One, watching episodes).

However, the moment I saw Ted on the silver screen, along with his buddies who traverse with him along this trip: Barney, the womanizer, Marshall & Lily, the domesticated engaged couple, and Robyn, a girl that can easily fly along with the guys. It was literally watching some of the people I run into or I end up closely interact with as friends come into play. All surrounding a guy who is working toward something successful (at least hopes so), who likes to do crazy things, spend time with friends, and yes... do weird things with the liberty bells.

Perhaps one thing that I love about Barney & Ted is that they do crazy things. Barney one time led Ted to go to Philly two, of who they think, are silly girls down... Turns out that they were taken, but the two ended up doing something even better... Licking the Liberty Bell. Sounds crazy, but there's only so much time in life, and nothing better than doing something that is just completely out of the ordinary.

Sometimes I feel that a lot of people in medical school, with the stresses, with the logicality, with the professionalism that comes with it, lose that vibrance and that love for doing the extraordinary. I'll admit that some the things that Ted ends up doing aren't exactly up my alley, but the adventurous things that he does with his friends in the midst of New York City are things I truly admire. That's one of the parts I miss about undergrad and something I'm looking forward to in rotations and the real world, a little more adventure... and little less reliance on safety by not being adventurous.

Perhaps its just a weird way of putting my desire towards being home and having freedom? Perhaps its truly my aggravation of being in a purely academic environment, where the focus of just about everyone is to study. Who knows... but that shouldn't matter. It shouldn't affect my game plan to go adventurous.

Did I ever tell you that I rang the Liberty Bell replica at Disneyworld last year... it might not have been the same thing, but that same adventurous attitude made me reach for the ringer and whip the bell to a loud ring... in a large crowd :P. It's a start. It's time to keep moving toward newer and better things, but it starts with breaking out of the shell.

I'm going to go do some crazy things. Alright, within the limits of life, but gotta remember... form tests, like boards come first... for now.

Quite Frenchy

Above: A typical morning out on the streets waiting for my bus to Roseau (Taken: Aug 2007)

YEARS OF HIGH SCHOOL SPANISH...

THREE HOURS OF COMMUNICATING

IN THE YEAR 1996, I remember sitting in a room with a bunch of my sixth grade peers taking some type of language aptitude exam. Being in Spanish class and getting a head start on the four years in high school was absolutely the chic thing to do. We sat there and all we did was listen to some unknown (and rather obsolete) foreign language come off of the record player, and figure out if we could understand it. OH YEAH, WE WERE KINDA FIBBING WHEN WE MARKED A BUBBLE SAYING WE KNEW WHAT WAS GOING ON...

FROM THE YEARS 1997-2003, I spent 6 years learning Spanish in middle and high school, learning everything from nouns to verbs to conjunctive forms to attempting to learning how to swear (which apparently is hard to do without a student from a truly Hispanic background in your class to whisper it to you behind the teacher's back, as I learned years later).

And then afterwards... I thought it was all downhill... I thought I would never use Spanish practically again!

That is, UNTIL THE YEAR 2009. Week 7 in Semester 5 brings along the OBGYN (babies & female reproductive) rotations for two weeks. Today, we interviewed a patient who had trouble speaking and understanding English & spoke French creole... We knew we had a challenge on our hands. Fortunately, I was on rotations with a pair of Dominicans, and they really pulled out their trump card. Turns out that they're bilingual. However, there's a bug in all of that... I don't speak French Creole (which actually is quite a common finding in Dominica with its French origins), so I found myself always tapping one of them on the shoulder or shouting across the bed to another one of them to ask...

"Can you translate that response back to me again?"

After about 20 minutes of asking that with literally every other question (sometimes a bit of English would actually paid off), I had our patient laughing on her bed. She looked me right in the eye and then told me:

I speaks Spanish...

Now, why would she finally come up with that idea? Is it my hispanic-derived good looks? And my brain went into double-overdrive... I had to start yanking out Spanish from my left and right. Although my spanish was broken at times (putting together a bit of English with a slice of Creole which I learned from the last hour would crack in), I sometimes was able to help get out questions to the patient and our history taking was underway. I would never think I'd be pulling out words like dolor, cabeza, and even conjugate a word into the command form ever again. But I was doing it as it turned out the skills were still there... OKAY, SOME OF THEM. :P

Walking out of that room three hours later (a normal work-up of history and examination of a patient usually undertakes 1 hour), we were tired, but we learned a lot (another one of my colleagues wasn't exactly hot with her creole, but she did a great job as she realized). Not to mention, we all had a good time... our patient was an absolute fan of our looks of flabbergasted-ness (not a word, but you get the point :P). You know, sometimes those semesters or years in foreign language may actually play a key in skill in the future. Also knowing how to handle issues like that with your team can make a big difference in helping out patients who come to your office feel more like they're getting taken care of appropriately.

If I have an opportunity to go out and refresh my Spanish, you know what: I'm going to go do it. No voy a hacer más combinaciónes de "Spanglish." No más.

Oh Captain, My Captain

Above: Robin Williams as Mr. Keating in the 1989 film.

"QUESTION EVERYTHING..."

I just had to watch it. Yes, its the 1989 film Dead Poets Society that you probably ended up watching in English class somewhere between in middle or high school (provided you were born in the 1980s). For some of you that haven't been paying attention to pop culture, this film features Robin Williams as Mr. Keating, an English teacher at one of the best boarding schools in 1950s America. He basically teaches his students different ways of challenging life & what it presents. Although some critics said that the movie was so moving, he "had to vomit," (Roger Ebert), many critics said acclaimed the movie as very powerful. I have to agree with those that fit with the latter. Last night, as I sat down tired after practicing physical exams for my midterm for hours, I decided to pop in the film.

It all came back to me why this film easily fits as one of my favorite films of all time.

My revelation had to come with how it had to appeal to learning medicine. One of the stereotypes of medicine that I had gotten is that it is basically a memorization science. Each and every time I'd sit down and study, it seemed that way...

Tamoxifen... SERM... Raloxifen... Different SERM... [rinse, repeat, and recycle]

Tamoxifen... SERM... Raloxifen... ... ... [snore]

However, Mr. Keating... he brings up a good point while in class. After telling his students to take a look at a new perspective (which he does by telling each one of them to stand up straight on his desk and look down upon the classroom), he tells them to... question everything. I interpreted that as not accepting everything for an answer. From what I've been vying while studying for boards is, that's so true... I can understand things so much better if I place importance on it by questioning it and figuring out, for instance, why condition X causes Ys symptoms. Sometimes I'll let my mind flow and I'll link random things together... like the movie emphasizes: Freedom of Thought.

MEDICINE IS NOT MEMORIZATION... ITS THE ART OF ENGINEERING...

On the other hand, medical students I'm sure can vie for me: we don't have the time to just "art" our way through exams. Nor does it seem possible to cover so much information in such a short time (about two years). We have to know the inside outs of the human body... everything from mechanisms to things that go wrong to parts of anatomy... and we could go on forever. That was one of the hardest things to get used to, was limiting my thought (or now I see it as shortcutting) via memorization so I could get the grade (or just pass), but not getting a full understanding. It's just like that systematic thought idea that I learned in the OR several weeks ago.

In the end, my mind would give up and say something like: So what if Tamoxifen is a SERM... whoop de doodle... (THEN I WOULD FORGET ABOUT THE DRUG)

For those of you who are new to the medical field, beginning in the basic sciences, I encourage you to find a way... a way of thought... to motivate yourself to somehow start linking things medically from the beginning, because that flowing thought is what you're going to see in clinicals... you're going to need that freedom away from memorization, studying from grades, in order to have that true understanding to save that patient.

I everyone had a Mr. Keating in their med school career. To teach students to be thinkers (by teaching them how to think) and to teach students to understand (and not just get the material). Then, med school wouldn't just be flash cards and powerpoint slides anymore... it'd be like painting or creating your own vision of the human body. And with that, the field of medicine, as I see it, could be yours.

For some odd reason, I hope I can be in the position in the future to help med students see things that way... provided that I master this skill in medical school.

In that way, I want to be a Mr. Keating.