Shortie: How I Truly Blog

"HOW EXACTLY DO YOU BLOG?"

... is a question I have been asked by some of my readers. Well, here's a true screenshot of how I get my uploads onto Blogger. For more, click on the image.

(And yes, I do turn on my Doogie Howser, M.D. Theme music as I type).

The Iced Coffee Property

Above: A motivational graphic provided courtesy, Dr. James F. Catroppo, Ross University.

Becoming a doctor requires a lot of sacrifices... time... effort... but the most significant sacrifice of all was brought up by a late New York Times article...

"... A TEMPORARY LOSS
OF THE SENSE OF SELF."

We'll get to that in a second.

Saturday. I need to take breaks. Some of the latest research has said that taking breaks is actually quintessential to remembering and organizing material (the brain does some subconscious file-sorting thing). Or, sometimes I could just be using a break to push back studying the next 70 psych drugs I need to memorize. So, I have one of three choices:

1) Stand up, grab some random book on the shelf that looks interesting, and read it.
2) Sit at my computer and Facebook and Gchat away.
3) Stare at a nearby window and start daydreaming about being outside.

On Saturday Night, I was at one of my local Starbucks, so #1 really isn't an option, and #3 was already next to me (the Starbucks next to me has some amazingly giganormous windows), so #2 was up my alley. After strumming along, I notice that my friend Cathy posted up an article from the New York Times, with the following title: Taking Time for the Self on the Path to Becoming a Doctor.

I started to read, getting the main gist of the article about the sacrifice and how us medical students embrace that sacrifice to have this sense of disconnect between our professional and our personal lives. Let's back it up a step, and put it in less technical terms. The article acknowledges through a John Hopkins University School of Medicine research study that although medicine is a time and resource demanding job, finding that appropriate time to spend with family, enjoying hobbies, and enjoying time with self, will lead to less burnout in the future.

(The article put it dramatically with the sacrifice as stated above... LOSING MYSELF? I CAN'T LOSE MYSELF!)

I learned that disconnect between was a horrible thing back in Undergrad. My friend Neal taught me that I need to be in touch with my personal self, by doing a lot of the things the Johns Hopkins' study provided and by spending that quality time with me. However, through the Illinois Leadership Center, I also learned that introducing personality and embracing a job as a "hobby" of one's own allows for a gratifying crossover between the two seemingly separate worlds. I think that both are critical for maintaining my morale.

When I was done, I looked up and there was a perfect example of how to accomplish some of this... right in front of me.

Sunday Night. I go to many coffeehouses in my area. There's some with free wi-fi, some with comfy leather chairs, others that serve time-saving lunch and dinner, and even some with all of the above. Like I said before, I can't study at home. However, this one Starbucks near my house has one characteristic that all the other coffeehouses, even other Starbucks, didn't have.

I'm observing one of the baristas, Adam, and how he interacts daily with customers, such as myself:

"Hey, how you doing today?"
"Great! How are you doing?"
"Doing well. What can I get you started with today?"
[Insert customized Starbucks order here]
"What are you guys up to tonight?"

And through this, he started a conversation learning a few things about what people get to do on a staurday night, and all with a genuine smile that says, I'm enjoying my job. I've seen him have a great dialogue on race and the suburbs with several people who just walked in, and even talk about computers with a guy who set up his own office in the corner of the shop. And on Sunday night, he came and talked to me about medical school. As I kept watching, I felt that same aura of the rewards he was reaping through simply talking; it was that enjoyment of getting to know people.

Don't get me wrong though, he was still getting his job done (and well, may I say), cleaning up floors at appropriate intervals, taking customers up as they were walking in the door (even mid-conversation), and even putting bags of coffee on the shelf appropriately. His interactions with his co-workers were also noteworthy (with Adam and Chaz at the counter, it can get quite entertaining).

You know, he could easly be a Barista who:

1) Did his job, day in and day out, not caring about the interactions with his customer. (Burnout in the forseeable future, no?)
2) Talked and talked, but never did anything for his job. (Just a talker, not a doer.)

But he was neither. He did something what many doctors can't do (combine doing their job while enjoying learning from their customers)... in a coffeeshop. And thus, with this, I name the following The Iced Coffee Property.*

"To live every day of my life with medicine, a day I don't learn just more about the science itself, but to also enjoy learning from the people who I take care of everyday, not just about medicine, but about the fulfilling lives they live. And to encourage them to live their life to their fullest, through encouragement and through allowing my personality to penetrate the job."

And there, folks, is my hobby, my way of envisioning crossing my personal and my professional life... a way to make sure that I live my love for medicine, while satisfying my thirst for always learning something new. For those of you who struggle with the idea that medicine is a burnout field, go grab some iced coffee. Then you'll see.

Source: The New York Times.

*Named after my regular item on the menu: A grande iced coffee with nonfat milk, and sugar-free vanilla sweetner. I have to watch my calories you know.

Blue Collar, Blue Scrubs

Above: Michael Collins, author of the 2009 book Blue Collar, Blue Scrubs.

"BELIEVE IN
THE SYSTEM."

I needed some inspiration... but we'll get to that in a second.

Two weeks ago. Just past nine in the morning, central standard time, I'm walking up to my standard desk at a local library, and oddly enough, a plastic placard was standing on it. I knew it wasn't there yesterday, but my mind was eerily perplexed why of all desks, my desk, had to have a placard on it. After laying down my bookbag on the floor, my eyes zipped right to the title heading the advertisement.

"A Night with Dr. Michael J. Collins, M.D."

Doctor coming to speak? At first I thought, meh. Well, I kept reading the mysterious placard for more... It was then I learned he was a construction worker, then turned medical student, then turned Mayo Clinic resident, into a distinguished orthopedic surgeon. He was there to promote his new book, Blue Collar Blue Scrubs, a story about his experiences before and during medical school, a transition from working in construction to medicine.

Whoa, I thought. Mind you, at this point I've been days into studying for the boards. The books were starting to get to me... I needed some inspiration to kick me back into gear.

So, I signed up.

Last night. As usual, things never go as expected. I always thought 15 minutes to my library would be just enough time to get there (it usually takes me five). Unfortunately, storms in the area, and an accident down the road, almost made me tardy for something I was really excited to go to. However, as soon as I got into the library's meeting room, dripping wet from a failed dry-dash across the parking lot, something surprised me about the audience.

Not a single med student.

In fact, I probably was the only patron under probably about the age of forty in the room. I sat in the back row, and patiently waited for Dr. Collins to make his entrance, starting to wonder if this was going to be a presentation that would be exactly tailored to me. I have material to study, my time is quite a commodity right now.

It turned out to be a well-spent 45 minutes in that room. My eyes were glazing up, watching him as he read a few passages about his experiences from transitioning from construction work into medicine, and then as he lived a life that... well was quite similar to one that I'm leading right now. Here's a few highlights & quotes:

---

He said: "It's easy to fall into something and just drift along."
It's so true. Collins was referring to him choosing to go into construction initially, and enjoying it. See, it wasn't until he had an "epiphany" wondering how he could do something useful and good with his life that he started thinking about the medical field. To me, I saw this quote as referring to my tendency to believe its just easy to pass exams, and be satisified with just passing. I'm just drifting along medical school... but to improve, there's gotta be a challenge: the academic challenge to get out of the rut of just passing.

"Who wants a 25 year old beer guzzler in their medical school?"
Collins was referring to his doubts about getting into medical school when the idea came along. He overcame that doubt to get on the track of where he is now. Quite, quite impressive.

"Work isn't painful, it's rewarding."
So true... us med students gotta remember what we're here for, and it'll remind us that the work that we put toward it is all worthwhile.

"If you love enough and care enough, can't we get through the obstacles that get in our way?"
Sometimes I end up thinking like this if things don't work out. However, I'm glad that I'm not the only one pulling up those doubts sometimes. With the rigor of medical school, its hard to see sometimes when the obstacles end, and it goes back to one of the themes of Collins' book: Hard work results in accomplishments.

"Believe in the system."
During the question and answer session, I raised my hand. Upon his eye contact, signalling that I could ask my question, words came flying out of my mouth... "Understanding that a humanitarian drive called you toward medicine, when you were in the first years of medical school, faced with the loads of scientific and non-human seeming information, how did you get through it all?" After a deep pause, Collins said he didn't like the first years of medical school and compared it to a kid in the library carrying 30 books in his hands (so true). But he said that believing in medical education carrying students through is what got him through. I'm thinking about finally putting some trust into it too, even though it may be hard at times to do so.

"There is nothing like medicine."
The man's interest in medicine resonated in his voice when he said this to the crowd.

"Keep the faith."
I got a second chance to shoot another question at Collins. This time I asked, "Looking back on your experience years later, if you had one piece of advice to give a medical student, what would it be?" I felt a drop of sweat plop against my skin after the question, as one of the ladies in the audience told someone next to them, "He must be a medical student." When I heard that, I'll admit that I kind of laughed under my breath. However, again, with a deep pause, Collins replied back to me that simple quote. He then said, "As medical students, you come in idealistic... as residents, you might come out cynical." True, medical school can do so much to the students that are in it (I think I see some cynics already :P).

---

At the end of all this, I can see some of you saying... Yeah, anyone can say any of that. True, but with these quotes coming from someone who broke through the obstacle of a non-scientific background to become a distinguished physician... to me, it means so much more. I'm now ready to hit my notepads and books once again.

I'm looking forward to reading Dr. Collins' Blue Collar Blue Scrubs... but for now, I gotta believe in the system.

Shortie: Family Values

Above: No other great family gathering than getting around greasy Chinese food.

Last sunday. I'm at one of the nearby Chinese buffets (which by the way are unbelievably unhealthy, but yet so irresistable). As my mom and dad are I having some healthy conversation on what's going on in my mom's workplace (which is always pretty entertaining), I look over and there's a pretty attractive girl sitting there with her family. There I am... staring... actually getting kinda distracted (okay, horrendously)... and then she pulled the ultimate turn off...

She yanks out her cell phone and starts texting in the middle of a family conversation.

And she keeps texting... and texting... and texting... Minutes pass by; minutes that I see precious enough to spend with family. Quite disgusting, if you ask me.

Folks, I'm not even close to married yet, and It feels weird to already have these warning lights flashing. It's just that the coherent concept of family is so important. I just can't stress the importance from family being the indestructible backbone of support to their kids to families keeping open channels of communication. And, how can I speak of this? It's because I experienced how critical family support has been in getting me to where I am right now.

In a world where communication devices (cell phones, e-mail... Twitter?) can bring people together and make the world a smaller place, I can see how they can easily take families apart. No: I'm not wishing every minute to be family-centric, as every teen should have the right to go hang out with friends and be young. Nobody's young forever, you know. However, in a society that's getting busier every minute and won't stop for anyone, I believe its definitely rewarding to give a few hours to have that quality bonding time with family.

Remember: your mom and dad's clocks are ticking too...

What's really behind your decisions?

Above: Ming Hsu, according to LASNews, one of the pioneers in a growing field called NeuroEconomics. Picture courtesy: Illinois Today.

One thing that I love about the University of Illinois at Urbana-Champaign, my Alma Mater, is the loads of Alumni publications that I recieved from the land-grant university, established in 1869. One of them comes from the college that my major (Integrative Biology) belongs to, called LASNews (LAS = Liberal Arts and Sciences). In it are loads of articles with updates on how the school is doing, what research is going on from the various fields in the college, and not to mention, the classic requests for giving back to the Alma Mater.

The front cover of this semester's magazine had a picture of a brain CT scan, with a stash of cash superimposed on it. The headliner goes something like this:

"Money on the Brain: THERE'S A LOGICAL DECISION WHY WE SOMETIMES MAKE IRRATIONAL DECISIONS - ITS HOW WE ARE WIRED."

Economics, to me, is quite an interesting subject, as it can be related to every single day of our lives. Why? At least in high school, I learned that the field has a lot to do with how we consider the benefits and costs of decisions in order to make them. Ming Hsu, as featured in this article took this decision making further: looking at how different parts of our brain contribute to that decision making.

As medical students: our dip into neurology involves which parts of the brain affect different aspects of how our body is regulated, everything from the involuntary (breathing, heart rate, sensation) to the voluntary (movement of our limbs). However, most of the neuropsychology research that I did in undergrad really didn't make the cut toward the medical curriculum.

The brain is one of the most perplexing things known to man. We know already that there are centers for many of our different brain functions, such as the amygdala for our emotions, our hippocampus for creating new memories (go rent Memento, one of the most realistic examples of amnesia on the big screen), and the hypothalamus, which regulates many of the processes that go on within our bodies without us even knowing it. Even broader areas of the brain have been loosely defined, such as the left side, for most of us, the center of calculation, while the right side of the brain has been shown for more abstract, artsy thought.

Through a use of various neuroimaging technologies (where basically the brain lights up as different colors depending on how active each part is) and putting people through standardized decision making (such as the reknowned economics ultimatum game), Hsu can see how different areas of the brain contribute to our daily tasks of making decisions. By combining economics, neuroscience, and psychology, he has become a pioneer in a new field called neuroeconomics.

I'd love to see what conclusions Hsu has... maybe finally after some type of traumatic event or neurodegenerative disease we can have a better idea how decision making may be affected. We know that some diseases affect specific areas of the brain. Who knows, perhaps it will be more comforting to the families of brain trauma patients, if clinicians could give them a better idea of what types of cognitive challenges their loved one may face. They would know when the decision was considered appropriately and when exactly to assist in making appropriate decisions, allowing the patient a degree of independence & confidence (instead of thinking that every moment their loved one was incapable of making decisions for themselves).

With a little predictability due to neuroeconomics, us clinicians could make life a little less frustrating for patients and their families.

Source: LASNews Magazine, University of Illinois at Urbana-Champaign.

Humble Beginnings

Above: A doctor making a quiet appearance in Robert McCall's mural Reaching for the Stars, 1982.

"EGO IS THE BIGGEST
ENEMY OF HUMANS."
-- The Rig Veda, a collection of over 1,000 hymns, which contain the mythology of the Hindu gods.

I don't know if it was truly planned this way, but I think that Ross gave me a neccesary humbling view of the medical profession...

A few weeks ago... During COMP studying, I was sitting in my typical spot at one of the public libraries. While working on questions, I look up and there was one of the people I went to high school with (keep in mind, long story, but high school wasn't exactly a Cinderella story for me). When I looked up she was about to head in another direction when our eyes linked, and the first thing that came out of my mouth was, "Hey!" She walks over and says "I see you're studying for the Step too." I knew that she went to a U.S. Medical School, so I told her about how Ross gives us the COMP, how I'm away from Dominica now, and the nine-yards about coming from a Caribbean Medical School. The whole time I could tell she had one of those smiles that kinda was put there for kicks. When I finished, all she could say was "Good luck." I wished her the same, and she walked away.

I turned around back to my computer screen, thinking, "Wow, she seemed really snotty."

For those of you unfamiliar with the medical school stories, in short there's definitely discrimination of us Caribbean students pitted against the traditional US student. Our programs are virtually the same in many manners, from organization, to class structure, to topics taught. There's not enough space to fit all of us future doctors in the states, so Caribbean schools were opened, one of the first for this purpose was Ross University in 1978. Although there are many similarities, that "I'm better than you" sentiment has been felt and seen with many of my friends interacting with US Medical Students at residencies and rotations. However, the feedback has been good for us Ross students, with many of our rotation sites saying that our performance has been equivalent or better than U.S. students.

So there :P. But I'm not here to get egotistical about our performance, for a reason.

Going to Ross has made me think retrospectively: had I gone to a med school in the states would I be acting the same way to someone who hasn't made it into med school? Would I be acting the same to my friends who went to a Caribbean med school? I'll be honest, I don't know. But what I can say is that being in this position has really taught me that, no matter who you are, Caribbean or US Medical Student, we're all in the same boat right now: about to take one of the most important exams of our lives, the Step.

Yes, going to a US Medical School is quite an accomplishment, as getting in over thousands of students is no easy job, but in truth, wearing that ego may do more damage to the profession than one may think. We're all going to become doctors, we all have the goal to help the health of the human race. Who cares what school one went to: a respectful sharing of knowledge, fighting for the patient, and effective teamwork is what us doctors need to do to carry medicine forward. When working separately, and not sharing knowledge appropriately, who knows if our decisions are the best ones made or if we overlooked a detail or two? How about encouraging other doctors to perform their best, even if it may seem bettering others than ourselves? Our pride as doctors should, in the end, benefit our patients not our ego.

To me, an ego can only stand in the way of taking care of our focus: patients. An ego won't get any of us closer to our goals as doctors, will it?

Being Positive about Thinking Negatively

Above: Atul Gawande in surgical scrubs (From the Harvard University Gazette archives).

"NEGATIVE THINKING MAY BE EXACTLY WHAT WE NEED."

In the eyes of a positive thinker... that quote shocked the hell out of me!

Atul Gawande, one of my inspirations behind starting up this blog, is one of my favorite medical authors. I've read two of his books, Complications and Better. They deal with the essence of medicine's imperfections and how doctors maximize their own performance, respectively. Through the books, Gawande's excellent narration guides the reader to feel like he/she is in the action, actually holding the surgical instruments and under those huge, bright surgical lamps in the operating room. Also via adding appropriate detail, he also sets the aura and emotion (for both doctors and patients) that makes every medical situation exciting and unique. I read his books to remind me of the excitement the medical field whenever studying pages of raw material in my review books starts to make me feel all punchy in the ole' noggin.

As I was scanning through Gawande's site a few nights ago, one link caught my eye. In a 2007 New York Times article called The Power of Negative Thinking, Gawande describes the need for antagonistic-like thinking. He uses the then-current controversial situation at Walter Reed Hospital to describe two-sides of hospital care there: how staff before and during medical treatment were taught to negatively think, while post-treatment, staff kept their positive thinking. The results: deep analysis of problems that patients had resulted in better treatment, while all who thought that everything was "A-ok" in the rehabilitation process ended up harming the patients down the road.

Gawande's right. It is discouraging to think negatively for ourselves; most of us want to think positively to get through things (sometimes to even avoid them, I think). It's easy to avoid wanting to think that there's imperfections within us... I could see how for a perfectionist that thinking negatively could lead to what Gawande calls "a state of perpetual dissatisfaction." (Just imagine every moment of the day leading to some type of criticism... disturbing!) However, let's spin this idea positively: how do situations improve if one doesn't know the imperfections to look at? Progress of humanity doesn't come without changing a few things around, especially obstacles that block getting to goals. It seemed like Gawande's ultimate point was this: without thinking negatively in business or humanitarian situations, loopholes can be missed, resulting in failures.

After reading this article, I can see how the two opposites work best hand-in-hand. Through negative thinking, issues that need to be addressed can be identified, but I believe it is through a positive (and forward) attitude that they'll be actually be addressed (and addressed well).

Put the yin and the yang together... and there's one of man's greatest gifts: critical thinking.