Mile 3452: Answers on the Asphalt

Above: I-95 Northbound near Brickell. An overhead shot of this strip was used in the TV series Miami Medical.

FOLLOW-UP PATIENTS
ARE MY FAVORITE.

A patient that I saw a few days ago comes in for a follow-up. He/she looked excited to see me, and that brought a smile to my face. A firm, solid handshake confirmed the camaraderie. A few weeks ago, I saw this patient in a much different state, rather sick with severe pulmonary & cardiac symptoms. Earlier in the rotation, I said to myself that I hated the idea of moving on, and well here was another case of it. The last time i saw him/her, the patient had smoked for more than 20 years and didn't want to quit. Now, he/she was just starting to quit, and I was so proud of the initiative, I had to shake his/her hand. Gosh, I was about to build a good patient-doctor relationship here, and now I have to leave. I started to get to know the patient's family, culture and more, and I would have loved to see the progress that he/she was having to reclaiming his/her own life from smoking...

I'll admit that interaction today was a good ending to a wonderful rotation in Miami. My last two weeks were spent at a more conventional medical center in the Miami area. However, our attending taught us a lot of practicality in medicine while we went through it (why we avoid certain medications, the business aspects of medicine, and just to be more confident in what we do). Now, I know how it feels to start to "want to do everything." I got hooked to treating adults too. I'll admit, that its still early in the game for me, but I hope that a week on the road can give me some answers. Driving has always been my way to think deeply about all that goes around me... There are times I think so much that I just let the dashed white lines in the road come to a blur.

Road? Yup, I'm about to start on a mini-vacation, to be myself for a week (not a medical student), think on the road, and get ready for 12 weeks of Internal Medicine which will take place at Westlake Community Hospital near Chicago. Throughout my trip, I'll be seeing some time at campus I've been at (the University of Illinois and Indiana University), meeting a few folks that helped me to get where I am today, and exploring the world in ways that I haven't been before. It's going to be exciting. However, as much as I love to travel, I miss Chicago. It's my town, Chicago is.

Thank you Miami for a wonderful experience. May the travels begin.

Mile 1125: Writer's Block

Above: The Robert Ross Parkway that runs in front of Ross University in Dominica.

"EASY READING IS
DAMN HARD WRITING."
Nathaniel Hawthorne

One of the reasons I started up this blog is I wanted to get used to writing about myself. And a year later, I feel that I've definitely opened up to the web with my experiences (it's still a work in progress, however). I'm not perfect though, and I'll be the first one to admit it. Here are several bad writing/proofreading habits I'm prone to:

1. The pothole - Some entries I type a lot of stuff, without thinking. Then I'll have a great idea, and think that putting a whole bunch of ideas somewhere else would be better. Ctrl+C... Click cursor in appropriate place... Ctrl+V. Then, my mind will have another great idea... and soon I'll forget I just forgot to fill the hole I just made with something. Well, now you know what happened when I started talking about medicine and probably ended up jumping to talk about potato chips, without a transition.

2. Circumlocution - A strategy I had in trying to talk Spanish rears its ugly head with writing. The concept is that if I can't find a word, I try to word around it. For instance, if for odd reason I couldn't come up with the words "potato chip", I'd probably end up saying "thin-sliced potatoes that are fried." So, if you see some unbearably long parenthetical expression or phrase (that could be defined as one word), this is why.

----

With a whole slew of students starting to write their personal statements for residency, I decided to put my pen to paper (or in the digital world today, more like my hand to the keys), just to see what would come out. Even after months to write about myself, I found it hard to start something. I had many ideas, so many, that I wanted to put them all together. But nothing still came out.

Some people have mastered the art to writing about themselves. To me the challenges are, making sure I can present myself in a concise manner (okay, circumlocution is something I need to work on), selecting the right qualities of myself to present in that short essay, and writing something that doesn't seem like another "personal statement." It's tough to write, but fortunately in the digital age I only need to click and delete, making writing better a much faster process. I won't be killing trees by free-throwing my failed drafts one-by-one into a wastebasket.

At least I know I'm doing the environment a favor. Awesome!

Starting next week, I'll be starting my drive down to Miami, FL for my next rotation for Family Medicine. More on that soon...

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.