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Throwback circa 2008.

order generic neurontin I recently came across a very candid reflection I wrote during the summer following my sophomore year of college and thought I would share. I had just completed the Ruth and Vernon Taylor Fellowship, a summer program that enables select Macalester students the opportunity to explore the work of multiple healthcare professionals in various clinical settings to compare questions of interest as the students discern whether a career in healthcare is right for them. For me, it proved to be a momentous occasion and a truly life-defining experience.

For as long as I can remember, I have always held one desire very close to heart: to help others in need. The older I get, the more I realize just how many ways there are of doing so. Medicine would act as the perfect medium. But in order to practice medicine, I would have to take very challenging science classes, spend countless hours studying and preparing for the MCAT. Then I would have to go through the whole application process yet another time, not to mention the actual going to medical school part, which would consist of even more studying, loss of any hope for a social life, and the acquisition of the inescapable smell of cadavers filling every orifice. Only then, after four years of additional schooling, three years of residency, followed most likely by a few years of specialization, would I finally become a doctor. Long story short, it takes too much time and effort to utilize medicine as my choice medium for helping others. Sure, I have what it takes to become a doctor. I am gifted intellectually, am driven and passionate, meticulous, perfectionistic, and somewhat obsessive-compulsive. But just because I have what it takes does not mean that I therefore have to become a doctor. I should not have to sacrifice a significant percentage of my life in order to help others; there must be an easier, yet satisfactory, way of doing so, one that takes less time and effort on my behalf.

I hate to admit it, but this was the actual conclusion I had reached midway through my summer fellowship. By that time I had shadowed a gynecologist who owned his own private and highly exclusive clinic. I had also spent several hours at the county hospital, working in the emergency room, high-risk clinic, and in the labor and delivery ward. While I thoroughly enjoyed my time spent witnessing the miracle of life, at a mere five inches away, spending time with doctors who possessed more passion and compassion for all patients they encountered, I still convinced myself that the time and effort that these doctors had to sacrifice far out-weighed any good feeling or experience that could result.

I held tightly to this reasoning as I walked up to the University Medical Center. I was to spend the last few hours of my fellowship in the Pediatric Oncology-Hematology unit and in the Pediatric Blood and Marrow Transplant unit. While my first day began dwindling away, so too did my grasp on my previously tightly-held reasoning. By the time I arrived home, my outlook had completely changed. And I realized just how selfish my reasoning had been. Here I was, healthy as can be, dictating how I was to spend my time and deciding that, while I wanted to help others, it took too much time to be a doctor. Meanwhile, kids my age and younger were cooped up, sick, in aesthetically displeasing hospital rooms, putting their lives on hold for something that was completely out of their control. And they had no say in the matter; they were being robbed of their own time and their own life and they couldn’t do anything about it. And yet, I sat there thinking that I didn’t want to become a doctor because it took too much time. I sat there, privileged beyond means and yet didn’t want to help these kids, these peers of mine, because I would have to sacrifice too much of my own time.

Well, turns out that time is now the sole reason why I want more than anything to become a doctor. If I can spend my time so that others no longer have to be robbed of their own, I would not be losing anything; but rather, I would be gaining more than I could ever hope for.

I want to make a difference in this world. And I want to do so by providing others with the life they deserve. I don’t want anyone, young or old, to have to put their lives on hold for something they cannot prevent, when I have the opportunity to prevent it. And more importantly, I don’t want anyone to have to suffer alone. Medicine is my choice medium for helping others and I am so grateful to the Taylor Fellowship for allowing me to finally see the path that is before me.

Rotation 2: Dermatology – In the Eye of the Beholder.

During the summer following my first year of medical school, I had the opportunity to participate in Camp Discovery, a program that offers a unique summer experience to young people living with chronic skin conditions. After spending just a few days with the campers, my eyes (and heart) were opened and I realized just how narrow my original view of “dermatology” had been. While no one can deny the high prevalence of acne, it is but one of more than 2,000 skin conditions. The amazing young people I had the privilege of working with live with skin conditions far more complex and devastating, and, as a result, suffer from higher rates of psychological distress, social withdrawal, lack of confidence and depression.

Since my summer experience at Camp Discovery, I have spent a lot of time reflecting on the visual indications and ramifications of disease. More specifically, I have been intrigued by the subtle difference between wearing signs of disease for all to see (i.e. an insulin pump for a diabetic, a midline scar for someone requiring open heart surgery) and disease actually being what you see.

Throughout the course of my 3-week dermatology rotation (a rotation not originally in my schedule but added at the last minute due to my recent, newly discovered fascination in procedural-based medicine), I had the opportunity to further explore this idea of disease actually being what you see. Unlike the majority of specialists, dermatologists (as well as pathologists and radiologists) are unique in their heavy reliance on pattern recognition in order to establish a diagnosis. In other words, dermatologists see a pattern with their eyes; they use the morphology of the primary lesion as well as its color, pattern of configuration and distribution in order to recognize and diagnose the 2,000+ possible skin conditions. As 25 skin conditions account for 75% of all office visits, arriving at the correct diagnosis 100% of the time is not as easy feat; it takes a certain eye to be able to recognize something you may have only seen in a book, once, at some point in time.

While I enjoyed working with the dermatology residents, learning how to use my eyes and the patterns I saw in order to diagnose actinic keratoses, basal and squamous cell carcinomas, seborrheic keratoses and psoriasis, I found I was more interested in the process and in acquiring the skill than in skin itself. Although an incredibly useful rotation and one I would highly suggest, dermatology might not be the right fit for me. But only time will tell!

THAT Moment.

Have you ever had that moment? The moment when you feel like the world can’t shake you, can’t move you from that place because you are so sure, so confident that you are exactly where you are supposed to be?

I think it was a Thursday. I had just come home from a run and as I was standing in the kitchen getting ready to make lunch, I was flooded with an overwhelming sense of peace and excitement. I knew for a fact I was right where I was supposed to be, doing exactly what I was supposed to be doing. I was in the midst of studying for boards – 3 weeks in with 3 weeks left to go – and realized I was in my element. I was working hard, putting in long hours, but it was worth it. I was in my happy place. Studying so that I could one day use the knowledge I gained to save someone’s life, change someone’s life, improve the quality of someone’s life.

But then I saw this face:

Jack

And I immediately began to question that confidence and all those hours spent studying because HE is my happy place. We play trains and talk dinosaurs; he tells me he loves me from here to Pluto. And there is no place I would rather be than in that moment with him.

It’s a hard realization to have – to discover that you can love two things so much and feel so confident that both are the right things for you. I keep telling myself it will all be worth it in the end. But in fact, I must tell myself that it is all worth it right here and right now and in THIS moment in time. Because no matter what I find myself doing, I am but steps away from my happy place.

Rotation 1: Surgery – the Perfect Combination of Exhilarating yet Terrifying?

This is it. The moment I have been waiting for. The moment I have been working toward for 4 years of undergraduate, 2 years of medical school, and 6 weeks of studying for 6 days a week, 12 hours a day. The moment to be in a hospital, on a team, with actual responsibilities.

I was ready, excited, and utterly terrified.

I spent the first two weeks trying to figure out how to get into (and stay in) the OR without getting yelled at, i.e. figuring out how to scrub, gown and glove appropriately, how to move around the OR without contaminating myself or something else, how and where to stand so as to not be in the way but to also be able to see, how to not fog up my mask – the list goes on.

Then came the surgeon’s questions – sometimes about the patient or the procedure being performed, indications for surgery, possible complications, and post-op care; sometimes about completely random topics, both medically related and not. Bottom line, I had to constantly be engaged.

But at the heart of it all was the actual surgery itself. As a person who appreciates detail, is driven by meticulousness, strives for perfection, craves order and control, and thrives under pressure, surgery is a truly beautiful thing. For patients to place complete trust in surgeons and for life or death to be so close to their fingertips, surgery is also exhilarating yet truly terrifying.

Despite the long hours, early mornings, my initial OR anxiety, and the nerve wrecking question-answer sessions, I woke up every morning excited to start the day. While my role was small and my responsibilities quite minimal, I felt privileged to wear those blue scrubs and to be considered a member of their team – if only for 6 weeks.

Take 1

For six years of high school, I believed that there was one right way to live. As my school’s motto was to “discover truth, practice goodness and create beauty,” I read each great work of my classical education, from Aristotle to Dostoyevsky, Jane Austin to St. Augustine, searching for the one person who had all the answers. The one person who would tell me how to live a good life the right way. It wasn’t until my senior year when I came across John Stuart Mill that my perspective began to change. Mill described the acquisition of truth as a head-on train collision. By colliding two notions of truth, Mill explained that you can then sort through the remnants to put together some semblance of a better whole. That is, while no one person possesses all the answers, if you continue to allow your ideas and beliefs to be challenged by others, then you can piece together a greater, more complete understanding of the world – of its truth, of its goodness, and of its beauty.

I have come a long way since high school. And after spending my college years at Carleton and Macalester, I have since come to realize that there is an infinite number of ways to live a good life. So the question becomes, not what does my life need to look like, but rather, what do I want my life to look like?

At the moment, my life is consumed with family and school. My husband, 3-year-old son and I are quite inseparable. And my medical studies are in full-swing.

I can tell you where my life is headed but I’m still unsure of where I will end up. So the purpose of this blog becomes two-fold. The first is to somehow contribute to the train wreck – to discover truth, practice goodness and create beauty. The second is to use knowledge gained through reflection – to approach this next phase of my medical school education keeping the ultimate goal of leading a good life in mind.

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