Thursday Born

The everyday life of a medical student (who was born on a Thursday).

Even Women Doctors are still People Too

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About a week ago I went to a Women in Medicine lunch talk . There were five different women doctors on the panel, and the entire talk was question and answer format. Essentially all the questions had to do with marriage and having children (2 of the 5 did not have children; one could not, the other seems to want to but hasn’t started planning to yet), yet despite that, one of the main messages I got was simply that women doctors are people too, just like women are people, and doctors are people. Women Doctors are not some special grouping of human. Some of them enjoy four months of time off with their newborn babies and hesitate to go back to work. Some can’t wait to be back after just two weeks. Some are single mothers. Some are part-time doctors (one had a ~20hr/week contract). Some are part-time doctors but work full time, doing other things on the side (and not necessarily research, which was cool to see as an option. I really like the idea of doing public health and other community things). They are heads of their departments. They are married to doctors or to non-doctors.

Some of the other things they emphasized:

1) Don’t worry about finding a significant other. You will. It may take till you’re 35 (as in the case of one of the¬†doctors) or older, but it will happen.

2) Think about how much time you actually want to spend with your children. It varies from person to person.

3) A nanny can be a wonderful thing.

4) Don’t pick your career (ie, specialty) based on lifestyle. You can make your life work with whatever you want. (I think this was a bit misleading though. I think the real thing is to know what makes you feel fulfilled and prioritize that, and if that thing comes along with a demanding career, you’ll make it work).

5) None of them really felt that they were discriminated against or had any specific hardships that were because they were women.

I’m always interested in learning what the life of an actual doctor looks like, woman or man, so I really enjoyed the talk even though I didn’t come away with any grand epiphanies or revelations about my future as a woman doctor. I think one of my favorite things to learn about was doing part-time work not just so that you can spend the rest of your time raising children, but so that you can do other non-doctoring things that you want to do.

And before you go, I just wanted to show off my delicious dinner from the other night, through a much better picture courtesy of the camera my parents bought me for my birthday. It’s the newest version of my previous camera, so it’s somewhat familiar, but has some nicely updated features, and all in all, I’m happy with it. ūüôā The fish was a frozen tilapia¬†fillet¬†broiled in my toaster oven with a butter+mayo+olive oil+¬†parmesan¬†+seasonings sauce. Not my usual way to cook fish, but I was wanting something cheesy since a few nights before I’d thought I was going to have pizza for dinner and I didn’t. This didn’t quite get rid of the craving, but it certainly was healthier.

Written by Aba

October 17, 2010 at 11:05 pm

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Staying healthy

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Second year has been incredibly time consuming, and I’ve been cooking less often. There was recently a sale on sardines at Aldi’s ($0.79 a tin!) so sardines and crackers have been a rather frequent meal. ¬†Still, now that I’ve been pretty reliably feeding myself for two years, I’m trying to focus more on eating a proper variety. I do eat pretty healthily, but there’s definitely a distinct daily lack of enough fruits and vegetables. While I’m not a big fan of frozen meals, largely because they get expensive really quickly, I am a big fan of frozen meal components. Above is frozen spinach + frozen broccoli, mixed with paremsean, mozzerella, olive oil, salt, black pepper, about a teaspoon of butter, and a tiny bit of garlic. The result? Absolutely delicious. And in the other bowl is Trader Joe’s gnocchi, which I think I added black pepper and maybe a bit of garlic to. The next day I repeated most of the steps, but no broccoli, and I mixed the two dishes together. Even better!

I even made Ratatouille two weeks ago, which was a great way to get in a nice variety of vegetables everyday. Although I’ve seen and loved the pixar movie of the same name, I was still a little unsure exactly what Ratatouille is. In short, it’s a variety of vegetables, cooked individually, and then simmered slowly together. Seasoning is surprisingly minimal, given how flavorful it turns out; just ¬†some salt, some olive oil, a bay leaf, garlic, black pepper, rosemary and thyme. Mine had one eggplant (well, what was still edible of my eggplant), one zucchini, ¬†two yellow squash, four small red peppers, two or three small green peppers, a tomato or two, and approximately one yellow onion. I loosely followed this recipe, but borrowed some ideas from this recipe as well (mostly, the taking of the liquid from the main pot and boiling it down in a¬†separate¬†pot, to concentrate the flavor without overcooking the vegetables). I unfortunately did overcook mine a bit, because I hadn’t cooked the squash for long enough on their own, but it was still delicious, just a bit mushy and indistinct and not terribly photogenic. I also confess that I probably added way more olive oil than is reasonable, because I tend to be a bit heavy handed with olive oil. It doesn’t help that my cast iron pan really needs re-seasoning.

A few days ago, my friend Amrita sent me an email with a link of simple, healthy breakfast ideas. I hadn’t had breakfast yet and I’d been wanting to bake for a while, so I made the Scottish Oat Scones pretty much immediately. I forgot to actually mix the dry ingredients before I added the wet ingredients, so there was something very slightly unbalanced about them, but they were still pretty good! I might make these again. I’d be inclined to make multiple smaller ones though, instead of just one big large one, and I’m tempted to see what would happen if I let the oats soak in the wet ingredients before adding in the other dry ingredients. I love oatmeal though, so these were guaranteed to be at least a moderate success. They tasted best with my strawberry jam, but were okay with my peach butter. A cup of tea on the side is almost mandatory.

And back on the theme of staying healthy, I’ve started working out, sort of. I generally try to stay mindful of keeping active, and will do little things like trying to take the stairs most of the time (I live on the sixth floor of my apartment building) or walking home from school when the weather’s nice (1.8miles). Although I’ve been fire spinning again and I have a ballroom class once a week, ¬†I’m still a lot more sedentary than I’m used to because I spend a lot of my day sitting in front of my computer and watching lectures and reading notes. So I’ve started the One Hundred Push Ups workout (I’m doing knee push-ups), and I’m also doing Two Hundred Sit Ups. I like them because they’re really minimal and simple programs. I don’t like exercising just to exercise, but I’m finding that I almost enjoy this. Almost. I at least don’t mind it. And aside from missing two workouts last week due to my second older brother’s wedding (which was wonderful!), I’ve been really good about keeping up with it. I’m not sure what I’ll do once I’m done, or if I’ll do anything else, but it’s been nice so far. I definitely am noticing more muscle, which is strange and unexpected, but really nifty. ¬†I had wanted to do their Squats program too, but my knees have always been a little odd and they creak in a way that bothers me when I do squats and lunges. I’m not sure if it’s actually bad for my knees, but I’m going to respect their apparent desire to be left alone.

I’m really looking forward to being done with all this sitting. I like being on my feet, as long as I’m walking around (standing still = lower back pain), so I can’t wait to be in the hospital doing rotations.

Written by Aba

October 12, 2010 at 12:13 am

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Your Doctor Doesn’t Know Everything

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One thing I keep noticing in medical school, is that there is a lot that we aren’t explicitly taught. Yes this is obvious, but… there’s a lot I was expecting to be addressed that I’m realizing is nowhere in the curriculum (at least, not through till second year). There is a lot more that we will learn during third and fourth year, information that can’t/shouldn’t/simply isn’t taught through lectures and textbooks, and that will likely cover some of what I’m noticing is missing. Internship and residencies will take care of yet more information. And once we are properly out in the working medical world, we will still keep learning, because there is always more to know.

But there’s a lot that I think people assume doctors know, that we really don’t. Little gaps that you might think, “Well, she’s a doctor! Of course she knows the answer to this question!”¬†No. Don’t assume that. Not unless the question is, “Is it okay if I take my aspirin and ibuprofen together?” or “What are the major side effects of this drug?” ¬†Questions like, “Do I really need to drink eight glasses of water a day?” or “Is high fructose corn syrup actually bad for me or is it okay like those commercials say it is?” Those are questions that some of us may be willing to answer, but I can’t guarantee that our answers will be right, because we don’t have much more information than you on these topics. A registered¬†dietitian¬†knows much more about food than we do. A physical or occupational therapist knows a lot more about how your body moves and should move and what you need to do to get it optimally functional.

And even in the realm of information that we probably should know, there’s a chance we weren’t taught it. That we never came across a patient with your problem before so even though it exists, we’ve never heard about it or read about it before and can’t immediately help you. ¬†We want to help you, but maybe you’ll just have to be that first patient who inspires us to look a little deeper. Or maybe we’ll fail you and decide it’s all in your head or nothing to worry about and never think about your problem again.

I’ve been coming across this a lot as a medical student. My knowledge is very textbook so when people ask me more practical questions, Do you think this cut will need stitches? Should we ice this bruise?, I’m answering from a similar knowledge base to what they already have. Or I’m using the same resources (the internet!) to find out the answer. I admit I’m more driven to find out the answers now, so if someone asks me something I don’t know, I’m more likely to research it than to say “I don’t know” and leave it at that.

But the answer is always going to be “I don’t know” to some of these doctor-type questions, because I can’t know it all. And neither does your doctor. Trust us, and still ask us, because we do (I say we like I count, but I don’t just yet) have a wide knowledge base to draw from and we might be better able to find the answer. And I think it’s best to trust a doctor who occasionally says, “I’m not sure but I’ll look into it” than doctors who give half answers that show they’re just guessing and they’re not going to bother looking into it later. I’ve had those doctors before, as a patient, and yeah, they’re annoying.

Written by Aba

October 5, 2010 at 1:01 pm

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Block 2 of 6

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Last week we began a new block of classes, the CPR Block. We have Cardio, Pulmonary and Renal Pathophysiology as three separate course, and then in our Pathology course, we’re focusing on these three organs.

And in our Practice of Medicine class, we’re doing a little bit of this and little bit of that, in order to prepare us for our third year clerkships. A nice new addition to the course has been a radiology portion, which is being especially thorough considering they already exposed us to radiology through our Anatomy course. Beyond that, it’s a rather eclectic mix of small groups and lectures and hospital sessions. My hospital sessions have yet to be scheduled but I’m rather looking forward to them. Last year we were in groups of six students, one doctor, and two or three fourth years. This year, it will be just two students and one doctor, and we’ll have to present the cases of the patients we interview, which should be a great learning experience.

Considering that this block is seven weeks instead of three weeks, it’s a little surprising that the course not pile isn’t more than twice as high as the last block’s. I think we’re still missing a course packet though, and some of these new notes are ridiculously dense (and some are ridiculously indecipherable).

Keeping up with all this material has been difficult, especially in the light of my suddenly having a few more extra-curricular activities than usual (organizing ballroom, running the film society until we find first years to give it to, my roommate and I recently found people to fire spin with in this city, and my closest classmate friends now live in the same building. And I was supposed to be stage managing the musical, but it’s looking more like I’ll have to decline the position). I’ve finally caught up with this past week though, and I think keeping up will be easier now that I’m more aware of the fact that my evenings will not be nearly as free as I kept assuming they would be.

Written by Aba

September 20, 2010 at 1:09 am

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Life vs Medicine

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Family comes first for some who have finished residency

Bridging Gaps in Approach to Work, Life

Hiring a Young Gun

The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians
(odd one out article: In this one, it is shown that there is not much difference between the Baby Boomer generation, and Generation X, and no significant gender differences. However, in my post I am mostly wondering about my generation, Generation Y.)

On my last medical school interview, my interviewer asked me what I thought about women in medicine. I told him that I think that it is a good thing to have women doctors, because I think it’s good to have a diverse population of doctors to treat the diverse population of patients. There have certainly been times when I have preferred to have a female doctor, especially when I was child. ¬†However, I can’t really say anything about the larger implications for the field of medicine, and it remains to be see what the overall impact of women in medicine is going to be, and whether it will be positive or negative. He seemed content with my answer, and didn’t say much more on the topic. I half-wish I’d asked him what he thought.

Medicine really is changing. Doctors are changing. There are more women doctors, and women doctors are more likely to work part-time. The new men doctors are also wanting to cut back. Women still do a large share of the housework and childrearing, and men are less content to put work and being a provider ahead of actually getting to know their children.¬†As a generation, Generation Y really values their leisure time, their families, their life. And though we want to be Doctors, this does not negate those traits. This leads to fewer and fewer ¬†doctors who are willing to put in long, hard hours into being a doctor. It’s not that we don’t value medicine. No, we are still eager and we still think this is a noble calling and we want to help people. We just also want to play with our children, and maybe have a hobby or two, and maintain happy relationships with our spouses (who are more likely than before to also be doctors, now that both genders are in the field).

How much will this hurt the patient? How much is medicine going to have to change to accommodate our new expectations? I know for sure that I am not willing to work insane hours throughout my career, and that depending on how demanding my field ends up being, I can see myself switching to part time for a few years and then switching back to full time. Is it wrong that I have taken a spot in medical school? Should spots be preferentially given to people who are more likely to work more hours? Well, what about the MD/PhD students? Trained as doctors but often only spending 20% of their time being doctors and 80% doing research?

Part of the problem is that it is hard to predict who will give the most of themselves into being a doctor. But part of the problem is also, does it matter? Children need to be raised, research needs to be done (aside: ¬†I admit to often being frustrated about the resource divide between what goes into basic science research and what goes into public health and policy, but I’m seeing a trend toward valuing public health as a discipline so steps are being made in the right direction), and doctors deserve to be happy, fulfilled people just like the rest of the population. And medical students in the US pay for their own education, not the government (and therefore the population, ie, future patients), so does the public get to have a say in who is trained? What about as a purely¬†hypothetical, ethical discussion? Is it right to train doctors who will work fewer hours? Is it right to rely on foreign medical physicians to fill the gaps? They may be equally competent, sometimes better, but every doctor that comes to the US from another country, is a doctor missing from that country, and many countries suffer quite seriously from brain drain (I could be accused of contributing to that particular problem).

On the individual, personal level, I want to say it’s all fine. I want to say that it’s okay and in fact right, for my generation of Doctors to work fewer hours because we want to, to share patients with colleagues instead of having to come in during odd, unpredictable hours because we’re tied to a particular patient. I want to say that it’s wonderful that women are about half of the new physician work force, even if they’re more likely to work part-time. Maybe this is the right way to do it, and the previous generations of doctors, with their housewives who ran the home while they were gone most of the time, were the ones who were doing it wrong. Or maybe these are all right ways to do it. Or maybe these are all wrong ways.

Maybe there is no right way.

I’m only a second year medical student, so no doubt I will look back on this someday and think, How naive and ignorant I was back then! But this is what has been going through my mind for a while now, and I’ve yet to come to any conclusions.

Written by Aba

August 30, 2010 at 3:21 pm

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Still sane

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It’s really easy to neglect yourself when school heats up. I’m now down to one week before our first tests, and I’ve found myself trying to pretend I can spend all day needing to study and stay sane. It’s not that I was studying all day, but when you feel guilty every time you’re not studying, that leads to a lot of anxiety. The solution is essentially time management, which is honestly one of the best skills you can learn. It’s not just good for getting work done, but it’s also good for making sure you take the time to play. I’ve had to cut back a lot on the internet browsing I do (and I need to keep cutting back), but as I keep repeating (mostly because I need to keep hearing it) it’s healthy to have hobbies and other things you do for fun. I’ve kept up with my classwork this week which was great, but I spent several days idly browsing when I wasn’t studying instead of doing things I find more fun, like reading or writing in my blog. I need to keep a closer eye on that.

I’ve at least been eating well, which is not a given when I’m stressed. Usually I’ll eat too little. But I’ve been feeding myself for two years now and I’ve picked up a lot of tricks for keeping healthy food handy and accessible. Pictured above has been one of my meals for several days this week. I pre-sauteed (sounds so much better than fried) an onion, a tomato, and some turkish sausage (sucuk), and have been keeping the leftovers in the fridge. Microwave a few spoonfuls of the mix, add an english muffin, an egg, and an optional half avocado, and that’s a pretty filling meal! There is indeed an egg buried under all those onions in that picture. ūüôā It’s seasoned with a bit of salt, black pepper and some garlic (which I buy crushed, because crushing my garlic fresh is just one more barrier between me and a good tasting meal), and I was pretty heavy handed with the olive oil toward the end of the cooking.

Someday I will manage to make a good sunny side up egg (I haven’t yet been able to get all the white to cook before the bottom threatens to burn), but until that day, I am happy with my sunny side downs. I’m not sure why I want to make a sunny side up egg anyway, but I suppose it’s because it’s such a cute, peppy name for a cooking style, and it would be the best way to avoid needing to scrub the pan.

I also recently tried making granola, which is easy (oatmeal + some sort of sweetener + a bit of oil + nuts _ shredded coconut if you want + cinnamon/nutmeg/vanilla, bake at 350 F & stir occasionally, untill golden brown. Allow to cool, then add whichever dried fruit you want. Store in an airtight container, preferably in the fridge), except it’s not easy if you have a fickle oven. First batch burned. Second batch was a bit over baked, but salvageable. There’s a very fine line between “maybe a few more minutes” and “oh no the oven’s smoking!” ¬†The cinnamon made it more difficult to see if the oats had browned yet. Nevertheless, I turned half of it into power bars, which aren’t quite bars, but although it needs to be eaten with a spoon, the end result is tasty and makes a great side to fruit for a lighter meal. My granola was a bit too crisp to properly soak up the moisture and bind together into bar shape; and the nut butters I used had quite a bit of excess oil to start with, so next time I’ll add less oil, but more importantly, I’ll keep an even closer eye on my granola while it bakes.

Pictured next to the granola is my apricot syrup. When you make jam, there will be a point where your fruit will start foaming, and you will need to furiously alternate between stirring and scooping off the foam to avoid a boiling over disaster. The first time I made jam, I scooped the foam into the sink. Big mistake! Save the foam, because it will become a deliciously fruity simple syrup. I’m not entirely sure what to do with it, but I’m happy that I have it. ¬†It would be a good addition to a mixed alcoholic drink, and also a good substitute for plain sugar syrup in an iced tea. I think I’ll be trying the latter soon.

Written by Aba

August 27, 2010 at 9:46 pm

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Into the frying pan

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This is apparently 3 weeks of material... Yikes.

Three weeks worth of Course Packets...

I think second year is the frying pan stage of medical school, and third year will be the fire (note the idiom: Out of the frying pan and into the fire) . First year was difficult, yes, but I am already working harder than I did at any point first year and I still need to up the ante if I want to make High Pass, or maybe even Honors. Yes, we have grades this year. Pass, High Pass, and Honors.  Pass is usually about 70-80%, High Pass 80 to 90%, and Honors above 90%. It varies from course to course, but one consistency is that there is no grade curve. Everyone can get honors, everyone can only get a Pass.

There are six blocks this year, which in a way are mini-semesters, minus the vacation after each one (we have the usual 2 or 3 days for Thanksgiving, 2 weeks in December, and 1 week in March. Plus a day off here or there for a public holiday, but I forget which ones we actually do get off). Three blocks each semester, and our first block is a rather alarming 3 weeks. Well, alarming or comforting. Alarming because, only 3 weeks (almost 2 already!) till our first exams! Comforting because, only 3 weeks of class? How bad could it be?

I still haven’t ordered my copy of First Aid for the USMLE but I really should. I’m unsure what else to get or do for board prep, but I’ll figure it out along the way. I decided to follow conventional wisdom and not study over my summer vacation, so I should be consistent and also buy First Aid and review the relevant section after each block. It blows my mind that in theory, after this year is over I should only need about 2 weeks of hardcore full time + overtime studying to be ready for the test, but I know I burn out easily so again, I’m going to trust the masses and plan on that. I haven’t decided yet where I want to take the test, and more importantly, where I want to hole up for two weeks to study. My roommate Hao has offered to feed me if I stay, but Ahmet has also offered to house me, so we’ll see what happens. I can see benefits to both, and thankfully, I have ten months to think about it.

So far I’ve managed to keep up quite well with my classes (but it’s hard to¬†gauge¬†how well things are sticking in my head). I’m watching lecture videos the day of or the morning immediately after, but even more surprising, I’m consistently taking notes. This is a Big Deal for me, capital letters intentional. I am not, not, a note taker. But I’m making myself one. I finally really tried it during Neuro Block at the end of last year and I have to say it was helpful, so I’m trying to keep it up. It remains to be seen if I’ll use One Note or paper more, but I’ve already switched back to paper after just two days of using One Note. Handwriting is slower, but it’s familiar. And I can draw pictures and write formulas, which is key.

Last year of classroom learning! Time to put 18 years of practice to work and make this the best year of the bunch. Aside: 19 years of classroom learning once this is over?! And yeah, that math is right; I don’t mean 18. I could mean 20 if I wanted to count¬†Montessori, but that feels like cheating.

Written by Aba

August 19, 2010 at 11:37 am

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