It is true. I am surviving final exams, but as is evident by my lack of blog correspondence, the weeks leading up to finals have swallowed me up into a see of studying and a whirlwind of academic intensity I have not yet experienced.
What has happened in the last few weeks? There are some highlights:
1) The student leaders of the Healer's Art course, along with the faculty leads, met for dinner at a faculty member's house (Dr. Feldstein, the director of the class). We ate yummy sushi and reflected on the course - what went well, what didn't, and what we would like to see in the course next fall. Most of our conversation ended up focusing on the role of Stanford Medical School in training us to be the leaders they claim they want us to become. There was a lot of discussion about how well the curriculum does or does not support the med school's mission and what could be done to change it. It was a lively evening, that's for sure!
2) The rest of that week revolved around studying for my Biochemistry exam which I took on 12/2 and I passed. Glad to have that over with, but boy oh boy, getting used to a pass/fail grading system at a place like Stanford is quite tricky. I still can't wrap my head around it.
3) After our Friday final, the med school encouraged us to celebrate by offering open-bar at a local Palo Alto hot spot - The Patio. I think approximately 75% of my class was there to join in the festivities and celebrate completing final #1 of 6. Wahoo.
4) Alex and I ventured out to Big Basin State Park (on the west side of the Santa Cruz Mountains, southwest from the Palo Alto area). We went on a 4 hour hike through big redwood forests and we learned why Big Basin is called Big Basin. It was beautiful and it gave me a nice chance to 'reset' before I dove into studying for finals.
5) On Wednesday (12/7), I had a final exam for the clinical skills portion of my Practice of Medicine course. I had 20 minutes to interview a standardized patient, with the goal being to take an entire history/complete the whole medical interview within that time. A thorough history was not necessary, but we were supposed to go through all of the motions.
I was apprehensive because I knew this encounter would be especially artificial. We were in the exam rooms in the simulation center, so it felt like a real clinic setting, but the characters the actors assumed for the encounter lacked a lot of depth. That lack of depth was purposeful, since the more the patient says "no" to your questions about health risk factors and the more benign their other answers are, the faster the interview is and the greater the likelihood that you can get through everything in 20 minutes. Problem is, that just is not my style.
Anyway, I had to come to terms with that and I did. I used all 20 minutes, but the interview felt pretty good. The patient, however, had a somewhat stiff demeanor throughout the interview which through me off. After my 20 minutes was up, I exited the room, took an online survey to reflect on my experience, and then met with my E4C (Dr. Basaviah) in a different room to debrief.
She told me that I was "outstanding." She said that they rate us on a Likert Scale from 1-8 for a series of categories based on clinical competencies. At our young/newbie stage, they want to see us scoring between 4 and 6 for each competency and they count that as satisfactory. Anything above 6 is considered to be exceeding expectations and would not be seen often in young students since we have not learned many of the skills necessary to warrant those scores. Each section also has specific items that they want us to do in an interview and they check them off if we complete them.
Now, for my performance....First off, Dr. Basaviah checked each box for me and I scored in the 7-8 range for every competency (exceeds expectations for all). Wahoo! She was so proud and she reassured me that she is a hard grader. She had recommendations for things I could start doing in future interviews, but she stated that most of her suggestions reflected more advanced clinical skills that I will learn in a structured fashion in spring quarter and during second year.
Anyway, it was a very, very positive experience and I feel re-energized!
6) The rest of my time has been spent studying. I have never studied this much in my life! And, by the time Thursday at 12:30 rolls around I will be so so relieved to have all of these exams behind me. I have spent most of my time with my friend Nicole who has become my faithful study-buddy. We have gone into anatomy lab almost every day since our "dead week" started last Monday and we study throughout the day, with one exception...we run the campus loop once each day to shake of the staleness of studying. It has been a good system, although still very exhausting. Nicole came over on Saturday for a study party and Alex cooked for us (a rare event indeed). He made scrumptious turkey meatballs (homemade) and I was oh so proud!
That's where I am. I took my developmental biology exam today and I have my practice of medicine exam tomorrow (includes psychiatry, nutrition, population health, quantitative medicine, etc.). 4 days from now I will be in Oregon...hip hip hooray!!!
Monday, December 12, 2011
Saturday, November 26, 2011
Whirlwind Recap
Wowee...what a dense and wonderful rich few weeks.
With the transition to my Thanksgiving break and my flight back to the northwest, my focused shifted towards family time, cooking/baking, and catching up on sleep. I will provide a short recap of the highlights from the two weeks prior.
Sunday, November 13 - I spent the morning at Arbor Free Clinic again, this time in the regular clinic (rather than the Musculoskeletal or Women's Health specialty clinics). I only was able to see one patient due to the complex nature of the case (older Chinese woman with her daughter as an interpreter and a significant history of chest pain with other chronic conditions as well as a history of little medical care). The clinic was short staffed in terms of physicians that morning, so everything was backed up as all of the pre-clinical students 'lined up' to present their patients and proceed with the rest of the visit. I found my encounter/interview with the patient to be really wonderful and I feel like I am becoming more and more comfortable interviewing patients that cannot speak English. I am really grateful to be having some of these challenging patient scenarios very early in my medical education.
Alex returned from his trip to Oregon on Monday, the 14th, and then my week just sped up dramatically.
Tuesday, November 15th - I attended a Career Exploration Workshop led by the academic deans that gave us a glimpse into how people tend to find their niche in medicine and what considerations often play a part (and should) in deciding what specialty you want to go into. There was a focus on how much patient contact we want in our careers and how we want our specialty choice to support/nurture our other life goals. I found it to be a very useful session, although the prelude to residency applications and residency committee decisions seemed a little premature (although there were older students in attendance) and I found myself with a bit of the 'deer in the headlights' syndrome by the end of the evening.
Wednesday, November 16th - I had the usual pediatric rounds in the morning (wonderful as always), followed by a one-on-one meeting with my clinical advisor, then lunch with medical school admissions candidates. After that, I studied for a while, tutored, hung out with Alex at a local Peet's coffee, and then Alex treated me to a lovely early birthday dinner at a Mexican restaurant in Redwood City called Milagros. Yum!
Thursday, November 17th (my bday!) - Alex made me breakfast in bed, I attended a class, skipped a class to go for a walk around campus, had lunch (was surprised by a friend with a cupcake), attended anatomy lecture/lab (surprised by another friend with a balloon), studied for a bit, and then enjoyed an oh-so-lovely evening with my friends out in Palo Alto. Alex, Liana, Megan, Nicole, Lindsey, and I went to the Crepevine for dinner and I had a delicious greek-style salmon crepe. To follow that, we walked a few blocks over to this lovely wine bar called Vino Locale. It is located in an old house, just a half a block from the Apple Store and has a wonderful, relaxed feel to the place. The walls are covered with vibrant artwork by local artists and the staff are enthusiastic and very friendly. We had reserved the back patio, complete with heaters and blankets and decorated with Christmas lights. The tables set aside for us had candles on them and the owner came out to greet/welcome us. It was so cute. We had the whole patio to ourselves and took full advantage of it. We shared a few bottles of red wine, waited for Kelsey to arrive, and then they surprised me with a cake from a local bakery. (Alex also had a special slice of pumpkin cheesecake - my favorite - brought to me, with the candle lit, and everyone singing the first full rendition of the birthday song I had heard that day) The evening was really, really wonderful! It was nice to relax with my friends and enjoy a very different pace for once. All in all, an amazing bday!
Friday, November 18 - In the afternoon, I had another clinical skills session. This one focused on having conversations with patients about intimate partner violence. I think it was an extraordinarily meaningful session for all of us and I thought it actually went really well, although of course the content was complex and heavy.
Friday evening, Kelsey came over to our place for dinner (roasted zucchini, potatoes, cauliflower, and sauteed chicken). We then went back to Palo Alto to meet up with my classmate Rich (who shares my 11/17/86 birthday) at a bar called Nola's. My whole class was invited to help us celebrate and celebrate the beginning of break and tons of people showed up. I spent hours talking with people and drinking too much of some concoction Kelsey kept providing me with entitled a "Hurricane Bowl." Well Saturday morning, I certainly felt like I had been through a hurricane, so despite the fun festivities of the evening before, I spent all of Saturday leading up to my flight in bed. At about 3:30pm, Alex congratulated me for making it upstairs. Haha, oh the simple joys found in small accomplishments!
Saturday, November 19th - After finally rousing in the late afternoon and mustering the energy/equilibrium to pack, I made it to the airport and by 9:45 that evening I was in Seattle!
I spent the rest of that evening and the next morning reconnecting with my cousin Shannon. We were able to share some nice relaxing time, including a trip to Geraldine's Counter in Columbia City for Sunday brunch and a walk around Seward Park. The Puget Sound weather was beautiful when I arrived. I couldn't have ordered a better reintroduction to the area. A crisp, cool late fall morning, with trees still full of color and tons of snow on the mountains. Love it!
Shannon dropped me off at the ferry in the early afternoon and then I was able to spend the afternoon/evening with my family. I was very ready for the reunion! My mom made me cajun shrimp and grits as a belated birthday celebration and we (Danielle, Chris, Weston, my parents and I) enjoyed some scrumptious homemade pumpkin-marble cheesecake for dessert.
The rest of the week was filled with family time, some academic tasks, and preparations for Thanksgiving. (Monday evening I had another little reunion with my friend Laura - classmate from UPS and fellow rower - which was fantastic and long overdue).
Thanksgiving was incredible and my mom teamed well (as we usually do) to produce an amazing feast. We started on Wednesday - I baked two pies (pumpkin and pecan) and my mom started cranking out multiple batches of rolls (she ended up with 4 types - whole wheat and regular butter flake, sweet potato, and dill-oatmeal rolls). On Thursday, I was responsible for the turkey (orange and mustard basted). The rest of our menu included: roasted brussel sprouts, a roasted vegetable medley (yams, butternut squash, and beets), sausage and apple stuffing, green beans with sauteed mushrooms and slivered almonds, cranberry relish, cranberry sauce, onion-raisin port relish, Waldorf salad, mashed potatoes, and gravy (and probably other stuff I am not remembering). Everything was a hit and Chris ate about half of the pecan pie (this version had a high proportion of pecans and a bit of molasses for an added depth of flavor).
Yesterday, I made a chocolate ganache-sour cherry tart for an evening event with my aunts, uncles, parents, and a few of my cousins. The tart was a success and there were many jokes thrown around about how my family both loves me and my ganache. Fortunately, my identity and that of the ganache I make have not merged yet.
Now, I am preparing to head back to CA and looking back over the week, it has gone by way too fast!! I want to rewind a bit and savor the experiences and the opportunities with family before I am thrown back into a sea of schoolwork and preparations for finals. I have 6 finals ahead of me: one this coming week, one the week after, and then four, back to back, the last week before I am on vacation (for real this time). I can't wait to be free of academic obligation for a bit and not have to wonder how I should be spending my time, whether that means focusing on family or focusing on med school.
In closing, I would like to take a moment to express what I am grateful/thankful for, given the holiday that has just passed. I am thankful for the path that I am on, the institution I am fortunate enough to be a part of, and the phenomenal classmates that will share in the roller coaster-like ride of medical school. I am grateful for the continued support, encouragement, and love of my family and friends, for the inspiration I receive from those most dear to me, from the opportunities before me, and I am very very thankful to share the journey with my dear dear boyfriend Alex.
Let the holiday season begin!
With the transition to my Thanksgiving break and my flight back to the northwest, my focused shifted towards family time, cooking/baking, and catching up on sleep. I will provide a short recap of the highlights from the two weeks prior.
Sunday, November 13 - I spent the morning at Arbor Free Clinic again, this time in the regular clinic (rather than the Musculoskeletal or Women's Health specialty clinics). I only was able to see one patient due to the complex nature of the case (older Chinese woman with her daughter as an interpreter and a significant history of chest pain with other chronic conditions as well as a history of little medical care). The clinic was short staffed in terms of physicians that morning, so everything was backed up as all of the pre-clinical students 'lined up' to present their patients and proceed with the rest of the visit. I found my encounter/interview with the patient to be really wonderful and I feel like I am becoming more and more comfortable interviewing patients that cannot speak English. I am really grateful to be having some of these challenging patient scenarios very early in my medical education.
Alex returned from his trip to Oregon on Monday, the 14th, and then my week just sped up dramatically.
Tuesday, November 15th - I attended a Career Exploration Workshop led by the academic deans that gave us a glimpse into how people tend to find their niche in medicine and what considerations often play a part (and should) in deciding what specialty you want to go into. There was a focus on how much patient contact we want in our careers and how we want our specialty choice to support/nurture our other life goals. I found it to be a very useful session, although the prelude to residency applications and residency committee decisions seemed a little premature (although there were older students in attendance) and I found myself with a bit of the 'deer in the headlights' syndrome by the end of the evening.
Wednesday, November 16th - I had the usual pediatric rounds in the morning (wonderful as always), followed by a one-on-one meeting with my clinical advisor, then lunch with medical school admissions candidates. After that, I studied for a while, tutored, hung out with Alex at a local Peet's coffee, and then Alex treated me to a lovely early birthday dinner at a Mexican restaurant in Redwood City called Milagros. Yum!
Thursday, November 17th (my bday!) - Alex made me breakfast in bed, I attended a class, skipped a class to go for a walk around campus, had lunch (was surprised by a friend with a cupcake), attended anatomy lecture/lab (surprised by another friend with a balloon), studied for a bit, and then enjoyed an oh-so-lovely evening with my friends out in Palo Alto. Alex, Liana, Megan, Nicole, Lindsey, and I went to the Crepevine for dinner and I had a delicious greek-style salmon crepe. To follow that, we walked a few blocks over to this lovely wine bar called Vino Locale. It is located in an old house, just a half a block from the Apple Store and has a wonderful, relaxed feel to the place. The walls are covered with vibrant artwork by local artists and the staff are enthusiastic and very friendly. We had reserved the back patio, complete with heaters and blankets and decorated with Christmas lights. The tables set aside for us had candles on them and the owner came out to greet/welcome us. It was so cute. We had the whole patio to ourselves and took full advantage of it. We shared a few bottles of red wine, waited for Kelsey to arrive, and then they surprised me with a cake from a local bakery. (Alex also had a special slice of pumpkin cheesecake - my favorite - brought to me, with the candle lit, and everyone singing the first full rendition of the birthday song I had heard that day) The evening was really, really wonderful! It was nice to relax with my friends and enjoy a very different pace for once. All in all, an amazing bday!
Friday, November 18 - In the afternoon, I had another clinical skills session. This one focused on having conversations with patients about intimate partner violence. I think it was an extraordinarily meaningful session for all of us and I thought it actually went really well, although of course the content was complex and heavy.
Friday evening, Kelsey came over to our place for dinner (roasted zucchini, potatoes, cauliflower, and sauteed chicken). We then went back to Palo Alto to meet up with my classmate Rich (who shares my 11/17/86 birthday) at a bar called Nola's. My whole class was invited to help us celebrate and celebrate the beginning of break and tons of people showed up. I spent hours talking with people and drinking too much of some concoction Kelsey kept providing me with entitled a "Hurricane Bowl." Well Saturday morning, I certainly felt like I had been through a hurricane, so despite the fun festivities of the evening before, I spent all of Saturday leading up to my flight in bed. At about 3:30pm, Alex congratulated me for making it upstairs. Haha, oh the simple joys found in small accomplishments!
Saturday, November 19th - After finally rousing in the late afternoon and mustering the energy/equilibrium to pack, I made it to the airport and by 9:45 that evening I was in Seattle!
I spent the rest of that evening and the next morning reconnecting with my cousin Shannon. We were able to share some nice relaxing time, including a trip to Geraldine's Counter in Columbia City for Sunday brunch and a walk around Seward Park. The Puget Sound weather was beautiful when I arrived. I couldn't have ordered a better reintroduction to the area. A crisp, cool late fall morning, with trees still full of color and tons of snow on the mountains. Love it!
Shannon dropped me off at the ferry in the early afternoon and then I was able to spend the afternoon/evening with my family. I was very ready for the reunion! My mom made me cajun shrimp and grits as a belated birthday celebration and we (Danielle, Chris, Weston, my parents and I) enjoyed some scrumptious homemade pumpkin-marble cheesecake for dessert.
The rest of the week was filled with family time, some academic tasks, and preparations for Thanksgiving. (Monday evening I had another little reunion with my friend Laura - classmate from UPS and fellow rower - which was fantastic and long overdue).
Thanksgiving was incredible and my mom teamed well (as we usually do) to produce an amazing feast. We started on Wednesday - I baked two pies (pumpkin and pecan) and my mom started cranking out multiple batches of rolls (she ended up with 4 types - whole wheat and regular butter flake, sweet potato, and dill-oatmeal rolls). On Thursday, I was responsible for the turkey (orange and mustard basted). The rest of our menu included: roasted brussel sprouts, a roasted vegetable medley (yams, butternut squash, and beets), sausage and apple stuffing, green beans with sauteed mushrooms and slivered almonds, cranberry relish, cranberry sauce, onion-raisin port relish, Waldorf salad, mashed potatoes, and gravy (and probably other stuff I am not remembering). Everything was a hit and Chris ate about half of the pecan pie (this version had a high proportion of pecans and a bit of molasses for an added depth of flavor).
Yesterday, I made a chocolate ganache-sour cherry tart for an evening event with my aunts, uncles, parents, and a few of my cousins. The tart was a success and there were many jokes thrown around about how my family both loves me and my ganache. Fortunately, my identity and that of the ganache I make have not merged yet.
Now, I am preparing to head back to CA and looking back over the week, it has gone by way too fast!! I want to rewind a bit and savor the experiences and the opportunities with family before I am thrown back into a sea of schoolwork and preparations for finals. I have 6 finals ahead of me: one this coming week, one the week after, and then four, back to back, the last week before I am on vacation (for real this time). I can't wait to be free of academic obligation for a bit and not have to wonder how I should be spending my time, whether that means focusing on family or focusing on med school.
In closing, I would like to take a moment to express what I am grateful/thankful for, given the holiday that has just passed. I am thankful for the path that I am on, the institution I am fortunate enough to be a part of, and the phenomenal classmates that will share in the roller coaster-like ride of medical school. I am grateful for the continued support, encouragement, and love of my family and friends, for the inspiration I receive from those most dear to me, from the opportunities before me, and I am very very thankful to share the journey with my dear dear boyfriend Alex.
Let the holiday season begin!
Sunday, November 13, 2011
What it means to serve...
Another week completed and one more to go before I get a much-anticipated week off from school.
Last week was good. I had imagined that I would have much more time to get things done because Alex is home in Oregon, but turns out, when you have evening commitments, combined with class from 9-5 everyday, there is not much time for getting ahead on homework. :)
Wednesday, I spent much of the day doing miscellaneous errands, such as buying food for my last Healer's Art class or going to a blood-draw visit for a vaccine study I am participating in. I also participated in a simulation study on laparoscopic surgery and tutored, before spending the entire evening in my Healer's Art class.
The laparoscopic surgery simulation was quite something. I had signed up for this study weeks beforehand, having received an email offering to teach participants some surgically related skills and feed them pizza. Thus, when I went to the simulation center in the med school on Wednesday, I had no idea what to expect. I was told that I needed to complete a simple task using laparoscopic tools, picking up rings from six pegs on the left with the tool in my non-dominant hand, transferring the ring to the tool in my dominant hand and dropping the ring on a peg on the right half of the board. I had to do that for each of the six rings on the left and then do the reverse. They videotaped me, timed me, and then sent me into a room where I received feedback from a surgeon. During the task, I was excited. I had never done this before, but I was up for the challenge, plus I am genuinely curious about surgery, so this felt like a good opportunity to try something related to the field. I felt like I did pretty good job executing the task. Therefore, I was quite surprised when I received feedback from the surgeon that I had performed among the lowest of my peers (first-year med students with no prior experience), he reminded me of the validity of this type of task and predicted surgical aptitude and he thought that knowing my low performance could be helpful in future decision-making.
I was stunned! Dumb-founded! I just stared at him with complete disbelief. After he spoke, I was relocated to the "break room" where the was deep-dish pizza and snacks. I was so so bummed. I had a half an hour to kill before I was supposed to do the task again and I was just thinking - "Why on earth did I volunteer for this study? I don't need this, I want to decide whether surgery is right for me on my own terms, not because of a task I completed as part of a simulation study." There were a few of my classmates in the same room, but we were not supposed to discuss the study. Long story short, I learned after completing the task again that the point of the study was to explore the impact of positive/negative feedback on subsequent performance. I was the kind of guinea pig they wanted - I completely bought their story! I was so relieved after the 'ruse' was revealed that I got tears in my eyes. The surgeon who had given me the feedback purposely sought me out to reassure me that I actually had done quite well, because, although I had been silent, he could tell that I was quite upset by the feedback I had received.
A complete emotional roller-coaster all in one hour's time. Crazy! It's a good story to tell now though.
My Healer's Art class Wednesday evening served as a wonderful ending to my otherwise busy and bemusing day. To close this incredible class series, we started with some scrumptious Mediterranean food (which I ordered from a great family run restaurant in Palo Alto - the owner actually recognized me when he dropped the food off, based on the 2 whole times I have come by his place, ordered hummus and pita, and sat outside to enjoy it - I was always given complimentary tea and falafel which was a treat). After our dinner, we immediately broke into our small groups and had a chance to share what this class has meant to us. One common theme: it reminded all of us how much depth each person that we interact with in passing has, there is so much to know about a person and we tend to overlook that depth and that richness even with those people we work with day after day after day. I felt a great connection to my small group members and I felt honored to have had the chance to get to know them better. I think the shared experience fostered by the Healer's Art class will be carried with all of us for a long time coming. We are already planning the reunion!
After small group time, we came back together - all 22+ of us - and we had time to contemplate what devoting your life to service through medicine really means, not only to the field, but to us individually. Our instructor spoke of us having a job that does not inform how we live, but instead allows us to express our highest values every day. The messages he reiterated about service and compassion and improving yourself through work that upholds those two values was an great inspiration. I felt uplifted by the energy in that room. Just being amidst such an amazing group of motivated, talented, and truly humble aspiring physicians was something I won't be able to replicate any time soon.
At the very end, we wrote statements of service and read them allowed, repeating our statement to let the words sink in, before the next person read theirs. Each person lit a small votive after sharing their words and placed the votive in the center of the room. The room was dark and a "talking candle" was passed from person to person, serving as the spark for each of our messages of service.
Mine was as follows:
Strengthen me to give to others with love and without pause, to listen not judge, and to care for all who seek my help as I would care for those most dear to me. Empower me to embrace the diversity I see in the people I meet and to stand as a fierce advocate for the underprivileged, no matter the obstacles. Enable me to nurture my role as a physician while also nurturing my role as a friend, partner, daughter, sister, mother, mentor and teacher. Remind me to resonate with the meaning in all that I do and live with no regrets.
It was a powerful evening to say the least. I noted other immensely moving things expressed by my classmates, many of which I connected with at my core. Other key things I took away were the concepts of living without self-consciousness and defining success in my own terms. I felt empowered and ready to tackle the next 5-10 years of training with gusto. :)
To top of the whole night, we had an ice cream party. Perfect!
The rest of my week couldn't really compare to that. Although I did have a lovely wine tasting date with my classmate Lindsey on Thursday evening, followed by a SWEAT orientation reunion dinner at a Palo Alto Thai restaurant called Thaiphoon. Delicious!
Friday was stormy here and I took advantage of that to try and get some work down on Friday night. Not the most exciting way to spend one's Friday evening, but boy was I productive!
Saturday morning I baked pumpkin-bran-coconut-walnut-millet-dark chocolate chip cookies and then went tailgating for the big Stanford-Oregon game. I met up with a bunch of my classmates there, handed out cookies, found out that I get to be the lead planner of next year's Stanford Med outdoor orientation (yipee!) and then watched Stanford play a game somewhat akin to football (still can't quite put my finger on it).
The game was a huge disappointment, the entire stadium seemed to grieve the poor performance of their undefeated team, although there was a large contingent of ducks fans who were living it up! I left the game early and went out for sushi and frozen yogurt with Liana and Megan.
Today was BUSY. I worked at the free clinic for the first half of the day, which was a phenomenal experience per usual. The clinic was swamped with patients (i.e. plenty of students to see the patients, but not enough physicians), so I only saw one patient, but again I was able to have a cross-cultural exchange with an older Chinese woman whose daughter accompanied her to translate Mandarin. The afternoon was all tutoring, then studying, and here I am - about to start another week and then launch myself northward.
The weeks continue to be rich, but full. I am anxiously anticipating next week, which will also be rich in a different way and I know that when 11/24 rolls around, I will certainly be full!!
T-6 days and counting!!!
Last week was good. I had imagined that I would have much more time to get things done because Alex is home in Oregon, but turns out, when you have evening commitments, combined with class from 9-5 everyday, there is not much time for getting ahead on homework. :)
Wednesday, I spent much of the day doing miscellaneous errands, such as buying food for my last Healer's Art class or going to a blood-draw visit for a vaccine study I am participating in. I also participated in a simulation study on laparoscopic surgery and tutored, before spending the entire evening in my Healer's Art class.
The laparoscopic surgery simulation was quite something. I had signed up for this study weeks beforehand, having received an email offering to teach participants some surgically related skills and feed them pizza. Thus, when I went to the simulation center in the med school on Wednesday, I had no idea what to expect. I was told that I needed to complete a simple task using laparoscopic tools, picking up rings from six pegs on the left with the tool in my non-dominant hand, transferring the ring to the tool in my dominant hand and dropping the ring on a peg on the right half of the board. I had to do that for each of the six rings on the left and then do the reverse. They videotaped me, timed me, and then sent me into a room where I received feedback from a surgeon. During the task, I was excited. I had never done this before, but I was up for the challenge, plus I am genuinely curious about surgery, so this felt like a good opportunity to try something related to the field. I felt like I did pretty good job executing the task. Therefore, I was quite surprised when I received feedback from the surgeon that I had performed among the lowest of my peers (first-year med students with no prior experience), he reminded me of the validity of this type of task and predicted surgical aptitude and he thought that knowing my low performance could be helpful in future decision-making.
I was stunned! Dumb-founded! I just stared at him with complete disbelief. After he spoke, I was relocated to the "break room" where the was deep-dish pizza and snacks. I was so so bummed. I had a half an hour to kill before I was supposed to do the task again and I was just thinking - "Why on earth did I volunteer for this study? I don't need this, I want to decide whether surgery is right for me on my own terms, not because of a task I completed as part of a simulation study." There were a few of my classmates in the same room, but we were not supposed to discuss the study. Long story short, I learned after completing the task again that the point of the study was to explore the impact of positive/negative feedback on subsequent performance. I was the kind of guinea pig they wanted - I completely bought their story! I was so relieved after the 'ruse' was revealed that I got tears in my eyes. The surgeon who had given me the feedback purposely sought me out to reassure me that I actually had done quite well, because, although I had been silent, he could tell that I was quite upset by the feedback I had received.
A complete emotional roller-coaster all in one hour's time. Crazy! It's a good story to tell now though.
My Healer's Art class Wednesday evening served as a wonderful ending to my otherwise busy and bemusing day. To close this incredible class series, we started with some scrumptious Mediterranean food (which I ordered from a great family run restaurant in Palo Alto - the owner actually recognized me when he dropped the food off, based on the 2 whole times I have come by his place, ordered hummus and pita, and sat outside to enjoy it - I was always given complimentary tea and falafel which was a treat). After our dinner, we immediately broke into our small groups and had a chance to share what this class has meant to us. One common theme: it reminded all of us how much depth each person that we interact with in passing has, there is so much to know about a person and we tend to overlook that depth and that richness even with those people we work with day after day after day. I felt a great connection to my small group members and I felt honored to have had the chance to get to know them better. I think the shared experience fostered by the Healer's Art class will be carried with all of us for a long time coming. We are already planning the reunion!
After small group time, we came back together - all 22+ of us - and we had time to contemplate what devoting your life to service through medicine really means, not only to the field, but to us individually. Our instructor spoke of us having a job that does not inform how we live, but instead allows us to express our highest values every day. The messages he reiterated about service and compassion and improving yourself through work that upholds those two values was an great inspiration. I felt uplifted by the energy in that room. Just being amidst such an amazing group of motivated, talented, and truly humble aspiring physicians was something I won't be able to replicate any time soon.
At the very end, we wrote statements of service and read them allowed, repeating our statement to let the words sink in, before the next person read theirs. Each person lit a small votive after sharing their words and placed the votive in the center of the room. The room was dark and a "talking candle" was passed from person to person, serving as the spark for each of our messages of service.
Mine was as follows:
Strengthen me to give to others with love and without pause, to listen not judge, and to care for all who seek my help as I would care for those most dear to me. Empower me to embrace the diversity I see in the people I meet and to stand as a fierce advocate for the underprivileged, no matter the obstacles. Enable me to nurture my role as a physician while also nurturing my role as a friend, partner, daughter, sister, mother, mentor and teacher. Remind me to resonate with the meaning in all that I do and live with no regrets.
It was a powerful evening to say the least. I noted other immensely moving things expressed by my classmates, many of which I connected with at my core. Other key things I took away were the concepts of living without self-consciousness and defining success in my own terms. I felt empowered and ready to tackle the next 5-10 years of training with gusto. :)
To top of the whole night, we had an ice cream party. Perfect!
The rest of my week couldn't really compare to that. Although I did have a lovely wine tasting date with my classmate Lindsey on Thursday evening, followed by a SWEAT orientation reunion dinner at a Palo Alto Thai restaurant called Thaiphoon. Delicious!
Friday was stormy here and I took advantage of that to try and get some work down on Friday night. Not the most exciting way to spend one's Friday evening, but boy was I productive!
Saturday morning I baked pumpkin-bran-coconut-walnut-millet-dark chocolate chip cookies and then went tailgating for the big Stanford-Oregon game. I met up with a bunch of my classmates there, handed out cookies, found out that I get to be the lead planner of next year's Stanford Med outdoor orientation (yipee!) and then watched Stanford play a game somewhat akin to football (still can't quite put my finger on it).
The game was a huge disappointment, the entire stadium seemed to grieve the poor performance of their undefeated team, although there was a large contingent of ducks fans who were living it up! I left the game early and went out for sushi and frozen yogurt with Liana and Megan.
Today was BUSY. I worked at the free clinic for the first half of the day, which was a phenomenal experience per usual. The clinic was swamped with patients (i.e. plenty of students to see the patients, but not enough physicians), so I only saw one patient, but again I was able to have a cross-cultural exchange with an older Chinese woman whose daughter accompanied her to translate Mandarin. The afternoon was all tutoring, then studying, and here I am - about to start another week and then launch myself northward.
The weeks continue to be rich, but full. I am anxiously anticipating next week, which will also be rich in a different way and I know that when 11/24 rolls around, I will certainly be full!!
T-6 days and counting!!!
Wednesday, November 9, 2011
You know its fall when...
Happy November everyone! This is my favorite month, partly because I love fall, partly because I love birthdays, and mostly because I LOVE Thanksgiving! I am now in a 10 day countdown until I fly back to the Northwest for a week off from school. I am excited!
Since Halloween, when I last posted, my classwork has been pretty routine and my evenings have been filled with studying and completing homework assignments. This past weekend, I was able to hang out friends and make homemade butternut squash soup and bread. Making bread made me particularly happy. Not only because Saturday was an overcast day, so the smell of baking bread and the relaxing pace of a football-watching afternoon were well matched, but this was the first time I had baked bread since moving to California. For me, that says something. I love baking bread! When Alex and I last lived together I made bread at least weekly. At that time, I was nurturing a sourdough starter and I doubt we ever bought a loaf of bread that entire year. So, it was about time that I figured out a way to safeguard an afternoon from other commitments and make some bread! The whole culinary endeavor turned out wonderfully. :)
Other highlights of the past week stem from my clinical skills sessions where I interview standardized patients. The session for last Friday was titled the "Challenging Patient Encounter." Such a grand title certainly made it so me and many of my classmates were a little nervous about what exactly we would experience with our patients. Fortunately, I did not go first amongst my triad. My first group member had an older woman who would not stop talking! She lived alone, her husband had died somewhat recently, and she was experiencing numerous symptoms all of which she would describe while also telling a portion of her life story. As an outsider it was almost humorous to watch, but for my classmate it was very challenging to figure out how to tactfully interrupt her and guide the conversation.
My patient was an older man who presented with a persistent cough and he was convinced he needed a prescription for antibiotics. He stated that he had been diagnosed with bronchitis two years ago and that his doctor had not prescribed anything, so he took some leftover antibiotics from one of his friends and that had seemed to work wonders. I acknowledged all of that, gathered more information from him, and proceed to take a more thorough history. Meanwhile, I was thinking to myself, What is challenging in this patient? What am I missing? Because of the way the clinical skills session had been set up, I was worried that I was completely overlooking something. The interview went well and when debriefing with my group I learned that the patient's desire for antibiotics was supposed to be the challenge, but rather than let it be an issue, I deferred the responsibility of determining whether the antibiotic was appropriate for the patient at this time to my supervising physician. The entire encounter was surprising to me, but successful nonetheless.
On Monday of this week, we had another clinical skills session, this time revolving around third-party interviewing (interviewing with a third party present - such as a caregiver, interpreter, etc.). In our room, we had three stations with language interpreters and one with a man suffering from dementia and his caregiver (a daughter). I ended up interviewing a young woman experiencing abdominal pain who communicated with American Sign Language. While I worked with an interpreter two weeks ago at the free clinic, this was completely different. The pace of sign language is slower and I had to learn how to adjust my questions and the tempo of my speech to allow for a smoother experience. This was all done on the fly, so I found the encounter much more challenging, but I was so happy to have been thrown into that kind of experience and see what I could do. We only had 10 minutes for the interview, which flew by amidst all of the necessary interpretation. I think that session was a favorite among my classmates. It required all of us to step up and take some risks, but we also came away with real tangible lessons that will easily translate to future patient visits.
This week, I am on my own at home. Alex is in Oregon helping to take care of his mom who is recovering from her second hip replacement surgery and I am going to try and capitalize on some alone time to get a jump start on studying and lower the amount of work I will need to do while up on Whidbey over the Thanksgiving holiday.
Life outside of school is good. I am grateful to have established a pretty solid group of friends already and I am beginning to embrace the notion that the Palo Alto area will be 'home' for the next few years of my life. For some reason, accepting that this transition is more than a temporary experience is taking a while for me. I do miss the turning of the seasons that one feels much more in other parts of the country, but the evenings have begun to get much cooler here and I am occasionally having to bring layers to accommodate the larger swing in temperatures (mid 60s in the day to mid 40s in the evening). I am someone who loves bundling up, so crisp evenings and mornings are a welcome occurrence!
This week, I have a reunion dinner on Thursday with the group I went backpacking with during orientation and the highlight of the weekend will be the big football game between Stanford and Oregon. Should be fun!
I will give a recap of the weekend's festivities Sunday evening or Monday morning hopefully. :)
Big hugs to all!
Since Halloween, when I last posted, my classwork has been pretty routine and my evenings have been filled with studying and completing homework assignments. This past weekend, I was able to hang out friends and make homemade butternut squash soup and bread. Making bread made me particularly happy. Not only because Saturday was an overcast day, so the smell of baking bread and the relaxing pace of a football-watching afternoon were well matched, but this was the first time I had baked bread since moving to California. For me, that says something. I love baking bread! When Alex and I last lived together I made bread at least weekly. At that time, I was nurturing a sourdough starter and I doubt we ever bought a loaf of bread that entire year. So, it was about time that I figured out a way to safeguard an afternoon from other commitments and make some bread! The whole culinary endeavor turned out wonderfully. :)
Other highlights of the past week stem from my clinical skills sessions where I interview standardized patients. The session for last Friday was titled the "Challenging Patient Encounter." Such a grand title certainly made it so me and many of my classmates were a little nervous about what exactly we would experience with our patients. Fortunately, I did not go first amongst my triad. My first group member had an older woman who would not stop talking! She lived alone, her husband had died somewhat recently, and she was experiencing numerous symptoms all of which she would describe while also telling a portion of her life story. As an outsider it was almost humorous to watch, but for my classmate it was very challenging to figure out how to tactfully interrupt her and guide the conversation.
My patient was an older man who presented with a persistent cough and he was convinced he needed a prescription for antibiotics. He stated that he had been diagnosed with bronchitis two years ago and that his doctor had not prescribed anything, so he took some leftover antibiotics from one of his friends and that had seemed to work wonders. I acknowledged all of that, gathered more information from him, and proceed to take a more thorough history. Meanwhile, I was thinking to myself, What is challenging in this patient? What am I missing? Because of the way the clinical skills session had been set up, I was worried that I was completely overlooking something. The interview went well and when debriefing with my group I learned that the patient's desire for antibiotics was supposed to be the challenge, but rather than let it be an issue, I deferred the responsibility of determining whether the antibiotic was appropriate for the patient at this time to my supervising physician. The entire encounter was surprising to me, but successful nonetheless.
On Monday of this week, we had another clinical skills session, this time revolving around third-party interviewing (interviewing with a third party present - such as a caregiver, interpreter, etc.). In our room, we had three stations with language interpreters and one with a man suffering from dementia and his caregiver (a daughter). I ended up interviewing a young woman experiencing abdominal pain who communicated with American Sign Language. While I worked with an interpreter two weeks ago at the free clinic, this was completely different. The pace of sign language is slower and I had to learn how to adjust my questions and the tempo of my speech to allow for a smoother experience. This was all done on the fly, so I found the encounter much more challenging, but I was so happy to have been thrown into that kind of experience and see what I could do. We only had 10 minutes for the interview, which flew by amidst all of the necessary interpretation. I think that session was a favorite among my classmates. It required all of us to step up and take some risks, but we also came away with real tangible lessons that will easily translate to future patient visits.
This week, I am on my own at home. Alex is in Oregon helping to take care of his mom who is recovering from her second hip replacement surgery and I am going to try and capitalize on some alone time to get a jump start on studying and lower the amount of work I will need to do while up on Whidbey over the Thanksgiving holiday.
Life outside of school is good. I am grateful to have established a pretty solid group of friends already and I am beginning to embrace the notion that the Palo Alto area will be 'home' for the next few years of my life. For some reason, accepting that this transition is more than a temporary experience is taking a while for me. I do miss the turning of the seasons that one feels much more in other parts of the country, but the evenings have begun to get much cooler here and I am occasionally having to bring layers to accommodate the larger swing in temperatures (mid 60s in the day to mid 40s in the evening). I am someone who loves bundling up, so crisp evenings and mornings are a welcome occurrence!
This week, I have a reunion dinner on Thursday with the group I went backpacking with during orientation and the highlight of the weekend will be the big football game between Stanford and Oregon. Should be fun!
I will give a recap of the weekend's festivities Sunday evening or Monday morning hopefully. :)
Big hugs to all!
Sunday, October 30, 2011
Finishing up October on a high note!
This past week consisted of a lot of routine in terms of the academic rhythm, day in, day out. Yet, there were some wonderful highlights that inspired me and have left me feeling very very jazzed about the path I am upon.
Tuesday night, after getting out of anatomy early (yay for dissecting the pancreas!), I studied more, had dinner with Lindsey and then attended a welcome reception for new medical school candidates. Wow! So much fun to talk to the prospective students and answer the questions about Stanford and the interview process. It is still very weird to be on the other side of the medical school interview odyssey, let alone be speaking with aspiring med students who are highly qualified and impressive people that genuinely want my perspective on what makes Stanford Medical School unique. Alex joined me for the event and he was able to chit chat with a variety of applicants.
Alex has really become a part of the med school community. Of all of the significant others amongst my classmates, Alex has met and bonded with more people and attended more events. One of my classmates remarked about how great it is to see Alex around often and she said that she had told him that he is practically a first year, to which he replied that he is, he just doesn't have to do the homework and doesn't have the prestige. I think he is starting to feel connected to a good, enriching community here, just like I am.
On Friday, Alex and I hung out with Megan, Leo, and Liana, playing pictionary, watching movies, and eating DELICIOUS deep dish Chicago style pizza. Such a fun, fun night. We all crashed at Megan's place and then got up early n Saturday for the early bird's Basic Life Support class. The session only lasted a few hours, then the we went out for brunch and picked up ingredients for a chili bake and pumpkin squares before heading back to our house for an afternoon/evening of college football. Alex had a tutoring appointment so Liana and I made our way to our house earlier and started all of the cooking!
Liana is a huge football fan. She helped me with prep work for the meal and then positioned herself comfortably in front of the tv to thoroughly monitor the day's progress. As everything cooked, I worked on homework with the football in the background. The focus of the evening was th Stanford-USC game. In the fourth quarter, when things were getting really close, I stopped doing homework and joined Alex, Aaron (our football crazy housemate), and Liana to watch the events unfold. What a game! What a game! The game went into triple overtime and Stanford pulled it off. They are now 8-0 and we have good odds of being in the PAC-12 championships. So cool.
I spent Sunday at the free clinic, working at the musculoskeletal specialty clinic, and then tutored all afternoon. However, the best part of my Sunday reminded me of the special moments throughout this past week that have served as wonderful reminders as to why I am in the right place and pursuing the right career.
Back on Wednesday, I had a doctor's appointment at a Stanford clinic and after the nurse did the intake, I was greeted by a cheerful fourth year medical student. I told her that I am a medical student also and found out that she is actually going to school in Georgia, but she is here on an elective rotation. She already interviewed at Stanford for a residency program and she was describing the kind of experience she was having. She was excited, inspired, and she was taking advantage of every moment. More than that, she interviewed me with great pose and ease, and that in itself was very inspiring to me. Some day I will be there - on the cusp of residency, at a point where patients will do a double take, wondering whether I'm a student or a doctor, because it is hard to tell.
Then, on Friday, we had a Psychiatry lecture about addition and dependence. As a part of that lecture, we were fortunate enough to have a patient come in and speak with us about the conditions she was being treated for in the hospital. The psychiatrist leading our session interviewed the patient for about 30 minutes as a model of motivational interviewing. Watching the interview was very powerful, but it was a wonderful contrast to the sometimes dull lectures we seem to have on Friday afternoon. No one was dozing off, that's for sure and I feel badly for people who skipped lecture, because it was a great window into a realm of patient care that we have not been exposed to much (as of yet).
Immediately following the psychiatry session, we went off to practice our own motivational interviewing. I had a standardized patient who had tried to quit smoking when she started to notice asthmatic symptoms and subsequently has relapsed somewhat. She was seeking advice about what to do and how to address her worsening symptoms. I only had 10 minutes to talk with her, but it went very well. The whole encounter felt very smooth and questions just seemed to flow naturally. I think I even able to empower my patient a bit which is great! I felt really happy and confident after that interview. I received wonderfully encouraging feedback from my TA, the standardized patient, and my peers about my ability to connect with patient, maintain very attentive listening such that my questions stem directly from information the patient has given me, and that I enable the patient to both trust me and feel very comfortable. Yay! What an incredible end to the week.
Sunday was the icing on the cake! I volunteered at the musculoskeletal clinic and interview 'real' patients ON MY OWN for the FIRST TIME! I had a generous 20-30 minutes to interview the patients and I was completely on my own to do that. I was so nervous beforehand, but it turns out that in just a few short months I have gathered a nice collection of interviewing skills. In addition to interviewing for the first time, I also presented to an attending physician for the first time. Both aspects of my work at the clinic went really well. I was able to gather a lot of information and I communicated it back effectively and in an organized manner. The physicians were all very complimentary of my thoroughness in taking a history and my mannerisms with the patients.
One unique aspect of my time in clinic yesterday was my second patient encounter where my patient spoke only Cantonese and Mandarin and her daughter accompanied her as an interpreter. I had never experienced that before, but it went well and, at the end of the interview, they both thanked me for being so kind to them throughout their visit.
I mentioned that I felt pretty jazzed after Friday's standardized patient encounter, but that sense of enthusiasm pales in comparison to my time in clinic. All of I sudden, I had this image of my future career and the kind of physician and advocate I can be for my patients. The interviewing experience at Arbor was the perfect reminder that I am taking real steps towards becoming a physician and that I am learning a LOT, FAST!
So, even though my weekend went by quickly, I had a great one! I think my heart still races a bit when I think about how empowered I felt after seeing patients and truly contributing to their care.
In closing, I'll leave you all with a quote I heard this week (by Marcel Proust):
"The real voyage of discovery lies not in seeking new vistas, but in having new eyes."
Tuesday night, after getting out of anatomy early (yay for dissecting the pancreas!), I studied more, had dinner with Lindsey and then attended a welcome reception for new medical school candidates. Wow! So much fun to talk to the prospective students and answer the questions about Stanford and the interview process. It is still very weird to be on the other side of the medical school interview odyssey, let alone be speaking with aspiring med students who are highly qualified and impressive people that genuinely want my perspective on what makes Stanford Medical School unique. Alex joined me for the event and he was able to chit chat with a variety of applicants.
Alex has really become a part of the med school community. Of all of the significant others amongst my classmates, Alex has met and bonded with more people and attended more events. One of my classmates remarked about how great it is to see Alex around often and she said that she had told him that he is practically a first year, to which he replied that he is, he just doesn't have to do the homework and doesn't have the prestige. I think he is starting to feel connected to a good, enriching community here, just like I am.
On Friday, Alex and I hung out with Megan, Leo, and Liana, playing pictionary, watching movies, and eating DELICIOUS deep dish Chicago style pizza. Such a fun, fun night. We all crashed at Megan's place and then got up early n Saturday for the early bird's Basic Life Support class. The session only lasted a few hours, then the we went out for brunch and picked up ingredients for a chili bake and pumpkin squares before heading back to our house for an afternoon/evening of college football. Alex had a tutoring appointment so Liana and I made our way to our house earlier and started all of the cooking!
Liana is a huge football fan. She helped me with prep work for the meal and then positioned herself comfortably in front of the tv to thoroughly monitor the day's progress. As everything cooked, I worked on homework with the football in the background. The focus of the evening was th Stanford-USC game. In the fourth quarter, when things were getting really close, I stopped doing homework and joined Alex, Aaron (our football crazy housemate), and Liana to watch the events unfold. What a game! What a game! The game went into triple overtime and Stanford pulled it off. They are now 8-0 and we have good odds of being in the PAC-12 championships. So cool.
I spent Sunday at the free clinic, working at the musculoskeletal specialty clinic, and then tutored all afternoon. However, the best part of my Sunday reminded me of the special moments throughout this past week that have served as wonderful reminders as to why I am in the right place and pursuing the right career.
Back on Wednesday, I had a doctor's appointment at a Stanford clinic and after the nurse did the intake, I was greeted by a cheerful fourth year medical student. I told her that I am a medical student also and found out that she is actually going to school in Georgia, but she is here on an elective rotation. She already interviewed at Stanford for a residency program and she was describing the kind of experience she was having. She was excited, inspired, and she was taking advantage of every moment. More than that, she interviewed me with great pose and ease, and that in itself was very inspiring to me. Some day I will be there - on the cusp of residency, at a point where patients will do a double take, wondering whether I'm a student or a doctor, because it is hard to tell.
Then, on Friday, we had a Psychiatry lecture about addition and dependence. As a part of that lecture, we were fortunate enough to have a patient come in and speak with us about the conditions she was being treated for in the hospital. The psychiatrist leading our session interviewed the patient for about 30 minutes as a model of motivational interviewing. Watching the interview was very powerful, but it was a wonderful contrast to the sometimes dull lectures we seem to have on Friday afternoon. No one was dozing off, that's for sure and I feel badly for people who skipped lecture, because it was a great window into a realm of patient care that we have not been exposed to much (as of yet).
Immediately following the psychiatry session, we went off to practice our own motivational interviewing. I had a standardized patient who had tried to quit smoking when she started to notice asthmatic symptoms and subsequently has relapsed somewhat. She was seeking advice about what to do and how to address her worsening symptoms. I only had 10 minutes to talk with her, but it went very well. The whole encounter felt very smooth and questions just seemed to flow naturally. I think I even able to empower my patient a bit which is great! I felt really happy and confident after that interview. I received wonderfully encouraging feedback from my TA, the standardized patient, and my peers about my ability to connect with patient, maintain very attentive listening such that my questions stem directly from information the patient has given me, and that I enable the patient to both trust me and feel very comfortable. Yay! What an incredible end to the week.
Sunday was the icing on the cake! I volunteered at the musculoskeletal clinic and interview 'real' patients ON MY OWN for the FIRST TIME! I had a generous 20-30 minutes to interview the patients and I was completely on my own to do that. I was so nervous beforehand, but it turns out that in just a few short months I have gathered a nice collection of interviewing skills. In addition to interviewing for the first time, I also presented to an attending physician for the first time. Both aspects of my work at the clinic went really well. I was able to gather a lot of information and I communicated it back effectively and in an organized manner. The physicians were all very complimentary of my thoroughness in taking a history and my mannerisms with the patients.
One unique aspect of my time in clinic yesterday was my second patient encounter where my patient spoke only Cantonese and Mandarin and her daughter accompanied her as an interpreter. I had never experienced that before, but it went well and, at the end of the interview, they both thanked me for being so kind to them throughout their visit.
I mentioned that I felt pretty jazzed after Friday's standardized patient encounter, but that sense of enthusiasm pales in comparison to my time in clinic. All of I sudden, I had this image of my future career and the kind of physician and advocate I can be for my patients. The interviewing experience at Arbor was the perfect reminder that I am taking real steps towards becoming a physician and that I am learning a LOT, FAST!
So, even though my weekend went by quickly, I had a great one! I think my heart still races a bit when I think about how empowered I felt after seeing patients and truly contributing to their care.
In closing, I'll leave you all with a quote I heard this week (by Marcel Proust):
"The real voyage of discovery lies not in seeking new vistas, but in having new eyes."
Tuesday, October 25, 2011
Halfway through Quarter #1
As the result of a really great weekend full of football and anniversary festivities, my weekly post is a few days late. Better late than never! :)
Last week was a good one, nothing too notable in lecture, although we did get to cover both sexual history and nutrition/diet in our clinical skills class, which meant practicing having somewhat sensitive conversations with our standardized patients. I felt pretty good about my interviews, at least it seems that I am acquiring some rhythm in the conversation and it all happens more smoothly.
On Tuesday night last week, I attended a Pediatric Interest Group welcome dinner that was very inspiring. The room was packed full of predominantly first-years and a few second-years and we had a panel of pediatricians from Lucille-Packard Children's Hospital (Stanford's renowned children's hospital). These panelists ranged in experience level from long-standing tenure clinical professors to junior residents. They discussed why they went into pediatrics, what they see as unique about their discipline, and what kinds of challenges they have faced in their careers. The instructor of my Pediatric Physical Findings course, Dr. Charles Prober (also Associate Dean of the School of Medicine), was there - he is a pediatric infectious disease specialist - along with his wife who is a pediatric endocrinologist and as the senior physicians in the room, they certainly led the show. They are so jazzed about their jobs and explain that a lot of what is sustaining about a career in pediatrics is the resilience and optimism of their patient population. They spoke about the type of culture that is promoted in pediatrics and the residents highlighted that as one of the reasons they chose that area to specialize in. It sounds as if pediatrics makes a point of considering the whole person not only in terms of how they treat patients but also how they nurture the physicians and other health care professionals during their training and beyond.
I thought it was a wonderful event and the more and more I get connected with the world of pediatrics here, the more I feel like that field could be a very good fit for me. I am still keeping a very open mind of course, but if I do choose that path, Stanford is one of the best places to be for obtaining excellent training in pediatrics.
One large wrinkle in my week involved my catching a head cold, which really ramped up on Wednesday and by the time my Healer's Art course started Wednesday evening (the theme was Grief & Loss), my nose was running so much and I was using up so many napkins that I think everyone thought I was a tad overly connected to the topic. Despite my constant sniffling, the class was a very good one and we were able to discuss how our national culture views grief and loss and how that compares to the medical perspective pertaining to those issues. In small groups, we shared our own loss experiences, what we learned from them and the lessons we want to take from those and utilize in our careers as physicians.
On Friday, after a long day of class, Megan and her boyfriend Leo came over to my house while I cooked some African peanut stew in anticipation of Liana, Nicole, and Liana's sister arriving for some good food and good conversation. We had a wonderfully relaxed evening - we played games, watched Friends, and let ourselves unwind after a very full week.
Saturday was game day! Stanford vs. U. Washington and Stanford homecoming. Alex and I went to tailgate in the early afternoon, watched the game, which was somewhat painful as a former Husky, and then went to dinner with our friends Nick and Laurie (Washington natives - Nick is a friend from high school).
The tailgate was incredible - they had six kegs of beer (funded by an Stanford fraternity alumni group), a huge BBQ, tons of food, games, and a DJ (oh, and a big screen TV to watch the other games going on across the country). Alex and I left the game at the end of the third quarter (Stanford was already up 55 to 14). As we were walking to the restaurant in Palo Alto where we were meeting Nick and Laurie, we kept hearing the classic train sound that indicates Stanford scored - final: 65 to 21. Yowza!
Sunday marked 3 years for my relationship with Alex. We spent the morning walking to a local coffee shop we can reach from our house, midday was consisted of tutoring appointments, and then we had a picnic dinner at a Redwood City park and went to the nearby cinema to watch the new movie 50/50. It was a simple celebration, but wonderful! I can't believe it has been 3 years, but it is exciting and I feel very very lucky to have Alex down here to share in this journey with me.
That's my weekly recap. Hope you all are well!
Happy last week of October!
Last week was a good one, nothing too notable in lecture, although we did get to cover both sexual history and nutrition/diet in our clinical skills class, which meant practicing having somewhat sensitive conversations with our standardized patients. I felt pretty good about my interviews, at least it seems that I am acquiring some rhythm in the conversation and it all happens more smoothly.
On Tuesday night last week, I attended a Pediatric Interest Group welcome dinner that was very inspiring. The room was packed full of predominantly first-years and a few second-years and we had a panel of pediatricians from Lucille-Packard Children's Hospital (Stanford's renowned children's hospital). These panelists ranged in experience level from long-standing tenure clinical professors to junior residents. They discussed why they went into pediatrics, what they see as unique about their discipline, and what kinds of challenges they have faced in their careers. The instructor of my Pediatric Physical Findings course, Dr. Charles Prober (also Associate Dean of the School of Medicine), was there - he is a pediatric infectious disease specialist - along with his wife who is a pediatric endocrinologist and as the senior physicians in the room, they certainly led the show. They are so jazzed about their jobs and explain that a lot of what is sustaining about a career in pediatrics is the resilience and optimism of their patient population. They spoke about the type of culture that is promoted in pediatrics and the residents highlighted that as one of the reasons they chose that area to specialize in. It sounds as if pediatrics makes a point of considering the whole person not only in terms of how they treat patients but also how they nurture the physicians and other health care professionals during their training and beyond.
I thought it was a wonderful event and the more and more I get connected with the world of pediatrics here, the more I feel like that field could be a very good fit for me. I am still keeping a very open mind of course, but if I do choose that path, Stanford is one of the best places to be for obtaining excellent training in pediatrics.
One large wrinkle in my week involved my catching a head cold, which really ramped up on Wednesday and by the time my Healer's Art course started Wednesday evening (the theme was Grief & Loss), my nose was running so much and I was using up so many napkins that I think everyone thought I was a tad overly connected to the topic. Despite my constant sniffling, the class was a very good one and we were able to discuss how our national culture views grief and loss and how that compares to the medical perspective pertaining to those issues. In small groups, we shared our own loss experiences, what we learned from them and the lessons we want to take from those and utilize in our careers as physicians.
On Friday, after a long day of class, Megan and her boyfriend Leo came over to my house while I cooked some African peanut stew in anticipation of Liana, Nicole, and Liana's sister arriving for some good food and good conversation. We had a wonderfully relaxed evening - we played games, watched Friends, and let ourselves unwind after a very full week.
Saturday was game day! Stanford vs. U. Washington and Stanford homecoming. Alex and I went to tailgate in the early afternoon, watched the game, which was somewhat painful as a former Husky, and then went to dinner with our friends Nick and Laurie (Washington natives - Nick is a friend from high school).
The tailgate was incredible - they had six kegs of beer (funded by an Stanford fraternity alumni group), a huge BBQ, tons of food, games, and a DJ (oh, and a big screen TV to watch the other games going on across the country). Alex and I left the game at the end of the third quarter (Stanford was already up 55 to 14). As we were walking to the restaurant in Palo Alto where we were meeting Nick and Laurie, we kept hearing the classic train sound that indicates Stanford scored - final: 65 to 21. Yowza!
Sunday marked 3 years for my relationship with Alex. We spent the morning walking to a local coffee shop we can reach from our house, midday was consisted of tutoring appointments, and then we had a picnic dinner at a Redwood City park and went to the nearby cinema to watch the new movie 50/50. It was a simple celebration, but wonderful! I can't believe it has been 3 years, but it is exciting and I feel very very lucky to have Alex down here to share in this journey with me.
That's my weekly recap. Hope you all are well!
Happy last week of October!
Monday, October 17, 2011
White Coat to Black Dress
Another week begins!
Last week was good and full. Seems to be a trend these days.
What were the highlights?
Monday I had another standardized patient interview where the focus was on practicing gathering information related to the History of the Present Illness and the Past Medical History. I had 7 minutes to conduct the interview and the whole thing went by in a blink! Afterwards I received some wonderful feedback from the patient. He told me that he felt that I easily connected with him and he appreciated greatly how empathic I was. He said that I had a lot of "keepers" and gave me the thumbs up. As my triad stood up to migrate to the next station, I thanked him and he said, "No, thank you!" He proceeded to give me another thumbs up with an accompanying statement of "Really!" under his breath.
That whole experience was wonderful. Not only did I get some really energizing feedback, I also learned a lot. Those sessions can be very overwhelming. Everyone is in performance mode, the setting is very artificial, and we all are desperately trying to remember what we should ask and in what order that sometimes it is hard to actively listen. With practice, I am sure that the whole interview will feel more natural.
Monday evening, I tutored, biked home late, and then worked on more homework.
Tuesday - nothing too exciting happened. Wednesday, I had my Pediatric Physical Findings class which, as always, was quite moving and inspiring. We saw four patients - one baby with an unusual sinus tract beneath the bridge of his nose that had become infected and needed to be drained and then surgically repaired; two siblings with Cystic Fibrosis; and a boy with a recent diagnosis of medulloblastoma (brain tumor). The range of case severity was quite extreme and my rounding group of students met with the young boy last and were privileged enough to hear a very moving description of the journey the boy had gone through in the past few months, as related by his dutiful and loyal father. The boy was obviously depressed, but the pediatric resident who was rounding with us gave him a certificate for letting the students come and see him and he lit up! We saw his smile for the first time and the whole room seemed to brighten a bit. Such a hard situation to be in! His prognosis is uncertain, but it was a bit heartbreaking to feel just a little of the anguish and confusion experienced by that family. The boy had been healthy and vibrant not long before.
From a heavy and meaningful morning, I proceeded to spend my afternoon interviewing another round of medical school applicants. This time I was paired with another rater (a fellow first-year) and we were assigned to the 'group room.' To execute that rater assignment, I was supposed to rate the candidate giving instructions, while my classmate Rachel rated the candidate receiving instructions. Both candidates entered together, and their assignment was to try and communicate as necessary such that the picture in front of the 'receiver' matched the picture in front of the 'giver.' The pictures they had were comprised of simple shapes, but the giver's paper had more detail, so they had 5 minutes to assess what the differences were, the giver had to describe what to draw, and then at the end of that time period they had 3 minutes to debrief and give each other feedback on how the communication went. Participating in this component of the MMI was really interesting. It is amazing how task oriented people could get, where they thought the goal was to get through the whole picture as fast as possible and with the most accuracy, rather than trying to practice good communication techniques. A few people seemed to really understand the point of the exercise, but most let their perfectionist sides come out and then that 'station' in the MMI became a bit more stressful for them.
Thursday was just another day in terms of classes, but in the evening a group of my new girlfriends (Nicole, Jessie, Lindsey, and I) gathered together for fruit, sweets, and wine and took advantage of a rare moment just to unwind, catch up, and connect. It was wonderful and a rare treat in an otherwise very busy week.
Friday was also just another day. After class, several of us went to the nearby Stanford Shopping Center (aka the mall) to look for dresses and other accessories for our medical school formal event which happened on Saturday night. I found myself a nice black dress and some classy bling (earrings) and then Alex and I headed home for the night.
This weekend was a big tutoring weekend for me. I tutored two hours on Saturday, three hours on Sunday, squeezed studying in on either side of the tutoring commitments, but still had a splendid weekend diversion. On Saturday evening, Alex and I met up with 8 of my classmates and a few significant others for a big group dinner at Buca di Beppo (so much pasta!) and then headed to school to board the big charter buses that were taking everyone from Stanford to the San Jose Museum of Art. Moonlighting - the official name of the event (I preferred med school prom) - consisted of 300+ medical students and their significant others browsing the galleries, sipping on wine, beer, or a nice cocktail, eating chocolate fondue, chatting with each other, and dancing! The party started at 9 and went all the way until 2am, although Alex and I caught the earlier bus back (we left at 12:30 instead).
The whole evening was great! Such good, good people and the event was a huge success. So many of my classmates came, as well as a great representation of the upperclassmen. Alex seemed to really enjoy himself - one of my classmates remarked that she felt like Alex was another first-year. He seems to know a lot of people and he has also left most people with a great impression. Aw, shucks, so proud!
Yesterday (Sunday), aside from tutoring and studying, Alex and I managed to concoct some scrumptious things both for breakfast and dinner. Alex made me whole-wheat flaxseed banana pancakes for breakfast and we had butternut squash fries, baked cabbage with mozzarella, and turkey burgers for dinner. Delish!
The weather seems to holding up its end of the bargain for now. Lots of pretty warm, sunny days and the whole week is supposed to maintain that pattern. I don't have many notable things on this week's horizon, although I do have another Healer's Art class on Wednesday evening, so I will probably have lots to say about that in my next blog entry. The academic agenda this week consists of learning about implantation (in Developmental Biology), metabolic disorders with metabolic origin (Genetics), fat metabolism (Biochemistry), the ethics of confidentiality (ethics component of the Practice of Medicine course), the anatomy of the abdomen, and we will continue to breakdown the medical interview even further.
My life has acquired (and maintained) some rhythm and routine now and that is a welcome shift. One month from now I will be back in the PNW for Thanksgiving. Time is flying! I am enjoying it - the people, the academics, and the opportunities before me!
Ever onward!
Last week was good and full. Seems to be a trend these days.
What were the highlights?
Monday I had another standardized patient interview where the focus was on practicing gathering information related to the History of the Present Illness and the Past Medical History. I had 7 minutes to conduct the interview and the whole thing went by in a blink! Afterwards I received some wonderful feedback from the patient. He told me that he felt that I easily connected with him and he appreciated greatly how empathic I was. He said that I had a lot of "keepers" and gave me the thumbs up. As my triad stood up to migrate to the next station, I thanked him and he said, "No, thank you!" He proceeded to give me another thumbs up with an accompanying statement of "Really!" under his breath.
That whole experience was wonderful. Not only did I get some really energizing feedback, I also learned a lot. Those sessions can be very overwhelming. Everyone is in performance mode, the setting is very artificial, and we all are desperately trying to remember what we should ask and in what order that sometimes it is hard to actively listen. With practice, I am sure that the whole interview will feel more natural.
Monday evening, I tutored, biked home late, and then worked on more homework.
Tuesday - nothing too exciting happened. Wednesday, I had my Pediatric Physical Findings class which, as always, was quite moving and inspiring. We saw four patients - one baby with an unusual sinus tract beneath the bridge of his nose that had become infected and needed to be drained and then surgically repaired; two siblings with Cystic Fibrosis; and a boy with a recent diagnosis of medulloblastoma (brain tumor). The range of case severity was quite extreme and my rounding group of students met with the young boy last and were privileged enough to hear a very moving description of the journey the boy had gone through in the past few months, as related by his dutiful and loyal father. The boy was obviously depressed, but the pediatric resident who was rounding with us gave him a certificate for letting the students come and see him and he lit up! We saw his smile for the first time and the whole room seemed to brighten a bit. Such a hard situation to be in! His prognosis is uncertain, but it was a bit heartbreaking to feel just a little of the anguish and confusion experienced by that family. The boy had been healthy and vibrant not long before.
From a heavy and meaningful morning, I proceeded to spend my afternoon interviewing another round of medical school applicants. This time I was paired with another rater (a fellow first-year) and we were assigned to the 'group room.' To execute that rater assignment, I was supposed to rate the candidate giving instructions, while my classmate Rachel rated the candidate receiving instructions. Both candidates entered together, and their assignment was to try and communicate as necessary such that the picture in front of the 'receiver' matched the picture in front of the 'giver.' The pictures they had were comprised of simple shapes, but the giver's paper had more detail, so they had 5 minutes to assess what the differences were, the giver had to describe what to draw, and then at the end of that time period they had 3 minutes to debrief and give each other feedback on how the communication went. Participating in this component of the MMI was really interesting. It is amazing how task oriented people could get, where they thought the goal was to get through the whole picture as fast as possible and with the most accuracy, rather than trying to practice good communication techniques. A few people seemed to really understand the point of the exercise, but most let their perfectionist sides come out and then that 'station' in the MMI became a bit more stressful for them.
Thursday was just another day in terms of classes, but in the evening a group of my new girlfriends (Nicole, Jessie, Lindsey, and I) gathered together for fruit, sweets, and wine and took advantage of a rare moment just to unwind, catch up, and connect. It was wonderful and a rare treat in an otherwise very busy week.
Friday was also just another day. After class, several of us went to the nearby Stanford Shopping Center (aka the mall) to look for dresses and other accessories for our medical school formal event which happened on Saturday night. I found myself a nice black dress and some classy bling (earrings) and then Alex and I headed home for the night.
This weekend was a big tutoring weekend for me. I tutored two hours on Saturday, three hours on Sunday, squeezed studying in on either side of the tutoring commitments, but still had a splendid weekend diversion. On Saturday evening, Alex and I met up with 8 of my classmates and a few significant others for a big group dinner at Buca di Beppo (so much pasta!) and then headed to school to board the big charter buses that were taking everyone from Stanford to the San Jose Museum of Art. Moonlighting - the official name of the event (I preferred med school prom) - consisted of 300+ medical students and their significant others browsing the galleries, sipping on wine, beer, or a nice cocktail, eating chocolate fondue, chatting with each other, and dancing! The party started at 9 and went all the way until 2am, although Alex and I caught the earlier bus back (we left at 12:30 instead).
The whole evening was great! Such good, good people and the event was a huge success. So many of my classmates came, as well as a great representation of the upperclassmen. Alex seemed to really enjoy himself - one of my classmates remarked that she felt like Alex was another first-year. He seems to know a lot of people and he has also left most people with a great impression. Aw, shucks, so proud!
Yesterday (Sunday), aside from tutoring and studying, Alex and I managed to concoct some scrumptious things both for breakfast and dinner. Alex made me whole-wheat flaxseed banana pancakes for breakfast and we had butternut squash fries, baked cabbage with mozzarella, and turkey burgers for dinner. Delish!
The weather seems to holding up its end of the bargain for now. Lots of pretty warm, sunny days and the whole week is supposed to maintain that pattern. I don't have many notable things on this week's horizon, although I do have another Healer's Art class on Wednesday evening, so I will probably have lots to say about that in my next blog entry. The academic agenda this week consists of learning about implantation (in Developmental Biology), metabolic disorders with metabolic origin (Genetics), fat metabolism (Biochemistry), the ethics of confidentiality (ethics component of the Practice of Medicine course), the anatomy of the abdomen, and we will continue to breakdown the medical interview even further.
My life has acquired (and maintained) some rhythm and routine now and that is a welcome shift. One month from now I will be back in the PNW for Thanksgiving. Time is flying! I am enjoying it - the people, the academics, and the opportunities before me!
Ever onward!
Sunday, October 9, 2011
New this week - it does rain in Palo Alto :)
Thank goodness for having a little more space in one's life!
Last week was welcome respite from the craziness of exam week. Classes have been slow to ramp up (sometimes frustrating, but really allows some downtime for brain). On Monday, we had another standardized patient encounter, this time focusing on opening the medical interview and discussing the presenting illness with the patient. We worked in triads (three students at each station, with one standardized patient and one TA or prof). At each station, one of us was responsible for a 5-minute interview, while the rest of the team observed. After five minutes, the interviewer had time to reflect, the TA or prof then provided feedback, then the standardized patient did the same, and finally the remaining students had a chance to point out any other notable features of the interview. I really like these sessions! Although last week we only had one, typically we will have these every Monday and Friday, as we try and hone our skills associated with each portion of taking a history.
Tuesday, we had anatomy in the afternoon, which was fun, as always, but quite the shocker in terms of memory recall having been away from it for a week and a half. After anatomy, I tutored and then was lucky enough to participate in a dinner conversation with a physician from Penn who specializes in pediatric palliative care. We had a round table dinner discussion about palliative care, establishing trust and compassion in the doctor-patient relationship, and how to cultivate professional integrity in the patient encounter, even as medical students. I felt very moved by his comments and I was particularly impressed by how well he can articulate medical information in an open, honest, compassionate, and very tactful manner. A manner which promotes shared-decision-making in medical crisis and end of life situations.
Wednesday, I had Pediatric Physical Findings in the morning in the children's hospital. We were able to round on three different patients - one was a neonate with a rare skin condition known as icthyosis. She was 11 days old and recovering well from a serious, very rare congenital condition. As was true for the previous week, I left that 1.5 hr session feeling inspired and jazzed about medicine. I feel so so privileged to have as many opportunities as I do before me. It feels like I have a million doors open to me, and right now that is almost entirely exciting, not daunting (I imagine the switch between exciting and daunting will be a bit of a roller-coaster over the next 3 years as I try to figure out what type of physician I want to be).
Wednesday evening, I had my first class for the Healer's Art. Oh boy, is this class my cup of tea or what?! We had dinner followed by a large group discussion, then we broke up into small groups and discussed personal strengths we recognize in ourselves that we want to preserve, nurture, and cultivate during our medical training - characteristics we feel are personal assets, but we fear might be muted by the nature of medial school and resident education. Here is a link about this curriculum:
http://www.ishiprograms.org/programs/medical-educators-students/
The class is led by the Stanford Hospital chaplain (a former ER doc) and there are 3 other physician facilitators. Four of my classmates and I are serving as student advisors for the class and this class (comprised entirely of first-year medical students) is the largest in size since the class was first introduced at Stanford in 1990. My classmates are amazing people! I think I knew that before, but sitting in my small group that night, sharing personal stories, reflections, hopes, etc. I was reminded of just how impressive they are and how enriched our little community of 86 medical students really is. Yippee!
Thursday was a pretty average day (although I biked to school in the rain (very reminiscent of the PNW and we were able to dissect the hand in anatomy, which was sooooo cool!). Friday classes weren't very notable either, although we had our first ethics lecture in the afternoon, which quickly reignited my passion for clinical ethics problem-solving. I spoke with the director of the biomedical ethics program after the class and he seemed very enthusiastic about the session and about my potential role in the program in the future. I was all smiles, that's for sure!
Alex picked me up from school on Friday and we ventured to Monterey to visit his grandparents (Jay and Rita) and aunt, uncle, and cousins (Joanne, Tom, Kirsten, and Kyle). We had wonderful home-cooked meals (think tacos, french toast casserole, and homemade veggie chili), went to the Monterey Aquarium, reconnected with my college friend Larissa and her fiance Rob, then had more family time, and more great food.
Today, I trained to give flu vaccines as part of Stanford's "Flu Crew" Program. After training, I am now eligible to help vaccinate Stanford students, faculty, and staff at various events on campus, as well as help vaccinate migrant farm worker populations at an array of farms around San Mateo, Santa Clara, and Monterey counties.
After tutoring, studying, and more studying, here I am! Ready for the next week!
By the way, it is gratifying to know that even just under a month and a half into med school I can begin to problem-solve my way through medical problems and/or questions (when Alex's grandma asked about osteoporosis, I gave her a whole spiel about how the disease develops at the cellular level - it felt good!).
That's all for now - much love to all my dear friends and family!
Last week was welcome respite from the craziness of exam week. Classes have been slow to ramp up (sometimes frustrating, but really allows some downtime for brain). On Monday, we had another standardized patient encounter, this time focusing on opening the medical interview and discussing the presenting illness with the patient. We worked in triads (three students at each station, with one standardized patient and one TA or prof). At each station, one of us was responsible for a 5-minute interview, while the rest of the team observed. After five minutes, the interviewer had time to reflect, the TA or prof then provided feedback, then the standardized patient did the same, and finally the remaining students had a chance to point out any other notable features of the interview. I really like these sessions! Although last week we only had one, typically we will have these every Monday and Friday, as we try and hone our skills associated with each portion of taking a history.
Tuesday, we had anatomy in the afternoon, which was fun, as always, but quite the shocker in terms of memory recall having been away from it for a week and a half. After anatomy, I tutored and then was lucky enough to participate in a dinner conversation with a physician from Penn who specializes in pediatric palliative care. We had a round table dinner discussion about palliative care, establishing trust and compassion in the doctor-patient relationship, and how to cultivate professional integrity in the patient encounter, even as medical students. I felt very moved by his comments and I was particularly impressed by how well he can articulate medical information in an open, honest, compassionate, and very tactful manner. A manner which promotes shared-decision-making in medical crisis and end of life situations.
Wednesday, I had Pediatric Physical Findings in the morning in the children's hospital. We were able to round on three different patients - one was a neonate with a rare skin condition known as icthyosis. She was 11 days old and recovering well from a serious, very rare congenital condition. As was true for the previous week, I left that 1.5 hr session feeling inspired and jazzed about medicine. I feel so so privileged to have as many opportunities as I do before me. It feels like I have a million doors open to me, and right now that is almost entirely exciting, not daunting (I imagine the switch between exciting and daunting will be a bit of a roller-coaster over the next 3 years as I try to figure out what type of physician I want to be).
Wednesday evening, I had my first class for the Healer's Art. Oh boy, is this class my cup of tea or what?! We had dinner followed by a large group discussion, then we broke up into small groups and discussed personal strengths we recognize in ourselves that we want to preserve, nurture, and cultivate during our medical training - characteristics we feel are personal assets, but we fear might be muted by the nature of medial school and resident education. Here is a link about this curriculum:
http://www.ishiprograms.org/programs/medical-educators-students/
The class is led by the Stanford Hospital chaplain (a former ER doc) and there are 3 other physician facilitators. Four of my classmates and I are serving as student advisors for the class and this class (comprised entirely of first-year medical students) is the largest in size since the class was first introduced at Stanford in 1990. My classmates are amazing people! I think I knew that before, but sitting in my small group that night, sharing personal stories, reflections, hopes, etc. I was reminded of just how impressive they are and how enriched our little community of 86 medical students really is. Yippee!
Thursday was a pretty average day (although I biked to school in the rain (very reminiscent of the PNW and we were able to dissect the hand in anatomy, which was sooooo cool!). Friday classes weren't very notable either, although we had our first ethics lecture in the afternoon, which quickly reignited my passion for clinical ethics problem-solving. I spoke with the director of the biomedical ethics program after the class and he seemed very enthusiastic about the session and about my potential role in the program in the future. I was all smiles, that's for sure!
Alex picked me up from school on Friday and we ventured to Monterey to visit his grandparents (Jay and Rita) and aunt, uncle, and cousins (Joanne, Tom, Kirsten, and Kyle). We had wonderful home-cooked meals (think tacos, french toast casserole, and homemade veggie chili), went to the Monterey Aquarium, reconnected with my college friend Larissa and her fiance Rob, then had more family time, and more great food.
Today, I trained to give flu vaccines as part of Stanford's "Flu Crew" Program. After training, I am now eligible to help vaccinate Stanford students, faculty, and staff at various events on campus, as well as help vaccinate migrant farm worker populations at an array of farms around San Mateo, Santa Clara, and Monterey counties.
After tutoring, studying, and more studying, here I am! Ready for the next week!
By the way, it is gratifying to know that even just under a month and a half into med school I can begin to problem-solve my way through medical problems and/or questions (when Alex's grandma asked about osteoporosis, I gave her a whole spiel about how the disease develops at the cellular level - it felt good!).
That's all for now - much love to all my dear friends and family!
Sunday, October 2, 2011
So long mini-quarter
I did it!
I successfully completed my first week of medical school exams. As stressful as this week was, the change of pace was nice in a way. We had mornings off and exams in the afternoon.
First up, we had our histology exam on Monday afternoon. My class was divided into groups of eight and we were assigned a forty-five minute time slot between 1 and 5 to complete the test. We had to identify ten things from five different slides, all in silence - raising our hands and the TAs coming over to confirm whether our attempt was successful. If we were right or wrong, we never new, the TAs merely made a mark on their notepad. After the exam, more studying, some tutoring, then more studying.
On Tuesday, we had our Cells to Tissues exam - 3 hours to complete twenty-two pages and boy was at a tight squeeze. Everyone was there straight to the end. It was quite the exhausting exam. Apparently the professor added an additional question this year because the exam is open note/resource and the 'find' feature on iPads and computers makes finding things easier than normal. Well, 'find' or no 'find' it was a long exam for all of us.
After more studying and more studying, I had my Pediatric Physical Findings class on Wednesday morning. We met in the children's hospital, were introduced to the distinguishing characteristics of pediatrics by Dr. Prober (Associate Dean of Medicine and a pediatrician specializing in infectious diseases) and one of the senior pediatric residents. We got a tour of the NICU (neonatal intensive care unit), PICU (pediatric), and the normal pediatric floors. We finished our session with a visit to an 11 year old patient with an undiagnosed stomach problem.
I loved that whole experience! Some of the unique things about pediatrics, really unique challenges, drew me in - such as the challenge of working with a patient for whom verbal communication may not be possible, meaning the physician needs to be astute to body language cues and work well with families to get as much information as possible and provide the best care. I do love working with kids, and this class will be a great experience for me to test out how important that patient population is to me.
After that class, I participated as a rater in the Multi Mini Interview for Stanford's medical school admissions process. It took up much of my afternoon but was a very valuable experience for me to be able to see what it is like on the other side of the room. The question I had revolved around the possibility of initiating a preferential admissions process for medical school contingent on devoting 2-3 years at the start of one's career to working in a rural or underserved community. Interviewees were required to explore the pros and cons and discuss the topic from multiple perspectives over the course of ten minutes. I saw ten people and they were very different in the approach and communication style.
I went home after the MMI and studied, studied, studied in preparation for our closed-note Molecular Foundations class on Thursday. Staying up later and studying was increasingly challenging as the week went on because of the stress and strain of studying so much and the two-way (16 mile) bike rides I had been completing each day.
Anyway, after another morning of studying, I took my last exam and WOW, it sure did feel good to check that off the list. There was a keg waiting outside on the lawn for us when we were done (in contrast to the coffee that awaited us after our Tuesday exam). We all hung out, chatted, and glowed with relief. A few of us ventured to the center of campus for some frozen yogurt to celebrate - I was one of them, no big surprise. I tutored a new student in physics for an hour and then met Alex and a bunch of my classmates at a local favorite in Menlo Park - the Dutch Goose. We shared pitchers of beer and some greasy food, including sweet potato fries. I think our energy was quite infectious. We were all so so happy to be done with mini-quarter and the stress level had virtually disappeared. We hardly recognized each other.
Friday morning we had a clas that focused on learning how to give feedback to others and understanding the importance of critical reflection in medicine. In the afternoon, we were introduced to the content of our Practice of Medicine course - we start lectures on quantitative medicine and population health on Monday and we will be starting to deconstruct the medical interview in small groups and with standardized patients.
My friend Carolyn Anderson from UPS, currently studying at UC Davis, came to visit Friday afternoon and we spent the evening relaxing at ur house with a few of my med school friends,
Yesterday was all about enjoying a slow morning, grocery shopping and tailgating for the Stanford- UCLA football game. Alex and I joined some of my classmates for a big tailgating extravaganza. I had never experience this kind of tailgating event but it was so much fun! The game was awesome too. Having never been to a big football game, I was shocked to find myself five rows up from the in-zone (all of the student sections are right by the field and all Stanford students get in free). The Stanford team did amazingly well, I felt proud!
Now, a relaxing Sunday, finally! Hanging with Alex, making banana bread, going to the Farmer's Market in Palo Alto with my friend Lindsey, tutoring, going for a run, making good for the week, etc.
Tomorrow, I start a whole new set of class's, but it will be nice to wind back the dial a bit on the stress-o-meter. For a little while at least.
I successfully completed my first week of medical school exams. As stressful as this week was, the change of pace was nice in a way. We had mornings off and exams in the afternoon.
First up, we had our histology exam on Monday afternoon. My class was divided into groups of eight and we were assigned a forty-five minute time slot between 1 and 5 to complete the test. We had to identify ten things from five different slides, all in silence - raising our hands and the TAs coming over to confirm whether our attempt was successful. If we were right or wrong, we never new, the TAs merely made a mark on their notepad. After the exam, more studying, some tutoring, then more studying.
On Tuesday, we had our Cells to Tissues exam - 3 hours to complete twenty-two pages and boy was at a tight squeeze. Everyone was there straight to the end. It was quite the exhausting exam. Apparently the professor added an additional question this year because the exam is open note/resource and the 'find' feature on iPads and computers makes finding things easier than normal. Well, 'find' or no 'find' it was a long exam for all of us.
After more studying and more studying, I had my Pediatric Physical Findings class on Wednesday morning. We met in the children's hospital, were introduced to the distinguishing characteristics of pediatrics by Dr. Prober (Associate Dean of Medicine and a pediatrician specializing in infectious diseases) and one of the senior pediatric residents. We got a tour of the NICU (neonatal intensive care unit), PICU (pediatric), and the normal pediatric floors. We finished our session with a visit to an 11 year old patient with an undiagnosed stomach problem.
I loved that whole experience! Some of the unique things about pediatrics, really unique challenges, drew me in - such as the challenge of working with a patient for whom verbal communication may not be possible, meaning the physician needs to be astute to body language cues and work well with families to get as much information as possible and provide the best care. I do love working with kids, and this class will be a great experience for me to test out how important that patient population is to me.
After that class, I participated as a rater in the Multi Mini Interview for Stanford's medical school admissions process. It took up much of my afternoon but was a very valuable experience for me to be able to see what it is like on the other side of the room. The question I had revolved around the possibility of initiating a preferential admissions process for medical school contingent on devoting 2-3 years at the start of one's career to working in a rural or underserved community. Interviewees were required to explore the pros and cons and discuss the topic from multiple perspectives over the course of ten minutes. I saw ten people and they were very different in the approach and communication style.
I went home after the MMI and studied, studied, studied in preparation for our closed-note Molecular Foundations class on Thursday. Staying up later and studying was increasingly challenging as the week went on because of the stress and strain of studying so much and the two-way (16 mile) bike rides I had been completing each day.
Anyway, after another morning of studying, I took my last exam and WOW, it sure did feel good to check that off the list. There was a keg waiting outside on the lawn for us when we were done (in contrast to the coffee that awaited us after our Tuesday exam). We all hung out, chatted, and glowed with relief. A few of us ventured to the center of campus for some frozen yogurt to celebrate - I was one of them, no big surprise. I tutored a new student in physics for an hour and then met Alex and a bunch of my classmates at a local favorite in Menlo Park - the Dutch Goose. We shared pitchers of beer and some greasy food, including sweet potato fries. I think our energy was quite infectious. We were all so so happy to be done with mini-quarter and the stress level had virtually disappeared. We hardly recognized each other.
Friday morning we had a clas that focused on learning how to give feedback to others and understanding the importance of critical reflection in medicine. In the afternoon, we were introduced to the content of our Practice of Medicine course - we start lectures on quantitative medicine and population health on Monday and we will be starting to deconstruct the medical interview in small groups and with standardized patients.
My friend Carolyn Anderson from UPS, currently studying at UC Davis, came to visit Friday afternoon and we spent the evening relaxing at ur house with a few of my med school friends,
Yesterday was all about enjoying a slow morning, grocery shopping and tailgating for the Stanford- UCLA football game. Alex and I joined some of my classmates for a big tailgating extravaganza. I had never experience this kind of tailgating event but it was so much fun! The game was awesome too. Having never been to a big football game, I was shocked to find myself five rows up from the in-zone (all of the student sections are right by the field and all Stanford students get in free). The Stanford team did amazingly well, I felt proud!
Now, a relaxing Sunday, finally! Hanging with Alex, making banana bread, going to the Farmer's Market in Palo Alto with my friend Lindsey, tutoring, going for a run, making good for the week, etc.
Tomorrow, I start a whole new set of class's, but it will be nice to wind back the dial a bit on the stress-o-meter. For a little while at least.
Sunday, September 25, 2011
Oh, I remember - that's why I am here
This past week was another remarkably full one, but also great!
The stress level has been a bit higher among my classmates recently. The week before me is full of exams and the exams are mysterious enough that I, and most of my first-year classmates, am frantically studying and attempting to evaluate just how much sleep I need to sacrifice to pass our exams.
Last week had some refreshing moments that allowed me to reconnect with the real reason I am here. We had several occasions that reminded us of the healing art of medicine, the delicate balance between health, medicine, technology, and compassionate care. On Monday, we had a patient presentation regarding an unusual bone cancer. The patient presenting is a professor emeritus and Nobel prize winner. His story was incredible and it was wonderful to have him share so much with us. On Wednesday, we had a vital signs workshop where I honed my skills related to taking blood pressure, respiration rate, and pulse, testing for blood glucose levels, administering TB tests, performing intramuscular injections, and drawing blood. Much of that I had never done before and I successful drew blood from my fellow classmate on the first try (although he was so hydrated, my vial filled quickly - so I surpassed the couple of milliliters I was supposed to collect; as compensation I gave him a lollipop). I felt so happy after that workshop. I know that those skills are fairly mundane, but I am well-armed for being more useful at the free clinic and that is exciting.
On Thursday, the mother of a woman who had passed in June due to extremely aggressive metastatic lung cancer came and spoke with us about her experience sharing the diagnostic odyssey with her daughter and the challenges of a rapidly evolving terminal illness. She brought up several issues pertaining to doctor-patient communication, health team-family communication, and the confusion triggered by discontinuity in care plans among different health care providers (not enough cross-talk). She brought all of us back quickly to the emotional side of healing and reminded us that there is still a lot of room for improvement in terms of how we treat the patient and their family. She had a positive experience, overall, with how her daughter's illness had been handled by the health care team and she was so warm with us. To her, speaking with us and sharing her daughter's story was a privilege. I felt the same way about her being there.
The rest of my week consisted of wrapping up lectures, concocting various study groups and settings to help me and my classmates organize and synthesize all of the material we are accountable for.
Yesterday, Alex and I drove to Monterrey (Pacific Grove) to help celebrate his uncle Tom's 60th birthday. I studied on the way there and took an online molecular biology quiz at a lovely cafe (after having lunch on Cannery Row), which allowed me to relax a little bit. Having a midnight deadline hanging over my head during the birthday shindig would have been a bummer. After getting that out of the way, I was introduced to so many friends and family of Alex's uncle that my head was swimming. Still, I had a wonderful time - good food, great conversation, and an incredible view (right on the water, with the entire of Monterrey Bay before us).
Another perk of our Saturday excursion was having a taste of weather in the 60s. Overcast skies, sea mist, and a cool breeze - I was in love! Take me back to the northwest! :)
We drove back home late last night, both Alex and I tutored in the morning and afternoon, and more studying commenced. Now...more studying!!! Histology exam tomorrow, Cells to Tissues on Tuesday, and Molecular Foundations of Medicine on Thursday. In the midst of that, I will participate in the Multi-Mini Interview for the first medical school admissions interview on Wednesday. Go-go-go!
This coming weekend will be a nice treat. Practically no homework. My words will be leaping off the page next weekend.
The stress level has been a bit higher among my classmates recently. The week before me is full of exams and the exams are mysterious enough that I, and most of my first-year classmates, am frantically studying and attempting to evaluate just how much sleep I need to sacrifice to pass our exams.
Last week had some refreshing moments that allowed me to reconnect with the real reason I am here. We had several occasions that reminded us of the healing art of medicine, the delicate balance between health, medicine, technology, and compassionate care. On Monday, we had a patient presentation regarding an unusual bone cancer. The patient presenting is a professor emeritus and Nobel prize winner. His story was incredible and it was wonderful to have him share so much with us. On Wednesday, we had a vital signs workshop where I honed my skills related to taking blood pressure, respiration rate, and pulse, testing for blood glucose levels, administering TB tests, performing intramuscular injections, and drawing blood. Much of that I had never done before and I successful drew blood from my fellow classmate on the first try (although he was so hydrated, my vial filled quickly - so I surpassed the couple of milliliters I was supposed to collect; as compensation I gave him a lollipop). I felt so happy after that workshop. I know that those skills are fairly mundane, but I am well-armed for being more useful at the free clinic and that is exciting.
On Thursday, the mother of a woman who had passed in June due to extremely aggressive metastatic lung cancer came and spoke with us about her experience sharing the diagnostic odyssey with her daughter and the challenges of a rapidly evolving terminal illness. She brought up several issues pertaining to doctor-patient communication, health team-family communication, and the confusion triggered by discontinuity in care plans among different health care providers (not enough cross-talk). She brought all of us back quickly to the emotional side of healing and reminded us that there is still a lot of room for improvement in terms of how we treat the patient and their family. She had a positive experience, overall, with how her daughter's illness had been handled by the health care team and she was so warm with us. To her, speaking with us and sharing her daughter's story was a privilege. I felt the same way about her being there.
The rest of my week consisted of wrapping up lectures, concocting various study groups and settings to help me and my classmates organize and synthesize all of the material we are accountable for.
Yesterday, Alex and I drove to Monterrey (Pacific Grove) to help celebrate his uncle Tom's 60th birthday. I studied on the way there and took an online molecular biology quiz at a lovely cafe (after having lunch on Cannery Row), which allowed me to relax a little bit. Having a midnight deadline hanging over my head during the birthday shindig would have been a bummer. After getting that out of the way, I was introduced to so many friends and family of Alex's uncle that my head was swimming. Still, I had a wonderful time - good food, great conversation, and an incredible view (right on the water, with the entire of Monterrey Bay before us).
Another perk of our Saturday excursion was having a taste of weather in the 60s. Overcast skies, sea mist, and a cool breeze - I was in love! Take me back to the northwest! :)
We drove back home late last night, both Alex and I tutored in the morning and afternoon, and more studying commenced. Now...more studying!!! Histology exam tomorrow, Cells to Tissues on Tuesday, and Molecular Foundations of Medicine on Thursday. In the midst of that, I will participate in the Multi-Mini Interview for the first medical school admissions interview on Wednesday. Go-go-go!
This coming weekend will be a nice treat. Practically no homework. My words will be leaping off the page next weekend.
Sunday, September 18, 2011
Is Wednesday the new Saturday? I'm still not a believer...
The last week was another busy one, full of lectures about DNA, bone, cartilage, blood, stem cells, and dissections of the heart and major vessels.
Some notable parts of my week occurred on Wednesday. Turns out that at Stanford, Wednesdays are meant to be our 'off day.' We don't have lecture, but somehow the days just fill up. In a couple of weeks, our electives start and many of them take place on Wednesday. I am always so ready for Wednesday, because I convince myself that it will function as a bit of a mid-week reset. It does have a different pace, and for that I am grateful. Nevertheless, the day fills rapidly. This past Wednesday, I participated in a training to be an MMI rater (multi-mini interview), which means I will be contributing as an interviewer for the first set of medical school applicants on September 28. I am so excited! I think it will actually be quite therapeutic to begin to reformulate my association with the simulation floor in the medical school building (being on the other side of the interview process might make the ground floor a little less intimidating).
Funnily enough, immediately following that training I made my way directly for the ground floor of the med school building to the very rooms where I had been interviewed in February. I had not been down there since then and it felt a little eerie. The reason for my being down there was for my first patient encounter. Several of my classmates were there as well (ten in total) to complete our 'baseline' encounter in which we interviewed a patient without having received any instruction or training interview skills, how to take a history, etc. I was a bit terrified and the interaction I had was by no means a masterful interview, but I survived and so did the patient. It felt weird to be walking into an exam room, clipboard in hand and wearing a white coat, awkwardly shaking my patient's hand with my hands still wet from the hand sanitizer I was instructed to use upon entering the room. We had a great debrief with some older medial students afterwards and we could all move on with our days without the mystery of the baseline patient encounter looming over our heads.
The rest of the week went by fairly quickly. The intensity and density I have been mentioning repeatedly still held true this week, although I think I am less surprised by it. The reality of medical school is settling in a little bit and I am adjusting quite well - I think.
Friday, I spent the morning at the Medicine 2.0 conference that was hosted at the medical school. The speakers focused on issues related to how technology and social media are shaping the doctor-patient relationship and altering the patient experience. I found it fascinating, although the conference setup felt like being at a rock concert or a laser show. They took the technology theme way too seriously I think (the whole thing started about 30 minutes late because they were having some issues with the special effects). I only could stay for a short period before heading to my literature discussion group and histology lab, but I did get to meet a few really cool people (including an ER physician who spends portions of her year as the doctor for National Geographic expeditions - CRAZY! Sign me up!).
Yesterday was Alex's birthday and we had about 8 of my medical school classmates over for margaritas, a pinata, and other birthday festivities. I even had the chance to devote an hour to coming up with a baked concoction for his dessert (peanut butter-dark chocolate chip-oatmeal cookies with homemade applesauce to cut out some of the butter and fat). Everyone had a great time and I think Alex really enjoyed having the chance to hang with people our age. Plus, I think we did a good job of making Alex feel like 22 is the new 21 (see evidence below). :)
Now, I am readying for another busy week. This week is my last week of classes for mini-quarter. It will consist of quite a bit of review time, a vital signs workshop, and a dinner with my faculty mentor.
The week of the 26th is all exams and then I start new classes on October 3rd. It is unreal that this my fourth week of class, but I look forward to seeing how all of the material gets pulled together.
Some notable parts of my week occurred on Wednesday. Turns out that at Stanford, Wednesdays are meant to be our 'off day.' We don't have lecture, but somehow the days just fill up. In a couple of weeks, our electives start and many of them take place on Wednesday. I am always so ready for Wednesday, because I convince myself that it will function as a bit of a mid-week reset. It does have a different pace, and for that I am grateful. Nevertheless, the day fills rapidly. This past Wednesday, I participated in a training to be an MMI rater (multi-mini interview), which means I will be contributing as an interviewer for the first set of medical school applicants on September 28. I am so excited! I think it will actually be quite therapeutic to begin to reformulate my association with the simulation floor in the medical school building (being on the other side of the interview process might make the ground floor a little less intimidating).
Funnily enough, immediately following that training I made my way directly for the ground floor of the med school building to the very rooms where I had been interviewed in February. I had not been down there since then and it felt a little eerie. The reason for my being down there was for my first patient encounter. Several of my classmates were there as well (ten in total) to complete our 'baseline' encounter in which we interviewed a patient without having received any instruction or training interview skills, how to take a history, etc. I was a bit terrified and the interaction I had was by no means a masterful interview, but I survived and so did the patient. It felt weird to be walking into an exam room, clipboard in hand and wearing a white coat, awkwardly shaking my patient's hand with my hands still wet from the hand sanitizer I was instructed to use upon entering the room. We had a great debrief with some older medial students afterwards and we could all move on with our days without the mystery of the baseline patient encounter looming over our heads.
The rest of the week went by fairly quickly. The intensity and density I have been mentioning repeatedly still held true this week, although I think I am less surprised by it. The reality of medical school is settling in a little bit and I am adjusting quite well - I think.
Friday, I spent the morning at the Medicine 2.0 conference that was hosted at the medical school. The speakers focused on issues related to how technology and social media are shaping the doctor-patient relationship and altering the patient experience. I found it fascinating, although the conference setup felt like being at a rock concert or a laser show. They took the technology theme way too seriously I think (the whole thing started about 30 minutes late because they were having some issues with the special effects). I only could stay for a short period before heading to my literature discussion group and histology lab, but I did get to meet a few really cool people (including an ER physician who spends portions of her year as the doctor for National Geographic expeditions - CRAZY! Sign me up!).
Yesterday was Alex's birthday and we had about 8 of my medical school classmates over for margaritas, a pinata, and other birthday festivities. I even had the chance to devote an hour to coming up with a baked concoction for his dessert (peanut butter-dark chocolate chip-oatmeal cookies with homemade applesauce to cut out some of the butter and fat). Everyone had a great time and I think Alex really enjoyed having the chance to hang with people our age. Plus, I think we did a good job of making Alex feel like 22 is the new 21 (see evidence below). :)
Now, I am readying for another busy week. This week is my last week of classes for mini-quarter. It will consist of quite a bit of review time, a vital signs workshop, and a dinner with my faculty mentor.
The week of the 26th is all exams and then I start new classes on October 3rd. It is unreal that this my fourth week of class, but I look forward to seeing how all of the material gets pulled together.
Saturday, September 10, 2011
The Daily Marathon
Dean Pizzo told informed all of us at orientation that during medical school (and potentially beyond) we would become accustomed to a routine where every day feels like a marathon. I think I am beginning to understand what he meant that day.
After successfully completing two weeks of medical school, I am still excited, motivated, and increasingly inspired, but I am tired and trying my best to quickly establish the best kind of blend of school, friends, boyfriend, food, exercise, and sleep.
This week, I started biking from the Redwood City/Emerald Hills area to school. The route is a good one - the road isn't too busy, the scenery consists largely of beautiful residential neighborhoods, and although the ride is through rolling hills, it isn't too overwhelming. It takes me about 35 minutes to bike to school, and 40-45 minutes to bike back (more hills!). I like the fact that I now have structured exercise time and with the locker rooms provided in the medical school building I am able to easily shower and freshen up before class. Whether or not I continue to try and do another workouts with the personal trainers has yet to be determined. Bike commuting may be enough.
Our lectures progressed to discussions of cell cycles, muscular structure, gene expression, and gene regulation. In anatomy lab, we covered the lungs (an amazing dissection to see how big those suckers are!) and the heart. We had been warned by the anatomy TAs that the #($@! would hit the fan on Thursday, because now we are getting to the in-depth level of anatomical structure. In this case, they were referring to the vascularization of the heart and the process of understanding where all of the arteries and veins are in relation to one another and in relation to the other structures of the heart itself. I still love it. True, the sponge approach to learning anatomy is not quite as easy now that we are learning so many different terms, but the dissections are fascinating and it is great to learn from such enthusiastic professors. Our anatomy professors even performed a role-play for us on Thursday to demonstrate a differential diagnosis of a lung tumor that had invaded the pleural cavity. I love the integrative approach all of our professors use so that we can easily see how the content we are discussing in lecture might be relevant to clinical practice.
Alex started work this week, which has gone well so far, and I signed up to be a beta user for a new dining-deal website run by Stanford students. The bottom line is that Alex and I have gone out to eat (three dates) this week at good local restaurants essentially for free (very minimal financial burden for us...maybe $5-10 for the two of us for a $40 bill). It is fun and a nice treat, but we will have to be careful not to get too comfortable, because I only have one more week as a beta user and then it is back to the PB&J. :)
As for more about how things are going...I just have to rebuild the academic stamina I had as an undergrad and then strengthen it further. Being at school from 8am-6pm can be a drain and after that I still have to study at home. It is a nice break in the week to have Wednesdays free from class, but they easily get filled with meetings and study group sessions. Soon, they will also be filled with some elective coursework. We have had quizzes, problem sets, and other work to complete and in another two weeks we will be preparing for our big exams for our Cells to Tissues and Molecular Foundations courses. That will mark the end of mini-quarter and then we will start Developmental Biology, Applied Biochemistry, and Genetics. Woo hoo! Bring it on!
I am still completely in love with my classmates and continually find myself appreciating how warm, friendly, and inviting everyone is. On Thursday night, several of my new medical school classmates and I (all girls) got together for wine, cheese, and chocolate truffles to discuss a journal article we had to preview before a literature discussion yesterday. It was wonderful! We are already a community and I feel confident that I will be cultivating pretty phenomenal relationships via the camaraderie and intimacy that the medical school format fosters.
This afternoon, I have a reunion BBQ with my backpacking group from orientation and tomorrow I am volunteering at the Arbor Free Clinic (a student-run clinic) for the first half of the day - I get to wear my white coat and stethoscope for the first time - and then I am off to tutor two high school students before heading back home to study and take a quiz. The weekend will fly by I know, but I think it will give me enough time/space to refuel a bit. I will make the most of it!
Sending lots of love to you all!
After successfully completing two weeks of medical school, I am still excited, motivated, and increasingly inspired, but I am tired and trying my best to quickly establish the best kind of blend of school, friends, boyfriend, food, exercise, and sleep.
This week, I started biking from the Redwood City/Emerald Hills area to school. The route is a good one - the road isn't too busy, the scenery consists largely of beautiful residential neighborhoods, and although the ride is through rolling hills, it isn't too overwhelming. It takes me about 35 minutes to bike to school, and 40-45 minutes to bike back (more hills!). I like the fact that I now have structured exercise time and with the locker rooms provided in the medical school building I am able to easily shower and freshen up before class. Whether or not I continue to try and do another workouts with the personal trainers has yet to be determined. Bike commuting may be enough.
Our lectures progressed to discussions of cell cycles, muscular structure, gene expression, and gene regulation. In anatomy lab, we covered the lungs (an amazing dissection to see how big those suckers are!) and the heart. We had been warned by the anatomy TAs that the #($@! would hit the fan on Thursday, because now we are getting to the in-depth level of anatomical structure. In this case, they were referring to the vascularization of the heart and the process of understanding where all of the arteries and veins are in relation to one another and in relation to the other structures of the heart itself. I still love it. True, the sponge approach to learning anatomy is not quite as easy now that we are learning so many different terms, but the dissections are fascinating and it is great to learn from such enthusiastic professors. Our anatomy professors even performed a role-play for us on Thursday to demonstrate a differential diagnosis of a lung tumor that had invaded the pleural cavity. I love the integrative approach all of our professors use so that we can easily see how the content we are discussing in lecture might be relevant to clinical practice.
Alex started work this week, which has gone well so far, and I signed up to be a beta user for a new dining-deal website run by Stanford students. The bottom line is that Alex and I have gone out to eat (three dates) this week at good local restaurants essentially for free (very minimal financial burden for us...maybe $5-10 for the two of us for a $40 bill). It is fun and a nice treat, but we will have to be careful not to get too comfortable, because I only have one more week as a beta user and then it is back to the PB&J. :)
As for more about how things are going...I just have to rebuild the academic stamina I had as an undergrad and then strengthen it further. Being at school from 8am-6pm can be a drain and after that I still have to study at home. It is a nice break in the week to have Wednesdays free from class, but they easily get filled with meetings and study group sessions. Soon, they will also be filled with some elective coursework. We have had quizzes, problem sets, and other work to complete and in another two weeks we will be preparing for our big exams for our Cells to Tissues and Molecular Foundations courses. That will mark the end of mini-quarter and then we will start Developmental Biology, Applied Biochemistry, and Genetics. Woo hoo! Bring it on!
I am still completely in love with my classmates and continually find myself appreciating how warm, friendly, and inviting everyone is. On Thursday night, several of my new medical school classmates and I (all girls) got together for wine, cheese, and chocolate truffles to discuss a journal article we had to preview before a literature discussion yesterday. It was wonderful! We are already a community and I feel confident that I will be cultivating pretty phenomenal relationships via the camaraderie and intimacy that the medical school format fosters.
This afternoon, I have a reunion BBQ with my backpacking group from orientation and tomorrow I am volunteering at the Arbor Free Clinic (a student-run clinic) for the first half of the day - I get to wear my white coat and stethoscope for the first time - and then I am off to tutor two high school students before heading back home to study and take a quiz. The weekend will fly by I know, but I think it will give me enough time/space to refuel a bit. I will make the most of it!
Sending lots of love to you all!
Sunday, September 4, 2011
Adjustment and routine-setting
Wow, what an intense week! I am finally able to sit down, relax for a few moments, and reflect on the past week. The first week of med school was extremely intense. We were all so busy for the vast majority of each day and we were given so much information that one week felt much much longer.
On Tuesday, the highlight was our first gross anatomy lab. I was really really nervous beforehand and I was completely psyching myself out that I would not be able to handle the formaldehyde, or the cadavers, or I just would not be able to perform a dissection. Dressed in fresh, bright blue scrubs, we all descended into the basement of one of the clinical buildings and walked the long walk through bright green and orange hallways to the lab. Yes, it smelled like formaldehyde, but it was not as bad as I had Imagined it to be. The entire class gathered together with the professors at the start for an overview and to take a moment of silence to honor the people who had so generously donated their bodies to science. Next, standing beside my cadaver with my three anatomy teammates, all of the anticipation was getting to my head and I felt a bit iffy. Yet, the second we were given the thumbs up to open the bags and proceed with the dissection I was fine. In fact, I was more than fine. I had a terrific and exciting time in our first anatomy lab. Even before the go ahead, my group knew that we had a very petite cadaver compared to many of our classmates. Turns out we have a small older woman, probably less than 100 pounds, whereas others have large men and women - one group has a 300-pound individual who lived to be 91 years old. Turns out my group is lucky to have a petite, slender cadaver, since we do not have to deal with vast amounts of fat tissue during dissection.
We started with a midline cut from the top of the sternum to the bottom, then we made cuts from the midline across each clavicle, and then lower cuts across the lower ribs. Our objective was to separate The skin and deep fascia from the muscle so that the pectorals major (your breast muscle), the ribs, and other muscles would be exposed and ready for further dissection on Thursday. I left the lab that day feeling like I was on top of the world. Gross anatomy lab has the reputation of serving as a rite of passage for first year med students and I had successfully completed my first day.
After lab, I worked on some school stuff before heading to a personal training session with my classmate Nicole. We have become workout buddies and after our inaugural workout on Tuesday (a strength and cardio circuit that sufficiently kicked my ass), we did an ab session and a run on Wednesday, another circuit on Thursday, and a run with Alex on Friday. Hopefully we can keep up that routine amidst all of the other time constraints we have.
Wednesdays are technically our days off, but I arrived early for a learning strategy workshop, then worked out (the run Nicole and I have adopted is the campus loop which is gorgeous!), and then I studied, studied the rest of the day, both on my own and in a small study group, as we prepared for a histology quiz. Many people in my class felt surprised by the initial and sustained onslaught of information and how, as we studied for this quiz, we felt like we were preparing for a midterm, even after just 2 days of class. Well, after our study marathon, I went home to get things together and ready myself for Alex's arrival. He had spent all day Wednesday driving from Hood River to Palo Alto and was set to arrive around 7. I finished up school stuff, then we grabbed dinner, I completed my quiz and we called it a night.
Thursday was another good and very full day. We had lecture in the morning, a patient presentation with a family with myotonic dystrophy which was fascinating, a lunch pertaining to the Medical Education scholarly concentration, and anatomy lab in the afternoon. This time, during the anatomy lecture before the lab, we were able to test out how well our iPads accommodate drawing on the slides the anatomists give us to learn the tissues of the day. It was great and fun too. Dr. Gosling taught us about the muscles of the chest wall, the organization of the breast and about the innervation of the skin. Love it! Our dissection task was to separate the pectorals major from the pectoralis minor and expose the lateral side of serratus anterior muscle which rests along the outer edge of your rib cage. Once again, lab was successful, exciting, and very interesting.
Nicole and I made another visit to the personal trainers after having a brief literature discussion session and then I went home to meet Alex for dinner,
The rest of that evening was quite traumatic and I won't give the details here, but let's just say that I was kicked out of my apartment for no justifiable reason, Alex and I packed up all of my stuff that evening, and we both moved into our new place in Emerald Hills. The silver lining is I was able to move earlier in the month, move very quickly, and I don't have to deal with a crazy roommate situation that highlights the pitfalls of Craigslist-based deals. Ugh!
Friday was busy, but the day seemed to drag. I think all of us were so ready for the weekend and drained from the intensity and density of the first week, that we were all starting to tune out by the time our journal article discussion sessions commenced in the afternoon and, if not then, certainly by the time we got to histology lab.
At the end of the day, the Stanford Medical Students Association hosted a barbecue on the lawn in front of the med school building and Alex was able to join me for that. I was so happy to have him there and introduce him to many of my classmates. He heard a broken record story about how crazy the first week had been, how it had felt like a month, not a week, and how we are all still feeling the shock and awe of it. He connected easily with people and we both had a great time. Burgers, hot dogs, beer, and great people. What more could you ask for?
After that we met up with my friend Nick from high school and his fiancé Laurie for a little bite and some drinks in Palo Alto. Alex had never met either of them and I had not seen them since they so generously hosted me for my med school interview at Stanford. It was a great time for the four of us to connect in a better way and I am sure we will be seeing them more often.
Yesterday was largely all about outfitting our new place. We picked up a futon from the Stanford classifieds, went to a med student run tailgate for the Stanford - San Jose State game, went to Target, Costco, then back home to unload, and then we turned back around and went to Ikea for more furniture. I think we reminded ourselves of how exhausting moving can be. It was no big surprise that we crashed last night.
So, the first week was largely a big success. The quiz that me and my study buddies had frantically tried tried to prepare for was actually not that bad - we had over prepared. Actually, I think we were probably preparing more for the exam, but that's not a bad habit to get into. My roommate/apartment fiasco, while it has not been resolved, translated into an early move-in for Alex and I. I get to sleep in a place up in the hills, away from busy roads and the sounds of trains passing by at night. Today, I get to play catch up a bit, tutor a few kids in math and chemistry, meet up with some other med school couples at an old-fashioned creamery in Palo Alto and relax a bit more. A busy day, but busy in a great way.
Below you'll find a picture of my class after receiving our white coats (right before our stethoscope ceremony). Hope you all are well! Lots of hugs and love!
On Tuesday, the highlight was our first gross anatomy lab. I was really really nervous beforehand and I was completely psyching myself out that I would not be able to handle the formaldehyde, or the cadavers, or I just would not be able to perform a dissection. Dressed in fresh, bright blue scrubs, we all descended into the basement of one of the clinical buildings and walked the long walk through bright green and orange hallways to the lab. Yes, it smelled like formaldehyde, but it was not as bad as I had Imagined it to be. The entire class gathered together with the professors at the start for an overview and to take a moment of silence to honor the people who had so generously donated their bodies to science. Next, standing beside my cadaver with my three anatomy teammates, all of the anticipation was getting to my head and I felt a bit iffy. Yet, the second we were given the thumbs up to open the bags and proceed with the dissection I was fine. In fact, I was more than fine. I had a terrific and exciting time in our first anatomy lab. Even before the go ahead, my group knew that we had a very petite cadaver compared to many of our classmates. Turns out we have a small older woman, probably less than 100 pounds, whereas others have large men and women - one group has a 300-pound individual who lived to be 91 years old. Turns out my group is lucky to have a petite, slender cadaver, since we do not have to deal with vast amounts of fat tissue during dissection.
We started with a midline cut from the top of the sternum to the bottom, then we made cuts from the midline across each clavicle, and then lower cuts across the lower ribs. Our objective was to separate The skin and deep fascia from the muscle so that the pectorals major (your breast muscle), the ribs, and other muscles would be exposed and ready for further dissection on Thursday. I left the lab that day feeling like I was on top of the world. Gross anatomy lab has the reputation of serving as a rite of passage for first year med students and I had successfully completed my first day.
After lab, I worked on some school stuff before heading to a personal training session with my classmate Nicole. We have become workout buddies and after our inaugural workout on Tuesday (a strength and cardio circuit that sufficiently kicked my ass), we did an ab session and a run on Wednesday, another circuit on Thursday, and a run with Alex on Friday. Hopefully we can keep up that routine amidst all of the other time constraints we have.
Wednesdays are technically our days off, but I arrived early for a learning strategy workshop, then worked out (the run Nicole and I have adopted is the campus loop which is gorgeous!), and then I studied, studied the rest of the day, both on my own and in a small study group, as we prepared for a histology quiz. Many people in my class felt surprised by the initial and sustained onslaught of information and how, as we studied for this quiz, we felt like we were preparing for a midterm, even after just 2 days of class. Well, after our study marathon, I went home to get things together and ready myself for Alex's arrival. He had spent all day Wednesday driving from Hood River to Palo Alto and was set to arrive around 7. I finished up school stuff, then we grabbed dinner, I completed my quiz and we called it a night.
Thursday was another good and very full day. We had lecture in the morning, a patient presentation with a family with myotonic dystrophy which was fascinating, a lunch pertaining to the Medical Education scholarly concentration, and anatomy lab in the afternoon. This time, during the anatomy lecture before the lab, we were able to test out how well our iPads accommodate drawing on the slides the anatomists give us to learn the tissues of the day. It was great and fun too. Dr. Gosling taught us about the muscles of the chest wall, the organization of the breast and about the innervation of the skin. Love it! Our dissection task was to separate the pectorals major from the pectoralis minor and expose the lateral side of serratus anterior muscle which rests along the outer edge of your rib cage. Once again, lab was successful, exciting, and very interesting.
Nicole and I made another visit to the personal trainers after having a brief literature discussion session and then I went home to meet Alex for dinner,
The rest of that evening was quite traumatic and I won't give the details here, but let's just say that I was kicked out of my apartment for no justifiable reason, Alex and I packed up all of my stuff that evening, and we both moved into our new place in Emerald Hills. The silver lining is I was able to move earlier in the month, move very quickly, and I don't have to deal with a crazy roommate situation that highlights the pitfalls of Craigslist-based deals. Ugh!
Friday was busy, but the day seemed to drag. I think all of us were so ready for the weekend and drained from the intensity and density of the first week, that we were all starting to tune out by the time our journal article discussion sessions commenced in the afternoon and, if not then, certainly by the time we got to histology lab.
At the end of the day, the Stanford Medical Students Association hosted a barbecue on the lawn in front of the med school building and Alex was able to join me for that. I was so happy to have him there and introduce him to many of my classmates. He heard a broken record story about how crazy the first week had been, how it had felt like a month, not a week, and how we are all still feeling the shock and awe of it. He connected easily with people and we both had a great time. Burgers, hot dogs, beer, and great people. What more could you ask for?
After that we met up with my friend Nick from high school and his fiancé Laurie for a little bite and some drinks in Palo Alto. Alex had never met either of them and I had not seen them since they so generously hosted me for my med school interview at Stanford. It was a great time for the four of us to connect in a better way and I am sure we will be seeing them more often.
Yesterday was largely all about outfitting our new place. We picked up a futon from the Stanford classifieds, went to a med student run tailgate for the Stanford - San Jose State game, went to Target, Costco, then back home to unload, and then we turned back around and went to Ikea for more furniture. I think we reminded ourselves of how exhausting moving can be. It was no big surprise that we crashed last night.
So, the first week was largely a big success. The quiz that me and my study buddies had frantically tried tried to prepare for was actually not that bad - we had over prepared. Actually, I think we were probably preparing more for the exam, but that's not a bad habit to get into. My roommate/apartment fiasco, while it has not been resolved, translated into an early move-in for Alex and I. I get to sleep in a place up in the hills, away from busy roads and the sounds of trains passing by at night. Today, I get to play catch up a bit, tutor a few kids in math and chemistry, meet up with some other med school couples at an old-fashioned creamery in Palo Alto and relax a bit more. A busy day, but busy in a great way.
Below you'll find a picture of my class after receiving our white coats (right before our stethoscope ceremony). Hope you all are well! Lots of hugs and love!
Monday, August 29, 2011
Day 1- Shock, awe, and inspiration
Well... It has officially happened...I started medical school today. 3 hours of lecture, a 1.5 hour roundtable patient discussion, and 2 hours of histology lab and I am here to tell the tale.
I definitely left my house this morning with a great feeling of intimidation, but that emotion was quickly soothed into submission during Dr. Gil Chu's entertaining 2 hour lecture on the underpinnings of molecular biology. He was funny, engaging, but demanding of student participation such that we were bribed with candy for asking questions. I could not believe how easily the lecture flowed and found it of great relief that the ol' med school adage about "drinking from a fire hose" had not come true...yet.
Within minutes of starting our Cells to Tissues lecture with Dr. Julie Theriot, I think I, along with all of my classmates felt something very different. This was the shock and awe we had all dreaded. She spoke at a terrific pace and we barely made it through all of the slides that she had for our hour class session. The information about cellular structure, the makeup of the epithelium, cell trafficking, etc. was all very interesting mind you and she was very enthusiastic. However, I am pretty sure that half of the information went immediately over my head. The fortunate thing was that I think almost all of my classmates felt the exact same way.
Lunch time couldn't come quickly enough and we all quickly assembled into small groups in which we could reassure each other that yes, in fact, we all were a bit surprised by the lecture and the fact that as of Day 1 we could so easily feel behind. Ah well, at least found solace in numbers.
After lunch, we heard from three patients who have dealt with polycystic kidney disease (PKD). We heard their stories, journeys with an incurable disease, and we were able to ask questions. A fascinating discussion, directly connected to what we learned in the previous class, and a great way to start the med school experience. After that, we all migrated to the histology lab, separated into small groups, and sent the rest of the afternoon looking at tissue samples from various organs to help us understand the diversity of epithelial cells. I thought it was fascinating and refreshing - no more plant samples under the microscope, just real tissue and practical learning tasks to help bring together lecture with a hands on experience. Yay!
The rest of the day consisted of a meet and greet with our TAs, which consisted of chatting in the sun with complimentary beer, peanuts, and pretzels. Pretty nice. Then free Indian food at a student government informational meeting, a bike ride back home, homework reading, and off to the Wine Room in Palo Alto to help celebrate my classmate Lindsey's birthday (with a bunch of my classmates to join in the festivities).
Really, it was a wonderful first day. A bit shocking at times, but also inspirational, and just relieving to be at this point in my education! The backpacking trip with classmates (called SWEAT) was great - beautiful scenery and a terrific venue for bonding. The orientation back on campus was both very useful and extremely moving. Stanford has an extraordinary commitment to it's medical students and that becomes clear very quickly when listening to the deans, faculty, or staff speak. They see it as a privilege to work with us and they emphasize that they are here to help raise us as future innovators, leaders, healers, and physicians. I was overjoyed to be able to share some of that experience with my mom, particularly being given my white coat and stethoscope and having the time to be able to show her the kind of community I am quickly being welcomed into.
I could say a lot more, but, no surprise, I have some reading to do, so I will leave you with two things:
1) an explanation of my blog title: the term pluripotent is most often applied to stem cells and it refers to their ability to differentiate into any cell type. Basically, it implies that they have unlimited potential. Dean Pizzo, dean of medicine at Stanford, referred to all of us as pluripotent on Day 1 of orientation and at this stage in my development as a medical professional, I would love to be seen as a "pluripotent healer."
2) at the end of our Stethoscope Ceremony last Friday night, all of the first-years stood in unison and stated the Stanford Affirmation (their verion of the hippocratic oath). You will find it below and I hope be able to gain at least a small appreciation for why I already feel Stanford medical school is so special:
On my admission to the Practice of Medicine I pledge to devote my life to the service of humanity. The care of my patients will be my first consideration. I will strive to acquire and share new knowledge with my colleagues and my patients; I will practice my profession with conscience and dignity, and to the best of my ability and judgment. I will approach each patient with charity, attention, humility, and commitment; I will hold all life dear, and let knowledge, wisdom, courage, and compassion guide my therapy; I will use my medical knowledge and skills to promote human rights, social justice, and civil liberties; I will not permit considerations of age, disease, or disability, faith, ethnic origin, gender identity, nationality, race, sexual orientation, socia standing or other forms of discrimination to intervene between my duty and my patient; I will respect the confidences with which I will be entrusted; I will give gratitude and respect to those from whom I have learned my Science and my Art; I will uphold the integrity of the medical profession; I will cultivate peace in both personal conduct and political expression; I will not use my knowledge contrary to the spirit of this Affirmation. I make these promises in witness of those who have stood here before me, and those who will come after, solemnly, freely, and upon my honor.
I definitely left my house this morning with a great feeling of intimidation, but that emotion was quickly soothed into submission during Dr. Gil Chu's entertaining 2 hour lecture on the underpinnings of molecular biology. He was funny, engaging, but demanding of student participation such that we were bribed with candy for asking questions. I could not believe how easily the lecture flowed and found it of great relief that the ol' med school adage about "drinking from a fire hose" had not come true...yet.
Within minutes of starting our Cells to Tissues lecture with Dr. Julie Theriot, I think I, along with all of my classmates felt something very different. This was the shock and awe we had all dreaded. She spoke at a terrific pace and we barely made it through all of the slides that she had for our hour class session. The information about cellular structure, the makeup of the epithelium, cell trafficking, etc. was all very interesting mind you and she was very enthusiastic. However, I am pretty sure that half of the information went immediately over my head. The fortunate thing was that I think almost all of my classmates felt the exact same way.
Lunch time couldn't come quickly enough and we all quickly assembled into small groups in which we could reassure each other that yes, in fact, we all were a bit surprised by the lecture and the fact that as of Day 1 we could so easily feel behind. Ah well, at least found solace in numbers.
After lunch, we heard from three patients who have dealt with polycystic kidney disease (PKD). We heard their stories, journeys with an incurable disease, and we were able to ask questions. A fascinating discussion, directly connected to what we learned in the previous class, and a great way to start the med school experience. After that, we all migrated to the histology lab, separated into small groups, and sent the rest of the afternoon looking at tissue samples from various organs to help us understand the diversity of epithelial cells. I thought it was fascinating and refreshing - no more plant samples under the microscope, just real tissue and practical learning tasks to help bring together lecture with a hands on experience. Yay!
The rest of the day consisted of a meet and greet with our TAs, which consisted of chatting in the sun with complimentary beer, peanuts, and pretzels. Pretty nice. Then free Indian food at a student government informational meeting, a bike ride back home, homework reading, and off to the Wine Room in Palo Alto to help celebrate my classmate Lindsey's birthday (with a bunch of my classmates to join in the festivities).
Really, it was a wonderful first day. A bit shocking at times, but also inspirational, and just relieving to be at this point in my education! The backpacking trip with classmates (called SWEAT) was great - beautiful scenery and a terrific venue for bonding. The orientation back on campus was both very useful and extremely moving. Stanford has an extraordinary commitment to it's medical students and that becomes clear very quickly when listening to the deans, faculty, or staff speak. They see it as a privilege to work with us and they emphasize that they are here to help raise us as future innovators, leaders, healers, and physicians. I was overjoyed to be able to share some of that experience with my mom, particularly being given my white coat and stethoscope and having the time to be able to show her the kind of community I am quickly being welcomed into.
I could say a lot more, but, no surprise, I have some reading to do, so I will leave you with two things:
1) an explanation of my blog title: the term pluripotent is most often applied to stem cells and it refers to their ability to differentiate into any cell type. Basically, it implies that they have unlimited potential. Dean Pizzo, dean of medicine at Stanford, referred to all of us as pluripotent on Day 1 of orientation and at this stage in my development as a medical professional, I would love to be seen as a "pluripotent healer."
2) at the end of our Stethoscope Ceremony last Friday night, all of the first-years stood in unison and stated the Stanford Affirmation (their verion of the hippocratic oath). You will find it below and I hope be able to gain at least a small appreciation for why I already feel Stanford medical school is so special:
On my admission to the Practice of Medicine I pledge to devote my life to the service of humanity. The care of my patients will be my first consideration. I will strive to acquire and share new knowledge with my colleagues and my patients; I will practice my profession with conscience and dignity, and to the best of my ability and judgment. I will approach each patient with charity, attention, humility, and commitment; I will hold all life dear, and let knowledge, wisdom, courage, and compassion guide my therapy; I will use my medical knowledge and skills to promote human rights, social justice, and civil liberties; I will not permit considerations of age, disease, or disability, faith, ethnic origin, gender identity, nationality, race, sexual orientation, socia standing or other forms of discrimination to intervene between my duty and my patient; I will respect the confidences with which I will be entrusted; I will give gratitude and respect to those from whom I have learned my Science and my Art; I will uphold the integrity of the medical profession; I will cultivate peace in both personal conduct and political expression; I will not use my knowledge contrary to the spirit of this Affirmation. I make these promises in witness of those who have stood here before me, and those who will come after, solemnly, freely, and upon my honor.
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