|
smoke_ring
|
read my profile
sign my guestbook
Birthday: 1/20/1979
Gender: Male
Interests: learning the ropes at bbq, learning random facts about food, guitar, redeeming all those wasted years of piano lessons, npr, wnyc... stuff like that
Expertise: keeping people up past their bedtimes
Occupation: Student
Message: message me
Member Since:
7/29/2003
|
|
| it's been a while, eh? well, no use in lamenting over my procrastination.
I recently started a masters in public health program that focuses on urban health this past summer. that means I'm taking some time off from med school to get this extra training. It brings up a lot of thoughts, of which, I'll comment on three right now.
1. I wore a Krispy Kreme t-shirt today to class and had a hot-dog during break... I felt pretty guilty. I also have a peter luger t-shirt but I've only worn these two t-shirts a combined total of twice since I started my mph because it just didn't seem right. I've also found myself taking the stairs a lot more than usual. So do you think it makes a difference whether or not I, as public health student, encourage eating 300 calorie donuts and huge slabs of red meat (albeit, darned tasty meat)? Would that decrease my credibility if I try to start a neighborhood campaign to increase access to nutritious and diabetes-friendly foods? What if we extended these types of questions to all areas of our lives?
2. A lot of people ask me if I'm not anxious to just get school over with and move on to residency. However, I was really excited to take some time off from school, not because I'm realy tired or struggling with school, but because there is so much to medicine that we don't have time to learn as we rush though our four years of training. It's difficult to find time to take a step back and reflect on my personal journey, on the medical system, and life outside of the medical bubble. This year is sort of like a sabbatical year for me and as I see my friends struggling to figure out which residency specialties and programs to apply to, I get to think about stigmatization of immigrants, medical education, gentrification, local politics, and so much more. I'm going to a christian community development association conference in a few weeks and I'll actually get to go snowboarding this year too. I can take time to really pray and fast about whether I should apply to family practice or med/peds programs and which hospitals. I also have time to learn all the things I didn't learn in med school while I was too busy playing soccer and talking to friends and patients. To me, taking time off has been one of the best things I could have done.
However, this is all to say that I know that a lot of people don't have the means to take this type of time off. They can't afford to add another year of debt and need to start practicing as soon as possible so they can help out their parents who struggled so hard to help them get an education. priviledge. Perhaps I will figure out a way to help others have the same opportunities that I've had but never deserved.
3. When I originally broached the idea of taking time off with my dad he thought that maybe it would be a bad idea because it would put off the possibility of finding a girlfriend for yet another year. However, he quickly reversed his opinion, thinking that maybe I could find a girlfriend during my year off and gave his approval. I guess he was right...
| | |
| Awkward silence...
I dropped by my grandparent's house yesterday to pick up some groceries and frozen food that my parents had left for me. I was hoping to make it a short visit so I could go back to school and study, but once I got there, my grandma just took out some food from the refrigerator and started to cook. Since I don't know how to tell them to stop in chinese, I had to at least stay for dinner...
perhaps you've already caught on to "my need to go back to school and study." I really do need to study, but the deeper truth reveals problems and inadequacies in myself. I don't know how to communicate with them, which is really awkward, so I've been avoiding these types of situations all my life, "forgetting" to call my grandparents and "not having time" to visit them. It's profoundly embarassing for me to realize that I've known my grandparents for 27 years now, but still don't know how to say much more than "thank you," "this tastes good," and "I'm full."
The sad part is that I've gone completely out of my way to learn spanish, taking one year of college spanish and spending 6 months in Guatemala after college. I knew that immersion was the best way for me to learn the language and gladly accepted (perhaps, even looked forward to) the awkward silences that forced me to find ways to say what I needed. Yet, when it comes to Chinese, I avoided, rather than embraced the opportunity to spend time with my grandparents alone. My dad has confronted me before about not making it a priority to spend time with my grandparents. If I'm a Christian he asks, how have I shown them love? I guess he's right. If I really did love my Grandparents in the fullest sense of the word, I probably would spend at least some time, trying to learn how to communicate with them. Sort of condemning, eh?
I guess it's time to stop avoiding visiting my grandparents. It's time to stop putting my feelings of guilt, shame, and inadequacy ahead of the people that I should be loving. Even if it's just one small word or phrase with each new visit. Anyone want to help me out?
It's amazing what you can learn in the midst of awkward silence...
Maybe I'll learn to embrace it more one day.
| | |
| We talked about the parable of the good samaritan today and what it has to say to Christians in health care. It got me thinking...
The priest and the levite pass by the half dead man on the other side of the road, but the samaritan, "as he journeyed, came to where he was, and when he saw him, he had compassion. He went to him and bound up his wounds..." For those who know the story, the samaritan goes on to provide for the victim in a such a wholistic way that I'd guess, most of us have never done anything close to that degree.
When I think about the way I am on the hospital floors, I'm not sure I even get to the first thing that the samaritan does... coming to where the man was to actually see the need. When I'm honest with myself, it becomes clear just how much I preemptively avoid people in need. Even though I've reminded friends about the importance of talking with a patient's family, I still find myself avoiding a patient's room when I see the family inside because I know they'll ask questions I don't know how to answer and keep me in the hospital later than I prefer. I avoid asking my intern if he needs any help because I really only want to help out if it's something "manageable." I take the elevator in my apt when I'm tired and it's 3am less because I'm tired, but more because I'm afraid I'll run into a homeless man sleeping in the stairs and be conflicted about what to do.
Part of my problem is that I preempt myself from getting to the point where I have the opportunity to actually see the needs of this world. That's a startlling and sober realization for someone who often prays for God to help me see this world through his eyes. Do I really mean what I pray?
"But a Samaritan, as he journed, came to where he was..."
| | |
| I just got back from work a couple of minutes ago (so if there are
things that don't make any sense at all, you'll have to forgive
me)... actually, never mind
that last statement. It's now 5 hours later because I had to take
a nap after realizing just how incoherent I was. sort of brings
back some memories of trying to write some last minute papers during
college. And sorry that this post is so long!
Anyway, despite the obvious effects of not sleeping for so long, I've
actually found that I really enjoy overnight call, meaning that I work a
day shift and the night shift back to back (in this case, about 25 hrs
straight). That might not be surprising for some of you since
I've always been a night owl, but it's not just that I like being up
late at night. There's less people working at night and I find it
easier to get to know the residents and nurses that way. I feel
like I'm learning a lot more from them and since there's less people
working, my responsibility and contribution increases too. Last
night, some of the attendings bought the staff pizza and
donuts/bagels. not bad either. I also find that it's easier
to talk to patients when I'm on call.
Last night I had two patients last night from Guatemala, which was
really cool since I spent several months down there in the past.
One of the patients was actually from the same city that I had lived in
while I was there. I had a really good conversation with the
other patient from
Guatemala and her family members. This patient was particularly
interesting because she had a lot questions and was really hesitant
about all of the procedures being done to her, even if there were
extremely
simple, standard, and low-risk things like drawing blood. Of
course, her
hesitation about these procedures really slowed down the ability for
the resident and nurse to get their work done efficiently. Now,
I'm talking about a really good doc and nurse here, both of whom really
go out of their way to teach, explain things to patients, and run
around a lot without complaining much. But even in them, it
wasn't hard to sense their frustration. I was following this doc,
so I felt similar frustrations. I knew how much more work was
lined up
(including some very important tasks) and here you are getting stuck
trying to explain that drawing blood isn't dangerous. If they
just listened to you, things would be so much better for them,
yourself, and the other patients...
Yet, you could also see the fear and confusion in the patient's voice
and
expression. She actually has anemia and was worried that drawing
blood would worsen her anemia. She came in with her sister who
could speak more english but she wasn't around at the time. She
kept asking for her sister while we were drawing the blood and I knew
she was scared, looking for the one thing that was familiar in this
situation. This
happened a few other times during the evening for other very standard
and safe procedures and it made me wonder what it must be like for this
patient to go through this experience. She has two other children
so she's not unfamiliar to giving birth, just that the last two times
she was in Guatemala giving birth in her home with a midwife, with no
electronic monitors, IV's, or drawing of blood. There weren't all
these strangers (doctors, nurses, and med students) walking in and out
of the room, performing examinations, and I don't think anybody was
suturing her after the delivery.
Can you imagine what this experience must have been like, with
everything being so strange, yet everybody emphatically saying don't
worry, it's okay, just let us/them do this procedure. It reminds
me of how I felt going to the doctors and dentist when I was in
Guatemala, after getting amoebas and losing my dental fillings. Any of you get sick while being in another
country? or even just away from home? I got really sick one
year when I went to conference in Urbana, Illinois. It was such a terrible
experience to be have uncontrollable, almost violent chills on the
floor of an unfamiliar dorm room.
I wound up sticking around the patient's room a lot after the doctors
left to try and explain what was going on to her and why we performed
particular procedures. I stayed around to talk about Guatemala,
church over there and here in the US, foods that I missed from
Guatemala, and family. I knew it was important to spend more time
with her and maybe she would be able to relax and trust me more.
As she gave birth, I just stood by her side, just trying to coach her
and explain what was going on.
There are 3 students on-call last night, and we're lucky enough that
they let us split up shifts. I was supposed to go to bed in the
early morning, but I wanted to be there when these two women gave
birth. I stayed up all night and as a result didn't study at all
and had to take a much longer nap today. When I look at some of
the other students, I see another way of approaching my day, where I
would have studied for at least 3 hours during the night and gotten a
few hours of sleep while on call. I would have been awake this
morning and could have finished this post at 9am rather than 3pm, and
have gotten in 4 hours of studying by now, including time to take
breaks and play guitar... but if I had hid in the conference room and
studied, I probably would not have interacted with this patient. I had
so much more connection with her than any other patient I have
worked with during this rotation. At the end of the day, I found
my
self, heading back to the floors (after changing to go home) just so I
could
see how she was doing and to say bye. It was awesome. Yet,
I also know how
much studying I need to do, not just for tests, but to understand
completely and be able to clearly explain to patients like her, the
reason for every step in her medical management. These goals are
both really important but often seem mutually exclusive. so
that's the dilemna I find myself in...but perhaps it's also a good
place for me to be.
| | |
| I recently was talking to one of my friends about the supermarket
episode (see my last post) and started talking about how amazed I was
that the two kids, living on food stamps, didn't know how to better use
their scant resources. Did their parents just not teach them or
is it possible that their parents don't know how to make the most of
their resources either?
She started recounting an episode where her friend, a science teacher
at a public school, tried to develop a project that all her students
could do, given the limited economic background of her students.
The project involved using popsicle sticks or any resource available
(old orange juice cartons, etc.) to make a roller coaster.
Additionally they had to write a short paper on the history of roller
coasters. After giving out the project, she got some complaints
from a few parents that they could not afford the supplies for the
project. Even after she informed the parents that a large bag of
popsicle sticks were $1 at a 99-cent store 5 blocks away and that their
child could even do the project with another student to split the
costs, the parents still balked. Of course, their child was
wearing Air Jordan's...
So what's going on here? why do I feel like this story is more of
a common trend
than an exception? My friend started talking about the concept of
"ghetto fabulous," which she described as poor people spending money
they don't have to buy things they can't afford because they might be
dead in a few years. (I don't think there's a clear concensus on
the definition of the term, but the idea is still valid) Why work
so hard to do well in school, go to college, and get a job, when you
might not be around to enjoy any of it. So rent a nicer apt.
rather than save money in a cheaper place so you can finally afford
your own house or lease a Lexus or Lincoln Navigator that you can't
repay. Buy $250 shoes or a large flatscreen HDTV when you're
having trouble to put food on the table. On one hand, you can
sort of understand that motivation and might wonder if you'd do the
same if you grew up in the same environment. But you also know
that this kind of
lifestyle/mentality is perverse. In some ways, it enslaves people
and really hinders people
from achieving any true upward mobility and financial security.
The real question though, is what can we do about this...
If you have time, listen to this link.
It's from a program run by the new york NPR station called Radio
Rookies, which helps teenagers to make their own radio stories.
Since it's coming from teens, there are a lot of really interesting
perspectives that I don't often hear. That particular link is for a story
called "Fashion Obsession." Here are two separate quotes from the
story:
Sometimes I really wish Dee could use
his money and buy my mom a car, rather than buy gator shoes or that
Louis Vitton bag I forced him to buy me. He needs to take a step
back and look at the big picture. A car would enable my mm to
drop the baby at the sitters, and schooling at Long Island, and hold a
part-time job...
...to be quite honest with you, I
wear name brands to not look poor. If I didn't wear them, my
status would slowly shut down and after awhile, I would look as broke
as I really am.
By the way, don't misread what I'm saying. I'm not saying
this is merely a problem with peoples attitudes. There are
certainly larger
structural forces involved in their plight but this is one of many
contributing factors.
Isaiah 55:1-2
| | |
|
