On doing medicine while also having lady parts

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r1jeuwm0uajx4teyacavI’m baaaaaack, bitches. Remember what I said before about how medical school sometimes sucks your soul right up and makes it hard to do the things that you love to do? That still holds. I’m in constant awe of my friends who maintain long-distance relationships; my SO and I have a hard enough time spending non-study time with each other and we live less than 10 minutes apart. But now I’m on break and I’ve had some time to lollygag and I’m feeling refreshed (read: terrified to go back to school and face four weeks of uninterrupted pre-exam stress), so I’m here to throw down some bloggin knowledge. Also one of my New Year’s Resolutions (I know they never work, but I still make them) is to get back on here at least once a month and write words. So there’s that. Also among my resolutions, in case you were wondering: exercise in the morning and stop sleeping in like a little lazy sloth woman all the time; get back to yoga, please, 1-3 times per week; and grow my hair out until I can donate it and then chop it off and donate it to a) cancer patients, or b) someone who wants a truly awesome weave. I’m not even kidding about that second part. Onto business.

Hey, did you guys know that having a vagina is both awesome and terrible? I love being a woman, and I’m pretty lucky that my gender identity and my genitals agree with one another (they hive five each other a lot because they’re like, “Yeah! We agree!”). That fact saves me an awful lot of anguish. I can’t really explain why I like being a woman; I just do. It’s a powerful and beautiful thing for me to be, and I feel very comfortable in my own lady-style skin (except I’m pissed off at it right now for breaking out from all the aforementioned stress.) I’m speaking from a place of acknowledged privilege, though, when I say that I feel comfortable both being a woman and exercising control over my own life decisions. And even that, I’m learning, is more complicated than I thought, especially in medicine. But I get that my experience of womanhood is so different not only from the people with whom I spend most of my time, but also and especially from many of the women whom I’ll ultimately care for and from those with whom I’ll never come into contact. So I’m going to talk about my own experience since it’s the only one I know, acknowledging that it might sound pretty blind and skewed here and there. Okay. Big ol’ caveat established.

Y’all it’s freaking expensive to be a lady and pay for birth control, beauty potions, razors that cost like two bucks more than their marketed-to-men counterparts, etc. I know that those things are (sort of) optional luxuries. Except the birth control (I mean, it shouldn’t be a luxury. Or access to it restricted through legislation based on exactly no science but rather the whims of people who have zero vaginas, thank-you-very-much). Whatever, I’m not really going to unpack that huge mess o’ crap I just built; suffice to say that I realize that even the choice of whether to buy lotions and potions or not is more than whether I want to do that. Even so, whatever pressures and powers have molded me to feel this way, I like my womanly rituals. I really enjoy putting makeup on my face when I feel like it. Shaving my legs makes me feel nice. Sometimes I sit around in my silk dressing gown and pretend I’m as glamorous Liz Taylor and it’s awesome.

See how this is incredibly complicated? I can’t even talk about whether I like makeup or not without being like, “Gah this is a mess.” But now let’s talk about medicine and lady parts. You know how some people say, “Guys, race is no longer a problem in this country, and the fact that we’ve been doing target practice on unarmed black teenagers and choke-holding people for funsies is just a coincidence and remember about Barack Obama”? And you know how those people are dumb? Well, the same dumb people say that being a professional woman is no harder than being a professional man. That is a falsehood. I’ve had several people tell me that, among my classmates, I am the outspokenly radical liberal feminist. I find this both hilarious and awesome. But the reason is simply because I have opinions about being a lady and I sometimes express them. And that’s radical.

We have these little sessions where our medical school tries to indoctrinate us to want to be physician-scientists, because apparently it’s a glamorous and wonderful life to have, wherein researchers are invited to come talk to us about how their lives are the shit. On two occasions both of our guests have been women; in fact, I’m just now realizing that the guests have always (I’m pretty sure) been either both men or both women. Anywhosists, I won’t deal with that. On the first occasion on which our guests were women, I asked, “Do you ever feel like people take your work less seriously because you are young women?” Both said no (although I kind of doubt that it’s totally true that has never happened). The point, though, is that I could ask that question and have it be a question. Because it still is one. Is it possible that somebody might dismiss the seriousness of my professional work because I have a vagina? Yes, that is totally possible. If I act assertive might some people label me a bitch? Yup. And there are absolutely men I know who are class A dicks most of the time, but they don’t worry about whether that might hurt their medical careers. And it probably won’t.

It is also a reality that if I choose to become an OBGYN who provides abortions, I will have the unique position of performing the only medical procedure that is legislated the way it is based on how people feel about it. Aside from physician-assisted suicide, abortions are the only medical service that I might someday provide that I could totally get shot over. Is that because the evidence is overwhelmingly in favor of not providing abortions? Nope. It’s because some people, the vast majority of whom have absolutely no medical or scientific training, don’t think it’s a good idea to give women control over whether and how they build a family. And what do I have to say about that? I say a very strong no thank you.

And on top of all this I have to think about how my career is going to impact my own decisions about whether to reproduce or not and when I want to do it. And how the biological processes I’m learning in my training will change my choices. Like, my eggs are really going to get old and less … good at baby forming. And that sucks. (Although I did also learn that men’s sperm get less good at baby forming, too, so ha! We’re not the only ones.)

Anyway, this post is getting inordinately long and I have brunching to do, but I could obviously write about this for, like, a hundred years. And I probably shall have more reflections to make as I get further along in both my training and my age (can I just be 25 for a few more years? Kthanks.) But for now I shall say goodbye and see you in a month tops!

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As promised

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It’s been approximately one zillion years since I posted on here. Why come? Because it turns out I’m in med school now, and all these things that I thought I had the time and energy and patience for — yeah I don’t have that. That’s not to say that every bit of my life that isn’t med school has been eradicated; I still have time to go to shows on the weekends here and there or pop by and say hey to my Grandma (although not nearly as much as I would like … I need to figure out what she’s up to tomorrow). But med school definitely makes you figure out what you really have time for/want to make time for, and what must fall at the mercy of CBL (case-based learning, one of many acronymous modalities that now define my days).

Handbooks for improving writing abound. A personal favorite is The Elements of Style, and what I’ve extracted from that along with various other style manuals is: if you can say it in fewer words, do. Alas, no such style manual for medical school exists, because it’s so hard to figure out a formula or set of rules that makes med school work from one person to the next. Even from block to block I’ve been changing my habits depending upon volume, lecturers, whether I even care or not, etc. Luckily with this block I feel much more comfortable with my prioritizing than I did last block, wherein I learned many crucial lessons such as: after an end-of-block exam, do not plan to do anything that requires functioning as a normal human. Instead, plan to hibernate and maybe drink alcohol.

So with all this time that’s going into learning med school stuff, I must have gained some knowledge, right? Sort of. Insanely enough, I’ve actually only been in school for like eight weeks; it feels like it’s already been eight months. When pressed on my skill set, though, it’s pretty clear that I’m still a baby (though when I wear my white coat walking through the freshman campus over to the med school I do get to feeling some solid braggadocio). I can take a blood pressure, mostly, and I know how to ask somebody all the questions about their chest pain. Also I could probably diagnose diabetic keto-acidosis or medium-chain fatty acid dehydrogenase deficiency if given exemplary lab values. And I know that bacterial meningitis is the worst and why it’s the worst. So that’s some progress. Mostly what I’ve learned though is:

1) Med school is hard. I actually don’t spend that much time in lecture compared to many of my peers at other institutions, but I still feel like I study all. the. time. Sometimes people ask me how many hours a week I study, and I say, “Uh, when I’m awake?” That’s an exaggeration, but not too much of one.

2) Med school is fun. People who go to med school are smart and funny and an overall delight to be around. And you get to learn about all the coolest shit, like the human body. Do you guys even know how amazing your bodies are? SUPER AMAZING.

3) Med school is basically high school with more privileges and cooler toys, like stethoscopes! We have lockers and eat lunch together and gossip about who’s been smooching whom.

4) I will never learn everything. There is so much information out there. I can barely remember what I learned about topoisomerase II poisons just, like, a month ago. Actually I can barely remember what I learned about sepsis, like, a week ago. Except that it’s bad. Hypotension, you guys. Bad news bears.

So that’s pretty much all I have to say right now. I know it’s not much, but I’m getting sleepy, and narcoleptic tendencies have been really biting me in the back lately when I show up to microbiology lab and end up with my face smack dab in the middle of an HIV diagnostic test. I feel like now that I have my feet under me I’ll be able to return to this blog-situation more often. Happy almost-end-of-September everyone (what!?) More to come.

I am a marathon and you can, too

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In college I ran marathons. I’ve run seven of them, and I keep telling myself I’ll make it into an even ten one of these days. I qualified for Boston in 2010, in Memphis, but since then my legs have been on a marathoning hiatus. Ain’t nobody got time for that and med school and friends. In fact, I should probably be med-schooling right now; instead I decided to take a little time to blog, because of the crazies. Anywhosits, I’ve been reflecting on my marathon days a lot lately, because there are so many parallels between marathon training and med school. Here are a few:

  • They are both for crazy people who don’t mind a little self-inflicted harm here and there.
  • They both require eating copious carbohydrates, mainly in the form of pancakes.
  • Both of them are a lot easier if you have some solid Beyoncé tracks to keep you company on long days (but let’s be honest … when are Beyoncé tracks ever not solid?)
  • They are both exhausting. 
  • Medical school and marathons seem impossible to people who have never done them.

To the latter point: people say to me all the time, “You’ve run a marathon? I could never do that.” And I always say, “Yes you could. If Oprah can do it, you can do it. If Katie Holmes [who was married to Tom Cruise at the time and therefore OUT of her damn mind] can do it, you can do it.” Which is true. Anybody who doesn’t suffer from a medical limitation can run a marathon. And “I am too lazy” does not qualify as a medical limitation. I’m talking complete paralysis or some sort of glycogen storage disorder (what up, metabolism?). Even people without the use of their legs do marathons; I know because I was almost taken out by a wheelchair at the Marine Corps Marathon when the race organizers said, “Know what sounds like an awesome idea? Let’s have the wheelchairs start behind the runners and cause mass chaos on some downhills hahahahahaha.” 

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Sometimes Oprah makes a face like this

 

I imagine that expression to be the one she would make if someone immersed her in medical school for a couple of days. Because although I know Oprah can run a marathon, and I think pretty much anybody can, not anyone can do med school. Not to make myself sound special; I am not special. Compared to many of my classmates, I’m like Charles Barkley:

Remember when Charles Barkley said, "I'm a dumbass" on TV? Thats how I feel sometimes.

Remember when Charles Barkley said, “I’m a dumbass” on TV? Thats how I feel sometimes.

My point is not that you have to be so smart to go to medical school, or the most hardworking, although you do need to strike some balance of those two traits. It’s that you have to be able to keep the big picture in mind and remember why you even came to med school in the first place. I don’t think that the underlying motivation is the same for all (or even most) medical students, but I do think most people are too myopic for med school to work, because there has to be some larger framework that’s fueling your desire to study the TCA cycle, or why sorbitol is EVEN A THING.

This week med school is getting real, although I keep wondering whether I’m modulating my response appropriately. Like sometimes I wonder, “Is med school supposed to be a little harder? Everyone seems to be freaking out and I’m not really.” Or other times (sometimes like 10 minutes later) I think, “Is med school supposed to be this hard? I can haz naps now, pleez?” I don’t think we’ve hit the really real stuff yet, but we are definitely getting closer to it. And then I see my second-, third-, and fourth-year counterparts and wonder, “How did you even get to where you are? Am I going to know that stuff at some point? WHY HISTOLOGY (I am super the worst at histology)?” 

That brings me to another marathon analog, which is that I really think this med school thing has got to be one day at a time, just like marathons are built on a very, very gradual expansion based upon a foundation of: keep putting one foot in front of the other foot. When I first started running, I could run two miles before I needed to stop and M&Ms instead. But not too long after that time, I was running two miles 13.1 times. In a row. I would be at the starting line at 6:30 and by 12:30 I had marathoned, showered, eaten, and gotten into my lazy clothes for the next day and a half. And I would think back and wonder, “Wait, did I just actually run for almost 4 hours? Was that me?” I kind of hope the same thing will be true of med school. I’ll get to fourth year and just think, “Oh! Here I am. That wasn’t really so bad.” 

I think this med school thing is probably still a good idea, and in fact I really enjoy most of what we are learning (except that stuff about sorbitol. Sorbitol is a stupid molecule). But it’s also very clear that I’ll never feel like I’m doing the right amount of work, and I’m just going to have to keep plodding along and trying different things until I get past the markers I need to pass. 

One of which is my CBL case for tomorrow: 

4803657+_e6708dc15956903b7eee8b85e70cf6f3So there’s that. More to come!

Let myself feel the crazies

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I’m a fairly avid consumer of media. It’s not like I troll around on reddit all day or play a ton of video games, but I definitely like to have the radio on, and I check Gawker and Jezebel’s feeds like one hundred times a day (because what if Taylor Swift starts randomly handing out 90 dollars again and I miss it!?) At one point when I was probably supposed to be thinking about something important but I decided to think about nonsense instead, I came up with the idea that certain media take the place of comfort foods for me. Not to sound above the whole emotional eating thing; I’ll eat the crap out of some carb-laden deliciousness if things really start to go downhill (my main comfort food is really just straight up bread. My mother makes this amazing whole wheat doughy yumminess, and I would eat a whole loaf by myself under the right circumstances.)

Anyway, the point is that when I feel off kilter or emotionally drained there are a few books, movies, and radio shows that make me feel better, the way some people do when they go home, slap on a pair of eatin’ sweat pants, and scarf down a tray of mac and cheese. Practically every winter break, for example, I read at least one of the Harry Potter books. They’re like mashed potatoes for me. Warm and fluffy and grounding. Breakfast at Tiffany’s (the movie; I haven’t read the book yet) is for when I have the mean reds (duh). Angels in America — the script or the HBO series, depending on the flavor of my introspection — is my go-to when I’m feeling pensive and have a couple of hours to spare. There is nothing that will ever take the place of that play in my heart. Sometimes I sit down and read it in one sitting just because it’s so damned beautiful and my favorite thing on the planet.

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Weekly I need a dose of This American Life, and I turned it on today when I was feeling many-a-feels, principally of the frustration and loneliness category. Don’t get alarmed; I still love the ever-living daylights out of medical school. It’s like somebody reached into my brain, found all the secret hidden hopes I had for my life — about learning amazing things and taking care of folks and meeting the best people — and said, “Yeah, we’re just going to make those into school. YOU’RE WELCOME.” But there is no denying that this is also a highly emotional transition, and I think my amygdala just started to process and react to everything today. Hence the TAL. Ira Glass could say pretty much anything to me, and I would be like, “Yes, I am totally on board with that. You have my heart, sir.”

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BUT SERIOUSLY

Examples of things that Ira could say to me that nobody else could say to me:

-“Katie, I really think you should try to go a day without glasses or contacts. It seems like a good idea, and you will certainly not get killed dead by an oncoming truck. Or, for that matter, anything that moves.”

-“Puppies are stupid animals.”

-“Have you ever considered a permanent wave for the front part of your hair only?”

-“Cameron Diaz has something interesting to say about parenting.”

-“Jenny McCarthy.”

See? Those all sound dumb. But if Ira said them they would sound smart and, really, incontrovertible. The TAL episode I listened to today was about breaking up, about which Starlee Kine was talking to Phil Collins (because obviously). At one point she asked ol’ Phil, “Do you think I’ll feel better?” to which he replied (something to the effect of) “Well, you kind of like feeling bad, don’t you?” And I thought, “Aha! Ol’ Phil has got it!”

Here’s the deal: Nobody likes feeling sad, although I do think that melancholy is an underrated emotion. Like, you don’t want every song you hear or play to be in a major key, right? Because that is a snooze-fest, and you’re missing out on a whole range of music that is quite wonderful and expressive. So when you do feel sad, or stressed, or confused, you just have to let yourself feel that. I used to say things like, “I know I’m not supposed to/allowed to feel this way,” but then I said to myself, “That is the dumbest thing I’ve ever heard. Of course you are supposed to/allowed to feel whatever you’re feeling. That is how you feel. Just feel it.” Sometimes, instead of exercising, it is better to eat dark chocolate and drink wine and write a blog entry. And give yourself a couple of hours to yourself, for Jesus’s sake.

There’s this whole branch of psychotherapy called “Acceptance and Commitment Therapy” (ACT) that encourages us to get over this idea that we’re supposed to be happy all the time. False. Sometimes humans feel emotions that are not happiness. Instead of feeling guilt about not feeling happy, we should say, “Oh, hello there, emotion that is not happiness. How interesting to see you here. Do you mind if I acknowledge your presence and then go about my business?” It really works much better than trying to force yourself to turn complexity into simplicity, which is boring anyway. Sometimes it’s normal to think, “Am I the worst? Does anybody even like me? Will I fail at medical school?” But then you have to say, “These are the crazies. Hey, crazies. You are allowed to occupy a small part of my brain, but I’m not going to engage you.”

So this is what I have to say: sometimes you’ve got to just let yourself feel the crazies. That’s not to say that you shouldn’t try to figure out where they’re coming from, or talk to people about them. After all, they are not reality. That’s why I call them the crazies. Sometimes magical people like Steven come along and just happen to send you a text message that says that you are great when you are wondering if you are not great. And that happens because we are the BEST FRIENDS GANG.

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This is me giving advice to me (and anyone else who is also feeling the emotional/cognitive ups and downs of starting med school): Medical school asks you to acclimate to a totally new learning environment while simultaneously demanding that you establish your identity among an entirely new group of people who are incredibly smart and actually worth getting to know. You’ve got to acquire a whole new skill set and knowledge base in 14 short months. Taking blood pressure may seem easy, but sometimes you let all the air out of the bulb (hypothetically speaking, of course). So, you know, no big deal. Of course it’s normal to feel a little bit of anxiety. You should feel lonely every now and again. Otherwise you’re not paying attention. But, to anyone who is also feeling a little bit of what I am feeling re: transition jitters, I want to extend this invitation to talk to me about it (or anything else) absolutely any time. Because, as Maja said to me the other day, we’re all in this together (stupid High School Musical reference. I worked at a summer camp one year where it rained like ALL THE FREAKING TIME, and  we probably watched HSM six thousand times. I definitely know way too much about that movie.)

Lastly: here is me with my brand new stethoscope. Hooray!

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It’s almost like I’m a real live med student.

 

 

Bro, do you even medicine?

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This week is the first week of real medical school. Okay, that’s not true. Last week was med school, too, but it was the kind of med school that you don’t have to study for; you just have to talk about it. The topics we discussed — like health disparities and effective health care delivery — were actually quite foundational to becoming a practitioner and steward of our future patients’ wellbeing. Although we did have one talk that was the verbalized equivalent of one of those word maps, which themselves are the cotton candy of the writing world. They fill up a lot of space but have absolutely no substance and even though they might seem like a good idea at the time, later you just feel sick. See?:

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Doesn’t that make you feel nauseated? It SHOULD.

This week we have definitely moved past any cotton-candy like material. Right now we’re pretty much on an all insoluble fiber, low-sodium, low-sugar diet. Basically we are eating shredded wheat topped with broccoli, like, all the time. We are diving right into biochemistry, histology, genetics, and case-based learning. I go through these peaks and valleys where I’ll think to myself, “This is the freaking coolest stuff I’ve ever heard,” and then two seconds later I’ll be totally overwhelmed, and then I go back to being psyched.  Like in our histology lab yesterday, I spent half of the time thinking how amazing it is that our bodies take all these little pieces of basic machinery and make approximately a gazillion different functional units that work properly more often than they don’t. But then I would look at a slide and think, “This is just blue and pink lumps!” And Dr. Pettepher was like, “Bro, do you even medicine?” (That is false. The word “bro” did not come out of Dr. Pettepher’s mouth.) I have to keep reminding myself that other people, mostly smarter than I am but maybe even a few that are not as smart as I am, have done this before me. I can also do it.

Luckily, even though the academics are going to be difficult, I’m still totally on board with Vanderbilt’s approach to medical education, partially because it’s based on actual evidence about how people learn and retain information. In our very first lecture one of the course directors said, “It’s been shown that the way adults learn is through repetition,” and I was all like:

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(ASIDE: I really need to start watching RuPaul’s Drag Race. That bitch is fierce.)

Not that I know much about the science behind learning, but, for me at least, the different formats that synthesize the topics we’re learning is exactly what I need. And the whole reason we have that format is because Vanderbilt actually cares about whether their teaching is effective or not. So that’s cool.

You may be wondering to yourself, “Katie, if med school is so full of informashunz, why are you blogging right now?” The answer is twofold. One part of the answer is: I did VPIL, and therefore my sucker classmates are learning about their continuity clinical experiences while I get to do whatevah I want (just kidding, guys, you are not suckers.) The second part of the answer is: because this stuff is so very vast, I need to take time to process it every once in a while. I’m doing the part of med school where you also make sure that you stay a person and “do you,” as the kids these days are saying.

This brings me to the topic of “gunners.” I was going to try to avoid addressing that, because I have issues with that word that I will enumerate shortly, but it’s going to keep coming up. So here goes. What is a gunner, you ask? Well, depending on what corner of the internet you mostly inhabit, it could be this guy:

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THIS IS A WRESTLER NAMED THE GUNNER. Note too much beefiness in those lats and traps.

But that’s not what I’m talking about. Maybe you think of a gunner as someone who actually wields a firearm and hunts down enemy forces. That is also wrong. Here’s what Urban Dictionary says about being a gunner. (Also, here’s what Urban Dictionary says about Katie D. I swear I did not write that. Although the subsequent entry talks about how the verb “katie” means to make an ass of yourself. So, you know, fair and balanced.)

Some of my classmates seem to think that “gunner” carries no negative connotation, and that it is simply a term for someone who works really hard. I disagree; I think that “gunner” implies someone who competes to succeed at the expense of their personal health, their relationships with other people, and the ethical basis of the profession into which they’ve entered. In any case, I don’t like the word. Even though it is meant to describe those who work more or harder than is required, I think it tends to stigmatize people whose learning styles are different from what’s typical (whatever that means).

My study and life habits are weird. I like to make extensive lists; I have a whole notebook dedicated to them. For now I print off lectures and put them in a binder, because having them in tangible form makes me feel like I’ve done one step in cognitively processing the information (even though that is probably patently false from a brain sciencey perspective, this is how I put my mind at ease.) Personally, I need a lot of time to process information; that’s just how I roll. So there may be times when, yeah, it’s Friday, but to maintain my overall sanity I am going to stay in and study a little. Sorry, bros. There may also be times when I say, “Nope, it’s Friday, I’m going out.”

For all my own idiosyncracies, others of my classmates operate completely differently from me. Some can’t give themselves Friday off, and some will take every Friday to themselves for social time (you know, kickin’ in the front seat, lookin’ forward to the weekend). And that’s fine and, frankly, none of my business. Actually, even if someone is being a competitive jerk, that is also not my business. That is a personal problem. I’m going to have to contend with that stuff throughout my career and my life, so rather than making a big deal out of it now, I’m going to just get over it. Although I will offer one caveat soon about the difference between individual attitudes and study habits and an institution’s atmosphere as it contributes to one’s overall satisfaction as a student (or, I imagine, as a practitioner).

This is why I think our class should start a “gunner jar.” Since we have houses like in Harry Potter, this could be the analog to the house points system. Every time someone says “gunner” to put down what someone else chooses to do with their own damn time and their own damn life, that person has to put a dollar in the gunner jar and put the name of their college on a piece of paper to go in with it. At the end of the year, the college with the fewest violations gets to decide what we do with the money, but it has to be a fun activity in which everyone can participate and be collegial and all that stuff.

Last bit of wisdom before Katie goes and studies and such. If you are someone who is still in the process of choosing a medical school, the students’ attitudes about helping each other out is super important. Even though individual study habits are not yours to examine or criticize, having a cooperative overall culture makes everything that could be enormously stressful slightly less so. While you can’t exert any control over how the individual people around you behave, you can control (to a certain extent) the sphere you choose to inhabit and what kind of culture you want to encourage/be a part of. So basically I’m just telling everyone to come to Vandy, as it is the best and everyone is nicer than pie. Happy Wednesday, more soon!

 

CORONATION what?!

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First of all, this. I have to say, I am a little bit surprised. I thought they were for real. Whereas Kim has already made her intentions of being the next Elizabeth Taylor clear (WOMAN, YOU WILL NEVER BE ELIZABETH TAYLOR), and needs to marry at least four more men over the course of at least five more weddings. Tough cookies, Kanye. Also, there will never be another Liz and Dick. Sorry, y’all.

All right, now that we’ve gotten the important stuff out of the way, I can turn my attention back to the whole medical school thing. I know I’ve already mentioned my “all the degrees” idea, but at the risk of superfluousness, I wanted to share this quotation from one of our lectures today. I think it’s lovely:

“The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction” — Rudolf Virchow

Of course, Virchow doesn’t mean that all physicians need to become lawyers. He’s speaking figuratively. Actually, I suppose it’s more appropriate to say that he’s speaking synonymously and etymologically.

WAIT. Writing that sentence elated me. “Synonymously and etymologically.” Language is so. damned. beautiful. Can you even believe we have words like that? Please.

Anyway, the point is that Virchow (in my interpretation, at least, and seemingly in our professor’s) equates attorney with advocate, which comes from the Old French advocat, which itself derives from the Latin advocare (“to call [to one’s aid]: “ad” (“to”) “vocare” (“call”). By the by, etymology is out of this world. I love thinking about where words come from and how we use them. Like today, for example, I was reminded that “coronary” as it relates to the heart comes from the fact that the coronary arteries encircle the heart like a crown. Corona = latin for crown –> coronary. Like coronation! Like the ceremony! I mean, seriously. That is elegant like nobody’s business. It’s delightful to find a word that describes exactly what you mean, or even better, to  combine and rework words until you have created language to serve your purpose. YOU GUYS. I could go on about words forever.

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The point, however, is to talk about advocacy and, in a bit, empathy. One of my college mentors asked our group whether it is truly within the physician’s purview to concern herself with the social factors that impact patients and health equity (which, incidentally, is not the same as health equality. More on that, too, in a moment.) Some argued that, no, our job is to address only the concerns of those patients with whom we find ourselves in direct contact in the most immediate sense. After all, physicians are problem-solvers, often in the most pragmatic of senses.

My answer is categorically that we must concern ourselves with the social injustices that many of our patients will face. While it may not be the physician’s role to try to directly fix every factor that impacts a patient’s health, it is absolutely her role to work from a framework that dictates that every patient deserves the dignity of being accorded a certain baseline of human rights, including a right to full health and wellbeing. And if that is not our primary goal, then we are doing our jobs incorrectly. Period.

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So how do we make sure we’re according everyone the same level of respect, particularly as it concerns their rights to their health? Imagine being denied the things that make you feel healthy and whole. That, I imagine, would be intolerable to you. It certainly would to me. This brings me to the topic of empathy, which may seem straightforward to some and completely alien to others. I was chatting with my wonderful and dear friend Victor yesterday, and we both wondered whether it might actually be difficult for natural empaths such as ourselves to discuss empathy from an academic, even technical, standpoint. That is to say, a few of our classmates are undoubtedly much more technically skilled and scientifically-minded than we are, and may have to learn empathy (or at least behaviors that look like empathy) from an almost prescriptive model. On the other hand, Victor’s strengths and mine fall more on the “squishy” side of medicine, meaning that learning empathy from a set of bullet points, for us, is like learning how to breathe or how to walk from bullet points. You can imagine how terribly awkward it might be to try to walk based on bullet points.

  • Okay, pay attention to how you’re standing. What should you do with your hands? Is your weight evenly distributed. Whoa! Careful. Don’t fall down

hands (sorry for that HIMYM reference. It was topical).

  • Now, can you put one foot in fron– Wait! No. I said one foot! You look like a kangaroo. But you’re not nearly as cute.
  • Good. Yes, the right foot. But don’t swing your right arm at the same time as your right foot. And you have to actually pick your foot up, don’t drag it.

You get the idea. Terribly awkward. In the same vein, trying to use a checklist for “empathy” would probably make me really bad at it. Not to make myself sound like a lunatic, but it is impossible for me not to feel what other people are feeling. Practically all I ever want to do is talk to people about their feelings and let them know that I get where they are coming from. Sometimes I think this comes as a surprise, because there is also the side of me that makes dirty jokes and is pretty brash here and there, but that is just an externalization. There are very specific exceptions to the following generality, but mostly I am a natural empath and actually quite interested in people’s inner lives.

I have to recognize, from the standpoint of empathy, that what makes me feel healthy and what makes another person (perhaps a future patient) feel healthy may be totally different. Baseline wellbeing for me means time to myself, a good group of friends, healthy food, lots of reading, and time outdoors. For other people it means milkshakes, extensive time meeting strangers, Justin Bieber songs, and going hunting. I have to respect that those interests and mine are unaligned, but that (within the reasonable framework of respecting other people’s dignity as well — aka, no racism or killing or pillaging in order to meet your basic needs of “health and wellbeing”) each of us is entitled to do the things that, for us, make us feel whole and human. Furthermore, I may share absolutely zero in common with my patients in terms of background. And I actually have to be empathetic to the fact that some of my future patients may be suspicious of my motivations as a white lady. Although I am 100% convinced that I am entering the medical profession for the right reasons, that might not be everyone’s interpretation. Which is fine. But it is still more than my job to make sure that my future patients feel heard, validated, and fully cared for, regardless of what we share and what we may disagree about. It is my moral and ethical obligation.

Guys. I love humans. I really want to make all the humans feel as human as they can. I hope you love humans as much as I love humans. Please take a moment today to think about what you can do to make someone else feel more human and more loved. On my part, I have so much confidence in my future classmates and their ability to bring humanity and the humanities to the future of medicine. Seriously, pretty much everyone I’ve met has blown me AWAY with their talent, curiosity, and passion for this career. I can’t wait to see where we all are in just a few years. Congratulations and cheers to everyone who is embarking on this period of learning and growth with me. Hooray! Let’s cure the crap out of some people.