Negativity

I want to talk about negativity.

But first, look at this picture. My friend emailed it to me. It's a lake in Burma somewhere. See anything interesting about it? We'll revisit it at the end of this post.

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Negativity

So negativity - that swirling maelstrom of mind-draining horribleness. It's in ample supply everywhere these days, it seems. It's effusing the blogosphere, politics, my daily life, everything! I'm tired of it. Negativity is like a foul contaminant, only a tiny micron drop of it is enough to ruin things.

Last Friday while playing poker (I lost, of course) with the usual group of friends, the topic of the recently passed health care bill came up. Now in this group of med students I've rarely felt such negativity towards something. All they could see is the negative aspects that may (or may not) affect them/us.

And while they complained about possible reduction in pay and increased taxes, I mentioned, "It doesn't matter - in the end, I'm still going to be making more than my parents. Combined." I guess that wasn't good enough because they continued to go off. Aiden mentioned the notion of a federal mandate and how it may be unconstitutional. He was like, "Sure, it's federal mandate that you have to get auto insurance. But you don't have to drive. If you do drive, you're potentially putting yourself and others at risk, so it makes sense to have an insurance mandate there. With health care you can maybe make an argument, but not so much." To which I responded, "You know, every public health worker would disagree with you."

The following day, I said to Aiden (who'll be one of the M2 free clinic managers), "You know, with this health care bill, the free clinic would be obsolete because patients will have health insurance." To which he again replied, "If it's not struck down as unconstitutional in the Supreme Court." Almost as if he wants it to be struck down! It's just, I don't know - I'm rather speechless.

The health care bill wasn't exactly meant for health professionals, but for patients. It's for the people we're supposed to one day care for, not for us. Being doctors shouldn't be about the pay, we shouldn't be trying to maximize our own salaries. Sadly, the $160K+ loan screams otherwise. And all of that is just wrong. :-/

Do I think the health care bill is perfect or the next best thing since sliced bread? No. I'm sure it's greatly flawed. BUT I do sincerely feel that it's a step in the right direction.
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Positivity

Now I want to talk about positivity. I'll start with the health care bill since that's where I left off with. Again, I believe the health care bill is a step in the right direction. I was talking to a public health friend of mine, and she basically told me that the entire public health school was cheering. Odd - the public health sector cheers while the medicine sector groans. Shouldn't the two be more aligned?

Anyway, while I was in DC, I asked my friends about the health care bill. They were both overwhelmingly in support. My best friend told me that his girlfriend is basically counting on this health care bill to pass, because in a few months she'll have to be taken off her parents' health insurance (when she turns 26 or something). She has a heart condition for which she takes a pill every day (alas, I don't know what the heart condition is). As long as she takes her meds she's fine. But they're rather expensive and if she doesn't take them, she passes out. A lot. She's currently a nanny for a few families, and obviously that job has no health insurance. So she's basically hoping for this to pass by the time she's taken off her parents' health insurance and/or her meds run out.

So perhaps my experiences and the experiences of some of the people I know sway my thoughts. And it does seem that I have a more liberal bent to my views than many of my peers (which is odd, because in undergrad my views were pretty moderate). To learn more about the health care bill, the NY Times did an excellent job compiling several articles they wrong on the subject here. And this article in particular struck a chord.

In other news of positivity, I got both positions I ran for (as I mentioned in this post)! So I got the positions for APAMSA co-president and FMSA patient education co-chair. W00t! :-P This is exciting, now I have the power to enact changes to the frustration of the current systems. Hopefully my vision will be more efficient/effective than the outgoing people's.
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This doesn't really fall into either of the above categories (though I suppose it could fall under "Negativity"), but there are couple friends who I'll never come out to. I was chatting on AIM with Harry and the topic of homosexuality and bisexuality came up. He's basically uncomfortable with both because: 1.) it's against the natural order of things - like, evolutionary dead end; and 2.) he thinks most homosexuals are actually confused and not "really" gay. I spent a good while discussing with him how his views are inaccurate and fall apart easily. But I can only do so much without challenging him to a mental duel - which I would win but would lose him to my "cause" in the aftermath. Oh well.

And now, to reveal the specialness of the picture at the very beginning of this post . . .

That picture (supposedly) is taken on a particular day at a particular time. And if you flip the picture 90-degrees, you get this:
Isn't that cool?! I don't know if it's PhotoShop'd, but I sure hope not. It's pretty amazing.

---TANGENT---
And lastly before I go (I know I've ranted quite without much structure a bit in this post), I'd just like to say that I wonder where Dave from Daze Gone Bi is. Has anyone seen/heard from him? Last he blogged, his laptop had serious issues and needed to get fixed. But that was over a month ago. :-/

I sent him an email but he hasn't replied. I hope everything's alright and that he returns to the blogosphere very soon. I quite miss him and his posts. In the mean time, I hope everything's going well for him!!
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That Other Purpose

For what purpose do we practice medicine? To better ourselves or to help others? Trick question: it's both.
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Anyway, last night I went to a HIV/AIDS Awareness Night event that one of the student groups organized. The ID (infectious disease) doctor, Dr. P, I shadowed was there moderating the panel Q&A, and one of the HIV patients I saw while shadowing was there on the panel! It was a really well-organized event.

First there was a short 20-minute clip with two interviews of young people (early- to mid-2os) living with HIV while we got dinner. Then, Dr. P introduced himself as well as the 4 HIV patients on the panel and another ID doctor. They each introduced themselves in turn and the remaining hour-and-a-half or so was simply Q&A.

To hear what these patients went through, and still go through, was strangely motivating. To hear their stories, their ups and downs, their will to move on - it was all pretty incredible. 2 of the patients were diagnosed in the 1980s and the other 2 were diagnosed recently (within the last 10 years). As they recalled how they found out about their diagnosis, I can't forget the last patient (an African-American male) to speak. At the time (in the 1980s), he had divorced his wife and was raising his kids as a single parent. His doctor, a white male, thinking himself a savior (the patient's words), came to his door and told him the diagnosis. In front of his children. To say the least it shocked all of us that a doctor would have the audacity to do something to outrageous.

Throughout the panel discussion, the singular thought throughout the room of med students was: "How can we be better? How can we do better? How can we make things better for our future patients like you?" To say I learned a lot from this 2-hour period might be an understatement (certainly, the things I learned would stay with me longer than, say, lung physiology). I admire the patients for their courage to speak to all of us. I admire Dr. P for being there for his patients (I think they were all his patients) and the relationship he was able to develop with each of them. There were times were I felt like I was moved to tears, especially when one the patients told us about her experiences as a camp counselor for pediatric HIV patients.

Dr. P will say something that I think I'll remember for quite some time: "Even today, even though things are better, there's perhaps no other disease that still carries the stigma that an HIV diagnosis carries." And it's true. Even medical professionals, medical professionals, sometimes react abhorrently when hearing their patient has HIV.

After the event was over, I went down and talked to Dr. P, to tell him how much I appreciated him being there and how highly I thought of the event and the patient speakers. I also talked to the other ID doctor. We got talking on public health and all the things being done and researched with regards to a vaccine or cure against HIV. To talk about the vaccine studies and the "test-and-treat" model that's being proposed to "treat away the epidemic" was refreshing. Needless to say, it felt good to talk almost on par with a doctor on such things. He also regards the field of infectious disease as "primary care on steroids." I'd say I agree with that. :-P
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Today, I went to a lunch talk hosted by another student group. A speaker with Tourette's syndrome and Hirschsprung's disease came to give a talk. One of my labmates is apparently good friends with him, as they went to undergrad together.

Anyway, he talked about his life experiences with these two diseases as he tic'd away (physical and verbal tics). He was quite the charismatic speaker. He had aspirations to become a pediatric surgeon (in the footsteps of his pediatric surgeon who saved his life), but then realized that he could probably help many more people by doing public speaking like he was.

He, too, said something that I'll remember. There are things that doctors should probably do that med school doesn't prepare for. It doesn't prepare med students to care for people as whole people. Almost every class we have is a "basic science" class - biochem, anatomy, physiology, neurosci, pathology, microbio, pharmacology - but few classes prepare us for all the other things involved with a patient, that definitely impact his/her care. It doesn't teach us how to break the news of a HIV diagnosis, or how to counsel a HIV patient through stages of depression and grief, or how to help a middle-schooler with Tourette's make friends or talk to others about having Tourette's. We're taught how to break patients down to symptoms and pathologies, even while being told that it is indeed a person we're treating and not "HIV" or "Tourette's."

He left us with an acronym he came up with: HAATS. Humor. Acceptance. Advocacy. Tolerance. Support. Humor is a wonderful tool and perhaps one of the best coping mechanisms; laugh at oneself and at others. Acceptance of oneself (and others) with a condition or some difference. Advocacy for oneself or for others; so many times patients don't have an advocate for themselves, and so that role falls to the physician. Tolerance of others and that not everyone can or will understand - and that that's okay. Support from friends, family, medical staff, etc are critically important.
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So after reading those rather length accounts above, I ask again: for what purpose do we practice medicine - to better oneself or to help others? The answer's the same still. But I think it's worth remembering that other purpose. And not just for health professionals, but for all of us.

And if you want to read more about the Tourette's speaker, you can go to his website here at: www.whatmakesyoutic.com.

Spring Break, Part 2

There really isn't more to the story, per se, of my Spring Break. But I wanted to take this second part to just say how thankful I am to have my friends.

I almost forgot how much I missed them. It's been over a year since I last saw Jake (and he gave me the Chinese-English medical dictionary he got me while he was in China), and over 2 years I think since I last saw Don or Jake's girlfriend. It felt like old times again from undergrad, with the WC3 and the joking and such, lol. How a good part of me still misses those days. I'm glad that, though things change and we move to different places and age, some things still seem to stay the same.

You know how after you've hung around someone for a while, you begin to acquire some of their idiosyncrasies? Well, that's kind of how it's like with me - I tend to absorb bits and pieces of my closest friends, among them being Jake for sure. A lot of Jake's good friends from high school went to undergrad with him (and me), and I can easily tell that they've been friends for years because they all share similar qualities. For example, they make random funny noises when excited or frustrated. And they say similar things in response to certain things. Also, Jake knows me so well that he knows just what to say to "persuade" me into changing my decision on certain things. I find it quite amusing - I hope he puts that to good use in politics some day. :-P

I'm also thankful to the diversity of my undergrad friends. Like I've said several times before, I've many friends going into the health field as doctors, pharmacists, public health workers, etc. But I also have friends in other fields. Jake is pursuing his PhD in poli-sci, like I mentioned before; he's studying "comparative politics" I think so he can specialize in US-China relations. And Don is applying to international relations Master's programs, hoping to eventually get a position where he'll be in center of the weapons and defenses discussions. Jake's girlfriend, who I don't actually know as well, will be starting her Master's in speech pathology.

It seems all my close friends who I've kept in contact with, even those all the way back from elementary school, have aimed high and generally been met with at least some success. The vast majority of us from modest middle class to upper-middle class families have come a long way. Hopefully one day I'll have friends in high places, or I myself might be in a high place. ;-)

I was talking with a current classmate of mine over gchat about our respective Spring Breaks. He went home to CA to hang out with his family but more specifically his friends. Several of them have rather wealthy parents (or as my friend says, "baller") and they spent all their time and money partying hardcore - drinking, smoking cigarettes and weed, etc (doesn't sound too fun to me). So that's what rich Asian kids do, eh? I mean, he told me how his good friend from why back spent $300 in 30 minutes on clothes. Here I am, hesitant to spend even $200 on plane tickets! This then is the difference between us and our friends.

Well, I typed more but I deleted it as it had unexpectedly turned into a rant. I guess I'm just glad I have down-to-earth friends who strive for great goals in life and can understand the struggles of others. Sometimes like does attract like.

I can only wonder what the next decade will bring. How will things change by the time we next meet? Will we change with time and age, or remain recognizable as we currently are? Whatever happens, I look forward to that day.

Spring Break, Part 1

I returned from visiting my friends in Washington DC last night. It's been a great Spring Break so far. :-) I think I'll make this post in 2 parts, this part being the long picture-heavy post of my brief visit. So without further ado:

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March 15th (the Ides of March):

My friend, Jake (formerly JW-M on my blog), and his girlfriend picked me up at the airport. We stopped by their apartment where I dropped my stuff off and lounged around for an hour or so. Then his girlfriend dropped us off at a metro station (they live in Alexandria, VA outside Washington DC) which we took into DC.

We first went to the National Archives, where Jake's roommate, DJ-M (who I'll call Don here), works as an unpaid intern. We got in the line to see the Constitution and that was pretty much all we looked at (we also did see the nigh-illegible Magna Carta as well).

Then we went to visit Jake's campus, George Washington University (GWU), where he's doing his PhD in political science. There we also met up with Don who just got off work. Upon meeting, Don proclaimed, "A stranger arrives at the capitol on the ides of March, but Caesar's in the provinces today." I must say, their campus is far inferior to where the 3 of us went for undergrad. :-P

Lastly, we walked to a Chinese restaurant in downtown DC for dinner. Jake's girlfriend met us there. It's been a while since I've had good Chinese food (there's no really good Chinese food within a rather large radius of med school here, alas). Then we all went back to their apartment and played Warcraft 3 (WC3) for a couple hours before bed.
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March 16th:

Don took the day off work (and the following day as well) to hang out with me and Jake. :-) We planned to get up early and go to the Supreme Court for a tour or something, but they woke up too late. So we just decided to quickly walk through the Supreme Court instead.

Then we went to the Capitol Building. Apparently, they recently built a visitor's center.

After that, we went to the Library of Congress. I wouldn't mind studying there . . . if there were no tourists wandering through that is.

Then we walked along the National Mall, enjoying the nice weather.

We walked quite a ways to get to Chinatown (btw, the fakest Chinatown ever), where we ate Italian food at a place called Vapiano for lunch, lol. It was good food though, and the ambiance was nice.

Leaving the fakest Chinatown in the world, we walked through the Sculpture Garden near the Smithsonian Museum of Natural History (where we went next).

That concluded our day, so we took the metro back to Virginia. We order pizza for dinner and played more WC3, and discussed our excitement over Starcraft 2 coming out this summer. :-D
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March 17th (St. Patrick's Day):

This was one of the most epic days ever for me, lol (and certainly the most exciting St. Patrick's Day for me thus far). We took the metro to Rosslyn, VA (which I think must be the deepest station in the system), where we walked to the Theodore Roosevelt Island National Memorial Park, only to find it closed. So we walked along the Potomac River, enjoying the nice weather, until we reached a bridge that spanned the river.

We walked across the bridge and went to the Lincoln Memorial.

After that, we walked countless blocks through GWU campus, through downtown DC, to DuPont Circle, where we got delicious cupcakes from a place called "Hello Cupcake." I got a Bailey's Irish cream cupcake which was really good - though I'm not entirely sure that it's worth $3/cupcake.

Then we got on the train to Adams Morgan, where we got off and walked uphill to the National Cathedral. Our feet were hurting well before this, but we just kept trudging along.

We sat outside the National Cathedral for a while, resting our feet. At which point, I saw a little kid dressed up as Superman and that totally made my day. :-)

The National Cathedral was beautiful on the inside - pictures cannot capture the beauty that my eyes saw. Also, it had surprisingly amazing acoustics.
Also, I saw a rainbow on the floor of the National Cathedral. A sign perhaps?

We trudged back downhill to the Adams Morgan station, which we took to DuPont Circle again. We were going to try this Indian restaurant there, but decided it was a bit too pricey for us. So we walked the many blocks through downtown DC back near GWU campus, where we ate at another Indian restaurant, lol. It was most delicious and filling. All that had sustained me (as well as Jake and Don) all day until then was a bowl of cereal and the cupcake we bought at DuPont Circle.

Yes, I'm aware that DuPont circle is like the "gay district" of DC, but there was no way I'd be taking two straight guys to a gay bar/club with me (on St. Patrick's Day no less!) - also, I don't really like clubbing and our feet desperately needed rest.
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March 18th:

Jake's girlfriend and Don had to work. But Jake and I got up late, and just chilled in his apartment for a bit. We had a late lunch at a Chinese restaurant nearby where they served "northern Chinese dim sum," and it reminded Jake of Beijing (where he studied abroad all of last year) street food.

After that, we wandered around the Chinese store next to it before heading back to his apartment, where we played a game of WC3 before I left DC.

Happy Pi Day

I've been made aware (thanks to friends' statuses on Facebook) that today, 3.14, is Pi Day. Alas, I don't have a pie to celebrate; besides, I'd only be celebrating by myself today. But no worries, because tomorrow morning I'm flying out to Washington DC to visit a couple friends for a few days! And I still haven't packed yet . . .

So yeah, it's been a while since I last posted. Not much has happened - just had another grueling week of exams. I did better in physiology (thankfully) as well as cell & tissue biology (CTB), but I did considerably worse in neuroscience. Bah, truly the nervous system isn't my friend. It's all good - I still solidly passed.

After our last exam, my lab group went out to lunch. I like this new "tradition" of ours. :-P It's nice to just chill with some people and not have to worry about school and such for a few days at least. Even better that it's Spring Break now for us.

The "after exams" period is always a little strange for me. Life gets put on hold while studying for exams. Afterwards it comes rushing back, but sometimes there's an odd . . . gap. Sure it's great to celebrate with friends immediately after exams and such, but after that, when one's alone and everyone else has gone, it's . . . hmm, I don't have the words to describe this feeling. There are things I should be doing, things I mean to do, but all I sense right now is this gap.

I feel like I'm waiting for something, or someone, or some kind of sign. But if I could tell you what/who I'm waiting for, then I'd no long be waiting because I'd seek it out.

Anyway back to packing and such. I'll catch you all once I'm back from DC.

The Last Disciple

Last night I had a rather odd dream. I was in a pediatric clinic (as an M1, or M3, or doctor, I don't remember which) - in fact, I was in my mentor's office - and I remember seeing these two patients.

The first patient was this boy well into his teen years who came in for a sore throat or something. He came with his dad. At some point, the kid blurted out that he was bisexual and somehow that was important to the patient history or something. The dad was surprised but just sat there kind of stunned, as the kid talked about it rather matter-of-factly. I think I gave him the "alcohol, drugs, smoking, sex" talk that pediatricians often give to teens, lol.

The second patient was this boy, around the same age, who came in for a physical or something. As he undressed I noticed that this kid had a swimsuit under his T-shirt and jeans - a woman's swimsuit. This kid's dad is exasperated at this. This kid was somewhat thin and a tad effeminate. Apparently, the kid is a cross-dresser but only with swimwear. So for whatever reason, the kid just likes to dress up in women's swimsuits. o_O

And then my dream ends. Note: no one got fully undressed in my dream, lol.
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Incidentally, today (well, now yesterday), I shadowed my mentor.

At lunch I talked to this nice drug rep who's quitting her job in May to apply to med school because she hated working as a drug rep, lol. After lunch, my mentor took me to his office and basically gave me a nice lecture for half an hour on the privilege of being a doctor. He talked about how communication and caring about your patients are key to being a great doctor - not just technical skill/diagnosing prowess. He told me about his dad, who was a TV advertiser. At his dad's funeral, he said that the 2 most important people who showed up were the elevator lady who his dad always talked to, and his mechanic whose son he helped out once.

At the end of one's life, you want people to remember you positively. It doesn't matter how skilled you are, how amazingly talented you are at being a doctor, because if you're an asshole, people will remember you for that. And we should strive to be remembered as honorable people. I think this little spiel came as a result of him announcing his retirement from practicing medicine for about 35 years. As such, I am the last student to be paired up under him - his last disciple, as it were. I do feel truly lucky to have him as a mentor this year.

The clinic today was largely uneventful - mostly physical exams (PE's). Notably I was able to observe a couple PE's on pre-teens/teens, as both the kids and their parents were comfortable (indifferent?) enough with having me in the room. A PE on a pre-teen/teen is somewhat different than a PE on a little kid or baby, I've noticed. My mentor did actually give the "alcohol, drugs, smoking, sex" talk to a few of his patients today, haha.

I saw one baby with my mentor who had these cafe-au-lait spots. The moment I heard it mentioned, a switch turned on in my brain. I had heard that term somewhere before . . . The baby had 6+ of them and my mentor told the mom that the baby may have von Recklinghausen's disease. Then it clicked and in the back of my head I was thinking, "Hmm, are you sure it's not neurofibromatosis?" I had done research over a summer at one point in undergrad on neurofibromatosis, and cafe-au-lait spots are one of the features of the disease. I also instinctively tried to look at the baby's eyes for Lisch nodules (even though I couldn't remember what they looked like or how to find them). Afterwards, my mentor asked me to look up von Recklinghausen's disease and to my surprise, it's just another name for neurofibromatosis. Score! I got a diagnosis, lol. But now I feel bad for the baby if it's confirmed as neurofibromatosis. :-(

The last patient I saw with my mentor was a PE on a teenage boy. There was really nothing medically special about that patient - pretty ordinary and good kid. Curiously, he looked somewhat like the first patient in my dream. o_O Anyway, there was just something about the . . . "ordinary-ness" of today's clinic that left me smiling on my way back home.
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Today was also the 2nd day in a row that I studied until midnight. I've some pretty tough exams coming up next week. The brain is not my friend. My brain is rather sick of learning about itself. And I've made 4 charts/tables for renal physiology. And the bit of cardiovascular physiology on this block exam made no sense to me; I looked at a friend's typed up notes and was like, "Wait, we learned this?! How come none of this is even recognizable to me?!!" That was just so poorly taught. :-/

It's kind of funny - several of my friends and I are using how well/poorly something is taught to rule out specialties. We reason that by the end of med school it'll be easy to decide what to go into because there will be so few choices left, lol.

Radiology - ruled out
Cardiology - ruled out
Neurology - ruled out (not because it's not taught well, but because it doesn't click with me)
Ophthalmology - ruled out
Surgery - ruled out (because I don't ever want to do surgery)
Dermatology - ruled out (no interest - plus, I'm not #1-10 in my class)

My original interests of pediatrics, infectious disease, genetics, and endocrinology are still in the running though. So we'll see what the future brings.

Take Over

It's been pretty uneventful lately - lots of studying as exams are next week. :-( And then it's Spring Break! I'm going to Washington, DC to visit a couple friends there!! Pretty excited about that. :-D Not too sure what we're going to do once I'm there though . . .

Anyway, on Saturday I volunteered at the free clinic as a Patient Educator. I discussed with a friend (who took pity on me and came in to volunteer with me for - moral - support) on how horribly the Patient Education program is run. It was a great idea started by some students a couple years ago, but executed terribly. So we sat there for 4 hours with nothing to do but complain and discuss. Every now and then one of the free clinic managers (fellow classmates) came by and joined in. At the end, we had come up with an idea that could work, so I emailed the co-chair of the program (an M2). I also CC'd the email to my friend as well as 2 of the managers who were on that day. She emails me back and basically "turfs" it back to me and asks me to run for co-chair next year.

I had no intention of running for co-chair next year, but now I'm reconsidering. The program is set up so poorly that either someone has to completely revamp it or everyone just has to let it die. And now that this has been thrust upon me in a sense, I keep envisioning ways to revive it and make it better. I know what it'd take to make it work and I'm fairly good friends with a couple of the managers, so I can use that to my "advantage." Still though, the only way I'd run and take over the program is if I know I'll have a competent co-chair to lead with me.

Part of my reluctance to take over is because I want to become co-president of APAMSA (Asian Pacific American Medical Student Association) next year, as well as the president of LGBTPM (LGBT Persons in Medicine). As of right know, I'm aware of 3 people (including myself) vying for the 2 co-president positions of APAMSA. That leads to a bit of politics and intrigue, but I'm hoping that I can secure enough votes. And as for LGBTPM . . . I must say, that has to be the worst student group on campus. It's horribly organized (read: it's not organized) and it's at the point where the faculty adviser (the ID guy I shadowed) is worried if it'll still be around in coming years. I'm tempted to take it over not necessarily because I feel any sort of loyalty to that group (certainly not on the same level as I do towards APAMSA), but because I want to rise it out of its own craptastic ashes.

Anywho, where does this leave me for next year? Possibly co-chair of Patient Education (which is a part of FMSA - Family Medicine Student Association - which I'm not a member of, so I don't know how that'll all work), co-president of APAMSA, and president of LGBTPM. Hmm, I had considered running for like, secretary of PIG (Pediatrics Interest Group), but I think I'll pass on that now. :-P

As the M2's think only about the USMLE, let the take over begin . . . XD

---TANGENT---
I'd like to welcome an old blogger, BR from All Mixed Up in CA back to the blogosphere. He had stopped blogging a while back but just returned! He's a pretty casual blogger, but do go over and say hi. :-)
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