Catharsis

Now that this round of exams is done, the "what I learned at the GLMA Conference" post, as promised.

I just talked to Dr. P about it earlier today and how to move forward with the info we (I) learned. I've basically grouped it into 3 categories: immediately useful/actionable info, good to know info, and personal.

1. Immediately useful/actionable info
Students. 29% of LGB students aren't out, mainly because it's: nobody's business (fair enough), fear of discrimination, and fears of not getting into a residency of choice. About 60% of transgender med students aren't out. Few med students feel that med school curriculum has adequately prepared them to serve LGBT patients. Students want more clinical exposure, more cases, lectures, and supportive faculty that they can turn to. On average, med schools in the US and Canada spend about 5 hours over 4 years on LGBT health issues (not including HIV).

Med schools. Deans of med schools have a different view on things. Most (68%) have LGBT content interspersed throughout the 4 years. It should be noted that 79% of med schools have no LGBT clerkship rotation sites. Transgender health issues are rarely taught. The good news is that 52% of deans are willing to improve curriculum; but, they aren't too keen on developing new stuff (because it's time-consuming and hard).

Allies. The barriers to being an effective ally must be addressed. This might be: a desire to avoid controversy, afraid to be called gay/associated, and not asked to speak up. Some strategies to help remedy this include: getting educated about the issues, talking about it, have some symbol of support (like, a small rainbow pin or something), learn the "language," ask the right questions, assume nothing, and discuss confidentiality upfront.

Some of things that can be done here right now include: working with the Office of Student Diversity, working with the Admissions Office, working with the new curriculum committee, safe spaces/ally training, and just continue general awareness. Incidentally, I somehow ended up on the student diversity committee. I just happened to attend the one meeting - a case of being at the right place at the right time I guess.

2. Good to know info
I didn't learn much about LGBT issues and health care reform, though I went to a couple sessions. I did attend a few transgender health sessions though, and they were actually really interesting.

Transgender kids. Toddlers start developing gender identity around age 3-4. This process evolves until the kid's about 7. This process appears intrinsic. That said, some kids are "just in a phase" or gender-fluid. Thus follow-up and just observation over the years are important. These kids tend to get distressed between age 2-5 and again at puberty. To treat these kids, one gives them hormone blockers to delay puberty until they're old enough to make a decision about transitioning or not. Apparently only about 10% of "gender variant" kids do end up transitioning. The point is, that up to 33% of transgender youths attempt suicide. But by showing acceptance, support, and delaying puberty until age 15 or so, it greatly reduces the rates of suicide and depression. Furthermore, the medical home concept is quite apropos for these kids.

Transgender care. Holy crap it's complicated! Someone's got to do it but I do NOT want to be among them. When to give hormones, how much to give, how to pay for them - it's all so overwhelming. Don't get me wrong, I like endocrinology and all that, but this is like endocrinology on steroids (lol, pardon that pun).

Also, HPV can apparently survive under the fingernails for a while (apparently that's how straight guys can get anal cancer, who knew?). I need to remember to buy Purell . . . Don't know if on that random off chance I'll get HPV from shaking someone's hand.

3. Personal
So Dr. P asked me if the Conference did anything for me personally. I suppose it did. It was nice to just be away from the Midwest and meet new people and not talk about classes and such. Yeah, still surrounded by medicine and such, but at least it's not worrying for this exam or complaining about that lecturer or something comparatively petty like that. He did concede that in hindsight it was perhaps a bit too overwhelming for me to experience that all at once, lol.

But then it was also incredibly cathartic. I disclosed more about my personal life/struggle to him than I had anticipated or expected. I suppose I wanted some kind of answer from him, but I didn't get what I was looking for (whatever that was). There were moments of long silences - of him staring at me and me staring back, of him staring at me and me staring off in the distance to avoid his gaze. Words just abandoned me and the silence doesn't force him to say anything to break it.

It felt like the more he subtly pressed against my walls, the more I wanted to crumble. He didn't tell me anything new or anything I didn't already know about myself. Other than perhaps suggesting that going to a therapist might be good (though how I'd pay is questionable). In a way I guess he forced me to realize just how uncomfortable I still am with all of this and how lost I still feel.

This catharsis was paralyzing and deafening. I've clearly still got some work to do. It never ends. :-/

It Gets Better

I came across the It Gets Better Project yesterday. It was started by Dan Savage in the wake of the much-publicized recent LGBT youth suicides, and it basically collects video stories from people on YouTube telling LGBT teens that "it gets better."

Although I don't have a message to share, per se, there are a few I'd like to share (and I've quoted some of the lines they said that I could relate to). The first 2 are from the It Gets Better Project and the last one is a very emotional and moving vid.


"It gets better . . . well to be honest, I still have to believe that in myself. But I think it's gonna get better. And sometimes it feels like you're the absolute only person left in the world to care for yourself and even then you don't want to care for yourself. But, something you've gotta remember is that somebody out there needs you as much as you need somebody."


"I struggled a lot in high school with mostly myself, I suppose; I didn't have a lot of problem getting picked on, but I knew it wasn't acceptable or really smiled upon. So I struggled with feelings of guilt and shame and all that stuff that is very unpleasant and hard when you feel alone . . . and it's rough."

"My favorite memory is watching the sun rise on a mountaintop with this boy I was in love with and it was amazing, and if I didn't make it through high school I wouldn't've been able to do that. . . . Thank God that I'm human and able to experience this." Something about this bit really got to me.



So this post is for any of you readers out there who're having a difficult time. This is for you bloggers/ex-bloggers. This is for me. This is for us.

That Which Resonates

Earlier today, I organized a lunch panel discussion. Or rather, I emailed Dr. P months ago asking him if he'd be willing to give a lunch lecture on coming out. He said yes. Then he recruited one other physician to co-talk with him, and then about 2-3 weeks ago he decided to turn it into a panel.

Although I can't say with certainty why he decided to go the route he did, I suspect that he did it partly for me (and any others "like" me in the audience). There were 5 physicians and 1 bio-ethicist who was the moderator. The physicians included: 3 gays, 1 bi woman, and 1 lesbian. Many of the issues they talked about were in some way directed at me - whether they knew it or not.

They each gave their own personal coming out experiences in med school and beyond, if/when applicable. The one gay ED (emergency department) doc's story really resonated with me. He wasn't out in med school except to a few friends. He dated in med school but kept his private life separate from his professional/med school life. In residency he was out to a few more friends and co-residents, but still didn't make a huge thing of it. After residency he still didn't talk about it much, even though he had a partner, because it never really came up. Only when he was moving and told his boss why did he really come out. And since then he didn't look back.

The primary reasons why he didn't come out sooner was because: 1.) he wasn't fully comfortable with himself yet, 2.) it was no one's business, 3.) he had no pressing reason to, 4.) no one asked. It wasn't that the environment around him was anti-gay or not accepting, it was simply for those reasons listed.

And I think that's where I am with all this. It just hit me that that could be me. That that is me (minus dating and a partner). Some people know and do something about it. Others need more time. I think I've come a fair way since beginning this blog years ago. But I still have a ways to go. I won't pretend to say that I'm not scared, or that I don't know what to do, or how to do it, or what's next.

---TANGENT---
So, a cursory look at the blogs on the sidebar here seems to indicate that many of them are no longer active, as their authors haven't made a post in months. Where has everyone gone? I guess I may have to do some "cleaning up" with my blog roll. There are new blogs I came across and meant to start reading, but alas too busy. Also, I sometimes wonder if some are worth starting since they may end in the near future. Who knows.
---END TANGENT---

GLMA Conference

Okay, now or never. The long-awaited post on the GLMA Conference.

So if you recall, a few weeks ago I flew halfway across the US to San Diego, CA, for the GLMA Conference (9-22 to 9-25). I still haven't found the words to describe the experience. I'll do a separate post on what I learned there, rather than make this already lengthy post even longer.

Thursday, 9-23-10
Because of an obligation Wednesday night, I had to leave the morning of the 2nd day of the Conference. It was not a particularly good day. About 8 hours before my flight left (at about 6am), my roommate decided he was too tired from playing Settlers of Catan with some friends and didn't want to take me to the airport. Instead, he told a mutual friend to take me and that he'd pay $10 and I'd also have to pay $10 for this favor. He told me all this via another mutual friend on gchat.

Stressed as I was, I exploded. I was furious. First, my roommate decides he was too tired from playing a board game. Second, he decides to tell me this less than 24 hours before my flight leaves. Third, he gets me a ride from another friend who I'd have to pay (and he called it a win-win for everyone). Fourth, he didn't tell me any of this in person. Yeah, I was pissed.

I got another friend to agree to take me. So I woke up around 4am, checked that I had packed everything, and got ready to leave. I hear my roommate running down the hallway and enter our apartment just as I was finishing up. Evidently he "felt bad" and decided that he'd take me to the airport after all. I was still pissed. The whole ride there he kept saying how unfair it was that I was angry at him and that I shouldn't be expressing my frustrations towards him. -_-

Anyway, I got to the airport, got on my flight, and arrived in San Diego in one piece. I was tired from the flight and hadn't slept much at all. I keep forgetting how beautiful California is.

I call Dr. P soon after arriving and again once I got to the hotel. He came down to meet me and paid for my room (I still have to give him the hotel receipt so he can get reimbursed). I must've looked like shit. I register (Dr. P pays again), went to one session, then took a nap instead of getting lunch. I then attended whatever sessions interested me for the rest of the day.

The highlight of Thursday was meeting 2 people. The first was someone I took Spanish with in undergrad. She goes to med school where we both did undergrad. I'll call her "Lindsey" for this post. Anyway, it was good running into each other near the elevators; we exchanged numbers and went our separate ways that day.

The second person I ran into is "Keith." Keith is an Asian 3rd-year infectious disease (ID) fellow. He was apparently looking for me since Dr. P told him to say hi to me. He was really nice. It's possible that I could become Keith in 10 years, except he's way cuter and is a great dancer (more on that later). Perhaps that's why Dr. P sent him my way.

The rest of the day was uneventful. I didn't meet many other people, except a few friends of Keith who just finished residency. I was so tired that I decided not to go out with everyone. I just went to bed, and also I hadn't eaten anything all day.

Friday, 9-24-10
I woke up actually feeling pretty good, for once. I went down to get breakfast before the first plenary session. I ran into Dr. P and Lindsey there. Lindsey introduces me to the other 6 students from her med school there. I go into the first plenary session and sit with Dr. P and his physician friends. All of them had their iPhones and/or iPads out, and were typing on them or playing a game intermittently throughout the session. This included Dr. P at one point. I was amused.

As the session ended, Dr. P told me to find him around noon for lunch. We went our separate ways to different sessions. It just so happened that the session before noon was one that both Dr. P and I attended, so we sat near each other. Afterwards I just followed him out. We met up with his friends (and one of their med students in tow), and walked down the street for lunch.

The people in attendance at lunch were: Sports Med doc (from NY), Internal Med doc (from NY), Med-Peds doc (from OH), Dr. P, Dr. P's partner (a nurse), and another med student (also from NY). They were all great, and it was awesome listening to their stories and about their lives. Sports Med doc talked about his experiences with Latino patients, Internal Med doc talked about his practice in the LGBT community, and Med-Peds doc talked about starting up a clinic for LGBT patients in OH. They were pretty hilarious - especially Sports Med doc. He goes to the Sports Med conferences and he always wonders where all the gay guys are, but "at least there's a lot of eye candy there."

Then Dr. P mentions that I don't have texting. Instantly they all gasped and were like, "What do you mean you don't have texting?! You're just weird!" That was a bit embarrassing, lol. It was (apparently) inconceivable to them that any LGBT person wouldn't have texting. As Sports Med doc left, he told his med student to text him. ::facepalm::

I ran into Lindsey again after lunch and we went to one of the sessions together. A trans-woman M4 (Kelly) comes and chats with us. Apparently her mom, also a trans-woman, is the current president of GLMA (but I didn't figure that out till later).

In the evening, I hang out with Lindsey for a bit at a lesbian reception thing. Keith was there and introduced me to some residents. After the reception, Lindsey, a lesbian med student from IL, and I met up with other students to share a taxi to Urban MO's where the students' reception was being held. I'm not a huge fan of bars/clubs, but whatever - in a different city, an experience I'll likely only have once, so why not? Besides, Dr. P more or less "ordered" me to go, and he was going to stop by later to say hi.

We get there, wander a bit looking for other students, and finally find them towards the back of the bar near the dance floor. The Conference had opened and paid towards a bar tab, so the first x number of drinks we got were free. Lindsey was tipsy/drunk after her first drink. I get my second drink and gave just a bit to her to taste. I think each drink had to be equivalent to 2 shots - they just added so much alcohol in there! By the time I finished my second drink, I could finally feel the alcohol hit . . . and with that, the music and dancing. It seems I need about 4 shots to get me on the dance floor, lol. And even then I'm still aware of my incredible awkwardness, but I just seem to care less.

After a while, I saw the residents, fellows, and some physicians filter in. I saw this one anesthesiologist on the dance floor who had given a talk the day before. And then I spotted Keith. He had changed clothes in the interim and - maybe it's the alcohol or something - he was way attractive there on the dance floor dancing. I make my way over and ask if Dr. P was around, and soon after Dr. P comes up and says hi. Alas, I didn't see him drunk or dancing. He actually left for a different bar pretty soon after with other physicians. I dance with Keith for a little bit.

More dancing and I was feeling the alcohol wear off. I make my way to the bar and another med student (from OH) gets me a rum and coke. He was pretty drunk by then . . . I worried for him later that evening, but he somehow made it back to the hotel okay. As the night wore down, Lindsey and IL lesbian were getting quite into each other. I gave them their space and left with 2 med students and the Conference photographer (who's also an anesthesiologist). We chat in one of the hotel lobbies for a bit before retiring for the night.

Saturday, 9-25-10
The last day of the Conference! The sessions weren't as interesting as they were the previous days, but still pretty good. I met up with a med student (Frank) who I'd been chatting with for a few months since he came across this blog. It was good to finally meet him in person, though we didn't get much of a chance to hang out or talk at length.

At lunch, I went down to the pier and snapped a few pics. Here are some of them:

Later in the afternoon, I meet up with blogger Mike for a late lunch/early dinner somewhere in Hillcrest. We walked around and chatted, then had Thai. It was nice to meet in person after chatting online for years. He's pretty much exactly as I had pictured him. :-P

When I got back, it was time to head over to the Gala Banquet. I went with Kelly since she had her car there. We got lost for a little bit but finally found our way. It was a nice event, though I felt uncomfortably out of place. I sat at a table with this really attractive Australian lesbian (I assume she's a lesbian anyhow). There was more dancing, and this time many of the older people were on the dance floor. Imagine your mom or dad grinding on the dance floor. Yeah . . . I have a couple pics, but I won't post them here.

Sunday, 9-26-10
Since Frank and I had the same flight, we decided to ride to the airport together. I chose to get some sleep while he decided to go out (and didn't sleep). I set my alarm on my phone but I didn't wake up to it! So when he knocked on my door I literally shouted "Shit!" and leapt out of bed. We did make it to the airport shuttle on time. Phew! If he hadn't knocked on my door I would've sooo missed my flight.

Alas we sat at opposite ends of the plane. The guy sitting to my left was rather large and his arm overlapped onto me. Ugh. This is why I like aisle seats (or window seats).

And that's the GLMA Conference in summary.

OCPD

OCPD = Obsessive compulsive personality disorder (not to be confused with OCD)

- Become so preoccupied with details and rules that the major point of an activity is lost.
- Display perfectionism that interferes with task completion.
- Have inflexible values and are overly conscientious.
- Unable to discard worn-out or worthless objects.
- Reluctant to delegate tasks.
- Miserly spending style.
- Display rigidity and stubbornness.
- Excessively devoted to work.

Taken directly from my psych notes (exam tomorrow morning). Hmm, kinda sounds like I might meet some of the criteria for this. o_O Anywho, it's been over a week since I returned from the GLMA Conference. I should probably blog on that soon before I forget stuff . . .