Monday, October 13, 2008


Thursday, October 09, 2008


How time flies!

Do you do anagrams? You know, that word game where you have a set of letters and are supposed to spell as many words as you can before time runs out?

I used to be good at it, back when reading was still a hobby. Haven't played it in a while, but just had a chance to revisit the game recently.

Let's just say that the vocabulary has S-H-R-U-N-K!!

It's much harder to see the words in the scrambled letters, and the words that I'm creating now (stye, cation, etc) are not considered words!

Fluency in science/medical jargon doth not an anagramist make!

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Monday, June 23, 2008

Are you too critical?

If you're in medicine, have you noticed that there seem to be a lot of unhappy people around?

Maybe this is due to tunnel vision in the microniche that is a residency training program, but it seems like the faculty are also a relatively unhappy bunch. Well, maybe not *unhappy* per se, but pessimistic and cynical. (Note - this is in direct contrast to the visiting attendings who come around once a month and all seem to love their jobs/lives.)

Now, I think the real reason is much more complicated than this, and may include things like: poor reimbursement for trying to juggle a lot of different balls, disadvantages to working within a relatively inefficient system, bureaucratic/political issues, frustration with the perceived lack of work ethic in the current generation of trainees.

But humor me for a moment, while I digress on this hypothesis:

Maybe part of the reason why people involved in training programs are so unhappy is because of the way medical training is conducted in the United States.

What do I mean by this?

In medicine we are taught to see pathology. First year medical school is all about "normal," and then every year after that focuses on what goes wrong. We learn all about the pathological processes that can occur in the organ systems. Eventually we hit the wards and learn to fine tune our sense of what is normal and more importantly, what is not. We learn to eyeball a new patient and know that "things are not looking good." Each note we write reinforces this - the assessment and plan is a litany of different "problems" the patient has. We are trained to anticipate problems before they occur, to check labs for any signs of abnormalities or trends towards abnormality. With chief complaints, we are taught to think of the worst possible scenarios and rule them out. And make sure that bad possible scenarios numbered 2 through 14 are also ruled out. And all patients have multiple problems.

If one isn't careful to balance out this skewed view of life, it's easy to assume that all people are "full of problems." We forget that most live uneventful, healthy lives, and more importantly, we forget to look for the normal. That ability to hone in on the abnormal, while most useful in an acute patient care setting, becomes somewhat of a liability in our everyday lives. And while it may be easy for someone who works, AND has a life outside of work, suffice it to say that this is not the modus operandus of most residents (and most attendings, for that matter.) The end result? A group of high functioning individuals who have been well trained to look for what's "wrong" with the picture, who unfortunately become consumed with work and fail to see the forest for the trees.

Here's a completely different view of life:

A close friend works as a personal trainer. Her goal at work is to encourage clients to reach their maximum physical potential. This involves non-stop encouragement, which starts from "that's a great top you have on" to "you've improved so much since the last time we met." Her workday revolves around objectively evaluating a client's workout and using that for positive reinforcement. The day in, day out practicing of this positive mindframe spreads into her personal life.

I think we can learn a lot from how other professions think about things/carry themselves, and make sure that we only use the critical eye when it is needed. We owe it to ourselves to not drag ourselves (or the people around us!) down. Be on the lookout for normal today. Actively look for the positive. It's all around you - you just have to take it in.

Happy Monday!

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Saturday, June 21, 2008


Our longing for the eternal kindles our imagination to bless. Regardless of how we configure the eternal, the human heart continues to dream of a state of wholeness, that place where everything comes together, where loss will be made good, where blindness will transform into vision, where damage will be made whole, where the clenched question will open in the house of surprise, where the travails of life's journey will enjoy a homecoming. To invoke a blessing is to call some of that wholeness upon a person now.

-- John O'Donohue

Wednesday, June 04, 2008

Can't We Live and Let Live?

Wednesday, April 09, 2008

Wise words from a wise colleague

1) Identify the people you don't want to spend time with and force yourself to spend time with them.

2) You never really know what someone else is thinking. You may think you know, but you're wrong at least 70% of the time. To assume that someone is that different from you is often wrong.

3) Try and make everyone's life better for having interacted with you. Try and make everyone a better person for having known you. You may not always succeed, but you won't know until you try. And you never know who you may have an impact on, even with the smallest of acts.

4) There comes a point in your professional career where you've reached the limit of how far you can go. What matters in the rest of your life, and how you will be thought of and remembered, is how you treat the people around you.

5) Don't shy away from doing the above because it is hard. Don't use the excuse that you don't care.

6) You have to be fearless and do these things with a leap of faith. To hide behind the "I don't want to get hurt" is cowardly. After reaching this point in life, the things that you are "protecting," are not actually that valuable and in the long run don't matter.

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Wednesday, January 16, 2008


I saw a woman in clinic recently that really made me think.

The visit got off to a poor start, as she was steaming mad that she had been kept waiting and had verbally abused every staff member on her way in. Attempts at getting a history from said lady were met with "isn't it in the chart?" or "duh" and the like. But she eventually calmed down and after the anger passed, we actually had a meaningful visit. Turns out she is a grandmother that has been through some rough times. She lives in a neighborhood where young children carry guns and use them with reckless abandon. Her son was murdered by his best friend. She raised two kids by herself with minimal income. When her children with serious medical problems that needed expensive medicines that she needed to steal when she couldn't afford them.

For her to have gotten to today in one piece, mentally and physically, is a miracle. I have utmost admiration for her strength and her remarkable dedication to her children. And while she's not the most pleasant patient in the world, I'm not surprised that she angers easily. She is a survivor. It's been her against the world for a very, very long time. And while some may not agree with her past actions or her choices in life, I dare anyone not in a similar socioeconomic/environmental situation to try and imagine what this poor soul has gone through.

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Tuesday, December 25, 2007

Happy Holidays!

There's nothing like the holidays and a few days off to recharge and remember to be grateful for what we have.

Here's wishing everyone all the best this holiday season and may your dreams come true in 2008!!

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Thursday, October 25, 2007


The weather's getting cold, and leaves fade in shades of sunset rays.

It's fall and almost winter.

Wasn't winter just here? Was it that long ago, when people were complaining about winter never ending? Where did spring go? And summer? How did I miss the footsteps of fall, and fail to see the beauty of the changing seasons?

How time flies when one is busy. The intervals of surfacing for air are so very long and far in between. That one can pass from week to week and month to month without acute awareness of the pass of time seems like active denial of who and what we are.

Where has the last year gone? Where have the last five years gone?

And what am I doing as time passes by?

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Tuesday, October 09, 2007

Bad Relationship?

Bad relationships may increase your risk of heart disease.

Just out in the Archives of Internal Medicine:
A study of 9,011 British civil servants, most married, found that those with the worst close relationships were 34 percent more likely to have heart attacks or other heart trouble during 12 years of follow-up than those with good relationships. "Relationships" included that with partners, close relatives and friends.

What does it mean? Just more information suggesting that stress has a larger effect on one's general health that we previously assumed. Which makes intuitive sense, and people probably know/feel, but science has yet to catch up to this concept.

What to do? Easier said than done, but don't stay in bad relationships.

It's not worth risking your health.

Be safe!

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