MIA (aka: winter break!)

I've been frolicking around the snowy northeast for the past few days. Mostly catching up with friends, but also visiting BREAKTHROUGH: THE DRAMATIC STORY OF THE DISCOVERY OF INSULIN exhibit in New York City (if you're in the city, go! even knowing the story before hand, all the documents and relics they have makes it pretty cool), and meeting with my PI from this summer to discuss my research. We also discussed how I should spend the next two years of medical school, as I received my official acceptance for the smaller program in the state capital yesterday. His two cents, to which I agree, is that I should go. 3rd year is about throwing yourself into the medicine and experiencing all that you can. He strongly suggests I go to the place that will give me the most experience and will also encourage the advocacy work that I'm drawn to. He also talked to me about the taking a year off for research, about choosing 4th year electives, and about residency applications. I'm so lucky to have such a grounded mentor.

With that, tomorrow I leave for the UK. This is assuming that the airport does not fall victim to awful weather yet again and that my flight actually takes off (and lands). I'm going to spend the rest of break NOT thinking about medicine. Not thinking about the impending move . Not thinking about Step 1. Not thinking about all the research I'm involved in. Instead, hanging out with lots of Jews, many of which will have cute accents! Okay, so maybe, that is a bit of a lie. I am bringing some work to do and study material with me. But I refuse to beat myself up if I don't get much, or any, of it done. See you on the flip side! Happy holidays ya'll!

Humbling reminder

A beautifully written article from The Washington Post, "A mother's joys and a family's anguish shared via Facebook", is a humbling reminder of exactly what I am getting myself into. Read it, but have Kleenex near by. It highlights the limitations of modern day medicine in such a highly technologically savvy world. More importantly, it is a potent reminder that every patient is a person: a mother, a child, a friend, a sibling, a unique and valuable entity in this world. I pray that I never forget this; that I never see a person as a just a medical case. Also, that I never forget how fine the balance is. That in a brief moment things can change from completely joyous to utterly devastating.

choices, part 2

In an update to this post last month, I just sent in an application for the program. Still not completely sure it is what I want to do, but I am also not ready to give up on it. The sticking point is the possibility to work with state officials on improving health care. To work on health policy reform in the state capital! Or at least working within the hospital to make policy changes. That'd be SOOOOO cool and so up my alley. I figure that by applying I'm allowing someone else to decide for me &/or buying myself more time to decide on my own. Only time will tell how this all pans out!

pitty me, I'm a medical student

I'm currently having a bit of a pity party. Tonight there is a rather large benefit concert at a local bar, a holiday party with my Jewish community, and a bar take-over with the city's queer community.... yet it is not even 10pm and I am sitting on my couch with Lulav, watching TV.

It isn't that I'm totally unsocial, I just can't seem to handle big group gatherings. Last night I hung out with a classmate instead of going to an upperclassman's holiday party. I then spent all of today studying. Right after shabbat ended, I met up with a classmate to get manicures and then grab dinner at a local thai restaurant. Tomorrow will also be spent studying, followed by an abortion movie screening and dinner with another friend.

The self pity stems from frustration in lack of a work-life balance. Also in the realization that this balancing act will never get easier. I can tell myself that life will ease up post-step 1, or post-3rd year rotations, or post-internship year, or post-residency, or post-fellowship, or, or, or... I simply wonder if medical school is causing me to be less of an extrovert. Instead, turning me into an unsocial, exhausted, isolated, single minded, socially awkward monster. If I can't rally myself to hang out in the bigger world now, how am I going to maintain a large (and non-medically based) social community? How am I going to have conversations about real world topics? Or worse, how am ever going to meet people to date?

Conclusion: my pity parties always seem to fast track me to crazy cat lady status.

Living in the south is bad for women's health...

The National Women's Law Center in conjunction with Oregon Health and Science University published the "2010 health report card for women" today. This report card looks at all factors important to women's healthcare: access, family planning, abortion, wellness & prevention, policy, etc.

The first thing I did was to look up the state I currently live in: F. Then I looked up the states that surround me: F, F, F, F... The south (TN, KY, LA, AB, MS) = fail. While not at all surprising, it is beyond frustrating. We theoretically live in a rich country with access to some of the best healthcare in the world; except clearly not. Women should not be receiving inferior care based on their gender. Southern's should be at a disadvantage based on their geographic location. Aren't we all US citizens?

My very liberal view is that we need some serious healthcare care reform NOW. Bring on the universal care with a single payer plan! Bring on preventative medicine. Bring on health education. Better incorporate other professionals into a person's care plan: social workers, nutritionists, and the such. Integrate more reproductive health care into primary care. OR, I should just move to Canada, or England...

What is my role in all of this? How can I help to improve healthcare as a medical student? Should I be getting more involved in health policy? How can I better prepare myself to provider comprehensive healthcare in such a broken system?

Words of Choice

“What is a good and RATIONAL reason to have a baby?"

This question was posed to us at a really wonderful “Words of Choice” workshop, which I had the opportunity to attend at this weekend’s conference. The workshop was facilitated by Joan; a well spoken, spunky, experienced, and passionate activist who shared insightful wisdom. With her blessing, I’d like to pass on a brief cliff-notes version of some of the thoughts and practical ideas that were presented. Please note that my writing cannot actually give this workshop justice.

The follow-up to the above question: It is pretty difficult to determine rational reasons to have babies. So, why do we expect such reasons from those choosing to not be pregnant?

General advice we were given about responding to anti-abortion rhetoric:

-Take a deep breath and then speak on the out-breath; this will lower your voice, giving you more authority. It will also help to keep you calm.

-Give a fact and move on

-Briefly state personal opinion

-Offer a generalized statement to recognize the complex philosophy

-Agree to disagree

Drum roll for my favorite piece of advice….

–Instead of holding tension in your back, shoulders & neck during these interactions, do kegels! Improving your sex life totally beats a life of stressed induced back pain.

Specific ideas that were suggested to respond to rhetoric with:

-“Women regret abortions” --> “Any major life decision has the possibility of regret -why should this one be different?”

-“You’re going to hell” --> “I’ll see you there”

-Someone making a threat on you/your family -->“What I am doing is legal, threatening me is not”

-“What if your mother had aborted you?” --> “Then I wouldn’t be standing here dealing with you”

-“Baby killer” --> “I’m proud to offer this service, babies are too important to be an accident”

-“Why is the mother more important?” --> “The mother already exists, and a child needs a strong & ready mother.”

Some other comments:

-"My concern is for the living children in this world who aren't getting their needs met. That’s where I would rather focus my energy.”

-“I didn’t go into this [providing abortions] to become a judge, therefore woman’s well thought out choices are all valid to me”

-“If one believes that the soul is immortal...then for the soul, having an abortion is like missing the bus - the soul will wait around for the right woman to carry it when the time is right.”

-“Human life is too important for there to not be choice present.”

One of the best parts of this workshop, which I can’t sum up here, was the opportunity to think/talk through my own ideology in a safe space. I recognize that my opinions, experiences, and beliefs will develop as I continue on this path to becoming a provider. (They already have shifted a bit over my past year and a half in medical school.) I recognize that in order to allow for this growth and ensure that I don’t burnout, having these safe spaces are so important. Besides being grateful for the overall session, I’m super excited about all the kegels in my future!

Where is the line?

I've been thinking and talking a lot about abortion today. Day dreaming about women's reproductive health isn't totally uncommon for me, but because of the Med Students for Choice national conference I was at this weekend, it is especially on my mind. The conference was such a high. A total reminder of why I was drawn to medicine in the first place, what I hope to accomplish in my career, and that there is a world of like minded peers out there (even if I am separated from the majority of them by the Mason-Dixon line).

I have so much I want to tell you about the conference. I took notes during the workshops which include many ideas for blog posts scribbled in the margins. These posts will (hopefully) come in due time. Once I have finished processing, caught up on sleep, and no longer feel like I am drowning in renal pathology. Okay, okay, maybe I wont wait that long; but I am not yet ready to post about it all tonight.

In the meantime, I received a gchat message from a classmate today. A classmate that is very much a friend. This was the message: "http://www.makearightchoice.com/index.htm
that's an interesting website i found in my research. thought you might want to take a look. "

I can't tell what his intentions were for sharing with this me. Was this in response to my attending the conference? Or did he really just want to bring it to my attention that such websites exist? I am (pretty) sure he didn't mean it to be threatening or an intervention, but regardless of the intentions, it still stung a little. This is someone who I deeply respect, conservative views and all. We dialogue about our opinions, we agree to disagree, and we normally are very respectful of the other's perspective and ideology when interacting. However, intentional or subconscious, I feel that this crosses a line. This plays into my fears about the path that I am on. Regardless of my fear of overt or subtle harassment, I WILL NOT stop being an advocate for abortion and I WILL continue on my path to becoming a provider.

post conference blues

I spent the weekend in a hotel filled with activist medical students. It was insightful, inspiring, and empowering. It also gave me a glimpse of what my future career as a doctor might actually look like. I bonded with classmates, reconnected with old friends, and made new ones. I will be blogging much more about it in the days to come.

The plane landed back home an hour and a half ago, returning me to my reality. I leave these conferences empowered yet also impatient and discouraged. I already miss being around so many like minded peers. I am back in the conservative south and back to the demanding life of medical school. I am also overwhelmed with all that I have to accomplish in the next 2 weeks before winter break, and needing to start my step 1 studying. Most importantly right now is my mph paper that is due at 12pm tomorrow. High-ho, high-ho, it is off to writing I go!

p.s. This weekend also reminded me how happy snow makes me! Yes, I know, this (along with many other things) makes me weird.

forced cultural competency

This post is a place holder. In our "fluffy" class (the class that every school has to teach med students how to "doctor", though these courses never share the same name), we broke into small groups for cultural competency standardized patients. My group went this afternoon. The activity was poorly planned. Actually, it was even worse than that. That said, it was by far one of the more powerful experiences I have had thus far in med school. It is an experience I hope to carry with me throughout my training and future career. More then ever I feel strongly that my duty and responsibility is to my future patient(s), who I must not judge or underestimate, yet I also need to remain true to my own values and experience. The feedback I received from today included: "You are golden", "make sure you don't change", and "don't let the institution of medicine ruin you". It is the most proud of myself I have been in a long time, and yet, I nearly threw a few temper tantrums (and punches) during the exercise.

That said, until the last group goes next week, I can not openly write about the experience. I can't give too much away to my classmates who haven't yet done it (though I doubt they read my blog). Plus/more importantly, I really need to be reading for class tomorrow morning.