Wednesday, July 27, 2011

Brenner's army

Based off of The New Yorker article that came off this year, PBS put out this documentary on "doctor hotspots".   I propose we start Brenner's army: doing the research to find hotspots in our own cities and towns and implementing programs to change it.  It is about time we drastically change the way health care is accessed and better utilize our finite and precious resources!

Think there is any way that I can arrange a research year under Dr. Brenner next year?

Sunday, July 24, 2011

I'm one of the 1700

"The fact that medicine is still compelling enough for 17,000 people each year to commit a decade or more of their life to training is inspirational."
From Dr. Danielle Ofri's article "Why Would Anyone Choose to Become a Doctor?" in the NYT.

Thursday, July 21, 2011

Remember "O157:H7"

Increasingly often I seem to forget that I had a life before medical school.  Sure, I can recall my childhood, past experiences, and the different cities I lived in; but I forget the knowledge I acquired and the details of my other hobbies and interest.  A friend recently sent me an email asking about digital cameras which took me off guard.  My thought process consisted of: "Why is she asking me about cameras?!  Oh ya, I was a photography [and anthropology] major in undergrad.  I guess I should know something about this."  It took me days to respond, days to tap back into that old part of my brain and even still the response lacked finesse.  Talking about shutter speed, and apertures, and developing tricks used to be so second nature...

Dr. Goljan jokes that one should forget their own phone number in order to remember "O157:H7".  I'm beginning to think that it is a sarcastic joke, painfully illuminating what acquiring medical knowledge does to the rest of your brain.  Where does all that former knowledge go when it is replaced by pathophysiology and pharmacology?  Does previous knowledge come back when I reach residency? Post-residency &/or fellowship?  This [shiny pretty object] is your brain, this [deflated balloon/fried egg] is your brain on medical school...

Tuesday, July 19, 2011

Halfway mark

I'm halfway back to my normal life as a medical student: back to clinical rotations on the wards, back to activism and advocacy relating to women's health, back to national LGBT health organizing efforts, back to trying to publish the research I did last summer and possible starting on a new paper, back to completing my MPH requirements, back to not having enough hours in the day to work, study, eat, exercise and sleep.  Also, back to my cat and back to being within driving distance of a certain special someone. I couldn't be more excited!  The time can't go by quick enough.  I feel like a lazy sloth, wasting valuable time, simply sitting on my butt and cramming details into my head.

Last night I had a conference call for one of the national organizations with which I am involved.  I felt like I was letting my board down.  I was repetitively apologizing that between my medicine rotation and now dealing with personal issues (restudying for step 1) I haven't really done much of anything and that I wont be able to until after the middle of August.  They, my other board members, are nothing but encouraging and supportive.  They are other medical students, they get it.  I adore them [and am oh so very grateful for they way they are enhancing my med school experience].  But, I hate it!  These are issues I'm passionate about.  While I am sure I will continue to organize on issues of medical education and health equity throughout my life, I only have a year to serve in THIS position.  A year is not a long time to make significant strides and even less time when one has to solely concentrate on other things for a block of time during that year.

While I am so excited to get back to my normal, every day, chaotic life, I am also terrified.  This means I am halfway to retaking this stinking exam.  I feel like I've learned a lot and resolved some of my confusion in pharmacokenetics and pathophysology.  All of this studying has not been in vain.  This studying will also help me out later on the wards.  But my qbank scores are not really trending up.  Despite how much I study my score are staying pretty steady, right around where they peaked before I took the exam last time.  With every qbank set I do, I grow slightly more discouraged, fearing that step 1 will come out on top once again.  I plan on taking another NBME self assessment at the end of the week which hopefully (crossing fingers!) will show some growth and boost my confidence.

Friday, July 15, 2011

Spoke to soon

So, it turns that just because my state's government is on summer break doesn't mean that reproductive health battles aren't being fought in other areas of the US currently.

According to an article on, "Medical students and residents at the University of Wisconsin pursuing OB/GYN studies may not be able to complete their training -- and the school faces the prospect of losing its residency accreditation for training doctors in this specialty. Why? Because medical students and residents are being banned from learning the abortion and miscarriage management techniques that save women’s lives. Anti-choice politicians in Wisconsin tacked on a provision to the governor’s budget bill stating that state funds cannot be used for abortion care."  Check out the link and sign the petition.

Also, the National Partnership for Women & Families' policy report today highlighted that "Rep. Cliff Stearns (R-Fla.), chair of the House Energy and Commerce Subcommittee on Oversight and Investigations, said the panel plans to investigate the Planned Parenthood Federation of America and "possibly" hold a hearing on the group's federal funding."  Really?!  With soooo much of a national debt to overcome, we're wasting chasing after PP.  Besides the fact that I strongly believe Planned Parenthood deserves every cent of federal funding they receive, blocking $70 million in funding is not going to make a dent in the amount that needs to be cut from the federal budget.  Dearest republican party conservatives, can you please just get over yourselves and actually spend time on things that matter, things that will actually improve the health and welfare of Americans' lives?

Thursday, July 14, 2011

Being a lazy activist

I don't really have the time or energy right now to touch on current events in the way I'd like.  Due to step studying, I barely know what is going on in the world outside my window.  [Luckily, state congress is on summer break so access to reproductive health is not overtly being stripped away while I hide away inside.]  But, I wanted to lazily share a few recent [AMAZING] news articles, all of which happen to be from The New York Times. There was "First Study of Its Kind Shows Benefits of Providing Medical Insurance to Poor" published on July 7th.  There was an absolutely brilliant, and light-harted yet equally heavy piece,  "The Good Short Life With A.L.S." about how we face death in our society- really hitting on the need for open communication throughout one's life.  "New for Aspiring Doctors, the People Skills Test" takes a critical look at how medical students are screened in our country, and what some schools are doing in hopes of finding applicants with more people skills.  I personally hope that my own medical school would adopt such innovative interviewing methods.

Wednesday, July 13, 2011


I was diagnosed with celiac disease in December 2005, over winter break of my senior year of college. My diagnosis was somewhat happen chance. Sure, I was extremely sick, but in totally non-traditional celiac diagnosis type of ways. I'll spare you the exact details. My home doctor laughed at the suggestion that I should be tested for it, but the physician at student health services who had no other idea what was going on, figured it was worth tacking on to the lab work. I came back positive to all 4 antibodies. I was then shuffled off to see a GI doc who confirmed my diagnosis and sent me on my merry [gluten free] way.

Working on the healthcare team at a diabetes camp, I had learned a lot about celiac disease in the summers prior to diagnosis. I knew I was at a high risk due to my strong family history of autoimmune diseases and my personal history of type 1 diabetes. I had suspected that it might be the culprit to my gradual onset of chronic woes and I was the one who suggested the test to the student health doc. I had done my research and was prepared for the results when I came back positive. I wont deny that going gluten free sucked, but emotionally, I rebounded to the news pretty quickly and I was soooooo ready to start feeling better.

When I was diagnosed, it was suggested that my immediate family members get tested. None of them did. Today, 5 1/2 years later, my mom saw a new osteoporosis specialist who screens for anti-gliadin antibodies as part of his comprehensive panel. Turns out that she has celiac disease too. She's 66 years old and totally asymptomatic. Antibodies don't lie. Okay, so sometimes antibodies are confused, but in her case it is a true positive diagnosis.

Watching her come to terms with the reality that she now needs to drastically change her diet is difficult. While she is willing to, she lacks the physical motivation of illness that I had. I imagine that it is also much harder to change your habits at 66 than it was at 21.

To my dismay, my endocrinologist does not screen all of his type 1 diabetic patients for celiac. So every time I have seen him since my diagnosis, I have brought in scholarly literature about the need to annually screen patients with related autoimmune disorders. He argues that it will make a difference in seemingly asymptomatic patients; that they will be unwilling to change their diets for a disease that is not causing acute distress. In lieu of today's events I both understand not wanting to turn someone's life upside down and also the need screen for conditions the patient is at high risk for. Had this doctor not screened, my mom would get to continue to naively live her life the way that she's accustomed, and at 66, who knows if untreated celiac would have left her with any serious term sequela. At the same time, I believe that it is out obligation as physicians/future physicians to supply our patients with all of the information regarding their health despite our personal belief about what they'll do with the knowledge. Example: we need to educate our hypertensive patients on smoking cessation and dietary changes, and the impact not making these changes might have, even if we know that they're going to simply walk out the door with a cigarette still in hand.

Am I just being naive though? Is my endocrinologist right in that we shouldn't screen for problems that aren't yet screaming to be found? Would my mom be better off not knowing that she has celiac disease?

Monday, July 11, 2011

Horrible, no good, very bad biochemistry

In medical school, it seems that biochemistry continues to kick my butt again and again. First there was the challenge of passing first year biochem. Then there was learning how to incorporate the biochemical pathways that I didn't really understand into pharmacology. Then there was re-learning all fine details again for step 1. And now, there is relearning it a AGAIN to retake step 1. No matter how many times I look over this stuff, how many times I draw out the pathways, how many mnemonics or songs I use, I can't seem to get a grasp on the damn subject!

I have no doubt that my inability to retain biochem is part of what did me in the first time with step 1, as I seemed to have a TON of biochemistry questions I didn't know the answers to while taking it. I spent my whole first week of studying this time picking my way through rapid review. I've also used BRS, First Aid, and Doctors in Training sources. No matter what I do though, none of it sticks. Maybe it is because I was a post-bac student with very minimal science exposure pre-medical school? Regardless of the reason, I'm starting to get a little nervous that my inability to retain this one subject is going to be my down fall yet again.

Anyone have magical advice of how to make sense of it all/retain the intricate details of pathways, rate limiting steps, and dysfunction resulting in disease?

Thursday, July 7, 2011

Grand Rounds, Vol 7 Number 41: An Ode to Trainees

I was featured in this week's grand rounds: Grand Rounds, Vol 7 Number 41: An Ode to Trainee, hosted by A Cartoon Guide to Becoming a Doctor! I'm honored to be included and excited to see that my viewership has exponentially increased over the past few days. Hopefully I can entice some of you new (and old) readers to stick around as I continue on this crazy journey of activism and medical education.

So frustrating!

I took an NBME self assessment practice exam this morning, and got the exact same score as on the real step 1 that I took in April. Arg!!! So close to passing... yet not. Not even close to where I need to be. On the bright side, at least my score didn't go down and I still have 27 scheduled days of studying between now and my scheduled re-test date. Can I do this?

Saturday, July 2, 2011

Life imitates art? Art imitates life?

A few of my classmates and I started a list of pop-culture movies with heavy pathological themes. We were trying to figure out how much of medical school curriculum could be learned through movies. Specifically movies with much more substantial lessons of disease processes, biochemistry, and/or real doctoring than what can be gleaned from Scrubs, ER and Gray's Anatomy. Here is the list so far. What other movies can you think of? (I am sure there are more!)

*Gross Anatomy (1989): "A smart first-year med student takes nothing seriously, except the pursuit of his Gross Anatomy (human dissection)..."
*Extraordinary Measures (2010): "A drama centered on the efforts of John and Aileen Crowley to find a researcher who might have a cure for their two children's rare genetic disorder."
*The Elephant Man (1980): "A Victorian surgeon rescues a heavily disfigured man who is mistreated while scraping a living as a side-show freak. "
The Madness of King George (1994): "A meditation on power and the metaphor of the body of state, based on the real episode of dementia experienced by George III [now suspected a victim of porphyria, a blood disorder]."
Lorenzo's Oil (1992): "A boy develops a disease so rare that nobody is working on a cure, so his father decides to learn all about it and tackle the problem himself."
The Diving Bell and the Butterfly (2007): "The true story of Elle editor Jean-Dominique Bauby who suffers a stroke and has to live with an almost totally paralyzed body; only his left eye isn't paralyzed. "
*Love and Other Drugs (2010): "A woman suffering from Parkinson's befriends a drug rep working for Pfizer against 1990s Pittsburgh backdrop."
*Awakenings (1990): "The victims of an encephalitis epidemic many years ago have been catatonic ever since, but now a new drug offers the prospect of reviving them."
Outbreak (1995): "Extreme measures are necessary to contain an epidemic of a deadly airborne virus. But how extreme, exactly?"
And the Band Played On (TV 1993): "The story of the discovery of the AIDS epidemic and the political infighting of the scientific community hampering the early fight with it. "