Tuesday, January 29, 2013

Sybil's death

Being a few days after the showing of Downton Abby season 3 episode 4, I hope I'm not spoiling it for anyone.  However, consider yourself warned that this could be a spoiler for someone living completely under a rock, or maybe in 3rd year or residency or some other all life-consuming activity.

Sybil's death brought with it a flood of emotion for me.  I always find myself crying when a character dies regardless of the medium.  This dates all the way back to my obsession with "doom and gloom" and reading Luriene McDaniel books in middle school.  I still love books that make me cry and I often find myself crying in movie theaters (though airplanes are the only movie theaters I have time for now a days) so it comes as no surprise that tears flowed as Sybil died. 

The flood of emotion though was because of HOW Sybil died- in childbirth, from eclampsia.  While skewed in accuracy, especially with modern monitoring and treatments for pre-eclampsia and eclampsia, is still brings light to the gravity of birth.  Evolutionary pregnancy and birth have to happen for us to continue and so it does, but it does with great risk.  According to the CDC, "at the beginning of the 20th century, for every 1000 live births, six to nine women in the United States died of pregnancy-related complications".  Reported rates in Brittan were closer to 40 in a 1000 births.  Today, the rate is closer to 12.6 per 100,000 births in the United States, putting us at a rank of 21st in maternal mortality.  21st!!!  That's pretty shitty.  The rate is even more horrific in other parts of the world, and often from preventable and/or treatable causes.  We need to do better.

I believe the episode also brought to light the fact that practicing medicine is an art and not a science.  It requires knowing your patients and trusting your instincts.  Doctors are human and make mistakes.  Communication between doctors, patients, and families is key.  So are medical surrogates, medical power of attorney, and living wills.  If you don't already have one, take this as a sign to make one!  Have conversations with your loved ones about what you might want/not want to happen to you if you are ever in a situation where you can't decide for yourself.  Talk about organ donation. 

I know, I know.  It's only a television show.  Maybe I'm reading too much into the plot, or transposing too much of my daily life into it.  Oh well, so be it. 

Also, before anyone starts blaming western medicine on the risks of childbirth (I too have seen Business of Being Born), that is not what I'm implying.  To say this again: birth more often than not is VERY safe and does not require much, if any, medical intervention.  But, when things go wrong, they tend to go wrong fast and can have dire consequences.  Even during my 3rd year clerkship I saw both the beauty of birth and the devastation from horrible unexpected tragedy.  I try to focus on the beautify and fragility of human life in this amazing feat of the body; humbly remembering that I cannot always be in control of, or know what to expect from, every situation.

Monday, January 28, 2013


While not the best number ever, and not even the goal, I'm proud to announce that my A1C last week was 7.7!  This is 0.7 lower than it was at my last visit.  In fact, lower than it has been since I started medical school!  It's been a long time since I've had my A1C in the 7s...

Controlling my diabetes in medical school has been challenging at best.  I don't test my blood sugar nearly enough.  I keep myself slightly high on the wards out of fear for hypoglycemic episodes while dealing with patients or in surgery, or just fear of taking out my pump to bolus in front of residents and attendings.  I don't change my pump often enough and therefore have a higher than average rate of kinked tubes, pulled out sites from tape giving up, and ketonic episodes. I use expired insulin because I don't have time or energy to refill my prescription.  Stress alone bumps up my numbers because of excess cortisol release.  Basically, I am so busy trying to learn to take care of others' health that I neglect my own. 

But, oh, at last!  The golden 7.0 A1C is in sight!  The even more allusive 6.0 [in order to contemplate pregnancy] is right beyond it.*  Between ordering a shinny new continuous glucose monitor (that I hopefully wont be allergic to), a new bicycle to exercise on, and adopting a low-er carb diet... I guess we'll just have to see what my next  A1C has to say for itself.

*Not that I intend to get pregnant right now, or anytime in the near future. But it might be on my 5-10 year plan... It better be, after all, I'm already 28 and well aware of the risks involved with increasing egg age.

Wednesday, January 16, 2013

Forty years later, the same damn fight

Next Tuesday will mark 40 years since Roe v. Wade, and yet, access to safe abortions is majorly limited.  Women's rights in the US are being chipped away at daily, little by little, state by state, with no safety net in sight.  I'm honestly scared to see what happens with the abortion debate over the next 40 years.  If we continue on the current trajectory... I don't even want to imagine.  I'm going to keep fighting for my rights.  Are you?

Here are what other people are saying 40 years after Roe v Wade:

Happy Birthday to Roe v. Wade—What's Left of It

Forty years after Roe v. Wade, most under 30 don’t know case was about abortion

Roe v. Wade at 40: Most Oppose Overturning Abortion Decision

Roe at 40, in 2 Charts

Abortion poll: Keep Roe v. Wade

If Roe v. Wade Goes

Recalling the world before Roe v Wade'

Resources / Take action:
ACLU's list 
Unitarian Universalists (UUs) list

PS totally frustrated that when researching events and articles for this post, the anti-abortion movement has a FAR greater amount of content online (as least in a google search) than the pro-choice movement.  Arg!!! 

Thursday, January 10, 2013


That moment when you have a brilliant and inspired research idea, only to search google scholar/pubmed/etc to find that it has already been done,  and done exactly the way you wanted to do it.  Ugh! is both validated that it was a good enough idea to be published and yet disappointed that someone beat me to the punch. 

Tuesday, January 1, 2013

2013, mixed feelings

I have totally mixed feelings about this New Year.  2012 was an emotional roller-coaster.  The death of my grandmother, a rather jarring car accident, 2 trips to the Emergency room (as a patient), all the emotions of 3rd year clerkship, a hard break-up, then meeting someone new (and extraordinary), deciding to take a research year, moving to a new state, 2 cross country road trips, a trip to India... it has been a BIG and overwhelming year.

2013 was supposed to be the year I graduated medical school.  A huge part of me wishes it still would be the year I graduate medical school.  Instead, it is now becoming the year I figure out 4th year electives, begin residency applications, and try to *hopefully* get a publication out of all this research.  Ideally it will also be a year full of seeing my family, nurturing my relationship, taking better care of my health, and finding time to have fun.  Maybe I'll also make some art and learn some Spanish.