Monday, August 31, 2009

The Weight of Med School

Today I felt the weight of med school. It's just day 3, but we had class 9am to 6pm straight with just an hour for lunch (and an optional review from 7-8:30 that I decided to postpone until Wednesday)

Now I come home, hungry and dazed, with a plate full of studying ahead of me. Oh and preparing a journal club presentation for tomorrow (another day of 9am to 5pm straight class, followed by as much studying as I can handle in the evening).

It's a lot. I'm doing the best I can to review each day's material and prepare for the next, but I can already tell that it will become overwhelming fast, and this is mostly review material for me!

I'm going to do the best I can, and hopefully just hang on. Most importantly, I think running every day after class will really allow me to relax and clear my mind before another night chalk full of studying. Anyone with tips for remembering the development stages of erythropoeisis, please send them along!

Sunday, August 30, 2009

My place

My apartment is almost set. I really like how it's turned out so far.
Here's my living room:

and my workspace:
I still need to frame a few photos, clean up the dining room, and tidy up, but then it will be set!

Friday, August 28, 2009

Stethoscope Ceremony

Tonight I received my stethoscope and recited the Stanford Affirmation with my class as my official induction into medicine.

Here is an excerpt of the Stanford Affirmation:
"On my admission to the Practice of Medicine I pledge to devote my life to the service of humanity. The care of my patients will be my first consideration.....I will hold all life dear, and let knowledge, wisdom, courage and compassion guide my therapy. I will use my medical knowledge to promote human rights, social justice, and civil liberties...."

It was a wonderful evening and I'm so happy my family was able to be there. As I dive into my first preclinical year, full of molecular biology, genetics, and basic science courses, I hope to remember why I'm here, all the women and families I worked with at the BCC, and hope to begin to personify the quote Dr. Probe gave at the end of the night...

Cure sometimes
Relieve often
Comfort always

Thursday, August 27, 2009

First Day of Medical School!

It's been a long time coming. Today was my first day of medical school. It was interesting, fun, and not too overwhelming. Anatomy was interesting. My cadaver had cancer, I know because she has a port in her for chemotherapy delivery. I took the first cut, from the manubrium all the way down to the xiphisternum, one clean cut. Dead skin is not my favorite thing in the world, in fact, it might be my least favorite thing next to fat and fascia. I love muscle, and finding the long thoracic nerve, (stems from the brachial plexus and innervates the serratus anterior) was really neat. As for reflections, It struck me that I will learn more this year than I can possibly comprehend, my synaptic connections might triple. I'm really thankful Stanford is pass/fail. Tomorrow is my first histology lab, we'll be using microscopes to look at bone marrow and blood cells.

In other news, I FINALLY went for a run today. It was tough, not because I was going fast, but because I'm so out of shape. I am definitely going to run every day during med school, I think it's the only way I'll get fresh air.

PS. After vigorous hand washing and a long shower, I still smell like the anatomy lab.

Wednesday, August 26, 2009

Pearls of Wisdom from the 3rd and Final Day of Orientation

"Whenever I see a medical student on the wards cry, I am delighted because I know this means they will be a wonderful physician" -Abraham Verghese

"To be a good physician is to walk in your patient's shoes as best you can" -AV

"It means you haven't yet transitioned from your precynical years to the cynical years" -AV

"Don't be afraid to look stupid now, it's bad to be stupid later" -Gill Chu

Regarding the Health and Human Disease course: "You gotta be encyclopedic about medicine"
Tomorrow is officially my first day of medical school. I have a full schedule starting off with Molecular Foundations of Medicine, moving on to Cells to Tissue, and then finishing off the day in anatomy lab. I will do my best to follow Gill Chu's 3 pieces of advice:

1. Your first obligation is to yourself
2. Your second obligation is to your patients
3. Ask for help and get in the habit of asking for help because you never want to wing it on the wards.

Wish me luck!

Orentation Day 2 and a new theme: Stay Focused

One of today's themes at orientation was Academic Development. Stanford is really cool in that there are so many options and areas for academic development! Lauren Baker aptly described Stanford's resources when he said "it's like there are $20 bills lying all around everywhere all the time!". Exciting and overwhelming. Hmmm, this sounds like a repeat of Harvard undergrad.

The difference is that this time, I'm focused, and my theme is to stay focused. Professionally, I am starting to visualize the path through the forest of how I would like to spend my time here at Stanford. My primary goal is to become the best clinician I can be (duh). My secondary goal is to set myself up with the skills and knowledge to become an effective and innovative leader who can help make health care dramatically more patient-centered, safe, and efficient.

Here's the sketch of my plan:

The next 2 years: Work really hard to do my best during the pre-clinical years. Take many surgery electives, shadow many doctors, and look out for really innovative and inspiring physicians who could potentially be mentors, teachers, and advisers. Try to get involved in some kind of project by next summer that has a clinical focus, and work on a project the summer after that has a healthcare delivery focus. And can't forget the biggie: definitely rock Step 1 of the Boards.

3rd year: Go to the Business School to try to understand organizational behavior, ways to implement systems-based change, learn from other industries how we can make healthcare safer and perform at higher levels. Recruit all the b-school kids into health care reform and innovation.

4th and 5th years: Complete my clinical years, figure out exactly what type of medicine I find most fulfilling and want to practice. Work hard to hone my clinical judgement skills, work hard to make sure the folks I care for receive the best care for them. Actually be able to answer some of my family's medical questions.

This outline is really growing on me, and I see how I can make it work. We also had an Amazing Race all over campus, watched a really thought-provoking documentary called "Hold Your Breath" and then had a great dinner at Bucca de Bepo in downtown PA....I can't wait to see what our 3rd and final day of orientation will bring!

Best Advice of the Day

How to do well in med school:

1. 20 minute prep: Before the first day of every class, do a 20 minute review of the class. Review the syllabus, books, etc, determine what you will use and how you will study.

2. 20 minute closure: After the completion of the last day of any class you take, set a timer for 20 minutes and annotate your First Aid Review book.

3. Use the 2nd years: Ask 3-4 second years how to approach the class before you start it to get the inside scoop on study strategies and level of difficulty.

4. Q&A Blitzing: Each week, write 8-10 questions you think will be on the test. Meet once a week with a group of unlike-minded peers and blitz each other.

This advice was actually handed out yesterday afternoon, by learning specialist Sue Willows. It was too good not too pass on. I will do my best to follow it!

Monday, August 24, 2009

Reflections on my first day

In the morning, Dean Pizzo welcomed us to Stanford Medicine. He put our year in perspective by pointing out that 50 years ago, the year that Stanford Medicine moved to Palo Alto, the structure of DNA had been elucidated only 6 years prior, the polio vaccine discovered only 3 years prior, and now, our class will be the last to have courses in the old medical school buildings. He also shared several pearls of wisdom that I really appreciated:

1. "Bring the glow back"
2. "Become a champion"
3. "Make the U.S. number one"

1. In reference to his urge to preserve the moral high ground of physicians in the face of good clinical care and compassion competing with financial gain.
2. Ie. find your passion and pursue a path of medicine you really care about and want to improve
3. Improve health outcomes so that the U.S. is number one in more metrics of health care besides administrative expenditures (currently the only thing we are number one in).

Next came Dean Prober who gave a Top 10 list of reasons why we made the right choice to attend Stanford. My favorites included #10 (Geography) and #1 (Your Classmates). My 85 classmates (whose names I'm trying hard to learn!) are pretty cool folks, 20 countries are represented, 8 have PhDs, 12 have Masters degrees, 8 other were varsity athletes in college, and besides the stats, everyone I have met so far has been very genuine, interesting, and engaging. I think Dean Prober nailed it.

I feel so honored to be apart of this community and anticipate that medical school will change me in more ways than I can possibly understand at this moment. As I went to bed last night, I was thinking about quotations that encapsulated how I want to approach my education, here are a few that came across my mind:

"We are what we repeatedly do"
"Learn from others, learn from your mistakes, keep moving forward"
"Always do what you are afraid to do"

And, of course, my biggest focus: "Become the best damn doctor I can possibly be".

PS. What do you think of my new look?! :)

Medical School Orientation Starts Tomorrow!

Here I am, 1:30am, too excited to sleep the night before my first day of med school orientation. The theme tomorrow is "Leadership and Service", we get breakfast, lunch, and dinner, along with Welcomes and Introductions, a talk on "Advocating for Change", and a round robin discussion about community health and the Cardinal Free Clinics, with logistical stuff interspersed throughout the day.

I can't believe this day is already here. So much has happened in the past month since I finished my job at UCSF. I had a great week in Chicago, regrouped in Southern California, successfully moved in to my own place, and went on a 3-day hiking trip with other new medical students. The hike (SWEAT trip) was beautiful, we were in the Stanislaus National Forest, north of Yosemite and camped at a gorgeous lake (which I swam in!) for 2 nights. I really loved all the other folks on the trip and look forward to getting to know them better over the course of the year. Abbey and my Dad, and now my Mom too, have been helping me move in and get situated, which has been really helpful. I just need to get my internet installed and I'll be really set.

So, short story, I start orientation tomorrow and I'm stoked! And for a taste, here are two photos I took on the SWEAT trip:

Tuesday, August 4, 2009

BBQing up a storm

Scallop kabobs, chicken kabobs and corn on the cob. My mouth is
watering just looking at them!

UCSF Decision Services in the Wall Street Journal

In today's Wall Street Journal you can find a great article on the UCSF Decision Services program. The article, Weighty Choices, In Patient's Hands, delves into how and why providing patients with information and decision support, like the program I was apart of for the last 2 years can be better for all parties involved. There is even a photo of one of my very good friends, Alexandra (Jay) Teng, doing part of the service. Glad to hear this great program is finally getting some publicity.

Stir Crazy's famous banana wonton dessert!


Sunday, August 2, 2009

Quack Quack!

Saw this little guy at the Chicago Botanic Gardens today.