Sunday, January 31, 2010

A Reminder of My Purpose

In the midst of studying for our first HHD exam, I am reminded of the Stanford Affirmation that we recited at our ceremony way back in August:

"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."

More knowledge now = better doctor later = better care for my future patients.

My head is clear, my heart is full, I feel that my actions are aligned with my values, and I'm doing the best I can.  I go to bed restful, peaceful, and recharged, truly thankful for all that I have been given and all the wonderful people in my life.

Saturday, January 30, 2010

Jasper Ridge

Jasper Ridge is Stanford's private nature preserve. Several of us were luckily enough to go on a hike with Bob Siegel, one of our Health and Human Disease professors, who is a docent at Jasper Ridge. I really loved the area because it was so diverse, open areas, lakes, creeks, redwood groves. Really wonderful!

Neil and Peggy from The Spirit Catches You and You Fall Down

Neil and Peggy impressed me so much. They are the physicians depicted in Ann Fadiman's book The Spirit Catches You and You Fall Down. The book focuses on the medical care of a young Hmong girl named Lia, and chronicles both sides of the story, it is a sad story, full of examples of how it can be so hard to truly understand another person's, another culture's perspective at times. Taking care of Lia was the hardest thing Neil and Peggy have done in their professional careers, and what they learned the most from. I was so impressed with their humility and respect for their patients and the practice of medicine. I only hope to be as thoughtful and reflective during my career as they are. I was overwhelmed with how much I respected and appreciated their professionalism and approach to their careers. Truly an honor to meet both of them.

Wednesday, January 27, 2010

ZooBorns is the cutest website ever, it has pictures of newborn animals from zoos around the world. Just look at this baby elephant -how cute!

Monday, January 25, 2010

Fungi oh my!

In Health and Human Disease we learned about fungi last week. I think I was the only student in the lecture hall actually excited to learn about fungi. Why? Because on all the hikes around here you see so many different types of fungi! After a long week of class and huge rains, I got away to the woods on Saturday with three of my classmates, Clark, Aria, and Joe. It was great fun, there was snow, fungi, and raging rivers! What more could we ask for? Below is one of the coolest fungus I've seen yet, it was growing a fallen redwood tree.


1/30/2010 Update: Dr. Bob Siegel told me that fungus is called "Witch's Butter". Pretty awesome! It was very squishy

Tuesday, January 19, 2010

Be the best YOU can be

It's easy to get competitive, it's especially easy for ME to get competitive, prior athletics has engrained that streak in me for life, thus I refrain from silly games like yatzee, in which I have no control over the outcome and don't want to embarrass myself when I get overly competitive...I think I made my sister cry when she was 4 over a game of yatzee. Fortunately, college turned me into a technically-trained track athlete, a sport in which winning is  important, but secondary to whether or not you performed your best. Who cares if you win a bunch of javelin competitions throwing 140 feet when you can really throw 150. Track helped me learn that the most vital competition is the one with yourself. All other forms of competition are secondary.

Why this point now? In med school it's easy to slip into the mindset of "well I'm studying as much as Bobby", or "oh I got that random question right while Sally missed it, thus I know more than Sally", or as is often the case, "Bobby and Sally know all this stuff and I'm scrambling!". But these thoughts miss the purpose of med school. Med school is about making you the best physician you can be, instilling a strong work ethic, dedication to the sick, and a solid medical knowledge base. It's about YOU, your mind, your study habits, your humility and your care for patients. It ain't about anybody else. Whenever I focus on this, I find studying to be less stressful, classes more enjoyable, my peers more interesting and less formidable. Being the best I can be is much less stressful than being the best Stanford medical student, or the best surgeon, or the best javelin thrower, and probably makes all these things much more obtainable. So that's my lesson from today: Be the best YOU can be. It'll take you anywhere you want.

As for the rest of my life, here are some random updates:
  • It's been raining for 2 straight days -my car is flooding!
  • In anatomy today we opened the cranial cavity, which means I held a brain in my hands this afternoon. It was incredible, I am so thankful for anatomy, it gives you an understanding for the human body that is extraordinary.  
  • My family leaves for Paris tomorrow morning!
  • I'm going to be directing Stanford Med's SWEAT outdoor orientation program for the incoming class, along with my partner in crime, Erick, it's going to be a blast!

Thursday, January 14, 2010

Brains brains brains

Today I got to see a brain for the first time. My favorite parts so far include the cerebellum (it's beautiful), the cerebral aqueduct (who knew we have an ecological landmark in the middle of our brain?!), and the circle of willis. The brain has a lot of cool terminology like that, which I think makes it fun to learn, plus the brain is FASCINATING. In the evening I helped with H1N1 vaccinations on campus, I am very confident in my vaccination skills after 3 hours of straight vaccinating. After 12 hours on campus, I am very fortunate that caffeine crosses the blood-brain barrier, can't wait for the 3-day weekend!

Wednesday, January 13, 2010

Support Haitians

I donated and you can too. Life is about people, and people in Haiti are in need of all the help we can give them right now. I can't wait to be a surgeon so I will have skills I will be able to provide anywhere, anytime needed. Here is their latest news release about the situation.

Support Doctors Without Borders in Haiti

I love med school!

Days like today remind me how incredibly cool it is to be in medical school. I start the morning shadowing Dr. Osterberg at the VA's hypertension clinic, learning about all the different causes of secondary hypertension and the different ways to understand the source of someone's high blood pressure. Then I have an inspiring meeting with Dr. Salvatierra, who, through dogged determination created the US system of organ transplantation UNOS with Al Gore, basically saying I should aim high and never take no for an answer. Quick lunch and I'm learning about the new Stanford initiative to combat child mortality in war-torn chaotic places. Best part of my day, was my Surgical Anatomy and Techniques class. I learned how to do a bowel anastomosis! Basically how to suture together two torn parts of intestine, I learned how to use a GIA stapler and how to do a horizontal connell suture to tie it up nicely. But wait, I'm not done, then I went to the Muskuloskeletal exam class and learned how to do a basic hip and knee exam. I LOVE MY LIFE!!!!!

If only I didn't have to study all evening, oh well, it's not too bad to learn about the immune system and all the crazy bacteria that cause infection and disease, it's kinda fun.

Update: In case you're intrigued, here's a youtube video of the connel suture technqiue

Tuesday, January 12, 2010

Anatomy Update

Today I dissected the face. It was the day I've been dreading since the start of the year. It actually was not as terrible as I imagined. The face is incredibly interesting, tiny little nerves, torturous slender arteries, short, fast acting facial muscles. I spent 3 straight hours dissecting and I could have been there all night. After a while, it becomes so engrossing, methodical, and always interesting. I really don't know how surgeons do facial surgeries though, there is so much there! So little! Fascinating.

Sunday, January 10, 2010

A Saunter in the Woods

Yesterday I spent half the day sauntering through the woods, specifically the Portola Redwoods, abundant in banana slugs, mushrooms, newts, and deer. I specifically use the word saunter to describe our adventure, as I recently learned about John Muir's thoughts...

"Do you know the origin of that word 'saunter?' It's a beautiful word. Away back in the Middle Ages people used to go on pilgrimages to the Holy Land, and when people in the villages through which they passed asked where they were going, they would reply, "A la sainte terre,' 'To the Holy Land.' And so they became known as sainte-terre-ers or saunterers. Now these mountains are our Holy Land, and we ought to saunter through them reverently, not 'hike' through them." 

Saturday, January 9, 2010

Vital Amines

Vitamins were named "vital amines" when they were first discovered in 1911 because they were found to be essential for life.

My cool fact of the day.

Also: Happy Birthday Dad! Hope you enjoyed your Green Monster, it's full of vital amines. :)

Ready Set Go: Winter Quarter of MS1

It's true, winter quarter is mighty. Neurobiology, neuroanatomy, head and neck anatomy, immunology, microbiology are incredibly fascinating courses, but also completely foreign to the vast majority of medical students, including me. I am very thankful for the 3 courses of neurobiology I took in college, but quickly I realize that I learned the tip of the iceberg. Long class hours and short days do make it difficult to get sunlight when all our lecture halls lack windows.

There is a shining light of this quarter, the physical exam. In one week I learned how to do a basic pulmonary exam and cardiovascular exam. While last quarter we practiced our medical history-taking skills, now we are beginning to breakdown a big transition that happens for all physicians, the transition from a normal person, to specialist of the human body. Someone who can read the external signs of health and disease, who uses their eyes, ears, hands, and some fun tools to inspect, palpate, percuss, and auscultate a patient to understand what it really is that brought them to see the doctor. I really enjoy this part of medicine, even though it is the  most challenging for me. I already know how to study -it's not always fun, but I know I will do well in my science classes, because there is a formula for studying that I think I've mastered. Learning how to practice medicine is totally new, how do you learn to quickly differentiate a normal lung resonance from disease? See the internal jugular vein undulating at the surface of the neck as you're staring at a real, live person who probably gets nervous, scared, annoyed, and angry just like I would if someone stared at my neck for too long. How do I learn to correctly identify normal heart sounds from irregular sounds? I am now beginning the process of developing my senses, touch, hearing, visual, and smell in order to help others. It is very cool. In our introduction to health and human disease class, Dr. Parsonnet and other physicians told us that the number one skill that medical students need to develop first is the skill of determining if someone looks sick or not, and now I begin to really hone and develop that skill. Very cool.

I miss winter break. After Christmas, I did so much wonderful hiking, running, and javelin throwing. I realized that I had not devoted a good enough time to doing things I loved last quarter, so I will be trying to be better this quarter. I found several incredibly gems of nature right in my backyard, including Purisma Redwoods Open Preserve, Skyline Ridge Open Preserve, and Big Basin State Park. These hikes were incredible, memorable times I spent with my family and I can't wait to explore more... Alas, time to review immunology. Thanks for listening.

Wednesday, January 6, 2010