Thursday, February 18, 2010

Quote of the Day

"To each one of you the practice of medicine will be very much as you make it- to one a worry, a care, a perpetual annoyance; to another, a daily joy and a life of as much happiness and usefullness as can well fall to the lot of man"

-William Osler

What saves me when I have 6 hours of neuro class

Wednesday, February 17, 2010

Musings on medicine and money

The more problems I see with medicine, the more I blame the infusion of money and business for the erosion of the medical profession. As a profession, we need to do more to uphold the integrity and ethos of our practice. This means being open source, nonprofit, honest and transparent. It's easier now than ever to make money as a doctor, through biotech, boutique medicine, private practice, and if we want to keep medicine as a profession, we need to stop this. Patients should always feel 100% confident that the tests we order, the surgeries we do, and the visits we schedule, are in their best interests, there should be no doubt about this. If you want to join me in making sure that medicine stays an independent, noble, and honorable profession, please let me know. Support open source software, support the removal of big pharma from our education and practice, and speak up against those who say otherwise. I'm reclaiming medicine as an honorable profession, I'm proud to work hard now to help my patients in the future. The debt, time, and hard work is worth the honor and esteem that comes along with being a doctor, and mark my word I will be a physician of virtue and always act in the best interests of my patients. When the integrity of medicine is doubted, physicians lose their power. Our voices are supposed to be the ones advocating for better care for our patients, better political policies and social programs. It should NOT be the case that medical societies speak up in the name of their paycheck and not their patients. That is a disgrace to medicine and other physcians, me included, need to vocalize this dismay. If we don't, who will?

Tuesday, February 16, 2010

A Walk to Beautiful

"A powerful story of healing and hope for women in Ethiopia devastated by childbirth injuries." You can watch the entire documentary online here.

Tuesday, February 9, 2010

Anatomy Update

I love anatomy. I hate bone dust, the sound of saws, the sound of saws through bone, but I love dissecting. Today I spent about 3 hours dissecting out the submandibular region of the face. After a while, I get in a groove, losing complete sense of time, methodically probing and removing fascia to reveal the beautiful arteries, nerves, muscles, glands and such that enabled this altruistic person, now my cadaver, to sense the world, move about, speak and taste and do all the things that makes us human and who we are. I was lost in my work, humbled at finally finding the hyoglossus, a muscle that controls tongue movement, relieved to finally differentiate the submandibular duct from a vein whose name I do not yet know, inspired when I eventually came across the hypoglossal nerve and saw how it beautifully sent fibers to innervate the hyoglossus. Before I knew it, it was past 5:30pm, and me and my anatomy partner, Felipe, were the only 2 left still dissecting. It is such an honor to have this opportunity, I see people differently, I understand movements more clearly, I have such a better scientific sense of pain and feeling after traveling so many feet of nerves through the body. What once was a foreign thing, the idea of blood circulation, is obvious when you dissect out all the arteries and veins, how beautifully unique they flow, diverge, and connect as they become smaller and smaller. Yes, anatomy class is a blessing, I couldn't imagine learning medicine without it, dissections make the body real, the organ systems concrete, disease pathological. I have so much gratitude towards the men and women who bequeath their bodies for our learning. Sometimes I imagine that I'm the first person to ever dissect a body, how much attention to detail, perseverance, and dedication it took to complete the first Atlas of Human Anatomy. I wonder what it would have been like to come across the vast array of fascia, arteries, muscles, and nerves with no concept as to their function. What a thrill!

Sunday, February 7, 2010

How I Study

I spend most of my time these days studying, morning, afternoon, and night. I actually enjoy studying for the most part, since what we learn is interesting. Half the battle in medical school is figuring out the best way to study all the material you need to learn. Since I spend so much time studying, I figured I'd finally blog about it.

Two strategies I really like are "3 minute writes" and the "White Board" strategy". I do a 3-minute write at the end of my class-day, for each class I attended that day. It is exactly what it sounds like, for 3 minutes I write everything I can remember about the lecture. Then I know my starting point and go back with a different colored pen and fill in what I didn't remember/got wrong. For me, this is a great way of consolidating my knowledge and narrowing my studying to what I really don't know.

The second strategy, the "White Board strategy", is when I use the white board to study, I write all the major concepts and details on the board, in a way that I could teach it to someone else, and I talk through it aloud, either to myself or someone else. I'm great at big concepts, but the white board strategy ensures that I'm also covering the details I need to know and I've found it really effective for me.

Below are some of my white boards. If you have any advice on efficient and effective ways to study, let me know!

Microbiology fundamentals: 
Vasculature/Innervation of Head:
 
Cranial Nerve nuclei:
 
Usually all this studying means I'm at Stanford past sunset, makes for pretty sunsets at least!
 

Opthalmic Exams

Friday afternoon we learned how to do opthalmic exams on each other. I volunteered to have my eyelid flipped, to show how to remove an object from underneath the upper eyelid....



I know, I look really scary..Here's a pic of Shubha looking at Katherine's retina...So have no fear, I can do a full eye exam for you if needed! (Hopefully you'll never have to take me up on the offer...)

Stanford has a lake!


Usually Lake Lagunita is nonexistent, but after 2 weeks of rain, it's back and beautiful!