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For Real.

As of yesterday, I’m back to the real life: books, powerpoint slides without an end, and marker packs in so many colours the rainbow would be jealous.

But if all goes well, this year won’t be the same as last year. I mean, not that last year was bad or anything, it is just that I want this year to be even better. (Who doesn’t? … You don’t have to answer that.) Anyway, part of this whole New Year’s Resolutions thing is to actually follow through with good intentions.

It’s day three. How many of you have already broken your resolutions? Be honest with yourself, because I know the vast majority of you have. Well, okay, maybe only a few of you have since it is only day three. I’ll give you a couple of weeks.

I actually did make resolutions this year. I intend on keeping all of them, despite some of them nearing the verge of insanity (in my already crazy mind). Why? Because if I don’t make the changes for a healthy life now, when will I? Life will only get harder and habits will only set firmer. When I see myself in the future, I don’t see someone who would rather grab a bag of potato chips over an apple. …Okay, I do but only one time out of ten or so.

Cheers to a new year, and a slightly modified Kristin.

First, I am cutting out sweets from my diet. In case you were wondering, my sweet tooth takes up most of my face. Sorry, Pinterest. Your dessert folder is going to have to be ignored until a friend needs a cake baked for them. No sugar in my oatmeal. Black coffee when possible. No birthday cake at birthday celebrations (unless it is my own, of course). Crazy, huh?! Here’s the remaining sanity in it: I will allow myself all the gum I can chew, breath mints when needed, honey (in HEALTHY things like my homemade granola, which is way to fantastic to give up), a rare energy drink if needed prior to an exam, and ONE serving of sweets on holidays. Yes, my birthday is a holiday. No, Ground Hog’s day is not a holiday, nor is Presidents Day.

Second, I am going to work out SIX hours per week. This one is going to be the hardest for me to keep, because I can’t guarantee that I have six hours to spend in a gym EVERY.SINGLE.WEEK. The point of this resolution is to find the time. And if you think about it, that is less than an hour if I decide to go everyday. That’s not bad at all.

Related to the last one, I am shooting for a goal of running 300 miles this year. That is completely doable at less than 1 mile per day, even when taking holidays off. The thing is that I really am not a fan of running unless they have happy colour powder to throw at me every kilometer I run. (Side note: I’m already registered for the Colour Run this year! If there is one in a city near you, DO IT!)

Thirdly, I want to do as many random acts of kindness as I can afford. Which, on a med student budget, probably is like three. Sadly, the thing that I realized, though, is that someday I will be able to pay it off. The person I help doesn’t likely have that same luxury. It can be overwhelmingly blinding to look at my bank account and see nothing for several years in the near future. Take those blinders off, miss. There will be money there. Those loans will disappear, no matter how ginormous of a number they get to be.

And lastly, do more artistic ventures. I probably (most likely) have said that I love to do various art projects, crafts, writing, poetry, things and stuff. Med school shouldn’t prevent me from doing things like that. I’ve accumulated hoarded nearly everything I need for any project in my supposed-to-be-a-studying-office-that-has-become-more-of-an-art room.

The best part? Now that I have told you, I have just made you all accountable for my goals, too.

Even better? If you tell me your resolutions, I will remind you like none other that you should probably be sticking with whatever your resolutions are. For real, you made them for a reason.

 
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Posted by on January 3, 2013 in My Inspiration and Motivation

 

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My Top Ten Beats Letterman’s

Ten simple things I want to do when I grow up to change the community I live in:

1. Start/Host a book club.

2. Give presentations at grocery stores on how to read nutrition labels, what products are the healthier versions of the same food, and what foods are practical for everyone’s busy daily life.

3. Set up races (5K, 10K, etc) to promote physical activity, with proceeds going to providing gym memberships for others in the community.

4. Start a scholarship fund for both medical students and a high school student thinking of going to medical school eventually.

5. Find/Buy books to add to the local library collection.

6. Give a presentation to the high school students on reproductive health. I feel teachers dance around this topic or just exclude it from their teachings all together.

7. Start/Work in a community garden, donating my products to the local food shelf.

8. Either participate or open a free minute clinic for those who either cannot afford health insurance or health care.

9. Set up cooking classes in the community, where people rotate leading a session, in order to add quick healthy meals to people’s routines.

10. I would ideally love to have a second small house on my property that I could temporary rent out at a low prices to people who need a few months to get back on their feet.

 

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Boobs are Great and All, but…

“Put a heart (♥) on your wall with out comment, only a heart. Then send this message to all your female friends. Next, place a heart on the wall of the person who sent this message to you. And if someone asks you why you have so many hearts on your wall, do not reply. This is only for women to remember that this is a time to remember and care about breast cancer, and that we should always be breast aware.”

That is a copy and paste version of a mass message I got in my Facebook inbox this morning. I’m guessing that at least some of you have gotten this same one, or at least one about bra colors, where you leave your purse, or what you are craving when you are pregnant. If you haven’t, consider yourself darn lucky, because I’m pretty sure they are just sent to my inbox with intent to make me swell with rage all Hulk style. Well, okay, I am exaggerating with the severity of my negative emotions quite a bit in that statement. Why get so flustered over something so minute? Sit back, Jack, because this one is a doozy.

First off, posting these things on Facebook is, for some odd reason, NOT raising awareness for breast cancer. At all. If you want to raise awareness, say something about BRCA1 or BRCA2. Post a factual statement that one out of every eight women residing in the United States will develop breast cancer, or that breast cancer is the second-leading cause of cancer death among women in the United States. Most importantly, tell your friends and family to have regular examinations. Early diagnosis means several things: increased chances of being able to keep your boobs, increased chances of living, and increased likelihood that genetic screening will be done on your babies. (They are probably not too little anymore, but they are always babies to a mom.) The take-home point: early diagnosis = good prognosis.

Secondly, these posts always seem to include something about just sending it to only the women on your friends list. I hate to be the one to inform you all, but each year in the US alone, over 1000-2500 males are diagnosed with breast cancer. Every year, more and more man boobs are lost. Tragedy.

As a mini-side note, still on the same topic of course, I find it funny that I see at least three of these silly little messages sitting in my inbox each year, most of which talk about doing something ridiculous for “Breast Cancer Awareness Month.” Why am I getting this in March?? Breast Cancer Awareness Month is October. Mark it on your calender, ladies and gents, because we are going to paint the town pink. You know, to promote “breast cancer awareness” or being a girl or that pink is the best color or something. Envision my eyes rolling.

Then there is always the fact that we have to understand what is happening in cancer to be able to design drugs to be effective against it. (Translation: We have to conduct research in order to have a chance at understanding how cancer works.) “But what does this have to do with me?” you ask all innocently. This is when I will tell you, “It costs money to do research.” Being all smart, you will retort, “Yeah, I knew that. But again, what does this have to do with me? They get research grants and things to help them out.” “Ahah! I see you are an intelligent one,” I’d say. “But you seem have forgotten that breast cancer is still the number two cause of death in females here in the US. Researchers apparently haven’t found enough yet to decrease the mortality rate. More research must be done. More research means more money, and quite frankly, grant money in a lab is exhausted faster than Ms. Kardashian with her marriage.” As the light bulb turns on, you say, “I geeeeet it nowwww!” Then you will actually become involved in awareness and finding a cure instead of “raising awareness” via lame, encrypted statuses. It is my hope you would, anyways.

When it comes down to it, if I happen to be one of the unlucky eight women, I want to know that I did more than post a heart as my status, or tell someone I’m four months pregnant and am craving a Milky Way. I want to know that I did all I could do to save my lovely tatas. I’d like to think that I protected other people’s boobs as well, but much less so in a literal sense as the previous statement (though all you boys might be willing to take a literal interpretation on that one…). If you happen to agree with absolutely everything I wrote, it’s my lucky day. What I meant to say was: If you happen to agree with absolutely everything I wrote, I have included two websites that are 1. trustworthy, 2. informative, and 3. helpful when it comes time to being an active participant in the movement to “Save the Hooters.”

http://www.bcrfcure.org/inv.html

http://www.nationalbreastcancer.org/How-To-Help/Donate-Online.aspx?gclid=COOhoo7vu6wCFZIDQAodOCAqqw

 
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Posted by on November 16, 2011 in My Inspiration and Motivation

 

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The Best Medicine

Spending a day in bed, cuddled up with the best blanket and a magically, auto-refilling cup of vanilla soy chai lattes, repeatedly watching Wall-e is the only cure I can think of for this burnout mode I have found myself in.

 
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Posted by on October 8, 2011 in Snippets of Life

 

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Stop Playing Pretend

I can’t honestly say that my hopes and dreams have always been to be a doctor. What I can say is that I have put my heart and soul into the dream that I will someday be a doctor, once I had decided this was were I wanted my life to go. I won’t even try count the overnighters I have pulled,  or the gallons of coffee drank, because right now, my dreams are becoming a reality.

I found out just over a month ago I was accepted to medical school. Let me rephrase. One month ago, I was accepted to my top pick medical school. I can honestly say that it didn’t register as fact until I went to the pre-orientation session the college offered in order to get to know my fellow classmates. I fully expected to show up and my name not be on the list or there not be a name tag for me to wear. When I saw my name tag, my picture on the class listing, it finally registered. I, Kristin, am going to be a doctor, just like I had planned. Down to the school and everything.

For those of you that aren’t familiar with the process, let me summarize. 1. Excel in high school and get accepted to an upstanding undergraduate college. 2. Obtain primarily As, with an acceptable occasional B, on the undergraduate transcript with a majority of classes being upper level science classes. Volunteer weekly. Work, preferably tutoring sciences or in a hospital, throughout college. Participate in extracurriculars. Do undergraduate research, preferably in a top research institution (which I will add takes an application process all in itself), in unlikely hopes that a published paper including your name will result. Maintain sanity.  Shadow physicians, as many as are willing and as frequently as the schedule allows. 3. Study for the MCAT, the test that practically determines a person’s medical school acceptance. Studying should be about eight hours per day for the three months leading up to the test. Pay for the $235 test that would rather not be taken. Spend five hours in a testing center with limited, scheduled breaks. Score as high as possible on the test, wait 90 days, say a prayer, and look at the  score. 4. Sort through the list of all medical schools, finding the ones that coincide with interests and statistics being sought out. Start filling out primary applications to all the colleges that are on the potential list. Take out a personal loan, as this is not a cheap process. This initial process easily takes up $1000 or more if applying to more than a few schools. Write a personal statement regarding choosing to be a doctor. Revise statement, and proofread. Revise again. Proofread at least four more times, just in case. Ask at least three people (doctors, lab mentors, or professors) to write strong letters of recommendation. Remind them constantly of deadlines without seeming rude. Pay for transcripts to be sent. 5. Cross fingers, as many as possible, that e-mails stating the all of colleges would like a secondary application. Fill out all these supplemental applications as soon as possible, because time is critical. The earlier the application is done, the higher the chance of acceptance. Pay a second fee to submit these applications. 6. Wait as patiently as possible to hear that the colleges you completed supplemental applications for are offering an interview. Either that, or rejection letters start arriving. 7. Buy formal business attire for the interview. Buy plane tickets to the city the interview is in. Buy a hotel room. Buy a portfolio folder, so a resume, published scientific papers, poster presentations, and business cards are accessible and professional appearing. 8. Rock the socks of the interviewers with wit and charm, all while maintaining professionalism and compassion. (This includes not letting nerves overwhelm the situation.) Expect hard, random questions. 9. Once again, wait to hear if you are rejected, accepted, or placed on a wait list. 10a. Assuming acceptance to more than one school, start deciding which school best suits what medical school being sought after. This likely means more plane tickets, hotel rooms, business attire, school tours, and meet the faculty opportunities. 10b. Assuming all rejection letters, start back at numbers 2.5-4, depending on the particular application weakness, and start all over next year. Don’t feel bad. (Most people I know don’t get in on the first try.) Repeat until: 11. Ta Da! Acceptance into the medical school of your choice. Or any medical school at all, for that matter.

Now you may see why it took me a while to realize the accomplishment this was, acceptance on the first round despite average statistics. When you have been striving towards a goal for so long, then you finally meet it, it just seems like the reasonable question is, “Now what?” So, now what? It is now that I have to stop playing pretend. I have to become the big girl that I have been putting off for so long. I have to incorporate professionalism into my daily life; I have to represent being a doctor at all times. I have to up my game and study all day, every day for the next eight years or so. More or less. I have to learn to become a teacher at the same time I am being taught. I have to maintain my empathy, compassion, and enthusiasm to help others. I have to do all of this, just to follow my dreams. What does it take to follow your dream?

 
 

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Thanks for saving my life. *cough*

 In the emergency room, I find myself torn between wanting an adrenaline rushing, gory, severe patients and wanting people healthy. The cardiac arrests or heart attacks, stroke patients qualified for thrombolytics, medical mysteries, and overdoses: these are what makes emergency medicine worth pursuing. However, what kind of a person am I to secretly hope some unfortunate human being has to enter a hospital under those conditions? I feel… heartless. Yet at the same time, the people that aren’t significantly injured, such as the viral respiratory infections, chronic pain patients, sniffles, bumps, bruises, and coughs annoy me. Don’t waste the doctor’s time on such frivolous matters when there are people that are literally dying down the hall. The perfect example of this: We go from a heart attack victim’s room, into a mystery decreased level of consciousness patient’s room, into a room where a guy has a cough. This is where I feel as though I lack empathy and compassion. 

I do know that the patients are in pain. As a doctor, the mission is to find a cause for the pain and make it stop. The problem is this: there is a disconnect between the patient’s expectations and what the emergency medicine doctor is able to provide. The emergency department is a place where people go when they have something that could be considered a medical emergency. It seems like it should be a simple concept, yes? MMERrrrrr, wrong. The emergency department appears to have become a place to go when you don’t feel like making time to schedule an appointment later in the week with someone who would be able to better assess your symptoms and define a definite answer. Although severely painful, dental pain is not deadly. Ear infections are not life threatening. As Bill Nye the Science Guy would say: Did you know??? That over 80% of ear infections resolve on their own without antibiotics? Now you know! 

Emergency medicine is to rule out life threatening causes, not to find the exact source of your symptomatology. For example, there are hundreds of causes for chest pain. You walk into an ER and they are concerned for five: myocardial infarction, pulmonary embolism, coronary artery disease, acute coronary syndrome, and pneumonia severe enough to cause sepsis. Not concerned for one of those? Well, here is some pain meds and a discharge instruction sheet on unspecified chest pain with instruction to follow up with a primary care doctor. 

What about cancer? Cancer is life threatening. This is true. Additionally, cancer will not likely kill you within the next one or two days, especially if it is a primary diagnosis. That breast lump that has been present for two months and growing? The doctor will just take a simple chest xray, tell you it is a mass, and refer you to a primary care doctor or oncologist for a biopsy procedure. The first step could more than easily be performed in a primary care setting, for a lower cost, and wield one less hoop to jump through in the course of evaluation.

 Okay, okay. I understand that most hospitals will not accept a person for an appointment if they do not have health insurance and are unable to provide at least a down payment on their fees at the time of scheduling. I also understand that you will be paying a impressively greater amount on the exact same tests if you go to the emergency department.

Now that I have vented and clarified that issue, I have more to say. Many ER physicians become desensitized to the severity of situations. “Oh, you have a patient that had a stroke resulting in right hemiparesis today? Yeah, well, I had one with 98% arterial blockage in three of his coronary arteries, found after he was emergently sent for coronary angiogram.” A critical page is called and the doctors pull out their rock, paper, scissors hands to “fight” for what is being rushed in on ambulance. As the adrenaline begins pumping, it seems the majority lose all other human emotions. You do realize that when someone becomes scared, love is what gets them through? Doctors, even in urgent situations, need to remember this. When they observe a patient is severely ill, rudely asking family if they have any end of care life plans, with expectation of an immediate answer, is not appropriate. Again, I know this is valuable information that is needed in that moment, but there are better ways to approach this situation. 

Other situations that tear at my heart are the teenage mothers-to-be that come in all doe eyed in the headlights. They don’t know how to care for themselves, moreless for another very dependent being. Oftentimes, the mother does not have the support of the father, the grandmother/father to be, and lost most of her close friends because she is busy being responsible for the situation. Where is the love for these patients? Some doctors walk out of the room and make jokes about making sure to add “poor judgment” as a part of the physical examination. Give them a break. For the love of all that is good, leave them alone. They have it rough enough the way it is. Raising a healthy baby is not easy when it appears they are merely a product of their social class.

Then again, where is the line drawn? Am I supposed to feel sorry for the patient who has been non complaint with his dialysis treatments, not taking his recommended medications, and continuing to use substances that he has been reminded on numerous occasions is detrimental to his health? Am I supposed to feel empathy for the patient who has smoked two packs per day, dang near lived at McDonalds, rarely checked his blood sugars, and never exercised when he is told he is having a heart attack? What about the man with known treatable cancer, likely curable with chemotherapy and radiation, who refuses all treatments stating his God will cure him? I am not even going to begin on the drug addict, pain seeking, “accidentally” compulsive liars. Yes, a doctor is supposed to feel compassion and pain towards these self inflicted train wrecks.

All of this leaves me in limbo. How many jokes are appropriate to get me through those rough days? How many ill-timed, stifled giggles need to be tallied before I shift from having a sense of humor to becoming rude? Are any of those tallies erased when my heart goes out to a patient? I have seen several doctors struggle with the fine line between the wanted honesty and presumed mockery exacerbated by frustration.

 At least limbo has adrenaline, joy, humor, health, death, and a concoction of other elements that make me get into my very plain navy blue scrubs every morning. And it has coffee in all of its sweetly bitter, life giving deliciousness.

 
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Posted by on February 12, 2011 in My Inspiration and Motivation

 

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