something to think about...

“It doesn’t interest me what you do for a living, I want to know what you ache for, and if you dare to dream of meeting your heart’s longing.

It doesn’t interest me how old you are. I want to know if you will risk looking like a fool for love, for your dream, for the adventure of being alive.

It doesn’t interest me what planets are squaring your moon. I want to know if you have touched the center of your own sorrow, if you have been opened by life’s betrayals or have become shriveled and closed from fear of further pain. I want to know if you can sit with pain, mine or your own, without moving to hide it or fade it or fix it.

I want to know if you can be with joy, mine or your own, if you can dance with wildness and let the ecstasy fill you to the tips of your fingers and toes without cautioning us to be careful, to be realistic, to remember the limitations of being human.

It doesn’t matter to me if the story you are telling me is true. I want to know if you can disappoint another to be to yourself; if you can bear the accusation of betrayal and not betray your own soul; if you can be faithless and therefore trustworthy.

I want to know if you can see beauty, even when it’s not pretty, every day, and if you can source your own life from its presence.

I want to know if you can live with failure, yours and mine, and still stand on the edge of the lake and shout to the silver of the full moon, “Yes!”

It doesn’t interest me to know where you live or how much money you have. I want to know if you can get up, after the night of grief and despair, weary and bruised to the bone, and do what needs to be done to feed the children.

It doesn’t matter to me who you know or how you came to be here. I want to know if you will stand in the center of the fire with me and not shrink back.

It doesn’t matter to me where or what or with whom you have studied. I want to now what sustains you, from the inside, when all else falls away.

I want to know if you can be alone with yourself and if you truly like the company you keep in the empty moments.”
-Oriah

does faith and religion have a place in medicine?

i say absolutely yes! a recent study, as presented in our clinical medicine course, showed the effects that prayer has on patient outcome. beyond that, maybe it hasn't been shown through scientific research, but i think we all would agree that "complete" health comes from being mentally, emotionally, physically and i would add spiritually healthy. can we as physicians ignore the role that faith and religion play in our patient's lives? do we need to agree with their choice of religion, or is more important to acknowledge the role that it plays in their lives? should we respect our patients rights to pray and the prayer schedule that they must adhere to? as stated in class, we as physicians don't have a problem asking our patients about their sexual habits yet we won't ask them if they pray...why is that?

A Physician's Prayer

Dear Lord, thou Great Physician, I kneel before Thee. Since every good and perfect gift must come from Thee I pray, give skill to my hand, clear vision to my mind, kindness and sympathy to my heart.

Give me singleness of purpose, strength to lift at least a part of the burden of my suffering fellowmen and a true realization of the privilege that is mine.

Take from my heart all Guile and Worldliness that with the simple faith of a child I may rely on Thee.

AT Still

practice what you preach

pet peeve of mine...i have so many...

so you say you want to be a doctor. you want to help others be healthy...granted this may be my definition. but none the less, we will be tasked with the responsibility of helping our patients achieve health and counseling them on diet, nutrition, exercise, etc. so pray tell why you're eating mcdonalds, hotdogs, kentucky fried chicken, and / or popeyes for lunch? how do you dissect an obese cadever and see up close and personal the effects of poor nutrition and still continue to throw crap down your throat? how can you tell your patients they need to lose weight because it represents an increased risk for hypertension, high cholesterol, diabetes and you yourself are just as unhealthy. where is nutrition and it's impact on health in the medical school curriculum? i think it should be mandatory. how does the administration say "it's important for each of you to remain healthy and to exercise while you're in school" and the vending machines in school have nothing but processed chips, m&m's and candy? am i missing something? am i being too harsh? i have that tendency, so it wouldn't surprise me.

now i have room for improvement...i eat way more chocolate than i should and i went from doing vigorous exercise 6 days a week to moderate exercise 2 days a week. so right here and now, i'll be the first to practice what i preach...i can't realistically say i'll be able to go back to 6x/week of vigorous training, but i WILL do a minimum of 3x/week!!

you heard it hear first. if no one reads this, does that mean i have to do it?

coming up for air...

let's see...

well the first block of exams are over and i'm halfway through the second block. i've come to realize that part of the learning is actually learning how to learn. additionally, inherent in the process is not only academic / intellectual growth but a bit of emotional growth as well. as far as the academic, i'm slowly learning how to "drink from a fire hose"....i've got a few loose teeth but i figure if i adjust appropriately i should recover fairly well. the emotional growth is ever present and sometimes is more exhausting. i think to get through one has to have the right coping mechanism, and by right i mean what is right for you. the unfortunate thing is i'm seeing that most of my classmates haven't acquired those coping strategies because maybe they haven't experienced or haven't had their "will" tested like this before. granted, i'm no expert...i fumble, i doubt, i question....but when i truly sit, reflect and think of where i've been i know i can do this. will it be easy, absolutely not...but who wants it to be easy? now the tricky and exhausting part is not only do you have to find your coping mechanism, sometimes you're pulled into satisfying others..or at least they try to pull you in. being who / how i am, my initial tendency is to adjust myself to accommodate them / others, but i learned VERY quickly that there is no room for that. that may sound selfish and i'm not suggesting leaving someone out on a ledge...which as an aside it's scary to see and even think this, but you know how you can see someone's disposition change? you can literally see the stress on them and around them? it's almost as if they've bathed in it...it wafts off their clothes as they pass you in the hall. it's in their eyes, it's in the way they carry themselves...and it's way more subtle than "oh, that person doesn't smile anymore". i fear and worry about my classmates that are in this position. i worry that they won't make it. i worry that one day we'll get to school and they won't be there. how do you reach them? how do you help them when you yourself are holding onto the ledge by your fingernails at times. will there be a point when i will have my feet on solid ground and i'll be able to hold someone else up? will it be too late at that point? i don't know...i struggle with this one. so, i'm hanging on by my fingernails...am i or is any one us in the position to reach out and hold someone else up? i can't. i haven't given up trying to figure something out, but for now i keep holding on and keep trying to swing my legs up and get them underneath me.

after all that, i'm sure this will come as a surprise...or not a surprise if you know...i'm also the sga president. i absolutely love it. it represents the complete and perfect combination. i get to bring back my long-lost project management days, but this time use those skills to effect change as it relates to the osteopathic profession, community service, my medical education and my school. it just doesn't get any better than that. i was telling family and friends over the holiday, its almost embarrassing how much i'm enjoying the challenge of school and my latest presidency. should i consider lightening my load? why did i take on the added responsibility? i guess my answers would be no and why not. we all have one life to live. i have been given the unbelievable blessing of another chance and i owe it to myself, my mother and my sister to utilize all the talents that I have been blessed with...and i'm learning new ones...delegating. this one is a bit more difficult for me, but i'll get the hang of it...i'm slowly conquering the fire hose, i can learn to delegate. tangent again...in one of our classes we discussed the "addictive" personality that the majority of physicians and physicians in training possess. the very traits that will make us successful and allow us to endure the challenges of school, residency training and eventually to practice medicine are the very ones that predispose us to substance abuse. it was a sobering lecture...mostly because the traits he listed of addicts (drugs or alcohol) I and a good many of my classmates possess. so what does that mean? you can't turn off those traits, so how do you keep them in check? so at the end of the day, am i taking on too much? am i setting myself up to "crash"? will i end up being one of those students that allow gravity to pull me off the ledge? i say no...but the biggest thing for me is being as honest with myself as possible. secondly and most importantly is relying on my best friend to keep me in check. she knows me better than i know myself and can usually sense things before i can. so i talk to her and reach out to her when i feel myself slipping. huh, i guess i'm pulling her into my coping mechanism...interesting.

i have a thank you to go give...

where did the time go??

i wonder if there is a way to get more hours in the day? obviously there isn't but i could really use about another 10...i'll even take 5 at this point! but at the end of the day...whether it's a 24 or 34 hour day, have you absorbed everything you should have. imagine you're at a carnival...music playing, people everywhere, noises from all the games and the chatter. you step into the line for the most popular game, some people have even tried it 2 or 3x, but with minimal success. you figure, 'i can do this', so you wait patiently for your time. your turn is up...you step into the glass box and get yourself ready. you try to clear a space on the floor...you want to make sure you're not stepping on anything...and then the fan starts blowing. there is money flying everywhere and the idea is to catch as much as you can. time is limited so you reach, grab and tuck the money away, hoping it won't fall out and you reach again. you do this over and over and over...hoping that when the fan stops you've gathered a good amount of money (i can't take credit for this analogy - you know who you are). that's what it feels like...there is so much information, coming at you so fast and you have a limited amount of time to grab, process, tuck and move on to the next topic. it was also put another way...'in college learning was like drinking out of a glass, in medical school it's like drinking out of a fire hose'. at the end of the day, you hope you've grabbed / swallowed enough!

Is that going to be on the test?

when does this mentality change? when do people start learning, wanting to actively acquire knowledge because they desire it - not because they will be tested on it? day one of class and someone is already asking the question "on the test will you ask us..."? not to mention the other countless emails (according to him) that the professor received asking essentially the same question. if we, as future Physicians, are going to be given the PRIVILEGE, and that is exactly what it is, to provide medical care, shouldn't we need and want to know as much as we can? why does it matter what will be on a test. you're not in elementary, high school or college anymore. you are in training to be a Physician - start taking it seriously!! unfortunately, some individuals are still expecting to be spoon fed..."can you email your lecture before the class"...."can you make copies of your lecture to hand out"..."can we have copies of old tests"..."can you tell me what i need to study for the quiz"...anything else you'd like for the professors to give you? is your goal to learn the material and earn your degree and the privilege or to have someone hold your hand through the whole process? the professors that keep enabling this behavior are just as much to blame...JUST SAY NO!! i'll concede that it is helpful to have the powerpoint lectures...so you can actively listen and add only supplemental notes that help with your own understanding of the subject matter. but i also believe that professors providing their lecture is a gift, not a right...and we should be treating it as such. clearly that is not happening. check this out...a lecture has been made available on a website, it was announced that this is where students needed to go to get the lecture...and shockingly some still didn't do it. they show up and look confused and dumbfounded when the professor doesn't have copies for them..."i don't have a copy of the presentation"...why the heck not! you can go on facebook and aim and whatever other websites, but you're incapable of downloading a lecture needed for your educational enrichment? instead they pose the question of the professor, "can you just email your lecture to everybody"...i guess it is just too challenging to go to the website and download / print the lecture yourself. even better, the professor made changes to a few slides and made us aware of where the additions / changes were during her lecture...at the end of class a student asks - who by the way has just sat through the entire lecture - "can you email the revised powerpoint to everybody". ARE YOU KIDDING ME!! what the heck have you been doing for the last 2 hours, did you bother to take any notes, are you awake, do you have any cognitive function? Doesn't it make you feel good knowing that one day this person will be trusted with patient care, or charged with saving your life...i hope you bring some cliff notes / cheat sheets to give him, otherwise you're hosed!! why doesn't the administration hold the students accountable - put the responsibility on us? some professors aren't folding under the pressure and i thank them for that...they are forcing us to start acting like Physicians, to start thinking clinically and critically, to learn and fully connect the many pieces rather than just memorizing information...and they even call us Doctors! that's what our medical education should be about. let's see how things develop...for now i'll remain quiet.

Before I Forget

you have been stalking the mail man for weeks, waiting for "the envelope"...finally it arrives. you take a deep breath, say a prayer and then you break the seal. you unfold the letter...your sympathic nervous system goes into overdrive pumping adrenaline and stress hormones through your body, your heart races and your hands almost seem to shake. you start reading and you search frantically for the words "congratulations", "acceptance", "with great pleasure". they are all there...you can't believe it, you actually got into medical school...or did you? you read the letter 2, 3, 4 more times, making sure you did not put words on the paper...that in fact you did read it right. you did...CONGRATULATIONS, you got in! you breath, not realizing you had been holding your breath...your head instinctively bows and you say a prayer of thank you. after the frenzy of calls and text messages to your friends and family that have been waiting as anxiously as you have, you are left to start planning the next 5 months. so now what, what happens next, what do you need to think about, worry about and get settled? here are the things that were not in any of the books that i read. all the incidentals, costs and otherwise, that must be taken care of before you can start this crazy ride called medical school. this is not meant to be exhaustive, but rather just what i ran across...and i'll add to it as things come up.
1. acceptance deposit - this will hold your spot at the school
2. tuition deposit - i'm not sure if this is some percentage or just an arbitrary number, but it is a cost that you should plan for. being a non-traditional student and having to cover the costs out-of-pocket it was crucial for me to know and meticulously plan for any expenses. generally items and 1 & 2 will later be deducted from your tuition costs, so in theory you kinda get these funds "back".
3. books - obviously i knew i would need books, but had NO idea the volume and expense that would be incurred. if i were to buy every "required" book, the total cost would be approximately $1800. that is not including "recommended" books. keep in mind, after reading and searching for advice on this issue, the consensus seems to be to wait and buy your books. Here's a link for a good article about first year: http://studentdoctor.net/blog/2007/08/17/professional-school-%e2%80%93-the-first-year-what-you-need-to-know/#more-326.
4. health insurance - as i'm sure you know this will be required and the costs associated will have to come out of your financial aid (if you are borrowing money) or out-of-pocket. my understanding is the school will provide a "bare bones" option or you can buy insurance from any provider. if you happen to be a member of AMSA or SOMA (which i would highly recommend) then you can get discounted coverage. Check out either of their websites for additional information.
4. financial aid - oh my!! this has been the most confusing and frustrating portion of this experience...and for most, you will have to go through it, unless you are in the fortunate situation of being able to pay for school out-of-pocket. and what makes it even more frustrating is they seem to hire the most non-caring, dry, unresponsive individuals to work in the financial aid department. you know the kind...they are totally 'flat' when you talk to them and offer no support or understanding. they are in no hurry to get anything done...well except when it comes to collecting the two aforementioned fees. when it comes time to finalize your financial aid package and disburse funds...forget about it...they are nowhere to be found. i don't think it's unique to my school because talking to a friend who is getting her PhD...the same staffing agency was used to hire her financial aid counselors. did they write somewhere in the job description, "we are seeking individuals with poor organization skills, ineffective communication and people skills and most importantly those that are not capable of responding to phone calls and emails in a timely fashion". clearly this is a sore subject for me! but besides the frustrations of the financial aid counselors, here is what i've learned about financial aid. there is federal money and private money. obviously, taking out private loans will cost you more in interest and the terms may not be as favorable, so therefore I would recommend going with federal funding. within that, you've got stafford (subsidized and unsubsidized) and then for graduate / medical school you can also take out gradplus loans. all of these carry a somewhat pre-determined interest rate and allow for deferment while you're in school. as far as what lender to us, my school issued us a list of preferred lenders, however i opted to go outside of that list. I was given advice to look into Direct Loans, they are The Department of Educations Loan Program (http://www.ed.gov/offices/OSFAP/DirectLoan/index.html) ...the most direct way to the federal monies that are made available. my school unfortunately wouldn't allow me to use Direct Loans as a lender. As an aside, I don't fully understand this part, but apparently schools have certain lenders that they can work with, so check with your school prior to committing to a lender. since i could not use Direct Loans, I looked around for something similar and found Total Higher Eduction (http://www.northstar.org/). I have had a very good experience with them, the customer service has been great and they processed my application and disbursed my money to the school faster than any other lender!! Good luck with your search of a lender and hopefully your financial aid department will be helpful in that regard.
5. diagnostic equipment - you will need to purchase a set of equipment that you will use throughout your education and most certainly once you are out practicing. my school brought in a representative from Welch Allyn to give us a presentation on their equipment. thankfully we didn't have to search around for a distributor, but the cost for the equipment was approximately $900. granted this is an investment and the equipment should last you a lifetime, so they say, but it's still money that you need to budget for.

that about covers it for 'additional / unexpected' costs. hopefully you already knew all of this, but in the event you didn't , i hope it was helpful. if any other costs present themselves, i'll add them to the list.

back to biochem :-)

Range of Human Emotions

how is it possible to go from moments of joy, peace and contentment to moments of self-doubt, hurt, and confusion....all within a matter of hours. is there some clever medical diagnosis that i'll learn about in school that will explain it all. some simple clinical explanation...doubtful. anyway, i guess that is all part of the journey. you learn to live actively in the present. to enjoy the fleeting moments of simplicity and peacefulness because immediately around the corner there is the potential for someone / something to steal your serenity. do you think they do it on purpose? that some people actively seek and destroy? i don't know...i choose to believe that they don't. i choose to believe in the inherent good in people...that they should be given the benefit of the doubt...for now. however, there is an end to my understanding. well let's not dwell in the bad, there will be more than enough time for that. the good news is I successfully navigated a new city and found THE PERFECT apartment!! so i guess all that free time at starbucks...and the many phone calls that i made, turned out to be just what i needed. interesting how that works out huh? i will be moving this weekend, just under the wire and just in time for classes to start...gotta keep it interesting.

The Best Laid Plans...

so you make all the necessary phone calls, you schedule appointments and you lay out your strategy, hoping to leave as little to chance as possible. you want things to go as smoothly as possible, not to mention quickly. remember i mentioned that orientation starts in a week, so that now leaves me one week to find an apartment! somehow all my apartment planning and scheduling, at least up to this point, has not panned out. after another round of apartments fell through I made more appointments and I'm back in the city...once again hopeful that today will be the day i find something. well...the day has started with some setbacks. my 11am appointment called and re-scheduled for after 130pm. no worries, i've got another broker that i'm supposed to meet at 12...so i call him at 10am to confirm. yup, you guessed it...he forgot he had an open house, so now that appointment has been pushed back to sometime after 230pm. so i'm in the city, it's 1124am and my best laid plans have resulted in my sitting in starbucks.

do you ever just SIT and watch people as they go about their lives? wondering what their lives are about...where are they rushing off to, why are some casually strolling, some look content, focused, angry, tired, hung-over...human nature is a fabulous and fascinating thing!!

anyway, i digressed. so back to my sitting in starbucks. i've done another round of searches on craigslist, made some new phone calls, followed-up on calls that haven't been returned and now i have to wait. maybe that's the lesson in all this...to teach me patience and how sometimes it's ok to just SIT and RELAX...even in the middle of uneasiness. for those that know me, you know that is not my strong suit. and of course there is the obvious lesson of trusting and having faith that all the pieces that must come together will in fact do just that; come together. that in the end i will end up in the exact apartment i am supposed to be in...in a neighborhood that is safe, culturally rich and diverse, with parks and running room for samson (remember my dog, my baby boy) and that will be an easy commute to/from school. until that happens, at least for today, i'm sitting in the window of starbucks enjoying the parade of people and the individual 'stories' that they represent...or at least the ones that i give them.

The Road Less Traveled...

it's one week out...come september 4th i'll be at orientation for medical school!! how did i get here? it's been a ride...one that has cost A LOT in relationships; i've lost some very important ones and i've gained many in return (hopefully you know who you are). life has a way of recycling. they say that with each death there is a birth. do you believe that sometimes that birth can come in different forms? maybe it's you that has been re-born rather than a literal birth? that's how i feel. i lived what i thought was a full life...i was satisfied and content. then i got a wake-up call that changed my life forever. in fact i remember distinctly sitting on the floor of my bedroom with my brother, two cousins and my uncle and him saying to us, "nothing will ever be the same". i had no idea how true those words would turn out to be. that was over 6 years ago but i remember it as if it was yesterday. looking back, that was the beginning of my second chance. i ran away, emotionally and physically, and tried to hide and pretend that my reality wasn't my reality (by the way, that doesn't work....trust me, the pain and hurt always has a way of coming back...and it's always worse the next time around). the mind and the spirit are powerful things but they also have their breaking point and i found mine. thankfully, and truthfully i don't remember how this happened, but i slowly crawled my way back into experiencing life. you know, it's possible to wake up every morning and make it through the day without REALLY participating in life. that is where i was. but slowly i managed to get to the point where i started to interact, to experience life and more importantly WANTED to participate in things and activities going on around me. without the help of my family, friends and believe it or not and probably more than anybody else, my dog, i wouldn't be here today writing this. but i am and i'm so grateful and blessed to have been given another chance. my whole life has changed!! i'm healthier; mentally, physically, spiritually and emotionally. as an aside, that's part of what i've learned, our health is multi-dimensional...and if one area is laking all the other areas will suffer. so fast forward....orientation for medical school is one week away. if you haven't guessed, that's also part of my re-birth, if you will...i left construction / real estate development to be a doctor. welcome to the ride!! if the last 6 years are any indication it is sure to be interesting and if nothing else hopefully you'll learn something about yourself...what you're capable of and the awesome strength and resolve that we all possess and have access to if we put our faith and trust in the right places.