Let's get the whole world to dance!

So, I've been kinda blue lately. The cold weather and lack of warm sunshine sure doesn't help my mood (not to mention the ridiculous number of hours I've clocked bent over my notes studying!). But then I saw this great video on Friday. For those of you who don't live in the youtube world, I want you to see this. It's super precious and also just makes me smile. Plus, I love to dance. And so does he! I've watched a few times now and I still can't help giggling during some parts. Enjoy your time with Kid President! 

P.S. This post is dedicated to my good friend, Evin, since he informed me that he was disappointed in my lack of blogging lately. I hope this makes up for my absence from the blogosphere! 

Suture Clinic

Today we had a skills practice day and learned how to tie square knots as well as put in simple interrupted stitches into a wound. Our wounds were provided by the generous donation from several pigs (their feet in particular). It was a pretty fun time!

I suppose all those years learning how to sew paid off...let's be real, I never sew anything. My mother is  FAR too good of a seamstress for me to actually do any sewing of any consequence

Here are some of my stitches. With pig skin, it's hard to get a consistent depth, but I tried.
Not bad for the first time trying! I may not have a (successful) career in plastics ahead of me though. 

Tonight is two nights before our exam so Megan and I are carbo-loading. Sushi tomorrow!

presently

This past week I started reading a blog during my down-time (aka whenever I'm eating and need a brain break). The blog is all about living like you only have 37 days left to live. I've really enjoyed reading it because the lady that writes it has a very interesting point of view on life. She is not only a writer and motivational speaker, but also a mother of several children. She writes about the books she's reading, poetry, and things she finds beautiful. It's refreshing to read something positive juxtaposed against the majority of depressing news I read daily.

One of the posts I read was about living in the present moment. She talks about taking a positive pause every once in a while. I think this little break was definitely something I needed. I've been feeling behind in my studies and quite discouraged about how my upcoming exam would turn out, but one small reminder about the beauty of the world around me was just what I needed to put things into perspective.

This blog has me thinking though (dangerous, I know). What am I concerned with presently? Am I living in the current moment?

Absolutely not.

Truthfully, I am terrible at living in the now. I generally spend my time planning for the future. I've been trained to do so. Even now, I've been told that I should start considering where I want to do my residency (which is 3.5 years away), so that I can get an externship there my 4th year in med school, so they fall in love with me, pick me as a resident and so the rest of my life is perfect...yada, yada, yada. I've had to think at least 3 steps ahead of where I am for most of my academic career so that I could actually get into school and continue on my educational path. So what is it that is currently occupying my mind?

Presently, I am...

• worried about my upcoming exam.
• wishing it were summer so that I could travel!
• wondering what I will be doing over Spring Break.
• planning to make chex mix and puppy chow tomorrow. (I've been going through this odd period where I am always craving Chex Mix.)
• making a to-do list of all of the things I need to accomplish this weekend.
• thankful for the day off from classes on Monday.
• looking forward to sleeping on Thursday night after my exam...I have a feeling that this week will be exhausting! 
• excited to see my wonderful friend Beau in February when we go to the Harry Potter musical, Potted Potter!
• wishing I somehow (miraculously) understood cardiovascular physiology so that I didn't have to study anymore. 
• determining which days in the coming semester will be the best to go visit my preceptor.
• reminding myself to sign up for STD screening at the jail this semester. 
• wondering what I will do this summer to make an income and pass the time. 
• daydreaming of going to bed early tonight...although that's highly unlikely.
• looking forward to sushi this week as part of our pre-test ritual!
• thinking about makeovers/decorations for my apartment that someday I might have time to complete.

And the list goes on...none of those were now things. I really am terrible at the now. I always have been. Or at least I have been for as long as I can remember. 

I am vowing, here on the intrawebs where anyone and everyone can read it, to work on living in the now. I'm sure it won't be a quick transformation for me, but I am only vowing to work on it, not to perfect it. Here goes nothing! 

Cardiovascular Physiology

We're already a week into the semester. Not to worry, I'm feeling overwhelmed and behind on my studying already. It really is incredible how much information scientists know about the way our bodies function. It's less incredible when you try to stuff all of that information into your tiny little brain and comprehend it all though! Yikes.

In honor of all of our ECG lectures for the past week, I thought this picture fit perfectly! Just a little medical school humor for you...

P wave, QRS complex, T wave: I'm not sure that they are appropriately spaced.
Perhaps there's a bit of pathology present...?

Admittedly, most of the people reading my blog probably won't understand why that lovely little diagram is funny, but it made me smile and really that's what counts, right? It actually is pretty accurate as to how the semester flows as far as cramming, sleep and the studying lull in the few days between the beginning of a new unit and when you pick up the results from the previous exam. 

During our lectures on Friday we covered hemostasis (the process of blood clotting and anti-clotting for wound healing). Towards the end of one of the lectures our professor referenced two pages of "in a nutshell" diagrams and said, "This is all I want you to know about platelets. Is it too much? Probably." Oh, thanks. That's it? Don't worry, we've just spent the past two hours going over every single nitty gritty detail about platelet aggregation and you can just conveniently condense all of that information into 11 diagrams. I'll just memorize every single letter on each of these pages, no biggie. In actuality, it was pretty funny when he said that. At least our professors have a sense of humor! 

Unfortunately this picture isn't large
enough to be able to see all 150 billion details
that I should be memorizing. But you get the gist... 

Just the second page of "nutshell" information.
This "nut" must be stinking huge if the shell is this in-depth!

Our professor, a vegetarian, also spent a bit of time telling us about how beneficial omega fatty acids (found in fish) are for the body to reduce the incidence of heart disease. Well, I pride myself on being healthy, so I just had to have fish for dinner on Friday. And obviously it couldn't just be any type of fish, but it had to be sushi (Japanese people have a low prevalence of heart attacks because of the sushi they consume!). As I was oh-so-conveniently in Hastings for dinner, I convinced my parents to take me out to dinner (not having to pay for sushi makes it taste all the better! Clearly I'm not a spoiled only child at all....) at a sushi restaurant in Grand Island. It was absolutely delicious, as most sushi is! 

I swear it was all in the name of good heart health though... 

Don't fret Dr. Mehta, I plan to have a super healthy ticker for the remainder of my life! 

Now that my heart is in tip-top shape, I'm off to do some work on my brain and catch up on lectures!

Back to the Grind

Well, Christmas break is over now and school has started again. I'm not going to lie, it's been quite the upheaval to motivate myself to get back into the swing of things. The next 16 weeks are sure to fly by ever so quickly though, so I'm diving in head-first to tackle second semester.

Break was wonderful although I found myself missing medicine and school (as much as I hate to admit it!). So much so that I started (and may or may not have finished) watching Grey's Anatomy on Netflix. I hope that my residency experience isn't actually like anything at Seattle Grace Hospital, but it's still sort of medicine-y, so it was nice to watch to pass the time.

Physiology, here I come! More updates and excitement about cardio to come in the following days...

One semester down.

Okay, I'll admit that I chuckled at this.
Just a little genetics humor since
 we just finished a unit on genetics!

Yesterday, I took the final exam of the first semester of my medical school education.

What?!

Yeah...weird. It seems like just a few weeks ago I was stressing out about O-week and miraculously it's 18 weeks later and I am one step, although just a small one, closer to becoming a physician.

It's actually incredible how utterly different the atmosphere was before yesterday's exam as compared to our first few exams. We were all chatting about plans for vacation, and though there was a sense of urgency to just be done with the exam, there was a noticeable sense of calmness and congeniality that hasn't really been present before other exams so far this year. It really has been wonderful to get to know my classmates over the past semester and I look forward to the coming years as we transition into the workforce. I might be a little biased y'all, but I think the Class of 2016 is going to produce some seriously awesome physicians.

I have to admit that I was pretty pumped when I finished the exam. It was rough exam, sure, but it always feels good to finish an exam after studying for so long, plus it signified the beginning of a long break and, more importantly, the end of the semester. I survived! But even as excited and proud as I was, it was hard to really feel good about the day. Just before starting the exam, the news about the Sandy Hook Elementary tragedy broke and it was obviously heart-wrenching. It was/is hard to be happy about something that seems trivial comparatively.

I believe the English language fails us when it comes to articulating grief and sadness. Or maybe it just isn't the English language, but maybe just spoken and written language generally. The feelings experienced when losing people, whether just one or twenty-six, transcend the abilities of language. They cannot be talked about, but rather wholly and completely felt at our very core. Healing after something like this is not going to come easily, we shouldn't expect or hope it to. Human life is too valuable and precious not to fully honor it with the messy-ness/real-ness of our unencumbered emotions.

I am excited to have a break from school, but for now I mourn the lives of those lost in Friday's tragedy, as are thousands of other Americans. I also mourn those who have died as a result of less publicized acts of violence; their lives are just as valuable as those who have been, recently and unfortunately, thrust into the international spotlight, but too often they are out of sight and mind and ultimately forgotten. May a comforting Spirit be present throughout the United States, and the world, as we grieve for those lost as a result of all violent acts.

'Tis the season for...

Santa, Dr. Binhammer, & one of my classmates leading the caroling.

• caroling! Today we had a sing-a-long with one of our  professors. It was a blast! We even got some delicious cookies too. 
• Christmas socks (the ones I've been wearing all year) to be socially acceptable!
• gift exchanges at holiday gatherings with friends and family.
• final exams (unfortunately). I keep seeing updates from my HC friends about almost being done with finals...I'm a little bit sad that I won't be done until late Friday afternoon with my exam. 

Colored marshmallows,
whipped cream, caramel topping,
and mini chocolate chips!
It's low fat...right? 

• traveling--be safe y'all!
• SNOW!! But we haven't really had any yet. I'm sort of okay with it though because snowy days make it infinitely harder to be motivated to go to class.
• holiday races. Like this one in Memphis that I'm planning on doing this weekend. For those of you that know me well, you're sure to be surprised that I'm actually going to run, but the holiday lights make it seem more appealing. I'm still not convinced that running is fun. 
• hot chocolate. I needed a study snack the other night and this is how it ended up! Of course I couldn't just have normal hot chocolate. :)
• holiday treats. I love dessert and this is the best time of year for it! Cookies, pie, cinnamon ice cream, cobblers, crisps, homemade candies...YUM! I'm looking forward to Christmas baking once classes are done. 
• Christmas sweaters. Whether they're ugly or not, there's something dang special about a good Christmas sweater.
• rest and relaxation. The season of Advent is a season of waiting, take a moment (or several moments) to remember that each day amidst the business and commercialization of the season. 

Enough about how awesome the holidays are, it's time to study. 

2 days, 20 hours and 33 minutes until my exam. 

finals...blech!

Well, it's that time of year again...Christmas break is approaching and so are finals for most students. The time of year where you're tired of being in school and all you want to do is curl up and watch movies or go celebrate the season with your friends and family, but the looming exams (or papers!) prevent you from fully enjoying the greatness of Christmas. I'm counting down the days until I head to Memphis for a quick visit (T minus 7 days!) and home to Hastings after that. Unfortunately I still have a biochem exam separating me from my Southern vacation!

My exams sometimes feel like a fight-to-the-death match...
The Hunger Games don't have anything on medical school!

Yesterday we took our final ICE exam of this semester. It was over the stages of development from birth-death, mood disorders, death/dying/grieving. I didn't think it was too bad since I've covered much of the information before in my psych and Christian ed classes in undergrad. It's nice to have it out of the way though so that I can fully focus solely on biochem.

This biochemistry test will include genetics, bone/cartilage, blood, lymphatics, lipid & fatty acid metabolism, nucleotide metabolism, cell signaling & transport, and biochemical nutrition. Doesn't that just sound like the most fun a person could have?!

The countdown begins: 7 days and 30 minutes until our exam!

....and just because my main main Willie Smith is in this one! :) 

Happy Holidays! 

death and dying.

Yesterday we had a lecture and 2 hours of small group discussion about death and dying from the medical provider's perspective. We talked about the ideal situations where our patients die peacefully with appropriate advanced directives after leading a long, wonderful life. But then we also talked quite a bit about the untimely deaths, especially of children, which can never be predicted or planned for.

Truthfully, I think that the reason death is so scary is that "the specter of death destroys any illusion that we are in full control of our lives..." (Bass, 161). I don't know about y'all, but I like things much better in my life when I feel like I have some semblance of control. I would venture to guess that this is why doctors struggle with dying patients so frequently...because we are sworn to protect life and death is an abrupt reality check that we are not in complete control of that very same life. 

Because this is such a sensitive issue, we spent quite a bit of time actually talking about our feelings and experiences (not something we really do a whole lot of in medical school...feelings are just so touchy-feel-y!). Some of the questions that we talked about at some length included:

• How do you cope with your patients, with whom you've formed very intimate relationships (in the sense that many people will only tell their docs their innermost secrets), dying? 
• How do you help the family cope with the death of their loved one? 
• What is your role in the dying process for someone with a chronic and progressive disease process?
• What, if anything, do you do when a patient's quality of life drops below some vague, non-existent line demarcating "good" and "bad" lives? Is that even your jugement call to make as a physician?

All of these questions are obviously hard and, truthfully, there's not always a "right" or "wrong" answer for them. Sure, there are legal and ethical boundaries created for us, but they don't dictate whether or not you can cry in front of a patient or whether or not it's okay for you to send a card to the family or go to the funeral.

I guess I'm not all that nervous about these situations arising in my future. Obviously I don't look forward to them, but I'm not dreading them either. Let me explain... Death is inevitable; we all know that. I admit that it is often tragic too. My experiences working in a church have taught me that it can also be a beautiful process (clarification: beautiful, but not pretty...dying is very frequently an ugly and gross thing from a biological standpoint). I find it to be quite an honor to be included in some of the most intimate and loving moments experienced between families (I would like to add that many pastors agree with this sentiment on some level too). They are rich with family history because often family members are reminiscing about the soon-to-be-deceased/deceased. For those with awful chronic, painful diseases, dying ultimately becomes a reprieve from the pain of the physical world. Death is the end of suffering.

Do my personal religious beliefs skew my understandings of death? Absolutely. As a Christian I believe that God is stronger than death. That is the only way that resurrection of the body and soul are possible. I celebrate the Resurrection on Easter each year, but I realize that "even the resurrection does not erase from Christ's hands and feet the wounds of the crucifixion" (Bass, 168). Death is painful and ugly. too.

As I write about my personal beliefs, I must also acknowledge that we live in a multi-faith society and that many of my patients, as well as many others, do not share my personal beliefs on life and death. Not only do I respect that, I am grateful. I don't expect my opinions to be taken as Truth, but this is my blog after all, so I suppose my opinions are inevitable. 

Throughout the discussion yesterday, I was reminded of one of my experiences in the pediatric neurology clinic at LeBonheur Children's Hospital in Memphis. I originally blogged about my experience in another blog, but below are excerpts that apply to this post specifically.

I was shadowing a doctor in the clinic when the family of an 11-year-old boy came in. He had a progressive epilepsy disorder which made him unable to do anything except drool. And smile. Both of which he did constantly. He wasn't always wheelchair bound and he wasn't always blind or mute. In actuality, he used to be a normal, rambunctious boy, but his disorder took away any hopes of a "normal" childhood, or life for that matter. His parents were in the office to plan for their son's imminent death.

The doc I was shadowing didn't give me any warning about what we were walking into, so I was quite overcome with emotion when I was suddenly part of the conversation about advanced directives for an 11-year-old. We just don't expect children to die. I know this conversation wasn't a cake walk for his parents either, after all, it was their only son, for whom they had initially had big dreams and aspirations. But, unfortunately, that wasn't how their story panned out.

They were actually there at the request of their son.

You see, shortly before he lost his ability to talk, he had a seizure early in the morning. This was not an uncommon occurrence. This particular night, his mom put on a pot of coffee and sat down to chat with him before he made any futile attempts at falling asleep. It was then that he told his mother that he was moving soon. As any recently aroused mother would do, she inquired more deeply as to just what he was talking about. He pointed up and said "I'm moving in with Him." Her natural response, and essentially any adult's response, was simply "Huh?" He explained that he had talked to God and that soon he was going to move. He asked his mom to let him go when the time came and not to hold onto him forever. He didn't want to be trapped here, on earth, in a body he could no longer use. 

How incredible is it that a 10-year-old child embraced death more fully than those of us who are well beyond his years? I also think it's amazing and wonderful that his family is so "in-tune" with their sons needs and wants that they are able to overcome their own fears and hang-ups about death to honor his wishes. 

That little boy is never far from my heart; I actually think about him more frequently than I could have ever imagined. Although I wrote that initial blog post almost a year and a half ago, I still think that it's as true now as the day I wrote it. I'm glad that I wrote about my experience while the emotion of the situation was still raw and pure, because it allowed me to be real and present in the moment.

Raw. Pure. Real. Present. These are things that I re-learned that day from this incredible boy that I had forgotten in my "old age."

Children like him inspire me to continue on my path to becoming a doctor because they teach me to become more fully alive than I was before meeting them. This is not because they are knocking on death's door and cause me to have nostalgic feelings about my own life and loves, but because they re-ignite a part of me that has been buried by years of growing up. I truly believe that children can teach us all what it means to fundamentally be a human, without all of the pollution and convoluted-ness of adult life that has barnacled itself to us as we have matured. He stands fearlessly on the cliff, from which we all must make our eventual plunge, prompting each of us to live again. 

But most importantly he reminds me, reminds us all, to continue to smile. 

Yesterday he was not only my reminder smile, but also a reminder not to fear death itself.


Quotations are taken from Practicing our Faith: A Way of Life for a Searching People (2nd ed) by Dorothy Bass. 

giving thanks.

I took this past week off from blogging (and from studying.... :/ whoops!) for Thanksgiving. It has been a really great (and necessary) break! And now, I'm sitting in Starbucks re-listening to a lecture and catching up on my studies. I'm not sure I'm ready to head back to school for the final 3 weeks of this core/semester. At the same time, I cannot believe that we only have 3 weeks left of the first semester of our 1st year! I don't think I could have ever imagined the year going this quickly when we started school 14 weeks ago.

Over the past couple of weeks, I've had some excitement interspersed with my studies. I've decided to give y'all a quick review of the highlights.

Stanley Hauerwas. He's an American theologian who is at Duke University. He came to UNL to talk about the "Church as a Politic". The lecture sort of ended up as a medical ethics lecture, which I totally LOVED! I miss that portion of my medical education...I need some humanities mixed in with my hard science. It was also great to see my friends/roommate from Lincoln!

NAP. I had a brief meeting with the Omaha office of Nebraska AIDS Project about volunteering as an HIV tester and counselor. I've been involved with HIV/AIDS prevention education for 7 years now and it's definitely become a huge part of my life. I just can't imagine giving it up in the future, so I'm happy to be partnering with them! Speaking of HIV/AIDS awareness...this upcoming Saturday (December 1st) is World AIDS Day. I will be spending the morning at Douglas County Corrections presenting about STD/STIs and testing for chlamydia and gonorrhea (Douglas County has the highest rates of infection of any county in the United States) and will definitely be wearing my red ribbon. You should too! You can do a quick google search to see if there are any World AIDS Day events in your area to attend to increase your own knowledge AND general awareness of the epidemic.

Sunny D's 2.0. Closely related to my meeting with NAP, I am actually working on a project with a local group of AmeriCorps volunteers to create a group which would give HIV/AIDS prevention education presentations at a local high school. When I was in high school, I was in a group called Sunny D's and they're trying to model the program after that. We will be in conversation in the coming months as they work to shape their program to fit their particular needs, but they are excited to use my experiences and knowledge of groups of the like (I was also in PHIVE-O, Peer HIV Education Organization, at Hastings College, so I have several years of experience with teaching this demographic and the administrative difficulties that sometimes arise) in the meantime. Perhaps I will even get to co-teach with some of their volunteers!

Do JuSTIce. I was lucky enough to volunteer at the jail again to test for chlamydia and gonorrhea. I led the short presentation this last time which was actually a bit nerve-racking. I made it through it without any major slipups. I'm excited to go back this weekend also!

EMET. We had a short information meeting about the "Enhanced Medical Education Tracks" at UNMC the other day. There are 6 tracks: Aging and Integrated Medicine, Auto-Immune Diseases, Clinical Quality and Patient Safety, Comprehensive HIV Medicine, Medical Humanities and Arts, Preventative Medicine, and Underserved Health Care. They are "an opportunity to perform in-depth study of an interdisciplinary field of medicine that enhances the required curriculum without extending the time needed to graduate from medical school." I haven't decided whether or not I will actually apply, let alone be accepted, to a track, but I really like the idea of them. Of course I am interested in several of the tracks, so we shall see what will happen. The applications don't open until the end of the week so I still have some time to think about it.

Student Delegates. Well, I joined another extracurricular group (...no one is surprise, I'm sure). I had some help getting there though. My good friend Paul convinced me to join the "Student Delegates" after he read my blog post about healthcare reform. Essentially this group goes to our local political representatives to discuss/lobby our positions concerning issues about medicine and even issues that students deal with, such as Pell grants. I do have a passion for this sort of thing and the first meeting was fun, so it wasn't hard to convince me to join. I'm excited to continue learning more about the topics that will be covered in the upcoming legislative session!

Dance. I'm sure some of you are starting to think I'm a broken record, but I still really love going to dance class. It's such great stress relief and even better exercise! This is really the first time in about 10 years that I haven't been dancing for some sort of team performance or competition, so it's definitely something that I've had to get used to. I look forward to that hour and half of not studying/not thinking/not stressing/not sitting every week!

LCE. I spent another afternoon in the clinic this past week. I always enjoy my time with patients, so it was a good way to end a short week of classes. This upcoming week I will have my final visit of the semester. Don't worry, I will be back for 5 more visits next semester too!

Thanksgiving. Even though I'm a vegetarian, I was absolutely looking forward to Thanksgiving this year. Seriously, what could be better than green bean casserole, mashed potatoes and gravy, corn, and pie!?? Nothing! As an added bonus, I got to spend time with my wonderful family and take some time off from studying to relax. Lucky for me, we celebrated Thanksgiving over an entire week this year, so I got to spread out my food-induced comas. I'm also looking forward to the leftovers I have since home-cooked food is just so much better than some of the meals I make for myself on a regular basis.

Christmas Tree. Our Christmas tree is up! The weather has started getting colder practically overnight, Thanksgiving has come and gone, and December is just around the corner! I can't believe it's already the holiday season. This year I will be spending some time in Memphis and then time traveling around Nebraska catching up with friends and family. Just 3 weeks of classes and 2 tests are separating me from break...