Category: Lifestyle

Categories
Lifestyle

Just Give Me Ten Minutes

As medical students, we are undoubtedly busy. Between studying and trying to maintain some semblance of a normal life, we don’t pause. Sometimes the only quiet we get is the car ride to class, or the few minutes before we fall asleep. A recent experience showed me that we might need a little more of this “quiet.”

When I was volunteering at Hope Lodge, a place for cancer patients and their families, I led a few short segments on meditation. Each segment was only ten minutes, but its benefits lasted much longer. After only ten minutes of focusing on my breathing and my body, I felt rejuvenated. We are often told that thirty minutes of moderate exercise, five times a week, will help us feel awake and alive. While this is correct, it’s still hard to find time to go to the gym regularly (especially during exam week). For meditation, you don’t have to get sweaty, leave your room, or change your clothes. Don’t get me wrong—I still love and encourage regular exercise. Yet if you feel too overwhelmed, stressed, or tired to exercise at the gym, give yourself ten minutes of meditation. These ten minutes will give you the clarity your body is craving.

So, what exactly do you do?

You can go about meditating in three ways:

  1. Complete silence
  2. Soothing music or sounds (such as a steady waterfall, a running stream, or nature’s lovely birds)
  3. Guided mediation with a voice accompaniment
    Both (1) and (2) can be found on YouTube. One of my favorites for (c) is this 15 minute video.

Once you have made your choice, give yourself at least five minutes to reap the benefits. You’ll find that even five minutes of focused breathing can do wonders for your mind and body.

Sit down in a comfortable position, close your eyes, and start breathing. Breathe in through your nose and exhale through your mouth.

When you are done, get up, and enjoy your renewed alertness!

There is no right or wrong way to meditate, and I am far from an expert. I only ask that you try it.

Further strengthening the therapeutic value of meditation, an article by the Huffington Post discusses the role of meditation in cancer patients. We all know about telomeres—telomeres shorten as we age, and shortened telomeres increase one’s risk for cancer. This article discusses a study where patients who participated in a mindfulness intervention had longer telomeres.

So give yourself ten minutes. You won’t regret it.

 

Featured image:
Meditation Transcendence by Hartwig HTG

Categories
Lifestyle Opinion

Invest in Knowledge

One of the biggest lessons I learned during my first year of medical school is that there simply isn’t enough time. Not enough time to lead the same life I once did. Not enough time to study every last origin and insertion. And definitely not enough time for faculty to cover all the essential information. Some of the information that is inevitably left out is what happens after medical school.

How can we as residents and physicians manage both our newfound salary and our mounting pile of debt? What is a 401k? Roth? How do I save money for retirement without living like I am in college? These questions are incredibly important to answer sooner rather than later, because gaps in financial knowledge can have monumental consequences later in life. My suggestion to all medical students is to learn the basics of investing and budgeting now, so you won’t regret it later.

After realizing that this knowledge needed to be acquired on my own outside of medical school, I purchased a book called The White Coat Investor, which was published in 2014 and written by James Dahle, MD. This book is an easy read about financial information specific to future and current physicians. The bulleted information below has been paraphrased from Dr. Dahle’s text. All of the statements are his personal findings.

Pertaining to pre-med students

  • Be cautious when considering taking a gap year or more. Each year you take off is one year less of earning potential as a physician you may have. Take time off if it is to do something you are truly passionate about.
  • Apply to medical schools you can actually get into, and apply to many. It would be a large inconvenience to have to reapply because you did not apply to enough schools to begin with.
  • Go to the cheapest school at which you will be happy. There isn’t a huge difference in education from school to school.

Pertaining to med students

  • Choose a specialty wisely. Consider income and lifestyle, while still keeping yourself happy with the work you want to do (i.e. if Emergency Medicine and OB/GYN both make you happy, but Emergency has a better lifestyle and pay, go with that choice).
  • “Be a poor medical student.” Dr. Dahle states it’s a lot easier to be poor when all your friends are too. This will pay off later.

Pertaining to residents

  • Try not to buy a house. Likely you don’t have the down payment and it takes about three years to break even on this investment. Once you are at the end of residency or a physician, chances are you will want a different house (i.e. space for an incoming family).
  • Invest in a Roth 401(k) or traditional 401(k) if the Roth isn’t available, and do this up to the match by your employer. (Roth 401(k): You contribute money to this fund after taxes have been taken out and your employer will match the amount you put in, up to a set amount. This money accrues interest and can be taken out during retirement post age 55 ½ with no penalty. Dr. Dahle explains the Roth option is the way to go during residency because you are in a lower tax bracket than what you will be in the future. Traditional 401(k): You contribute pretax money to the account and your employer matches up to a predetermined amount. When you withdraw the money in retirement, you pay taxes then on the money. This is still a great option if the Roth isn’t available, because your employer is basically giving you free money).
  • Establish an emergency fund for up to 3-6 months of living cost.
  • Purchase disability, life, and liability insurance.
  • Pay down high interest debt (i.e. credit cards) and student loan debt.

Pertaining to physicians

  • Live like you are on a resident’s income (for three to five years, or as long as you can manage).
  • Live somewhere affordable, unless your dream is to live in California. Understand that higher living costs don’t necessarily correlate with higher wages.
  • Educate your family and make sure they are on the same page as you financially.
  • Don’t buy a house that has a price tag more than double your gross income. Try to put 20% down on the house.
  • A few things to consider if you want to hire a financial advisor: make sure they are fee-only, have gray hair, don’t mix insurance and investing, and offer physician specific help.
  • The biggest risk to your financial wellness is divorce. Spend time with your significant other and consider a prenuptial agreement.
  • The book contains much more on investing in stocks and real estate, plus additional info on protecting assets, taxes and how to make sure money goes to the right people in the event of your death.
If any of this information confuses (or empowers) you, be sure to read The White Coat Investor. Dr. Dahle does an excellent job of explaining financial material in an understandable way. He backs up all of his recommendations with solid arguments and life experience.
The advice given to medical students consists of common sense factoids, like “try not to rack up credit card debt and try to spend loan money wisely.” When we begin to earn an income in residency, the advice becomes more tangible, hence the difference in the amount of advice under medical students vs. residents in the bulleted list above. There isn’t a ton we can do right now while we are in medical school to be financially savvy, but we can invest. Not money (yet!), of course. Rather, we can invest in our own future by putting time and effort into learning the foundation of the financial world.
Featured image:
Tom Gores: Investing by Tom Gores
Categories
General Lifestyle

Coffee

Coffee. A 6-letter word that I am sure soothes the souls of many medical students around the world, including my own. That dark, rich color. That tempting, invigorating smell. I honestly can’t imagine my mornings without that cup of coffee. A full cup of homemade Starbucks coffee with a dash of almond milk and some sort of sweet pastry- the ideal morning routine that gets me going. However, ever since my first day of medical school, it doesn’t just stop at that morning cup. There’s a lunchtime Starbucks run, maybe one after class at 5, and don’t forget those evening teas, which average around 40 mg of caffeine per 8 fluid ounces! Come on, how else do my professors expect me to keep up with my daily studies?!

An article written in Medical News Today, entitled “Coffee drinking habits may influence risk of mild cognitive impairment”, discusses a study that has opened my eyes to just how much of an influence our coffee drinking habits could have on us! Drinking coffee, an act we think is going to wake us up so we can study and retain more, is in fact doing the COMPLETE opposite. It is not exactly the act of drinking coffee that is detrimental to us, but the pattern in which we are doing so. The article presents a study presented in the Journal of Alzheimer’s Disease, following the drinking habits of people between the ages of 65 and 85. The results they discovered are truly amazing! As quoted by the article’s author, Honor Whiteman, the results of the study revealed that “cognitively normal participants whose coffee consumption increased over time were also around 1.5 times more likely to develop MCI than those whose coffee consumption remained stable – no more or less than one cup of coffee each day”. Furthermore, “participants who consistently drank a moderate amount of coffee – defined as one or two cups daily – were at lower risk of MCI compared with those who never or rarely consumed coffee”. Who knew changing the AMOUNT of caffeine one drinks over time could have such a major effect on one’s memory and cognitive abilities?

It is very interesting to me that if you just keep a consistent, stable, predictable amount of intake, coffee has not shown to be detrimental for the body. This just goes to show that too much of anything is simply not good for you. Even though the pool of subjects was older in this study, there is definite potential that the correlation found could apply to the younger population. Once we near that final exam, and we start upping our intake to two, then three, then four cups a day, that is when the damage might ensue. This is the point I wanted to highlight. Trust me, I understand at that moment, at 1:00am in the middle of the night, you feel like that warm, steaming cup of coffee is the only thing keeping you from having a meltdown and simply giving up. However, I just want to call to your attention the possibility that the change in our coffee drinking patterns could actually be hindering our cognitive abilities, instead of helping. Next time you go to your Mr. Coffee to make that 4th cup of the day, please step back, and think of another alternative that could wake you up and recharge your engines. Perhaps a quick run. Maybe a phone call to an old friend or family to change your mindset. These are all possible substitutes that could work, if given the chance, AND that do not have such destructive effects.

Featured image:
cup of coffee by cactusbeetroot

Categories
Lifestyle Narrative Reflection

Lonely in a Room Full of People

Stock phrases:

“Hey mon, you alright?”
“You have a blessed day.”
“How is your morning walk pretty ladies?”
“Yeah mon, no worries. Everything alright.”

These ‘stock phrases’ are just a few of the things I heard each and every day while staying in Negril, Jamaica. I travelled to the island to take a short vacation and attend a destination wedding this past month. While on the island, I was pleasantly greeted by the local Jamaicans any time I left the bed and breakfast I stayed at. I was surprised at first at how friendly the locals were – I had heard from friends to be cautious of the crime in Jamaica. Nevertheless, I always responded to the locals, asking them how they were.

A few days into my trip I was with a Jamaican driver named Patcha, headed to another part of the island. I chatted with Patcha for quite a while. I asked him about his culture – his views on marriage, money, economy, etc. He was open and never held anything back. I mentioned to him how friendly I thought the Jamaicans all were. He kind of chuckled and asked if that was out of the ordinary for me. I told him America was different.

I went on to tell him that I am guilty of being unfriendly at times; not intentionally, but just by habit. He didn’t quite understand. I told him how common it is in America to be walking in a hallway or down a street with one other person and for neither of them to say hello to one another. Some people even say they feel lonely in a room full of people. He burst out laughing.

I started laughing too. Why do we do this? What stops us from just initiating a conversation with others? He asked why this is so. I started thinking and said, “Maybe it is because Americans are too stressed. We forget about other people because we are kind of on a mission each day.” Patcha responded, “Us Jamaicans are stressed too, we need to have food on the table every night.” I bit my tongue remembering Patcha had told me earlier that many Jamaicans live in poverty. He told me workers at some of the larger all-inclusive resorts on the island make only about ten US dollars a day and smaller establishments tend not to pay their workers on time or abuse their power over their employees in other ways.

Clearly, stress is a problem in Jamaica just as it is in America. So why is it only in the US where we insist on emotionally walling ourselves off? Why do we stray away from human contact when it is so easy to make a connection with another human? I couldn’t give Patcha an answer. I have been a shy person for the majority of my life, but by no means am I scared to strike up a conversation with anyone. When I returned to the United States I noticed myself falling into old habits, just politely smiling at the person next to me in line for coffee, but never saying hi or asking the how their day is going.

I wanted to write this blog post to hold myself accountable and also challenge my readers to break the silence. Say hello to strangers. Dare yourself to give someone a compliment. Make yourself more human.

As future medical professionals, part of our responsibility is to make our patients comfortable. I will count this challenge as daily practice for my career. I’ve seen many doctors put on a positive attitude for their patients, only to find them miserable when engaging in other social interactions. What makes a stranger in the grocery store any different from a patient in the hospital?

I hope this short story will help readers see that sometimes we all need a reality check. Whatever the reason is, our culture is heading down a path of loneliness, instead of solidarity. Let’s all take responsibility for this and make changes to unite one another.

Featured Image:
Humanity by Kevin Dooley

Categories
Lifestyle Reflection

The Hypocritical Oath

Taking the Hippocratic Oath is a rite of passage. Before any physician enters Exam Room 1, he recites these words, written by Hippocrates centuries ago. These words are powerful; so powerful that they are treated as more than just words. These words represent a physician’s love and devotion to his patients.

No matter how stressful this field can be, I have always seen physicians set these words—the oath—as their standard. As physicians (or budding physicians, in our case), we tell others to fill their bodies with nourishment and to practice a variety of healthy habits. But, the question remains: do we treat our own bodies the same way?

As a public health major, I’m all about “prevention.” My special interest is the prevention of chronic disease. Whenever I go home, I am the first to scrutinize my parents’ pantry—making sure their ketchup is devoid of high fructose corn syrup and that their fridge is filled with raw food. When I talk to my friends or relatives, I push them to exercise because “it really only takes thirty minutes of your day, and you’ll feel amazing afterwards!”

Basically, I play the pushy health coach. But is this health coach all talk and no walk?

Sadly, I don’t always abide by the values I preach. Even though I know I should be drinking water equivalent to half my body weight in ounces, I generally don’t. Well, why not? Sometimes I don’t make it a priority, and other times I forget. Many patients probably experience a similar scenario. Likewise, I often see my fellow classmates put academics above their health at school. I can be guilty of this too.

When I started thinking about our habits, I was hard on myself and my peers. As healthcare practitioners, our own health should never be placed on the backburner. More importantly, I don’t like the idea of telling my patients to do A, B, and C if I can’t do A or B or C myself. It just doesn’t seem very reasonable. I’ve come to the conclusion that there are two ways I can approach this in the future:

  1. Practice what I preach
    OR
  2. Preach with empathy

I’ve realized it’s okay to push those I love to be better, even if I’m far from that point myself. But this conversation should be accompanied by a discussion on health barriers. It’s hard to get your limp legs out of a warm bed in the morning, but what will help you rip off the covers and jump on the treadmill? Sleeping with your sports bra on? Placing your alarm farther away from the nightstand? We all know what “healthy” looks like; what we don’t always know is how to achieve it. I want to share my own obstacles with patients while also discussing theirs.

Bottom line: I don’t have to be perfect to offer health advice…I just need to be compassionate.

Featured image:
The road to health by Sarah Joy

Categories
General Lifestyle

Torn Between a “To Do List” and a “Social Life”

I have always been an overachiever, no doubt about it; always wanting to be one step ahead of the rest, always ahead of the game. For example, if I finished a school assignment by 7 o’clock in the evening, instead of taking the night off, I’d start on another assignment I knew was coming up. This was the motto I lived by all my life, until I finished my 1st year of medical school, that is. As a pre-med and 1st year medical student, I constantly told myself I’d fill my summer up with resume-building extracurriculars. But people kept telling me, “It is your FINAL summer off for years to come, enjoy your time!” Me?! Taking time off? Not being productive? I couldn’t even bear the thought. By midway into my 1st year, I already had research for the summer set up, in addition to potential shadowing opportunities in fields of interest to me. I factored it all into the schedule for my seemingly lengthy, but in reality limited, 6 weeks of summer: research, volunteering, shadowing, studying for boards. My plan was to complete all my research and volunteering positions throughout the days, and study a few hours for Boards at night.

Today, 2 days into my official summer vacation, I realized I had failed to factor some crucial aspects into my schedule: my family, friends, & outright sanity! I have worked too hard all year not to enjoy a few weeks of bliss. I deserve to wake up to a day filled not just with endless studies and a “To Do” list the size of my Grey’s Anatomy textbook, but rather to a day of, yes, some work and productivity, but also some well-deserved fun! Since this realization, I have altered my schedule drastically, allowing myself to live the next 6 weeks with this new mindset. On top of everything, my sister is tying the knot the last weekend of my summer, an event I underestimated in terms of the time and effort it would take to plan for. These happy times with family and friends will be memories I will cherish forever. Ok, so you can’t exactly add “planned sister’s wedding and hung out with friends and family” to your resume, but one cannot compare the value of building those precious memories with a completed “To Do” list. I know I will regret it down the line if I don’t allocate some time during the summer for my loved ones.

Of course, I am filling my schedule with productive, career-building endeavors; however, I am not overwhelming my life with these plans. I plan to enjoy my time and to experience exciting pursuits with my loved ones. I am extremely satisfied with the decision I’ve made: the decision to have a summer I can remember for the rest of my life, yes, but one that also includes a realistic amount of academic accomplishments.. I mean, after all, how much of my Boards studying am I REALLY going to remember? Five percent, if I’m lucky. And at the end of it all, I know one person who will be the MOST thankful and excited about my decision: my loving sister. I can spend some quality time with her, helping make the happiest time of her life one to cherish forever. For those of you who wish to fill your summers with career-building activities (a.k.a. my fellow overachievers), below I have listed some things that were on my list to achieve this summer. I hope they spark some inspiring ideas and fuel motivation that may have dwindled if you are anywhere close to the state of mind I am in after a year of hard work! Good luck to you all!

  • Volunteer at a Hospital around your area, or school’s area, or where you plan to apply for residency. It is never too early to get your foot in the door and start forming connections with program directors in residency programs you will be applying to in a couple of years! You can even find individual doctors in departments of interest to email and ask if you can shadow.
  • Volunteer for a humanitarian project. I am personally volunteering for the 2015 Special Olympics World Summer Games in Los Angeles, California. Any small gesture to give back to our community, preferably using the knowledge we have learned thus far, would be more than enough. A little help from a lot of people combined turns out to be surprisingly impactful!
  • Do research at your school. By finding a project at your school, you will be able to continue the research throughout the following year if the project extends past the summer. This shows longitudinal dedication, without adding an unmanageable workload on top of your coursework.
  • Light Boards studying. Key word: LIGHT. We are probably not going to remember much for the Boards from this summer. Maybe look over some drugs and bugs. Maybe Pathoma or Kaplan videos, focusing on topics that particularly confused you during your 1st year or that you were never able to grasp.
  • Pursue your hobby, and do it in a way that is applicable to medicine. Residency programs do look for a well-rounded applicant, after all. For example, I thoroughly enjoy writing, and now blog for the MSPress. This allows me to relish in my hobby, while giving me a solid accomplishment to add to my resume. For those of who might like to paint, paint a medical scene!

There are many many more, these were just a few. Above all, remember to always update your resume (you will regret it if your achievements pile up and you forget the details), and remember to enjoy life!

Featured image:
100! ;D by Abdulrahman AlZe3bi.

 

Categories
Disability Issues Lifestyle Opinion

Hearing Voices

“In examining disease, we gain wisdom about anatomy and physiology and biology. In examining the person with disease, we gain wisdom about life.”
― Oliver Sacks

Hallucinations are a window into the mind. They illustrate the complexity of the human mind and the pathways that can lead us astray. Art has explored the idea of madness over the centuries, translating paranoia into tragedies, delusions into dramas. It is only in the 20th century that hallucinations have been described as a sign of illness. In the past, hearing voices used to be linked with saintliness and spiritual enlightenment: a path towards God. Hallucinations are also heavy with cultural meanings: we can look back at Moses and the burning bush or Buddha beneath the Bo tree. Different cultures prescribe meaning to different senses: Protestants emphasise hearing while Catholics emphasise vision. Perhaps most interestingly, West Africans partake in kinesthesis; Westerners distrust unusual sensory experiences and label them as pathological.

The term auditory verbal hallucination refers to hearing a voice in the absence of an external stimulus. Auditory hallucinations are more common within the general population than many of us may think, especially in times of stress: up to 70% of people have been found to hear the voice of their dead relative during bereavement. Most of the people who report auditory hallucinations within population studies do not report any distress or impairment; they are able to live happily alongside these voices within their heads. Some people find that their voices can give them guidance through difficult times, while others see them as a companion or a best friend. After all, we do not consider it abnormal for a child to report that they have an imaginary friend. This relationship between the person and their voice is incredibly complex – as complex as any other relationship we may encounter, and we must tread softly when we deal with such intimacy.

Hearing Voices as a Disease
Hearing voices is not the same as having a sore throat. Hearing a voice can have a deep significant meaning to the person in a way that a sore throat cannot. So what makes the voice pathological?

Western Society sees hallucinations as pathognomonic of a serious mental health disorder. Serious psychotic disorders are however recognized across all cultures with a similar pattern of symptoms. Hallucinations that are linked with serious psychotic disorders are described as ‘pathoplastic’ – that is, they are shaped by local meanings. Behind the response to voices is the attitude of society. The society we grow up in has a lot to say about the meaning of these voices: Mexican-American relatives are more likely to display tolerance and sympathy for a relative hearing voices compared to Euro-American families, who are more likely to display criticism and hostility. If you grow up in a society where you are taught that hearing voices is wrong, this will affect your relationship with them. Imagine if you were a child hearing voices, and you turned to your parents to support and found they were even more afraid of the voices than you. Would you see your voices as an enemy, or a friend?

People experience the mind and its underlying symptoms differently depending on where they grow up. Prof Luhrmann found that US patients self-identify as schizophrenic, using the diagnosis to describe their condition through textbook definitions. They accept the medical diagnosis and are even able to recite the medical criteria – for them, the meaning of the voice is “to be crazy.” In general, the American sample did not treat their voices as a person and many of their voices were filled with violence. On the other hand, in Accra people described voices as a spiritual attack. Half of patients reported hearing only positive voices. Even when hearing negative voices, individuals also described good voices telling them to ignore these negative influences. Some people in Accra even said these voices kept them alive. In India, hearing voices is viewed differently yet again. Many of the doctors don’t mention a diagnosis and families don’t ask. None of the patient’s believed they had a devastating illness, and thus compared to the West, most of them expected to get better. Does this suggest that people suffering from hallucinations in the developed world have a better quality of life?

It has been suggested that within the Euro-American culture, an individual who is unable to distinguish between reality and imagination is labelled as pathological, while in many non-Western societies such rigidities do not exist. But this labelling goes beyond cultures; it transcends time. Mitchell and Vierkan compared hallucinations in an East Texas hospital both in the 1930s and then in the 1980s. They found that command hallucinations of the 1930s were found to be more religious, such as “lean on the Lord,” while those of the 1980s were more destructive, such as “kill yourself.” Perhaps such changes reflect the hostile environment we have created for our patients, and thus leads onto the questions: are we treating our patients with a dignified and open manner? Do we treat them as fellow individuals?

If you do not envision schizophrenia as a life sentence, you increase the chance that patients will be able to discover their own resilience.
– Prof Luhrmannn

Hearing Voices as a part of Life
In 1987 psychiatrist Marius Romme appeared on Dutch television with his patient Patsy Hague, a voice hearer, to publicise his new approach to voice hearing – that attributing meaning to one’s voices changed the way one responded to them. Four hundred and fifty people responded to this television appearance, reporting that they heard voices. More than half of the people who responded had never sought professional help: they lived happily with their voices. From this stemmed the world’s first Hearing Voices Congress held in Holland that year, and from this then grew the Hearing Voices Movement.

The Hearing Voices Movement states that hearing voices is part of human variation. It rejects the pathologising of auditory hallucinations and emphasizes empowerment of the individual. The Movement combats the stereotype of the “all-powerful psychiatrist” by giving more control to the voice-hearer and viewing the hallucinations not as a disease but as a key part of their identity. Eleanor Longden, a lady diagnosed with Schizophrenia is one example of how such a movement can have a significant impact on a person’s life. Below she describes how her meeting with the psychiatrist, Pat Bracken, became a turning point:

“[he] didn’t use this terrible, mechanistic, clinical language but just couched everything in normal language and normal experience”

Her story illustrates the road from “schizophrenic” to “voice-hearer” – from the clinical language of disease to the everyday language of emotions and experience. The stories of those diagnosed with schizophrenia can often be seen as disordered and incoherent, lacking any meaning. They are seen as having a defect. They are not entitled to a story. Hearing Voices Groups across the UK give people the opportunity to come together and share such stories in an open and trusting environment. The narrative contexts are the foundation blocks upon which these voices grow. It has been suggested that the inability to share stories about the self is part of the origins of psychopathology. We as healthcare professionals need to emphasize the point that hearing voices does not always lead to a life-long sentence of medication and institutionalization, as described eloquently by Eleanor Longden below:

If someone is reporting that they do not want their voices to stop then we must not automatically jump to the conclusion of poor insight. When the voices are distressing it is important to develop coping strategies that address this distress rather than the symptoms themselves. The problem is not the voice but the relationship one has with them. The goal of the Hearing Voices Network is for people to learn how to deal with their voices as one would deal with annoying roommates: with respect.

It has been argued that in Western medicine, doctors focus too much on a person hearing voices and not on what they say. Thus, anti-psychotics are seen as the answer with the devastating side effects described as a sacrifice for bringing someone back to the ‘norm.’ In order to understand the voices heard by our patients, we must first improve our knowledge of the cultural and social environments in which our patients reside and the practices and beliefs that our patients hold dear. If a clinician cannot take into account the cultural context of his or her patient, they cannot respond appropriately to their distress. And if a clinician is unable to respond appropriately to their patient’s distress, how can they ever hope to alleviate it?

“People with thought disorders do not keep a list of famous and successful people who share their problem. They can’t, because there is no such list. Comparatively few schizophrenics lead happy and productive lives; those who do aren’t in any hurry to tell the world about themselves.”
– Elyn Saks

 

References
1. Woods, A. et al. Interdisciplinary Approaches to the Phenomenology of Auditory Verbal Hallucinations. Schizophrenia Bulletin. 40:S246-S254
2. Laroi, F. et al. Culture and Hallucinations: Overview and Future Directions.Schizophrenia Bulletin. 40:S213-S220
3. Luhrmann, T.M. 2011. Hallucinations and Sensory Ovverides. Annual Review of Anthropology. 40:71-85
4. Woods, A. 2013. The voice-hearer. Journal of Mental Health. 22:263-270
5. Vaughan, S., Fowler, D. 2004. The distress experienced by voice hearers is associated with the perceived relationship between the voice hearer and the voice. British Journal of Clinical Psychology. 43:143-153
6. Ritsher, J.B., Lucksted, A., Otilingam, P.G., Grajales, M. 2004. Hearing Voices: Explanations and Implications. Psychiatric Rehabilitation Journal.27:219-227

Featured image:
Sound Waves: Loud Volume by Tess Watson

Categories
Humour Lifestyle

Study Strategies: The Good, The Bad, and The Ugly

The Tortoise
The tortoise is in it for the long haul. He studies for a fixed amount of time, every day. He has a routine. He never has to worry about cramming or catching up, because he’s always on top of things. The med school years for him are simple years; he studies and refrains from indulgence. Indulgence is too time consuming, and throws him off his rhythm. “If I party on Friday night,” he says, “then how will I get up at 6:30 to study on Saturday?”

The Hare
The hare is usually a social butterfly. So much energy, and so productive . . . in spurts. But the hare also enjoys taking time for herself. She takes evenings or maybe even whole days off studying. If she didn’t do this, she would fall victim to the dreaded burnout. At least that’s what she tells herself. Although she is often behind, her ability to catch up is second to none. Many of us have probably heard the adage that it’s impossible to cram in medical school. Well, not for the hare. Cramming for the hare just starts a few days earlier than it did in college. It really is impossible to cram for a neuro test the day before the test, but it is possible to pull 3 consecutive 20-hour cram days and still do well. As for long-term retention, who knows? Only boards will tell.

The Moocher
The moocher is lazy. He keeps to himself most weeks. He does not make study guides or contribute to anyone else’s learning. If at all possible, he will not show up to lecture. When a test is not looming, he can be found in his underwear at home, drinking beer and cruising the interwebs. Then, when a test looms near, he breaks free from his filthy cocoon of lethargy and can be seen on campus and social media snatching up all the condensed study guides everyone else in the class has made in the previous weeks. The moocher usually does okay on the tests, but one wonders how he will perform during rotations and residency when he does not have such helpful resources on hand.

The Memorizer
The memorizer is the queen of facts. Her ability to absorb large tables of seemingly random bits of information is unparalleled. While some may struggle to recall even the names of different medications, the memorizer will calmly recite all of the generic drug names, all of the brand names, how to spell them, how each of them is metabolized, their side effects, and which are contraindicated under what circumstances. She can do this after only going over the material once. Her classmates are in awe of her. Truly she is blessed.

The Reader
The reader… reads! Truly he is a rarity in our times. While he abhors the brute memorization of random facts, he loves to read textbooks. Bringing together a large body of knowledge into a logical system is what the reader enjoys most. He is a systematic learner who loves finding out how the little details fit into the bigger picture. The reader also must have strong shoulders, for textbooks are not known for being lightweight.

The High Yielder
The high yielder is focused first and foremost on the next exam. Perhaps it is a flaw, or maybe just an efficient allocation of her resources, but the only thing she cares about is information likely to be on the next test. She might be heard on campus saying something resembling the following: “Did the professor say that’s going to be on the test? No? Then I’m punting it. I’ll learn it later for boards if I have to.”

The Recluse
The recluse is only seen on mandatory days. Nobody really knows what he does. The only thing known for certain is that he does not go to class or social events. He doesn’t have a Facebook, and certainly shuns the company of others when he is forced to be on campus. The recluse may either be an actual loner, who would much rather be alone than in a group, or he may just be an older, married father of 3 who spends his time with family and studying at home. Either way, whenever he shows up, everybody turns and whispers to each other “Who IS that? Is he in our class?”

The Deity
The deity is revered by all. She is at the top of the class. Her study methods are mysterious. She somehow gets top scores on tests, actively participates in multiple clubs, is on student government, volunteers regularly at free clinics, and conducts research. She has a strong presence at social events and on social media. All of the students and professors adore her. Many have tried to discover her secret, but it remains a mystery. The current hypothesis is that she only sleeps 3 hours per night.

Featured image:
Studying in Starbucks by Nicola Sapiens De Mitri

Categories
Lifestyle Public Health Reflection

Giving Blood

When my cousin mentioned that she wanted to give blood, I was happy because she voiced a wish of my own. I had wanted to donate blood for years, but I never met the eligibility criteria: either I didn’t weigh enough or I was anaemic. I had been fully eligible for over a year, but I kept postponing my donation for no reason other than the fear of facing the unknown alone. Having found another person to share the experience with, I was finally brave enough to follow through and donate.

I am a medical student, an aspiring Emergency Medicine specialist, an advocate of blood and organ donation, and I am fully eligible to give blood. Who better to donate than me? How can I expect other people, who are less aware of the need for blood products or the process of blood giving, to volunteer for this seemingly unpleasant act, without serving as an example?

Let me tell you, it was not a big deal. The whole experience was actually quite different from what I expected. I expected to be in pain, to feel dizzy and to have to spend a whole day preparing and recovering from giving blood. Here is what actually happened:

After a usual day of classes and a light lunch, we walked to the Croatian Institute for Transfusion Medicine, nervous but excited. We were met by very friendly staff, who responded to my nervous humour with witty jokes. I have to give them credit, because they made a big difference in my first experience. While they joked and kept the mood light, they were professional and reassuring.

The nurse who welcomed me didn’t believe I weighed enough, but a quick consult with the scale proved him wrong. After a quick check of my haemoglobin level and a small routine examination, I was given a questionnaire to fill out about my medical history, medication use, lifestyle and traveling.

It was encouraging to see that quite a few donation beds were taken. A few people seemed to be regular donators, as they chatted between themselves and with the staff, looking completely at ease. While waiting for a donation bed to clear, the staff chatted with me about medical university workload and our health system. After a very short wait, I was shown to a donation bed and got comfortable in a head-and-feet-up position. My cousin couldn’t give blood herself as she was anaemic, so she kept me company. I have to admit my eyes did widen at the sight of the 16 gauge needle, but a nurse inserted it in my cubital vein quickly, and I can’t say that it hurt.

I squeezed my stress ball to keep the blood flowing, had sips of water, and chatted with my cousin and the staff. As I watched the red fluid flowing from my vein to the bag, I didn’t feel faint, as I expected. I did have a weird sensation I can’t describe, which was probably psychological, but there wasn’t pain, sweating, dizziness or any other symptom I expected I would have due to my low blood pressure. It didn’t last more than five minutes, which is a lot quicker than I thought it would be. Even though I felt completely fine, I was advised to stay on the bed for a few more minutes just to rest.

After a friendly goodbye from the staff, and a present of a pen that looks like a syringe, I was shown to the cafeteria where I got a drink, a warm meal and a doughnut. I left the site feeling happy knowing my blood will help someone else, and elated with the enjoyableness of the experience.

For the rest of the day, I made sure to keep hydrated and have healthy meals, but otherwise I went about my usual business: I walked my dog, studied and went to the gym (exercise isn’t recommended straight after giving blood, but I was careful not to strain myself).

I realise that giving blood isn’t the first thing to pop into your mind when you imagine a perfect day, but it’s a quick and easy thing to do. It doesn’t take a lot of time and effort on your part, but it can make a big difference in someone’s life.
Find out more about donating blood, eligibility criteria, and how to get ready for a donation, with special notes for first time donors.

A few facts from the American Red Cross:

  • Every two seconds someone in the U.S. needs blood.
  • More than 41,000 blood donations are needed every day.
  • Although an estimated 38% of the U.S. population is eligible to donate, less than 10% actually do each year.

Give blood, save lives.

Featured Image:
Blood Donation Appointment in Calendar/Journal by Oliver Symens

Categories
Disability Issues General Lifestyle

Deafness as a culture

“Try not to associate bodily defect with mental, my good friend, except for a solid reason”
– Charles Dickens, David Copperfield

What is the first thought that pops into your head when you think of the word deaf? Do you think of a disability? An inability to function in society? Do you think of loss? Of a deficiency in one of the most vital senses? Or do you think of group of people with similar values and beliefs, brought together through their experiences?

The medical model sees deafness as a disability, an impairment that needs to be fixed. A disability is defined in the Oxford Dictionary as a physical or mental condition that limits a person’s movements, senses or activities. In this sense, one could agree that deafness is considered a disability. However, deafness comes in two forms: deafness, indicating disability, and Deafness, indicating a culture.

Culture is defined as the ideas, customs, and social behaviors of a particular people or society. Deafness can therefore be viewed as a disability or an altered human experience. Deaf culture can include beliefs, behaviours, traditions, history, and values of the community. Deaf culture is an ethnocentric culture, based more upon sign language and relationships rather than a common native land – it is a global culture. Deaf Culture sees itself as a language minority than a disability.

 

Values and Beliefs

A culture tends to have its own beliefs and customs that are shared by its members, and deaf culture is no different. Deaf social protocol is based upon maintaining good visibility with others in the environment (Deaf Culture 2014).

Some examples of social customs within this culture include:

  • Rules of etiquette for getting attention and politely negotiating a signed environment
  • Keeping one another informed of what is going on in one’s environment – for example, letting someone know that one is going to the bathroom (in the hearing environment this is often not needed)

 

Arts and Literature

As with other cultures, deaf culture is rich in history and art. Storytelling also makes up a big part of the culture. Clayton Valli was an American deaf linguist who created works in ASL performed through handshape, movement and facial expression. One of his pieces of work, called Dandelion can be found here.

There is also a National Theatre of the Deaf in the USA that involves productions using ASL and spoken word. Their mission statement is to educate the public and open their eyes and ears to deaf culture (National Theatre of the Deaf 2014).

Media is a vital component in getting ones message heard, and many artistic groups throughout the world have increased awareness of deaf culture, helping to stem ignorance and begin a conversation about the experience of being deaf. Movies and TV programs also need to start promoting deafness not as a pathological condition but as a way of life, helping to banish this perception of disease and impairment.

 

Cochlear Implant Controversy

Cochlear implants are electronic devices that can be surgically implanted in patients who are deaf due to sensory hair cell damage. They can provide hearing in order to increase understanding of speech, and it is estimated that 324,000 people worldwide have received them as of 2012 (NIDCD 2013).
Although this may seem like an incredible treatment for those who have difficulty hearing, it also gives the suggestion that deafness is a condition that needs to be fixed. Some deaf people are not so much against the cochlear implant, than what it represents: a lack of respect for their culture. Indeed, some people have gone so far as to describe these devices as a means of cultural genocide.

It can be argued that deafness, as a cultural identity, should be encouraged to thrive and be supported in today’s diverse society. Others believe that every child should be given an equal chance in life. Through cochlear implants one will have opened the door to greater opportunities, such as better chances of finding employment, integrating with the community at large, and achieving a greater level of success. But why should a deviation from the norm result in fewer opportunities in the first place? Shouldn’t we be dealing with this inequality rather than trying to cover it?

Doctors may see a deaf child as missing something vital, being impaired and therefore not able to function in society. The word impairment implies fault; imagine the implications this can have on a child who is told they need to be fixed. Children should feel proud of who they are, not ashamed of what they were born with. What kind of impact would such thoughts have on their self-esteem? We all know how isolating it can feel to be different during childhood; why should we push these children further away from society?

Cochlear implants are seen as being oppressive: an illustration of our overreliance on the biomedical model. Instead of seeing a child as impaired, it would be more helpful to see the child as having a different natural language. We live in an age where we preach about acceptance and diversity. Shouldn’t we be embracing the deaf culture instead of annihilating it?

What does this mean about the future? If we find the cure for deafness tomorrow, does that eradicate an entire culture? Will there be people out there who will refuse to accept the cure for their child? And what implications will that have on the medical profession – can we accept this refusal? After all, every child deserves the best start in life. Where do we stand between respecting ones beliefs and doing the best for our patient?

 

Diversity

It has been suggested that deafness can be an isolating experience; you are part of a minority, cut off from the rest of the world. One could also argue that there are plenty of cultural minorities out there; despite English becoming more and more vital in our multicultural environment, there are many minor cultures out there who do not have English as their native tongue and are therefore cut off from a large part of civilization. Does that stop them from being a culture?

Diversity is a good thing: it is what makes society grow. It is needed for creativity, for quenching ignorance and progressing as a race. What is considered normal in this day and age? Having an illness gives you a new identity, a new way of looking at the world and translating your surroundings. What is considered illness to one person is considered normal to another. By embracing the different views on deafness, we embrace the diversity of mankind and what it has to offer.

 

References
Deaf Culture. 2014. Comparative chart: deaf and ethnic cultures [Accessed: 17thDecember 2014]
Deaf Cultural Centre. Arts & Culture [Accessed: 17th December 2014]
Jones, M.A. 2002. Deafness as Culture: A Psychosocial Perspective. Disability Studies Quarterly. 22:51-60
National Theatre of the Deaf. 2014. About the National Theatre of the Deaf [Accessed: 17th December 2014]

Featured image:
DEAF project #5 by Dario-Jacopo Lagana’