Thursday Born

The everyday life of a psychiatry resident (who was born on a Thursday).

Archive for August 2010

Life vs Medicine

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Family comes first for some who have finished residency

Bridging Gaps in Approach to Work, Life

Hiring a Young Gun

The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians
(odd one out article: In this one, it is shown that there is not much difference between the Baby Boomer generation, and Generation X, and no significant gender differences. However, in my post I am mostly wondering about my generation, Generation Y.)

On my last medical school interview, my interviewer asked me what I thought about women in medicine. I told him that I think that it is a good thing to have women doctors, because I think it’s good to have a diverse population of doctors to treat the diverse population of patients. There have certainly been times when I have preferred to have a female doctor, especially when I was child.  However, I can’t really say anything about the larger implications for the field of medicine, and it remains to be see what the overall impact of women in medicine is going to be, and whether it will be positive or negative. He seemed content with my answer, and didn’t say much more on the topic. I half-wish I’d asked him what he thought.

Medicine really is changing. Doctors are changing. There are more women doctors, and women doctors are more likely to work part-time. The new men doctors are also wanting to cut back. Women still do a large share of the housework and childrearing, and men are less content to put work and being a provider ahead of actually getting to know their children. As a generation, Generation Y really values their leisure time, their families, their life. And though we want to be Doctors, this does not negate those traits. This leads to fewer and fewer  doctors who are willing to put in long, hard hours into being a doctor. It’s not that we don’t value medicine. No, we are still eager and we still think this is a noble calling and we want to help people. We just also want to play with our children, and maybe have a hobby or two, and maintain happy relationships with our spouses (who are more likely than before to also be doctors, now that both genders are in the field).

How much will this hurt the patient? How much is medicine going to have to change to accommodate our new expectations? I know for sure that I am not willing to work insane hours throughout my career, and that depending on how demanding my field ends up being, I can see myself switching to part time for a few years and then switching back to full time. Is it wrong that I have taken a spot in medical school? Should spots be preferentially given to people who are more likely to work more hours? Well, what about the MD/PhD students? Trained as doctors but often only spending 20% of their time being doctors and 80% doing research?

Part of the problem is that it is hard to predict who will give the most of themselves into being a doctor. But part of the problem is also, does it matter? Children need to be raised, research needs to be done (aside:  I admit to often being frustrated about the resource divide between what goes into basic science research and what goes into public health and policy, but I’m seeing a trend toward valuing public health as a discipline so steps are being made in the right direction), and doctors deserve to be happy, fulfilled people just like the rest of the population. And medical students in the US pay for their own education, not the government (and therefore the population, ie, future patients), so does the public get to have a say in who is trained? What about as a purely hypothetical, ethical discussion? Is it right to train doctors who will work fewer hours? Is it right to rely on foreign medical physicians to fill the gaps? They may be equally competent, sometimes better, but every doctor that comes to the US from another country, is a doctor missing from that country, and many countries suffer quite seriously from brain drain (I could be accused of contributing to that particular problem).

On the individual, personal level, I want to say it’s all fine. I want to say that it’s okay and in fact right, for my generation of Doctors to work fewer hours because we want to, to share patients with colleagues instead of having to come in during odd, unpredictable hours because we’re tied to a particular patient. I want to say that it’s wonderful that women are about half of the new physician work force, even if they’re more likely to work part-time. Maybe this is the right way to do it, and the previous generations of doctors, with their housewives who ran the home while they were gone most of the time, were the ones who were doing it wrong. Or maybe these are all right ways to do it. Or maybe these are all wrong ways.

Maybe there is no right way.

I’m only a second year medical student, so no doubt I will look back on this someday and think, How naive and ignorant I was back then! But this is what has been going through my mind for a while now, and I’ve yet to come to any conclusions.

Written by Aba

August 30, 2010 at 3:21 pm

Still sane

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It’s really easy to neglect yourself when school heats up. I’m now down to one week before our first tests, and I’ve found myself trying to pretend I can spend all day needing to study and stay sane. It’s not that I was studying all day, but when you feel guilty every time you’re not studying, that leads to a lot of anxiety. The solution is essentially time management, which is honestly one of the best skills you can learn. It’s not just good for getting work done, but it’s also good for making sure you take the time to play. I’ve had to cut back a lot on the internet browsing I do (and I need to keep cutting back), but as I keep repeating (mostly because I need to keep hearing it) it’s healthy to have hobbies and other things you do for fun. I’ve kept up with my classwork this week which was great, but I spent several days idly browsing when I wasn’t studying instead of doing things I find more fun, like reading or writing in my blog. I need to keep a closer eye on that.

I’ve at least been eating well, which is not a given when I’m stressed. Usually I’ll eat too little. But I’ve been feeding myself for two years now and I’ve picked up a lot of tricks for keeping healthy food handy and accessible. Pictured above has been one of my meals for several days this week. I pre-sauteed (sounds so much better than fried) an onion, a tomato, and some turkish sausage (sucuk), and have been keeping the leftovers in the fridge. Microwave a few spoonfuls of the mix, add an english muffin, an egg, and an optional half avocado, and that’s a pretty filling meal! There is indeed an egg buried under all those onions in that picture. :) It’s seasoned with a bit of salt, black pepper and some garlic (which I buy crushed, because crushing my garlic fresh is just one more barrier between me and a good tasting meal), and I was pretty heavy handed with the olive oil toward the end of the cooking.

Someday I will manage to make a good sunny side up egg (I haven’t yet been able to get all the white to cook before the bottom threatens to burn), but until that day, I am happy with my sunny side downs. I’m not sure why I want to make a sunny side up egg anyway, but I suppose it’s because it’s such a cute, peppy name for a cooking style, and it would be the best way to avoid needing to scrub the pan.

I also recently tried making granola, which is easy (oatmeal + some sort of sweetener + a bit of oil + nuts _ shredded coconut if you want + cinnamon/nutmeg/vanilla, bake at 350 F & stir occasionally, untill golden brown. Allow to cool, then add whichever dried fruit you want. Store in an airtight container, preferably in the fridge), except it’s not easy if you have a fickle oven. First batch burned. Second batch was a bit over baked, but salvageable. There’s a very fine line between “maybe a few more minutes” and “oh no the oven’s smoking!”  The cinnamon made it more difficult to see if the oats had browned yet. Nevertheless, I turned half of it into power bars, which aren’t quite bars, but although it needs to be eaten with a spoon, the end result is tasty and makes a great side to fruit for a lighter meal. My granola was a bit too crisp to properly soak up the moisture and bind together into bar shape; and the nut butters I used had quite a bit of excess oil to start with, so next time I’ll add less oil, but more importantly, I’ll keep an even closer eye on my granola while it bakes.

Pictured next to the granola is my apricot syrup. When you make jam, there will be a point where your fruit will start foaming, and you will need to furiously alternate between stirring and scooping off the foam to avoid a boiling over disaster. The first time I made jam, I scooped the foam into the sink. Big mistake! Save the foam, because it will become a deliciously fruity simple syrup. I’m not entirely sure what to do with it, but I’m happy that I have it.  It would be a good addition to a mixed alcoholic drink, and also a good substitute for plain sugar syrup in an iced tea. I think I’ll be trying the latter soon.

Written by Aba

August 27, 2010 at 9:46 pm

Posted in Uncategorized

Into the frying pan

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This is apparently 3 weeks of material... Yikes.

Three weeks worth of Course Packets...

I think second year is the frying pan stage of medical school, and third year will be the fire (note the idiom: Out of the frying pan and into the fire) . First year was difficult, yes, but I am already working harder than I did at any point first year and I still need to up the ante if I want to make High Pass, or maybe even Honors. Yes, we have grades this year. Pass, High Pass, and Honors.  Pass is usually about 70-80%, High Pass 80 to 90%, and Honors above 90%. It varies from course to course, but one consistency is that there is no grade curve. Everyone can get honors, everyone can only get a Pass.

There are six blocks this year, which in a way are mini-semesters, minus the vacation after each one (we have the usual 2 or 3 days for Thanksgiving, 2 weeks in December, and 1 week in March. Plus a day off here or there for a public holiday, but I forget which ones we actually do get off). Three blocks each semester, and our first block is a rather alarming 3 weeks. Well, alarming or comforting. Alarming because, only 3 weeks (almost 2 already!) till our first exams! Comforting because, only 3 weeks of class? How bad could it be?

I still haven’t ordered my copy of First Aid for the USMLE but I really should. I’m unsure what else to get or do for board prep, but I’ll figure it out along the way. I decided to follow conventional wisdom and not study over my summer vacation, so I should be consistent and also buy First Aid and review the relevant section after each block. It blows my mind that in theory, after this year is over I should only need about 2 weeks of hardcore full time + overtime studying to be ready for the test, but I know I burn out easily so again, I’m going to trust the masses and plan on that. I haven’t decided yet where I want to take the test, and more importantly, where I want to hole up for two weeks to study. My roommate Hao has offered to feed me if I stay, but Ahmet has also offered to house me, so we’ll see what happens. I can see benefits to both, and thankfully, I have ten months to think about it.

So far I’ve managed to keep up quite well with my classes (but it’s hard to gauge how well things are sticking in my head). I’m watching lecture videos the day of or the morning immediately after, but even more surprising, I’m consistently taking notes. This is a Big Deal for me, capital letters intentional. I am not, not, a note taker. But I’m making myself one. I finally really tried it during Neuro Block at the end of last year and I have to say it was helpful, so I’m trying to keep it up. It remains to be seen if I’ll use One Note or paper more, but I’ve already switched back to paper after just two days of using One Note. Handwriting is slower, but it’s familiar. And I can draw pictures and write formulas, which is key.

Last year of classroom learning! Time to put 18 years of practice to work and make this the best year of the bunch. Aside: 19 years of classroom learning once this is over?! And yeah, that math is right; I don’t mean 18. I could mean 20 if I wanted to count Montessori, but that feels like cheating.

Written by Aba

August 19, 2010 at 11:37 am

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Back in the Saddle

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My vacations in Ghana and Turkey were wonderful, but while I’m apprehensive about starting second year, it is good to be back (don’t get me wrong though; I’d rather still be on vacation!). It’s good to be back largely because I miss my things. Not just because they’re mine, but because I own them because they are things I want to have around. It’s nice being able to make jam at a moment’s notice, or to have my phone with me (had to leave it behind to be sent in for repairs) so I can take my own pictures and blog whenever I get the urge. I may not get very attached to spaces, but I’m very attached to having my own space, where I know where everything is and can comfortably hide away.

So I’m back in the US, and rather thoroughly jetlagged but it’s (sort of) working in my favor. When you’re awake several hours before the others in your apartment, and trying to be quiet, it’s hard to stay unproductive the entire time because eventually, you’ll get bored and you can’t get yourself back to sleep so you really might as well organize your closet and finish unpacking.

On the plane ride from Istanbul to Munich (it took me three flights to get home), there was a little cup of muesli in yoghurt, which was surprisingly delicious. I’ve been meaning to make granola (and then my own granola bars) for a while now, but I think it’s best to try to save my oven use till the weather is cooler or till I have time to bake several things at once, so muesli is great compromise. Using my jetlag enabled early morning productive zone, I discovered that muesli is ridiculously easy to put together, and so voila! My breakfast this morning:

Approximately 2 tablespoons rolled oats (the actual spoon kind, not the measuring kind), 2 tablespoons vanilla whole milk yoghurt, enough soymilk to make it somewhat watery, 3/4 of a tiny gala apple (chopped with some lemon juice to ward off browning), and a small handful of the raw almond and dried blueberry mix that lives in my desk drawer. I let it sit in the fridge for nearly an hour, and in the end, it was delicious. Not too sweet, nicely cool and refreshing. As a kid, I always liked to eat oatmeal “raw” but didn’t realize it was okay to do so. And I didn’t realize that if you let it sit, it gets softer to chew but doesn’t get that heavy, almost slimy consistency of cooked oatmeal (which I do also like). I was also always confused by muesli, because again, I didn’t realize I needed to let it soak, so I never liked it. Well, now I do! Thank you, Lufthansa flight operated by Turkish Airlines, for showing me that muesli is a great summer breakfast. I should be able to make this overnight, leave it in the fridge in an airtight container, and eat it for breakfast. You can premix your muesli (and add things like wheat germ and flax seed and other dried fruits and nuts) and store it, or you can just wing it each time, which I think I might do unless I come across a winning combination that I must have on hand.

Classes start tomorrow, so I have orientation today (just one hour, as opposed to last year’s one week), and I get to meet my “little sib,” who will hopefully be awesome and worth baking for because that’s always fun. Until then, I’m making a batch of apricot jam, and there’s a lot of reshuffling of the living room to be done to make it more habitable for our squatters (and less of an eyesore for me). And in the midst of it all, I have plenty of shows to catch up on since I’ve been gone for four weeks. Not a bad Sunday agenda. :)

Written by Aba

August 15, 2010 at 12:45 pm

Posted in Uncategorized

Pre-Vacation Consummables

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I probably should’ve broken this up into multiple posts, but it’s been so long since these pictures were actually taken and I want to put them up so I can post new stuff.

Right before I went on vacation, I went to the farmer’s market and to the homebrew store. I wanted to make some jams as gifts to bring with me, and I wanted to start a new mead before I left.

This is the main haul from Aldi’s, the homebrew store and the farmer’s market. Lots of fruit, some new yeasts for my mead, and a capper for bottling my mead in smaller bottles like beer bottles.

Non-sequitur picture of my orchids. See the longer stalks? Those are the news ones that grew this spring and summer. And the smaller plant started growing a flowering stalk right before I left. Oh! Actually, this isn’t a complete non-sequitur picture; I went to Home Depot that day too and bought new pots for my poor orchids who needed more room for the roots they’ve been trying to grow, so this was the picture I took right after I re-potted them.

And of course, while I was taking pictures of the orchids, my conure Chu wanted attention, so I took some pictures of him. He begs for food and attention by hanging on the side of his cage like this and bouncing (and sometimes screaming…).

This isn’t all the blueberries! This is only what got turned into blueberry butter (a second batch; this made 8 or 9 eight oz jars).

Peach being turned into peach butter.

Hadn’t realized that I should’ve put lemon juice in my peach butter to preserve this beautiful peach color, so unfortunately the end result is brown. But this stage made me realize why the color peach is called peach.  :) It was hard to get a good picture of it, but the color was just lovely.

Remember my mead? So this is one of the first batches, after I siphoned it out of the original bottle and into a new one, leaving the dead yeast and the fruit (oranges and raisins) behind. I think they can be left alone now for a few months until I bottle them. So I think I have about…. 4/5 of a gallon, maybe less, of each batch (I made 2 one gallon bottles).

This is the other one before I siphoned it out, and also the new batch! Right now the new batch is just Cider from Whole foods with honey and yeast added. When I return I’ll be siphoning it into a new bottle and adding some spices, and them leaving it alone for a few weeks again.

And before I left, I also discovered that salmon burgers are really easy to make! I bought some really cheap individually wrapped frozen salmon fillets from Aldi’s, each about the right amount for a single patty. I defrost it in water, then mash it with my hands with some egg, some breadcrumbs, a bit of oil, and spices. And then I fry it, careful not to move it around too much until it’s cooked a bit and solidified properly into a single mass. In this one I used a whole egg, which is a bit too much. It comes together in the end, but it makes for a very watery raw patty. Half an egg worked better.

Written by Aba

August 3, 2010 at 8:16 am

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