Archive for July, 2008

Imus Ranch

Did you know Don Imus, the obnoxious radio talk show personality, has a ranch designed to help kids with (or recovering from) cancer and siblings of infants who died from SIDS (sudden infant death syndrome)? I was thoroughly impressed by this! His wife, Dierdre, is mostly in charge. They set up the ranch in Santa Fe after feeling like fund raising for kids with cancer wasn’t enough. The purpose of the ranch is to give kids some responsibility and physical exercise (chores) and purify their environment through organic, vegan foods, clean air, non-toxic paint, etc. I learned about this ranch by reading the introduction of “The Imus Ranch” cookbook. Very cool.

Love Hurts

I’m ovulating. I know it’s weird to share that information. Most men do not want to know these things, but I needed to share this because women’s behavior, thoughts and feelings change throughout their cycles. I remember learning in my undergrad endocrinology class that during the time of ovulation women tend to go out partying and dress up more often than during other times in their cycle.

Tonight I went to a “Dessert Party” for my friend who is putting together her third cookbook, which is a dessert cookbook. She makes all (or many) of the recipes in her books to have professional photographs taken and then invites people over to help her consume the dishes!!

I had the pleasure of hanging out with two incredible men in my life: an older swing dancing friend who’s house I’m staying at during colloquium and a younger friend I met because of our mutual enthusiasm for Osteopathy and our struggles with the Osteopathic Medical school system. Interestingly, I chose to wear a skirt and relatively “cute” shirt I usually only wear swing dancing. I had a lovely time talking to people and even had a chance to do a little dancing after the crowd thinned out. I’m not tired and as I was laying in bed I could feel tenderness in my LLQ (left lower quadrant). My last couple of periods have been very regular, the last one being exactly 28 days since the previous one. With this trend, I’m due to start menstruating on the day I take my COMLEX PE exam in Philadelphia (lovely!) and ovulating today would coincide with this schedule almost exactly.

Why am I writing such an extended analysis of my menstrual cycle? I think it has to do with a sense of unrest that I can’t shake. My friend who’s house I’m staying at is a good-looking guy, we get along beautifully and I love him dearly. The reason I hesitated to stay at his house was because I would have to require myself to suppress any romantic feelings I might experience. We are just friends and I like it that way. I’m comfortable, aside from suppressing some feelings of attraction. Remember the movie “When Harry Met Sally”? The whole premise of the movie was that men and women can not be friends without some sort of underlying attraction. The kicker for me is that I can’t imagine anyone being attracted to me. My friend cares about me and he always makes me feel comfortable. It’s weird to think semi-romantic thoughts about him because I don’t think he’d ever return the sentiments. But then I think, “What if he did?” How awkward would THAT be?? It’s really a no-win situation, which is why it is best to avoid these situations altogether. However, I’m here, I’m grateful for the place to stay and I enjoy his company. Sometimes I wish the pain would just go away, but love hurts. Its nice to know I feel connections with some people, even if they are a little twisted and not completely healthy…

Home Coming

It is so interesting to be back on campus in Biddeford after being away for a year. I actually came to campus a few times during the year to go to the library or talk to my favorite Neuroanatomy professor. However, it’s different to be back with all my classmates. We had 4 hours of Emergency Medicine lectures this morning. I was constantly reflecting on my own experiences this past year and noticed my critical thinking was a bit different from the first 2 years of lectures. I had more insight into the clinical setting these docs were referring to.

The other interesting issue is interacting with classmates again. It took some effort for me to maintain confidence in my own experience when hearing about what other people have done or are setting up for the future. The most difficult part was talking to a G, classmate who was a bit of a friend last year until I realized the guy I was interested in was interested in her. She’s beautiful, tall, bright eyes, enthusiastic, chipper demeanor: everything I’m lacking except for the bright eyes. She went through a divorce last year and now she’s pregnant and getting married again. Although the divorce was a difficult time for her, I am ridiculously jealous of her. And then she wants to chat over tea. It hurts me to just think about her. I can imagine the torture of hanging out for an hour or so. No thank you. I appreciate the offer, but my heart doesn’t need that kind of abuse right now.

To Serve

I had a minor revelation that I think will help me through this next year and residency. My revelation was simply that my purpose is to serve. As corny as that sounds, that is why I pursued becoming a doctor rather than working in a biochemistry lab- academic or (gasp!) for a pharm company. I feel that ~80% of my problems with depression occur when I lose this focus. I am a naturally altruistic person and feel better when I help others. This medical school thing is very selfish and when I get into the selfish mode, I feel terrible about myself and the world. Even my anger with the Osteopathic medical community can be subdued when I return my focus to serving. I’ve decided that I have to accept my vocation as a sacred path dedicated to serving a higher power, similar to a nun. If I apply my heart and soul, then maybe the void in my heart where a family of my own should be, will be filled with love from another source.

Letter to C

The previous post regarding my frustration with the preceptor I had during family practice rotation was immature and out of control, but one of the purposes of this blog is to vent my anger safely. Below is a more mature and appropriate letter I wrote as a final catharsis for this situation. I’m not going to actually send it to him thanks to feedback from a good friend and my own better judgement. Still it felt good to write it.

C,
I feel like I need to talk to you. I realize email is not the same as
talking, but it’s the best I can do right now and besides, I have a very
difficult time talking to you directly. You tend to talk “at” me rather than
with me, not recognizing what I’ve said and this causes me to shut down. Not
to mention the fact that I tend to cry easily, which is due to both my low
threshold for crying and your approach to personal encounters.

I am still in pain from how you confronted me on Wednesday. I was already in
a precarious position in regards to my confidence about my chosen profession.
You say you want to help, but then you offer medication, a band-aid. You
admit to not understanding me, so then how can you help me? I purposely chose
not to share myself with you because I knew you wouldn’t understand and my
sharing was not a required part of the rotation. I was supposed to learn
family medicine from your perspective. That’s it. If we had connected, I may
have shared more about myself, but we didn’t connect. I admit that breaking
down crying before seeing a patient is not healthy, but would you rather me
walk around like a robot and have no feelings? I’m a sensitive person and
most of my patient encounters were very positive with people wanting me to be
their doctor. I obviously connect with patients. It didn’t seem like you
perceived that in me. You only saw my faults and the first step in helping
someone is seeing what they are good at and what they have to offer.

I am also angry about your perception of Osteopathy. Healthy skepticism is
important to maintain integrity in our profession, but you completely
disregard everything about Osteopathy that I hold dear. It would be one thing
if you were just my FP preceptor, but you are also our OMT preceptor. I have
a hard time forgiving this. Since beginning school 3 years ago I have
experienced so much disappointment in the Osteopathic profession that I have
reached my limit. I can forgive DOs who spend their lives completely immersed
in the allopathic world, becoming experts in their fields who do not use OMT
(i.e. Dr. O, nephrologist). And, I have a huge amount of respect for FPs who
try to incorporate OMT into their practice even though my imagine of an ideal
FP DO is one who only uses OMT for all issues.

I am stubborn, idealistic and possibly delusional, but there was a time when
Osteopathy thrived and I am on a quest to find that “essence”. I don’t want
to settle for mediocrity. Much of my depression and anger stem from this
disappointment and then having to traverse the medical school jungle anyway
because I’m so completely in debt.

I have my issues and I am constantly working on them. Every counselor I have
ever seen has said I have great insight and if I had felt comfortable enough
to talk with you, you would have noticed this too. C, there were a few
moments I actually learned something from you. However, those moments are
overshadowed by me learning to interact with you without being completely
overcome by insubordination. You are the first person I’ve worked with where
I felt so strongly. I may be part of the problem, but you have also
contributed to the dissonance in our relationship.

MG

Dancing around the world


watch it in high quality (click the link beneath the screen) – 5 million plus viewers can’t be wrong………..

http://www.youtube.com/watch?v=zlfKdbWwruY

and here’s the nytimes piece that lead me to it:

http://www.nytimes.com/2008/07/08/arts/television/08dancer.html?scp=1&sq=matt%20dancing&st=cse

Correct response?

Is it better to cry or hold it in?

Should a person with depression take antidepressants if they don’t want to?

Is it healthy to receive feedback from someone you don’t get along with?

I consider myself a fairly mature person.  However, when it comes to interacting with one of my preceptors, I became very immature: passive aggressive, non-communicative, angry.  He’s often telling patients with psych problems that they need to let out their emotions and then when I cry he says I’m depressed and need to try medication.  I refuse to discuss my issues with him because he’s a complete ass and yet thinks he knows what’s best for me.  We last worked together and he gave me feedback on Weds.  I’m still upset by what he said to me.  There was no way to win.  I hated him and yet he was my primary preceptor.  I couldn’t exactly be honest or else I’d be called insubordinate, which wouldn’t be the first time in my life.  So I played the passive aggressive game, which makes me hate myself and him that much more.  I know I have issues.  We all have issues.  I don’t want to do pelvic exams and I get overwhelmed with emotions when I have to do it.  I used my reaction as an indication NOT to go in to family practice and yet he says there is something wrong with me and questioning me belonging in the field medicine.  Would it be better if I was a robot and did everything I was told without feeling a god damned thing???  Besides, I don’t WANT to be an MD.  I want to be a DO.  I want to analyze problems based on the anatomy, the blood/nerve supply and venous/lymphatic drainage.  THAT IS WHAT I WANT and yet he (the DO hired to teach us OMT) doesn’t fucking believe in Osteopathy!!   IT makes me want to scream so loud that I burst my own ear drums.  There’s something wrong with me?  He should look at his own lazy ass and say the same fucking thing.  Thank goodness there were some DO’s throughout the year who were able to teach me something and give me their thoughtful feedback regarding the present state of Osteopathy.

Please pardon my profanity.  It took me 2 days to recover my shattered self-esteem and now I’m just writhing with anger.

Neuroscience of Dance

I haven’t read this article, but a swing dancing friend of mine did and this is what she had to say about it:

The July 2008 issue of Scientific American contains
an article titled “The Neuroscience of Dance”. It describes the
authors’ efforts to map regions of the brain involved in dancing. I
didn’t see any startling or amusing revelations, but a couple of
findings that confirm what you know from common sense:

(1) “The ability or rehearse a movement in your mind is indeed vital
to learning motor skills” (i.e. actively watching the teacher and
imagining yourself doing the move is a good idea);
(2) “the more expert people become at some motor pattern, the better
they can imagine how that pattern feels and the more effortless it
probably becomes to carry out.” (i.e. the better you get, the easier
it is to learn new stuff.)
(3)When you tap your foot unconsciously to a rhythm, the signal from
your ears bypasses your cerebral cortex and goes directly to your
cerebellum and thence to your feet. (Gosh – doesn’t that sort of
define “unconscious?”)
(4)They theorize that dance “began as a form of representational
communication” because its brain activity patterns are closely
related to those of music and language.

BUT the MOST interesting info. came from a sidebars to the article.
In 2007, other researchers found that tango dancing improved mobility
in Parkinson’s patients. After 20 tango classes, subjects “froze”
less often, had better balance and were less at risk of falling. I
betcha these benefits apply to everyone who dances1 Also, when
knocked off balance, trained dancers right themselves far more
quickly than untrained subjects. “As the brain learns to dance, it
also apparently learns to update feedback from the body to the brain
more quickly.”

We Didn’t Start the Fire

Something amusing!!  😛  You gotta a take a moment to watch…

http://yeli.us/Flash/Fire.html

Full Circle

My last post received an invitation to join an online discussion forum about Osteopathy (sacralmusings.com).  The cool thing is I already met the fellow who created sacralmusings online last year through another online social network.  He had invited me to join the site when he created it, but I was feeling overwhelmed starting rotations and never got around to it.  So, I went to this site and checked out the conversations going on there and decided to join when I saw my blog posted in one of the discussions, presumably from the same person who invited my to take a look.  How cool is that?  Small world!!

On another thread, I’ve been emailing a DO in NYC adn we had a rather extensive conversation yesterday.  He pushes the envelope in regards to the “energy medicine” side of Osteopathy, but he also has a very mechanical approach to patient care.  Every new patient receives an evaluation for a heel lift, not based on leg length discrepancies or x-rays showing sacral base unleveling.  He approaches heel lifts from a thoroughly function stand point.  By putting his hands on the patient’s hips and SI joints and then shifting their weight from side to side, he can tell which side is “functionally” lower thereby requiring a heel lift.  He then proceeds to find how much lift the leg needs to reach a functional equilibrium with the other leg.  This adjustment allows the patients to self-correct throughout the next week to month with alleviation of symptoms.  They come back for a readjustment, sometimes the same leg needs more or less and sometimes the lift is required on the other side!  How wild.  Now THAT is something I can wrap my head around.  I want to learn it and teach it to every osteopath out there!!