Archive for January, 2010

Jan 27

drugs are hell.

i met a 16-year-old patient today who truly made my heart ache. she was born addicted to heroin, grew up watching her mother continue to use, and lost her mother to overdose. at that time, this girl – 14 years old at the time – began to use. two years later, she is lost to her addiction and terrified that she will meet the same fate as her mom.

listening to this girl’s story was so so hard.. and i fear that she won’t break the cycle.  she has been to rehab 5 times and never stopped using, even while in these programs.  her dad kicked her out of the house, and she is living in a youth group home that is not equipped to handle addicted teens.  while her withdrawal is over, the urge is still there and the pain is great.  i felt helpless, and it was exhausting just taking it all in.

the doc i work with was incredibly understanding, compassionate, and up front with her.  he was so very honest and genuine, and it was so clear that he truly wanted to work with her to help her escape the cycle.  the way that he was able to affirm her, hear her experience, and offer hope – THIS is what being a healer is all about.  this type of approach is what i will continue to strive for.

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Jan 03

where life is calling me, right now

I’d like to outline my current involvement in various spheres, as it will help readers to understand some of my interests, and provide a framework for some of the topics that will arise in future blog entries.

Commitments in medical school
*Specialization in underserved medicine:
There are too many people who are dying because they don’t have a doctor to care for them, or a doctor who cares.  I care, and I especially care for those who are often forgotten in our society – the poor, the non-citizens, the elderly, to name a few.  So when I learned of the opportunity to be a part of an innovative curriculum that trains students to be compassionate physicians for the medically underserved through inner-city, rural, and international clerkships, I jumped at the chance.  This program really takes off in my clinical years (and I am excited to begin sharing my experiences as I enter rotations in July), but in the meantime, this commitment to the underserved is something that I maintain as my raison d’être in medicine, the inspiration that keeps me going even through the tough parts.
*Volunteer at sliding-scale clinic:
This is one of those commitments where I have probably felt the least confident, not because of a lack of experience with uninsured/underinsured patients and many of the associated issues, but because my mentor has challenged me to test my clinical skills, which are still often tentative and uncertain.  As a pre-clinical student, the intensive curriculum demands a focus on the intellectual knowledge we must cultivate, with less room for honing our hands-on technique on a regular basis.  I am facing a fear through my time at this clinic, shadowing and assisting the physician, but also leaning on my natural abilities in health education to spearhead a complementary diabetes program that is greatly needed to enhance the care of many patients.
*Lesbian, Gay, Bisexual, Transgender, Allies:
It should be obvious at this point that I have a special sensitivity and need to reach out to those who are medically vulnerable.  While this normally calls to mind the poor and uninsured members of our society, financial barriers are not the only obstacle to care in our country.  The LGBT community experiences a great deal of prejudice on the part of health care providers, and insufficient training and insensitivity lead to low-quality health care.  As such, many LGBT individuals do not seek regular health care, which can be compounded with many other biopsychosocial issues that arise with the difficulty of being non-heterosexual in a heterosexist world.  I strive to increase awareness about this issue and campaign for more intensive training of our medical students to be able to better serve this population in the future.
*American Medical Women’s Association:
It’s hard to believe that female physicians used to be a minority (although in many highly specialized fields, they still are).  Still, there are many challenges that are faced by women in medicine even today, and there is great value in creating a community of women in our field to support one another and address these challenges.  I joined the executive board of this organization to organize awareness events and service activities and help amplify the voice of my female peers.
*Family Medicine Interest Group:
It is no secret that primary care is a hurting area in medicine, and the reasons for that will undoubtedly be explored in future entries.  I knew I wanted to go into medicine to fill a need, and I knew I would be able to fulfill that goal by being a generalist.  I became a leader in the FMIG to help others understand this need and feel called to this specialty, as well. How wonderful to be able to provide care from the “womb to the tomb”.  More on this later.
*American Medical Association:
I serve as a student liaison to the physicians of the local medical society, promoting communication between physicians and physicians-in-training.  I think that the gap that often exists between these two groups is unfortunate.  Students have a lot they can learn from those who have been in the field for awhile, but they also have wonderful and innovative ideas to share to encourage progress and important change in medicine where needed.
*School ambassador:
I have very positive feelings towards my medical school, and feel called to roles that can share this perspective with prospective students and also to help facilitate a positive experience for current students.  To that end, I am an extremely enthusiastic tour guide, a fearless student representative on the committee for c/o 2012 student affairs, and have very much enjoyed serving as an interviewer for applicants, orientation leader for new students, and tutor for existing students.
*Council of health professions students:
We are all in this together.  Doctors, nurses, techs – we have different educational backgrounds, but we are all in the field of medicine to help others get well and stay well.  And a positive work environment that promotes collaboration (NOT competition) between different health care providers helps to ensure a higher caliber of care for  patients.  I feel so strongly about this that I joined a student council that promotes camaraderie between the different schools of medicine on our university campus, through social and community service events.

Other things I do
*Scholarship Foundation Advisory Board:
These people helped make my college education possible, so I am doing what I can, along with the help of my tech-savvy boyfriend, to help make the foundation stay current, innovative, and sustainable.
*Vagina Monologues
I was starving for a creative outlet and more strong community with women, so I auditioned for Eve Ensler’s play based on the stories of women around the world.  I was blessed with a tiny part, which has removed the stress of adding further memorization to my routine as a medical student, and allowed me to focus on the more awesome part of getting to know an amazing group of women and collaborate on vital activist projects to combat violence against women.
*Unitarian Universalism
I discovered UU in my college years and it’s the best home I’ve found spiritually, which has allowed me the freedom to explore my faith without guilt but instead with a healthy curiosity.  While I don’t attend services as often as I’d like, it’s an important base for me to navigate my spiritual compass as I mosey forward on that journey in my life.
*NIA
I hadn’t experienced such a personally affirming and holistic approach to physical health and energy since I had been a yoga student at Gilda’s Club in the wake of my bereavement for my mother.  NIA is an integrative exercise modality that draws from the martial arts, dance, and healing arts.  I always leave NIA class with a feeling of revitalization and a renewed attitude to confront life’s challenges.  Amazing!
*I am grateful to be doing more reading and writing these days – good for reflection, expression, and creativity.
*I’m doing my darnedest to maintain alive relationships with my five siblings and their beautiful children.
*I am living with the love of my life, who is thankfully quite accommodating my self-induced chaotic lifestyle, but definitely lets me know when I’m pushing the limit and need to reset my balance beam.

If you haven’t figured it out by now, I tend to frame myself in terms of what I do – but that’s because I consider myself an activist in many spheres, and I find great value in the doing.  Still, I know that that is only one aspect of my identity, and as this blog progresses, I will explore more about my values, my goals, and my inner self as it influences my life as a healer-in-training.

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Jan 03

i was there in the room

i am currently a member of the vagina monologues 2010 cast at my university, and i have been thinking a lot about the final monologue that is performed, “i was there in the room”. the monologue talks about all the physicality mixed with pain and otherworldliness and joy and so many other emotions that arise in the miracle of childbirth.  it is written from the point of view of the author, eve ensler, as she witnessed the birth of her granddaughter.

this monologue carries a greater significance to me now after i was graced with the opportunity of witnessing my first vaginal birth in guatemala, delivered by a mayan midwife.

it was amazing to watch the dynamics between these two women – the young, first-time mother howling into the unforgiving silence, calling on the saints to end the pain, while la comadrona fought against her resistance, pulling her knees up towards her chin, spreading her wide and forcing her to push.  it was almost comical to see them struggle against each other, and so vastly different from the gentle, supportive, alternative birth assistant that one visualizes in american culture, cooing words of encouragement into the woman’s ear and rubbing her feet with lavender oil.  while i couldn’t understand the admonishments in quiché, it was clear that the midwife was using her years of experience and wisdom in the ways of pregnancy and birth and women’s health to strong-arm this overwhelmed indigenous woman to face the reality of the sacrifice she was about to make.

the escalating pain with each contraction, the timid and resistant birth-naive vagina “a deep well with a tiny stuck child inside//waiting to be rescued”, and she was scaling, scaling amidst the shouts of the midwife, clutching a rag to her forehead, trying and giving up at the same time, and the finger was turning, turning, offering a glimpse of what was to come.

it happened so fast.  when it seemed like the young woman could take no more, the child crowned and seemed to flow effortlessly into the wise comadrona’s arms.  she cut and burned the cord to its ashen demise, wiped him clean, and handed the little one to me to swaddle in bits of cloth as she prepared for her other patients of the day.  i kneeled at the bed, clothing him and staring in complete awe at a tiny new addition to this world.  what was so very ordinary to these women was an incredible wonder to me, an immense gift, a tribute to the organic power of women.  i was there in the room.  and it was beautiful.

The heart is able to forgive and repair.
It can change its shape to let us in.
It can expand to let us out.
So can the vagina.
It can ache for us and stretch for us, die for us
and bleed and bleed us into this difficult, wondrous world.

-eve ensler


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