How we spend our time

I was recently part of a discussion about the time we spend exposed to the media and how it affects us based solely on sheer volume. I went online to find some data- just how many hours/wk do we watch tv? (Haven't quite found the answer, but most people seem to say ~3hrs/day, at least during the week...) In the process I found this blog http://www.shirky.com/herecomeseverybody/mt/mt-tb.cgi/19, and thought it was very interesting. The main point is that ALL the time we spend watching tv is a "surplus" of time- imagine how MUCH we could accomplish if we spent only a small portion of that time being productive?!? I believe the author's point was that we're trending away from "passive media" (just watching tv) towards "active medica" (internet sites which allow response, involve the viewer, like blogs!) But it's easy to take his thoughts one step further- just how much time do we waste? Certainly, we need some down time, and I would even call that productive time, as it's an essential "re-charging" so we can continue to be productive. But beyond a certain level (a level which is incredibly hard to pinpoint), we as a culture seem to have vast amounts of time in which we accomplish nothing... imagine WHAT we could if we used some of that time! And then, on a personal note, imagine what I could do if used more of my time more productively. I've often heard "the richest place on earth is a graveyard because of all the wasted potential there." Wasted potential. Hmm. Another quote comes to mind, something about being an ordinary person doing extraordinary things. If we want to have influence, leave a legacy, we have don't have to be exceptionally wise, talented, wealthy... all we have to do is not waste our potential. Easier said than done, no doubt. But maybe the next time I'm tempted to sit and watch tv, or do kakuro (more challenging than sudoku), I should pause and wonder if that's a productive use of time (do I need 30 minutes to unwind after a 30-hr shift at the hospital?) or am I wasting potential... potential to write, to practice the piano or violin, to read the Bible, to send an encouraging email, to exercise... so many things we can invest our time in. Even some media- certain movies, novels- stretch and challenge me, and are productive uses of my time. But I think it's a valuable exercise to pause before each activity and just question what value it has, what potential I'm investing in... or if I'm being a faithful steward of my time. (And for the record, I cringe as I write this because I hate "being productive" when it means cleaning or cooking or exercising... but I don't want to waste any potential God has entrusted to me, ability He's given me trusting that I'll use it for him. No wasted potential in my grave! http://www.shirky.com/herecomeseverybody/mt/mt-tb.cgi/19 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

27 Years

I've been "contemplative" lately. This mood typically comes up at certain times of year- Easter, Christmas, significant milestones in school... and my birthday- which is tomorrow. I'll be 27 years old. I've been thinking lately "what have I done with the 27 years God has entrusted to me? What have I accomplished in this time? I know when you usually think of 27 as an age, you don't necessarily except that much. Some education, a job, maybe started a family. But since we're blessed with enough health to live to 70, 80, even 90 (my grandfather, who is 92 or 93, is flying out to CO today from CA- I want to be that healthy in my 90's!) we don't really expect that much from a 27 year old- they have decades left in which to "accomplish something"- and most significant accomplishments are made later in life, in part because of the wisdom and experience gained throughout life. But lets think about 27 in a different way. How do we respond when someone has held the same job for 27 years? Or worked in the same volunteer position for 27 years? How about being married, attending a church, living in the same house, for 27 years? suddenly we realize it is actually a long time! And that's what got me thinking- How have I used the 27 years God has given me so far? They are as much a gift- and responsibility- as any future decades He has planned for me. So let's look back... Initially, I learned the basics. Walking, talking. Feeding myself, dressing myself. Reading and writing. Basic relationship skills- things like sharing. So granted, several of my 27 years were devoted to nothing exceptional, simply the things we all learn. (Another reason we expect less from a 27 year-old). But those skills are important, and gifts. There many people who can't walk or talk or take care of themselves. So those are all accomplishments, meant to enable me for the future. Let's move on. I learned more "advanced skills." More education- things like algebra, history, essay-writing, German. I also began to think about the future- "what will I be when I grow up." I did some traveling- California, Yellowstone... Germany. I was building relationship skills, learning valuable lessons like not building yourself up by putting others down, and not putting friends before family. And, in 3rd grade, my mom started taking us to church. Of course there were accomplishments- becoming an Honor Star, then an Honor Sponsor, being in the choir and orchestra... but those things aren't what church is all about. I can't even remember the first time I asked Jesus to be my Savior (I loved the idea of eternity in heaven) but I remember very clearly the December night when I was in middle school that I finally asked Him to be my Lord. I had seen "something different" in some of the wonderful godly people He had put in my life and I wanted what they had, wanted to know Him and not just of Him. I think that decision was probably the most significant in my life- making Him Lord has, I'm sure, changed the course of my life. Yes, I probably still would've been a doctor, still would love parrots and piano... but I'd be a very different person. And in some sense, I suppose the more relevant question right now is not what I've done with 27 years but what I've done with the years since I made Him Lord- how have I served Him? I've continued in school- through middle school, high school, college and now more than 3/4 of medical school. I'm proud of that- not just because it's been hard work, but because I know it's all been by God's design. I know He called me to be a doctor, I know He called me to CC, I know He called me to Pittsburgh. There is absolutely no doubt about that. And as I am even now in the midst of applying to residency, I'm trusting He'll guide me to the program and city He intends for me to spend the next season of my life in. Aside from education... I've progressed a lot in violin, piano and singing, and have been in multiple choirs and orchestras. That, too, I believe, pleases Him- I love to worship with my voice, with instruments... with my heart. I've built strong relationships with my family- and come understand the value of family. I've also found a few lifetime friends, friends to cherish. I've had a few jobs- the music library at CC, working on the 5th floor at Penrose, pediatric neurosurgery at Children's, and now as a tour guide for the med school. All of them were significant and God-ordained. They were jobs I enjoyed where I connected with people and gained skills that I'll use in the future. I'm sure I could go on- I recently had to update my "CV"- my resume for residency applications. I've done a lot. But in some ways I'm just beginning- my main call in life is to be a doctor, and next year I get to start to live that out. I certainly want a family someday- I'm not even close to beginning that! It's easy to feel that I haven't accomplished much in these years, that I'm still "investing in the future." But taking time to prepare for your future calling is a significant accomplishment, and an important season God calls each of us to. Some of us find ourselves in prison like Joseph, some of us wander the desert like Moses... and some of us round on patients at 4am and stand in a cold OR for 7 hour surgeries! But those times of preparation are not only significant, they're essential. So I'm proud to have spent my time preparing to be who He called me to be, even if I haven't "been" that person yet. But I think I've also made more contributions to His Kingdom during this time of preparation than I realize. I used to remind myself over and over "don't despise the day of small things." Moses was a blessing to his Midianite family, and Joseph was a blessing to the head guard in the prison, not to mention the baker and butler. So even while I'm "preparing", I'm accomplishing. I've taught precious children that God loves them, I've shown my wonderful co-workers what it means to really serve God. I'd like to think I've been a blessing to my family and friends. I recently found myself thinking about the "mundane tasks of ordinary life." When I'm taking the dog out, emptying the dishwasher or running to the grocery store, I'm to do those things as for the Lord. When I'm seeing patients in the hospital, writing progress notes, or studying for endless tests, I'm serving the Lord. Sometimes we thing we have to do remarkable things in order to call it significant. But what makes it "remarkable"- it's something that someone else finds worth mentioning- something they'll remark on. If God is my Lord, then my goal should be to do whatever He finds remarkable- and His value system is very different from the worlds. My friend that stays home and teaches piano lessons is one of the most remarkable people I know. She doesn't have a fancy degree or impressive title- but she impacts countless lives, is totally committed to her family, and has a heart that serves God in all she does. That's the kind of "remarkable" I want to be. I think the most important thing I've done with my 27 years, or perhaps I should say the last 14 years, has been developing the relationship I have with Jesus. I've read the Bible- yes, Dr Edington, the entire Bible- several times. I've learned to pray throughout my day, to trust God when I don't know where He's leading or how He'll get me through. I've learned surrender, and hope, and repent. I'm learning how to pour His life into others, and how to seek His Kingdom before any earthly thing. But most importantly, I've made Him first in my life such that I know in the present, no matter how small my task, He's pleased when I do it with a heart for Him. And in the future, regardless the mistakes I may make or the seasons I might go through, I'll always be His, and He'll always be my Lord. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

One More Book

One more book (for now). But first, I can hear you asking "how does a med student have time to read all these non-medical books?" Well, you need to know- I'm an avid reader. That's one of those phrases that gets thrown around but what does it really mean? Well, for me it means a couple of things. One, I'm addicted to books. When I get really stressed- like so stressed chocolate chip cookies won't cut it (and that's really stressed!)- the best "therapy" I know is to wander around in a bookstore- for hours. My mom is always amazed at how long I can spend in a bookstore. I tell her the longer the better- I spend several hours browsing books, I end up buying just a few. If I tried to leave real quickly, I'd end up buying everything I saw instead of spending time figuring out what I really want. At least, that's what I tell myself. Anyway, being an avid reader also means that I wish I could read a lot of books on a lot of subjects all at once- and I usually try! But what this lack of patience usually ends up meaning is that I get a few chapters into a book, and think it's really good- but then get distracted by another really good book that I can't wait to read... and before you know it I have 5 or 10 or 20 books lying around, all with bookmarks at various places, and if I want to finish any of them I have to start back at the beginning because it's been too long since I started it and I can't remember the part I've read! Finally, and most relevant to this blog, being an avid reader for me means that once I start a book, I can't put it down until I finish it. Wait a minute! I just said exactly the opposite! Well, maybe I should put it this way. If I start a book and don't finish it right away, I probably won't finish it because I'll get engrossed in several other books before I have a chance to get back to it. But when I do pick up a good book, I usually want to read and read and read... I can sit for hours at time, and it's quite normal for me to read an entire book in 2 days. So how can a med student read so many books? I very carefully choose when to pick up a new book- I choose a time when I know I can devote several hours to it for the next few days without compromising my "obligations" to school. So, true to form, yesterday I picked up "Uncharted" by Angela Hunt (a Christian novelist). Now, the last time I read a novel (I'm not even sure I remember which one it was!) I had the usual sense of "guilt" for spending so much time reading a novel- the overachiever med student in me thinks I should be more productive than that- but I actually don't read novels that often, and when I do they are carefully chosen and usually speak to me in powerful ways (otherwise I lose interest and go study instead!) Anyway, after reading "Uncharted" I felt no such guilt. It makes such a powerful statement, I still feel my heart skip a beat when I think about it, and feel far too challenged by it to regret taking time to read it. It's an allegory, about 6 friends from college who promise to stay close but lose touch until many years later when one of them dies and the other 5 are reunited. It's very well written and grabs your interest quickly, but as you get deeper into the book and the allegory begins to come together, it is all that the subtitle promises: expect the unexpected. Please read it- let me know what you think. It has such a power, is so different from what you expect. The subtitle truly says it all... and this book will leave me thinking and pondering and wondering for days... until some new book grabs my fancy! (And actually, tomorrow is my day off so I might just go hunting for a book right now...) This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

A very challenging book

Ok, so here's my next recommended book- Stolen Innocence by Elissa Wall. Sound familiar? It's very prominently displayed in the bookstores these days, and was featured on GMA (side note- I am a huge fan of Robyn Roberts!!! But I saw it on the show while I was in a patients room- that usually is the only news I see each morning, whatever the patients have on when I go in to see how they're doing!) Anyway, Elissa was born into the FLDS. What's that you ask? Well, let me give you a little background. About a year ago there was a TV series about "secret people" (can't remember the exact name). The only episode I saw was about a group of Mormons who still practice bigamy. They spent most of the movie with one family, talking about what it was like to have "2 wives" or to be a "sister wife" and trying to send the message that this community is happy and the children do not feel oppressed but happy to be there and free to make their own choices as they grow up. But the movie also mentioned a nearby town- I think about 20 minutes away- which was also known to practice bigamy, but which hated outsiders. The police of the town were chasing the media out, telling them NO outsiders are allowed. The point of the show was that this secretive town was the source of the "rumors" of these secret people who lived in bigamy, were suppressed by their authority figures and forced into that lifestyle, and incredibly hostile to anyone else. And the family most of the show focused on was attempting to dispel that myth. Well, I couldn't remember any of the details- the names or locations of these towns- but I never forgot about it... you can't help but turn the tv off still wondering... Well, then I heard Elissa Wall talking on TV about her book, and about her life growing up in a world of plural marriage- and I was intrigued. Wow. Her story is intense- you have to be ready for it if you're going to read it. Elissa grew up in the FLDS church, as I mentioned. It stands for the fundamental latter day saints. They are only one of MANY offshoots of mainstream mormonism who still believe God commands and requires plural marriage. The group that was so hostile on the tv program I saw very likely was the town where Elissa grew up, part of the FLDS. The town that was so friendly and inviting and the main focus of the show was the "Centennial Park Group." (If you want to know more, go to http://www.mormonfundamentalism.com/index.html It is a website meant to explain to mainstream mormons what fundamentalism is and why it's "wrong"- but it is very helpful if you want to understand this subject. If you spend enough time clicking back and forth, you will understand the flow chart on the page the link takes you to. Without any of the background however, you can quickly see how there are many fundamentalist offshoots- just like there are many Christian denominations- and the Centennial group and Elissa's FLDS group are just 2 examples.) In the course of reading Elissa's book and exploring some websites, I learned a LOT. I could write a very long blog here, but I'm not going to. I just want to leave you with this little teaser. If you do pick up Elissa's book, I believe you will be different by the time you finish. It affected me in a very powerful way. I felt such compassion for Elissa and her family, for the people who grow up in these fundamentalist groups, who are SO sheltered and have never heard of a faith in grace, of a life where needn't be constantly afraid of losing one's salvation... Elissa's story captured my heart- I felt compelled to learn more, until I truly understood the history and nature or mormon fundamentalism, so I could pray... and perhaps one day God will lead someone from that background- or still in the midst of it- into my life, and I'll be able to minister to them because I'll have some understanding of where they're coming from. At the same time I was reading this book, the news was reporting the children in texas who were removed from their homes- a very rare but not unheard of event where these small, private groups become very publicly known. I don't know how closely you followed those events, and I don't know what your initial response to it all was, but I guarantee I thought about it very differently after reading Elissa's story. I'm going stop there- if God has put this calling on your heart, wants you, too, to be ready to reach this "people group" in some way, then reading Elissa's book and seeking other resources will stir your heart more powerfully than I ever could. And if you this doesn't interest you at all- then maybe you could just take a minute to think about what you are passionate about. Maybe it's Muslim women, or the orphans in Africa who have AIDS and lost their parents to AIDS, or maybe it's the unborn babies of America, or teens who don't know the trap they're falling into when they try their first illegal drug... you know I could go on and on. Many, many people in this world are in need of the Lord's mercy. Take some time to hear God speaking to your heart, whispering the ones He wants you to reach, and faithfully obey. It reminds me of the movie Amazing Grace- William Wilburforce found himself consumed by a longing to free the slaves. For a brief time, I felt that same all-consuming longing for the FLDS church... I think perhaps that what God meant in Isaiah when He said Jesus (and we also should be) "numbered with the transgressors." Whatever the unique burden He wishes to place on your heart, allow yourself, even if only briefly, to feel the grief that He feels when He thinks of those people, and allow that pain to motivate your prayers. Finally, if you do want to learn more about the fundamental Mormons and how to minister to them, go to http://www.shieldandrefuge.org/ They have a Christian ministry in Utah, and have also made very informative ministry videos which are available online. May we never grow too calloused to hurt for the lost. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

Some serious blogging- my first book recommendation

I have some serious blogging to do! Or, at least some serious catch-up to do! I've been working on a blog about a particular topic (it's a secret...) for what seems like forever now... and in the meantime other topics keep piling up. So let me at least get caught up with the books I've read recently! First, there's "Me, Myself and Bob" by none other than Phil Vischer. If by now, you don't recognize the name of "Bob" or "Phil Vischer", then you need to stop here and go rent "Dave and the Giant Pickle." If, however, you do like to waltz with potatoes, you WANT to read on! When I was in the store, I saw a tomato on a book cover and thought "it couldn't be!" But it was- Phil Vischer wrote the story of VeggieTales! What was even more intriguing, however, was that the book promised to explain not just the creation of VeggieTales, but also the downfall- I remember the sense of disappointment when we learned it was to be sold. This wonderful strongly Christian ministry had such a HUGE impact, so far reaching- and with it being sold, I somehow knew the Christian message would be tarnished- likely to be "watered down" by a different company- and then that opportunity to influence not just the church but the lost would be lost. I remember at the time hearing people say "they got too big too quick, mismanaged money..." Well, having read the book, I can say "yes... but no." The first half of the book is fascinating- did you know Larry came first? Do you remember the early days, when we all knew why the characters were vegetables? Do you know how Silly Songs with Larry came about? Or how the first episode was made- literally copied- and how orders were taken? That part of the book is also wonderful for encouraging anyone with a God-given dream to have the courage to recognize and pursue it, and it makes it so clear how God can take very diverse interests, talents and experiences within one life and use them all together for an amazing purpose. But as the story moves along, Phil is so honest, so transparent. He doesn't just explain how VeggieTales went bankrupt, he gives a very thoughtful analysis of why it happened. He examines himself- his motives, his misconceptions, his very personal experience of tremendous success and utter failure. And it's one of the best books I've ever read about facing failure and understanding why God allows us to go through such dark times even when we've had "the purest of motives"- all within a book about people who are made happy by squash! If you've ever failed- or feared failure, if you've ever had a dream and feared or dared to pursue it... or if you've ever wondered how a vegetable can walk without feet and hold things without hands- then you must read this book! Some websites you might want to check-out are http://www.philvischer.com/ and http://www.jellyfishland.com/about/default.html This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

How does one become a doctor?

Well, how was your week? It seems like this week went quickly- the end of my CCM rotation (I spent the last month in the transplant ICU- learning alot, working with great doctors, really enjoyed it.) Monday I start my Medicine AI- finally! So what does that mean? Well, since I would like to use part of this blog to explain the process of medical school, this seems like a good time to start! I have learned over the past 4 years that MANY people have no idea what it takes to become a doctor, how one would ever go about teacihng ALL that a dr needs to know... and although there are books out there about the experience of residency, not many cover the subject of medical school. So let me give a very brief overview, and we'll explore various topics in detail in coming blogs. But for today, an overview and then the subject of the AI. Ok- so medical school is a 4 year process. You must have completed a college degree before starting (with a few rare exceptions). So when someone is "pre-med" they are in college and planning to go on to med school (MANY change their minds). When one says they are in med school, they are no longer pre-med, they are "true med"- in grad school after college, literally on their way to becoming a doctor. A lot of people I know think I am "pre-med" because I look young, they didn't know me when I was in college, and the lingo is totally confusing! But if you ever meet a "med student"- please know that they have already done college and definitely chosen medicine as their career, and more significantly, they are working MUCH harder than any college student- that's why we sometimes bristle when we get called "pre-med." I'm doing a LOT more work than pre-med! Ok, off my soap box! You apply, you get in (a crazy process that I'm not doing justice to at ALL but I'll talk about it another time)... the first 2 years (with a few notable exceptions) are "lecture years." Most schools involve some amount of patient contact, small group activities, etc, but for the most part, this is similar to college. Except- so as not to contradict myself- it is MUCH harder. My mom was once told by a doctor that medical school is like drinking from a fire hydrant- the material comes at you SOOO fast you can't help but feel overwhelmed and yes, it IS impossible to keep up. Much of the first 2 years is all about learning how to learn effectively in a setting where you will never know enough! Anyway, the fire hydrant image has become a theme in my conversations with my mom over the past several years- it's a very good analogy. Just as you're getting comfortable with this new pace or memorizing and test-taking, 2nd yr ends and it's time for USMLE Step 1. If you ever talk to a 2nd or 4th yr med student, you will hear them mention "the boards." I'll cover this in more detail at some point too, but for now know that it's the licensing exam for the US to say "we're qualified to be doctors"- just like the bar exam for lawyers or the RN exam for nurses. But for medicine, there are 3 parts. Part one- or "step 1" is taken at the end of 2nd yr; step 2 (which actually has 2 parts) is taken during 4th year. And Step 3 is taken after your 1st year of residency (and it's NOT the last test you take either...) After the huge milestone of step 1, you move on to "the clinical years." For 3rd and 4th yr, a med student spends most of their time with patients. With the exception of a few hours a week, lectures are a thing of the past. Even the tests are less frequent and usually (not always) less stressful. You are literally doing what you want to do- being a doctor- except that you're learning much more than you're doing, and throughout the years of med school and residency you gradually acquire more and more competence and independence. During 4th year you're back to the "the boards" (step 2) as well as applying for residency- but first you have to choose your specialty! (Another future subject will be "residency" vs "fellowship" vs "internship" and specialties vs primary care vs subspecialties... subjects that really are pertinent to any patient but explained to very few!) In either case, one of the requirements of 4th yr to prepare for applying to residency is the AI, or "acting internship" (hence AI), at some schools called a "sub-internship" (usually shortened to "sub-i")- It's a month in which you function as if you were already in residency. That means you take more responsibility for your patients, work longer hours, and get to teach the 3rd yr medical students-it's your first step up the medical hierarchy! Hmm... I want to explain what it is I actually DO all day with patients (a question I get asked a LOT), but I think I need to explain more of the hierarchy first. The medical student (1st-3rd yr) is the bottom of the totem pole- the one who knows (almost) nothing and has (almost) no experience. You are typically the information gatherer, there to perform mindless tasks and absorb information like a sponge (ok, maybe we do a little more than that, but not always!) the next tiny step up the ladder is the 4th year med student or Acting Intern. This is the person who isn't really a doctor but has learned enough to sort of practice being a doctor, with a lot of guidance. I'll describe that in more detail in a minute. The next step up- a BIG step- is the "intern" or 1st-year resident. I have to stop here and explain the terminology- probably the most confusing in the whole medical system. Traditionally, on the job training after medical school was called "internship" and the people in training were interns. Over time, however, medicine has gotten more complicated and so has training. So that "apprenticeship time" after med school is typically called residency and lasts for 3-5 years depending on the specialty. In SOME specialties, the 1st year of residency still resembles the traditional "internship" and thus 1st year residents are sometimes called interns, and the terms intern/resident and internship/residency get very confused. But for all intents and purposes, they're all the same. After residency, if you want to subspecialize (say, a pediatrician who wants to focus on cardiology) you can do further training called fellowship. In any academic center (where there are med students/residents +/or fellows in training), the doctor who is DONE with all their training is called the "attending." Ok, so back to the hierarchy. The med student, the AI, the first yr resident or intern- this is the person who does MOST of the work, sees MOST of the patients, and also teaches the med students/AI's. This is when you really learn based on massive amounts of experience. This is when the infamous long hours kick in... currently there are limits, so IF a program follows them, you can't work more than 80 hrs/wk, and you can't work more than 30 hrs/shift. Yes, this is an improvement- residencies like surgery used to commonly work 120 hrs/wk [go ahead and calculate- that leaves 48 hrs/wk for sleep, cooking/cleaning/shopping, studying and "relaxation" or a "social life." (If you get the recommended 8 hrs of sleep/night, that would be 56 hrs/wk).... you can see why they the limit of 80 is such an improvement!] Ok, so the med student eventually becomes an AI, then makes the big jump to intern/1st-yr-resident, then in your 2nd and 3rd (and sometimes more) years of residency, you begin to supervise- you're pseudo-in-charge of the interns, AI's and med students on your team, in charge of being sure they are taking proper care of the patients, and you're also responsible for teaching them all. But you're only "pseudo" in charge- the attending is the one who is really responsible (if a mistake happens, it's the attending who has to answer, not the trainees under them). So naturally, the next step up the ladder from resident is... chief resident or fellow! A chief resident is someone who has finished residency but takes a year off to teach- their main job is teaching the residents and med students. So they don'tt really oversee patient care, but they are a step above the residents as far as knowledge and experience. Then there are the fellows- the ones who are subspecializing and doing further training after residency. Not all teams will have them, but if they do, they are actually supervising the residents/students and they are still being supervised by the attendings, but they do have a lot more autonomy. And yes, the FINAL rung is attending. Well, sort of. Because then you have attendings with different faculty status (just like the different levels of professor in a university), and all of the attendings within a department (like orthopedic surgery, for example) answer to the chief of the department. But the hierarchy "on the floor"- the hoarde of white coats caring for the patient in a teaching hospital- is composed of students, residents, sometimes a fellow and an occasionally-seen attending! So where was I going with all that? Oh yes, the AI. My first step up the ladder, finally! What will I be doing as an AI? Well, I get to the hospital early (~7, some specialties start earlier, a FEW start later). I get information from whoever was there overnight on what has happened with my patients, and learn if I have any new patients. Then I go "see" my patients- that means I wake them up from what is probably the only sleep they've gotten all night and ask them how they feel and expect a meaningful answer, something other than "tired!" Seriously, I find out how they feel, if they have any questions/complaints. I do a quick exam (heart/lungs/abdomen and anything related the why they are there), then go to the nurse, the chart, the computer, etc to get all the information on their vital signs, labs, tests, etc. Then I "write a note"- summarize everything I've just learned, and develop a "plan for the day" (things like ordering a new medicine or new test or sending them home). Then I meet with my team- the other students and residents and sometimes the attending- and we go around and tell each other about our patients, so the resident in charge (the 2nd or 3rd yr resident) can tell us if we missed anything, if our plan needs to be changed at all, and so we can learn from the other patients that we're not following ourselves. Then we do our "work"- this could mean procedures like drawing blood, making phone calls to other specialists or to the family, writing orders for a patient going home, etc. In the afternoon we "round" again- look up new test results, check in on our patients, and eventually sign out- tell the person who will be there overnight what's going on with our patients, what to watch out for, what to do if such and such happens, etc. That's a typical day- unless you're "on call" which means YOU are the one who will be there overnight and everyone else signs out to you and you stay up and take care of all the patients who get sick overnight, etc. I also left out new admissions- there's a complicated system for who takes which patients but generally each day you are likely to get new patients assigned for you to follow. When you get a new patient, you do a detailed exam, like if you went to the doctor for a yearly check-up, and you get LOTS of information about them, not just how they've felt overnight. And when you're done, you still write it all in a note and tell the resident and attending about them and write orders for meds, tests, etc... I think one of the reasons I enjoy it is because it's so diverse. I talk to patients, I talk to other doctors, I examine patients, I write orders, I read xrays and interpret lab results, I research diseases I don't know much about, I do procedures- it's awesome! Well, when you're not struggling to stay awake, that is. Ok, as I wrote all that, I realized one other topic I will have to cover at some point- medical jargon! Through the arduous process of medical school, we truly learn a new language, and it becomes so engrained that it's hard to remember "English"- and if you have ever been a patient, you'll appreciate a bit of a translation! So all that and more to come... but right now my arm needs a break from typing! This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

The Reason I Clean

So, how was your weekend? I am always MOST grateful when we get a 3-day weekend- we can't always even count on a 2-day weekend! But school was nice to us this time. Here's how I spent my time--- Friday- got home early, took a nap, watched Judge Judy... can't really remember what else I did. Probably spent time on the computer. Saturday- fought off a cold, took a lot of naps. Found websites about fundamental mormonism (more later). Read some of my ICU book. Don't remember much else. Sunday- church! Walked around the Waterfront, then spent several hours hours on the grass, reading and watching the birds (chasing cardinals). Got free food from my landlord (she doesn't think it's right to eat canned spaghettios for dinner on a holiday weekend :) Monday- slept LATE, woke up to realize my allergies WERE going to make me pay for all that time on the grass. Went kayaking with friends from school. Came home exhausted- nap time! BUT... all weekend I was determined to "attack my kitchen" and get my laundry done. Guess what??? I'm doing my laundry and my kitchen is already half-clean! It will feel SO good to have that done. Ok, so what's the point? Well, it's self-discipline. I live alone. I'm the only one who ever sees my mess. Why should I cook- for myself? Why should I clean- for myself? Actually, I SHOULD cook and clean for myself! Because NOT cooking and NOT cleaning is a huge source of stress- I worry constantly about the money I spend on eating out because I have no food at home. I frequently berate myself for not cleaning, because I think it's something I "should" do and when I don't I feel like I've been lazy or lack self-control. (In reality, every medical student I know has a dirty kitchen so it actually says nothing about me and is simply proof that I'm in med school!) So perhaps I should stop feeling guilty for things I don't do because I don't "have" to but feel I "should" do- and instead just do those things I feel I "should" because I feel so much better about having them done! If only it were that simple. But far too often my desire to see my kitchen clean or my closet full of clean clothing isn't enough motivation to make me actually get up and get to work. It's easier to say I need to study, or to say I'll do it tomorrow when I have more time, or most of the time, to think it's such a mess and I'm so far behind already, one more day won't make a difference... Inevitably I reach the point where it's bugging me TOO much... when I just can't walk past those dirty dishes for another day- then I clean. (I know this sounds a lot like aimless rambling here but stay with me, I really am heading somewhere!) Everytime I DO get everything clean, I tell myself I'm going to keep up, not let things pile up, stay disciplined... and somehow it never works. This is where you come in- I always come up with answers much more quickly when I think outloud. So thanks for listening in! Why do I have such trouble keeping up with routine chores? Is it lack of discipline- I'm lazy? Or lack of motivation- I really don't have a reason to until it's bugging me, since there's no one else here to be bothered? Is it a personality- some people need everything clean, some people are happy being more "chaotic"? Or is it something more than all that, something deeper. Does my ability to "keep up with chores" reflect some state of my heart, perhaps how I feel about myself? Or how I feel about life- how much hope I have? Somehow, it's easier to clean when I know I'm doing well in school than when I'm worried about a test. Somehow that good feeling I get from seeing my apartment clean seems a lot more important when I'm happy with myself as a person, instead of discouraged by all my faults. God wants me to be a faithful steward of all He's entrusted to me. He wants to see that I'm well-able to manage my "kingdom" before He expands it. Maybe the next time I'm tempted to leave that dirty plate on the table, or put the laundry off for another day- maybe that's when I need to say "I'm doing this for you Lord"- and feel good that not only is my home clean, my Lord is pleased. Not because I'm not lazy, not because I'm not undisciplined, but because I'm doing my best with what He's given me, because I want to bring Him glory in all I do, even in how I take care of my apartment. Wow. I've never really thought of cleaning that way. Maybe I should go finish cleaning my kitchen! Coming in future blogs: how I'm doing w/keeping up with chores, God's grace for all the things we "should" do, how this discussion relates to how we use our time and how God wants us to use our time... and unrelated subjects like fundamental Mormonism (as promised), books I've read recently, the baby ducks on the Allegheny River (at least I think it was the Allegheny...)... and life in the ICU! This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.

Introducing Myself

Hi! My name is Tiffany- but I go by "drtiff09" since I will be a dr in May 2009! Much more to follow on that subject. But for now, some trivia about myself... Favorite Colors: purple and "teal green"Favorite Music: in general, Christian and classic. Specifically, Mozart, Beethoven, Rachmaninoff, Shumann... Hillsongs, Lakewood, Life Church!, Abundant Life (in England), certain random albums like "The Power of Praise" (David Clydesdale) and "Make It Glorious" (Tommy Walker) Favorite Foods: chocolate! cheesecake, marinated artichoke hearts, cream-filled donuts, Mexican and Italian, my dad's cooking (pepper steak, twice-baked potatoes, even scrambled eggs!) Least Favorite Foods: cottage cheese, eggs (except my dad's) Hobbies: violin, piano, singing, reading (actually- save that for the next category...) "chasing" cardinals (following their singing to find them and take pictures), photography, playing with my cockatiel and eclectus parrot, painting (NOT a skill or talent of mine, but fun nonetheless), writing/talking (hence the blog...) Addictions: books! office supplies, chocolate chip cookies Favorite Movies: Cary Grant (especially I Was a Male War Bride), Princess Diaries 1&2, Cars, Sweet Home Alabama Favorite TV Shows: Full House, Cosby, Extreme Makeover: Home Edition, Biggest Loser, Super Nanny Favorite VeggieTales episode: Dave and the Giant Pickle Collections: stuffed/ceramic frogs, smilie faces, hearts, keychains, cookbooks I never use :) Future Plans: Med-Peds residency possibly followed by a preventative medicine residency/ MPH program for a future in QI (preventing medical errors) and caring for patients all ages Favorite Parts of Medicine: Pediatrics and Geriatrics, QI/patient safety Least Favorite Parts of Medicine: GI!!!! As you can probably conclude from my favorite websites, I attend Life Church in Monroeville PA (I LOVE it- the people are wonderful, the worship is awesome and the pastor is real- and it's never boring!) I graduated from Colorado College in 2002 and now attend the University of Pittsburgh med school (UPSOM)... and grew up in Colorado Springs. Can you think of other categories I should add? Send me a message! This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License.