My Philosophy Explained: Two Cases

                What is my philosophy in life? I would say that my philosophy in life is to pursue what you want to pursue despite what others say you should pursue. If you love something or someone enough, there will be nothing that will stop you from doing what you want to do or being with the person you love. When it comes to people, you have to respect their boundaries. I don’t know how many times guys have asked me out on the bus, or have violated some very personal boundaries without getting to know me as a person. It freaks me out when guys touch me in some intimate way or want to have sex on the first date. The rules of winning a woman over is to move very slowly, and allow the woman to set the pace. Don’t assume that if she is letting you touch her hair that she is ready to make out. I had one guy take me to a dark area and rub my neck. This really turned me off, as I don’t really know him. He then progressed to trying to French kiss me. This was a no-no. Granted, I will no longer see this guy again due to my fear that he will fondle or rape me, I have learned that I am not anticipating dating anytime soon. Guys should honor this and try not to force themselves on me, as I am not ready, nor do I think I ever be, for that serious relationship. Really, since I have no feelings for this guy, I don’t think we can progress much further than just fellow students studying with each other. This means no kissing and no hugging, but it also means that I will be within my own comfort zone and there won’t be things done that either one of us will regret.

                When it comes to pursuing your dreams, I would say to go for it as long as it truly makes you happy. There will always be that person that chooses to be the one that talks down to you. Don’t allow that person to discourage you from doing the things that you love to do. Dream big, aim for the sky and shoot. The worse that you can do when shooting for the moon is to fall short and land among the stars. I have discovered that life is riddled with its difficulties, but these difficulties have the power to render you a helpless, crippled , crying heap or they can build you up into a better person, it is all in how we choose to view life that determines whether or not we will be effective people or ineffective bumps on a log. Don’t allow anyone’s talk bring you down, do what you love and love what you do (just as long as what you love to do can also pay the bills). So don’t be afraid to aim high, after all, you will be a better person for what difficulties you undergo in life.

The Game of Life

Life is a game; there are those that are good at this game, and there are those who are terrible at it. What determines who is good at the game of life and who is not good at it? Survival and what you make of it makes this game of life worth playing. Some people merely exist, mere shadows of whom they are and who they want to become. Then there are those that more than survive, making the most out of life’s rules and having fun while at it. These people turn the horns of life around not to nail them in the butt, but to nail life in the butt. They don’t merely exist, their life is flavored by a sense of fun and excitement and they walk with purpose. I am both of these people at times; there are days where life is exciting and there are days where it is bland. After all, people can’t play all the time, as this is life. Play will eventually exhaust you, so there must be times that you rest. I guess life is what you make of it, and that will be what determines your mastery of it. Nothing in this world matters much except other people and God. Nothing will give you more of a sense of accomplishment than seeing how you can help other people and serving God; not money, a large house, and many material possessions. The happiest people aren’t those with everything, aren’t those who don’t have to worry about financial problems because they have all the money in the world. The happiest people are those who have nothing yet are able to give all. These are the experts of the game of life, for they know life’s hidden treasures and know the true value of relationships. They are rich despite being poor. They are the kind that are always surrounded by people and can be seen with a smile on their face. They don’t worry about what toy they need next because they have never gotten to taste that addictive luxury. To them, the holidays aren’t about how many presents they got, but about the time they spend with family and other people. They are selfless in nature, making sure the needs of others are met before their own needs are met. These are the people to be admired, for they have the treasures that are the most valuable treasures you will find: a sense of genuine love for people and for God, which is a quality that is dying off in mankind and being replaced with a kind of greed. These people are the people who can smile even though their valuables have been stolen. I admire and want to become more like one of these people, as these are the true diamonds in society that no one should dispose of in favor of a lump of coal.

The Way I View Difficulties

I think people will try to talk me out of medicine because of my mental illness. Allow me to present my rebuttal to such an argument. I am like many other people; I have dreams, desires, relationships and responsibilities. The only difference that I have from other people is how my mind functions. Some people’s minds are focused on math and science, crunching numbers from the moment they get up to the moment they go to sleep. Other people’s minds are focused on the arts, allowing music to gauge their emotions and what they are experiencing at a particular moment. I am a healthy mix of the two. Some days I allow myself to trail off on a harmonic symphony; other days, I enjoy learning about science. Just because my mind operates on these two different levels doesn’t negate the impact I could have on someone’s life, nor does it negate my devotion to a career field.

It is said that many medical students are depressed in medical school, especially female medical students. While I have seen the role that conflicts tends to play on the attitudes of medical students (I have a medical student friend who has recently found it difficult to want to stick with medicine and has found herself questioning why she had even gotten into the profession), I believe I possess an advantage over my peers. 56% (or possibly even more) of all medical students in one study were discovered to have clinical symptoms of depression. Most of these people may not be getting actual treatment for it. That is where I possess the greatest advantage. I am aware of my problems and am getting treatment for it. While I do struggle with symptoms every once in a while, I at least have some control over them. I am not allowing it to dictate my life, as these students may be allowing them to do. Second of all, the treatment for my depression can also help me get advice on how to reduce stress during school, how to manage time well, how to balance my personal and professional life, how to deal with family and conflict and so on and so forth. In this respect, therapy for me is mostly beneficial.

The question of the century on this topic is how will my mental disorders affect my professional ability to administer medicine in a compassionate, patient-centered way? Being mentally ill has no negative deviation towards any unhealthy tendency when properly treated. Just because I am getting treatment wouldn’t make me any less of a great physician or nurse. In fact, the opposite is true: getting treatment will improve my ability to be able to give the kind of prestigious, world-class care that is often demanded of the profession. Treatment has liberated me to think clearly, communicate effectively, and overcome obstacles that would otherwise still loom before me. Not getting treatment would have been detrimental to both me and those that I would care for, as I would still be interrupting due to racing thoughts, and I wouldn’t be able to learn as much as I have, which would end up detrimentally affecting my patients when I would make medical errors.

Another question that should be assessed is: how do you think you will cope with the stresses of medical school and the medical profession? The answer: I think I would cope better than most people with these stresses now that I have the tools to be able to cope and handle these stresses when they are thrown at me. I have a lot of resources at my disposal, and I am not afraid to utilize them when I need. Most people figure that they can handle things on their own and will struggle with them for a prolonged period of time before realizing that they need help. In acknowledging my shortcomings, I also acknowledge that it will be the help of others that will help me get through the difficult times in my life. I spend less time floundering about on my own and more time seeking help from others. This helps me to realize not only the potential in myself, but the potential in others. Medical school, I believe, should be focused on building a community of people that will work together for the care of their patients, not as a means of competition against peers. I have utilized community resources wherever I went and have discovered that there is more power in five minutes of asking for someone’s help than there is in five hours of frustratingly trying and failing to figure things out on your own.

Overall, I believe strongly that mental illness is no reason to discount someone from attending medical school. If someone is passionate enough for the field, there will be nothing that will stop them from succeeding at whatever they put their mind to. In the end, mental illness may prove beneficial in helping patients overcome their own shortcomings in life and to potentially seek out the advice of other health care professionals and professional counselors should they need it. Talking about an illness and genuinely experiencing one are two completely different things. I believe that by experiencing a disease, the health care worker, be it physician, nurse or even CNA, they gain an appreciation and genuine understanding of what their patients are going through at a particular moment. Not only that, but often the difficulties of our life form us into better people and therefore better healthcare workers. I often see these times of difficulty as the proverbial heat and pressure that forms the coal into a diamond. This view has allowed me to conquer many difficult times in my life and to rise above them. My life is not dictated by a series of defeats, but rather an alternating series of victories and defeats that have refined me into who I am. I am not always at war, but I’m also not always at peace. I have learned to take these moments in stride, and to learn to live life in the moment, never worrying needlessly about the future and not allowing myself to be haunted by my past. I think that this is what is often required in medicine, and I strongly believe that I will do well in this field despite my shortcomings. It is all in the way that I look at my difficulties and life.

Dreamer

Dreams, what are these worth to people? To some, dreams are interference, a wall that ends up splitting people from the world of reality. To others, dreams are reality, the means that they can use to do great things for many people. I am no exception. My ultimate dream is to become a doctor, to transcend the barriers of poverty that have so easily constrained me for many years. I know that I can do it, but how is another question. I will need help, but where will that help come from. I don’t know now, but I know that I will meet many people along the way and that I will touch the lives of these people in very special ways. I have already touched the lives of others. People look to me for inspiration, a sort of example of what perseverance entails.

My life hasn’t been the perfect life. I am the image of a broken person, a person that has been made new through experience and relationship. Through my times of brokenness I have learned to value things more than some of my counterparts. For the most part, family is very important, a sort of cheerleader troupe to encourage you through life. Each of us is given a different family, and whether we are born into a family who cares or not is pure luck. For those that are born into a loving family, I have discovered that a lot of people take this for granted. They tend to resent the kind of care that their family has for them. For those not born into a loving family, I have discovered that they resent not being loved. What does this mean? This only demonstrates that the world is not perfect, and that we, as people, are not content. The best that we can get is a temporary sense of elation, but true happiness is often elusive. Where is this true happiness? I think that true happiness is not found in things or even people, but in simple living and loving God and others. In realizing this, I hope that I can provide better care for my patients.

I admit, I am a dreamer; I hope to teach others in medicine and hope to be taught myself. However, my heart is for the poor and the hurting, which is what drives me to become the best physician I can be. My vision is to help the poor, as I have been helped by others in the past. I want others to receive the kind of compassionate care that I have received in the past, despite not being able to afford the care. Who are we to decide who gets medical care and who doesn’t? It is not up to us as physicians to turn people away who need it. That is why I want to work with the poor. On top of it, I have discovered that some of the best stories come from those who are poor, and I want to hear those stories and learn from those who have learned a lot. I refuse to turn these people away like they have been turned away in the past.

Like I mentioned before, I need help to realize this dream. In order to fulfill my dream, I need help, from studying for the MCATs to financial help for medical school. I ask that you pray about what you feel is in your heart to give. I will take just about anything, as that will help me to turn my dreams into reality and to turn my dreams into something that will benefit the world. Like my persuasion teacher said, “God transforms nations through transformed people.” Please help me transform nations through my transformed self.

Victory is Yours, It's in the Way You View Life

Happy November to you all! Can you believe that it's November already? It seems like yesterday was summer. Time goes by quick, almost too quick for my liking. Before I know it, I will be applying for nursing and then medical school.

I am relegated this fine Tuesday morning to wait for the 7:30 bus, so I have some time to burn before I have to leave for CCU for my counseling appointment. I thought I would update everyone on how I've been doing these last few weeks. The change from the medications I'm on is starting to become noticeable. Here are the things I have noticed most:

1) No more thoughts of suicide: This is really important and great, since antidepressants can increase these in children, teens, and young adults especially during the first few months of therapy. The question that my doctors have been asking the most has been if I have had any suicidal thoughts, and frankly it kind of makes me annoyed. I went on antidepressants to keep from feeling this way, why on earth would I be thinking about these things? Then again, I realize that they have to ask these questions to make sure that the medications are working, which is the only reason why I don't say anything about these questions or act particularly perturbed when it has been asked for the seven millionth time it seems.

2) More confident, natural flow of conversation and interaction with others: This was a big problem for me. My schizophrenia made it difficult to trust others and because of that,  I wouldn't talk to others readily. I feared their rejection. Now I feel like I can talk to other people and that they genuinely care about me. I have no more doubts about whether or not they will shun me. I know that they love and care about me and won't do anything to purposely harm me. If they do turn me away, I feel confident that I can voice my concerns and be heard without feeling like people are totally and irrevocably angry at me for all eternity. I also want to mention that my primary care doctor commented that my conversations were more natural and not so strained, like they were in the past. She hardly knows me and even she noticed this, which means that this is more noticeable than I once thought.

3) My thoughts are organized: I can actually stay on one topic and complete a thought without jumping all over the place. This makes writing papers a whole lot easier and I am getting higher marks because I'm not going on tangents, which makes me a lot more confident in my own writing abilities. As you can even tell in this post, I am able to focus for long periods of time on one topic, which makes me incredibly happy.

4) I can remember things easier: I thought my memory was good before I went on the medications, but now it is better than ever. During my morning workouts, I would often space out on what number rep I was on because I had so many thoughts swirling around in my head. I now don't have this problem. I also can remember facts, statistics, and what I read a lot easier than I was in the past.

5) I no longer have the delusions of being a horse: For once in my life I feel human and know that there is no possible way that I could be a horse. Granted, I still love the wind blowing through my hair, I believe that my hands are hands and not hooves. There will still be that love for horses, but there will no longer be that prancing around, neighing like one.

6) I can concentrate on my schoolwork for long periods of time: This was becoming a problem and was one of the main reasons that I sought out professional help like I did. I felt like my grades were starting to slip because I couldn't concentrate long enough to get anything done. I wanted to either pretend to be an opera singer at Carnegie Hall or I wanted to prance around like a horse, both of which were not conducive to what I wanted to accomplish in life.

These are all the good things I have noticed, but there are a few bad things I have noticed as well:

1) I can't drink alcohol: This is a huge bummer for me, depending that my 21st birthday is coming up in a few months. I was looking forward to getting a drink on that special day, but I won't be able to do that now. In place of getting a drink I have planned a night of bowling with friends, so this should turn out to be an excellent night, even though I won't get to drink.

2)I can't take NSAIDs (Aspirin, Ibuprofen) with the Prozac: This is a huge downfall for me, because I had nothing but NSAIDs to get rid of my headaches. What will happen if I take an NSAID with Prozac? Nothing immediately noticeable, but depending on the NSAID, it could render the Prozac ineffective or could increase my risk for bleeding. Prozac thins the blood, and so do NSAIDs, so the two combined could be fatal. The only thing I can take for my headaches is Acetaminophen (Tylenol), and even with that I have to be careful to not go over 3,000 mg (3 grams or 6 pills per day) or I could damage my liver. Lucky for me, most of my headaches respond to two Tylenol. I have only had one that didn't respond to two Tylenol, but what I did was take two more, and it went away until later that day when I needed to eat. Then it responded to food and caffeine and two Tylenol. I guess it's a small price to pay to feel in touch with reality.

3) If I don't get enough sleep, I end up tired/with a migraine: I, before going on these medications, would get a migraine after several nights of cutting on my sleep. Now it only takes one and I will have a migraine. This sucks because my rhythm is one where I go to bed at 8 PM and wake up at 5 AM, and if I skimp on that, I am either running on empty or feeling like my head will split apart.

4) I clean the house and count my pills constantly: I don't know if this is necessarily a bad thing, as we desperately need to keep the apartment clean most days, but I have put it in the bad category because I normally would hate to clean. I also count my pills every time I take them to see if I am still on track with them and to make sure that I haven't taken more than I needed. So far so good! However, this tells me that I have some obsessive-compulsive tendencies, but I don't necessarily think that they are all bad.

5) My emotions are dulled down a lot: This isn't necessarily a bad thing, but my emotions have been really dulled. I can still feel emotions, but they don't drive me as much as they did before. I loved being able to feel emotions deeply, but some days it feels like I am dead in emotions (these are also the days that I end up tired/with a migraine because I haven't gotten enough sleep and I haven't had my cup of joe). I guess there is a price to be paid though, and the dulling down of my emotions will help me focus more on what I need to do rather than on what I am feeling. In the past, my emotions were crippling, and now they are dulled down to the point where they are no longer this way. See, there's always good in something that's intended for evil!

So far, I am satisfied with what I have been experiencing on these medications. While I may experience headaches every so often, it's never something that a few Tylenol can't take away. I am on the mend and can feel it in my heart and mind.

I wanted to end on this note. No matter what your family may communicate to you, they do care. My father, after learning that I had consulted a psychiatrist, is starting to spend more time with me. The lack of time spent with my family was the one thing that drove me into depression, so this is a very good thing for both me and my dad. Granted, I haven't told him my diagnosis yet (I plan to do so this Friday, because I wanted to tell him when I was a little more stable on my medication), I know that I have the confidence to tell him and the courage to accept what may come (it will be good). Your family loves you and doesn't want to see you go down the wrong road. If you don't have a family, you do have a makeshift "family," a group of people that genuinely care for you and want to see you succeed. Me, I have both, and I genuinely believe that there are few people that want to see my destruction. I hope you feel the way I do and if you don't, I pray that you will feel the way I do in the end. Victory is yours, it's all in the way that you view life.

Life...One Step at a Time

For those following my blog and not on my Facebook, you aren't aware of the struggles I've had over the last week. Anyway, I recently attempted suicide, wanting to slit my wrists and sit in a hot tub of water. Seeing myself like this scared me, so I sought out the help of a psychiatrist in the ER, which made me feel much worse. A few days later, I had an appointment with a different psychiatrist, where I not only mentioned what happened on Tuesday, but what I was experiencing. On the outside, I portrayed a life that was well put-together. On the inside, I was falling to pieces.

I had made the appointment a week prior to when I actually went. I was concerned because I was manifesting what I thought to be symptoms of Schizophrenia, and then I began to show symptoms of depression. I couldn't concentrate on the things I loved the most, and I didn't have any desire to do things that I used to love doing, which were the symptoms of the depression. I also didn't trust people and I didn't want to help others because of the fact that I felt that they would use me. I also questioned what other people thought of me, and thought that when people were silent, they were indifferent or they all-out hated me. I also manifested myself as a horse, believing that I had the abilities and functions of a horse. I really believed that my body and my mind was that of a horse, and that I could gallop like a horse. I reared, kicked, jumped and whinnied like a horse. I wanted to be around horses, to socialize with them because I knew, inside, I wasn't human, but I was horse. I had no interest in people, but I had interest in animals instead. These were the symptoms of Schizophrenia that I was so scared about.

I was declining gradually over the last few years, becoming more and more cautious about people. The relationships I used to form became distant and something that was only external. I could never truly relate to others, nor could I actually become close to them. I began to hate them, and because I hated people, I hated myself.

For many years, I was afraid of going to a psychiatrist, fearing that the drugs that I would be put on would make me a walking robot, always sleeping and having no emotion. However, I had the decision to make, if I did have Schizophrenia by chance, would I rather deal with the decline to what my mother experienced, thereby exposing my family to a life similar to mine, or I could deal with the side-effects of the medications? Seeing other people dealing with depression and seeing the other route made the choice easy, I would face my fears and seek the opinion of another.

The diagnosis was major depressive disorder and I was prescribed Prozac for during the day. I was also prescribed an anti-psychotic, Risperdal, that I would take at night. I did my own research on this and Risperdal is used to treat Schizophrenia, so I may have Schizophrenia. If I do, this will be treated with the Risperdal.

It has been two days since I have started the medication, so there is still a ways that I need to go before feeling the full effects. I am starting to sleep and eat better than I was over the past week, but I know that I won't feel the full effects until about two or so weeks. Thing is, I am not experiencing negative side-effects yet, which is a good thing.

As this week ends, I am thankful that the worse is over and I am optimistic about the future. I hope that some of the problems I have experienced will be resolved, and that maybe one day in the future, I can help my mom, who is more mentally ill than I, to get the help that she needs. For now, I will take life one step at a time.

The Importance of Double Checking

So, yesterday was a great day. I rubbed elbows with some of the medical students on campus, ones that are aspiring to become psychiatrists. What was scheduled and what I attended was termed an interview, but you couldn't really call it that. I would say that it was more of a counseling appointment with a group of second-year medical students training to become psychiatrists. It was incredibly refreshing, like a refreshing cool down on a hot summer's day right after a refreshing downpour. Granted, no rain from these eyes fell that day, it was no less impactful.

So here's the narrative of all that went on yesterday. I sat down in a small room with about 8 medical students and one professor, and I spent an hour and a half talking about the experiences that I had with my mother. In the past, even the mention of my mother threw me into a rage, but I am now working on keeping that rage caged. Rather than view my life as something that my mom has messed up, I view my life as something that my mother, through her often careless and downright heartless actions, has improved. How can I view my life this way when my mom has clearly done so much to try to destroy it? Simple, I view the things that have intended to bring me down to my knees as something that has improved me. What was intended to tear me down I have utilized to build me up. I guess that is what I partially got across to these students. I have been handed great adversity and I have used it to improve my life. Adversity, in my opinion, can either tear us down or fortify our walls; it's all in how we view it.

Using a combination of witty humor and cookies (yes, I did cook cookies for this occasion, proof that I do things other than studying on occasion), I hope my story is one that they will remember for a while. I know that the experience that I had yesterday will be one that I will not forget for months at the very least. At the end of the session, the floor was opened up to questions, and one male student, who I thought was very compassionate and understanding, had clarified a few things for me. I don't know what his intent was, but I think by asking the questions that he did helped to clarify the immense power I had to overcome the obstacles that I was handed, and how I will overcome any other obstacle that I may have in the future. I forget if it was the same student or another one that brought up an excellent point. I had communicated earlier that I was afraid of my mother finding me and harrassing me, whether it would be at home, at work, or elsewhere. He asked me this question:

"Do you think that perhaps you are not afraid of your mother, but more of the uncertainty that she brings?"

I had never thought of this before, but he hit the nail on the head. Thinking about it logically, I am more scared of the uncertainty that she brings. I have finally found stability in school and volunteering, and I know that if she finds me, she will throw a wrench in my day. My perfect days of studying, singing, and watching those that I admire would then be tainted by court battles, verbal and physical arguments, constant fear of being followed by my mother, and my mother's unpredictable actions in response to my words and actions. These were all things that characterized my teenage years and are all things that I have sworn to myself that I would not allow in my life or the lives that I care about. If I were to have my mother in my life, I would view this as a broken promise to myself; something that I learned to resent in my childhood. I believe that if promises are made, whether to yourself or to someone else, those promises should be kept. My mother would force me to break that promise; something that I fear and resent at the same time. That is partially why I end up resentful when I hear my mother mentioned.

Another thing that another student had brought up was that I felt that I feel that I have the responsibility to protect my family from future harm from my mother. This, again, was hit right on the head. Whenever I hear that my mother has caused emotional or physical harm to someone that I love, I immediately go into protectionist mode and I want to do all that I can to prevent it from happening again. One of the students then said this:

"Isn't that a heavy burden to carry?"

While it is a heavy burden to carry, it is one that I must carry (just look at all the books I carry, do you think I am used to carrying a heavy load?). I am the one that is closest to my mom and am the one that she has formed as close as she will have to an intimate relationship with. That means that if something will change in her life, it will probably be through me. If she is to get help, it will most likely be as a result of the boundaries that I set with her. While I am aware that I carry this burden, I know I do not carry it alone. I have many people that I converse with that have gone through the same thing that I have that come alongside me and help me get through this. After all, I do learn best when someone is there to challenge me in multiple ways.

I am not the normal person. I am what Reba McIntyre would term a survivor. My job currently is to overcome the hurdles that are thrown in my way and to grow into a very strong person that will one day be able to help others carry their burdens when they can't carry them on their own. I already have many others confiding in me, looking to me to help them find their way when they are lost in the twisted maze of confusion and raging emotions. I am a helper, I will be there when others are not. I am a friend, a teacher, a healer. I realize the potential I have, but I do not desire to keep it for myself. I want to share the power that I have felt overcoming my fears and obstacles with others, especially with those that could share the same role as I share. That is why I spoke with these students as I did. After all, the most memorable people are those that turn shards of glass that are thrown at them into glitter. I certainly have done so.

In thinking about how this day had went, I totally spaced that I had a class ending. I ended up getting an e-mail from my instructor wanting to know why I hadn't turned in my final assignments. I had assumed that it was due on Sunday, and I wrote this back to her. Before she could respond, I looked up the due date and realized that it was past due (insert face palm here). The professor had grace and allowed me to turn it in today without penalty, but having not started on it wasn't in my favor (I think I had the professor's respect when I had gotten a C on a paper and decided to rewrite it). I had to volunteer the next day, so I started to freak. I contemplated taking the day off of my volunteer assignment to work on it, but decided to volunteer anyways. I'm glad that I did, as I showed the people that I volunteer with and for that I realized my mistakes (I was beginning to slack off, or more like I was starting to experience burn-out) and could learn from them. I worked hard then decided that I would go and work on my paper and presentation. I worked for six long hours on it, and when I finally got it done, I felt a great deal of accomplishment. I even wrote a note to myself, which said:

"Good job, I'm so proud of you. You got this done before it really got dark outside. That is absolutely great. I know that you will do well in Nursing school and you will get in and succeed in medical school as well. You have the drive to do well and you will not give up on something until it is done. And I'm glad that you chose to eat well today. Overall, it was a job well done and worth the effort. It was fun doing this project and I know that you will go far in whatever you do.

Love bunches,
Yourself (LiL A)"

Sometimes we need to write ourselves letters like this. We don't believe we need to encourage ourselves and we can wear ourselves thin and stop believing in ourselves. When this happens, we experience burn-out. We need to believe in ourselves more than we do sometimes. We have done and can do great things, I think we need to remind ourselves constantly how far we have come and how far we are going to go.

What I learned from the paper being late: I don't believe in my own capabilities and you have to look at the due date before assuming anything. In the end, I really wasn't hurt by my mistake, but it will cost me in the future. By looking at the due date, I will ensure that this will not end up being a repeat in the future, thereby ensuring success on my part. As for believing in myself, that will be a process that could take many years to learn. At least I am starting on that long road now rather than never travelling it. I hope and look forward to meeting those that will walk with me on this road, as I don't travel it alone.

What Will I Do With My Life?

Lately I have been looking at Nursing schools in Colorado, and this journey has led me to CU. Now, I have had the experience of being a Ram, but never a Buff. I admit, while I came from CSU, I never really liked the school itself. It was too big and I found myself getting lost among the faces. CCU has been a refreshing venture away from everything big and busy.

However, life isn't always what we dream it to be. Sometimes it hits us where it hurts, as it has me. Looking at CCU, I realized that attending this small school is something that may not be realistic for me to strive to attain. The requirements are too much. So, I, a mature adult, must consider looking for something a little more reasonable. And that is where the idea of becoming a Buff got into my head.

I have been to the medical campus many times before, and am setting my goals high. I would like to enroll in medical school, the ultimate demonstration that hard work, determination, and the ability to dream will help you achieve much. However, last night proved to me that my dreams are once again grounded.

So, here is the problem, before I can even think of applying to the school of Nursing, I must have all of my pre-requisites done. Unfortunately, applications are due by October 15th for the program I am eligible for, and I still have one additional semester of pre-reqs to fullfill. What this means is that even if I do finish these classes, I have to wait a whole year before I can even apply. I would then have a whole year off or a whole year to flounder around. Maybe this isn't a bad thing, as it would give me plenty of time to complete any medical school pre-requisites that I would have, but then again, it moves my graduation date out even further. It's a mixed blessing in a way. Then again, if I do complete all the pre-requisites for medical school, I might as well apply for medical school alongside applying for Nursing school. If I fail in getting into medical school, I still have Nursing school to fall back on. However, if I get into medical school by chance, I will hop on it. I probably need to take a different view on it, but right now, I'm not too thrilled about it. There is still a lot that needs to be investigated before I take that step forward.

The Plight of the Poor

As a college student whose mother was a single mother, I have had to really think long and hard about finances. When I came to CCU, that kind of went out the window, but now that I am thinking about completing my Nursing degree, I realize that I really need to start putting my finances in the forefront of my thinking again. I only have a certain amount of funds to work off of, so I really need to utilize what I have now. I have a dilemma, which means no matter what I do, there will be some bad done, good done, and some beneficial things left undone.

Here is my dilemma. While at CCU, I ended up really messing up, and got 3 Cs and one D, thereby lowering my GPA to below 3.0. To get that up to where CCU's Nursing school wants it would take an act of God almost literally. In addition to this problem, there is the high probability that if I do get into the Nursing program, that there would be some part of my tuition left unpaid (CCU doesn't want to increase my financial aid award letter even though I would be considered a full time student and would be eligible for it). To add to this confusion, my dad wants me to keep my options open and wants me to take the Chemistry and Nutrition courses as a non-degree seeking student. The kicker to that: I would have to pay for these classes myself as I would not be eligible for financial aid or scholarships. I digress.

I did some investigating and maybe I'm jumping the gun a little and thinking too far ahead, but I was looking at CU Denver (someone wanted me to look into the Community College of Aurora's partnership with CU Denver's Nursing school, and that program is useless and meaningless to me, as it requires too many prerequisites). From what I see, transferring in the Spring of 2012 would leave me with 10 credit hours of further prerequisites that I would have to do. Not only that, but the cost would be much less (a little over half the price), I would have more financial aid to work with, and the GPA requirement would be attainable for me. If all works well and I would only have 10 more hours of prerequisites, I would even be able to take some of my pre-med courses as well. My dad says for me to keep my horizons open, and I am doing that. By transferring to CU, I would be aiming for admittance into medical school or something higher than the BSN I would be receiving and I would be gaining more science education than I could be getting at CCU. While it is wonderful that I would be integrating my faith into medical practice, I really need to keep in mind the reality of attending CCU's Nursing school. I don't meet the minimum requirements and it would take me twice as many credit hours to attain these requirements. Really, CCU was something that going to was a dream, but completing was a fantasy. While I wasn't ready for state college a few years ago due to allowing my faith to rule me, I now have learned to put my faith aside and to work hard without allowing it to dictate my life. I do still have my faith, but I need to stop allowing it to affect me the way it does. It really separates me from those that I could be reaching.

So my dilemma is do I contradict my father, risk his disappointment and anger to go to CU or do I risk not being able to pay for Nursing school or not getting admitted due to low GPA and make my dad happy? I know that this is within my boundary, that this is a decision that I have to make, and this is one that I will not make lightly. I'm really investigating the likelihood and benefits and costs of each. I'm going to contact an admission counselor for CU soon, and I hope to get in touch with the Dean of Nursing to be able to talk about the likelihood of being accepted into CCU's school of Nursing and how heavily my GPA would weigh on it. If it's like I think and they won't budge on the GPA requirements, than indeed attending CCU is a fantasy and my best bet is to transfer to CU. If the GPA can be negotiated, then I might have a chance. However, from the way that I see it, I will most definitely make it into CU's Nursing program at the very least. This wouldn't be too bad a position, but I really need to think about some things now rather than later, or I will be caught upstream without a paddle.

My Promises in Medicine

This is my version of "my Hippocratic Oath" that I formed while contemplating what my role of health care worker would entail.

21 Promises

1) I will respect and honor those currently teaching me, both inside and outside a formal teaching setting.

2) I will never forget the past lessons I have learned and the people who have helped me to learn them.

3) I will strive to learn something new every day. I won’t be closed off to trying new things unless they have the potential to injure or otherwise compromise my service to others, or have the possibility of seriously injuring myself or others, or in which the benefits do not outweigh the risks.

4) I will never forget that the people I serve and the patients I treat and work with are ­people and that they have their own unique set of scars, both physical and otherwise, that they bear that tell the stories of their lives as well as what they may be currently feeling. I will do my best to honor the person behind these scars and to respect the story that these scars tell.

5) I will show empathy to and encourage those I serve to the best of my abilities. If they are doing something that I perceive may be harmful to them, I will not be afraid to let them know and extend courtesy and support for them should they desire to change.

6) I will strive to forgive readily. I understand, in life, you will be hurt by people and that forgiveness has immense healing properties, both physically and otherwise.

7) I will strive to be an example to all what compassionate care entails.

8) I will remember that no person is perfect, and that even I will fall short sometimes. I refuse to hold others, including myself, to unrealistic expectations.

9) I will remember that there is great gift in life, and that I have the power to give it or take it away. I will never abuse this power, and I will honor each person’s right to life and death, that which is still within the constraints of law and ethics.

10) I will be grateful for every person I serve and treat, as any person can teach me a very valuable lesson. From the newborn baby to the frail, elderly person dying in their deathbed, I will remember that each life is valuable in God’s eyes. I will thank God for every opportunity to interact with people, especially when they transform me or they, themselves, are transformed. I will remember that these interactions are often fragile and can be broken at a whim, and will respect the decision of those that decide to go elsewhere for care, as it is their decision and within their boundaries, which I have no right to violate.

11) I will strive in making the person feel better, not just in improving a list of symptoms. I will be open to people’s desires and needs and will strive to meet them the best I can.

12) I will not be afraid to say, “I know not,” knowing that by being honest, I may risk losing or angering the patient. I pledge that this will not become a means of avoiding treatment. I also pledge to, when appropriate, follow these words up with either a referral to someone who can help, an explanation as to why further treatment is no longer necessary, or the willingness to learn more about its diagnosis and treatment, possibly in conjunction with the patient’s learning should they communicate a desire to learn.

13) I will not do unnecessary tests or prescribe medication as a means of making money off the patient. I will prescribe when I feel that the patient will benefit from the prescription.

14) I will not hesitate in saying no to something I feel is not in the patient’s best interest, be it procedure or drug.

15) I will offer the patient knowledge into their diagnosis when appropriate, and will not discourage them from doing their own research into their diagnosis and drugs. If the patient brings information before me that I feel is inaccurate, I will explain why it is inaccurate and provide correct information. If I feel that a patient has misinterpreted information, I will not be afraid to let them know this, and encourage them to think differently about what they have. I will strive not to withhold information that may be pertinent in their care, and I will present difficult information in a caring and empathic manner.

16) I will strive to allow patient input when appropriate. I will listen to the patient and will try to come to a consensus with them. If I deem a treatment or request inappropriate, I will offer an explanation and, when appropriate, a possible alternative. I will strive to help them understand why this may not be appropriate, and why another might be more appropriate, in a way and using language they understand.

17) I will not talk down to patients, as I do not desire to be talked down to as a patient. It would do me well to remember what it felt like to be a patient, and to avoid doing things that I would not want my physician to do to me as a patient.

18) I will remember that, in medicine, the roles are easily reversed. I may be treating people one day, and the next, I could end up being the patient. I will not forget the responsibilities that either patient or physician have, and will do my best to ease the burden on my doctor when I am put into the role of patient.

19) I will remember that medicine is an inexact science, and that certain treatments take time and many trials and errors to perfect. I will remember that each body is unique and will react differently to different procedures and drugs. I will be sensitive to any resulting pain and suffering, but I will also not do or prescribe anything unless I have a plan in place for what to do if things do not go as planned.

20) I will remember that my role is not only that of a healthcare worker, but that of a healer. While some people may need healing, I realize that others may not need healing. However, eventually all people will fail and will need a healer, and I will gratefully step up to this role. I will remember that people have emotional and psychological needs, and as a healer, I will respect and meet the needs the best way that I can.

21) I will not forget the transformative power of good health on people’s lives, and will be open to this power teaching me valuable lessons. I will strive to pass this transformative learning that has taken place in my life to people of various roles, patient, colleague, and even stranger.

Happy July 4th!

For all those reading my blog, happy 4th of July!

I don't really have any important things to say. Just going off to be with family like I usually do this time of year. Just a few friendly reminders.

Enjoy time with family, as there may be a time where you will not have them.

Don't set off illegal fireworks, as that can get you arrested and/or fined.

Don't drink and drive, as this decision may end up impacting the lives of other people in a negative way.

Enjoy the professional fireworks displays, as good money is invested in them.

If you are working during the 4th, thank you so much. I know how hard it must be not to be able to celebrate the 4th with family and friends because you have to work a shift.

As always, be careful and spend time with those you love. Don't do anything that will hurt you or others or land you or others in jail.

This is the greatest nation in the world, so celebrate your freedoms, but do it in a smart way.

Happy 4th of July!

Love,

LiL A

My New Laptop

So I’ve been off for a little while, and you are probably wondering why. My old computer was going on the fritz, resorting to forcing me to spend hours doing work that would normally take me only a matter of minutes to do. I counted the seconds between freezing episodes, and the most time I had between them was a grand total of five seconds. Last night, I finally realized, after becoming extremely frustrated at the computer and threatening to throw it out my window a few times, that it was probably best for me to get a new laptop. This one had served its time and was going to become a money pit.

The work this laptop would have needed was extensive. It was going to need to have its operating system custom installed, which would have preserved none of my programs. I would have then needed to buy and reinstall the Office Suite that I would have lost, as I do not have the original discs or code for the computer. On top of it, the battery had no life (less than 3 minutes) and the charging port would have needed to be replaced. It would have been more money than it was worth, and there was no way that I could have done what was needed to get it up and running smoothly and get it back to where it was needed without putting major money into it. It just wasn’t worth the headache and the cost.

So I’ve gone from HP to Samsung, and my HP is now being retired to the equivalence of DVD player. It has been with me for about 1 ½ years, but it has been around for about 3 years. The custom installed operating system is falling down around its ears. It’s only a matter of time before the thing actually stops working, turning off only never to turn back on again.

So now I have to go to a new love. It almost feels like I am cheating, having an affair with another laptop, while my old HP sits in the room, watching me schmooze over the new Windows 7 Samsung. I know that this is not the case, which I am only upgrading to a more reliable system, but I still feel an attachment to my old laptop. That thing has been with me during some really rough times in my life, and has served me well. I guess it is time for me to let it go, and put the laptop into a computer retirement home, or at least retire it to less strenuous exercise.

Other than that, I like the new laptop. I like the look of it, the 4 gigabyte RAM is really great, and much better than the constricted RAM of my old laptop. I don’t have it freezing every five seconds, as I was able to complete this post in the matter of a few minutes rather than a few hours, as what happened on my old laptop. It’s faster on the internet when it wants to be, and is much lighter than my old 17 inch. What I don’t like about it is that it feels like it is pretty cheap. I feel like if I dropped it, it would shatter in a thousand little pieces. Overall, I think it will take time for me to adjust to the new laptop and system.

The Tides are Changing

Today was relatively slow, much like many days of the week. The only thing I really did was found a Primary Care Doctor who I really feel that I can relate to.

I admit that I was becoming a little impatient myself, but as soon as the doctor came in, that impatience quickly dissolved. She had looked like she was about ready to cry or that she had done so (I'm sure she had cried). She apologized for her late presence, saying that she had gotten bad news about a patient of hers and she was pretty close to them. A small practice allows you to do this. I felt for her, because I know how hearing bad news about someone really impacts someone that you really care for. I am praying for the patient, the family, and my doctor.

I had written a letter that addressed the things I have been ruminating on to her, and, amazingly, she had read it (usually if something is written like that, most physicians will pass it up, skim it and if it doesn't contain information pertinent to the medical history, toss it aside, never reading it in its entirety. There is a reason that I had written it, because I knew that there was going to be no way that I was going to remember all that, and it sets up the atmosphere for both of us to be open. If it weren't for the letter, I don't think that she would have been open enough to go into detail about why she was late.

Anyways, we had a lovely conversation, of which she told me that she totally agreed with me on everything that I had addressed in my letter. This was a rarity, as many physicians don't ever really have a conversation. She mentioned her 5 year-old daughter who had asked her if she had killed someone. The answer was no, and she then said that this was the reason that she left Kaiser, as there was so much work and there would definitely eventually be a costly mistake made. In medicine, mistakes have consequences, but these consequences are much more costly than anything else, and health professionals are aware of this. Sometimes it is hard enough to know that you made a mistake as a physician and a lawsuit will only make things much, much worse for the physician. I think a good rule of thumb is if the physician shows an understanding that he or she made a mistake and is remorseful about it, then you don't need to burden them with a lawsuit on top of it (it might be different for cases where quality of life may be impacted, at that point, the patient should try to work with the same physician to improve it and if it can't be done, then a lawsuit should be considered, but a settlement should probably be sought, not an actual judgment, as that might end up being turned into spite, and that is not conducive to this relationship and may leak into other relationships). Be willing to forgive easily if the physician works with you. If they don't, then you are free to speak out about him or her without slandering him or her. However, if you have a beef with the physician, talk to them about it and try to work it out. It could be a simple lack of communication that is causing your frustrations, and talking about it might work it out. If he or she skates over your frustrations, it may be time to find a physician that is a better fit for you.

It was refreshing to see a doctor who cares so much for her patients. I get the sense that she cares for a lot of them so much that she tries to follow what they do outside of the clinic as well. This is a rarity in medicine and is often a quality that is abandoned, as protective measures of being impersonal and often angry at patients is adopted. Keep it up, there will be many rewards in this in the future. This is what makes a great doctor, and I am proud to have you as my PCP.

Anyways, another thing, her daughter is really intelligent. I'm sure that she will do great things when she gets older. This demonstrates that she is also a great mother. Having lived in a Section 8 neighborhood before, I have seen parents not care if their children wandered around at 3 AM (I have also seen them change too, so people aren't always stuck in their ways). I have also witnessed pretty severe poverty myself. If it wasn't for my housing deposit being refunded, I would have started having to look to other means of eating that wouldn't cost me anything (part of the reason I volunteer). For the span of a week, I was having to wash my clothes by hand because I had $3 total to my name. By the grace of God go I. Anyways, this is not about me, as I really think that Dr. Black is more than just a good doctor, but a good person and mother. I admire that in her, and I'm sure that if it weren't for the restrictions placed on physicians, that we would end up becoming friends.

I have been observing a changing paradigm towards more empathic care lately. However, it's still not widely practiced. When it is widely practiced and a relationship is encouraged, the quality of care will be increased and the likelihood for error decreased. I am looking forward to when it is widely practiced, as impersonal care is driving me bananas.

I'm singing praises for her, while homework is sitting, undone. It won't get itself done, so I need to end this here. The bottom line: if you want a good doctor, you have to be open and have to look for them. They can be found, just as this proves (this is the second really good doctor that I have found, and I admit that I had to do my research about them before I made the final decision to see them). It takes work on your part, but it is well worth the time and the effort.

Books: The Key to Success

So I'm currently enrolled in Human Anatomy and Physiology, and I am in week 7 of a 10 week course. The bad thing is that I wasn't able to get the main book for the class until now. I won't get it for another week, so let's hope that I don't fail any more tests (I failed the two on the skeleton).

Let's just say that I have had to be resourceful in order to pass the other tests. I did happen to get a 95% on the first test on muscle anatomy, so that is great, but I know that it may only be a fluke. I could end up failing the next one without having my book. That is why, as soon as the money came in for it, I got the book that I needed.

The moral of the story: order your books ahead of time. If you can't, let me warn you that it will be tough and will require a lot of discipline and you may or may not get the right information. Get the book, as it will give you the information required to pass the course.

There are means of getting the book at reduced costs. You can get them used, which will cut your cost for the book in as much as half. You can also rent your book from such websites as Chegg and Bookrenter, but you will not be able to keep your book. If it is something that you will use later in your major, your best bet is to go more expensive and buy the book. Some people have also advised getting older editions, and I want to speak a word of warning against this. If you are going into such fields as Psychology and Medicine, there will be new information that will be in the textbook and old information that has been either proven wrong or obsolete. Go for the current edition required in class, or you might work off of old, faulty information. If it is something that isn't changing all the time or if it is for a class such as English, a foreign language, or even economics, then you might be able to get away with an older version, especially if the required book is a novel. However, some foreign language books, such as Greek or Hebrew, may have errors in older versions that you may not catch. In this case, always cross-reference versions with someone else in the class.

As always, study hard and take care of yourself. Get proper sleep, eat right, and exercise. All of these come together to help you succeed in college so that you will be able to walk down the aisle on graduation day with your head held high.

My First Day

Today was the first day of the rest of my life...not really. It was just the first day in my volunteer position. Let's just say, I love the job that I do. I get good food for a great price, but best of all, I get to sit and talk with people, which is exactly what I did today.

I felt kind of bad for sitting around talking, but I think I made someone's day today. I guess I was really beating myself up internally because I have this image of a hard-working volunteer. Perhaps I need to let go of this image and just do what will make the most of someone's day. If that is talking with someone, then that is it.

It's really an interesting and laid-back atmosphere, and almost feels like home. I love it so far, but it is still the first day. There is always a honeymoon period.

Anyways, there was a question that this woman I talked with asked that really got me to thinking about why I'm in the Nursing program rather than just in the Pre-Medicine program. CCU has both, but why am I so attracted to Nursing? The reason I came up with was that I wanted to get experience with the patient first, then go into medical school. When I am exposed to the patient and realize the reality of treating the patient first, I will be less likely to have the deep compassion and empathy for my patients stomped out by the grueling hours that medical school requires. To me, it makes sense to go into Nursing first. I guess it is my way of easing into the medical profession. If I like it and crave more and deeper learning, I will go deeper into that pool of medicine. If I feel that Nursing is right for me, I won't venture further. It lets me be open in my decision.

We also talked about doctors and empathy, and we both feel that there are some really bad doctors out there. Doctors can sometimes be condescending, and talking to her revealed that sometimes doctors can really not be in control of their emotions, especially judgment and anger. When this happens, the trust between patient and physician is broken and the quality of care is diminished. While I do realize that we aren't all perfect and physicians are people (which is why I think that patients should be allowed to tell their doctors to calm down if needed without feeling like their doctor will kick them out of their practice), but physicians have had more experience than the patient in this matter. I think that open judgment with hostility has no place in medicine unless it is followed up by a sense of caring for the patient (and then the physician really has to try to be sensitive because once the patient feels hurt, it takes so much to get them to trust the physician again, especially if there is no real relationship that exists-patients are more likely to work through this and to forgive when a relationship was built over time). I strongly believe that one cannot practice medicine without empathy without ending up with negative effects from it (in the relationship, to the patient and to the doctor as well). I know that many medical students go to medical school out of a sense of care for the patient and for helping relieve the suffering of others, and I urge those physicians who forgot that sense of care to remember why they went to medical school in the first place and for those physicians who haven't lost sight of it to never forget the reason they are doctors. I know that you doctors care deep down for your patients, don't be afraid to show it! Showing you care will not end up in a lawsuit. In fact, it will improve patient satisfaction and will foster a relationship with your patients. You'll be able to care very well for your patients, and they will come to you for insight rather than getting misinformation from other sources. This is the ideal situation that we should be aiming for, not isolation from the patient and an emotionless and mechanical way of diagnosing disease. If I wanted this kind of treatment, I would strive to invent a machine that can do this without the personal relationship that a physician provides. People need a stronger sense of understanding when injured and ill, not less, to help them heal, and physicians as well as nurses should provide this caring relationship (and perhaps even touch when appropriate).

On to ranting again. I really need to stop getting on my soapbox.

Anyways, I had a lovely day today, and can't wait until I go back tomorrow. I wonder what will happen tomorrow! I hope it will be a great surprise!

Good night all, and blessings and peace to all!

LiL A

My Sad Life

It's sad when your life is so boring that getting hit by a car on your bike turns out to be the only big thing that happened that day.

So I probably have a few of you asking, "LiL A, did you really get hit by a car on your bike?" To answer your questions, yes indeed I did get hit by a car on my bike. Here is my take on the story.

I was crossing the street on my bike, and making sure that I had the signal to cross and that all the cars that were in the intersection came to a complete stop. To my horror, just as I start to cross, the white SUV that was at a complete stop goes forward and nails my bike. Luckily, it wasn't hard enough to do any damage to me or my bike, and I get up, get my water, and meet the driver. He was a middle age man, and he was asking if I was okay. We agree not to call the cops, as there was no real damage done to either of us, so I get on my bike and get home. I do have a little bit of whiplash, but not something that a little bit of Ibuprofen won't take the edge off of. I guess I was lucky, because I don't even have a bruise from it, and I still have a functional bike.

I consider something like this to be inevitable. I would have eventually been hit no matter what kind of precautions I take to keep myself safe. No, I do not have a helmet, as helmets will not save you in the case of high-impact accidents. I also do not have the money for one, although, if I did add a couple elbow pads to it, I would look like a child with my knee braces and stuff. However, I do have a bone to pick with drivers. I have become very cautious when I cross the road and never cross when I don't have the signal to cross. Despite all of this, I still have almost been hit because people turn and do not look to see if there are any pedestrians in the crosswalk. Sometimes they may not even look and almost get hit head on while turning. I want to caution those of you that drive to be a little more attentive and understanding of pedestrians and bicyclists. I have had my share of people honk at me because I am not crossing the street fast enough. Bicyclists and pedestrians most of the time are not as fast as cars, so to expect us to be is wrong. I plead you to have a little more patience, as waiting for us to cross will not make you much later for your appointment that you are already late for, but hitting us will. While it is up to the pedestrian/bicyclist to make sure that cars are stopped, it is also up to the driver to make sure that they are looking both directions before they go.

While I am lucky to have walked away like I did, a lot more people do not get this privilege. There are many other people who are killed in accidents just like mine, and the driver does not know how resilient the other person's body will be to blows like this. Hence, it is important for both the bicyclist and the motorist to ensure that each is safe. It is up to the bicyclist to make sure that all cars are stopped, and it is up to the motorist to make sure that there is no one in the intersection before they turn. When these responsibilities are recognized and carried out, then the road is safer one motorist/bicyclist/pedestrian at a time.

Empathy and the Practice of Medicine part 3

What does empathy mean? I liked how the author of today's chapter put it. Empathy is knowing that it could be you that is the patient, that you could one day go crazy and lose it all, including your sanity. Oftentimes, we as healthcare workers take for granted the suffering of our patients, saying that it could never be us because we have never been diagnosed with that before. However, let me remind everyone that you can come down ill with anything at any time, and no one is immune to everything. You could be dealing with cancer patients, and one day you could be a cancer patient yourself. You could be working with hospice patients, ready to die and see God's face, and one day you may be one yourself. Just because you aren't a patient now doesn't mean that you won't be one in the future.

On the other hand, I do realize that empathizing with someone with an illness that you have never had can be pretty hard to do indeed. Oftentimes, we naturally empathize with people who have or have had the same illnesses that we have struggled with personally. It is human nature: you say, "Hey, I've dealt with that before so I totally know what you are going through." Communicating this may help put the patient at ease, because it may communicate that you have a pretty extensive knowledge into it, if you bothered to research it at all to increase the quality of care you received. Most of all, it communicates that you understand completely what they have gone through, or are currently going through, and can relate to them. This can help promote the feeling that you will do whatever it takes to help the patient find relief.

The harder cases to relate to are those in which you have never had any personal experience. Often it would be easy to toss empathy by the wayside in order to gain a list of symptoms from the patient to construct your list of possible conditions. While this is something that needs to be done, empathy cannot be tossed by the wayside when the physician is doing this. The best physicians utilize both empathy and science at the same time, and are conscious to maintaining both in their practice of medicine. For those cases that are harder to empathize with, I would, as a physician, strive to imagine myself in the shoes of the patient. What would I feel? Would I be frustrated? Angry? Depressed? Happy? Non-respondent? What would I desire my standard of living to be? What would I expect from others? I would then use this kind of information to provide for my patients what they need. Of course, assumptions can be dangerous, that is why it is important first to ask the patient what they need and to help meet those needs (even if it is getting a simple glass of water). Go above and beyond what people expect, and they will come back to you in the future. Listen to people and you will be listened to. Treat people with no mercy, and people will torment you mercilessly. The practice of medicine, just like every other interaction with people, depends on adherence to the Golden Rule: do unto others what you would have them do unto you. That is why it is important to integrate empathy into the practice of medicine.

Empathy and the Practice of Medicine: part 2

This is the second part of the series that I will be writing.

As I mentioned before, I am reading a book by this title. Anyways, rather than rambling on like I usually do, I thought that it would be interesting and beneficial for me and many others that may be reading this post to allow for some interaction and opinions on a few of the sections of my reading today that I thought were provocative. Here goes!

"Francis Peabody...has had an immense positive influence on medical education and the quality of medical care in this country. His lecture, "The Care of the Patient" appeared in The Journal of the American Medical Association in 1927. Almost at the start, he said, "The most common criticism made at present by older practitioner is that young graduates have been taught a great deal about the mechanism of disease, but very little about the practice of medicine-or, to put it more bluntly, they are too scientific." In disagreeing, Peabody then went on to say, "[The practice of medicine] is an art, based to an increasing extent on the medical sciences, but comprising much that still remains outside the realm of any science. The art of medicine and the science of medicine are not antagonistic but supplementary to each other." He then provided an eloquent description of the blending of medical science with the sympathetic understanding of the life of the patients, whether the disease be organic or functional. He emphasized that getting to know the patient should be regarded as a major portion of the art of medicine. He explained how the patient should be regarded as a major portion of the art of medicine. He explained how the information thus obtained about the patient's symptoms, pattern of living, family life, and so forth should be integrated with the physical aspects, including test results and special examinations, the total comprising the scientific evaluation of the patient's problems (107)."

What are your thoughts on this issue? Is there a place for empathy in medicine, or is it considered too personal? Should a physician become friendly with their patients? Should they get to know their patients, or is there a certain boundary that would be crossed if a physician did so? Is the art of medicine and the science of medicine antagonistic? If so, how?

"Excellent physicians are those who spend time with the patient and thereby gain an understanding of both the clinical problems and the patient's life situation. They must be sensitive, appreciating nuances that creep into the patient's conversation, and sympathetic without always allowing the patient to know it. The patient regards the physician as an authority and wants the opinions and decisions of a scholarly, experienced expert. Physicians who deliberately cultivate empathy, who place themselves in the patient's position, will not be able to reliably fulfill all of these requirements. For example, physicians who are empathic may be so emotionally involved with their patients (Spiro speaks of passion as a desired result of empathy) that their body language and verbal hesitancy may contradict what they are saying. More important, by placing themselves in their patients' position, they may be unable to make the best decision. In short, encouraging physicians to cultivate empathy in their relationships with patients will undermine their ability to function as wise, understanding doctors who give themselves in guiding patients through life's concerns and illnesses (108)."

What are some of your thoughts on this topic? Have you had any experience of the "excellent physician" you would like to share? Can the physician still be empathic with the patient without diminishing the quality of care provided? Are there any other traits you would add that come together to form the "excellent physician"?

And the final quote.

"There are obvious situations in which empathy is almost inevitable. If physicians have experienced the same disease or symptoms as a patient, placing themselves in that patient's position may become almost automatic. Having experienced the disorder will almost certainly assist in making the diagnosis and appreciating the patient's pain and discomfort. Whenever the physician is empathic, however, wisdom dictates that every effort should be made to minimize the emotion when making decisions and speaking to the patient...Effective physicians give patients sufficient time to react and ask questions and learn that they have a sense of humor. They will be sensitive, sympathetic, imperturbable, understanding and occasionally empathic, but by far the least employed of these traits will be empathy (p. 108-9)."

For those who are physicians, have you had a time where a previous diagnosis as a patient has helped you to better empathize with a patient you have had? Does emotion play any role in communicating with patients? Do you agree that empathy is the least practiced trait among medicine? Why or why not?

I know that this can seem like another college message board that is posted online, but I genuinely would like to know what others think on this topic. I would like some input on this, as input would probably help shape me as a future nurse and possible physician. Thank you bunches, and I'll hear from you later!

Now off to get lost in the tunnels under National Jewish!

LiL A

Orientation

Today was orientation for new volunteers, and I think I have a really good clue about how things might be hereafter. Granted, I was a little perturbed when I got up at 6 o'clock this morning, I discovered that it was well worth getting up for.

I registered for the employee and volunteer orientation because I wanted to get a foretaste of what kind of people I would possibly be seeing and working around in the future. I met a nurse, and one person in the "class" was a security guard that will work here, and I even met one person who will be going to medical school after she takes a year off. I really admire her, because that is where I want to be in 10 or so years. Not now, because I really need the experience with the patients and the staff before I go for medical school. Overall, it was a laid-back setting, and I think that I will enjoy volunteering here.

We went over privacy policies and all that kind of fun stuff. It was quite dry, but the person who presented did a pretty good job trying to get people to follow along. It would be quite easy to lose people in the droning on and on of the policies and stuff here, but they are important to all that are employed or volunteering here. It's good to pay attention to this kind of stuff, because you never know when it will come in handy.

I can't wait until I start next week (I don't start until then because I'm a part of a research study and I have to do some things for that on Thursday), and I can't wait to meet some more of the staff and become friendly with them. I also can't wait to meet some of the other people here as well, such as some of the patients and their families. I just can't wait period. Right now, I'm going to read some more, maybe post later, and perhaps get lost in the underground tunnels. Catch you all later!

LiL A

Empathy and the Practice of Medicine

I am reading a book from the Gerald Tucker library at National Jewish, and this book has been really eye-opening. I am reading a chapter a day, and today's chapter (Chapter 9: The Empathic Physician) talked about how empathy is no longer taught in medical schools or practiced in medicine. I can see this rampant in today's medical practices, and it saddens me to know that doctors are no longer taught to take care of the whole patient. Often, they relegate the duties of caring for the patient's emotional needs to the nurse, but they never actually think about giving empathy to their patients themselves. As a patient, there have been times that what I needed most from my physician was a sense of understanding, a sense of empathy, and I couldn't get that. When they turned their backs on that need, it only served to make me angry and spiteful at the doctor.

My anger was, perhaps, a little misdirected. I didn't understand the position that physicians and other healthcare workers are put into by major corporations and large hospitals until recently. One of the volunteer positions I'm being offered requires me to help patients go from one area of the hospital to another area in time for their appointments. While this is fine and good and I would love to do it, personal relationships and getting to know the patient is discouraged, and it made me wonder if the physicians and nurses are held to that same standard, both at National Jewish and elsewhere. The thing that must be understood is that it is not possible to give high quality, individualized care to patients without somewhat hearing their stories (history) and being exposed to who they are and to their beliefs, culture, values and emotions at least a little bit. When we try to isolate ourselves from the patient by distancing ourselves from the patient as a person, care becomes mechanical and impersonal. The person becomes one more body to throw drugs into, one more story to be lost among the crowd, and when they die, one more body in the morgue. They aren't viewed as people who changed others' lives, who influenced others to be better people. They aren't someone who brought smiles to dying peoples' faces, who brought laughter to children who would be otherwise hurting and sad. They had a physical presence on this earth, but nothing more. That is how patients are being portrayed among physicians.

I am confident that there are patients that can teach physicians huge lessons about life and their profession, they just need to keep their eyes and hearts open to the change that will take place. Caring for someone, whether medically or physically, is a personal deed. Getting to know that person, their fears, dreams, desires and way of life may improve care significantly; only if the "big guns" would see and acknowledge it. Healthcare workers have the power to change someone's world and the community they serve only if they are allowed to do so. People are not machines, we have emotional needs as well as physical needs and those emotional needs have to be met as well. As a healthcare worker, you take care of the patient holistically, which means the psychological aspect of it shouldn't be tossed along the wayside.

Psychology and medicine are inextricably linked, as can be seen by the disorders that are caused by psychological issues (ie psychosomatic illnesses). When one has a psychological disorder, it can affect the person physically as well, as can be demonstrated through the presence of bodily aches and fatigue related to depression. On top of it, psychology is taking on the appearance of medicine more and more every day. So why are we tossing psychology by the wayside in the care of patients? I can only suggest that physicians assume that others will bear this role, such as family and friends. This may be true in many cases, but what about the times where the patient doesn't have family or friends to take on this role, or where these people have no clue where to start in this role? This might be where the healthcare worker steps in, however, it can't be done when they are constrained by the big wigs to not get personal with their patients. This needs to change, and it will change when we have empathic doctors and nurses in the power of authority. Until then, people who do not understand the benefit of close physician/nurse-patient relationships will be dictating to us how healthcare workers are to give their care and will remain out of touch with what is needed and best for the patient.

The book I'm reading also says that there are a lot of people working in the sciences, while behavioral sciences are often understaffed. This is inexcusable. I believe that this is communicating the belief that people do not have an emotional, inner aspect to them or, if acknowledged, this inner person has little to no value in medicine. This is preposterous, as even science has proven that attitude and other psychological can affect the chances of becoming ill and recovery from those illnesses. If the inner person has no value, why are many hospitals changing to cater to the patient's desires and needs? Why are they spending so much on making the patient happy? It is because of this power that psychology can have on healing. We place so much emphasis on patient satisfaction, but we forget a part of making the patient satisfied is listening to them and showing empathy to them. With what restrictions are in place currently, there is no way that empathy can be openly practiced, it is something that is what I would term "black market medical practice," where when it is given, it is done under the radar of those higher up. Yet, this empathy improves the relationship that the physician has with the patient and therefore the care.

The inner person shouldn't be tossed at the wayside, which is why it's important for empathy to be encouraged to among medical students. Often, as the book states, this is done with clinical exposure early in the education of new doctors. It is said that some of the most empathic doctors come from Isreal, and why is this? It is because medical schools in Israel, rather than discouraging a relationship between the physician and the patient as well as the demonstration of empathy from the physician, they encourage these things in their students. When empathy and a relationship are encouraged rather than discouraged, medicine becomes more individualized than the one-size-fits-all kind of care that is too often practiced and encouraged in medical schools and hospitals around the world.

As A Diamond

All of my life I have been told by people that I couldn’t do something. My mother told me that, though I would go to college at the Christian university that I’m currently attending, that I would drop out after a few years, overburdened by finances and not able to make ends meet. I have completed my second year and I am going on to complete my third year and am going for my BSN. While I know that this may speak volumes about my determination, it also speaks volumes about those who “support” you, yet beat you down, that they may not really support you at all.

I have learned a lot in the last two years, as these two years have been some of the most formative years in my life. In ending contact with my mother during my freshman year in college, I became independent of her, physically, financially, and emotionally. I also learned about healthy boundaries in my life, of which she was crossing on a nearly daily basis. My eyes were opened to the abusive nature that some people may take, and I vowed to never make the mistake of getting involved with someone that was abusive ever again, even if it was with a family member.

Some of the hardest lessons to learn are those that require one to submit to a higher authority. The situations that I have gone through has forced me to trust in and believe in God, as that is the only way that I have gotten through these situations without wanting to take my life (that and the community was very supportive of me). There were many times that I wanted to do things my way, but I discovered later that my way wasn’t always the best. For example, my mother took a credit card of mine and maxed it out on a bankruptcy attorney and stopped paying it when I ended contact with her. It went to collections and I received the backlash from it. Trying to correct the problem was more burdensome, as people did not believe that this could ever happen. The cops told me to take it civil (as if a college student who owed the college $1000+ at the time had any means of paying a retainer for an attorney to sue her Schizophrenic mother) and the bank refused to do anything about it, even insulting me and making me feel terrible. Numerous conversations and two police reports later, I lost hope and gave up. I began to believe that I would have to drop out of college, as the bills were mounting up and there was no way for me to get a student loan because my mother really did a trick on me. I was beginning to fall into the pit of despair, but I also wanted to put my mom through more suffering than she did with me (I wanted to arrest her and have her tried for Forgery, which would have ended her Food Stamp benefits and would have kept her from getting a job, in essence leaving her homeless). Then my dad suggested something radical: to contact the news stations about my story. I did so, believing that my story would be tossed by the wayside and that no one wanted to help me. I would be just one more person, forgotten and wandering the streets alone, unloved and uncared for. However, one did pick it up and contacted Wells Fargo. Within a few days of sending out my story, the debt was absolved and to be taken off my credit report. I would finally be free of this burden that my mom tossed on me, just to get even and to spite me and I didn't have to ruin her life because she didn't ruin mine.

I have been met with much more adversity than this, but through it all, I have discovered that you need to believe. Believe that things will get better because they will. Believe that you are loved because you are. Believe that you aren’t alone because there are others that are going through something similar to what you are going through. Granted, it was very difficult at times and I wanted to throw in the towel and become a hermit more times than I can count, I can say from experience that sticking it through the rough times has been the best decision I have made in my life. It has allowed me to begin to see things from both sides of the story rather than just my selfish side or the side of someone I was close to. It has also formed who I am today, and has changed me from a shy, quietly bitter, selfish and frankly very childish girl to an outspoken, open, selfless, and mature woman. As a diamond is formed under intense heat and pressure, so am I. So instead of viewing these times of hardship with spite and hatred, I embrace and accept them. I wouldn’t trade them for anything, and I hope that you can learn the same in your life as well.