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.

How it Went

I got the volunteer position, but that doesn't end there. I want to talk about the experience and perhaps give a little insight to those who are interviewing for positions in the future.

So I showed up about 10 minutes early, having have spent an hour and a half in the medical library reading a book on empathy in medicine that grabbed my attention from the first word. Anyways, I rang the bell and waited expectantly for a short while before before being led back by the volunteer coordinator to her office. On her desk was a folder and some papers. I was offered something to drink and the interview began.

At first I was incredibly nervous and excited and this would have impeded any chance I would have of communicating anything about myself to her. However, as time went on, the interview felt more like a conversation, and we talked about many aspects of the healthcare field. I eventually told her my philosophy of medicine, and she totally agreed with it and said that it was something very wise and intelligent. Eventually, she commented that I would do well in my field, and taking the complement, I gratefully thanked her. This interview showed that I went above and beyond, because I had only visited a few times beforehand (enough to find the library and begin reading a book that drew my interest), but it showed that I had above average knowledge about the place and healthcare in general. This greatly impressed my interviewer.

I want to devote the last half of this to giving a few tips on interviewing for those who desire to get into the medical field (can be applied to other fields as well) after they have the education.

1) Remain calm. There are a million thoughts going through your mind right before the interview, but being overly nervous will only make you forget what you want to say as soon as you enter the room to be interviewed. While being somewhat nervous is a good thing, not having control over your nerves can show and turn employers or other interviewers off to you. Walk into the room confident, and walk out of the room even more so.

2) Be genuine. There is nothing more irritating to employers than someone who is faking just to get the position. It is obvious when someone is saying something that means nothing to them, yet they are passing it off as a "truth" that they "believe" in. Not only is it saying that you are not comfortable with yourself, it is also giving the employer the impression that you are not an honest person, and what employer wants to knowing hire a dishonest person? Not only that, but by lying and playing things off, you are only setting yourself up for failure. You want a job that you can do well in that plays to your strengths and interests. Playing things off will only make it possible for you to get the job, but you may end up hating the job later on. Being genuine can help you and the employer decide if you would be a nice fit for the position. If you aren't, then move on. There are many jobs in the healthcare field, so there will most likely be one that you will enjoy and is a right fit for you, you just have to spend time looking for it.

3) Try to make it more of a conversation. This can sometimes be hard if the person isn't much of a talker, but other times, it may be relatively easy. In a conversation, it is easier to be open with what you believe, therefore the employer will get a glimpse into more of the true person, rather than the one being played off. However, one still needs to reserve a fair amount of professionalism. This is not a conversation about who did what, so gossip has no place in this kind of conversation. However, your insight into the position you are looking into may help, as it may show that you have a knowledge of the role you will play in your job, which may impress your interviewer. Also, a little research is needing to be done. Show that you are committed to the place you want to work at by looking up information about it and perhaps even visiting it a few times. Make sure that you have your facts straight before going in, though, as nothing is more embarrassing than walking into an interview with facts that are not precise and being corrected by your interviewer. Having questions about the position and its benefits will also help, but don't make it sound like money is all that you are after. After all, the patient/customer is first and making them happy and treating them right is the #1 priority (I would say treating them right is above making them happy because sometimes what is right and will be beneficial to the patient will not always make them happy, and what will make them happy is not beneficial-sometimes in medicine you will have to sacrifice popularity in order for the patient to benefit the most from your care).

4) Silence is golden. As humans, we hate silence, especially in this world where we are constantly being bombarded with noise. However, constant noise is not always good, as silence can help to bring peace to the heart and mind. The same can be said in interviews. It is fine to not talk for a minute or two to gather your thoughts. In fact, it is recommended, as it makes you look more intelligent because you are not bumbling, making obscene noises while searching for the words you want to say. So allow some silence, but don't allow it to become a long, drawn-out silence, as that is only awkward.

5) Talking too fast or saying too much or using complex vocabulary is a turn off. You may be talking to people in your field, you may not be. You don't always know the experience or the credentials of who you will be interviewed by, so this is not a good time to talk about current concepts in medicine, because the people interviewing you may have little to no insight into this topic. While it is good to show a bit of what you know, make sure that you don't ramble on and on and make sure that you can link it to how knowing it makes you better suited for the job at hand. Also, make sure you pace your speech, because it is hard to follow a chipmunk-on-coffee talker. If they don't understand what you are saying, they will most likely not hire you as a result.

6) Rehearse what you want to say beforehand. This is important so that you have a gist of what you want to say. While we don't know what questions will be asked by our interviewer, it might be beneficial to have a few of the answers to some common interview questions at hand. However, what proves most useful is knowing how my skills and knowledge that you bring will benefit the company. This requires no rote memorization and doesn't gamble on chance like practicing answers to typical interview questions does. Overall, what do I know and how can I apply it to the job?

7) Talk from the heart, don't cater to what they want to hear. When you talk from what you believe (without allowing yourself to be tinged with anger or resentment), it is easier to remember when you come in for the interview. This goes back to being genuine as well. Don't just tell them what you think they want to hear, as the same probably has been done by nearly everyone applying for the same position. Tell them something unique about you and how your unique self can contribute greatly to the company. This will go much further than fabricated answers based off what you believe they want to hear.

8) Know what is appropriate and when it's appropriate. This can be a killer in an interview. You don't talk about health advances during an interview for a job at Target, just like you don't talk about the products at Target when interviewing for your Nursing job. Keep the information you present relevant to the position and to the company. Don't go into long rants about your personal problems, as this communicates that you have problems with people and would have problems working there or that you are a negative person and will bring down your coworkers. Defamatory, insulting language and swear words have no place in an interview, as using these show that you do not respect other people and possibly authority as well. Who wants to hire someone who will not submit to the leadership of another and who will fight and insult and use dirty language whenever possible? Using this language will kill any possibility of getting the job, as it shows that you do not have the professionalism required to do the job.

9) Dress for success. While people can get away with wearing jeans if they have the right words to say, dressing for your interview will help you significantly in getting the job. Dressing in a painter's shirt and jeans was only individualistic before Will Smith did the same on "The Pursuit of Happyness", now it is viewed as being unprofessional and is frowned upon. For upper end (doctor, psychologist, professor, etc) and executive jobs, a suit for either sex may be required, but for lower end jobs (nurse, fast food worker, secretary, etc), one can get away with a nice shirt and nice pants that aren't jeans. Make sure that you are well-groomed, have showered, and choose to wear clothes that are clean. Nothing turns more employers off (and turns their stomachs) than someone who smells like they have just walked out of a sewer and looks like they are clean off the street, begging for money. If you do wear aftershave or perfume, make sure that it isn't something overwhelmingly strong. As for makeup, choose something that is more natural, and not something that looks like you are ready to go out on the town tonight, looking for the next single to hook up with. Don't overdue makeup, jewelry, or the good-smelling sweets, as it can hurt your chances at getting the job.

10) Reward yourself after for a job well-done. When done with the interview, go reward yourself afterward for a job well-done, even if you don't get the job. Give yourself a positive self-talk, not one where you beat yourself down. This will help boost your confidence for other interviews in the future. Also by rewarding yourself and not punishing yourself, you are actually training yourself to do better on interviews. So, go ahead, plunge into that ice cream. After all, you deserve it!

Interview and Nerves

I have an interview for a volunteer position at National Jewish today, and my nerves are starting to get on edge. My stomach is starting to tumble and I my cooped up energy is starting to mount. I don't know what to expect, but I want to be able to get a few things across:

1) I am not volunteering for vain selfishness. While I may be volunteering partially to gain access of their library and for possible help in the future with a few of my expenses for college, I am not doing it mostly for these selfish gains. It is about the patient and the visitor first, and I will strive to do my best to serve these people the best I can and to provide for their wants and needs within reason.

2) I cannot say who I will be six months from now. I hope that this will not end up being a killer to getting the position. When I say this, I am not saying that I will not be someone that is a bad person six months from now. What I am saying is that I have discovered that it is best for me to constantly learn from experiences and people, and to never close myself off to these kinds of experiences. They can come in the things we least expect when we least expect it, so we should have the wisdom to see this and take advantage of this. I have changed a lot from who I was 6 months ago, and I will continue to change as I get older, wiser and a bit more humble.

3) I have been handed adversity from every angle, yet I have overcome it and use it to my advantage. This is a really easy one for me, as it seems like I have some sort of adversity every single year. Just recently, it was treating my ever-present knee pain from my Chondromalacia Patellae. I have finished 3 months of physical therapy, and my malaligned patellas are in good shape, but they weren't that way before physical therapy. The only problem I have now is pain, which can be pretty bad at times, and I am relegated to taking pain relievers when things flare up. Even in this, I keep the patient and those that I serve first and refuse to take anything that would detract from giving my full attention to those that I am serving. On top of it, the many other adversities have shaped who I am and have helped me learn important lessons that I am passing on to others, who are both older and younger than me. I want to be able to demonstrate and put into practice what I have learned every day in the way that I serve people, and I want to eventually pass this on to the staff as well.

4) One must constantly learn and adapt in their position to do well. I couldn't say anything truer. Things must be changed and new strategies must be employed for me to do my job well. On top of that, I should have knowledge into a broad range of topics, and I should be open to new suggestions from other people. I should try new things and only toss them by the wayside if they either don't work or aren't right for me or the people that I serve. I also must be willing to find out new things as new situations arise, and I should use this knowledge that I gain in the future, as there will most likely be a situation that will require this knowledge again in the near future.

5) The best attitudes to take with visitors, patients and staff alike is one of humility and empathy. I don't know how many times I have seen physicians not practice these attitudes and end up in deep trouble, whether they cause a sense of distrust in their patients or whether they say or do something stupid, insensitive, or unwarranted. An attitude of humility and empathy can go a long ways in building trust and a relationship between the patient and the physician or nurse. I know this full well and want to take advantage of this. I care for others very deeply and feel for them when they are hurting and confused, both emotionally and physically. It is my job to make them feel better, and empathy will keep me from becoming another burdensome nurse/doctor/person to them. I want to say, "I care," through my actions and my words. However, I must have the humility and wisdom to realize when I am not doing this and when I need to change. I also need the wisdom to say when I am wrong and to ask people for forgiveness, and I also need the humility to know when there is nothing more that needs to be done or that can be done and to be open in communicating this to people. "I know not," or "I cannot do more," are two really scary sayings among medical settings, but they are two sayings that require great humility that should be admired rather than disdained by the patient.

6) I serve people, not anything else, so I must employ empathy for those people that I serve. I need to remember that, as either a volunteer, nurse, or physician, it is people that I serve and nothing else. When I forget humanity, I forget the very reason why I care for people, and I might as well go out and watch a bunch of goats all day. People have their own testimonies, a collection of emotional and physical scars that makes them unique, and I need to respect these stories (and perhaps listen to them if I have the time and the ability). I have seen physicians treat their patients in a very impersonal manner, almost as if they were just another cadaver to examine and cut open. This costs them dearly, as trust and communication may be broken due to the condescending attitude that these physicians employ towards their patients.

I'm feeling better now that I have these things written down. I might just decide to print it out so that I have some of my thoughts down on paper for this interview. To think that I will have more interviews like this, but more intense, nerve-racking and with more on the line, is pretty humbling. For now, I am off to interview for a volunteer position. Wish me the best!

Reflection on My Earlier College Years

Many people have their addictions. Some are addicted to TV, others to narcotics, and the list goes on and on. I guess my preverbial addiction is to writing. I crave writing like food, and I like the release that writing can have on me. It’s almost like I open gate to let my dreams, beliefs, feelings, and knowledge run wild as I press the keys.

I was never like this, never an extravagant writer. In fact, I hated writing, despised it as a supertaster would despise bitter foods. This hatred for writing was bred after I had taken the SAT tests in high school. Feeling confident I would do well, I wrote on the topic assigned to my heart’s content. When I got the scores back, my heart sank. I had bombed on the writing portion of the SAT’s and I convinced myself that a baboon could write better than I could. I swore that I would never write extravagantly again, never put effort into my writing. After all, I would give them a reason to give me low scores on the SAT.

Luckily, this only lasted the last few years of high school and my first semester in college. The way I wrote papers seemed like a first grade student was at the laptop, typing about his favorite pet. “My dog ran. My dog peed on the bush. My dog killed the bush. My dog got punished. My dog got angry. My dog ate the carpet. My parents killed my dog,” is only an example of how I wrote most of the time. I wouldn’t get much more creative or vary my sentence structure more than that. This changed when I came to Colorado Christian University.

I was in a class called Research Writing and we had to write a 20-page paper for the final product. What subject would I choose? I had many things that I wanted to write on, but I knew that I didn’t have the ability to write well unless it was a topic that I could throw myself into and could lose myself in. Difficulties with my mom made the decision final: I would research on the benefits of forgiveness, as I saw unwillingness to forgive as a nasty trait that a lot of people possessed.

The best topics are those topics that shape you while you are doing research on them, and will continue to shape you even after you have turned the final paper in. While researching, I thought about myself and the real reason that I was writing. Wasn’t I not willing to forgive? Due to this, am I not a hypocrite? If I am, why should anyone listen to me? I had the intent to throw this paper in my parents’ faces and say, “Grow the heck up!” I’m glad I didn’t, because it took a lot of spite on my part to be able to write such a paper as this. Had I actually shown the final product to my parents, I would be in a very different position than I am in now. The final bound product is sitting among my boxed items, waiting to be read by my parents. The time isn’t ripe for it, as it needs more editing and I still have more to experience in life before I have the strength to be able to tell them about this.

I read the paper every now and then, and have made a few corrections. It is opinionated, yes, but it is the truth. Littered throughout the pages are instances where I have perceived I have been wronged, glimpses into my life. They are the emotional scars that I bear and the things that I don’t think about day-to-day. I have added to and taken away ever since I first wrote it, but the fact remains constant: I place a lot of value in forgiveness. This paper has molded me and shaped me, as the people who know me best can attest to. It has also influenced me to write about topics that I love and those that I feel strongly about, even though academia may place me lower on the totem pole. If you read it, read it with care and an open mind, as the facts presented in it are pretty revealing and the experiences laden with emotion. After all, I wish it to change people’s lives and attitudes towards each other when they interact with each other.

http://www.4shared.com/file/bGjvqAhB/The_Power_of_Forgiveness_in_Di.html

When communication is broken, the quality of care is diminished

I like to write, but I never thought that my writing would be good enough to be published. That is until now.

This is a piece that I wrote as a guest writer on KevinMD, a blog for physicians.

I have been in and out of the doctor’s office ever since I was little, and I have had my share of good and bad experiences during this time.

These experiences can shape the expectations of both the physician and the patient, in both negative and positive ways. While the perfect relationship between physician and patient is unattainable, I believe that there are several things that both patients and physicians should keep in mind when diagnosing and treating a condition.

Physicians: Patients are not as knowledgeable as you may think, and sometimes things need to be explained in such a way that they understand. This should be offered to those who want it or seem frustrated from a lack of guidance from past physicians. While it is up to the patient to seek out care, it is up to the physician to explain and provide the care needed. Also, adversarial care has its own downsides. While it may protect you from being sued for malpractice, if it is allowed to taint your attitude toward the patient, it may break down the lines of communication and the sense of trust the patient has for you.

Patients may decide to withhold important information in fear of chastisement or judgment from their physician. Patients do not like being told they are wrong. Don’t we all? So rather than continually pointing out their flaws all the time, physicians should encourage them in things that they are doing right in addition to providing insight into things they are doing wrong. Additionally, sometimes the best thing that physicians can give to patients, and even their families, is empathy, as empathy will break down walls between the physician and patient and promote a sense of honesty in the patient. Not only this, but sometimes it is better to honestly say that you do not have answers and offer a referral than to think that you have the answers and finding out, after a long list of tests later, that you do not have the answers that you thought you had. Admitting this demonstrates that you are willing to be honest and that you are willing to find someone who might be able to help.

Patients: While physicians know a lot, they do not know everything, and “I don’t know” can sometimes be the only answer that they can give. Medicine is an ever-changing subject, and what people in the medical field do not know now may end up being discovered later. Patience is something that patients need to keep in mind. Yes, you can get your burger and fries in a few minutes, but you will not be able to find an immediate cure to the medical conditions that you have. It will take time to find it, as each person is different and will react differently to medications and results of procedures and tests will be different for different people at different times. A test today can be negative, but three months later you may have very different results. In addition to patience, patients need to realize that communication is key. No one can read minds, so it is also up to you as the patient to talk with your doctor to ensure you are getting the quality care that you desire. It is up to the doctor to provide quality care, however it is also up to the patient to seek the kind of care that they want.

Overall, there is not just one party that we can point fingers at when it comes to the lack of quality care (besides governmental and insurance reimbursement issues, which is another issue that I can write loads about). The patient-physician relationship is one in which both parties must both talk and listen. When one party is discouraged from communicating or refuses to do so, the line of communication is broken, and the quality of care is diminished. That is why both parties need to conscious about how they interact with and about each other, both inside and outside the clinic. Only then can we help to improve healthcare, one small step at a time.

Here is the website URL if you are a skeptic and don't believe me.

http://www.kevinmd.com/blog/2011/06/communication-broken-quality-care-diminished.html#comment-168212

Also, I have edited it a little because the language was a bit repetitive and rough now that I read through it a second, third and plus time. This post is not the same exact post word for word.