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Empty your mind

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Submission by: Douglas O’Connell, OMS III

Lens, Camera, Taking Photos, Photography, Focus
Image accessed from: https://pixabay.com/photos/lens-camera-taking-photos-3046269/

We’re in the constant noise of the 21st century.

There is so much around us and so much to take in.

We see vibrant ads pop up on our computer screens or out our windows. We hear our neighbor’s tasteless music.

We are badgered by the incessant alerts on our smart phones all while craving just one more dopamine hit.

I ask you. I urge you.

Find your focus.

Right now, I’m constantly thinking about all the things I have to do.

There’s definitely an email or two I’ve forgotten to send, and I’ve put off a paper to write day after day. There are notes to write and patients to see. There are things to read and presentations to prepare for.

Dinner? Dishes? Also, my room is a complete mess. As things pile up outside, we forget they pile up inside as well. Everything takes it toll.

I ask you. I urge you. Find your focus.

Some people get lost in a world of imagination.

Others breathe deeply and hum or become a downward dog and sometimes practically resemble a pretzel.

I’ve even seen people sew or knit for hours on end. I’ve even witnessed people telling themselves they want to go someplace else, and then proceed to get there fast, on their own two feet.

Occasionally, people take a stick and hit a small ball into a faraway hole.

I ask you. I urge you. Find your focus.

It could be a goal. It could be a simple task. It’s your way to get away.

Your way to escape the hustle and bustle of your surroundings and the world.

It’s your way to leave the ads, alerts, papers, patients, dinner, dishes, and messes behind.

It’s your passion.

It’s about discovering clarity and breaking free from the chains of your mind. Even if it’s just for a few minutes.

Sudoku? Do it. Everyday. A mountain? Climb it.

I ask you.

I urge you.

Find your focus.

Let us know what YOU do to empty your mind and focus on the NOW

A Letter of Gratitude

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Submission by: David Sobel, MD

Image accessed from: https://www.flickr.com/photos/36767313@N00/29681183870

I have been reflecting of late on the many teachers and mentors who I am grateful for. I have taken to recontacting (by phone or letter) some of these special and generous people. 

Here is a letter I wrote to one of them. It shows how even a brief “teaching moment” can have valuable impact throughout a career.

Make each moment,

each encounter (with students, patients, and colleagues)

count. 

Dear XXX,

This is a letter of thanks and gratitude that I have been meaning to write for several decades.

This story is about my encounter with you one night while I was on call as an intern and you were the attending physician. It is very likely that you have no recollection of this brief encounter but it was one that, as it turns out, had a great impact on my life and career.

Let me explain. One night as an intern on call at PMC I admitted a patient with a GI bleed. We called the attending to come in to consult that night, and it happened to be you. You came in and after hearing the history of the patient, you turned to me and said, “What would you do to manage the patient?” I replied that I would summon the gastroenterologist on call and get their advice on management.

You replied, “What if I were not here, what would you do?” I was somewhat taken back by this, and responded, I would call another gastroenterologist. “Well,” you said. “I want you to analyze the situation and give it your best shot. What would you do? I won’t let you harm a patient with over or under treatment, but I really want you to think through the problem as though I was not here. And, I don’t care if I have to stay all night while we figure this out.”

I was stunned. Most attending physicians and teachers wanted to swoop in, demonstrate how much they knew, impress the interns, and get back home as quickly as possible. You were different. You created a safe environment in which no patient would be harmed. But you wanted me to grow-up as a physician and think through decisions in advance of asking for help. Your insight and generosity as a teacher has stuck with me for many years. I cannot tell you how many times I have shared this story with others as an example of effective teaching.

I have applied what I learned that night to my interactions with patients. I have found that my questions can be more powerful than answers. I have often found it more effective to elicit patient-generated solutions by asking “What do you think might help or work for you?” rather than flooding them with advice.

Similarly, when managing co-workers I will often ask them, “If I were not here, what would you recommend doing or deciding?” I have found this often builds their competence, confidence and leadership ability.

So you see, your night of teaching me at PMC has had happy repercussions throughout my career and I am very grateful to you.

I do hope you are thriving!

Your “student,”

David Sobel, MD

Teacher

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Submission By: La Donna R. Porter, MD

St. Joseph’s Medical Center, Stockton CA, Family Medicine Residency Program Director

clipart of the apple teacher

Image accessed from: https://pixy.org/4390466/

My inspiration for this poem was truly my love for teaching Family Medicine Residents and medical students.

However, I realized that my passion for teaching was also due in part to the Family Medicine Faculty, Residents, Specialists, Nurses, Hospital Staff and last but not least the patients I care for, ALL of whom were instrumental in training me.

I have become, in many ways, the Physician and Teacher I am because of them. 

Teacher

Teacher, teacher what can I say 

You chose me to stretch beyond any normal boring day 

With thoughts of scalpels and sutures and retractors swimming around in my head 

You chose me for a different journey than that for which I had been led 

To what do I owe you 

Can you or will you ever know 

How much you have done for me there is so much to say 

How much I have learned each and every day 

Oh teacher, teacher what am I to do 

When this beautiful journey ends 

I will most certainly miss you 

How can I say it, where will I begin 

But as a sorority, of which I am a member for life 

You too are with me forever 

I cannot tell you how much I went through to meet you 

As much as I can, I will leave you never 

Here I am teaching those as you have taught me 

The biopsychosocial model swims lovingly in my head 

Differential diagnoses are where the learners are led 

In this journey planned out for me, more incredible discovery 

So now that I have told you all that you need to know 

How much I truly have grown because you have loved me so 

Thank you for stretching me beyond where I thought that I could never go 

An incredible teacher I have become, to you I know I owe 

Teacher, teacher what can I say 

Thank you Family Medicine  

For training and raising me  

In your amazing way

La Donna R. Porter, MD

AWE

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Submission by: Kwabena Adubofour, MD

Could your life be more awesome? The scientific study of AWE is relatively new; the Greater Good Science Center’s director, Dacher Keltner (UC Berkeley), has been one of its pioneers. Already studies have linked it to better health and increased generosity, and researchers are zeroing in on how to cultivate more of it in our everyday lives.

What is an Awe Walk?
“An awe walk is a walk within a place of meaning and beauty, where your sole task is to encounter something that amazes and transcends, be it big or small. I look for awe walks during my work day, with my family at night, and in rural and urban settings. And on very fortunate days I get to do awe walks, in a places like Muir Woods National Monument.”
Learn more about Awe Walks here https://www.mindful.org/awewalk/

“Awe is the experience we have when we encounter things that are vast and large and that transcend our current understanding of the world.“

Overlooked Being a Woman in Medicine

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Submission by: Sukhpreet Janda, OMSIII

Women In Medicine Month: Podcast Spotlight
Image from: http://blog.pepid.com/2019/09/05/women-in-medicine-month-podcast-spotlight/

When I’m at the library talking to my female peers, the conversation frequently comes up that we are not recognized in medicine. When someone asks what I’m pursing and I reply “medicine”, the next question is,

“No, like a doctor. I’m in medical school.”

“Oh, like for nurses right?”

At this point, I tend to give up and just say okay. But this conversation has happened more than a couple times, and for many of my female peers, it’s a similar story. Even on rotations, I can see how sometimes I am treated more like the student whose job it is to go fetch things and console crying children while the male students get taught medicine. What’s sad is when female residents and attendings acknowledge this is happening and say they have had to face it as well.

Here’s a quote from Marianne Williamson’s book, A Woman’s Worth to further illustrate how I and many women in the field of medicine feel on a daily basis:

“…the more of us who understand the game and see through the lie and forge ahead in support of every other woman’s right to a passionate response to life, the more we will hasten the end of our jail term. Women have been imprisoned for ages, and in our cells, our hearts, we have carried our true feelings like sleeping children, our spiritual issuance, our love. The prison walls are melting. We’re almost out. And when we fly free, we will carry with us such gifts to the outside world. Our gifts haven’t atrophied; they have grown in power. They have been waiting for centuries, and so have we.

Let’s keep our eyes on the sky. They’ll throw tomatoes; they’ll lie about us and try to discredit us. When we rise, they’ll try to undermine us. But when they do, we’ll remember the truth and bless our enemies and find strength in God. The regime of oppression is almost over; its life force is waning, and only its ghost remains. Don’t tarry too long to mourn its effects; celebrate and rejoice in the new. The past is over. Wipe the dirt off your feet.”
― Marianne Williamson, A Woman’s Worth

Marianne Williamson’s poem really emphasizes standing together, embracing your qualities, and moving forward to prove your worth.

So yes, I am a woman in medicine, studying to be a doctor. I am compassionate, caring, take the time to listen, can console many crying children (which parents and other patients sure appreciate during the visit), anticipate what my patients need and have that ready, sense my patients’ insecurities and fears and address these in a nonjudgmental and caring way, ALL while being their doctor and working with them to provide the best care possible.

Message: Our Deepest Fear – Imposter Syndrome & How to Get Out of the Cycle

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Submission by: Sukhpreet Janda, OMSIII

The term imposter syndrome has come to seem like the perfect definition of me. Rotations, as amazing and rewarding as they have been, bring forth feelings of insecurity and self-doubt more than I had ever imagined. Sometimes I don’t even know if I am capable of being a doctor. Getting the pimp questions wrong, pronouncing procedure names incorrectly, and just plain making a fool of myself in front of the residents and attendings makes it seem like I learned nothing in the past three years correctly.

While deep down I know these feelings do not define me or my ability to practice medicine, it can be hard to overcome them and move forward. I first read this poem in high school, and it has stuck with me since. This poem helps me overcome the fear associated with imposter syndrome. I’ve been told by countless peers, friends, and family, that I sell myself short. Most of this is out of fear, as the poem below illustrates. If we do not address imposter syndrome, we start to limit ourselves in applying to residences, promotions, and most of all, providing the best care for out patients. If I am not confident in myself, how will I provide the best care and empathy for my patients, why would they listen to someone who seems frightened all the time? Our fears are as Marianne Williamson says below:

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”

Reciting this poem during rotations, and sharing it with other students, residents, and attendings has helped more than just me. It has taught us all to acknowledge the fear and self-doubt, and create strategies to make ourselves stronger from that. Here’s some strategies I’ve used throughout the year to help:

  • Collect all your positive memories and experiences in some way, shape, or form.
    For me, this has been through pictures, notes from patients and colleagues, and writings. When I feel down, I look back at all the people’s lives I’ve had some sort of impact in. It really helps lift your mood and strive to provide better care and impact more patients positively.
  • Have a support system ready.
    For me, this has been my friends. We studied for 4 years together. We know each other’s strengths and weaknesses very well. When a stressful or doubtful situation arises, you can rest assured that I will call my best friend ASAP and talk about how I’m feeling. And it doesn’t take but 5-10 minutes for him to remind me why I’m here and reinforce all the positive aspects I bring to medicine.
  • Tell yourself, many many times, QUESTIONS aren’t BAD!
    This is a big one for me. I feel that if I ask a question, I’ll just sound dumb because everyone probably knows the answer already. Don’t every feel like that! When you truly don’t understand something, just ask. You will learn a lot more overall and you would be surprised how much it helps when you later go in to speak to your patients. You develop a better understanding and can engage your patients on a much deeper level.
  • Sit and talk to your patients.
    It can sometimes be annoying, okay really annoying, when your attending only assigns you 1-2 patients THE WHOLE DAY. You think, seriously, what I am going to learn from 1-2 patients. I want to see more, learn more. While we cannot always change this, we can make the most out of the opportunity. What I learned is, when I have free time after rounds and when I just don’t feel like studying, I go check up on my patients. I sit with them and just listen to them talk. Sometimes it’s about their illness, sometimes their grandkids, sometimes its how bad hospital food is and how good mom’s cooking really is, sometimes its keeping them company during hemodialysis. It seems like nothing to us, but for our patients, it means the WORLD. Seriously. They light up when you sit and talk to them. And you learn about their lives, which can help understand their condition more too.

We have worked hard to get here. We are in a demanding and difficult profession. But do not forget, we are healers. It may seem like we have little impact now, but we are on the road to making a place in the hearts of many. Keep going strong, take off that imposter mask and be your true compassionate self!

Meditations by Marcus Aurelius

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Submission by: David Go, OMSIII

“When you wake up in the morning, tell yourself: The people I deal with today will be meddling, ungrateful, arrogant, dishonest, jealous, and surly. They are like this because they can’t tell good from evil. But I have seen the beauty of good, and the ugliness of evil, and have recognized that the wrongdoer has a nature related to my own… not of the same blood or birth, but the same mind, and possessing a share of the divine. And so none of them can hurt me. No one can implicate me in ugliness. Nor can I feel angry at my relative, or hate him. We were born to work together like feet, hands, and eyes, like the two rows of teeth, upper and lower. To obstruct each other is unnatural. To feel anger at someone, to turn your back on him: these are obstructions.”

Marcus Aurelius (Meditations)

I chose this quote for daily dose of humanities to remind us that there will be some difficult patients that we will encounter as physicians, but we must remain composed. We cannot let our frustrations compromise our level of care and compassion. Instead, try to understand why is it that the patient is frustrated. Sometimes listening and being present with the patient provides healing on its own. Patient health especially those with chronic disease is only achieved when patient’s trust their doctor and work together as a team to achieve the goal.