Wednesday, July 22, 2015

Letters to a Young First Year

Welcome Class of 2021!  You are about to embark on a most wonderful adventure.  You have worked so very hard to get to this moment and I hope in the midst of the craziness of orientation you find a moment to appreciate all you have accomplished, all you have sacrificed. I would also like to wish you a hearty congratulations. You have just acquired 109 new brothers and sisters—oh the birthdays you’ll have to keep track of! I know you’re all very busy assembling your new IKEA furniture so I’ll keep it short, here is a list of everything I know about success in medical school

1. For better or for worse (mostly better) you are now family. Treat each other as such. Show love and patience when it is difficult to do so. Respond to texts and emails even though you’re tired, post helpful resources, bake cookies, don’t park your bike like an asshole (and wear a helmet—your brain just became exponentially more valuable).

2. Medical school is a beast. You’ll need a good team by your side to get through it. Think of who your people are (you know the one’s you would call to help move a dead body). Not to be uncouth, but soon you will find you actually really need help moving a dead body in anatomy lab. You’ll also need people to talk to, to cook for you occasionally, drink with you, exercise with you, remind you to shower and vent/cry/whine to. Make sure your people know how very much they mean to you and that your victories in med school will be theirs too.

3. Take every piece of advice you are given with a grain of salt. Mostly people have your best interests at heart, and just want to tell you about stuff that worked for them. What was right for someone else may not be right for you. Ask lots of different people how they studied, what resources they liked, how they felt about classes and how they managed their time. Pick and choose what you like best and what you feel like helps you the most. Also…know that the library and several other indoor spaces are ironically and planet-destroyingly really cold right now. Come prepared with a sweatshirt, blanket, parka, snow shoes and snacks.

4. Numbers are not real. I think every math teacher I ever had is now sorely disappointed in me—but this is a helpful concept to keep in mind. Those loans you just took out—imaginary money which only exists on paper in the office of some boring stiff working at the Federal Reserve. You have too many important things to do, like loving others to worry about how much debt you have. And no…you can’t pay back your loans by donating a kidney to the financial aid office—trust me I asked. The number that you see when you submit your very first quiz (and let’s be honest every exam from here on) will send your heart plummeting to the pits of your omentum. These numbers are also of very little consequence. You are not how many you missed, you are not how many you got right and you are especially not how many you got right compared to anyone else. You are you, not a number, not a statistic. What you have to offer is worth more than any value could ever contain.

5. Help will always be given at UC Davis to those who ask for it (I actually said this in my interview. I guess it worked because I got in—I mean who can resist a good Harry Potter quote). Seriously though, all you need to do is ask. Dr. B will meet with you as many times as you like for anatomy, life advice or tips on growing a beard. Second years will give you their two cents—whether you ask for it or not. OSLER or Netflix, CAPS or coffee, its all right here, and its all for you.

6. Sleep. Get some. Arianna Huffington of the Huffington Post extols the virtures of sleep to her employees. Showing up sleep deprived is like showing up drunk. Getting enough rest will help you learn better, perform better on quizzes and be less of a grouch to be around. When we sleep, we win. And no...checking email on your phone while laying in bed does not count as sleeping. 

7. Crying. Someone told me that if you don’t have at least one melt down a block then you’re not showing up. Not totally sure that I think there’s a hard and fast rule to that one. But know that’s it okay to feel whatever emotions come to you—and in turn give others permission to do the same. I’m British, so we have no emotions, soul or tear ducts. But its hard when you see bad things happen to people, you’re tired and stressed and pushed to the limit and then you watch a Hallmark commercial or a video of our Armed Forces returning home--- and Lord Jesus why is it raining indoors? Also fyi, they do this small group talk prior to anatomy lab about death and dying. I may or may not have sobbed through the entire thing.

8. Eating. Not only is eating important—its one of my favorite past times. Eating keeps you alive and gives you the energy you need to function. Ice cream is also a cure for most every ailment—except lactose intolerance. There will be free food. If you see food out in the lounge, just remember to use your best judgment. I ate salsa that had been sitting out for over a week last year—good thing my immune system is made of steel. There will be free pizza, every day, all the time. Use caution. Medical school was not kind to my waistline (can I get an amen second years). Eat vegetables. Buy them with your imaginary loan money. You can’t put a price on being healthy. Also we are going to be telling our patients to eat right—so try to walk the walk (and jog the jog) and stuff. 

9. Dance it out (pants optional). Sometimes you just need a dance party. Sometimes that dance party is in Med Ed at 2am. Sometimes its when you’re alone in your room with a hairbrush microphone. TSwift has some sick beats and life is too short and too full of joy not to dance. So go on…get down with your bad selves.

10. Life is nothing but a series of experiences in which we learn more about ourselves. God, that was deep. What I mean to say, is find your voice here. If you love something, keep doing it. Or find new things to love. Writing is great—you don’t have to show it to anyone if you don't want to. Join a SIG, go rock climbing, just promise me you’ll put the books down once in a while okay?

And that’s it. That’s all I know about medical school and basically life in general too. For more Harry Potter quotes, wry humor and vicious rhetoric follow my blog! I try to write every week for your procrastination pleasure-- I'm not like a regular mom, I'm a cool mom. You can get to know us-- the Class of 2018 better at the link below.

Welcome to the best 4 years of your life. Make yourself at home, drinks are in the fridge.


Sunday, July 19, 2015

Reform and Unrest

Greetings Gentle Reader, 
In so very many ways my blog has helped me deal with the challenges of life, med school and things I just can’t understand. Sometimes what I write is fluffy and dumb—of no real consequence. Sometimes I may overdo it with a metaphor or two—but it makes me feel better nonetheless. But the posts that have meant the most to me—and incidentally the ones that have been most widely read are those that say something important.

Its scary to say the things that matter—especially on the internet. I don’t like conflict. I want to say things that everyone agrees with. The problem with that is I end up saying nothing at all. I also think its important not to write about things one knows nothing about, so this week I am grateful to my dear friend for his words and his honesty, (because he has a real adult job on main campus he has asked me not to use his name here.)

I think his post is particularly well timed following a certain set of doctoring lectures that were the topic of much conversation. Speaking up is hard. Listening, harder still.

And with that I give you this week’s post,


Reform and Unrest
by Anonymous 

Speaking up is hard. I work at UC Davis (the big campus not the medical center) and the work I do centers around supporting and advocating for educational equity, and working to create spaces for marginalized communities to have their voices heard and to have a say in how we do education. It’s hard for me to speak up sometimes. I’m younger, and a product of the very institution I am now critiquing and challenging. I hope be the Chancellor one day. I’ll change everything. But this post isn’t really about me. I want to talk about the undergrad students I work with and how awesome and brave they are. I hope that this sparks a thought or two around the intersections between how we “do” health care in the United States, and what reform really means. In my opinion (and isn’t that what blogs are all about) how we educate and care for those in the margins of our society reflects our true nature as a society. And what we do needs some changing, because we aren’t doing too great right now.  Let me also say I recognize that I am coming into this not sharing a ton about myself, my background, or how I have come to think about things the way I do. That’s just how this is going to be!  I am a guy with some thoughts who is focusing right now on what other folks should be doing. I recognize that, and the privilege anonymity carries.

Between November 2014 and June 2015 our campus was buzzing with the kinetic energy of student activism and unrest.  A lot of controversial things happened over that span of time both nationally and in our own community. The murder of black and brown men at the hands of police… the fight for marriage equality… cultural appropriation… pro-life preachers… the list goes on and on. Many students were rightfully upset about these things, and as folks with the privilege of education and access to resources that the majority of the United States does not have, they recognized their obligation to take action.

I am so incredibly proud of students who have taken a stand when they have encountered injustice on our campus and in our society. Whether I agree or disagree with a group’s stance or viewpoint, the bravery it takes to make your voice heard is empowering. In my two years at UC Davis, we’ve dealt with “themed parties”, where students have dressed up in clothing that mocks communities that are already oppressed and marginalized in the United States. There have been protests between pro-life groups and pro-choice groups on campus that have cut to the core of people’s faith and beliefs. Students have marched in the streets to protest tuition hikes and LGBTQIA rights, and have advocated for the needs of Native American and Chicano students in higher education. Our universities are a microcosm of our society, and if these brave activities are any indication of where our society is headed, I have faith that our students have the courage to fight to make sure all voices are heard and valued.

OK future doctors, in a couple years, you’re going to be some pretty influential people (who are we kidding, you’re pretty important now). You will hold the actual lives of real people in your hands, and the decisions you make will shape peoples futures. You have an obligation to do right by these people. Your patients will be rich and they will be poor. Some will not speak English. Some will look down on you and some will see you as their only hope. Each patient has lived a full, substantive, real life, and has somehow ended up in front of you. They are not statistics, trends, problems, or nuisances. They are you ad you’re really busy, I get it.

So I imagine sometimes it’s hard to focus on that stuff. You’re taking lots of classes, and learning words and concepts that I’ll never understand. And you’re probably not eating well, working out much, or sleeping either. But you are going to be a doctor someday! Think about that. You have an opportunity to really change things. And it begins now. While you’re filling your brain full of facts and numbers, use this time to also develop opinions about things related to how we do medicine. How we care for our poor and our voiceless. How you choose to care, every single day. This can be your activism. You do not need to “die in” to make a point. You don’t need to send tweets or donate $10 to Red Cross on Facebook (or write blog posts). You do not need to march, or occupy buildings either. While these are very important acts of civil disobedience, they are for the powerless (you can not rebuild a country with the tools of the master.) But I firmly believe that true activism for those with access and privilege (read, future doctors) begins with how you choose to live your life, and do what you do. And then, you need to challenge others.

I imagine sitting in a classroom with an old man doctor telling you things he believes to be fact can be intimidating and scary and controversial, but if you believe he is wrong, say something. You will inspire others, and you will be doing more than any thing you’re going to accomplish with a student organization. You will be interrupting the narrative. Even if you say something that others disagree with (and invariably you will, remember, no one is neutral), discourse is valid, necessary, and important. That’s how you grow. I am a firm believer in listening to others to understand before refuting. But refute you must. The longer you stay silent, the more the system wins. Silence = oppression. You have an opportunity to make change. And then, you need to give back. Make yourself good, help make your peers and educators better, and then enrich and invest in your community, and your field. Make medicine welcoming to women. Inspire poor kids to become doctors. You’re one person, but if everyone who reads this invests their time in inspiring some people to go into medicine as a profession who have never thought of it as a space where they belong, well, then we’ve got something. And do this regardless of your background.

I sometimes wonder if I would care so much if I weren’t a brown man growing up in the US. But what I have come to realize is that true social justice is working for equity for all people, with the understanding that a socially just society is what’s best for everyone. I need to stand up for women, for the LGBTQIA community, for adopted folks those who are differently-abled…  anyone who has been pushed to the side and told they are not enough, not worthy of dignity. I need to actively care, love, and support these people, every day. That’s something I am 100% in control of, and that I believe is right. I can be an activist every day.

And this also means loving and supporting those who want to be allies, but are still figuring out how to do that (Hint: if you’re not part of the group being oppressed, the most powerful thing you can do –in my opinion- is listen to the narratives of those who are silenced. And if you’re part of the group that’s in power in our society, talk to others like yourself. They’ll hear you in a way that they may never hear those whose voices have been marginalized.)

I saw a photo on social media of a white person holding up a sign that said “#alllivesmatter.” Their caption said something along the lines of “Oh you know out here just doing my part to FIGHT FOR JUSTICE.” Now, this bothered me for a variety of reasons that I won’t get into here. But underneath that photo was a comment from a person I’ll never meet that summed up everything I wanted to say to the person in the photo. It has stuck with me as I continue to think about how I can support all students during such troubling times. “Yes, they all do. But right now we’re focused on the black and brown ones, because they’re under attack. Thank you for being present.”

The free expression of thoughts and ideas are at the heart of education, and no single person can be the arbiter of what’s right and what’s wrong. Universities (and yes, medical schools too) are responsible for providing a space for students to explore and challenge what they are learning in the classroom, while also engaging in critical debates about the important and controversial issues happening every day around us. Through these experiences, we will create more dynamic and socially conscious thinkers. Thinkers who will plant seeds for reform, deconstruct hierarchies, and rebuild us into a society that will care and nurture those lives that are at risk. Thinkers that I hope you all aspire to become.

Saturday, July 11, 2015

Happy and you know it

Do we learn anything from being happy? The pursuit of happiness I would say is where the lessons are learned, where life is the most real and meanings most deeply understood. But actually being happy, although blissful—is easy. It doesn’t require the hardships and struggles or the insight that it takes to get there. I am not anti-happiness, rather pro-happy-awareness.

As an avid film watcher (and studying avoider) the best films—both documentaries and dramas alike-- are where the conflicts and struggles are the most acute. It is these plot lines that make things interesting, where I see the most growth of the characters and where we learn and imagine how to handle similar situations in our own lives.

In an episode of Modern Family, the oldest daughter has to write her college admissions essay. Having lived a comfortable middle class life (and being a sitcom character) she laments that she cannot write it as she has never experienced struggle or hardship. So her mom leaves her at the side of the road 10 miles from home and let’s her find her way back—just so she has something to write about. While fitting with the humor and fluff consistent of a television show, the episode brings up an important point. If we find ourselves in harmonious sitcom bliss—should we go searching for struggle?

Happiness is not motivational. In fact studies have shown that having it too easy in life is actually harmful. Teens who are very popular in high school don’t tend to do as well in adult life as their less popular counterparts. Children of very wealthy parents also don’t tend to achieve as much of their own success in life. Is this because they’ve had too much of a good thing?

When you imagine happiness, what do you see? Right now I imagine mojitos on a patio. Oh—and a car with working air conditioning would be okay by me too. But I’m guessing happiness is actually a little more complicated and tenuous than we know. And I’d bet that by pursing it, we find it. Oh the irony.

If you’re like most of us and don’t always find yourself in harmonious union with every aspect of life, what are you going to do about it? Study until your eyes bleed? Work out? Drink a box of wine a night?

We humans have such an incredible drive to continually alter our circumstance. Frustration, sadness, fear, anxiety lead us to action. Sometimes self destructive actions, and sometimes to the opportunity for us to show the world what we are really made of. Which one you choose is up to you.

Use your frustration, your anger, your fear, your sadness to your benefit. That's what those feelings are there for. Stress, worry, anxiety keeps us working, keeps us moving forward like happiness never could.

I don’t wish a life of uphill battles for you. But I do wish that you are never completely satisfied, so that you keep pushing, keep moving forward, keep wanting. I wish you joy—but also sadness, so you may know and cherish the good times better. I wish you success, but also failure, so you can know how truly great your accomplishments are. And I wish you peace of mind, tempered by worry, so you may better know how rare it is that any of us are here at all. Out of all of the things that can go terribly wrong in life, here you are, reading this, you amazing miracle you. 

Think about what you wrote in your personal statement for med school. I bet you wrote honestly about your life. And I bet the most interesting parts were when things weren’t all sunshine and lollipops. Hardships make us. How boring would it be if we were always happy? We would have so little to talk about. No substance. No way of relating to people. No drive to work hard to achieve the important things, or to strive to improve our communities or ourselves.

Happiness is nice. But it must be earned to be truly appreciated. From the worry lines across your forehead, to the scars no one can see, to the heaviness in your heart, embrace your struggle, your conflict. Let it motivate you as much as it scares you. And when you feel joy, embrace it too, for it was hard fought.