October in Review

October in review, for all of the things that I’ve wanted to say this month but haven’t had the time or energy to channel them out into the world wide web.

Maybe it’s better this way. I’m not sure. I’m still trying to figure out how to keep this blog going while in medical school.

October was a challenging month. It started with the end of the neuro block, 8-weeks of grueling coursework in the nervous system. With all of our exams on Monday mornings, it makes it really challenging to take a guilt-free weekend off from studying. By the time we got to the end of neuro I was tired and beaten down, but we picked ourselves back up to start the GI tract the next day. The rest of October passed in a blur of brown-tinged jokes and complaints of abdominal pain. What causes diarrhea you ask? It feels like a million things.

My patience was tested. My focus was tested. My ability to find that elusive balance was tested.

On October 1st, I saw a beating heart. In a human body.

On October 1st, I got the opportunity to shadow a cardiothoracic surgeon while he did an open repair of someone’s ascending aorta. Those are basically all fancy words for the tube that comes off of your heart and sends blood to all of the different organs in your body. It’s pretty important that it is strong and sturdy, but sometimes they become stretched too thin and that’s when we worry about them breaking. So, this surgeon went in and replaced a piece of this man’s aorta with a manufactured tube. It was incredible and exhilarating and humbling, all at the same time. I was also terrified of the possibility of tripping and falling onto the patient the whole surgery. My mantra for the day, “do not fall, do not fall”.

On October 8th, we finished neuro and promptly ate our weight in Denver Biscuit Company.

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On October 10th, it snowed.

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On October 12th, my friends and I went to the ballet, Sleeping Beauty. We put on our fancy dresses, I put on some new lipstick and we pretended to not be medical students for one night. Which was actually pretty difficult because we went to the ballet with the CU School of Medicine Alumni Association… Also, I may or may not have rested my eyes during the first act.

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On October 27th, my 2011 MacBook Pro was considered to be a “vintage machine”. I don’t think they understand what the word “vintage” means, but I bought a new computer anyways.

I had been thinking this month about some of the things I was thankful for because my cousin Katie was running a series on her blog about resistance and gratitude. I sent her 5 things, but I left out one. I’m really thankful for student loans because without them I wouldn’t be able to get through medical school. So, while I have to pay them back eventually, at this moment in time I am able to focus on becoming the best doctor I can be, while not having to worry about where my next meal, rent check or gas money will come from. Because of student loans, I can purchase a new computer. This is a privilege.

All through October, we studied a lot, making tables and graphs of the diseases of the GI tract, and having a little bit of fun along the way. Now here we are, on the edge of November.

This month I was challenged to be faithful; to trust in what is coming and what I cannot yet see. To trust that this hard work will pay off and that the season will change. I am encouraged.

How has October been for you?

 

 

Keep Going

We’ve been on a road of neurons and the connections their axons make. A road filled with the cranial nerves, stroke consequences, brain tumors, and psychiatric disorders.

Everything brain.

A rhythmic pulse of a beating heart.

A rise and fall of expanding lungs.

Tears of joy, ecstasy, sorrow.

A decision to choose. To say yes or no.

These are all things brain. The axons are highways and side roads that traverse through our bodies. They cross in predictable places and they carry predictable information. They are critically important, yet fragile all the same. Learning the mystery of the brain has been both rich and exhausting, and if you’ll have me, then I’d like to tell you a story.

It starts with a man and is a story of resilience in the face of hopelessness.

Resilience is the ability to spring back, to adapt to change, to grow out of the dust of defeat and to keep going when everything else around you is yelling for you to get down. 


This man came to us as part of our psychiatry course. This is how it works:

  • The school puts out a call for volunteers to be interviewed by students.
  • A volunteer shows up on the prescribed day and enters a room full of 8 medical students and two facilitators, 1 psychiatrist, and 1 psychologist.
  • The volunteer is asked questions about their experiences with Depression, Anxiety, Psychosis, Autism Spectrum Disorder, PTSD, Substance Use to name a few examples.
  • After the volunteer leaves, we discuss their stories as a group with our facilitators.

This man, he entered the room, carrying a cup of coffee and wearing a hat with the words “Resist”. His wide eyes sagged like he hadn’t been sleeping well and he told us a story of assault, depression, and anxiety. This story had twists and turns, frustrations and sorrow. He told us that he attempted suicide, twice. Sleeping two hours a night gave him the dark circles under his eyes and panic grabs hold when he thinks about what his life will be like when his loved ones are gone.

As I listened to him share his story I felt sadness and despair. I thought to myself that this man knows what it’s like to be pushed down and told not to get back up.

When I asked him, “What motivates you to choose to continue living?”, he said my family, my grandchildren. He said, today my depression doesn’t feel that bad. Today is not as dark as yesterday. This man picks himself up and he chooses to brush the dirt out of his scrapes to try again. As I was reflecting on his story and our interview with him I thought to myself, if he can keep going then so should I.

Sometimes I forget how lucky I am to be given the opportunity to be in medical school. Lately, when I feel defeated and beaten down by the number of things there are to learn and the amount of time I have to learn them, I try to remind myself of all the people that are anxiously waiting to hear about an interview. I try to remind myself of the privilege that I am given because, one day, I am going to be a doctor. In moments of doubt and uncertainty, I try to remind myself if he can keep going then so should I.

So, we build resilience. Every time we fall, stand up, rub the dirt out of our scrapes and try again.

“The phoenix must burn to emerge” – Janet Fitch

A Story

Once a month, at the Swallow Hill Music Hall in Denver there is a gathering of people. To listen to strangers share their fears, accomplishments, comedy, sadness, and adventure. It’s beautiful to watch someone walk up on stage, brave enough to speak out loud some of the most vulnerable details of their lives. This is the Moth story slam.

10 stories. Five minutes. Three judging teams. One slide whistle. One winner and a theme.

I’ve been to the Moth a few times now and listened to people share narratives about love, dirt, collaboration, and control. You never know where the evening will end up. You might find yourself in a backyard while a man gains the trust of a wild dog, or with a couple as they race down a mountain trail while lightning strikes all around them. Each one unique and captivating.

In Bob Goff’s latest book, Everybody Always, he talks about the power of extravagant love and excessive grace. It makes me a little sad because when I look around, I see that we have too little of this. We have too little compassion and empathy for one another.

It’s all about ourselves; how can we be better, how can we make more money, how can we climb the ladder a little higher. We are so tired from the constant focus on self-improvement that somehow we don’t even have enough grace for ourselves.

In medical school, we talk a lot about becoming compassionate and empathic doctors. We have communications sessions where we “practice” talking to patients. These are supposed to help us refine our language to include open-ended questions, to demonstrate empathy, and to learn to listen to the patient’s concerns, think of how all their symptoms come together and know what comes next. I struggle with this a little bit because we can practice saying the words, “that must have been difficult for you” instead of “I’m sorry”, but as much as we practice, it won’t help us be authentic when we find ourselves in a patient room. In order to do that, we need to pull from within our own experiences of hardship or loss, celebration or joy.

This is where our stories come in, as they shape our identities and our actions. They allow us to relate to one another, to stretch our minds to consider another person’s point of view, and to be true to our hearts when we speak.

There’s something so powerful in the words “Me Too”. They say I hear you, I see you, and I know you. In “Me Too” there is an overflow of extravagant love and an abundance of grace, but we can’t get there is we don’t know our own stories first.