RIP

So I thought my next post would be about food again. But sometimes things in life happen when you don't expect them.

Today I was reminded of my own mortality from the death of my husband's friend. She was in her mid-20s, in school, healthy, and the last person you'd expect to find out passed away.

Our lives are ephemeral. I am young, fit, and healthy--the probability game says yep, things are going to be fine for a while. And they most likely will be. But walking across the street, going taking the short cut home, or just not taking care of yourself and getting sick can just erase you from this world.

I went running today, and had a serious over-production of saliva, so I spit into the Charles from the bridge above. I could see it fall into the river, and stay there, then diffuse over about 30 seconds, and I thought it was very pretty. I got home and found out a friend had passed away, and oddly I thought of the spit.

We are here for a short while, probably 60-70 years, but who knows? My goal is to make sure I'm happy for those days, as many of them as I can. I cannot view my life as on hold simply because I'm in school, or I'm busy, or anything. Life has started, life is now, and I can't ever get that back.

I hope that she will rest in peace, that she had happy thoughts, and happy moments. That she loved and lived. She reminded me to live my life, and I hope hers was fan-fucking-tastic. RIP.

For the Sake of Truth Part 4: Krugman-style

So I had a post idea all set, and then I read the NYTimes, and Paul Krugman says it way better. 

If you don't want to read the article, here's the gist: 

1. Many on the conservative side are now trying to appeal to the logic that yes, President Obama did something good (didn't defund FEMA for one thing), but if he gets re-elected, do you think he'll be able to get anything done in this bipartisan congress? No. 

2. So based on that, you should vote for Romney! Because if dear Mittens takes office, well, the democrats are much more reasonable than the extremist Republicans in congress and wouldn't...you know, go through debt ceiling crisis round 2: how-crazy-can-we-get edition. But, the Republicans would be willing to work with President R. 

3. Also, do you really think he's going to be that extreme when he gets into office? Defunding Planned Parenthood? Giving FEMA "back to the states"....no silly! That's just what he says to get elected. What's he's going to do is totally different. Yeah, right. 

This isn't written with my typical poise, probably because I just got done studying for an exam and the poise fell out of my head when I shoved the hypogastric nerves in, but it's all true. And it doesn't make any sense. If you agree with Romney, vote for him (although I truly wish that you just sleep through election day), but don't go for the the "holding America hostage" argument--it's ridiculous and frankly embarrassing. 

For the Sake of Truth, Part 3: People Do Die from Lack of Insurance

Previously known as On the Offensive...I've been posting these on facebook, but decided to switch it over to my blog.

Fact:  On Wednesday October 10th, Mitt Romney said that people don't die from lack of health insurance.

"We don't have people that become ill, who die in their apartment because they don't have insurance. We don't have a setting across this country where if you don't have insurance, we just say to you, 'Tough luck, you're going to die when you have your heart attack.' No, you go to the hospital, you get treated, you get care, and it's paid for, either by charity, the government or by the hospital."

Fact: Absolutely correct. As a future physician, I am not going to turn a person away from medical care they need. So yes, if you show up to a hospital ER, you will get treatment.

Will it be preventative? By definition, no.

Will it be long-term? Be definition, "emergency," no. 

Will it be expensive? Yes. Not everyone that comes into the ER can pay their bills. That cost gets shifted on to the other patients by raising costs on their insurance companies (hence why a Tylenol pill costs $7 at the hospital). In turn, the insurance companies raise premiums on their customers. 

Fact: People do die because of lack of health insurance. If you have insurance, you are more likely to go to a doctor, to catch illnesses ahead of time, to treat them before it becomes out of control. Think: heart disease, diabetes...diseases that are prevalent in communities that are a part of poor communities that usually do not have health insurance. Tell them that not having health insurance does not lead to death, and a painful death.

Opinion: Gov. Romeny goes around saying people need to have "personal responsibility" for their actions. I agree, but do we punish someone so severely by taking away the quality of their life if they make the silly mistake of not purchasing health insurance, or worse, not being able to afford health insurance? No. We are a first world country. We are socially advanced. We are a nation that takes care of each other, especially when others can't take care of themselves. 

His comments are a hallmark of an individual who has not had any experience with or even taken the time to reflect on the condition of people who don't have health insurance. It's really hard to imagine it unless you really, really try, or see it and experience it first or second-hand. This is not an individual who should be making policy. 

Opinion Why does not expanding insurance matter as much to him? Because the people who need it the most are the 47% that are not important Americans to him--they will not vote for him anyways. 

Educate yourself before you vote. 

Articles: 

Death by Ideology -- Paul Krugman, NYTimes

A Possibly Fatal Mistake, Nicholas Kristof, NYTimes

Romney: People Don't Die From Lack of Insurance, NPR

Dill Butter and Salad Dressing

It's been a while blog, it's been a while. Apparently medical school is just as time-consuming as everybody made it out to be--shocker! Well, I was a little. I was surprised by how quickly the day goes by, how I will how generally choose studying over everything else, and how quickly time moves.

It's amazing...I've been in medical school for nearly 2 months and now (as of 10 minutes ago) taken an exam in every core subject that I have. It's a bit crazy to think about. I think I've been pretty good at maintaining my stress level, but this weekend threw me for a loop. It was weird, I lashed out at people I love more than I normally would, which made me feel terrible, which made me not happy, which made me study more furiously, which made me not want to study period.

It's a vicious cycle I tell you, vicious. But a learning experience nonetheless. It was important for me to once again realize that medical school was not life, it's just medical school. Yes, it's stressful, yeah, it's a lot of things to learn, but it's not the number one most important thing in the world.

However, my mental health, which largely depends on the happiness of those I love and my own sanity, is the most important thing in the world.

It's only going to get harder from this, so learning to stay calm, not lash out at those closest to me, and realizing again that hey, other people have stuff happening in their lives too. Whether it's objectively as hard as what I am doing doesn't matter, it's stuff, and it's important, because it's their stuff. So this is my note to myself to get over myself, and keep that calm that I've spent years, years, building. After all, it's just school.

Now...a recipe! So I've recently become a little enamored with dill. I use it in salad dressing, mix it into butter (courtesy of some great dill butter sandwiches from Sonali), mix it with olive oil, lemon, salt, and pepper to make a pasta sauce...basically in anything.

But I don't have a ton of time to cook unfortunately, so my new obsession is the EarthBound Herb Puree. Sounds odd, but it's amazing, and it lasts a LONG time. Try it, and you'll love it--it'll jazz up any regular old salad dressing, oh hey, like the one below.

Dill Dressing

0.25 cup olive oil
2 tbsp. lemon juice
1 tsp. minced garlic
A squeeze of the dill puree (about 1 tbsp)
Salt and pepper to taste

**Optional: a splash of heavy cream or a small spoonful of sour cream or non-flavored yogurt to make it creamy**

Which all these things together and in a small bowl, and drizzle on top of salad, pasta, bread, or just use it to marinade veggies! 

What Teach for America Gave Me

I meant to write this all summer. In fact, I meant to write this before I left San Antonio, Texas--my Teach for America home for 2 years after college. But for some reason, I just never did until I happened to see this article on the NYTimes setting up the debate about the effectiveness of TFA.

When I joined Teach for America in 2010 in the San Antonio Charter Corps, I knew I would be leaving for medical school in 2 years. I knew that TFA was notoriously difficult because of the high expectations placed on its corps members and the situation they were placed in.

Coming right out of college, wide-eyed and idealistic, it's a bit of a shock to go into a classroom prepared to pull a "Stand and Deliver" moment, only to be completely unsure of what to do when a student starts yelling racial slurs across the room, and another picks up a chair looking to throw it.

But how could I enter the world of medicine, saying I wanted to effect a change in health policy and work with the underserved population, when my experiences were primarily in volunteering? I did Teach for America because I knew it would give me perspective on the social, economic, cultural, and academic impacts of American poverty. In return, I could provide 2 years of my dedicated, unrelenting effort to my students as a science teacher.

I was provided about 6 weeks of in-class training, and then training throughout the school year about being at teacher. Most people, especially those who did semester or year long in-class training, gawk at that. How can you possible learn to drive an effective classroom in that amount of time? The answer is simple: you can't. I didn't, and I doubt anyone does. But what it gave me was a template of how to prepare lesson plans, focus on academic achievement, and set high standards for my students. More importantly, it slapped the wide-eyed innocence right out of me. It showed me what I would have to do, gave me the tools on how to handle it, and sent me off--trembling from excitement and a healthy dose of fear of failure.

But that's why Teach For America has a rigorous selection process. It's not all a numbers game: it's about leadership. After all -- what are you if not the leader, commander, and director of your classroom? Though it is not fool proof, it does effectively recruit people who are goal-driven, hard workers and will not give up at the first, second, third, or fourteenth failure.

I gave everything I could to my students over the 2 years that I worked for San Antonio Independent School District. I promised them I would teach them Biology, and I did. I promised them I would get them above and beyond passing the state Biology exam, and for most, I did. I promised them I would never give up on them, and I didn't. People often ask me if I feel that I made an actual impact on my students' lives--and I'm honestly not sure. I can tell you that there are students that will never remember, and students that will always remember me. I can tell that I had the opportunity to work with children to take them from knowing very little about Biology, to being conversational in basic Biology by the end of the year. I can tell them that I made students feel, and therefore be, smart. But a lasting impact? Only time will tell.

But my time with them gave me more. From an educational standpoint, TFA has made an education advocate out of me for life. I have internalized the impact that schools can have on students even when communities and families are struggling. I understand what it is like to be a teacher in an over-crowded underfunded classroom. And I know now what it's like to want to help your students so badly, but face a seemingly insurmountable sociocultural and political barriers. Education is no longer the great equalizer in our country, I see that clearer than ever, and I will work to ensure that changes.

From a medical standpoint, starting my future-physician career, I am more aware of how the world works. I can not only identify the socioeconomic determinants of health and health care delivery, but I have seen and internalized them. Two years gave me the time and experience to look at my school community broadly and learn why my students and their families make some of the choices they do, both helpful and harmful. I believe it has given me the beginnings of insight into what could be implementable and effective in these communities to better health outcomes. Or I could be wrong, but at the very least it has fueled my desire to learn more and push my career in medicine towards community health care and closing our health outcomes gap.

Do I think Teach for America is the answer to our educational woes? No, it's a very big band-aid on the wound that is our bleeding education system. I never took TFA for the answer--but rather a program that will push people who normally wouldn't be interested in education (either because of the extraordinarily low pay or the lack of respect the profession can engenders, or both) and change that,  making them more aware of the problem. TFA alums, no matter where we go, either staying in education or moving on to a different career, will always have our students and our experience in the back of our minds, consciously or subconsciously influencing our actions.

So back to my main point--what TFA has given me. It's given me a direction. A direction I was tentatively leaning towards after college, but now am barreling towards in medical school. A direction I can only hope will be worth the high monetary investment in my teacher training and classroom, and will help to shape the communities I was privileged enough to work in for 2 years. 

Medical School Starts With White

So it's been a while. Mostly because in the past few weeks after getting back from Paris, we've been running around like chickens with our heads just barely still attached.

We ran to IKEA, bought all of our furniture, built all of said furniture, dealt with an IKEA delivery mishap (they forgot to deliver one piece of furniture), unpacked all of our stuff, went on a trip to Hawaii (awesome!), came back, painted the apartment, cooked food for a month to feed us, went to Acadia (awesome!), came back, finished unpacking, and oh yeah...started medical school.

Ziplining in Kauai

A morning swim. Tyler and Adele. 

Our jam-packed apartment! 

My dad and I picked blueberries in Maine!

Hiking in Acadia

Surreal

Typical

More Hiking!

Love and a red hat :-)

My lovely sister in law and her frog

After a life time of dreams, moments of wavering fears, and still completely unsure of what's to come, I am now a medical student. Not a pre-med. Not a doctor. A medical student. A physician-in-training, as one of our professors put it.

One of the major events that most medical students in the US all experience is the "White Coat Ceremony." At the beginning of your medical school career (or in some cases, later) you are given a white coat by your school, signifying that you are now on the path to becoming a physician. Our coats are shorter than the actual doctor's coats, with a plastic name tag that we pin to our pockets, but they were significant none the less.

Cotton, slightly larger than expected, and white, they represented the culmination of the work we had all done to get to this place. The studying, the activism, the caring, the growth and maturation as individuals. But more importantly, the coat was humbling.

It's amazing that a piece of clothing humble you, but I should have known putting on a white coat would. I realized, or rather re-realized, that in a few short years, after my brain has been jammed packed with more information that I thought possible, people will be opening up their world to me. The life, the secrets, the illness, the pain, the happiness--all of it wrapped up into one person for me to care for. I became suddenly and uncomfortably aware of my ignorance. There is much to learn in the next four years, both in terms of the science and the humanity of medicine, before I really can touch my first patient. It is scary. But I am thankful for that time to learn, thankful for the support and guidance, and thankful I have seen my family go before me and do it well. I am not afraid.

So the white coat ceremony is done, my white coat is neatly put away, waiting to be taken out for my Introduction to Clinical Medicine class where I take my first steps talking to patients. Classes have started, and my time is spent primarily on concepts of Biochemistry and, soon, Anatomy. But every once in a while, when I open my closet and see my coat, and I get that tingly feeling of excitement for the day it becomes just a bit longer. 

Politics on vacation

Unsurprisingly, I have been avoiding writing about politics much on vacation. I have read about it, rolled my eyes at it, became over joyed by it, but definitely did not write about it. Why? Because I am in Paris. But there are things happening abound that must needs be discussed.

 

1. Justice Roberts restored some of my faith in the Supreme Court. He shook his fist at judicial activism and instead, a month before the decision was to be rendered, told his good friends Antonin, Clarence, and Anthony that they were going to be ridin' solo on this decision, since he wasn't going to allow petty partisianship to affect the decision that he, the Cheif Justice of the highest judicial body in all the land, would make. While I am a bit disheartened at just how happy I am that a conservative justice put the constitution above politics, I can rest easy knowing that America is on it's way to becoming a more morally correct country.

To those who oppose it: we will all use the health care system at least once in our lives. To ensure that our system can actually remain solvent, we must compel everyone to purchase health insurance, prior to actually being sick. This way, we can reduce the number of emergency-room-and-not-gonna-pay visits, allow for physicians to actually provide preventative health care to all (including the underserved population) while knowing that they're going to get paid, push our system to become more efficient and evidence-based, all the while increasing the health outcomes of our nation. More than that though--more people will be able to save money on their premiums, which will help overall. To those who think we should let people without insurance die on the side of the road: I hope a pigeon craps on your head.

 

2. Mitt Romney saying people should get as much education as they can afford. I completely agree with the sentiment--you're trying to say that people strive for higher education and spend their money on that. That being said, your idea of what people can "afford" is a bit skewed Mr. MoneyBags. Not everyone collects $200 dollars when they pass go. Most students and their families cannot "afford" to pay for any real higher education, that's why we have these things called grants and loans. As for your suggestion that people join the military and the government will cover the cost of your education--this is definitely not a feasible option for all those students in our country that cannot afford a higher education, nor is it ideal for all.

Also, the concept of, "if you're willing to serve, we can help you" as he puts it baffles me because increasing our rate of higher education IS serving--the more highly educated individual we have, the more economic output they can produce, the happier the general population will be. Either way, this further underscores my concern that Mr. Romney's childhood and subsequent life bathed in wealth has pushed him far out of touch with the "common man." So much so that the small bouts of volunteer work or interactions with the masses cannot mend the gaping hole in his understanding of the life the common folk. A man like this cannot be the President of the 99%.