“My two rules of mandible fractures: 1. The patient usually deserved it. 2. Mandible fracture repairs are never fun.”

 — Trauma ENT surgeon. NB: Mandible fracture patients’ HPI’s usually include fist fights, most likely under influence.

“The doctors, it seemed, never really had enough time for all the patients, try as they might. And over the course of six months, I would corner them in the hallway and ask them a sort of naive, but fundamental question. If you had unlimited resources, what’s the one thing you would give your patients? And I heard the same story again and again, a story we’ve heard hundreds of times since then… ‘Child has an ear infection. I prescribe antibiotics, but the real issue is there’s no food at home. The real issue is that child is living with 12 other people in a two-bedroom apartment, and I don’t even ask about those issues because there’s nothing I can do. I have 13 minutes with each patient. Patients are piling up in the clinic waiting room. I have no idea where the nearest food pantry is, and I don’t even have any help.’”

 — Rebecca Onie talking about a program she started, Health Leads, that trains college students to help patients find ways to get food, heating, water - basic living requirements allowing doctors at partner institutions (my hospital is one of them!) to give such “prescriptions.”

This is a real problem - as I have seen personally rotating in Baltimore hospitals and clinics. I’m so glad there are programs like these out there. I hope it expands to include many other institutions and/or other people are inspired to do something similar for their hospitals/clinics.

But I would also argue that something else a doctor always wishes he/she could give more of to their patients is time. I’m sure Rebecca Onie also got that answer when she asked her naive, fundamental question to those doctors.

“One of the things that I keep going back to over and over again is how do we sensitize clinicians to the patient’s cultural worlds so that we can better understand what’s normal for them and what’s abnormal for them, because only once we’ve done that can we then start to tailor our treatments plans to help our patients in the ways they need in order to lead the lives they want.”

 — Asian American Mental Health - YouTube project from 4th year psychiatry resident at Columbia

“You don’t train someone for all of those years of medical school and residency, particularly people who want to help others optimize their physical and psychological health, and then have them run a claims-processing operation for insurance companies.”

 — Malcolm Gladwell, from Forbes’ "Tell People What it’s Really Like to be a Physician"

It was really hard picking one section to quote because I loved almost every line of this article. <3 Malcolm Gladwell. Is he married?? Lol, joking.

On applying to elective opportunities like global health

I really found this inspiring. I love that she found motivation from her grandma. Go grandmas!

I’ll be honest- I didn’t think I had a smidgen of a chance of becoming a Global Health Corps fellow. I had two reactions upon reading the position descriptions and mission statement of GHC. 1) Unprecedented excitement. I knew this was the opportunity I had been looking for, the next step in my career and the chance to actually apply my college education and internship experience into the real world of public health – basically my dream. The combination of fieldwork and professional development, but with an emphasis on fostering a community of leaders dedicated to achieving global health equity, seemed almost too good to be true. This led to thought number 2) Self-doubt. Although on paper I felt qualified for the position I was interested in, and I definitely had the passion and commitment GHC was looking for, I lacked confidence in my ability to persuade the GHC and mothers2mothers teams that I could be the one. Intimidated is an understatement for how I felt while perusing the GHC website. I didn’t have a Masters degree, wasn’t a doctor treating thousands of people on my own, and hadn’t established an NGO at the age of 18. Was I good enough to be one of those smiling faces? Nah, definitely not. Yet, I couldn’t get GHC off my mind. I had to at least make an attempt.

I will admit that I am the Queen of procrastination. I couldn’t bring myself to actually sit down and complete the application. I had the essay topics written on napkins that I tacked over my bed, hoping that I’d get some inspiration in the middle of the night and magically produce acceptance worthy essays. Obviously that did not happen. A week before the application was due, I hadn’t written one word. At this point in time, I had just graduated from George Washington University with an undergraduate degree and was working and traveling around Indonesia. I had a scheduled Skype date with my parents, and as a special surprise, my 92 year-old Grandma joined as well. I excitedly told my family about the GHC application, but as quickly as I lit up about the job posting at mothers2mothers, I followed with a negative remark along the lines of  “I’ll never get it-there’s no point blah blah blah woe is me.” My Grandma abruptly shut me up, told me if I didn’t apply she’d disown me, and proceeded to detail all of the reasons why I would be an exceptional candidate. She wouldn’t sign off of Skype until I virtually pinky promised her that I’d apply no matter what. There was something compelling about my Grandma screaming into the computer because she thought being halfway across the world implied that I wouldn’t be able to hear her. Her point came across loud and clear. I signed off after taking an award winning screenshot (see below), went for a surf, and mulled over my options. I could a) not apply, lie to my Grandma, and feel guilty for the rest of my life (this is dramatic but entirely true), b) apply, not become a fellow, but know that I at least gave it a shot, or, c) apply, BECOME A FELLOW, and be one step closer towards pursuing my dreams.  A few interviews and one acceptance email later, I became one of the 90 chosen as part of the 2012-2013 GHC fellow class.

Low vitamin D and pregnancy risks

And this just after seeing my preceptor order vitamin D levels on her patients that confuse her because she’s so sure, she rants, that low vitamin D is the culprit whenever something is going on that you otherwise can’t explain…and now this. :)

In the news: Low vitamin D and pregnancy risks (NYTimes)

Bedside manners

5 Simple Habits Can Help Doctors Connect With Patients http://n.pr/1aNFntJ

1. Introducing yourself
2. Explaining your role in the patient’s care
3. Sitting down (done only 9% of the time! Not surprised.)
4. Touching (hand shake, a simple touch on the shoulder)
5. Asking open ended questions