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When Words Fail, Music Speaks

Music has always been a core piece of my life. I attended an arts elementary school where I learned to play the piano and started to sing. I have sung in choirs and show choirs, musicals, a cappella groups and weddings. I taught myself to play the guitar, ukulele, and most recently have tried my hand(s) at the violin. Needless to say, it is a huge part of my identity.

For me, music has been a form of self-expression and the best kind of therapy. A perfect afternoon was always sitting on my bed with my guitar, getting lost in a song. A perfect night was much the same, but in a coffee shop in front of a small crowd from my hometown. The music brought me peace.

Despite participating in a cappella and musical theater during my years as an undergraduate student, I felt disconnected from music. I lost a sense of what music meant to me. I needed to feel the music again, and I was determined to rekindle that passion in medical school. My mental well-being depended on it.

About a week into my M1 year, I received an email from the Medical Arts Program Artists’ Guild (MAPAG) about their upcoming showcase. They were calling for performers of all kinds (singers, instrumentalists, rappers, poets, storytellers, etc.) to come showcase their passions. I thought back to my years in high school singing in small coffee shops and decided to give it a go. I filled out the interest form (it was that easy) and began practicing.

The showcase took place on a warm evening in late September. I showed up early (as I always do) and tuned my guitar. I could feel my heart in my throat. Has it really been that long since I’ve played like this? I began my soundcheck and quickly realized that oh man, I should have brought my acoustic electric guitar but I just like this guitar better okay and I guess it’s good that you can hardly hear it because I keep messing up I am so nervous! Then Kevin, my fellow M1 and guitar ROCKSTAR, offered me use of his guitar. It was the exact same as mine, but could be plugged in so people could actually hear it. I hesitantly agreed…

My friends and classmates began to fill the seats. I helped myself to a plate of cookies to calm my nerves. Then, the show began. I wish I could say it went off without a hitch but, honestly, I messed up! And so did other people! And it was okay, because it was fun. Being up on the stage in front of a small crowd, just me and my guitar, made me feel things I haven’t felt in a long time.

Fall 2018 MAPAG Showcase

The talent in the room was unbelievable. It was humbling. It is easy to see your fellow medical students and think about how smart they are, but the reality is that there is so much more to each of them than being a medical student. For us musicians, MAPAG gave us an opportunity to engage in that part of our lives, to celebrate that part of ourselves, and to remember why we love music. That night reminded me that music is a way in which I can connect with emotions that I otherwise leave unspoken. When words fail, music speaks.

Of course, it takes more than one amazing night to reconnect with a lost love, but I am well on my way.

The Summer Accelerator Program for Incoming M1s

The University of Michigan Medical School (UMMS) works hard to provide their students opportunities to create impact in people’s lives very early on. The Impact Curriculum at UMMS offers students that opportunity throughout their journey through medical school. Students, prior to graduation, must create and execute a Capstone for Impact project. These projects can span the very broad spectrum of health care and that broadness allows students the opportunity to pursue their diverse passions while working to create real, positive change.

Incoming students are offered a chance to begin their impact early on through the Summer Accelerator Program. Students are instructed to have a mentor for their project, and can complete this project anywhere they are in the world. Their mentor also does not need to be affiliated with UMMS. At that time, I did not have a mentor for the project I wanted to pursue. I found out, as many incoming students do, that an email will go a long way here at UMMS. I sent my interest to the program director, Dr. Englesbe, who then connected me to my now mentor Dr. Cherry. I worked throughout the summer with Dr. Cherry to build a project around nutrition application development. The project we started is one that I will pursue and build upon throughout my medical education.

The summer accelerator program allowed for me to begin pursuing my interest in nutrition without the added responsibility of classes during the summer. It also demonstrated to me the commitment of UMMS for their student’s passions and desires to create impact in the world of medicine. The Summer Accelerator Program is a unique opportunity for incoming students and is one that participants will benefit from throughout and beyond their medical education.

Thanks for reading. Take care and Go Blue!

 

With my parents at the White Coat Ceremony

Learning from My First Patient

The annual University of Michigan anatomical donor memorial service is a time to remember and honor those who have chosen to donate their bodies to science and research after their death, both for families of the donors and University faculty and students. The seat I sat in at the service was an act of random chance; I had filled into Rackham Auditorium with a group of other first-year medical students and was at the end of the line when we shuffled into the chosen row. This left me in the seat next to a family of one of the anatomical donors and a conversation that has changed my experience not only in anatomy but in every interaction I have had with a patient thus far.

When I sat down, all I knew about the woman next to me was that she had lost a loved one and her loved one had been brave enough to donate their own body for the sake of education and research. By the end of the conversation, we had discovered that we had mutual friends and experiences, despite our generational difference. I had also discovered that the family member that had become an anatomical donor was an outgoing, smart, and, above all, kind person who loved their family and were deeply loved by their family in return. They had a lifetime of love, hardships, and memories before they had passed away. And they had decided that they wanted to continue to serve a larger purpose after their life ended. I cried with the woman who told me all of this several times before we parted that night and have thought about this experience often since.

Because of this experience, every time I see the anatomical donor I have been paired with, I think of how much they loved and were loved in return. I think about how they used their body to survive and thrive, to teach and to learn. This reminds me to treat their body with the utmost care and respect as I learn from them. And with every living patient I encounter, it reminds me of how little of their life we see. Outside of the clinic doors, these patients love and are loved in return. By the act of coming to an academic medical center, they donate their time and privacy for the benefit of our learning and we must also treat them with the utmost respect.

The random chance of sitting down next to a woman who was so willing to share the story of her loved one has completely transformed my medical education and deepened the meaning of each interaction I have with a patient, living or not. The patients we encounter in our education have diverse lives and experiences, yet they all choose to be not only patients but also our teachers. With this in mind, we must always treat our first patients, our first teachers with kindness and respect.

The anatomy group that I am lucky enough to learn with (left to right): Samantha Lyons (M1), Kevin McCrawly (M1), Kevin Walsh (M1), and Alyssa Warburton.

A Fiddling Physician

To say that medical training is a big commitment would be an understatement. As an older non-traditional student, the undertaking also meant giving up a life in California that I had already worked to establish, including a prior career and a beloved home and community. Complicating the decision further, in my case, was the fact that I knew I was deciding between time spent playing fiddle and time spent studying. Luckily, I had plenty of time to come to terms with that predicament as I slowly waded through pre-requisite night classes.

I’m in my last year of medical school now, busy preparing for residency interviews in emergency medicine and excited about being a resident soon. I really do love emergency department work. And looking back, it seems like I did get to play some music in medical school after all.

Playing for a dear friend’s wedding on a farm in Pennsylvania. September 2016.

I had gotten some contacts from people back home in California before I came out here. A friend of a friend had a friend who was a mandolin player in Ann Arbor. He kindly invited me to a weekly jam in his garage, and we quickly became fast friends. I got to know and play with his talented circle of musicians.

Playing at Johnny’s Speakeasy, a unique venue in Ann Arbor. October 2016.

There are some nice venues for bluegrass and related genres in the Ann Arbor area. Some spots to check out for this type of music are The Ark, Chelsea Alehouse Brewery, Old Town Tavern, Johnny’s Speakeasy and the Detroit Street Filling Station. There are also a number of traditional music festivals in the summer in Michigan.

As a pre-clinical student, my schedule was laid out for me in advance, so I was able to take some gigs and fit in a little practice time here and there.

A rainy day at Holler Fest with The Emergency Bluegrass System. August 2016.

Double fiddles at the Chelsea Alehouse Brewery with my friend Aaron Jonah Lewis. February 2017. Photo: http://www.lifeinmichigan.com/emergency-bluegrass-system-chelsea-alehouse-brewery/

M3 clerkships were a different story. We usually got our schedules on the first day of the rotation, so I couldn’t plan on taking any gigs. Nor did I have time to keep up my chops or learn new material. Sleep was a commodity.

M4 year has so far been a mixed bag for music. This year alone, I have spent time in Michigan, Mexico, California, Colorado and Colombia. I have worked in six different hospitals in the last six months. While this travel schedule has certainly made for limited playing opportunities in many ways, I was able to spend two of those months working on a multidisciplinary project of my own, supported by University of Michigan Medical School’s Medical Humanities Path of Excellence.

Together with a talented collaborator I recruited from the U-M School of Music, Theatre & Dance Performance Arts Technology program, we designed and built a brain-computer interface and biofeedback tool using an open-source electroencephalogram (EEG), incorporating real-time digital signal processing of EEG data into electronic and improvised music in live performances. Basically, that means I get to play the violin and DJ with my brain at the same time. Combining my background in music performance and engineering with medical school neuroscience and access to U-M’s diverse resources allowed me to make this concept a reality. We named our act Brain Command.

Beta test of the brain-computer interface at the Kerrytown Concert House. December 2016.

Brain Command at a house concert in Ann Arbor. March 2018. Photo: Aisling Zhao

While I am committed to prioritizing my residency training over playing music, it would be lying to say that it is not a little hard to see my friends getting to play gigs that I am no longer available for, or that I might not be able to hack right now. I guess I just focus on making peace with the idea that maybe I can’t do everything I want to do all at the same time. I have been blessed to get to play as much as I have in the past and will be happy to get back to it when I am finished with my medical training, as a full-fledged fiddling physician.

A Month of Wilderness Medicine

From the moment I started medical school at Michigan, I had been looking forward to September of my M4 year, and not for the reason that might come to mind first – residency applications – but for the Wilderness Medicine elective. Spending a month mostly outdoors learning how to care for injured hikers, climbers and kayakers as well as a week backpacking at Isle Royale National Park seemed too good to be true. Then I heard about the caving. I had found the catch. I’m rather claustrophobic and there was no fiber of my being that wanted to go into a cave. The allure of backpacking on Isle Royale, however, won out and that’s how I found myself in a cave outside of Bloomington, Indiana.

One of the stunning views from our trip Isle Royale National Park that never grew old. Photo credit – Owen Brown, M4.

The caving trip was the last in a series of adventures of the Wilderness Medicine rotation. The first adventure was a drive to Copper Harbor, Michigan, population 108, on the tip of the Keweenaw peninsula followed by a 3.5-hour ferry to Isle Royale National Park, the least visited National Park. On Isle Royale we backpacked for five days along rugged, rocky coastline and across the central ridge of the island. In the evenings, after a dip in the frigidly refreshing Lake Superior, we had peer teaching on different wilderness medicine and survival concepts including foraging, emergency shelters and animal trapping. Upon our return to Ann Arbor, we kayaked and practiced drowning rescues, went rock climbing, and participated in the Midwest MedWar – a trail race with medical obstacles and orienteering. Suddenly three weeks had passed, which meant it was time for our our last adventure – caving.

We arrived at Buckner cave, outside of Bloomington, in the heart of cave country midday on the last Monday of the rotation. Once we got geared up and packed – helmet, headlamp, backup flashlight, backup candle, knee pads, snack – we entered the cave led by several members of the National Cave Rescue Commission. We spent five hours exploring the cave starting with about a ten-foot army crawl followed by hands and knees crawling that gradually progressed to crouching and then to standing. Our path – the Circle Route – consisted of narrow passages that opened into rooms where our group of just under 20 could sit comfortably and learn about various medical scenarios that occur in caves from strains and sprains to pelvic fractures to heart attacks to hypothermia – many similar injuries and medical conditions one would expect to see in the hospital just with fewer resources and tighter quarters. My favorite session was practicing with the Palmer furnace – a surprisingly effective hypothermia prevention technique that involves a candle and a garbage bag. Within minutes, I was nice and toasty in the 55 degree cave.

After a night tent camping in the field next to the cave, we spent an hour learning about how to actually extract an injured or sick caver using two different types of litters. Then we tested our knowledge by actually coordinating a mock rescue ourselves. Surprisingly the rescue was less about medical knowledge and more about communication, teamwork, problem solving and preventing hypothermia. After several hours, our group of 16 successfully got our “patient” out of the cave! Much to my surprise, I actually really enjoyed the cave rescue scenario. By focusing on the problem and what needed to happen to get the team out of the cave, I forgot about my claustrophobia.

Cave rescue in action. Photo Credit: Phil Azouz, M4.

Starting a Student Org to Solve Medical Problems

When I first started college at the University of Michigan, I had never expected to get involved in entrepreneurship, let alone lead and advise other students in their ventures. Yet here I am, seven years later, one of the founding presidents of Sling Health. Over the past two years of my time in medical school, as part of Sling Health, I’ve helped students from across the university form and develop multidisciplinary teams to address health care problems with innovation and entrepreneurship!

Here is a part of our executive board this year (from left to right): Ayush Arora, Allison Powell, (M2), Mario Russo, and Emily Dixon. Not pictured: Sudharsan Srinivasan (M1), Abhinav Appukutty (M2), and Phillip Yang (M1)

But how did I even get into entrepreneurship?

Oddly, almost overnight. During my senior year studying biomedical engineering at Michigan, I created an alternative communication device for people with ALS with another biomedical engineer. We didn’t want to leave it in the classroom, so I found myself plowing full speed ahead with the venture to hopefully get it to the people who needed it.

Leap ahead to getting into medical school. When I was looking at schools to apply, I had a driving biomedical engineering/design emphasis. Beyond just the medical school itself, would I be able to still pursue my interest in the collaboration of biomedical engineering and medicine?

Through my previous experience in entrepreneurship, I got connected with medical students looking into founding a chapter of Sling Health on campus. Sling Health is a student-run organization that brings together graduate and undergraduate students from multiple disciplines including medicine, engineering, law and business to collaborate and address medical problems. We created an incubator to support team formation, development and acceleration into health care solutions.

The University of Michigan as a whole was the perfect fit for Sling Health. Our task was to unite students with different perspectives but similar passions.

With extraordinary support from the University of Michigan Medical School, the Zell Lurie Institute, the AAMC, and our national Sling Health chapter in St. Louis, we were able to found our chapter and hit the ground running.

We are now in our third year as a Sling Health chapter, coming full circle to our first event of the year, Problem Day! During the last month, we had interested members apply, including team leaders interested in leading a project. Our team leaders, equipped with a couple of clinical problems they are interested in solving, pitched ideas to members. Members then mixed in with the leads, discussing backgrounds that align with one another to find a project they fit with.

Teams forming at Problem Day this year

Looking forward, teams will present their progress at a series of Design Reviews throughout the upcoming year and receive feedback from professors across campus. The faculty are extremely influential in ensuring student success both in and out of the classroom, and many of them take time from their weekends to guide our teams!

Our experiences both define and guide us towards where we want to be. I could not be happier with seeing teams learn, sometimes struggle, but flourish. I had many people who helped guide me through this process when I first started, and getting to be a guide and mentor for others has been such an incredible part of my first two years at the medical school.

Seven years ago, I never would have imagined I would be here today helping push the needle on medical innovation. As I start my clinical rotations, I look forward to seeing Sling Health grow and continue to have a positive impact on the medical entrepreneurship community at Michigan!