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Spring Break in the Rockies

It really felt like Spring Break could not have come at a more opportune time. Many of my classmates, including myself, were ready for a change after our unit on the central nervous system. The brain is fascinating, but there sure are a lot of parts to memorize! The nuclei, and tracts, and many specific anatomical features in the head and neck can seem never-ending. After CNS, we had a week of practicing our diagnostic skills during Chief Concern week, and then we were finally off to Spring Break.

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Beautiful hike over packed snow

I spent the first half of break in Colorado with one of my college roommates, Martha. We spent a few days in Boulder and in Denver and had a chance to hike up the Flatirons and across frozen lakes and up mountains in Rocky Mountain National Park. The experience was exhilarating. I had never been that high up on a mountain before! The panoramic views were incredible and I just couldn’t contain my excitement. It’s amazing how much better food tastes, too, after spending all day moving.

Now that break is almost over, I feel so much more refreshed and ready to head back into a stretch of intense learning. (I wish my ears would catch up though; they have yet to equalize the pressure correctly post-mountains. After CNS I can picture exactly what my Eustachian tube needs to do to re-equilibrate). The M1s are starting the infectious disease sequence on Monday, which I have heard great things about. You know a class has to be good if the upperclassmen have made T-shirts with the professor on them. After this trip, I’m also a lot more motivated to keep up with a rigorous exercise routine so I can take on harder hiking and climbing routes this summer. Here’s to new challenges, warmer days, and staying mentally well in this last stretch of the semester!

 

Traveling to Capitol Hill

In my last post, I promised an update on the advocacy efforts of our student chapter of the AMA, and I have many developments to report! In February, we hosted a seminar where students had the opportunity to learn from Dr. Sharon Swindell and pediatrics residents about how they advocate for patients. It was inspiring to hear stories about how their actions have improved the lives of their patients even beyond the medical realm. In particular, Dr. Swindell presented a pyramid chart on the different levels of advocacy that really resonated with me. The base was built upon advocating for one patient/family at a time, with the next level as office-based family advocacy services, followed by community advocacy through programs like CATCH grants, and finally legislative advocacy. Each physician can choose to be part of any or all levels of advocacy for patients.

Even before medical school, I would have considered myself a pragmatist. Now, even more so, I believe in the power of incremental positive change. I had the chance to be a part of that this past week at an advocacy and region conference of the AMA in Washington, DC.

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University of Michigan delegation to advocacy conference in Washington DC

I felt well prepared to speak with legislators and their staffers after previously attending Washtenaw County Medical Society legislative update meetings and trainings through the AMA conference. The issues that we focused on on Capitol Hill were public service loan forgiveness programs and protecting graduate medical education funding. Personal stories have the power to influence the actions and votes that our representatives in Congress take! It is both a privilege and a responsibility to make our voices heard as medical students.

At the Intel Science Talent Search poster presentation

At the Intel Science Talent Search poster presentation with Michelle Hackman and Caitlin Sullivan

In DC, I also had a chance to attend my favorite science fair, the Intel Science Talent Search, with friend and fellow STS 2011 alum, Michelle Hackman, and it was great to reminisce and see all of the fascinating projects presented by current STS finalists. And, I still managed to make time for some March Madness and see my alma mater (Duke) play in the ACC conference in DC.

I had just taken my missed quiz after the conference when I was called in the middle in the night and found out that the pregnant patient I had been following since October was in labor! I was so excited that I arrived at the hospital several hours before needed and was able to be a part of two deliveries. I am so grateful to those patients for allowing me the privilege to participate in and learn from that important moment in their lives.

Time to return to memorizing tracts and nuclei for the current M1 CNS sequence.

Dr. Mona Hanna-Attisha Inspires us to Advocate for Patients

Today Dr. Mona Hanna-Attisha spoke at the School of Public Health on the Flint water crisis. I walked in thinking that I may leave feeling more discouraged than uplifted, given the gravity of the situation in Flint and the many children and families that have been harmed by the toxic levels of lead in the water. However, I left feeling inspired and propelled forward to act by the words of this physician and public health advocate.

The talk was so popular that many of us ended up in overflow rooms to see the live stream!

Dr. Hanna-Attisha emphasized that her role as a pediatrician is to be an advocate, going so far as to say, “Everything about pediatrics is public health.” I had never thought about it in quite those terms, but I realized that she is right – pediatricians counsel daily on the importance of nutrition, safety, and contraception, among other topics. These lessons serve not only the children they see in clinic but the broader communities around them. Children can’t advocate for themselves on tougher gun control or environmental safety, but they need us to speak for them.

In the talk, she helped us become familiar with different tenets of public health, such as primary vs. secondary prevention. In Flint, it is too late for primary prevention – children have already been exposed to lead. However, secondary prevention is all the more critical, and Dr. Hana-Attisha’s strategy relies on the principles of assessing, monitoring, and intervening. By tracking children’s neurodevelopmental development and intervening as early as possible, she hopes that the community can buffer the effects of the lead poisoning.

As she told us about her research team and how they had used their data to bring the crisis to the attention of the state, I was struck by the immediate importance research can have. Like she said, some research is more suited for an immediate press conference than waiting several months to publish in a peer-reviewed journal!

“Pay attention in your bio-stats class. Data can help you move mountains.” –Dr. Mona Hana-Attisha

Furthermore, I was inspired by the ways in which her pediatric clinic interacts with the community at large. It is located on the second floor of a farmer’s market in Flint, and she is able to give families “prescriptions” and coupons for proper nutrition! I learned that nutrition plays a key role in buffering the negative effects of lead. I was so surprised to hear of this location. The previous week, my classmates and I attended a design workshop, “Doctor as Designer” lead by Dr. Joyce Lee. In that workshop, we designed our ideal clinic workflow. One of my classmates, Aisling Zhao, had the idea of placing doctor’s offices in prominent community locations, such as grocery stores and public libraries, so that patients could integrate their health monitoring into their daily lives. I was so excited to hear that this vision is already a reality in Flint!

Finally, I was struck by her comment that what the Flint community needs now is not more water, but an investment in tomorrow. Each child needs the opportunity to have a medical home in which a physician can follow their neurodevelopmental progress and refer them to appropriate resources if needed.

As a leader of our AMA chapter at the University of Michigan, I’ve been working on a project to bring a Pediatric Advocacy Workshop to students next week. By partnering with faculty and residents, we hope to shed light on what students can do now to advocate for pediatric patients in clinic and the legislature. I’m so thankful to Dr. Hanna-Attisha for showing us what an impact we can make for children in our communities. Stay tuned for an update!

“You Can’t Buy Perspective”

Today, we [M1s] attended a panel with four incredible women who told their stories of being patients or caregivers. In the hospital, at first glance, what we may see is an ill woman wearing an uncomfortable hospital gown, but it’s up to us to remember that person is a musician, a professional, a teacher, a mom, or any other characteristic that defines them much more than just “patient.” Hearing from patients and learning from their experiences reminds us of that. Some patients spend many days and nights in the hospital, and their quality of life in the hospital reflects on their quality of life in general. Patients talked about how services like art and music therapy and child life specialists can make their hospital stays more manageable, and even enjoyable in parts. Towards the end, I was most moved by one patient who talked about how “you can’t buy perspective.” The experiences we have, and the struggles we face shape who we are as people and help us see life from a different vantage point. Our values change, our priorities shift, and sometimes our adaptability increases.

Brené Brown on Empathy

Resilience is a word that wasn’t brought up in the panel, but it’s a word that came to mind for me throughout. Resilience on behalf of both the patients and the physicians. We have to find it in ourselves to keep moving even when life throws us new curveballs, for some of our patients on a daily basis. It takes a different kind of resilience to confront illness daily from the perspective of a physician or of a caregiver. One of the videos we watched, Brené Brown on Empathy [3 min], can give you a small taste of what we talked about during the session.

In my apartment, we accumulate random snippets on our fridge, but two constants have been a list of quotes (about failure, interestingly enough, a post for another day!) and a list of ways to practice gratitude from MHealthy. I like to think of gratitude as a skill, something to be cultivated daily, not only reserved for a special day in November. Still, I am very grateful for the holiday itself because it gives us one more reason to come together with friends and family and celebrate our relationships with each other. Many ‘friendsgivings’ have been happening across campus, and we are no exception (Veggie chili, grown up mac and cheese, sweet potatoes, pumpkin corn bread, acorn squash with quinoa filling, and chocolate pecan pie…food coma)! I felt very fortunate to have friends from several different parts of my life present.

Happy Thanksgiving from Dose of Reality!

Travelling to the Peach State for AMA National Meeting

Medical school is full of “firsts.” First organ-based sequence (cardio/respiratory) – check! First time taking a history for a standardized patient – check. And now, first health policy conference! The past few days I’ve been away from Ann Arbor in the wonderful city of Atlanta, Georgia at the AMA National Interim meeting. My interest in health policy started at Duke, and this week it has been fascinating to see the impact that physicians (and students) can have on local and national health policy. For instance, did you know the smoking ban in airplanes started as a medical student resolution for the AMA?

Listening to debate in the medical students section

In the medical student section (MSS), we learned about and passed several resolutions that were proposed by our colleagues. The topics ranged from addressing drug prices and shortages to pipeline programs for minority youth to enter medicine. We also had the opportunity to interact with many residents, fellows, and attendings in different fields across the country. I learned more about specialties that were unfamiliar to me, such as radiology, urology, and ob/gyn. In particular, I attended a reception specifically for Michigan physicians and loved getting to know people from our own state who are just as passionate about issues of health care access and quality!

Taking a "biopsy"

Another highlight of the weekend was the clinical skills workshop. Here’s a picture of me biopsying an abnormal growth (a strawberry!). I may have gone a little bit too far and also sampled a piece of the tablecloth. Shh…good thing I’m still an M1 and not a resident. We laughed it off, and I enjoyed seeing how ultrasound can be used to guide physicians to finding the correct location to biopsy. I hope I have better luck next time, and fortunately I was a lot better at placing an airway in our (fake) pediatric patient. It was great to put some of our anatomy in practice.

Atlanta has had other perks as well, such as catching up with college friends Samhita and Dan! So good to see them and learn what life has been like for them the past few years. I am fortunate to still feel connected to my college family.

Until next time!