Clinic Volunteering

The good news is I enjoy what I do. 

Yesterday after coming back from a 3-hour day at the church clinic, I decided to teach Nancy, my youngest sister how to take blood pressure. She's a good student and learned pretty well. She even knows that you place the bladder on the medial side of the arm, that you place the stethoscope over the brachial artery, and that you first take the palpable systolic. Hopefully, she will decide that medicine would be a noble career choice for herself. 

Some highlights from today's clinic: 

-Elderly woman lost her insulin at the airport eight days ago and hasn't had any since. Her blood sugar today? 578. 

-Woman with accompanying husband, mother, and 3 year old son ask if there is an ultrasound at the clinic: they want to know if she is 7 months or 8 months pregnant. Before leaving, they ask if they can go to a hospital that will deliver their baby so that it has American citizenship before going back to Egypt. Sorry, ma'am, no OB is going to deliver a premature baby if they don't have to. 

-Monica's "kissed" pretzels with an M&M on top: .....how are these siyami??

Being Kicked off the Pedestal

I have a space in my heart for anthropologists. I love their passion, their approach to  academics and perhaps the most, their provocative styles. Prof. Wende Marshall, a Princeton Alumna, is UVA's notorious Medical Anthropology instructor. Today, she was invited to our Social Issues in Medicine class to talk about Health Disparities. As soon as I saw her name, I laughed. Not because I was laughing at her but because I knew she would  stir up some emotions in my medical school class. 

Wende started her talk to first year medical students by saying that she has little faith in biomedicine. This first line probably offended many---we are here to learn medicine for the next 4 years of our lives. She said a few other things (she only had 20 minutes to actually speak as the 50 minute lecture was split with another speaker) that should not have been surprising to a student of an undergraduate liberal arts curriculum but clearly, that wasn't the case with my class. People got very defensive very quickly and the room was very tense. Students defended that they didn't have time to worry about injustice because they had too much biochemistry to learn. Others argued that science was inherently non-biased. And possibly, the most ignorant comment was that of a student telling our invited speaker that she interrupted a student's comment.

After the talk, one of my classmates went to Wende to apologize for our class' behavior.  I wondered about my class and really was embarassed by how we had presented ourselves. Instead of showing that we came into medicine to change our societies by serving the sick and vulnerable, we PROVED Wende's criticisms that physicians are isolated from their societies, that they don't know how people are really living and are not willing to get off their comfortable pedestal. As the Vice President of this class, I really wish people would get over themselves. Being a medical student does not entitle you to disrespect others, to put value judgements on unfamiliar opinions and thoughts, to be immature and to be low-class. Start acting like professionals or at least mature adults. And if communicating to people, being polite, being congenial, and being aware of your world is too much for you, you probably should not have gone into medical school. And finally, please read something other than Netter's. A physician is a scholar. We should all be able to converse about theories, philosophies and current events. Today was so shocking to people perhaps because they skipped (or slept through) some important lectures about humanity, religion and family systems. In your practice, your patient is going to be more aware of you not being aware of them as a person, as a human being, than you needing to look up more information about their mystery diagnosis. 

Let's get real here. 

Loneliness

Yesterday we visited Trinity Mission nursing home. This place was described to us as "the place that accepted individuals that got rejected from everywhere else." I was personally nervous because I never enjoy nursing home visits and I'd heard from others that the patients they interviewed were barely coherent and extremely demented. Benjie and I got lucky though...

Mrs. M is an early 70's year old woman living in Trinity Mission. I wheeled her back up to the room, we grabbed chairs and we chatted for about an hour and did the mini-mental assessment screening. When I saw the pink cross hung up near her dresser, I asked her what she does during the day. She told me she reads the Scriptures and lamented that there weren't enough people in the nursing home that were genuinly interested in living their faith. If she's not reading the Bible, she's watching sermons on t.v. Later on, we found out that she comes from a relatively large family (she has/had 5 other siblings and three kids) but that she doesnt get visitors often. She blamed a lot of that on tension in her family as a result of her divorce. She cried multiple times during the interview; Benjie got her tissue, I patted her back and we sat in silence. She thanked us for allowing her to talk, "I'm sorry you had to go through this but if just feel so good to talk...All my life I've had friends, but I've never had really close friends. "

Hearing her story reminded me about what's important in life....our relationships. Her divorce had clearly resulted in a lot of heartbreak, mainly because of the tension it created between her and her children. But throughout her life, she had been lonely and still is. And if loneliness isn't one of the biggest side effects of being in a nursing home, I don't know what is. I hope that God can fill Mrs. M's heart with love and intimacy with him. After all, He is the lover of our souls and our heart's desire. Benjie and I are planning on visiting Mrs. M after exams.

As a side note, can you imagine living in a place where you have to get a new roommate every couple months because the other one died?

False Alarm

I've joked many times about the real potential of killing my fish. For those of you who don't know I have two beta fish (separated by a colored plastic divider of course so they don't kill each other). I noticed today that I've neglected cleaning their tank. As usual, I turned on the water in the sink, unplugged the bottom of the tank to drain the old water out and began "refilling". Everything was normal until I saw my fish having spasms!!!! I felt the water and it seemed warm, probably TOO warm for their wellness. Yikes!! I tried to make the water colder but it seemed I was starting to lose them. Their gills went into hyperactive mode and my heart was racing. I couldn't believe this was happening. I rushed to throw in food, "Maybe they need extra nutrition to help them survive this." I filled up the rest of the tank with room-temp water and put them on their stand. The two of them were floating on the top.....and I didn't know what to do. They were laying on their side, collapsing to the bottom of the tank and then rising again to the top. I decided to give them some time to "recover" from the water-temp induced trauma. 

Thank God, they are doing much better now. They're still fairly fatigued and not 100% responsive but will get there soon hopefully. I need to find a better way to clean this tank and to water my plant, which is also actively dying despite my best efforts. 

FYI

According to myth, the Charites were daughters of King Zeus and the Oceanid Eurynome.
There were three Charites in Greek Mythology: Aglaia, the Grace that symbolized Beauty, Euphrosyne, the Grace of Delight and Thalia, the Grace of Blossom. According to Greek poet Pindar, these enchanting goddesses were created to fill the world with pleasant moments and goodwill. Usually the Graces were attending the Greek goddess of Beauty Aphrodite and her companion Eros and loved dancing around in a circle to Apollo's divine music, together with the Nymphs and the Muses.

Talking to the Family

This week in POM, we began to learn how to deliver bad news. I knew and still know that the subject of death, but dying even more so, is one that always brings me to tears. It seems that we've had many deaths, unexpected ones, in our Church family and the memories of those funerals are still with me.

Today, I went to a lunch time talk and performance of a harpist who plays for patients at the hospital as therapy. From the moment she began, I fell in love with the melodies and just wanted to lay down in an open field. Then, my Literature and Medicine professor entered the room and came and sat next to me. We made small talk about what we had read recently, experiences at med school and election day. I had noticed that her eyes were red and watery but didn't feel like I should ask. A few minutes later, she asked me if I remembered one of the poems we read, "Talking to the Family," in class. I told her I did and she teared up while telling me that the poet, a good friend of hers had just died today. I told her I was sorry. She shared a couple stories about him and then we ate our free pizza.

I felt so incompetent empathizing with my professor. Should I have held her hand, hugged her? I didn't know how to react but I did truly feel sorry. I may be sensitive and compassionate but I have yet to learn how to communicate that with others.

The harpist played a melody, arrhythmic, that she plays for her "actively dying" patients. I started tearing up imagining the scenario. Being in the same room as Death. Helping the person let go. Accepting that the person has to go and is gone.