Organic Food: Healthier? Greener?

Just wanted to share an EXCELLENT article addressing some common myths about organic food. Some of my favorite lines:

"Some point to an "epidemic of cancer". In fact, there is no epidemic of cancer. When age-standardised, cancer rates are falling dramatically and have been doing so for 50 years." Yep.

"Sixty years ago, all Britain's food was organic; we lived only until our early sixties, malnutrition and food poisoning were rife. Now, modern agriculture (including the careful use of well-tested chemicals) makes food cheap and safe and we live into our eighties." :) :) :)

"No clear conclusions about the quality of organic food can be reached using the results of present literature and research results." Botton line. Stop wasting your money, splurge on shoes instead.

Love is Not the Same thing as Marriage

Let me start by saying, I find CNN to be an incredibly frustrating source of any news whatsoever, let alone insights into popular culture. But this article really irritated. The author basically concludes that religious views (attacking Christians, again) of marriage as a lifetime commitment are outmoded. He says, he won't be stating the line "till death do us part" at his own wedding (you will probably never get married if you feel that is a superfluous add-on, friend).

Unfortunatetly, because Americans are so independent-minded, living in an isolative, "self-gratification is everything" culture, they fit right into what he is saying. The principle of the Church telling them how to live their lives (even though, it is full of blessings and rewards) is unfathomable; it's downright oppressive---which is why the author argues attendance rates continue to fall. Well guess what? You're not doing God or the Church a favor by bumping our attendance rates. We don't care about attendance rates or how many "Christians" are actually abstinent until marriage. We're not looking for fans. God wants followers. Followers that have God's Word in their hearts and practice the teachings of Christ, the teachings of the Church.

Yes, Love is not the same as Marriage. Americans view "love" as an emotional thing, which is why when things just dont work out, they can get a divorce, or move out of the apartment their cohabitant and them share. Marriage, in the Orthodox Church, is a sacrament, a mystery by God's grace. The Orthodox marriage ceremony is the most romantic and un-romantic way to commit to someone else and God. The couple doesn't put rings on each other; the priest does. The priest symbolizes God, that once those rings are put on, they cannot be removed because God Himself has created one flesh out of the two. The crowns that the couple wears are not just because now they are King and Queen of their household, they are crowns of the cross the couple will bear--when things are difficult, when money is tight, when a child is stricken with a life-threatening disease. Our Church is the complete antithesis of the opinions of this article. But then again, we are not popular cultures. Orthodoxy is for those who recognize that the ways of the world are all in vain and lead to self-destruction. Christ said "My yoke is sweet and my burden is light." How true are those words, O Lord! God have mercy on all of us.

Five Months To The Big Day

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Yep, I Love Her

Once again, Frederica Matthewes-Green outdoes herself. A GREAT perspective on the Orthodox stance on same-sex attraction.

Un-Challenge

I'm on dermatology this month which is pretty cool because its great hours, short appointments (usually) and ever so often, you see something interesting. Today, I joined one of the residents on a consult we were called to see. He was a middle-aged man that looked much older than his stated age. He was in the hospital for alcoholic hepatitis. He was as yellow as mustard (especially the whites of his eyes) and his belly was full of ascites (fluid), making it harder for him to breathe (like when a pregnant woman needs to breath faster and more shallow because her gravid uterus is pushing up on her diaphragm). We were consulted because he had a "rash". It was apparent when we were examining him, that tinea had totally taken over this man's skin. My attending and resident both agreed it was the most extensive tinea infection they had seen, ever. Although this man's skin findings were remarkable, I couldn't help but try to imagine what was going through his head as he laid in his hospital bed with his wife and oh-so-cute ginger-headed daughter beside him.

A couple weeks ago, I had a med school applicant tell me that they think their greatest challenge in medicine will be the temptation to judge patients that create their "own sick beds." I understood what he meant. I thought the same thing before I entered med school. I remember thinking similarly about HIV/AIDS. They chose to engage in behaviors that cause it; let them suffer the consequences of their diseases. And then I met a patient with HIV. I do believe that all your theoretical judgments naturally dissolve (or should) when you meet, see, touch, be in the presence of a sick person, regardless of their responsibility in the causation of the disease. Whether the patient is obese and suffering the consequences of obesity, an alcoholic suffering from cirrhosis, the smoker with COPD or an innocent 7 year old kid of the nicest family who just got diagnosed with cancer, once a person is a patient, we ought to take care of them and not add to the guilt and regret they beat themselves up with, all by themselves.

Panda Love

Every Friday, one of the local bridal attire shops gives away a "Friday Freebie". You can see this here! Well, I won the give-away a couple weeks ago and my package arrived! I won an adoption package---I got one of the giant pandas at the National Zoo, with his picture and factsheet! It arrived in an awesome box with holes and "Do not Feed!" and "Gentle!" which scared my mom and sister who didn't know what to expect inside...I also got a beautiful sterling silver charm bracelet with a panda charm! Woohoo for winning stuff!

R & G

Since I am a big fan of lolcats, I thought this was appropriate. :)

Will You Be My Bridesmaid??

Let's just say that when your favorite hobby is perusing wedding blogs, you end up doing something like this. I made "Will You Be my Bridesmaid??" gift bags for each of my bridesmaids. I thought it would be a nice way to get them excited for their part in the wedding and to also set the stage that this will be a wedding of lots of nice, thoughtful details.

I included the most perfect card from Papyrus that had a cute, glittery pink bridesmaid dress on a hanger that said "Will you be in my wedding?" along with a gift card to my favorite self-serve froyo place in NoVA (Josie's!!!) and a lavender pillow mist (because I'm hoping to incorporate lavender into the wedding).

So Hard to Not Love

Today was "African drumming & Dance" night at camp. It was an ensemble of 4 drummers and 1 dancer, decked out in West African garb. I went because the African Drumming & Dance group at UVA was one of my favorite things. Well, this time it was no different. If anything, it was almost more magical because they had the kids participate. Half of the kids were on drums while the other half danced and then they switched.

A few times this past week, I've been upset with the kids...how they act, the things that come out of their mouth, etc. But tonight, it was hard to not just smile and be proud of them. I loved watching them be carefree....dancing to the drums or totally focused on the beat. I loved how the kids encouraged each other, too. It's hard to describe in words but I realized, doesn't matter if kids have cerebral palsy or type I diabetes or HIV, they are so loveable and so full of love to give. God bless them.

Never Again.

Since a recent sermon series, I've tried hard to not complain (especially hard because I know for med students, it's 2nd nature for us to complain). But I really need to blog about our camp-out. These two weeks, I'm working at a camp for kids with chronic diseases. A couple days ago, it was our "camp out". Usually, we sleep in air-conditioned cabins at camp but that night, the girls were going to sleep on top of a hill nearby and the boys were at a separate site. Well, that sounds like fun but we had two huge down-pours around 7 and 8 o clock so the entire area was wet and a lot of areas were also flooded. The camp directors decided to go on with camp-out plans because alas, there were to be no more rainstorms the rest of the night. I had been praying quite hard that there would be so that this ingenious idea would be canceled. We went up at around 9 pm to what would normally be a nice camp site, I guess. For the next 2 hours though, the kids and their counselors went on a "refridgerator walk"--sorry long story, won't explain--and my job as "Med Staff" was to literally guard the fort and keep the campfire alive (only so that when they returned, the counselors can stay up and be obnoxiously loud).

I was left all alone in the wilderness. What if a bear came out of the woods? What would I do if I saw a snake? WHAT IF WHAT IF WHAT IF WHAT IF? At 10 pm, I hid in my wet sleeping bag with my cell phone in one hand and my flashlight in the other. And I waited until they came an hour later with fear and trembling. Ok, so I survived that part. Can't get any worse.

Well it did. From 11 pm to midnight, 10-15 year old girls yelled "shut up" at each other non-stop. The girl next to me was snoring her head off so I moved my sleeping bag to another location. (OH! I forgot to mention we were sleeping on wooden planks....not inside TENTS like civilized campers.)Once the girls finally quieted down, the counselors were hollering at the campfire that was a couple hundred feet away so that there was really no hope in falling asleep. I think I slept for 45 minutes before my bladder woke me up at 1:45 am. I NEVER NEED TO PEE AT NIGHT. Why now was I having nocturia???!!!! I was so mad. After 15 minutes of being angry at myself for needing to pee and recognizing that I wouldn't be able to sleep because my bladder was demanding emptying, I got out of my sleeping bag and walked to the edge of the woods. Never again, I thought.

Since I was already up and angry at the world, I decided I would check on the diabetic girls' blood glucose levels. I got my kit out. One girl was good. The other, unsurprisingly, was low so I got her orange juice and graham crackers. And yes, I am now the master of checking sleeping kids' blood glucose in the dark in the wild. I am just sparing a lot of details...

I tried to go back to sleep, feeling exhausted. But one girl had the worst hacking cough q4 minutes. I guess my body was done fighting and I eventually slept until my classmate woke me up at 6 am to ask if I remembered to check the diabetics (she had slept through her alarm). I tried to sleep for a little more but couldn't because it was FREEZING AND WET so I woke up, wiped the dew off my face, packed my sleeping bag and hiked back to the med corner.

Things I Love Right Now

1. Blueberries
2. Crystal Light To-go mixes (I'm finally drinking water....thanks to a month in Nephrology)
3. Ginger snaps
4. Peds Heme/Onc
5. Coming home at 3:30 and taking a nap if I feel like it. :) 4th year is the best!!!

Peds Nephrology: Recap

People have been telling me to try to have a couple specialties in mind since if you decide to specialize, you apply for fellowship in the beginning of second year (!!!) and....you're really too busy intern year to have time to experiment with different fields. I just finished my month in peds nephrology which I NEVER considered before but .....actually, I really liked it.

1. Kids are actually sick. And we know how I feel about seeing healthy patients...
2. You see patients in a variety of settings-outpatient clinic, ICU, wards, dialysis center.
3. You are a consult to some patients but are a primary care doctor to the renal patients (too sick to see a general pediatrician).
4. Treating kids with CKD is like taking care of adult medicine patients but better...because they actually get transplants. I loved the idea of a multiple problem list in internal medicine...I just didn't like the patients too much. And in adult nephrology (like most adult medicine), there is a progressive worsening of disease; whereas in kids, they actually get the kidney transplant, their whole life changes for the better and then you get to manage their transplants!
5. Nephrotic syndrome is fascinating
6. Great lifestyle--the fellow told me that over the last year, he's only had to actually come into the hospital TWICE. (Most of renal's decisions are based on lab results not the physical exam).

Cons:
1. Didn't really like the urologic issues (mainly, vesicoureteral reflux)
2. Not enough chances to do procedures. only procedure really is the renal biopsy. (In my month, we had only one of these).
3. Wonder if there are enough patients to have a 4 times a day clinic. We had 2 1/2 day-3 day clinic (max). I didn't know if thats because UVA just doesnt have enough patients in general or if that was specific to nephrology. Obviously...this goes into $$$. That being said, both of the attendings I worked with seemed to be more than comfortable. Also-with more preemies surviving, more of these kids are getting renal insufficiency in childhood....and with childhood obesity on the rise, more of these kids are requiring management by a peds nephrologist until pediatricians learn how to manage those conditions.

Worst Personal Trainer

Not mine (I can't afford one). I was at the gym when these two guys got on the treadmills next to me. "Get on and put it to 5, do that for a minute." "Okay, now put it on 2." 1 minute later...."Put it on 5 for 3 minutes...you're not getting tired, are you?" I was so annoyed with this guy. His client was an obese black young man...not unlike some of the kids we see in preventative cardiovascular clinic, who was clearly starting to work out in an effort to lose weight. But, he was being talked to as if he was inferior...inferior because of his weight. And then the worst thing happened. Two other black guys came to the gym and I guess recognized their friend trying to exercise, and were laughing at him and taunting him...

I was SO TEMPTED to go to the front desk to complain about those guys. I'm sorry that not everyone at the gym has a normal BMI. But the gym is not a place for people trying to lose weight or get fit to be bullied by others. And if you actually cared about your friend or family member, you would learn how to be supportive and not condescending and AT THE LEAST, not a bully to them.

As someone who works in an area where we see the beginning of obesity, I have zero tolerance for people that do not help the problem and only make it worse. Thin people are not morally superior to fat people. Fat people struggle with so many things, the most superficial of which is food intake. And finally, perhaps learned best from Glee, we all have insecurities and things we hate about ourselves. Fat people are an easy target. Let's all do our part to take our words and jokes seriously and stop the bullying on fat people.

Hating What We Do

I feel bad for patients. Really. From the time they step into clinic, they quickly become engulfed in the surgery whirlwind. Imaging reveals stenotic artery or cancer in the colon. Sign this box. No, we didn't mention it was the consent. But at least now it's in your chart. Please move to the next room where we'll take your blood and run our tests. Next please find your way to radiology to get your chest x-ray. Where is radiology? Just go to the elevator and there's a sign that will tell you where....it's easy, you'll figure it out. Please do all of this today....if you don't it'll delay your surgery.

Patient returns very early the morning of surgery. Put to sleep. Surgery done. Arteries unclogged. Colon resected with an ostomy bag placed, anastomosis couldn't be accomplished. You won't be able to move your neck for a couple weeks and let us know if you have stroke-like symptoms. Don't worry about this ostomy bag. Yes you have stool coming out of your abdominal wall to this plastic bag and people might be able to smell it (and all self-image good feelings will be gone) and you'll have to empty the bag and clean it because you won't poop anymore out of your rectum ...but some people really like the ostomy bag! You'll get used to it, don't worry.

Stay in a hospital for a few days after surgery. Every morning and every afternoon a group of twelve white coats come, poke at your belly, at your neck and look at the wound site. Man that wound looks good! We did a nice job sewing! Sorry if we forgot to look at your eyes. We have lots of patients to round on, we'll be back later if you have more questions. Are you anxious? Are you scared? Are you lonely? Do you feel abandoned? Are you angry? Are you hungry, thirsty? Do you hate us? Do you hate yourself? Do you hate God for allowing you to go through this? Do you want to know the truth? The truth that you had liver metastases during your colon resection? You will...but only when we feel like we've pulled ourselves together to break the bad news. It might be easier just to get an oncology consult. They can tell them... But now we'll focus on how good your urine output is. Two of us will attend to your wound (your wound, not you, silly) while the rest of us talk about how good dinner was last night and laugh and joke. You watch the tragedy, the reality.

Cultural Competency

I felt like I needed to write a little something about abortion since it came up quite often in my OB/GYN month. Unfortunately, the majority of abortion issues that I saw where young girls (16-24) who had elective abortions just for the sake of not wanting a baby. 99% of my patients were on welfare, very uneducated, and trapped in a culture that was not only foreign, but disturbing on many levels. For them abortion was just the next thing you do when you have an unplanned pregnancy because you don't know how to use contraception. What also blew my mind was that these girls were just accustomed to having their bodies being subject to OB/GYN procedures...which are really...kind of terrible. Getting your cervix biopsied at age 20 because of abnormal Pap smears....getting neoplastic changes zapped off your genitals at age 17 in the operating room...these were just testaments that this was a different population than the group I grew up with. We were stressed about our AP exams, getting into college. We would have crushes, some of us had boyfriends. Did we think it was normal to get pregnant in high school? No. Were our mothers excited if we were 18 and pregnant? No. And no mom should be. And no kids should be having kids. I felt bad for these girls because they had a distorted idea that their lives were normal and that this is how all people are.

And then I realized gradually no wonder the lower-class doesn't really trust the medical system. Whether we admit it or not, doctors come from a different class than our patients on welfare. Several times a day, my classmates and I would just be bewildered by some of our patients. They made terrible life choices and it was obvious that they would continue to. We saw multi-generations in a clinic room who all made the same choices, that would trap them in a low quality of life. Blahhhhh...I don't know.

Deprived

Lecture got out early and now I have an hour before I report to work. My eyes already hurt, feeling dry. I am exhausted. I'm on night float on Labor & Delivery this week which means I get up around 2 to make it for afternoon lectures and then work until 6:15 in the morning, typically running around, assisting in C-sections and showing up at the rare normal spontaneous vaginal delivery. I was really sick all weekend with a high fever and sore throat and am still getting over this URI. It doesn't help that my body hates me right now for trying to change its circadian rhythm.

When I want to text someone, I can't because its 3 am. When I get out of work, I go straight to bed knowing I only have a few hours to sleep before lecture. I eat for the purpose of not fainting in the OR. I feel alone these days and I remember our Dean telling us in the first week of med school to get married before we graduate because residency is long and tiring and it sucks to come home to nobody. I know what he means now. Nobody is expecting me home at any time. Yesterday the chief resident was looking for a home to buy for his wife and kid out in California for his new job. Four-bedroom home with a fire pit in the backyard, an hour away from Lake Tahoe "for weekend retreats". And I wondered if that would be me in 4 years when I'm finishing up my residency. Would I be married? Would I have a kid?

I miss having someone to talk about being a med student with. I am sad that the Devil is using my sleep deprivation and fatigue to make me miss what I used to have. To return to asking God why. To telling God that I'm not happy and I want to be happy. That I deserve to be happy. But now, I am sad and alone, broken and sick physically and emotionally. I am tired, God.