Sunday, January 24, 2010

Not so Daily Haiku #6

The decor is hip
Skinny mocha latte grand
addiction is weird

Not so Daily Haiku #5

Cold blue desert sky
At the funeral, we sob
Snowy mountains watch

Monday, January 18, 2010

Not so Daily Haiku #4

I went to the gym
I made a nice home cooked meal
I did not do work

Sunday, January 17, 2010

Escapism



When i was 16, i found it to be rather annoying. Age 21-23 were only mildly less angsty, but far more thrilling.



I was profoundly uppity. How disgraceful, i thought, were backward looking people. Youth is a frivolity. May I let it be with grace may i not fear responsibility nor cling to juniors department clothing. Great sorrow must be faced, the work of the world attended to, and excessive, higher quality alcohol consumed



But the work of the world is as tedious as it is exquisite. 16 is an annoying time. But its virtue is not yet realizing how annoying all the other years are as well. Thank goodness wanton escapism serves to last us the decades.

Friday, January 15, 2010

The Right Stuff

This very bloody morning as i am bumbling around my dark room confused as to what city i am in (Fresno) or why i am in a carpeted room (University housing) or who is that dark body in the distance (roomate), and i think to myself, you know what--all those personality tests are WRONG. I am introvert. I want to be alone. I am neurotic. I want be a misanthropic hum bugging micro-scholar and pshaw to being a warm blooded creature.

I finally sat down to read the paper a mere 40 minutes later, and as the coffee melts the ice in in my veins (and withdrawal in my brain), the NY Times apparently writes an article called: "Do you have the 'Right Stuff' to be a Doctor".

This is of course a sore spot. For all intents and purposes, if i just keep showing up for the next 4-6 years, the state of California will in fact license me as a physician. But what a big bloody if. Showing up is hard, particularly when its between 4-6 am.

The article proceeds to outline a study that indicated that personality testing was a better predictor of how well students did than other variables, like MCAT.

"The investigators found that the results of the personality test had a striking correlation with the students’ performance. Neuroticism, or an individual’s likelihood of becoming emotionally upset, was a constant predictor of a student’s poor academic performance and even attrition. Being conscientious, on the other hand, was a particularly important predictor of success throughout medical school. And the importance of openness and agreeableness increased over time, though neither did as significantly as extraversion. Extraverts invariably struggled early on but ended up excelling as their training entailed less time in the classroom and more time with patients."

There is a caveat of course: “If a medical school is all about graduating great researchers, then I would tell them not to weigh the results of the personality test that heavily,” Dr. Ones said. “But if you want doctors who are practitioners, valued members in terms of serving greater public, then you have to pay close attention to these results.” Research monkeys need not be nice, or really even sober. Just very OCD.

That was upsetting as i was just beginning to really embrace my future as a curmudgeon.

Thursday, January 14, 2010

Somewhat daily haiku #3

I heard the story
I examined the body
I like doing this

Wednesday, January 13, 2010

Not So Daily Haiku #2

I got it all wrong
The diagnosis is wrong
The gym does not help

Mood Indigo, p IV (final)

"Sleep is the best meditation." ~His Holiness, the Dalai Lama

Tuesday, January 12, 2010

Mood Indigo, p III

From The New York Times

Behind the promotion of Western ideas of mental health and healing lie a variety of cultural assumptions about human nature. Westerners share, for instance, evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is more healthy than stoic silence. We’ve come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection — a penchant for “psychologizing” daily existence. These ideas remain deeply influenced by the Cartesian split between the mind and the body, the Freudian duality between the conscious and unconscious, as well as the many self-help philosophies and schools of therapy that have encouraged Americans to separate the health of the individual from the health of the group...

All cultures struggle with intractable mental illnesses with varying degrees of compassion and cruelty, equanimity and fear. Looking at ourselves through the eyes of those living in places where madness and psychological trauma are still embedded in complex religious and cultural narratives, however, we get a glimpse of ourselves as an increasingly insecure and fearful people. Some philosophers and psychiatrists have suggested that we are investing our great wealth in researching and treating mental illness — medicalizing ever larger swaths of human experience — because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering.

Mood Indigo, p II

"Be kind whenever possible. It is always possible."~His Holiness, the Dalai Lama

White Coat, Mood Indigo

From New England Journal

"Although rates of depression among students entering medical school is similar to that among other people, the prevalence increases disproportionaly over the course of medical school"

"Why does being a medical student increase the risk of depression? Raymond believes that students’ coping strategies and
personal health deteriorate as they progress through medical school. Students “see themselves going into a very narrow tunnel,” she said. “A lot of the depression we see halfway through the [first] year — it’s a reaction to having constricted themselves down to studying these subjects in a very intense way. It’s pretty unidimensional.”

Symptoms of depression in medical students can be difficult to distinguish from the effects of the stress inherent in student life. Students often dismiss their feelings of despondency as a normal emotional response to medical school, where they live from test to test and don't take time for themselves.

"It's hard to ask about depression in medical students, because you ask about sleep, and all medical students aren't sleeping," explained Angela Nuzzarello, a psychiatrist and dean of students at Northwestern University's Feinberg School of Medicine in Chicago. "They are overwhelmed, they are working hard, and they aren't having fun socially. . . . Of course they are fatigued."

The emotional and academic challenges involved in becoming a physician wear on students. Their initial encounters with illness and death may unmask psychological vulnerabilities. Such encounters often resonate with unresolved episodes of loss or trauma in the student's past or come as a shock to those who have had little experience with death. The treatment of death as a part of the daily routine may appear cold and calculating to students, who may fear becoming emotionally detached. Some become overwhelmed by the emotional toll of caring for others.

Students may become depressed at any point in medical school, but Gartrell has found that the period of greatest distress occurs during the third and fourth years, when students rotate through the hospitals and clinics. "In the clinical years, there's just far greater commitment of time, plus as match pressure begins to emerge, it's an extremely stressful time for a lot of people," she said. Students are often separated from friends and classmates and must work with a constantly changing set of residents and attending physicians, which contributes to their sense of isolation. Gartrell said that many of the female students she sees are worried that the mounting demands of training and clinical practice will not allow them time to find a partner, marry, and have children. Haynes noted that the increase in sleep deprivation during rotations may also expose mood disorders."

Monday, January 11, 2010

Daily Haiku #1

Fresno, its easy
Well, you can park anywhere
That is about it.

Thursday, January 7, 2010

Storming

Hrm

" 'The art of any art is the art of obsession,' she said. 'This is not something that people in general tend to understand. They encourage you to be well-rounded, which bemuses me in a society that tends to reward the specialists – the obsessives – those who decided to excel at one thing instead of becoming good at a hundred or competent at a thousand.' "

In another note, the psychiatry professor ruminated outloud to the lecture hall full of med studnets,"Yes most of you have class C personality disorders, thats probably how you have got this far in your training."

per wikipedia:
Cluster C (anxious or fearful disorders)
Avoidant personality disorder (DSM-IV code 301.82): social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction.
Dependent personality disorder (DSM-IV code 301.6): pervasive psychological dependence on other people.
Obsessive-compulsive personality disorder (not the same as obsessive-compulsive disorder) (DSM-IV code 301.4): characterized by rigid conformity to rules, moral codes and excessive orderliness.

Debated with M the merit of 10,000 hours, while he casually took apart his electric keyboard and reconstructed it.

Sunday, January 3, 2010

Journeys

From: NY Times

Every year in October, when the Nobel Prizes in chemistry, physics and medicine or physiology are announced, the predictable parade of American honorees is reported on television and in the papers with a combination of patriotic glee and almost total befuddlement about the nature of the work being honored. Hardly anyone pauses to think about the educational system that has been so fabulously productive in turning out scientists in this country. It is a system limited to about 120 research institutions, and at the upper, rarefied reaches of that system are the elite universities. As James Anderson, chairman of Harvard's chemistry department, puts it: ''The students here are spectacularly good, very bright, very committed. They want to win Nobel Prizes, and some of them will, and some of them want to do it before they're 30.''

Graduate study in the sciences, however, is a very unsentimental education. It requires the intellectual evolution from undergrad who can ace tests of textbook knowledge to original thinker who can initiate and execute research about which the textbooks have yet to be written. What is less often acknowledged is that this intense education involves an equally arduous psychological transition, almost a second rebellious adolescence. The passage from callow, eager-to-please first-year student in awe of an often-famous faculty adviser to confident, independent-minded researcher willing to challenge, and sometimes defy, a mentor is a requisite part of the journey.