Global Health Challenge

“From malnutrition to safe water, chronic disease to access to quality healthcare, a wide variety of diverse global health challenges exist today. Meeting those challenges and improving the quality of life of the world’s most vulnerable populations will require a great deal of innovation, critical thinking and new solutions to today’s most pressing problems.”

…and so began the prompt that drove Julian Hinson, Jay-Sheree Allen, and Andrew Marshall to compete to join Timmy Global health on their next operation in Ecuador, Guatemala or The Dominican Republic.

Now it’s out of our hands and into yours. Vote for our team at the link below.

http://www.medplusadvantageghc.com/north-of-charlotte-video/

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Thought of the day.

“Nothing helps a patient more than putting them in a position to help someone else”

– For those of you that have been patients, how do you think your doctor could help you help others?

Tongue Depressors and Depressing Tongues

Over the recent month of Family Medicine, quite a bit has been made of the need for us to have conversations with our patients concerning their diet and tobacco smoking habits. As a Minnesotan, I was shall-we-say less exposed to the ailments of smokers than most. If I am not mistaken, they have banned the activity in public indoor spaces and pushed most cigarette sales into the tiny, poorly-lit part of gas stations. Down here in the south however – It’s pretty pervasive, as are its effects.

They teach us not to react to the amount patients smoke, not to speak condescendingly, or remain overly fixated on the effect it has on their children. A conversation with a state representative revealed that libertarianism runs so deep in the south that they believe no law should exist that bans families from smoking in the car with confined kids. As you can imagine, I was crushed to examine the mouths of a couple kids in this rural clinic to see that they’d had some pretty extensive dental decay, multiple extractions, and visible tar on their tongues.

It’s rough out here in rural America. Even rougher if your parents decide that your lungs aren’t worth the pain of breaking away from an addiction.

The flipside. I had a mother tell me that she quit smoking (Like a G.) As soon as she received a positive pregnancy test.
Boom – Just like that. A doctor told her that smoking increased the chances of a premature pregnancy…and she tossed the habit like a dirty vacuum bag.

Her kid looks like it. Happy, energized, and maybe just a little too curious about my examination of his ears. We discussed the teenage mutant ninja turtles (donatello is our shared favorite), and as I examined his oral cavity with the tongue depressor the poor guy burped, gurgled a bit, and threw up…

I’ve never laughed harder. Hearing that his mom quit smoking before his birth made everything that followed look, sound, and smell wonderful. He was a great sport about it too…and seemed awfully concerned about my white coat. There was no need, I dodged that flying fluid like Neo in the Matrix.

Medical education is crazy. In one day you can see a best and worst case scenario and experience helplessness while realizing your power all in an hour.

These are a few of my favorite things…

Like most families, my Winter/Christmas traditions have often included that same album of Christmas jazz that never made it out of the CD changer, and that aging copy of “The Sound of Music” that keeps making it back (despite multiple conversions) into rotation on network television. But as this new year prepares to turn, I’ve noticed the dawn of some truly exciting changes in my study of medicine and the overall practice of healthcare. I will write about them in my next post. For now, I will break down a more appropriate series of thoughts.

Raindrops on Roses)
Freezing rain here in TN. MSU is going to the Rose Bowl. and this year I discovered Bouqs.com – the single greatest thing to happen to long-distance-boyfriends in need of an “I love you” gift. $40 bucks for two dozen roses? ($30 with a coupon? dear sweet Lord yes!)

Whiskers on Kittens)
I NEVER recommend cat videos….except for this one. (Trust me, you’ll appreciate the level of awesome so-sufficient that I felt the need to share.)
Corridordigital Kittens on the Beat

Bright Copper Kettles)
Rediscovered the power of the french press this year! My favorite combination thus far has been raw ginger, peach tea, and whatever crumbs of earl-grey I can pull from the bottom of the can.

(&) Warm woolen mittens:
Bought my first pair of gloves since leaving MN.
Haven’t used them.
Instead – I’ve been wearing a pair of fingerless mitts that make me look like the artful dodger.

Brown Paper Packages (tied up with string) :
Lost it a bit on Black Friday…and yet never left my house. I’m not a retail guy….too much of that stuff can be found on Ebay/Craigslist, but the occasional pair of kente socks, or the keyboard to your tablet….those benefit immensely from 50% off. Besides…NPR just reported that for the 5th year in a row, the discounts deepened, but the profit margins stayed the same…and yet, in store shopping experienced a 20% decline. (Something is fishy about the pricing schemes here)

yes….these are a few of my favorite things.

Cream Colored ponies
Seems like as good a time as any to talk about my new stylus!
purchased one of those fancy “pencil”s by the company “fiftythree” known for their app “paper”
It’s awesome.

Crisp apple strudel:
Had to advise a patient that pop-tarts shouldn’t be part of their kid’s balanced breakfast. It tore me up inside given how much I loved pillsbury’s toaster’s strudel. It seems a season has ended in my life, and the one that followed left no room for sugary sweets.

Doorbells&Sleighbells:
Over the course of family medicine, i’ve been assigned to a rural post….2.5 hours out of town. As such, two days weekly – I show up to my professor’s apartment at 7:45 AM and we drive in his (Sleigh-like) Range Rover all the way to Tullahoma TN…a place so rural that Santa probably sends his gifts via Amazon like the rest of us.

& Schnitzel w/ noodles:
WHO EATS THAT?

Wild geese that fly (with the moon on their wings:
Let’s take a moment to talk about how glad I am that these birds are gone…because parking under trees in this state had become a bit hazardous…you leave your black sedan and return to find it a white-speckled shell of it’s former prom-bound glory.

Girls in white Dresses w/ blue satin sashes:
Duke lost that game to FSU…so I doubt anyone is currently wearing white and blue.
P.S – to all those whose weddings I missed this year congratulations…I couldn’t be happier for you.

Snowflakes that stay on my nose and eyelashes:
Can we talk about the fact that TN closes its schools a day in advance because of the THREAT of freezing rain?
not the presence of 15 inches of snow that morning w/ a layer of ice underneath it NooOOOoo…..Over here, they shut you down because the weatherman got nervous.

Silver White Winters that melt into springs:
It’s right about this time of year that I actually do miss Minnesota. In the winter, River Road along the Mississippi at 7:00 AM is among this world’s most beautiful sights. Snow caked on the branches of trees turns one whole side of the world into a white canvas, dotted lightly with stubborn evergreens.

When the Dog Bites:
A classmate of mine has adopted a pet Chihuahua (despite a no-pet policy in the campus apartment) and has been leaving poo-bombs all over the apartment lawn. Well today, THEY FINALLY NAILED THAT B’…..wait…uh..that female dog. I can see how you’d get confused though.

When the Bee Stings:
Health Biz Decoded – 3D printing in Healthcare
I wanted to badly to share this…and I didnt know where to put it.

When i’m feeling sad:
The Passing of Mandela was a loss for which this world could never prepare itself. But let it be known, I do not mourn the death of those that live to 95. I celebrate their life. If anywhere you hear that Mandela “succumbed” as CNN might have you believe, “call-shenanigans” He didn’t succumb “to nutt’n’ “. Rather when this life was out of challenges for him to beat….he rolled out like a combination of John Wayne and the Terminator of Judgement day with his Peace fingers in the air.

May you have a merry Holiday Season and a Blesse’d Christmas
and remember, you have been apptly chosen.

Video

The Single Story

For those that may have never heard the talk that inspired me to pursue the humanities as well as medicine –

Here is Chimamanda Adichie – and her TED talk about “the Single Story”

2033

There’s an electricity that builds when two people share the same vision. At times it feels almost palpable enough to electrocute – to the point that neither party wants the meeting to end.

That was yesterday – during a chance meeting with my “Little Medical School in the South’s” V.P. of Foundation and Corporate affairs. It seems that there are more than a few people who live life backwards – “first seeing the future, then living into it. ”

Medical schools across the country are making the effort to be on the front end of the digital and social revolution taking place in our society. Everyone from Standford X to TED-MED is highlighting the arrival of “The New Age of Medicine” . In this new age, we’re expecting medical school to change as well –  Check out this video for an idea of what’s coming down the pipe

Lightyears Beyond Flexner

 

Thanking a patient

I recently wrote about an Incision and Drainage I started and my attending finished (with hilarious results)
I had forgotten about one of the more important lessons learned during that procedure –

Never betray your inexperience.

It’s been a hard one for me to learn, as medical school has tested my confidence in enough ways to prevent me from erring on the side of self-assurance. My patient was in the middle of having a small knife jammed into a lump on his back – and he was being such a trooper that I felt the need to notify him of his graciousness.

“You’re handling this really well, I know it’s not comfortable”

My next words, designed to only further comfort him, could only have been the worst anyone can hear,

“You’re a great patient to learn on”

*Expletive* – I knew it the moment it came out of my mouth. Learn on? who wants to hear that the guy literally sticking the knife in your back is learning

Not I.

But my lil’ school in the south is filled with more than its fair-share of gracious professors, residents, and patients.

I shall require them all.

Dodge.

Years ago now, while I was still in high school I started working at a Veterinary clinic to pay back my family for the cost of some (minor) car repairs. As many of you know, the experience was actually the inspiration for my desire to “do” medicine. I hadn’t been on the job -but-a-week or so, before being asked if I wanted to see a miniature surgery. Excited as most skinny-lil-boy’s would be at the prospect, I planted my self squarely over the vets right shoulder and stared intensely as he evacuated an inflamed “anal gland”

From what I understand, dogs and cats have the same gland that skunks use to ruin your day – it’s just grown dormant over time…and occasionally gets infected. This one was properly palpable, and sadly, ready to burst. With a slight squeeze and a prick of a scalpel – it popped, sending its nausea-inducing fluid over his right shoulder…and onto my freshly ironed (yes…at the time I ironed my scrubs) blue scrubs. Like the memory of childbirth, I’ve long forgotten the stench…and how much of it got on my face.

But last week it all came back.

Few of you probably know how timid medical students really are. Grey’s anatomy would have you believing that we’re all down-to-slice between midnight trysts in the on-call room, but most of us are actually somewhat squeamish about breaking the skin of another human being.

Allow me to explain, My patient had a rather cyst in the center of his back (just to the right of his lumbar spine) 3 cm wide and shaped like a mussel. Standard procedure with such nuisances is a quick slice known as an I &D (incision and drainage) we poke a hole – lil’ fluid drains out – and we stuff the hole with sterile strands of absorbent paper. The patient goes home smiling, able to sleep on their back for the first time since who-knows-when.

The downside? It hurts like all get-out. You know that sensitive feeling of an inflamed hair follicle? Imagine sticking a needle into it three times over…even if only to fill it with an anaesthetic.

Well we did so, and the guy handled it like a champ. However his cyst – boy that thing was as uncooperative as a two-year-old at toys-r-us. Despite my multiple attempts to carve out a large enough exit wound for the goop to flow, nothing was coming out. My resident finally lost his patience and stepped in to complete the procedure; pressing forcefully on the sides of the cyst to ease some more fluid out. With his full weight leaned on the lump, it burst….all over the right side of his face.

*expletive*

Usually Sh@!)$(* rolls down hill….but sometimes, it shoots up.

Apptlychosen.

The challenge of ‘it all’

It’s 6:00 A.M. and I’ve already finished my workout.
Ok, let me restart that. It’s 6:00 A.M, and for the first time in recent memory I finished an exercise routine before the cock crowed.

It hurts.

All this here studying and learning and applying of medicine has its effect on the ‘ol waistline. I knew it was bad when visiting one of my classmates from high school only to find that he and his newly-minted-doctor girlfriend had just come back from a run – requiring only ‘a stretch’ before some socialization.

Meanwhile I popped open my (second) can of ginger beer soda and mourned my slim-fit youth.

Last night, while discussing a video project for the AAMC with some MS-II’s (did I mention I’m a third-year now?) I found myself waxing nostalgic about ‘all the time’ I had first year. The discussion inevitably turned to lamentations over how many goals seemed unachievable while in the medical environment, and how the numerous mini skills being developed seemed oft-more attractive than the long term goal of serving the ill.

It’s a challenge to ‘do it all’, to write for a blog, eat healthy, maintain one’s mind, spirit, and body, date, learn new skills, read a book, watch breaking-bad/the newsroom, attend med school, care for friends/family, plan for a future, enact novel ideas, and…sleep.

Usually about this time I get a message from mom that says ‘I love you’ and realize-
These are first-world problems.

So I invite any and all wisdom on ‘balance’ and how to achieve it.
All I know is…it doesn’t get easier, you just get better.

Apptlychosen+Undetourred