Tuesday, December 29, 2009

Everyone Finds Their "Third Place"

Starbucks calls it the "Third Place," the place where you go when you want to feel relaxed, content, and genuinely happy to be alive. It seems as though I have found that place, and I still can't quite believe that it is the emergency room.

In addition to volunteering in the UCSF ED, I am now a San Francisco General Hospital (SFGH) ED Research Intern, and an ED Scribe (paid) at Mills-Peninsula Hospital. To many, this may seem like hospital overload, but quite honestly, I absolutely love it and wouldn't have it any other way.

I wish that I could eloquently convey the feeling that I have when I watch gurneys with ailing patients wheel by or doctors ask one another whether they are ready to receive report. Though I am only an observer of these events, I feel like I am part of something greater, witnessing the world in action, life happening in its most raw form all around me. You see people of all colors, shapes, sizes, smells, and economic backgrounds in the ED, but once their clothes come off and the awkward paper-thin gown goes on, it is as though they are all the same...there to be helped, cured, fed, or bathed. All the differences and labels are erased. I love that.

I've been thinking about this a lot, and really, I think what it comes down to is that the Emergency Department functions like a well oiled machine. Everyone has their role and it all comes together like clockwork. We all rely on one another and each of us, in our own way, plays a part in making the ED run. We're all in a team and everyone is valued and appreciated.

There is a certain energy, perhaps and ebb and flow in the ED that makes it exciting. Even on so-called "boring" days when relatively few "interesting" cases come in, doctors, nurses, interns, and volunteers, are all enjoying the lull and preparing for the next Code or crash. As soon as a code is announced its like everyone comes alive and assumes their position. Its amazing to watch.

At this point, though still 1.5 years away from applying, I am nearly 100% dead set on becoming an Emergency Department doctor. I absolutely love it and can't see myself anywhere else. I am keeping an open mind, however, because I have not witnessed many of the other specialities but out of the ones I have seen (internal medicine, family practice, and clinic work) this is by far the most interesting to me. Everyone always says that once you're in medical school you figure out what you want to do and they are probably right. For instance, I absolutely LOVED anatomy last spring and I miss it dearly...perhaps being a surgeon is really what I am meant to do. After all, I did start this whole process leaning towards surgery. So, really, who knows. But all I can say right now is that I am so blessed to have found "my thing" and I'm so grateful to everyone that has helped me get here. I really think that I am going to become a Doctor.

Oh, here is a great website with awesome ED stories. Enjoy!


Wednesday, September 16, 2009

To The Young Patient at the ED Tonight...

You came in to the ED with lips as blue as sapphires and skin as purple as fresh spring lavender. You were writhing in gut-wrenching pain as the nurse tried to place an oxygen mask around your perfect nose. You refused. It hurt too much. You've been here before. Your blood flows the wrong way in your heart and you have reverse pulmonary hypertension. They can't operate. You're "end stage."

I watched as a team of 20+ medical professionals attend to your care, wanting, trying, hoping to do everything that they could. My pulse quickened and my blood pressure elevated. Just like yours. I wanted nothing more than to help, but I couldn't. I'm only a volunteer.

As I stood there watching your low blood oxygen saturation levels and frighteningly high blood pressure I was thinking about how excited I am to be entering the medical profession. I can't wait to gain the knowledge and expertise so that one day I can be on your team of doctors, performing an ultrasound of your abdominal cavity to determine what is wrong. I'm pursuing this path for you and the countless others like you out there so that I can help make a difference in your lives.

We are only on this earth once. I don't want to squander my time here in the frivolous pursuit of wealth of material satisfactions. I want to helps others to live, to experience the amazing phenomenon that is human existence for as long as they can.

I know that you are strong and will fight till the very last day. I may never know what happens to you. Just know that you are a special gift to me and I promise that I will do everything I can to become the best Doctor I can be. For you.

Sunday, September 6, 2009

Some Thoughts About the World...

So, I don't know whether turning 26 next Tuesday has sparked some sort of weird philosophical need in me, but I have been thinking about a million things recently, not least of which have been about very deep things...It is also entirely possible that watching 4 seasons of Lost in the past month have also caused me to think about lots of things...I don't know. I guess I'm trying to make sense of life and what it means to be human. Don't we all?

So, first off, on Wednesday when Iwalked into the UCSF ER to volunteer, the first thing that I saw was one of the 5150 patients (mental patients, for those of you who don't know what a 5150 is) lying on his bed, seemingly asleep, with his penis just hanging out of his gown. This normally wouldn't phase me, cause really, 1/2 the world has a penis, but for some reason this really got me thinking. Here was someone who at that moment didn't really care what anyone thought about him and was free to do what he wanted to do, which I guess included showing off his naked self to the world. I think that some part of me envied him.

This brings me to my second point. I've been feeling like a peon for a long time now, endlessly moving along a pre-written path towards that thing which we all strive for, "success." Perhaps I'm just tired and feeling a little burned out from all this Pre-Med stuff, but recently I feel like I am just a cog in a machine that just keeps moving forward and that really sucks. I mean, we are all here on earth trying to survive. First we go to school, then to college, and then we get jobs and get married. At some point we are supposed to feel empowered and successful, like we have accomplished something great and that we are moving forward! But really, we all slog through the week, most of us in clothes that we don't want to wear, not spending enough time with our loved ones or ourselves. This causes us to be fat, unhealthy, stressed out, and mad at the world. I think most of us as children did not envision ourselves leading lives like this. I for one, sure didn't.

Yeah, some of us are better at leading balanced lives by doing things like yoga class or spending time with friends, but I really don't think that it makes a difference. To me, its comical. Its like there is a set of rules for how we are supposed to live our lives, and then, when stress hits, there is a set of things that should be done to mitigate the stress. In essence, because most of us are following this path, we lose a bit of our individuality. Which brings me to my next point...

I'm starting to believe that to be successful one has to be a sheep. As I was walking to work today I was observing people as usual and the thought came to me that by golly we all dress and act exactly the same! It was so wierd! I was hit with this overwhelming sense that I was the odd one out. I mean, everywhere I looked people were wearing some combination of jeans, a trendy shirt, overpriced generic leather blingy handbag and then some other ridiculous accessory in the form of high heels, coiffured hair, or flashy jewelry. Yeah, people looked great for the most part, but actually everybody looked the same. It's like there is some un-stated rule for what must be worn in order to be accepted. I mean, I should have learned this in middle school when clothes were all that mattered, but for some reason the lesson escaped me.

Finally, driving on 280 back home, it was as if I was not really driving my car, but observing myself living my life, completely detached from my actual physical body. There must be some sort of psychology term for this. I have felt this before but not for a long time. I wonder what it is.

I guess, really, I am realizing that I don't just want to be a peon in this thing we call life. I want to be my own person, free to muse about the workings of the universe, humanity as a whole, and the status of the living, breathing planet we inhabit. I hate feeling like I have to be somewhere, do something, or befriend people who are petty and quite happy living a completely unexamined life. I think maybe, deep down, I feel that the lives we lead are too complex and that perhaps, we were never meant to live like this. Is it really so weird to wish for time to spend in the great outdoors, and to contemplate existence on an almost daily basis? I hate dealing with money and loans and bureaucracy and red tape and bosses telling me how to do things when they don't even know how to do things themselves. All I want is to be able to slow down and breathe, smelling the smells of the world around me and trying to understand their meaning.

Maybe I'm not cut out for the system. But to survive you have to make money and that is what I am trying to go to school for...At this point I have so much debt that I almost have to become a Doctor. Don't get me wrong, I want to be a doctor with my whole being, but the path to get there is just so darn tiring and stressful. I really need to sit down and evaluate what is the best path to take to get there....

Thursday, August 6, 2009

ER Volunteering

Having spent the last six weeks volunteering at the UCSF Emergency Department for four hours every Wednesday night, I figured that I would chronicle some of my experiences. I figure that because I am supposed to be learning from this experience I should make note of the things that strike me as important, fascinating, or otherwise interesting. When it comes time for medical school applications, looking back on my posts will give me food for thought.

Being an ED volunteer means that I get to assist what the hospital calls "PCA's," or Patient Care Assistants, with their tasks. This means doing a whole lot random things including re-folding linens, cleaning rooms, feeding patients, getting blood from the blood bank, running to material services for random items, talking to patients, and pretty much anything and everything else that is asked of me. Quite honestly, I don't enjoy doing most of these tasks but I know that I am really helping out the two PCAs. Also, running up and down the stairs and around random floors of the hospital keeps me moving and I get to see lots of different areas of the hospital that I otherwise wouldn't be able to see. And I have to say, going to the blood bank still wierds me out a little bit. I mean, they essentially give you a packet of half frozen blood in a red bag. Something about half frozen blood wierds me out. Blood is supposed to be warm and oozing, not freezing. It's not that the blood itself makes me unnerved, its the sterility and coldness of those little packets...

There are many things which make being in the ED very interesting, not least of which is getting to see all the different types of patients that come in with a whole host of problems. I'm not gonna lie when I say that there is something really neat about getting to see people's wounds and ailments and how they handle themselves when they are in pain. It really is an exercise in social observation. For example, last night a young man (who was really attractive I might add) came in with a completely dislocated ankle. And by completely dislocated, I mean his foot was pointing perpendicularly to his tibia instead of straight forward! Ouch! I got to watch two Doctors inject him with not one, but TWO huge vials of local anesthetic before they proceeded to literally yank his foot back into place. Now, for me, this was crazy cool because I had never seen a bone being "popped" back into place. The room became really tense before they the "popping" action because they knew how painful this would be for the poor soccer player. He braced himself for the pain and then grinned and bared it whilst the bones were re-set. Absolutely amazing. The patient was such a strong individual. Props to him and his Doctors. So, yeah.

Two weeks before that I got to watch CT scans being performed on two separate patients, one of which was being tested for stroke. The actual machine is really menacing becuase you are lying on a "bed" with your upper body and head surrounding by a huge spinning, whirring disk. And you have to stay absolutely still. The amazing part, however, were the pictures that the CT scan generated. You could see the inside of the body and brain really well, along with all of the major arteries and organs. Having taken anatomy the semester before made these images that much more poignant because I know what they really look like on the inside of the body. The CT scan technician pointed out landmarks like the Circle of Willis and the carotid arteries to me, and was surprised that I actually knew where they were. I really enjoyed being able to use that knowledge in "real life" and I can't wait to grow my knowledge base about the human body.

Overall, volunteering in the ED has been a really positive experience thus far. No, the UCSF ED is not a trauma ED so I don't get to see lots of gun shot wounds or women in labor, but this is a nice start. I'm learning the ropes and it feels really good to be in and around those actually practicing medicine, helping them out in the small ways that I can. Who knows, maybe I'll find a way to work in the SFGH ED where the real fun happens ;)

Friday, July 17, 2009

And Life Goes On...

So, a lot of things have happened since the last time I wrote a blog about my life, some good, some bad, but I am slowly learning to accept and embrace the new state of affairs. To quickly summarize, Zac and I are no longer dating or living together. I have since reluctantly moved back home to my mother's house and am learning to share the space with her. This has been an incredibly difficult undertaking and I hope that with time we learn to work together in a way that will not drive either of us crazy. It looks like I am going to be here for the foreseable so this task must become a priority for me. Other than that, I am taking summer school, making new friends, and adjusting to life as a single person. I turn 26 in a few months and am looking forward to the new "year." I am very slowly coming into myself and I am looking forward to what the future will bring.

Perhaps it takes monumental changes in life for us to slow down and re-evaluate ourselves and our place within the world, but I feel like the past three months have taught me some lessons that I could never have learned within the context of my "old" life with Zac. I am still trying to piece together the fragments of insights that occur every once in a while, but I know that slowly but surely I am figuring out who I am and what I want to do when I grow up, which is very exciting.

I believe that we are sent messages from time to time, be it through dreams, people, or other random occurances, about where we are at in life and whether or not we are on the right path. I have learned to listen to these gifts from above and trust that my instincts are correct. For instance, yesterday I was at UCSF to volunteer at the ED. Prior to my shift, I felt like I should go to Panda Express for terrible, greasy Chinese food even though I wasn't particularly hungry. I figured that the craving I was having was for salt or warm food. Anyway, I always read my fortunes in the fortune cookies. Lo and behold, the fortune read, "You are moving in the right direction. " Awesome! How cool is that?!? I'm sitting in the middle of the UCSF cafeteria about to volunteer, the night before a physics exam, and I receive this lovely little piece of life-affirmation. I was so excited to get that fortune and I truly felt that whoever sent it to me knew that that was what I needed to hear at the time. So, I guess I really am moving in the right direction. I trust that I will continue to make the correct decisions and turn my life around.

Thursday, March 26, 2009

Required Volunteering

As every pre-medical student knows, one of the important components in the formula to getting into medical school is volunteering. It is preferred that this volunteering be of the clinical variety, exposing volunteers to direct patient interaction and those providers that give the health care. In my quest for medical school admission, I have decided to succumb to what I call the "formula" and have started volunteering for two great locations: Lyon Martin Health Services and the UCSF Emergency Department.

I've been at Lyon Martin now for five weeks and it has been a fantastic experience thus far. All of the staff and health care providers are great people and they are always willing to answer any questions, however petty, that I may have. As a Volunteer Clinical Assistant, my duties will ultimately include rooming patients, taking histories, room-cleaning, and other patient-centered activities. Right now, I spend most of my time filing stacks of charts and assisting the front desk with whatever tasks they need help with. This is not nearly as interesting as rooming patients, but it is valuable in teaching me how the clinic operates and getting me familiar with the kinds of patients that we see.

Lyon Martin is a women's clinic that focuses on LGBT and transgender medicine. I know. What is this straight as an arrow person doing at this clinic? Hah. I ask myself that sometimes too. I am very passionate about ensuring that everyone has access to adequate health care, no matter what their background or status in life may be. Yes, 1/3 of the patients are transgender, but this is because we provide great care and treat all patients as equal. Especially in that community, this is not the norm. Many transgender individuals have nerve-wracking and biased health care experiences and they often choose to forgo basic care due to the discrimination that they may face. So, why am I dedicating my time to this clinic? Because I first and foremost care about people and I want to be part of a clinic that cares about people as well.

In addition to my service at Lyon Martin, I have also decided to volunteer at UCSF in the Emergency Department. I have not started yet, but I just attended the ED orientation last night. Let me tell you, this is going to be an entirely different experience from that at Lyon Martin. The UCSF ED is not like the ED at SFGH. There is not usually a lot of trauma or low-income patients, comparatively. To me, it doesn't matter. I want to learn about how treatment is done in a hospital environment and I figured that the UCSF ED would be a good place to start.

Now, after last night's orientation I must admit that I am quite nervous. There are so many things to remember, the least of which is trying not to bring any lawsuits upon the ED. LEAST OF WHICH!!! Sure, I am not going to be diagnosing or treating patients in any way, but I am going to be speaking with them and ensuring that they as comfortable as they can be. I know it is going to take me a while to figure out what exactly is my responsibility and what I can and cannot do; I just hope that people are understanding with me and help to guide me in the right direction. My next step is to set up a time to shadow another volunteer. This will hopefully get done next week. And then, I'll be on my own ;)

Yes, clinical experience is critical to understanding how health care is provided and to figure out whether being a health care provider is truly the right career path for me. So far, I have absolutely loved my volunteer experiences and I look forward to continuing to learn and contribute as much as I can. Lyon Martin and UCSF are two completely different environments and I specifically wanted it this way. Hopefully by the time I **get in** to medical school I will have a firm understanding of whether I want to work in a hospital or a small clinic and what kinds of patients I am most comfortable interacting with. Now I just have to sit back, relax, and let the fun continue...

Monday, January 12, 2009

Spa Day

I have spent the last five days in Poipu Beach on Kauai. I have had a fantabulous time so far and I can't believe that three days from now I have to head back home to Berkeley. Anyway, today I awoke around 9:30 am to a completely empty house, except for Zac, of course. He needed to get some work done so we ended up leaving the house around 10:40 am for what we thought would be breakfast burritos at Brennecke's Deli. We got to Brennecke's only to find out that they stopped serving breakfast at 10 am, so we walked back to the condo and made our own breakfast.

Around 11:40 we hear the door open and Jason called out to us stating that they were leaving for the farmer's market RIGHT NOW. So, Zac and I reluctantly got up and piled into the car to head over to Kolo'a for another farmer's market. Now, we were already not so enthusiastic about having had left so quickly, but when we got there we realized that neither one of us actually had cash on us. This made purchasing fruit quite difficult, i.e., impossible. So, this fact, in combination with the hourdes of tourists, led Zac and I to wander away to a picnic table in a shack by a nearby playing field. We sat, sweated, and chatted about how the trip has been so much fun thus far. About 20 minutes later, the rest of the family found us and we all piled back into the rental van with the newly acquired papayas, rambutans, star fruit, pineapples, and various veggies.

We decided to stop for lunch a the Koloa Fish Market where we picked up an assortment of tuna, lau lau pork, and kahlua pork platters. We then stopped at Brennecke's Beach to consume all of the delicious food. At 1:15 pm, the women drove back to the condo to prepare for the spa day ahead. Really, all we did was take a few moments to pee. Then, we were off to Anara Spa at the Hyatt.

The Hyatt here on Kauai is absolutely gorgeous. Right when you walk in, you walk into a luscious, green, plant-filled courtyard, opening out right on to the beach. We were escorted to the spa which was off in the back of the hotel. We checked in and were given the grand tour of the facilities, which included beautiful lava rock showers and a variety of saunas, steam rooms, and jacuzzis. Absolutely gorgeous. I then met my masseuse, Leilani, an over-makeuped white lady, and was off to begin the spa day. I had never had a massage before so I told her to explain to me what exactly I had to do. I was already naked under my bath robe and she told me to lay face down on the table, and to take off all of my jewelry. I did as I was told and she began the full body Anara massage.

She started on my back, which is what I expected. I did not expect, however, that she would move the towel to basically expose my upper buttocks and that she would actually massage my butt. Very odd, but it did feel great. She also used her forearms and elbows, which was also new to me. She discovered that my upper back had lots of "gristle" in the muscle, as she called it, and that the knots were from stress and the way that I carry myself. She joked that I need to get more massage treatments to work those knots out. Right, cause I have so much money to pay for massage. Anyway, she worked on the rest of my body and all was well. It was a great first massage. I will definitely try to get massages on a more frequent basis after this experience. We'll see. After the massage I got a great 50 minute pedicure which started out with a foot soak in delicious smelling mango lime water. The pedicure was awesome and my toes are now a fun bright red, orange color ;) Overall, I think my first spa experience was really fun, but I don't think that I would have done if it I hadn't been treated to the experience. I don't think I could justify paying those prices....

When we all got back to the cabin, the men were waiting for us and Zac said that he loved my feet and that they looked happy. I was happy that he noticed my feet. Yeah for observant boyfriends!

We all had a fantastic dinner of grilled ahi tuna, sauteed fiddlehead ferns and bok choy, and Lappert's ice cream. Oh how I love Kauai.

Anyway, tomorrow we head for the Na Pali coast to go hiking and swimming in Ke'e Beach. I'm very excited and definitely don't want this trip to end.