so i haven't blogged in a long time. i have been busy, but i've also been thinking a lot about where i am and where i'm going down this pathway of life. i've been reflecting on failure, on what that means to me, on what has to be different the next time around. thanks to all of you who listened to me in call rooms, on the phone, in your living room, or over instant messenger. im always impressed by how forgiving and supportive friends and family are when im confronted with their reactions and compare them to my own.
it's interesting how failure can overshadow all the other successes in your life. it's irrational, but it's the way many of us, especially in med school culture, are programmed to work, our self-worth tied not to how well we take care of patients or our relationships with others, but on evaluations, standardized test scores, grades. i try to remind myself to judge myself by other criteria too, but no one is giving me an end-of-the-month evaluation on what kind of leader, friend, wife, or daughter i am. i don't get graded on what i contribute to the community, the number of emails i send, or how i love. one thing ive definitely realized through my most recent setback is that i love my life and i love the communities i live and work in. ive also become a lot more comfortable talking about failure and not being embarassed about it. indeed, i think that admitting to failure and dealing with it (both privately and publicly) is one of the hardest things i've had to do.
when i found out that i failed, i felt as if i had taken a majorly wrong turn in the maze of life and i wasn't sure if i was going to be able to recover, to advance to the next level (power up!) or to put a band-aid over my damaged self-worth. luckily, my go-get-em personality and overwhelming desire to make to-do lists took over. is it painful to know that some boxes you checked off with a flourish must now be unchecked? yes. however, is it fun to make a whole new series of boxes and schedules with different permutations because you suddenly have a lot more time than you had originally anticipated before graduating? TOTALLY. yes, i am a nerd, and yes, i do think that it is super awesome.
since im not graduating for a whole another year (spring 2009), i am applying to a series of dual degree programs. right now, im pushing to try and do a MPP (master's in public policy) over an MPH (master's in public health), but will be happy to also do an MPH with a concentration in health mgt and policy. i had originally thought to pursue these degrees sometime during residency/fellowship, but am super excited about doing them now. yesterday, i went to an information session at the Ford School of Public Policy (here at UMich) about the Science, Technology, and Public Policy graduate certificate and became totally pumped about being a graduate (and not professional) student. more on this to come!
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4 comments:
Having noticed your blog-I live in Chiang Mai w/Thai wife & luk keung daughter, having moved here from LA a year ago....so luk seow can attend an international school here-while trying to gather info & insight w/regards sesame oil from Mae Hong Son (for some reason my google search words snagged your blog-entry of your Luang Prubang trip). Your communicatin skills, combined w/the your reported work associated here with AHRN piqued more interest: the father of one of my daughter's school friends is head of AHRN here....presumably you know him: Ton Smits. But I digress, from my purpose of contact: Simply, that the world--with a continuing amplification of a quality of people, such as yourself--can most certainly find it's way towards a quality of of civilization which suffers so much less; and the alleviation of suffering is, indeed, primary principle and compassionate virtue of healing art, yes?....a life of worth notwithstanding. Thank you for taking the time to share your fascinating life experiences to date....there is much more to come, I might expect, and most certainly wish for you and your husband....and family and friends.
One additional mention....as you continue to secure your pursuit/passion of medicine, perhaps consider the alternative edge of practice (as in CAM..Complimentary Alternative Medicine); your husband may not be quite so well considered as "problem patient" as characterized by a passage mentioned with his bout with Giardia, diarrhea, etc
(with which he was reportedly stricken), and Flagyl
& Cipro might be either considered in a different light....at the very least, with the even larger comprehension that the disruption of "gut flora" requires as much attention to it's restoration, as does the cessation of infestation and the manifest symptoms of Giardia. From the perspective of health maintenance and health disorder prevention, this last observation of gut health restoration is nothing less than key....otherwise, the door is further opened for cascades of continuing adverse microbial and metabolic insult to the individual. Therefore, both pro-biotic & prebiotic nutritional therapy becomes an essential co-factor of antibiotic therapy.
And this is as good as anyplace to begin what could be an approach to CAM practice: as nutrition is not to be ignored as it has been for so long, but rather vast improvements in the understanding and teaching of...and there's much being brought to light about this currently.
To quote from your brief entry about selecting Internal Medicine:
"And when a patient comes in with high blood pressure, you can prescribe one of a wide variety of drugs, including beta-blockers, diuretics, and ACE inhibitors."
This demonstrates your already established and growing inventory of "tools", to which I issue a caution....and one good instance is the prescribing of statins to a patient who, obviously, reveals issues relating to cardio-vascular. Statins strip away production and presence of CoQ10, and that is most unwise to ignore, unless ATP production is not a priority for muscular/Heart energy supplies, which of course--it is.
So, just another example of CAM practice consideration....but you need another parental voice pushing you like you need less sleep....not!
I, incidentally, have not credentials whatsoever in the healing arts...my curriculim vitae, is simply my own association and personal experimentation with bio-nutrients (nutriceuticals, supplements, functional foods....many ways to tag such substances), which of more recent years was prompted by bouts of illnesses too varied to mention, but to drop a mention: IV stage lymphoma. And I felt an urgency to start looking after myself...and to merely let doctor's lab tests inform me of status, for the most part....all depends what's going on, from my foolish perspective, anyway.
All the best,
Mark Lebovitz/ Chiang Mai dweller
In retrospect--and certainly to undo any perception of trivializing high blood pressure--high BP does very definitely require management, or the results are ultimately disastrous....whatever the time-frame turns out to be. And further, there are not so many nutriceuticals, herbs, accupuncture procedures, etc. which can so often alleviate/palliate, easily acknowledged herein. Major life-style & dietary adaptations often can, over time effect solution, but when someone has onset diabetes II-or worse, type I-and stroke looms imminent, then lowering the high BP is paramount, no doubt.
But statins...and the larger picture of cholesterol-- as most commonly viewed by current allopathic medical science and practices--is, by the scientific observations and interpretations of many experienced and illumined medical/scientific minds, a most controversial matter and the myriad implications of "Big Pharma's" production and marketing of statins with regards real outcomes of patients' conditions is quite circumspect. Most succinctly stated, trials are so often either: misdirected because of inherently flawed design, side-tracked by surprising and compelling associations arising, or focused on an anticipated outcome--and in some cases, a combination of all three--that the results lead towards long periods of sadly misguided premises--and the applications thereof. Further, I have always been more than a little amused by the shrug of so very many doctors and scientists who casually admit to the 40 + year advocacy of margarine in lieu of butter for healthy cardiovascular outcomes.....this reality is anything but trivial....but not wishing to cast aspersions, this example, rather ought to serve as a signature of how far off the mark of good science and it's beneficial application we can actually wander. In the case of trans-fats, we erred disastrously, yes, but never really budged from the current and popular correlations of cholesterol and heart disease....which, if allowed re-evaluation by significant numbers of scientists and medical practioners (ostensibly to the immediate horror of "Big Pharma") might also reveal such drastic conflicts and ultimate changes, that the commercial imact could not allow for industrialized re-tooling, nearly fast enough. I am therefore concerned that any such changes to the current--and popular--cholesterol management paradigm which might just actually need a dramatic shift in approaches--for large segments of populations (with a mind to the onset of genetic phenotyping of individuals w/regards to dietary/supplements/pharmaceutical guidance/adherences) might be ignored further, and to the great disadvantage of our civilization.
But maybe that's just me....and a small legion of others, of which many are not so ignorant, inexperienced, or uneducated.
Again, all the best,
Mark
I think the comment about not getting monthly evals on the other parts of your life is a really good one. We, of all people, always are rather good at keeping things in perspective. But when you only get feedback on one aspect, it's hard to keep in mind the others, which really are more important in the long run. Only proves my theory: evaluations (and standardized tests) are stupid and useless. Period.
Tanya - here's your eval from me
Friendship: 9/9
Keeping in touch: 9/9
Compassion: 9/9
Integrity: 9/9
Commitment to better the world: 9/9
Overall performance: 9/9
Final Grade: HONORS
XOXOXO
I think your comments about failure are quite telling, both in the maturity you show discussing it as well as the deeper truth: it's really hard to deal with failure. Particularly for those of us walking the medical path. Frankly, if you learn how to deal with that better, that right there is huge...
And it needs hardly be said, but you do rock, indeed. Enjoy the MLI!
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