Sigh...my dad was just diagnosed with diabetes. A fitting end to my family medicine rotation. After treating 50,000 patients a day with diabetes it seems kind of routine, but he's helped me remember that for each individual patient it's not necessarily routine at all (especially the initial diagnosis) and he's really depressed about it. Not that he's totally turned his diet around, but he's trying.
Seeing all my relatives over winter break (and just having any break at all) has been great. Here's hoping for the best in the new year!!!
Thursday, December 31, 2009
Sunday, December 20, 2009
Every Day Low Prices
Say what you will about Wal-Mart, it definitely serves a purpose. So much convenience, so many low prices...I do most of my grocery shopping there now and the selection is pretty good, even the produce. Plus, the prices are pretty damn good. Don't take my word for it...this study showed that in poor communities Wal-Mart actually improved customer health. In other health news, the price wars between pharmacies Wal-Mart started by offering so many generics at $4 for a month supply has immeasureably helped patients bear the cost of their endless medication lists. Seriously, check it out...you can control high blood pressure for $40 a year. As much as I loved living in New York City, the one thing I missed (and this may sound sacreligious) was a big Wal-Mart where I could buy basic supplies, yarn, really anything, at a reasonable price all in one store. For better or worse this may soon become a possibility.
I agree with a recent poll that found that Wal-Mart Best Symbolizes America. A little scary, yes, but when I think of America, as vast and diverse as it is, one unmistakable feature is the big shopping complexes located near highways that are the same anywhere you go and usually include a Wal-Mart. Wal-Mart is super sized...convenient, generic, but when it uses it's power for good maybe it could even save the environment. Of course, Wal-Mart also has its huge share of problems. Yes, it employs a lot of people (yay!), but it sure could treat them better (boo). Then there's always the question of what means Wal-Mart uses to keep its prices quite so low, and the damage it causes to local businesses.
And let's not forget the breathtaking creatures on display at your local store. What could possibly be more American?
I agree with a recent poll that found that Wal-Mart Best Symbolizes America. A little scary, yes, but when I think of America, as vast and diverse as it is, one unmistakable feature is the big shopping complexes located near highways that are the same anywhere you go and usually include a Wal-Mart. Wal-Mart is super sized...convenient, generic, but when it uses it's power for good maybe it could even save the environment. Of course, Wal-Mart also has its huge share of problems. Yes, it employs a lot of people (yay!), but it sure could treat them better (boo). Then there's always the question of what means Wal-Mart uses to keep its prices quite so low, and the damage it causes to local businesses.
And let's not forget the breathtaking creatures on display at your local store. What could possibly be more American?
Tuesday, December 8, 2009
Stories
My first day of family medicine I saw a 2 week old and a 99 year old. That pretty much sums up what makes it cool...the range of what you get to see is, well, everything! Still, I can't get away from the fact that dealing with diabetes and hypertension in non-compliant, obese patients would frustrate me over time. At least in theory. In the room, with the patient, you really just want to help and encourage and hope the best for them. But what most of the patients need isn't a doctor...it's a lifestyle overhaul...and probably a doctor too. You can manage the problems, but you can't cure most of them...at least not until the singularity. Following patients and families through the years would be wonderful. Really knowing the patient's life, their history and social situation, and having the skills to treat most of their problems is how I always pictured a good family doctor...and just a good doctor period. I love stories. More than any other doctors I've worked with, the family practitioners seem interested in the med student's back stories and the stories of their patients. One of the books I read for my medical anthropology class long ago, "A Fortune Man: The Story of a Country Doctor" about John Sassall, a general practitioner working in rural England, completely captivated me...the compassion and solidarity he showed with his patients is remarkable. If only being a doctor was like that now...though maybe you can get too close...he ultimately committed suicide.
"The human condition is not curable." -Our family medicine preceptor
While I've been all broken up about genocide and kids with cancer, family medicine has made me realize how much depression so many people are dealing with on a regular basis. A series of unfortunate events. Being laid off, kids who won't graduate for high school, abuse, obesity, retirement, death, realizing your life hasn't turned out the way you wanted...it's not that I'm completely naive and refuse to acknowledge all of these things exist...I've just been fortunate to not have to confront them head on on a regular basis. Yet, this seems to be the majority of what we see in family practice (and the physical manifestations of these problems). If you've got tons of fungus growing in your fat folds, you know you have a problem. I get depressed just thinking about it...but that's life. And if a doctor can try to help with pills, or encouragement, or anything that's great. Of course, the people who make regular trips to the doctor aren't really a random sampling of humanity either. I really like the doctor I'm working with, she's about my mom's age and just totally competent and spot on with most things. But my favorite patients are still the few kids we get to see. I like to dream that with the right influence from their pediatrician, kids can fulfill their potential and avoid a life plagued by regrets.
"The human condition is not curable." -Our family medicine preceptor
While I've been all broken up about genocide and kids with cancer, family medicine has made me realize how much depression so many people are dealing with on a regular basis. A series of unfortunate events. Being laid off, kids who won't graduate for high school, abuse, obesity, retirement, death, realizing your life hasn't turned out the way you wanted...it's not that I'm completely naive and refuse to acknowledge all of these things exist...I've just been fortunate to not have to confront them head on on a regular basis. Yet, this seems to be the majority of what we see in family practice (and the physical manifestations of these problems). If you've got tons of fungus growing in your fat folds, you know you have a problem. I get depressed just thinking about it...but that's life. And if a doctor can try to help with pills, or encouragement, or anything that's great. Of course, the people who make regular trips to the doctor aren't really a random sampling of humanity either. I really like the doctor I'm working with, she's about my mom's age and just totally competent and spot on with most things. But my favorite patients are still the few kids we get to see. I like to dream that with the right influence from their pediatrician, kids can fulfill their potential and avoid a life plagued by regrets.
Thursday, December 3, 2009
An Imperfect Offering
Physicians for Human Rights is finally starting to establish itself here on campus. So far this year we've had journal club meetings, a documentary showing and a World AIDS Day quasi-event. While I got into the group mainly due to my interest in global health I'm slowly getting drawn into the more activist side of things. It's a little rough sometimes...I'm not one to force ideas on people or even argue all that much and I'm not wild about petition signing (except for the 10,000 in 10 days campaign for women's rights) but I'm getting there. And it's a way to stand up and rant again and fight for something. Perhaps it's even an outlet for the lack of drama in my personal life...which is a completely wonderful thing...it just could use the occassional shot of chaos. Gossip Girl helps with that too (especially with it's Thanksgiving episode) but it's not always the most fulfilling endeavor. I can't wait to go to Kenya for 2 months in early 2011 for the OB/GYN elective...it just seems so far away...
Before running away to China for the summer, Andrei gave me three books..."Becoming a Doctor" (a biographical book by an anthropologist who went back to med school), "The Knot Book of Wedding Lists" (pretty self explanatory), and "An Imperfect Offering: Humanitarian Action for the Twenty-First Century" (by Dr. James Orbinski, a former president of Doctors Without Borders, who has done some crazy stuff in his time like working in Rwanda during the genocide in 1994). Guess which one captivated me? I may not be destined for war zones, but it's hard not to respond to the book. While his eye witness account contains some of the most horrifying stories I've ever heard (how can people just start slaughtering their neighbors?), his intelligent, compassionate response is ultimately hopeful. He's a realistic optimist! We decided to show the companion documentary, "Triage: Dr. James Orbinski's Humanitarian Dilemma", for a PHR event (with Noodles!). The book and the documentary cover similar territory and Dr. Orbinski is shown trying to write the book in the documentary as he revisits Rwanda and Somalia. Intense. But I held it together. What finally made me lose it was watching "Hotel Rwanda". After studying the genocide but thinking about it as something that happened 15 years ago, watching a movie that put you right there was just too much. I was sobbing uncontrollably the majority of the time...between all the little kids with cancer and being confronted with the fact of genocide, the pain and senselessness in the world seemed overwhelming. And now I can say something about how Thanksgiving with my wonderful family restored my faith in humanity...but that doesn't really solve anything.
Before running away to China for the summer, Andrei gave me three books..."Becoming a Doctor" (a biographical book by an anthropologist who went back to med school), "The Knot Book of Wedding Lists" (pretty self explanatory), and "An Imperfect Offering: Humanitarian Action for the Twenty-First Century" (by Dr. James Orbinski, a former president of Doctors Without Borders, who has done some crazy stuff in his time like working in Rwanda during the genocide in 1994). Guess which one captivated me? I may not be destined for war zones, but it's hard not to respond to the book. While his eye witness account contains some of the most horrifying stories I've ever heard (how can people just start slaughtering their neighbors?), his intelligent, compassionate response is ultimately hopeful. He's a realistic optimist! We decided to show the companion documentary, "Triage: Dr. James Orbinski's Humanitarian Dilemma", for a PHR event (with Noodles!). The book and the documentary cover similar territory and Dr. Orbinski is shown trying to write the book in the documentary as he revisits Rwanda and Somalia. Intense. But I held it together. What finally made me lose it was watching "Hotel Rwanda". After studying the genocide but thinking about it as something that happened 15 years ago, watching a movie that put you right there was just too much. I was sobbing uncontrollably the majority of the time...between all the little kids with cancer and being confronted with the fact of genocide, the pain and senselessness in the world seemed overwhelming. And now I can say something about how Thanksgiving with my wonderful family restored my faith in humanity...but that doesn't really solve anything.
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