Stress Reduction In Medical Students

The stress begins just trying to get accepted INTO med school. The GPA. The letters of recommendation. The volunteer work. The MCATs. The applications. The interviews (you have to pay for all travel and accommodations).

Then there is the move. And the first day of medical school! At last, it is the dream come true! I remember eating lunch on the lawn with a circle of my classmates, in a formal 'small group getting to know each other' setting. We bought our own white coats--now these are given in a small 'ceremony' to the entering students. (Remember, the shorter the coat, the newer the student! The longer the coat, then they are 'attendings'.) But the Dean of the school gave us a chilling lecture--she said, 'This is the first day in your career you won't be behind!'

She was right. The amount of facts mastered in the first two years was mind-boggling. I literally studied until I couldn't learn any more and went to sleep. There were tests and practicals and 'introduction to being in the hospital' classes. That same dean told us to allow about three hours a day for our needs--one hobby, exercise, meals, housekeeping. Everything else was spent learning medicine.

I took a special course that took extra time: Medical Spanish. I decided to not have to wait for the interpreter the rest of my career. But this took my lunch hours on Tuesdays and Thursdays, and Thursday afternoons I went to a clinic that was Latino to practice--for two years straight!

A group of us was interested in Alternative Medicine. We had a class and I learned during this elective about Ayurveda, acupuncture, massage, herbal medicine…many things.

A classmate was a karate black belt, and he offered classes for us. It was 'Yo Shu Kai' karate. I earned my yellow belt. Others were ballroom dancers, and we would practice in breaks between classes and sometimes go downtown together to try out our 'stuff'.

My favorite was wednesday nights. I took Jazz dance (Hip Hop) at the rec center. I couldn't afford ballet at the studio my friend went to . But together we went to Salsa dancing until ten at night. It was the best fun I had all year.

I also had a year pass to the local zoo, and went to mass every week.

Second year, I actually taught massage to the first years, as part of a new course in Stress Reduction.

Some schools now have more formal courses, and a few include Reiki.

Here is an article on the latest news about stress reduction techniques in medical student education: http://www.examiner.com/article/meditation-is-helping-medical-students

What is NOT written in this, and is important to note, is that work hours ARE limited for both medical students in the hospital rotations (they are generally excused at three in the afternoon 'to go read') and residents (eighty hour work week). There are NO work hour limits for physicians.

After sixteen hours awake, studies have shown that impairment is equivalent to one alcoholic drink.

Some hospitals take this seriously, just as they would for pilots, and truckers. They have a 'breaker' person come in to give a four-hour nap to the on-call anesthesiologist in the O.R. and immediately after, the O.B. anesthesiologist. (I do not know about the other specialties).

Others, like my own, assign twenty-four hour shifts and do not guarantee more than 'the short room' for the following post-call day.

This is an important part of health care no one likes to discuss.

I think you should know.


Aloha and Mahalos,
Namaste,

Reiki Doc


P.S. eating RAW vegan gives me the energy I need to 'keep up' with all-night shifts. It makes a tremendous difference in my stamina. Also, 'light lunches' keep me from getting sleepy in the O.R. which is often very dark after lunch.

Doctors Make Bad Patients

Yesterday I called the allergist who is helping us sort through the many allergies and sinus infections my boy has been experiencing since last October. Without antibiotics, he relapses and gets a terrible sinus infection again. Even with a three week break just to see if his immunity would kick in over the holidays, he got sicker and sicker until asthma started to kick in. I had to take two weeks off from work. Unpaid leave. No one else could get his medications right and keep the asthma under control. It was also difficult since he would get afraid and cry, which made his asthma worse. I had to distract  him and keep him content.

We got an appointment. We had a three-thirty time. We showed up at three-ten; we were early.

You know that part at the front desk where they take your copayment and your insurance card? It is called, in the business, 'the wallet biopsy'. I have to fill out those forms just like you. I dislike it.

So we sat in the waiting room and waited. We waited long enough for my boy to give me back his iPad, he was that bored.

We went into the examination room, and waited. We waited an hour. The doctor was frustrated because the boy did not improve after three weeks of antibiotics were done. I also misunderstood the plan from last time, and did not schedule intradermal allergy testing during the three weeks of antibiotics. The plan was for sinus x-ray (CT scanning is actually better, per my ENT friends), blood test for immune deficiency (Ig A deficiency, Kartagener's disease would have that too--but also situs inversus), and spirometry (blowing on a tube to measure for asthma and other lung disease).

I explained politely that I work a lot. I have a hard time getting off from work. And would it be possible to get more antibiotics, because he can't stay home this week and is just going to get sicker while we sort these things out? I also asked, politely, if there was any way we could get the spirometry test done today too? We could wait.

And wait we did.

I got on the phone to call radiology at the adjacent hospital to see if I needed an appointment for the films or could walk in--while we waited for the spirometry technician, I was on hold so long I took the 'call back' option which is like FastPass at the Land. Once on the phone, I felt like I was in an alternate Universe. The radiology clerk kept thinking I was at some clinic five miles away.
No, I am LOOKING at the Hospital; it is within walking distance from the medical office I am in.

My boy had gone from spinning in the doctors' chair to jumping on the scale just outside the spirometry room. Ever since he heard the word 'blood test' and 'needle' he could not control himself and got pseudo ADD. I would say, 'Stop it' and he would say, 'okay' and then he would do exactly what I said to stop doing again three seconds later.

It was having to schedule the spirometry test six months ago that made us stop with the work-up.

It was the nature of my work, and the unpredictable hours, that made us go to Urgent Care as our Family Doctor (they combine both).

It wasn't until the owner of the urgent care started over-testing to make more money that we stopped going to Primary Care all together.

That's right. I don't have a doctor. I am a doctor, but due to my scheduling at work, and how doctors like to double-book three months in advance, I never have the chance to go when I am sick. I have not found a pediatrician for my son for that same reason. They want an 'initial visit' --read, two hundred dollars--before you can go to them when you are sick. It takes one hour and a whole day off from work! I fired them too. (Once I tried sending Dad--he couldn't fill out the questionnaires and didn't have a copy of the insurance card for our son. I pay for all of the medical care. All of it. Even though the court said he would pay half of all the medical expenses. How do you collect? Ew.)

At the hospital, at the x-ray booth, I had to fill out more forms and undergo a second 'wallet biopsy'. I initialed and signed almost as many times as I did when I bought my car. All the little highlighted spaces on things I simply did not read.

The x-ray tech was quick, but then stalled about thirty minutes on the computer, trying to contact the radiologist with telemedicine (to look at the film remotely), and also to send the report/call the office of our doctor. I had to go look at a picture of him to make sure it got sent to the right place. Then the blood draw lady was waiting for us when we got out. She was nice but made me sit in a chair across the room instead of touching my kid while she poked him. There was a series of colored dots randomly placed on the ceiling; when he screamed she said, 'Find the red dot!'. He was faster than anyone she had ever worked with, and ran out of dots before the procedure was done. She had to improvise.

After this, he wanted the cafeteria for dinner. Yup. More Hospital Food!

I am realizing that for Raw Vegans there are next to no food options out there in standardized places. As my son tied his shoes outside Starbucks in the morning, I scanned the menus on two restaurants next door--one fine food, another a pub. Every entree had meat. Or cheese. At Target for lunch, we were both starving. He took the last cheese pizza. The next one would have been seven minutes. We didn't have seven minutes. I took the pepperoni and picked the pepperoni off. At the cafeteria, I had spinach blend, which I hate RAW--spinach doesn't agree with me, garbanzos, beets, tomatoes, and carrots with oil and vinegar. None of it was organic. I took a yoplait lemon because I needed something. It was the sugar and not the sweetener kind. I couldn't join my son in burger, fries and coke. It just didn't appeal to  my appetite.

On the good side, all of the utensils and dinnerware were paper and recyclable.

Have you ever heard of a 'decree'? Here is a link explaining them. You can make them, too. Heaven listens, and the Universe provides. http://pleiadedolphininfos.blogspot.com/2013/04/andy-bojarski-create-your-world-through.html

I just made a decree for everyone to have a chance to heal using the best technology available in the Universe.

I like my job doing anesthesia. I love helping people. But in my heart of hearts, the entire health care system is in need of radical change.

No wonder why everyone wants Integrative Medicine and Alternative Medicine! The waits are interminable, the scheduling is too slow, and insurance is a nightmare!

Did you know that the family has retained an attorney to see to it that our mother's health care needs are met? A lawyer has to work against her health care system who is tired of spending money. She has been their patient in different facilities since the day after Christmas. She has almost died three times.

It's that bad.

So make a decree. Any decree. Stand back and wait for it to happen.

It will.

I guarantee it.

And while you are waiting, be sure to give yourself a great big hug from me and my boy and my family and mother. Thank you all for your caring support through these difficult times.

Namaste,

Reiki Doc

Felder and Rousseau

Spirit guided me to the used book store. Let me describe it as 'acres of books'.  It was an interesting 'assignment' because of two things:

1. Spirit clearly guided me to 'Elementary Principles of Chemical Processes', second edition, by Richard M. Felder and Ronald W. Rousseau, part of the Wiley series in Chemical Engineering. I smiled, inwardly. I was a nerd! All the way through High School, I loved my chemistry enough to put up with a horrible teacher who said that chemistry was where the axe fell in college and separated the men from the boys! On having a perfect exam this one would take off points for grammar! It was devastating! I had this book my senior year in undergrad! It wasn't 'my' book, but I enjoyed looking through it and seeing how 'smart' with numbers I once had been.  Chapter One was especially endearing to me, 'What Chemical Engineers Sometimes Do for a Living'. Did you know Frank Capra of 'It's a Wonderful Life' was a chemical engineer? Cindy Crawford too. 
2. As I stood near the metaphysical section, I looked carefully for 'what category' my present 'work' with Doctors With Reiki would go? There wasn't even a 'Reiki Section'. Miscellanous Metaphysical would be not right...I was thinking...and then I glanced to the shelves of books OPPOSITE the metaphysical. Diseases by Alphabet. Many nurtition and other health books, some as overviews by big names such as 'Hah-vahd'. It was then the energy started to flow--a lot of it, right down through my head, and I realized,  neither one is right without the other! Someone needs to 'link' the two specialties-body and spirit! Once I realized this, the energy stopped. And at checkout I found a small pocket-sized copy of my favorite book ever, A Wrinkle In Time by Madeleine L'Engle! They had just bought it on Saturday. And I was able to buy it for me. <3

It is a good thing Spirit has spoken. Look at this recent assessment of medical care in the U.S.--http://shiftfrequency.com/michael-snyder-50-signs-that-the-u-s-health-care-system-is-a-gigantic-money-making-scam-that-is-about-to-collapse/

Greed and power is its undoing. After the system implodes, I hope we can work together to built our 'bridge' between the world of Spirit and the world of Medicine. We can go back to the days of the Kahuna once again.

Namaste,

Reiki Doc

At the Crossroads

Sam is a hypothetical surgical technician. He is about forty-three and has a life that he enjoys. He works full time to support his family, never liked much to read, but is always seeing the new movies as soon as they are released. He is knowledgable and skilled in his work. The entire OR staff enjoys working with Sam.

One day Sam feels a lump. It is cancer. For someone with his training, he knows more than the lay person what type of treatment his cancer entails. It is debilitating, forces him to take time off work, and the success rate, based on what he has seen at work, is not as great as testicular or Hodgekin's Lymphoma, in other words, it is not a slam dunk. He is in it for the long haul.

Sam faces a dilemma. Everyone has a recommendation, from the family member who supports alternative medicine to his surgical oncologist who is his friend. How is he to make an informed decision? If he looks at oncology sources, they will encourage cure at the cost of painful treatments that will make him feel sick and lose his hair in the goal of eradicating disease. They will cite evidence based medicine to direct his care. If, on the other hand, he looks into holistic healing, the focus will be on relieving his suffering, treating him as a whole person (instead of a patient with disease), and focus on healing. Detoxification is a word commonly used in this kind of approach. The studies are weaker, statistically, but in his mind the focus is on his life instead of his cancer.

What we have here are two conflicting ways of looking at healing. Conventional medicine is based on measurement, observation, and the scientific method in a Newtonian Approach. Holistic Medicine, which is not readily measured and considered less effective because of this, may very well be a Quantum Paradigm: measurement itself produces observation effect and 'distortions', making the whole truth difficult to quantify and write papers.

As a sovereign patient, Sam has the right to make autonomous decisions for his health based on sound information, and not fear.

Option 1: Convention Medicine at a large facility
Option 2:  Conventional Medicine at a smaller community hospital near home
Option 3: Conventional Medicine at a Large Nationally important Cancer Center, possibly relocating
Option 4:  Allow disease to take its course. Palliative care only.
Option 5: Alternative Medicine instead of Conventional Medicine
Option 6:  Complimentary Medicine along with Conventional Medicine
           A: Do not tell Conventional Providers  about Complimentary Treatments
           B:  Openly discuss Complimentary Treatments  with Conventional Provider
Option 7: seek Integrative Medicine (example at Cleveland Clinic http://my.clevelandclinic.org/departments/integrativemedicine/about.aspx)

What makes sense? Itis a personal decision, one with far-reaching ramifications. Without having this kind of conversation with a knowledgeable coordinator of his care such as his oncologist, he may choose an option out of a sense of needing not to offend, or perhaps please, someone else in the treatmentof his life-threatening illness. Time is of the essence. Open communication is vital to all people in Sam's life about his treatment plan, from family to acupuncturist.

We all wish for Sam to have as positive experience as possible in light of his serious condition. Only Sam can decide for himself what is truly right for him.

A wise doula once said about childbirth: the important thing is to make an informed decision every step of the way.

Here are some resources:
http://nccam.nih.gov
/http://www.cancer.gov/
http://www.cochrane.org/cochrane-reviews
http://www.mskcc.org/
http://www.webmd.com/balance/what-is-alternative-medicine

The Urologist and the Nephrologist On Lunch

Nothing soothes the soul like a proper spot of tea

This story was told to me by my favorite female urologist:

She has had a collaborative working relationship with a nephrologist, who is open to alternative treatments. They rarely see each other. One day, at the hospital, the nephrologist, who is also female, spotted the urologist having lunch.

Lunch, was something in a styrofoam box from the Doctor's Dining Room, eaten as rapidly as possible. In this case, I think it was a salad.

The nephrologist was shocked! "You can't eat like that!" she said. "You have to slow down! You have to experience your food, interact with it, smell it, taste it, and get pleasure from it!"

The urologist never said anything to the nephrologist, but her look to me as she was telling the story says it all: No duh. I know. I have a very busy schedule. It is 'eat like this, or starve'.

She said, 'Any surgeon, OB-Gyn, E.R. doc, anesthesiologist, or anyone that works in the O.R. will understand the time pressures at lunch time. The internal medicine people that work in the Office just haven't got a clue!'

I laughed and shared that sometimes at work I eat when I am not hungry, when I have the time, because I do not know when the time will come up again for the rest of that day!

Discussions like this help bridge the gap between specialties and places of care.

There is a lot to be said for the thought: walk a mile in my shoes.

Namaste,

Reiki Doc