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The Patient’s Family

Looking through my old drafts, I found a post written when I was starting medical school that was never published. (Written September 28th, 2008) I’m glad to see I still agree with the feelings and thoughts I had then. Published now three years later as I am about to graduate from medical school. Unedited for authenticity. 

Every week in medical school, we have a class that focuses on how to be a good doctor. In this class we discuss how to take a history, what your posture should be like and how to empathize with patients. At this point in our education, our class generally finds the material confusing, considering we know nothing about anatomy and disease. How does listening to their concerns about their daily function going to help us heal them? How does talking to their family have anything to do with treating a disease? It all seem cryptic until, you’re on the other side.

My Grandpa was hospitalized a few days ago. He had just finished his Sunday afternoon lunch when he started having a shortness of breath. With each breath, there was an increasing pain in his chest. An hour later, he couldn’t breathe. When he was brought in to the hospital, the doctors discovered his right lung had collapsed due to a tension pneumothorax. My Grandpa is 86 years old and has had declining health in the past year. The doctors put in a 22 French chest tube into my Grandpa’s chest and moved him to the ICU. The last time I had been in a hospital was when I saw my Grandma lose her fight to cancer.

As medical students, we sometimes get desensitized from what it means to be sick and how it affects a family. We learn about all sorts of strange diseases in our lectures and labs and we spend enormous amounts of time studying them. After many hours in the library, we understand their pathology, biochemical reactions and common treatments, but we often forget how sickness impacts a patient’s life and their family members.

Even though I am a medical student who understands the science and complications behind my Grandpa’s collapsed lung, I was weak when I heard the bad news. I was overwhelmed with fear and worries. I asked about my Grandpa’s condition and if he would get better. I Google’d his condition and looked for answers. I hung on to every word from the doctor’s mouth. I was just as helpless as any other person.

It is from these experiences – when you become the patient and their family member – that the value of our patient-care classes become meaningful. I want a doctor who is competent AND can explain to things to me clearly and patiently. I want a doctor who will listen to our concerns and will work with us according to our values. Who will take the time to go over everything and ask if there are any other questions. A doctor who not only treats the disease but also heals the patient and their families.

I hope this feeling of uneasiness and nervousness stays with me throughout my journey through medicine. I want to remember how serious sickness can be and how it can cause family members to fly in from all around the world to unite with a loved one. I don’t want to forget how much of an impact illness can have on a family and how scary losing someone can be. I don’t know how my Grandpa will be. He is old and has lived a full life, but I want him to stay… if even for just a bit longer. I still want to talk to him and have dinner with him while listening to his crazy stories. If he passes away, I know my family and my aunts and uncles and cousins will grow more distant.

I don’t want to forget my Grandpa and Grandma. I don’t want to forget what it’s like to be a patient or to be dealing with a sickness in a loved one.

25 Tricks to Remembering Names

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Being good with names is a skill everyone can benefit from. It makes meeting new friends easier, socializing smoother and people will respect you. As Dale Carnegie puts it, “a person’s name is to that person the sweetest and most important sound in any language.” We want doctors to care and remembering our names is one of the easiest steps to show it. People have received job rejection letters over misspelled names. Names are important! They make our daily interactions more pleasant and people will be more likely to remember your name if you remember theirs!

I used to be pretty bad with remembering names. Some would stick while others I would be forgotten within the first few seconds. However with trial and practice, I have used several methods that have helped me remember 95% of the names of people I’ve met, if even only for several minutes. I sat down and brainstormed all the tricks I use for helping me remember names. Hope this helps!

  1. Commit Yourself - Remembering names is just like any other skill. The more you practice, the better you get. Make a deliberate effort to remembering people’s names. Don’t make excuses of having a bad memory – remembering other people’s names is a conscious action.
  2. Pay Full Attention: Stop and Listen – The crucial period for remembering a name is within the first 5-10 seconds of hearing it. Concentrate and focus when a person says their name. Mentally repeat the name to yourself a few times. The most common reason for forgetting a name is that people don’t paying attention or were not listening when a person said their name. How can you remember a name if you didn’t even hear it? Treat this first interaction as if they were announcing the winning numbers of a lottery draw. Often, I find paying attention to the introduction of a name the first time is often enough to make me remember their name. Don’t think about your own introduction and how you’ll make a good first impression when somebody is introducing themselves. Remembering their names will be one of the best first impressions you can do.
  3. Repeat Their Name, Name, Name in your Head – three times usually does the trick
  4. For Tricky Names – ask for pronunciation - If the name is Tricky or Uncommon – Ask them to pronounce - Very often you’ll hear a name that you can’t make out clearly or a name that you haven’t heard of before. This happens a lot with cultural names. Instead of making a fool out of yourself by butchering their name, ask them to repeat their name slowly or even better yet to spell it out. Again, people aren’t offended if you didn’t catch their name on the first go. They’ll be glad that you took the time to get their name correct. Even for common English names, I find that asking them to spell their name helps me remember them. It can be as simple as clarifying whether the name was Kevin, Calvin or Kelvin.
  5. Spell out their Name – Is that S-T-U-A-R-T or S-T-E-W-A-R-T?
  6. Ask for First and Last Name – I’ve been guilty of this, sometimes I ask what’s your name (if I forgot), they’ll say their first name, and then I’ll say, “Sorry, I meant your last name”
  7. Ask for the story behind Unique Names (nicknames) – How does someone get a name like Sarge? Apparently he was in the army…
  8. Ask for a nickname (Do they prefer) – Do you prefer Mike or Michael?
  9. Exaggerate Sounds, Words and Letters of their Name – It’s related to saying their name in your head with a twist. Instead of saying Murray, I might say murRAY in my head, anchoring it more uniquely in my memory.
  10. Write down their name right away! – One of the easiest tips, especially if you’re in a meeting and you have paper in front of you. Just write down people’s names and where they are sitting, and use it as a cheat sheet.
  11. Make Visual Associations with the Name - Building upon the concept of remembering a name in multiple ways, mental imagery or silly sounds will help solidify a name. For instance, if you meet a Victoria, you could picture her dressed up in Victorian-era clothes. The more exaggerated and wacky the associations the more likely is it going to stick. If the person has a shared name with a celebrity or another friend, you can look for common associations between the two. Even creating a mental imagery of the two people standing together will help you remember. Picturing your best friend Kevin with the Kevin you just met will create an image you can refer back to if you ever forget their name.
  12. Associate Name with someone you know – Kevin? Just like your best friend Kevin right?
  13. Associate Name with someone famous – Justin? He does look like Justin Beiber
  14. Use their name during conversations – Once you hear their name, repeat it, repeat it, repeat it. Say it to yourself in your head several times. Use it in the conversation to address the person. For instance, if somebody introduces themselves as Sally, you could follow it up with “it’s nice to meet you Sally.” Just the action of saying a name out loud makes it hard to forget. It strengthens your memory of the name through different senses. I guarantee that if you say their name immediately, you will remember their name until at least the conversation is over. It will make the conversation more natural too, but don’t overuse their name either.
  15. If you forget, admit it and ask again – Sometimes, despite our best efforts we will forget our name and it can be embarrassing. However, you should immediately ask for their name once you forget. The sooner you do, the less awkward it will be. To forget somebody’s name in the first ten minutes is totally acceptable, to not know their name after meeting them multiple times will be a big turn-off. You could say, “Sorry, I’m bad with names and I forget your name, could you repeat it again.” People will actually appreciate your honesty and won’t take any offense to it. In fact, people will be happy that you found them important enough to take the time to find out their name. If you meet the person for a second time and forgot their name, you could say, “I remember your face, but I can’t recall your name.” Admitting what that you don’t know is sincere and people appreciate the honesty.
  16. Use a Third Party to Help – Hey buddy, I forgot your friend’s name over there, what was it again?
  17. Eavesdrop for name – look for information on a sheet of paper they’re holding, overhear it in a conversation, look at their name tag
  18. Substitute a name to stall for time – man, pal, buddy, bro, maam, my friend
  19. Ask for Contact Information- ask for email and phone number – You can combine this with what’s your last name?
  20. Write down their name afterwards – After talking to someone, writing down their name will help you recall who they are the next time you meet them.I usually do this after meeting a lot of people I know I might meet again. I will open up a word document or usually a piece of paper will do. I start with the date and location and then attempt to write down the names of the people I met along with a brief description. A sample entry would be, “Welcome BBQ – Paul – shaggy hair, thick glasses, funny, likes tennis.” I try to include a physical description along with some personal details to make it as memorable as possible. It will only take several minutes to do it but the benefits will be far greater than the time spent. Again, just the fact that you’ve added a layer of writing to your memory will solidify your remembering that much more. Furthermore, if you know there’s a chance you’ll be in the same setting again, you can always open up the word document and do a quick scan to refresh your name memories.
  21. Use Technology to Help You – There are so many technologies that can help you remember names. You can ask for an email or phone number after meeting someone to stay in touch. Social networks like Facebook or Twitter is just another tool that can help you remember someone. Just add them after meeting them and you would have created a names list. You can also extend the conversation on the Internet to further to get to know them. Interacting with people is not limited to face to face time, use whatever means you’re comfortable with.
  22. Don’t make excuses – Don’t ever think I’ll never meet this person again. A stranger is just a friend you haven’t met!
  23. Follow up with further meetings – Hey let’s hang out next week…
  24. If you see them again, and you’ve forgotten, Re-introduce yourself – I usually say, I remember your face and talking to you last time, but I’m horrible with names. My name is xxx, what was yours again?
  25. Be Genuinely Interested in Them – I have found that showing a genuine interest in other people to be the best way to remembering their names. I never forget the names of people that I find entertaining. I don’t have a hard time remembering someone who did a favor for me. Try to find something interesting and positive in everyone you meet and get to know the person. Build a story around them and it will make remembering that name that much easier.

There are several phases. The initial introduction being the most important and the step that most people neglect. Concentrate on the first few tricks listed. If you do the first few steps well, the rest of the tips will not be necessary. Second part is to prolong the time in the name introduction, enough time for your brain to process. Next is to solidify the name with different associations, whether it be by audio or visual methods. If you’ve forgotten, there are some tricks to draw out a name again. The last few tips are for long term memory.

Remembering names is an important skill to develop! If you have any tricks or methods that worked for you, please feel free to share in the comments below.

5 Simple Tips to Start Off the School Year Right

Whether you are just starting university or just beginning medical school, there are simple things every student can do to ensure their school year gets off on the right foot. Most of this advice is generic and old, but despite how many times you have heard it before in the past, it’s always good to take wise advice and put it into practice.

School is more than just getting good grades. It is a place where you can grow and mature as a person, pursue your interests and experience life. And by preparing yourself for an academic year, it is possible to have good marks and a good time at school. So here are just five tips that I always consider when September comes around. I hope you find them as useful for you as it has been for me.

1. Set Goals

If you don’t know where you are going, you will probably end up somewhere else.  ~Lawrence J. Peter

One of the most important activities that anyone can benefit from is frequent goal setting. If you don’t have an end destination in mind, life often takes you whichever way it wants, often not to your liking. Do you want to achieve a certain grade point average? Do you want to get to know a few professors that could write you references in the future? Do you want to live healthier, socialize more or try something new? Without setting concrete goals down on paper, goals rarely actualize by themselves.

If you’ve never picked up this habit of setting goals, one effective system to follow is the SMART Goal Setting. Goals should be Specific, Measurable, Attainable, Realistic and Timely. Success doesn’t happen by accident. It takes a focused and concerted effort to actualize your dreams.

So if you haven’t so already, take a few minutes and a piece of paper to jot down your top three to five goals you want to accomplish this school year. Be realistic yet strive to do your best. You’ll find your goals will change from year to year, so I always have a few short-term, mid-term and long-term goals. I adjust them often. Goals act as a compass for our actions. Often when we’re lost or confused about what to do next, all you have to do is to look at the goals you have set out to do to realize where you should go next.

2. Set a Schedule

Time is our most valuable resource. It is a scarce and non-renewable commodity. Once we use it, it never comes back. And yet we are all equally given the same number of hours in a day and it is up to each person to use it effectively. Setting up a schedule is crucial because it helps you manage your time to the best.

Everyone should have a basic calendar or timeline set up. Whether that’s using Google’s free Calendar or a simple white board calendar, you should have a schedule to help you organize. Write down all the new year’s important deadlines. Schedule in social events and holidays. Being able to see how your time is spent will help you use your time wisely. Remember to update and refer to your calendar frequently.

At the very least, you’ll save yourself time always having to look up dates and deadlines if you have everything recorded properly. It will seem like a lot of work at first putting in all the specific dates and events, but I can assure you and anyone who does keep a regular schedule, that the effort is worth it.

3. Get Organized

If time is so important, being organized ensures that we are efficient with our time. Instead of spending several minutes trying to look for an assignment or hours of gathering notes to study, you can use that time to actually work on the assignment and study. Getting organized is one of the easiest things you can do!

4. Know the Expectations

Check your course syllabus. Know how your marks will be distributed. Know what assignments are due and their deadlines. Knowing what to expect allows you to prepare accordingly.

5. Ask for Help when Needed

If you’re struggling early on, ask for help immediately. Go into office hours to get extra help. I remember asking a Professor who taught Chemistry 101, a class where of at least a thousand, how many people could get extra help if they wanted. His answer shocked me. He was lucky to get even one single student during his office hours every week. Go find resources to help you when you need help.

Additional Links

A New Beginning

So starts my second year in the long arduous journey of medicine. In the last year, I feel as if I’ve definitely changed as a person; to what extent I still do not know. But I also find myself more focused now and a bit more certain about the kind of future I want to make possible.

And as usual with the start of the school year, I will be getting back into a routine and running this blog/website will definitely be a part of my schedule. Many changes to come including adding ads and sponsored links. I hope my readers won’t mind. It’s still a pretty big experiment for me but the whole idea came from a book I have just finished reading called Free: The Future of a Radical Price

Basically, the premise is in order for things to be “Free” – especially for web content – there should be a model that ensures it is possible. And for digital information, the advertising model is one of the best and most effective ways to do so. In fact, to a point where customers (readers) actually prefer to have them on websites as it helps bring relevant information to them.

I don’t know if what I’m doing is the right move or readership-suicide, but it’s something that I’m going to try and if it doesn’t work out, I can always revert back.

More updates to come!

Why the MCAT is Necessary

A lot of people complain about the MCAT. I know I wasn’t too keen to study for it. I hated grueling through long verbal passages and needing to practice writing “MCAT-styled” essays. But in the back of my mind, I always thought of the MCAT as an essential and important test to have taken regardless of your score.

The Journey, not just the destination – I’m a firm believer that the process matters just as much as the results in anything we do. There is always such a strong emphasis of getting a good score in the MCAT and needing to meet cut-offs and school requirements that not many pay attention to how they study for the MCAT.

I can only speak from personal experience but I know that studying for the MCAT definitely made me a better student. And it wasn’t because I got a “good” score. Instead, it was during the process of preparing for the MCAT that I was able to develop effective study habits and disciplined time management.

More than another hoop to jump through – Many people see the MCAT as just another obstacle between them and medical school. It’s a thing you just do to get it over with. I urge you to take this opportunity to improve yourself and become a better student and hopefully one day a better doctor. With every challenge and difficult circumstance we face in life, there is also an opportunity for change and growth.

Really analyze how you study, how you learn and what peaks your interest. Find your strengths and weaknesses and nurture and compensate for them. If you were never the type of student to have a focused time-schedule, now may be the best opportunity to try it out. I know I played around with several different learning styles before I settled down on the best one for me.

Life-long Skills - Build your stamina and endurance. Practice learning and reading for fun. Learn something new each day. Learn how to tolerate stressful situations and doing things in a limited amount of time. One practical habit I acquired after writing the MCAT was to read the news everyday. I started out reading the news to get ideas for the MCAT essay. I now read it to learn more about our world.

A lot of premeds always ask me how to get into medical school. And when I tell them about the MCAT and what type of a test it is, the majority fear or dread writing the exam. They wish they would rather not have to write it. I disagree.

The MCAT is as much of a discovery process as it is a proof of your critical thinking abilities and test readiness. It’s the type of test where you CAN study for and prepare yourself accordingly. It’s not just testing your inherent intelligence but also how much you prepared to take it. If you haven’t taken the MCAT, I’m not sure if you are ready for the rigors of medical school.

Up to that point, how many 5 hour exams would you have written? Would you know how to study effectively and efficiently? Would you have the endurance and persistence that medicine requires?

That’s why I think the MCAT is not only necessary for standardizing scores, it is an essential part of the medical school admissions process. It’s a badge of honor, a reward for your hard work. Work hard for the MCAT and I guarantee that you will learn more than just physical sciences and biology. In partaking in this exam, one of which thousands have gone before, you are completing another rite of passage of medicine. Cause face it, there will be many more exams after this one, you might as well get the most out of it.

Links

Work has been busy. I’ve been doing all sorts of stuff related with Swine Flu. I haven’t had time to write anything, so instead here are some links to articles I have read recently (big reader of NYTimes anyone?) and also some links to useful study websites. Hopefully this will be stimulating and help with your school work. Sorry for the lack of posts. I’ve working on another project for now that’s taking most of my time.

One thing I’ve found is the more I learn about medicine, the more I have to know than just the science, pathology and clinical skills. Medicine is truly an art – a combination of communication skills, leadership, management, negotiation tactics and patient compassion. There’s also many fields that you must be aware of like public health, political advocacy, career-lifestyle challenges and health economics, even if they are not your areas of expertise. It’s challenging but also rewarding.

Health Care

A Doctor by Choice, a Businessman by Necessity

Does More Sleep Make for Better Doctors?

Tweeting From the Operating Room

When Doctors Make Mistakes

Links

Study Hacks by Cal Newport

Student Hacks

Zen Habits

Second Rate

Sorry for the lack of updates. I have just started YET another summer of research and there’s an awful lot to learn. I have also been doing some traveling here and there and enjoying one of my last summers.

The Waitlist

I know firsthand from talking to my classmates that a lot of medical students that were accepted off the waitlist often feel like they are second-rate students. They weren’t good enough for the first round of selections and they only got in because the school had a quota to fill.

They call this the alternate syndrome.

The Solution

To any applicant accepted off the wailist, let me reiterate and repeat that regardless of your background, degree or ranking by the admissions committee: everyone is starting at the same starting line

Medical school is a brand new start. A clean slate for everyone. If you keep comparing yourself to others and what they have already done, you will miss the picture of what you are about to do! Medical school is an interesting and challenging period and each individual handles it differently.

Some of the best undergraduates end up being below-average medical students while waitlisted students excel. Your past matters only up to a point. When you begin medical school, your efforts and dedication from there on will determine how far you will go.There really is no difference between the 100th ranked student and the 101st who just happens to be on the waitlist.

So if you just got off the waitlist, congratulations! You are going to be a medical student and eventually a doctor. What do you call a medical student that graduated at the bottom of his class? A doctor. Don’t let this alternate syndrome mentality prevent you from trying and being your best.

Unsustainable

First: I would like to thank everyone for their comments / emails / support. I greatly appreciate them all.

I have been running this site for almost a year now. During that time, I have had several popular posts, I made a fairly complete flow chart outlining the whole medical school admissions process and I have had several thousand readers. However, I believe this site is not sustainable without some changes and further personal  incentive.

I’m not trying to be greedy. There is a cost to run this site, it’s approximately $80 a year for the server, domain name, etc. Additionally, the time needed to run this site, maintain it, and create more content can be quite a burden. For all the time (and time is precious) I put in, I don’t get any money out of it. And lately, less and less satisfaction. If only this site could be more sustainable…

I believe if there was a reward system (Either personal satisfaction or monetary) in place, I would be more inclined to create content. I know this is the internet, information should be for free! But considering my knowledge and experience, I think I could go out and easily charge $50 / hour doing medical school admission consulting. I don’t want to charge money for this site. For my qualifications: I got into medical school early, I did well in my undergrad studies,  and I believe I did fairly well on my interview. Furthermore, I have helped out with the admissions process, reviewed essays and references, been an interviewer and have successfully helped more than 10 people I know successful get admitted.

So I’m asking readers, What should I do? Should I switch to advertising, a subscription, sponsorship or a donation model to keep this site running. Each will have its own pros and benefits. It sucks that I have to even consider this, but I have to consider my own needs too and as a medical student with doing well in my studies as a priority and growing debt, I don’t want to have to worry about this site.

Any help would be appreciated. Thanks for posting comments, I appreciate all of them. Some of them are very helpful, encouraging and thought provoking.

EDIT: The main purpose of running this site is NOT for the money. A commenter posted out that there are a lot of free services out there I could use to. After reading that, I think what I actually want is a connection between the effort and work I put into this site and a reward or personal satisfaction. (I posted in the comments about this). I am not planning to shut down my site, just perhaps find some motivation and reevaluate my reasons for running this site.

It feels like I’m writing to an empty audience sometimes, a monoquily if you will. The main purpose of this blog is not to journal my day, write about my feelings and thoughts (although I do that now and then). It want to help people understand the medical admissions process, help them become better students and make them more informed about health issues.

Perhaps it’s a writer’s block or burnout, but there are days when I log-on and I just don’t want to do anything. Somewhere along the way, I lost a bit of the joy I had in the beginning. It’s partly due to doing the same thing over and over again – helping people with their “What are my Chances” questions or the should I take Organic Chemistry in the summer? – but another aspect is it’s hard to get satisfaction out of helping an anonymous person you have never met and who’s only purpose in contacting you is to get something out of it.

I help out people all the time in person, giving them strategy and tips on how to do better in school, what medical school is like, etc. And although that’s the same thing, I get some personal satisfaction. I can see my results. I will hear back from them if they get into medical school and that makes it worth it. There is a connection between my efforts and a final reward, whether that is personal satisfaction or gratitude.

Why I don’t think I will be a Primary Care Doc

I have nothing against primary doctors. Family physicians and front-line health care workers are important. They are severely understaffed. The shortage is a real concern. But the more I think about what I want as a career, what type of a balanced life I want to live and what type of things interest me in medicine, the more it seems as if becoming a specialist is for me.

While looking at how doctors choose their residency, I came upon a survey published in the CMAJ.

And don’t get me wrong, it’s not the prestige and money that’s attracting me to choosing a specialty. I think it’s the academic challenge and ability to pursue intellectual interests is what appeals to me. I love teaching, I have tutored and taught science classes for the last 4-5 years. I enjoy research, as long as I get a fair bit of autonomy and responsibility.

Finally, I love academia. I’m pretty certain I want to pursue academic medicine, practice in a university-hospital setting, have teaching hours. If I didn’t pursue medicine, graduate school would have been my next choice.

I guess I still haven’t gotten any closer to deciding on what specialty I would like. More to come, as I find out myself.

Mind Your Manners

Despite helping the sick and needy, it still surprises me as to how rude some doctors can be to their staff, students and patients.

A simple please or thank you. Facing your patient when talking to them. Not yelling at people to follow instructions. Being punctual with your appointments, apologizing for the long waits.

Perhaps they have been in a position of power too long or that patients are willing to do anything they say, but doctors should not look down on their staff and patients.

People say bedside manner does not matter as long as your doctor is smart, finds the right diagnosis and gets the job done. I disagree.

The process is just as important as the end result. Compassion is as important as hard work and precision to details. It’s not that one is greater than another, it’s that both are needed!

“Nobody cares how much you know, until they know how much you care”

And patients who have doctors who care are much more compliant with their treatment and much more likely to follow instructions. Manners do matter.

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