choking on yogurt (and other learning experiences)

Last week, we had a series of lectures on health and healthcare for people with disabilities. It began with a brief introduction lecture after which we were divided into small groups designed to teach us about what it might feel like to have a disability. Each group attended a panel discussion about living with a disability (mine was on children with autism) and a simulation lab of some of the difficulties of specific disability (mine was on swallowing disabilities).

In the swallowing simulation we had to do an exercise where we held tongue depressors between our teeth on the right side, and had to try to eat yogurt using just our left hand in order to mimic what eating after a stroke would feel like. It was not easy and definitely not a pretty sight; it turns out, when you can't close your mouth all the way, you produce a lot of spit that comes straight out of your mouth and drools all over your shirt. There were other groups that had to race around the medical school in wheelchairs, only to discover that one of the elevators was permanently broken; another group wore different glasses distorting their vision while navigating through a cafeteria.

The panel I attended was with four other students, and two mothers of children with autism, one who had brought her son. Having just had a lecture on autism, it was awesome to have REAL people talk about their REAL life experiences. One of the mothers talked about how kids with autism present differently because they are attuned to different senses. For example, she did a mock case with her son where he came in and said, "my tongue hurts". So like the good medical students we are, we started asking him questions:

when did it start? (a few weeks ago)

does it always feel like this? (a lot of the time)

when does it hurt? (mostly at night time)

what makes it start hurting? (mostly night time; I wake up and have to touch my tongue)

what does it feel like? (really hurts on my tongue)

does anything make it feel better? (sitting up, sometimes, and touching my tongue)

does anything make it worse? (dunno)

has this ever happened to you before? (nope)

etc.

except what we didn't ask him was: does anything else hurt too?

(to which he would have replied: my stomach - because what he had was acid reflux but because he was so sensitive to the sensation on his tongue, he didn't mention any burning pain in his abdomen. so cool to think about, also because I think probably a lot of kids don't present with the same symptoms as adults.

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mom to her son, who is an autistic 2nd grade: "honey, there are all these terms for kids with autism. do you want to be known as 'an autistic kid' or a 'kid with autism'?"

son: (thinks really hard for a moment) "I want to be known as a kid with autism AND ENTHUSIASM"

mom: done.

7th graders teach medical school

because a lot has been going on, this post is mostly lists, but I wanted to make sure I got these thoughts out there - and those of you who know me well, know that sometimes I think in lists!

a day of medical taught almost entirely by 7th graders - pretty much the greatest idea ever.

example: one girl is trying to answer a question about her favorite subject in school. while she's thinking the boy next to her goes, "well I know what her favorite activity is: kissing brian samuels". She rolled with it so well, and just dismissed him with, "actually it's soccer" ohhhh 7th grade.

then we asked them how doctors could be better with adolescents. they had great suggestions including:

*don't use big words we don't understand

*ask us questions that don't sound like you're interrogating us - like, about not just our medical health but our LIFE

*wait for us to talk - sometimes it takes us longer

*ask about our friends

*ask if we're worried about anything

*don't talk to us like we're not real people who know a lot

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"I guess this is going to be a jigsaw kind of year"

-from one of the poems read to us by the 7th graders today

let's talk about sex

yesterday we practiced taking sexual histories of standardized patients in small groups. We saw three different "patients" (a standardized patient is basically an actor-patient): a teenager who came in for birth control but was engaging in group oral sex with a group of other high schoolers, a man in his 50s who was concerned about his medication causing erectile dysfunction, and a woman who had just started a new relationship in her 50s and had all sorts of questions about what were "normal" sexual practices.

it was pretty fascinating stuff. the things my group learned were pretty effective in taking a sexual history, no matter what the situation is to:

*start by talking about confidentiality and safe spaces - to sort of set the tone for openness.

*make sure the person feels safe (and get details on how they're making sure they're safe) - whether this means barriers to prevent STDs or feeling emotionally safe in whatever relationship

*make sure the patient feels comfortable

*don't forget entirely about medical problems (for example, erectile dysfunction can be caused by medication side effects, but also by drinking more alcohol, as well as some vascular diseases)

*make sure you answer all the questions or figure out resources where the questions can be answered

*be careful about defining normal - we decided to stick to "normal can be lots of things, but what we want to make sure is that it's making you happy and that you feel safe"

any tips ya'll want to add?

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"we are recorders and reporters of the facts - not judges of the behavior we describe"

-alfred kinsey, zoologist, sexologist

medicine | heroes

heard a great story this weekend from a friend of a friend who is working like a madwoman in architecture grad school about her favorite doctor story.

when she lived in NYC, she biked from brooklyn to manhattan as her daily commute to work, often amongst throngs of other bikers. One day, she was biking over a bridge, when this guy speeded past her on his bike, and before she had time to be annoyed, his bike was lodged in the metal fencing of the bridge and he was sprawled out on the concrete on his back.

according to her, all the bikers (and walkers) stopped immediately in shock and were moving towards calling 911 when a short man on a road bike skidded to a stop in front of the man lying on the ground, dismounted from his bike, took off his helmet, walked past the open-mouthed bystanders, bent over the man's body and said, "Hi. My name is Daniel. I'm a doctor and I'm going to stay with you until we make sure you're okay".

this friend said at that moment she wasn't sure if she wanted to be like him, marry him, have him as her father or create a shrine to him - but in that moment, a calm comfort fell over the people on the bridge and everyone knew everything would be okay.

at what point in this "becoming a doctor" journey will I feel capable of that?

What a powerful goal though, right?

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"I think of a hero as someone who understands the degree of responsibility that comes with his freedom" - Bob Dylan

The Science of Monsters & Adding Chunks (aka Learning about Babies)

We started a new class last week that is designed to fill in all the gaps in our medical knowledge following the entire life cycle - so we are starting with pregnancy and pre-natal health and moving toward neonatal health to baby health.

I vasolate between being petrified and So Entertained.

some random pieces of knowledge I've stumbled upon this week in lecture, small groups, or conversations before/after:

*the concept of baby self vs. business self

the theory that children (and adults) can be totally together at work (or kindergarten) but have occasional (or not so occasional) breakthroughs of their "baby selves" where it becomes all about feeding their exact desires at that moment. Our super prestigious professor told us that he needs at least ten minutes of "baby self time" when he gets home from work before he can effectively interact with his family. I've started saying "okay, BABY SELF TIME!" whenever I feel like I just need to go into total comfort mode.

*teratology = the study of the things that can disrupt normal gestational development; directly translates as "the study of monsters" - horrible (except that I get a really warm and fuzzy feeling about monsters lately, which I've tried to check when it's people calling other people monsters).

*TIPS for PARENTING:

(disclaimer: I'm so not a parent, this is straight from my professor)

(1) figure out what you can and cannot control; what you can: how you act, the environment; what you cannot: your child

(2) get Crazy, because sometimes it works (one professor told us about one family's response to their child throwing a tantrum on the floor of aisle 6 in a grocery store was to drop their bags and get down on the floor with him, screaming and waving their arms like him. apparently the child stopped and walked into the next aisle, like "who are those craaaaazy people?"

(3) choices are really important for helping kids feel empowered, and also helping them feel like the world isn't created to thwart their fun, but that they are participating in it and shaping their world. but the choices don't necessarily have to be real choices. As in, not: do you want to me to check your ears? (most kids would say NO WAY) but "do you want me to check your right or your left ear first?" is a real choice that still gets you to where you want to be.

(4) also, a note about Choices is that if you give a child 2 choices - they always pick the second. at least until they are 2. Our professor's advice was to take advantage of this as much as possible. As in: "hey toddler of mine, do you want to watch Barney or THE DARK KNIGHT?

(I'm totally reviewing his lecture when I have children)

*a discussion of intellectual disability and developmental disorders

check out: www.imtyler.org

more on abilities and disabilities soon...

oh, and in case you're wondering what else has happened in my life that I forget to blog about, check out the lovely krista terminalis post on October.

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"cause I'm a man and not a boy, and there are things you can't avoid - you have to face them, when you're not prepared to face them"

-fight test, by the flaming lips

halloween medical school style

does this reveal the nerdiness factor? friends and I dressed up as characters from the (nickolodeon) TV series, Avatar the Last Airbender (not the movie, the movie was awful). A bunch more friends and I watched all 3 seasons of this cartoon/anime show all throughout our course on nutrition, metabolism, and the GI system last spring. It felt like such a homecoming to watch more episodes in preparation for our costumes (which we MADE!!!) Check out our pose below -we're earth and water bending (in case, for some crazy reason, that's unclear).

we are missing Adam, who would have been:

next year.

and for some nerdy fun, a link to characteristics of characters in scifi/fantasy series

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"Azazel: I see you are the surly, temperamental one who instigates, Wolverine. You cannot be the leader, then."

— The Uncanny X-men Issue #432