Dissecting Grief

My rotation through Internal Medicine started off with a month-long stint in the Intensive Care Unit (ICU). Names were often misleading in the hospital regarding what types of patients you were going to encounter; I would see patients strolling into the Emergency Room for the common cold and another patient with trauma and major parts of his hand missing to the “low-key” walk-in outpatient clinic. However, the ICU was perhaps the most aptly titled unit I had rotated through, and the experience was intense in more ways than one. Where I was often used to seeing ten different patients with one acute problem elsewhere, I now saw one patient with ten chronic problems here. Looking back now, the entire month was one big blur where days bled into one another, quick rounds turned into endurance-testing marathons, and one dysfunctional organ system precipitated the downfall of another, like dominoes.

The ICU renders itself as a gateway for the acutely and chronically weak, patient’s whose lives are literally placed in the mercy of a higher power: what that power is depends on who you ask. I would be lying however, if I didn’t admit that the ICU has a distinct aura of holiness. Family members often tiptoe and whisper in profound deference to the medical team and to the patients as if the patency of the patients’ airways depends directly on their ability to minimize all sound. All who enter seek antidotes for their crisis, a distress composed of both physical and emotional elements and sometimes, the emotional masquerading as physical. Replace the pews with endless stretchers, the stronghold confessional with a curtain-veiled bed, and a priest cloaked in black bearing a cross with a physician shrouded in white bearing a stethoscope. Trade religious fervor for actual fevers, church bells for code calls. Some find God in a stained glass, we see god in a CBC. What we lack in offering salvation and moral and spiritual guidance, we make reparations for by providing physical and mental relief often in the form of pharmacological deliverance.

However, just as prayers are often not enough, so are the limitations of science. What do you do when your knowledge is failing, your faith wavering? When you’re forced to make a home out of a barricade? Continue reading

The Beat of A Different Drum

As a student known to sleep through a larger portion of my immunology lectures, the material, for me personally, lacked a little oomph. IgM. APC. CD28. C4b2a3b. A litany of cells, cytokines, and receptor molecules with unimaginative names and, often, even less enticing tasks that sounded more like a roll call for Star Wars characters. Little did I know, however, that the lessons imprinted on me in immunology translated to a much broader message.

Our biological well-being relies on the body’s meticulous ability to distinguish between the innate and the foreign. Thus, recognizing our own self is a lesson imbued to us by our own immune system. If the crux of good health relies on our body’s ability to recognize the “self” from “non-self” then being a good doctor, in my opinion, is about recognizing one’s own motives, perceptions, and attitudes against the backdrop of competing interests.

While conducting a research study on undertreated pain in sickle cell patients in a small middle-income nation, I interviewed around 40 sickle cell patients. After several long weeks of talking to patients, they all seemed to blend together as one in my head. However, one particular patient would always stick out in my mind. William, as I’ll call him, was rather gaunt and scraggly when he walked into the clinic where I was conducting interviews. His uncharacteristically hollow and worn face spoke volumes about his disposition and how mismanaged his pain was as a result of his disease.

Nevertheless, it wasn’t his face or his stature that made him more noticeable in my mind, but rather something about his eyes. There was a glaring yellowish tone within them, signs of full-blown jaundice, a common symptom of the disease, but even that was far from what made them distinctive. It was, instead, the dejected look he carried about him, a man who lost that sustaining spark to carry on. More so than his body, it was his spirit that was crippled. Continue reading

New York Times Response

St. George’s University was recently mentioned within an article entitled Medical Schools in Region Fight Caribbean Flow within the New York Times. I was initially baffled beyond words when I read this article. However, the very same preconceived notions and mendacious judgements highlighted in this article are the same ones that must be tackled by any and all students choosing to attend foreign medical schools. The article states nothing more than that deans from New York’s medical schools are trying to make it more difficult for medical students of foreign graduate medical schools to obtain clinical rotations/clerkships in New York hospitals due to the high volume of these students and low slots available. New York offers a unique niche to fledgling medical interns in terms of exposure to various cases, patients, and situations and thus, is high in demand as a location site for clinical rotations. I’d like to point out some of the inadequacies in the arguments (and possibly beat to a bloody pulp some of the people that stand by them). Continue reading

Where Does Your Loyalty Lie?

My research mentor for most of my undergraduate career.

As an undergrad at UW, I was fortunate to work in James Thomson’s regenerative biology lab. Jamie (as he was fondly known) was the first cellular biologist in the world to derive the first set of human embryonic stem cell lines and in 2007, matched his previous brilliance with a new ability to program adult skin cells into becoming pluripotent stem cells. Although rather demure in nature, Jamie’s novel work catapulted him into not only the limelight of scientific endeavor but also the ire of certain conservatives as well. His breakthroughs were discussed in terms of not only medical impact and potential for progress but initiated tangents on moral and ethical guidelines. From the Bush administration to the Obama administration, regulating stem cell research is a topic still laced with obstacles and contrived of many ill-formed perspectives. The promise stem cells hold in terms of treatment towards many debilitating diseases on the face of planet today is boundless and immense—something I won’t even attempt to approach in this blog. Likewise, the amount of funding poured into such research endeavors stands to be astounding, especially if the president is allowed to lift the limit on how much funding can be provided. Continue reading

Of Hope and Hogwartz

I’ve been meaning to write this particular post for a while now. In the midst of getting ready for Grenada, and moving out of Madison, I haven’t fully had time to reflect on all that I’ve learned while I was out visiting with my girlfriend’s grandparents. They live in a massive retirement community spanning three counties  in Florida called The Villages intact with pools, movie theaters, communal squares, shops, golf courses and all of these places are accessible by golf carts…I’m probably not the only 23-year-old drooling over this palatial retirement resort.

We visited the Harry Potter portion at Universal Studios in Orlando. Hogsmeade is pictured above.

Over the week, I relished in the honor of getting to know my girlfriend’s grandmother, Peggy, very well. Her life in recent years has emerged as an overlapping case report of medical episodes. She suffers from peripheral neuropathy where she gradually continues to lose sensation in the tips of her fingers and toes. She also simultaneously suffers from diabetes type 2. After gaining sores in her feet from what would be only the second pedicure of her life, her life led into a downhill spiral full of doctor’s visits and treatments. As her sore was getting better on her right leg, doctors discovered a blood clot in that very leg. It might not have been so bad with diabetes alone but that compounded with 40 years of smoking history only served to exacerbate the situation. She had a catheter placed within her that delivered chemicals to diminish her clot. While the clot successfully lessened, severe immobility due to the placement of the catheter worsened her sores. It was only through rehab that she regained movement of her foot. Continue reading