The Power of ‘Meaning’

Angie, Fourth Year Medical StudentWhile boiling raw beets for my mom- she swears by them for helping lower her blood pressure- I came across a Google news story titled, “Tearjerker! Angelina Jolie’s Speech at the Governors Awards Will Make You Cry.” Curious, I clicked on the link and found myself indeed moved by Angelina Jolie’s speech.

Above all [my mother] was very clear that nothing would mean anything if I didn’t live a life of use to others. I didn’t know what that meant for a long time… it was only when I began to travel and look and live beyond my home that I understand my responsibility to others. -Angelina Jolie

I could not agree more with her words about living a purposeful life to the fullest. During the last couple months, I have asked myself too many times why I am choosing to pursue a career that will daily ask demand me to choose between two jealous loves I love most- my patients and those I call family. The next four years of residency will be brutal, exhilarating, and exhausting because it will be the time to try to learn everything in the field of obstetrics and gynecology to come out ready to practice or pursue fellowship. I am realistic- it will be stressful making sacrifices and feeling like I may not be able to make everyone 100% happy all the time.

So why am I still here? It is because the pursuit of medicine in the field of obstetrics and gynecology brings my life meaning. With the skills, experiences, and support I have been blessed with these twenty-seven years, I find greatest peace and energy when I am placing the wellbeing and comfort of my patients before that of my own. This seems counterintuitive, but a TED talk by health psychologist Kelly McGonigal recently helped me see that the new science also supports this idea that stress- when attached to something meaningful- may actually be beneficial. One study looked at the impact of stress on longevity: overall, there was a 43% increase in the risk of death for those who believed they had high stress and that stress had a large impact on health. However, those with high stress who did not perceive stress as negative were amongst those least likely to die. Furthermore, another study found the positive impact of giving to others on stress-related mortality.

I have been so thankful for my parents who have not asked me for anything more than to come home to have dinner with them when I am free. I am also so thankful for my sister who has taken the time to travel with me to some of my interviews; my significant other who helped me first survive, then taught me to thrive in medical school; and my lifelong friends who have forgiven me for my selfishness and stuck by me through the toughest times. These people bring my life meaning, and will continue to balance the negative stress that I will inevitably face at times.

This interview process has been ‘stressful.’ When I talk with my interviewers about my passion for women’s health and medicine, my heart begins racing and the rate of my words speeds up. But I remind myself that this stress is positive, and just a natural response to my perception of a worthy challenge in the pursuit of living a meaningful and responsible life helping others.

It has been a wonderful experience meeting my fellow applicants and and I wish you all the best as we continue to pursue the common goal of becoming excellent OBGYN doctors!

You can trust yourself to handle life’s challenges. And you’re remembering you don’t have to face them alone. –Kelly McGonigal

-angiek

Lessons Learned Abroad

Paige, Second Year Medical StudentThe summer between the first and second years of medical school is really and truly the last summer break of our lives.  We have 2 months to soak up all the sun and fun we can before we begin the arduous process of tackling second year and USMLE Step 1, which is then followed promptly by beginning our clinical rotations of third year.  Medical students choose to spend this last glorious summer break in a variety of ways; those interested in competitive residency programs pursue summer research programs, others choose to take the summer to travel and spend time with family before allowing medical school to once again take over every aspect of their lives, and others choose to spend time as student missionaries in one of the many locations that Loma Linda sponsors.

Spending my summer as a student missionary was at the top of my list of things to do this summer and has been for quite some time.  I had never been on a mission trip before because I had been waiting until this summer between my first and second years of medical with the hope that I would be able to utilize some of the minimal medical knowledge that I have accumulated in the last year to do some tangible good in the community that I would be serving.  This summer I was privileged to have the opportunity to travel to Honduras, Central America to work in the Hospital Adventista Valle de Angeles.  I was able to serve alongside three of my classmates and a pre-medical student from Union College for four weeks in this beautiful country, and the lessons I learned while on this mission trip will undoubtedly shape my personal and professional life for many years to come.  Below is one of the lessons I learned about short-term mission trips.  I hope that by reading this experience you will think about the impact that short-term mission trips have on the lives of those we serve and on our own lives.

I had my first doubts about the benefits of short-term mission trips while I was boarding my plane from Houston to Tegucigalpa.  The vast majority of travelers boarding the plane with us were Americans wearing bright colored matching t-shirts with “Honduras Mission Trip 2013” printed across their backs.  Most people visiting Honduras were not doing so to enjoy the vast natural beauty of its tropical rainforests, or to explore the rich history of the Mayan ruins, or to immerse themselves in the loving and hospitable culture of the Honduran people.  Instead, nearly everyone on that plane was venturing to Honduras with the hope that they would be able to serve the Honduran people in some way, whether that was through building a church or a school or offering medical or teaching services.  Although this is without question a noble motive, it made me wonder if we had pigeonholed this country into being a place that needs “our generosity.”  I refused to believe that I would be serving the people of Honduras more than they would be serving me because I knew that I would likely learn more from this trip than I would ever be able to repay in service to my teachers.  I knew that I would gain many insights during my time in Honduras and I prayed that God would use me in even the smallest of ways to at least make a small impact on the people that I would encounter.

As the trip progressed, I realized how much I was changing as a result of seeing the things that this country had to offer and how little I felt that I was contributing.  Not being able to speak the language meant that I could not communicate well with those around me; this made it difficult for me to feel like I had made any impact on anyone’s life.  That all changed when Miss Marjorie, a retired teacher from the local Adventist school came into our lives.  We had requested the opportunity to go into the local school and teach the children about healthy living; Miss Marjorie was the person who made this request a reality.  One week, Miss Marjorie was presenting a special English Sabbath School lesson about prayer to our group.  She talked about times that prayers had been answered and shared a personal testimony about how a recent prayer of hers had been answered.  To our amazement, she actually told us that we were the answer to her prayer.  Earlier in the year, she had left her position at the school and never had a chance to say goodbye to her students.  Ever since, she had been praying that she would find a way to get back into the school to see her kids and explain to them why she had to leave.  She said that when the hospital had contacted her about 4 students from Loma Linda who only spoke English and who wanted to work with the kids in the school, she knew that God had worked to answer her prayer to get her back into contact with her kids.  Miss Marjorie showed us that God was using us in ways that we couldn’t have even imagined.

I still believe that the vast majority of short-term mission trips benefit those who go on the trips more than those who are being served.  I also believe that this is rightfully so.  It is important for people going on short-term mission trips to realize that they will likely learn more from their experiences and change more as a result than those who they go to serve.  Having an open mind about choosing to learn and grow from these experiences does not imply selfish motives, in fact, I believe that it is selfish to think that we can go on short-term mission trips and always make a life-changing impact on the communities we serve.  That being said, there is no doubt that God can use us to touch the lives of others on short-term mission trips in ways that we cannot foresee and blesses us immensely through the process.

I am so grateful for the experiences that I had while in Honduras, I grew immensely spiritually, emotionally, and professionally, and I am assured that God was able to use us in ways that we may never even know.  I would argue that there is no better way to spend the summer between the first and second years of medical school.

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live. love. VOLUNTEER.

I have this big button that I got in college that is on my backpack that says “Live. Love. Volunteer.” The pin always tends to fall out of place and inconveniently pokes my finger when I reach for my backpack, but I always put it back in place because every time I see those 3 words I recount back to when the last time I had volunteered was. During exam seasons during first and second year, it would seem like weeks or even months since I had and I would feel secretly ashamed for having that button declaring to the world that I was promoting service. But that pin helps remind me that most times it is just that simple and that I should just get out there. To live, you must love. To love like Jesus you must volunteer your time to others when it seems to cost the most.

So if you feel called to give some of your time to serving others, come join your fellow peers in these opportunities to do so!

Street Medicine
If you desire to serve the homeless population, here is an exciting new project started by a few medical students last year. I feel like the video above speaks volumes on what the mission and heart of the project are. Visit the Street Medicine website to get more information on how you can start volunteering and stay tuned for exciting leadership opportunities coming up!

Healthy Neighborhood Projects
As one of the Co-Directors for Healthy Neighborhood Projects (HNP), the rest of the team and I have been excited for the influx of new volunteers who want to be involved in the lives of the kids in our community. The faculty advisers and student leaders met in August for a rewarding and informative leadership seminar so that we would know how to best serve the projects this year.

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Learning about the population and city of San Bernardino.

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Project leaders (Clockwise from top left): Project Hope ladies, Special Ops’ Neil Patel, CAPS’ Tina Pruna and CPC mother who generously provided lunch, CKC Tutoring’s Chris Chung and Aldo Espinoza, and CKC Music’s Ariana Anugerah.

We then had a chapel service dedicated to service in September, and Dr. Marti Baum spoke about the various community projects including:

  • Project Hope: mentoring expectant teen moms weekly
  • CKC Tutoring: tutoring youth ages 5-16 weekly
  • CKC Music: giving youth ages 5-18 violin, piano, and cello lesson weekl
  • Special Ops: mentoring 5th and 6th grade “at-risk” boys by participating in sports and outdoor activities weekly
  • Kids ROCK: Teaching kids about Christ through skits, activities, Bible stories, and more every Saturday
  • Community Parent Connection: program for parents including monthly meetings, ESL, nutrition, computer literacy, health courses, and more
  • SACHS Clinic: providing low-cost medical care to the uninsured and underserved
  • Street Medicine: newest service project serving the homeless by offering free medical care at weekly clinic and street walks

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It’s not too late to get involved. You can visit the website or message me to get started!

I can’t wait to share all the more incredible things we do this year!

-angiek

Pediatric Diabetic Camp

4th year has been fun so far!  In a previous post, I mentioned how exciting it is to choose electives.  Well, one of the elective I chose is Pediatric Diabetic Camp and Endocrinology.

This is a 2-week elective, which consists of 1 week of Diabetic Camp at Camp Conrad-Chinnock in Angelus Oaks (near Big Bear) and 1 week of Outpatient Pediatric Endocrinology at LLUCH Subspecialty Clinics in San Bernardino (a mile from LLU).  Though I was at camp on an elective, you do not need to be a 4th year LLU medical student to volunteer.

I was part of the medical staff at Camp Conrad-Chinnock, and it was a blast.  I recommend this experience to medical students of all levels, premed students, doctors, PAs, nurses, and anybody else who wants to learn about diabetes and/or chronic diseases while having fun with the kids.

Although I am going into Adult Neurology, I found my camp experience to be relevant to my future career because I will be working with patients living with chronic diseases.  Besides, I want to take full advantage of gaining broad medical knowledge while I am still a medical student.

You can learn more about Camp Conrad-Chinnock here: http://campconradchinnock.weebly.com/ Mark your calendars for next year!

View from Outside of the Medical Infirmary at Camp Conrad-Chinnock

This past week, I had an amazing time in the San Bernardino Mountains learning how to manage Type 1 Diabetes while enjoying camp life.  The week I attended, Session 4, had approximately seventy type 1 diabetic campers between the ages of 7 to 12 years old.  Some were diagnosed only 3 months ago, while others had already been living with diabetes as infants or toddlers.  Because diabetes does not discriminate, there was a diverse group of children with diabetes.  The majority of the program staff and counselors had diabetes too, and many were also past campers, which showed me how valuable camp is to these diabetic kids.

Picture of Campers and Staff

While at Camp Conrad-Chinnock, I was assigned a cabin with ten campers to follow and manage for the session I attended, with the supervision of excellent physicians.  Before meals and snacks, I would help them figure out how much insulin they needed to administer, adjusting for carb intake and their glucose corrections.  I also made sure they received their daily medications and drew up injections.  Many children, however, had insulin pumps, which are attached to areas with subcutaneous fat on their bodies.  It is a device that resembles a pager where the user can enter in how much insulin will be delivered.  It is connected to tubing that attaches to the user’s body.  The insulin pumps remind me of IV’s because they are always attached.  Of course, the tubing and pager part can be taken out for showering and swimming.  I thought they were a convenient way of administering insulin.  Rather than getting 4 injections each day, those with an insulin pump just needed to change their infusion site every 3 days.  One of the days at camp, a representative from Medtronic, an insulin pump manufacturer, came to teach some of the kids about the insulin pump.  Those that did not have the pump got to try what it feels like to have the pump infusion set placed on their bodies.  Although I do not have diabetes, the Medtronic representative let me try too.  I had the infusion set placed on my abdomen.  Before I came to camp, I did not know how to calculate insulin dosing, and I did not know that insulin pumps exist.  What a difference a week makes.

This is an Insulin Pump Infusion Set Attached to My Abdomen

In addition to helping campers figure out insulin dosages before meals and snacks, medical volunteers were assigned shifts, in which we staffed the infirmary.  Campers would come to the infirmary for high or low blood glucose readings, in addition to treatment for common medical problems, such as headaches, injuries, and more.  Doctors, PAs, nurses, and other students volunteer as medical staff.  Honestly, being a medical member of Camp Conrad-Chinnock was a lot of work, but it was also a lot of fun.  During free time, I could enjoy camp activities (arts & crafts, rifles, archery, swimming, nature, sports, etc.) or take a hike in Angelus Oaks.

Another Medical Staff Member and I Hiking in Angelus Oaks

Below is roughly how I spent each day:

  • 6:30am= wake up, shower, stock supplies, get campers’ meds ready, check overnight events
  • 7:30am= record campers’ blood sugars before breakfast, calculate insulin dosing, prepare insulin injections, check insulin pumps
  • 8:30am= eat breakfast
  • 9:15am= camp staff meeting
  • 10:00am= free time or staffing the infirmary
  • 12:15pm= stock supplies, get campers’ meds ready, check morning events
  • 12:30pm= record campers’ blood sugars before lunch, calculate insulin dosing, prepare insulin injections, check insulin pumps
  • 1:15pm= lunch
  • 2:00pm= free time or staffing the infirmary
  • 5:15pm= stock supplies, get campers’ meds ready, check afternoon events
  • 5:30pm= record campers’ blood sugars before dinner, calculate insulin dosing, prepare insulin injections, check insulin pumps
  • 6:15pm= dinner
  • 7:00pm= medical staff meeting
  • 7:30pm= free time or staffing the infirmary
  • 9:15pm= stock supplies, get campers’ meds ready, check evening events
  • 9:30pm = record campers’ blood sugars before bedtime snack, calculate insulin dosing, prepare insulin injections, check insulin pumps
  • 10:00pm= bedtime snack
  • 10:30pm= prepare list of campers for midnight rounds, stock supplies
  • 12:00am= midnight rounds or bedtime
  • 3:00am= 3am rounds or bedtime

Archery Area

Camp was an intensive introduction to living with Type 1 Diabetes.  Every other day, I had to do midnight rounds, which consisted of bringing lancets (aka pokers) and glucose meters to my assigned cabins and testing certain campers’ blood sugar levels.  A group of us medical staff would bring the supplies to each cabin and use flashlights to find the campers that needed to be tested.  Since most of the children were already sleeping, I would usually just grab their hands, poke their fingers, and drop their blood on a glucose meter.  This would get a bit complicated when testing the children on the top bunk beds.  What was funny is that most of the campers did not even wake up when I tested them.  However, we did need to wake up the kids whose sugar readings were below 100 or above 300.  These campers were given juice or a snack if their readings were low, or asked to test for urine ketones if their readings were high.  Getting them out of bed was sometimes a challenge.  For one night during the week, I was also assigned to do 3am rounds on the children who had concerning glucose levels at midnight.  Although some days were busy, it was a wonderful learning experience, and everyone seemed to have a good time.

Some Members of the Medical Staff

The most valuable thing I learned from Diabetic Camp is what life is like living with a chronic disease.  As a diabetic, there are definitely challenges.  Blood glucose levels change with different activities and different types of foods.  Sometimes, it can be a struggle to determine the appropriate carbohydrate to insulin ratio and basal rates of each child.  Each person is also unique in their responses to insulin dosages and responses to changes in activity and diet.  It was certainly very interesting to witness how the various campers responded to their insulin regimens at this camp, which was at high altitudes in the mountains.  At times, I would find myself frustrated when my campers’ blood glucose readings were fluctuating.  Luckily, there were no campers during Session 4 who had sugar readings that were too high or too low to the point of going into diabetic ketoacidosis or having seizures.  Overall, our medical staff did a good job of managing the campers’ insulin regimens.  The children, obviously, also did an excellent job of counting carbs and reporting when they over-ate or felt that something was wrong.  I was very impressed with how much knowledge these young children had of managing their diabetes on their own, especially at the young age of 7 to 12 years old.  I could tell the campers also had a lot of fun.

Water Slide for Campers to Enjoy

Although living with diabetes can be challenging, I have seen that it is not limiting.  Having diabetes, or any chronic disease for that matter, does not necessarily mean that the person must cease all activity.  At Camp Conrad-Chinnock, each day was packed with various activities for the campers to do.  These included: swimming, shooting rifles, doing archery, climbing an adventure wall, playing sports, and more.  There were also water fights and dances.  One of the days, the whole camp hiked to Jenks Lake, and we went canoeing.  This was exciting for me because it was my first time riding in a canoe.  With careful management, having diabetes is not restrictive.  Working at camp showed me that people with diabetes can do activities and eat food just like everybody else as long as they are aware of their bodies’ changes in glucose levels.

Canoeing at Jenks Lake

Ultimately, I enjoyed my experience managing children with diabetes at Camp Conrad-Chinnock.  Since I do not have diabetes or any other chronic disease myself, I feel a greater appreciation of my own health.  I feel fortunate that I can eat whatever I want or do whatever activity I desire without having to worry how my glucose-insulin balance will be affected.  At the same time, I believe I have also become more aware of the needs of others living with diabetes or other chronic diseases.  This experience has been very valuable to my medical education and future career as a neurologist.  As a neurologist, I will certainly deal with patients who have chronic medical issues.  I would recommend this rotation to anyone looking for a unique, hands-on experience learning about diabetes and living with a chronic disease.  This is truly an amazing elective, and Camp Conrad-Chinnock even provides housing and food for medical volunteers.  I also got to shoot a rifle for the first time.  What more can I ask for?  Can you believe I actually get elective credit for having fun at camp?

Shooting a Rifle

on Special Ops.

I often find myself in difficult situations, situations that frustrate me.  I choose to do something simply because I want to, or I like the idea of it, regardless of whether I can do it well.  Actually, most of the time, I’m probably not that good at it.  But I want to do it, so I do.  But, on the other hand, not being good at something makes me want to do it more to see if I can master it, and overcome the difficulty, winning over my frustration. Take this student blog for example:  I really liked the idea of it, so I agreed to be a contributor.  But, as my number of posts reveals, I am not too good at blogging regularly.  When I don’t post for a while, I feel as though I’ve let the organizer down, and therefore put unnecessary pressure on myself to write, but the pressure also intimidates me. So blogs end up unwritten.

Special Ops is another situation similar to this blog; I really like the idea of it, but I am not good at it.  Special Ops is a program at LLU where students go to a local high school every Friday afternoon to mentor at-risk high school students, so every Friday several other mentors and I carpool to San Gorgonio High School.

This last Friday at San G (that’s how savvy people refer to it) we broke up into small groups, with one mentor to three or four students.  I don’t know if every mentor felt this way, but I felt that all of the most difficult kids to work with ended up in my group.  They were the most distracting, most distracted, and most resistant.  I do not have a dominating character, nor a dominating voice, so leading the discussion was very difficult.

I sat with them in a circle of desks, juggling their focuses.  I would get one, only to let two others be thrown up into the air.  And while occasionally they would answer one of my questions, which were actually meant to seed a discussion, they would usually state something random, or even tell me to be quiet.  I couldn’t help but laugh, both at the difficulty of the situation and at the things they would say.  I am glad I am going into medicine and not dentistry, because that discussion could be referred to as being “like pulling teeth,” and I don’t know if I could “pull teeth” like that every day.

While the discussion wasn’t as successful as intended, I can’t say it was a complete failure, either.  These kids are smart; they’re just distracted; distracted by their peers and all the pressure they bring. Distracted by insecurities they try so hard to disguise. Distracted by differences and masking their misunderstandings with stereotypes. Distracted.  It’s so hard to get them to focus, but that’s all they need.  They gave good answers to the questions I posed, but refused to focus on the discussion, succumbing to the distractions instead of focusing through them.  But at least I got answers from them.  Good answers.  But I only can see this in hindsight.  I walked away from San G frustrated at my inability to connect with the kids the way the Special Ops leader can.  But Special Ops is something I enjoy overall, and is something I want to do and am glad to be doing.  So I look forward to the difficulties and frustrations of next Friday.