October 7, 2017

Comparing yourself to others

Looking at the heavy-hitters in the medical field never fails to spark in me both a sense of admiration and of dread. Physicians who take time to teach the general public about medicine (Atul Gawande); physicians who devote their lives to the raising up communities (Paul Farmer); physicians who make the most out of their dual degrees (Anoop Raman, see article below). [For some reason, I'm unable to summon up a female physician's name. Whether this is due to my limited knowledge or some deeper challenge that women face, I don't know.]

Hearing their accomplishments makes me reflect on my own and I feel that I pale in comparison. My heart beats a little faster and I imagine that stomach drops an inch or two - anxiety starts to gnaw away at me. My brain starts to list out my every failure and a vicious cycle of feeling sorry for myself begins. A voice inside me says, "I don't work hard enough, I don't care for others enough, and I am certainly not smart enough!". I've been working on squelching this voice through journaling and mindfulness techniques, but I haven't faced it head on.

Because my current rotation is psychiatry, my concerns about comparing myself have been at the forefront of my mind. I recently learned about cognitive-behavior therapy, a technique for addressing distorted thoughts about yourself and breaking the vicious cycle of negativity. It's not enough to simply say to yourself, "Stop it! Stop comparing yourself with others." If this was the case, therapists and doctors could cure everyone within a month or two. "Stop deluding yourself!", "Stop late-night snacking!" And they'd probably stop wars too.

Cognitive-behavior therapy (CBT) is based on a trifecta of thoughts, actions, and emotions. One way of looking at how it works is that our negative thoughts leads to actions (or poor behaviors) that reinforce our emotions of feeling bad about ourselves. CBT, combined often with pharmacotherapy, has been shown to have great success in treating those with anxiety disorders, a group of conditions that include OCD, social anxiety, and PTSD. Here are the general (and very logical) steps involved:

Step 1. Identify and challenge problematic thoughts and beliefs
Step 2. Create pleasant activities that challenge problematic beliefs, like calling a friend for someone who believes no one likes them
Step 3. Extended exposure to anxiety-eliciting stimuli to decrease our panic response

While I'm on this relevant rotation, I'll be trying out some self-CBT in order to work on my bad habit of comparing myself with others. In my last rotation, family medicine taught me about motivational interviewing, a technique for building up motivation in patients to change their habits for the better. By working on both these techniques, I hope that I'll be better at encouraging patients to take good care of themselves!

Few things I've been reading:



http://www.aafp.org/afp/2015/1101/p807.html "Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders"
*Note that it's likely that psychiatric disorders or mental illness is really a spectrum. There's no clear black or white status of yes, you're mentally ill vs. no, you're just maladjusted. We all have positive things to gain about becoming self-aware of our mental health. :)

September 30, 2017

What I've been reading

Hi, quick and messy message as I fly by the blogosphere. I've finished up my family med rotation and my thoughts have been trending more and more toward doing a family medicine residency, and less and less toward specializing. By becoming a family med doc, I'd be doing the type of medicine physicians centuries ago only wished they could do. There's so much information out there, so much new medicine and technology, that it's exciting to be someone that can synthesize all of that for patients.

1. https://orionmagazine.org/article/forget-shorter-showers/
True true, we humans make minor impact on day-to-day basis but we should still strive to be minimally impactful on our world's resources.

2. https://www.newyorker.com/books/page-turner/the-promise-and-potential-of-fan-fiction

3. http://mentalfloss.com/article/79912/15-writers-who-were-also-medical-doctors
I have this funny dream that one day I can publish a book of poems, so that led me down the Google rabbit-hole of checking who else balances writing and being a physician. Turns out, it's men for the most part.

4. https://www.theguardian.com/books/2015/oct/11/nawal-el-saadawi-interview-do-you-feel-you-are-liberated-not
Which led to me to read this.

5. https://www.buzzfeed.com/hannahallam/a-foreign-policy-expert-says-calling-out-trumps-hate-speech?utm_term=.gv54WXAvJ#.pwA92nEKV
The actions of our President continue to astound and shock me, and it seems to have placed many good folks in politics in tough situations.

6. 99% invisible
- El Gordo: expensive lottery tickets lead to whole towns being lifted economically upward, neat!

7. NYT The Daily
- Friday, Sept. 29, 2017: pleading insanity for murder and mental health stigma

8. This American Life - story on Proudboys

9. Finished Rumi and Slice of Life :) Going to try working on my speedreading because I am feeling that FOMO on missing out on knowledge!

September 10, 2017

What I've been reading

I'm taking a hot minute from studying to write an update. I'm under self-induced stress to meet several deadlines, because me being me, I pushed them all to the last minute. However, I like to think I work better under pressure. ( ´ ▽ ` )b

While I was busy ignoring what I needed to do, I read some stuff and cringe-watched my way through some other stuff. Stuff!

AO3's KakaIru Archive, and doujin
I never really understood this pairing. During high school, I was swept by the major ship at the time - Naruto and Sasuke! And I have to admit, not a fan of any of Kishimoto's female characters (except for Anko). All things have changed. I love the world-building Naruto lends itself to and I love that both Kakashi and Iruka are sane adults who have no revenge plots brewing in the back of their heads. I'm still not a fan of Kishimoto's portrayal of women in Naruto, but that doesn't mean I don't love who they could be in another fannish world.

I recommend any fic written by pentapus <3.

NYT No Benefit Seen in No-Salt Diets
In fact, there may be increased risk of heart disease from the rise in triglyceride fats, more insulin resistance, and increased sympathetic nervous system function. Salt in moderation!

NYT Taxing the wealthy
We used to have a 90% tax for those in the highest income bracket, and we were all happy with it until some president (cough Johnson) decided to start a movement toward lowering it. Now we're at about 40% for the highest income bracket. Not to mention the offshore accounts most wealthy folks stuff their extra cash in. Money in moderation!

The King's Woman
Not recommended. Way too much dubious consent and outright nonconsensual advances going on in this series. :/

Okay, back to the hole from whence I came.

August 11, 2017

What's I've been reading

Hello out there! It's been awhile. I've relocated to a new city (or rather, my old city) and have moved into a great apartment. We have a small backyard and to our left is our neighbor's vegetable garden and to our right is our other neighbor's flower garden. There's also a peach tree that's beginning to bear fruit with some of its branches in our territory - which means possible peach crisp come autumn!

Exciting things have been happening - first, my 8-year laptop got fried and I had to get a new one. I'm now a HP convert with one of those fancy 2-in-1 laptops. Finally, a laptop that doesn't weigh 5lb! My back is grateful. Then I started my ob-gyn rotation and it has been relentless work until now. I've finished my shelf this morning and I'm looking forward to a relaxing weekend and finally having the chance to enjoy what's left of my summer.

Things that I have been consuming!!

- My sweet childhood memories. Now that I have a PC, I can finally play Maplestory again! They've made it really easy to level-up. Nearly lvl 100, what!

Brooklyn Nine-Nine S4
- I like to think I'm Raymond Holt, but I'm actually Amy Santiago.

Ode to Joy Season 2 (on viki.com)
- One of the best modern-day dramas out there and focused on strong relationships between women
- Some parts I skip and I was rather disappointed with Guan Guan's love story, but still I loved it.

Pretty Li Hui Zhen (The King's Woman) (on viki.com)
- Dilraba and Zhang Bin Bin really impressed me here, but I had to stop watching half-way through because the male lead was too stiff and didn't have the same chemistry Dilraba and Zhang Bin Bin did.
- Good thing those two will be starring in the The King's Woman! Still, in antagonistic roles, but I'm hopeful for some great scenes between the two of them.

Don't Give Up, Dodo! (on viki.com)
- Chinese web series of 10 episodes, 20 minutes each - a really solid comedy with all the quirks of Chinese culture hidden inside.

Fun medical facts!Spinnbarkeit is the term used to describe cervical mucus just before ovulation. Mittelschmerz is the term used to the describe the pain some women feel mid-cycle as their ovarian follicle erupts and releases the egg.

May 14, 2017

What I've been reading

I'll be transferring to schools in the fall and returning back to my old city and back to live with my husband. I still can't quite believe that I was accepted. This week's been a doozy. It's been filled with strange encounters with patients and their next of kin, an impromptu therapy session, and the start of my final meals with friends in this town.

I've started studying for Step 1 full-time, armed with UWorld and Tomato-timer.com. There's a lot of sitting in my future.

Here's what I've been consuming in the past few weeks:

Shallow cabinet heaven! A gorgeous modern apartment that's warm and filled with space-saving tricks.

Lauryn Hills - Miseducation of Lauryn Hills
Depeche Mode - did you hear them playing as the background to the Atomic Blonde trailer?? (so excited for that movie to come out!)
Dresden Dolls
Yoshida Brothers
Bastion Soundtrack/Antique Beats

Marimekko’s pattern of progressive design - I thought the company was Japanese, when actually it's Finnish.

Amazon opens their first bookstore in Chicago - It's unlikely that I'll step foot in there. For me, and for this article's author, bookstores are a place to discover a book you never knew about and to try out new things.

Sylvia Plath's letters - I remember my friends taking turns and renting The Bell Jar during high school.

Reading beyond our bubbles - On DFW

Ali Wong
Two Weeks Notice
Today's Special
(I'm looking forward to season 2 of Ode to Joy, starting later this month!)

Guardian Long Reads - Hermitage - There's a short bit in this story where she talks about how wealthy English landowners used to sign contracts with hermits to live on their estates, in caves, because of the belief that hermits spread good luck and kindness. Hermits signed because they were hungry and needed a stable home.

BBC's Food Program - On Herbs - I found myself desperate to taste all the varieties of spearmint during this podcast. It's likely we're renting a basement home, but if there's any hope of sunlight, I'm definitely having a mini-herb garden inside.

Still gnawing on Slice of Life. Started Coleman Barks edited version of Rumi poetry as well as The Story of Philosophy by Will Durant. There are so many pages devoted to my dear Aristotle. My dear bland, logical, precise, and rational Aristotle, the founder of biology, the founder of logic, the founder of ethics and thinking about what it means to live a good life. And the inventor of everyday science terms. <3

One last bag left of Celestial's Tension Tamer, which really grew on me.
I just bought their new Lemon Lavender herbal tea and it smells wonderfully lavvy.

I'm nearly out of Windsor fruit teas. :(
And I finally found Celestial's chai bags, only on Amazon and only available in bulk. Once I move, this will be my first purchase. Can you imagine! Every day, perfectly perfume-y and gingery chai to start the morning.

I've been enjoying the teas with Belvita biscuits.

Til next time!

April 9, 2017

What I've been reading

I'm studying for Step 1, which is coming up faster than I thought. So here are the things I read and watched when I wasn't reading UWorld explanations:

1. The Strange Persistence of Guilt
It's an article arguing for a 'return' to religion to assuage the guilt induced by the knowledge that we're destroying the world/society, and by we, McClay seems to mean upper class, male, heterosexual Caucasian. How does becoming religious solve global warming? I'm not sure. :/

2. Amy Adams interview with The Guardian
"But what’s really changed is how I process work,” she says. “I used to have a dysfunctional relationship with my work, where I was bringing home all my insecurities and expectations, and if I felt a director didn’t love what I did, it would just plague me. That had to change."

"I remember looking at my husband and saying, ‘If I can’t figure this out, I can’t work any more, I’ll have to do something else. I don’t want to be that person, not for my daughter.’ So I figured it out.”

How to stop getting so emotionally caught up in your work?

“Yes. The first couple of years I couldn’t quite figure out the balance, and I didn’t have a clear separation between work and home. But I’m not living in this sort of obsessed space any more. It’s not that I don’t find my work important. It’s just that I now know, at the end of the day, I’ll be back home reading stories to my daughter,” she says.

This balance is what I need to figure out.

3. Chimamanda Ngozi Adichie interview with The Guardian
I love her view of feminism.

4. Why Rory Needs to End Up with Logan
Read this way back in winter, when the Netflix special of Gilmore Girls released. I agree 100% - Rory has changed so much, and not into the person I hoped she would become.

5. The literary tomboy is dead
The tomboy may stay dead; here’s hoping that one day, we can discuss female characters as individuals rather than stereotypes. I hope the Strong Female Character will also fade away, as we begin normalising the idea of women who are strong in myriad ways, not just masculine ones. But perhaps this very disdain of femininity proves that the tomboy is actually alive – it’s just been repackaged.

I really don't only read the Guardian articles. I read other things too! Their articles have just been catching my eye recently.

6. Why people prefer unequal societies
"Worries about inequality are conflated with worries about poverty, an erosion of basic rights, and—as we have focused on here—unfairness." Agreed.

Note Frankfurt's On Inequality book to check out for later.

7. Deliciously Ella
A feel-good healthy food blog :)

Two Poems

Such Simple Love

The Fat Old Couple Whirling Around

One video, one movie, one TV series

- On GMOs
This YouTube video explains my complicated feelings toward GMOs. It's the business construct around them (the same construct that allows them to thrive) that can be dangerous and place small businesses at risk. GMOs themselves, with proper research oversight, are safe.

- Grace and Frankie Season 3!!!

- Miss Pettigrew Lives for a Day

One last note from GreatDay.com:

Doubt and ego push against each other, and neither of them does you any good. Your best move is to toss them both out of your awareness.

Replace doubt with humility and replace ego with intention. 

April 3, 2017

Grades and self-worth

I know I should know better. I know it's better for my mental health and that grades are often a percentage of how many boxes you were able to tick off. However, getting an average grade lingers far longer in my mind than I want it to. (Yeah, I'm one of those people; the type A in the corner triple-checking her work - although to be honest, these days, I'm finding it harder to care as much.) I want the lingering to be shed instantaneously, to be so confident in myself that I know that I'm more than the weighted average of my transcript.

It's clear what greater forces led me here - genetics for sure, my experience as a woman and a medical student, parental pressure, mostly only knowing the confines of higher ed, and the culmination of those factors into my own free will to continue to make the choice of agonizing and fretting about tiny things that don't matter. I once organized a container of buttons by size, shape, and color because it felt wrong not to. The poor lonely mixed up buttons, looking for their families! Neurotic justification.

How do I snap myself out of it? It is time, reflection, going for walks, reading? Those sound like short-term solutions to me, like taking ibuprofen for headaches from a growing pituitary tumor. I've got to cut it out - what's the source? It's a fear of not being enough - that I cannot succeed (whatever that might mean) if I don't do things perfectly. Not enough for myself, for my friends, for my family - but mostly for myself. And then to built an identity on that fear and to call myself type A, to hear others call me type A - suddenly, there is the expectation that you must succeed (again, whatever that means). It's an expectation felt in the ether, formed in the minds of others and expressed in what they say to you, how they look at you, and what they assume about you.

But here's the truth: none of that matters. Success is a table filled with the material goods of luxury, the imaginary titles of power formed through social contracts, and it's a table I want to flip over angrily and watch it all shatter.

March 31, 2017

What I've been reading

I've been working my way through Americanah by Adichie. We had a rough start, but I'm beginning to really enjoy it.

Also on Adichie, I read her New Yorker article back in Dec 2016 on the post-Trump atmosphere. She pins down our ambiguous feelings so well; I admire her decisiveness.

One more thing on Adichie - this NYTimes interview back in Nov 2016 on the overlap between beauty, makeup, and feminism.

Speaking of makeup and feminism, Emma Watson's Top Shelf interview on her beauty routine reminded me that I should be making more socially conscious choices of make up brands (just, my wallet, it cries).

I've also been reading A Slice of Life - a food writing anthology published 2003. I'm stuck on page 33 in the middle of a WASP-y guilt slog of dinner as performance. Looking forward to the MFK Fisher essay after it (which I've already read before, but I love her writing too much not to reread).

This Racked article on fake news building up a very real reputation - huh, doesn't that sound familiar - specifically the myth of a law stating men can divorce their wives if he's tricked into marriage via witchcraft (AKA that burnt twig she used for eyeliner). Damn did I trick my husband into marrying me then.

On life, I discovered a blog called Reading My Tea Leaves that renewed my motivation to live a simpler, more sustainable life.

And to help with a simpler life, there's this essay in Nautilus on famous scientists' work-life balance that I like but have conflicted feelings about liking. I like because work-life balance, come on, even Darwin achieved it. I don't like because the implication is that we should rest in order to work better. Ew. I want to rest to rest.

I was asked in clinic a while back "where I'm from" in the tone where they expect me to say someplace exotic, just so they could say "Oh, how interesting". Normally, these questions don't faze me, especially if they're asked by nice patients who seem genuinely interested in me and how school's going for me. But this was asked out of the blue by a patient's relative. I wasn't even interviewing them. I was shadowing in the corner and hadn't said anything throughout the whole visit. I couldn't help but feel slightly revulsed by their look, even though they asked and looked at me politely. I felt like a specimen right then. Should I have? What was their intention?

March 30, 2017

Forgot we were political creatures

In clinic the other day, something funny happened to me. A peer had just wrapped up a patient visit and she turned to me, saying "I hate it when patients start talking about their political views." Yup, that can be super annoying. "It's the worst when liberals start talking about this-and-that - don't they know they're in a conservative place!"

Uh. Honey, have you seen my rainbow caduceus pin (the two snake Hermes symbol that hasn't granted me the power of flight yet, but I'm still hoping) right there on my white coat, in front of your eyes? My "I'll go with you" transgender support pin on my backpack? The fact that I have alluded to my immense hatred for Trump in our prior conversations?

For some reason, I continue to assume that doctors are innately destined to be liberals (Hi Ben Carson, forgot you existed briefly), at least social liberals. We're in a career that is so centered on "helping people" that we can't even say during medical school interviews that we want to help people - because it's such a given! Doesn't helping people mean looking after them not only when they need healthcare, but then they can't afford healthcare, when they can't afford housing, when they can't afford the basic living standards that others can? What's all this about selectively helping people? It starts to sound like being a doctor is just a bottom-line paycheck career.

I continue to be flummoxed.