Monthly Archives: November 2010

Who knew closing the gender and race gap could be so easy?

I thought this article on a 15 minute writing exercise that improved the performance of women in physics and students of color in high school was beautiful in its simplicity.

Think about the things that are important to you. Perhaps you care about creativity, family relationships, your career, or having a sense of humour. Pick two or three of these values and write a few sentences about why they are important to you. You have fifteen minutes. It could change your life.

This simple writing exercise may not seem like anything ground-breaking, but its effects speak for themselves. In a university physics class, Akira Miyake from the University of Colorado used it to close the gap between male and female performance. In the university’s physics course, men typically do better than women but Miyake’s study shows that this has nothing to do with innate ability. With nothing but his fifteen-minute exercise, performed twice at the beginning of the year, he virtually abolished the gender divide and allowed the female physicists to challenge their male peers.

The exercise is designed to affirm a person’s values, boosting their sense of self-worth and integrity, and reinforcing their belief in themselves. For people who suffer from negative stereotypes, this can make all the difference between success and failure.

People who are in the minority (and I mean a power minority, not a numerical one) – people of color, women in science classes, disabled people, etc. – often feel that their values and needs are invisible in an academic situation. This exercise simply affirms that this is not necessarily true.

I want to go into academics one day. I may need to do this exercise in my classes.

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So, what’s going on?

Sorry I have been letting the blog languish.

What’s going on? Well, I am finishing up my second month of internal medicine. I had a different attending physician for each month. It is interesting to see how two different attending physicians will approach similar conditions. There is a lot of flexibility in the standard of care. Neither of them is wrong by any stretch of the imagination. Just different.

It is also amazing how much of a difference a good, well informed resident can make. I was blessed with amazing residents for my first month. I am not going to say much about the one I had for the first two weeks of my second month, because, well, if I can’t say something nice, I am going to keep quiet. And I can’t say anything nice. Anything.

We had a lot of patients with chest tubes this month. My attending blames it on me. He says that he probably won’t get this many patients with chest tubes in an entire year. I got to scrub in on a video-assisted thoracostomy surgery (VATS), with pleurodesis. It was an incredible procedure. I got to see a pulsating aortic arch. Wow. I got to see the beating heart. Double wow.

This was a really interesting case. She had a collapsed lung and a pleural effusion. This procedure allowed us to take a biopsy, drain the pleural effusion, cut adhesions that had formed between the lung and the pleura that were keeping the lung from fully expanding, and do the pleurodesis. The pleurodesis was twofold: the surgeon performed mechanical abrasions on the pleura, and then used talc as a chemical pleurodesis. The concept behind a pleurodesis is intriguing – you irritate the pleura, the sac surrounding the lung, to try to form adhesions to keep the lung from collapsing again. Yes, she already had adhesions, but the lung wasn’t fully inflated when they formed, so they were holding the lung in a partially collapsed position. The point of the chemical and mechanical pleurodesis was to attach the lung to the pleura when it is fully inflated. The space between the pleura and the lung is supposed to be a “virtual space”. Having air or fluid in that space is pathological.

The same cardiothoracic surgeon did sclerotherapy on another patient we had with a collapsed lung and pleural effusion, but with a different etiology. This is a similar process, but a chemical irritant, in this case doxycycline, is introduced via the chest tube. It was interesting to see two different treatments for a similar condition in two different patients. It was a good example of how one can’t just follow a cookie cutter approach to medicine, and care needs to be tailored to the individual situation and history.

As for my personal life, it’s moving along. I moved someone into the house to help with the kids and the laundry. So far, it is wonderful. She is a pre-med student who needed a place to stay and a job. I needed someone get the kids up, fed and to school in the morning, so I didn’t have to drag them to their grandmother’s house at 6 a.m.

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Droop off

One dreary weekend day, I was stuck at the hospital instead of being home with my kids. I had been there since five a.m. with the promise we would get out by noon, and it was suspiciously creeping closer to three p.m. Suddenly, my eye caught a sign in the fourth floor charting area that had been bothering me every day:

“Doctor’s, please sign and date all order’s. Thank you!”

Argh! I couldn’t control myself any longer. I whipped out my pen and drew an X through each offending apostrophe. I was still stuck at the hospital, but I felt just a tiny bit better.

Well, I had a really frustrating day at a lab recently. I won’t name any names, but let’s just say their name rhymes with ShabCorp. After having a tech loudly insist she wasn’t going to get fired over my request (huh?), I was left at the counter to fume as she ranted about me loudly to her coworkers then fought over the phone with the person who ordered the test.

I didn’t end up getting what I wanted from dear ShabCorp and the lady who saved her job by denying me my obviously unreasonable request, but I did get to snap some lovely camera phone pictures of the high quality of work she is protecting as their intrepid office manager:

droop off by nurse

In case you were wondering, it wasn’t a simple oversight. It’s on the spine of the binder, too:

I thought maybe it was a binder where she could record the names of sleepy residents and medical students who are falling asleep while they are charting. Except, this is a private lab that is on the grounds of the hospital, but isn’t part of the teaching program.

Maybe I didn’t get my lab work done, but hey, I feel better. It’s the little things.

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Thinking

Thinking about elective rotations. Thinking about step two boards. Thinking about residency sites.

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