Category Archives: Travel

A foodies delights in London

02 Wednesday Jan 2013

Posted by in Food, Travel

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For the new year I went off on a trip with a mate to London. While here, one of the first things we did which was totally off the beaten track was a trip to Borough market. The market was foodie heaven- and I wasn’t the only one enjoying the gastronomic delights.

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There were a half dozen cheese places with some delicious cheeses sourced from places with names as quaint as Gloucestershire. The goat cheeses were deliciously flavored and textured.

The crowning glory for me was the burgers however. I grabbed a 3M burger from Boston Market (named after the original Boston in Lincolnshire) which was a deliciously crafted pork burger succulent and dripping with flavor. For the vegetarians there was a host of veggie stuff- from burgers, sandwiches etc.

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(My mate enjoying a burger!)

The last place I tried was a little hot sandwich place. Expecting delicious food, seeing the long lines we chose to try the food from there. While not bad, it didn’t favorably compare to the burgers etc. we had eaten earlier.Image

Indoctrination

24 Monday Dec 2012

Posted by in Bioethics, Medicine, Travel

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Funny thing about life, things you thought you’d never be able to do become a habit. And once that habit forms it’s dreadfully hard to break or even step away from.

The first months of med school I was always worried I’d never be able to put in the work. I was worried that the sheer quantity of what I needed to know was so much I’d be discouraged and apathetic and stop before I start. That was before I realized the potent power of indoctrination.

This winter break marks one and a half years since I began medical school. I’m three days into break, and all three days I’d catch myself thinking of things I had to do. Thinking, wait I didn’t hear lecture. No, wait there was no lecture…. I think of tasks, lectures, studying, emails, work all that needs to be done. And I’ve consciously had to stop myself from thinking of the work.

Instead I’ve thrown myself into all the things I’ve neglected these past six months in medical school. This involves exciting things like endless hours of TV. Getting up to go to the gym’s surprisingly become a chore since I have to break away from the fascination of Newsroom or Royal Pains. I think I’m succesfully resisting the indoctrination at this point- getting 10 hours of sleep a day, eating relaxed meals and not doing anything. The bliss of stillness (relatively speaking of course) is unparalleled.

I still however have work to do, and I intend to do it smack in the middle of my vacation. Since my bioethics program is so relaxed I have papers still due, however I intend to do them in the next few days- sitting at a little cafe in London.

So that’s how I intend to get away from this before I start the torture of preparing for my Boards. For those of you who remain blissfully unaware- the boards are the licensing exams we have to take over our medical education. The first one, Step 1, is to be taken at the end of second year. It covers all the material we’ve learnt in the first two years of medical school and is a 8 hour behemoth. So, I intend to profess ignorance at my eventual fate and enjoy the next few days in London.

Happy Holidays!

A Glimpse into Insanity- A case study

15 Thursday Nov 2012

Posted by in Medicine, Travel

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In true medical school style, I’m going to present a case study, but with the following disclaimer.

The following case studies are completely fictional.

A 26 year old male and a 24 year old female both present to your psychiatric practice.

The male reports recent risk taking behavior- increased alcohol intake, numerous sexual partners, and ignoring “the things that are important because they get to be too much.” He also reports recent binge eating, decreased motivation and drive and less willingness to do work.

The female reports increased risk taking behavior of a different kind. She says that she ‘like the country song’ went skydiving, Rocky Mountain climbing, bull riding etc. She reports an increase in “retail therapy” in the hundreds of dollars as well as frequent trips to the bars so she can feel pretty and like a person again.

As they keep talking, they both report symptoms of a compulsive disorder. They report feeling pressured and forced into doing something that doesn’t always bring them joy. Fearing abuse, you question them further. They report shirking their “duty” for awhile, just so they can pretend they don’t have to do it- then experiencing guilt, until they return to their duty- resentful and angry.

Realizing that your typical medical interview’s gone to the dogs, you ask them what duty? And what do they do for a living?
Oh, they reply, we’re medical students.

At this point, you’re shaking your head at me and wondering if the glimpse into Insanity is talking about the case study or me… Read on.

While tongue in cheek and fictional, the stories above are amalgams of real people.  The point they’re meant to illustrate is the nature of medicine- medical school in particular. Everyone has coping mechanisms for dealing with life, and everyone has things to cope with. Medical school’s no different- we all have coping mechanisms and things that keep us sane. The only difference is the level of the assault on our sanity. Our sanity is assaulted on a regular basis, by a cycle of exams, recovery, scrambling to catch up, and exams again… There’s a constant stream of information coming at a medical student- things to learn, things to do and places to be. The stress is institutionalized in the way medicine is taught- and I’ll leave discussions of right/wrong to a later post. At the moment, it is- and it must be endured.

We all have coping mechanisms- some healthy, some not. For me, my coping mechanisms are simple. Exercise is a big one. One day a week is too busy for exercise. And that day I’m pretty miserable- I guess I’m addicted. But, a rowing class or a yoga class can have me walking out feeling like a million bucks.

The next big coping mechanism I use is escaping the rat race. We all feel the need to excel, to stand out. I (now more so than before) realize that studying for hours on end to learn specious detail isn’t joyful and exciting- and it’s not how I’m going to stand out. Instead, I choose to do things that make me stand out. Like my Masters in Bioethics, or a research project I’m doing, or a dozen other little things. They make me feel accomplished, without reducing my net self worth to my grades.

Family and friends are another great one.  I keep myself sane using the people who matter to me. My family, who I don’t see often enough. My friends, who I never really tell how valuable they are to me. For a lot of my classmates, I think their spouses and kids (despite how annoying they might be) are their best way of keeping sane.

Also, since if you know me or have glanced at the rest of the blog- the other escape that works for me is crazy stuff. For example, (if all goes well), I’m going flying next weekend. *The FAA/TSA probably won’t give me trouble. There’s no worry about a brown guy wanting to learn to fly right?*

And it’s not like med school has a monopoly on hard situations, so everyone ends up using coping mechanisms in life. I think the important thing is realizing that you do need to cope, and recognizing how you choose to cope. What say? How do you cope?

How to Survive Medical School (or What I do instead of studying Cardio)

16 Tuesday Oct 2012

Posted by in Bioethics, Medicine, Travel

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Take a look around a medical school around this time of year and you’ll see two very different groups of people.

The first group seems delighted to be there- happy, motivated, driven, “gunning it”, ready to go out there and save the world. For the most part, they enjoy the rigors of medical school. They’re the people with perky looks, dressed nicely, smiling and being pleasant.

Then, there’s a second group. The second group has bags under their eyes. They’re tired, cranky, a little depressed, constantly cursing at being in medical school. They walk with their heads down, their eyes seem sunken and their clothes are most often sweatpants and T-shirts. There may be coffee stains on their clothes, and as they pass out in a mound of books- drool coming out of a corner of their mouths.

The first batch, as any medical student could tell you, are first years. The second batch are second years.

First year of medical school as you walk in the door, you’re excited, driven, motivated. You’re in med school! You “gun” everything- studying for hours upon hours till exhaustion, and then once the test is done partying and drinking to oblivion. You’re excited about almost everything, you’re brand new and you want to learn- and by golly you show it!

Second years, by contrast have been through the cycle. Having been forcefed vast tracts of information every 6 weeks (on average, 120 hours of lecture total) full of arcane facts that aren’t clinically relevant and despite the school (and the block’s) stated policies of testing “big picture” stuff will still be tested. So you prepare to be able to recite Bernoulli’s equation, the resistance of a vessel, the histology of polyarteritis nodosa, or some other information that in all likelihood is never tested. That’s okay you say, we all jump through hoops. Now do it again, and again, and again. Take a weekend- sometimes between the end of one and the start of the other. At the same time, realize that you’re actually supposed to be taking care of patients in a year- so try to learn to do that as well. Then, add in the required doctoring material- some exceptionally good, some mindblowingly boring. Plus minor things, like eating, cooking, working out, laundry, showers…

The thing you learn somewhere halfway through first year is that medical school is a collection of 200ish of the smartest people you can imagine. We all went through college getting accolades, being told we were brilliant, seeing amazing grades and awesome results. Then, when you get to medical school you see the scariest thing of all. A passing score- or an average score. And then you realize that the thing you based your self worth on- your intelligence- no longer sets you apart from the herd. You’re somewhere smack in the middle. Truth be told, most people in med school are about as smart as one another. The difference is the hours people put in. Some, seeking to maintain that self worth, put in 15-18 hour days regularly- and cringe when they see a 94% on a test. Others, work hard but try to balance- and are happy with a mid 80’s grade. Still others realize the futility of the system and how irrelevant some of it is to clinical practice, and cherish having their lives- cheerfully taking the 70s-80s they get. None of those is “better” than the other- each seeks to maintain their self worth and sanity how they can.

But, if you’re in the second or third category- before too long, if you’re not careful you start completely losing your mind. So, how do you hold onto your sanity in this crazy pressure cooker of a system? Here’s my secret. I add in the things that make my life meaningful to me. (I never said it wasn’t an obvious secret…)

Most of us get addicted to something- I chose to get addicted to exercise rather than alcohol or other “helpers”. So, I work out. If I don’t, as I likely won’t be able to for much of this week, I feel the withdrawal. Medical school is such an isolating and lonely experience that I realized the value of the people in my life rather quickly. The value of a support system, people to talk to, go do things with, people to share the neurosis that medical school creates can’t be overstressed. It keeps most of my classmates holding onto the last shreds of their sanity. And for me, it lets me hold onto the last thread.

What else? I added on a masters program. Yes, I added more work to a medical school career. Clearly, I’ve gone around the bend and need to be committed. But, fact is- I was a philosophy major in college and I feel the need to think about the world we’re living in. I need to consider the why’s, the what for’s. If I don’t do that in a disciplined or a more direct way I end up asking myself the why and the what for about medical school- which is a terrible idea, trust me.

Also, I travel. I go where I can, when I can. More so, I do what I can. I have a fear of heights, so I jumped out of an airplane. This weekend, I’m going jet skiing on the Hudson River with a friend after our exam. I’m travelling to London with the same friend for New Years. I’m meeting up with my family in Hong Kong (maybe- or we may go somewhere else) after I’m done with Step 1. I’m going to take a flying lesson or two in the next few weeks. Not to mention, scuba diving, skiing, snowboarding. Med school makes my days rather boring, bland, and frankly depressing. So, I choose to inject what enjoyment I can into it- as easily as I can.

Also, one of the biggest things I’ve learnt to do as I became a second year medical student is to clean up your baggage. In my experience, every person has people in their life who demand but don’t give. People who are either too hard to hold on to, or that one just can’t help. I’ve learnt to let go easier- so that I can spend more time with the people who are really important to me. It took a close friend passing to learn that lesson.

And the last way I cope? This blog. I like to write, and I enjoy dispensing my words of narcissism, questionable wisdom, and nonsense with reckless abandon!

If you’re in med school- relax. You’ll get through it- just realize that the system’s nuts, chuckle, bitch about it to the people who you trust and who’ll listen. And then keep going. What’s that famous quote? “If you find yourself in hell, keep going?”

If you’re going to med school- the one person who you shouldn’t be asking about med school’s value is the med student who’s $100,000+ in debt, has spent a year and a half buried in a mound of textbooks away from what they came to medical school to do- practice medicine. The same med student’s “paranoid, antisocial, and weird” (Erich Segal) and that’s what medical school turns you into. At the same time, as you walk out of a class and discuss something you covered over a year ago, subconsciously the right answer will push its way out. Perhaps madness is it’s method for medical school.

And if you’re sending your loved one to medical school- don’t stress. It’s hard work, but it’s doable. Just tell them to find what they have to do to get through it and proceed to do it. Preferably nothing illegal. A medical degree is of limited use if one’s license is then suspended for criminal charges…

The Joys of Travelling Part II: Cancelled Flights

13 Friday Jul 2012

Posted by in Travel

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So, this post isn’t about me directly. It’s about my classmate who was doing a project with me here in India, and her lovely travel situation from my perspective.

The flight she was taking from the city we were working in to Delhi was the first one in the morning, getting her there with well over 3.5 hours to her international flight. Perfect.

Except, an hour after we dropped her off in the airport, her flight had gotten cancelled. The reason? Inclement weather.  I heard that and looked quizzically at the sky. The reason for my amazement was that there wasn’t a single cloud in the sky despite it being monsoon season. Yet, apparently in the 400 kms between the two cities there was some sort of inclement weather that grounded only that carrier’s planes.

Then began the rush of trying to find her an alternative. She managed to get a seat on the next available flight out, but missed her international flight.

Now by all accounts, she did nothing wrong. The missed international flight was due to the cancelled local flight, not her own doing. The international carrier, rather fairly, refused to pay any of the associated fees since it wasn’t their fault. The local flight operated by a large, well renowned international carrier refused too. But for no good reason. They just refused, saying that was a risk the customer took. Consequently, she ended up having to pay for a hotel room and the change fees in Delhi.

Thankfully, she got home safe. But, the fact remains that the airline which caused the fault isn’t culpable in India for any of the resulting issues.

To my knowledge, since I’ve had the pleasant experience of being bumped a few times, most airlines in the continental US will cover the situation above. However, according to the law, (http://www.usa.gov/topics/travel/air/resolve-problems/flight.shtml) they are not required to. Most European Airlines are required to compensate for delayed or cancelled flights, but weather is an exception (http://www.independenttraveler.com/travel-tips/air-travel/passenger-rights).

As someone who’s doing the same trip in a month, I’m now scrambling for options. Having derided travel insurance as unnecessary, I’m looking into it now, as well as credit card protection for travel issues.

I do believe that this is something that needs to be addressed in one form or the other for passengers- at the very least to add clarity to the situation, even if nothing per se is changed.

Any thoughts?