jenniferhawke.com

a med school blog

Posts Tagged ‘ books ’

“Madame Michel has the elegance of a hedgehog: on the outside, she’s covered in quills, a real fortress, but my gut feeling is that on the inside, she has the same simple refinement as the hedgehog: a deceptively indolent little creature, fiercely solitary — and terribly elegant.”

At first this book scared me because I thought I was too dumbed down by science textbooks to enjoy its’ more lofty philosophical and artistic qualities.

But I’m about 2/3rds through now and I really, really like it.

My friend Kev sent me a present in the mail in February 2007, shortly after I found out I was accepted to MUA. Pauline Chen wrote about her experiences as a liver transplant surgeon and hooked me as a reader for life.

As such, I’m immensely thankful when readers (thanks, Jay!) forward me articles by her in the NY Times.

How Mindfulness Can Make for Better Doctors

Looking Beyond MCATs to Pick Future Doctors

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*note: This photo is from February 2007 and boy, do I ever miss my red chair. Oh, and I agree with the way the NY Times pluralizes MCATs!

A 10-year old could learn how to read EKG’s from Dubin.

That’s how I know this book is good.

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sidenote: I’ve never liked using “apostrophe-s” to pluralize acronyms. I realize EKGs looks funny, but EKG’s looks possessive and doesn’t make sense to me.

So, I got an email the other week from a publisher wondering if I’d like a review copy of Atul Gawande’s new book, “The Checklist Manifesto.”

I responded, “Heck yes”. I LOVE LISTS.

I am a big fan of Gawande’s other two titles, “Better” and “Complications” and was considering investing in his next book. Once it came out on something cheaper than hardcover, of course.

And then it showed up on my doorstep. Hardcover and all. I’ve burned through the chapters in a couple of days, but can tell I will go back and re-read most of it. It’s a simple but inspiring solution to succeeding at highly complex and unpredictable jobs: make a checklist so you don’t miss anything.

“We have accumulated stupendous know how. We have put it in the hands of some of the most highly trained, highly skilled, and hardworking people in our society. And, with it, they have indeed accomplished extraordinary things. Nonetheless, that know-how is often unmanageable. Avoidable failures are common and persistent, not to mentioned demoralizing and frustrating, across many fields — from medicine to finance, business to government.

… the volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably.”

Gawande is a surgeon. And nowhere is this more true than in medicine. In med school we joke that it’s like trying to take a sip of water from a firehose. There is just so much information to memorize. As physicians, you may not need to know tiny details of the glucose degredation enzyme pathway on a daily basis, but there are still a ton of details to manage with an emergency case of DKA in a patient.

Right now, as a student, I’m practicing an established set of checklists that were created by people who studied medicine before me: labs, reviews of systems, medications, allergies, etc. I ask a predetermined set of questions in a history & physical to make sure I don’t miss anything. I check the same CBC and BMP values every morning. Pre-rounds have a different set of questions for a patient with pancreatitis than frostbite. The checklists evolve according to each situation, but I still feel certain things falling through the cracks with my lack of knowledge and experience.

I’m curious to see how the book ends. And I’ll be sure to share the checklist I come up with to help organize my daily 3rd year med student tasks.

“… one could even consider it a minor defect given the chaotic syntax, the absence of full stops, the complete lack of very necessary parentheses, the obsessive elimination of paragraphs, the random use of commas and, most unforgivable sin of all, the intentional and almost diabolical abolition of the capital letter, which, can you imagine, is even omitted from the actual signature of the letter and replaced by a lower-case d.”

~ José Saramago

Abolition of the capital letter! Unforgivable!

this photo is of the OKC skyline on our way home the other day. i kind of like how there aren’t a ton of tall buildings and condos clustered together. downtown is relatively short. maybe that’s the way it has to be in Tornado alley.

but i digress. i’m leaving for the clinic in 7 minutes and i don’t really want to go.

Doing what you love should be a good thing, right? Who hasn’t dreamed of taking their hobby and turning it into their business? But what happens when that act of joy becomes the thing you wake up to every morning—the thing you have to do? Or, even worse, the thing you dread doing?

Our hobbies are hobbies because we enjoy doing them. If ever that changes we give them up and go on to something else. But what to do when the hobby becomes a responsibility? How do you cope when your joy becomes your job? How do you stay inspired, stay creative, how do you keep up the momentum?

~ Tea & Cookies via Col

i love learning and i love medicine.

while i don’t need to stay inspired or creative to do either of those things, i understand the dread and burnout. i was falling over myself excited to PRE-READ anatomy textbooks the summer before i started MUA. i bounded out of bed at 4am, excited at all the NEW THINGS i would learn that day. sure, class was always sort of boring because i didn’t get to set the pace, but i was LEARNING. flashcards AWESOME. textbooks smell so GOOD.

and now, 5am feels earlier than it should. my gas-pedal foot drags a little as i hit the interstate each morning. i am eager to leave the clinic at the end of the day. i think about doing things that are totally ANTI-learning, like watching TV for more 30 minutes at a time.

i have been asked before if i would ever try to “go pro” in photography and make a job out of something i love to do. it’s a popular route with a few Flickr folks in our economically down-trodden depression-recession society. my answer was always a resounding “no.” to back it up, i would quote the study i read in one of my undergrad psychology classes: they rewarded kids (with stickers or whatever) for colouring and found that with the reward in place, kids actually colored less.

and now i went and turned my very favourite hobby of reading and learning into a job. i don’t want a sticker. i just want to colour for the sake of colouring.

more Tea & Cookies (because i don’t have a conclusion or answers and don’t expect one to magically appear):

I’m not entirely sure, I’m trying to figure it out. The more writing becomes my work, the more arduous it sometimes feels. I’m not sure how to retain that bit of wonder that made it so special in the first place. I don’t want it to become the thing I dread. When I first started writing about food it felt dizzying, thrilling, like falling in love. Now I’m afraid I’ve hit the seven-year itch.

So perhaps you could do me a favor, if you don’t mind. I’d love to hear about what you do that you love—be it hobby, job, or dream—and how you keep the spark alive. Whether it’s cooking, writing, a relationship, or underwater basket weaving—do you ever run out of steam with the things you love? What do you do to avoid/get over the burnout? Do you take a break or plow through? Is it better to churn out something uninspired, or wait for inspiration to strike? Have you taken a pleasure and turned it into a job? (and how did that work for you?). You can even tell me what you’d like to see on this site. I’d love to hear. These days I’m looking for inspiration.

“I cry when my goal always outweighs my greatest ability.”
~ Bonnie Richardson

i got caught up reading this story in Sport Illustrated over lunch yesterday. then i read it again.

“They call her the lass
With the delicate air!… “

~ Alan Bradley

i’m trying out this new math equation that involves > reading and < writing.

which means i read your email and i'm sorry i didn't write back yet.

it also means i have a Core Clerkship exam in OB/GYN coming up and a very diverse Family Medicine experience that requires me to look up at least a dozen things when i get home each day. oh, and i'm trying to learn Spanish too.

and then there's the stack of personal reading i'm making time for each night before bed:

The Last Lecture – present to Brandon from his mom
How to Be a Canadian – present to Brandon from Jill
The Sweetness at the Bottom of the Pie – birthday gift certificate from Christina
The Story of Edgar Sawtelle – bought with a birthday gift certificate from Christina
One Hundred Years of Solitude – was somehow the only book that made it from Saskatchewan. i figure it deserves a re-read for hitching a stowaway ride.
The Brain that Changes Itself - present from RAEB
My Stroke of Insight – Christmas present from my dad

in my pre-med-school days, i’d try to keep one fiction and one non-fiction on-the-go at any given time. that way, i’d usually have something to suit my mood on any given day.

i already know what’s next on the list when it comes out in paperback. i’ll probably pass it on to my dad after reading it because King Lear is his favourite Shakespeare play. i’m sure he’s convinced his darling daughters will betray him one day.

at any rate, i’ll be back soon.

“So that was a setback. But I kept my mantra in mind: The brick walls are there for a reason. They’re not there to keep us out. The brick walls are there to give us a chance to show how badly we want something.”

~ Randy Pausch

Mr. Pausch found out he had pancreatic cancer that spread to his liver and left him with mere months to live. he delivered a “last lecture” at Carnegie Mellon and wrote a book — effectively leaving behind a legacy of how to really-for-real achieve your wildest and most awesome childhood dreams. the best part is that these aren’t crazy dreams he decided to fulfill just because he was diagnosed with a terminal illness. even before he was sick, he spent his entire life dreaming big and shooting for the moon.

this is a book that teaches us to encourage children to dream and reminds us of the vast potential we knew the planet used to hold for us.

and still does.

huge thanks to Ricardo for thinking of me when he saw this book and sending it my way. it’s quite literally blowing my mind.

“The cerebral cortex,” he says of the thin outer layer of the brain, “is actually selectively refining its processing capacities to fit each task at hand.” It doesn’t simply learn; it is always “learning how to learn.” The brain Merzenich describes is not an inanimate vessel that we fill; rather it is more like a living creature with an appetite, one that can grow and change itself with proper nourishment and exercise. Before Merzenich’s work, the brain was seen as a complex machine, having unalterable limits on memory, processing speed, and intelligence. Merzenich has shown that each of these assumptions is wrong.

~ Norman Doidge, M.D.

i’m abandoning the localizationism theories we memorized in Basic Sciences and would love to have “neuroplastician” on my business card someday.