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  • Positive Override!

    Posted on August 24th, 2007 dabao No comments

    Malcolm Gladwell’s Blink talks about a couple of states of mind. Positive override vs negative override. Positive Override is where you are generally happy and anything negative is just a fluke that you roll with and Negative is the opposite where you are generally miserable and anything good that happens is just a temporary run of dumb luck that probably will go away.

    Today I find myself DEFINITELY in positive override! I won’t overanalyze but I think its a combination of things most important of which is that I am REALLY loving it at Dartmouth these days especially after being back from my “away” rotation at Children’s Hospital of Orange County in California and seeing what it is like in the real world of medicine where interns are too busy to learn and told to spend LESS time with patients to be more efficient and doctors generally are rewarded for efficiency, not critical thought or patient care. The management and rewards system there is definitely messed up!

    Contrast that with Dartmouth where we spent a whole day on talking and reflecting about Death and Dying with our Associate Dean who happens to be a practicing oncologist trained at MGH with 30+ years of experience talking with patients. And today got to watch Hillary Clinton come to DHMC and give an excellent talk on healthcare (btw, I think she won my confidence today for candidate most informed and capable on improving healthcare in this country). Then proceeded to interview a former drug user who has turned her life around as part of our substance abuse discussion today. Btw, I think I am going to be really good at psychiatry.

    Anyway, besides that, I am really happy to be around my classmates and friends who love and support me. Just found out that one (and probably another one) of my classmates is sticking around for an extra year and will probably be graduating with Jane and I which will be great!

    Today I feel like I am learning, growing as a person and feeling very happy with my life and relationships. Its a great feeling!

    Hope everyone else is doing well too!

  • First Post-call day!

    Posted on August 2nd, 2007 dabao No comments

    Man, what a weird last 48hrs. It started two nights ago with my resident Kamran text paging me to bring my toothbrush. Started yesterday morning at 6:50am, had a full day at Children’s Hospital of Orange County (in Cali baby!) including my first presentation at morning rounds. Then spent the rest of the afternoon kinda bored just reading and doing a progress note. Did figure out a cool problem of a kid with superinfected eczema who probably had Wiskott Aldrich syndrome (a rare immune deficiency disease) posed by Dr. A, one of the ID docs at the hospital (one of those senior docs everyone is afraid of but respects b/c he is a really smart but intense guy). Around 8pm got to do my first admit, a 7mo old girl who had lost her developmental milestones and had gone from being a happy cooing, feeding baby to one that was always crying and wouldn’t feed. Still not sure what is wrong with this one although likely something bad like a neurological disorder or metabolic deficiency. Then made my first diagnosis of a little 15mo old with Myasthenia Gravis, made more likely by approval from my senior residents at rounds and my intern who credited me! Got 5 hrs of sleep and then rounded on my patient in the morning wrote my first admit and progress notes which were included in her chart and then came home around 2pm excited at having done all these firsts only to crash literally sleeping on the floor with the TV on missing two phone calls. I just woke up, its 5pm and has been 36hrs since I started my first call day.

    Amazing! I think part of medicine is that you get tortured so much with lack of sleep, scut-work, getting yelled at that the littlest things, a small complement from a senior, getting thanked by a patient or learning about a new diagnosis literally makes your day. This is a new way of finding happiness by lowering ones expectations to the point that just getting by is enough. You also become so efficient with your time that you can even manage your free time more effectively.
    Still not sure if I want this life but surprisingly after 36 hours I am still feeling pretty good about myself! :)