Top Ten: Hit me with your best shot, volume 2.

Well, well, well. What do you know. . . .I've had the questions for part two of "Hit me with your best shot" sitting in a draft form for more than two months. And seeing as I'm overdue for a top ten, I figured I'd go ahead and tackle some more of these questions.

For those who missed the first installment of this, essentially it all started when I got asked three separate times to do a "ask the gradydoctor" post. And since writing a post called "ask the gradydoctor" seems barf-tacularly self-important, instead I asked folks to "hit me with their best shot" (or questions.) The fact that I referenced the great Pat Benetar put people in the mood to ask me stuff. Admittedly, I was rather scared that it'd be met with

*crickets*

But nope. Y'all were awesome -- you asked some great questions. You hit me with your best shot (or shots.) Yep, you fired away. With some SUPER random ones, too. My fave of the randoms was "what do you think of sectional sofas?"  (Answer: They're gnarly, baby! Who cares if Martha Stewart and Nate Berkus don't approve?)

Anyways. You asked great questions. And a lot of them. Some, I still have in queue. As promised, I've done my best to keep the askers anonymous. Oh, and if you have additional ones, just leave it in the comments (I won't publish it) or just email me and if I have enough, I'll do a volume three at some point. If not, it was fun while it lasted. Heh.

Without further ado, I bring you:

HIT ME WITH YOUR BEST SHOT, 

VOLUME TWO (A TOP TEN POST.)

Like to hear it? Here it go!

#10  --  Everybody hurts.

Is there anything that gets you down? You always seem so cheerful and upbeat. How do you not let the ish at Grady in medicine bring you down? Asking for tips to stay up in my medical practice. 

Hmmm. Good question. The answer is . . .

Uhhh, OF COURSE there are things that get me down. Such as. . . seeing elders who are unhappy. Especially ones who've lived hard lives. They deserve to be happy. Like, the other day when my F.P. was crying in front of me because life was hard for him? That pretty much haunted me. It is still haunting me. His face, his tears, his body crumbling while he squeezed my hand. That got me down.

One of the things that helps me is writing and reflecting. I sit and think about perspectives and how things affect people. I try to learn from what I see. That always makes me feel better.

And one other thing? My dear friend the Profesora in Pittsburgh always tells me that caring for patients is a privilege. I have that graffiti-ed across my head. I hear it like a chant on the hardest days and like a song on the best days.

A privilege. A privilege. A privilege.

Then I always feel better because it is a privilege.

This morning in the underpass near Grady. Taken from my car window.

People being poor and without resources gets me down, too. Like this person I saw this morning who was likely disabled but sleeping outside on the ground beside their wheelchair. A wheelchair that could and would likely be stolen if they weren't paying extremely close attention. Those kind of things hurt my heart.

I am what I'd like to call a spiritual person. For me, a lot of this calls for turning inward to my faith (which happens to be Christian faith.) For someone else being spiritual means something else--and that's cool. A lot of me being upbeat has to do with how blessed I feel and believing that by letting my light shine, others will shine, too.



#9  -- What's the REAL scoop on getting into med school?

I am a pre-med student with a burning passion for medicine. That being said, I have a few questions about the whole med school process... Does college reputation really matter when applying to med school or are they primarily concerned with actual grades. (I ask because I hear differing opinions and I am not at any super prestigious school or anything, as I am at a local state college). Also, I am a little bit older the average med school applicant. My grades are good, but I know they are not competitive as compared to some others who will be applying. Are grades the main thing schools look at? Besides all of my volunteer work etc, is there anything else you could think of or recommend that would really show admission committees that I would be a good fit for their school and would make a good doctor? Exactly how personal should a personal statement be? I ask that because I feel like some of my honest, true feelings sound cliche and I worry about that. I also don't want it to sound too sad.  

Well, dang. That is not even one question, my pre-med compadre. Ha ha ha! But it's all good because these are important questions. Let me try tackling this little packet of queries.

College reputation, does it matter?  Well. That depends upon the school to which you're applying. Really,super competitive schools tend to slant toward more prestigious schools. This can be overcome if and only if your grades at the less swanky school are spectacular. If they aren't, it could get tricky with some of the more competitive medicals schools. Applying to state medical schools or less competitive ones could help get around that. And honestly? They are so much cheaper and many are super good schools. Don't rule those out.

Are grades the main thing?  No. But they do get your foot in the door. The truth is this -- all application processes are now electronic. This means people can set filters to not even look at applications for people with GPAs under a certain number or MCAT scores below a threshold. Which sucks, right? I'd also be curious to know what you mean by "not as competitive."  Straight A's with two B's is good. All B's, not so good for med school. And 2-point-anything GPA could present a virtually impossible hill to climb.

Note--this is globally speaking and is in no way reflective of Emory. This is just my take on it from talking to and knowing lots of people in Medical Education.

Besides volunteer work? Life experiences. Well-roundedness. Interesting things that you do. Like, I once interviewed someone who taught hip hop dance and had made the finals on "So You Think You Can Dance." Which, to me, was rad.

As for the personal statement, peep this post on the subject. I like them fairly personal but strategic. They should underscore your strengths and what you're proud of. The personal statement can often drive your interview so put stuff in there that you'd like to discuss. If something sad has shaped a part of who you are, fine. As long as you'll be game for talking about it.

Hope this helps.


#8   -- Are you crazy? No, really, are you?

When Doctors tell people it must be anxiety, are they really just saying, "It's all in your head?"

Yes and no. Yes, in that anxiety can cause a lot of symptoms to be amplified. No, in that it doesn't mean we think you're making it up. So that part is "in your head" but not in the "let me trivialize your symptoms and blow you off" kind of way. I can speak for myself and say that when I suggest that anxiety is making someone sick, it's because I really think that. I see debilitating anxiety as a medical issue and one that should be treated carefully. There are some complicated psychiatric disorders that are beyond my expertise that can cause significant physical symptoms. Like real, real significant ones.


#7 -- Move it or muzzle it?

If you had to give a percentage of the importance of exercise and what you eat, how would you rate it? (meaning, in overall health, how important is how much we move and how important is what we eat) Hope that makes sense. probably not. ha! And, what does a typical breakfast for you look like? So random, I know.

 Maaaan. This is also not even one question. Hee hee. (But I'm the type that would ask a battery of questions, too, so hakuna matata.)

Okay. So here's what I think--which is NOT EVEN based on my doctor-ious knowledge. . . .

You ready for it? 

Bread is the devil. (Read about our break-up on the hyperlink.)

Okay, maybe not the devil. But seriously? Once you get over about thirty-five? You can exercise all you want. But unless you are watching your caloric intake, fuggeddaboudit--your ass will eke up a little in its badonkadonkness every single year. Believe that. Even if you run marathons. Which reminds me. Have you ever seen a surprisingly . . .errr. . .dense marathon runner? Of course you have.

Mmmm hmmm.

I also think weight training is very, very necessary. Especially of your big muscles like the thighs and glutes. Muscle burns fat. Build those and you'll better maintain your weight. And yes. I also think that carbs in excess will give you a spare tire if you aren't in your twenties or a lucky person with ridiculously awesome genetic makeup. Oh and drinking calories with abandon? Epic fail if you want to fit your clothes consistently. No frozen drink at 550 calories tastes better to me than how it feels to fit my jeans. Yep. I said it. When it comes to the spirits, I usually lean toward white or red wine. My fix during margarita season (summer) was 120 calorie Mexican beers with lime and a salted glass. Genius, I tell you. I also gave up all sodas nearly a year ago. (Yes, I know that Mexican cervezas are carbonated but that's different because that's cerveza in moderation.) Even diet sodas. I am now a believer that the fake sweeteners trick your brain's satiety center into eating more.

Breakfast? I believe in breakfast. I like to have an egg and some turkey bacon. I will eat healthy carbs in the morning, like Grape Nuts cereal or a Greek yogurt with some Grape Nuts on it for crunch. No matter what, though, I don't skip breakfast. That, too, can leave you with more junk than you want in your trunk. (Slows the metabolism when you skip meals, ya dig?)


#6 --  The memorable ones.

 Who was your most difficult/frustrating patient? Who is your all time favorite patient and why? do you have any unusual talents/random facts that most people don't know... What are they?

The patients aren't usually the most frustrating. I'd say one of my most frustrating moments have involved the doting family members. This one in particular was rough.

Collectively, the Grady elders are my favorites. My patient who used to smize with me was awesome. But I'd have to say. . . .of all time? That's rough. Mrs. Zebedee would be up there. Of course, my dear, dear F.P. who always cries every time I see him. The man who always called me by my first name was amazing. And I'll forever love the woman who made me think about this and that.

Unusual talents? Uuuhhh. I draw pretty well. But that's not so unusual. I have a scary-good memory. Like, even old phone numbers and all kinds of quirky things. I don't forget most people or details. Ever.

Oh yeah! I was a great stepper in my younger sorority days. I still can perform and remember an abnormal amount of most of our step routines. I was kind of bad ass, actually. Ha ha.

This is from the year some M2s convinced me to teach them some steps. Ha ha!

#5  -- Sole to souls.

Kind of a question here... the top photo reminded me of one of your best posts (IMHO). If one wanted to collect men's shoes, can you help one make sure said collection ends up at the right spot?

Well, guess what? I called the social worker office to find out where to drop off donations of shoes at Grady. The main social work office on 1A at Grady would love to have them. I also know that our primary care clinic social worker definitely would accept them if it's only a few that you have.

Oh yeah! My dear friends Carol R. and Katie B. work at the Central Presbyterian Church Men's Night Shelter in downtown Atlanta. I bet money that shoes would be needed there. They read this blog so I know one of them will email me or respond. Coach B? Weigh in. Carol, I know you're all shy with the comments so an email would be lovely. :)


#4  -- Med/Peds versus Family Medicine

My question for you is basically the question I have been debating with myself as I choose my electives. Why did you decide on Med/Peds as opposed to Family Medicine?

Ooooh. Good question. Well, first, let me preface this by saying that this is just my own opinion and my own experience. The fast answer is that I was rather torn between the two and was advised to just do the combined program. Nothing too deep. I wasn't certain about whether I'd want to do a subspecialty in Internal Medicine or Pediatrics, so achieving dual board certification would give me more options.

Now. I think the real question is, "What's the difference between doing Family Medicine and Med/Peds?" I think that both are amazing specialties. I am also not in the camp that believes that IM/Peds is superior to Family Medicine--not one bit. If someone is absolutely certain that they'd like to lean toward being an ambulatory specialist for families, Family Medicine is a great option. This idea that IM/Peds people "know more" (I hear that often) is not really true. It depends, of course, on your program and on what knowledge one is talking about. Like FP residents run circles around IM/Peds when it comes to knowing how to run a practice when they finish. IM/Peds trainees would be better equipped for sicker inpatients and ICU patients. But really? I see all training programs as like getting a driver's license--sure you can drive when you get licensed, but it takes years to get really, really proficient. 

Med/Peds does give you the option of doing a fellowship in an IM or Pediatrics specialty. Having a dual board sounds "sexy" to a lot of people and can make you more marketable. It's great to have the experience with sick patients of all ages if you're interested in global health, too. Even though I don't do Peds any more, I have never regretted doing the combined training. I think each specialty complemented the other. I've maintained both certifications and loved my training.

That said, I don't consider myself the poster child for Med/Peds. I think it was a good fit for me. I think it's a really tough training and it ain't for whiners or punks. (Sorry to be blunt.) But if you can survive it? It's a great thing to have done.

#3   Three for the price of one

Hi! I have three questions for you :) 

#1: What do you think is the best way to get along with doctors and nurses who have been doing their jobs forever, who have forgotten more than you've ever known, and who are more than twice your age (like seriously, three or four times my age).... when you don't agree with what they're saying, or worse, when you need to question what they're doing? I'm a 28 year old girl who gets carded for buying lottery tickets (age limit: 19), and whether I'm being there for my kid, or as a patient myself, this situation is pretty common. 

Aaaah. The best thing to do is to be nice, hardworking and smart--in that order. First--learn the names of every single nurse and doctor working with you. Be collaborative. Don't take things personally. Get thick skin. Respect their experience and lean on them. Be careful with the "question what they're doing" part. You'd be surprised how right the nurses often are. (Maybe you wouldn't be if you'd been around as long as me.) When you're kind and have built a rapport, disagreements aren't awkward. They're just discussions about how best to care for the patient.

Lastly, check yourself. Make sure you don't have a chip on your shoulder. We all do sometimes. Once you flick it off, not much bothers you. I know that I try to be nice, hardworking and smart--in that order. I know I'm a good doctor that tries to treat people like they are valuable. I know this because I work hard at it. When someone isn't being kind, I recognize that it's usually more complicated than I realize. I try to understand. And you know what? It always ends up working out.

#2: In the same vein, what would you think would be the best way to deal with the same health care professionals when they get frustrated and start calling your parenting into question? Or start acting really paternalistic because I look the same age as their daughters (or worse, am)?

 Ha ha. I think the last answer applies here, too. Oh--check out this post on how to get the nurses to hate you--and this one, too. Not so much about parenting, but still could be amusing, if not helpful.

If someone calls your parenting into question and they're your doctor--get a new one. If they are just rude people? Just look at them like they're stupid and keep it moving. Or you could just do this.

And third question is: Can you please please please do more posts on culture in the South? I'm Canadian (from the Maritimes), and I find them so fascinating, especially anything about food and manners.

Yes! I hope that you've gleaned more about the South since asking this. But, yes, I'll keep this in mind. I love cultural competency and feel honored that you want to know more. I want to know more a-boot you Canadians, too.

#2  --  Don't sleep!

 Hi GradyDoctor, I'm a college senior thinking about medical school. The one thing that scares me most about med school, residency, etc. is sleep deprivation. I just hate the idea of not feeling/looking/performing my best because I didn't have enough sleep! How did you (do you?) deal with this, physically and emotionally?

The truth is that you have it exactly right. Sleep deprivation sucks in ways more royal than Harry, William and the Duchess all rolled into one.  It is like torture to not sleep and it isn't really normal.

But. The good news is that in this day and age, nobody really gets the full sleep deprivation that we knew in medical school and residency. We got hazed big time. Remember when my friend Neil W. mowed down a row of cars after being up for 48 hours? If not, read that post. Or my idiotic decision to take two calls back to back. But now? That's all illegal. People get to sleep. They get to go home and get into their beds. They get days off.

So as far as that part goes? You're good.

But seriously, though? The best thing you can do is sleep when it's time to sleep. Don't let people talk you into going out when you should be getting rest and also make sure you're exercising--that always helps you to sleep better.

#1 -- The biggest losers.

 What is the biggest problem you see with our healthcare system today? Specifically, your frustrations as a doctor. Not trying to start a political debate here! 

That's easy. Lack of access to affordable health care for so many people. The dichotomy between the haves and the have-nots when it comes to getting care. Lumps that can't get biopsied. Meds that can't be purchased. Private ERs that send people out with broken bones in scotch tape splints and a note that says "Go to Grady" (or insert your favorite safety net hospital.)

The poor have it bad in this country. A lot of it is a vicious cycle. It's overwhelming sometimes. It really is.

Last year on the way to Grady. Same spot as above.

BONUS:

Quick! What were three funny things you heard at Grady today?

#1  -   A Grady elder saw another younger person in the hall way as I was walking in. They greeted each other and the elder said (in a SUPER LOUD VOICE):

"Damn, girl! You done got fat, ain't you?"

#2  -  A young dude walked up to me and asked if I would marry him. Marry him, y'all. Just like that. Or rather, like this:  "Excuse me, baby. Will you marry me?"  I said, "Uuuuh, no. But thanks for asking." And he said, "Awww, come on RED. How you gon' do a brotha?"

Hee hee.

#3  -  I was coming to see a patient that the resident had just finished seeing. He was walking out of the room as I was going in.

"Sir? Where you going? I was just about to see you."

"I'm going to the bathroom."

"Oh, okay. I'll just wait for you then. No problem."

"You can if you won't to, but I'm jest tellin' you it might be a minute."

"Uuhhh, okay. Are you alright, sir?"

"Oh, I'm fine. I jest feel my stomach boilin' . . .you know. . . like I got to boo-boo tha's all. So if I do, it might be a minute."

0_0

Uuuhh, yeah.


***

Happy Thursday.  Look forward to the next time you hit me with your best shots. Stay tuned!

Now playing. . . . a little Trace Adkins singing the bread-eaters anthem -- Honky Tonk Badonkadonk! *You're welcome*