Thursday, October 31, 2013

More Medical Musings!

YAY for the Red Sox winning the World Series!!!

This is a short one, no opinions involved just some good and interesting links to keep ya'll informed:

(1) How do you fix a torn ACL? You can watch it right here as it was tweeted!

(2) For those of you dressing up for Halloween, please avoid the costume contact lenses--your vision will be thanking you! Basically, they're extremely dangerous especially if non-prescriptive and not fitted to your cornea. They can cause corneal abrasions and other injuries that can lead to scarring and vision loss. Just avoid them, especially since they're not even FDA approved.

(3) Don't have time for the gym? The least you can do is spend 7 minutes and follow this quick workout. I've aquired a jump-rope into this on days I don't make it to the gym or yoga. Point is KEEP MOVING!

(4) Just throwing this in there since I don't think I've addressed diabetes much on my blog and want to be clear that I take diabetes extremely seriously considering I am at risk for it (genetically.) The bottom line: if you don't have the time to eat healthy or the will-power to hold back on certain sugary items you will most-likely have to deal with diabetes and it is a chronic life-long illness that will force you to make the changes. Please just make them now, it's much harder the longer you wait. As a future physician I definitely aim to employ lifestyle and preventative measures in my practice to diminish this.

(5) Here's a nice and easy chart that relates fitness activity with your personality type. You'll be much more inclined to partake in physical activities that are suited to your personality and that you find fun!

(6) I'm fascinated by surgery primarily because I see so much engineering involved in it. Here's an interesting piece:
on surgical skill. To follow-up with this, I've posted this before last year but as a reminder we can and should always strive for improvement in all avenues in life: Coaching a Surgeon
For the past year now I've been engaged in the relentless pursuit of how to become an expert in a field. I really don't know what kind of medicine I want to do, but one I do know is that whatever I do I want to be highly specialized and have the opportunity to be innovative.

(7) Lastly, in honor of Halloween find out your fitness age!
Link is from this article on fitness age from the Times.
I'm 24 yay!

Sunday, October 27, 2013

Medical Musings Part three: Medicine and Mindfulness, Other news

Another Lengthy one, but filled with info on mindfulness, yoga, and better health!

(1) I am trying to practice what I preach. I want to be stronger and I want to be a physician that doesn't lose sight of why I went into a really tough profession in the first place. I realized that before I get there I had to fix some things about me along the way. Essentially, I recognized that I can best serve by example and by already taking care of myself. Thus, I picked up some super important things in my time in Boston many of which I posted in my previous Medical Musings posts.

The importance of mindfulness. This isn't just some hokey spiritual thing, I think at its core it really means being aware of yourself and your surroundings and acknowledging the value in all living things. Meditation and mindful practice has been proven to  improve cognition, reduce stress, improves attention and my list can go on, just pubmed though to find more! The hospitals I've been affiliated with have even offered meditation classes for employees and patients.

My point of bringing this up is that being a practicing physician is a profession that requires immense sacrifice, sometimes of oneself and one's needs. These articles and  and have illustrated that this can happen in any specialty and the process by which this happens can be akin to living in a torturous hell. What I like is that they offer a solution that might help is mindfulness--workshops and lifestyle changes that can be made even amidst a 100 hour work week. 

I wanted to bring this up first because I wanted to present and propose something to my readers. As facebook and other social media may appear to bring us closer together, I sincerely believe the reality is that it does the exact opposite. This recent study has actually illustrated that social media/the internet makes us feel more apart and lonely. What does this all have to do with mindfulness? The point I'm trying to make is that mindfulness and being alone are not one in the same. The internet has effectually tricked us into believing we are not alone. Instead of falling into the trap of thinking our lives are filled (with the internet) I urge my readers to take that time to meditate, notice others and your surroundings, and spend the time more meaningfully. Mindfulness is a state of heightened awareness (to yourself and by extension to others.) Meditation is the personal practice of mindfulness, but its application extends far beyond the self and its benefits can (rather significantly) improve your life as well as the lives of those around you. The internet is not real. I mean this in the sense that you cannot touch, feel, smell a webpage. It does not give us memories in the same way as going out and being a part of the world does. Seek to notice your world with all your senses. Become fully engaged. Even sniff a little. Perhaps if more of us did this there would be less depression. These are very abstract ideas and I promise I will spend the time to breakdown a more elucidated discussion of this later, but the big take away is to just be present and seek to experience the world and all it has to offer with your whole self--not just your mind/vision engaged in an unreal, intangible world of the internet; if for no better motivation than when you leave this earth you will wish you had spent more time in reality rather than living in the virtual world.

(2) I talked in my previous post about choosing hormone-free meat and antibiotic resistance is a major reason to do so. The recent outbreaks of salmonella food-poisoning ( and their resistance to antibiotics ( is another reason why opting for grass-fed meat that were grown without antibiotics is a good choice.

(3) A little word about yoga. I live upstairs from a yoga studio so I decided to give it a second chance. I had tried yoga many years ago and did not take to it since I felt it was too slow-paced. This time, however, I have joined out of necessity since there really isn't a close enough spa to where I live that offers deep-tissue massages and I am having some tension in my shoulder. Anyway, what I like about yoga is that it is a solid hour to do something beneficial for my body and to focus on my body. I can't remember the last time I had that. Even when I would spa-hop on a weekly basis back in Boston my mind was always elsewhere, but in yoga (and this is a hot-yoga studio) I am forced to really concentrate on my body. Yes it's still slow, but the difference is that I am more mindful and have the ability to calm my mind--something I did not have in my early 20s. I also want to become better acclimated to being active in 93-degree weather considering the earth is not getting any cooler and I need to be able to withstand hotter temperatures and be active in them in order to survive and evolve as a human with Global Warming and all. Additionally, as I devour The 4-hour chef and plow through grad school (which I am LOVING by the way)  I am inspired every day to really learn anything I stumble upon, even if it doesn't interest me, and I am driven to become extremely skilled in it. That motivation alone drives me to go back to yoga and exceed what I did the last time. As an Indian person, I do find it odd how mainstream yoga has become that a lot of studios have deviated so far from its spiritual and mental roots. So much so that it really does seem at times that some places are just bastardizing my culture (and also the Sanskrit language.) The thing is though, I have to learn somewhere so I am putting that aside and luckily the studio I'm at right now has been ok so far. The fact that many of the ladies that are at this studio are over 40 with multiple children and having amazing bodies, are glowing, and look like they're 20-That's reason enough to participate. Anyway, here's an infographic on how yoga changes your body the day you begin.

Sunday, October 20, 2013

Musings/Lessons learned

Ok, so glad the panda cam is back on air.  My goodness. I can't believe I spent 2 weeks without seeing these little guys. A major life goal of mine is to get a hug from a panda. If you don't think I'm being serious then you clearly have never met me or knew me from age 5-11.

I'll post my last part of medical musings later, this week proved to be eventful for me so I'm going to post some random musings instead.

(1) Wowza...apparently calling 911 doesn't necessarily mean they can get to you on time. They have to be able to access your building and if your landlord hasn't given them access check to make sure they do!!!!!

(2) I have learned a great deal about life by watching Master Chef Junior. I normally don't take well to children. They're usually hyperactive and annoying and I just don't like small things that move. Plus they always try to follow me around since I'm short I can only assume that they think I'm a big kid. I, however, love this show because it's small children acting like adults. Not only is their skill level impeccable, their ability to strategize and be competitive seems right out of The Art of War.

(3) Can we please please please end Group Think???? I do think collaboration has its place in academia and in the workplace and when people come together great things can really happen. What I contest is the endless notion that it's imperative to integrate groupwork into each and every part of the process. People (myself especially) need time to duck down and work on ourselves by ourselves in order to produce things. The only thing I've found is that being in a group early in the process hampers my own ability to excel because I get lost within the group. I'm much better off preparing beforehand, producing, and then coming together to put all the pieces together and trade ideas.

(4) I'll only comment on this briefly, but why is it so hard for people in my generation to take responsibility for their actions? We live in a digital world no doubt, but the more digital we become the more easy it is to file away and dispose of things that are real--friendships and family.

(5) I'm a little ticked today so so bear with me. I'm becoming increasingly irritated with the hypocrisy that infiltrates my generation. We complain about having no money and yet see no issue spending things on frivolities. We claim to be conscientious with  health and yet have no issue with imbibing toxins as if it were water and still claiming that we live a healthy lifestyle. It's one thing when that hypocrisy only affects your own life, but when you bring others into it and affect their lives it's quite another (ie allegedly healthy person running around drinking and driving every weekend.) Are you still an organic person? Hell no and it shows. You can diet and yoga for 1,000 hours afterwards, but you're still not really respecting yourself and your integrity so you can't really elicit respect to others. There's merit to the rural lifestyle I observed in my last trip to India. These people are happy even though they've don't have some things the Western world considers basic necessities. What is most striking is that these people are generous. Without thinking twice, they were over eager to properly feed a guest and offer them gifts. It's ironic when you think about it that sometimes the people with the least often have more to offer.

Lastly, while I'm sad about the Tigers....I must say GO RED SOX!

Saturday, October 12, 2013

Medical Musings Part Deux: Budget Cuts, Medical Teaching, Healthy living/Food for Thought!

(1) Not much more can be said than what this article has already articulated, but the point is that research and technology are important to progress in a society.  The Nobel prizes were announced this past week for physiology/medicine, physics and chem and they illustrates the profound impact that basic science research has on not just medicine and technology, but also on society. Curtailing the funding for such research is equivalent to curtailing significant progress in medicine. I have stated in previous posts that I believe that medicine (in all its forms) collectively enhances a society. In understanding ourselves at the molecular level we not only understand each other better, but also understand the world in which we live in far better. We are governed by science and what can be proven scientifically is something that can be applied cosmically. By doing we begin to deepen our progress as a civilization

(2) I love this posting primarily because it is from a physician of my generation that foresees the issues of compromising quality healthcare just to meet and beat the numbers. In a few of Atul Gawande's books he also addressed the urgency of focusing on providing quality healthcare through small changes that end up having a larger impact on healthcare expenditures. (I'm referring to both the Checklist Manifesto and implementing handwashing in rural areas in third world countries as presented in Better.) Perhaps the answer isn't succumbing to the trivial nuance in order to save money. This article alone indicates that the problems run much deeper than that (yes, a bag of saline can cost $500 when you're in a hospital and yes you most likely paid that amount if you ever ended up in the ER or were hospitalized.) As a future physician, I seek to take the pledge to become more conscientious about healthcare and expenses but not at the cost of treating someone with quality medical care. I believe the answer lies at the cross-roads of simple practicality and a little ingenuity.

(3) In light of my recent post on the Healthcare Exchange, I have decided that I want to start some postings about health, food, and cooking in a segment called Food For Thought. First of all, and needless to say, I've taken way to long to apply to medical school, let alone get in and pass and become a doctor. I believe things will eventually work out, but there's no reason I should not act now to better my community's health knowing what I know and having a plethora of resources in front of me as it is. This is especially important since the people in my state are not eligible for the recent Exchange, they can at least use this blog to get free tips and more education on eating healthier. I firmly believe that part of why healthcare costs are so high is that healthcare education is aberrant. I'm still learning a lot about food and it wasn't until recently that I realized how ignorant I was on it. Here are a series of my go-to guides that I use to make meal plans. Yes, Step 1 is making meal-plans. Knowing what you need to buy before you go to the grocery store is a simple way to save time and money and calories. Having something you've already prepared ahead of time in the fridge is a great way to avoid impromptu snack purchases. Mainly, the world will be full of packaged nonsense but by planning you are two steps ahead that you won't be hungry when you're around the packaged goods. As with all planning, be flexible, but having a plan is critical to success:
  • If anyone is at a loss as to where to start on eating healthier use this infographic guide: 
    • More or less everything on that chart is very informative and easy to undertake (depending on where you live of course.) Think that switching from regular to diet coke or not munching on sugar cookies every day is helping you? Well think about what else you are eating. Potatoes and sandwiches can often be just as bad. This article tells us that not everything is as it seems. I've started cooking again and I feel better already. I'll post my recipes as they come (probably on a different blog since I don't want to clutter maritime adventures and act like a foodie.) I'm learning too so I'm not entirely sugar or fat or grain free.
  • I've recently placed more importance for antibiotic free meat. The health effects alone are reason enough, but my massage therapist also brought to light a totally different factor: how can anything/animal that was tortured its whole life, injected with hormones/antibiotics, and killed with malice provide meat that is good for you? Something that was killed through malice can neither physically nor spiritually have value left in it. Basically, you're eating a tortured soul. Additionally, in my next post I have an article about the antibiotic resistance bacteria. Just know that there is a relationship between the drugs given to meat to keep them "clean" as they are stuffed in close quarters with other animals and the bugs that affect humans that are drug-resistant. (Usually they're not the same strain but the bugs are related.)
Here are more resources:
  • And after my bouts of food-poisoning, one of which landed me in the hospital for a week and bedridden for 3 weeks after. here's a guide to food safety. 
(4) Lastly, one of the most important changes I've recently made is learning how to breathe properly. Yes, breathe. You might be asking "isn't that something anyone does without thinking?" Who knew there was a wrong way to breathe? The NAVY SEALS DID. I read this book earlier this year written by a SEAL that talked about mental toughness. In the book he indicated that a way SEALs are trained to control their heart rate and stress response in extreme situations is by controlling their breath. Simple instructions: inhale to a count of 5, hold for a count of 5, exhale to the same 5 count and hold again for 5 (no breath) then inhale again and count to 5. The link also lists its benefits and here's an infographic that shows some more. Since then I've read numerous other (non-SEAL related) books that have put forth the exact same principle. I do this while meditating, but it is also extremely helpful to bring your mind back to the present and control your response to any extremely stressful situation. Practicing deep-breathing is a good way to work all your muscles and something my massage therapist told me to do since I constantly elevate my shoulders and have a lot of tension. Additionally, a friend of mine introduced me to alternate nostril breathing which has worked wonders with my anxiety, my TMJ, and even when I have trouble falling asleep. I'll talk more about the yoga I've recently rejoined later.

Ok looks like this will become a 3 parter! Stay tuned for more healthcare/medicine related stuff and sorry for the length--just have so much info out there that I wanted compiled and I hope it is helping someone!

Thursday, October 10, 2013

Medical Musings: Part One--Healthcare exchange and women in medicine

Long post so I'll split this into a two parter. I had a lot of random articles I have been saving to post so here's tonight's:

With the recent healthcare exchange, I'd like to post some links and my thoughts:

(1) Despite the effort to expand medicaid there are still a vast majority who need the expansion but will not receive coverage. The eye-opening part of this is that the 26 states that are "not participating in an expansion of Medicaid are home to a disproportionate share of the nation’s poorest uninsured residents." What this means is that a good portion of individuals who need the expansion most (those living in some of the poorest states) will not getting it because the State Government has decided not to participate in the expansion. These states are not only some of the most populous, but also some of the poorest and also have the some of the highest concentrations of illnesses. To distill this down: the poorest and sickest are not benefiting because a choice was made not to allow them to be covered. What happened to the days where the purpose of the government was to consider the welfare of the people? All the people, not just the rich ones. A look at the charts below show that it just so happens that a large portion of these poor and uninsured will be blacks and other minorities. Something tells me that this correlates with the disparity in social mobility between races (another topic that the Times published over the summer.) It's hard to go to work when you're ailing and it's even harder to go to school instead of work when you're buried in medical bills. And it's harder to accumulate wealth when all of it is going towards paying for said medical bills. BAH humbug for the empathy gap.

Here's the fast and easy breakdown:

 For the full article click here:

Here's some answers to some common questions about what these changes may bring:

Here's one more article:

(2) Not sure how I missed this at the first go, but as someone who has some interest in academic medicine, it appears that the prospect of succeeding is still a little grim for women unfortunately. As if I need any more evidence about gender discrimination,  this is an old study so let's hope the past decade has brought some progress (not necessary to read, but I like to substantiate what I write here with evidence-based results.)

Some more links (most are short but the NYtimes one at the end is long but I believe the most important.)

Women Still Missing From Medicine’s Top Ranks and we're also still paid less.
Although apparently this also happens in Silicon Valley and they're know as the Silicon Valley Mafia.
This article is extremely interesting though (why are there so few women in science?)

To briefly comment on this, I was recently shocked to find that the department I used to do research at in Boston (a very very very large hospital) had zero women attendings (full-time physicians.) Sure there were residents (physician's still in training but already with their medical degree and learning how to practice in their specialties), but no female attendings in sight. I did a quick search at my current institution and sure enough, again, no female attendings here either in that particular specialty. Sure there are plenty of excuses and explanations such as this being a grueling surgical specialty that has a lot of manual labor involved and long hours so perhaps women steer away from it. Not really accurate assumptions since they appear to be fine going through the hard 5 year residency training. What is concerning is that although it is great that there are some female residents, who can they look to for guidance and mentorship as well as being examples of respected females in this field? Furthermore, how do the men who are training beside these female surgeons become accustomed to having female superiors and equals if none exist? Additionally, this specialty is a 5 year residency plus 1-2 year fellowship. That means that in the past 5-7 years not a single female was hired as an attending in this specialty despite there being qualified candidates. I'm afraid to look up the numbers of females that graduated from residency in this specialty. Something tells me that it's not zero. This sends the message to male surgeons-in-training that their current female classmates are temporary and will somehow disappear after fellowship or worse just can't "hack-it" along the way and drop out or, at the very least, just aren't real contenders in the field to end up at these top institutions. The fact that there are female residents indicates that they are accepted to train as surgeons, they're just not allowed to get hired and actually practice the craft. Mind you, these are two of the nation's largest hospitals sitting at the forefront of medical care. Precluding women from opportunities to learn and contribute at these institutions, teach at them, and mentor others is a loss for future physicians and future patients. I haven't bothered to fully research this at all institutions so I can only comment on what's in front of me but the prospect doesn't seem promising to say the least. 

Wednesday, October 2, 2013

Letter to US Government: Please reopen for the sake of Panda Cam

Dear Government,

Please reopen. I have recently discovered the Panda Cam and much to my dismay it has gone off the air due to your shutdown. This is an outrage. It is absolutely ridonkulous that as citizens of the United States we are left to the wayside only to imagine what those Pandas are doing today. Luckily, thanks to People magazine, I have some pictures to guide my memory, but nothing beats the real-deal.

Please reopen soon.