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 http://opinionator.blogs.nytimes.com/2013/10/02/who-will-heal-the-doctors/?src=recg&_r=3 and http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/  and http://well.blogs.nytimes.com/2013/09/26/easing-doctor-burnout-with-mindfulness/ 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.

http://www.fammed.wisc.edu/mindfulness
http://www.ishiprograms.org/programs/medical-educators-students/ 

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 (http://www.nytimes.com/2013/10/16/opinion/bittman-should-you-eat-chicken.html?src=recg) and their resistance to antibiotics (http://www.nytimes.com/2013/10/19/opinion/continuing-salmonella-outbreaks.html?src=recg) 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.

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!

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.

FOOD FOR THOUGHT
(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: www.bulletproofexec.com/the-complete-illustrated-one-page-bulletproof-diet/ 
• 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:

• Infographic showing that everything must go together, diet, SLEEP, and exercise along with mindfulness/stress reduction. I'm still trying to do my steps (I was competing with my Dad over last summer whose employer had a 12,000 step program) but since I've moved to a less walkable city I'm having a hard time. What I think I might do is post my step count on my weekly posts. The goal is 12,000! Back in Boston I used to average 11,000. Better get moving. And for all y'all who think skimping on sleep is fine, maybe this will make you reconsider.

• Here's a fast guide to selecting fish.

• 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. 

• Quick rundown on vitamins--what foods have them and what they are good for.   

(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!

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: http://www.nytimes.com/interactive/2013/10/02/us/uninsured-americans-map.html?ref=health

 For the full article click here: http://www.nytimes.com/2013/10/03/health/millions-of-poor-are-left-uncovered-by-health-law.html

Here's some answers to some common questions about what these changes may bring: http://www.nytimes.com/2013/10/05/your-money/estimating-income-and-other-questions-on-the-health-care-plan.html?nl=todaysheadlines&emc=edit_th_20131005

Here's one more article: http://www.nytimes.com/2013/09/27/business/as-some-companies-turn-to-health-exchanges-ge-goes-another-direction.html?src=recg&_r=3&

(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.)

http://annals.org/article.aspx?articleid=713512

http://link.springer.com/article/10.1007%2Fs11606-012-2207-1

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. 

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.

Sincerely, 

Swimming

The art of being a lady...in a man's world

I don't talk enough about this and I should as I seem to constantly find myself in environments where I'm the only female (or the closest thing to one) and should own up to my responsibility of being a prime example of woman in male-dominated fields more often. (I'm still on my way to my next male-dominated profession, but practice makes perfect and hopefully by the time I get to where I want to be I'll have had enough practice.) At any rate, I recently found this blog by a female surgeon and her post about Men in Surgery was poignantly sardonic and wittingly ironic. (She makes the case for why surgery is a woman's field and that men are the minority.) Behind the irony, however, lies a great deal of truth about what many women face whilst pursuing careers in predominantly male fields.

I'm lucky to have an older sister who is already an ENT surgeon (one of the most competitive specialties even among surgery.) There are scores of schmucks who consistently discourage women from fulfilling their full potential by scaring them off with comments such as "you'll never match, surgery is super competitive" or worse "why don't you try a profession that's more economical for women than medicine?" or actually the worst is "what will you do if you don't succeed?" (a scary question for anyone, but in my experience no one has ever dared to ask that same question upfront to any male I've worked with.) Being related to a prime example of someone who has surpassed those comments and still accomplished what she wanted to pursue, I recognize the importance to just deflect and dissipate those remarks along the way. That doesn't mean that they don't sting a little and I'm not sure what the appropriate responses to those questions should be, but I sense that keeping quiet or seriously responding to those are not the best approach to rectify the mentality. 

What I would like to shed light on is (1) why are those comments or questions considered appropriate at all? (2) Why have those comments/questions only been directed towards women, and lastly (3) what really is the best way to respond to men who ask those questions without coming off as the PMS-ing b*tch or the weak and inferior/compliant underdog? What I love so much about the Men in Surgery post was that it actually turned the tables and illustrates the fact that sometimes, even in a "man's field", women often have the advantage (either biological or otherwise) and the fact that we must work so hard just to belong is completely preposterous when the facts defy any notion that women don't belong in the field.

My overarching question really nests in the inquiry of what is the art of being a lady when you are in a field that's seen so few and does not know how to break its insularity? Sure one answer is to just strap on boots, stuff your pants, and act like a man. The alternative is preserving your identity and your second X chromosome and hopefully addressing issues politely yet firmly as they arise. I think it's time to recognize that we have a third option and that's being upfront about what's appropriate in the first place before things become hostile or uncomfortable.

It's been a number of years since I left the engineering/defense industry behind, but my experience there has stuck with me since specifically because of the stark contrast of working for a corporation versus being in medicine. Believe it or not, there are things I've encountered in medicine that would never be acceptable in a corporation. There are measures set in place to ensure that those things do not occur or escalate in companies. I attribute that to our female predecessors in corporate America that addressed those things upfront in the previous decade to set the standard of how women deserve to be treated equally in the workforce. (I was not aware that those efforts did not apply to every industry. Silly me.) This act alone made working in an industry as conventionally male as the military an experience that I look back on rather fondly.

Don't get me wrong, I love medicine, all it stands for, all it aspires to be, all it can do for people and more. I firmly believe that medicine has the power to not only change individuals, but also to collectively change a society for the better. That is why I gave everything up to apply to medical school and become a doctor. I'm just wondering if there will ever be a day where it can make a little more room for women to be women in an OR without being discredited or discouraged. That responsibility rests with the men in the field, the women that are already there, and the women who aspire to be a part of it. To make real contributions to humanity the stride is collective and involves everyone's willingness to move forward and break ridiculous traditions and mindsets that women don't belong or don't have the ability or aptitude to belong.

This week's musings

(1) Very informative piece on Detroit's woes and how it got there.
#SaveDetroit

(2) Maybe I should've tried harder to actually go to my fencing lessons.

(3) 7 things you should NEVER say to someone (click on the link for why)
"I don't care"
"You're wrong"
"You can't do it"
"This should be easy"
"I told you so"
"As I just said before"
"Good Luck"

(4) Exercise and eat less!
and yay for teens that are exercising more and eating less sugar!

(5) Infographic poster: how to take a perfect nap!
although I'm not someone who cannot nap.

(6) From PK, a hilarious documentation of men that take up too much space on subway stations: http://mentakingup2muchspaceonthetrain.tumblr.com/
PK and I often discuss the psychology and sociological implications of stature in public and workplace interactions; it speaks volumes about the gender gap (and also how evolutionary habits die hard.) It's also just poor manners in my opinion. Hopefully I'll find time this year to join that women's group, but until then Swimming will try to take up as much space as possible to try to fill the gender gap. After all, your body language really does shape who you are.

In other news Swimming has invested in some pepper spray. Burglars beware. I haven't used it yet so let's see how the year goes!

Lastly: Congrats to SM on her engagement!!!! Yay and super excited!!!

Best way to propose? FLASH MOB, Musings and more

(1) I absolutely love this <3<3<3: Utah Man Proposes to Boyfriend with Help From a Flash Mob in Home Depot

Link to story

(2) In case you don't know about the situation in Syria, here are some good links to help:
http://www.washingtonpost.com/blogs/worldviews/wp/2013/08/29/9-questions-about-syria-you-were-too-embarrassed-to-ask/

http://www.washingtonpost.com/blogs/worldviews/wp/2013/08/27/the-one-map-that-shows-why-syria-is-so-complicated/

http://www.nytimes.com/2013/09/15/opinion/sunday/kristof-hearing-you-out.html?nl=todaysheadlines&emc=edit_th_20130915

(3) Since I've been trying to be more conscientious about the environment I started to reduce my usage of disposable plastic water bottles. Here's another reason to do so:high BPA levels (a chemical found in plastics) are linked to higher obesity risks for children

(4) While I love my classes, I am increasingly aware that I ought to be more well-trained in self-defense. Crime even in the daytime and consequently I have already had to tone down my style as to not attract goofy people with nefarious intentions. Swimming apparently needs a better plan of action so I hope to expand on this, but here are some quick safety tips I found for ladies everywhere:
http://www.thenonprofits.com/safety.htm
http://www.cosmopolitan.com/advice/tips/safety-tips-every-woman-should-know

(5) Why people need to stop complaining about how busy they are
Nothing is more annoying than when others complain about how busy they are. In this economy it's a luxury to have work and a gift to have work that you like and want to do. More often than not it isn't the people like residents that work 90+ hours a week or those with families and jobs that somehow always manage to make time for others amidst a busy schedule that complain. Those individuals chose their lifestyle and are content with giving their time to get better at their craft or balancing their career and family life. It appears that the people who complain about how busy they are probably are not truly content with their life and work. My mum used to tell me that not every day can be the same. That's the truth and on days that aren't so great t's important to be grateful for and realize we're a lot luckier than many others around the world. (See #2 above if you don't believe that.) Take a few moments to be grateful regardless of what kind of day you're having or how busy you are and then I suggest you TOGGL your time to see how you can better spend it if you are one of those people who are "soooo busy."

(6) While I'll refrain from any comments on my own experiences, I just wanted to put this out there from the Times: http://www.nytimes.com/2013/09/08/education/harvard-case-study-gender-equity.html?pagewanted=all&_r=0

(7) Chart from CDC via the Economist: Obesity in America

(8) To top off the musings list another story from Utah where a Dad tries to teach daughter lesson about short shorts

My two favorites in one video

My two favorites in one video!

The Art of War (lessons)

The Art of War is actually one of my favorites. I refer to it frequently to heed advice on becoming more tough and also to reinforce my conviction that the way I've chosen to go about things is really the best way for me and aligns with my philosophical belief system. Things are rarely what they appear to be; I've waited to do things which has brought many others to question my commitment, interest, and conviction to succeed and pursue what I've set out to pursue. Moving and starting graduate school I am definitely closer to what I eventually want to do, but what most don't know is that grad school was in my plans for a while now (years in fact) and it's nice to be in a program that values my approach to medicine and is trying to help me get there in the best way possible. Here's to a kind fall!