Tuesday, November 23, 2010

Time for a vacation

Right about this time of year, I get cranky, tired, sleepy etc. And ready for a break. I think that 19 and counting years of education have got me programmed to living my life is chunks of terms/semesters. So right about now, Christmas vacation is looming in my head and in my body.

I wonder what life will be like outside Christmas vacation, spring break, summer vacations all set in semi-stone.

Tuesday, November 16, 2010


There's a Ghanaian proverb/saying- Sankofa. Which basically means that to move forward, you need to return to your roots. Or something like that. I'm interpreting it today to mean, that to continue to grow as a person, spiritually and emotionally, I need to look back and see how far God has brought me. This is not a post to congratulate myself and pat myself on the back. It's actually a critical post.

I remembered today, that God has never let me down. He's got my back and He's showed me that countless times and in different ways. So why I let fears and the need to be in control and impatience and a whole lot of other things distract me and cause all sorts of distress is baffling me. Why I persist in trying to run before God and trying to drag Him along, rather than to rest in Him and follow him is also baffling. And yet I do it. Time and time again. It has to stop.

So here's one way I hope learn and one thing I hope to change ASAP. I need to just relax and follow God and watch Him open doors, work miracles and basically take care of me. Not that I can take care of myself- and any idea that I can is simply an illusion. So, here's to learning how to rest and relax in God.

On the other hand, when God opens a door, I have to walk through it. He does His part, I do mine. Everything I do, I need to do for His glory with all my effort. I've become so lazy of late, that I feel like I'm ignoring open doors and just being very lazy and sitting on my ass. So this too has to change, and change now.

Monday, November 8, 2010

Interactions, expectations, perceptions.

In the past few months since rotations started, I've met a great diversity of people- much more  than I did in my 1st 2 years. This, of course, is not a surprise to anyone. The first two years were spent mostly in class with the same group of students. Now in effect, I'm exposed to what the real world of CT looks like- well at least a fraction of the real world of CT.

The interesting/ sometimes fun part of a being an African (or black) petite, looks younger than she really is female, is watching peoples reactions to me. Some people couldn't care less when I explain that I'm a med student. Others, mostly older black women, give me this amazing grin and tell me, in words or actions, that they're proud of me. A few people have asked, in direct or subtle ways how old I am and many quietly wonder if I have any idea what I'm doing or if my parents know that their baby is masquerading as an adult in a white coat.

Of all these reactions, one of the one that warms my heart most was an interaction, well a series of interactions I had with a 90 something y/o black woman. She was kinda cantankerous really, giving everyone around her a hard time. But she would listen to what I had to say with a smile that said "aww, look at this cute baby girl". And she told me, countless times, that she never believed that in her lifetime, she would see a young black woman doctor. She was amazed, she was proud and she was happy. You see, if I ever doubted if I could do this (and yes, I doubted myself often, especially in 2nd yr) I never doubted because I'm female, or African or black. I doubted because it wasn't always clear why I was on this path and if I wanted to remain on the path. Neither of those issues had anything to do with race or gender, but were wholly within myself. To this old lady though, the issue was a very different one. And I think that meeting her gave me a much greater appreciation of the perspective of older people of color in this country. 

I grew up in a time and place where there were no limitations set on me by virtue of my gender, size, height, skin color, ethnicity, nationality- nothing. I grew up knowing that I could go as far and as high as I wanted and as God would bless me to go. I never really thought about how the world perceives me in my journey towards this or any profession 

I'll be honest and say that most, in fact, almost all patients I've come across in my rotations have been perfectly nice to me and I've had some good conversations with some of them. Sometimes, I think that the medical team, the attendings, nurses, allied health staff, residents and even myself are the ones who are more likely to be loud, rude, condescending and irritated with patients.

But every now and then, the 90 something yr old African American lady, the 70 something year old Italian lady,  the 50 something year old African lady and the 30 something year old Caribbean man, the 16 year old Hispanic girl strike me a little differently and remind me that things have not been and are not always as cut and dry for others as they are for me. Even for people who may have been born in similar circumstances and times as I, the gifts, talents and opportunities I take for granted are not as blase as I think. So no, I'm not a super special case or anything, but I do have particular blessings that I need to share with others- even if means being a familiar young face or a familiar female face or a familiar black face. And sometimes, really, the thing that makes the difference is a smile between two people, regardless of who they are.

Tuesday, October 19, 2010

Home is where the heart is?

I used to argue furiously with anyone who expressed the least bit of doubt about living a successful life in Ghana. From where I stood, I grew up in Ghana, reasonably comfortably, didn't die of cholera or dysentery or some other infectious disease, went to good schools and really, had no notion of extreme poverty or hardship. True, things might have been a lot worse if my parents didn't make the sacrifices they did, but I figured, if they did, then everyone else should be able to.

These days, I don't really care what who says. Part of it is my apathy showing, but part of it is also maturity in realizing that life happens. People start out with great idealistic plans and then realize that things aren't as easy as they seemed to be from afar. Some people left Ghana under terrible conditions and so really have no desire to return; others haven't been to Ghana in about 20 years and have a very warped view of what Gh is like.

Either way, whether or not someone returns to Ghana/the land of their birth/ancestry to live is a very personal decision- not one to be made by consensus or by some 18 y/o idealist who thinks she has all the answers.

Why do I bring this up, because it was an old post I started and didn't get round to finishing till now. But also because I found that priorities and ideas change with time. My desire to go back and work and like in Gh is no longer driven by some idealistic ideal of saving Gh from itself. Nah, its based in a very selfish desire actually. I want my kids, if they ever get born, to know their family and to be close to their grandparents, uncles, aunts, cousins and all the craziness that is my extended family.  I want my kids to grow up in the secure way I did, and to know what it is to be surrounded by family and by love. I want to live a comfortable life, knowing that with all its good and bad and ugly, I'm in the place where I feel most comfortable and most confident. In effect, I want to maintain what I had growing up, and the best place I know to do that is home.

This is me at twenty something. At 18, I sounded very different and had very different ideals. Somehow, I suspect that at 30, my priorities and outlook will have shifted again, perhaps become more clarified. I don't know. All I do know is that I have a dream and a goal, and I'ma keep working towards that. Let me do me and work towards what works for me. As to what decisions other people make about where to settle or with whom or how or if........that's their business, not mine.

Cynicism and what it does to you

I've been called cynical by some of my friends. I counter that by saying I'm not cynical, just realistic. I'll admit though that yeah, in some things, I can be a bit of cynic. But my cynicism or lack thereof is  not the point of this entry. This is about cynicism in the medical field.

It appears that something happens when people graduate from med sch and become residents. They get tired, they see the same stuff day in and day out. Unfortunately they are confronted by less than stellar behaviors from pts. They work long hours, get paid next to nothing and are the workhorses of hospitals. They're very tired (did I say that already?) and their buttons are much more easily pushed. As a result of all this, residents, I find, have little patience for some patients. Especially the ones who represent the "typical problem patient" for which ever specialty is involved. It may be the alcoholic who gets discharged from alcohol induced pancreatitis, and then returns to the hospital a few days later with the same problem. Or one who is convinced that he has some dire surgical emergency that never is. Or the one who comes and tells a sob story about having a pain or panic attack and only wants to abuse prescription medications. And on and on and on....

After seeing enough of these patients, the residents quickly lose their sympathy, and quite frankly have better things to do than to aid such behavior. So they send these pts out as quickly and efficiently as possible, and move on with their days. What happens then, when a patient actually has legit pain from cancer mets? or when a patient's pancreatitis is not from alcohol because they've been sober? Or the patient has undiagnosed or untreated psychiatric issues? or the patient goes home and tries to harm themselves? Unfortunately, these patients, with real and legit needs get shafted because of the actions of others- and in fact, sometimes due to their own prior actions.

The med students are the suckers who believe any and every story. In a sense, they're still fresh and new and unjaded. The attendings are removed enough and balanced enough that they can be a little more objective in recognizing real from unreal, and are more likely to give the benefit of the doubt. And even when the attending knows that this patient is faking or making things unnecessarily difficult, they have the foresight to see why this is and sometimes they address it.

In the end, a lot of different factors go into shaping a patient's care. Sometimes the cynicism is undeserved and represents a barrier to rapport building and sometimes to effective care. Other times, the cynicism is well deserved and every one breathes a sigh of relief when the pt is gone.  Eitherway, the task for the medical team is to remember that every pt needs the best care and needs an equal chance. But seriously, the medical team is made up of human beings, not cleverly trained androids who just churn out cures. I wish there was a more just way of rationing care and keeping people who abuse the system confined or contained. Then people who dont abuse the system wont have to pay for the misdeeds of others who do.

Thursday, October 7, 2010

Failure, and the fear thereof

Why do the most random things bother me? Why do I feel like I've failed at something which is really beyond my control? Why do I insist on basing my self worth on extraneous things and not on what truly matters- that I'm a child of God, who was wonderfully and fearfully made? Why do I keep looking to worldly markers of success, when I know that they're false? Why do I keep wondering what I look like in the eyes of the world? Why do I keep feeling so emotionally far from people sometimes? Like I always make the effort to reach out? Like I'm not really needed by many of my friends? Why do I need to be needed, and yet feel constrained by the demands of people? How and when did I get so selfish? Why am I so afraid that some dreams will never come true?

A friend of mine said in an email "I miss your no-nonsense ways" and I've often been called "the practical one". I don't feel nor sound very no-nonsense or practical right now.

"In repentance and rest is your salvation, in quietness and trust is your strength" Isiah 30:15. I need to keep remembering and claiming this verse. I need to learn to rest and be quiet and be still in my God.

I am not a surgeon

I am not a surgeon. This is obvious. I'm a med student. But in the deeper aspect- I'm not cut out to be a surgeon. I dont have the talent, temperament or patience for that field, and this in pt surgery rotation is turning out to be some styles. See, it's not about what they do- I think the art of surgery is very cool. It's about the characters, and I'm really not liking the character's that I'm working with this month. This is a problem, because I need to become an active part of the team, and I need to suppress my dislike and disdain for the members of the team.

If I learn nothing at all during this rotation, I will learn that being a team player often means putting your thoughts and feelings aside and working with all sorts of people.

In the mean time, I need to keep doing the best I can and try to love all people. 1/2 way there.....

Saturday, September 25, 2010

To God and to a friend

Like everyone else, I have many insecurities and fears. Some are pretty obvious....anyone who knows me half well, will get a hint of them. Others are so deeply covered up, that sometimes even I forget that they're there. Or I can bs my way around them and have the world and myself fooled. But they're there......lurking beneath the facade of the sometimes confident 25 y/o woman who's still in school, but seeing a small flickering light at the end of the tunnel. Maybe the facade isn't that good anyways, and I just don't realize it.  Dunno. I wish I could see what others see when they see me. I've tried asking people that.......never really works out well, because honestly, its kind of an awkward question to ask, and its not really something that most people think about actively. 

Anyways, I digress. This evening, I've had to uncover some of them and deal with them. At least examine them. And it's an unsettling process. But thank God for friends and strong, wise women who aid the process.

So to my friend, J, who may never read this post. Thanks for being there. Thanks for listening and for talking. Thanks for showing me things that I don't want to see. Thanks for having my back. Thanks for making me cry, then making me laugh, but in all things, making me think. Most of all, thanks for reminding me that I have to relinquish control to God. Not that I have much control anyways, but still.....

Now, this medium being cathartic as it is and all, I'm not about to list my fears on the internet where anyone can stumble on them. That's what paper journals are there for. But at least, this is a start. 


One of the things about adult medicine that frustrates me, is that many health problems are self inflicted. Many, certainly not all. Time, age, genetics, environmental factors...........all those play a part. But alcohol and tobacco really really really jack you up!!

In the past month, I've met a couple of patients who are alcoholics and are suffering from the effects of that disease. After a few days of hearing the same story in a different body, I began to get very very annoyed. Why on earth did people put themselves through this kind of pain? Why on earth did they even start only to find themselves so addicted and unable to stop? Why, really, why ? But then God started to work on me and remind me that I too have certain addictions. True, I'm addicted to neither alcohol nor tobacco, but how about blogs? books? cleaning my ears? food? And while the things I'm addicted to wont necessarily show up in physical manifestations and aren't inherently dangerous, they affect how I use my time, money, effort, thoughts, speech, world view etc.

So, I still get upset, angry even, when I see what abuse of substances do to a person. But I also remind myself, that people's stories and lives are more complex than their diseases. People don't just become alcoholics because they want to end up in liver failure neither do they become drug addicts because "well, why not?" Very often there are hurts and damages that go well beneath the surface and go way back in time. The substance abuse is often a huge and devastating symptom of a much darker and deeper problem. The thing is, knowing this doesn't make it easier to take or to understand. And it doesn't make it right. And it doesn't make the pain for the pt go away either.

Sometimes I hate these ambiguous thoughts/ideas/feelings that have no conclusions and no answers.

Sunday, September 5, 2010

A timely reminder

Today at church I was reminded that God has good things in store for me in this life. It sounds like a very basic principle, and it actually is. But I get so caught up in the hard things I see on the floors and that I hear about, that I forget that much of life is good, rather than bad. At least, it has been in my experience.

And so as I go through rotations and ponder questions about health, illness, life and death, I think I have to keep repeating to my self- "God has good things in store for you". Where is this coming from? Mostly from the fact that hospitals are sad places. I've said this before but it still stands.

Patients in the hospital are often in pain, very vulnerable, at some low points in their lives. Their families and friends are in the midst of all this with them- it's not an easy thing for any body. The role of the medical team is to talk to them, to try and heal or at worst keep them comfortable. I think this is a heavy calling, and one that I find draining.

Then there are also the patients that no one takes serious for whatever reason- mostly social. Sometimes I cant help but be irritated with them. But sometimes, behind the social issues are real hard core  medical issues that can be missed, and the team has to be careful to not dismiss a pt or his symptoms. But it's hard to remain objective in the face of a patient who is annoying you and pushing every single button that you have.

Medicine is a heavy calling. One that drains me, even as I like it and thrive. But I'm finding so far, that I'm not entirely sure that I'm cut out for the hospitalist setting. I'm also learning very quickly that I have to learn to leave "work" at "work". The dreams about patients and illnesses and everything are becoming a little too much now.

Monday, August 23, 2010

My life according to NYTimes

According to NYT and CNN (NYT mostly), single successful black women are a somewhat hopeless species because no one wants to marry us.

According to the same media outlet, 20 somethings are shiftless people who are delaying adulthood and responsibilities, who have no strong work ethic and who mooch of parents so much that we generally, as a generation, suck.

So according to this media outlet, I should just curl up in a pitiful useless ball because I'm a 20 something black woman who's on her way to being succesful.

How nice to know that I can prove them wrong, and also to know that my identity and self worth do not lie in what any "expert" or "non expert" thinks of me, my race, my gender or my generation. And really, why do people spend so much time pointing fingers at other people who they think are "poor" and "pitiable" ? Isn't is simply more efficient to write about wars and hunger and politics all that, and indeed to not just write but do something about it, than to speculate on job and marriage prospects of entire swaths of the population?

Whatever. I have work to. I'm well on my way to becoming a fabulous, successful 20 something year old black woman!

Tuesday, August 10, 2010

My new interest- the world of black people in America

I made a comment earlier about how sometimes I identify as "Black". That's an obvious enough way to identify- after all, no one will ever mistake me for any other race if they lay eyes on me. And yet, in my head, and perhaps in real life, there's a slight difference in identifying as a Ghanaian immigrant and as a black person who happens to be a Ghanaian immigrant. Ghana is so steeped in my blood and psyche- everyone asks me where home is and it's an automatic response. And yet, I find myself reading a lot of blogs by Black people who are not necessarily African, I find myself searching out novels by Black authors who are not necessarily African. I'm learning about a whole new culture and its actually a lot of fun. Strange in some ways to be on the outside, but not fully and not obviously so, but to also recognize traits of behaviors and cultures that have endured even with years of separation and divergent experiences, heritages and histories.

When I met my first Jamaican friend and eventual college roommate, I was intrigued by the similarities between her and me, my culture and hers. I wanted to learn a whole lot more, and I did learn some. Of course, as fresh of the boat immigrants, our views of our college world and of America were very similar. In a strange way, several years after freshman year, I feel like I'm again discovering yet another culture and am just as intrigued by similarities and differences.

I think I'm beginning to understand the worldview of Ghanaian-Americans (for lack of a better word) who can be both Ghanaian and Black and African and American and all things in between. It's a talent, I think, that some people perfect and others don't get so well. But how someone views themselves  is none of my business. Me, I'm working on trying to understand me.

This world of medicine

I keep telling myself to write about something other than the world of school and hospitals. I mean, seriously, I like to think that I have more thoughts in my head than those that revolve around this career.

However, today, it dawned on me how small the world is and how uncomfortable that can be. You see, I saw a patient today. She happens to be someone I know quite well. And on the list of differential diagnoses for her condition were some things that are not so pleasant for anyone to deal with. Test results will be available tomorrow, but I spent a lot of time thinking about how these things work- what it means to be a patient in the same institution where you work or your family member works. What it means to have your doctors and dentists be your friends and colleagues. What it means for someone you went to school with to see you in the vulnerable position of being a patient or family member of a patient........and on and on and on.

I know that this is not new to the world, and it's actually not even new to me. But it has never really hit home this clearly. See, now I know more about this lady that I really ever wanted, and regardless of what test results show, I will know even more still.  She didn't mind that I was there. In fact, I think it comforted her a little bit to see a somewhat familiar face- enough that she let go of some of her annoyance to tease me like always. But I'm hoping and praying and hoping and praying that those test results are ok. I can't even begin to deal with what will happen if they're not ok.

Tuesday, August 3, 2010

Me and hospitals

I don't like hospitals. I really really don't like them. This is ironic, considering the field I'm about to enter, and its even more ironic considering that I am becoming more and more comfortable in the white coat and in hospitals. But here's the thing. Most people in hospitals are pretty sick, very vulnerable, sometimes sad, sometimes barely here. Which is of course why they need the extra care and help, but which can also be very hard to see everyday, all the time.

There's this weird thing that happens in medicine, especially in teaching centers. To learn to restore health as best as we can, we must become very intimate with sickness and sick people. So much that we can sometimes lose sight of the person within the body as we focus on their body and their disease. And really, healing is not entirely in our control- we're simply vessels- if you will, of the Master Healer. And yet, it can be easy to lose sight of the family and social interactions and everything that makes the patient unique. At the same time, a health care worker, no matter what stage, cant get so wrapped up in each patient that they lose their objectivity and their own sanity.

So what's a girl to do? Some doctors are very good at keeping the whole person in perspective and some specialties lend themselves to broader look at different layers of complexity. I guess this might be one of the things that makes the difference between an adequate, good or great doctor. How you make your patients feel and if you can somehow identify with them as fellow travelers in this walk of life, without losing pieces of your heart or worse yet, breaking your heart with every encounter.

This is why I'm still a student. This needs to be worked out in my head. In the mean time, I still don't like hospitals all that much.

Monday, August 2, 2010

Family and Social history

I just finished my inpatient psych rotation. It was a lot of fun, a lot more fun that I was expecting, and while I knew I would learn a lot, I learnt a lot more than I bargained for. One of the many things that struck me was the importance of 2 things- family history and social history. In the medical world, these are simply two headings under which questions must be asked, and truth be told, these are sometimes very easy to overlook. But in the psych ward, I think every single patient I met had a family history of psych issues- depression, bipolar diasease, schizophrenia, anxiety name it, and many of them had significant stories of trauma as children. These two facts made me realize some things....
1. There is a lot more evil in the world than I know and than I want to know. I still dont understand it and really, I hope I never get desensitized to the point that I understand it or that I dont care.
2. Psych issues aren't as rare as I'd like to believe.
3. There's a very good reason for Ghanaian "elders" to say "wo ko awarea, bisa" (before you get married, ask around). Every family has their thing- go in with your eyes open and deal with whatever issues your new family has.
4. Some people will tug at your heart like nothing you can imagine. And even the patients that you might least expect. 

The question of identity

A conversation that started with a friend, and then followed with some family members has had me thinking long and hard about the issue of identity. See, now if you'd asked me a few years ago how I identify myself, I'd have said "I'm a Ghanaian, Christian girl". End of story really. Now, I find that that answer is a lot more nuanced. Ghanaian is still there, Christian is still there and now I find that I fit in a woman's skin a lot more easily than I did before. But now, occasionally I'll think more African than specifically Ghanaian, and more likely to think Black. And I think that Black, as opposed to only Ghanaian is a subtle thing but points to a shift in my psyche.

So then I began to wonder how identities are formed. What makes me Ghanaian exactly? and is it possible to be Ghanaian if you dont live there for an extended time? Is there any such thing as pure Ghanaian? and who gets to determine what that is? Is there anything wrong or right with being Ghanaian as opposed to African as opposed to Black? Does it change my focus or my dreams or future plans if my identity changes or do does my evolving identity wrap around those dreams and desires?

I dont think there are any answers, or at least obvious answers. But those are some random thoughts floating around my head.

Almost a year since

It's been almost a year since I last wrote on here, and what a wild ride it's been. Honestly, I dont think anyone missed my stellar writing (jk) but I missed this. This opportunity to put my thoughts on something, and by doing that maybe get clarity. I still have some angst about the whole blogging thing- which is funny because I'm addicted to some blogs, but whatever....

Anyways, the past few months were long, hard, painful, confusing- and it wasn't just because of academic work. But in the midst of all that I discovered some things about myself. I have an incredible, absolutely loving and stunning set of family and friends. I've always known that, but I was shown that in spades this past academic year. And to all of you, even those who will never read this, I must say thanks and I'm ever grateful for the fact that you love me so.

I also learnt that I'm a wimp. Apparently I dont like the tests that God sends my way via life. I resisit them, I complain, I whine. But thank God for grace and mercy and growth. There's still hope for me yet.

And now that a new academic year and a new portion of my education has started, I can boldly say that I'm smiling again. From the inside. Loving this journey of learning. Learning so much from all corners. I told myself that I didn't want this to become yet another medical blog, and I'll try my best to stick to my word. But I've seen and learnt a lot in the past month, and I know that there a whoooooole lot more ahead- I may need to find clarity here every now and then.

So, it seems I didn't let the blog totally die and I'm back........