Let Food Be Thy Medicine

That's what Hippocrates said over 2000 years ago.
Maybe it should be incorporated into the Hippocratic Oath??

Of course...everyone knows "it's important to eat healthy." Lately, I've been a little obsessed with nutrition after watching two documentaries about food, Forks Over Knives and Food Inc. My obsession is only fueled by seeing a near total lack of nutritional knowledge and/or concern in most of the patients I see each and every daily.

But, does society really know how to eat healthy? I'm becoming more and more convinced that we don't. I thought it was crazy to hear about infants and toddlers being fed coffee in Haiti. Welp, here in America we feed our kids pop from a bottle. (That's straight from Bay City, MI) How about a 3 year old girl who weighs 60 pounds (...that's 20lbs above the average weight for a 3 year old!) and is still being fed from a bottle at night before bed. It's made me question our approach to medicine. And if we need more dietitians than primary care docs.

With all the regulating and big business that goes on in the food industry, with all of the recommendations supplied by the USDA, and with our superior American lifestyles, I'm realizing, through daily encounters with patients, we are often just as far from health as the people in Haiti. Maybe because some people just don't know, but I think it's that most people really don't want to try. Or maybe just aren't willing to change. After all, I suppose it's human nature to want what is easy.

In Forks Over Knives, it highlights two doctors who shop with patients and show them how to cook. Maybe that's what it takes. Maybe I'll start making house calls as a doc someday. I think I might like that.

Dr. Esselstyn promotes a whole foods, plant based diet in Forks Over Knives. No meat, eggs, cheese, or milk. His reasons for doing so are medically motivated and based on published research in medical journals, but still, he said he knows in America this diet seems extreme. I love his response to those who think his diet is extreme (myself partially included). "A half a million people in this country this year, who will have to have their body divided, their heart exposed, then veins will be taken from their leg, and sewed onto their heart. Some people would call that extreme." Touche.

How do I get people to change their diet as a doctor? Especially when they claim they don't have any money, don't have any time, don't care (it's been said by more than one patient...), or especially when they are already totally dependent on their "cholesterol lowering, blood pressure controlling, insulin providing, depression treating, erectile creating, pain eliminating cocktail" they take every day with breakfast and dinner. How do I do it when I (the big talker at this current moment) have a hard time eating veggies over Oreos dipped in peanut butter dipped in milk sometimes? Habits are hard to change. Food rehab perhaps?

I think doctor's worst enemies in successful nutrition treatment for problems like heart disease and obesity are themselves. It's too easy to take a pill. And they're too easy to prescribe.
(And maybe fast food, too. It's too easy to pull into a drive through. Trust me..I know. But driving by the long lines at the drive thru are starting to make me cringe).

Mr. Gas Man

Dear Mr. Sam's Club Gas Attendant,


You made my day. Thanks. I hope your sweet corn grows better than it ever has.

Sincerely,
A Ford Focus owner drenched by the rain






When I switched lanes at the last minute and decided to get gas at Sam's Club I didn't know it would become the highlight of my day. It's not everyday I interact with a gas station attendant out roaming the pumps who starts up a casual conversation with a, "Did ya get the rain I sent?" ...as I got soaked stepping out of my car. He then preceded to tell me how high his sweet corn was growing, how many pepper plants were blooming, and encouraged me to start a tomato garden in my house. "Why wait til next summer?" he said. He was an older gentleman, which while in my pediatric rotation, was a good reminder of why I'm not sure if I could give up working with people over the age of 65.

Also, he was an inspiration to me to never let life get dull. To go out and make it interesting. There are no excuses for being bored or stuck in a circumstance that is not seemingly ideal. I've never wanted to be a gas station attendant until tonight. But that man seriously made me want to be one. I think I'll always go there to get my gas. 100% worth it. I danced in my car the whole way home.

Forgetting

Whenever we find that our religious life is making us feel that we are good—above all, that we are better than someone else—I think we may be sure that we are being acted on, not by God, but by the devil. The real test of being in the presence of God is that you either forget about yourself altogether or see yourself as a small, dirty object. It is better to forget about yourself altogether.

CS Lewis

Really Good Days

There are good days, and then there are really good days. Today was really good.

Here's why:
- I forgot to tell the pediatrician I had a meeting this morning, but he was late too and I still met him and got to see two brand new babies this morning. After the nurses told me he still hadn't arrived after our meeting, I silently thought to myself, "Everything always works out." And smiled to myself.
- I really like pediatrics. The kids are so great, even the parents that everyone seemed to complain about. Some of them (most of them) so obviously love their kids.
- I got to see some patients on my own. I love doing that. I kinda feel like I'm still playing doctor.
- I'm learning SO much. It's worth feeling like I still have SO much to learn.
- An 11 year old asked me a series of questions that made me smile: Are you new here, I've never seen you? Are you going to be a CRNA? Do you work at the hospital? Will you always be here? How old are you? Do you have any kids? Can I look at that (in reference to the otoscope)? Can I listen to that (in reference to the stethoscope)? She ended with a statement, You're really pretty. She was cute. That last part made me really like her.
- I saw a patient with severe autism--he was nonverbal and rambunctious. He also had an autistic brother with him. After leaving the doc said the main reason he wanted me to see that patient was to meet his caretaker (their Grandma). They were her son's kids. He'd passed away in a car accident and their mother had substance abuse problems and wasn't able to care for them. She was amazing. He told me in his Indian accent, "There are some really special people in the world, I wanted to you to meet her because she is definitely one of them." She was amazing. I loved how much the doc praised her and pointed that out to me. If a heart could smile, mine was.
- I was so motivated to study today after work. There is so much to learn! Motivated studying feels good for a change.
- I finally saw what an ear infection looks like. It's been so vague and hard to appreciate. But today it clicked and I saw it.
- I listened to a girl with pneumonia...she had text book lung sounds and a textbook x-ray. Thank you girl with pneumonia.
- I have a new favorite drink. Vitamin Water Zero: Squeezed. It's lemonade flavored and delicious.

If I was a pediatrician I could decorate with pictures like this! 

Friends

I was asked to share a little about how the Christian Medical and Dental Association has blessed me since starting med school and wanted to document it here. I feel so lucky to have been at MSU and to have met the people I have. If I had a dollar for every time I told someone about my awesome friends from school, I don't think I'd need the military to pay for med school. 

The best part about my first 2 years of medical school has been, without a doubt, the people I've met through our CMDA group. [And, to be complete here, some others outside of it too...] They've become like family. To have their encouragement has been 100% invaluable.

 Beginning at MSU, I could not have imagined how much my faith would be challenged and strengthened. Through our weekly Bible study, one-on-one spiritual mentoring with our CMDA staff on campus, attending conferences and retreats, experiencing missions with a team in Haiti, and gaining insight from local physicians on practicing Christian healthcare, my vision for practicing medicine has become more of a lifestyle and less of a career. It's taken on a God must become more, and I must become less approach that I'm learning to incorporate into my life as a student. 

In fact, using Luke 12 as our guide, another CMDA student and I sat down and wrote a detailed covenant that explains how we commit to building the kingdom of God as physicians by focusing on relationships, finances, and the community. We've promised to continually examine each other's lives to live and work according to God's Word, not the world. I am more aware of the physician God is molding me to be and so so thankful that I have the accountability through my friends from CMDA to encourage me to stay true to my calling as a disciple of Christ. 

Hebrews 12 has never been so true for me: 

Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, ² fixing our eyes on Jesus, the pioneer and perfecter of faith. For the joy set before him he endured the cross, scorning its shame, and sat down at the right hand of the throne of God.³ Consider him who endured such opposition from sinners, so that you will not grow weary and lose heart.

What to do?

I can't stop thinking about the last patient I saw today in clinic.

From an objective viewpoint, this middle aged man was in a wheelchair, over 400 pounds, had severe lymphedema (he was retaining tons of water in his legs), and, he radiated a painful odor. I've never experienced anything like it. He was in atrial fibrillation, and the reason for his visit was to monitor whether his coumadin level was still within a therapeutic range. So, that's what we checked. His INR. But unfortunately, the only thing most of the medical team talked about during his time in the office was the odor. It quite literally would take your breath away. But, as we saw him, talked with him, and rushed out of the room, I couldn't help but wonder why the most obvious clinical finding, the one everyone was talking about, was being medically ignored. 

It broke my heart. Because from a subjective, humane viewpoint, he was kind. Verbally expressing his desire to not cause difficulties and seemingly cheerful despite his current state.

I wondered, who was going to take care of his smell? Who was going to investigate it? Who was going to touch him or help clean him? Yeah, the schedule said INR check, but was that really his chief complaint?? It wouldn't be mine...I asked the resident who was supposed to take care of the patients sores that had begun to ooze and smell, a complication of his lymphedema and immobility. I wondered if maybe it should be mine.

In a world of specialties, we are so quick to assume it is someone else's responsibility to tend to problems we either feel inadequate to address or simply don't want to address.

I don't know this gentleman's story. But, I wonder what he'd say if I asked. He is a modern day Leper in our world today. I have to figure out how to be a third year medical student, with limited capabilities and a chain of command, in which, I am at the bottom, while still being the hand of Christ, filled with compassion, that reached out and healed the leper. Where and when can I treat patients the way my heart tells me to and where and when do I just do as I am told? And am I making the distinction more complicated than it needs to be? I don't think I can just stand back for two more years, though. With a little creativity I hope I won't need to.

God doesn’t require us to succeed; he only requires that you try.

- Mother Theresa

Year 3

Today is sort of like the first day of my third year of medical school. Step 1 of boards is officially behind me, I found out last night that I passed! So far things in Bay City are going well. It recently dawned on me that this isn't just a short shadowing experience as we've started to see the same patients back for follow-up and I've started scheduling some rotations in the next few months. It finally feels real. Also, my preceptor is awesome. I kinda wanna be her. 

A brief update...

1. Bre Marchand becomes Bre Maxwell!

2. Kaylyn Blaauw becomes Kaylyn Piaskowy!

3. Katie Hunt becomes Katie Mueller!

4. I love dancing at wedding receptions!

5. Mal got toxic shock syndrome and proves to me that disseminated intravascular coagulation (DIC) can happen outside of the text books. I've learned a lot from her about what not to do as a doctor and what patients actually care about as a patient.

6. Moved to Bay City. This already marks week 3. Time flies. 

7.Started working at the resident's clinic and am realizing I really like the pediatric patients. I also met a foster family. It made me wonder if I may ever want to be a foster parent..??

8. I purchased an ENO hammock for camping/relaxing in our backyard. I spent the night in it this past weekend. I love it. A lot.

9. Super fun camping explorations in Little Rock, AK and Missouri in June on our road trip to Bre's wedding. It made me want to drive and camp everywhere and not fly ever again. It's so much fun to explore. Shout out to Amanda, Erin, and Megan...I've never had such a stress free, fun, relaxed camping road trip. Next time I think I want to conquer the great north...the UP.

10. And lastly, here's to trying not to become jaded by the medical system. And to more importantly loving patients (and co-workers) with patience and selflessness.