Improving yourself.

And that's what I love most about life... You can always learn new things. Become stronger. Think more positively. Develop new skills. Run faster. Give back more often. Hate less. Love more.

In some way, your new self can always be better than your old self.

The Glorious Week of Dating Bald Men

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Finding a boyfriend is awfully challenging. Recently, it seems like finding someone with whom I have great chemistry is nearly impossible. I sometimes feel like I’m on that old TV show called “Next!” I go out on a date and just want to say, “Next, please!” And the times I want to say, “Ok, you can stay” they are simultaneously saying, “Next!” Someday, perhaps, the stars will align.

I’ve been on a bunch of unsuccessful dates lately. From the rich doctor who was so into himself he seemed to forget I existed. Or the guy who talked about his car like it was as precious as a small child.  Or the super hot and successful guy who found anything that resembled commitment to be scarier than a haunted house. I’ve analyzed why I wasn’t interested in dating these men, and while there are various reasons I’ve found one strong factor that they all have in common: a full head of hair.

Now if you know me well, you’ll know I have a slight inclination towards dating prematurely balding men. Some of you (ok, all of you) think this is a little weird. But, humor me, while I list reasons why they are indeed the best type of men to date.

In general, prematurely balding men are super attractive, but just don’t know it. Losing hair early can be a little traumatic to young men and they have the potential to lose a small amount of confidence in their physical beauty. This creates the desired characteristic of being slightly humbled. And then, they struggle, and finally decide to shave off all their hair. In addition to be extremely sexy, a shaved head is an outward sign of embracing life’s challenges and making the best out of what they are given. Humble and able to conquer adversity. I’m also convinced that prematurely balding men have more testosterone. (Testosterone, well actually dihydrotestosterone, is one mechanism that can lead to hair loss.) They are therefore just exude MANLINESS. Plus, their head just feels awesome.

I meet about half the guys I go out on dates with randomly. The other half I meet on an online dating site. Since dating men with a full head of hair has been problematic to me recently, I decided to do a search for “bald” men on said dating site. Low and behold I found a handful of sexy, successful and interesting bald men. I have four dates lined up in the coming week.

So wish me luck, friends, as I solve the problems associated with man hair and spend the week dating this rare and often under-appreciated breed of men! Amen.

Provider Empathy and Angry Patients

Our patient looked at us with anger, resentment and defiance. His voice overpowered our own when he yelled, “I just need to get out of this hospital. No one else has ever kept me in the hospital and I will never f***ing stay here again. Take out this IV now. I’m leaving. I will not sign your f***ing paperwork.” We tried to reason and compromise with our patient. We explained the benefits of staying in the hospital and the potential risks of leaving the hospital before we found the source of his infection. Any explanation seemed to enrage the patient further. He quickly unbuttoned his gown and threw it to the side. Sitting now in just jeans, he tried to determine how to remove his own IV so he could leave as quickly as possible.

Empathy is a useful skill for a healthcare provider and is defined as “engaged curiosity about another’s particular emotional perspective.” Research has shown that it can lead to better therapeutic outcomes and patient adherence to medications because empathy enhances trust between patient and provider. Additionally, patients’ are more likely to share information with providers who are emotionally present. It is easier for providers to be empathetic when patients are compliant, well mannered and kind. Negative emotions, such as anger and frustration, spread quickly from person-to-person and lead to deterioration of empathy and increased emotional distance between providers and patients.

While difficult, it is important for providers to empathize with patients who are displaying negative emotions. Providers should analyze the patients’ potential reasoning for their negative emotion. This subsequently leads to increase in helping behavior by the providers, which reduces overall anger and increases the therapeutic impact. This display of empathy can allow physicians to uncover patients’ unspoken panic, angst and suffering.

Jodi Halpern, in her article entitled “Empathy and Patient-Physician Conflict” describes a method that physicians can use to increase their empathy when the patient is exhibiting negative emotions. The first step is recognizing one’s own emotion by cultivating self-awareness. Additionally, over time providers should reflect on these emotions and the meaning that these feelings have on their life and the life of the patient. Providers should then make a conscious effort to find the patients’ nonverbal emotional messages implicit in their anger. Finally, and often most difficult, providers should be receptive to the patients’ negative feedback. This feedback should be accepted without defense. The deferment of our defensive impulses to blame or anger provides a gateway to increased empathy.

Dr. Halpern’s framework can be applied to our patient. My first reaction to our patient’s angry outburst and medical noncompliance was frustration. The patient clearly needed additional medical attention that he was not willing to receive. Since negative emotions are highly transmissible affects, my increased frustration likely escalated his anger. The patient had multiple reasons to act upset. From his history, he clearly suffered from abuse during his childhood. He reported smoking a pack of cigarettes per day beginning at age seven. At age 22, he had no teeth because infection and rotting made it necessary for a dentist to pull out all his teeth. Even these two facts make it apparent that parents were not present to encourage good behaviors, but they likely fostered an environment filled with vices and a blatant disregard for their child’s health or his general wellbeing. The patient also reports that he and his mother were over $65,000 in debt and this hospitalization would further contribute to their financial problems. The patient’s basis for his current anger was probably rooted in an upbringing where health was a low priority and financial problems caused family disputes and increased stress. The combination of these reasons likely contributed to his decision to leave the hospital against medical advice. Finally, I should accept this patient’s negative feedback and use it as a reminder to be aware of how social factors and suffering affect patients’ current emotional state. If I am cognizant, I can use empathy to at least partially offset patients’ negative emotions. 

Reference

Halpern, Jodi. Empathy and Patient-Physician Conflicts. Society of General Internal Medicine. 22:696-700. 2006.

Connections of Love Lasts the Longest

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I walked into Brad’s hospital room to see how his night went. Brad was a 59-year-old male with severe Alzheimer’s disease who had recently suffered from a new-onset seizure. He now had an altered mental status and was confused, delirious and agitated.

He rolled around in bed restlessly. His arms had bruises imprinted on their side from his flailing arms hitting the sides of the bed. His hands were covered with white padded mittens to prevent him from pulling out his feeding tube and lines. He wore a diaper because he was incontinent. A red rash caused from a side effect of a new anti-seizure medication covered the side of his face, his chest and the left side of one leg. Blankets were crumbled up on one side of the bed. He thrashed, he thrashed, and he thrashed.

“Brad!” I started, “It’s Liz, the med student.” I decided first to assess orientation. “What’s your name?” His eyes were partly closed. He rolled to one side, then the other. Mumbling constantly. He finally stated through his mumbling that his name was Brad. I stated that this was correct and asked for his last name. Brad mumbled some more, unable to answer. He wasn’t able to speak in complete sentences and did not know where he was or the year.

Then I asked, “Brad, can you tell me your wife’s name?” Brad halted. He immediately stopped rolling and looked off into the distance. The sounds of Brad restless movements were replaced by silence. Pure silence. Brad’s agitated face slowly relaxed. His gasping breath became calm. He looked at me briefly, rolled over, and stated, “It’s Caitlin Miller. And I love her.” A moment of clarity. In a brain that was slowly succumbing to Alzheimer’s disease. In a brain that had been acutely altered for days due to a seizure. In a confused person who is unable to identify his full name, location or the year. In that moment, he still knew love.

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I met another patient named Patty a few months ago. I was working at the neurology clinic and had the opportunity to see Patty on three separate occasions. Patty had been suffering for years from Huntington’s disease. Patty’s ability to move her muscles was becoming increasingly impaired. She sat stiff and hunched forward in a wheel chair, but her body often burst into uncontrollable jerking movements. The effect of this disease on her body resulted in abnormal facial expressions, difficulty chewing, swallowing and speaking. She required constant care and was accompanied by her home nurse.  She did not and could not speak to answer my questions. She just stared straight ahead, her body writhing uncontrollably, while her nurse did all the talking.

I took the interim history from the nurse. At one point, I asked about family in the area that might also be able to support Patty. The nurse explained that all family was out of the state and that they do occasionally communicate by sending pictures of Patty’s grandchildren. I reached over to touch Patty’s knee as I asked, “How are your grandchildren doing?” I looked at Patty’s face. A face that rarely showed emotion. A face that is losing the ability to express itself due to her disease. A face I’ve looked into for over two hours that always had remained expressionless.  The corners of her lips slowly inched upward. Her eyes softened and she glanced longingly ahead. And during a rare moment of clarity and understanding, she thought of her grandchildren, and smiled.

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I have an inkling. That in a brain being slowly overcome by disease, there are certain connections that remains intact the longest. As demonstrated by Brad and Patty, these connections, just might be, the ones of love.  

What I want to be when I grow up

I went into med school feeling really confident that I would be an Ob/Gyn. I loved reproductive health. I loved women's health. So then, I was all like...

But then, all these people were like... "What about work / life balance?" "Do you know how hard Ob/Gyn residents work?" "Did you know it's the specialty where the most people quit and change to another specialty?" "All the Ob/Gyn doctors that I know are fat and depressed." So then, I was all like....

Then people started telling me in graphic detail about all the smells, sounds and liquid and semi-solid fluids involved in the birthing process. Then I was all like...

 

 So then, I thought, maybe I should think about some other things that I enjoy. I did my pediatrics rotation. The kids were cute. We blew bubbles together. The girls and I talked about our favorite classes in school and our favorite princesses. So then I thought, maybe I should be a pediatrician! I was all like...

After contemplating peds for a few months, I realized that I just didn't feel passionate about the specialty. I liked all my rotations, but I didn't love any of them. I didn't know what I wanted to do with my life, so I was all like...

Then as I was studying for my tests and performing clinical rotations, I thought about how I could open a free clinic for homeless women focusing on preventive women's health. I thought about how I could live in developing countries and teach about ob/gyn surgeries... or work on public health projects to increase access to family planning. I kept thinking and I was all like...

 

That made me happy. I have my Ob/ Gyn rotation in May and June. I'm nervous that I won't like it. So right now, I'm all like... 

But, please cross your fingers for me. That in a few months, I'll just be like....

Don't Sweat the Small Stuff

Advice I was given today:

When you get impatient/ mad/ angry/ upset/ annoyed etc. ask yourself, 

"Will this matter a year from now?"

The Person Whom I’m Going to be with my Entire Life

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I’ve found the person with whom I’m going to be spending the rest of my life! Blond hair, blue eyes. Stubborn. Hard-working. Enthusiastic. Caring. Impatient.

And that person is… me.

No, I haven’t given up in the search for love just yet. But what I do know for certain, is that there is one person that I’ll be with forever. Every moment of every day. Every millisecond. With every breath I take. I better like this person a lot. I better like… me.

In yoga last week, we were supposed to dedicate our daily practice to one person. People ran through my mind… my mom, the guy I’m currently dating, ex-boyfriends, best friends. I chose someone I recently dated because he made me feel good about myself. He comforted me and had brought me joy. But my next thought was, “Wait just a moment.  Why didn’t I think of myself? I should bring myself comfort and joy.” At that moment, I decided to dedicate my yoga practice that day… to me.

Later that day, I wanted to further explore finding inner peace and happiness through oneself, rather than relying on others. I spent this week focused on “dating myself.”

And yeah, I was annoying sometimes. I leave clothes on the floor and the occasional dirty dish in the sink. I got frustrated with others which prevented me from enjoying that moment. I was impatient when I had to wait. I wanted my own way.

But, I also shared some awesome moments with myself. Each time in the week when I felt content or happy, I explored the characteristics I was exhibiting that led to that moment. I took mental notes to bring out those characteristics more often in the future.

Continuing to improve oneself is one of life’s greatest challenges. I’ve attempted this multiple times throughout my life. I’ve educated myself, read books, exercised, tried to improve my negative qualities and enhance my good ones. What I never thought of is why. Why do I better myself? To me, it’s because I have to spend my entire life with myself. When I get annoyed, stubborn, or impatient it mainly hurts me. In those moments, I don’t feel at peace with myself. Bettering oneself allows you to enhance your positive qualities and to make life more enjoyable.

So, date yourself. Find ways you can comfort yourself. Enjoy being with yourself. Support yourself. Be your own biggest fan.

For, it’s just one person and one personality that you’re blessed to be around for an eternity. One person you will never live without. And that person is YOU.