The Age of Disconnect

We live in the age of disconnect. Cell phones, internet, social networking, technologies designed for the purpose of bringing people together are subtly tearing us apart. (Many readers, who like myself, spend far too much time playing with their smart phone and fiddling on Facebook, are already thinking of a rebuttal to this post).

This epiphany came to me after a four hour long experience with T-mobile’s customer service. In this time I had to re-explain my situation three times as I was juggled between employees, I was called a liar—or told that my wife is a liar rather—and ended the conversation with nothing resolved and my Saturday afternoon wasted. At some point in the conversation I asked the person his name which he said he couldn’t give (yet he had all my information right there in front of him) and I filed a complaint (the only form of accountability I could think of). Once the conversation ended I vented to my wife for an hour and am just starting to cool down as I sit to write this post. Would I have been treated this way if I were talking to this person face-to-face? I’m sure we’ve all had an experience similar to the one I just described.

Studies have shown that a person’s personality changes when they are wearing a mask. My parents would never let me wear masked Halloween costumes and I had to settle for the Batman costume that looked more like a bonnet. Masks are no longer limited to costumes and the new villains are people like telemarketers and cyber bullies.

I watched a really good movie recently called Up in the Air. You may have seen it, George Clooney, 2009 best picture nomination? The main character is one of those old timers who is disconnected the old fashioned way: leaving home on business trips and accumulating frequent flyer miles. His job is to fly all around the country to lay people off. His company has decided to meld into the digital age. A young woman, fresh out of college, spear heads a new development in which the employees no longer have to travel, but instead lay people off through online video chat. Could you imagine being fired by some stranger on the internet?! Now that’s disconnect. I won’t spoil the rest of the movie for anyone (it’s lovely), but thought this transition between the old way of being disconnected and our new way was profound.

Where is our brave new world headed (yeah I just used the title of this blog to cheese-ify this post)? I notice that my online interactions can very easily take a wrong turn as strangers argue about touchy subjects like politics, religion, and basketball (I guess it’s redundant to mention basketball having already mentioned religion). Will the World of Warcraft turn out to be a foreshadow of our future? Or are movies like Avatar or Surrogates better indicators?

Let’s do ourselves a favor and turn these trends around. We can rebuild our social capital by getting to know our neighbors, limiting our time on social networking sites, or giving someone a hug. I tend to believe that small changes, while inconvenient, can go a long way.

 

After note: Melanie called customer service and got the whole mess resolved within half an hour. Does that discredit this whole idea? Haha, at least I feel better.

Leia Mais…

Devan’s Stand Up

So, my little brother, Devan, does stand up comedy. He performs with the BYU group Humor U. Some of my loyal readers (yeah I don’t have any of those, but I like to pretend I do) may remember that I posted one of his first shows on my blog a couple years ago. Now he is much better! So for your enjoyment here are a couple of his shows. Hope you like them as much as I do. And ladies, he’s single and I need a new sister-in-law ;).

Leia Mais…

GOMERs and GOMEREs

I just finished reading The House of God by Samuel Shem, MD. The House of God is a medical satire about a group of interns’ experience during their first year of residency. The book follows Dr. Roy Basch, a ‘red-hot’ medical doctor fresh out the the ‘Best Medical School’ and starting his residency at The House of God, a prestigious hospital in Boston affiliated with the Best Medical School (Harvard, I assume). The book was referred to me by a friend in medical school who said it’s the most popular medical novel written to date. Expecting to get some fresh insight into what life is like as an intern, I approached this book with anticipation and excitement. In fact, Mel would tell you I looked at every used-book store in Nepal hoping to find this book. My enthusiasm quickly turned to confusion and even distress as the author paints a very cynical picture of medical education. Roy and his fellow interns are tortured with being on call every third night (and at times every second night), working 100+ hour weeks, being tortured by GOMERs and LOL in NADs, and slowly realizing the idealized physician’s life they all desire is turning out to look more like a nightmare than a dream. As these young doctors become disillusioned they lose their humanness, break down (one jumping to his death from a hospital window), and at one time or another become despicable.

I want to focus on one of the terms this book introduces, the GOMER. This derogatory term is defined by The Fat Man to mean “Get Out of My Emergency Room, a human being who has lost—often through age—what goes into being a human being.” It describes elderly people suffering from diseases such as dementia, whom the interns must care for in unflattering ways such as disimpacting hard stools. They can’t die, and are constantly abused by the medical staff. For example, one the the rules in The House Of God is GOMERS GO TO GROUND, meaning they fall out of bed. The interns use this rule in order to TURF their GOMERs to ORTHO or NEURO by setting the hospital beds up at dangerous heights. The treatment of these people portrayed by this satire is disturbing.

During my undergraduate education, I worked part-time as a certified nursing aide at two different nursing homes. One man for whom I provided care (I will call him James) was a WWII veteran, learned Chinese, and taught Chinese literature at Brigham Young University. In his old age dementia had left him miserable. He relied on CNAs for everything, and many CNAs resented him. James’ dementia made him violent, especially at night and he would punch, kick, spit, and do anything he could to prevent the aides from helping him. I remember one aide who even resorted to hitting James back. She lost her job. Whenever James’ call light went off, the aides would do their best to ignore him, or try and persuade another aide to go see what he wanted. Shem would call James a GOMER.

I became a ‘go-to guy’ when it came to James’ care. James liked me. I think he started to like me the first summer I grew a beard. A gruff man himself, James would say “you and I need a shave” with the biggest grin on his face. I found that James was rarely resistant towards care if I sat down and talked with him for a few moments before attempting anything. An avid reader, James enjoyed showing me what he was reading, and I would occasionally show him what I was reading. I would sometimes greet him with a ‘nee hau’ or begin by throwing his boot, which he hated, across the room to which he would applaud. He loved to tell me about his travels, about his family, and other such things. While his mind was ill, his soul was not. One day when I was struggling with my faith, James bore his testimony to me of the Book of Mormon and of the Restoration. James’ testimony is one of the most powerful spiritual experiences I have had in my life. James became a dear friend of mine.

The purpose in sharing this is to help encourage better understanding. James was treated as less than human because of his dementia. I discovered that James is a beautiful person who enriched my life greatly. People yearn to feel loved and respected. Treating people like GOMERs or GOMEREs (the feminine version of GOMER) is not acceptable. A lot of people have inherited a tough situation in life. I think one of our duties as human beings is to help each other out and encourage better understanding. Let’s think again about how we and others treat people like James.

Leia Mais…

Doctors’ Diaries

I received wonderful news this week. I will be attending the University of Rochester School of Medicine and Dentistry in August as a first-year medical student! As Melanie and I research activities and sights in New York, where we are going to live, how we are going to pay for tuition, and other logistical necessities, I continue to find my mind wandering and worrying about what lies up ahead. In an effort to demystify my future I decided to watch a PBS NOVA special called Doctors’ Diaries. This program follows seven doctors starting from their first day of medical school at Harvard. The program does a fantastic job at showing the different students’ personalities, and allows the viewer to get a glimpse of what it takes to become a doctor and what being a doctor entails.

Some aspects of the documentary are disturbing. As an intern, talking about the stressfulness of being a physician, one doctor says he’s “become this person that [he] doesn’t particularly like.” Another says “I’m gradually just getting more and more tired.” Several of the doctors go through a divorce or two (or three). A wife describes the time her husband is able to give her as a “shell” of the man she married. I also watched an intern connect with her patient before heart surgery and then, after six hours in the OR, pronounce that patient dead. These are some of the things I fear.

One doctor says, “In my years of practice now I’ve seen all the range of extreme tragedy, extreme joy. I can’t think of anything that’s grounded me so much in my life as being a doctor.”

There are also many uplifting aspects to the documentary. My favorite aspect is the film subjects’ interaction with patients and other doctors. These students and interns genuinely care for the people they are helping. One doctor develops a way to get eyeglasses distributed to rural areas of China. It is refreshing to see genuine care provided by all the physicians documented since this type of care is the reason many (including myself) go into medicine to begin with.

“You’re going to be okay. We’re going to take care of you and you’re going to be alright.” Being able to say (and mean) this is what satisfies one physician in the documentary. “I wouldn’t trade that for the world.”

Leia Mais…

Nepal Video

So I used Windows Live Movie Maker for the first time and made this:

Enjoy!

Leia Mais…

Nepal

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I am now back in Bangkok (which feels like home… strange). For the past month I have been in Nepal spending time in the Himalayas. Here are some notes on my trip:

We arrived at Kathmandu airport on Tuesday, March 29. The airport was a worn-down dust box. Guards stood around holding automatic firearms, employees begged for money after helping lift baggage onto a cart, and the line for immigration seemed to drag as slowly as it possibly could. Not a good first impression. We arrived later that day at our hotel in Thamel (a tourist area inside Kathmandu).  The trip didn’t start out well. One easily gets a headache in Kathmandu from the incessant beeping of cars and motorbikes warning pedestrians of their whereabouts on the absurdly narrow roads. Dust seeps into every physical space possible, a nightmare for your lungs. By the second day I found myself clinging to a toilet, puking in the dark after unwisely eating a cold pizza from the local bakery. The symptoms of food poisoning lasted the next three days including a ten hour van ride across the winding road that leads to Pokhara. We stayed an extra day in Pokhara to allow my symptoms to subside before we started our trek.

The first day of the trek was fantastic. We left the dust, blaring horns, bad hygiene, and unsafe food in the city and replaced it with good exercise and gorgeous scenery. The trek was great for our physical well being--our party being in dire need of conditioning. The first day we walked for 8 hours and ascended about 1000 meters of steeps stairs. At the end of the day we were utterly exhausted. This was the first of many physically taxing days. We spend our nights in tea houses. The tea houses were great, they include a room with a light, food available for order (we got used to eating primarily potatoes and eggs), and even a hot shower. Far from roughing it, we enjoyed each others company, read, played cards, washed clothes, and made friends from all over the world. I feel closer to every one of my family members thanks to these wonderful places.

Eventually, after over a week of grueling effort, we made it to our destination: Annapurna Base Camp! I immediately found a cozy place to sit high above the moraine where I watched Annapurna 1 for over an hour. Here, I experienced relaxation beyond anything I had ever felt before. I sat listening to the ambient noise. Just in front of me I could hear the occasional sound of a rock tumbling down the cliff. High above me I watched the slow, hypnotic movement of avalanches thundering down the mountain. I was reminded of nature’s subtle power. Mel and I read a chapter of the Book of Mormon together. Sitting Indian-style on a patch of grass I watched birds playing in the strong winds rushing up the cliff. Their grace translated to my peace. To me, that spot is sacred ground.

We stayed a couple days at the top and then slowly descended back down to Pokhara, ending our two week trek. We then spend another week in Pokhara and Kathmandu where I found that if you don’t eat cold pizza you can find delicious food that is inexpensive. I now sit here in Bangkok feeling utterly refreshed. What a great get-away!

Leia Mais…

The Reformer

"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who would profit by the new order, this lukewarmness arising partly from fear of their adversaries … and partly from the incredulity of mankind, who do not truly believe in anything new until they have had actual experience of it."

– Niccolo Machiavelli, The Prince

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Analyzing life’s fears…

In five months I will sit in on my first medical school lecture and officially begin my professional education. This thought is both exhilarating and terrifying. I am excited to take my education to the next level, to apply my scientific background to the art of practicing medicine. I am also terrified at the idea of eventually cutting somebody open, allowing people to put trust in me knowing their lives are in my hands. Can I, with good conscience, cut somebody open and have the confidence that they will actually come out better in the end? At times these thoughts overwhelm my mind, causing me to doubt the reasons I am going into the well-protected field of medicine.
This is not the first time that these types of thoughts have bounced around in my head. When called to learn the Hmong language I often found myself doubting I would ever actually understand what was spoken, or be able to articulate with power what my heart desired to communicate. At Brigham Young University I often doubted my abilities when a subject would come slow to me, or when I would feel the impending doom of an upcoming exam. I feel similar feelings when I think about the future, having a child, and being expected to raise him well. Life is scary and often we measure ourselves as inadequate when standing in front of our challenges.
I would guess everyone feels this way, nobody excluded. Even the heroes of history are human like you and I. I think on the continuum between gifted and maladroit, most of who history has deemed ‘geniuses’ lie somewhere in the middle. I read a book called Outliers by Malcolm Gladwell. Gladwell’s thesis is that the most successful people are not gifted in the sense we usually think, that challenges aren’t somehow less difficult for them. Geniuses, instead, are molded by their environments, chance playing more of a role than God-given talent. Gladwell describes the rule of 10,000 hours. He says that people such as Bill gates or the Beatles all had to practice for at least 10,000 hours in order to reach the status they achieved. Bill Gates had a unique opportunity to get many hours of computer programming experience at a time when even college students studying computer science didn’t have the type of access Bill did. The Beatles played all-day shows for years, getting hours upon hours of stage experience before they finally made it big. While I question whether or not the hour amount can be quantified, I agree with Gladwell that the environments these people created for themselves led to their success. What sets these people apart from others isn’t necessarily talent, but their ability to practice and get valuable experience.
In a book I am currently reading about surgery, Atul Gawande says,

The most important talent may be the talent of practice itself. K Anders Ericsson, a cognitive psychologist and expert on performance, notes that the most important way in which innate factors play a role may be in one’s willingness to engage in sustained training. He’s found, for example, that top performers dislike practicing just as much as others do. (That’s why, for example, athletes and musicians usually quit practicing when they retire.) But for more than others, they have the will to keep at it anyway.

I find these ideas fascinating. In my own experience, I rarely feel that I have any sort of natural advantage over my peers. What has separated me from others is my willingness to work, to study for hours on end, to read books and get involved in activities relevant to my field of interest. At times, I do feel like I understand things better than many of my classmates, but attribute this to my experience reservoir and not to natural ability. While many people go off during the summer and sell security systems I work long hours at a nursing home. While many students use their free time to do anything that isn’t related to school, I follow a reaction’s progress I started in my lab or read a book about evolution and medicine. Another key to success is to expend energies on things that are of the most value. An undergraduate must work, so why not find a job relevant to your field? An avid reader must read, so why not choose books relevant to what you will study this semester in class? By choosing activities of high value, I have learned some valuable lessons in patient care, critical thinking, and have made countless boneheaded mistakes in the process. Experience is what produces greatness. This is the key to my successes in the classroom and the most relevant tool I will bring with me this year as I begin my first year of medical school.
Worthy challenges seem impossible when first confronted. At one time the Hmong language was impossible in my mind, but I just spent the last week in the mountains of Thailand conversing freely with hilltribe people. Everything I have accomplished in my life, from pen tricks and guitar licks to scoring well on the MCAT, is due to the fact that I don’t ever give up. Once you recognize that the impossible can be overcome, you will take on bigger and more intimidating challenges. In this way greatness is accomplished. I believe I will become a great physician someday and will heal many people, but there is much to experience before that day comes.

Leia Mais…

SCUBA

Even though I want my blog to be more focused, I will still have the occasional picture post of fun things Mel and I are doing. This is one of them :)

We spent the last week in Koh Tao (Turtle Island) in Southern Thailand. This is a remote backpacker’s island which offers the best value scuba diving in the world (or so I’m told). I took the PADI open-water diving course and am now certified! For anyone who hasn’t been diving yet the experience is thrilling. It is an amazing feeling to breath underwater, find a neutral buoyancy (a sensation unlike any other), and explore the intricate world hidden in the coral reefs.  Not only was the diving phenomenal, the island itself was a small paradise. It offered me some of the best food I’ve eaten in Thailand, great volleyball, a great little used bookstore, an oil massage, some pleasant reading spots, and a much needed getaway. Enjoy these pictures.

 

 

 Cheers!

  

 

 

 

Leia Mais…

A More Focused Approach to Blogging

The new year has come and gone. During this time of year many people reflect on their lives. This leads to people adjusting their focus and resolving to change a few things.

It’s time for a change in OUR BRAVE NEW WORLD. Up to this point my posts are schizophrenic in nature, lacking a common theme. A good blog is predictable, the reader knows what he or she may find and comes back because the topics interest them. The blogs I add to Google Reader all have individual themes written by doctors, philosophers, theologians, sports nuts, etc.

In short, it’s time to renovate this bad boy and I want your input. Listed below are my favorite blog posts I have written. I feel good knowing these posts exist online and reflect my thoughts. I wish my blog only contained posts like these. Read these posts, let me know what you think, and give suggestions on what you may want to hear me blog about.

• Same-sex marriage (if you haven't yet, read this!)
• Science v. Religion: Which should we turn to?
• Taoism and me
• A Short Essay on Altruism
• How to love people using psychology

Leia Mais…