Fall 2011 - School of Medicine

WELLNESSCHRONICLE
Vol XIV No. 4 Fall 2011
Remembering Our Roots
John P. Schlegel, S.J.
Former Creighton University President
Excerpt from Spring 2007 Creighton University Magazine with introduction by Marcia Shadle-Cusic, Chaplain.
The following article was printed in the Creighton Magazine and gives a nice summary about the
Creighton Family, as they obviously have had an impact on your life. I hope that you will continue to
know about the people who have gone before you and appreciate all that others have done for you.
“John and his brother Edward, the sons of hard-working Irish immigrants, came to Omaha in the
mid-1800s by way of Ohio, where their family built successful farms. As a teenager, Edward hauled
freight—timber, foodstocks, construction tools, etc.—with a wagon and a team of horses given to
him by his father.
Omaha was little more than a dusty frontier town on the banks of the Missouri when the brothers
arrived. Edward returned to Ohio to marry Mary Lucretia Wareham, and John later wed Mary’s
sister, Sarah Emily. The families then set down roots in Omaha.
They found success in a variety of business ventures, most notably erecting telegraph lines
westward. Through their efforts, both coasts would be linked via this new communication. Even as
their success grew, they remained humble. Edward died in 1874, without a will, and his wife, Mary
Lucretia, died a year later, bequeathing $100,000 to establish Creighton College, fulfilling a dream
of her late husband.
Creighton opened its doors on Sept. 2, 1878, a free school for boys, mostly serving Omaha’s
minority Irish, Catholic community. Instruction was at the secondary school level.” In 1892 the
Creighton School of Medicine was established and included one woman in the class.
“John Creighton and Sarah Emily carried on the family’s philanthropy. As detailed in The History
of Creighton University 1878-2003, by University historian Dennis Mihelich, Ph.D., John Creighton
‘made weekly visits to St. Joseph Hospital to distribute candy to the patients as “sugar pills,” he
entertained…children at Christmas and provided them with gifts, and he had the matron of the city
jail alert him to incarcerated individuals in need of help.’ He also built the first American convert for
the Sisters of the Poor Clares. His generosity earned him the title ‘Count,’ bestowed by Pope Leo
XIII.
John and Sarah also provided for a young Creighton University — establishing the medical
college; Creighton Memorial St. Joseph’s Hospital (today’s Creighton University Medical Center);
the schools of law, dentistry, and pharmacy and health professions; and St. John’s Church.
Count John A. Creighton died Feb. 7, 1907, but, he, along with the rest of the Creighton family, left
an enduring legacy in Creighton University. As the late Creighton PR director Bob Reilly once wrote
about these two sons of immigrants, who achieved the American dream: ‘What looked like
opportunity to them has now flowered into opportunity for thousands of others.’”
Schlegel, John P. "Remembering Our Roots." Creighton University Magazine Spring 2007: 3. Web. 10 Sept. 2011. <http://www.creighton.edu/
creightonmagazine/>.
In This Issue
Remembering Our Roots
1
The Grey Area
4
Sit Less, Move More
2
Life’s Accompanying
Relationships
5
Medical Beads
5
Thinking Globally
6
Living in Ohm-aha
7
p.r.n.
Shrink Rap
Finding God in Medicine
2
3
4
Getting to the Heart of It
8
Medical Musings
9
Greek Chicken
9
Big News
10
Kate’s Cookbook
12
WELLNESS
CHRONICLE
FACULTY ADVISOR
Dr. Michael Kavan, Ph.D.
EDITORS IN CHIEF
Catherine Weaver
Angela Chon
CONTRIBUTORS
Liz Ferguson
Michael Kavan
Michele Millard
John Schlegel
Marcia Shadle-Cusic
Kate Forrester
Pat Laughlin
Ryan Miller
Megan Stinar
Catherine Weaver
Laura August-Schmidt
Nathan Barusch
Hannatu Tunga-Lergo
Amanda Wellnitz
Roy Norris
Sit Less, Move M o r
Liz Ferguson
Events Coordinator,
Office of Student Affairs
e
were asked, "During the past year, on an
average day (not counting time spent at your
job), how many hours a day did you spend
sitting (watching television, reading, etc.)?"
After adjusting for smoking, height/weight, and
other factors, Patel's team found that compared
to sitting less than three hours a day, sitting six
or more hours a day:
• Increased the death rate by about 40% in
women
• Increased the death rate by about 20% in men
• Increased the death rate by 94% in the least
active women
• Increased the death rate by 48% in the least
active men
It wasn't just that they weren't getting
exercise. Patel and colleagues found that sitting
itself was detrimental to health. Sitting
increased risk of cancer death, but the main
death risk linked to sitting was heart disease. "It
is beneficial to encourage sedentary individuals
to stand up and walk around as well as to reach
optimal levels of physical activity," Patel and
colleagues conclude.
Do you spend a significant portion of your
day sitting? A study published in 2010 points
out that sitting can be detrimental to your
health. So get up and move. Take short walk
breaks during studying, take the longer route to
your next destination, and maybe even look for
a parking spot a bit further away from school.
Getting some exercise each day (even in 10-15
minute increments) will help to keep you more
focused, less likely to get fatigued while
studying and improve your overall health.
Sit at leisure, die at haste, an American
Cancer Society study finds. In this 14-year
study, people who spent at least 6 hours of their
daily leisure time sitting died sooner than
people who sat less than 3 hours. And people
who both sit a lot and exercise little are at an
even higher risk of death, finds ACS
epidemiologist Alpa V. Patel, PhD, and
colleagues. The effect is stronger for women
than for men but significant for both sexes.
Patel's data comes from 53,440 U.S. men and
69,776 women who were 50-74 years old when
the study began in 1992. Study participants
SOURCE:
Patel, A.V. American Journal of Epidemiology, published
online July 22, 2010.
p.r.n.
Top Ten Tricks for Using Dodge Street
(as collated from Wikipedia and ancient Omaha lore)
Roy Norris
M1
1. Always eat a big breakfast and get lots of sleep before you use Dodge Street.
2. Remember: it was designed by the same ancient Chinese inventor that came up with
the finger trap. Just relaaaax, and the panic will subside.
3. TRTTL. Turn right to turn left...Yuuup.
4. Alternatively, MALAD. Make a left and die :D
5. If at any time during an Eastward journey the road suddenly swerves and becomes
Douglas Street, it means you’ve angered Dodge Street and are unworthy to continue.
6. You anger Dodge Street by driving flippantly in the variable direction lane for too long.
7. When an unstoppable force meets an immovable object, you get the intersection with
Saddle Creek.
8. When an unstoppable force meets M.C. Escher, you get the West Dodge Expressway.
9. It is said…that for very short periods…in the wee hours of the morning…when you’re
driving alone…Dodge Street makes the variable lane green in BOTH directions.
BEWARE!
10. Dodge Street knows when you use it to go tanning at Ashley Lynn’s.
"
Shrink Rap:
Medical Student Depression –
What Is It and How Can I Prevent It?
Michael G. Kavan, Ph.D.
Associate Dean for Student Affairs
As I walked into work on this sunny September morning—
watching the sprinklers watering the lush green grass (sorry
Arizonans), hearing the birds chirping on our beautiful campus and
remembering the ol’ tune, let me see, how does it go—“Zip-a-deedoo-dah…”—my thoughts drifted to one of my favorite topics:
depression. Oh, you may say “I’m sick” or that I have finally “lost
it,” but I truly love this topic. Why you may ask? Well, because it
is something that impacts so many people, including medical
students—okay stay with me, but, more importantly, it is a
problem that is so treatable and preventable. It’s truly an area that
we can make a true difference in people’s lives including medical
students.
image courtesy of steveseay.com
• Appetite – typically decreased with weight loss, but may
increase with weight gain
• Psychomotor Retardation/Agitation – slowed speech or
body movements/ inability to sit still
• Suicide – recurrent thoughts of death, suicidal ideation, or
a suicide attempt or specific plan
• + Mood – depressed mood, feeling sad, feeling empty
How Common is Depression
In the U.S., 6.7% of adults experience depression during any
given 12-month period with over 30% of these cases classified as
severe. The lifetime prevalence of depression is 16.5% in adults
with women being 70% more likely than men to experience
depression during their lifetime. Those persons aged 18-25 have
the highest 12-month prevalence rates of depression (8.7%), and
this decreases as one ages. How about medical students? Studies
suggest that 14% of medical students experience symptoms
consistent with moderate to severe depression and up to one-third
significant depression. In these studies on medical students,
women were more likely to acknowledge mood symptoms, and
depressed students, in general, were more likely to seriously think
about suicide or dropping out of school and were more sensitive to
the stigma associate with being recognized as depressed by peers
and teachers. Unfortunately, depression may continue into
residency and future practice unless measures are taken now to
address this problem. Fortunately, there are things you, as medical
students, can do to prevent and manage depression.
Major depressive episode is defined as having 5 out of these 9
symptoms, with one being either depressed mood or decreased
interests, occurring nearly every day for at least two weeks.
Am I Depressed?
The first step toward working through depression is its
recognition. Although most people occasionally feel sad or blue for
a day or two, the essential feature of major depression is either
feeling depressed or losing interest or pleasure in nearly all
activities for at least two weeks, which causes distress and
impairment in social, occupational, or other important areas of
functioning in your life. I like to use the SIG E CAPS + Mood
mnemonic (if you are depressed you need a SIGnature for Energy
CAPSules):
• Sleep – typically decreased with early morning
awakening, but may increase
• Interests – markedly diminished interest or pleasure in
activities
• Guilt – excessive or inappropriate guilt or feelings of
worthlessness
• Energy – fatigue or loss of energy
• Concentration – diminished ability to think or concentrate
or indecisiveness
Management
If you are depressed and cannot seem to kick these feelings, there
are several options for help. They include the above-mentioned
prevention strategies, but also a referral to the Center for Health
and Counseling where they have several Ph.D.-level psychologists
and Masters-level counselors who can provide free, effective, and
confidential services, such as cognitive-behavior therapy, which
has been shown to be extremely effective in the management of
depression. Also available at the CHC is a psychiatrist who can
assist with medication as needed. Keep in mind that no one in the
medical school will ever know you are seeing anyone there. Their
number is 402-280-2735. If you need to talk to me about referral
options, please let me know. Again, this will NOT go down in your
academic record nor will it end up on your MSPE (Dean’s Letter).
My goal is to get you help, not hurt your career. So please, if you
are depressed or have thoughts of suicide, get help. You will not
only feel better now, but you will learn strategies to enhance your
well-being into the future. All the best!
Prevention
One of the best ways to prevent depression is to stay active. In
1621, Robert Burton wrote that “There is no greater cause of
melancholy than idleness, no better cure than business.” Exercise
continues to be one of the best ways to fight off and to prevent
depression, so get active. Also, stay active with things you enjoy
doing such as recreational activities, hobbies, socializing with
friends, and so forth. Although you all have busy schedules, the
time to do these things is when you don’t have time to do them. No
excuse—Just Do It! Also, watch your thoughts. It is easy to harbor
self-doubts as you progress through a tough curriculum. Talk to
peers (they are most likely thinking the same thing) and challenge
negative thinking that may creep in. Remember what Stuart
Smalley said, “I’m good enough, I’m smart enough, and doggone
it, people like me.”
3
Pat Laughlin
M3
Finding God in Medicine
God would take him peacefully so that he wouldn’t have to suffer
any more. She went on that she had envisioned what the final
moments would be like several times in her head. However, on the
day that would end up being Ed’s last day, his actual passing was
nothing like she had imagined.
Although her husband had not sat up in weeks, in his last
moment, he sat straight up, with tears in his eyes and a calming
smile on his face and said, “Michael…” And with that, he
breathed his last breath and died. She immediately went to call her
children and grandchildren to break the news to them. It was only
moments later, when she called her daughter who lived in Denver
that she found out that her 19-year-old grandson, Michael, had
been killed in a motor vehicle accident only an hour earlier. At this
point, she was crying as she told me the story. “He saw him…I
know he did, and they went up together. So neither one of them
had to be scared…” At this point, after having handed her several
tissues, I had to take one for myself.
As tragic of a story as this is, it is also one of the most powerful
that I’ve ever heard, and it was one that stuck with me ever since.
Stories like this remind me that no matter what religion you might
be—Muslim, Hindu, Christian, Jewish, or whatever—you’ve got
to acknowledge that there is someone or something out there that is
much bigger than this short life we get to experience here on earth.
I have always considered myself to be a man of decently strong
faith. I don’t ever try to push my spiritual beliefs or my religion on
anyone, but I had an experience in my first clerkship that made me
stop and really acknowledge a greater power. So here is a
disclaimer to the following story: it is not my intent to do any
“Bible beating,” but I think it is worth hearing.
I was in my 2nd month of clinic during my ambulatory medicine
rotation in August. I usually saw patients with my attending at this
particular clinic, but on this day I got to see an elderly woman by
myself. We’ll call her Ruth. She was seeing my attending for her
annual check up. She began by telling me about how she has been
doing since her husband (we’ll call him Ed) had died around 6
months ago. His health had been failing for the last several years,
despite a very healthy lifestyle up to that point. He was simply old,
over 80, and his body had begun to quit on him. Towards the end
of his life, he lost his ability to speak, and most communication in
his final days was done with his eyes. Ruth explained how with
enough time, all the days were beginning to blend together, as she
essentially worked with the hospice team in providing end-of-life
care for her husband. She explained to me that she had prayed that
The Grey Area: Ready, Set, Time-Out
Laura August-Schmidt
M2
A few thousand years ago, in the dorm room of a west coast
university, a school which had the surreal and eerie feeling of
perpetual summer camp, a young kid was losing her marbles.
They were dancing about in her pockets everywhere she went,
and if the weather was just right they’d tumble out with the wind,
down onto the ground, like a little trail of bread crumbs no one
cared to follow or at least notice. The endless stress of the luxury
of an education and the means and support to see it through,
slithered like sneaky little fingers around a trigger. Every day was
a tap dance on eggshells with that gun in my head. The hammer
beating on and on over the constant debate: give up or get up?
Laid out prostrate with a pile of books and diagrams, flashcards,
review books, crushing down the ribs of the graduate students of
the world, we all suffer through our own ugly breed of witch
hunt. Are you cut out for this? We’ve danced with the devil. The
so-called survival of the fittest has become a contest: the winners
lose their sanity, and the losers their morale. The elusive truth
slips quietly out the back while everyone secretly suffocates
under the weight of it all, misguided by the insufferable ideal of
perfection and immortal energy. The truth, dear friends, is we are
not robots, though it does feel like sometimes a screw gets
loose… As much as we try, we can’t just plug in our batteries or
flip open our solar panels. Our tanks run dry, and our body starts
to sag. We all embark on our own private battles with our
irritating mortality. Slowly hygiene becomes a chore, our bladders
and bowels like a ball and chain, and meals get stretched out
rack-like between long hours, peppered with vitamins to cut your
losses. Somehow in the war, the determined armor of the warrior
starts to hide the ghost of a human being floating inside.
“Almost there, keep it up, just a few more days, months,
years…”
Is it ever going to be enough?
Will you get to the finish line, wherever it is this time around,
and find you’ve become a stranger to yourself? The fear of failure
is contagious, the 21st century plague. If you wear yourself to
brittle bones, held together with medical facts, blinded by the
possibility of more and more and more, the plague will find you,
vulnerable and hollow, and it will take you, wholly and
mercilessly.
The only antidote is life.
You remember life? It’s that thing blinking on your dashboard.
It’s the neglected grumbling coming from your belly. It’s the
missed call left unanswered, the crumbling remnants of
vegetation, friendships, health. It’s that thing that goes on,
whether or not—it doesn’t need you, but you need it…and the
sooner you figure that out the better your prognosis.
It’s not too late. There is a cure.
Close the computer, put down the notes, re-shelf the book, walk
out the door, and get a life. It’s time to reengage. Take a deep
breath. Do it now. Ready, set, time out.
4
Medical
Beads
Photo by
Catherine
Weaver, M3
Life’s Accompanying Relationships
Hannatu Tunga-Lergo
M2
I woke up from an abysmal slumber.
My past trailing away in a haze I no longer remember.
Blinded by her serenity of light.
I saw her chocolate pools glistening with joy and delight.
I’d recognized that voice that’d hummed me to wake.
And yes! I remembered the thunder and boom of his voice emitting a love and protection that I gladly take.
Their relationship pure, passionate, and sacrificial woke me up
Thus, I began my journey in this world.
Forging relationships multitudes, dear and untold.
I began by loving him and him.
Guiding, laughing, fighting, fulfilling my duty assigned by HIM.
I cloaked them in my sibling love.
Knitted of the finest silk, collecting my thread and needle from above.
Our relationship bound by blood, wrapped in understanding toughened me up.
She tapped me on the shoulder.
Startled was I by a strength and bond together that could move a boulder.
Not from the torrent that swims in my veins. Yet, my sister she became.
My sister filled with the essence of HIS whose breath we came.
Relationship of knowing friendship, it inspired me to grow up.
He eased across my way
Floating thru life for a soul visited me by the Transcendental way.
His soul satisfying presence eased the pains of life.
His companionship a cavern where I felt free and safe from strife.
The flit and flutter of my heart beat
Wafted in a sublime love unexpectedly and expectedly painful and sweet.
Unhinged, unbiased, ecstatic love forced me to humble up.
I slammed into a practical world.
An academic island surrounded by the variety revealing how God’s creativity unfolds.
A meticulously chosen few.
Hand picked, polished, then planted facing disparities, revealing what is true.
A tentative, hesitant, and unsure relationship.
Blossomed imperfectly in a torrid and necessary courtship.
A pact made, collective and unifying relationships blessed, enlightened me right up.
Relationships have been gifted to me. Oh! The beauty of another!
Grateful am I for delicious sips of life enjoyed because of others.
From golden mountain tops to murky swamps.
With them I can trudge on emerging as a champ.
Love the language spoken in wisps
The dewy hair breaths that accompanies all relationships.
My existence beautifully dressed by the relationships that make me stand up.
%
A Student’s Prayer
Hannatu Tunga-Lergo
M2
What am I lacking? I lack in so much, but
I'm okay with it. Because if I search for
truth and wisdom, God will grant them. I
ask you, God, what is my purpose? What
would you have me do? Direct me, and I
will follow. I will go where you take me. I
will bear whatever yoke you will have me
carry. For I know with you I am most
content. I am most alive. I am most within
the deep blue place that is you. I want to
Love more. I want to know more. I want
to experience more. I want to help more. I
just want to be who I really am more. I
have a dream, a vision to help my people.
Is that my path? Health is Love.
You created us from this earth, from this
dirt, and that is what we are, nothing more,
nothing less. Life sustaining dirt. Yet, you
gave your breath to us. All of us from the
same breath. I am from you, and I am a
part of we. My soul, our souls, one breath.
I just really want, Lord, to contribute, to
give, to enhance this breath that we have
before I finish my sojourn and return
home. I am here to do something so I will
listen and watch for your direction. I will
strive using your breath to move this dirt
towards excellence. I cannot stifle myself
anymore. I cannot return to discontent. I
will change Lord. I want to transcend
towards you, Father, and exhale your
breath of love, wisdom, and truth. I will be
a doctor, Father. I will build my healing
center. I will grow, Father. I will love,
Father. I will teach, Father, and give,
Father. So, I pray, Lord, for blessings. I
pray that I see the fruits of my efforts. As
the rain washes away the top layer of soil
revealing fresh, rich soil, so I pray that
here at Creighton I am bathed by your
light so that I am revealed as your breath
wiser, truthful, and loving. Amen.
Thinking Globally:
Preventative Medicine in Peru
Megan Stinar
M3
If this picture had been found in a rundown
neighborhood of an American town, one would drive
by assuming it to be an abandoned, insignificant space
that would eventually be demolished and replaced
with some new urban renewal project. Outside Cusco
however, this seemingly inhospitable building is, in
fact, an important health clinic in a poverty-stricken
neighborhood comprised of poor Peruvian natives and
Bolivian immigrant workers. While traveling on a
CURA trip to Peru two summers ago, part of my
group came to this community clinic for a few days to
lend a helping hand. After a day’s work, I knew that I
would be the one who ultimately benefitted as I was
going to learn more from assisting at this destitute
clinic than any amount of help I could ever give to
them.
For two days I worked with the obstetrician, who
received what was considered to be a license to
practice after five years of technical training to
become an obstetrician. The line of patients outside
her door waited patiently for one of two reasons: birth control or
prenatal care. I immediately noticed each patient came in with a
standardized pamphlet meant to record routine healthcare
evaluations as suggested by the World Health Organization.1
These pamphlets helped the patient, the obstetrician, and the
Peruvian government healthcare body, Seguro Integral de Salud
(SIS), to have quick access to important information, such as
when the patient is due for her choice of contraception or charting
her progress of pregnancy. I also quickly realized the lack of
resources available to this clinic, highlighted by the fact that the
small office we were in would be the examination and procedure
room for every woman waiting in line.
Over the next two days, I learned to take vitals, to perform basic
examinations of the women, and to document it all in the
pamphlets, one copy for the patient and one for SIS. More
importantly, however, I was witness to countless conversations
between the obstetrician and the patients; I was most intrigued by
the interviews with the pregnant mothers. Even now I remember
the important points the obstetrician discussed with each motherto-be: good nutrition including protein, which was often saved for
the male members of the family, safe sex practices, benefits of
breastfeeding, family planning, and avoiding difficult or strenuous
work. I listened carefully as the obstetrician often took a scolding
tone with the mothers who were not gaining weight because they
were sharing the scarce food supplies at home with husbands or
other children rather than getting the proper nutrition they needed
for a safe and successful pregnancy. While I felt humbled and
blessed to witness healthcare in a country very unlike the United
States, it wasn’t until doing some personal research for this piece
that I could appreciate that I was witness to a human rights
movement for women’s health in a country where women’s rights
were hindered by the machismo culture.2
From 1989–1996, the maternal mortality rate was as high as 265
deaths per 100,000 births.3 In contrast, the maternal mortality rate
in the United States in 1995 was 7.1 deaths per 100,000 births.4
However, with simple measures suggested by the World Health
Organization’s Department of Making Pregnancy Safer, the SIS
began to standardize care for pregnant women. Included in the
Health clinic outside Cusco, Peru
Photo by Megan Stinar, M3
government’s goals were initiatives to monitor the growth of
mothers and their fetuses, to provide opportunities to continually
educate mothers during prenatal care, administer immunizations,
and provide better access to healthcare facilities capable of handling
the complications of pregnancy.5 The process I had seen in the tiny,
rundown community clinic was part of a much larger public health
movement. More importantly, the simple educational points and
standardized prenatal care I had witnessed was effective. In 2008,
UNICEF reported the maternal mortality rate had dropped to 98
deaths per 100,000 births.6
While this piece was not meant to be a research paper, there was
an important message I learned: even minimal primary care works,
and it works well. Peru’s maternal mortality rate wasn’t dropping
because of expensive hospitals with advanced healthcare
equipment, at least not in rural clinics like the one I had visited. The
rate was dropping because of the community obstetricians who
utilized effective interview techniques and regular physical
examinations to deduce which women were in need of more care
and which women were heading towards a healthy and safe
delivery. At the conclusion of my first third year rotation, it is
evident that on a daily basis, doctors save lives simply by executing
thorough interviews and standard physical examinations.
Are you interested in global medicine?
Check out Creighton’s Global Medicine
Student Interest Group (GMSIG)!
1 Bristol, Nellie. "Dying To Give Birth: Fighting Maternal Mortality In Peru." Creighton
University Health Sciences Library - EZProxy Login. Health Affairs. Web. 27 Aug. 2011.
<http://content.healthaffairs.org.cuhsl.creighton.edu/content/28/4/997.long>
2 "A Case Study: The Impact of Maternal Health in Peru." Www.care.org. Care. Web. 27
Aug. 2011. <http://www.care.org/campaigns/mothersmatter/downloads/Peru-CaseStudy.pdf>.
3 "International Brief: Population Trends: Peru." U.S. Census Bureau. Web. 27 Aug.
2011. <http://www.census.gov/population/international/files/ib99-1.pdf>.
4 "Births, Deaths, Marriages and Divorces." U.S. Census Bureau. Web. 27 Aug. 2011.
<http://www.census.gov/compendia/statab/2011/tables/11s0113.pdf>.
5 "WHO Recommended Interventions for Improving Maternal and Newborn Health."
World Health Organization, 2009. Web. 27 Aug. 2011. <http://whqlibdoc.who.int/hq/
2007/WHO_MPS_07.05_eng.pdf>.
6 "UNICEF - At a Glance: Peru - Statistics." UNICEF - UNICEF Home. Web. 02 Sept.
2011. <http://www.unicef.org/infobycountry/peru_statistics.html>.
6
Living in Ohm-aha
There and Back Again: A Med Student’s Tale
Nathan Barusch
M2
Two days before coming back to Omaha I
found myself in my dentist’s chair, preparing
to have a cavity filled. My dentist, a family
friend since before I was born, asked how I
liked med school. “Honestly, I don’t have
much nice to say about it,” I responded. He
gave me a knowing glance. A similar
interaction with my optometrist led to a story
about him telling his dean he had decided to
drop out of med school. “Is this only the first
time you’ve come to that conclusion?” was
the dean’s response.
I find it distressing and discouraging to
have such a negative attitude about
something that is such a big part of my life.
I’ve never been one to believe in delayed
gratification; life is a dance, not a race to a
destination, and, well, my feet are killing me.
At the end of the year the prospect of not
returning loomed large in my mind. And yet
here I am. As much as I try to stay positive, I
can’t find much joy in memorization
sessions. I resent the lack of balance. In my
lowest moments I look ahead in my life and
wonder when will I “arrive” at whatever
destination in the name of which I am
enduring this. Will I enjoy the hard hours of
residency? When I finally arrive at a practice
will I have become so embittered by the
sacrifices I have made that I become one of
those doctors I have always loathed: selfcentered, materialistic, arrogant?
The winter of last year was something of
a low point in my life, the stress had gotten
to me, and I was at the point of breaking. I
gained fifteen pounds; I was depressed; my
blood pressure was so inexplicably high I
was put on antihypertensives. I had been
grinding my teeth so badly my jaw popped
out of its socket whenever I yawned. My
only joy came from counting down the days
to my return home, when I would get a few
precious days of relaxing with friends and
exploring my spiritual refuges in the
mountains of Utah. Then back to the grind.
This summer I interned at the World
Health Organization. The experience was
everything medical school is not. Leisure
time abounded; on my first day my boss’s
first instructions were, “We take French
lunches here—two hours is fine,” shortly
followed by, “and you’ll want to know where
the nap room is.” The work was monotonous
at times, but I was surrounded by incredibly
intellectually stimulating people. Leisure
time was spent drinking wine with new
friends on the shores of Lake Geneva, going
to free concerts, skiing on glaciers, hiking
the Alps. Work was what I made of it—no
fear of failure, no deadlines; I presented what
I had done to my boss, who always
responded with enthusiasm and insight.
And here is where I tell you that I missed
medical school, that I discovered the things I
disliked were actually perks. Well that’s not
quite how it is. So why did I come back?
Well…my visa expired. No…I came back
for reasons. One is I discovered the damage
done to my psyche and body last year was
reversible. Sometime in June I realized I felt
like myself again, and I hadn’t felt that way
in a long, long time. I lost almost all the
weight; my jaw no longer popped; my blood
pressure went way down. Things were all
right. More importantly I was meeting
incredible people doing incredible things
with their MDs. I helped write a book on
Vital Signs Teambuilding 2011
7
global public health with a doctor from
South Africa who had left his practice as an
emergency room physician in the slums of
Johannesburg to distribute vital medications
to the third world. I met people who
volunteered with Doctors without Borders:
researchers, advocates, and even a couple
practicing physicians. I was reminded of a
value I had completely forgotten about in the
stress of school. It’s the value that brought
me to Creighton in the first place, the desire
to be an “Agent of Social Justice.” The work
these people were doing was making the
lives of the disenfranchised just a little better.
What more could one strive for?
I frequently commiserated with a friend
who had a similar lack of passion for med
school. Why are we going back, we asked
each other, sharing a bottle of wine by the
lake, watching the sun set over the Alps. I
could stay here, work for one of these
wonderful organizations, have a great work
life balance, and be healthy, happy, in a
wonderful place. But we both knew we
would return; we would finish. Masochism?
Stubbornness? Fear of the unknown? Yes.
But there is another thing: it is the doctors
who were speaking at our meetings, who
flew to Africa to hand out the meds, who had
the option to be in Geneva, America, Sudan,
or anywhere in the world, and could do good
wherever they go. Merited or not, when an
MD speaks, people listen. I want to serve
humanity, and I want a life full of joy,
friends, recreation, and meaning. I don’t
know exactly where that will take me. But I
know that what I’m doing now is going in
the right direction, and that’s all I could hope
for.
Photos by Michele Millard
Getting to the Heart of It
Michele Millard
Academic Success Consultant
You know what it feels
like. . .panic when your mind
goes blank in the middle of a
test, anger when the driver
cuts you off on the interstate,
irritation when you spill your
coffee over your lecture notes.
It’s like a roller coaster where
your emotions take control
and lead you on a wild ride
that ends in poor performance,
rocky relationships, and
diminished health. T h o s e
negative emotions that
sometimes seem to control us
create a state of “being out of
sync.” Your sympathetic
nervous system kicks in and
prepares you for fight or flight
while your parasympathetic
nervous system attempts in
vain to calm you down. It’s
like having one foot on the gas
and the other on the brake,
resulting in a rather bumpy ride that will
eventually wear you out. When you are in
the middle of this tug-of-war, it is difficult to
function. . .you can’t think clearly, problemsolving goes out the window, and your
emotional maturity becomes, well. . .that of a
four-year-old. That’s not a great place to be,
especially if you are in the middle of
studying, exams, and a thousand other
demands on your time and energy.
The question is, “How do you take back
the control?” One way in the office of
Academic Success is the use of biofeedback,
which is a way for you to actually see what
is going on with you physiologically and
emotionally by measuring your heart rate
variability and seeing it projected on the
computer screen. HRV is the speedup and
slowdown of the heart that is regulated by
the activity of the autonomic nervous system
—again, that sympathetic system that speeds
things up and parasympathetic system that
slows things down. When we are in a
stressed state with the two systems fighting
against each other, a jagged and erratic HRV
is produced and is broadcast throughout the
rest of your body, creating a kind of static in
the brain and resulting in cortical
inhibition. . .you can’t think clearly, solve
problems well, or recall information. On the
other hand, when you are experiencing
positive feelings of appreciation and
gratitude, biofeedback will reveal a smooth
and even HRV, which again is broadcast to
the rest of your body, resulting in
“coherence,” peak performance, and
increased cortical functioning. The end result
is increased recall of information, clarity of
thought, and enhanced problem-solving and
insight; essentially it is a state of being in the
“zone” or having a feeling of “flow.”
So, the key is the heart. What happens in
the heart affects the rest of you. When
emotions are negative, the heart is out of
sync. . .and so are you. When emotions are
positive, the heart beats smoothly and
rhythmically. . .and so do you. The good
news is that we can have some control over
our emotions. Instead of feeling negative
(
emotions like anger,
frustration, anxiety, and
worry, we can choose to
feel positive emotions like
joy, appreciation, care,
and kindness. When we
make that shift to positive
emotions, we not only
impact our physiology but
our cognitions.
Coherence via a positive
emotional shift can be
used in the midst of stress.
The stress response only
takes a few hundred
milliseconds, and using an
emotion-based technique
can short circuit this
process.
Breathing
techniques are useful for
lowering sympathetic
arousal levels but often
don’t address the
underlying emotional
patterns that can be retriggered the next time
a stressful situation is encountered. This is an
emotional self-regulation technique, and it’s
not hard. . .just three easy steps:
1. Heart Focus: Center your attention
on your heart.
2. Heart Breathing: While breathing
slowly and deeply, imagine that
your breath is coming from your
heart.
3. Heart Feeling: Generate a feeling of
appreciation, love, or gratitude for a
person, place, or thing. Hint: don’t
just think about something nice;
generate a feeling of appreciation
that comes from the heart.
That’s it. The emotional shift will shift
your physiology which will shift you into
coherence. If you’d like to see that with your
own eyes, make an appointment for
biofeedback. May your new motto be, “Shift
happens!” For more information, check out
www.heartmath.org.
Medical Musings:
M3 Year, Day 1- Emergency Situation: Code Yellow
Ryan Miller
M3
I'm on OB/Gyn 24-hour call on my very first day of third
year. I've heard stories of humiliation from many before me, so I
knew coming in all I could do was pray I don't do something
silly . . . at least not right away. Unfortunately I couldn't quite get
much past the 12 hour mark, around which time my fashioning of
scrub attire reached its nadir.
Between newborn deliveries, I decide I have a solid 5 minutes to
unload the roughly 1/4 gallon of [former] coffee working its way
into my bladder. I head to the restroom, the one shared with patients'
families. While standing in front of the toilet, I look down at the
mess of a knot I have tied at the top of my pants, encasing my
wedding band and forming a tidy, superficial bow. Then the
deliberations begin—this knotted strap is seriously tight . . . but is it
so tight that I can't force open my scrubs at the waist, pull out my,
you know, and aim toward the toilet?
I decide there’s no need to untie the knot. I’m feeling risky.
Except the pant strap is so tight that once I relax naught but a drop
of urine falls into the toilet. Of course this presents a problem.
There's enough real estate between my pinching pant strap and the
Amanda Wellnitz’s (M2) Greek Chicken
!
(perfect for wowing drop-in guests with minimal effort!)
4 boneless, skinless chicken breasts, butterflied
1/2 c. mayonnaise
1/2 to 2/3 c. goat cheese (or feta cheese, either is fine)
1/2 cup spinach, chopped
Fresh parsley, chopped
Garlic salt (to taste)
Pepper and Salt (to taste)
Paprika (I like smoked paprika, but regular is fine)
1/8 c. flour
1. Preheat oven to 350.
2. In a small bowl, combine mayonnaise, goat cheese, spinach, and parsley. Add garlic salt
to taste. Fill each chicken breast with ~1/3 c. of the goat cheese mixture. Season tops
of chicken breasts with flour, salt, pepper, papricka, and additional garlic salt to taste.
3. Place chicken breasts on a baking pan and bake for ~20-30 minutes, or until juices run
clear. Makes 4 servings.
9
image courtesy of peapodannouncements.com
sphincter of my bladder to make exactly the kind of mess I'm about
to describe.
First, I try to make more room by pulling on the front of my
pants. Nothing. What is one to do? I can't untie the knot one-handed
while my other hand is busy maintaining circulation. And so I tense
up again and assume that whatever drippage I experience will
quickly absorb into my boxers. Wrong. Instead, I basically pee my
pants. According to the bathroom mirror, I let the full fury of a
bulging bladder loose. Exacerbated by the sight, I stand there,
powerless, and watch the watermarks expand, covering most of my
left thigh and part of my shin. And I know I need to be back outside
in just a few minutes. My imagination gets the better of me, as I
fast-forward in my mind to encounters with my teachers and peers
and see them smirk, eyes darting toward my crotch.
No, that mustn't happen. I frantically begin disassembling the knot
in my trousers. Precious seconds, perhaps even a minute goes by
until this rat's nest is unraveled. I reach for paper towels, then toilet
paper. I know I need to do something about the smell, and fast. I run
water over a paper towel and start scrubbing. Then I begin
fanning. First just with one hand, then with both. I know the clock is
ticking. But I need to get out of there before anyone becomes
suspicious. I need to get to a chair, sit down and look busy.
And that's exactly what I did. Looks pretty dry now. Enjoy.
Big News
Kate (M3) and Drew Forrester
Married: June 10, 2011, St. Louis, MO
Janel Brown (M2) and Jared Brink
Engaged: July 21, 2010
Wedding: June 16, 2012, Georgetown, CO
John Paul Whittaker Naomi (M3) and Brian Whittaker Born: May 9, 2011
Weight: 8 lbs, 10.5 oz, Length: 20.75 in
Catherine Berger Pass (M1) and Chad Olinger Wedding: July 30, 2011
Tyson (M2) and Amanda Hickle
Wedding: July 30, 2011, Two Harbors, MN
10
Lindsay Wiesner (M3) and Adam Bragg
Engaged: April 16, 2011
Wedding: June 1, 2013, Eden Prairie, MN
Gretchen (M3) and Mike Butler Wedding: June 18, 2011, Cold Spring, MN
Lucas Ryder Greene Kelly Ryder (M2) and Dylan Greene (M3) Born: August 10, 2011
Weight: 7 lbs, 13 oz; Length: 20.5 in
Abby Fall (M3) and Nick Mancuso (M2)
Engaged: April 22, 2011
Wedding: June 30, 2012, Omaha, NE
Julie Zitterkopf (M4) and Michael Larson (M3)
Engaged: April 16, 2011
Wedding: November 18, 2011, Scottsbluff, NE
Jordan (M2) and Leigh Crow Wedding: July 16, 2011, Minneapolis, MN
11
Kate’s Cookbook
!
Serves
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Kate Forrester
M3
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12