I'm Reading

This week, I'm reading Edwidge Danticat's Brother I’m Dying.  A 2009 MacArthur Fellow, Danticat is a brilliant storyteller. She uses the power of creative nonfiction to bring you closer to the stories unfolding offering layers of complexity.  I have already shed tears.    The stories about Haiti's recent earthquake have faded from the media. Ruins remain.  Catastrophic devastation in Haiti is better understood in it's historical context. Brother I’m Dying delivers a paradigm to help us help Haiti. Danticat's storytelling about her family is about Haitian culture and life. Listen to Edwidge and maybe you will read her books.       

Rhythms for life: Step By Step

I'm a steady walker who has taken to jogging more and more.  Some days  I walk more than I jog as I'm intentional about keeping a healthy stride.  I set goals.  Taking out 30 to 45 minutes a few times a week to walk or jog  has helped me find balance for healthy living and rhythms for life.

 I use the Nike+ pedometer system with my iPod  to keep track of my distance and pace while listening to all kinds of music motivating me to press on.  Parks, beaches, trails even city walks make my long distance efforts more enjoyable. There are a few places that I return to over and over again.   The sunshine offers an open invitation to get moving outdoors.  I do have tough times with staying on course, but have noticed that early spring through late fall offer me the best of times.  


I'll set new goals and find new places to enjoy this season.  New challenges and paths await. 


Whether you are making time to go for a leisurely walk or more ambitious run the benefits to your mind and body make it a worthy pursuit.  Early morning offers the dew and sunrise that can be a refreshing way to start the day.  Starting out just before dusk can yield the quiet needed after a long day.  Some weekends I get to enjoy the park in the afternoon as it fills with families and friends sharing good times. When you are outdoors think about safety.  


Let's keep moving!

Sisters in Medicine: Healers

America will change with health care reform, but there is more work to be done. I had the opportunity to go to a lunch time talk with Bylle Avery, she's a long-time community organizing activist and founder of the now Washington, D.C. based Black Women's Health Imperative.  Her enriching and inspiring talk for a small diverse group of physicians, women in ministry and others working in communities throughout New York City was just the motivation I needed.


This talk was part of a day long program "Raising Women's Voices for the Health Care We Need." Dr. Avery was reflective and also gave her perspective on the current issues that women continue to battle, while there have been some victories there is still more required.  She offered story-telling and lessons in self-care for women. Her reflections on the women's movement revealed even more of the need for women to keep pressing on collectively to work for change in America because far too many don't have the access to opportunities that allow for healthy living. 

The afternoon continued with a talk by Dr. Janet Taylor, psychiatrist and health strategist on "Fighting the Blues" and stress management tips.  She clarified the difference between "the blues" and major depression.  Do you know the signs of depression? Check out this screening tool to help yourself, your loved ones and those around you who may be suffering from depression.  Seek professional help if you have more than "the blues" and encourage those around you to do the same if they seem a little more than blue. Here's a glimpse of statistics of the statistics:

We also talked about the effects of chronic stress on the mind and body, you can visit my previous post on this topic.  Dr. Taylor discussed self-help strategies to help reduce stress by :

• using coping strategies
• identifying your sources of support
• creating downtime for yourself
• understanding "No" is a complete sentence
• living your own values
• getting out of abusive relationships
• exercising regularly
• practicing relaxation and meditation techniques

It's great to bear witness with sisters in medicine and those who are committed to healing for themselves and our communities. A new day is here and there more resources available to help those who need it and that's good news. 

The Long Position

Health reform in America brings a new day. The passage of a new bill by Congress and the signing on Tuesday by the President will bring changes health for many lives in America.  The year-long process has been like nothing we have seen in the history of American politics.  From my view, I believe the long position has to be an option for those who have worked so hard we must continue on.


One piece of legislation will not yield the full effect so there is more work to do.  Yes, we will celebrate on Tuesday when President Obama will sign legislation into law in the morning, but the Senate will begin their debate in the afternoon on the reconciliation legislation. This process will take time. 


Don't give up because there are more challenges, change is hard work.  The problems in health care are tough, complicated deserving the long view beyond the political election cycle.  Just like the battle for survival in many chronic diseases and prolonged illnesses there have to phases in treatment and it takes more than one dose to cure. Additional efforts are required, healing takes time.


In the financial market taking the long position is considered practical in investing where you hold your on to your position (in a security, bond, or future) to to maximize profitability.  Those who have invested their support in health reform need to continue to hold on until more work is done to yield the full benefit.  Even when though we cant' see a clearing or the end in sight we should continue trust the process. Tenacity is the tool we need for progress.


We don't want to just treat America, we want to heal America. Let's keep on working.  

Come Sunday

11:30 am:  I'm hopeful about this Sunday as an important milestone for health reform in America is here.  In the hours ahead the United States Congress will focus on passing legislation to change the course of health in the lives of people across the nation.  I'm saying my prayers, calling my Congressman and watching it all unfold while dealing with more personal matters of health care in my own family.


11:30 pm:  Planning, mobilizing and working for change, has resulted in change. There is progress with both HR 3590 the Senate health bill and HR 4872 the reconciliation bill passing that includes student aid reform too.  There's still more work to be done, but this is progress. HR 3590 goes to the President's desk and HR 4872 moves over the Senate. 

My colleagues and I at the American Medical Student Association have pressed forward in this movement and together, we are shaping the future with advocacy and activism the fourth dimension of medicine after patient care, teaching and research.

You can find details on both bills at www.amsa.org/hcreform  and look at how Representative voted on HR 3590 at the House website or at the New York Times 


Thanks to Farheen Qurashi, AMSA's JRL Legislative Director  and the AMSA National Health Policy team team for leading the way in teaching us all how to stay involved.  I serve on AMSA's national leadership team as grassroots organizing coordinator on the student life committee.

A medical emergency - calling for health care reform

It's a judgement call to ask for help, to know and acknowledge when a situation is beyond your control or resources. Last night, I was in the kitchen trying out a new recipe of chickpeas and spinach when my mother told me about about an unrelenting sharp pain she was having, she said that it was severe and interrupting her ability to breathe. I made her comfortable then I called 911. In a parental tone she was challenging my actions trying to downplay the episode. As I was dialing she voiced her fears, "I wonder if my health insurance will cover this?" was the first question mom asked as I continued to hold for the 911 operator. As I went through a few simple questions about my mother's present condition and history of illness with the EMS operator it became clear to me that my judgement call was clearly a good decision. She was rushed to the hospital.


Learn the signs so that you can respond in emergency situations by knowing when to call for help.

While my mom continues an ongoing battle for her health, I will continue to advocate for health care reform and continue my training to become a physician in family medicine.  My mom's story like so many other stories I know is an American story of hard work as she has been gainfully employed for half a century. She maintains a healthy and active lifestyle that is complicated by stress.  We are working together to establish new habits and learning to make better lifestyle choices, change is hard work.


While she continues with medical treatment, we hope and pray that healing will come.


In the meantime, I hear the voice of Civil Rights Leader Fannie Lou Hamer  crying out to us "I am sick and tired of being sick and tired."  


Health care reform in America has chance this weekend. I have hope. One of the most important lessons we can learn from the Civil Rights Movement is that unrelenting public pressure can keep the focus on health reform until there is justice. It's a battle worth fighting for now and in the days ahead until there is justice.

Time Out with a Friend

What does time do to our friendships?  When one of my dearest childhood friend keeps coming to mind it prompts me to call her  When we chat or have a chance to see each other my friend and I quickly establish the common ground required to have a meaningful conversation about the trajectory of our lives.  


I remember playing and sharing our dreams.  Now we laugh hard about how different our lives turned out.  When we share it's from a special place in our history of growing up that we can discuss the present and our hope for the future.  In growth and development the American Academy of Pediatrics states that "making friends is one of the most important missions of middle childhood -- a social skill that will endure throughout their lives."


"Besties" is the new term for those real friendships that you make along the road in life.  When I talk with my dear friend, we usually take a moment to go back in time.  While we get to chuckle about the awkward years of our youth other times have allowed for truth-telling that heals.  


We still speak our minds,
we still hold each other's dreams
we still hope and trust 
we still share and 
we still take time out to be friends


We need relationships in our lives that allow for healing so that we don't remain entangled in the vestiges of hurt or brokenness.  Relationships that help us dig out, free us from self-harm and/or give us hope have real power to change the world.

Plan, Study, Do, Act - More on Time Management

The plan, do, study, act (pdsa) model is an approach and tool that while used with organizational teams is a change management approach that can work on a personal level.  In this model you have what seems like rigid frame, but it can help spur creativity in moving a concept or vision toward reality.  

The origins of PDSA have a rich history with well-known innovators. PDSA is an outgrowth of the plan, do, check and act (pdca) model developed by Dr. W. Edwards Deming the father of modern quality control and the Shewhart Cycle (named after Deming's collaborator from Bell Telephone Laboratories, Walter A. Shewhart). It's a tool that corporations and organizations utilize to bring great minds together to do new things and change the world.

Whatever your dream or idea it's worth writing it down as the power of the pen (or the keystroke at the computer) connects your thoughts to a physical experience.  Let the vision ruminate and grow within. Discuss your plan with different kinds of people including mentors, critics, friends and family.  If you believe in the power of your dreams and trust you imagination as agent of change the possibilities abound.  Excitement and energy levels may wax and wane with each phase of a new effort, but the tenacity to keep at it is a strength that can be empowered with a plan.

Helpful link about PDSA:  IHI's Organizational PDSA Management Tool

Time Management - "I'm Busy"

I often hear people make the vague statement "I'm busy" as a reason to reject another commitment or engagement.   When people tell me they are busy, I try to listen closely to hear more.

Life can be full and overwhelming. Just moving through the routines of the activities of daily living can be time consuming, yet these mundane tasks help to shape the quality of your life and determine how well you function. Getting adequate amounts of sleep and rest each day is a goal worth setting in your time management plan.  It takes time for your body and mind to adjust to new schedules and demands so you should consider the cost when adding new activities to your schedule or workload.  Are you an early bird or a late night owl? Do you need a nap during the day? What are your highest and lowest points of the day? Understanding the answers to these questions may help you to become more productive and effective with time management.


One of my favorite talks on time management is "The Last Lecture: Really Achieving Your Childhood Dreams" by Randy Pausch. It's a candid talk about pursuing life with your God given dreams and working creatively to make them a reality. He offers practical lessons for example, understanding the "Four Quadrant To-Do List" to help you prioritize tasks by showing you how to put more focus on the what matters most in your time. 


I have read a few other helpful books on time management and will share more in future posts. Time management strategies can help you find balance in your life and improve your well-being.

Stress

On Sunday evening, I arrived at the LAX airport to find madness and mayhem.  The biblical weather in the northeast challenged the airways resulting in delayed travel plans for many frustrated and fatigued passengers, my flight was overbooked too.  The tense moment gave way when I decided to give up my seat in exchange for a few extra days in southern California that came with hotel accommodations, meals, a rebooked flight at no additional cost along with a travel voucher for my next round-trip.  While I have a long to-do list, I decided not to move according to the travel itinerary, but to embrace the change in plans. 


To my surprise, the hotel was green, stellar and lush with super healthy organic food choices on the menu. I did the things I was supposed to do and it was a productive time. I also tended to a few business matters.  In the evening, I went to Manhattan Beach, a seaside town in the California. Wow! I had great time and got a better glimpse of life on the west coast. I'm flying out tomorrow and the weather is clear from here to JFK so glad I'm glad that I had the opportunity to wait out the storm.  


Stress will come in your life, it's a reaction to emotional or physical threats (i.e. stimuli) that can be actual or imaginary. Learning to find some peace of mind if only for a few moments whether through prayer, meditation, going for a long walk or just sitting still for a few minutes will help you establish your peace baseline so that when stress emerges you know and can act to remedy the situation.  Stress releases the hormone epinephrine in your body and this adrenaline rush works effectively to raise your blood pressure, increase your heart-rate and open your airways to prepare you for an immediate response to a threat. Prolonged stress is not good for your health, it makes managing chronic disease more challenging as it counters the healing process and hinders our immune response system. Cortisol is another hormone is elevated during stress and it works to relax and return the body to homeostasis it's natural place of balance, but prolonged elevated cortisol levels may alter metabolism and hinder weight loss.  You can be eating a healthy reduced-calorie diet, getting exercise, but if you are stressed out by work, family matters and life issues the stress hinders your weight loss efforts. You may also become fatigued and drained, which may lead to irritability.


Do you gauge the stress in you life?  Try taking a simple stress test. It's helpful to check-in with yourself and to see how well you are responding to stressors in your life and how well you are managing stress. Don't be afraid to seek professional help about stress and employing strategies that help with life balance.

Mondays can be filled with stress, many people find themselves restless and don't get a good night sleep on Sundays due to fear and anxiety about the week ahead.  Stress does real harm to the body, mind and soul and it should be addressed.  Do you have stress-reducing techniques built into your life.  Are you prepared for the unexpected? It's takes knowledge and work to navigate change and negotiate stress in our lives.  Stress will come and so the physiological flight-or-fight response is well worth studying.


The lesson I learned from this situation is that if you can deal with a change in plans you may find unexpected opportunities that fulfill your needs and allow you peace of mind, less stress and balance in life.

Sundays

Sunday is a day when I relax, spend time with family and friends. First I attend worship services where the inspirational message of the sermon, fellowship and singing as well as dancing from the pew offer a high spirited time. I take time to reflect on the week gone by and anticipate the days ahead.  Some Sundays I go for a long walk, take time for some writing and/or reading.  Other Sundays, a long talk with a good friend will do.

Last Sunday, I had a chance to visit the New York Botanical Gardens with a friend to see the exhibit of the spectacular display of orchids.  Orchids bear beautiful flowers yet there elements are tough.  Orchid plants withstand seasons to bloom and bloom again. Did you know that the orchid genus Vanilla yields the flavor used in cooking. It was a brisk day, but worth the trip to share and discover in nature.  This Sunday, I've just finished up with presenting at a medical convention and now sit outside in the warmth of the sunshine to write, here and now.

My time and schedule continues to change with the demands of medical training and related pursuits.  It's not always easy to find balance. I try to keep my appointment to check-in with myself and God on Sundays about my dreams, hopes, desires, needs. There are some Sundays when sleep and rest are the best remedy and this may be especially true as today is time when many of you will "spring forward" for daylight savings time.

What do you do for self-care and wellness?  Did you have a good Sunday experience? Please share.

World House Medicine

I'm training to be a physician and it's been a journey of intellectual, physical and spiritual pursuit. We know that  health is more than the absence of disease or cure it's a about well-being. In today's high-tech, fast paced world quality of life is not always apparent for those who live with convenience and over abundance.  Yet in most of the world where resources are scarce the days are long and hard just to maintain a meager household. It's a challenge for to stay healthy, but it's not impossible.  This blog experience is about a journey and commitment to well-being and whole person medicine.

Dr. Martin Luther King calls for "a world-wide fellowship that lifts neighborly concern beyond one’s tribe, race, class and nation is in reality a call for an all-embracing and unconditional love for all" in his "World House" essay and this concept is the context for the World House Medicine Blog.

In the days ahead I will reflect and share strategies that aim at healing and well-being beyond treatment and cure.  Join me and share your thoughts.