A Tribute to Oliver Sacks

“Every act of perception, is to some degree an act of creation, and every act of memory is to some degree, an act of imagination.”

Oliver Sacks

Oliver Sacks, a renowned writer and neurologist passed away yesterday at the age of 82 due to his ocular melanoma, as many of us may know by now. Not only was Sacks a physician, but he was also a brilliant writer, polymath, humanist, musician, and a weight-lifter. Perhaps one of the most interesting qualities Oliver Sacks possessed was his intellectual curiosity that really sparked a light through which everyone realized his profound insight on subjects such as psychology or cognitive science. He ultimately took medicine to the next level, by melding science into the art of storytelling!

“Music can lift us out of depression or move us to tears- it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity.”

Check out these books by Oliver Sacks:

  1. Musicophilia
  2. Hallucinations
  3. Awakenings
  4. On the Move
  5. The Mind’s Eye
  6. An Anthropologist on Mars
  7. The Island of the Colorblind

What Are You Going to Do With Your MD?

When I started out this blog, I deliberately geared it towards young pre-meds or high school students who thought they wanted to be pre-meds in the future. Over the past year, a variety of people, including people who were already in the medical field starting reading it, and that felt so gratifying. The fact that a young high school teenager like me could reach out to such a vast crowd was quite amazing! However, the aim of this blog post is to commence thought-provoking questions in students who aim to be MDs or Doctors of Medicine in the future.

So it’s 2015, and the Medical School Admissions process has changed dramatically. They no longer want robots that could solve an organic chemistry equation in 30 seconds, or rocket scientists who can develop ground-breaking technology, although that would be neat. They want students who KNOW what they WANT to do with their medical school education! Even though this sounds painfully obvious, there are numerous students I see apply each year, in hopes to get in, not for themselves but for their parents, or simply for the label of being a physician. At the end of the day though, you want to be able to look at yourself and say, “Wow, I am actually ecstatic to be who I am..” So, the underlying question is, “What do you want to do with your MD?” I haven’t been through the medical school admissions process myself, but from what i have researched and read upon, medical schools will be interested in knowing what an applicant wants to offer to the school, or any institution, hospital, or country for that matter. Of course it is crucial for the applicant to be well-rounded, but it all comes down to what you are going to give back to the community, if you even intend to!

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Here is a list of ideas I came up with for what I would do with my MD:

1) Doctors Without Borders – If you’re a person who doesn’t mind taking a few risks to save dozens of lives on the field in different countries, this is suitable for you. Also, if you’re interested in using your expertise to serve the purpose of helping others through a humanitarian cause, or simply love traveling, you may want to check it out. Although this job is not as easy as I make it sound, people have done it successfully! Here is a link to the kind of health care professionals this organization looks for : http://www.doctorswithoutborders.org/work-us/work-field/who-we-need

2) UN Volunteers – UNV is a great organization associated with the United Nations that recruits volunteers from different areas of health care to help combat diseases in developing countries and help out with preventive measures and workshops. This kind of work builds up strong experience so when you apply for a UN Medical Officer position or some other high-rank job within the UN Medical realm, it can come in handy. Here is a link to the UNV page: http://www.unv.org/en/about-us.html. Here is the general UN Career Page: https://careers.un.org/lbw/home.aspx?viewtype=SC.

3) UNICEF – Here’s another humanitarian organization that hires professionals such as medical doctors to serve domestically, or internationally: http://www.unicef.org/about/employ/index_careers.html.

4) Community Events – No matter where you live, there are doctors almost everywhere that are willing to offer free medical services to the poor or the uninsured. See if that fits your niche.

5) Writing Health Policies – This can’t be done without additional training such as aquiring an MHA or Masters of Health Administration, but it can be a rewarding career! After all, if you were assigned to write health policies for a developing country, or even the United States, that would be a huge responsibility and a gratifying one as well.

Although some of these prospects mays seem out of reach for you, there is still SO MUCH out there that you could possibly delve into. The number of possibilities within the field of medicine itself is amazing! This may not even be an eighth of them, but I hope this article serves to motivate you to think about what it is that you would do with your medical degree, if you were to pursue it!

The Soul of a Doctor

During the past week, I became very interested in reading a book about how medical students deal with their first encounters with patients and what they experience being so close to the life-and-death situation. This book was called, “The Soul of a Doctor,” by Susan Pories MD, Sachin H. Jain, Gordon Harper MD, and Jerome E. Groopman MD. It essentially is a compilation of essays written by fellow students of Harvard Medical School, divided into four sections: Communication, Empathy, Easing Suffering and Loss, and Finding a Better Way. It targets aspiring medical and pre-medical students to capture moments in the lives of actual medical students who have to assess all these patients, ranging from slightly ill to terminally ill.

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In the Foreword of the novel, Jerome E. Groopman, MD, makes a connection between the themes in literature to medicine. He describes that in literature, there’s a person that goes on a journey and that there is a stranger that comes to town. Likewise, in medicine, the person is the patient, accompanied by the doctor and the stranger is the illness that disrupts the equilibrium of life. Similarly, Sachin H. Jain makes a connection between the political science phenomenon of “social criticism” described by Micheal Walzer and the medical student in his Introduction of the novel. He states that the ideal social critic is someone who is embedded in society but is still able to apply external values to critiquing it. This is a crucial aspect to incorporate into medicine as well. He explains how the medical students are knowledgable about medicine but are still idealistic and have not yet been changed by the “norms of practice.” Another words, the medical student has a fresh perspective about the world of medicine and healing and is not affected by the habits other doctors may have. That is why the medical student may be able to effectively reflect on the health care system and uncover defects. That is why we want to hear from THEM in this book!

Delving into the first main concept of the book, Communication, a medical student named Amanda A. Munoz describes her worried patient and the little that doctors do to support. She talks about how the ideal patient-dcotor relationship is taught in classrooms and shown on videotapes in medical school, but it’s very hard to maintain that when everything is so fast-paced. A lot of times, doctors tend to place their efficiency, interests and performance over the patient’s feelings and questions. That in turn, leads to bad communication! This part of the book really stuck out to me because I always thought of the doctor actually comforting the patient and assessing their question(s) but never did I realize, that not all doctors think it’s necessary to do that!

The second concept discussed was Empathy, and in this section of the book,  a medical student named Rajesh G. Shah discussed how doctors can sometimes let their nature of prejudice get in the way of connecting with their patients and actually addressing their needs. Doctors may have preconceived notions about disorders such as anxiety and don’t consider it as a real, inhibiting condition, but when they actually see it occur in individuals, that completely changes their perspective. In this way, Rajesh G. Shah connected with his patient by learning from her condition and assessing her needs.

The third part of the book, Easing Suffering and Loss included numerous scenarios in which patients were extremely ill and perhaps living the last moments of their life, with only their doctors and a few loved ones. The important issue discussed in this section was that when doctors know that their patient doesn’t have much time, how can they ease suffering and loss? How can doctors assure their patients that they have been given the best care they can possibly recieve? How can doctors inform the loved ones that someone so close to them is going to die inevitably? These were some important questions that really got me thinking about how close one can get to the realm of mortality in the medical field.

The last section, Finding a Better Way, was mainly about the importance of ingenuity in medicine and started off with a remarkable quote by W.E.B. DuBois: “Education must not simply teach work- It must teach Life.” This quote is really significant because being pre-med and medical students, we can learn from older fellows, residents, and attendings, not just how to efficiently complete our tasks, but also to apply our knowledge to all aspects of our work and eventually form a bond with the patient we are dealing with. That is typically what, “The Soul of a Doctor” should constitute of. I know for some of us, it is way too early to even think about how patients should be treated or how their problems should be considered, but perhaps an important message to learn from this book would be this:

It is important to do the very best YOU can to provide the very best for the person YOU are caring for!

I would recommend this book to anyone who wants to get a glimpse of what medicine today is really like and whether it is what they want to go into. If you are interested in checking out other books relating to the medical field, look over to the right in my goodreads section!

The Upstreamist Approach to Health Care

Recently, I was watching this TED Talk by Dr. Rishi Manchanda, which emphasized the importance of asking patients about their living conditions and overall environment, because many of these factors can affect their health. He called this approach the “upstreamist” way of thinking and now it serves health care in such a beneficial way.

As we come to think of it now, people are more concerned with receiving immediate care for their illnesses than actually taking the time to dig deeper into the root cause of the problem. Although factors like genetics play a huge role in illnesses, there are also many environmental triggers involved. Check out the “Upstreamist” website and the TED Talk on it. It will definitely make an impact on how you view the medical field.

http://www.upstreamists.org

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The Old and New Brain Phenomena

Recently, I was reading a book called, “Quiet-The Power of Introverts in a World That Can’t Stop Talking” by Susan Cain and was very interested in how the brain’s biological processes can impact our behavior or personalities. The book was basically about how the extrovert ideal of this generation really suggested for quiet people to step out of their comfort zone, which isn’t necessarily bad. However, it talked about some of the rewarding aspects introverts, and highly-reactive or sensitive people had, based on scientific research.

This whole concept of neuroscience really struck me and I wanted to go deeper and deeper. Of course, I can’t go that deep into it because I would have to be a neuroscientist or an M.D. to understand certain things. Regardless, there are some things that are just so interesting about the human brain!

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So, the book referred to the limbic system of our brain, which we share with the most primitive animals, to be the “old brain.” Now, this “old brain” is emotional and instinctive. It includes various structures, including the amygdala, which is our fear and emotional response center, and that is connected to our nucleus accumbens (a.k.a. the brain’s pleasure center.) There is also a part of the old brain that plays a huge role in reward-seeking and pleasure.

The “new brain,” on the other hand, is the neocortex, which evolved many thousands of years after the limbic system. The new brain was described to be responsible for thinking, planning, language and decision-making- some of the very faculties that make us human. So what is the correlation between the old brain and the new brain?

The old brain, as mentioned before is instinctive, and is interested only in survival, whereas the new brain is where our feelings are stored. So, if the old brain senses some danger, it may send a message to your new brain, making you in turn, fearful to that situation… Isn’t that wicked?! The brain works in amazing ways that we sometimes can’t even seem to comprehend.

Going back to the “pleasure center” of the brain, including the orbitofrontal cortex, the nucleus accumbens and the amygdala, we can really get excited about potential goodies like money or pictures of attractive people. It’s amazing to see that there is a certain part of the brain that lights up during an fMRI for a particular rewarding feeling! In fact, research has now proven that the more dopamine your brain releases, the more likely you are to go after rewards like sex, chocolate, money and status.. Isn’t that crazy?! That’s why cocaine and heroin make you euphoric, but that shouldn’t convince you to go risk your life on these drugs. However, going out to experience positive rewarding experiences are amazing, and there is simply no way that could go wrong for you..

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With that being said, this book has made me realize that there is a neuroscientific explanation for almost every single activity you perform, and that certainly impacts your personality. If you seek status or money, then you are likely to be using your old brain, but if you value family relationships and love more than you do money and status, then you may be using your neocortex or your new brain. If you think about this from an evolutionary aspect, we don’t have to fight so hard now to get food and shelter. Don’t get me wrong. There are millions of people struggling through poverty today but it would make sense to say that we are using more of our new brains now, because this is a new era. That’s why evolution makes SO MUCH sense! There is a need to emphasize that!…

You Don’t Even Need Drugs

While studying about the different types of stimulants, depressants and hallucinogens in Psychology class today, we talked about how these type of drugs affect certain neurotransmitters, especially dopamine.

People usually take drugs like MDMA (ecstasy), Cocaine, Amphetamines etc., to boost the dopamine activity in their brain. Their emotions for the particular drive that dopamine produces, another words, the motivation that they need all comes from drugs. There are millions of people who become so dependent on these drugs to function normally as well, and it is just so sad. I’m not stating that drugs are absolutely horrible, because they are not. Marijuana can have miraculous effects on cancer patients and can fix headaches! However, in terms of motivation, and the joy that everyone craves for, it isn’t necessary to take drugs that may have potential adverse reactions. Ever heard of the “Runner’s High?” You can even train your brain to release dopamine by simply exercising.

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Who would’ve thought feelings of euphoria could be associated with strenuous exercise like prolonged running.?! An article in the New York Times called, “Phys Ed: What Really Causes the Runner’s High?” explains this phenomenon very well!

Not only does running provide that amazing rapture, there’s also other motivating ways to boost dopamine activity in the brain, or at least bump it up to a point where you’re satisfied. See, the thing is, you don’t want to have excess dopamine, because then you may be schizophrenic, and you definitely don’t want to have too less of it because then you will be depressed. So how can we naturally have an equilibrium in our brains?

It all comes down to our DIET! Remember that famous quote I mentioned earlier as well, “You are what you eat…” ? Well, your brain’s neurotransmitters will definitely act upon their receptors in response to what you eat.  Eating protein-rich foods like eggs, and fish-oil supplements or eating the fish itself, is essential to increasing the brain’s dopamine activity. Also, eating bananas can help since they’re a good source of tyrosine, which is an amino acid that neurons eventually turn into norepinephrine (another neurotransmitter boosting adrenaline or alertness) and dopamine.

Really, one of the easiest ways to stay active, have an elevated mood, and maintained levels of dopamine, is to be Bulletproof! (:

P.S..: Just in case you think I’m stupid for stressing dopamine again and again, be sure to check out this cool article that explains part of the reason why:

http://news.vanderbilt.edu/2012/05/dopamine-impacts-your-willingness-to-work/