Medical Mondays Blog Hop!

   Hey everyone!  Welcome! It's that time again - time to explore more medical-related blogs.  Head on over to Your Doctor's Wife to check out all the bloggers that linked up!

   So the other day, I was working with an attending in primary care, and like many attendings do, he asked me, "So, have you decided what you don't wanna go into?"  I have never heard it asked that way before, and I thought it was an odd twist on the typical, "What specialty are you interested in?" that most attendings/residents ask us malleable med students.  If you are new to my blog, then you probably don't know: I am super gung-ho about OB/Gyn.  So when he asked me that question, I politely answered, "Well, I guess (I don't want to go into) anything other than OB/Gyn."  Then he went on to scoff about how "self-assured" of me it was to say that.  Dude, you asked!

   That set the tone for the rest of the conversation.  We happened to be working with a lot of geriatric patients that day, so he goes on to talk about one of his colleagues, and how old she was when she had her baby, so maybe I'll work with geriatric patients at times.  I felt bad for one of the female residents who then awkwardly admits, "Oh, I'm 39 and I'd still like to have a child." He then proceeded to go off on some awkward mommy-issue-rooted rant about how women shouldn't have children any later than 40: because then "they don't get to spend any time with their kids or grandkids because they die too soon." He talked about how his mom died when he was 29, so "she missed out on my life and meeting her grandkids."  Then he boasted about how his wife had their youngest child when she was 37 because of this very issue.  

   I think it's really easy to determine how women should or should not raise families when you are a man, because you totally know what you're talking about, and you totally know from experience.  What particularly pissed me off was the fact that he shut down that poor female resident with his stupid rant.  If he would have taken time to actually listen to her, he would have realized that she has been married for many years, has been busy pursuing a career in medicine, so in attempt to be responsible has been waiting, and finally is ready to have kids.  He would have heard that she actually has been trying to get pregnant for a few years now, but it doesn't happen overnight.  

   I've gotten to the point this year where I'm tired of getting walked all over every day as a med student, and then getting graded on how well you lie on the floor after being walked on.  So I decided to say something to this attending, because he was out of line.  I said, "You know, unfortunately these days, if you want to pursue a challenging career, especially one in medicine, many women choose to put that part of their life on hold, and end up having to have children later."  It wasn't a profound statement by any means, but he looked sort of dumbfounded, and then realized his audience - and shut up.  

Oh No He DIDN'T...

   Today I was sitting with a few of my classmates, and one classmate started to brag about his latest "heroic" act.  He said that he was walking down the street, and saw some man push an obviously pregnant lady, so he automatically assumed there was some sort of domestic dispute going on and decided to take action.  He proceeded to tackle the man and bring him to the ground, holding his hands behind his back, and shouted to the cop across the street.  While I applaud his decision to do something about what he saw, I don't necessarily agree with his approach.  Personally, I think he could have just flagged down the cop in the first place, and allowed the cop (who is trained to handle situations like this) to decide what the best course of action was.  This particular classmate of mine is one of those guys who feels the need to demonstrate masculinity and power at very opportunity possible, probably because he is insecure about himself.

   But I digress from the point of telling this story, which is that just after he finished boasting about how he "just couldn't stand to see such a thing, and just had to do something to protect that lady," immediately joked, "I mean, who knows if that lady deserved it (to be pushed), but the baby didn't deserve it.  That's for sure!"

......................................  

   Just pause for a second and take that in.  Obviously, this tool performed his "heroic" act for the completely wrong reasons.  All he cared about was exerting his power over this other man and looking super rough-and-tough after the fact.  How dare he joke around that maybe this pregnant woman somehow deserved to be pushed by her partner?!

   So, after he said that, my "oh-no-you-DIDN'T" face immediately took form, and I said, "Excuuusee me?!"

   He goes, "Ohh please.... it's a joke."

   "Well, it's not a very funny one.  I don't think that's funny."

   "Oh come on, don't make me roll my eyes at you..."

   "Go ahead... I hope they get stuck up there."

   "Geeze, can't you take a joke?!"

   "Yeah, and obviously I've got 'jokes' too..."

   Anyway, I'm normally a pretty patient person, or at least that's my perception of myself, but I cannot tolerate "jokes" degrading women.  Everyone has their trigger points, and mine is chauvinism.  Nothing else infuriates me like it.  Back in college I had a group of friends who used to make degrading jokes about women ALL THE TIME.  At first, I just ignored it, because I figured maybe I was being too sensitive.  My friends knew very well that these "jokes" upset me, yet they just kept on with them.  Every time I would bring it up, they would dismiss it by saying I was over-reacting.  It got to the point where I would go home and cry after hanging out with those friends, because I would get so upset.  Eventually, I stopped hanging out with those friends, because I realized that there are a lot of people out there who don't feel the need to belittle women with constant jokes.

   Ever since then, I've decided that it's OK to speak up when people make rude jokes that offend me.  And my hope is that by doing this, people will react by either:

A) Not making those jokes anymore (the didn't realize how offensive to women it was, and now they realize)

B) Not making those jokes anymore - around me

C) Not hanging out with me

   Obviously, option A is ideal, but I'm fine with B or C.

Vaginoplasty: The Difference Between Plastic Surgeons And OB/Gyns

   Just came across this article about how ACOG is concerned about the medical validity of vaginal and vulvar reconstructive procedures.  I think they are concerned for good reason!  Since when does someone's vulva have to fit a cookie cutter mold?!  One of the coolest parts of being a woman is how unique our girly parts are, or at least that's what I think.  Also, women are undergoing these procedures to "boost their self-esteem" or improve their sex life, however, one of the potential side effects of these reconstructive surgeries is loss of sensation, which seems a bit counterproductive.

   I think this issue demonstrates the difference between the way plastic surgeons and OB/Gyns think.  OB/Gyns are all about taking care of women, concerned about their well-being, and they accept the wonderful uniqueness to each and every person.  Plastic surgeons just see the potential to "fix" yet another non-existent "flaw", and make everyone look the same.  I know plastic surgeons do a lot of good work too, but there is a lot that they do that makes my nostrils flare.  If you wanna pull people's faces back so they look like snakes, and make women's breasts look like oranges sitting on their chest, that's one thing, but keep your hands off of women's va-jay jays, okay?

Feminist Dilemma In The Hospital

    The other day I was checking in on one of my patients, a pleasant old man whom I enjoy chatting with every morning.  I had been following him for a few days, and on this particular day, when I was doing his physical exam, and my male intern happened to be in the room with me, I told him I had to check his belly, and the patient said, "Sure, do whatever you have to do! You're the nurse! And he's the doctor!"

    Unfortunately, this is not the first time this has happened to me, and it will definitely not be the last.  I wasn't angry at him at all, because he honestly didn't mean anything malicious by it.  He just assumed that I was the nurse because I am a woman, even though I was wearing the exact same green scrubs and white coat that my intern was, and the nurses in our hospital wear blue.  It's fine though, a lot of patients don't even notice the subtle clues about who's who in the hospital.  I mean, how would they know?!  And I can't really blame them.  Each patient probably have between 10-30 different healthcare workers coming in and out of their rooms every day, many of whom don't even introduce themselves, so no wonder they can't keep track of everyone.

    I realize that this stereotype of women being nurses and men being doctors isn't going to change any time soon, so I have learned not to get upset with patients making honest mistakes.  However, when this happened the other day I found myself in a dilemma of whether or not I should set the patient straight.  Should I just keep my mouth shut, and let him go on thinking I was a nurse?  Does it really matter if he knows my "title"?  Or should I speak up, and let him know that I am actually almost a doctor?

   I decided that there was nothing wrong with telling him that I was actually a medical student, who will become a doctor in the near future.  Of course, there was no reason for me to be confrontational, because he didn't do anything wrong, so with a smile on my face, I said very matter-of-factly, "Oh, actually I'm a medical student.  I'm training to be a doctor!"  He replied, "Oh! Well, you've got to get your training somehow!"  And everyone was happy.

Final Finals

   So here I am, in "med student limbo".  It's the awkward transition between second year and third year - where you've finished finals (and most likely passed), so you are no longer a second year... BUT you still have the huge hurdle to overcome (USMLE Step 1 board exam) before you are officially a third year.  So now I am an MS2.5?  It still hasn't hit me yet that second year is over.  Finals went pretty well, so I'm not worried about passing Block 5.  

   There was a really strange vibe throughout Block 5.  Nobody wanted to study for classes (which is totally normal), however, the weird part was that everyone wanted to be studying for boards.  Some of us joked around that the school must have been performing reverse psychology on us: making us so sick of Block 5, that we were itching to study for boards instead.  I'm really glad Block 5 is over, especially because I had a really hard time putting effort towards studying ortho or derm.  Don't even get me started on how ridiculous it is that our curriculum spends the same amount of time (50 minutes) presenting all of contraception as it does presenting "cosmetic dermatology".  Yep, we spent the same amount of time in lecture learning about ALL the contraception methods out there (in an outdated, inadequate lecture, mind you) as we spent learning about freaking Botox and Latisse.  Seriously?! Thank goodness for our MSFC Contraception Lecture Series that supplements our inadequate curriculum.  Anyway, I'll keep the rest of my derm-is-stupid rant to myself. 

   Second year was even better than first year, I'd say.  This year I got a lot closer to my med school friends.  It's really cool to think about the fact that these are the people that I am going to be friends with for years to come - these are my future colleagues that I will call up to ask quick questions about things outside my expertise, or to ask for quick favors.  And I'm sure they will do the same to me, and I hope they do!  

The MS1s made us a slide show and sang to us on our last day of class

Last day of class with my anatomy buddies (+ D)

Baby Z, being her usual silly self during finals week

   So now that finals is over, I am taking a few days off, except for a practice test tomorrow.  After our last final ever was over, my friends and I went beer-tasting at Sierra Nevada in Chico.  This weekend has been super fun, vegging out with BF.  Last night, I hosted a UCLA Alumni Dinner For 12 Strangers, which was hilarious and entertaining - look out for a post on that soon.  After our practice test tomorrow, my friends and I are going to make a little trip to San Francisco, so that will be our "last hurrah" before we hibernate in our study caves for a month.  I think I'm ready.  I hope I am, at least!

BF and I at beer-tasting

Sierra Nevada

Sierra Nevada

Jezebel's Woman Of The Year

No, it's not Hilary Clinton.  No, it's not Oprah.  It's Dr. X: an abortion providing physician who chooses to remain anonymous because she risks her life every day for reproductive rights.  I'm happy with that choice.  Don't get me wrong, I love Hilary and Oprah, but I LOVE repro rights!  The full article is here.

On a related note, if you would like to read a memoir written by a physician similar to Dr. X (but obviously not anonymous) check out this book: This Common Secret: My Journey as an Abortion Doctor by Susan Wicklund.  It's quite eye-opening and made me cry in the first chapter, so that's always a good quality.

Trust Women

Yesterday, I went to the regional conference for Medical Students for Choice in San Francisco.  It was such an inspiring, informative day!

Here are some lingering thoughts I have/things that really stuck out to me:

• Only 4% of women of reproductive age in the US are using long acting reversible contraception (IUD, implant, etc) vs. 20% in Europe.   I wonder why?!  I also think its very interesting that even though the IUD has been found to be safe to use in women who have not yet had children, it is still mainly marketed towards married women who have already had children.  I feel like these long acting reversible contraception methods are an untapped resource.  FYI: the Mirena IUD is more effective at preventing pregnancy than tubal ligation!
• There is much debate over whether contraceptives should be covered in health care reform as a preventative service.  I just don't get why this is even a question?!  Obviously, if you prevent pregnancies with contraception, you will reduce the number of unintended pregnancies... which translates to less abortions and live births, BOTH of which are much more expensive than contraceptives.  For every $1 you spend on contraceptives, you save $9 that would be spent later on.  Regardless of whether you believe women (and men) should have the right to chose when they are ready to become parents, not offering contraceptives as a preventative service is fiscally irresponsible.  
• I also learned a lot about Catholic Health Association, and what kind of ethical guidelines they use in treating patients in Catholic hospitals.  I'm not even going to write any details about this, but let's just say you won't ever find me working in a Catholic hospital.  And if I was pregnant, I would not go to a Catholic hospital because it could cost me my life.
• I love the "Trust Women" silver ribbon campaign.  "The silver ribbon represents science over ideology.  Those who proudly wear it support reproductive rights, free access to birth control, and keeping abortion legal and accessible."  I wear my ribbon proudly on my badge because I trust women.

Happy Birthday, Gloria Steinem!

Gloria Steinem turns 77 today.  What a cool lady (click her name for more details).  She is also one of the cofounders of my favorite magazine (Ms.)

I love what she is saying in this clip, and I promise to do an "outrageous act" this weekend!  (Does dedicating my Saturday to attending a Medical Students for Choice conference count?) 

Food For Thought

I came across this quote from a physician involved with Physicians for Reproductive Choice and Health today.  This physician is an abortion provider.  Pretty insightful, I thought.

"It's not my role to judge the patients.  I'm not God.  My patients have rights.  My patients have feelings.  My patients have needs, and I listen to them.  We live in a world where we don't have a fail-proof method of birth control.  We don't have a school system that allows us to teach young children where babies come from.  We don't have a police system that prevents rape and incest.  We don't have a scientific community that can guarantee every woman, when she's pregnant, that the fetus is normal.  As long as we live in this imperfect society, women have to have the right to be able to terminate a pregnancy.  If we could guarantee every woman that she's only pregnant when she wants to be, we wouldn't have to have abortions any more."      Robert Tamis, MD

Birth Control

While reading an article on my favorite feminist blog - www.jezebel.com - about whether oral contraceptives should be included as what will be free in the new health care bill (I think it should be), I came upon this wonderful little quote from the Conference of Catholic Bishops:

"I don't want to overstate or understate our level of concern," said McQuade, the Catholic bishops' spokesperson. "We consider [birth control] an elective drug. Married women can practice periodic abstinence. Other women can abstain altogether. Not having sex doesn't make you sick." 


I'm not even going to go into the issue of reproductive rights, but notice that "women can practice periodic abstinence" and "women can abstain altogether"...  I can't stand how birth control is always considered the responsibility of the woman.  Last time I checked, (reproductive) sex takes at least two people, and so I think it is every bit as much of the man's responsibility as the woman's.  Not every form of contraception works for every couple, but that's why you should talk about it (imagine that! communication! *gasp*) and figure out together what works for you.  I'm sick of hearing how so-and-so "got herself pregnant" and now it's somehow her issue to deal with.  Unless so-and-so went and got AI - good for her if that's what she wanted - then she didn't "get herself pregnant".  Guys: it is your responsibility to find out if your partner is on any form of birth control method, because any potential pregnancy is 50% your fault, so don't just assume she is going to "take care of it".  


And on that note, I would love to see more research and development of birth control methods for men.  Thank you and that is all for now.