Finding Support

 

Atkins Headshot 2017Our guest post today is from Sarah a graduate of the OHSU School of Nursing’s Pediatric Nurse Practitioner Master’s program this past June from OHSU. She is currently finishing her Doctor of Nursing Practice degree at OHSU and working at a pediatric primary care clinic in the Portland Metro area. She is thrilled to be partnering with Northwest Kidney Kids for her DNP project!

A map dot was where my directions took me on a hot and hazy August afternoon. Knowing only a handful of people beforehand, I was slightly nervous but overall excited for the weekend ahead. When I pulled into the parking lot and entered the main building, I could feel my worries evaporating from my body. The hallway was filled laughter, smiles, and hugs. This weekend was Northwest Kidney Kid’s Family Camp, the annual opportunity to meet and connect with families who have a child with kidney disease. NW Kidney Kids is an organization dedicated to supporting and educating children with chronic kidney disease and their families, and it is the only organization with a focus on serving youth with chronic kidney disease and their families in the Northwest. As a pediatric nurse practitioner and DNP student, I am so excited to be partnering with NW Kidney Kids for my DNP project and working to further support their mission. Attending Family Camp was a unique opportunity to learn more about the organization and the population they serve and to gather information to inform the direction of my DNP project.

As the weekend unfolded, I learned how the children with kidney disease were diagnosed at all ages. Some were diagnosed as toddlers, others as high-schoolers, and some were found to have kidney problems on their prenatal ultrasounds. I learned how these families have navigated the complex medical system and continue to rally through hospitalizations, appointments, blood draws, medications, new diagnoses, dialysis, and transplant. Families who have been attending camp for over a decade spoke passionately about how camp made them feel less alone and how they eagerly want to meet families with a child newly diagnosed with kidney disease to walk beside them on their journey. Other families said the beauty of Family Camp is “not having to explain” because their fellow NW Kidney Kids families have experienced so much of the same ups and downs as well.

What struck me was observing how kidney disease affects all walks of life – babies, toddlers, teens, traditional families, blended families, varying ethnicities, languages, socioeconomic statuses. The beauty of NW Kidney Kids is that regardless of your attributes, you were welcomed with open arms. Their message of “we want you here” shown like bursting fireworks lighting an otherwise dark night sky. It did not matter if you had a G-tube, wheelchair, timed medications, or a torso-length scar. You were welcome. You were important. You were loved.

During the 3 days of Family Camp, NW Kidney Kids scattered 600 Love Rocks on the retreat property. Love Rocks are small rocks with brightly colored, patterned fabric hearts and created by another wonderful organization. These Love Rocks dispersed on the retreat property by NW Kidney Kids were symbols of strength, love, joy, hope, success. You could either keep the rock you found for personal inspiration or take it home with the intention of giving it to someone else and uplifting them. Wouldn’t it be great if we could all be Love Rocks for one another?

After reflecting on my time at Family Camp, I am going to focus on the role of siblings of children with chronic health needs and how to support these siblings for my DNP project. I intend to start a pilot program Sibshop for siblings of children with chronic kidney disease in the Portland Metro area.

Resources and Event

If you are interested in supporting Northwest Kidney Kids, please consider registering for Strut Your Kidney, the first annual NW Kidney Kids’ 10k, 5k, or 1k fun run/walk. On Sunday, September 24, we have the opportunity to celebrate, honor, and raise awareness for children with chronic kidney disease, and all proceeds raised go to Northwest Kidney Kids. For more information, go to https://www.crowdrise.com/StrutYourKidney.

It is possible to make SAD not even seasonal!!!

I am writing my first blog post based on my experiences in Portland and my struggle with depression soon after I landed here. I am not writing this to bring about sympathy or pity but just to boldly put it out there and encourage all of us to break our inhibitions and talk to the helpful community in our vicinity.

I still remember the excitement in me when I came for the interview at OHSU in Feb 2015. It was a rainy, windy and gloomy day. Little did I know that it was a nearly perfect image of Portland in February.

The excited me saw everything as a lovely experience. After the interviews, while I had a good impression about the university itself, I really didn’t want to live in Portland. One of the main reasons being its weather. Fast forward to that moment in March of 2015 when I was biking to my lab in the warm California sunshine and I received an email that I have been accepted into the PMCB program.

My heart jumped with joy. I accepted the admission offer and started working towards wrapping up my work at Stanford. I figured that I would cope to the weather of Portland. Who knew it would take me a year to cope with it?

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Twenty-Six Months in the Making?

For every day that I have spent introducing myself to patients as Lauren Liebling, “a physician assistant student working with Dr. So-and-so” I have been met with at least one “Oh that’s wonderful! How far along in your training are you? How long is your schooling?”  It has become a bit routine by now- I smile, reply that I am on my Nth rotation, and that school is 26 months long. Then…. Pause.

Twenty-six months. What can anyone possibly learn in the span of 26 months?  How can a person transform from student to provider in such a short length of time? To understand these questions you truly have to go back to the beginning, well before matriculation day on June 29, 2015.

For me it was January of 2011. I was in a small ski town in eastern California living my dream as a professional ski patroler. I was a newly certified EMT and the ski resort provided me ample exposure to complex traumas. I loved my job and began to dream of a career in health care…someday.  But then the faucet turned off and the snow stopped falling. Ski resorts don’t do much business during drought and I was laid off. Frustrated and financially stressed I did what any rational adult would do – I packed my car and drove to Jackson Hole, Wyoming. I needed a plan for how to move forward, and it was right then and there that I enrolled in community college to take prerequisite coursework for PA school.

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Reflections after analyzing data from a failed experiment

The feeling is sickening. Your stomach sinks immediately, plunging thickly into darkness. Then, a sense of vertigo, a chilling Hitchcockian background-moving-but-character-standing-still effect where your eyes are forced to continually adjust to your computer screen.

You’re looking at nothing. Well, not nothing, exactly. Just not what you expect, which feels like nothing. Feels worse than nothing, because this so-called “something”, this shadow-something, is a hollow, almost mocking facsimile of a something.

You think: What went wrong? You think: Did I make some catastrophic mistake? You think: You shouldn’t have allowed yourself to hope.

In science, hope is a dangerous thing. Hope is not objective. Hope is not convinced by negative data or swayed by repeated failure. Hope endures; it perseveres. “Hope is a thing with feathers,” wrote Emily Dickinson, “that…sings the tune without the words, and never stops at all.” Well, sorry, Emily, but in graduate school, your feathered hope is an endangered species, and science is slowly encroaching, licking its lips.

You’ll try again, of course. Repeat the experiment, perhaps. Or try something different. It doesn’t matter. You’ll move on. The only way to succeed is to maintain forward momentum.

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I went to OHSU Research Week and all I got was a lot of valuable advice and experience

RW web 1OHSU StudentSpeak is pleased to present this guest post by Rebecca Hood, a fourth-year graduate student in the Behavioral Neuroscience Graduate Program, OHSU School of Medicine.

I’ll confess: OHSU Research Week, to me, used to connote a free shirt, time to socialize with friends I don’t often see and lots of opportunities for free food. Throughout my attendance at Research Week events over the years, and as I’ve gotten more involved, however, I’ve come to realize how rewarding the event is (beyond the freebies) and how hard everyone involved works to make Research Week helpful and worthwhile.

Amy Williams, a fourth-year graduate student in the Behavioral Neuroscience Graduate Program, served as the Graduate Student Organization liaison on the Research Week Steering Committee. While her role as liaison required her to plan and organize all Research Week events, Amy was most heavily involved in the conception and overseeing of all of the Student Day events and selecting the student’s choice keynote lecturer, Nicholas Strausfeld, Ph.D. When asked why she chose to take on all of these responsibilities in addition to the normal workload of a Ph.D. student, Amy said, “I wanted to be involved in Research Week because I think it is a wonderful tradition of celebrating all research occurring at OHSU, and I wanted to be a part of that tradition.” She added, “Research Week is a truly unique opportunity at OHSU to discover research that is entirely outside of your area of expertise but occurring at your same institution.  There are also great Student Day events meant to help students with research, communication, mentorship, career development, writing and even research promotion in the modern world.”

To balance out how much I’ve taken advantage of Research Week events to provide me with free meals, I volunteered as part of the Student Day subcommittee this year.  I was struck by how many people worked exhaustively behind the scenes to make Research Week happen. Members of the planning committee included faculty, administrators and students from various offices and schools around campus. Additional volunteers worked in the weeks beforehand to get everything ready for Research Week participants (I will never take conference nametags for granted again), while still more volunteers helped to check in presenters, moderate sessions and judge presentations.

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Live from SGIM in D.C.

Participating in the world of academic medicine has exposed me to some truly unique patients. I have also been fortunate to work with attendings who value research and innovation and encourage their students to participate. Through this very combination of a unique patient case and a preceptor who believed that I was prepared to engage with the greater medical community, I found myself boarding a red-eye flight to present a clinical vignette at the Society of General Internal Medicine’s national conference in Washington, D.C.

The conference took place at a large hotel in downtown Washington with the theme “Resilience and Grit.” The days were filled with presentations on research and innovation, clinical vignettes, and small group discussions on a variety of hot topics in general internal medicine and health care. Each hour offered dozens of small sessions for special interest groups covering everything from diabetes to the social determinants of health. There was a tremendous emphasis on provider wellness to combat burnout, the non-opioid treatment of chronic pain, and the use of mobile technology to improve patient access and follow up. Significant time was dedicated to better engaging medical students and residents to improve the medical education process. There was an undeniable feminist undercurrent supporting women in STEM. There were many, many lattes.

The hourDC poster-long block of time in which I presented my clinical vignette is what brought me to D.C., but it was surprisingly not the most meaningful part of my trip. Interacting with other attendees in a small group where we were tasked with diagnosing patients with atypical presentations of mystery illnesses underscored the depth of the knowledge I have received in my training thus far. I expected to feel like a timid P.A. student in an sea of qualified and accomplished practitioners and teachers of medicine. Instead I found myself comfortable, almost confident as I collaborated with my future colleagues.

At the conclusion of the week’s festivities I had a half-day to explore Washington D.C. Despite the pouring rain, I laced up my running shoes in an attempt to see as many sites as DC imageI could along the National Mall. In a matter of hours I saw beautiful tributes to Martin Luther King, Jr., Abraham Lincoln, Korean War veterans and several others. It was Earth Day and a large March for Science was taking place at the Washington Monument, complete with guest speaker / childhood idol Bill Nye, the science guy.

Participating in a national meeting of such talented researchers and educators in the field of general internal medicine was an incredible honor. I felt proud of my training and the institution that I represented while in D.C.  I departed the nation’s capital feeling a greater responsibility to participate in medicine beyond my role as a practitioner as well as be an advocate for research and a protector of access to health care for all people. I am thankful for the support of my attending Dr. Jonathan Robbins, as well as P.A. program faculty for allowing me this incredible opportunity that I will not soon forget.

Flow and work

OHSU StudentSpeak is pleased to present this guest post from Gary Josephsen, M.D., an affiliate professor of emergency medicine, OHSU School of Medicine, and student preceptor.

The surprising way the concept of flow can turn our most challenging moments into our best moments

“How we spend our days is of course how we spend our lives.”
-Annie Dillard

The rules of medical education are: never stand when you can sit, never sit when you can lie down, and if you do lie down for a few minutes, never ever ask yourself if this will make you truly happy. Something like this probably happened to the British philosopher John Stuart Mill when he wrote, “Ask yourself whether you are happy, and you cease to be so.”

Mills, although brilliant, was not a particularly happy person, but don’t you deserve to be happy? Not just happy, but even ecstatic on a regular basis? Studies show that we are bad at predicting what will make ourselves happy. Many people overestimate how happy they will be after reaching major goals or even attaining financial success. You are, after all, investing a great deal of money in your education as a medical professional. Measures of happiness do increase with income, but only until it rises just above the poverty line. After that point, more income doesn’t translate into higher levels of happiness. Sure, money can’t buy happiness but should we get a little bump from the added security of solid finances, the privileges of travel, leisure, or even early retirement? When asked what they want to do in retirement, most answer either travel or drinks on a beach, but even then most fall short of “happily ever after.”

image001Why is happiness such a mirage in modern professional life? To answer this question, one might turn to Mihaly Csikszentmihalyi (pronounced just like is looks, |chek-sent’-me-high|), a psychologist most known for his study of happiness across cultures and circumstances. He describes our tendency toward affluent existential angst in his book, Flow: the psychology of optimal experience (Harper, 1990), a treatise on why we can’t “just be happy” and what to do about it:

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Med school life in Zambia

OHSU StudentSpeak is pleased to present this guest post from Malerie Pratt, a medical student in the M.D. Class of 2018 and a Swindells Family Scholar.

ZambiaSurgery1

I’m thankful for the faculty at OHSU and Dr. Karen Kwong, my global health research mentor, for all the time and effort they put in to helping me have the opportunity to study and learn about the Zambian medical education and health care system for the last three months. My hope is that sharing my experience will encourage more medical students to collaborate with other medical education programs abroad so that we may learn from each other and form partnerships to continue improving access to health care globally.

I’m really sensitive about medical tourism and was afraid my trip may take more resources from the Zambian hospital than I would be able to give back, but I think this has been the best thing I could have done right now in my education, as it helped me cement my current and future goals. Being able to participate in hospitals internationally as a medical student taught me lessons on adaptability and resourcefulness that I will carry in my future work internationally. Over the last three months I made friends with dozens of African doctors throughout Zambia (many of them Congolese, Zimbabwean and Tanzanian). I look forward to collaborating with them to set up future projects.

Here is a journal entry I wrote about the patients and my time there:

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Final thoughts from the Emergency Department

It is 8 p.m. Two hours remain on my final shift in the Emergency Department. The lobby is full and we are working at a fast pace. My preceptor asks me to go see the patient in bed three. A ninety-something-year-old man with chest pain.* I know the routine. I jot down a few notes, including a differential diagnosis and a list of labs and tests that I will likely order with my preceptor after interviewing the patient. I hop off the counter height stool at the nurse’s station and stride with the confidence of a student on her last day of a rotation toward the patient in bed six.

I draw the curtain, smile, and introduce myself to the patient first, and then to his adult daughter who is at the bedside. I am calculated as I speak more slowly and clearly than I normally would; it is loud in the chaotic ED and this patient is wearing hearing aids.

I interview the patient about his symptoms which are far more vague than the words “chest pain” initially led me to believe. He has been feeling ill for days. He has abdominal pain, nausea, and shortness of breath. His skin is pale and his tongue is dry. He can answer the slurry of questions used to evaluate his mental status, but more specific inquiries about his symptoms are met with “I don’t know.” His daughter looks increasingly concerned, and she begins chiming in to clarify the details of the events leading up to his arrival in the ED.

I conclude my exam and assure the patient and his daughter that I will return shortly. I present his case to my preceptor. This patient is far sicker than he or his daughter realizes. As the results of his studies appear in his chart his diagnosis becomes clear. Just as Occam’s razor dictates, all symptoms can be attributed to a single cause.

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Acknowledge is power

David EdwardsIt’s a common enough thing, the dissertation defense. The seats are packed with students and faculty members, many of whom you haven’t seen in months. The air is crackling with excitement and anticipation. Today is the day that the student—your classmate, your colleague, your friend—becomes a doctor, and everybody knows it.

The head of the student’s dissertation advisory committee stands up, introducing the proceedings and announcing the terms of the defense. Sure, it’s a reminder that you’re technically watching part of an exam, but this bit of formality does nothing to diminish the joyous atmosphere in the room. Then the PI stands up and introduces the student, sometimes with complete sincerity, other times accompanied by embarrassing photos of the student, yet always delivered with an undercurrent of gratitude. You laugh easily, because jokes, even bad ones, are always funnier when spoken in celebration.

And then, finally, the student stands up. They thank their mentor and begin speaking, their voice growing with confidence, first describing their research broadly, comprehensively, then diving deeply into their findings. You stare wordlessly at the presentation, wondering how in the hell you’ll ever produce that much polished, publication-worthy data over the coming months (or years). Then the conclusions, the future directions, the suggestion of experiments that everyone knows the student probably won’t do because, after all, today is transitional. Today is the day they become a doctor.

Then, finally, the acknowledgements. Thank you, they say, to the core facilities and their lab members and their collaborators; and thank you to their mentors and their committee members; and thank you, most of all, to their friends and their family and loved ones. The slides are filled with pictures of smiling, happy faces, some of which you recognize but all of which clearly represent someone special, someone significant, someone irreplaceable.

Sometimes, at this point, the student becomes emotional, fumbling over prepared words while the audience waits patiently, expectantly. The student, and everyone in that room, comes face-to-face with the realization that this moment is the culmination of years of work, of countless successes and failures, and that today, this very day, is the day that the student finally becomes a doctor.

Yes, it’s a common enough thing, the dissertation defense. But to me, the acknowledgements will always be special. They offer a unique, behind-the-scenes glimpse into the student’s personal life, something that’s never publicly shown. For the first time, the dispassionate façade of the scientific presentation crumbles, and we are all witnesses to the complex, red-blooded emotions that accompany this experience of graduate school.

With the acknowledgements, we are shown photos of get-togethers and vacations and late nights spent drinking, all those necessary moments that, in aggregation, shine a spotlight on the actual person behind the research. Because ultimately, the dissertation defense isn’t about celebrating good science but celebrating a good scientist. We formally recognize someone deserving of the title of doctor, someone who will use that doctorate and will, in their own way, following their own path, somehow improve the world.

I’m thankful for any opportunity to humanize my work. At the risk of appearing tautological, I want to formally acknowledge acknowledgements. Someday (hopefully someday soon!), when I’m giving my own dissertation defense, amid the complicated graphs and the embarrassing photos and the overwhelming sense of relief, I’ll be excited to show my appreciation to all those people who have supported me throughout graduate school. Because those are people who, on that day, will have transformed my common enough thing into something truly special.

StudentSpeak

StudentSpeak

Ever wondered what life is like as a student at OHSU? What does it take to become a researcher? Just how gross is gross anatomy? Welcome to the blog that answers these – and many other – questions. It’s students writing first-hand about their commitment to careers in science and health care. It’s honest about the challenges as well as the joys. It’s not always pretty. But it is our story. Thank you for sharing it with us. And please, let us know what you think.

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