Tiger Blood

Adalie-bannerThis week I will be sitting down with a group of applicants who are interviewing for positions in next year’s PA cohort. As the sage old PA student, I thought I would gather together my new-found wisdom to share with these potential students:

  • The first introductions with your new classmates can be intimidating. Getting into a competitive school like OHSU means that everyone is stupidly brilliant with seriously impressive work and volunteer backgrounds. Recognize that your feelings of imposter syndrome are normal, and will fade with each exam you crush.
    • If you still need a boost of confidence repeat to yourself this Charlie Sheen quote: “I have a different constitution. I have a different brain. I have a different heart. I got tiger blood, man.”
  • Don’t Lone Wolf your studies. Find like-minded students and study with them. It was wonderful to realize that OHSU doesn’t just preach a collaborative culture, but aims to actively create one. While I had never previously been a fan of collective studying, I now seek out small groups to work with, and am more successful because of it.
    • IE: Very bright people surround you. Dig into their minds for the knowledge you are lacking.
      • By this I do not mean to use your classmates’ brains as a zombie would. There is definitely a policy against that in the Student Code of Conduct.
  • Being a PA student can make you feel like your body is just a convenient way to transport your brain to and from class, but try and exercise daily. Then you can impress people with your razor sharp mind and your killer bod. Truly a win-win situation.
    • Also, this is the only time in the day to re-watch True Detective and not feel guilty.
      • Side note: Should one ever feel guilty about watching those modern day prophets Matthew McConaughey and Woody Harrelson? No sir.

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My First OSCE: A Tale of Tears

Ally-Rich-banner“Now, this last comment is personal advice for you as you move forward in medicine.”

It was the fall of 2013, and I was in my first year of medical school. Specifically, I was receiving feedback from my standardized patient—notably an OHSU physician—in my first OSCE (objective structured clinical examination). For those of you who don’t know, an OSCE is a series of encounters with standardized patients where you must show your ability to effectively communicate while exhibiting your mastery of taking a history and performing a physical exam. At the end of the encounter, the standardized patient gives feedback on your performance.

My standardized patient wanted to know how I thought the encounter went. I told her that I thought that the most difficult part for me was the pretending. Indeed, OSCEs entail one to act the part of a doctor, and at the beginning of my first year in medical school I felt like nothing of the sort. I can remember waiting until the last second to put on my white coat for preceptorship, afraid that a patient or non-healthcare worker would assume I was a doctor.

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From Zambia to Medical School

StudentSpeak is pleased to share an excerpt of M.D. student Malerie Pratt‘s winning essay for the Student Scholarship and Worldwide Community Ambassador Award presented by Giva. Malerie is a member of the M.D. Class of 2018 and a Swindells Family Scholar.

MalerieZambiaBecause my parents raised me to be goal-oriented, it did not surprise me when my dad asked me to write my goals for the next ten years when I was only nine. My goals focused on helping people and protecting the environment. Most importantly, I wanted to build and to run orphanages in Africa.

However, ten years later when I stepped off a plane in Zambia, Africa, I planned only to volunteer at a school for handicapped children. Although I did eventually help build a home for children, my time in Zambia made me realize that I could have a wider, more powerful impact on people in need if I would become a doctor.

I drew this conclusion early in my stay when I left my sheltered and guarded compound to experience life from the perspective of the local people. I witnessed child prostitution, malnourishment, disease, poverty and corruption; however, I also saw a beautiful and complex culture. I wanted to make a difference outside of my protected walls, so I traveled hours to visit an AIDS hospice for the dying and terminally ill.

Immediately, as I walked into the hospice, I smelled rotting bodies and saw skeletal bodies lying on mats screaming in pain. Although in shock and wanting to run away, I knew I had to remain calm and confident. Therefore, I spoke with the patients in what little of the local language I knew. They laughed at me because they were surprised and happy to see a foreigner trying to speak their language. Unknowingly, I had distracted them, for a short time, from their pain. It was the most horrific place I had been, but I realized that this is where I needed to spend my time in Zambia. As people brought their loved ones to the hospice in wheelbarrows, hoping to find them a comfortable place to die, I learned never to be fazed by a person’s physical state, but to greet him or her with compassion, to bathe and feed them, and to make their last days as comfortable as possible.

Read Malerie’s full essay on givainc.com and watch her talk from TEDxBend

Town Doctor

David Steinhardt, MS4

eastern-oregonThe road to the town where I did my rural clerkship travels east from Portland until you reach a sharp turn off Highway 84 that heads south. Soon after leaving the highway, you lose cellphone service and have to brave the rest of the route on your own. The hills are vast, beautiful, and seemingly endless, covered in green and yellow-shaded grass with scattered trees and occasional ponds sparkling in the sunlight. Compared to Portland, it feels like another planet, with wide-open space in every direction and far more cows than people. The town’s welcome sign sits in front of two large historic tractors, signaling arrival to a town that prides itself on working in the fields – growing wheat and raising cattle.

On the first morning of my rural clerkship, I felt like I had traveled back in time. The hospital was a single-hallway building consisting of an Emergency Department, ten hospital beds, and a nursing home facility all under one roof. The clinic was just up the road, allowing the doctors and staff to cover the ED, inpatient service, and clinic all at the same time. Immediately, I was struck by the friendliness of the nurses and the rest of the staff – the visiting medical student (me) was a familiar tradition, transitioning every 5 weeks from one of us to another, but they didn’t seem to mind the consistently rotating wheel of new faces.

That first morning, I rounded on an elderly gentleman who had suffered a devastating stroke two days prior, but had been started on steroid medication and his mental status was beginning to improve. We talked for a while that morning, and I learned that he was on hospice care, likely destined to spend the rest of his life in this small rural hospital. We parted ways that morning, and at that point he was simply a patient, similar to the patients I had met and treated at OHSU.

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Tomorrow’s lessons


Dear ——–,

You were my patient for four days. On the first day, we treated your many diseases. On the second day, we removed all but comfort measures. When I arrive at the hospital tomorrow, you will not be there. My boyfriend worries about me tonight, as you are my first patient to die. I am surprised to tell him that I feel only gratitude for you.

Thank you for being my first patient to die. Thank you for being old and frail. Thank you for displaying clearly and eloquently, despite an illness that has robbed you of speech, your desire to move on.  Thank you for smiling at me on day one, for asking my name, introducing yourself. Thank you for clutching my hand on days two, three and four when I came to wet your lips and ask you if you were in pain. Thank you for not being in too much pain. Thank you for having a caring family who loves you but does not depend upon you, who will have each other to share memories and grief on days five, six, seven.

I am so sad that you will die tonight. I am sad for your children, who have hovered around you over the past four days, and for your spouse, whom you cared for with love and kindness. I am so sad that we don’t get to unpack your ailments together, one by one, stating them in a problem list and labeling them – acute, worsening, improving, resolved. I don’t know how to write a discharge summary for you. I can’t discharge you from my mind: your kind eyes, your thin, frail skin, your erratic, persistent breath, your fervent dignity in the face of your body’s determined deterioration. Thank you for sharing this part of your life with me. Thank you for sharing your death with me. Thank you for your teachings over the past four days and for the lessons that await me tomorrow.  Thank you.

The Trouble With Girls and Women Scientists and Why We Won’t Just Stick to Shoe Shopping

Let’s be clear—the word “woman” is a noun. It is not an adjective.

And yet the inclusion of the word “woman” as an adjective, to subtly yet profoundly undermine the notion that women are capable, is everywhere. This prefix is not accidental, it’s diminutive, an inherent nod to the notion that women are somehow out of place in the sciences. The word “woman” as an adjective is used to suggest that there’s some kind of novelty to a female working as a professional scientist;  “Look at this woman scientist—she’s even wearing a lab coat! Isn’t she trying her best? Adorable!”

Take, for example, the comments made recently by Nobel laureate Tim Hunt. At the World Conference of Science Journalists in Seoul, South Korea, Hunt described the trouble with girls: “Let me tell you about my trouble with girls … three things happen when they are in the lab … You fall in love with them, they fall in love with you and when you criticize them, they cry” (You can read more about his comments at The Guardian).

I’ll be honest you guys….I’ve cried in lab. A little saline never hurt a tissue sample, right? I just don’t understand how a NOBEL LAUREATE could think that the experiences he’s had with a few women in his laboratory could ever possibly be extrapolated and applied to ALL women?

In 2013 Fang, Bennet, and Cassadevall published a study in which they analyzed the 228 instances of scientific misconduct reported to the Office of Research Integrity and found that over two thirds of the cases involving fraud were committed by men, a number that “exceeds the overall proportion of males among life science trainees and faculty.” But who is talking about that? Where is the female Nobel Laureate condemning men at scientific conferences, decrying their role in labs; “Good point, Hunt, you really got me there. I was just about to kiss you and cry, but I thought I’d make this counterpoint first; the trouble with boys in lab is that they lie and make up data and ruin their careers and yours in the process. I’d love to hire more men, but you just can’t trust ’em. Plus they’re so tantalizing. Does anyone have brownies?”

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A Plan with Not Quite Enough Time

Lumbad-student-speak-banner“Patient is a 26 y/o otherwise healthy, devastatingly handsome male with a history of PSVT. He presents to the ED with three ex-EMS personnel all equipped in softball attire. Patient states that he’s had 4-5 episodes of heart palpitations for the past hour. He’s attempted valsalva maneuvers with some success, but cannot ‘get out of this one.’ Patient reports lightheadedness and tunnel vision. He relates paresthesias and hypothermia of all four extremities and says ‘walking feels like there’s cement in my shoes.’ He denies chest pain but confirms precordial numbness. On physical exam he’s alert, oriented, and does not display any speech deficits. He’s hypotensive at 88/46 right arm supine and O2 sat at 93%. A 12-lead ECG reveals a regular, narrow complex tachycardia at 180 bpm without visible p-waves. ECG is negative for T-wave inversion, ST elevation and Q-waves. Delta waves also absent…”

In light of my recent trip to the ED, I was reminded exactly how impressed I should be with the human heart. In my chest there it is lubbing and dubbing – autonomically, instinctively, protectively. Normally, I don’t have to tell it when or how hard to beat. But rather, it tells me two things: 1) “you’re alive” and 2) “dude, you’re out of shape” when I take the stairs from the first to fifth floor in the CLSB. When we moved into this spaceship of a building last June, I would have been completely lost in the medical jargon the ER attending and resident were throwing around me during my ED visit. Now, my classmates and I are running the final lap of the didactic 4-minute mile with just over a week to go. We’ve covered the human body from head-to-toe, from preconception to old age and back over again. We ran ACLS megacodes for when a patient’s life is at stake, and this week we focus on how to intervene and prolong life in the O.R. The amount of information that has been crammed into our brains and regurgitated to our professors, clinician mentors and patients is mind-numbing and down right impressive.

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Veterans Affairs Nursing Academic Partnership (VANAP)

StudentSpeak is pleased to present this guest post by Jason Warren. Jason is a Senior Nursing student at OHSU and Student Nurse Technician (SNT) at the VA Portland Health Care System. Jason will be spending his senior year at the Portland VA ICU for his Integrative Practicum. In his free time, he enjoys rock climbing and bouldering, disc golf, and playing guitar.


Prior to starting my first term of nursing school at OHSU, I had the opportunity along with sixteen other students to join a new program focused on preparing future nurses to care for the complex needs of our veterans. Students do not have to be a veteran or have any connection to the military to be a part of this program, just the desire to work with veterans. However, the Veteran Affairs Nursing Academic Partnership (VANAP) appealed to me because I have veteran family members and a family member in active duty.

Almost two years after I signed up for VANAP, I can say that the experience has been truly amazing. My clinical experience has been nothing but positive. I have had the privileged to learn from RNs at the Portland VA on 8D (Acute 1 & 2), the Vancouver VA’s Community Living Center (Chronic 1 & 2), and most recently the Veteran’s Recovery House (a residential rehabilitation treatment program for alcohol and substance abuse) in Vancouver, WA.

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The Best is Yet to Come, Part II: Reflections on Graduate School

StudentSpeak is pleased to share this guest post from Kelly Chacón, who graduates June 5 with her doctorate in Biochemistry and Molecular Biology.

For Part I of Kelly’s post, click here.

Finally my fifth year arrived. I was ready to finish, even if I wasn’t actually ready to finish. My third paper was published, which is the deal we make for graduation in my lab. And I was accepted to give a little “data blitz” at my sub-field’s main scientific conference. A key professor saw me give that 5-minute, ridiculous presentation (I’m sure 3MT’ers can relate), and invited me to give a real talk at another conference. That was terrifying, and awesome, and I accidentally switched the U and the L in the word “results” on my slide.

I’ll let you spell that out.

I only mention those talks because they led to something unexpected. At that conference, I invited a professor to give a joint seminar for OHSU and Portland State (my alma mater). While having a beer with the speaker after their seminar, a friend alerted me to an open assistant professor position in chemistry at Reed College, here in Portland. Reed?! That’s my dream job! But I’m sure it’s too soon. Nevertheless, I decided to send in an agonized-over cover letter, if only to develop some resilience to being rejected. It turned out that Reed and I were actually soul mates. After three months and a long interview process, I was offered the job! And all because of a 5-minute data blitz.

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The Best is Yet to Come: Reflections on Graduate School

StudentSpeak is pleased to share this guest post from Kelly Chacón, who graduates June 5 with her doctorate in Biochemistry and Molecular Biology.

Sometimes I like to tell people that graduate school is a lot like marriage, but to a place and people that you love, but aren’t, like, in love with.

This feeling about grad school has only sharpened now that I am a newly-minted Ph.D. (well, so long as I get my butt in gear and incorporate the pile of edits my thesis committee has requested). Anyway, I find myself waxing nostalgic about my experiences of the past five years…to a point. So here, in these two posts, I will try to summarize the insanity of my time as doctoral candidate as well as some of the highlights along the way. Brace yourselves, because it will be a lot like an episode of M*A*S*H* – one part maudlin, and one part irreverent…and completely fueled by gin.*

Let’s see…years one and two: Instantaneously gaining 10 pounds (still with me three years later), overwhelming imposter syndrome, fleeting – false – moments of feeling smart, and overall indignation at the way I had only gone from being an “undergraduate baby” in the eyes of the world to “graduate baby.” Arrrrgh I’m 29 years old for crying out loud, I’m not a baby anymore! JUST FORGET IT I’LL BE IN MY ROOM WITH MY SMITHS ALBUMS, OK?!

Good times! No, but seriously – at least I was in grad school, actually getting paid to do science in a nice university and with a pretty cool mentor, too.

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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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