Up a Wall Without a Paddle… Or Something Like That

I’m not crazy, but people have given me looks that suggest otherwise. These situations usually occur after I’ve mentioned I’m a graduate student. The probability of receiving the “look” increases when I say I’m in the Behavioral Neuroscience program, and it increases further when I explain that it will take 5-7 years to graduate. When I explain a post-doctoral fellowship is routine, the look is a near certainty.

“Well, you’ll be able to help diagnose my migraines then” was one well-intentioned response.

Cue head banging against the wall.

Sometimes though, I think they might be on to something. Or prolonged periods spent in a dark room talking to rodents is doing funny things to me. Because why else am I still excited to be on this career path? It’s not the promise of riches, I can tell you that much. Mention the current funding situation in a room filled with graduate students, and you’ll wonder how a collective sigh could contain so much angst.

During my last break, I completed a 10 mile long obstacle course (Note: This has been another occasion for which my sanity has been questioned.) One of the hardest obstacles for me during the course was a curved wall participants run up. Think Ninja Warrior if you’re familiar with it. The first time I tried running up it, I wasn’t even close. It eventually took me 4 tries, 1 pep talk from a kind stranger, and 2 fellow participants pulling me up to get me on the top of that thing, after which I enjoyed a brief moment of pride. Then, I realized I needed to get down quickly because heights aren’t my thing.

Thus, I present to you my metaphor for this post:  Graduate school is a 10 mile obstacle course.

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Nursing School Here I Come!

I realize I’ve come into my blog writing experience half-way through my 5-term nursing program, so I’ll try to backdate a bit to take you through the whole journey.

After being accepted into OHSU’s School of Nursing, the excitement of making it in gradually turned into the overwhelming feeling of “what did I get myself into!” After all, I had been out of college for 12 years so how was I going to adjust to becoming a full-time student? My wife and I had always joked that there was no way we could have ever been married while I was in school (I had a seat in the library with my name on it back then); this joke became even more funny with the addition of 5 kids to our family – school – yeah right!! I guess we should never laugh about things we say we’d never do!

Nevertheless, after many accommodations, plans and sacrifices in our family’s crazy schedule of work days, appointments and outings we made it work, and there I was on the first day of school.  I was quite excited to find a class with people of varied backgrounds and ages from many different walks of life (several also with kids), and I immediately felt at home.  In addition to my classmates (who quickly become great friends), the faculty was warm and welcoming and most importantly ready to help us make our way through the program.  It seemed last fall that photos were all over social media of happy (or sad) little children holding signs up saying “first day of kindergarten,” well I guess I got my own sign – First Day of Nursing School!

 

Null Data, or What It Isn’t

Fourth year. It means different things to different people. Sometimes it means the end is in sight, you have a paper out and next year you will graduate. Sometimes it means that the end was in sight, but it has relocated somewhere on the map, you can’t find it, and you’ve stumbled into a very dark cavern where the walls are getting closer and closer as you move forward. And sometimes it just means you are chugging forward, sometimes running, sometimes sprinting, sometimes taking a water break. There is no universal experience for fourth year of graduate school. Heck, there’s no universal experience for graduate school, period.

My fourth year has been full. Our lab changed buildings. I am more involved with the Graduate Student Organization this year. Vikings killed off my favorite character (RIP Aethelstan). Carey Elwes (aka Dread Pirate Roberts  for you Princess Bride aficionados) told me my name is beautiful (EEK!!!!!!!!). And the real kicker – I have spent most of the year with a gluttony of null data. What is null data, you ask? Null data is data that isn’t. It is data that tells you what your answer is not. It is the exact opposite of telling you what your answer is. Is it valuable? Is it garbage? The debate is fierce, and off-hand remarks about it can leave a graduate student scorched, like a thatched roof house after a viking raid.

Here’s a fun fact. If you look null up on Urban Dictionary, you get the following definition: NULL – n., adj. – signifying the absence of data. Things such as character strings and various types of numeric values can be described as “NULL” when they contain no data. (shadow:light::NULL:data).

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Health Care Equity Week 2015

 

Note: If you’d like to get involved with HCEW, please contact Taryn Hansen (cansler@ohsu.edu)

First and second year medical students spend a lot of time in classrooms. Despite electives, preceptor experiences and volunteer commitments outside of schoolwork, most of us spend more time than we would like listening to lectures, studying and proving our knowledge on standardized tests. During Health Care Equity Week (April 20 – 26), students from various disciplines are attempting to extend our classroom walls. During the week, we will have various lunchtime talks from local experts in healthcare disparities and efforts to provide affordable, quality healthcare for all. On Sunday, April 26, medical, dental, nursing and pharmacy students will set up camp in a parking garage in Bryant Park to provide health care for Portland’s homeless, hurting and underserved population.

One day of foot cleaning, blood pressure screenings and ten-minute doctor’s visits will not fix many problems, but we are optimistic that we can raise public awareness of health disparities, raise our own awareness and provide some much-needed services. We are studying medicine in the context of significant changes to our health care system, but it is important for us to remember, and see, those whose situations will not change through the Affordable Care Act – those who are still vulnerable due to their living situation, immigration status or reticence to engage in the traditional health care system.

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I Am Bad at Science

 

This was the conclusion I reached on Friday. What else could explain the fact that my previous experiment, after months of work, did not work, and my current experiment, designed to salvage that last project, is also not working? It had to be me. It is me.  I’m bad at science. There’s no other explanation.

I told this to my PI in his office at 8:30 that morning while we perused my data, my excel spreadsheet stretched to fill his entire monitor. “Well, you know,” he said leaning toward the computer, “I’m not at all convinced there’s a null effect here—”

“I’m bad at the surgeries!” I blurted out before he could finish, hoping to convince him of my ineptitude. “That’s what it is, I guess…I’m just bad at the surgeries.” His eyes narrowed and he tilted his head and told me, “I think you’re taking this too personally.”

And he was right. Of course he was right. But how do we not take these things personally when they feel so personal? How do you separate yourself from the quality of your ideas when the ability of those ideas to produce sexy, significant data is what will propel you forward? How do you “turn it off” when you’re in a career where advancing relies on your ability to quickly and routinely demonstrate that you are “good enough?” Honestly, I don’t know.

I think, like most things in life, it’s about your frame of mind. In the end, it always seems to come down to perspective. When things go wrong you can stew in the failure, or you can rise to the challenge of getting it right. For me, the difference between those two states of mind relies heavily on whether or not I’ve had lunch yet and how many of my coworkers tell me to stop moping.

So maybe I’m not bad at science. Maybe I’m just….a little sensitive. But it was the end of the week, and nothing was working, and I had just filed my taxes – the trifecta – and I just needed to let it out.

On being a medical student – and a human being

StudentSpeak is pleased to present this guest post by Sophia “Sophie” Davis, MS1. Sophie is a first-year medical student in the OHSU School of Medicine’s YOUR M.D. curriculum. She is also participating in the American Medical Association meeting at OHSU April 13-14 to share innovative ideas on transforming medical education.

For a moment, my attention was drawn away from the patient and towards the exchanges between attending and resident physicians—the transfer of surgical instruments, hushed instructions, and steadying assurances. The hand in mine tightened and pulled my body closer to the operating table. “Please, keep talking to me.” It was the dark vulnerability of fear in her eyes that broke me, dissolved my desire to join the two physicians at the foot of the table.

And so I held her hand—just slightly smaller than mine—and was drawn fully into the realm of the patient. I was absorbed with the task of monitoring every flicker of expression on her face. The moment we would stop talking, her body would tighten. When the procedure was finished, she let go of my hand and thanked me, adding that she could not have faced the experience without my company. What she could not have known was the flood of gratitude that I felt towards her. It is a rare privilege to be welcomed and needed by another person in a moment of vulnerability. The explicit trust and expression of human connection were exceptional gifts.

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Students Teaching Students: Passion, Collaboration, Innovation

“Students Teaching Students: Passion, Collaboration, Innovation” originally appeared on the blog, Wing of Zock.

Larissa Guran wrote last month about our “Leadership, Education, and Structural Competency” course at OHSU, and I would like to add to her thoughts. As a reminder, we developed the course to learn facilitative leadership skills, strengthen our understanding of social determinants of health, and develop and facilitate five small-group sessions about structural competency for the new MS1 curriculum. After a session on implicit bias, we introduced the concept of taking an “Affective Time Out” to reflect on the emotional, mental, and intellectual preconceptions we bring to each patient encounter. As we approach our final MS1 session, I wanted to take my own “time out” of sorts and reflect on this experience.

Here’s what I’ve learned:

Collaborative learning works if it’s authentic and student-driven. For this class, three to four students developed the curriculum for each MS1 session, and we workshopped each session for over two hours as a large group. I learned how best to engage with my peers on sensitive issues; for example, we had a somewhat tense discussion during one workshop after which a classmate provided candid feedback about my communication style and body language.

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“Is this the real Caesar’s Palace?” NAPNAP 2015 Annual Conference Las Vegas

This year I had the privilege to experience the 2015 Annual NAPNAP (National Association of Pediatric Nurse Practitioners) Conference in Las Vegas! This was my first exposure to a professional conference for PNPs. I was lucky to have two of my PNP instructors in attendance so I was not completely lost. As I arrived Tuesday night at Caesars Palace, I was already overwhelmed. I was trying to figure out how I was going to experience everything the conference had to offer as well as study for finals (scheduled the Monday after I returned). My journey started on a high note with an upgrade to a spa suite for one night because the hotel was overbooked. After fully enjoying the suite and getting a good night sleep, I was ready for the conference opening session Wednesday morning.

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Interprofessionalism Outside of the Classroom

StudentSpeak is pleased to welcome this guest post from Kelsey Priest, MPH, MS1 (M.D./Ph.D. candidate). Kelsey is the West Coast Regional Leader for the Institute for Healthcare Improvement Open School.

Interprofessionalism. What does it mean? Why is it important? What does it look like? As health professions students of the twenty-first century, we are learning and exploring the answers to these questions in our newly founded interprofessional education curriculum.

I sought out interprofessional extra-curricular activities prior to starting medical school while I was a first-year public health student at Portland State University (PSU). Upon taking my first course in continual health care improvement, I was inspired because of the power of teams and quality improvement methodology to rapidly improve care at both the individual and population level. This inspiration and interest was also connected to my own interprofessional training ambitions (public health and medicine). Since that time, through leadership opportunities with the Institute for Healthcare Improvement (IHI) Open School I have worked interprofessionally with exceptional learners and faculty across disciplines, institutions, and a wide variety of experiences and talents. Learning and working together around concepts of quality and population health improvement we have created and contributed to small-scale projects to improve health in our local communities.

One of our recent projects for this academic year is the creation of a large-scale interprofessional learning event for students across the IHI Open School West Coast Region. This conference, the West Coast Regional Conference, is the first of its kind and will host 200 interprofessional local and regional students on April 17-18, 2015.

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Instituting “Affective Time Outs”

StudentSpeak is pleased to present this guest post by Larissa Guran, MPH, MS2. Instituting “Affective Time Outs” originally appeared on the blog, Wing of Zock

This year, Oregon Health & Science University rolled out a new medical school curriculum for incoming first year students. YOUR MD is an innovative program, with a completely new schedule and focus; it is replacing the current curriculum, which is retiring after it serves my classmates and me. This is an exciting time to be a student at OHSU, but one of the drawbacks of this transition year is the disconnect between first- and second-year students. Our school has a strong tradition of previous classes supporting and guiding new medical students through the overwhelming experience of the first year. From our Big/Little Sib program to the Sage Books of wisdom and advice passed down to the next class, we’ve worked hard as a class to stay connected to and supportive of the new students. One way we have done it is through an elective called “Leadership, Education, and Structural Competency.”

Through this class, a group of MS2s including myself are learning about structural competency and how to lead discussions, write lesson plans, and build collaborative learning experiences. After months of training and practice, we are leading several small-group sessions to discuss structural competency. This emerging concept in medical education builds medical student skills in dealing with patients’ social determinants of health. Social determinants (like socioeconomic status, built environment, education, and social support) are often considered a “can of worms” by many medical students. In this class, we learned that contextualizing care relative to these social determinants can significantly improve patient outcomes.

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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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