Friday, November 28, 2008

What Do You Do, Exactly??

I get asked this question all the time: "Hovig, what exactly is it that you do in your 'rotations'?"

An excellent question for an outside observer. Here is the quick answer: as a medical student, a whole lot and a whole lotta nothing all at the same time. Sure, I see patients all day, interview them, get their story on paper, check all their vitals and do a physical exam, give shots if needed, then report all this to the Doctor. In this sense, I do quite a bit throughout the day.

But in reality, I don't do anything - everything I do is determined by the Doctor. I don't make any decisions - just carry them out! In this sense, my brain isn't all that tired by the end of the day because I don't really have to come up with the correct diagnosis, proper treatment regimen and worry if I got it all right.

Of course, what we actually do as students can still be quite taxing. And for a GREAT and hilarious run down with lots of specifics, I suggest you check out my friend Nareg's posting on the subject by clicking here. It pretty much captures what we "do" during the day. The only difference between him and me: I don't drink coffee - at all. The man goes through jugs of it. I don't touch it. Other than that, I have all the same books (since I'm in Family Medicine right now and he is actually in Internal Medicine, he told me the books I should get before I do Internal, hence, we have the same books!) Enjoy the read!

Thursday, November 27, 2008

Happy Thanksgiving!

Incredible amounts to be thankful for - more than is ever possible to state here without forgetting things. Therefore, permit me a blanket statement: Thank you Lord for all the wonderful blessing in my life - my family, friends, health, schooling opportunities, and ability to connect with those in need.

I hope you all have a very wonderful Thanksgiving day, whether spent with family, friends or "other" - may you have a blessed day.

Friday, November 21, 2008

Did You Know!

It has been a while since the Did You Know segment has made an appearance on my blog and some of you have complained about this. I apologize - chalk it up to being distracted by so many other things in New York! :)

Today's Did You Know is actually a very simple one, but so extremely important. I am currently doing my Family Medicine rotation and have found that the majority (not all, but majority) of patient cases revolve around diabetes, hypertension, hyperlipidemia, general aches and pains, run of the mill colds/fevers, and stomach aches.

Therefore, DID YOU KNOW that if you lose just 10% of your current weight (if you are overweight, which I definitely am and many Americans seem to be as well) you can significantly reduce your risk of hypertension and all the terrible risks associated with that (most significantly, a heart attack!) So, I'm issuing a weight loss challenge to all of us. I need to lose about 40 pounds (especially because my insurance, I just found out, upped the price of my insurance by 25% because I'm considered high risk due to my weight!!!!!). I know that there are others of us who read the blog who need to lose weight, so let's all support each other. We will be each other's cheer leaders and motivation.

As a first step, I am now officially signed up at my new gym here in NYC, I got a great deal on some starter trainer packages, and I'm ready to return to a healthy weight. Just remember - it is not just about the weight NUMBER - this is a lifestyle decision to eat and live healthier. God calls upon us to take care of our bodies - it is our temple and a gift from Him. So, here goes!


NY Sites - The NY Public Library

Most of my free time I spend exploring this absolutely amazing city. It is so exciting and full of energy that I just can't justify spending time at home when I could be outside walking around. You never know when you are going to find something super cool in a nook or cranny of the city!

Therefore, I'm starting a new segment in my blog entitled "NY Sites" where I will chronicle some of the cool places I have had the honor of visiting.

The first site to be chronicled is the NY Public Library located in midtown, near Times Square and Bryant Park. This library is IMMENSE. The actual historic building, from what I could tell, seems to mostly hold exhibits and an absolutely GRAND reading room (see the pic - I couldn't even capture the rows and rows of tables to study at!) The majority of the stacks are located in a separate building located across the street. As you walk up the stairs to the main entrance, the sheer size of the building grabs your attention. NY takes its library seriously! There is an exhibit about the history of the building that I perused and found interesting, but not interesting enough to devote precious brain space away from remembering what blood pressure number is considered borderline versus hypertensive versus hecka serious (obviously not the scientific term).

Every corner of the library is grand and displays the grandeur for which NY is often known. It truly is a great place to spend an hour in if you are just perusing, or the whole day in if you are actually studying. And the best part is that there isn't a deafening silence in the place - there is some mild and quiet noise to keep your eardrums fascinated even as your eyes take in the statues and paintings and enormity of the place. Definitely a must see!

UPDATE: One of my very good friends here in NYC from med school shared this extra tidbit of library trivia in the comments section: The names of the marble lions that guard the entrance-way are Patience (south) and Fortitude (north). They were named by Mayor LaGuardia during the Great Depression, signifying virtues he believed New Yorkers would need in order to weather the economic storm of the time. Thank you to my friend for sharing this!

Next to be chronicled: Stay tuned to see some paintings from Van Gogh that are on display at the Museum of Modern Art in NY. This includes my favorite, the Starry Night!

Saturday, November 15, 2008

The Kindness of New Yorkers

New Yorkers get a pretty hard rap from just about everyone else in the country. Sure, there are those who are gruff and difficult to deal with. And yes, some times there are occurrences that would be shrugged off elsewhere, especially California, that turn into full-blown shouting matches here in NYC. And YES, there are moments when people mow you down as you pass them.

But hear me out: the SUBWAY, of all places, has displayed some of the outright kindness and generosity of New Yorkers. One example happened to me. A few years ago, I came up with the bright idea to use the subway to get to the airport...despite having two big bags, a roller carry-on, a back pack and a smaller carry-on. YES I KNOW - DUMB! I realized just how dumb when I got to the first staircase and looked with horror at all the steps rising above me. But, every single time, a perfect stranger would pick up one of the big bags and just take it up the steps. They would not look back for a thank you (which would be the understatement of the moment). They would just do it, almost intuitively, knowing that this city is a hard place for all of us to live in, so doing their little part to make it just a little nicer. It was like God sent an angel down at the moment to help me.

There are other examples:
1. Last week, an elderly gentleman was struggling to get up the stairs because the elevator was broken. Two young men who some might have considered trouble by what they were wearing, stood on either side of him and short of lifting him up, basically lifted him up and to the street.

2. Two weeks ago, a young man who was leaving the train at the same exit as me, noticed an elderly lady digging for her metro pass. She couldn't find it the whole time we were climbing the stairs. So, when we got to the turnstyle, the young man just offered to swipe his own card for the lady. She said she wouldn't accept unless he took the $2 fare. He refused, swiped his card and said it was too late, then started walking away. She yelled thank you after him, he smiled, waved his hand, and that was it.

3. Directions - this one is a pretty constant observation. If you ever look confused at a station, especially bigger ones that cater to tourists regularly, count on a local noticing you from a mile away, coming over and offering help/directions/whatever you need to be on your way. It will blow your mind because it is so unexpected. And for those of us who shy away from asking for help or directions, it is again a Godsend.

I'm sure during the rest of my time in NYC, I will see many more examples of the kindness of New Yorkers. I look forward to sharing them with you all as they happen. In the meantime, remember that Thanksgiving is fast approaching, so stock your fridge now and get the best and biggest Turkeys!!

Friday, November 14, 2008

Week 1 of Family Medicine: Done

Well, the first week of my Family Medicine rotation is now complete. I am fortunate to be at a Spanish speaking practice, therefore I'm definitely learning a lot of terms used by patients to describe their pains and troubles - skills that will definitely come in handy when I return to California to start a practice myself!

Some highlights:
1. Most family practice visits are due to things like hypertension (high blood pressure), hyperlipidemia / high cholesterol, general aches and pains, and physicals / well visits.

2. The Doctor is a SUPER nice dude. He graduated from the medical school in Guadalajara, Mexico and is extremely kind and helpful. But the man WORKS us. We are there from 10am until 6 or even 730pm! Quite a long day for a student - because we are expected to go home and study!

3. The cool thing about Family Practice is that there are pediatric patients as well. And I am discovering that nothing makes me happier than a child who smiles at you when you engage them in discussion and work to make their visit as pleasant as possible. Every time a Peds case comes in, I try to snag that folder so I can work with them.

4. Middle aged women love my smile...and do NOT shy away from letting me know. Well, middle aged AND older patients...but females only. I have gotten complimented at least once each day I have been there. It does help the ego.

5. Running a solo practice is difficult - the Doctor was telling us that he barely makes ends meat after expenses. It is safer to enter an established group, like Kaiser, where all expenses are taken care of. HOWEVER, although riskier, opening up your own practice can be more lucrative and more rewarding in some ways. So, he was explaining to us you have to decide - more risk with the potential for more reward or stability with shift work.

On the whole, I am just excited to finally be seeing patients. I am a bit disappointed in how little team work exists in our profession. I know some of you who read this are Ross Med School students - and I love you, but some of your colleagues are just plain rude, unprofessional, and unpleasant to be around. In fact, they are downright nasty and intolerable. But that's ok, because every interaction teaches me something and helps me become a better and stronger person and doctor.

Thursday, November 6, 2008

Yes We Can


  • be a nation that dreams big and gives the opportunity to all to accomplish those dreams.
  • be a nation that can look into the face of every child and truly say "Yes, you can do whatever you put your mind to!"
  • be proud that a white boy from California had the amazing opportunity to serve beautiful children in Baltimore City and help them dream big...because we learned on Tuesday night that the "DREAM BIG" ideas he always espoused in his classroom can come true.
  • VOTE FOR CHANGE and a new direction.
  • demand from our nation's leaders that they do better without fear of being killed as in other nations.
  • be so excited that we live in the greatest nation in the world. In every way, America is such an awesome place - we are all so blessed and regardless of our political leanings, we should wake up every morning with such thanks in our heart to the Lord for allowing us to be born and/or live in America.
I have had trouble trying to figure out how to truly capture such an historic moment in our nation's history as this. I know many of you who read this are thinking politically and disagree with me - but please, if you can for a moment, switch your view and picture the hundreds of students who used to stare back at me. Some had already lost hope at the age of 13. Others had in their minds already that the color of their skin (all my students were African-American) would absolutely prevent them from achieving great things - or any thing of significance. And while I can't and won't make excuses for some of the behavior I used to see, I know in my heart of hearts that at least one of my students remembered me on Tuesday night and remembered what I always used to say - that "as a black lady or gentleman, you can't just be good, you have to be the best...And you can't just dream small dreams, you have to shoot for the moon!"

While the nation celebrates a national historical day, I celebrate small victories for when I was a teacher in a classroom with amazing kids who now can see somebody like them - who isn't just good, but he is the best. He didn't just dream small dreams, but he shot for the moon and made it.


Saturday, November 1, 2008

Quick Updates

1. I will be hopefully moving into my apartment tomorrow (Sunday). Latest is Monday. They are replacing the carpeting in my bedroom and finishing redoing the sheet rock and paint on the walls. The place is awesome. And it is only about five blocks away from the hospital or the train or, most importantly, a Target!

2. I love the subways in NYC. I can get anywhere, anytime without worrying. I love it. Granted, on weekends and late nights, all bets are off about how long it will take to get to a destination. But during the week, the MTA has got your covered. Now if there was only an efficient train to get your from Brooklyn to Queens. As it stands, you must go through Manhattan because all trains are basically oriented to get people into the city.

3. I love going to St. Vartan Cathedral in Manhattan. It is a bit sad that there are not many parishioners, since most Armenians no longer live in the area. But alas, the Church stands as a beautiful testament to our faith as Armenians and our struggle to make the Church relevant to our daily lives.

4. I have been able to see SOOOO many old friends! From Fresno, from my days teaching in Baltimore City, and from med school in St. Martin. I also plan on seeing some of my friends who found me on Facebook that I went to school with back in 2nd grade in NYC. Amazing!

5. I found out about two weeks ago that the California Commission on Teacher Credentialing had denied my application for a credential because my letter of recommendation was from an Assistant Principal instead of HR, stating that I had worked competently for two years. Apparently, the letter must be from HR. I told the Commission that they would be waiting for around 2.8 years before they ever got a call returned from BCPSS. Well, alas, it sure doesn't matter anymore at this point, as I continue my studies - but it was sure looking critical a few weeks ago before I found out my exam results!

6. I finished my first week of a two week rotation in Radiology. My schedule in a typical day went like this:
6am: Wake up and get ready
7am: Leave the house and take subway
815am: Arrive to hospital
815-845am: Eat breakfast in cafeteria
9am: Check in for rotation and find a Doctor willing to accept students, but not already filled with 10 or more of them.
1030 or 1130am: Doctor says "that's enough for today, have a great day!" and dismisses

In other words, most days my commute time took longer than the actual teaching time. I'm learning quite quickly that the current system of teaching and education of Doctors in America is quite flawed and lacking in substance. No wonder that although we are one of the three true "professions" in society, meaning we should be allowed to self-govern, other segments of society (like politicians) are demanding more and more oversight. And why shouldn't they - in a field that absolutely demands sharing of resources and teaching younger Docs, we see minimal, if any, quality teaching. Sad.

7. To end on a happy note, HAPPY HALLOWEEN! My first Halloween in NYC (as an adult) went by with tons of fun. We saw a parade of various costumes, some very creative, and just had a jolly time together enjoying NYC.

8. One more thing: I love the subways in NYC!!!!!