Wednesday, October 10, 2012

A Cloud's Silver Lining: How Depression May Help In the Long Ru

Depression is a debilitating disease that has cost our country billions of dollars and thousands of lives each year. However, despite the debilitating problems that mentally stressed and depressed people face, there is growing evidence that those persons may possess qualities that make them better leaders in times of crisis than “normal” people.

Nassir Ghaemi explains why in his novel, A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness. Dr. Ghaemi, a professor of Psychiatry at Tufts University School of Medicine, has studied the mental health of famous leaders including Winston Churchill, Martin Luther King, Jr. and Abraham Lincoln. Do some qualities of depressed or mentally distressed persons bestow good leadership skills?




Dr. Ghaemi says yes – especially in times of war or social oppression. "Depression makes leaders more realistic and empathetic," whereas non-depressed people, while they make great leaders in normal times, may be held back in times of crisis by what psychologists call “positive illusion,” a mildly high self-regard or a “slightly inflated sense of how much they control the world around them.”

Ghaemi suggests that this connection can be explained by the depressive realism hypothesis. This theory argues that "[depressed people] are depressed because they see reality more clearly than other people do." This may explain why one study showed that persons with a history of depressive symptoms usually score higher on tests for standard measures of empathy than a non-depressed cohort of college students. “This was the case even when patients were not currently depressed but had experienced depression in the past,” Ghaemi writes. “Depression seems to prepare the mind for a long-term habit of appreciating others' point of view.”

For example, social leaders like Mohandas Gandhi and Martin Luther King, Jr., who both are known for their overwhelming empathy in leadership, also battled depression. King had made at least two suicide attempts in his youth. As he became a social icon in the 1950s and ‘60s, his colleagues noticed periods of underlying psychological distress that Ghaemi later described to be “clinical depression.”

However, King’s depression may have been the key to his development of a radically empathetic strategy to achieving social change. He often taught his followers to approach their oppressors as psychiatrists approach their patients. They were suffering from racism, which King described as a psychiatric disease that should be treated using nonviolent methods – similar to the treatment tactics of a psychiatrist. This is one of the many examples of a leader using empathy in creative ways that can drive a population through troubled waters.

In addition to higher levels of empathy and realism, some professionals believe that the effects of treating depression with psychotherapy may also bestow benefits that non-depressed people often don’t access: self-knowledge. In her Healthy Minds blog, Dr. Gina Newsome Duncan, Associate Professor of Psychiatry at Georgia Health Sciences University, believes one crucial characteristic of mental health involves knowing oneself and being self-aware. She often tells her depressed or anxious patients that “they are in a position to be some of the most mentally healthy people around, because their illness has forced them to grapple with unhealthy patterns and learn new skills to cope with the stresses of everyday life.” This shows the importance of seeking professional help when one is suffering psychologically. It can save a life.

Though these qualities may give depression an upside, I don't want to misrepresent the suffering and pain that those with depression experience. If left untreated, depression can put a person on a slippery slope. "Suicidal thoughts occur in about half of clinical depressive episodes," writes Ghaemi. Ten percent of people with depression take their own lives. "The benefits of depression come at a painful, if not deadly price."

Sunday, September 23, 2012

Interview Day For Smarties: What To Expect

It's that time of year again: medical school interview time.

Every year a group of lucky medical school applicants are invited to their dream (or safety) schools to demonstrate how qualified they are. I had to do it, so do you.

When I was applying for medical school in 2008, I concurrently worked as a career adviser who gave mock interviews to other students--- some of whom were applying to my application cycle. It was an interesting (and slightly awkward) time. However, despite how stressful interviewing can be. Be sure it wont be like the interview below:

Now it's time I bestow a few interview tips to the next generation of applicants:
  • First of all, if you get an interview to medical school, consider yourself lucky. An interview is a very good indication that the school is seriously considering you as an applicant. 
  • Beyond academic excellence, however, medical schools are generally looking for maturity, passion about medicine, altruism, exposure to the medical field, and strong interpersonal skills.
  • For most schools, an interview day usually includes two or three interviews with a campus tour, information session, and possibly breakfast and/or lunch.
    • Make sure to treat the whole day as an "interview," as if you are being watched closely by everyone--- including the secretary. 
    • Try to avoid intimidation from other applicants. You will encounter the "what scores did you get?" guy and the "I interviewed in x y and z." girl.  Just focus on you and keep your head level. It never hurts to make friends as well.
    • Make friends with the secretaries. They can be your best friends. Strike a friendly conversation with them about the weather, where you're from, the latest celebrity gossip, etc. Not only will this give you good marks in the admissions office. It can distract you from your nervousness. I often made an effort to talk about Jennifer Aniston and Brad Pitt.
  • Do:
    • Read and populate SDN's Interview Feedback Page: A comprehensive list of school-specific interview experiences--- written by interviewees. It even includes sample school-specific questions.
    • Ask Smart Questions: Yes, the school wants to learn more about you, but you should use the opportunity to learn more about the school. Many interviewers judge your interest in their school by the quality of your questions. What's a smart question? A question that isn't easily answerable on the school's website. (i.e. Does your school's curriculum include LGBTQ issues?). I prepared

Monday, September 10, 2012

The Birthday Bike Ride of The Century

As a birthday gift to myself (my birthday is today), I decided to take on the NYC Century yesterday-- it's the cyclist's version of a marathon. 100 miles of pure bliss and blisters.


http://nyccentury.org/sites/all/themes/adaptivetheme/nyccentury_2012/css/images/century-logo.png
That day, we rode a total of 108 miles, which spanned four marvelous Burroughs of New York City: Manhattan, Brooklyn, Queens, and The Bronx. From start to finish, our total ride took 12 hours-- including time for breaks and hydration-- thanks to a two-bottle hydration belt (below) I wore that enabled me to go for long periods without stopping. We rode along the ocean, through various parks, and across concrete bridges.


Before the race, I told friends, coworkers, and colleagues about the century, and I got mixed reactions: "How is that possible?" "Good for you!" "Are you sure you want to do that?" "I couldn't possibly do that myself." "You must have huge legs!" They focused on the idea of riding such a great distance.

However, I prided myself on choosing a goal and sticking with it until the end. It all started in June. I had dinner with a friend from church to celebrate his buying a brand new bike, at which I near-jokingly suggested that we ride 100 miles. Neither of us had done something like this before. We were both trying to get back into shape and lose weight. When we found out about the Century Bike Tour, we set our goal.


Then we trained. and trained. and trained. During our first bike trip around Manhattan, we covered an astonishing 33 miles, followed by a 45-mile trip up to Mount Kisko the following week. Our group grew. Another guy used an iPhone app to track our mileage and speed. I bought my first pair of  bike shorts, which left a stark tan line on my thighs a few weeks before the race. During my lunch break, I sneaked over to the gym for afternoon spin classes to strengthen my legs and keep up my endurance. 

After months of prep, I made it across the finish line at 110th street and Lenox Avenue-- and I wasn't last!

It forces me to reflect on other goals in progress: losing 20 pounds by Christmas, reading 10 books before the New Year, become a doctor. Yes, that medical journey is still in progress and doesn't show signs of stopping. I intend to cross that finish line soon.

Friday, September 7, 2012

Memoirs of an Obese Physician

To my fellow medical students who are on the heavy side: ignore the haters.



Three years ago I took an online sexuality course with the American Medical Student Association. We broached the topic of body image. In our small group, one of my classmates, who attended a nearby medical school, vented about how other classmates looked down upon her because of her weight--- especially during lectures on diabetes or obesity. She would receive dirty or arrogant looks from her slimmer classmates.

As someone who has always struggled with weight and body image, it struck a chord. Medical students are trained to not tolerate those who happen to have a BMI greater than 25--- a sign that one is considered 'overweight' by medical standards.

I get it. We live in America. People here are fat--- or rather, huge. There are also countless studies that show how obesity can increase your risks deadly diseases like diabetes, hypertension, heart disease, cancer--- you name it.

However, does this give us the excuse to be such assholes? (Pardon my French)

Joseph F. Majdan, MD, a cardiologist at Jefferson Medical College, doesn't think so. In his Memoirs of an Obese Physician, he recounts the negative experiences that has continuously shattered his self-esteem throughout his career:


"I vividly recall that during medical school, a physician approached me as I stood with my tray in the cafeteria line. He said loudly for all to hear, 'You know you should watch what you eat. Don’t you see yourself?'"
"While putting on my scrubs during my surgery clerkship, an attending surgeon looked at me with disgust and sarcastically bellowed, “Hey, hey, hey, it’s Fat Albert!”
"During my internal medicine residency, staff physicians would often— unilaterally and in the presence of colleagues and nurses— offer me their unsolicited opinions on how and why I should lose weight. I wondered why physicians would be so insensitive and callous."
"A surgeon stopped me on the floors and told me I needed gastric bypass surgery; another internist sat down next to me at a nurses’ station and openly guessed my weight, then pontificated on what my approach to weight loss should be."
"A fellow cardiologist stopped me on the street to tell me I looked “disgusting” and asked whether I 'had no shame.'"

His memoirs, which was published in the Annals of Internal Medicine, revealed many doctors' perceptions of the obese: "ugly, weak-willed, sloppy, and lazy." However, this may not be the case.

A recent study published in the European Heart Journal discovered that obese persons who have an adequate level of physical fitness were "metabolically healthy" and had "no greater risk of developing or dying from cardiovascular disease or cancer than normal weight people."

In their study researchers measured height, weight, waist circumference, and body fat percentage on 43,265 obese participants. They also assessed physical fitness with a treadmill test. They initially found that nearly half, 43%, of individuals were already metabolically healthy according to the cardio exercise tests. After following them for several years, they found that these metabolically healthy obese people didn't develop the deadly diseases that the metabolically unhealthy participants developed.

Based on the study, Dr Francisco Ortega, PhD from the University of Grenada made these comments to Science Daily, "Physician[s] should take into consideration that not all obese people have the same prognosis. Physician could assess fitness, fatness and metabolic markers to do a better estimation of the risk of cardiovascular disease and cancer of obese patients. Our data support the idea that interventions might be more urgently needed in metabolically unhealthy and unfit obese people, since they are at a higher risk. This research highlights once again the important role of physical fitness as a health marker."

...so not only may some physicians' callous remarks and opinions about the overweight/obese be just plain rude, it may also be unfounded as well--- nearly half may be as healthy or healthier as you.


Hence, to my fellow medical students on the slim side: Don't be a hater.

Dire Apologies

It's been 759 days since my last post--- I can't believe it's been that long since my African road trip.


Since then: I've read many books (skimmed some of them), saw many patients, gained more friends (and lost some), shed many tears, had at least two breakdowns, and took a 18 month trial of antidepressants. 

But who said medical school was easy anyway? ... aside from the satirists and the compulsive liars, of course.

Now, I'm a different person--- wiser, braver, fatter, and more realistic than before. I look back on my eager first days of medical school with nostalgia and a twinge of embarrassment. I have finished my third year of medical school, and I'm closer to being a doctor than ever. However, I'm taking an "academic" leave of absence to take a job as a medical journalist--- to get away from the perils of school and develop my interest in writing.

I couldn't be happier with my decision; with no academic commitments and a full salary, it's nice to be a real person again.

Now, it's time to start where I've left off. I still want to build this blog into a good resource for medical students and pre-med students.

Sorry for the delay.

Click here for my brand new post--- I dare you.

Wednesday, August 11, 2010

Kisumu

Back to day 4 of my backpacking trip: Kisumu (point C, here), smaller than Nairobi, resides in the region where Barack Obama, Sr. grew up. Our bus left an hour late from Nairobi, but I was still able to arrive to Kisumu around 5pm – before dark. After I checked into the Sooper Hotel, I knew what I had to do: see the infamous great lake – the purpose of my entire trip. Fortunately, the hotel had a terrace at its roof. 38 steps later I was there – at least at one of its many bays.

I made it.

The lake and I needed to get more closely acquainted, so I immediately left the hotel and walked down Oginga Odinga road toward its end, where I found a shore-side car wash, a few fish restaurants, and the water of a lake fit for a queen – Queen Victoria. As I stood between the truck and the sedan and rinsed off my shoes with the murky water, this Great Lakes man had finally encountered the “other” great lake before the sun went down.

Tomorrow, during my less than 20-hour stay in Kisumu, I hope to take a boat tour of the lake before boarding a 12:30 bus to Kampala, Uganda. I also will be north of the Equator for the first time since June!

That initial view of the lake – one of many, hopefully – made my trip worthwhile. I can go home happy.

My flashlight saved my life.

The god of irony strikes again. I’ve been able to safely traverse Lake Victoria alone; however, the day I find my way back to familiar Moshi "home," a stranger almost attacks me on my first day back.

I went to my favorite internet café down the road to get more waffles and ice cream and skype a friend. As I waited for him to go online, it got dark, so I forfeited the skype and started my 20-minute solo journey back home down the rural, poorly lit Lima Road. I took one of those maglites to help guide my way.

Others were walking – a slight comfort. I noticed a white-shirted man walking behind me and allowed him to pass. As I kept watch, he turned down a side street and stopped. Pretending not to notice, I kept walking and soon found him jogging behind me. My light skin tone must've labeled me as a “rich” Mzungu (foreigner). I froze to let him run past, but he stopped beside me and asked something in Swahili.

“Si fahamu.” – I don’t understand – I replied as I increased my distance from this strange gentleman. He wouldn’t let up. I knew what was happening. It was dark. The road was empty. When he poked my left pocket, I had had enough.

“GET BACK!” I screamed multiple times as I charged him – maglite in hand. I took a few retaliation swings. They got harder. The man backed away. The screams got louder. He lifted his arms for self-protection. I could feel the adrenaline surging through my veins. Primal impulses returned after 2 million years of evolutionary dormancy. He realized my anger. I managed to strike his forearm before he ran in the opposite direction.

After checking the perimeter, I continued my journey– sweating and more freaked out than before. Though I was happy to be alone, I slightly regretted not pursuing this man and striking his head. At the moment, I was a Mzungu not to be reckoned with.

It was my fault, I shouldn’t have walked alone at night. I had learned my lesson.

As I write this, after four hours of cool down time, my nerves are still a tad shaky. Being a 6 foot tall half-black man from Detroit helped -- though I realize my luck. I tried to call someone to talk about it, but the connection was shaky, so now I write this to help process what happened.

Please don’t be freaked out by this post – I only have 3 days left here. I will post more updates on the backpack trip later.