Med School Musings

Drawing the Curtains

As we all enter residency, we are thinking of how we are going to be the best doctor we can be in our respective specialty. Regardless of the field we are going into, I believe we all have common goals: to be compassionate, patient-centered, culturally sensitive, and evidence-based. These are the qualities we will all be constantly working on throughout the rest of our careers. Despite these noble goals, I believe there is one topic incredibly important to medicine we neglect. That topic is death and dying. Thus while I will strive to achieve the common goals of being compassionate, etc., I hope to reach a point in my career as a physician where I truly understand and am sensitive to the matters of death and bereavement.

From the outsiders’ point of views, patients see physicians as people who are regularly in contact with death. Doctors give the prognosis of death, they announce the time of death, and they heartbreakingly relay the news to family and friends. Thus shouldn’t doctors be most comfortable with death? Shouldn’t physicians know how to deal with those who are grieving and those who are dying? Wrong. In fact, most doctors are extremely uncomfortable with death and are at lost on what to do to help patients through their dying processes or to console family members and friends.

“I had insinuated my hand into that mysterious nexus of stars and fate and destiny, and I had reduced that great passing of life into an arbitrarily calculated moment in time.” –Dr. Chen on the practice of announcing time of death.

Why do we suck at this? After dealing and being in the presence of death multiple times over years, physicians should have developed some sort of method to handle this heavy part of being in medicine. Unfortunately for most physicians, the method has been to become unfeeling, detached, or awkward.

Who can blame them? Dealing with death is hard. Hard does not even begin to describe it. Regardless of the Kubler-Ross stages we are taught, every person deals with death differently – every family does. The ways people approach death and grief depend on family dynamics, culture, personality, and past history. The process is not the same for any two people.

Many years ago in my death and dying class in undergrad, we had to pick a death/bereavement topic and write a paper on it. During that time, I had some recent developments in my life, and I saw my family go through a personal, heartbreaking loss and then something else I’ve never seen them go through before. I’ll spare the details, but the memories I have of those moments of black, white, kneeling, despair, and anger-anger-anger-anger drove me to look into how the Khmer Rouge affected modern-day Khmers’ grieving processes.

For context, my parents and their brothers and sisters fled Cambodia in the 70’s to America because of the Khmer Rouge. Cambodians went through a horrific, terrible time between the years of 1975-1979. The civil war/genocide was a nightmarish time of bodies left stranded on the roads, humans violently killed, and mass graves left to rot. By the end of the war, around one to two million people died; about 20% of Cambodia’s population. There was no way to bury a family member, and many surviving Cambodians were left not knowing where the bodies of their deceased family members were, and not knowing how to properly bury and grieve for them.

Grief was interrupted for many of them and left unresolved. Many never had any closure and many felt guilty over not being able to give their family members a proper burial. Then years later, the mannerisms of Cambodians changed; they became more secretive and closed off. Articles stated that as they became more closed off, Khmer families began to approach death with anger and resentment. It was a way of coping with grief adopted from the war where many blamed deaths on Pol Pot (the leader of the genocide).

What’s my point of bringing this up? Just to show that death and bereavement is complicated with each person.  Each human has a history that a doctor most likely won’t be aware of, and thus there is already a lack of understanding from the start. It’s a puzzle, a never ending dark maze that physicians get dropped into – they don’t know the beginning or the end.

So how do we, as future doctors, act in these situations? How do we make our patients the most comfortable when they are in a painful area no human should be at?

There is no right answer.

But there are some good answers.

The quote I used above is from one of my favorite books called Final Exam: A Surgeon’s Reflections on Mortality by Pauline W. Chen. As a brilliant, compassionate transplant surgeon, Dr. Chen reflects on her experiences and from them, I take away many messages but one story stands out particularly to me.

While still a resident, Dr. Chen said that she usually found herself pulling away during the last minutes of a patient’s life, making herself busy while waiting for her patient to die all the while watching family members move in and out of the rooms with teary faces and bunched up tissues. One night, however, as she left the room again of another dying patient, she watched as her attending resident drew the curtains around himself and the wife and the dying husband. Curious, she peeked into the room to see the attending leading the wife to the bedside and then slowly whispering something to her as she cried. Those words, as she found out later, were words explaining how life leaves the body, giving the patient a peaceful death. Days later, she received a letter from the wife thanking the team for ensuring her husband’s peaceful death. Dr. Chen described it as an experience that showed her a new world of medicine; it showed her that she could do more as a physician than just cure or diagnose. Ever since then, she states that she’s never left the dying and the family alone. She drew the curtains around all of them, spoke to the family slowly, and touched and hugged family members.

Dealing with this will never be easy, but I pray, as a future doctor, that I will have moments like this that unveils to me a different way to approach death. A different way to provide something to patients when I have nothing good left to give. Let us always remember to not run from death, but to take it on, and to morph it into something compassionate and dignified. This will be one of my main pursuits in becoming a physician.

“By evading death, we miss one of the best opportunities for us to learn how “to doctor”, because dealing with the dying allows us to nurture our best humanistic tendencies.” – Dr. Chen

And that says it all.

-M

Travel - Asia

How to Spend 3 Days in Phuket – Elephants, Boat Noodle Soup, Magic, Oh My!

(scroll down for itinerary/tips)

SET THE SCENE

White sand beaches that trail into ocean water reflecting the pale sand underneath – the make-up of the line of beaches of Phuket. Standing with your feet in the crumbly sand and the taste of ocean in the air, you can see the pretty coastline from any angle. In the distance, there are green trees covering certain parts of the coastlines and parasailers floating languidly in sky. The waves oscillate between gentle and bursts of power hinting of potential thunderstorms and larger waves to come. If you come around June and July, be prepared for low cast clouds and occasional days of pouring rain with peeks of sunshine on your lucky moments. The beaches are lined with umbrellas, mats, and the occasional random tree swing. There are swimmers enjoying the warm water and people on jetski’s moving around. In the distance you can see the further islands of Thailand looking remote in all of its glory.

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Phi Phi Coast

SUGGESTED 3 DAY ITINERARY

DAY 1: My family arrived around the afternoon and we were still recovering from Bangkok so we decided to chill at our hotel which had a great pool and poolside bar! Then we went out looking for a Thai massage to finish off the relaxing day (and you can find plenty of massage parlors everywhere!)

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Poolside Bar (rec: get a hotel with one!)

DAY 2: Chilling at Patong Beach! And booking the Phi Phi Tour and FantaSea show.

DAY 3: Phi Phi Tour and FantaSea show at night

PHUKET TRAVEL TIPS:

-BEACHES: Phuket is located on the coast so you have plenty of beaches to choose from. I honestly just walked to the nearest beach from my hotel which was Patong Beach. When you get to the beach, there are going to be a lot of locals that will try and get you to buy a chair or umbrella from them to sit under – avoid the cost and just spread out a towel unless the sun is absolutely horrendous that day. Many of the locals also offer kayaking, parasailing, jetskis, etc.

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Patong Beach

-MARKETS: There are plenty of markets to shop in and eat at in Phuket but the following two are where I went:

Phuket Floating Market: Think of this as a more modern, clean floating market. When I went with my family on a random weekday morning, a lot of the shops were closed so I recommend maybe coming on a weekend afternoon. WHAT TO EAT: I found the BEST fried chicken I have ever had in my life here! The flavoring on the chicken was unbeatable! You also have to try the boat noodle soup and the duck noodle soup!

Night Market outside Banzaan Fresh Market: Plenty of food to stuff your face! You can also go inside the Banzaan Fresh Market and buy fresh seafood, have a restaurant on the second floor cook it, and eat it super fresh! WHAT TO EAT: Thai rolled ice cream, ice cream in a coconut, meat skewers, fish maw soup, papaya salad

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-NIGHTLIFE: The famous Bangla Road. It’s pretty fun to walk through at night!

-THAI MASSAGE: I completely forgot to mention this on my Bangkok blog, but do not leave Thailand without getting a Thai massage! They are so cheap for 1 hour. My cousins and I spent our evenings post-beach getting massages that completely relaxed our muscles.

-LEAVING PHUKET: Phuket is a tourist trap so you will see a million flyers to do tours to different islands off the coast of Thailand such as Phi Phi and James Bond Island. Since I had limited time with my family, we booked a tour through a travel agency that let us go see Phi Phi Island and snorkel for a day. It was great feeling the wind in my hair my feet over the ocean on the boat but the part of Phi Phi the tour company took us to was pretty touristy and the beaches were dirty. If you are craving some good island time, a lack of tourists, and untouched beaches, I suggest actually spending a few nights on Phi Phi like one of my friends did. And taking one of these boats below:

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-SHOWS: Phuket has a couple famous shows. The one I went to see was FantaSea. There is a park surrounding the stage where the show happens and the park is like Thailand Disneyland. There are a ton of fun games to play and elephants walking around. The show was also pretty entertaining to see – complete with elephants, acrobats, and magic! We also got a deal through a tour company in Phuket. Oh you can buy tickets for just the show or show + buffet dinner (since my family are notorious buffet eats, we went with the buffet package and the food was decent).

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FantaSea (outside the stage)

-WHERE TO EAT: Phuket is a tourist trap. You will see endless of pad thai and not so great quality. I do recommend one restaurant that truly wowed me with their food – No.9 Restaurant. Probably why it has great TripAdvisor ratings and a line outside the restaurant.

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To find a complete list of what to eat in Thailand, check out my Bangkok blog!

 

Happy traveling!

-M

food, Travel - USA

The San Antonio Ultimate Where/What to Eat and Drink List

Dedicated to my med school friends who’ve been with me on this food adventure!

As my four years of medical school comes to a close at San Antonio, I decided to write a master post of one of my favorite topics and hobbies: FOOD.

From first year to these very last weeks, my friends and I have done our best with our limited time and money to sample what’s the best of San Antonio. I’m known in my class to have an Instagram that is basically a food Instagram, and I just wanted to close off my year with a compilation post of the best places to eat and drink in SA (in my opinion)!

(These aren’t full reviews – just my recommended places, hours, what to know, and what to order!)

NEW AMERICAN

Biga on the Banks

What to Order: Do a tasting menu! Around $70-80 depending on 5 or 6 course meal. Really, really fills you up and gives you a good view of what their menu is like!
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Bliss

What to Order: Oyster sliders, George’s Bank Sea Scallops (some of the best scallops I’ve ever had! So buttery and tender)20140820_211612

Cured

What to Order: Pig cheek poutine, charcuterie boards
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Boudro’s on the Riverwalk

What to Order: House guacamole (they make it at the table for you!)
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Alchemy Kombucha and Culture

What to Order: Ramen. The great thing about this restaurant is that the menu changes often and by season so there is always something new to try.

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Cullum’s Attagirl

What to Order: Southern fried chicken, 3 piece hot

Max & Louie’s New York Diner

What to Order: Pastrami chili cheese fries, philly cheese steak, reuben sandwich
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Mash’D – The Rim

What to Order: The menu often changes and you can usually find something good on there to order.

The General Public

What to Order: Bone marrow, Fish ‘n’ Chips

Pam’s Patio Kitchen

What to Order: Chicken saltimboca
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Didn’t Get to Try (but heard good things about from other people): Bella on the River, Restaurant Gwendolyn, Periphery, Picnikins Patio Café, Southerleigh, Supper, Josephine Street, Signature, J Alexander, The Fig Tree, Luce

Continue reading “The San Antonio Ultimate Where/What to Eat and Drink List”

Travel - Asia

The Complete Guide to Bangkok, Thailand – Serenity and Spice

(scroll down for itinerary/tips)

SET THE SCENE

Just landing in Suvarnabhumi Airport and walking around the luggage pick-up area gives you the first glimpse of just how visited Thailand is. Left and right there are backpackers, family, and friends from all over the world, the different languages filling the air, moving around. You already feel a rush of excitement being in the midst of it.

You get to the streets and realize just how populated the city is. Taxi and random cars dot the highways, each following each other in a slow crawl. The July air is thick with humidity and the random spaces where shade lingers provides a much needed coolness. But beyond the sunshine are the thick gray clouds waiting to roll in and sprinkle droplets on the pavement and roofs. The Skyrail system whistles as it soars through the rails above the buildings and people shuffle in and out at rapid paces, destinations in mind.

Then there’s the Chao Phraya River, the major body of water flowing through Bangkok, and it’s a magnificent view. Hotels dot the side of the river – not so much like towering skyscrapers in New York or Hong Kong, but more so like scattered tall towers, each unique in architecture. With sunrise or sundown, the sky lights up in magnificent shades of red, orange, and yellow – the streaks going for miles and the rays peeking behind buildings. The boats and ferries on the river move merrily down and become illuminated when darkness lays its blanket over the city. Quiet and strong – tis the river spirit.

On one side of town, the streets and tiny alleyways are bustling in markets. Crates of overflowing dried shrimp, dried squid and street carts of noodles being fried or sausages cooked and served on sticks. The aroma of fresh spices and fried food punches through the air calling all locals and tourists. Shops with jewelry and shoes are in between everything else. Jumping on the Skytrain takes you to another part of town – one surrounded in four corners by glorious shopping malls. The malls are an attraction itself with several floors, some of them differently themed. There is a mall called Terminal 21 that transports you to different parts of the world. Then there are the four big shopping centers glittering with its expensive brand names and grocery stores equivalent to Whole Foods back in the states.

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Take a taxi or ferry to an area of town filled with Wats. Forward and backward, you see the magnificent towers of Wat Arun and the sparkling colors of the Grand Palace. There’s tourists all around you filing in lines to get in these areas and wander the sacred grounds. Tall, thick white walls surrounding some of the temples, hiding away the precious Buddhas from passerby’s eyes. The sides of the streets are lively with souvenir shops and carts pushing around fresh coconuts to enjoy in the blazing sun.

And that is Bangkok in a nutshell.

SUGGESTED 3 DAY ITINERARY OF BANGKOK

DAY 1

-I always say the first day in any city after a period of travel should be devoted to exploring the area nearby and relaxing. If it’s your first day of your entire trip, you may feel more energetic to go further but I just got done with a couple days in Hong Kong so I needed a day to rest my legs a bit.

-My family and I spent time wandering around the streets around Chinatown and sampling different street food. You can scroll down below to see what you should eat in Thailand!

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-SILAM AREA: You can take the Skytrain or MRT to this area. What can you do in this area? Explore Lumphini Park which is Bangkok’s biggest park.

-Also take time to wander around any market you see. While there are some famous ones, there are little ones in alleyways everywhere!

-At night after dinner, my cousins and I spent some time at a bar near the Chao Phraya River – I highly suggest this place – the Long Bar at the Shangri-La Hotel. The views of Bangkok and the river at night are something you cannot miss so check it out at night whether at a river side bar or a rooftop bar!

DAY 2

-You need to spend one day dedicated to exploring the temples in Bangkok. They are absolutely beautiful and pretty cheap to get in. They are also all clustered around each other and thus an easy walking distance from one to one. Must not miss:

  • Grand Palace and Wat Phra Kaew (Temple of the Emerald Buddha) – you can walk in for free and explore the grounds around the two areas but to walk around the Grand Palace and go inside Wat Phra Kaew.
  • Wat Pho – this is where you will see the gorgeous, spectacular giant Buddha.
  • Wat Arun – Temple of the Dawn
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Wat Pho – Giant Reclining Buddha

DAY 3

-Before you leave Bangkok, you should definitely check out the shopping areas. There is one spot in Siam that is the shopping center of the city – contains Central World, Siam Paragon, Siam Center, Siam Discovery, MBK, and Terminal 21.

-I ended up at Terminal 21 – a pretty cool mall built to mimic an airport! Every floor is a different terminal at a different city around the world! There’s also a great mall food court on the 6th floor I think (or some floor near the 6th) – it’s the only floor not dedicated to an airport terminal. You’re probably thinking that you don’t want to eat at a mall, but trust me, the food is delicious, cheap, and there are so many options to choose from!

OTHER THINGS TO DO (that I didn’t get to):

  • Wat Prayoon
  • Markets: Klongsan Plaza Night Market, Flower Market, Klog Toey Fresh Market, Pratunam Market
  • Lumpinee Thai Boxing Stadium to watch a Muay Thai Show – the VIP ticket is ringside but second and third class tickets still give good view and the whole arena has A/C.

BANGKOK TRAVEL TIPS:

-CURRENCY: Baht. Can exchange at any airport and plenty of currency exchangers everywhere.

-HOTELS: If you can, I would suggest booking a room with a view of the Chao Phraya River. It is absolutely beautiful at sunrise and sunset.

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-TAXIS: to avoid being ripped off, agree on one price for the trip or have the driver agree to use the meter. Some drivers will try and rip you off by letting you get into the car and overcharging you for a price or charging each person per luggage. Do not take no for an answer! Don’t get into those taxis that do that. Also, you will find a lot of taxi drivers do not know where they are going (I don’t know why but this made for many amusing stories for us). Lastly, the traffic in Bangkok is insane – especially around peak time starting around 3-4PM. It will take forever to get from one place to another so be wary of that and take the Skytrain, tuk tuk, ferry, or walk.

-SKYTRAIN: a really useful and inexpensive way to getting around Bangkok – it is their above ground metro system. Unfortunately, it does not cover all of Bangkok yet – their goal is to be able to access all parts of the city using this system in the future. Take this route of transportation if you are trying to get to the mall areas and Silam area. If you are trying to get to the WAT AREAS, there is no skytrain that takes you there – you will have to taxi, tuk tuk, ferry, or walk. HOW TO USE: you can either buy a ticket at the window or exchange money into coins you use to buy at the machine. You have to decide your ending stop in order to buy the ticket (how far you go will determine how much the ticket is). Watch the trains to see which way the train is going. Some platforms have trains that run in either direction of the lines.

-WATS: remember to dress appropriately. This means no tank tops and all pants, dresses, or skirts must be long enough to brush the top of your feet. Just below the knee won’t cut it. Wat Phra Kaew (Temple of Emerald Buddha) is 400 baht (you get to see the Grand Palace too). Wat Pho and Wat Arun are 100 baht.

-RIVER CRUISES: there are several river cruise lines on the Chao Phraya River and I suggest doing one of them. It’s a great way to travel the river at night and see the beautiful lit up buildings and take in some fresh air. Most of them include dinner and entertainment. Some lines are buffet and some are a la carte. Some also might have bars and others won’t. Just do your research! My family and I took the Riverside Bangkok Cruiseline. It was a buffet that included pretty decent food and unlimited prawns as well.

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View from our river cruise

-ROOFTOP OR RIVERSIDE BARS: there are some famous rooftop bars that will give you a gorgeous view of the city: Muse Hotel, Bangkok Marriott Hotel, and the Moon Bar at Banyan Tree Hotel. My cousins and I didn’t get around to going to the rooftop ones, but there is one riverside bar we recommend: the Long Bar at Shangri-La Hotel. With its expansive windows and plush seats, you feel as though you are sitting right by the Chao Phraya River. It’s a gorgeous view and not to mention, the drink menu is extensive and made well there. They also give complimentary taro chips and peanuts!

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Long Bar at the Shangri-La Hotel

WHAT TO EAT IN THAILAND

Every restaurant, especially in tourist trap areas, will serve the typical Thai fanfare you think of: pad thai,  pad see ew, curry in every flavor, and tom yum soup. But below is my list of local foods you should consider trying!

-Fried chicken – I know, I know. This is not something you would think of ordering in Thailand but I swear I have had some of the best fried chicken I’ve ever had in this country. Of course, it depends on the stall you’re getting it from but try to find a street stall or a stall in a market that is making golden crispy fried chicken with a ton of seasoning on top.

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-Pandan – This is a dessert I discovered at a street cart. I bought it on a whim as it looks like a golden brown cake rolled in some green paste and I discovered how delicious it was. The green paste which is made from pandan is a hard taste to pin down but I highly encourage everyone to give it a try!

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-Papaya Salad or Som Tam – made of shredded green papaya, tomatoes, toasted peanuts, and chili! Can have it not very spicy to very spicy!

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-Meat Skewers – Usually they are skewers of grilled pork or chicken and they are fantastic, juicy snacks while browsing the streets of Thailand. Sometimes it even comes with sticky rice!

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-Larb – This is one of my favorite Thai dishes ever. It’s basically minced pork salad but what makes this dish delicious are all the spices the pork is cooked with. The pork is usually combined with lime juice, different herbs, and onions.

-Steamed Lime Fish – This is a huge dish to share amongst family or friends. Many seafood restaurants will let you pick out the fish you want and then the fish is brought out in a fish dish and heated throughout your dinner with a flame. The fish is topped with fresh chili, lime, and garlic!

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-Grilled Fish – Made on a grill with lots of salt and stuffed with lemongrass – dip it into different dipping sauces!

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-Duck Noodle Soup – a great dish in the markets – the soup is so flavorful and the duck is tender!

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-Thai Boat Noodle Soup – If you happen to find yourself in a floating market, then this is a fantastic dish to eat for lunch or dinner. The soup is incredibly flavorful and some places will add liver in as well (which is super tasty if you haven’t tried it). Really one of my favorite dishes to eat in Thailand. Apparently the secret to this broth is a dash of pig’s blood (hope that doesn’t turn anyone off!).

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-Kuay Jab – or basically rice noodle roll soup

-Radna – Basically noodles with gravy. The brown gravy with red chili flakes over the noodles is a fantastic dish to try! You can get it really cheap at the Terminal 21 mall food court.

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Radna is the bottom dish with the fried egg

-Cockles – For those of you more adventurous and a lover of clams and oysters – this is something you have to try. I ate a ton of these on my Bangkok river cruise and each piece was incredibly flavorful. You just can’t stop eating them! Beware: could cause the runs – I got lucky but I think it was because I didn’t eat it off the side of the street.

-Thai Tea – although a cliché thing to have, I have to suggest it just because every single Thai tea I had in Thailand was delicious and not overly sweet or bland.

-Pad Thai – I’m only including this on the list to suggest that if you see someone frying pad thai on the side of the street, then get it – it’s fresh and usually a great snack to munch on while you walk around. The best pad thai I had in Thailand though was in Phuket at No.9 restaurant.

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-Tom Yum Soup – this is a very common dish you will find in every restaurant and surprisingly no matter where I went, I found the soup to always be extremely flavorful and really spicy (if you want it to be!)

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-Mango with sticky rice – Mhmm. The best dessert ever!

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-Thai Rolled Ice Cream or Ice Cream in a Coconut – can be found at street carts! They are both delicious and a must try!

-Fruit off the street carts such as pineapple and coconuts!

Happy traveling in Bangkok!

-M

Uncategorized

From Refugee to Citizen

I would like to start off by saying I am usually not very vocal about my views on politics and policy, but this recent development is something I cannot stay silent on. I do not write this to express the cons and pros of this policy, but more so to reach out on a more personal level on why this new anti-immigration policy is a step backwards from who we are as a country.

As many of you all know, President Trump issued an executive order on Friday that would stop the citizens of Syria from entering the United States along with a suspension of immigration for a certain amount of days from other countries linked to terrorism. Furthermore, there has been a suspension of the program that admits refugees from around the world for a certain amount of days while the government creates revised policies for entry to the US.

Syria is a country currently being run through with civil war. Its people’s struggles are splashing our daily headlines with constant news of violence and horrific images. Syria and many other countries in the area are the new refugee crisis of this decade.

It was only a couple decades ago when Cambodia was going through its own civil war. It seems like lifetimes ago to many people, and it only appears as a few sentences in most history books taught around the nation, but to my parents, aunts, and uncles, it was years of life-changing strife.

Years of bloodshed, losing family, friends, losing a home, living on unclean water and food, and surviving just to see the dawn break over the next day. It was years of feeling utter loneliness and despair and living in a real version of hell. The small country and its people went through so many years of struggles and going unnoticed by the rest of the world.

My mom and dad went through this, and I won’t make this post longer with details of their horrendous stories. What I want to stress is that my parents found the little light in their personal prison cell in the form of entrance to the United States. They came to this country as refugees and put themselves through full time jobs and night school to learn English and to make something out of themselves. Today my parents stand before me as strong and educated citizens, and I cannot even imagine that their teenage years were filled with genocide and warfare.

Today is Chinese New Year, and I found myself reflecting on all of this as I whispered my thanks into my prayers. I am forever more than grateful to those who worked hard to bring in the forgotten refugees of Cambodia into America many years ago. They gave my family hope when it seemed like every other path to take led to more danger.

I am constantly surrounded and amazed by friends and colleagues with ancestry from all over the world. I grew up proud that the country I lived in thrived off its reputation of being a ‘melting pot’. A place where so many cultures and religions intertwined together, and it was normal. A land of promises, safety, and security. A country that had the powers to compassionately open its doors to refugees and others in forgotten places, and to give so many people a second chance and an escape from death and further torture.

And that is why this new development saddens me to my core. This ban echoes everything America is not.

Syria, Iraq, Iran, Libya, Somalia, Sudan, and Yemen are another Cambodia. Maybe on a grander, more public scale this time and definitely with more controversial issues. But to the core, they are countries of refugees and of people who are innocent and unfairly and unjustly suffering through different regimes’ power struggles and religious clashes. So please. Please. Let’s think of the children, women, and men drowning in a battle they never asked for before we close our doors on them.

 

Agree or disagree with me on this new development, but regardless, this is my family’s story. I am so ever proud and grateful to the powers of America taking in my parents many years ago. This is America’s strength, and let it never disappear in the midst of fear and misguided beliefs.

-M

P.S. Do not even get me started on the reinstatement of the Global Gag Rule. It saddens and frustrates me to see what this means for the future of global health and women’s health around the globe. That itself is a whole other rant.

P.S.S. – To those wondering why my family and I celebrate Chinese New Year: I have some Chinese ancestry in my background.

Education, Med School Musings, Uncategorized

Dear Third Year Student

Dear upcoming third year student who must be so incredibly thrilled to be done with the Kreb Cycle,

Welcome to the year of being ‘The Wallflower’! Now bear with me before turning the page and shaking your head in disbelief. Dictionaries define ‘wallflower’ as someone who is shy and thus blends into the sidelines. I think the word, if you take out shy, defines third year in a nutshell. You’re about to embark on a year of switching rotations. A journey of constantly feeling uneasy and then comfortable only to have to fall back into that uneasy emotion in a matter of days or weeks. You’re going to pass through every emotion in the book. The bad ones (nervousness, awkwardness, discomfort, confusion, pity, anger, fatigue, sadness, apathy, helplessness, jadedness), but I promise, also the good ones (pride, awe, wonder, curious, comfortable, confident, decisive, empathy, sympathy, appreciative, contemplative, joy, happiness)!

Now you must be thinking, ‘What a depressing letter to read’, but I urge you to forge ahead.  Third year means you’re the least experienced of the medical team. You’re going to have plenty of moments where you don’t feel like you’re helping or that you’re actually more of a burden. Residents and attendings will discuss plans at rapid fire, and you’ll feel lost to the terminology, trying desperately to figure out when is the right time to ask a question or rapidly browsing through UpToDate to figure out what exactly is happening with a patient. As the patient workload increases, you’ll start to feel like someone just merging with the sidelines. A wallflower.

I write this letter to remind you all that when you’re starting to feel like that, please remember that this is not a bad thing. Your duty as the third year medical student is to not come up with drug dosages or perfect solutions to a patient’s decompensating heart failure or treatment of ovarian cancer. You are there to learn. To be constantly curious. To observe. As the wallflower, you get a special advantage over residents and attendings. You have more time with patients and more time with your thoughts. So use that time wisely, open your eyes and ears, reflect, and truly take in your surroundings.

On emergency medicine, understand how swiftly death and disability can fall upon humans and build compassion for those patients lost in the frenzied haze of white walls and numerous diagnostic tests. On neurology, appreciate how intricate the human brain is but also understand that complex neuro terms fall on deaf ears of patients. On surgery, acknowledge every kind of fear people have going under the knife and be in awe of how intricate the human body is. On medicine, think beyond the heart failure and cirrhosis to what living and social situations your patients will encounter post-hospital. On pediatrics, embrace your inner child, revel in the innocence of babies, and step into the shoes of a worried mother or father. On family medicine, truly wonder why a patient is not progressing in care – transportation, culture, unsafe neighborhoods. On OB/GYN, be awed by the miracle of childbirth and learn to be gentle with sensitive matters of unwanted pregnancies, miscarriages, and vaginal bleeding. On psychiatry, draw up your empathy and do not let their illnesses define who they are.

Appreciate the residents and the attendings. Be in awe of how they juggle their patients and their home lives. Thank those who take time out of their busy hands to teach you. Be grateful to the nurses, PAs, NPs, techs, and support staff who guide you in the right direction. Welcome the caffeine and infrequent extra sleep hours. Hold the patients’ hands that want to be held. Offer a tissue to those who are crying and return the hugs rarely given by patients. Smile. Make eye contact. Communicate. Listen.

This year will be the game changer in your medical career. You’re going to learn what specialty is right for you, and you’re going to learn so much about medicine and human nature in general. Just remember to take with you the lessons you’ve gathered and observed and let it guide your future practice.

‘The best way to find yourself is to lose yourself in the service of others’ – Mahatma Gandhi

Enjoy third year!!!

Best,

M

(I write this as I come to the end of my fourth year of medical school as a piece for the upcoming third year students at my med school as well as a reflection on what MS3 was like)

My Little Things, Uncategorized

Winter Holidays Little Things

I’ve had this idea bouncing around in my head for a while, and I’ve decided to finally act upon it. Now before I dive into this little new blog idea I have, I want to give all credit to my inspiration: http://justlittlethings.net/ [just visit her blog! It’s an inspiration and her book is a very cute gift to give around the holiday times]

Background Story:

After stumbling upon that blog about six years ago, I became absolutely enraptured and inspired by it. The idea seemed so simple but monumental – to remind yourself and others around you how important the little things are in people’s lives. The little things, to me, are tiny events or objects that occur in daily life which lead to a smile externally or subconsciously but most people don’t pass a second thought over it. At the end of the day, these little things may be the only thing that upturns a day or makes it better.

At first, I took it as a daily subconscious exercise. If something happened to me or if I stumbled across something that fit the above definition of a ‘little thing’, I would catalog it into my phone and add it to my Microsoft Word list that slowly became longer and longer. My friends caught on to what I was doing and encouraged me to share it, hence, my little thing e-mail list started. My e-mail list contained family, friends, colleagues, and professors and the responses I received were humbling.

Now six years later, I’m in the 1600s count! I have been tinkering with the idea for a while to share my little things on this blog…and here I am years later finally acting on the idea. I’ll start at my number 1 and make my way down my list in sporadic posts and everything will be tagged ‘mylittlethings’.

But in honor of my favorite time of the year – the holidays, of course! – I am dedicating this first Little Things post to the theme of the winter holidays.

Winter Holiday Themed Little Things

89. Untouched snow
144. Snow days
192. Christmas lights at night
383. Seeing your breath on cold days
385. Seasonal beverages during the holidays
392. Holiday music on the radio
400. Watching Christmas decorations go up
401. Driving around and seeing Christmas lights
408. Lit-up Christmas trees
416. Walking into a heated building after being outside in the cold
420. Singing Christmas songs with friends
425. Making the first tracks in fresh snow
447. Wrapping your cold hands around a cup of a warm drink
697. Getting into a warm car when it’s cold outside
710. Realizing the Starbucks Christmas cups are back
711. Pulling on winter boots and clothes and realizing its winter
713. Having heater seats in the car on a cold morning
729. Cold, sunny days
737. The way the house smells during the holidays
748. Christmas decorations
756. Hot soup on a cold day
758. Driving home for the holidays and then finally seeing your home in the distance
760. Watching little kids run around in their Christmas dresses and outfits and being excited for Santa
762. The sound of your footsteps in the snow
764. Seeing lighted Christmas trees through windows at night
766. Waking up on Christmas morning
767. First white Christmas
768. Christmas mail
789. Waking up to snow
794. Holiday themed cakes
1084. The sight of your name on a Christmas present
1085. The warmth of a bonfire in the winter
1113. Buying holiday scented Febreeze
1171. Putting socks on cold feet
1210. When the Christmas tree gives the only light in the room
1217. That moment near the holidays when there’s suddenly cookies, chocolate, and candy everywhere
1473. Waking up warm in the winter
1524. Snapchat holiday snaps
1545. Holiday themed meals at the cafeteria

And like I tell everyone on my e-mail mailing list, I am always open to suggestions and will gladly add it to my list! I love to hear what little things people stumble across in their lives! Leave it in the comment sections! [the odd numbering is due to how it appears on my actual list]

Happy Holidays everyone!

-M