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Health Disparities, Medical Education, Patient Care, SMS Unplugged

In medicine, showing empathy isn’t enough

In medicine, showing empathy isn't enough

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

SMS_image_072214As a medical student, it’s difficult to face a situation where everything possible is done for a patient, yet due to circumstances (seemingly) beyond our control, the risk of future harm remains uncomfortably certain. The majority of our medical school learning focuses on how to cure illness; unfortunately we’re not always taught how to deal with the real-world issues that face our patients and that threaten the medicine we practice.

This month I’ve been on my neurology rotation at Santa Clara Valley Medical Center, a county hospital with patient demographics quite different from those seen at Stanford Hospital. As I serve a more diverse and disadvantaged socio-economic population, it’s often the case that the information in the patient’s “Social History” section, which I usually quickly pass over, becomes a defining piece in deciding next steps. The 20-something-year-old with daily seizures because he’s so high on methamphetamine that he forgets to take his pills, the 40-year-old with left-sided paralysis who keeps checking in to the emergency department because she feels unsafe living alone in a trailer park, the 60-year-old who didn’t present to the hospital until days after suffering a stroke because he couldn’t physically get to the door to call for help: These patients demonstrate how social situations can make efforts to provide medical care at times seem futile.

In medical school, we’re taught the pathophysiology of disease and systematic approaches to medical management, but not how to deal with social contributors to health. (The latter is a not-so-glamorous aspect of medicine relegated to the hidden curriculum of clerkships.) During pre-clinical years we spend a lot of time discussing how to make empathy a part of our clinical skill-set, but a pitfall to practicing medicine in a way that is sensitive to a patient’s social context is the belief that showing empathy is enough. To express concern for a patient is different from really understanding a patient’s challenges. Things like the fear that drives a patient to repeatedly present to the emergency room for “inappropriate” reasons and the thought process behind not getting an MRI done since it would mean missing work may not fit traditional logic, but they represent an important piece in delivering care.

What can’t be taught in school is an inherent understanding of the difficulties that some patients face, which is why the push for future physicians to be individuals representative of the various backgrounds that patients come from is so important. (It can be surmised that students who have endured these difficulties, themselves or through family, socio-economic or health related, could better relate to patients they come in contact with.) While socio-economic demographics are easily seen on paper, though, what is harder to select for and recruit is the student who has lived the real-world environment characterized by social issues like multiplicity of chronic illness, housing insecurity, and financial hardship. And, of course, many students in this very position never make it to the point of training for a health profession as a result of the very hardships that make them more attune to the social issues that may contribute to poor health.

Medical school recruitment has changed in ways that will hopefully improve diversity of recruited students and contribute to a greater understanding of the background of all sorts of patients among health-care providers. However, more still needs to be done to support students from less-traditional and under-represented backgrounds so they reach the point of applying in the first place. Instead of being discouraged by their less-than-ideal journeys to medical school, students who have endured educational, financial, and social hurdles should be encouraged to use their learned experiences as a frame of reference to positively impact the delivery of health care.

Moises Gallegos is a medical student in between his third and fourth year. He’ll be going into emergency medicine, and he’s interested in public-health topics such as health education, health promotion and global health.

Drawing by Moises Gallegos

Medical Education, Medical Schools

Does medical school debt cause students to choose more lucrative specialties?

Last week, we re-published a Wing of Zock post on medical school debt. Over on that same blog, Julie Fresne, director of student financial services for the Association of American Medical Colleges (AAMC), takes issue with one of the original writer’s points: that concern over medical school debt affects students’ decision about specialties. Fresne writes:

While many claim that debt leads medical students to choose more lucrative specialties, AAMC research indicates that debt does not play a determining role in specialty choice for most students. The report, “Physician Education Debt and the Cost to Attend Medical School,” includes a section outlining evidence on the “minor role of debt in specialty choice.” Studies show that specialty choice is a complex and personal decision involving many factors. Some students with high debt do in fact choose primary care and AAMC data suggests that there is no systematic bias away from primary care specialties by graduates with higher debt levels…

Previously: It’s time for innovation in how we pay for medical school, 8 reasons medical school debt won’t control my life and Will debt forgiveness program remedy doctor shortage?

Medical Education, Medicine and Society, SMS Unplugged

The woman in the elevator: dealing with death in medical training

The woman in the elevator: dealing with death in medical training

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

flowersAlmost every patient I meet gives me the gift and curse of forcing me to confront a new side of my own vulnerability. I see new ways to die, new ways to suffer, new kinds of setbacks or losses. Of course, very little of this knowledge is technically new: My mother taught me that everyone dies, life isn’t fair, and so on. But since starting clinical training, what is new is the intimacy with which I live that knowledge.

On my neurology rotation, I was sent to examine a little boy in the ICU who had become unresponsive. I will never forget what I saw when I lifted his eyelids. His right pupil was rapidly changing shape from lumpy oval, to diamond, to a slit like a cat’s eye.

I alerted my attending, who somberly explained that that the boy’s brain was probably herniating – in other words, it was under so much pressure that it was being pushed into places it shouldn’t go. A few minutes later, a CT scan showed massive bleeding in his brain. The neurosurgeons were called, but determined they couldn’t save his life. As we left, a curtain was pulled in front of the room.

A few minutes later, already back to work in other parts of the hospital, my team stepped into an elevator. Before the door could close, a young woman ran in behind us. As the elevator ascended, she sunk to the ground and wailed, “Am I going to lose my baby? Please don’t let me lose my baby.” When the doors opened, she sprinted toward the ICU. With horror, I realized the woman was my patient’s mother. Her baby was already gone.

The next morning was a gorgeous Saturday. I had the weekend off so I put on my grungiest clothes and headed to my community garden plot, determined to separate myself from the week’s experiences. Weeds had crept in during a few especially difficult clinical months. I placed a shovel in the dirt, put all my weight on it – and it didn’t budge. I tried again, but the soil wouldn’t yield. I discarded the shovel and reached to pull a huge weed. The dead branches crinkled off in my hand, roots still entrenched in the hard, dry California earth. I sat down among the weeds, defeated, face in my hands.

A woman working another plot – a fellow student gardener I had never met – walked over and asked, “Are you okay?”

“I’m just not strong enough to do this. I should give up my plot.”

“I’ll help you clean it up,” she offered.

“Thanks… Sorry… I’ve just had a bad week.”

“Lots of final exams?”

“No. But I watched a little kid die yesterday.”

My new friend didn’t miss a beat. She knelt down, gave me a hug and said, “You are strong enough. Let’s get your garden cleaned up.”

I believed her, and kept gardening. I proudly told myself I had found an outlet to successfully cope and put the horrible experience behind me.

But it turns out things like watching that child die aren’t processed and compartmentalized so neatly, and can come back to haunt even the best and most personal times. A few months later, on the night before my daughter was born, my husband and I arrived at the hospital full of excitement, and stepped onto the elevator on our way to Labor and Delivery. But as the doors slid shut, I couldn’t suppress the mental image of the last time I rode that same elevator: a desperate young woman on her knees, repeating “Am I going to lose my baby?” For the thousandth time in medical school, I knew the fragility of my own blessings.

I have come to believe that coping doesn’t mean finding a way to separate “personal” life from “professional” experiences. There is no healthy coping mechanism that will let me walk away from experiences like this unaffected. Instead, I just keep telling stories like this one over and over – to myself, my friends and family, and now you – hoping that in the retellings I will find some meaning, some wisdom, some gratitude, or some peace.

Jennifer DeCoste-Lopez is a final-year Stanford medical student applying to residency in Pediatrics this year. She was born and raised in Kentucky and went to college at Harvard. She currently splits her time between clinical rotations, developing a new curriculum in end-of-life care, and caring for her young daughter.

Photo courtesy of Jennifer DeCoste-Lopez

Medical Education, SMS Unplugged

Fewer than six degrees of separation: the small world of higher education

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category

six degreesSeven months ago, almost on an impulse, I decided I wanted to spend summer 2014 doing research back in Boston (home to my undergrad institution), instead of at Stanford. To this end, I started looking into possible research mentors, and after browsing through the Boston Children’s Hospital website, I found one person whose research interests aligned with my own, sent this person an e-mail and went back to studying for finals. Less than an hour later, I received a response. Two days later, we spoke on the phone. By the end of the week, I was all set for a summer in Boston.

What struck me the most about this entire exchange was not the speed with which it was conducted but the happenstance that accompanied it: I found out during the phone meeting that my now-mentor had actually attended Stanford medical school as well! What, I wondered, were the odds that the single person I chose to e-mail had graduated from the same institution that I now attended?

I thought about this coincidence more in the months that followed, and the more I thought about it, the less it felt like pure luck. Indeed, the past year has shown me just how small the world of higher education can be. Nearly 50 percent of my 102-person med school class comes from four institutions: Harvard, Yale, MIT and Stanford. One of my closest friends in medical school not only went to college with both the girls I’m living with this summer but also lived with one of my current roommates during a summer in undergrad. One of the other med students with whom I’m working with this summer gave med-school advice to the girlfriend of one of my undergrad buddies and – get this – both this coworker and I, unknowingly, performed at the same dance competition last year.

Moments like these make me feel that the “six degrees of separation” theory would more appropriately be called the “two (or fewer) degrees of separation” theory in the world of higher education. And what I’m wondering is whether or not this is a good thing.

Don’t get me wrong – I love playing the Name Game when I meet someone new (“Hi, I’m Hamsika! Where are you from? Yale? Oh, wait – do you know person X, person Y, or person Z? You know all three! No way!”). But there’s something to be said for diversity, not only in terms of race and culture (the two that seem to receive the most media buzz) but in terms of educational background, as well.

I summarized my thoughts on this “small world of higher education” phenomenon to a Harvard Med friend (incidentally, I met this friend at Stanford Med’s Admit Weekend) a few nights ago, and his response was – “Well, it kind of makes sense. If you go to a school like Harvard for undergrad, you’re probably going to end up at a similarly high-ranked institution for grad school. And,” he added as almost an afterthought, “your parents are probably decently well-off, as well.”

Could it be that we’re creating a self-perpetuating cycle in which the world of higher education becomes smaller and smaller and those who miss the “train,” per se, particularly at the “station” of undergrad education, are “derailed”?

I can’t say I know the right answer, but I’d love to hear your thoughts, as the topic of education – as you might notice from the two-liner at the end of each of my entries – is of particular interest to me. Feel free to add a comment below!

Hamsika Chandrasekar just finished her first year at Stanford’s medical school. She has an interest in medical education and pediatrics. 

Photo by Beth Kanter

Medical Education, Medical Schools

It’s time for innovation in how we pay for medical school

handstiedThere is a tremendous amount of handwringing among students, workforce researchers, and medical school deans about the record amount of debt that medical students incur – more than $175,000, according to the Association of American Medical Colleges. This has unintended consequences, including student selection of more lucrative specialties and placing medical education beyond the reach of low-income and minority students. The average household income for a matriculating medical student is more than $110,000 per year. We must get serious about reducing this debt. A talented medical workforce is a national priority.

[Louis Sullivan, MD,] authored an op-ed piece published in the Washington Post on June 9, 2014, “The Outrageous Cost of Working in Medicine.” In the piece, Sullivan discusses this challenge from both diversity and equity perspectives. He wrote, “You shouldn’t have to come from a wealthy family (or be willing to tolerate a lifetime burden of debt or the deferral of buying a home and starting a family) to go into health care.” Yet 60 percent of medical students hail from families with incomes in the top 20 percent of the nation. Meanwhile only 3 percent come from families with incomes in the lowest 20 percent.

National policymakers believe that, because professionals with medical degrees have high earning potential, they should therefore be in a position to repay loans in excess of $250,000 to $300,000. It simply hasn’t worked out that way for many talented young people who have turned away from the health professions altogether. The “gentrification of health care” serves no one well.

(In this post, I’m not talking about financing graduate medical education – GME – which is funded by Medicare, Medicaid, and academic institutions. In March 2001, Joe Newhouse, PhD, and Gail Wilensky, PhD, published an article in Health Affairs on GME asserting that it does not meet the economist’s definition of “public good:” benefits that are equally available to everyone that cannot exclude consumers from consumption. In the same issue, Uwe Reinhardt, PhD, and Adepeju Gbadebo, MD, pointed out that if GME is indeed a public good, society must also be willing to pay reasonable costs. In return, the leaders of academic medicine must inform society what each component of their social mission really costs, and be willing to be held more formally accountable for their use of the resources.)

What options exist to decrease undergraduate medical school debt?

Decrease medical school tuition and increase efficiencies. Tuition is actually a small part of most medical schools’ revenue. Most revenue comes from clinical services, transfers from teaching hospitals, and research funding. Although less than 5 percent of total revenue at most schools, tuition payments are still significant enough that their loss would impair the institutions’ ability to sustain their missions. There is significant variation in medical school tuition between and among public and private institutions. We could analyze the costs of education to determine if efficiencies can be realized using shared core faculty, distance learning, and MOOCs (massive open online courses) “to inform society what each component of their social mission really costs, and be willing to be held more formally accountable for the use of resources,” per Reinhardt and Gbadebo.

Make medical school free and government-funded. Peter Bach, MD, and Bob Kocher, MD, propose that medical school should be free. In their May 28, 2011, New York Times editorial, they advocated a new way of paying for medical training to address the looming shortage of primary care doctors and to better match the costs of specialty training to the income it delivers. They proposed that the government pay medical school tuition and then defray the costs of $2.5 billion per year by charging doctors for specialty training. This is not the first proposal to recommend making primary care training more accessible. The National Health Service Corps helps doctors repay their loans in exchange for a commitment to work in an underserved area, but few doctors sign up.

Make medical school more affordable for students committed to public service. The Wall Street Journal on April 22, 2014, published an analysis of federal student loan debt forgiveness programs, which increased nearly 40 percent in the past six months. One program, “Pay As You Go,” requires borrowers to pay 10 percent a year of their discretionary income – annual income above 150 percent of the poverty level – in monthly installments. Under the plan, the unpaid balances for those working in the public sector or for nonprofits are then forgiven after 10 years. At least 1.3 million Americans are enrolled in the program.

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Medical Education, SMS Unplugged

Countdown to clinics: The 5 best things about jumping into third year

Countdown to clinics: The 5 best things about jumping into third year

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.  

cake2Here at SMS Unplugged, we’ve been counting down to July 1, when current second-year medical students make the leap from pre-clinical to clinical trainees – arguably the most formative transition in medical training. We started our countdown with the most challenging aspects of the third year transition, and continued with the most pleasant surprises. Now that the long-awaited day is finally here, we present the final installment in this series: the best parts about jumping into third year.

5. Reclaiming your mornings
The silver lining of early mornings on the wards is the moment around noon every day when you realize that you and your team have completed almost a full day’s work. Of course the day is only half over, but still: Third year will make you into an early-morning All-Star (whether you like it or not).

4. Medicine as a survey course
As difficult as it is to start an entirely new rotation every few weeks, there’s something to be said for being a ‘chameleon’: blending in wherever you go, sampling a little bit of everything and entering each rotation open-minded. Hate suturing wounds? Don’t worry, surgery rotation will be over soon. Had second thoughts and can’t wait to get back to the operating room? Good news – it’s only a matter of time until a surgery elective comes around.

3. Delivering babies
Each rotation has its own highlights, but obstetrics and gynecology takes the (birthday) cake. Even those of us who are headed toward a different specialty can always look back and say our hands helped to guide a new life into the world.

2. Everything is interesting
For all the agonizing about picking a specialty, there’s another side of the coin: When everything is interesting, it’s hard to go wrong by picking one over the others. And for those who truly can’t make up their minds, there are fields like Emergency Medicine that still see everything.

1. Finally doing what you signed up for
After two years of studying for and taking an endless array of multiple-choice tests, it’s time to start doing what you signed up for: seeing real patients with very real needs. One of our professors would start morning rounds every day by saying, “Let’s go save some lives!” He was only half joking.

To all the new third-year students out there: Congratulations and welcome to clinical rotations!

Mihir Gupta is a third-year medical student at Stanford. He grew up in Minnesota and attended Harvard College. Prior to writing for Scope, Mihir served as co-editor in chief of H&P, Stanford medical school’s student journal.

Previously: Countdown to clinics: 5 pleasant surprises of jumping into third year and Countdown to clinics: 7 challenges of jumping into third year
Photo by Kimberly Vardeman

Medical Education, SMS Unplugged

Student transitions in medicine: putting blinders on

Student transitions in medicine: putting blinders on

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category

MCAT2MCAT, AMCAS, NBME, USMLE, NRMP, ERAS. These abbreviations are a bane for many students of medicine, pre-meds to fourth-years, during the summer months. Nervous excitement tingles in the fingertips of undergraduates and post-bacs as they complete their personal statements and prepare to submit MCAT scores and AMCAS applications to medical schools. Pre-clinical students straddle the fence between longing for more time and desiring to hit the fast-forward button as their Step 1 date nears. Clinical students revel in leaving behind the classroom, only to realize there’s a mountain of medicine before that they’ve yet to learn. And final-year students like myself are beginning to suit up, prepping once again to tackle the adventure that is application season.

This past month I’ve been e-mailing with several undergrads whom I’ve had the privilege to meet: bright future physicians who are taking the plunge and applying to medical school this cycle. Reading their personal stories, seeing their ambition and hearing their excitement brings me back to when I was in their shoes. I remember the insecurities of the time, feeling as if my story wasn’t good enough and that I hadn’t done enough for my résumé to reflect my professional desires. Sadly, my excitement was overpowered with fear. I couldn’t turn to my family as I was the first to even attempt such a thing, and I was too embarrassed to seek out professors.  Ultimately it was the support and guidance from peers who had been through the unknown that helped me the most to persevere. It’s because of this that I contribute to efforts providing support along the path to medical school through mentorship, especially for students from socioeconomic groups traditionally underrepresented in medicine.

As I head into residency applications, I’m finding myself reliving the same  insecurities that I’ve been telling my former mentees to ignore. What I realize is that I’m making the same mistake I try to help them avoid: I’m drawing comparisons. I see the people who I’ll be “competing” with for residency spots, and I begin to weigh the differences between my application and theirs (as if I know everything about them). Mentorship is easy when it’s between people who are on opposite sides of the transition in question, but not so much when you’re going through it simultaneously.

This is where Stanford’s shift away from the traditional grading paradigm has helped me. What refocuses me when I find myself getting caught up in comparing myself to other students is telling myself they’re not just “other students” and we’re not “competing.” With no grades, rankings or honor societies that commonly create competition and division, I was allowed from the beginning to focus on making friends, colleagues and support systems. Yes, we may be applying into the same fields at the same time, but we never contended before, and it won’t happen now.

It can be easy to get overwhelmed during the seemingly never-ending application steps of a medical career, but I think it’s important to remember what this first-world problem represents. The medical education-training pipeline may be marked with hurdles and stressors, but reaching the finish line is a blessed opportunity; we’ve been given the chance to be part of a profession that will allow us to interact with people in beautiful, challenging and often life-changing ways. We just have to “focus-up,” “put blinders on,” and “do work.” ERAS, here I come.

Moises Gallegos is a medical student in between his third and fourth year. He’ll be going into emergency medicine, and he’s interested in public-health topics such as health education, health promotion and global health. 

Drawing by Moises Gallegos

Medical Education, Pregnancy, SMS Unplugged

The hospital becomes a different place: pregnant in medical school

The hospital becomes a different place: pregnant in medical school

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

bun_oven2“What was it like to be pregnant on the wards?”

I was pregnant throughout most of my third year of med school, so I’ve been asked this question a lot. For a while I had a habit of brushing it off. “Being pregnant isn’t extra work,” I would point out. “The baby-growing happens automatically while you go about your day.” But over time, I realized that the hospital became a different place for me when I became pregnant, both because of the mental state I brought to my learning and because of how I was treated by others. Here are some of the best and the worst aspects of my own 40 weeks living in that world.

Good stuff:

  • An incredibly meaningful OB/GYN rotation. Being pregnant when I first coached a woman through labor and delivered her baby made an already surreal, beautiful experience even more personal. Furthermore, delivering other people’s babies demystified childbirth for me, making it way less scary when it was my turn.
  • Being taken more seriously by some families on Pediatrics. Fairly or not, many parents trust other parents more than they trust the clinical training of a pediatrician. Although I wasn’t a parent yet, I looked kind of like one. So I was often granted some (unearned) credibility in their eyes.
  • A powerful reminder of how health affects everything else. I was lucky to have an easy pregnancy by most standards, but there were days when minor symptoms—nausea, joint pain, headaches I couldn’t treat with medication, or just feeling a little off—made the already draining demands of med school take more of a toll. After this experience, I try to have more patience when I ask my patients to navigate complex health systems or make major life decisions all while suffering from symptoms far more severe than the ones that brought me down.

Bad stuff:

  • Feeling like my identity was reduced to “the pregnant student” in the minds of some of my superiors. A handful of attendings thought that pointing at my belly and asking “What’s going on in there?” was totally appropriate behavior for rounds. One resident would greet me by asking “still pregnant?” when it had been only two hours since he had last seen me. Another time I was pointedly quizzed in clinic about the recommended amount of weight gain during pregnancy (not OB/GYN clinic, which would have made sense).
  • Assumptions about my professional seriousness based on my appearance. I was once scrubbed into the operating room during my third trimester and the attending surgeon asked me if I was interested in Surgery. Before I could answer, the resident blurted out incredulously, “does she look like she’s interested in Surgery?” Few times in my life have I been more aware of my gender and the barriers that come with it. The flip side of that coin is that when people found out I was interested in Pediatrics, they would often respond with a knowing nod and say, “of course, that makes sense.” I wanted to explain that I am interested in Peds for reasons that I find professionally compelling, and wanting to have my own kids is a separate decision.
  • Never being able to get my work done without having to answer well-meaning pregnancy questions. While I was pregnant, many people I had to collaborate with in the hospital wouldn’t get around to talking about the patient with me until I at least shared my due date and explained that it’s not a boy even though I “carry it all in the front.” It wasn’t the end of the world enduring some overly personal small talk, but it did sometimes get frustrating.

In the great scheme of things, the way Stanford Med handled my pregnancy gets an A+ in all the most important, practical ways. My mentors and advisors were overwhelmingly supportive, I was never penalized for having to attend medical appointments, and I was granted a huge amount of control over my academic schedule and timeline. Nonetheless, the learning environment was undeniably different because of my pregnancy. I hope that by speaking openly about it, I can help future students in my position experience more of the good lessons that came with pregnancy on the wards, and less of the negative assumptions.

Jennifer DeCoste-Lopez entered medical school at Stanford in 2010. She was born and raised in Kentucky and went to college at Harvard before heading to the West Coast for medical school. She currently splits her time between clinical rotations, a medical education project in end-of-life care, and caring for her daughter, who was born in 2013. 

Photo by Chip Harlan

Medical Education, Science, Stanford News

Bio-X Kids Science Day inspires young scientists

Bio-X Kids Science Day inspires young scientists

sciencefair_2691What better way to spend a sunny Friday afternoon than by letting a gooey cornstarch slurry ooze between your grubby fingers.

No? Then perhaps investigating the bacteria of your nose (the outside) is more of an end of the week treat. In the case of my kids, attempting a tae kwon do sparring match with a reluctant robot was another great way to enjoy the tenth annual Stanford Bio-X Kids Science Day.

About 200 kids showed up to the Clark Center courtyard June 13 to explore 15 booths of interactive fun. In the ten years of this event, Heideh Fattaey, executive director of operations & programs for Bio-X, said that around 2,000 kids have come to learn about science and have fun – and by extension, to discover that learning about science is fun.

Other booths had an array of magnets to investigate, pools of water with a collection of toys for learning about mass and volume, and a demonstration of the 50 cent paper microscope developed by bioengineer Manu Prakash, PhD, and his lab.

Every 20 minutes or so, an explosion from air-powered, t-shirt-shooting robot interrupted the festivities (finders keepers on the t-shirt).

sciencefair_2771In the center of the courtyard, undergraduate student Tony Pratkanis stood watch over the PS2 personal robot, not far from a bubble machine that held several kids in thrall. The robot had, on another day, made an independent coffee run for the lab of computer scientist Kenneth Salisbury. On Friday the robot was set to dole out high fives, though that program met its match with my son’s kicking.

Fattaey told me that the day is intended not just to wear out active kids, but to inspire the next generation of scientists who will be picking up biomedical innovation where today’s Bio-X faculty leave off.

Case in point, Fattaey said she talked with a high school student she knew who was going to be doing a summer internship in a Clark Center lab. “He said seeing all the kids have fun brought back memories of when he attended Kids Science Day,” she said.

Previously: Stanford Medicine community gathers for Health Matters event, At Med School 101, teens learn that it’s “so cool to be a doctor”, A day in the lab: Stanford scientists share their stories, what fuels their work, Stanford’s Clark Center, home to Bio-X, turns 10 and Bay Area students get a front-row seat to practicing medicine, scientific research
Photos, of Quinn and Reid Monahan playing with a cornstarch slurry, and of Reid Monahan sparring with the PS2 personal robot, by Amy Adams

Events, Medical Education, Medical Schools, Stanford News

Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicine

Abraham Verghese urges Stanford grads to always remember the heritage and rituals of medicine

Dr. Abraham Verghese, MD, MACP a speech at the Stanford University School of Medicine Convocation on Saturday, June 14, 2014. ( Norbert von der Groeben/ Stanford School of Medicine )

More now from Saturday’s commencement ceremony, courtesy of my colleague Tracie White, who recounts the sentiments of the day in a medical school news story. During the event, White reports, graduates reflected on their years of hard work, thanked their loved ones and faculty members for their support, and took their first steps as doctors.

During his opening remarks, School of Medicine Dean Lloyd Minor, MD, told the new doctors, “Have the courage to follow unmarked paths… Listen to your patients. They are trying to tell you the diagnosis… Above all else, listen to your heart.” He was soon followed by Stanford physician and best-selling author Abraham Verghese, MD, who delivered the keynote speech and urged graduates to look to the time-honored role of the physician-patient connection and learn from this relationship. As White wrote:

[Verghese] began his remarks with words of warning, noting that soon-to-be-published research shows that medical students spend as much as five to six hours per day in front of the computer during their clerkships.

“That just astonishes me and worries me, and you are not doing it by choice, but because that has become the nature of our work,” he said. “You will need courage and determination to push back when things detrimental to your time and your care of the patient are being thrust at you. Electronic medical records don’t take care of patients: You and our amazing colleagues in nursing and the other health-care professions care for patients.

“People take care of other people,” he said to loud and long applause from the audience.

Both heritage and rituals, like the ritual of commencement, play an important role in the career of a physician, he said.

“You are also participating in a timeless ritual… when you get to examine a patient. You are in a ceremonial white gown. They are in a ceremonial paper gown. You stand there not as yourself, but as the doctor. As part of that ritual they will allow you the privilege of touching their body, something that in any other walk of life would be considered assault…

“The ritual properly performed earns you a bond with the patient… The ritual is timeless, and it matters.”

More photos from the day can be found in this gallery, published earlier on Scope, and on the medical school’s Flickr page.

Previously: Stanford Medicine honors its newest graduates, Congratulations to the Class of 2013!, Stanford medical school alum fulfills lifelong dream to participate in commencement ceremony and In commencement address and Atul Gawande calls for innovation around “entire packages of care”
Photo by Norbert von der Groeben

Stanford Medicine Resources: