Remedial Thoughts @nifty-nicole - Tumblr Blog

A Moment of Respite for What Will Come Next

I remember everything in shocking detail as though it was a traumatic event. In fact, it was the opposite of traumatic. The only other person in the kitchen was my dad, who was arguably more nervous than me that day.

When I found out that I was accepted into PLME, Brown’s super ridiculously awesome prestigious BA/MD program, the first thing I did was head to the nearest corner of my kitchen and sobbed.

This is not a go-to reaction for anything. I have never reacted in such a way. But I guess reflecting on it, it was the only way, myself, Nicole, should have handled it.

Under the joyous wailing, I exclaimed, “Why?” “No,” “I do not deserve this.” Most likely in that order.

My dad’s only reaction, after I made sure he read the letter correctly, was that it shows that I am grateful.

Well, I am beyond grateful. This will bring opportunities that I have never even dreamed of and that I am sure I never even thought about.

I am not the perfect “ivy” applicant. I do not have the stellar AP scores or the near-perfect SATs. I have not established a non-profit or have been published in a scientific journal. But I do recognize, under all of this self-doubt, that this accomplishment was something I wanted for years and I made sure that I tried my hardest to even get close to achieving it.

So, I decided to write today about that moment in my life because I am in a weird place right now. It is raining, I have done nothing today, and I will be getting up soon to face some responsibilities. During this April break, my friends are in Spain or in NOLA or in the spring musical. I am not involved in anything due to my financial situation (the half million dollars which now hangs over my head) and my amatuer theater skills, which I think is a first in my life. I have felt down these past 48 hrs because I felt afraid that I was missing key moments and I felt like I deserved these experiences.

It’s hard to put things in perspective. It’s even harder to do that when you do not know what your future will contain. I know that I will be at Brown for the next eight years. I know that I will be a doctor. I know that I will travel beyond Spain and New Orleans. And I know that I have worked so hard to get where I am today. But what will all this mean to me as a person? Will I change for the better? Will I be able to appreciate everything I have?

This mix of emotions this past couple of days are just #teenagethings I hope. I am coming of age. Of course I am feeling this way (?). I reread that past paragraph and I am saying to myself, “What more could you want?”

I just hope in these confusing times, I will look back on the most extraordinary moment of my life. (to date)

Raimondo Appoints Working Group to Reinvent Medicaid

I will be following this very closely and I hope to attend one of the public forums. The press release states,"Despite Medicaid eligibility rates in line with the national average and neighboring states, Rhode Island spends more than 30 cents of every state dollar on Medicaid and has the nation's second highest cost per enrollee."

In my research, it has been very hard to analyze data and come to conclusions. Of course there are people whose jobs are to do this in RI govn't - I just want to be part of it too!

It's exciting to see a professor from Brown as part of a very diverse team. I hope their plans succeed.

As an intern on Raimondo's campaign, this means so much to me if this works.

Bus Stop Blues

On my way back from NYC after seeing Don Giovanni at the Met (it was awesome) with friends we stopped at a rest stop in CT.

On my way out, I noticed one of those "minute clinics." I had been aware of them before and was interested in their impact. It was the first time I had actually seen one in person. All I remember is seeing a plastic box with enticing graphics.

The irony hit me in the car. Lo and behold a fast way to see a doctor...across from a McDonalds.

There are many pros and cons to these clinics. Many people ignore illness or have no other choice to ignore it because of many reasons - health care place, work hours, family obligations, etc. Many people do not have the time for the sometimes messy process with a doctors office so this becomes an option.

However, I see this as a new "band-aid" in the health care, a shiny, attractive, fast-acting, money-making solution that is merely a patch over the true festering wound that is our health care system. These places are not treating the human being, they are treating the symptoms.

I am not fully educated in these clinics, but I couldn't help but think of the patients that use these clinics for the relief of symptoms of a larger, systemic issue in their bodies that need an attentive evaluation from a medical team.

What I've Been Doing With My Snow Days P. 2: 24/7/365 The Evolution of Emergency Medicine

This documentary which was a thoughtful look into the field of emergency medicine was directed by Dr. Mark Brady. I heard about it back in December on RIPR actually leaving RI Hospital after a shift because PBS was airing it. I forgot about it until one of my friends at school, Margaux, emailed me the link and I finally had time to watch.

I enjoyed it extensively. I thought it showed unseen perspectives surrounding emergency medicine in clinical and also in emotional ways.

"A graduate of LaSalle Academy and Providence College, Dr. Mark Brady received early acceptance into Brown Alpert School of Medicine. He deferred admission to work at a children's hospital in Cambodia then walk the Appalachian Trail for a year. While attending medical school at Brown, Brady concurrently earned a master’s degree in biomechanical engineering. He received a scholarship to do a master’s in public health at Harvard for a year. Then, he did an NIH fellowship in Peru and Bolivia for a year, studying emerging infectious diseases. He spent a few months doing an internship, writing at the Discovery Health Channel. He completed a 4-year Emergency Medicine residency at Yale, where he was chief resident. At Yale, he earned a diploma in tropical medicine from the London School of Hygiene and Tropical Medicine, went back to volunteer in Cambodia and spent some time working in Liberia as the only emergency doctor in the country. Currently an emergency medicine physician, Mark also serves in the Navy Reserves."

http://rhodeislandpbs.blogspot.com/2014/11/24-7-365-evolution-of-emergency-medicine.html

#24|7|365: The Evolution of Emergency Medicine #The Evolution of Emergency Medicine

What I've Been Doing With My Snow Days P.1: Mountains Beyond Mountains

When I realized on Monday that I would likely have the next two days off, I knew I did not want to spend those days in bed with Netflix. Since exams ended, the second semester began so I did not have lots of homework to do.

During my free period, I reserved "Mountains Beyond Mountains" through Barnes and Noble's online service. I have been recommended this book on two accounts. When I had a discussion with Emily, a Brown MPH student, she suggested I read it. As part of my service class, one topic was college and expectations and fears. My teacher, Mr. Daly, a very kind and cool guy, was asking questions to each one of us about our first choice colleges, what type of college, potential major, careers, etc. When he heard that I will be majoring concentrating in Public Health he asked if I had read "Mountains."

I saw this time as an opportunity since I rarely have time to read during the school year. I braved the rough roads, as the snow had already starting falling early that afternoon and parked my Honda Civic in the nearly empty bookstore parking lot. When I was checking out, the lady at the register took one look at the book and told me it was a terrific book and that "Paul Farmer is basically the world's only saint."

I finished the book in 24 hours.

One major surprise after finishing and subsequently looking for everything on the Internet about it, was that Jim was recently appointed to head of the World Bank. (?!?!?!?!) The memory of reading how the World Bank was at one time an enemy for Partners In Health was still fresh in my brain. I thought it was amazing how a 10-20 year snapshot of peoples' lives is not reflective of their entire livelihood.

One of my major goals as a doctor is to be an advocate for underserved communities and to provide medical care for victims of unfair health care systems. I plan to make grand changes and fight for the right of health care.

My reason was because its just who I am. My morals and values call me to be that person and I believe that it's my calling.

However, when I read this, I realized that that is the true reality and that is why I feel the way I do. No matter how comfortable I can make my life with a medical degree, I will not be successful, nor happy, if I do not provide my skills to people who truly need them.

Farmer's story means much more than his constant travels and duty to the world. It means to me that the field of public health has been alive and is alive for me enter it. I have the wonderful privilege of inheriting the wealth of every public health official's and health worker's work. I hope that I will be able to turn to Farmer's story for inspiration in dark times and for strength when I feel weak.

#mountainsbeyondmountains

2015 SOTU

http://www.whitehouse.gov/blog/2015/01/21/precision-medicine-improving-health-and-treating-disease

Pictured above: Reporter Kristin Gourlay and Panelists Amy Nunn and Lynn Taylor

Hepatitis C: Cure, Cost, and Challenge

Moderator: Kristin Gourlay - Health Care Reporter, Rhode Island Public Radio

Panelists:

Michael Poshkus, MD - Thundermist Health Center

Amy Nunn, ScD - Executive Director, Rhode Island Public Health Institute, Assistant Professor of Public Health, Brown University

Thomas Sepe, MD - Director, Liver Center at University Gastroenterology & Clinical Associate Professor, Brown University

Thomas Stopka, PhD - Assistant Professor of Public Health and Community Medicine Tufts University School of Medicine

Lynn Taylor, MD - RI Defeats Hep C, Assistant Professor of Medicine, Brown University and the Miriam Hospital

Last Thursday, I attended a forum sponsored by Rhode Island Public Radio, Brown University School of Public Health, and the Rhode Island Public Health Institute about Hepatitis C.

The first thing I thought leaving the Metcalf after the hour-long discussion (plus another half hour of Q and A), was "Why did I not know about Hep C until now?"

I went to the event because I was hearing about it on RIPR all week, I appreciate Gourlay's work, and I was interested in learning more about the disease. However, I did not know that Hepatitis C was such a massive issue.

Although I came home to a large amount of homework to do, I was glad I went. It seems as though I was only high school student there, but I think the small number of rather young looking people were college/public health/med students. I did not realize until the discussion started, but the rest of the people in the room were doctors and health care workers or public health officials.

One moment from the panel that I keep thinking about is the discussion between Nunn and Taylor. They were obviously very passionate about their jobs and both incredibly hard working. It got tense at one point when discussing the issue of the cost of treating Hep C. Nunn kept insisting on pressing government and business for price cuts as an answer to high costs. However, Taylor responded with saying that we should not even have to do that since these medications cost only dollars per each dosage.

As soon as they said this, there was these waves of pangs inside of me. In my research, I have come across this issue of the cost of medicine and pharmaceutical companies again and again and again.

Each time I find that it hinders patients' wellbeings, I get angry and incredibly frustrated. When I look at it from a larger perspective all I see greed and injustice but most of all - irrationality.

Below is a link with audio and highlights of the event and a link to Gourlay's series on Hep C called At The Crossroads.

http://ripr.org/post/crossroads-road-ahead-hep-c

http://ripr.org/topic/crossroads-rise-hepatitis-c-and-fight-stop-it

#ripr #atthecrossroads #hepatitisc #brown university

My Purple Stethoscope

For Christmas, my parents Santa graciously gifted me with a stethoscope - a purple stethoscope. I see the gift as a symbol of their support. Their belief and trust in me, which was never entirely clear when I solidified my choice to pursue medicine, but today they are my number one fans.

It turns out there are many interesting things about stethoscopes that I did not realize until I had one under my ownership. For example, the correct positioning of the ear pieces and the fact that there are two sides to the chest piece - the diaphragm and the bell. This was mind-blowing for me when I was trying to hear my Grade 1 heart murmur late one night during vacation.

Luckily, my dad snapped a picture when I opened the box. My brother is fumbling with my grandma's new Nook while I attempt to use a stethoscope for the first time. The photo showcases some other gifts such as Malala Yousafzai's memoir and the robe...with cupcakes. (I feel very silly wearing it, but I know deep down inside I would have chosen it.)

Beginnings

I have decided to create this blog because for a long time I have had so many thoughts and moments that were important to me that I felt were being lost because they were not being recorded. In many ways I have already started my future in the health care field, however, with this blog, I hope to start something I can turn to or look back on during my journey in my career.

To a Happy New Year!

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