October 2017

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The Rush
By Mimi Phan, M1

“The grass is always greener on the other side.” For me, the other side was my future. I rushed through my high school and college years, always fixated on the next goal, keeping a tunnel vision toward the next mountain I had to climb. It was a notion I had unconsciously created in my head—the idea that attaining a particular goal would make me fulfilled. I felt as if nothing but reaching certain milestones in my life would lead me to happiness. It wasn’t until I started questioning this ideology that I realized the fulfillment I was looking for could never come from any extrinsic achievement.

I recently visited a small village in Vietnam where one of my distant uncles resides. He lived with no air conditioning or water with his wife and two kids, in a home about the size of a study room in HPEB. Every day, he woke up at 3 a.m. to collect items and travel to sell them at a market in the next town. It seemed, by modern standards, a difficult and laborious life, but I had never met anyone as happy and joyful as he was. He appreciated even the small things that he had and radiated deep love for his family. He constantly had a large smile on his face, grinning from ear to ear, even after a long day’s work. It wasn’t that he had done anything particularly special. He just did what he always did, and he was happy doing it. That was accomplishment enough.

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Being able to step back from what I was doing and see the bigger picture induced a monumental change in my mindset, allowing me to focus on the motivations and passions that drive my desire to accomplish certain goals rather than the goals themselves. My uncle taught me a great lesson about perspective.

While I don’t think success necessarily leads to happiness, I do believe that happiness can lead to success. Doing what makes you happy, in my eyes, is all that is needed to live a successful life. And while I do still value my ambitious end goals, I have learned to enjoy the rush in every day.


The Best of Humanity in the Worst of Times
By Jonathan Brewer, M3

To a medical student, perspective is everything. The way we view our time spent studying in the classroom, how we learn from patient encounters during our clinical rotations, and our path to developing our identities as physicians all prepare us for the day that someone will call us “Doctor.” What happens when we are forced to slow time and change our perspectives? What happens when life produces an event that changes everything? Hurricane Harvey was that inciting event for many.

When Harvey struck, millions of Texans were affected. Entire communities were devastated, families were displaced from their homes, and at least 75 people lost their lives. The cost of the physical damage, let alone the emotional impact of having to rebuild a life, was estimated to be 45-65 billion dollars. This hurricane was described as potentially the costliest hurricane in recorded history in the United States. However, in the midst of this chaos, I believe that the true nature of humanity was shown. Carl Jung believed in a theory called “humanism,” in which humans are believed to be inherently good beings who sometimes make mistakes. In a world that is currently plagued by disasters, hateful speech, and many other negativities, I am proud to say that the state of Texas truly showed its humanistic nature.

Southern Evergreen. By Agnieszka Grabon, PhD.

Southern Evergreen. By Agnieszka Grabon, PhD.

Dallas and Houston are known to be rivals in almost every aspect. From sports to schools to styles of driving, these sister cities showcase their “sibling rivalry” with every passing day. But what makes these cities so great is that when one is in trouble, the other will stand up in support. Immediately following the evacuations of the communities destroyed by Harvey, the City of Dallas created multiple shelters to house, feed, clothe, and care for those who now had nothing. One shelter in particular, the Dallas “megashelter” at the Kay Bailey Hutchison Convention Center, housed around 2,650 evacuees at its peak with thousands more in the surrounding areas. Hundreds of volunteers arrived to help care for these evacuees. I was one of those who were blessed enough to be a part of this great endeavor.

In conjunction with the medical students at UT Southwestern, Texas A&M College of Medicine students participated in a variety of clinical duties at the Dallas megashelter. We staffed the medical clinic from 6 a.m. to midnight every single day for 19 consecutive days. During this time, students, ranging from first year to fourth year, participated in almost every aspect of the medical clinic, from triaging patients to even participating as a member of the command staff. Thousands of patients were successfully treated due to the combined efforts of UT Southwestern, Texas A&M, the Dallas Fire Department, the Dallas County Medical Society, and many other organizations. When called upon, medical students spanning two large institutions bonded together to work through long hours and stressful conditions with no expectation of return. They were able to showcase the true meaning of being a “healer,” all while participating in pre-clinical and clinical duties. Even though there was no expectation of personal benefit, I believe that every student took something valuable away from this experience.

I cannot speak for everyone, but I can say that disasters have a way of uniting individuals and bringing out the best in humanity. For some odd reason, humanism truly shows its face when it is needed most. It’s what inspires individuals to go abroad and perform mission work in communities that they have no association with. It’s what inspires our soldiers to provide toys to children in areas in which they are deployed and currently fighting an enemy. And it’s what inspired the people of Dallas to step up when our southern sister city was struck by tragedy. I truly hope that every volunteer at this shelter learned as much as I did and is now able to showcase the best in humanity for the rest of their career. I hope that this event shaped the perspectives of every medical student who participated and allowed each and every one of us to discover our “identity” as a physician.


How Often Do We…?
By Radhika Shah, M1


How often do we
As future healers
Try to be
Anti-feelers

How often do we
Hurt and hurt
And neglect to see
That we are inert

How often do we
Become the patient?

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Life Changing Experience
By Kory Gill, DO


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Great-Grandmother
By David Harmon, M4

“She has just kind of lost the will to live.” My patient’s daughter worriedly described to me her mother’s current mood. My patient, who had multiple severely diseased coronary arteries, was not amenable to minimally invasive procedures, and she was also deemed ineligible for a more invasive bypass surgery. Upon receiving this news, my patient stopped moving. Completely. Family members would feed her, and nurses would fluff her pillow. Physical therapy was able to move her to a chair only with assistance. Her comorbidities and prognosis were only worsened by this depression.

I had been following her for only a few days, even though she had been in the hospital just short of one month. She was polite as I greeted her every morning, but I hated seeing her immense suffering.

Her family pulled me aside to discuss what, if anything, could help. After reviewing all the medical treatments we were providing her, I voiced my concern, “What is it that she has to live for? What is motivating to her?”

Her family unanimously told me about the newest addition to the family, a one-month-old great-grandchild, whom the patient had only seen once. The patient’s daughter expectantly asked, “Can we bring the baby here?” They assumed special permission was required.

I knew approval by the charge nurse was necessary, but, she was understanding of the difficult and unique situation, and my patient was allowed to hold the most adorable, chunky one-month-old later that afternoon. A warm, contented smile spread across my patient’s face when I walked in the door. “David, meet Jolene,” she proudly announced. Having seen this patient on rounds for over three weeks, and closely followed her for a few days, I had never seen her smile. In this moment, there was nothing on earth that could suppress this happiness, this excitement on her face. She looked so pleasant, so at peace, and, dare I say, healthy, holding her beautiful one-month-old great-granddaughter.

I dropped by the room one last time in the evening, before leaving for the day, to address any questions or concerns, as I do with all my patients. Her voice, still hoarse from two weeks of prior intubation, rasped a “come closer,” along with a slight hand gesture as she sat on the side of her bed. I stooped over, bringing my ear near her mouth to listen clearly. She quickly threw her tired arms around my neck and, with tears in her eyes, uttered, “Thank you. You have no idea what that meant to me.” Maybe I really didn’t.

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The following day, my patient’s blood pressure dropped, her heart rate slowed, and we called the family to the hospital as her code status was DNR. With tears in my eyes, I squeezed my patient’s hand and looked into her dying eyes. “It’s okay to rest now,” I said softly. She knew.

I helped this great-grandmother to see the one thing she loved most on this earthher legacy. With a final warm embrace of family and a final kiss to her great-grandchild, she was able to rest. I was privileged to care for a woman who raised a loving family and who allowed me the privilege to help in some small way.

Words are inadequate to describe how this experience made me feel, but I know I will never hesitate to ask “What keeps you going?” in hopes that I can provide some aid.


Seriously Studious Studiers Studying Studiously
By Rahul Dhuka, M2


Exploring the Principles of Sathya Sai Ideal Healthcare
By Anu Rao, M2

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Love all, serve all. Help ever, hurt never. These two phrases perfectly describe the teachings of Sathya Sai and were embodied by every presenter who took the stage on Labor Day weekend in Anaheim, California. At the annual Sathya Sai International Organization Medical Conference, you were made to feel like more than just an attendee; you were part of the Sai family.

My first taste of this came just as I landed at LAX early Saturday morning. I had been told that there would be a shuttle arranged to pick me and others up. My driver was a volunteer with the local Sai center who had kindly lent his day and his vehicle to drive conference attendees from the airport to our respective hotels. Unexpectedly, a smiling Anshul, my driver, greeted me with a boxed lunch, three water bottles, and plenty of granola bars, trail mix, and chocolate. After picking up a pair of fellow conference attendees, we were on our way to our hotel. His thoughtfulness helped get my conference experience off to an amazing start. 

The conference began with a melodious musical offering by a few local center devotees. After a brief introduction from the emcee, the first round of speakers commenced. Dr. Narendranath Reddy, one of the conference organizers, introduced us to the premise of this conference. He talked about several lessons he learned while working as an endocrinologist at the Sathya Sai Institute of Higher Medical Sciences (SSIHMS). I was amazed by the range of free services offered by the institute. It provided services ranging from eyeglasses to advanced surgical procedures. The technology available included state-of-the-art cardiac catheterization suites.

Sathya Sai Baba left this earth more than 6 years ago, but his belief that healthcare is a right for every person regardless of caste, creed, or age is carried on in his legacy with these beautiful hospitalsthe Temples of Healing. The three hospitals under the banner of SSIHMS were among the first in India to address the issue of how to get villagers necessary medical care. Knowing that one bus ticket costs about one day’s wage for a village family, the organizers implemented mobile clinics and telehealth. Village hospitals can be monitored and medical decisions can be overseen by remote physicians. The speaker's last lesson to us was: Don’t worry be happy, as every ounce of effort is spent in Sathya Sai Baba’s name.

The next speaker, Dr. Christina Puchalski, a professor at the George Washington University School of Medicine, talked about spirituality in medicine. Her experience in treating patients alongside chaplains gave her insight that bringing spirituality and faith into medicine helps improve healing, authenticity, and dignity, especially in palliative and hospice medicine. One of the most fascinating takeaways from her talk was the medicine and spirituality curriculum she establishedteaching medical students to bring up the subject of faith with their patients, even if the medical students are uncomfortable with it, and most importantly, adding it to the assessment and plan. Her group's SOAP note/HPI template includes physical, emotional, social, and spiritual content in their assessment/plan section. This innovative structure helps physicians think about the patient’s spirituality as part of their overall health.

One of the most relevant talks for us as young healthcare professionals came from Dr. Soumya Panchanathan, the associate program director for the pediatrics residency at Phoenix Children’s Hospital. She implemented a curriculum of mindfulness for the residents and talked about how to incorporate technology in a way that promotes mindfulness within the patient-physician relationship. Mindfulness involves removing your own problems from your mind before interacting with the patient. Sounds simple, right? However, it’s often more complicated than just sitting down and meditating for 20 minutes a day. In the medical field it is easy to feel like you are constantly bombarded with complaints and problems. An easy solution is to learn to frame the situation in a positive light. For example, instead of saying “this patient is always noncompliant with his medicine," we could say “I’m going to find a way to make sure this patient is willing and able to take their medicine”. This puts the situation in a more positive light because instead of being a passive complainer, you have become an active problem solver. This primes you to become a better listener and approach each patient with a blank slate. This approach has been helpful in restoring the budding physician’s empathy and job satisfaction. Additionally, using computers while talking to a patient usually reduces how much the physician listens to the patient. However, Dr. Panchanathan trains medical students and physicians to use a mobile laptop like an iPad to engage more with the patient during their medical care. This has not only improved patient care but also increased physician satisfaction.

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The rest of the conference consisted of small-group workshops exploring different areas such as telehealth, preventive medicine, and compassionate care. The telehealth workshop focused on a variety of methods that the SSIHMS employs in order to provide health care in rural villages. By utilizing telehealth and ICU physicians, medical professionals at SSIHMS can provide the same level of specialized healthcare available at the main hospitals in Whitefield and Puttaparthi. We were shown some innovative techniques used by specialists at the main hospital who follow up with patients who have returned to their village simply by using Skype from different business locations and internet cafes. Partnering with Dell, SSIHMS turned a van into a mobile healthcare system able to provide a wide range of services including ophthalmology, diabetic care, and cardiology services, just to name a few.

Perhaps the most memorable lecture was by Dr. Geetha Govindarajana physician at the Friend Family Health Center, a federally funded medical home in one of Chicago’s poorest neighborhoods. She talked about working with patients who live in housing projects and shop at grocery stores where fast food and cigarettes predominate over fresh fruit and vegetables. She herself became disillusioned with the difficulty of dealing with patients who miss appointments and don’t meet their healthcare goals until she started to try to connect with her patients by better understanding the problems they face. Something as simple as starting a community garden so that patients could grow and harvest healthy foods is one of the many approaches she has used in practice. Finally, she told a story of the clinic’s receptionist who, after dealing with addiction and heart disease for several decades, had a massive stroke that initially left her unable to speak or move. She worked at getting her strength back and came back to the clinic within 3 months. Her motto, and subsequently the clinic’s mindset, became: I have no complaints.

At the Sathya Sai International Organization Annual Medical Conference, I had the opportunity to interact with fellow medical students and young health professionals who strive to live their careers following the simple principles of Sathya Sai Ideal healthcareuniversal state-of-the-art healthcare at no cost to the needy; compassionate care; a comprehensive and holistic approach to treating the mind, body, and spirit; and preventive healthcare. 


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Hanna Fanous, Copy Editor
Garret Hisle, Copy Editor
Hasan Sumdani, Copy Editor
Anandini Rao, Copy Editor

Puja Panwar, Chairman of the Board
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THANK YOU

A special thanks to... 
Dr. Karen Wakefield for being our faculty editor,
Dr. Barbara Gastel for serving as editorial mentor,
and Dr. Gül Russell for providing support and encouragement.