Living with uncertainty

I recently met a patient whose credit card wouldn't go through as she was checking out. The problem was with the machine, not her card, but she was instantly on high alert for credit card fraud. "You have to understand," she said, "as a paralegal, I see identity fraud every day, and I'm paranoid that it will happen to me." We (the other students at the clinic and I) got it: we study diseases every day, with signs and symptoms that often appear relatively benign and familiar (fatigue, enlarged lymph nodes, etc.). Thus, med student syndrome. Yes, the possibility exists that one has lymphoma or lupus--but probably, hopefully, not.

Similarly, failing an exam--and with that, losing your summer or having to repeat the year--is always within the realm of possibility. Before med school, "failing" for many of us meant a bad grade; now, passing is a one-shot deal, determined by one exam at the end of the course. There are relatively few questions on that exam, and it's up to your best guess as to what material will be covered. This makes med school is a relatively unique and stressful experience.

So what do we do? One thing we can to is to accept the possibility and let go. Find activities that are pleasurable, soothing, distracting--like cooking! And if you choose to cook, don't worry so much about getting it exactly right: even if it's not perfect, it will likely taste just fine. G = MD.

Refreshing "mud season" salad (before spring veggies have quite hit their stride):

• fresh spinach
• handful of cilantro
• 1/2 apple
• 1/4 lemon
• olive oil or balsamic vinegar optional

Chop the spinach and cilantro. Cut the apple into 1-cm cubes. Pack up with the lemon wedge. Before eating, squeeze the lemon over the leaves and toss together. For added substance, serve with: cheddar or goat cheese, toasted walnuts, pumpkin seeds, lentils, quinoa, or yogurt on the side.

Adds a little bit of sunshine to your day!

Come for the policy, stay for the food

Over the past year, I've had a great experience getting involved with Students for a National Health Program, a national and on-campus advocacy group. The organization's long-term goal is to reform health care financing in favor of a single, public insurance offering for all Americans (the "single payer" movement). Its short-term goal is to increase grassroots support among physicians and health professional students (see www.pnhp.org).

One thing I've learned in this experience is that a tight social bond around an issue can provide much of the ongoing impetus to keep pushing the work forward. As a group, we keep each other on task; more than that, I actually look forward to our meetings. Without this group of friends I would lose the reassurance that I have peers who are interested in the same broader questions as I am. As one friend said tonight, “I don’t want to be forcing single payer down people’s throats, I want to be having intellectual discussions with my classmates.”

Comparing this project to so many other ideas that I've had, started to work on, and then deprioritized, it's not the passion that I lacked, it was the social support.

Tonight we had a big potluck dinner and discussion. The food was great, the conversation even better -- I even had one of those "out of med school moments."

Potato latkes: You can use any online simple recipe, with a couple of simple tips. After grating the potato and onion together, fold them into a large kitchen cloth and wring out as much water as possible. Then toss with other ingredients (you can use flour instead of matzoh meal). Fry at high heat and don't be afraid of oil!

Apple sauce: Wash and core apples. In a large pot with a lid, add the apples, about half a cup of water, and cinnamon to taste (or one cinnamon stick if you have them). Leaving the lid on, cook over medium-low heat for about half an hour, until the apples are completely soft and falling off the skins. Stir occasionally and add more water as needed to prevent apples from sticking. At the end, use an immersion or regular blender to puree the skins. 

Having escaped maternal rejection

It was a wake-up call to recently find myself scribbling "what happens to sperm not ejaculated? do they die?" without a concern in the world other than whether sperm left in the epididymis are phagocytosed after a few weeks and by what. Makes you want to take a hard look in the mirror at what you've become.

Yesterday we learned that maternal white blood cells can recognize fetal blood cells as "foreign" (if they happen to come in contact) and may then develop antibodies against them. The mother "mounts an immune response" against the developing fetus in her uterus -- leading to problems down the road. "The ultimate maternal rejection," as my professor put it.

But my mother loves me, so why not post a simple recipe that she taught me?

Haroset (technically a dish for Passover, but such a good snack...)

• 2 large green apples
• 1/4-1/2 cup walnuts
• ~1 tbsp cinnamon
• ~1/4 red wine (or grape juice; a smaller amount of balsamic vinegar would probably work too)

Chop the apples into 1-cm or less chunks. Roughly chop the walnuts (untoasted). Toss all together. Makes a great snack! I confess that I brought some to school for lunch, wine and all.