Better: A Surgeon’s Notes on Performance

The first book I’ve read and then reread by Atul Gawande. An excellent read for anyone in the medical field. A few things that I’ve learned:

1. Improving outcomes is not only about inventing new technologies, but changing your practice with the resources that are available. 

2. Don’t be afraid to try new things even if the evidence is not strong/available yet. If the technique/intervention can work on a few people, you may end up saving their lives and/or improving their quality of life.

3. Better your practice by looking for what more you could do. And always do right by our patients, whatever that may mean for that individual patient.

If the doctors in rural India can learn multiple specialties and take on more than they can handle with the lack of supplies/personnel, you can definitely change your practice too.

How can you improve your outcomes? 

Option B

Great book overall regarding resilience after loss/failure.

1. Bad things happen to everyone and it can be out of your control. What matters is your reaction to the situation; how do you get back up?

2. Acknowledge the elephant in the room. Open up and let others in -people have more in common with you than you think. Plus, opening up will allow others to support you. Most people just don’t know what to say or do. And if you know someone who is grieving, offer something to show that you care. What matters is that you are present.

3. Resilience is not a fixed trait; it’s flexible and it’s a team-effort. You can be resilient, and you will be. Ask for help when you need it, and be honest with your feelings.

Loneliness: Human Nature and The Need for Social Connection

1. Every individual has his/her minimal requirement of social connection, depending on his/her genetics, upbringing, interests.

2. Loneliness can negatively affect executive function (e.g. eating unhealthy foods in unhealthy amounts).

3. Lonely individuals perceive less reward from positive social connections, and are more likely to look for threats in their environment. 

4. Human beings are gregarious creatures, and it is normal to need social interaction much like food. When you are hungry, you crave food; When you are lonely, you crave social connection. But the lonelier individuals have a harder time reaching out to others.

5. Ease back into social connection. For me, this can mean don’t turn others away for making small talk. This can be a way that they are slowly stepping outside their comfort zone to make a social connection.

White Noise

The doubt and anxiety that I’ve been feeling has become deafening. To the point where I can no longer ignore their voices and echoes in my mind. I’ve tried to shut out the noise and to focus on the present; to focus on the things that I know I can change and remediate. But that, like most things in life, has a limit too. I can only build up my wall for so long before running out of glue or before I need to rest. I can only run so long before needing some water. After all, we’re all human.

The more I learn, the less I know. Sometimes I feel small and less confident. Perhaps I'm not good enough. But for whom?

Chance Encounter

It's really amazing how one person can really turn your day around. Yesterday at work, I was standing in a patient room talking to my patient and her family member when I experienced a sudden episode of dizziness. One moment I was fine, the next moment I felt as though I came to a sudden stop after being spun around and around on a chair.

Know your worth. Know what you deserve. Don't accept any less. Someone who's going to fight for you. Someone who's excited about you and for you. Someone who wants to know how your day went. Someone honest. Someone earnest. Be that someone too.

Happy Birthday

Happy birthday

I stopped looking forward to birthdays at a certain age. Many people around me got older and they too were not too keen about being a year older. What's so good about being old? Sure there are lessons to be learned every year, every milestone, every heartbreak and new beginning. Even my professor in grad school exclaimed "sucks to get old!" Of course she was talking about the physiological changes as we grow older. But everywhere I look, people are face aging with a grim disposition.

But what if we can change that? No, we cannot reverse the aging process. But what if we change our outlook of aging. Instead of celebrating another year older, why not celebrate another year of life conquered? Another year of shared memories. Another year of claiming "this year is going to be the year." Another year of new fears, new insights, and new beginnings. Another year of loving your loved ones. Go ahead, let them know. Another year of feeling alive.

Here's to you who is still breathing and embracing life. Happy birthday.

Moments of doubt. Moments of feeling small. Moments of yearning for more. The insatiable hunger for happiness and peace. When the water is calm and you can take a dip. First with your toes, then slowly creeping your whole body in. I've heard it time and again that we have to learn everything we can from the storm until the calm. Instead of getting soaked while looking for shelter, I should embrace the rain falling on my face. I tell myself this and that. I'm practically telling people to do this and that all day. Now if I can only listen to myself as well as my A+++ patients would. The least I can tell myself is that I am good enough, that I am going to get better. The only way to go is up. While scanning for environmental obstacles of course.

How much does MONEY affect the healthcare system and the quality of care provided to patients?

The feeling that you get when someone whom you met just last week, needs you; appreciates you; finds you irreplaceable. 

I have a few new pts this week, and already, there is an emotional connection between me and them. I can feel it, and one of the pts already said to me on her first day, “I like you Keiko.” A family member whose mother has been unable to get out of bed due to orthostasis was genuinely sad when I told her that I won’t be her mother’s PT from next week.  I am overwhelmed, yet grateful, for the responsibility and trust that my patients and their family members have given me. It’s one of the greatest feelings to have what you love to do, love you back in return. 

It makes me want to be a better clinician: not only clinically, but also emotionally. Authoritative, stern, yet warm and empathetic.

When something doesn’t feel like enough.

Reminders on Love

Don’t make mediocre love your final destination for romance. We all have an idea of how we want to feel when we’re with someone. I want to feel safe, embraced, and loved. I want to be with someone who cares about my day; someone who wants to know how I felt; someone who cares. Someone I could see myself growing old with. Someone I want to embrace with love, compassion, and all the warm feelings.

Work hard for the best love. Find your best love and keep it. Nurture it, especially when times are rough. Relationship goals? Achieve them because you worked hard for them. 

Continue to always learn more about your partner. Ask questions and listen.

When you look at your reflection, what do you see? Are you someone you want to be? Are you someone others want to be around? 

And why?

What would you have said 1 year ago, 5 years ago, or even yesterday?

Everyday I want to wake up a little better than yesterday, but no more than tomorrow. I want to feel a little more, see a little more, and surprise myself a little more each and everyday. 

What motivates you?  I used to be motivated by my own desires. I want this; I want that. I want to look good. I want to dress well. I want to eat delicious food and show everyone. Because it will make me happy. What is a stronger motivator than happiness, especially when it can be effortlessly achieved? Only recently did I realize that happiness can’t be achieved by helping yourself. Happiness can’t be achieved by showing the world how “happy” you may be. It’s from within. Of course I don’t know what the secret to happiness is. But I believe happiness can be achieved by being selfless and taking actions to better others’ lives. Only from helping people can we discover what it is that people need and feel, and not what we think they may need from the outside perspective. 

Everyday I want to wake up with the conviction that there is something I can do for someone out there. Understand, empathize, think, act.

誰かの為に出来る事とは何？

Big Moves

Accepted a job offer as a physical therapist at New York Methodist. It still feels extremely unreal that I will finally stop being a student and being an autonomous employee at a hospital.

Anxious, yet excited. Keeping my eyes open, hands steady, and embracing my beating heart.

I want to wake up and know I am exactly where I need to be.

Inspired to Come Clean

You have to be clear of your past before you are able to allow the energy of love to flow. Only then can you live in the present and be true to yourself and to others. Only in the desert with nothing but empty dunes, can you hear the wind. Clear your mind and listen. Be free of the weight of your past.

I want to remember this as I move forward and collect more memories.