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We Are In Trouble -- Just Look At Our Medical Students

3/31/2017

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Raising confident, self-reliant children should be a priority in  modern society.  The combination of gratitude and perseverance will  serve them all their lives. 
Dr Chris Baker's  book, REAL, gives life strategies, including guidance for parents wanting to raise responsible, mature  children.
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A sense of personal responsibility is vital for children to develop happy and productive lives. 
Dr John Rosemond's book, New Parent Power!, is a classic work on how to raise emotionally mature, stable and responsible children. 
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Putting your children on the right path to emotional stability and maturity requires giving them life tasks that accustom them to responsibility and confidence. 
Her mother and father are in grief, probably still every day.  Maybe she had siblings who are as well.  She died one morning in August, 2016, when she took her life, jumping from her eighth floor medical school dorm room in New York City.  

The medical school is scrambling to “pledge more compassion,”  according to the dean of the Mount Sinai Medical School in his essay in the New England Journal of Medicine.  

Why would he say that?  People who go into Medicine are typically quite compassionate to begin with.  They care about others.  Most of them. 

Of course, within any group of people, there are those who may be driven more by financial reasons, or who have mental health issues, even severe ones.  But still, why would he say they will pledge more compassion?  He’s on the hot-seat.  His school has lost two medical students to suicide recently. 

So, the spokesperson for the school has to respond.


Let us look at what seems to be going on. 
Firstly: Culture of blame/victimhood.  Our culture has become one of blame - both through our human wish to not think “bad” things are our fault and through our legal system that follows and assigns blame, and quite honestly, punishment, for the blamed. 

Shall we call it blame? 

Or shall we call it victim-mentality? 

We have lost way too much of our sense of personal responsibility.  We are not teaching our children responsibility.  Our culture is rife with children who are not growing up well.  The media is full of information about how the millennials, our young people “need” more support and direction in the workforce, and are not as capable of full responsibility and enjoyment in the working world as their predecessors.

Should a physician not be one of the MOST responsible members of society? The “millennials” are reputed to be sensitive, incapable of the kind of responsibility and commitment that their parents and grandparents exhibit.  They have been called “snowflakes” referring to their fragility.  

Do we want fragile physicians?


Secondly: Belief in mental issues, mental illness, and need for psychiatric counseling. The follow-up to the medical student suicides has the schools looking at how they can provide more support to the students in the area of psychiatric visits for mental health support at discounted fees, and “breaks” after the adult medical students experience the death of a patient.  

Reading a recent Wall Street Journal article (Lagnado L, After Tragedy, Med School Pledges More Compassion. WSJ 2017.03.23), I found myself agape.  


As a 10-year critical care nurse, I not only experienced death of patients on a regular basis, but was responsible for the life-saving measures to attempt to save and prolong life.  Did we nurses feel affected when a patient died? 

Of course.  What did I feel when the cardiologist patted me on the shoulder, and said, “Do what you can,” and left the ICU?  I felt a sense of huge responsibility, commitment, love and concern for the patient and family. 

What did I feel when we had lost a child patient in the emergency room and the attending ER doc said, “Would you go tell the family?”  Huge responsibility, commitment, love and concern.  I knew I could do that well, even knowing I would most likely be teary with the parents, and help them through the first moments.  


And these docs who delegated huge responsibility to a capable and dedicated nurse were not snowflakes.  They were quite responsible with venerable careers in medicine who were sharing shouldering the burden of human suffering.  

​None of my colleagues nor the physicians that I knew well had psychiatric or psychologic counseling or “breaks” when the patient died.  We all grew emotionally, spiritually, and in our awareness of the preciousness of life as well as the limitations of life, medicine — even modern medicine.


For me and my colleagues, in medicine and  in patient care, each day is one full of anticipation and  excitement for what we can bring to our patients.  It is a day full of Gratitude as the day’s operative belief.   

Why are medical school academics not familiar and comfortable for the medical student?
OK - I went to dental school, AND worked basically full-time as a nurse, through my four years of dental school. I have been appointed to faculties at 3 dental schools and taught medical and dental students, and I have been part of admission committees deciding which applicants get an interview, and which of the interviewees get an offer to be a student in that school. 

I have watched my son become a dental school faculty member after his medical school education, and in addition to his huge responsibilities running two clinics, faculty practice, and the other a patient care clinic, he is doing his post-doctoral Master’s in Public Health and being an active husband and father in his nuclear family. (And yes, he has a wonderful wife!)   He loves it all.  It makes for a wonderful life of love of others.


As to the medical education and its academic pressures:  The students admitted to medical school have demonstrated academic ability in the tough pre-med courses, and finish those with high GPA’s, high MCAT scores, and high involvement in extra-curricular activities.  In fact, the committees aren’t interested in students who have not shown a high involvement in extra-curricular areas, including work. 

Why?  Because, the student who has not handled the well-rounded schedule of schoolwork, community work, and other areas of teamwork, will not thrive in medical school.  Other areas of teamwork include athletics, music (choir, band, etc.), volunteer work.  These help show an applicant’s balance and “whole-person-ness.”


Grueling academics?  Sure, it’s top-level academics.  Don’t you want your physician to know stuff?  But grueling?  These students have shown they can handle their demanding academics and still handle life.  There are days, weeks, semesters, in medical school that challenge one, and especially the student with a young family, or with family members who are very ill, or a marriage that is not solid. 

And, the schools might need to improve their support of those students in that the student should be encouraged to take a leave of absence in order to deal with the life-challenges and then come back to medical school if they feel — and are — ready. 

Surely, even our most capable students, admitted to medical school, having grown up in our victim-culture, modern media, including news, movies and social-media, and resultant societal beliefs, are vulnerable to, as the articles suggest, the “burn-out” and depression of being a medical student.  


It is the school’s responsibility to help any students that are not thriving, to be identified and counseled that the fit of the profession may not be for them, to encourage student groups to discuss and help each other in the experiences of medical training.  But to decide that, as Mt Sinai has done, that “honors” should be given to more than just the 25% that earned it, that “high pass” should also be given to a bigger group, is absurd. Their rationale is that the system “PROVOKED  intense rivalry among students,” is the same sort of thinking that leads every soccer player to get a trophy. 

And so, Mt Sinai med school  “hopes to drop these limits altogether.”  Every student will be equal. 

REALLY? 

Isn’t that more of what got us into this mess already?  When the students have no evaluations or performance grading, how will the residencies and post-doctoral specialty programs choose their applicants from the pool.  The suicidal med student will be an equivalent candidate to the most mature med student?


What kind of medical care will be provided by the student who has been told he is “honors” material when he is not, or by the student who believes he is “burned out” when he graduates, or by the student who utilizes the psychiatrist who is treating the mental health issues the young physician believes he has?  Do you want your physician to be one of those doctors?

And, as my husband Claude points out, after his law school education, what a field-day the lawyers will have when a family or patient sues the doctor who has a history of psychiatric /psychologic counseling throughout school and beyond. (HIPAA, you say? 

​There is no such thing as confidentiality today.  Just ask the leakers of the highest level confidential and classified information in the news, no less.  No, on top of burn out, those physicians will have a hell of a time with the lawyers.  


Yes, the medical schools owe their students the responsibility of taking the most ready, capable, mature, mentally healthy applicants, and then monitoring them at every level possible, and guiding, supporting and mentoring them to remain capable, mature, and mentally healthy.  The schools must understand that what we believe is what we become. 

The physicians who are responsible for these medical students must be brave enough to notice, say so, help as they can, including limiting the at-risk student to a leave of absence, or out of school.  That is far better than seeing medical student lives lost to suicide, AND patient lives lost to mentally fragile physicians.  


And we as parents must work on teaching our children responsibility and not victimhood.  Let us have days full of Gratitude as the day’s operative belief.  It is time.  
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Handheld Devices Should be Banned for Children

3/21/2017

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Activities for children where they  learn real-life skills are far healthier than screen use. 
Cris A. Rowan's book, Virtual Child, describes the dangers to children created by screen use.
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Excluding screen use by children helps create a bright future for your child.  

Handheld Devices should be banned for children under the age of 12, AND screens and technology should be severely limited with all children.

Why?  The American Academy of Pediatrics and the Canadian Society of Pediatrics say:  

Because use of screen technology (TV, cell phones, electronic games, internet, iPads, tablets, computers) is associated with:

  1. stunted, delayed, impaired, and decreased brain growth.
  2. developmental delays, poorer literacy, poorer learning and poorer academic achievement;
  3. obesity and diabetes;
  4. poor sleep;
  5. poorer grades;
  6. mental illnesses, including depression, anxiety, attachment disorder, attention deficit disorder, autism, bipolar disorder, psychosis, behavioral problems and aggression;
  7. decreased concentration and memory, due to the brain not developing neuronal tracks to the frontal cortex;
  8. addictions;
  9. radiation illnesses, including cancer.  Children are more sensitive than adults because their brains and immune systems are still developing;
  10. lack of a good future.

Pediatricians report seeing patients age 3 to 6 years old who have become addicted to their devices and do not sleep more than 4 hours a night, and cannot cope with the device being taken away.  

High frequency gamma brainwaves are associated with perception and higher brain activity, and are present when a child is telling a story, listening to a story, drawing or playing imaginatively with other children. 

Research shows this brain activity flatlines (is ABSENT) when children are on screens.  This is serious, especially in a child whose brain should be rapidly developing at age 2...  or 3... or 4...  or 8 or 9…  


Instead, the doctors are seeing the children because they do not sleep, have delayed speech and have persistent headaches, ADD, ADHD.

The terrifying truth is that technology is taking our children’s futures!  Read:  Virtual Child: The Terrifying Truth About What Technology is Doing to Children by Cris A. Rowan . (See the  left column to order this book.)

We have gone down the wrong path.  Technology as a learning mechanism is just plain wrong.  I know, I know.  How could alll these educators be wrong?  We don’t know until we know.  Now we are seeing the results, number 1 through 10, above.  

Protect your child.  Take away the handheld devices;  seriously limit ALL screens - TV’s, movies, games, iPads, tablets and all!
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Rich and Wonderful

3/19/2017

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"It is time to believe in the preciousness of life -- and spend your hours of your days savoring and enjoying it. "
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It is "Time to tell your loved ones and friends how much you love them." 
It’s time.

Time to start finding and hanging with people who lift you higher and higher.

Time to notice when you are worrying - and go to gratitude.

Time to believe in the preciousness of life - and spend your hours of your days savoring and enjoying it.

Time to make all your decisions, every time, to take you in the direction of your dreams - your food; your exercise, your time; your actions that take you where you want to go!

“What you get by achieving your goals is not as important as what you become by achieving your goals.”      ~ Henry David Thoreau

Time to find and read inspirational words for 15 minutes every day.

Time to tell your loved ones and friends how much you love them!

Time to be kind to everyone you meet.  Time to remember each is doing the best they can at that moment, with the resources they have.

Time to say thank you - when people are nice to you - and when they are not.  Find a way you can appreciate them.  Give them love anyway.  They will love you for it.

Time to choose joy, to choose to be happy!

Time to savor your rich and wonderful life.

No matter what, no matter what.

Love,


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From your morning coffee to...

3/12/2017

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Every morning, my husband Claude and I enjoy our coffee from a French press pot. We have several, but this one is our favorite. 
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From your breezy glorious spring mornings, to winter’s blustery last reminder, to snowy skies and starry skies; 

From bright pea green leaf shoots on winter’s awakening trees to herb seedlings popping through the ground; 

From strawberry season’s herald to the anticipation of harvesting the first peaches; 

From your morning coffee (yummy with a bit of chocolate and cream) to your evening salad of spinach, gorgonzola dolce (mild and creamy), walnuts, prosciutto and tangy onion chutney; 

From a knock on the door’s excitement to a flight to a far and exotic place; 

From blue jeans to tuxedo and all their comforts and sharing; 

From your sleepy opening of your eyes to the morning golden light to your sleepy closing of your eyes to precious sleep,

Bask in your gratitude for each and every moment.

Grateful for you,
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On his way outta Dodge - Santa couldn’t resist the warmly spiced, buttery, scent of crumb-topped coffee cake fresh out of the oven.

3/10/2017

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Dr Chris honed her cooking skills while in dental school. She subscribed to Bon Appetit Magazine and learned new recipes each month. 
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Some Thursdays, we open my orthodontics office earlier, from 7am until 3pm. 

A few months ago, I thought those hours might give parents some early morning appointments, to avoid the conflict of school and orthodontic appointments.  Turns out, it seems to be quite popular.  Since the staff, Claude and I get up quite early to be at the office “ bright-eyed and bushy-tailed” and ready for the patients, I usually provide “breakfast.”  


Breakfast has included yummy fresh baked croissants and pain au chocolate (chocolate croissants) from Spinney’s, that absolutely brilliant, gorgeous food emporium, as well as other nifty pastries. 

Yesterday I enjoyed making a Sour Cream Coffee Cake to take in this morning. 

It was fun to share it with the staff and with several of the early morning moms. Since every single mom wanted the recipe, I thought it would be fun to share with you here.  In fact,  I think I’ll share recipes regularly with you, as I absolutely love to cook, AND have some fabulous recipes.


This particular recipe’s history is part of my dental education.   When I was in dental school, there was no money to be “going out” to eat.  The money we had was hard-earned at the hospital where I worked as a nurse throughout dental school.  Those evening shifts definitely paid the basic expenses, but not any going out expenses. 

So, I subscribed to Bon Appetit  magazine during the dental school years (only 9.95 per year - a veritable steal!). Each month a treasured new edition of recipes came to my mailbox.  During the ensuing month, I made many of the recipes in each Bon Appetit, and boy! did I learn a lot about cooking!   Oh - and boy,  did we eat some great food!  For cheap!


It so spoiled us that now eating at home beats the heck out of going out most any place you can name.  Seriously!  

One of the recipes discovered along the way is this one.  

Sour Cream Coffee Cake.  

350 degree oven (177 C)

Butter a bundt pan

Mix and chop in the processor, then set aside:
2T sugar
1T cinnamon
½ c pecans or walnuts

Mix in food processor in this order: 
2 sticks of butter, softened in the microwave for 20 seconds
2c sugar


Then:
2 eggs
1 c sour cream, preferably Daisy brand (no junk/preservatives) 
    or Lebneh if you are in the UAE
1t Baking Powder
1/8t salt
1/2t vanilla extract


And then:
2 c flour 


Finally:
1/3-1/2c of chocolate chips – just barely mix in Processor using short on-off turns

Spoon into bundt pan.  Spoon about half in several large spoonfuls into pan, and sprinkle about half of cinnamon-sugar mixture over the batter, then spoon the other half into the bundt pan and sprinkle the rest of the cinnamon-sugar mixture over that.

Pop into the oven for about 1 hour, or until  a little bamboo skewer comes out clean.  Mine often take 1 hour and 10-15 minutes additional.

You should know that this melt-in-your-mouth cake that begs for coffee alongside, has been our family’s tradition on Thanksgiving morning and Christmas morning, ever since dental school.  And, you can make several up one evening, and repeat another evening, and freeze them wrapped in foil, and into a ziplock bag, and have amazing presents for colleagues and friends. 

We have started making these cakes some years around Thanksgiving weekend. We'll have a freezer full of 10-12 or more  ready to take out of the freezer on an evening, and the next morning put a big red bow on it to  delight someone.


It’s also nice to have your Christmas breakfast ready and waiting.  Take it out of the freezer on Christmas Eve, and the next morning it will be ready to serve.  That is if Santa hasn’t helped himself on his way outta Dodge. 

Though the warm spice and butter-sugar cake scent wafting through the house makes it surely tempting to bake and then eat warm, right out of the oven. And it is goo-ooo-ood!

If you’re going to freeze them, BE SURE to let the cake cool completely to room temperature after it comes out of the oven, before you wrap and freeze.  

Be sure to let me know just how yummy you think this recipe is, AND any ideas for enjoying it!  You know I love to expand my cooking and baking in every way possible.
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What are your beliefs?

3/5/2017

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As we journey through our lives, we have almost constant choices to make along our path. 
Jeff Olson's excellent book, The Slight Edge, is a great guide for turning your goals into reality. 
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Make the pursuit of your dreams a joyous path. 
As we journey through our lives, we have almost constant choices to make.  Those choices will make or break our life’s joy.  It is truly our choices that determine our  results. 

​Jeff Olson has said that each choice is a simple decision moving us the way we truly want to go, or a small error in judgement that takes us away from joy.  


And over time, these choices/actions create our results (our life.)

What determines your choice?  — Your beliefs which make up your attitude.

"The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say or do. It is more important than appearance, giftedness, or skill. It will make or break a company ... a church ... a home. The remarkable thing is we have a choice every day regarding the attitude we will embrace for that day. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude ... I am convinced that life is 10% what happens to me, and 90% how I react to it. And so it is with you ... we are in charge of our Attitudes.”
       
~ Chuck Swindoll

This week, you can decide to make choices that take you toward your goals, your joy, the life of your dreams.  You can act “as if”.  Another way to say it is, “fake it till you feel it.” 

Because, as you act like the successful, joyous person you want to be, you are putting energy toward your joy, your goals, your dreamlife.  


You do not need to know all the pieces of the whole picture of your life, but rather you need only the missing piece at this moment, the thing that will get you started, the motivation to start on the path. This could be the realization that you and only you are responsible for changing your life to what you want.  

On this day of decision,  you may not know where you're going, but you're on the pursuit.  And the pursuit is joyous in itself.

Today - grab hold - take hold of your life - make decisions - every single one - that make your ride what YOU want.


Keep walking on your path - joyously.
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    Dr Chris Baker

    America's most-trusted teacher of orthodontic continuing education, Dr. Chris Baker has practiced and taught for more than 30 years, and is a current or former faculty member of three U.S. dental schools.  She is a pediatric dentist, author, blogger, dental practice consultant, and mentor.  Dr. Chris is also Past President and Senior Instructor of the American Orthodontic Society.  She is based in Texas, USA, but lectures around the world.

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