Posts tagged: selective

Making a Difference: My Reflection on El Salvador &

By , March 26, 2009 at 2:51 pm

Meet Jorge Raul. Jorge has never met me, nor have I ever met him, but I have met and seen many faces of Jorge in my recent trip down to El Salvador on a medical mission with Mayo Clinic and Operation Blessing. When you realize that much of the world has it much worse off than you, suddenly life takes on a new perspective. Take for example my experience working with our doctors examining the many old ladies who came into our free rural clinic in El Salvador complaining of muscle fatigue and bone pain. Muscle fatigue was simple: despite their old age, they were still working hard in the fields in the scorching sun to scratch out a living. The bone pain? Easier to diagnose than to treat. These ladies, despite their best nutrition, were calcium deficient and are developing osteoporosis. “Increase your calcium intake” we advised them, advised them until we realize that their nutrition consisted of only rice and beans, day in and day out: “milk is too expensive,” they told us. Cheese was a fantasy.

Such societal disparity was shocking to me as I worked in the mountain villages of El Salvador where just a short 40 minutes away was the commercialized hub of San Salvador where I had just dined on sushi at Benihana’s the night before and was comfortably lodged in our air-conditioned hotel with wifi, a flat screen TV, bottled water, and a daily hot breakfast. Suddenly a knot of guilt tightened across my belly as I tried to swallow the fried chicken, biscuit, and slaw that was being served to me during our lunch break at the rural clinic. “These starving people are so graciously watching me stuff my face with chicken,” I thought to myself, “I wonder if these children have even tasted chicken before?”

While we took no measures to provide ourselves with any extravagance on this trip, in contrast we were basking in luxury compared to the lifestyles of these people whom we were serving. Our $26 a night hotels and “U.S. comparatively half-priced” Benihana’s dinners suddenly carried a lot more superfluous cost when we learned that these people living in the hills had to buy their bottled water on the few weekly dollars that somehow they generated through their agriculture or industry.

I could go on complaining about the deprave social condition that we as humanity have let ourselves stoop to, that such circumstances that I’ve described actually exist, but in continuing to do so, I lend my voice to nothing more than the numerous politicians, the bureaucrats, and the institutions that talk the talk of change and do little in effect to make a difference.

So let us talk about making a difference. In 2006 Muhammed Yunus, a Bangladesh economist was awarded the Nobel Peace Prize for his work in microloan banking. Gambling against human self interest, Yunus took a chance at the novel notion that poor people nonetheless being poor were still good people. These were people who didn’t want to remain poor, Yunus thought. They were products of social circumstance and were suspended because of no means of upward economic mobility. So, Yunus thus started the Grameen Bank in which he started loaning outmoney to the indigent that had a need for money – a plan for industry, or an idea to help themselves out, and what he discovered was a phenomenon that is growing globally today.

There are people like Jorge out there who have an idea, who have an industry, who have a means to get themselves out of the poverty that is tethering them down — but they lack the equity, the first chance, and the gamble of trust that most financial intuitions operate by when they calculate the odds of their institution ever seeing the money they loan again. Here’s were you and I and come in.

Kiva, a non-profit organization which works with other global NPO’s and NGO’s find people like Jorge who have a plan and have a need. In fact Jorge even had a bio:

Jorge is 42 years old and he lives with his wife and children. He has three children that are the ages of 15, 9, and 4 years old. They are all in public school. Jorge sells chicken and his wife sells food, and they used to always have leftovers. They always used to have to pay people to take away the leftovers until Jorge got the idea to raise pigs and to feed the leftovers to the pigs. He now has 180 pigs. Jorge needs $525 to buy live pigs and food for them. Since Jorge has been in the group Finca, he has progressed economically. Also, he has learned to be punctual in making his payments on loans for his business. Jorge’s dream is to buy a truck for his business.

Merging Yunus’s microloans ideas with the global reaches of the internet, Kiva has harnessed the individual’s capacity to make a difference. Philantropy now crosses all boundaries as individuals can help individuals directly for as little as extending a $25 loan to someone in need. The beauty of this social experiment is that Yunus’s gamble paid off. To date, over 98% of his loans are repaid, and Kiva through their affiliate partners boasts similar returns.

Though this is but a small step in the marathon humanity runs against poverty, it’s one small step that I’ve taken to make a difference directly in someone’s life. You can choose to donate separately to Kiva if you wish, but Kiva, unlike many other institutions that will skim your donation, assures you that 100% your money is going where you intend it to go.

Foregoing a meal at Benihana’s today may be a small sacrifice that I make, but with I hope that that sacrifice can make a bigger difference in Jorge’s life. I invite you to learn more and make a difference at:

Greenwich: Straddling the Hemispheres

By , December 6, 2008 at 11:55 pm

Greenwich is famous for its standard time (GMT) that bisects the world into eastern and western hemispheres at 0 degrees longitude, and also known as the prime meridian (the international dateline is its analog on the otherside, but that zig zags around certain islands). Anyways, Greenwich was a great 20 minute boat detour down the Thames. Picking up a high speed ferry from the Tower of London we headed to this smaller city and its observatory in the park and university that is central to the town. As dusk set, you are able to visualize the prime meridian as a powerful green laser beams its path above the point that I’m bouncing around and over in the picture here. You can see our Greenwich pictures in Europe Gallery allery 6, starting from our ferry ride. It’s not everyday that you have a picture that spans two hemispheres, let along having the opportunity of bouncing back and forth between them.

I See London, I See France…

By , November 24, 2008 at 7:52 pm

And we might also have seen some underpants (or lack thereof) in one of these galleries documenting our dinner excursion through the Montmarte district of Paris. Rest assured the facade of these buildings including the historic Moulin Rouge was as far as we got as we settled for a nice little Italian bistro over the cabaret that evening. In a whirlwind 8 day trip, our journey spanned over 11,000 miles with over 60 hours of travel and as we straddled Greenwich–even crossing over two hemispheres. I brought along the Canon XSi to break in – so pardon some duplicate series of pictures as I was trying to play with the settings and didn’t prune these 3000+ (40GB+) worth of photos yet, everything here was taken as is, minus the videos, and scaled down to smaller size. Just as a reference itinerary, this is what David and I covered in the 8 days that we were gone on our version of The Amazing Race:

  1. Sunday November 16, 2008: Travel 350 miles by car from Rochester, MN to Chicago O’Hare, hop on a connector flight to Dulles, Washington D.C., enjoy a three hour layover, jump aboard another plane for an 8-hour flight to London Heathrow, figure out how to use the London Underground system and buy an Oyster card, jump on Monday morning’s 7am commute to St. Pancras station.

  2. Monday November 17, 2008: Realizing that we arrived too early for our 1 pm Eurostar train to Paris, we meandered the British Library near St. Pancras, enjoying the Magna Carta and various original texts such as Leonardo Da Vinci’s notes, Isaac Newton’s letters, and Galileo’s sketches. The Eurostar was a lost memory due to sleep deprivation, but after pit-stopping in Paris, we walked the Champ de Mars, and ascended the Eiffel Tower

  3. Tuesday November 18, 2008: Visited the Palace of Versailles, the Hospital Museum (Musée de l’Assistance publique – Hôpitaux de Paris) and walked by Notre Dame Cathedral by night. Ascended the Arc de Triomphe, and ended up in Montmarte for dinner and shopping.
  4. Wednesday November 19, 2008: Revisted and ascended Notre Dame Cathedral (Notre Dame de Paris) proper, saw the museum and crypts of Notre Dame, walked through Hotel Dieu and then saw 2-million skeletons in the Catacombs of Paris. We finished the day blitzing through the Orsay Museum, blistering our feet through the Louvre and finished the day at Place Monge, which ironically enough was not happening at all at 10:30 pm at night, though we managed to sup on escargot outdoors at a cafe that spoke not a speck of English.
  5. Thursday November 20, 2008: 5 am Eurostar trip back to London was equally not the most exciting though we arrived plenty early in London to beat the opening of most places at 10 am. We hit up the British Museum, ate out of the supermarkets where food was actually affordable, and visited the Hunterian Museum of John Hunter (1728–1793) as we came in part to study history of medicine by also reading the biography of John Hunter: The Knife Man. We went by Westminster and Parliament but by 3 pm apparently the sun sets in London so we decided to go crash and recoup from sleep deprivation early.
  6. Friday November 21, 2008: London Bridge (Tower Bridge), and the Tower of London started off our day, and effectively ended the daylight too since there was only about five hour’s worth. We took a boat to Greenwich and straddled the Prime Meridian with a foot in each hemisphere. A walk through Leicester Square and Trafalgar Square ended our evening.
  7. Saturday November 22, 2008: More walking. More blisters and bursitis. Buckingham Palace probably had a changing of the guard, but we were too pooped to wait and find out, so we walked onwards and across the Thames from Parliament and Big Ben and Westmister Abbey, in fact we walked all the way to the Imperial War Museum where we stayed longer than we expected, and ended up skipping St. Paul’s Cathedral, though we walked in and looked around without paying its hefty entrance fee. Finishing the night in Oxford Circus we supped on fish and chips in an English Pub, and nearly died on the late-night tube back to London Heathrow Airport (but that’s a story you’ll have to ask either David or me)
  8. Sunday November 23, 2008: After a night slouched in the Heathrow airport, reverse Sunday November 16, 2008th itinerary from Heathrow, add 1 hour of lost luggage in Chicago, and we’ve made it back home from our week of too much fun which was catalyzed by the two of us discovering $48 round trip tickets to London from Chicago.

So in the end David and I left our families behind for a week, squandered their wealth, studied some history of medicine, had a great time, came home bearing gifts, and now our trip is yours to enjoy vicariously in these many galleries! (Click the links below to enter each respective gallery which are arranged by 500 images each in chronological order)

Weeks 47-51: Summer Vacation and China Trip

By , July 13, 2008 at 6:08 pm

Well I’m hopelessly behind in my blog, and out of time to do much updating as my 5 weeks of summer has wound down. But needless to say I had a great summer, 2 weeks of which I spent with a classmate David, and his wife Meghan in China all over the place. I’ll fill in the details as I revise this post eventually, but in the mean time I wanted to include the pictures (note I’m still filling in captions so eventually they’ll be all updated) that I took for everyone to get an early look at prior to my eventual detail filling. Enjoy!

Weeks 39-40: Research Selective

By , April 27, 2008 at 12:01 pm

I spent the greater part of this selective learning about clinical research as I’ve started a project studying atrial arrhythmia’s in patients undergoing hip surgery. We’ve met with statisticians and our work is in progress and I will report more on this as it is presented and published.

Weeks 31-32: Surgery Sective – Fresh Frozen Virtual Living Pigs?

By , April 14, 2008 at 12:01 pm

I guess I really need to be less meticulous when it come to life, take blog writing as an example. The current date is September 30, 2008 and this article is pre-dated back to April, that’s a good 5 months behind, but I guess this call-it-what-you-may “attentions for detail” helps me out in at least considering surgery as an option.

We spent a week this selective learning and practicing some basic skills on tissue, on simulation, and then I real live pigs! It was pretty interesting as we learned some of the ins and outs of suturing, knot-tying, making incisions as we worked on day one on some fresh frozen tissues next to some ENT residents who were also working on their skills on dismembered heads. Despite being acclimated to this type of environment I still find it very surreal and disturbing that yes indeed there is much ‘practice’ in medicine, and sometimes in the most morbid of circumstances to say the least. I mean no disrespect in saying so though as I am extremely grateful for the donors who are willing to help in medical education — it just seems so primative though for how far along we’ve come, I would’ve thought that an entire anatomy dissection would have been in full 3D high definition tacticle reproduction right now – I guess I’m realizing that I just don’t have the greatest stomach for gross (in all of meanings) anatomy and perhaps that I’m lowering pathology and radiology from my list of possible career choices.

Strangely enough I find surgery fascinating though and I guess the ‘gross’ factor dissipates a little more in ‘real life.’ I shadowed an orthopod doing hand and shoulder surgery this week and saw a rotator cuff repair as well as a procedure that removed some bones in the hand. We also had a session in Mayo’s Sim Center where we did virtual colonoscopies, endoscopies, knot tying and sutures with instruments, and even a gallbladder removal that we ended up performing on a living though anesthetized pig! The good news? We got the gallbladder out without the pig crashing. The bad news? Wilbur’s prognosis despite the fact was still terminal as they don’t wake him up from that sleep again. I guess you can think of it as a better cause than $14.99 in your butcher’s case though. Poor pig.

Well that was a taste of surgery for me, another step into a confusing realm of seemingly endless prospects to my intial urge to “want to help people.” Now I just need to figure out how.

Week 23-24: Winter Break

By , March 9, 2008 at 1:18 pm

Well my mom came up from Salt Lake City, Utah to visit our family and she really enjoyed spending time with Michael in particular. We decided to take this two week holiday to go and explore some of northern Minnesota so we took a drive up to Duluth, MN to see the North Shore area of Lake Superior. We swung by Split Rock Lighthouse State Park and Mikey loved the water that we saw and wanted to play in it despite the sub-zero Fahrenheit temperatures that we were in. Here’s a collage of pictures over the break that I hope you enjoy!

Family Snowmen Our Christmas Tree
Christmas Morning Mikey & Grandma
Giant Microbes New Paint Pents
Sledding Ice ‘Skating’
Mikey & Gramdma Duluth. MN
Winter Swimming The Beach
Mikey & Grandma Lake Superior
Split Rock Lighthouse Shoreline
Winter Hiking Ellingson Island
Rock Sitting Stuffing Face
Camera Shy Balls!

Week 19: A Surgeon’s Bane

By , December 9, 2007 at 9:14 pm

The surgery work week continued Monday back in clinic from 7am-5:30pm, surgery Tuesday from 7am-5:30pm, and Wednesday and Thursday followed suit in clinic and surgery respectively. Each of the surgery days I left before the last case of the day was even over as the chief resident Dr. Shridarani stayed often to 10-11pm each night and was back at it 6:00 am the next morning. Don’t get me wrong, I found from the experiences I had watching multiple surgeries scrubbed in and patient side holding retractors, pretending to review my anatomy in situ, very rewarding and very interesting, but after this week a new realization of the surgeon’s lifestyle really hit me. A surgeon’s schedule stinks!

Not only was I physically and mentally drained at the end of every day, but with 4-6 hour spine surgeries under hot lights, sweating, and standing on one foot watching the time go by one surgery at a time is unrelenting as well. I mean you could pay me $700 and hour, but at the end of the day, and the end of the week, and the end of my life I probably wouldn’t even have the time or energy to spend it all! It is amazing what Dr. Huddleston does in the time he has each day – and that he manages to be so involved in everything on top of it all, from being the president of the bone bank, sitting on various Mayo committees including education, and also being a lieutenant colonel in the U.S. Army as well.

Friday I took off just to recover as our leadership block started up on Monday. At the end of this selective I really reflected a bit on the fact that despite surgery being very interesting, it is also a lifestyle hardship making me question whether radiology or anesthesiology might fare better to allowing me to actually see Mikey grow up which I missed this week.

For now my doors are still open – but in my two weeks to attempt self-discovery in orthopedics I think I found myself with more questions than I have answers for in choosing a specialty.

Week 18: Thanksgiving Touring Orthopedics

By , December 9, 2007 at 9:14 pm

For my selective this time I went back with my mentor Dr. Huddleston in orthopedics and followed him. Being the week of Thanksgiving I took Thursday and Friday off to be with Carolyn and Michael as we hosted dinner this year with some friends. Carolyn has the details in the family blog.

On Monday I started off observing Dr. Huddleston’s chief resident working in the cadaver lab as he exposed iliac crest for bone graft harvesting. Tuesday started off early at 6:30 am for spine conference in which I learned about how MRI’s were not great diagnostic indicators of a patient’s recovery. By 8:00 am I was in the operating room as I scrubbed into surgery and got a first hand view of three surgeries, the first being a Anterior Lumbar Interbody Fusion (ALIF) L5-S1 in which I even got to hold retractors. In the second procedure I watched an irrigation and debridement of a case in which the person had developed staff infection following back surgery so they needed to clean out his wound. Finally to end the day, I watched another decompression and even got to suture a bit at the end of surgery closing up the incision. Wednesday I spent the entire day in clinic as we met with pre-op and post-op patients. Dr. Huddleston even had me take a patient history of a lady. Needless to say Thursday and Friday were much welcomed days for rest and relaxation.

Week 11: Emotions Revealed – Anatomy Begins

By , December 2, 2007 at 3:36 pm

I scrubbed in on Monday morning to end my four day weekend a little earlier to observe another spinal surgery. I had a chance this time to watch the L5-S1 fusion from start to finish as the case went about 4 hours from first incision to last suture. They went in anteriorly through the abdomen and exposed the vertebral bodies, scraping the out the herniated vertebral disc, added a bone graft, a titanium plate, and six screws before closing the patient back up. I got a front row seat scrubbed in and got to play around with the mushy vertebral disc when it was taken out. By the end of the week with the start of gross anatomy I would learn that I was mashing up nucleus pulposus and annulus fibrosus of the vertebral disc.

Anatomy started early on Wednesday, skipped Thursday, and continued Friday as we substituted two days out of this selective for Friends and Family weekend over the weekend of October 11-12. With anatomy beginning the fun began as we were introduced to our cadavers on Wednesday and the same day began dissection on the back – with that the fun of learning muscles, nerves, insertions, origins, etc. began [in retrospect: what we thought was nigh impossible to learn in these first two days of anatomy would prove at the end of six weeks leaps and bounds easier than our final week and a half of anatomy trying to learn head and neck and lower limb in seven days]. Being sensitive to the nature of our dissections, the donors privacy and also confidentiality I will not divulge in any details or specifics regarding our cadaver or procedures, but for those of you who are truly interested in what we are doing, you can take a look at the University of Wisconsin anatomy site for anatomical dissection videos that will give you a first person perspective of what we did in the anatomy lab.

We ended the week with a training workshop by the Ekman Group that was paid for by the medical school. The Ekman Group is a team of specialists trained in facial recognition that works with security agencies worldwide and trains personnel in the technique of facial expression recognition and micro expressions. Purported to be more accurate than polygraph, facial expressions are hard to unlearn and retrain – especially micro expressions that only last fractions of a second – but when picked up by experts can be far more revealing that any other means. We looked at footage from the O.J. Simpson trial, various CEO TV interviews before secret corporate corruption was exposed and saw how micro expressions of contempt and disgust were long in existence despite their cheerful faces. It was an interesting seminar and as we trained, it hopefully helped us learn to analyze our patient contact better in hopes of better ascertaining hidden concerns. I thought it was some pretty hi-tech stuff that I sure didn’t anticipate learning in medical school to say the least.

Copyright 2004-2013 Dan & Carolyn Chan