I was forced!!!

It was a sad day on Wednesday. In order to fly home this coming Thursday for my little sister Jami's wedding, I needed current driver's licence. My old one expires tomorrow and since I renewed it last time by mail, I would've had to go in to renew it in person and take an eye exam in order to retain a Utah licence. Despite my flirtations with the clerk over the phone, she said there were no exceptions. So using my only option to be able to fly on thurdsay, I reluctantly drove 20 min to the DMV here in Iowa. It turned out to be more of a hassle than I was expecting. I had to prove that I had lived here in Iowa for at least 30 days, so i brought a letter signed by the dean of the medical school, dated on the 15th of January 2008(I needed a letter back then to show another company I was a current resident), that was on official letterhead, stating my address and that I had been living there since august. You would think that would've been good enough and at least equal to a pay stub from an employer to show my residency. But the good employers of the state of Iowa didn't think so. It was either a rental agreement, utility bill, or pay stub...no exceptions! Knowing I had an intense Physical Diagnosis exam the next day to study for, I tried my best to persuade and even flirt with the clerk to let it slide. Nope, it didn't work. I drove 20 min back to my apartment, got my rental agreement, 20 min back to the DMV, waited another 45 min to get the licence, had to surrender my sweet, old school 1998 Utah license and then drove the 20 min back to the apt. So two and half good study hours later...I am an Iowa resident with a pink drivers licence in my wallet...but at least I can fly home, eh. And the good news is that I am registered to vote! I'll be casting my vote for whomever is againt socialized medicine(I'll be doing my research over the summer when I have more time...but I can tell you hillary won't be getting my vote.) The other funny thing is that my picture doesn't look that much different from my 16 yr old picture, and I only got to add 1 inch to my height and 10 lbs to my weight...and that was being generous! haha I should be grateful that I can't put on weight I guess.

My other exciting event of the week happened yesterday. I volunteered for the first time at an OFL event which stands for Osteopathic Finish Line. This is where first and second year med students give free Osteopathic treatments to participants just finishing a race...this time a 5k that was a fundraiser for AIDS. We treated all lower body muscles, the sacrum and lumbar spine, fixing the structures that were out of alignment which is supposed to lead to better funtion of the whole body. This Osteopathic medicine is different than Chiropractics. We use the muscles by a technique called Muscle Energy to help return the bones to their proper alignment with the idea that body functions are related to structure and that the nerves, blood vessels, and lymphatics related to those muscle groups will have better function as a result. It was fun to actually treat real people and see them leave with a smile on their face. I'm glad we are being taught OMM, but it makes our life busier than our MD Collegues. We are taking all of the same classes because we will do the same thing, but we have the Osteopathic medicine in addition to everything else. But its all good and if anyone wants a free full body treatment when I come home for the summer just leave a comment and i'll get ya set up!

Spirituality and medicine

Today in medical ethics we discussed religion and spirituality and its role in the healing process. Initially, I believed that my job as a physician would be to present the facts, educate and let the patient find his/her own way in regards to spirituality, almost like a separation between church and state. I am slowy becoming convinced that physicians should have a role in the spirituality of their patients especially during end of life care. I'm currently trying to determine what exactly that role should be in my own practice. Should a physician pray with his patients? Should a physician ask questions during the new patient interview about an individuals religious beliefs? How would you feel if a doctor asked about your faith? In Utah, we almost expect everyone shares our beliefs and think the doctor would know, for example, that we would want a blessing if the situation arose. But nearly everywhere else, that is not the case. I feel that as a patient going to a doctor who asked about my religious beliefs that if he sought understanding, then I would appreciate the inquiry about my faith and what I would want done during an end of life scenario. Some of my collegues disagreed believing that it is personal and should stay personal. I guess it is really up to the patient. Which brings up the issue of when it should be asked, during the new patient visit or after the patient has been diagnosed with cancer? Both have potential pitfalls. Who would be thinking straight after being told they were diagnosed with a life threatening illness and would want a talk about spirituality and religion? Not me. The other issue is time. A doctors schedule is already packed and visits already shortened, would talking about spiritual things take away from other essential interactions of the doctor/patient?
Another interesting thing is to look at what is the difference between spirtuality and religion? Are they different or the same? Do you have any spiritual beliefs outside of your religion? I feel like my religion is inexplicably tied to my spirituality. Again, several of my collegues don't feel the same way, and thats ok.

In other exciting news, I spent four hours this morning calculating the risk of breast cancer for individuals at a breast cancer awareness conference in West Des Moines. Some of those survivors were the most optimistic people I have ever met.