Lessons learned from some Jim Rohn, Anthony Robbins, Jack Canfield & Arnold Nerenberg

So I woke up at 2am today and decided to watch some motivational speakers on youtube. This is a summary of what I’ve learned:

“Work harder on yourself than your job” – Jim Rohn

Anthony robbins says that:

- The difference between those who succeed and those who don’t is in their musts and shoulds so you should turn your shoulds into musts (basically must be disciplined)

- life will pay any price you ask of it- if you only want 25 cents, you will get only 25 cents

- clarity is power- so you know the exact result you want in all aspects of your life

- purpose- ask yourself why you want to do this?

- you must use RPM to get to your goal:

result- you must know what result you want to succeed (clarity of it)

power,

massive action plan? – what do you need to do to make it happen

Jack Canfield says that

- it is very important to plan your day the night before because then you know what YOU want and you won’t just be responding to the needs of others

Arnold Nerenberg says that

- keeping your priority requires you to have a congruency of words and actions (something I definitely need to work on…funny he said “im going to study…and then you dont study” LOL exactly what i’m not doing now)

-priorities are governed by pleasure and pain (we are motivated by avoiding the pain and maximizing the pleasure) and this is tied together with your values (i.e. family)

Practice makes perfect concept applies to cooking too!

Yesterday when I was making eggs benedict my hollandaise sauce ended up being too buttery and my poached eggs were an epic fail, the egg yolk was totally separated from the strands of egg white. It was quite disgusting. Today morning I woke up and decided to try it once more. The hollandaise sauce was much better and tastier, not too buttery and my poached eggs were beautiful (well it’s still not perfect but it’s one step closer to what it should look like!). Voila! (I’m well aware that I should have a slice of ham on it and an english muffin instead of a piece of toast, but I had to improvise since I wasn’t planning on making eggs benedict this week at all and so didn’t buy proper ingredients from Coles a few days ago!)

There is NO CHEMICAL SUBSTITUTE for sleep!

So on the flight back from Los Angeles to Brisbane, I watched a whole bunch of shows available via the in-flight entertainment system- amongst them I watched the movie Julie/ Julia (a good movie about this girl who decides to undertake the mission of cooking all of Julia Child’s recipes from her Joy of Cooking book + her rise to fame by writing a food blog!) and this documentary called “Awake is the New Sleep” and “Planet Insomnia”. So like a good nerd, while watching this documentary , I took notes on 2 puke bags (double sided too! so I had to rip open the puke bag – I’m pretty sure I got some weird stares). Anyways, here are some notes that I took from both documentaries that I felt were pretty cool/ important/ eye-opening:

- Apparently you need 8 hours of sleep a night- 3 hours for shallow sleep, 3 hours for deep sleep (needed to revitalize the body) and 2 hours for dream sleep (needed to recharge the mind)

But we get 90 minutes less sleep than our ancestors and as a result, we carry a SLEEP DEBT that we pay the price for it

How vital is dreaming?

- Harvard Medical School research has found that during dreaming, our brain plays through the learning sequence and this is the time where the brain consolidates memory

- With sleep deprivation you get, cognitive slowing, attention lapses which is then followed by microsleep (where brain grabs quick naps without your knowledge)

- after 16hours of not sleeping, you get impairment similar to someone with a blood alcohol level of 0.08%! (HEY, who needs alcohol when you can just hallucinate and feel drunk by just not sleeping?!?!)

- After 5 days of 3 hours of sleep a day, your REM mechanism is activated while you are awake and you also get hallucinations

- Also, you start to lose the ability to regulate your temperature (you get very cold, and in fact, this phenomenon is seen when your body is under extreme stress)

There is a new technology called the OptaAlert that uses the fact that when drowsy, your eyelid blinks 3 times slower, helps detect if you are in fact fatigued

How does the mind suffer from lack of sleep?

- you have this unpredictability – where you get induced parasomnia and also experience something called a “reverie” whereby random thoughts intrude into another to give mental disorientation

In fact, there is also a connection between lack of sleep and mood- in children, the risk of depression is linked to sleep deprivation

How about sleep loss and your immune system?

Sleep loss is related to a decrease in immune system response

How about sleep loss and risk of diabetes?

When you simulate an older person’s sleep (whereby you don’t get deep sleep, so only shallow sleep), it was found that you increase risk of diabetes b y 50%

sleep deprivation = stress = inhibits pancreas from releasing insulin

How about sleep loss and weight gain?

Your hypothalamus is deaf in sleep deprived individuals (lateral and ventral hypothalamus as I learned before in a physiology course) and you get excessive hunger and weight gain! (So all of that jet lag explains why on the plane my body is confused as to when to eat/ how much to eat/ if I’m full or not…Cool!)

- In fact, in the individual part of the documentary’s study, in just 1 week of sleep deprivation, he had lowered his insulin production to 1/2 of what it was, his leptin levels (signals of satiety) dropped by 50% and his C-reactive proteins had dropped significantly as well…WOW i totally was unaware that sleep deprivation had such a large impact on our body’s physiology!

There is essentially NO CHEMICAL SUBSTITUTE FOR SLEEP!

Many people have forgotten what it feels like to be fully awake!

Sleep is essentially a pillar of health too!

Alright, as for the documentary “Planet Insomnia”, this is what I’ve gathered:

- Insomnia: defined as the inability to fall/ remain asleep

- It is actually the world’s most common medical disorder (I always wonder about the accuracy of these sorts of statements- “world’s most common”- so the next time in class this ever comes up, I’m going to mention this answer and see if it’s the right answer or not)

- There was an interesting case whereby a sleeping pill triggered this lady to break and enter without her knowledge…now that’s pretty bizarre! (I know for sure I’d stay from those pills…not that I do take any…but for future purposes I meant)

What happens to make you fall asleep?

Melatonin switches on the sleep switch and the thinking brain is turned off – so in those individuals with chronic insomnia, they have to exhaust their thinking brain so that it eventually turns off! So there is some logic as to “tiring” yourself out before you sleep. I suppose then thinking exercises would exhaust your brain more than just physical exercises then? Alright, I’m severely jet lagged now, WHERE’S BOGGLE?!? (Yeah, I don’t do well with riddles)

What about sleeping patterns and growing adolescents?

In developing teens, you see a delayed phase insomnia where their sleep cycle is altered to be later than usual due to growth hormones coursing through them. So teens essentially don’t get enough sleep and this has been linked to depression and suicide (I say this is good reason to start classes later…like NOT 8am…reason: well, you don’t want kids killing themselves now would you teach?)

Other things can disrupt this sleep cycle rhythm as well, irregular bed time & jet lag that causes circadian rhythm insomnia that is apparently very common the trucking industry.

Apparently, shift work is the biggest disruption of body cycles (funny how my mom had mentioned this to me before because I had told her that I loved emergency medicine and would LOVE to work in the ER as a career…and I’m starting to see her points through these scientifically-based documentaries…now I’m starting to wonder how she knows about so much of these things!) and individuals doing shift work suffers insomnia 3 times more than normal folks (now that ER career doesn’t sound AS appealing now…)

How can you treat insomnia?

Changing patients’ perspectives on sleep- insomniacs think that they are not asleep when they are- when an experiment was conducted whereby individuals were woken up in different time periods and asked how long they thought they were asleep, they said none when in fact they had been sleeping for a period of time!

Behavioural therapy- this usually works for adults- like getting them to do yoga (or anything that really brings their anxiety level down a notch because stress makes you release cortisol and cortisol in turn inhibits melatonin that is needed to get you to sleep!)

Bright light therapy- exposure to light of a certain wavelength(because only a particular wavelength of light that resets our biological clock) to reset clock to appropriate times

In fact, there is a portable device now that you can use to reset your circadian rhythm that can cure shift work induced insomnia (so does that mean that shift work isn’t AS bad then? I’m going to delve deeper into this and find out for sure then!)

How does Ambien work?

- It turns on receptors in the sleep switch!

What’s the relationship between caffeine and insomnia?

Apparently, caffeine can trigger insomnia (uh oh, this is news to those who love coffee…)

And that’s it! So I think I’m going to try to sleep for a full 8 hours and see how much more awake I will be. Will I feel 10 times more epically awesome? Will the fully awake me give our more hugs? Will I sing more? Tis to be discovered in 8 hours! Until then, good night and sleep tight!

Loin chops with garlic & herb butter from Gordon Ramsay’s Fast Food

I haven’t been able to sit down to do any of my med work yet. I have a quiz coming up in less than a week and I have around 3 weeks worth of schoolwork to catch up on…so I decided to accomplish something in my life aka cook something from Gordon Ramsay’s Fast Food cookbook that I just recently bought from amazon.ca. So here it goes:

For the garlic and herb butter sauce you blend some softened butter with garlic, herbs (parsley and mint) and salt and pepper. The actual recipe tells you to chill while you prepare the chops but I basically did the sauce making while preparing the chops

Then I seasoned the pork chops with freshly ground pepper + salt and pan fried it in the skillet (the actual recipe told me to use thyme sprigs but I didn’t have any and so I used rosemary sprigs).

It also says there to spoon the juices over the chops as it cooks, except that my chops had no juice to pan with so I was a little confused.

Then place the garlic and herb butter sauce onto the pork chops and VOILA, you are done! I also boiled some sweet corn on the side. Delish!

This has got to be one of the easiest recipes from Gordon Ramsay!

Herb Crusted Rack of Lamb (served medium rare)- Gordon Ramsay F Word style

I’ve been wanting to savour rack of lamb for the longest time so I decided to make it myself. I totally forgot to buy bread crumbs or parmesan cheese- so i improvised. Well for the bread crumbs I toasted wholewheat bread and just mashed it and placed it in the blender and as for the parmesan cheese, I borrowed my roommates (Good thing she had some). Anyways, here’s how I did it:

Season lamb cutlets with salt and pepper – rub it in

Pan fry it for a few seconds until both sides brown

Preheat oven to 350F (around there) and bake it for 7-8 minutes

To make the herb crust, mix bread crumbs, parsley, thyme and rosemary, salt and pepper and parmesan cheese and a tinge of olive oil to make it all stick together and place it all into the blender (I didn’t use as much thyme because I ran out)

When lamb cutlet is done being baked, put on dijon mustard on it and then dip this into the herb crust

Bake in the oven for another 2-3 minutes

Voila you are done!

Reflection on my much-needed break back to Canada:

I had a really really good break because I had a chance to catch up with my close friends (spent some quality hangout time- got to cook a recipe together with a good friend and with another one I got to play some songs on the electric keyboard while she played around on her drum set- though we never got recording it was still a memorable moment- we also got to do our traditional Keg dinner and reminisce on old times) and though I didn’t get to spend much time with my sister (she studied a lot due to her crazy exam schedule and I never got down to studying after my philosophy exam), I did get to see her (so I cooked her a few dishes from Gordon Ramsay’s cookbook such as pork chop in piquant sauce and chicken breasts wrapped in prosciutto and stuffed with sage and ricotta cheese to help her de-stress/ lessen cooking time so she can study more). I was actually fairly pleased that she liked the dishes I made for her because she is very picky and has very high standards. I also got to go dancing at Rouge and at Lavish and got hammered both nights and both nights ended on very high notes (somehow I always do end up smoking a lot of cigarettes when I’m drunk and also shisha) I should really stop shortening my life haha! I also got a chance to shop for things- I was actually surprised at what an efficient shopper I was- I bought everything I had made a list for in 1/1/2 days. I think it’s also touching to know that some of my friends (that I’m not as close to) set aside a few hours to hang out especially when they were nowhere near ready for their 60% final exam that was on the next day & doing poorly would affect their entrance into professional school)- instead they are going to sacrifice a few hours of sleep. It was also super refreshing to be able to drive myself around. Also, I found an old childhood friend on facebook. Well I had her on msn all along but never really realized it. Turns out she is currently in Sydney and would love to show me around. She seems very spontaneous and adventurous so I’ve decided that in my 6 years in Australia, I will come down to Sydney and visit her. It’s funny because when I moved to Australia a few months ago I thought I didn’t know anyone there (except for a few cousins) but now I remembered that most of my classmates from middle school all went to Australia and that I would still have them on facebook. Tis the power of facebook! It’s funny how when you think one door closes (the path in Canada), another one opens (the new life in Australia). For example, in Australia I’m basically forced to be more active since I have to bike everywhere to get to places. I also find that in Australia, the more relaxed and laid back me is brought out more. (Though I’d say my parents would argue that I am too laid back for my own good sometimes. I disagree however!)

With all these things being said though, I think the most important thing was the realization of these things back home:

- My friendships with my close friends are strong enough to evolve into an adult friendship status- where you don’t have to see each other constantly to maintain the friendship (we can be apart for months on end without much contact and meet up and catch up like old times) I am very grateful to know this.

- Though we are all going in different directions, I know that we will all still keep in touch no matter the distance or circumstances

- I want a girl that makes me feel the same kind of euphoria I do when I sing and dance

- It’s these friendships and closeness to others that empowers me

- Learning new things/ being excited about things fires me up. I want to stay curious and keep on asking those questions, even though some may come across as being stupid!

Reading, oh how I've missed thee!

While waiting for my flight from Brisbane to LA, I had 3 hours to kill and I decided to browse through a bookstore. My love for reading actually died down many years ago. I think the last time I read a whole book outside of the required readings dictated in school was about 3-4 years ago and even then I never really sat down to read that much anyways. It’s one of those “I’m too busy for this” things that happened. However, after reading the book “Who Moved My Cheese” (Also as a sidenote, my sister was like “Who reads a book called who moved my cheese?!?!?!” umm apparently me haha!) and seeing other titles of books, I have decided to make time to read every day. Also, I think that reading about the opinions and ideas of others, you can improve yourself in many aspects of your life and I can’t wait to be a better person with these regards. I think doing medicine does not have a time limit to it (there is just so much to learn that even if you studied for 24/7 you wouldn’t possibly be able to know everything there is to it- which I think is a pretty humbling thing that there is just SO MUCH information out there), so you can choose to do it 24/7 or you can do it as a career and not let it take over your life. I think most of the time before getting into medical school I’ve been caught up with getting in that I’ve forgotten about / not cared as much about what goes on in the world around me. In this manner, I feel like I’ve lost touch with the real world.

A couple of book titles that caught my attention were

- Daniel Tammet’s Born on a Blue Day that chronicles his way through life being a savant

- Michael J Fox’s Always Looking Up that chronicles his very positive view though he was diagnosed with Parkinson’s disease at the height of his career

- Mitch Albom’s the 5 people you meet in heaven

I also read a few food magazines and jotted down a few recommended restaurants in Melbourne and Sydney since I will be spending at least 2 weeks in Melbourne this coming June. I just actually started really getting into cooking only recently and I’m in awe with regards to how much there is to learn about cooking! It’s not as simple as I thought it would be. There is so much art involved in it and I believe that what attracts me the most to it is the fact that you could go on an adventure while cooking. Also, to watch Gordon Ramsay and the passion he always has when cooking (at least in his F word show videos) is very inspiring. I absolutely LOVE seeing people very passionate about what they do. It’s a very very very beautiful thing.

What happens in my brain (instead of the idea of sleep) when the in-flight entertainment doesn’t work for the first part of the flight…

So I was getting my meal for my Qantas flight from Brisbane to LA and don’t get me wrong, the food was pretty good by airplane food standards because it was edible and had some sort of a flavour (full cream milk and weet-a-bix and yoghurt), but what bothered me more though, was the fact that Qantas provided full cream milk instead of 2% milk, and butter instead of margarine. How many people actually drink full cream milk in the first place and who gets to decide what selection is provided? It is no wonder that obesity is very prevalent in Western countries. Also, the yoghurt we got at the airplane was definitely what I would NOT eat regularly because of the amount of sugar in that thing. 14.5 g of sugar in a serving of yoghurt, no matter how good it tastes, is a ridiculous amount! Plus, they also had a LOT of dairy for breakfast- yoghurt, full cream milk and very little whole grain- like the 6 pieces of weet-a-bix you were fed. My musings about serving healthy food on the plane was spurred on by recent discussion with my Aussie roommates Matt and Pranav the night before my departure from Townsville about which brand of yoghurt to go with- basically one with the least fat and sugar yet still somewhat tasty (this is a very late realization, but basically I realized that natural yoghurt tastes really sour and it is the sugar that makes it edible).
Also, what bothered me was how much plastic and packaging was involved with each serving of airplane food. For my tray I had those plastic utensils, then the aluminium foil that covered the food for dinner, or the cereal box that was a plastic bowl, the full cream milk carton…the more I count, the more guilty I feel. Considering how many people fly every single day (also with long haul flights, you usually get 2-3 meals plus snacks), I just wonder how much conserving we can do simply by starting change at the airline level (rather than just aimed at the household level). At the same time, I thought back to the amount of plastic packaging are involved with snacks, the blankets, the headphones…you get the point. Could I write a letter to them expressing my concern? Where can I get some statistics with how much waste is produced by the airline industry and more importantly, will they even care about my concern?

What I Learned from Who Moved My Cheese

So while waiting for my flight out from Townsville to Brisbane, I finally got down to read the book “Who Moved My Cheese”. The story is actually very simple that even a kindergarten kid would understand it. The power in the book’s message lies in the readers’ interpretation and these are the important lessons that I learned from this book:
- Always prepare yourself for change – things always change and you won’t be caught off-guard when this is so- in other words, be adaptable and flexible
o The way to do this is to have enthusiasm and carry around a fighting spirit (not the hostile kind, but the excited to take on the world kind and ready for anything kind of fighting spirit)
- Always be aware of your environment to scope out for signs of change to occur – pay attention and be knowledgeable enough to be able to do this
- Celebrate change- change doesn’t always have to be bad- It is bad only if you think it is bad
o If it is bad, then change your perspectives on it- see it as a challenge instead
o Some people can argue that changing your perspectives about something be a sign of weakness. Is it simply a defense mechanism so you won’t get hurt? Let’s say if your friend betrays your trust and you have the option of a) being miserable about it and sulking about it for days then perpetuate revenge b) feel hurt but move on and learn lesson from it. In this case (like in any other case), the situation stays the same- your friend no matter what, already betrayed your trust. Similarly, how others react to you telling them the news stays the same- they will feel bad for you and they will be concerned about your well-being and try to cheer you up. The only thing that doesn’t change is the fact that you are still hurt. You can choose to be miserable. Only you yourself can make you feel miserable. If you pick a, you will lose out because there is simply not enough time in the world to not be happy. You can choose action b and learn a lesson from it. In both cases, both actions do not give us the same results, especially FUTURE results. The way I see it is that by learning a lesson from each time that we feel that we’ve failed, we become better-skilled, more experienced and wiser.
- Don’t let the fear of failure hold you back- the way I see things now – there are certain fears that are helpful to survival and so one should have them to preserve one’s own life i.e. the fear of dying would prevent you from jumping in front of a bus, but there are other fears that I feel would be debilitating
o I think that the fear of failure can be overcome with a change of perspectives, like weighing out what the worst situation can happen and work with that
i.e. the worst that could happen is for me to lose 1000$ and I do have 1000$ to spare anyways and the best situation is for me to secure a business deal and move up higher in my job position so there is actually not that much to lose- so by employing such a technique, you would have more confidence and would be more likely to succeed and end up not losing that 1000$
- You shouldn’t expect to do the same thing over and over to only expect different results- that’s just not being realistic and foolish
o Change the way you are doing things, THEN expect a change in results

Pork chop with Piquant Sauce - Gordon Ramsay Style

So while I was in Canada I decided to start cooking from Gordon Ramsay's cook books (I bought 2 online off of amazon.ca). I chose pork chop with piquant sauce since my sister doesn't like steak/ lamb chops that much and I don't really like chicken, so pork is our common ground.
When I read recipes, I don't really read them carefully, so I did not pay attention to the fact thatI would need more tomatoes. So while making the piquant sauce, I had to cook it for longer and had to add more sugar than usual and had to keep on garnishing it. The sauce did turn out well (my sister said it was delicious) but for next time, read the recipe more carefully! Though my mom did say that real cooking doesn't involve recipes. (I do agree with that to some extent now...but when I first heard it I was like, come on mom, throw me a bone here...I just started cooking!) So here is the end product and at this point, I'm too lazy to write down how I made it:

Cooking is all about experimenting & trial and error

So I decided to make salad for my sister- and I put together this:

It's basically toasted pine nuts, steamed butternut squash, chopped tomatoes, rocket salad and sweet onion sauce. I should put in red onions too which I forgot, I'm going to do that now. As a closing note, Pranav (my Aussie roomie) used to say cooking is all about experimenting and trial and error. Tis true!

Don't you love it when you discover a very uplifting song that speaks to you?

This is a song by Craig David called World Filled with Love:

Cause I'm caught living in a world filled with love,
so when tear drops fall from me like rain from above,
I can brush my troubles away,
know that deep down inside,
I got sun shining in my life.

I'm gonna ride this beautiful life

So my good friend Kan came over yesterday for lunch and we cooked Gordon Ramsay's chicken breasts stuffed with prosciutto and sage from his Healthy Appetite book. It was a really good chill-out time plus we got to make amazing food. Apparently my excitement for food/ newfound passion for food has inspired Kan to be a better cook and might have changed the rest of his life (he was not excited before about a lot of things but he said he left feeling super excited to cook). I think you can express how much you care for someone by cooking for them and also you can cheer them up. It's an act of spreading love :) I love Gordon Ramsay's way of cooking because he combines relatively few ingredients and makes the food amazing. It is also super easy to follow.

So the recipe is as follows:- cut chicken breast in the center so you have an opening to stuff ricotta cheese in- for the filling, mince sage and mix in salt + pepper
- wrap the chicken breast in prosciutto and slip in some sage leaves

- pan fry the chicken breast wrapped in prosciutto until it browns

- place thyme sprig on chicken breast and put this in oven at 350 for 12 minutes
- VOILA! Amazing homemade food :)

The final product:

How to write a specialist referral letter, mock case conferences and everything in between

Wow, I feel utterly exhausted now. I think it's because of the heat. I've forgotten how hot it can get here in Townsville and the heat was sort of back today (hotter than what we've been experiencing anyways for the past 2 weeks). Anyways, today we had our ecology of health guided learning session and our human biology guided learning session. In our ecology of health guided learning session, we learned how to write up a drug prescription, a specialist referral letter and how to fill a diagnostic imaging referral form. The drug prescription was actually pretty cool because we discussed in class how if the patient did have hypertension for example and you told them that they are alright but that they would have to take a medication 3 times a day for the rest of their lives, they would basically be like wtf? I think it's easy to get carried away with the Science side of things and forget about how it feels to be a patient. So our lecturer (who is a general practitioner) told us that it would probably be better to give them another medication given 1 time a day for a longer period of time to not make them panic that something is very wrong. It's basically really important because these little things will make them trust you/ not trust your recommendations and thus affect their compliance. Also for the specialist referral letter, it's interesting that you write them an actual letter (I thought it was just like forwarding their medical chart of some sort) and you have to sort out which medical history of your patient is relevant to their specific condition you are referring them about.

We also did a mock case conference whereby students role-played different medical professionals (we had students pretending to be physiotherapists, dieticians, social workers, podiatrists, endocrinologists, general practitioner and a diabetes educator). Basically we were to pretend as if the general practitioner is holding a teleconference whereby he wishes to consult medical specialties from different fields of expertise to help his patient (who happens to be an obese woman with diabetes, hypertension and osteoarthritis in both knees who is feeling depressed about her condition and has a son who is also frustrated that the treatment offered by their general practitioner has not been working). It was really amazing to see the level of knowledge each medical expertise had and what they contributed to the treatment plan. For example,
- the podiatrist was concerned about the neuropathy that could result from the patients' diabetes and recommended her get massages from the physiotherapist, going in for checks of the rate of loss of sensation in her feet and also going in for checks of range of motion in her feet. Also, she was also recommended to get orthotics installed in her shoes to make her more mobile
- the dieticians told her that they would formulate an eating plan for her and make sure that it was gradual so it doesn't feel like its' impossible to stick to and recommended that the patient talk to her son about this
- the patient herself got to talk about how she is feeling and her reactions to the treatment plan recommended
- the social worker suggested that the patient could look into help groups near her home where she could get financial help with her situation, ask for support (nurse) that could perhaps take care of her while her son took a break from caring for her
- the endocrinologist suggested that the patient tell them what medications are working and what are not and recommended some medications for it - they worded it in a way that was asking her basically why she was not taking her medications regularly - "was it because you are scared that you don't understand how they work?", "how are they affecting you?"

so on an so forth. We actually ran the mock case conference realistically where students had to act as if they were specifically addressing the patient and their relatives on a treatment plan and word things correctly (don't offend them by saying directly that they are obese and need to lose weight but find a nicer way of putting things)It was just really really really cool to see how much teamwork in a healthcare setting really works. Our facilitator also mentioned though that sometimes we might run into problems in these conferences where some specialties overlap such as physiotherapists and occupational therapies whereby health professionals can often feel like "oh, there goes my idea because we are suggesting the same thing". However, it is important to keep in mind that the purpose of such case conferences is to treat the patient and that it should be patient focused.

In our human biology guided learning session, we talked about the social context of reproduction and how people's attitudes and society's attitudes towards menstruation has changed by looking at advertisements from the 1940s compared to that found in the 1980s. (We never got around to looking at ads found in the 2000s). And for that we watched light-hearted ads aimed at this topic and got a good laugh about it. Also, we talked about different reproductive technology- embryo freezing, artificial insemination, genetic screening of blastocysts and egg donation- and what their implications are to health professionals, friends + families, legal and political systems, economic system and society in general. We also talked about how infertility affects the female and her partner and others in terms of feelings of inadequacy, disappointment and also expectations from others to have children and also feeling like they're not fulfilling their role in society.

Although these sessions at first glance do seem pointless and common-sensical, it's these activities I think that really hammer it home and makes a difference as to how good of a doctor you can be not only by showing compassion, but also really trying to understand things from the patient's perspective. I'm really happy that we are learning these sorts of things :) Thanks James Cook.

A short list of some life goals

So I just happened upon Missy Higgin's live performance on youtube for her song This is how it goes (She performed at Sydney's Darling Harbour) and the view of where she was performing just blew me away:
http://www.youtube.com/watch?v=vmRnVlhMYrw&feature=related

It made me think of some goals for my life that I would like to achieve (outside of medicine). So here goes the list so far:
-record a song cover with close friends
-record a song cover with a personal touch to it (add in some of my own musical ideas)
-record a song by the beachside
-attend a John Mayer concert
-DJ one night at a club
-dance at Sensation White at New Years Eve
-learn to play the guitar
-act in a musical
-learn a hip hop routine and perform it
-buy a keyboard and experiment with other instruments
-perform a song (doesn't matter if it's a song cover/ my own composition) at Darling Harbour (might have to wait a long long time for this one to ever happen but I can always hope)
-work in a kitchen as a chef for a full day
-eat at a Michelin star restaurant
-eat at Gordon Ramsay's restaurant at least once
-eat at El Bulli run by Ferran Adria (maybe if I get a reservation)
-take a picture against the sunset by the beach (like an artistic shot, not the typical profile picture shot)
-take an artistic shot of something that means a lot to me

Thats it for now, until I find newer goals to do in the near future!

Red Wine Beef Burger Recipe

Still recovering from a crazy dancing night out last night! Poor life choices rock - just had another glass of red wine for dinner today (after having a whole bottle of red wine to myself last night). To be fair, I had a really good buzz going on through the whole night (I started drinking at around 730 pm until about 1030pm so it was a good gradual buzz lasting me the whole night). Anyways, I just thought that I would start blogging about food that I cook. Today for dinner I made red wine burgers and it was a great success! Recipe is as follows:

Done in this order:
- marinate burger in red wine+pepper (i think freshly ground ones would be best)+salt for about an hour
-caramelize the onions- i used brown sugar (around 2 teaspoons but i used heaps of onions though) and then add in some worchestire sauce
-pan fry burger patty (best to grill but we dont have a grill)
-grill burger buns (we used the toaster oven)
-place cheese on bun (i used cheddar cheese)
voila!

I tried using Jack Daniels bbq sauce on the side but it didn't work well with the actual burger itself so I ate the burger by itself without any side sauces and it was amazing! You could really taste the red wine in the burger patty and the sweetness/ smokey taste of the caramelized onions.

Me and my roommate Pranav ate this with a side of red wine (Cabernet Sauvignon).

Talk about having the perfect dinner!

Dear Ecology of Health, you are not so useless after all!

Today in our Ecology of Health class our lecturer (who is a rural general practitioner) brought his 2 patients in so that we could learn some interviewing skills hands-on in order to get a complete patient history. I think it was a very useful exercise because oftentimes as doctors, you can forget about how patients see you so it's good to think things from their perspective. For example, the patient said that she would actually be more reassured/ appreciate more if the doctor admitted that he or she did not know what specifically was wrong with the patient rather than give false reassurance that the patient will get better. Also, the teenaged patient revealed that it would be better if the doctor talked directly to her rather than to their parents during the consultation.

For this past week we have learned some interviewing skills and non-verbal communication skills. For example, the way your practice is set up is important to make them feel dominated / reassured. Sitting across from the patient makes them to likely feel intimidated because you assume the dominant position. Seating them in a corner makes them feel less threatened and is more conducive. Seating them beside you, you are then assuming a more co-operative position. We also watched a video showing us the importance of the way you greet your patients before they enter the room- how much eye contact you give them, your body language (are you leaning forwards, or crossing your legs, or are you seated too far away from the patient, are you turning your back against your patient when they walk in, do you seem interested in them as an individual). I think these things are more important than what people make it out to be because it was just eye-opening to realize the differences in practices that I've been to in Singapore (GP vs specialist) vs that in Canada (GP vs specialist). Many of the practices in Singapore that I've been to have placed the patient across from the doctor, and to be honest, it did make me feel intimidated like the doctor is dominating. I think these things, though they appear to be small/ sometimes seemingly insignificant, makes the difference in providing the ideal environment/ circumstances for potential patients to open up and really tell you about their conditions. (Also apparently many doctors tend to cut off their patients within 15 seconds of them talking and don't get the full picture of what's going on so the key point here is to listen more than you talk).

Also, in class today it was mentioned that patients don't actually have an accurate way of judging how good of a doctor you are. They usually gauge that by how much you seem to care about them as an individual. So I mean it really comes down to how you present yourself for that first impression and also your interpersonal skills.

Though it sounded very common-sensical, I think it's a lot harder to master than it looks or sounds. It's certainly challenging I think sometimes to reassure potential patients with regards to their conditions, try to figure out what you think is causing their symptoms and at the same time to watch what you say (how you word things basically). I think it's amazing how just asking for their medical history, social history, family history, their current symptoms, how that's affecting their daily lives, what they expect from this consultation and what their allergies are can tell you so much about their lives and who they are as as individual. And to know that some of the things they are telling you, sometimes even their significant others don't even know. The trust they put in you is quite empowering. Also we were taught to reinforce what they just said to make sure you are on the same page as them and to show to them that you are in fact listening. Some good questions to ask would be like:
- What brings you here today? (like a good greeting message)
- How is this condition affecting your life?
- What kinds of treatment have you gotten for it and how have you responded to it?
- Who have you seen about this?
- What have you tried to do yourself to relieve these symptoms?
- Have you done something out of the ordinary recently that you think might have caused this symptom?
- How long have you had this symptom/ these symptoms for? Does anyone from your family have this condition?
- What is the pain like? (asking for quality of pain)

Finally when you do offer them the range of possible treatments, ask them how they feel about it (also have to read their body language and respond accordingly)

I think what intrigues me the most when given all this information is how it's similar to putting together a puzzle basically. The best part is that every patient presents with different symptoms (even if they are diagnosed with the same disease) because even though there is a normal range in things (like normal BP is usually 120/80), different heights and different individuals present with different blood pressures and can still be considered to be "normal". Also, often I think it would also be interesting to treat certain conditions when they have other conditions affecting them because it would definitely affect how you manage their condition and the advice they give you.

We also talked about the shift towards a more teamwork based healthcare system rather than the traditional view that the doctor is the dominant person in healthcare/ center of healthcare.

I'm really looking forward to that general practice placement in Melbourne this June where I'll hopefully observe a GP and help take some patient history. And that's the beauty in it :)