Body Image and The Separation of Beauty and Health

Body image. What a loaded topic but the world needs to start talking about it. We live in a society with one of the strangest paradigms. We are the most obese and unhealthy we have ever been but yet perhaps the most obsessed with being thin. Here are my thoughts on this (fyi, I’ll be talking more women because I am female. I realize men have body image issues too but I am not a male, therefore feel weird addressing that):

First of all, I know that there are many different body types. My sweet Gram made me very aware of this on my last visit home in March. She was comparing how differently my sister and I were shaped. She compared Rach to Jennifer Lopez and then concluded about me, “Not you Mon. You more like that Justin Bieber boy.”  Thanks Gram. However, replay that in your head said by a tiny Filipino woman in broken English and it can never be insulting. But that is not what this is about.

So anyways, I realize much of what I’m about to say is easy for me sitting here at 5’2” with a similar frame as Justin Bieber. But here it goes:

We have a problem. Our country is obese. People who we now consider ‘average’ or just ‘over weight’ are in reality actually obese because the bell curve of our society’s weight distribution has shifted to the right. But lots of these women are so beautiful!!

First, what is beauty anyways? Historically, beauty has been associated with actually being overweight. If you look at historical paintings, the women are much fuller. But back then, that meant you had money for food, lived a stable life, and perhaps didn’t have to do manual labor all day. What about now? Beauty is considered very thin and fit. Is that because thin fit people have more time to exercise? They have money for gym memberships? Don’t say because they have money for healthy food because we are broke as crap right now and I pack a giant salad every day for lunch with a boiled egg, carrots, and celery on it and that costs about 50 cents/meal.

I have many friends and family members who are overweight/obese who are some of the most stunning women I know.  They have awesome skin or ridiculous great hair and are 1000x more fashionable then me. I love this latest Facebook trend that asks people to post 5 pictures you feel most beautiful in. I had an overweight friend who told me even when she feels pretty, she feels ashamed saying it. I think it’s probably therapeutic for some people to declare publicly that they feel beautiful.  Scream it to the mountain tops, because you are beautiful! And it is more then ok to feel so!

BUT. Here comes the but. Just because one is beautiful does not mean that we should stop trying to be better. I think we need to separate the ideas of ‘beautiful’ and ‘healthy.’ What do I see when I have a patient who is this stunning women with a super great outfit on…who also happens to be over weight? I see a high risk for diabetes, heart disease, and a list of other health issues. So ladies, if weight is something that you struggle with, you are most certainly beautiful, but that doesn’t mean we can’t stop improving ourselves. I often hear/read “I’m finally learning to accept my body how it is.” Nooo! That breaks my heart. You are so beautiful, and I want you to live a healthy long life! Just because I’m shaped like Justin Bieber doesn’t mean I don’t need to exercise and eat good food too.

So here are my final thoughts:

At a recent Christian Medical and Dental Association dinner we talked about Philippians 4:8.  It says, “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable--if anything is excellent or praiseworthy—meditate on such things.”

The only way to truly change somebody’s life and help them is to affirm them and meet them where they are. So instead of scolding a patient with diabetes who just told me that they are still drinking 5 regular Pepsis every day, instead I should say “I realize that that must be difficult to admit to me because you know I want your blood sugar levels to be better. Thank you for being brave and honest. I know you really must want your health to improve otherwise you wouldn’t have told me that.”

People who are overweight have to wear their health issue externally for the entire world to scrutinize. I’ve got my own problems, and I am so thankful I don’t have to display them for everybody to see every day and I can’t image how difficult that must be. So rather then point out somebody’s imperfections, do as Philippians 4:8 says and mediate on what is right, pure, lovely, admirable, excellent, and praiseworthy about them. If you see them at the gym or outside exercising, make them feel welcome and say hello! Maybe even introduce yourself so you can call them by name next time you see them. Gyms and places of exercise, such as the greenway, are scary places for somebody out of shape. If you see them over and over again, tell them you admire their dedications! If you like their outfit, if they did something great at work, etc, say so! The world is really just one big community, and we need to take care of each other. We can start by affirming what is lovely about each other so we have the courage and confidence to start working on what could be better.

So here are my 5 pictures. 

I feel beautiful when I spend time outside.

I feel beautiful when I feel strong. 

I feel beautiful when I spend time with Seth, who encourages and loves me.

I feel beautiful when I am with my family, because I smile and laugh a lot.

I feel beautiful when I spend time in beautiful places.

How I am learning to change the world on my Infectious Disease rotation.

First let me begin with some school logistics, because it is pertinent to a point I’d like to get across today. I just started my elective rotation in infectious disease. One of my favorite classes in undergrad was microbiology, and I did research with the bacteria Pseudomonas. I remember that period of my education. I LOVED learning. One of my favorite parts of the day was going to that class, studying for it, going to do my research, or reading articles to prepare my research. I chose an infectious disease rotation because of this, but sadly Monday morning on my first day I wasn’t excited at all to go in.

PA school is a learning lover killer. It’s where people who love to learn go to intellectually die. It basically takes 4 years of medical school, does some condensing, but then essentially shoves it into 2 years and then you’re expected to go off into the world after that time and take care of people. It’s horrible. The classic analogy is trying to take a drink from a fire hydrant. Anyways…lately I have thought and said, “I am really just tired of learning.” Last month I was on OB/Gyn (Women’s Health), and although I didn’t mind it, I only ‘minded it.’ That’s the point.

I just finished my first week on infectious disease and all I can say is that my love for learning has been reawakened. We are all wired to love different things, and I have been wired with a special affection for microbes. I could eat, drink, live all things bacteria, viruses, and fungi. I don’t know why, but I just love ‘em! And I am excited to come home and study about them regardless that I just spent a long day at the hospital!

Microbes are so fascinating; but they are not the sole cause of this love for learning re-awakening. So what has evoked this? My attending physician overseeing me and the residents. This man takes so much extra time to talk me through every single patient, asks questions to help me process through their signs and symptoms, tests to be ordered, a diagnosis, and treatment plan. It would be much faster and easier if he just told me what they have, why, and what we’re going to do for them. When we go see patients, he introduces me to every single one. I feel like I matter, that I am contributing, and that my education is important to him. He includes me in discussions with other physicians and asks what I think. He will do menial tasks like get me a pair of gloves or showing me how to do a basic trick on the electronic medical record software. He also takes so much time with each of the patients, explaining to them what is going on, asks them about their families, asks them about their lives, and is just so sincerely kind to them.

In the basic gist: he cares about people, a lot. He respects and serves people, in big tasks like taking care of their life threatening infections to showing me a trick on the computer to make the resident’s lives easier. After an afternoon with him I have learned so much, not only because he has a wealth of information to share but because I feel included and that what I am contributing is important.

Some of you reading this may feel like your job or what you do with your time isn’t important and that it makes no difference, but I am telling you that it does. We have small interactions with lots of people on a daily basis, and doing something as simple as fetching a pair of rubber gloves from a cardboard box stuck to the wall for the PA student is hugely impactful on the quality of her education. We can all be impactful in big ways with small things, and it all starts with just caring about each other.

How to Travel When You're Broke

A few people have asked how we can travel being so broke. Ok, we aren’t super broke. The bills get paid, and we have a little left over sometimes for little luxuries like movies and dinner out, but we save our pennies for trips, and here’s how we afford them:

1)   Airbnb.com. One of the biggest expenses of traveling is lodging, and this has been our life saver. This is how we stayed in the Outer Banks, NYC, and Boston. Basically people with extra space in their house rent it out for super cheap. Our place in the Outer Banks was a legitimate bed and breakfast, but our place in NYC was literally a bedroom and bathroom in the apartment of 2 guys who just needed the extra income to pay rent, and our place in Boston was a floor of a house a single lady rents that we split with 3 of my classmates who also attended the AAPA conference in Boston. There’s all kinds of options on there, and we highly recommend it. It's safe, you make a profile so hosts can screen you, the hosts have profiles and reviews (we don't stay places with <5-10ish reviews), etc. Also, we don't travel to sit in our room. We travel to see wherever we're going! So our standards is somewhere clean and safe to sleep and shower.

2)   Eating is a big part of our travel experience. We do splurge on at least one great meal a day. But we don’t eat out breakfast, lunch, and dinner every single day. Typically we just buy a bag of bagels and some fruit for breakfast to eat wherever we’re staying, have snacks to carry with us during the day, split lunch, and have an awesome dinner. Also, alcohol is expensive people. Sure, on one nice dinner I’ll get a glass of wine or if there’s some interesting local beer, Seth will get something. But if you’re going to booze it up, just stay home. Being drunk in NYC is the same as being drunk at home, and you may as well save yourself the expense of going all the way to NYC.

3)   Honesty, we don’t spend a lot of money when we go places. We really just like to walk around and eat good food. In NYC, we made lists of places we wanted to see on different parts of Manhattan, walked all day to see them, and spent on eating (splurged on ice-skating in Central Park on Christmas Day. WORTH IT). In the Outer Banks, the beach is free, the National Seashore (so amazing) is free,  the lost colony of Jamestown is free, I think it was $10 to go up in the Bodie Island lighthouse, but other then that what did we do? We walked around and ate. Boston was the same. The things to do in Boston is see all the historical sites and walk the Freedom Trail. So I guess it depends on what you want to do. Museums cost money, so usually we forgo those unless there are discounted/free days. We do our research ahead of time of the places to see and don’t go on guided tours that cost money. We don’t like to shop, and we take advantage of free entertainment at our restaurant choices. I guess I would have liked to see a show on Broadway in NYC or go scuba diving in the Outer Banks, but for our budget, we still had awesome trips without those things.

4)   Other big expense of traveling: actual transportation. We drove to the Outer Banks (only 5.5ish hours). To save on parking and gas, we drove to DC and took a bus to NYC (way more convenient anyways). We, by some miracle, got round trip tickets from Charlotte, NC to Boston for $120/each. But a major saver is when we arrive places, we walk. A LOT. MILES. EVERYWHERE. Subway tickets, gas, taxis, etc., add up quickly, and also you just see more when you walk. You'll discover places you normally wouldn't have and you really experience a place how locals do by just walking around, and that's what we like. Anyways, it helps to have your lodging in a strategic location to allow for this.

Hope this is helpful for somebody! Our trips are by no means luxurious, but we are seeing and doing lots!

Mother's Day Woes

 I should be studying platelets and the coagulation cascade (how our body forms clots) right now. This seems to be the bread and butter of cardiothoracic surgery; maintaining a perfect balance of not causing your patient to bleed spontaneously but also keep them from forming clots and causing strokes, pulmonary emboli, etc. post operation. But I got up at 4:45 this morning, worked 10 hours today, cleaned, and ran 3 miles. So I’d rather write something else. It’s about to get personal up in here.

Mother’s Day. It’s coming up this Sunday. Holidays like this are meant to be celebrated, but with them comes lots of baggage and awkwardness. Me for example: I don’t have a mom. Many people know this. Without going into too many details, basically since I was 11-12ish I haven’t had one. Starting around age 11, mom was in and out with lots of ugliness in between ultimately resulting in my dad officially a single parent by the time I was 15. Some people (insensitive ones might I add) say “well it’s not like you were a baby when she left.” Right. She was only the most abusive and then completely absent during very pivotal times of growth and development into a young adult. That’s much better. Thanks @$$hole (sorry, but sometimes dingleberry just doesn’t cut it for a noun).

 So anyways. back to Mother’s Day. I always have mixed feelings about this holiday. I am not upset or angry at my mom for what happened anymore. But it’s just so dang sad! It weighs heavy on my heart that she is missing out on my sister and I’s life. It makes me sad that my poor dad had to go through the loss of a marriage and also carry the great task of dealing with 2 pre-teen/teenage girls on his own. It also makes me wonder what the future holds for me as I become a mom one day and the fact I just don’t really know what that looks like.

But in the midst of all this yuckiness, there are lots of wonderful mom/female figures in my life. First of all, my Gram. Grandma Gloria is actually my maternal grandmother, but she has always and is a huge part of my life regardless that my mom is no longer part of my life. My mom’s entire side is actually fairly dysfunctional, but my Gram is the kindest, gentlest woman on this planet and always rescuing everybody. She truly is the matriarch that holds the universe together. Not to mention, how many 81 year olds do you know still fish, pick berries, and camp in the wilderness of Alaska? Then there is wonderful Holly, Dad’s fiancé. Holly has been around for, what seems like, forever, and her and Dad made the transition of joining our families very gracefully. She is everything I could ever want for my dad, and everything I would want for a step-mom. There’s also Elizabeth, my mother-in-law, who since Seth and I started dating back in high school has welcomed me into their family as one of her and Rob’s own. So am I sad about my mom? Yes, but quite frankly, my dad is a better mom then some moms are and I have so many wonderful women in my life.

So this Mother’s Day, lets celebrate all kinds of motherly love we receive from all kinds of people. <3

Guts Everywhere! Surgery and Life Beyond.

This month I’ve been on my surgery rotation in beautiful Banner Elk, NC. This is THE coveted surgery rotation of my program, and I have been anxiously awaiting it since clinical year started.

The PA students get to be first assist in the operating room. Aka: It’s me right across from the surgeon doing the actual procedure and the two surgical tech nurses there to rescue me from doing something stupid or take over to assist when things get crazy. Just this week I have had my hands full of yards of live human intestines, held a gallbladder, navigated an abdomen with a laparoscopic camera, drained an abscess the size of my fist in a location I won’t describe, done a partial mastectomy (removal of breast tissue), gotten to close (or suture) many of the wounds, and many other things.

A typical day starts around 6:30AM when I go see all the patients who have been admitted to the hospital who are recovering from their surgery, then I go to the operating room and get the first patient ready with the nurses, surgery starts at 8, after the surgery I follow the patient to the recovery room where they wake up from anesthesia and are either stabilized to go home or get admitted, and then repeat with the next case. After all the surgeries are done, we go to the clinic and see people who might need surgery (consults) or see people a few weeks after they had surgeries (follow ups). Then after that I go round on all the admitted patients again and then I go home around 6PM. And then I’m on call, which I’ve been called in twice this week after hours, but luckily I haven’t had to work past midnight any night.

This has been a good rotation too, because I’m learning about how to manage patients who are in the hospital. I think in bigger hospitals the surgeon just literally operates and then hands off the patients to a ‘hospitalist’ who then manages them as an inpatient (somebody who has to stay in the hospital over night). When do they need IV fluid? What kind? How much? Do they need antibiotics? When is it appropriate to order x-rays or CT scans? What do you do with that information? How does a patient’s care change based on their age? What do I do with all these labs? What are all these instruments!? Learning SO MUCH!

I am loving every second of this. As my friend Brittany, who is a general surgery PA, says, “I love seeing people’s insides!” It really is fascinating. Surgery is so task oriented and satisfying. When something is wrong, we operate and fix it (for the most part). The day also flies by. The operating room is like a time vortex. You start a surgery and next thing you know you’re with the patient in the recovery room and 3 hours had gone by when it felt like 20 minutes. I have always known I would absolutely love this rotation and have been waiting for it since clinical year started. And how glamorous and, as my professors say, ‘sexy’ is it to say you work in surgery?

 I would LOVE to work in surgery after school is over, however these hours are atrocious. No matter how much I love my job, I will love being at home with Seth more.  His next few years might be crazy though as he pursues graduate school himself and works so maybe I should do surgery for awhile? Who knows. I want to love my job. That’s kind of been the point of going through all this schooling, so I can do what I love. But on the other hand, I am not defined by my career. It will be interesting come July/August when I start applying to jobs and see what opportunities come about and decisions to be made. Until then, I am enjoying myself, feel so lucky to be here, and just trying to make it through one last month of this away rotation marathon.