Friday, June 28, 2013

two things I learned from first year of living in Philly

Beyond learning actual knowledge, I learned some soft skills first year of dental school. I already wrote about why resilience is so important, and how I hope to better harbor into resilience to push through my second year of dental school next year. There are other skills relevant to living in this great urban Philadelphia.

1. Living without a car is not only possible but kind of nice.

When I said bye-bye to Kasey and left Houston sans car, (I’d already signed the least on my current apartment which does not have a garage) I panicked a little. I’d gotten so used to driving around everywhere. Last year I thought my gym was far away at two miles: I would drive there, work out for 30 minutes, then drive back.

I got used to using public transportation during my summer vacation and learned to use that time catching up on texts, emails, and reading. Buses, subways, trolleys, there are so many options to get anywhere you want at just $1.55 a ride. It’s just wonderful- it’s especially better when you get a trolley operator giving you a tour guide: “And now, just like migratory birds in the springtime, we will travel north up, up, up….”

carless

2. It’s really fun having different seasons!

Houston has only one season: the hot and humid summer. All year around it’s just varying degrees of humidity and heat that will have you running for indoor relief. (Maybe why having a car was so necessary?)

With every month full of exams and non-distinct semesters, I would have never noticed the seasons had I not been in Philadelphia. The beautiful Locust Walk with lush green canopy, tulips and hydrangeas blooming, cherry blossoms forming pink mattresses on top of cars… Marveling at nature and taking time to breathe. Oh- and the snow. Loved it too.

petalsall

Also miscellaneous ones:

- Food trucks are awesome. During cadaver lab, we walked home along the row of food trucks on Penn campus with their delicious sights and delicious smells. Many trucks have vegan and vegetarian options too!

- Cockroaches and mice aren’t that big of a deal. Sad but true. “You saw a mouse?” “YES!!!!” “At least it wasn’t a rat.”

- Look both ways, even on a one-way street. The main streets that run East-West are one-way’s but still, remember to look both ways before crossing the street. Trust me on this.

Thursday, June 27, 2013

eating foods with braces

It’s been a while since I talked about my braces- in March! So let’s do that today. Another dental school friend just got braces. We were at a fancy reception together and I was munching on some chips (they also had softest-looking pastries… but with pastrami). She was surprised I could eat chips with my braces. Crunch. Crunch. Yeah… I do, but I probably shouldn’t.

For example, look at this extensive list by Dr. Malerman on his wonderful website of braces-friendly recipes. He is also a clinical professor of orthodontics at Penn! :) Extensive? Yes, but so sad.

stayaway

And this isn’t even the complete list. I will admit that I eat those typically dangerous foods: popcorn. apples (I like mine a little mushy so I can bite into them!), pens, brazel nuts/pecans/walnuts, and raisins. But by the grace of my wonderful orthodontist, my brackets have stayed put. My wire hasn’t budged a bit.

Each time I got in for my monthly adjustments (heavier wire, step-down’s, lately powerchains!), I am on an all-juice, all soft-pastries diet for the next 24 hours. But once I get used to the pressure, I’m back to my healthy crunchy chewy eating spree.

I love wheatgrass. Four Seasons juice bar in RTM has made me a converter.

juices bar

So far, so good. We’re still pulling down my anteriors and rotating those twisty molars. Summer traveling is going to throw my orthodontics scheduling off a little bit but no worries. Only for a few weeks.

Snapshot_20130605_4

Yesterday I shared my lunch of walnuts and strawberries with the little birds. That lunch was a nightmare for people with braces. Walnuts are hard and crunchy and strawberries with those pesky little seeds? But so good and perfect for the beautiful sunny weather underneath the tree shade.

lunchtime with birdie

What’s your favorite braces-unfriendly food? Have you ever had a braces “accident”? Fortunately Helen’s never received an emergency visit from me yet.

Wednesday, June 26, 2013

medical errors: just say you’re sorry.

Honesty is an important virtue. But when the scariest two words in healthcare are on the line- malpractice lawsuit- it’s not just your virtue on the line but also possibly your career, reputations and lifetime’s worth of work. Admitting you made a mistake? That you did something wrong? Um, scary.

Picture: if you understand why this picture is here… you must be a musical geek.tumblr_lj9mmn3ih91qivatvo1_500

Most of us when we go to the dentist don’t understand what’s going on. I’m a dental student and I don’t fully understand the procedures I’m observing at times. Sitting in the chair, we don’t know what’s going on in our mouths, let alone see what’s being done there. So patients probably won’t know if/when their dentist makes a mistake… right?

According to a shocking report in 2001 by Institute of Medicine titled “To Err is Human”, a whooping 98,000 people are estimated to die annually from medical errors. This makes the average person more likely to die from medical errors than from car accidents. I was reading about malpractice and came upon this new (to me) concept for dealing with malpractice litigation: saying sorry. In this New York Times article “Doctors say ‘I’m sorry’”, this new approach of “promptly disclosing medical errors and offering earnest apologies and fair compensation” works to “restore integrity to dealing with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits.”

This new model of early disclosure and offer (D&O) program was implemented at University of Michigan in 2001. A crucial tenet of this program is open conversation with patients, said to be a “radical departure from the traditional ‘deny and defend’ paradigm”. The hospital is ready to offer an apology and fair compensation if there’s been fault at administration of care.

Here are some concrete data for the success of The Michigan Model:

results-of-medical-error-disclosure-program-at-the-university-of-michigan-health-system

Recent numbers show a similar pattern: rate of lawsuits per 100,000 patients per months went from 2.13 suits to 0.75 in 2013. Median time for resolution dropped from 1.36 to 0.95 years (American College of Surgeons- March 2, 2013). Legal defense costs at UMHS dropped 61%.

In context of national spending, we can expect a decrease in direct costs (estimated to be $35 billion annually). Not only that, but also a $66 billion decrease in defensive medicine spendings- “increase [in] volume or intensity of healthcare services… to protect against possible lawsuits” (such as ordering computerized tomography instead of a simple X-ray)- Numbers from Congressional Budget Office “Tort Reform” Analysis, 2009).

UMichiganmalpractice1

Many patients sue because they feel it’s the only effective way to gain the hospitals’ attention- read this frightening account by Dr. Jonathan Welch about his own mother dying from medical errors. In his case a letter was ineffective in getting “an explanation for what happened… an apology… assurances that it would never makes these mistakes again.” He cites successful systems encouraging such conversation in places like UMich, they see “litigation as a last resort.”

One UMHS patient JW whose breast cancer was undiagnosed for months, went through such open conversation with her physician and the hospital. She described her outcome as below (from Journal of Health and Life Sciences Law, January 2009):

"”What that apology meant to me was that they had listened finally and I had been heard.”

She’s still a patient at UMHS.

A Penn dental alum told me the #1 rule to succeeding as a dentist: “Take care of your patients. Put them first above anything else.” Another professor in my clinic keeps reminding us: “If you make a mistake, tell them. They’ll trust you as a dentist and stick with you.” Not just for your own integrity but because honesty and humility works- we’ve got the data to prove it.

Sunday, June 23, 2013

a very long sunday

I woke up at 3AM today. I think it was the coffee I drank at 7PM yesterday. My body’s been weaning off coffee and I’ve been sleeping SO MUCH lately. I couldn’t go back to sleep so my day began at 3AM, starting with a night meal (breakfast #1), me making my master to-do list for the week ahead.

to-do list checked off2

I was so productive today! I had a long chat with parents in Korea (time zone fell just right), made it to mass, and got tons of reading done. I’m taking an online class on Health Care Reform & the Affordable Care Act and I’m learning all these cool (perhaps obvious) facts. Like, in the U.S. medical insurance is employer-based. I never thought about that or wondered how that came to be. (Employers used such fringe benefits to attract workers.)

reading at bn2

I also almost finished The Fault in Our Stars. I’m just at the pivotal part where important information is revealed (if I spoil it for you, you would never go read this masterpiece)… Even when I’m not reading that book, I’m constantly thinking about Hazel and Augustus.

Yawn. It’s barely 9:15PM and I’m sleepy. Today feels like two long days blended into one. I’ll close with some beautiful shots of the Schuylkill I took on my jog this morning. The water was so blue and the trees so green.

river2

Good night, including you night owls! Happy kind-of-last week of June ahead.

Friday, June 21, 2013

I’m getting better every day.

It’s such a great feeling. We got our dental simulations teeth back- the ones we drilled with our DentSim handpieces without knowing what the heck we were doing. That was our first semester of dental school so I barely knew 1) what to do and 2) why we were making certain shapes or outlines.

I had a blast looking at every single tooth. I had marked the ones I thought were good. Looking at even those “better” ones now, I know they would never have passed in our preclinic laboratory class.

first semester dental simulations teeth

I don’t know what happened in this Class II amalgam preparation box. It looks like an angry person dug into it, like craters or something awful. Dear future patients, I swear my hand skills are much better now since this mess eight months ago.

iblameheavierhandpieces

First days in GRD lab, I remember looking at the sample prepped teeth and wondering how they got the outlines to be so smooth and so flowing. I prepped these teeth for my “enrichment” class this summer. This took me two hours to do. The outline is off (not a clear dovetail on PM, extensions have sharp edges) but I am so happy with how crisp and smooth my outlines are!

outline is questionable but still clean cut happy

Simple reminders that I am getting better every day, and that I’ll continue to get better. Even through all the tears and sweat this year, I know this is a fact. I only hope I can look back on these preps and laugh- “I thought these were good? Yesle-circa-2013 should look at my magic hands now…”

In this way I love that dental school (and being a dentist) is concrete work. You get a final product (preparation or a restoration) after your long day at work day to day. Getting to be that consistently good takes hard work but it’s learning that skill.

What have you worked hard at to achieve?
What are you better at today than you were one year ago? (I’m also a better runner! And a much better stress manager.)

Thursday, June 20, 2013

free summer

Summertime is so lovely- especially after nine months of dental school madness. I love waking up after multiple snoozes, taking long walks around Philly, and eating the best fruits in season- watermelons and nectarines. I bought a huge watermelon and spent an hour chopping them up into little joy boxes in my fridge:

watermelons are for summers

I’ve been strolling around Farmer’s Markets and eating spontaneous good foods like this vegan banh mi from Kung Fu Hoagies (Check their twitter on the link to see when they’ll be nearby!). I’d been meaning to go all through the dental school year!

kung fu hoagies mmm

Between good foods, yoga and amazing massages (I felt like I was meat being tenderized. Is that a weird analogy?) I’m so happy zen right now. And as weird as it is to say this (my biggest pet peeve is people telling me to “take it easy”)… I am taking it easy.

And 2 weeks until I’m reunited with my girls who make me this happy. I see more culinary adventures & margarita confessions in our near future!

FOTB4C2

I am so glad I took this summer off from dental school things. I’m working on a few projects right now but it’s nothing like the crazy bustlin’ of dental student life. I feel like myself again and have time to do things: my apartment is getting a makeover & I’m actually cooking good food to eat. Okay, time to go grocery shopping & run some errands with an iced coffee in my hand. xx!

How is your summer going? What’s your favorite summer fruit?

Tuesday, June 18, 2013

Nutrition and oral hygiene.

We know what foods put you at high risk for dental caries: sports drinks, sugar-sweetened-beverages, coffee, tea, and fruit juices. But what should you eat to keep your teeth and mouth in tip-top shape?

just a party picnic dish

Let’s first talk about fruits. Fruits contain fructose which can feed the bacteria on your mouth- fructose is sugar, after all. This study by Arora and Evans looking at school-aged children in New Zealand found that higher consumption of fruits is associated with higher rates of dental caries. However it’s difficult to make judgments on diets based on their effect on teeth alone. Fruits contain such great micronutrients and antioxidants for your entire body.

So the current agreement is not to limit your consumption of these wholesome citrus fruits- American Dental Association recommends U.S. Government’s MyPlate as an ideal eating guideline with quarter of supper plates filled with fruits. Plus, the ADA focuses on reducing unhealthy foods from patients’ diets with “limits on calories, sodium, and unhealthy fats” and replacing them with healthier snacks such as dairy and nuts, fruits and vegetables. After all, fruits and vegetables are better for you than soft drinks and sports drinks- and they contain fiber! Just don’t brush your teeth right after consuming these acidic foods when your teeth are softened and therefore more prone to demineralization.

Current dietary recommendations focus more on preventing demineralization after consuming possibly cariogenic foods by using fluoride toothpastes and making policy changes for fluoridation of water supplies- not on reducing foods solely based on their cariogenic factor.

Daegu homemade meals

I know that a diet of wholesome, natural foods (made with love) can make you feel better. It’s amazing how much food can affect your daily energy and positivity levels. It’s also amazing how people respond differently to various diets- I for one, cannot live on fruits alone. I crash HARD with all that fructose.

I was inspired by this video by Dr. Michael Gregor of NutritionFacts.org to look into this topic. I was curious to see if there was a diet out there best for healthy mouths… this goes to show that we need to think about the patients not as mouths with teeth but as a holistic human being with intricate co-functioning systems.

Sunday, June 16, 2013

power of habits- into everyday life.

I read these tips from The Levo League on how to decrease decision fatigue, including one I am going to adopt: have the same thing for breakfast. To peer into the refrigerator trying to decide what I am going to eat can be exhausting, especially so early in the morning.

I recently finished The Power of Habit by Charles Duhigg (Add me on Goodreads and see what I’m reading here!). For the brain to think about every single decision we are making is energy-consuming. By forming these routine neural pathways we take mental shortcuts to make our actions automatic, which can be good and bad. The book also gives suggestions to create or change new habits- my favorite part! First step to changing a habit is to identify the cue, the routine, and the reward.

For this summer, I wanted to build some healthy habits. Mainly waking up earlier and working out in the mornings. Especially since it is getting hotter, I find that if I don’t go to the gym when it is cool outside, I definitely will not make it there when it starts heating up.

First week of summer has ended and I’m pretty happy with my “progress”. I’ve been napping every day, writing a lot of emails, and reading a lot. You’ll see Living History has been on my “Currently reading” list for a long time… I’m now halfway through it, and the timing is perfect because Madame President is happening.

I love you grassy plants

Like eating vegetarian was rough at first. I didn’t know what to eat! I was eating PB&J sandwiches, pretzels, and oatmeal half the time. I was pretty stressed out figuring out vegetarian eating during crazy-busy dental school this was another stress in itself. Now grocery shopping and menu planning comes naturally. The initial phase was rough but now it’s automatic.

I love this post from my favorite blogger, Penelope Trunk.

It’s so much easier to do things on the list that don’t matter. Sometimes I think the point of making a to do list is so I can organize things into categories: things I must do to be happy and things I will do to procrastinate making myself happy.

What you really need to know is that you will ruin your life if you don’t do the most important thing on your list every day. We get self-esteem from getting things done that matter. Not everything on our list matters to us. There is stuff that is there because it should be there, like things that involve making money, and there is stuff there because it fills our soul. You have to do the stuff that makes you feel good about yourself. Do it first. I put it off for a week, and it ruined my week.

Doing that first thing takes extra focus because the thing that matters most is the thing that’s hardest to do – it’s easier to do something when there’s nothing at stake.

I was making my to-do list at volunteering yesterday and another volunteer asked me, “Are you writing in your diary?” That’s how long my to-do list was. I get too much fulfillment out of crossing things out until the last one left is the most important one I’ve been putting off. So touche, Penelope.

Go do your #1 item on your to-do list right now! And… what’s your favorite vegetarian dish?

Thursday, June 13, 2013

make a living, make a life.

When you think “paying the rent”, do you think: “writing a check out to my landlord at the beginning of every month” or “making the payment necessary to sustain my place of living”? Same thing about “working”. Is it: “Being somewhere from 9-5 to get money” or “Finding personal fulfillment from my passion and contributing to the society and beyond”?

I had the most amazing meeting with a professor earlier this week. We got to talking about his research which is really interesting but I was more moved by his reason for pursuing this field. He sees his work as a way to bring care to those who need it desperately, especially in third world countries where people cannot afford $1 a day on medicine. He sees his research as a possible way to bridge that injustice gap. I know this motivates him to work harder- work smarter- because he sees his work as something more than a way of making money.

It was so inspiring and SO moving. It was my first time chatting with this professor and I was tearing up! (Okay, not that crying in front of a professor is anything new for me.) I coughed a little and tried to blame allergies.

Remind myself this every day

I received this fortune cookie at Pho dinner last weekend. So this thought had been on my mind, going into this meeting.

What does a career mean for me? What motivates me to succeed in my career? What do I want to achieve with my career? Are career achievements the goal or a means for something else? For this meeting to occur right after this cookie, I believe the Universe is telling me something.

Wednesday, June 12, 2013

Dating like a dentist

We learned to say, “when can I see you again?” so we schedule appointments for patients. It’s just like dating, said our professor. Right, but it may be a year before you see that cutie again if you date like a dentist.

an-education-4v7i5351Picture

Today’s New York Times article suggests that annual dental exams may be enough- not every six months as previously suggested. In the same issue though is another article on the dangers of oral cancer, especially in heterosexual middle-aged men. I found this ironic because dentists are trained to look for and recognize signs of oral cancer in the mouth- six month recalls may not be necessary for teeth decay, gingivitis or periodontitis, but what about oral cancer?

And if you haven’t seen this, 15 reasons to date a dentist including 6. Free check-up’s and immediate access to emergency dental care- right, because we carry our high-speed drills with us at all times…

Monday, June 10, 2013

first weekend off! Six Flags and boot camp-ing

I took my first FULLY FUN weekend in a long time! When I had dental school classes I always felt like I should be doing school stuff but this was an irresponsible amazing weekend all for myself.

We had annual Disney passes growing up- Disneyland when we lived in California and Disney World when we were living in Tampa. We used to bring in homemade brownies (rule-breakers!) so now I associate amusement park-going with brownies!

2013-06-06 17.55.50

So I made black bean brownies to take to Six Flags which didn’t happen because I ended up eating them all before Sunday (I gave some away too!). We also made this raw vegan fruit tart for a birthday boy, a recipe from my birthday present cookbook.

Six Flags was a lot of fun! I only took a mini ID pouch with me so I don’t have a lot of photos but I got so much good adrenaline high’s on this short day. Six Flags is supposed to be a more grown-up scary theme park, right? That’s what I always thought living in Cali.

We rode Kingda Ka in the front row!!! The ride lasts twenty seconds but ohmygosh so crazy. Just watching this video gives me the heebie-jeebies.

2013-06-09 12.18.42

Saturday I went to the Be Well Philly Magazine Boot Camp on Drexel campus. An entire day of sweating, massages, free foods, info sessions and chats with like-minded health-conscious women. Liz and I had a ton of fun and left with a bunch of free goodies.

bwphily

We got corrective massages and my poor neck and shoulder from dentist training got so pampered. It felt amazing to take an entire weekend off! Summer’s only started and I already feel SO MUCH more relaxed and de-stressed compared to the dental school year. It’s a great feeling.

Friday, June 7, 2013

The end of first year dental school- on resilience

I can’t stop smiling this morning because we are completely done with our first year of dental school! A quarter of our way to becoming dentists!!! This year was crazy: I learned just how sensitive I am to criticism, how much stress can wreck me, and despite it all, how excited I am to be on this career track.

Something a classmate said yesterday really stuck out to me. A professor had just said, “oh, it gets harder next year” or something to that effect. He replied: “Yeah, but I’ll be a better man next year.”

What do you think? I have been repeating this story to everyone because this is exactly what I hope to do with this summer. Next year may not be necessarily easier but I want to take this summer to become stronger, not just physically but also mentally, emotionally, spiritually!!!

summertime

I’m hoping that next year whatever hits me, I will be able to better deal with it. It’s the same belief Sharon talked about, that even if something were to happen she was confident she could handle it.

And to put things into perspective, after getting really upset at school Wednesday afternoon, I got home to receive this month’s issue of Runner’s World with feature stories on this year’s Boston Marathon attacks and got a picture message from Laura- she’d been in a huge car accident on the freeway and despite her car being totaled was thankfully okay. Actually all of my college girlfriends have been going through some rough things lately… It’s a wave of group messages to my phone 24/7.

deleteall

For now, I’m enjoying this end of my first year of dental school & not checking my phone/email/blog 24/7. And cleaning out my computer with this year’s school stuff. So many PDF’s, so many Excel spreadsheets!

Thursday, June 6, 2013

how I spent my last D1 weekend

This weekend I sent out some emails I’d been putting off since forever. Sunday I woke up (strangely much earlier than I planned on) and in my sleepy state, typed up those emails and sent them out. Some things are easier when you’re only half awake. I had such a huge build-up for something that took really five minutes.

Saturday evening Lan, Ze and I made hoddeok (호떡)- Korean street vendor snacks that are sweet pancakes with brown sugar inside- for an end of D1 celebration at Jackie’s.

hoddeok.jpg

I’m so excited about getting to cook more! Farmer’s markets are back in season and it’s a lot of fun picking out produce on the spot. And more running (it’s hot so that will force me to be a morning runner). Would you agree these two will offset each other?

2013-06-02 19.10.53

…with more adorable sights like this. I wanted to get closer but the mother goose was eyeing me really closely.

2013-06-02 19.08.10

I also sat outside and studied for our second to last exam (out of something ridiculous like 55 in our first year of dental school). I had walked to school but couldn’t bear to be in the library in this gorgeous Philly weather.

2013-06-01 13.30.35

Is summer your favorite season?
What’s been lingering on your to-do list lately?

Tuesday, June 4, 2013

one more week til D1/D2 summa!

One thing sad about summer is that the television shows I sneaked in between dental school studying are on hiatus. (Thankfully The Levo League put together a list of oldies TV shows I can watch and learn about being a professional women from.)

Clockwise from top L: Nikita, The Mindy Project, Suburgatory, Modern Family
Picture sources: 1, 2, 3, 4tvshows.jpg_thumb2

Of course that doesn’t mean I don’t want summer to start. I’m excited about being free to plan my days out however I want, without classes or studying or clinic obligations. But I still plan on having some structure and routine... I like this from last week’s Brain Pickings: Seth Godin on separating needless routines from constructive and creativity-promoting ones:

The strategy is simple, I think. The strategy is to have a practice, and what it means to have a practice is to regularly and reliably do the work in a habitual way.

There are many ways you can signify to yourself that you are doing your practice. For example, some people wear a white lab coat or a particular pair of glasses, or always work in a specific place — in doing these things, they are professionalizing their art.

To get myself “in the zone”, I’ll be starting with some iced coffee while possibly still wearing my pajamas…

(Picture)tumblr_m6s0ea03pK1rn5d5vo1_500_large

What television shows are you sad to see on hold this summer?
Any summer TV/movie suggestions?

Monday, June 3, 2013

compassionate dentists

I woke up early yesterday morning (too hot, too many thoughts) and was browsing the internet in my bed and found this wonderful article on XOJane: My dentist was made to believe I was dead and it made me realize why I shouldn’t kill myself and you shouldn’t either.

Picturetumblr_lq9ivqlHIu1qfk6vyo1_400

I love this because Dr. Chen- or whoever she might be- is a great example of a compassionate caring dentist who’ll think of you as more than a mouth with a set of teeth. And it speaks to me personally because a dentist can be more than someone who takes care of your teeth.

This was a happy and inspiring article to wake up to.

Saturday, June 1, 2013

may gratitudes- 24th birthday

I’m 24 everybody! I don’t feel too different. We had an outdoor picnic by the dental school last weekend. It had rained the day before so we briefly considered moving our picnic indoors but thankfully by Saturday morning it was sunny and almost a little chilly.

Everyone ate secret vegan meals. We had the Fresh Tomato and Avocado Salad from The China Study Cookbook and banana “ice creams” with only one ingredient- frozen bananas blended in Vitamix. Plus treats lovely ladies brought in to munch on.

2013-05-25 12.37.44

A classmate happened to be walking by! So we got a group picture from the award-winning photographer Lan La (‘s camera I mean…). Can you tell how green sunny beautiful it was this day? I’m blending into the background.

052613 bday2

Emily brought me a vegan cupcake topped with an Oreo (Oreos are vegan- but only in America). I devoured this sparkly goodness as an afternoon snack.

2013-05-25 14.15.22

When I was in Houston I had a birthday picnic last year too! (This made me nostalgic for that sunny day and reading this post from Helen in Peace Corp made me so sad and relieved and still sad.) My birthday always falls in the summer after everyone has left for the semester. This is the first year my birthday has fallen in the middle of the semester so I think this is one pro of having an extra-long spring semester.

Will you be picnic-ing out this summer?
What’s your favorite picnic food?