Tag Archives: growth mindset

Intention: Humanity

I’ve heard that at the beginning of a yoga session, people may set an intention to guide that period of time and help it translate into life as a whole.  While I haven’t formally done yoga before, I really like the idea of setting intentions.

In past years, I’ve picked a word or phrase to help guide the year in lieu of writing out a list of January resolutions (which I never seem to look at again anyways).  This year, I set an intention to be curious about life and each new experience it brings.  I was in the tentative first few weeks of a new relationship as 2016 rolled in, and my goal of embracing curiosity helped me to keep my heart open to the day-by-day unfolding of what has now become a beautiful part of my life.


I’m finding that sometimes life can knock the wind out of you, and other times it can give you wings to fly.  The relationship that started with curiosity has been an incredibly wonderful instance of the latter.

Time has been moving quickly, and now I’m exactly 30 days away from starting my first clinical rotation.  The idea of setting an intention is coming up again, this time because I’ve spent a portion of the past two days thinking about what it means to be a compassionate medical caregiver.  I’ve also been spending a good deal of time pondering how on earth I’m going to manage being a clinical student.  I’m 26 now, and I can see that I’ve grown a lot (especially in the past year), but I’m still trying to figure out who I am.  So perhaps part of this is a cry from my soul to reaffirm who I am, to reconnect with the reasons I am in medicine.


I’ve decided I want to set an official intention for my clinical years.  I already have one (hopefully) realistic goal for clinics: walk into my rotation on Day 1 with my head up, get along well with my team, learn from the mistakes I make, connect with the patients I’m assigned to follow, and walk out the door at the end of the day with my head still up.

As the lyrics go, chin up buttercup.

I also want to have a broader intention for my full 16 months of clerkships.  I think I’m starting to sort that out as I try to chart the courses of the rivers draining into the cognitive and emotional depths of who I am.  What are the reasons at the core of why I want to be a physician?  Why am I doing this?  What is going to get me out of bed every day for the next several decades?

It reminds me of when I was in the throes of applying to medical school several years ago, asking the same question–why medicine?–as I agonized over my AMCAS application form and the ensuing secondary essay questions. I actually went back to some of those essays today, blowing dust from the computer files.  It was like opening a time capsule and reliving the tense anticipation of applying to medical school: waiting for a secondary application invitation…waiting for an interview…waiting on pins-and-needles for an acceptance.


Are my reasons still the same as they were when I was a 22-year old student fresh out of undergrad?  I believe they are, at their core, although they’ve evolved and grown with the passage of time.

Sitting down with my journal, I parsed out four reasons why I am in medicine:

  1. When I’m able to bring a moment of compassionate connection into a hospital room or patient interaction, I feel like my soul has been nourished (and hope the feeling is mutual with the person I’ve connected with).
  2. I enjoy being able to share information; it’s gratifying and gives me the sense that I’m contributing something to other’s lives.
  3. Medicine is full of stories if I stop to pay attention and listen to them.  I want to learn people’s stories and give them the space to share them, if they want to.  This ties in to reason #1.
  4. Learning engages my mind and makes me feel incredibly happy and alive.  The medical field is one of lifelong learning.  This leads to reason #2.

Ultimately, I found that everything can be reduced to the following: (1) I find compassionate connection with other humans to be deeply satisfying and meaningful and (2) I enjoy the personal growth and sense of contribution to society that comes from learning new information, thinking critically, and teaching others.

So these are the bare-bones reasons of why I am in medicine.  Medicine is an environment where compassion and information-sharing can be practiced on a daily basis, and it positions me at a time point in peoples’ lives where this is especially needed.  I personally found, when undergoing a minor (but painful) medical procedure recently, the only two things I cared about were whether I trusted my provider (i.e. whether I felt he cared about and respected me as a person) and whether he was competent (i.e. could do everything efficiency and effectively).  I know everyone has unique priorities when interacting with the medical team, but I feel that trust and competency would likely show up as common themes.  And those are words I’d like to be able to be applied to me.

I actually feel a bit vulnerable sharing all this on my blog, because it gets down to why I’m doing what I’m doing.  And of course, there’s always the question, is it enough?  Are my reasons good enough?  And am I?  I have to believe that I am, and that I can do this.  I may not become the absolute best at what I do, but I will try my absolute best.

So my intention for the next year and a half?  To be compassionate, to pay attention to people’s stories, to accept that I’ll make mistakes, and to do what I can to learn from them.

In a word?



Deliberate Practice

I’ve never really spent much time looking at the bricks inlaid on the path that runs past the Li Ka Shing Center, but yesterday morning I snapped pictures of the following words while on break between lectures.  I was trying to catch an impression that I wanted to write about without exactly knowing what it was, but today I think I know.




It came together after reading from the Harvard Business Review.

I hadn’t realized how breathtakingly relevant pieces from this journal could be to my training in medicine. As part of my Managing Difficult Conversations class, however, I was reading through an article in the HBR this morning when the following sentences jumped off the page and into my lap like an oversized tabby cat:

“Not all practice makes perfect. You need a particular kind of practice—deliberate practice—to develop expertise. When most people practice, they focus on the things they already know how to do. Deliberate practice is different. It entails considerable, specific, and sustained efforts to do something you can’t do well—or even at all.”

This was particularly relevant because, just yesterday, I was mulling over how I am hesitant to do some parts of the physical exam when working with actual patients. The parts where I’m not yet confident of my skills.

Certain things I’ve practiced enough to feel mostly comfortable with—for example, placing the stethoscope in the four positions on the chest wall to listen to the heart. And some things are straightforward enough that they are no longer intimidating.  I am confident while feeling for the rush of blood through the carotid arteries, listening for bowel sounds, or examining the extremities for edema.

Other things leave me feeling like I’m approaching a forest with mist swirling about my feet. How exactly do I test strength and reflexes in a patient who is unable to leave the hospital bed?  Is that really the thyroid gland I’m feeling…or should I ask them to swallow one more time as I feel for the subtle slide of lobes beneath the skin? What if I forget to test one of the cranial nerves while doing the neurological exam?  What if I don’t feel something that is there, or if I think I feel something there that isn’t?

What if I mess up?

For me, our Practicum sessions this quarter have brought some of these anxieties to the forefront of my consciousness. In Practicum, we spend an afternoon in the hospital every other week, and during this time we each meet with an assigned patient to gather their history and perform parts of the physical exam. After the history and physical, we join our preceptor and present our patient’s case in (what is hopefully) a concise, organized manner. All this comes together to prepare us for when we start our clinical rotations, and it is an invaluable opportunity to gain actual experience in the hospital setting.

As I reflect on my own performance, however, I realize that my times of practice aren’t fully yielding the dividends I seek. This isn’t a fault of the sessions–Practicum gives me all the opportunities I need.  Since a good portion of my time is spent alone with my patient, I am the one who decides which questions to ask and which physical exam maneuvers to perform.  And as a student, I have the rare gift of time to do so.

But I have been drawn towards the things I already know how to do fairly well. I have the human love of discovery, but I also very much have the human love of competence. It’s uncomfortable pushing myself out onto the tight wire that spans the cliffs between what I am and what I can become.

As I read on, one other sentence in the HBR article caught my attention.  It especially stood out since we’ve been receiving coaching on how to improve the cohesiveness, clarity and delivery of our oral presentations in Practicum:

“Bear in mind that even Winston Churchill, one of the most charismatic figures of the twentieth century, practiced his oratory style in front of a mirror.”

It’s awkward to do so, perhaps, but this echoes what I’ve told about improving my presentation delivery by practicing out loud on my own.  More than any other time since starting medical school, I’m sensing that the way forward is through focused, intentional practice above and beyond what I would normally do in my sessions.  I need this deliberate practice–the sort of practice that drives me into the realms where I am not skilled, past all the whispering shadows of fears that would try to keep me out.

By embracing the discomfort of what I can’t do well, I will be in position to move forward in the way I need and want to.  I know who I am and who I have been; I am not one to back down in the face of challenges.  But somehow, my journey as a medical student is revealing vulnerabilities that have laid latent within my soul.

That’s okay, though.  As I talk with some of my classmates about these areas, I find that I’m not alone in how I feel.  We all have our own uncertainties, hopes, visions and vulnerabilities, and although on individual journeys, we’re still in this together.

I’m excited to see how far we’ll all have come a few years from now!  And since I’ve realized how to engage in deliberate practice, I’m not as afraid of falling short of my vision of who I want to be as a third- and fourth-year medical student.  I have a plan moving forward, and I believe I can actually get there.

I really do.

Growing Places

We just finished our first afternoon of emergency medicine training, which for my group meant a practical review of phlebotomy (on ourselves) and lessons in how to place Foley catheters and nasogastric tubes (in mannequins).  While preparing for class, I learned that nasogastric tubes can be used to administer medications such as activated charcoal (which can be used to prevent the absorption of ingested chemicals).  Although I didn’t personally have the opportunity to try a nasogastric tube, I did have a chance to taste a sample of activated charcoal.

I eyed the charcoal solution for at least a minute, swirling it around the little cup like some odd potion in a paper flask.  It had come from a tube that reminded me of toothpaste, and I wondered whether drinking it would turn my teeth an unsightly gray before a meeting later that evening.  Would it be as bad as eating blueberries before going out in public?  Blueberries always have a way of messing with my teeth.  However, driven by a sense of curiosity and duty (and besides, my classmates were watching), I tipped back the paper cup and took it in one dramatic gulp.  As there was only about a tablespoon of liquid in the cup, my gulp wasn’t particularly dramatic, but oh well.

How does activated charcoal taste?  Well, imagine drinking something the color of octopus ink, with the taste of hummingbird nectar and the texture of a thinned-out protein powder shake, and you’ll have an idea of what it was like.  A good dose of sorbitol accounted for the sickly sweet flavor, but other than that it really wasn’t bad at all.  If I’d had it delivered through my nose, I probably would’ve felt differently.  

Running my tongue over my teeth (which thankfully remained white), I threw away the paper cup and prepared myself to practice with the Foley catheters.  Like with the other procedures we learned that day, preparation, organization and methodical work would be essential.  We learned to always test the balloon at the tip of the catheter to ensure that it properly inflates and deflates before insertion to avoid mid-procedure problems with inflating the balloon.  This, along with other things such as making sure everything is in place before starting, helps make the procedure easier for both the physician and the patient.

Learning how to do procedures is exciting but also leaves me feeling like I’m a kid wearing shoes a few sizes too large, waiting for my feet to grow into them.  It’s the same feeling I get when I walk the hospital halls in my white coat.  While my coat fits quite well physically, I’m still growing into it in other ways.

Growing is something that’s been on my mind lately, so when I literally crossed paths with these words the other week near the Engineering Quad, they made me smile.

photo 2

Later in the week, I received a copy of the book Mindset.  It’s authored by Carol Dweck, a Stanford psychologist of world renown, and I was excited to begin reading it since I’m on a journey to adjust the palette of my perspective and develop greater resiliency.   Within a few pages, I came across the same phrase, its black font on the white page an echo of the white-on-gray letters chalked on the sidewalk stones.

Growth mindset.  It seemed to be more than just a coincidence, especially when my mom told me the next day that she had just requested the same book from the library, and then the topic spontaneously came up a few days later in a conversation with a friend.

So, I think that “growth mindset” is my learning assignment for this quarter.  Perhaps for my whole life–after all, I’ll never be fully “grown up” in the sense that I need to stop growing.  One of the things I’m growing in at this time is confidence, as I am beginning to realize that this is one of the ways I can be beautiful without changing my outward appearance.  To be able to walk tall, knowing that I am on a journey and that I am strong enough to address my shortcomings rather than defining myself by them.  To become comfortable with who I am, rather than continually wondering if I measure up to what I think others think of me.

The knowledge that I am continually growing is a gift that gives me the opportunity to focus, and it lets me to build on my past and present experiences.  It allows me to move forward when I hit bumps along the way, and to laugh at myself more.  To take some things more seriously and other things less so.

This is one of my growing places.

photo 1

Life is full of growing places…they’re especially prevalent beneath bumps in the road and around unexpected turns.  They are the damp mist in the shadows that makes the moss and ferns grow green.

Where are your growing places?