Posts Tagged ‘Clinical Research’


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This may come as a shock, but not every moment of parenting is filled with heroic deeds, warm hugs or high fives. There are tasks we parents do that won’t be making it to the big screen any time soon. One of those tasks is the parent-teacher meeting. It’s probably a good thing that this event won’t be a summer blockbuster. Not sure how many people would go and see the movie “Parent-Teacher Meeting: Goals Defined!”

And so it was that I drove over to my son’s school and sat down in his Math class, looking forward to meeting his teacher, but expecting a fairly generic description of the goals for the term ahead. But Mr. M surprised us all and instead whipped out a Math word problem for us to solve. But instead of jumping straight to a calculation, he got us to ask two questions “What do I notice?” and “What do I wonder?” This is the approach he takes with the students because of a growing revelation in education that many students do not know how to effectively approach verbal problems. They leap to calculation before really  understanding the problem. Asking what you notice and what you wonder first relieves you of the pressure to instantly be right and simply allows you to take in the information and process the problem in a non-linear way.

If there is one feeling you have in medicine, it’s the pressure to be instantly right. Even now, while I’m on research leave, I felt I needed to be correct when asked what I thought of the results I had just assembled for one of my research projects. But interestingly, my research group leader  used almost identical phrasing to Mr. M, the math teacher. She simply asked, when we were looking at the data tables, “What do you notice?” We are evaluating the literature to determine the effectiveness of a certain modality for treating nerve injury. I noticed that one muscle group seemed to improve much more than the others with this treatment. Why? (What do you wonder?) Could it really be that you can approach an 8th grade Math problem and a Neurosurgical research article with the same two questions?

And if so, where else could those questions be used effectively to solve problems?

What if spouses took the time to notice and wonder about each other? On second thought, there is probably a lot of noticing and wondering that goes on already “I notice you’ve walked onto the carpet with dirty shoes” “I’m wondering which couch you’d like to sleep on” but what if these questions were asked from a place of renewed curiosity and possibility?

With parents and children.

With employees and employers.

With ourselves.

We can get to the point where everything is about bottom lines and definitive answers. We stop noticing and worse, stop wondering. At that point, innovation is stymied, relationships stagnate and personal growth is stunted.

I first broached this question on Twitter earlier this week. As it happened, I have a mischievous friend who responded with a few notice/wonder questions of his own. I will leave you with one of his cheeky creations . . .

What do I notice? I can’t feel my foot

What do I wonder? If this crocodile will let go soon . . .

Research Graphic

Quite unexpectedly, I have found myself taking a detour in my medical school journey. I will spend the next 2 years on a research leave of absence from medical school in which I will pursue a Masters in Clinical Research through the School of Public Health at the University of Michigan. I will then apply to residency in September 2016 and graduate in May 2017 to start residency in July 2017.

This Masters program, though, does not begin till September this year so I get to spend the summer with my whole family in Elk Grove (Sacramento) California. Anne just joined us from LA after completing a grueling first year in her Masters of Architecture program. I’m extremely proud of her.

I plan to take advantage of this summer to dig into Neurosurgery research. I am currently working on two projects: the first project is based on my research at Kijabe Hospital earlier this year, focusing on hidden costs to families in obtaining pediatric neurosurgical care in Kenya. The second project looks at a rare but significant complication of the treatment for SubArachnoid Hemorrhage (bleeding in the brain). This complication is called PRES (Posterior Reversible Encephalopathy Syndrome) and occurs when fluid and proteins escape the blood vessels and thus cross the blood brain barrier. This is apparently more likely to occur when the blood pressure is high, which is exactly what we want to raise to treat vasospasm (narrowing) of vessels following sub-arachnoid hemorrhage. So this represents a classic medical dilemma: What do you do when the treatment for one condition precipitates another?

I am enjoying this research, but I must admit I was initially wary about engaging in such a dedicated period of study. I was concerned about long hours in front of a computer screen and limited human contact. Unlike some of my other endeavors like medical globe-trotting and teaching Improv, protracted research seemed decidedly unsexy! I miss the clinical scene, but research is striking unexpected chords within me. There is something captivating about seeking unearthed knowledge and adding something new to the literature. Research allows you to share knowledge that can potentially affect the care of millions of patients. Research appeals to the big picture, the “why” of medicine and that is compelling. You see, I don’t think doctors should be let off the hook of being challenged to think big. Yes, medicine is noble and takes a lot of work and that should be acknowledged. But becoming a doctor is only the beginning. Are we thinking big enough? Empathetically enough? Or is it simply easier to hide self-interest under a white coat?

This surprising level of engagement in research led me to wonder what other things I underplay that may, in fact, be meaningful. We decide early on that certain pursuits are not for us and justify that saying “That’s not me” or “That doesn’t fit my personality” but this rationale presumes that we have a complete and accurate perception of who we are. It also ignores the fascinating contradictions that make us human. What happens, instead, if you only decide who you are after you pursue certain paths instead of pre-judging the path based on a potentially imperfect perception of yourself?

You might just surprise yourself . . .