Long Call, Long Haul

A three-part series describing the demands of life on the wards … and what you can do about it!

Part 1:  The “life” of an intern

On July 1, 2011 the new ACGME rules on intern duty hours in hospitals took effect. Interns, though not residents, were no longer allowed to work 27-hour shifts as residents everywhere historically had done. The 80-hour work-week still applied, but instead of staying in-house overnight, interns were supposed to have ten full hours away from the hospital between every shift.

Also on July 1, 2011 I started my intern year at Mount Sinai Hospital in New York City. I had done routine 27-hour shifts during medical school, as a fourth year sub-intern in the Cardiac Care Unit (CCU) and as a third year on labor and delivery shifts, a standard part of the OBGYN rotation. And while these were something of a distant memory following a very chilled out fourth year filled with electives and one trip to Africa, I remembered them well enough. The slightly dizzy feeling of walking out of the hospital into the sun at 11am followed by a brief period of sleep-deprivation-induced mania; the great excuse to cram my face with my favorite pastry from the bakery down the street; and the 4-5 hours of slightly nauseated waves of sleep before getting up and having “a day off,” for me usually consisting of a yoga class and dinner before going to bed. Read More »

Physician, treat thyself (from time to time)!

After having made it through another holiday season of family gatherings and cocktail parties, I thought I had been asked every possible ‘first year of medical school’ question in existence: What kind of doctor do you want to be? Are you interested in what you’re learning? How’s the stress level? Do you like your classmates? – and the like. But over dinner with an old friend last week, I was finally confronted with a new and thought-provoking one: How has learning about the body changed the way you live? Read More »

living anatome for Better Living & Learning

As a first year medical student, I made a promise to try to do yoga at least once a week. Not only did I fail to keep that promise, I think I only did yoga three times that entire year! As I progressed through medical school, I could not help thinking about this ever present question; don’t I deserve to treat my body with the same respect as I would recommend to my patients? Seems like a simple concept, yet surprisingly medical schools around the country do not seem to regard this as important. It’s not necessarily that medical schools lacks the resources or that medical students are unwilling to participate in self-care. Self-care just always seems to end up at the bottom of the to-do list. Read More »

LA feature: Pilates Style magazine, “Anatomy Lessons”

This profile of living anatome in Pilates Style magazine is short, sweet & to the point!

My favorite quote is from Carrie, eloquently stating the LA mantra:  “It’s paradoxical, but there is not much emphasis on self-care in the education of a medical student… But I believe all medical professionals have an obligation to maintain their own health. We can’t communicate with patients effectively about the importance of exercise and eating happens if we can’t practice what we preach!”

Read More »

Learn by experience (not just lecture!)

I came to medical school ready and excited to learn.  I felt that the knowledge was right there for the taking – I just had to go to lecture, listen, read, and the learning would happen.  However, while slogging through the dense biochemistry pathways and memorizing the names of all the muscles in the hand, I began to get the sense that there was more to learning than effort and following the rules.  It was not until I was well into my clinical rotations that I was able to truly appreciate that much of learning happens through experience.  I don’t remember the Raf/MEK pathway, but I can tell you the possible reasons why a 24 year old man may have liver failure – I had to figure out the answer to that question in order to help a patient.

As I’ve gone through residency and fellowship training, the notion that you have to create an experience in order to learn something has become more and more entrenched in my thinking about education.  That sounds nice, but how does one actually create these experiences?

Read More »

Bye-Bye Back Pain!

My back’s been bugging me lately. I figure my life is kind of like a doctor’s — I see clients for several hours a day, am constantly on my feet, and have started to feel a tightness in the low back that sometimes aches. Similarly, all my physician friends have been telling me how tight their low backs feel after long shifts at the hospital. This one is for you guys!

Recently, I realized that I have been relieving that compressed-back feeling in the wrong way: I kept arching my low back (think cat-cow from yoga), or twisting side to side in a futile attempt to get the tight, painful feeling to go away.

Then I discovered a little trick for low back decompression that helped immensely:

Stand facing a wall and place your hands on the wall, lower than shoulder height. Walk your feet back a few steps, flex your hips, and lower your back into a flat, “tabletop” position (so that your back is perpendicular to your thighs). If this position is difficult, slightly bend your knees. Think of your ischial tuberosities (sits bones) reaching back toward the wall behind you. Now think of letting those sits bones turn upward towards the ceiling. You will probably feel a lengthening in the hamstrings; you might even feel a stretch of your lumbar spine. Breathe in, and breathe out. As you exhale, think of your femur heads dropping back into the hip socket. Think of space being created between your lumbar verterbrae. Breathe again, and decompress.

Staying in this position, think of your sits bones changing position, from pointing towards the ceiling to reaching toward the floor. In reaching them toward the floor, find a place where your tailbone drops and becomes heavy, forming a tucked position. Breathe deeply and allow your quadratus lumborum to lengthen (remember your QL extends between your iliac crest and your bottom rib).

Now bend your right knee, and let your left sits bone reach long behind you. Then switch, bending your left knee, and letting your right sits bone reach back. Feel the fascia along your back and gluteal muscles release. Breathe deeply and switch back and forth.

Doing this stretch daily should help you feel some relief – enjoy!

About the author

Priti Radhakrishnan is a Pilates teacher at Kinected, in New York city. In addition to her journey as a Pilates teacher, Priti has worked for nearly a decade as an attorney fighting for access to affordable medicines for patients living in poverty in the developing world. She loves to combine therapeutic Pilates with her experience working in clinical and low-income settings: her dream is to ensure that Pilates is available to everyone, regardless of economic status.

Watch your back!

“Let’s face it”, I told my sister earlier this year. “At the rate your shoulders have been elevating, they will be past your ears by graduation.”

“Not fair”, she retaliated. “I’ve been working hard. Med school is no cakewalk!”

No one says that the path to becoming a doctor is easy. So those of us who work in the movement world often worry about our friends in the medical arena. As Matt McCulloch, a Master Pilates Trainer in New York City, says: Watching students progress through medical school calls to mind a “reverse evolution,” as their thoracic spines become increasingly rounded and the students subsequently lose a few centimeters in height (and he should know, he met his wife while she was in med school!). Between studying, heavy pockets on white coats, and leaning over hospital beds, White Coat Kyphosis has become today’s norm.

There is a solution: watch your back.

I put this solution to the test earlier this year. I gave my sister 3 simple tasks to do to ensure that her spine remained erect, and that her shoulders stopped rising like lava bubbling out of a volcano. The tasks involved paying attention to 3 parts of the body: Read More »

How Dr. X got his groove back

I have a friend. Let’s call him Dr. X. And like many of my other close friends and family members, as he went through medical school and residency, he lost his core.

Before Dr. X became an M.D., homeboy had it goin’ on! He was fit, he played all kinds of sports regularly, went to the gym often, and even let it drop to the ladies that his six-pack was in fiiiine shape. But with the long study hours, the all-consuming focus on medicine, and the insane hours of lectures, rotations, and residency, everything changed. And he started to notice changes around his middle, as his rectus abdominis slackened and (gasp) love handles started to appear. His low back had even started to hurt.

He was determined to get his groove back. He called me up and bemoaned the physical changes, asking for advice. Talking to the ladies was not feeling the same. He still had at least six years left of residency and fellowship – what to do?

Read More »

3 Conscious Breaths: The 20-Second Meditation

As a medical student, you may currently be in one of the most demanding phases of your life.  Meeting academic challenges, taking care of patients’ needs, dealing with hectic schedules, and trying to have a personal life, could easily exhaust you.  Achieving all of this requires a calm, focused mind and a strong sense of center.  In order to expend your energy in so many different directions successfully, you have to operate from the deep, calm core of who you are.  This way, everything you do will be much more effective and seemingly effortless.

Meditation increases your ability to stay calm and focused.   It’s not as mysterious as some may think.   Read More »

Calm your mind with the Wei

You’re not done studying for the shelf exam, you still have a power point presentation to work on, and—even though you’re exhausted–you’d really like to be prepared for rounds tomorrow morning. Sigh. With so much to do, you’re not even sure where to begin. If only your mind were calm, you could do more and enjoy life more while in med school.

Enter flower essences.

Allow me to explain: Flower essences are aqueous infusions of flowers that elevate your state of mind through the acupuncture meridians. Flower essences are therefore like acupuncture without the needles. Read More »