Secrets of Happiness

A Harvard study of which has been running from the 1960s to the present found that there were seven characteristics common to the happiest of the men studied. The characteristics were: mature adaptations (chosing altruism, humor etc in response to difficult situations), education, stable marriage, not smoking, not abusing alcohol, some exercise, and healthy weight.

The complete article can be found here.

Here is an exerpt from the article taken from The Atlantic:

What happened to you?

You grew up in a kind of fairy tale, in a big-city brownstone with 11 rooms and three baths. Your father practiced medicine and made a mint. When you were a college sophomore, you described him as thoughtful, funny, and patient. “Once in awhile his children get his goat,” you wrote, “but he never gets sore without a cause.” Your mother painted and served on prominent boards. You called her “artistic” and civic-minded.

As a child, you played all the sports, were good to your two sisters, and loved church. You and some other boys from Sunday school—it met at your house—used to study the families in your neighborhood, choosing one every year to present with Christmas baskets. When the garbageman’s wife found out you had polio, she cried. But you recovered fully, that was your way. “I could discover no problems of importance,” the study’s social worker concluded after seeing your family. “The atmosphere of the home is one of happiness and harmony.”

At Harvard, you continued to shine. “Perhaps more than any other boy who has been in the Grant Study,” the staff noted about you, “the following participant exemplifies the qualities of a superior personality: stability, intelligence, good judgment, health, high purpose, and ideals.” Basically, they were in a swoon. They described you as especially likely to achieve “both external and internal satisfactions.” And you seemed well on your way. After a stint in the Air Force—“the whole thing was like a game,” you said—you studied for work in a helping profession. “Our lives are like the talents in the parable of the three stewards,” you wrote. “It is something that has been given to us for the time being and we have the opportunity and privilege of doing our best with this precious gift.”

And then what happened? You married, and took a posting overseas. You started smoking and drinking. In 1951—you were 31—you wrote, “I think the most important element that has emerged in my own psychic picture is a fuller realization of my own hostilities. In early years I used to pride myself on not having any. This was probably because they were too deeply buried and I unwilling and afraid to face them.” By your mid-30s, you had basically dropped out of sight. You stopped returning questionnaires. “Please, please … let us hear from you,” Dr. Vaillant wrote you in 1967. You wrote to say you’d come see him in Cambridge, and that you’d return the last survey, but the next thing the study heard of you, you had died of a sudden disease.

Dr. Vaillant tracked down your therapist. You seemed unable to grow up, the therapist said. You had an affair with a girl he considered psychotic. You looked steadily more disheveled. You had come to see your father as overpowering and distant, your mother as overbearing. She made you feel like a black sheep in your illustrious family. Your parents had split up, it turns out.

In your last days, you “could not settle down,” a friend told Dr. Vaillant. You “just sort of wandered,” sometimes offering ad hoc therapy groups, often sitting in peace protests. You broke out spontaneously into Greek and Latin poetry. You lived on a houseboat. You smoked dope. But you still had a beautiful sense of humor. “One of the most perplexing and charming people I have ever met in my life,” your friend said. Your obituary made you sound like a hell of a man—a war hero, a peace activist, a baseball fan.

Don’t!

Here's an interesting article on delayed gratification, something I'm sure most medical and pre-med students are all too aware of:

Dept. of Science: Don’t!: Reporting & Essays: The New Yorker

Valuable Orthopedic Websites

Here are a couple of valuable websites that I've looked at:

Orthopedic basics from the AAOS:
http://orthoinfo.aaos.org/topic.cfm?topic=A00274&return_link=0

A listing of all orthopedic programs in the US:
http://www.orthosurg.net/orthopedic-residency/programs.asp

A site of everything otheropedics, that I haven't used much myself but that other's have recommended:
http://www.orthogate.org/

Questions to Ask While Interviewing for Orthopedic Residencies

A little preparation can go a long way to showing your interest, this was provided by one of the fourth year students:


General Questions
What is the structure of didactic curriculum?
Is there time allotted for electives?
Do the residents have a high operative volume?
How busy is the ER? Level 1 trauma center? What types of trauma?
Do residents attend national conferences? Is it funded?
Where do the graduating residents go?

Questions for Residents
What are the strengths/weaknesses?
Did you ever consider leaving the program?
How many facilities do you cover? How do you like that? A lot of driving? Any required rotations in different cities?
Do fellows take away from learning experience?
What is call schedule like? How are the call rooms? Do you sleep while on call?
Do you have ample time to read?
How is the balance between autonomy and supervision?
How is ancillary staff? Are they helpful and pleasant to work with?
Is there a lot of scut work?
How is your relationship with the staff?
How do the residents get along? Do you hang-out outside of work? Are there any sports teams that you play on?
Do the residents get along with other residents in the hospital?
How do you like the city?
How are the benefits? Parking? Meals paid for?
Do you have moonlighting opportunities?

Questions for Chairman/PD/Attendings
What are your plans for the future?
How do you see the program changing in size or structure over the next five years?
How long have you been here? Do you plan on staying at this program for the next 5 years?
What is the status of the programs accreditation?
How highly do you emphasize resident education?
How do you feel the relationship is between the staff and the residents?
What are the research opportunities like? Is it required? How is it funded?
How are the residents evaluated?
How do the residents perform on OITE? Boards?
What do you look for in a candidate? How many people do you rank?

Some Tips From the 4th Year Students on Getting Into Orthopedics

Some notes from our 4th year panel last night:

1) Ways to get around your school's limits on away rotations
a) Do a “research” month somewhere you want to go
b) Use weeks off to get a feel for the program, just contact the people at the program beforehand

2) Get a blackberry, iPhone or other smartphone. When it comes time for interviews, hospitals will send out an email to 100 students, the first 80 students to schedule an email will be interviewed the rest won’t

3) How do you have a chance to match out west/east etc (a region where you aren't in medical school)?
a) Rotate in the region
b) Better chances if you are from out there
c) “I like the weather” is a bad answer if they ask why you want to come here

4) Be prepared for crazy questions on interviews
a) Tell us a joke
b) Do puzzles while answering questions

7) Letters of recommendation
a) Most places only want to look at ortho letters

8) Step 1 advice
a) Average nationwide is 231 for those who matched
b) People from have matched with a 217 on Step 1…and a 250 on Step 2, can use the Step 2 to make up for a low Step 1
c) Vastly different views on how to prepare, do what’s best for you
One just read = 256
One did all questions = 255
d) Once you get an interview, all the scores go out the window and everyone is on an even playing field

9) Interview trail
a) Rank all programs that you would rather go to than sit around for a year if you don’t match
b) Don’t rank multiple specialties unless you would be happy doing either, there are lot’s of miserable radiologists that really only wanted to do ortho
c) Be ready to answer the question, “What would you do if you didn’t match this year?”

10) Your school's alumni
a) Contact people for free places to stay, i.e. many doctors will put you up for a month in another town for free during your rotations, the school has a directory

Med School Videos From the School of Hard Knocks

...warning, some use of profanity...

Book Review: Hot Lights, Cold Steel

Although I've mentioned this book in prior posts, I thought it only fitting that one of my all time favorite medical books is given a post all to itself. First I'll include a summary, followed by my review and a link to where you can buy it off of Amazon.

Hot Lights, Cold Steel: Life, Death, and Sleepless Nights in a Surgeon's First Years
by Dr. Michael J Collins

"If he didn't feel overwhelmed before the Mayo Clinic senior orthopedic surgery resident lobbed a beeper at him with the nonchalant order, "Cover for me," 29-year-old ex-cabdriver, ex-construction worker, and, at the time, brand-new resident Collins certainly did then. It was his first day on the job, and
instantly he began fielding calls from staff nurses requesting orders for patients he hadn't laid eyes on. If it hadn't been for his innate sense of humor--brilliantly demonstrated in this memoir of his Mayo residency--and a sense of perspective derived from that experience, he might have failed. He didn't, and here he honors those who helped him along the way and those whom he helped. As a man who recognizes that he, too, makes his living with his hands, Collins anguishes over the options available to a carpenter who had severed four fingers. After assisting at a young cancer patient's leg amputation, only to learn later that she had died within months, anyway, he agonizes over what drew him to his profession in the first place and what could possibly keep him on course. "I wanted to be the guy who confronted the arbitrariness of life and strangled the unfairness out of it." Instead, while honing his craft, he learned from a Vietnam vet that the main thing patients deserve is compassion. If Collins' scalpel is as sharp as his pen, his patients are in capable hands, indeed."

Hot Lights, Cold Steele is a firsthand account of what it is like to be an orthopedic resident at one of the busiest and best hospitals in the nation. For the unindoctrinated, the Mayo Clinic is generally thought of as the best program to get into in terms of the training experience for orthopedic residents. I've heard that getting in is so difficult, that medical students who scored below a 240 on the USMLE need not apply because they will not even look at your application (a 240 and above includes only the upper 4% of test takers or so). In other words, aside from being a very interesting story in its own right, it shows what it is like at the best orthopedic training hospital in the country.

Interwoven through Dr. Collins story is the theme of choices. The story opens with a dilema as to whether he should try to save the arm of a boy who nearly had it ripped from his body when it became intangled in a combine, or amputate the arm immediately. The choice to moonlight at another hospital, or get some extra sleep. The choice to go to church with his family, or use that extra time to relax.

At once both lighthearted and introspective, Hot Lights, Cold Steel challenges the reader the reader to put themselves in the shoes of an orthopedic surgeon (which is why I loved it). It tells the story of one of the most loved patients he saw, a patient who all the nurses talked about and kept tabs on once she left the hospital, and you can't help but experience the hurt when he later finds out that she died a few months later.

During the lighter times, I found myself laughing at the similarities to my own life. When he talks about going from one clunker to the next, I'm reminded of my own experiences with cars (I've been getting in the passenger door and climbing over for the past 10 months). When he talks about making choices between medicine and family or medicine and faith, I think of all the similar choices I've had to make.

In summary, this is a book that will make you laugh and make you cry, and I don't think that you have to be a medical student, or a budding orthopedic surgeon to love it.

Discussion on Orthopedics and What it Takes to Get Into an Orthopedic Residency

Here's a video discussion about orthopedics in general and what it takes to get into an orthopedic residency program.

How To Do Well in Your 3rd Year Surgical Clerkship

Here is a form on the internet from Vanderbilt University detailing how students
are scored on their surgical clerkship.

My Lecture May Be Awful, But At Least I Have Travel Pictures To Show

Have you ever noticed that some of the dryest presenters put pictures of all their travels in their presentation. It always seems to be the dermatology people--it's like they want to rub it in your face that they have tons of free time and are making money hand-over-fist.