Posted on 03.08.10 by Sharon Lin, DO

 

"Let's Seize Reform. It's Within Our Grasp!!!" - President Obama

This past weekend, I had the opportunity to go to Sacramento and learn more about the health care reform debate from Lori Heim, MD, the president of the American Academy of Family Physicians.  Unlike the daily articles that focused on the feud between Democrats and Republicans, I had a chance to learn about the details of the House, Senate, and president's health care reform proposals. 

Health care reform needs to happen, no question about that. What I didn't know was whether these proposed reforms would actually help Americans become healthier.  Isn't HEALTH the bottom line?  The US ranks 37^th in the world on health outcomes, according to the World Health Organization, while spending twice the percent of GDP than any of the developed nations.  For nearly 40 million Americans, our health care system is nonexistent piecemeal at best, as if this were a developing world.  What a shame.

After hashing out the details of the proposals, I've concluded that I want Congress to pass their health care reform NOW.  Why? Because I believe this reform will create a healthier America, a smarter America, a more cost-effective America, and a more just America.

Coverage, health promotion and disease prevention, Medical Homes for everyone, insurance market limitations, affordability, access. All these things need to happen with an initial $100 billion per year investment for a $1 trillion per decade savings.  What I want to see from reform is the opportunity for ALL Americans to have a better quality of life through good healthy living so we all can live our BEST life. 

That is why I am STANDING UP for Health Care Reform.  It needs to happen NOW.

Watch President Obama speak on this issue by clicking here

Posted on 02.01.10 by Sharon Lin, DO

 

Being a new mom is a bit like deciding to become an adult. I've always wondered what being an adult was really about. Lately for me, it means I need to make decisions about how I want to live, what I want to do, and what I need to do to get there. It's not like I've never thought about these things before, but now I feel the impetus to make firm commitments to myself.

1) Functioning Financially: I have to admit ever since I've been receiving paychecks in residency, I really have no idea how to properly manage the money I make. I know that this is not unique to me. Residents can barely cook themselves a meal each day, let alone think about their finances. Making money has allowed me to live day-to-day without borrowing hundreds of thousands of dollars as I did in school over the entirety of my adult life thus far. My first step in taking control was deciding to go to the library on a golden weekend and check out a few books on money matters so that I could learn the lingo and figure out what financial products are out there. With a huge debt, a lame-duck bank account, and no foresight on investments, I feel every bit as inadequate and ignorant about my future as the next person. It is evident that if I really want to live out my dreams, I have to understand how to function well financially.

2) Functioning Osteopathicaly: When I was an undergraduate freshman at UC Davis, I was introduced to the concepts of osteopathic medicine and met several alumni who decided to take this unconventional route. I immediately was intrigued by the principles of osteopathic healing such as approaching the body as a whole, using the power of listening with our hands to understand the bodys function in relation to its structure, and to help the body in its own healing process. I am so proud to be a DO and to have the foundation of these guiding principles as I try to relate to my patients on a meaningful level. It is definitely not easy to live holistically or practice holistic healing, but it is a definite goal for me as well as the people I interact with.

3) Functioning as Modern Woman: I am the third generation of women on my maternal side who have worked full time both inside and outside the home. I watched my mother tackle multiple roles while still putting dinner on the table, managing the family's finances, and helping her siblings and parents on so many levels. She never had time for herself. It wasn't until she graduated from working that she started breathing fresh air, paying attention to her body, and discovering the joy of hobbies and spirituality. I'm trying to figure out what being a modern woman will be for my generation. Is working part time the solution? Can I afford to do that as long as I live a simple life?

I dont have the answers in front of me. I'm thinking about it, talking to people, and reading about it. Carving out the time to think about these issues is important to me, as much as being out in nature or getting together friends and family. Who knows how the future will play out, but I yearn to be in control of my own destiny.

Posted on 01.07.10 by Sharon Lin, DO

One last inpatient service as a second year before I spend two more months in outpatient in my third trimester of pregnancy.  I can't believe R-2 year is halfway over. Having stacked several inpatient rotations today, I am just flying through like a mad woman - with my huge belly swaying up and down the halls. Somehow I've been blessed with little fatigue and a huge appetite for anything edible. Amazingly, I am still grateful for our comp'ed cafeteria food! 

My partner says I look like Santa Claus the way my scrubs ride high on my belly.  I suppose I need suspenders to keep them from falling completely off since most days my gigantic belly sticks out like Pebbles Flintstone's.

Other than when I catch my own reflection, I am still in huge denial of being pregnant.  Residency seems to dominate most of everyone's lives and thoughts, and it will be interesting to have a competing interest when I become a mom. The only thing momma-like I've done was when I went to a holiday craft fair recently and found an egg necklace booth.  There were these adorable quail egg necklaces that can be carefully crafted with small scenes inside them.  You can't even imagine the joy I had when I found this booth and brought home one with a scene of two quails over their nest of eggs.  Ahhh... nesting. I am SO loving the nesting. It's so silly - yet so, so satifsying.

I am ready for a whole lot of nesting. Even with a Q 4 in patient schedule, I'm making precious time to nest, decorate, cook, celebrate, and simply enjoy sleeping in a cozy bed.

Posted on 11.2.09 by Sharon Lin, DO

Now that I've had a few weeks to recuperate from long inpatient hours, I'm feeling more alive. It's been a few months now that I've neglected thinking outside the box.  Now I have the energy and motivation to send out a green signal, get out of the box, and rejoin society again at large.  A faculty mentor, Ben Brown, once told me that life would always be undulating with ups and downs. I'm trending up again - yippeee!

I cleaned my room, brought out the winter things, organized my life, stretched my stiff body, rewrote a few simple goals and taped it to my bedroom wall, got a haircut and actually spent time carefully brushing my hair and trimming my nails ... yes, it's those human things that we residents never take for granted.

More importantly, I'm investing my new extra time not only taking care of myself, but checking in more with my colleagues.  We need to keep supporting each other whenever we can.

Recently the few minorities in the program met over dinner for the first time and spoke candidly about our feelings, explored intuitively as we haven't been able to put into words, and made a good effort to improve the communication of our shared experience. It was truly a humbling and wonderful opportunity.  Open-minded communication in all directions is always the most important lesson of any working environment.   I am grateful for the women and minorities who have created the path to having a presence and a voice over these past few decades.

Lastly, the question of what will our collective future holds has trickled back into my mind.  It makes me excited to think that in order for me to be where I want to be in five, 10, 20 years from now, I need to start planning and building now, in the present moment.  There are so many opportunities: health care reform advocacy, clinic efficiency and Patient Centered Medical Home, and community capacity-building.  I want to do it all, but I only have so much time. How about beginning with simply being. Yes, I am happy simply being in this moment.

The bright orange pumpkins still sit invitingly on doorsteps.  The morning fog lingers over all the porches like a veiled ladies waiting for their carriages.  The air is crisp and fresh.  With a kick-step, today I will start my day.

Posted on 10.12.09 by Sharon Lin, DO

It's been four months since I started my second year of residency and I started off with three tough months of inpatient work and another month of Spanish emersion abroad in between.  Working my butt off in the beginning of second year has really prevented me from having the space to breathe and reflect, but alas the time has come that I now have a moment to recollect my thoughts and write again. I am again grateful for so many things that I never had the energy to appreciate in those long 80-hour weeks, when day and night bled into one other.  Now I can see the sky, smell the rain, touch the leaves now golden and red, reflect on the changes in my belly - four months of a new life developing within!

Pregnancy! Miraculously, this new life slipped into my tumultuous routine and made it through to the light of day.  Together, we have been lucky by avoiding morning sickness and fatigue while managing to sneak in monthly prenatal appointments post-call.  It has been a challenge to set my efficient well-oiled machine-like mind aside, to look into my patients' eyes and once again connect with their souls, not just their ailments.  I miss that kind of connection; the kind of connection that comes so easily to med students and to new interns.

I am consciously starting to make that missing link a new priority, starting with my pregnancy.  This week, at four months gestation, I am giving my pregnancy a chance to be listening to. It took this long because work occupied so much of my attention and so much of my effort.  What I once enjoyed as a tremendous learning opportunity, I now called "work," and the glimmer of curiosity and empathy became overshadowed by hospital efficiency and protocol.  Pregnancy, I hear you. Patients, I will be there.  To my spirit, let the reparations come gently.

Grateful I am to my precious golden weekends that I fill with long hikes down winding coastal trails. Grateful I am to my family and friends.  Grateful I am for the changing seasons.  Grateful I am for the love my partner and I share, and for the love that came out of our love.

Posted on 06.19.09 by Sharon Lin, DO

Intern year has ended and I made it out alive - barely.  After getting yet another viral URI, I finally succumbed to my weakened immune system and called in sick for the first time this year.  I slept for 14 hours to catch up on two weeks of sleep deprivation due to working nearly 90-hour weeks.  Now that I passed the finishing line, I'm on a two-week reprieve called Transition and Renewal as I gear up for the responsibilities of being a second-year resident.  I've waited very patiently for renewal (sigh) and expect rosier cheeks and a hop to my step by the time I'm through with it.

There will be gardening, advocacy work, teaching at a local school, creative writing and the like to help in this wonderful process of renewal.  There will also be some time to reflect on what we want to accomplish in the larger picture.  Don't you just wish every employer allowed people to renew their spirits and nourish their souls?  Just imagine what that could do for our society.

In my sparest of spare times, I've been dreaming up some grand projects to help create community, improve quality of life, and reduce social disparities.  On July 15, I will moderate a Grand Rounds panel discussion addressing poverty in Sonoma County and reducing the social disparities gap.  The panelists include the leaders of our county's Public Health, Economic Development, Education, and NGOs sectors.  It will be videotaped on put on a multi-media Web portal addressing quality of life from street to society. 

I'm so excited about this upcoming event after a year of planning and networking.  I hope you will all be able to see it and give me advice or feedback!

Posted on 5.26.09 by Sharon Lin, DO

We often see people in the midst of their pain body. Sometimes, we can even see our own pain bodies.  These pain bodies have negative repetitive thoughts that cause suffering and suffocation.  I have been learning a lot about how to best interact with pain bodies.  My teachers say we should be observers in suffering as well as of our own suffering.  Awareness of thoughts is the first step in changing the way thoughts affect our actions and words.  Being present and conscious is a difficult practice, but I have been told it gets easier when you keep working at it.  There is stillness within the rustling leaves.  There is grace within my slowest exhalations. I am catching repetitive thoughts.  Let there be a breeze of peace.

Practicing the art of medicine is a spiritual journey - storytelling cloaked in incidents and adventure.  I am carried through the lives of many people, some grateful, some lacking hope, and many quite endearing.  Taking the time to process these experiences with spiritual exploration is an important aspect of this art form.  We are all capable of having a spectrum of emotions because we are human and the energy we carry with us can be put to wonderful uses as well as detrimental ones.  I am taking this moment to acknowledge how it feels to be humbly alive.  I am forever learning.

Posted on 4.30.09 by Sharon Lin, DO

By now, students who have matched with their respective residency programs can let out a huge sigh of relief because they now know where there will be during the next three years.  The poor partners of these residents have closure as well after months of searching and wishful thinking.  The torment of not knowing "WHERE???" is finally over. 

I remember feeling so elated about my new residency destination a year ago, I immediately started thinking about what it would be like and what my new role would be.  Of course, everyone warned me about the long hours and, naturally, I wondered if I had what it took - physically and intellectually - to survive.  Intern year is different for everyone, and drastically so even within the same program, but for me, intern year has been lovely. 

Lovely? Really? Yes. Compared to med school, residency is fantastic. Not only do I have good rapport and continuity with my patients, I have a supportive environment of people who care so much about other people, the community, and the world at large.  I don't know if I will ever have the opportunity to be surrounded by so many wonderful folks.  Family medicine brings out the best of med students. I am biased, but that is what I've experienced.  Of note, my quality of life is BETTER. Work hard, play hard, and the balance of the two is key.

So Congratulations! Cheers to the newly matched residents. I wish fun, adventure, and reflection as you finish your fourth year and become interns in a few weeks.

Posted on 4.07.09 by Sharon Lin, DO

After watching Barack Obama's campaign to the presidency, I am buoyed up by the idea of community organizing and the power of hope and change. I love this time of year, when my energy and spirit match the spring weather.  Hope. Change.  It is hard to believe we are already in the month of April because so many changes are happening so fast. I have been prepping all fall and winter for the spring launch of my community leadership project.  The themes of social capitol, disparities, quality of life, integrated strategic planning, and networking have weaved together during my intern year and I am finally able to tell you what it is I'm up to.

Together with leaders from the Public Health and Economic Development sectors, I am working to create a public-private partnership network in Sonoma County that will address community health within a socio-economic context.  People are just beginning to adequately acknowledge that the environment, education, health, and economy are all intricately connected. There are so many common goals and fundamental social determinants affecting community health, why not work together to make our society stronger?  I am looking for leaders, people who care about creating a strong foundation for well-being for all.  My role is to pull these people together and make them stick together to create innovative solutions. No easy task.

Isn't this what community organizing is all about?  Before medical school, when I was working as a community organizer in New York City, I felt more ALIVE than ever before.  Working with people from different sectors and bringing them together into a room created so much energy and hope.  However, this time I won't have the luxury of full-time organizing.  I will have to piece-meal my spare time in residency to meet new faces and build relationships from scratch.  I've already spent this past year meeting many wonderful and passionate people in Sonoma County, but now I'll have to kick it up a notch.  I'm throwing myself out there to inspire and be inspired.  Wish me luck!

Posted on 3.12.09 by Sharon Lin, DO  

Communication is a huge theme in residency, but it's not easy. I have to negotiate good communication in every interaction, whether it's with nurses, attending physicians, other residents, or patients.  There are so many nuances to working within a hierarchal structure where information flows differently in between and within each traditional rank and individual. I have to pick up on the preferences, expectations, desires, agendas, demands, prejudices, and traditions that are intricately woven into my daily interaction. Sometimes, what is to be conveyed is so subtle to me, yet so obvious to others and vice versa, that I am left feeling overwhelmed.

So what is the recipe for Good Communication?

Step 1) Take one cup trust, two-eye contact, and 1/4 cup of ego-free attitude. Mix all in a bowl until you are present.

Step 2) Mix these ingredients with three cups of empathy, a stick of patience, and two tablespoons of legible handwriting.  Be sure to smooth out any remaining biases.

Step 3) Add a clover of forgiveness and a handful of charm. Put the ingredients into a large vat of language skills and churn. Refrigerate until solid.

Step 4) Scoop out communication for you and your partner and add sprinkles of adequate time on top.

Enjoy!

I want to do well with recipe, maybe as much as I can without expecting perfection.  Physician-patient communication is emphasized very well in many residencies, but I feel more practice is needed within the inpatient and outpatient team model.  Docs can no longer go about the world just telling people what to do; we have to get better working in partnership with others, as a team, to get the best results.

Are we prepared to be Team Leaders?

Posted on 2.25.09

I'm reading a book called Three Cups of Tea - it's about a Bay Area nurse who decides to build a school in Pakistan. With no experience, he decides this will be his focus; he talks to people about his idea and, over time, he auspiciously finds random people who help him logistically and financially. All along the arduous journey, he keeps a steady focus. This is empowerment.

There are exquisite moments in life when things start happening.  Passions become quests and you find yourself making bold decisions.  Life takes a fascinating turn with purpose.  I am intrigued by these stories of how resourceful people pull through and pull out of their struggles. This is empowerment.

In clinic, I witness my patients' struggle through financial hardships and disempowered circumstances.  I listen, take notes, and think about them throughout the day.  Some articulate how they are barely surviving while others tell me how they have managed to flourish. "What advice would you give to others in similar circumstances?" I ask. This is empowerment.

Community health workers go out and see our most downtrodden patients.  They share resources, offer support and comfort.  They speak the same language, understand the culture, and often come from the same struggles.  This is empowerment.

At my residency, fresh new books sit at a little library, waiting for us to read them. A list of personally recommended books was collected and a library was created.  This is where I picked up Three Cups of Tea.  It's the small touches people bring that make my day significant.  This is empowerment.

Posted on 01.19.09

These days as a night-float resident, I am quite satisfied with the business of being a doctor. Our friendly old community hospital on the hill takes a huge sigh by evening as the lights get dimmer, people talk softer, and the ill patients turn in for an attempt at a peaceful slumber.  On some odd hour, one could find that the only noise down the hallway is the squeaking walker of a tireless patient roaming with his light blue gown flapping like a cape in the moonlight.  This night float experience has faired far better for me than being a daytime house officer when the chaos of my to do list and the whirlwind dashing of the staff inhibit me from spending adequate quality time with each of my patients. 

It has been my goal to approach my patients with a handshake - a gesture of humanity amidst the beeping and rumbling machines - before I begin a barrage of questions and examinations.  I try to retain names of family members and friends who visit my patients, greeting them in the halls and acknowledging their own healing powers.  One particular patient is dying and as the morning drowns her room with soft white light, I sit on her bed as she recounts her fears as well as her beaus that have danced in and out of her life.

Daytime is for sleeping. I mill around the house, watering my plants and scrounging my cupboards for food, before I head off again in the evening back to the hospital.  Last night I helped one of my clinic patients deliver her first child, a dewy sweet girl with dark brown hair.  Mom and dad burst into tears of joy at the first site of their child, a cord wrapped tightly around her pale blue body.  This one was going to make it all right.  Once again I couldn't help but feel so lucky to participate in the intimate life of other people.  I feel blessed.

Posted on 01.05.09

As the nation rallies around a new administration, I am excited about the potential of having a fresh perspective on health. Health is not just about the health care delivery system.  The health care system is a participant within the larger arena of our communities.

Though family physicians know the importance of disease prevention and coordination of care, acknowledging a broader definition of health is useful.   With a public health perspective, we can advocate for healthier communities every day, encouraging health promotion and disease prevention within the socio-economic, political, and environmental context that surrounds our patients' lives.  We must advocate for reducing social inequalities, bridging the economic and racial divides.  Let's acknowledge the health of our economy, education system and environment.  There sectors are inextricably linked.  What I know for sure is that we will need to expand our definition of the health of our nation.

I've been speaking to mentors, peers, friends, and colleagues about my leadership project, thinking largely about health. All the residents are required to conduct a leadership project over the three years of residency.  Some have started an integrative medicine clinic, a weekly yoga class, a safety net for new diabetics, teen health education, etc. I am not sure how to label my leadership project since my interests are so broad, but I do know what I want it to feel like. I want to belong to a like-minded group of people that inspires cutting-edge innovation and encourages interdisciplinary approaches to wellness that include business, education, faith communities, environmental, social and governmental collaboration.  I want to see the village come together to help the villagers within.  If we are spread too thin, how will be form the social bonds that connect us back to well-being?

The picture attached shows dogs and their owners at a watering hole as a snapshot example of health. There is joy and socialization with a strong sense of belonging and community.  People are out being physically active, making friends and feeling safe and good about their morning.  This is just one example of community health.  How can each person feel a strong empowered sense of healthy community and belonging?

I am hungry to find out what communities are already doing in cities such as Sonoma and San Francisco as well as courageous cities, counties and states all across the country - and countries around the world. The Commonwealth Fund, World Health Organization, Robert Wood Johnson Foundation, and Kaiser Family Foundation are all doing great work on reporting on the health of our communities.  In California, the Center for Civic Partnerships http://www.civicpartnerships.org/ helps networks cities in California towards health.  They feature publications about city projects, free toolkits, and other valuable resources.

Our families are doing what they can, given the barriers of time, energy, and cost restraints.  Nonetheless, Americans know how to persevere. There are common-day leaders in every family making small, yet big, decisions every moment.  Perhaps someone today will recognize them for that.

Posted on 12.5.08

As I sit here in Shanghai, China, I've come to realize just how vast the American social sector is. I Googled "social innovation China" and was surprised to see how little information there was on the web. In contrast, there are so many social sector organizations in the U.S.

tackling problems in local communities--everything from education to health, the environment to job training. We are very fortunate.

In China, there is construction on every block and around every corner. The people seem both hard-working and humble. I see building cranes for miles and miles in every direction; skyscrapers fill the skyline. I'm staying with my father in the Zhangjiang area, a place that looks and feels like a new Silicon Valley. While the Bay Area feels like innovation and health, New York feels like raw energy and Shanghai feels like bustling growth.

Since I'm still on California time, I spend the wee morning hours surfing the net. I can spend all my free time reading about the interesting things people are doing around the world. I get inspired every second to be a part of this new thriving movement.

Here are a few tips for exploring this movement that I've found helpful:

1) Surf the net

2) Check out Stanford's "The Social Innovation Conversations" podcasts

3) Watch "Ashoka: Innovators for the Public" [http://www.youtube.com/watch?v=DttTSJEO47g] on YouTube for inspiration

4) Download key articles from a few of your favorite organizations' Web sites

5) Attend local social sector events in your community and talk to people there

6) Join organizations/associations for causes that you care about

7) Register at www.change.gov to tell your story on "An American Moment"

8) Start having conversations with everyone you know about your passion

9) Write for yourself and for a larger audience

10) Set up meetings with people who work in the social sector that interests you

Posted on 11.19.08

This month of Behavioral Medicine/Leadership Development has been so rejuvenating and needed after my Medicine month.  I've never been one to like hospitalist work because holistic healing that acknowledges simple dignity and respect for humanity is, for me, so difficult to come by. Now I have to say, our hospital has some of the sweetest people taking care of our patients.  But, our health care system makes the care feel fragmented, incomplete, and disorienting. We are working within an acute care model when most of these folks have chronic conditions that are too difficult for them to manage on their own.

In these last few weeks I've had the wonderful opportunity to peek inside local community organizations.  I had meetings with the county department of health, our local CAFP chapter, an adult day care services organization, a hospice interdisciplinary group, an HIV clinic, a women's homeless services/shelter, a drug rehab center, a local WIC office, and a parenting institution.  WOW! I had such an amazing time talking to the directors of each of these places; passionate people who reconfirmed for me the importance of community social capital. Robert Putman describes this in his social capital book Bowling Alone: The Collapse and Revival of American Community.

Whereas physical capital refers to objects and human capital refers to the properties of individuals, social capital is our connection among individuals-social networks and the norms of reciprocity and trustworthiness that arise from them. In that sense, social capital is closely related to what some have called civic virtue. The difference between is that social capital calls attention to the fact that civic virtue is most powerful when embedded in a sense network of reciprocal social relations. A society of many virtuous but isolated individuals is not necessarily rich in social capital.     

This is the stuff that really gets my gears going. I find the community networks, family dynamics, fellowship, business, and neighborhood - all of these alliances that build a culture and reinforce behavior - so fascinating. How can I tap into this gold mine? How can I learn from these community leaders and members?  What can I do?  I ask a million questions because I know people have answers that I don't. I love listening to podcasts about social innovations across the world.  I believe people have answers and are already doing great work out there. It is very centering and empowering to participate in this dialogue for social change.  As this particular leadership rotation ends, I hope that I won't get too bogged down by medicine.  I've got to keep an open mind.