MINDFUL OF MEDICINE

Your daily life is your temple and your religion. When you enter into it take with you your all.                                 - Khalil Gibran

Hi everyone! I can’t believe I’ve taken a 5-day hiatus from posting here on the blog. I guess time really does fly when you’re busy. These days I’m finishing up my last block of second year while studying for boards. While my “dedicated” 6-week board study period won’t start until May 1st, I am still trying to get through all of the Step 1 material at least once before really diving in. Being in the midst of a crazy study schedule, it’s easy to get stressed without even realizing the toll your body and mind take. Self care is such an integral part of success but it is often overlooked. Learning to recognize high-stress levels and managing how you deal with it is a skill you learn only with experience. It’s all about knowing what works for you. So here are some tips on stress relief, prevention, and management especially for stressed-out students like myself!

Mindfulness. In our busy lives it is incredibly easy to lose sight of the bigger picture. Our exams and goals consume our thoughts, and though they are essential on our path to academic / career success, they are part of a bigger whole. And nothing is more essential to that “whole” than the integrity of our inner peace. Mindfulness is a state of being present and calmly accepting life as it comes while remaining conscious and aware. Stress is a motivating factor if directed appropriately. As students it is important to acknowledge when we are stressed, and be able to direct that energy in a positive way. Whether that means re-organizing your study schedule or taking a day off, the main goal should be to take care of yourself holistically.

Environment. Setting up your study space to include as few distractions as possible is so important. That means putting your phone or other entertainment outlets out of reach, turned off, or in another room entirely. Minimizing distractions helps you study more efficiently and prevents you from wasting time that will amount to stress in the form of extra studying or re-reading something you didn’t focus on the first time around. Your physical location is also a big factor. I personally don’t like to study at the library and only rarely do so. Nevertheless, regardless of where I am - library or home study space - I make sure I have natural lighting near a window. Feeling “connected” to the outside world relaxes me and reduces my anxiety while spending countless hours confined to my desk! In terms of auditory stimulation I have found two wonderful resources. When I’m doing my “normal” intensity studying I like to listen to the sound of rain, since even classical music distracts me. I’ve used ambient mood sounds since undergrad and it really works for me. You can find other ambient mood sounds here. When I’m really focusing, like when I’m going through practice questions, I like to block out all sound using ear plugs. This is to simulate the conditions of taking Step 1 (or the MCAT) where noise-canceling devices are offered.

Breathing. More often than I’d like to admit I catch myself feeling what I would describe as “clouded.” And then I realize I’m not breathing properly. Breathing is something we do all day everyday, but did you know that it is one of our - if not the most - potent tools against stress? Focused breathing elicits what The American Institute of Stress calls the “Relaxation Response.” This is described as a state of deep rest that changes the physical and emotional responses to stress including: decreased heart rate, blood pressure, respiratory rate and muscle tension. A list of mindful breathing exercises can be found here. My favorite is the 4-7-8 exercise, especially before bed when I’m trying to quiet my thoughts.

Exercise. We all know that exercise is vital to our health and well-being. On average you should be doing active, cardiovascular exercise for 150 minutes a week for maintenance of muscle mass and cardiovascular function. Engaging in exercises that you genuinely enjoy is key to maintaining a sustainable exercise regimen. Exercise can also be a wonderful source of stress relief, management and prevention! Our bodies are beautifully intricate machines that should be taken care of in order to function optimally. With my busy schedule I have found that studying while exercising is an excellent use of my time. Not only is it efficient but it actually helps me learn and retain things longer. I podcast my school lectures or watch Pathoma lectures on my iPad while working out on my elliptical for around 60 minutes Monday - Friday. Some days I don’t have to watch any lectures and I get to treat myself to Netflix while working out! If I had more time on my hands I would probably go to a few classes at the gym but since I don’t, this works for me and keeps me fit. It’s all about what works for you! Remember your body will only help you if you take care of it. Exercising meaningfully and regularly helps bring nutrients and oxygen to your brain and other organs, increases energy levels, and pushes you to make healthier choices everyday.

Hydration. If you’re ever feeling sluggish or just not well in general, chances are you’re dehydrated. Ensuring that you’re drinking enough water is vital to maintaining proper perfusion of your tissues - especially your brain! It will help you function better and think more clearly. Most of all, it will help you feel good and increase overall performance. Cutting out all non-water beverages is a great strategy. I’m not a coffee drinker myself but many students are. I personally drink lots...and lots, of green tea. But drinks like coffee and green tea contain caffeine, which is a diuretic (causes your body to lose water). One way to curb this is to drink an equivalent amount of water for every amount of coffee / tea on top of your required water intake for the day.

Nutrition. Your body functions only as well as the quality of food you nourish it with. I’ve always known that nutrition is the biggest part of maintaining a healthy body but it became even clearer after my first year of med school where I spent countless hours working on my group’s cadaver. I truly realized that the human body is strong, yet fragile. And it was absolutely astonishing to visualize the processed junk we put through our bodies expecting our tissues to bear such a burden without any consequences. Be mindful of the food you are putting in your body. Try not to eat things that are refined or have been extensively processed. I try to eat a more plant-based diet, high in protein, and low in saturated fats.

Quality time. I like to spend time with my husband whenever I can. Sometimes I’ll even take a day off from studying to hang out with him. He’s my best friend and spending time with him is always a stress reliever. I also get to vent about what’s bothering me or listen to him tell me about what he’s stressed about. Spending quality time with the one you love is a great way to get away from the stresses of studying and reminds you of what’s really important in life!

Limits.  Above all, preventing, relieving and managing stress is about knowing your limits. If you are feeling stressed, take a step back and assess what you could be doing to improve your situation or mindset so that you can deal with the stressful factors in a more meaningful, positive way. It’s all about giving yourself the best possible chance both physically and mentally.

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My husband J and I were lucky enough to have met each other four years ago. Within a month we fell so in love and decided to pursue a life together. Sure we were only 20 and still in college, but we were absolutely certain that we couldn’t live without each other. And now we’ve been married for nearly three years. After two-and-a-half years of being long distance we finally moved in together right before I started med school & he started his masters program. Living together and starting the “adult” chapter of our lives was really exciting. I mean, who wouldn’t want to see their best friend all day every day?

It was during that first semester of living together that it hit us: we want; No, we need a baby. Of course it was somewhat of a silly idea. After all, we were only 22 and definitely didn’t want to compromise our future, or the well-being of a baby by not being able to provide all the things a child needs & deserves. Nevertheless we couldn’t shake the desire to have a baby of our own. We had openly discussed the topic of children since the very beginning of our relationship - how many, when, girl names, boy names, what sports they’ll play, will they be a doctor like mommy or an engineer like baba? And hopefully one day that dream of ours will come true.

At that time in our lives we knew a baby wasn’t a responsible choice for us, but we knew that we had so much love to give and we wanted to be able to care for and love something together. It was also a spiritual decision in that, religiously, there are good deeds for showing kindness toward any living creature. So one day during my second semester I was searching local dog breeders when I came across a listing that sold mostly yorkies. I thought a yorkie would be practical, small and easy to care for so it seemed like a good place to start. I sent J the link and he suggested we go check them out. That weekend we drove up to the breeders house. Under a pile of loud yorkies laid a shih-tzu* puppy with the sweetest face in the world. He was so meek amidst 5-6 crazy little yorkies and seemed to not mind that they were jumping on him and using him as a stool. I knew immediately that he belonged with us. Funny enough, I found out later that my husband had seen a picture of him on the breeder's site and wanted him but didn't mention it because I had been so insistent on a yorkie, lol. But this little puppy was so calm and sweet that the name we had chosen for him before even meeting him was perfect: Melo, short for Carmelo...specifically, Carmelo Anthony. At 2.5 lbs, Melo was the smallest thing we have ever fallen in love with.

[caption id="attachment_128" align="alignright" width="300"] The day we brought Melo home[/caption]

I knew having Melo during med school would be challenging. Up until we brought him home I had been attending lectures in the mornings instead of podcasting. But that all changed. I knew he needed to be potty trained and taken care of. At only 8 weeks old he was basically an infant. I decided to stay home and podcast all of my lectures so that I could spend more time with him. I still attended my required lectures, clinical sessions and other club / research meetings, but most of my days were spent studying from home with Melo. It kills me to leave him at home alone and I honestly would not have gotten him if I had not been absolutely sure that I would be able to give him the attention and love he deserves. It took Melo about 2-3 months to be fully potty trained. And though he had a few accidents here and there, the hard work of training him really paid off.

[caption id="attachment_129" align="alignright" width="156"] Potty training is tiring[/caption]

Switching from attending lectures to podcasting was probably the best thing I did for my time management goals and I wouldn’t have done it without Melo. My current day-to-day schedule with Melo goes a little something like this. At about 7:45am I take Melo on a 1 mile walk which is just enough activity to get him to nap for a few hours in the morning while I do my most intense studying. That means doing my daily firecracker questions (~200) for about 2 hours followed by 1-2 hours of podcasting at 2x speed while I’m on the elliptical. In the afternoon I typically review first aid and flag some more topics on firecracker. In the evening I review topics from previous weeks. I think having Melo has made me more efficient and more conscious of how I’m spending my time. It has also taught me to take breaks and relax, usually by taking him out to the yard to walk around or play fetch for a bit while I get some fresh air. On days when I have to be gone for a few hours I make sure to tire him out before I leave so that he can sleep. If I have an extra-long day ahead, which doesn’t happen often, J will come home during his lunch break and walk Melo.


Balancing med school with having a dog is doable and has brought me so much joy and balance overall. When I begin my third year rotations in June I won’t be able to be home as much as I’d like so we will be getting a new puppy to add to our family so that Melo has a little buddy to play with!

It is crazy to think how much Melo has grown in the year that we’ve had him. He has such a big personality and is truly the love of our life. He’s taught us so much about what it means to love a creature so much that you would do anything for them. He has also taught us a lot about ourselves as partners and valuable lessons about patience, being observant and being present. We hope that these lessons will make us better parents to Melo and to our future children.

* Melo later turned out to be a pekingese / shih-tzu / lahsa apso mix which we discovered through DNA testing. We are actually relieved to know he was a mix and is healthier because of it. The breeder was, surprisingly, cooperative and we resolved the issue financially. Later I googled her name and it turns out there were many fraud claims against her business so be sure to do your research before buying a puppy!