Eternal Optimism

Eternal optimism: a coupling of words I do not believe I have heard before today. In times of adversity and hardship, an eternal optimist looks on the bright side – the glass half full – the grass greener – things could always be worse and we are headed in the right direction.

I just arrived home from The Atlantic‘s Health Care Forum in D.C. where today’s experts in medicine, public health, public policy, and health administration (a medley of self-proclaimed eternal optimists) gathered to discuss our nation’s health care system and future direction. Considering I have been pursuing health care as a career for the past five years, I should have heard the phrase “eternal optimism” before, but this was one of my first experiences where the primary discussion was policy as opposed to health itself. Perhaps health practitioners are forced into realistic worst-case scenarios, and policy-makers are forced to plan optimistically. Somehow, I thought it would be more the opposite. Politicians by nature disagree constantly; the voice of the opposition endlessly proclaims how the current administration is screwing up. That’s one of the many reasons we alternate between Democrat and Republican administrations. On the other end, practitioners provide treatment options, suggesting that patients can heal, that there is hope. Even hospice care is a field that empowers patients to take control and accept their conditions as they are – to enjoy the short time that is left, living to the fullest capacity. In any case, it seemed that eternal optimism was a theme throughout the talk, and it got me thinking…

I consider myself extremely fortunate. My parents immigrated from Iran to earn American educations and to live the American dream. It might sound cliché, but it’s true. I constantly hear about my friends who want to get out – out of their current city, state, region, or the country altogether. Meanwhile, I am a total homebody. I love where I grew up, and I cannot imagine living permanently in any country besides my own. My parents raised me in a manner that made me appreciate something certainly taken for granted in the United States – freedom. Even within the household, my brother and I were free to believe what we wanted, say what we believed, and do what we wanted. Both of us became independent at a young age with discrete moral beliefs and thrived as very different individuals who chose very different paths. That is the beauty of freedom.

There are classic human rights we automatically think of: freedom of religion, freedom of expression, and freedom of assembly (to name a few). I think one big freedom has unfortunately become a privilege in our country – an appropriate standard of living. “Everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing, and medical care” (UN Universal Declaration of Human Rights). Certainly, not all things are in our control. A lot of health is determined by genetics, but we have the power to change the environmental and societal impacts on health. We can assume very different prognoses of a sick child  based on where the family falls in the socioeconomic hierarchy, and nobody should be okay with that.

Again, I consider myself extremely fortunate. I have always been healthy. Anytime I complained about co-pays, my parents reminded me to never think of money when it comes to health, that life is more valuable than any dollar amount – especially for preventative services. Unfortunately, the money game for Americans changes quality of life, access to resources, and health outcomes. A big part of today’s health forum discussion revolved around treating the social determinants of health, like education and poverty, investments with positive downstream effects that ultimately reduce costs. The US spends a whopping 17% of its GDP on health expenditures, and yet we have some of the worst health outcomes in the developed world. Stemming from talks of “eternal optimism”, I see so much potential in where our country can head in terms of health care policy, a potential that I do not want to see wasted as I progress up the ladder as a medical professional.

Preventive health care should be the epicenter of medicine, where diseases are detected and treated in early stages. We would like to think we are invincible; in reality, we will all die sometime between this very second and the next century. It’s a shame that primary care is downplayed in the hierarchy of medicine. Specialties are glamorous: there is more money and more respect. At least we are on a positive trend in the medical education system incentivizing careers in preventive health care, but health policies should encourage preventive health as well.

I have heard talk about rationing health care due to limited resources and high expenses, but we can change this thinking if we approach health care differently. When you address treatments before a disease state progresses, you avoid greater costs down the line. For example, it’s better to pay tens of thousands a year for hepatitis treatment early on than to wait until the disease requires a liver transplant upwards of a half million dollars (an intriguing article in case you’re interested in hepatitis C health care spending in relation to new drugs on the market: http://www.usatoday.com/story/news/nation/2014/03/03/stateline-hepatitis-c-drugs-health-care-spending/5973133/). Besides catching chronic and acute illnesses at their early stages (behavioral illnesses included), we should publicly address the burden of health costs. For a chronic illness like Gaucher disease (although this is quite rare), annual enzyme replacement therapy costs about $200,000 a year. Imagine the quality of life of an individual with Gaucher disease who has to struggle with both a physical ailment as well as the unrelenting costs of a chronic illness. Paying premiums suck, but knowing that the money is an investment in one’s future health and covers treatment costs for other individuals with severe health problems makes me better understand the complexities of the system.

We have a long way to go, but I see why there is so much eternal optimism; it fuels movement into a positive direction. By no means am I as educated on this topic as I should be, but I think these are interesting topics to ponder. Hopefully we can all sympathize with the plights of the current health care system and think of ways to improve it for the future of our nation.

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The powerful play goes on, and you may contribute a verse

Quote

O Me! O Life!

Oh me! Oh life! of the questions of these recurring,
Of the endless trains of the faithless, of cities fill’d with the foolish,
Of myself forever reproaching myself, (for who more foolish than I, and who more faithless?)
Of eyes that vainly crave the light, of the objects mean, of the struggle ever renew’d,
Of the poor results of all, of the plodding and sordid crowds I see around me,
Of the empty and useless years of the rest, with the rest me intertwined,
The question, O me! so sad, recurring—What good amid these, O me, O life?

Answer.
That you are here—that life exists and identity,
That the powerful play goes on, and you may contribute a verse.
– Walt Whitman

Wild Turkey on the loose

I had another turkey sighting Saturday before Norouz festivities part deux. I am now considering this turkey a good omen because Saturday was fabulous. Woke up early for body combat and body pump, ran a few miles with Andrew and then walked a couple more, did some errands, filled out AF commissioning/USUHS contract paperwork (gotta love government paperwork), went to a belated St. Patty’s party of a close college friend, and then went to my aunt’s place for another family Norouz. Twas an excellent weekend of productivity and happiness and life. We should drink wild turkey around every Norouz in my omen’s honor.

Eid Norouz

I woke up this morning just like any other day, complained to Andrew that there was too much light creeping through the sheer curtains, complained that I didn’t want to get out of our oh-too-comfortable bed, complained that it was too cold outside for spring. I wanted to eat eggs and watch Desperate Housewives like our Monday snow day, maybe stay in bed and wear pajama pants while reading about the hippocampus and writing an outline for work. Yes, I thought this was going to be like just another day.

I did not pick up on the little things though. Like how I forgot to lay out my clothes the night before, but I picked them out effortlessly in the morning. Like how I didn’t have leftovers to bring for lunch, but I had time to put together the classic PB&J, Persian yogurt, carrots, a banana, and an orange. My tumbler – already clean, a rarity for my kitchen – got to sample the likes of a new chai I purchased on Saturday. No pimples today. My hair required little effort. It felt routine.

I shoved toast in my mouth and rushed out the door. Hitting traffic early on the toll road, I decided to escape to the back roads. At a three-way stop sign, I had wondered why no car was moving. I set out to turn right. Then stopped. In front of me was a turkey strolling along the street. You know how they say, “Why did the chicken cross the road?”…well, maybe it was never a chicken after all. This was definitely a turkey, and I still don’t have the answer for you.

This turkey encounter threw my morning off. I got caught behind a bus stopping every other street, something I had never experienced the dozens of times I have taken this route at the same time of rush hour. At each waiting moment, I was telling myself, “I did not actually see a turkey. That is odd. This is weird.” Eventually I made it to work fully convinced I did not know what turkeys actually looked like anymore. I Googled turkeys on my phone – and alas, there was the culprit. Google also reminded me: it was the first day of spring, and so, the Persian New Year! My winter coat was convincing me otherwise.

Work felt different today. I heard more laughs and saw more smiles. People exchanged pleasantries, and the day passed smoothly. The bagels my coworker brought in helped too (those asiago bagels with salmon schmear…mhmm). I left a few minutes before 5pm with an air of accomplishment. What I thought would be just another ordinary day was quite different. It was the first day of Spring. It was Norouz. The suffocating weight of life stresses had been lifted.

Norouz dinner was spent with family. Lots of snacking from the extravagant haft seen and making fun of the absence of goldfish (nobody could successfully keep the fish alive in the last few years, so my parents decided against them this time around). The food was great, money was given, and we were all merry. Tea and pastries helped calm our stomachs after the meal, and I thought – yes, this was quite the day. Norouz is time to shed the past, welcome the new, and reinvigorate life to the fullest. It’s about love and happiness in all aspects of living.

Cleansed. Renewed. Healed. Makes me ready to wake up for just another day.

The crownless again shall be king

Quote

All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.

From the ashes a fire shall be woken,
A light from the shadows shall spring;
Renewed shall be blade that was broken,
The crownless again shall be king.
― J.R.R. Tolkien, The Fellowship of the Ring

Oh, the places you’ll go!

T minus 74 days until my last day at NIH, and 4 weeks after that I will head to Commissioned Officer Training in Alabama. From there on out, I will be a busy busy medical student. Surprisingly, I am not too worried for medical school because classroom academics used to be my jam. It’ll be an interesting transition, but I am looking forward to it. Plus, I’ll be close to amazing friends, my nuclear family, and I’ll have Andrew for emotional support at home when I hit the books day in and day out.

In the meantime, I have a massive to-do list. To touch on a few of these would be awesome, but I want to take advantage of the time I have before the ball gets rolling.

  • Travels galore – – I am truly a homebody, but I appreciate going to new places and seeing how life away from home is. Every new place gives me a better understanding of the world and how I fit into it. Mostly though, I like visiting friends and having them teach me about their lives in a different location. Just returned from Czech Republic and Austria (blog post TBA), with future plans to go to Chicago, Canada, New York, Boston, Maine, and Brazil.
  • I have been gunning for an independent project and first-author publication at work since I interviewed and asked about writing opportunities for the lab’s Post-baccalaureate IRTAs (Intramural Research Training Awardees). Fun fact: when someone is selling a position to you, the delivered information isn’t 100% honest. Different IRTAs in my lab have completely different opportunities based on their mentors and the work they have inherited, mine being a fight-for-everything-you-want sort of position. After two years of blood (oh so much blood), sweat (the lab can get hot), and tears (not just my own), I can safely say that I love the science of child psychiatry.
  • Physically prepare myself – – I am one of those individuals who barely makes the weight requirements. I needed to diet and exercise like a beast to lose 15 pounds before my USUHS weigh in (thank you for the time, government shutdown), and I will likely need to lose the weight I gained back for my next medical exam. I also want to get in tip top shape for running (not my forte) as well as the push-ups and sit-ups. Pretty sure I can currently pass the sports physical, but I don’t want to be close to the cut-off. Don’t get me wrong: I love working out. I absolutely love exercising when I have the time. I just wish that we could include more body combat, weight lifting, and yoga into PT.
  • Learn Farsi. Apparently learning my native tongue would make me more money in the Air Force – talk about motivation! I am working on my Rosetta Stone and have my family for back-up. Growing up with Farsi at home made me comfortable with listening, but I want to get the alphabet down and solidly learn the speaking basics. Afterwards, I can start thinking about Russian again.
  • Read up! I should appreciate reading while I have the time for it. I have fiction novels, detox books, and my guide to being an Air Force officer. My to-read list keeps growing and growing, including a few French novels to brush up on mon français.
  • Dabble in piano like the good old days. Jazz, classics, some pop songs that I can sing to by my lonesome. Time to invest in a portable keyboard because my Sojin is staying with the parents.
  • Enjoy down time. I know the average 23-year-old wants to go out and party, but I REALLY love doing nothing. I’ll appreciate lazy Sundays while I have them 🙂