How to gain weight in medical school without dying early

Unfortunately, I don't have the answer but I am looking for an honestly, good answer. Ever since I was a kid, I already had a hard time gaining weight. I already had my thyroid hormones checked (just in case they were the cause), but they turned out normal. So anyway, I would be having my junior internship next year, which means 36 hours of duty, more sleepless nights, more stress and apparently, a great tendency to skip meals. I actually want to gain a decent amount of weight before the next school year so I won't look like a wasted patient or no one would joke about me being emaciated.

If anyone knows a good way to gain weight (pregnancy is not a solution, in case someone might consider suggesting it), please let me know. :)

Here we go again.

It's that time of the month again. that time where everyone seems to panic because they are unprepared. That time of the month when everyone seems to be on the edge--PMS-like. That time of the month where my bed and I have a love-hate relationship for about a week (with love being the dominating value of "our relationship"). Yes, it's evaluation exams again. And yes, I came in unprepared, nowhere near being on-the-edge (probably before the week ends, I might start snapping at people. haha!) and had a so-so sleep. Somehow I regret being unprepared but a part of me is just plain happy that I got to go home the past weekend especially since I don't get to do so with exams coming.

Anyway, I hope my exams turn out well. 9 more days to go before sembreak. Wooohoo~!

The Inevitable(?) Detachment

Back when I was in 1st year, I remember a certain professor recalling the story of a certain patient of his a few years back. He told us about how this certain patient underwent an operation due to a condition(i actually forgot what it was) and how they were not able to return the patient's organs inside his/her body. Yes, the case was disheartening to hear, what actually struck me was my professor's reaction as he told us the story. As he mentioned the words "sa sobrang laki e di na maibalik" ( (the organs) were too large to be placed back(in the body) ), he suddenly laughed. Of course, some of the class laughed (which I have no idea why they did). I, on the other hand, felt bad for my professor. Was it because he's been a doctor for too long that the idea of death or tragedy was so ordinary or comedic? Did he take it upon himself to see the patient's fate as a funny stress-reliever? Did the thought of "better him/her than me" gave him such a relief that he decided to show it by laughing? Or was he just too detached from the patient that he couldn't give an emphatic response? I don't know.

A study was made a few months/years ago about why empathy has declined among medical students and residents. The following findings struck me:

"Nearly all of the studies in our review showed that empathy declines significantly on entering the clinical practice phase of training and with increased contact with patients. One possible explanation for this phenomenon may be that encountering morbidity and mortality heightens trainees' feelings of vulnerability. As a result, students and residents may overidentify with patients, causing them to suffer more from distress themselves; they thus become unable to provide rational health care or protect themselves by dehumanizing patients.

Another critical experience during initial clinical practice is trainees' increased responsibility for the patient, which is often guided by their unrealistic expectations that medicine can always cure and that there is always "a right thing" to do. Students' and residents' expectations may lead them to react to the stress of overwhelming responsibility in undesirable ways—such as detached concern and decreased empathy—as they concentrate only on molecules, organs, reports, and data rather than on the patient.

Another key factor of empathy decline among medical students and residents is distress (e.g., burnout, reduced quality of life, depression), which is probably caused by the previously mentioned elements of the "hidden curriculum."

The medical students and interns surveyed were asked which factors they viewed as affecting empathy during education. They considered "mentoring and clinical experiences that promote professional growth" to be the most important; "negative feelings and attitudes toward patients" and "negative school and work experiences" were less important in their view."

(for full article: http://www.medscape.com/viewarticle/747624)

When I read--skimmed the article, I actually felt scared that in the next year, I might just be like the medical student in this study. Too stressed to care or too hurt that will lead to eventually not caring or worse, becoming like my professor. Okay, maybe he's not all bad and that I shouldn't generalize him based on that one incident.. but I still feel that he shouldn't have laughed at the patient's fate. Sure, he didn't laugh in front of her or her family, but doing it in front of the class, might as well be as awful as doing the former. Like what the article said, mentoring and clinical experiences that promote professional growth was the most important factor affecting empathy during education. If professor just does not seem to care, what message is he sending his students?

A patient is a patient. A human being. Someone in need. Dehumanizing them to do one's responsibilities would not help one bit. A doctor cares for the sick not for the sickness. It is for that reason that I admire consultants/residents who actually take time to get to know the patient or actually knowing how the patient was, instead of throwing the generic "how are you today?" and leaving 1-2 minutes later. Sure, most doctors would probably argue that having dozens of patients won't give them enough time to have small chit-chats with their patients, but how come certain doctors can still take the time to do so?

Back when I was in 1st year, a professor told us a story of a certain patient and laughed at how his/her organs could no longer be placed back inside his/her body which, among other things, led to the patient's death. I pray, one day, when I become a nurse-doctor, I won't be detached like he was.. that I would still be human enough to feel and care.