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Writer's pictureRobin Ortiz, MD

Question: Others see it, but we don't; what's wrong with this picture?

A commentary on the ability for healthcare to reconnect with the big picture of healing and how it starts with reconnecting to yourself.

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This past weekend I was blessed with the ability to reconnect. I booked a trip a few months ago when some of my friends from LEAPS 2011 and I decided we were overdue for a much needed reunion of sorts and, well, soul reconnection. Go ahead and insert your eye rolls and dismissive smirks here, but these really are the kind of friends that you see and immediately snap out of workaholic mode into laughter mode – that deep, heart felt kind of laughter. It worked out to settle on the location of Boston. This worked out for me, selfishly, as it also allowed me the opportunity to reconnect with my good ‘ol stomping ground (aka the city in which I attended undergrad) and one of my mentors.


-----My mentor, (who we will call Dr. WIN for woman in science, among other connotations), was one of my first research “principal investigators”. She is a neuropharmacologist. I found my way to training in her laboratory through my first semester of the PharmD program I was in (soon to be my last semester of it). Psychopharmacology was taught by Dr. WIN. I instantly became fascinated with the unknown mechanisms of the brain that this practice of neuroscience aimed to uncover them. When I returned to the classroom four months later and after an internship that assured me medicine was my true calling, I switched my major to Behaviornal Neuroscience. In an effort to maintain some continuity, I bridged the two curricular tracks by conducting a project with Dr. WIN.


Under her guidance I went on to win two grants and a fellowship award, acceptance to present two posters at the annual conference for the Society for Neuroscience (which, I believe, is the largest national research society with 42,000 members) and complete my first independent research project (studying a neurotrophic/protective factor in Parkinson’s disease) that would become my honors thesis. During this time I struggled to gather materials for my medical school applications and attempted to study for the MCAT (a few times). Through it all she remained my, “cheerleader” (as she refers to herself). She never doubted my becoming a physician-scientist and she never has, to this day. She will always be one of my role-models for strong female scientists.


To this day we are in touch, occasionally revisiting projects that have stemmed from my thesis work. Reconnecting with her reminded me that good mentors are always with you, if only in spirit. They come out when you reconnect with parts of yourself that they helped to form and shape. I reconnected with my inner cheerleader through Dr. WIN. Both are caught saying, “it may be healthy to question, but never doubt your ability to achieve your dreams”… maybe it was more along the lines of, “H-2-Q, remember to DO-YOU!” (insert waving pom-poms and a few back flips here). This, ‘reconnecting to self’ is a lesson I only recently learned and continue to grow into.-----


On Saturday evening my friends and I met up with two other LEAP-ers. Now, keep in mind, we are all medical students more than three-quarters of the way to our degrees. Three of us are obtaining additional training in research (one at Spaulding Rehabilitation Hospital, one as an MD/PhD student and, yours truly, at NIH). I dare say we are solid physician-scientists in the making. During conversation, a topic that surfaced that I instantly knew would make for the topic of my next post. We begin discussing food, as is inevitable over the dinner table (especially when a couple of them are crazy vegans – cough cough), yet we discussed food in the context of the struggles of science and medicine. Immediately, a story came to my mind. It’s a story I’d been holding in over the past few months with the lack of appropriate audience to share it with. This was my moment (and I’m reconnecting with that moment as I share it again here with you).

I currently live in DC as a member of a select group of medical students in a year-long research program. However, I have quite a few friends in the area who work and associate outside of the medical community. They are a composed of a variety of intelligent people – in business, education, international affairs and the like. I was out one night with this eclectic group of friends, away from the usual medical student crew. Yet again, I found myself in a “social eating” setting and my lifestyle choices inevitably rose as topic of conversation (it just happens when you order something where the main ingredient is a vegetable, or you ask if the soup is free of chicken broth).

With that, somehow it came up that I choose to cook 90% of my meals, even instead of opting for the free meals provided by my fellowship program after lectures and seminars. ”What?! Why would you give up free food?” a friend asked. I explained how it was just not healthy. I mean my program does an amaaazing job of catering to special diets (in that there is always a “vegetarian option”), but by no means do they cater to special lifestyles. I suppose I can’t rule out that they might, if I asked, but it’s a bit over-presumptuous of me to say, “Oh, sure, you want to know my dietary restrictions? No problem. I eat local, organic and seasonal foods with no added salt or preservatives consisting mainly of plant-based and free of all animal products.” Yea, right!That would be JUST what every vegan-resistant (or dare I say ‘hater’) would love to hear; a self-fulfilling prophecy that would allow them to secure the belief, “Ugh, I knew those vegans were pretentious and full of themselves, never-mind, ungrateful for what’s being offered to them for FREE”. So instead of confronting any of these even remote possible circumstances, I refrain and opt to humbly return home after every lecture to cook in my own kitchen and fulfill my own self-prophecy that my dietary “restrictions” are the most liberating.


My non-medical friends could not fathom, stating something along the lines of, “So you mean a program that is training the ‘best and brightest’ medical students on the frontier of biomedical research doesn’t serve foods that have been linked (through science) to health or, at least, reducing disease risk?”


What I continued to share with my LEAPS friends was the enhanced irony of the story. The part about how I am fearful to bring up my dietary choices to my classmates. When I have, they have questioned how it relates at all to my concerns for inflammation, never mind my lymphadenopathy or belief that a diet can be preventive of cancer or other disease outcomes. I know you must be thinking, but that’s a good opportunity for disseminating knowledge. Well, yes, it is. I often attempt to capitalize on it, however, sometimes it’s appropriate to let it go and other times I, admittedly, just want to eat in peace. Besides, shouldn’t it be the job of medical education as a system to implement this knowledge rather than one of its trainees?


Caveat: I feel the need to add an emphasis on some disclaimers here. My friends and colleagues are all extremely intelligent, supportive and whole-hearted people. Further, as I state elsewhere on my site, the views I express here in no way reflect those of the institutions or programs I’m affiliated with or mention in this post. The donors and administrators of the program I’m blessed and grateful to be a part of are more than accommodating and have given me more than I could have imagined this year. These thoughts in no way detract from the amazing science I am learning and the fulfillment of the aims of the program that I’m experiencing. My exaggerations are for stereotyped fears I hold about my own choices in knowing they are not the norm and are often challenged by others or what is ‘conventional’. This story is being told to serve as a commentary on our healthcare system and society as a whole rather than any one player in my tale. It just makes me wonder, “what is wrong with this picture?” Why am I fearful of sharing my healthy lifestyle choices with my future physician-scientist colleagues, yet ‘lay people’ outside of medicine find the fact that I even have to deviate from the group in order to commit to my health-y choices simply barbaric? The comments from my non-medical and medical friends taken together suggest that others see a problem with our own field that we don’t.


Medicine has become a practice that fears its own goals. No physician is willing to use the terms “healer” or “cure”, just as I’m scared to share how I believe my lifestyle choices facilitate my own healing. As physicians, we are trained to be aware of our every liability. Defensive medicine isn’t just about over-ordering expensive tests, it has forced us behind the shield of our own beliefs and goals. How is it that those choosing to practice medicine are receiving training that has become so reduced* it leaves out the big picture of healing and the modalities that facilitate it (including lifestyle/dietary modification)? *Note: I am not negating the reductionistic approach, especially in medicine where our collective knowledge base is exponentially growing along with technology so that no one person can know it all–literally, and in research where the elimination of confounding variables is essential in optimal testing of the null hypothesis like Dr. WIN taught me. However, one can have reductionistic approaches to problem solving, while aiming to address a big picture. The two are not mutually exclusive. What will it take for physicians (and the practice of medicine as a whole) to reconnect with the art of facilitating healing? Note: My LEAPS colleagues and I feel that facilitating healing is actually what we strive to do and, I hate to say it, but it takes a little heat off of the liability issue as well. 


My solution is to paint my own picture. I’ll keep standing strong for the healthy lifestyle I believe in from cooking to conducting sound, reductionistic, research while keeping an open mind to the big picture. My solution is to let my picture hang like a painting in a museum that each person in my life becomes a visitor of. I choose to lead by example, by reconnecting with myself, others that support me and still others who share my passions; all the while facilitating my own healing.


For my readers: is there something in your life that is due for a new painting? So I pose to you… others see it, but we don’t; what is wrong with this picture?


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