Total Consecration to Jesus, through Mary

I began my fifth year of total consecration this past Thursday. It's hard for me to explain, so I'll let St. Louis-Marie de Montfort do it for me. (Emphasis mine; I added it because the quote is long and I tend to skim the latter half of long quotes.)

St. Louis de Montfort noticed that the saints

stay at home with their mother—that is, they have an esteem for quietness, love the interior life and are assiduous in prayer. They always remain in the company of the Blessed Virgin, their Mother and Model, whose glory is wholly interior and who during her whole life dearly loved seclusion and prayer. It is true, at times they do venture out into the world, but only to fulfill the duties of their state of life, in obedience to the will of God and the will of their Mother.

No matter how great their accomplishments may appear to others, they attach far more importance to what they do within themselves in their interior life, in the company of the Blessed Virgin. For there they work at the great task of perfection, compared to which all other work is mere child's play. At times their brothers and sisters are working outside with great energy, skill and success, and win the praise and approbation of the world. But they [the saints] know by the light of the Holy Spirit, that there is far more good, more glory and more joy in remaining hidden and recollected with our Lord, in complete and perfect submission to Mary, than there is in performing by themselves marvelous works of nature and grace in the world....

Lord Jesus, how lovely is your dwelling place!¹

In this consecration, I give all my possessions—corporeal and spiritual, present and future—to Mary, so that she may dispose of them as she wishes. In this way, I make her my superior in life. Mary, not to be outdone in generosity, lends me her virtues, and molds me perfectly to Jesus. (I remember reading the biography of a Carmelite nun; on the first day of her postulancy the superior took her to the foot of a statue of Mary and said, "ask her to make you a perfect spouse of Christ." This is what this little consecration is.)

Examine this verse (a favorite at this time of year):

...and she gave birth to her firstborn son. She wrapped him in swaddling clothes and laid him in a manger, because there was no room for them in the inn.²

The inn is the world, and there is no room for Christ in a heart full of worldliness.^{3, 4} Instead, Our Lady lays Jesus in the wood of the manger which, like the wood of Noah's ark, is a symbol of the Church. The Church, empty of all other glory, is able to receive Him.⁵ This consecration enables a soul to be empty, so that Christ can enter as He ordained: at the hands of Mary.

Please contact me with any questions about this devotion! Footnotes are after the jump.

Decorum

Last month sometime, I shared an article to Facebook, a new development in the abortion-breast cancer link debate. The source site is on the reactionary end of the political spectrum, but it was only reporting the news, not performing the study. I posted the article and forgot about it (not being very fb-savvy).

The next thing I know, it is a few days later and I get a text (from fb) alerting me of a message from a classmate whose name I didn't recognize at first. She was very apologetic about something:

I just wanted you to know I wasn't even remotely trying to attack you when I posted on your abortion-breast cancer link. After Emily started ranting, I just thought you should know I wasn't enraged by your article, just skeptical as I am of a lot of things! I'm going to look into the subject more and come to my own conclusions on it, but I just wanted to thank you for posting. I hope you're well and weren't alarmed by my comment!

Attack me? Alarmed? I realized this must be related to the article I shared, and I returned to the post to find 22 comments, including a debate between an old TAC classmate and a medical school classmate in another town (a "fb-friend," not even an acquaintance). I know the TAC classmate well, since we were in section together as sophomores. He usually needed things reworded, he brought up issues not quite to the point, he displayed poor etiquette, etc.

In the comments to my post he was at it again, debating with my pro-choice classmate. His first comment was 385 words, a cardinal sin on a microblogging site and a faux-pas in the new evangelization anyway. Without waiting for a response he posted six links in a row, asking his opponent to read all of them. He got frustrated when she responded with a two-sentence argument (not having read the links), and answered in another chunky paragraph of 172.

The discussion became more equal as the medical student began to answer in longer bursts. The posts back and forth took on what I thought was a pedagogical, competitive tone, like two contestants instead of two people in discussion. I looked at the times of the comments: it was rushed. In fact, the TACer typed, "Perhaps you just answered it [a question he asked], I haven't read your latest response as you just posted it as I'm writing ths.[his latest argument, sic]"

Long posts, all caps, responses out of order, rebuttals to multiple points fragmenting the debate.... I became terrified, feeling like I'd created a monster without realizing it. I quickly commented, hoping to resolve the mess. I guess I judged hastily and those two were happy with their discussion! The TACer posted some hours later, disliking my comment:

[Medicalmatins], I'm not sure what you are referring to. As far as I can tell, the conversation has not gotten out of hand (whatever you mean by this). It was a civil discussion albeit, the participants on both sides feel strongly about their respective positions. There were no ad hominem attacks on either side. The discussion was going fine. Moreover, although you claim that [the medical student] doesn't want to "debate", [she] has not made that clear to me. Perhaps you should let [the medical student] speak for herself on this one. On the contrary, [she] seemed to be very much willing to discuss the issues and I've enjoyed the exchange.

I almost posted “I wince reading it. You two are missing each other by miles at every point. Too much vitriol, too much rhetoric, too little openness....” Instead, I just removed the share and all the comments.

Here's where the story gets dramatic (where I get confused and think all the characters are high school girls). The TACer posts to his wall:

It's sad when someone deletes a fruitful discussion from their wall because they are hyper-sensitive and over-react to innocuous comments that are made. Oh well, what can you do?

Friends of his that I did not know were already commenting:

Must have been a Calvinist... depraved beyond all hope. ;)

if an individual was THAT concerned with either what I or they wrote....more power to them, lol, let them feel that morsel of control in this huge world if that's what they need ;-]

Ouch. I private messaged the TACer:

[Name], forgive me. My intentions were good; I feel as though I don't deserve the hurt your causing.

Response the same day:

No offense, but you know what they say about the road to hell and good intentions. I think you were imprudent to chastise me in public about something that was merely your perception. You have to realize that you have a habit of being hyper-sensitive when a discussion doesn't meet your uber high standards of decorum. You have to consider that there can still be a good discussion even if it does not meet your ideal standards. Moreover, you need to consider that perhaps what you take to be impolite or uncivil conversation is merely what you are reading into the discussion. It is an online discussion so it is easy to misconstrue passionate conversation as uncivilized or undignified. As far as any hurt I'm causing, I know of none.

Ouch ouch ouch (and interesting comment about chastisement in public).... My final message:

I'll keep your advice in mind. Thank you.

He's right in a few things: I added tones of voice to the discussion (inevitable in electronic media); perhaps I made mistakes in some of those. And I am sensitive to decorum. But decorum is vital in discussions. Nothing gets done without it.

"It's a Baby When We Want it to Be"

This post by Catholic blogger Joe Heshmyer is so refreshingly logical.

It's a Baby When We Want it to Be: "...when it's politically advantageous, they're not “fetuses,” they're “unborn children,” and they need to be protected *now *from [anything] that can harm them in the womb...."

Last anatomy lab

Parts of this post are hidden and contain graphic recollections of cadaver dissection. 12/2/11 was my last day of dissection. (I'll go into lab to study for the test a week from today, but I will never again take scalpel, probe, forceps, scissors, box saw, chisel, spoon, baster, or hand to a cadaver again.) We dissected the oral and nasal cavities by hemisecting the head. My partner actually broke a hand saw while dividing the bone. As we were washing our instruments and closing our tank, Semisonic's "Closing Time" came on (we almost always listen to music, courtesy of Pandora, during lab).
How wrong this has seemed! Only my facade has changed over the past five months. Fascinating? Yes. Disturbing? Yes. I am grateful to be through with it. Another thing I am grateful for: I was told it was inevitable to dream about one's cadaver, but this did not happen to me.
I dreamt I was a cadaver and I also dreamt of dead children coming to me and holding my hands, but I never dreamt about my cadavers.)

In the past five months, I have watched twenty persons' bodies be picked down to ghoulish parts. Much of what horrified me were cuts to bone, as we sawed off a leg to see a hemisected pelvis. But not everything awful was orthopedic: we cut little vertical slits below the lower eyelids, like the makeup on a mime, to see intraocular muscles.

I did not like opening ribcages like mailboxes, cutting out organs, peeling off skin like old linoleum. I did not like to hear people calling parts of bodies "junk" and "crap." I did not like some of the music they played in lab (I marched to the front of the room and skipped a track from Rocky Horror Picture Show once.) I hated the way people spoke about this body or that—"the old girl was well-fed," or "that's just sad" (male external genitalia dissection). I hated the sound of saws, the smell of open bone, the stench of preservatives, the stinging hands and eyes. I will try to forget holding skeletal hands and arms that bent back from rigor mortis; I will try to forget emptying the rectum; I will try to forget our penultimate cadaver molded and the bleach added to the smell.

And I will be all right. Oddly, I like to dissect: to cut is fun, to clean is satisfying. (To stitch is wonderful, but we didn't do that in class.) But I thank God it is finished.
Today (12/9/11) was our last exam in our anatomy class. I walked out of the lab at about 5:00pm in a mix of fatigue and shock, unable to feel the emotions I had built up for that moment. Again, although I might not feel much, I reiterate: Deo gratias!

Partes huius celatae sunt, quia recollectiones dissectionis cadaveris pavefactae continent. Ut articulus in toto videre, vise legem parentem. Ad fraterculos meos: non id legere...mox id vobis intimabo.

Decorum

Last week I received some unsolicited advice.

You have to realize that you have a habit of being hyper-sensitive when a discussion doesn't meet your uber high standards of decorum. You have to consider that there can still be a good discussion even if it does not meet your ideal standards.

When I get constructive criticism I try to respond "fiat" and improve in the area highlighted if I see that the critic is right. But I don't think I'll act on this one. Decorum is vital in discussions; nothing gets done without it.

Decorum is a certain organization between people to facilitate a discussion. Sometimes, two people in discussion are so motivated by the truth that they need no help staying focused (like a bowler rolling a perfect strike); more often, some outside help is necessary (like rails on a bowling alley) in the form of protocols. I was taught a timed, structured debate style between two persons: opening statements, rebuttal, closing statements. However, decorum is not limited to this degree of structure. For instance, although discussions at TAC are in a loose seminar style and have a large number of people participating (between fifteen and twenty), policies like the dress code and the use of surnames add enough formality to hold everyone's attention on one topic. The more structured and focused a group, the more it accomplishes.

However, decorum is more than protocol. It includes politeness. Logic does little to convince unless they are put well and proposed gently, at a pace suitable to the opponent or audience. My first true debate was on contraception. (This was my senior year in high school, in ethics class.) I was con and one of my best friends was pro. Unbeknownst to the teacher, the stakes were very high: we were each defending our beliefs, the doctrine of our churches, and the practices of our parents. I remember the experience vividly: my logic overpowered her, and I saw it in her face. At my closing remark, I had the opportunity to triumphantly describe the clear defeat, but I did not. I tried to be tender. (We did not speak for a little while after class, but we are on wonderful terms now and she is a Catholic. Lauda Christi!)

(I can't resist showing this to you as I see it: a Euclidean compound ratio. Disregard this parenthesis if it is unhelpful. Decorum bears to debate a ratio compounded of the ratio logic bears to thought with the ratio politeness bears to counsel. Or, to be Cartesian:

decorum    =      logic ·  politeness

debate           thought    counsel

How I miss geometry! Anatomy was such a tease; my imagination longs for perfect solids and gnomons.)

Without logic, reasoning is poor and the search for truth is harder; without kindness, counsel repels and the struggle for virtue is longer. I prize decorum because I think it is a formal principle for truth and virtue. We must not lose it, especially considering our responsibility in the new evangelization!

Amazing stew

Above: the ingredients. Roll over the image for the complete list. Below: cranberries, one of nature's meanest tricks. They're so beautiful (their beauty made me take a picture and that's why they're in the post)...and yet so unbelievably sour that a venus fly trap seems more honest.	Above: makin' the meatballs. I made them polite-bite-sized...they're so hard to eat otherwise! Apparently you're not supposed to knead meatballs too vigorously, so I tried to be gentle. Everything turned out tasty. Below: This lasted a week and was extremely filling...I credit the turkey stock.

Dearth of Advent wreaths...

I went shopping for an Advent wreath yesterday, knowing that I wanted to make an investment in a beautiful piece that would last my adult life. I expected to have to compare several choices. But I couldn't find one. How is that possible? I guess I went to all the wrong places:

1. Walmart
2. Target
3. World Market
4. Pier One
5. Bed Bath & Beyond
6. Michael's
7. Hobby Lobby
8. an antique store

At about #3, I got tired of people giving me quizzical looks when I said "Advent wreath." So, I started giving kindergarten-CCD descriptions (it's like a wreath with spots for four candles...?) Everyone sent me to "wreaths" or "Advent calendars." Why don't people know what an Advent wreath is?? Walmart had menorahs in prominent display, and no one would mess up on those! Eventually, I gave up on finding an actual Advent wreath and tried craft stores to see if I could make one. Still, nothing suitable appeared.

I'll keep trying this weekend. Sorry I'm late, Lord!

Insecurity and Intimacy

We had the coolest Ethics lecture ever on Tuesday. It was cool for several reasons:

1. it was the last one
2. it was...
1. genuine
2. helpful/relevant
3. humorous
4. worthy

The speaker was an older family doc in the navy—he was actually an admiral—. The topic was professional insecurity. Having induced a universal from our previous lectures, I thought this would be a powerpoint full of half-baked slides about our litigious society and our collective psychological failings.

But I was wrong. There was no powerpoint. There were no stupid, unnecessary definitions and bullets to introduce us to the topic. Instead the admiral dove into the idea, assuming we all knew what it was.

"We are bilaminar creatures," he said, explaining that we have a confident outer face, and an inner quivering/normal face. The outer face matches what we and others think of our profession; the inner face is ourselves, terrified at the position in which we've been placed. He said that this insecurity is with us throughout our lives.

Further, he said, there are several "nodal points" where insecurity becomes most obvious. Until this time, he didn't have my full attention. But as soon as he began to write nodal points on the board I was all ears, because without knowing a thing about me or my curriculum he recited what I went through this semester.

Nodal Points

1. First day of medical school
2. First exam(s)
3. Clerkships
4. Graduation
5. Internship

I'm sure he could've noted more. But this is exactly how I felt!! At the White Coat ceremony I remember thinking to myself, "I am the admissions' committee's mistake. They keep joking about it and reassuring us...but this is real. They didn't know how behind I am, how dumb I am. How can any TACer do this? I am going to fail painfully. How embarrassing. And after I fail, then what?"

This admiral told stories from his first day, his first test, his clerkships, and his graduation. He was hilarious! He also had some hard stories: after doing what he was told by his attending, he was rebuked by a staff internist for sending a woman home when she should've been sent to the ICU or CCU, and for a while he thought he had cost the patient her life. How horrible, how crushing! (He later discovered the woman was okay.)

He soon moved on to solutions to this insecurity problem, which makes anyone unhappy and dysfunctional. He listed several possible ideas: alcohol, drugs, other addictions, other distractions, superspecialization, more degrees.... He rejected all of those (some more quickly than others). Then, he wrote what he thought was the true solution on the board, in six-inch letters.

[Intimacy]

He said we must find a person to trust and show them our interior—our inner layer, the insecure one—confessing our imperfection, ignorance, and ordinariness. And not to only one person (like a spouse); to a network, a team.

It's a risk. Sometimes, he said, when you show someone your imperfection they laugh and alert everyone, giving you pain. "But most times," he continued, when you show someone your imperfection their response is a relieved and desperate reciprocation, and you create an immediate community.

I've been reading about some fascinating social experiements that go right along with this! Also, I'm reading The Seven Levels of Intimacy.... One of our greatest desires is to be known. And of course, it all goes back to desiring God in the beatific vision. I cannot wait for heaven!

What an excellent lecture. The more we are humble and frank with everyone and the more we can be truly intimate with those God gives us...the better for our profession, our patients, and our country.

Breast Cancer/Abortion

I'm still really interested in this.... Here are two links I found today:

• Abortion Nearly Triples Breast Cancer Risk, New Study Finds
• Epidemiologic Studies: Induced Abortion and BC Risk 1957-2011

Interesting. Listening, AMA?

Two other cool tidbits about motherhood:

• Breastfeeding lowers infants' risk of ear infections! (We did oral cavity and Eustachian tubes today, and I'm sad the lecturer missed this point. There are so many plusses to lactation I can't control my enthusiasm.) 
• This picture of Our Lady (right) is the third result when I google "mother." (I'm searching for reusable images with safesearch.)

Stand by the roads, and look and ask for the ancient paths, where the good way is and walk in it, and find rest for your souls.

This is an article by a non-Catholic businessman. He speaks so kindly of the Church, and his view is so refreshingly accurate! This article was written in '03. A must-read, especially at the beginning of Advent when we rekindle enthusiasm.
http://www.ewtnnews.com/catholic-news/US.php?id=380

Butternut squash soup (and apple tarts)

 Butternut squash (cubed, from my freezer but less immediately from Sam's)
+ chopped baby carrots
+ half a large onion
+ a tablespoon of ginger root (from ♥Mom♥)
+ crockpot
+ blender

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A yummy, tasty soup for chilled lunches; accompanied well by nuts and bacon. Next time, I might actually be patient enough to roast the squash first. But probably not.

Pretty, and pretty tasty.












Baby food....I mean healthy cuisine. Umm...












And because I still had half an onion (and a ton of apple slices left over from Thanksgiving dessert), I decided to make apple/onion/pecan tarts. An ambitious and random project that tasted good but looked...ambitious and random.

And my pie-crust skills need improvement. The dough wasn't uniform enough. However, it was still fun and tasty, as anything with butter will inevitably be.

Clearly, I cannot divide a chunk of dough into four equal pieces! At left is the only pretty shell (the empty one). I finally realized that I should probably form the sides of the tart before I stuck the stuff in.

Today, I also made soda bread, which came out like sandwich thins (exactly as I'd planned). Since they looked sort of underwhelming, I'll post about them later. I believe my long semester of questing for the perfect homebaked bread for the medical student is almost over....

Medical Ethics is ending...

...which means I can look forward to the post-test, the repeat exam that is supposed to show that this class made me "more moral" (a quote from the course director at the beginning of the course).

I am continually mystified by the purpose of this course. In a post-Christian yet pre-Aristotelian society (i.e. we're post Christianity but can't reach the height of the pagans before Christ) we feel the need to do something about ethics, but can't articulate anything with certainty. Some verbatim quotes from the course director exemplify this:

"[Ethics is] the study of the principles of human behavior with respect to moral actions."

"[Beneficence is to] do what is good; help others further their own legitimate interests."

"[Justice is] the duty or obligation to allocate social burdens and benefits."

"I have no answers."

Each of these statements has philosophical (and even logical) problems.

Found a hospital

The other night, my sister and I spent two hours on the phone talking about dreams. Big dreams. She described a wonderful school she wants to start; I admitted that I want to start a hospital.

Her school is very well conceived. She wants to make good use of students' time instead of stressing them out by keeping them in fruitless programs during the day and activities until late at night. She wants to pay teachers based on merit, teach practical skills (e.g. home ec), and incorporate service. I'm so impressed by her desires to mold better people without all the fat in our current schooldays!

My hospital was less complete in my mind. First, I am very unsatisfied with the nursing shortage, the over-technicalization of patient care, and the treatment of crises instead of persons. I'm especially fed up with these problems because of my visits to nursing homes. I want dedicated persons who will stay with patients and get to know them, instead of coming in when the light is on or when there is a form to fill out.

In addition, I want a hospital that is wholly Catholic—half retreat-house, half hospital! I want the chaplaincy to be about truth (not comfort), and I want it to be very available. I want to hang Crucifixes in the rooms instead of TVs, and place placards with good quotes from the saints and scriptures. Being ill is like beauty—a natural thing that jerks our attention to the supernatural. In a culture so bent away from God, sickness is an ever-remaining crack that Christ can use to pry His way in. A holy hospital can do great good in saving souls!

Then, my sister and I started talking about the breakdown of the family; then, we voiced hopes that our family of origin will remain close together (our extended family is stretched all over, and I think we don't want that for the next generation); finally, we ended up dreaming of creating a Catholic planned community outside some city. Think: if there were two thousand Catholic cities all over the nation, what sort of effect could there be! A concentrated effort can be better than a dispersed one; my hospital would be safe from legislation there (since it would serve primarily Catholics); studies could show how good social teaching improves economies, moods, etc.... So, pretty much I want to go start a city now. (This is what happens when two girls stay up late on the phone!)

God keep this desire to spread holiness in me; God show me how I ought to direct it.

Beauty

Even though I stopped doing ballet after ten years, I'm still a dancer inside. I was struck by this picture, so I thought I'd add some thoughts and post it.

Beauty is a miraculous part of our world! It is such a mercy of God to allow this journey to be sprinkled with lovely moments, like wholesome physical beauty, or hidden psychological consolations, or the elegance of nature's laws, or a holy soul or a holy deed.

And as an aside, one of the things I think of the most when I think of beauty is the feminine body and soul. So, this picture says a lot: in every ordinary woman there is a natural beauty inside.

ballet | Tumblr (clipped to polyvore.com)

Recipes for fall...

Hosting a dinner party left me with tons of leftovers in very maldistributed sections of the food pyramid! I am forced to be creative.

1. Butternut squash soup
2. Meatball soup
3. Roasted onions
4. Shrimp
5. Pigs in a blanket
6. Hamburgers, meatloaf...

Yum!

Painting!!

In the middle of studying the cranial nerves, I took an hour to paint!

Way back in August or September, my roommate suggested that we decorate by painting some blank canvases. I was fine with blank walls--they looked really Carmelite, but I wanted to be a good roommate and hanging stuff on the walls certainly couldn't hurt. We bought two three-by-four foot canvases, a bunch of paint, and some snazzy brushes at Hobby Lobby. Then...the canvases sat blank for months. We had to think of things to paint, prime the canvases, and draw some pencil lines. These steps aren't very impressive, and when they're spread out over months of busy life, they're even less so. So today (when I finally applied color to canvas) was wonderful!

The painting is going to be of a darkened theater, with five period silhouettes in the foreground. Right now, I've painted the side of the theater (dark and grey as the light from onstage filters across it) and put some leftover black paint in the middle of the silhouettes (it looks really weird--sorry about that). The third picture is the rough draft I created on my computer, which I scaled to the canvas before I began to paint.

I remember liking to paint as a kid, just like everyone did. I was sad to lose art in seventh grade, and sort of sad to not paint in high school. All through those years, I'd have these great ideas for paintings, but I wouldn't have time or tools (or talent!) to execute them. However, I'm committed to stay with painting now--it's so wonderful and addictive! The upper left corner of my painting is an inky black (not quite black--there is some red and blue in it, but it's still very dark), and it was tremendous to watch my brush change the canvas so dramatically.

If you watched the video I linked above (or just the last few moments of it), then you saw a nun writing an icon. For some time, that has captured me completely! New aspiration: become an iconographer.

Anatomy is almost over!!

As I approach the end of the semester, I find myself counting down anatomy labs. (As of 3:30 today, five left, and I am only dissecting for two of them, orbit and nasal cavity!) Today, we sawed a crown-like cut through the skull and removed the brain. I tolerated seeing the cadaver's face (last Monday) pretty well. He had been a handsome, older man. I noticed that his brows were slightly knit in an expression of effort or light pain; otherwise, his countenance was peaceful.

Also of note: this morning I spoke to the professor I saw at Planned Parenthood. (It turns out, he hadn't recognized me.) He was as polite as ever, explaining that he'd read pathology reports from before Roe vs. Wade, and never wanted someone to die such a horrible death. He and I acknowledged that we both care about women, but that the battle across the fence was nevertheless real. He even called it "ferocious." I told him in parting to keep caring about women, and that I would do the same.

The brevity of this post is hardly excusable, but I hope you'll believe me when I judge it inappropriate to spend much longer online--I have a comprehensive histo quiz, an ethics test (gah) to take, and an exam (the penultimate of the semester!) next week.

OB/GYN shadowing

I started taking advantage of the OB/GYN mentorship program last week, shadowing a local OB/GYN for a morning in clinic. In three hours, Dr. A saw five or six patients at her group practice, and six or seven patients at a prenatal clinic linked to the FQHC I wrote about last week. Miraculously, she didn't seem rushed!

She was full of energy, she cared about the patients and spoke at their level, although she was by habit brief. The best part was, she allowed me to palpate some women's abdomens to feel babies' heads and buttocks! (She now believes I can find fundal heights, which is laughable.) Then, she started to let me use the fetal heart doppler. By noon, I was finally getting used to placing the transducer on the patient and hearing the (other patient's) rapid heartbeat!

One of the first things Dr. A asked me was where I was from and where I went to school. Hearing that I went to a Catholic college, she surprised me by praising the Church for working for the poor in healthcare throughout history. This was followed by a brief comment about how she was not "down with" some of the other things the Catholic Church does. I could tell by her wall decor that she was liberal (the Obama '08 sticker removed most of my doubt), later that morning she lauded Clinton, and told a NP and I that she is on the board of Planned Parenthood in the largest city nearby. (PP is eating all my mentors.)

I have no concluding thesis or thought from this experience, except that the degree to which pro-choice stuff soaks our culture is confusing. (She measures heartbeats but approves abortions?) It was, however, nice to shadow an OB/GYN. I like what I saw (and did!) a lot. I hope I can find a place where I can be tolerated, and I wonder whether I need to find a mentor who isn't pro-choice.

Dinner party

From the past few posts, it looks like it's all been fun lately. (I've been working, too; I promise.) I wanted to share a fun thing: I cooked for more than three!

I racked up a huge grocery bill to create shish kabobs. The menu included chicken, bacon-wrapped shrimp, and beef sausages. I marinaded the chicken in something I mixed up myself! 3:1 white vinegar to olive oil, plus some premade chipotle seasoning my Mom gave me. I combined the meat with onions, bell peppers (green, orange, red, yellow), pineapple, butternut squash, and button mushrooms. I drizzled the veggies with basalmic vinegar, lined up a row of kabobs on a baking pan, and baked them for ten minutes. I served rice on the side.

As always, there are surprises in the kitchen. For instance, I didn't realize the shrimp needed peeling (they still had shells and legs) until the last minute! Happily, most of the surprises were good ones: my guests brought more food than I thought. Someone brought half a birthday cake, another brought a pie and cupcakes, a third brought a fruit plate and a huge loaf of garlic bread! Someone even brought wine. We forgot to open it, he wouldn't take it home, and since I'm a teetotaler I think it's going to age until I think up something to cook it in.

A few happy moments: someone who I occasionally experience tension with complimented me on the chicken. She said it was moist and flavorful, and this especially encouraged me because of that homemade marinade! Everyone insisted that the food was good and that I should do this more often; one of my friends even sent an email afterwards. The world is so bright today!

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Edit: I added pictures today (12/13/11) since a tankmate posted them on facebook!

Lack of discernment = unhappiness

Whoops! I failed to think through and pray about several medium-sized things during this section of the curriculum. I signed on to shadow an OB/GYN the day before the exam, I missed the test reviews (vital vital stuff happens at those!) by double-booking myself and simple forgetfulness, I'm giving a dinner on the same day as the CMA-SS meeting, I went home last weekend instead of studying.... oh dear!

Discernment should've been in the front of my mind. Unfortunately, I don't have a habit of discerning. I have the opposite habit: making decisions (quickly or slowly) based on what sounds good to me. I need to use my time and energy more carefully in the future.

FQHC's

A federally-qualified health center (FQHC) is a practice that receives grants from the Health Resources and Services Administration (HRSA, the same people that offer rural loan forgiveness to medical students and residents). I read more about them here.

When I first heard of FQHC's, I thought they were a good idea and even thought I'd like to practice in one. It's a good idea to provide care to people who need it, yes? And these are the poorest of the poor, yes?

But on Friday I shadowed a pediatrician in an FQHC. I'm not a fan any more.

I was surprised by the sick-child visits. Children came in with no true complaint. I thought this must be due to low health literacy. (A 99° fever is not a reason to worry, especially if the fever doesn't register on a thermometer and the only reason for the visit is "he feels hot to the touch.") I asked the the doctor I was shadowing about this. She agreed with my assessment, but added another reason for these empty visits.

"It's so cheap" to come in, she said, that patients come in at the drop of a hat. She added that sometimes they are using their visit to skip school. If I were a provider to this population, I would much prefer these patients get good phone advice and go to school! But the doctor again surprised me.

She laughs at these empty visits and says it's "good for the numbers." An FQHC must maintain a certain volume of visits, otherwise it loses its funding. Upshot: he better the education she provides, the worse the numbers. Moreover, the more FQHC's that are established in an area (the fewer visits at each one), the worse the numbers. "Bad for business," this doctor sighed when she told me three satellite clinics were being established this year.

Now I have problems with FQHC's.

1. The Republican in me: our taxes are paying for what? (Not all these patients are here legally!)
2. The ethicist in me: where money is on the line, who can provide patient, solid counseling to patients?
3. The patient advocate in me: this arrangement is worse for patients; they become dependent on the doctor because they are not taught how to take care of themselves, the underlying cause of their visit (problems in school?) aren't addressed, and they receive poor-quality care (this was my experience yesterday and might not be universal).
4. The idealist in me: why is the patient's good bad for doctors?

There must be some better way to take care of the poorest of the poor; some way that does not involve government programs and conflict of interest, some way to provide true education and quality care. FQHC's make me sad because they're so close to a solution, but at the same time so problematic! Our system seems so misguided.

The Fence

I have a lot of favorite professors, but this post is about one of them in particular. He more than other professors reminds me of a TAC tutor—he loves his science, loves teaching, and doesn't mind what the world thinks of him. He is very polished and thoughtful. His lectures are a little scatterbrained, but that's also endearing and reminiscent of a few TAC faculty I admire. I sit in the front row and I feel like I got to know him. (I silently notify him when his microphone turns off; I answer questions, I make eye contact.) I wish I could tell you more, but I shouldn't give identifying information.

This past week, he presented the female reproductive system as his last lecture to us. We clapped when he finished; mine was an applause of gratitude and recognition of excellence.

Conscience Rights

A few newsbites:

• USCCB writes open letter to protect conscience rights. CMA, NCBC, Knights of Columbus, Catholic colleges sign on.
• An NJ hospital pressures 12 nurses who refused to assist in abortions.
• Christian Medical Association criticizes Obamacare's useless conscience clause (scroll down for Jonathan Imbody and David Stevens' editorials)

I got this summary from an AAPLOG email:

In a nutshell, Health & Human Services (HHS) has adopted the most limited right of conscience language ever to be used in federal law in its new contraceptive mandate to health insurance. Using language developed by the ACLU, the mandate now requires all policies issued to cover all forms of FDA-approved contraceptives, sterilization and counseling with no co-pay. The only entities exempt are those that:

1. Have the inculcation of religious values as their purpose;
2. primarily employ persons who share its religious tenets;
3. primarily serves persons who share their religious tenets; and
4. are non-profit organizations under section 6033(a)(1) and section 6033(a)(3)(A)(i) or (iii) of the Code.

Practically, this means that ROC protections are limited to churches. The one-in-six hospitals in the country that are Catholic must provide coverage for birth control and sterilization. Christian practices and non-profits that serve the poor must provide coverage for morning after pills.

Missionary for a moment

"You're Catholic, right?"

I was eating/studying over lunch with a classmate, and he asked this toward the end of the break. I wondered why he had to ask: I wear a San Damiano crucifix, I've blasted the entire medical school with two emails about the Catholic Medical Association, and I had blessed my food in front of him. I supposed that he was just speaking for the sake of something to say. But after he got my happy "yes," he kept going.

"What do you think of the pope?"

What do I think of the pope?? He's my vicar, my father, my teacher, my superior.... "What do you mean?" I asked him.

We talked about the pope for a little while, touching on authority, succession, and publicity. I tried my best to listen although I was bursting at the seams to say lots of theological stuff! It was fortunate that I held my tongue, because we stopped talking about the pope when my classmate got to the heart of the issue: faith and knowledge. How can you assert something without being able to prove it?

I was able to answer that question, goofing at first but then growing more simple and less scholastic. I told him that not everything that is not rational is irrational; not everything that is not natural is unnatural. And he actually seemed to be thinking about what I said.

Histology was our next class and we are in different labs, so we parted after my few sentences. But I was a missionary for a moment. (As an aside: thank goodness I am not a full-time missionary. I sort of shrivel up at the thought!) How wonderful; I hope I was a good tool.

Faith in Action Blog | Thomas Aquinas College

Reblogged from Faith in Action Blog | Thomas Aquinas College:

Theologian / ethicist / cultural commentator Dr. Pia de Solenni (’93) has a new column in Headline Bistro about the “strange, weird, and … largely unregulated world of assisted reproductive technologies.” In it she makes an important distinction between “having a child and being a parent,” noting:

“There are many opportunities for people to become parents, either by having their own children naturally or by adopting children desperately in need of a home (and parents). In either case, there may still be situations where people view children as a fancy accessory or possession. The fact that they’re having a child naturally or adopting doesn’t mean that their intentions are necessarily good. But at least the child isn’t being custom ordered like a car or a piece of furniture.”

Dr. de Solenni is also a regular guest on the Catholic Answers Live radio program, and recently defended the Church on NPR.

Warning: long cooking post ahead

So, it's been way too long since I last blasted my cooking exploits up here! I've made apple sauce, apple butter, meatloaf, and oat cakes. As always, I learn a lot when I was in the kitchen.

The apple sauce was very fun and easy. I grated six apples. (Next time I'll just chop them!) I put these in the slow cooker with some ginger, ground cloves, and cinnamon. I also threw in some frozen strawberries and dried apricots, because I had them on hand.



Low heat for four hours made the house smell like autumnal heaven, but there had been little cooking going on. I should've vented the lid so that the whole batch would go to apple butter in that time (which was my original intent).

I put half the mixture in an old pickle jar (clean!!) as applesauce. Then I kept the pot on low overnight, venting the lid by raising it off the pot with two spoons. I didn't mean to, but I woke up in the middle of the night and checked on it. In the morning: scrumptious apple butter.

I also made the meatloaf in the crock pot. Ground beef, an onion, beef bouillon, eggs, a little milk.... I cooked it on high for a little over three hours. The internal temp was good and the outside developed a nice cooked-sausauge color. It was very moist and soft, and it was not easy to take out. Luckily, I'd made a few foil slings underneath it; next time I'll line the whole base of the loaf. I squished it into a large tupperware and it'll last all week. I didn't realize the recipe proportions were probably meant for a larger cooker.

Oat cakes! I've had this recipe on my sidebar for months but haven't tried it yet. It calls for three cups of dry ingredients (half oats, half wheat flour), four cups of wet (half milk, half water), plus a tablespoon each of yeast and salt. First reaction: how weird to put yeast in a batter (it's going to be flat anyway!); second reaction: that's really salty!

Being a good Catholic, I know how to obey things that don't make sense at first. So, I mixed everything together and poured it into a well-greased frying pan.

UTTER FAILURE. I made two fail-cakes (this is when I discovered how salty they were). I decided that, since the recipe wasn't speaking ex cathedra, I needed a different plan.

Experiment: I oiled and floured a baking pan.
Result: better, but not perfect. They were a little underdone on the bottom. Also, it was time-consuming to cut the sheet into slice-of-bread-sized pieces.
Solution: tent with foil. 
Solution: separate with foil during baking.

Second batch: better, but still imperfect. The sheets were easier to separate, though I forgot to tent and therefore bottoms were still a little soft.

I froze the oat cakes for the upcoming weeks' sandwich bread. Time will tell if this is a better method than bread. Things I already like: 

1. I won't have to slice these in the morning when you're in a hurry.
2. They're thinner than bread slices.
3. They cook faster.
4. They're all the same size.
5. They won't mold in the freezer.
6. I won't need an icepack to keep my cheese cool.

Iconography

Our Lady of Częstochowa

I love icons: I have a diptych in my study carrel at school, and a Russian nicopeia in my bedroom. I've often wanted to write icons, especially when I am reading about a favorite saint. However,  I'm woefully ignorant, so I am reading about iconography on my weekend off. (I had an exam last Friday and won't have another one for two weeks!)

I found rich quotes from the Catholic Encyclopedia and an insightful interview with iconographer Marek Czarnecki. I was most impressed with two points: the powerful, subtle way icons teach and the remarkable mentality of iconcographers.

First point: icons are designed to teach through every detail. Czarnecki had this to say:

We can compare an icon to a carefully constructed poem. Indeed, this is why we call it icon ‘writing’ instead of ‘painting.’ Every ‘word’ or element of it fits very concisely and precisely to contribute to the overall meaning and integrity of the whole.

He called iconography an "eternal language," providing a way to depict the Church's saints until the end of time. "Iconography is called, rightly so, a liturgical art. Just like a priest has a rite for saying Mass, so we also have our guidelines...the consensus and example of tradition." He also informed me about the importance of icons in our human lives:

In the eighth century, an ecumenical council was convened. At that time, St. John of Damascus determined that icons were not an ‘option,’ but rather a necessity in explaining the Incarnation of Christ. To not have icons would be a denial of the Incarnation itself.

It reminds me of the importance of the beauty of architecture, which I realized when TAC dedicated the Chapel my sophomore year. It was designed to be a church that teaches, so that the marbles used and the positions of the materials impressed on TACers truths of the faith. In the same way, shapes and colors on the wood of an icon impress us with truths. I've seen that the richest lessons are the ones I learn gradually and gently, unfolding day by day. The icons in my life do this.

Indirect Sterilization

The genetics lecturer yesterday had dozens of case studies. Here's one, which mainly surprised me because of the polled response she received from the audience. (Because of a technical difficulty, the audience excluded me and everyone at my site; only the remote sites to which the talk was teleconferenced were able to vote.)

Mrs. _____ has a family history of breast cancer. She wants a TAH/BSO [total abdominal hysterectomy and removal of both ovaries] for prevention. You offered her genetic counseling and genetic testing which she declined. Do you comply with her request?

1. Yes
2. No
3. Maybe

As soon as the question appeared, I snorted a quiet "no" to myself. This is indirect sterilization: a procedure resulting in loss of fertility (direct sterilization is a procedure that brings about the loss of fertility as its only purpose.) Then the results appeared:

1. Yes - 47%
2. No - 17%
3. Maybe - 36%

I was shocked that the largest group of my peers would remove this woman's healthy generative organs. Since this poll was on my mind, I looked up the relevant Church teaching.

Autonomy (again!)

There was a fascinating (read "scandalizing") lecture yesterday in Med Ethics. A geneticist spoke in very distracted fashion about the ethics of her science. I was mostly studying embryology during this (and emailing the minutes of the CMA-SS meeting), so I happily didn't have much of an occasion to get angry. However, the members of my small group all came in frustrated with the disorganization and opinions expressed. I did pay enough attention to catch some highlights for you:

...you may have your own moral beliefs, and that's fine, but you have a duty to refer the patients to get complete care.

Context: the patient wants contraceptives or abortion, and those desires are "complete care." The lecturer then continued, saying that she provides what she calls "non-directive counseling," that is, she "will talk about termination" with patients. Still speaking decisions regarding abortion and contraception, she said:

It is not your decision to make, it is the patient's decision to make.
...[W]e make those decisions [the decision not to counsel abortion or contraception] based on our own experience, our religious beliefs, and a number of other things; but patients make those decisions that same way we do, so their decisions may be different than yours.

Apparently, the patient and I can't arrive at the same answer, because we have two impossibly different collections of rules to follow.

But people don't make decisions by consulting a slab of mental commandments and tabulating the dilemmas they create when they intersect! We make decisions based on what is the good we see and the habits we have. I could go on a long rant about principlism, but now is not the time; in fact, now is the time to study for Friday's test. But principlism as an explanation for human behavior fails. The truth is, we act according to the goods and habits described by virtue ethics (Aristotle was right).

There was more to be said about this lecture, but I'll split up the material into two posts.

ACOG Patient Information

Last post, I linked some of ACOG's literature for providers. Now, I'll examine some of their literature for patients. I received five patient-information pamphlets when I became a member (yes, I am a member, but I also joined AAPLOG). ACOG sells these pamphlets to OB/GYNs in private practice. From their list of literature, I chose these five to receive:

1. Birth Control Pills
2. Emergency Contraception
3. Human Papillomavirus Infection
4. HIV and Women
5. How to Prevent Sexually Transmitted Diseases

(I purposefully chose the hot-button issues because I expect that when "reproductive rights" are not involved, ACOG's recommendations are medically sound.) Let's just look at Emergency Contraception (EC).

ACOG Conference

I readily talked about CMA. Now I have to drag myself into talking about ACOG. The American Congress of Obstetricians and Gynecologists does not send me into raptures like the CMA does. In fact, ACOG's opinions are influenced by politicians and advocate a very sad agenda for women (abortion, contraception, selective reduction, etc).

I went to an ACOG conference last Saturday. I swept past several contraceptive companies and IVF providers, and dodged the free demos of IUDs that were being given out to the medical students.  Even so, most of the booths were encouraging: a new women's hospital was opening, a cord-blood bank was giving out stuff, and a lab company was showing off their pap-smear swabs right across from a da Vinci robot (which I got to play with!!!). I think this is because my district of ACOG is rather conservative.

Nationally speaking, ACOG seems very misled morally. Take a look at Committee Opinion 385, drafted in 2007 and reaffirmed last year. Other interesting ACOG opinions:

• Understanding and Using the U.S. Medical Eligibility Criteria for Contraceptive Use
• Forming a Just Health Care System
• The Obstetric-Gynecologic Hospitalist
• Increasing Use of Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy 
• Menstrual Manipulation for Adolescents with Disabilities 
• Induced Abortion and Breast Cancer Risk 
• Abortion Access and Training 
• Misoprostol for Postabortion Care 
• Hormone Therapy and Heart Disease 
• End-of-Life Decision Making 
• Surgery and Patient Choice

All these links provide access to PDFs that open in this window; these documents belong to ACOG but are available online. I'd like to discuss some of these here in the future (the funnest posts I write are the ones where I dip into my philosophy background—closely seconded by the food posts). However, right now genetics beckons.

CMA plug

The Catholic Medical Association (CMA) is an excellent group: its theology is orthodox and its priorities are straight. I've been to one of their conferences before, and I was floored: solid philosophy, wholesome theology, strong science, daily Mass and confessions, relics of St. Gianna Molla, exposition of the Blessed Sacrament...I could go on. It has a Students Section (CMA-SS), and a student wrote a reflection on this year's conference:

This year’s national conference could not have come at a better time in my medical school career, a time when I am nervous about choosing my specialty and honestly struggling to balance my work responsibilities with the time needed to lead a fulfilling, God-centered life. I feel like God placed this 3 days of conference right where I needed them to re-center my purpose in medicine and to rededicate myself to a life centered around Christ. I once read that it is the most important things in life that we need reminded of most often. This conference was my reminder.

Continue Reading A Reflection on 2011 CMA Conference

Brian B., another student of CMA-SS blogs at The Catholic Medical Student. He is very articulate and writes longer, more focused pieces than I do. I highly recommend his work.

I am becoming a leader in my school's chapter of CMA-SS, so I'm thinking a lot about the CMA lately. I hope I can be a good leader; there are some lukewarm Catholics among my classmates, and I would love to aid Christ in seizing their souls.

Relativism and Autonomy

I want your opinion:

A 48 year-old black women has developed stage III non-Hodgkin's lymphoma and needs combination chemotherapy for treatment. Without therapy she has no hope of survival beyond a few weeks or months. With therapy she has an 80% chance of complete remission. She understands this entirely, but insists that she simply does not want the therapy. There is no evidence of depression.

Which of the following is the most appropriate action?

1. Honor the patient's wishes
2. Ask the family for their opinion
3. Offer radiotherapy instead
4. Psychiatric evaluation
5. Seek a court appointed guardian
6. Risk management evaluation

This was a question on our Medical Ethics midterm. The correct answer was (A) because the end-of-life lecture heavily emphasized autonomy. (Because I know how to jump through hoops, I knew the answer they wanted, but I chose (C) in defiance. None of the other answers make sense; the patient is competent.)

But (A) does not make sense, given the information provided. The principle of autonomy does not allow a physician to lay aside his duty (rather, it binds him to respect the dignity of his patient as equal to his own). Choice (A) does not respect this patient; it betrays her.

The real answer is neither (A) nor (C). The real answer is: sit down with the patient; find out why she does not want this treatment. Her risk-to-benefit ratio is so low! What is she afraid of, or what does she believe about this treatment? And how can I help allay help her make the right choice?

Our Ethics class has operated from the very first lecture on the premise that there are no right answers. As a result, there is no "right choice" for a patient to make in a given situation. There is only the patient's desires and the doctor's opinion. In a world where there are no right answers, (A) makes sense. Ironic that I got the answer wrong in this world of relativism.

I'm contacting the course administrator about the question; we'll see what happens. (The grade does not matter, but the truth does.)

Healthcare disparities

Finally! A good lecture in Medical Humanities. Most of our lecturers make three mistakes:

1. They openly lean left. This is pedagogical.
2. They do not defend their conclusions. This is a cross for the TACer (and any intellect).
3. They employ heavy filler in their presentations (this hurts the medical student soul; we're constantly thinking, "is this a good use of time?? I need to study G-coupled protein receptors!!").

Today, we had a woman who made none of these mistakes. She gave a stimulating lecture, had strong ethos to support her position, and reached beyond politics and academia for the good of patients. Some highlights:

• people do not need to look the same to treat each other without unjust disparity (she was asked before the lecture whether, if the racial distribution of doctors matched the racial distribution of patients, healthcare disparities would disappear)

Living wills and healthcare proxy

Our professors have asked us half a dozen times: "who in here has a living will?" Very few hands go up, and the professor berates us for being young and shortsighted. Every time we're asked, I diligently make a mental note: "I'm going to go home and do that...it's a good idea and I should set an example...." But every time, I forget! (So I still haven't raised my hand.)

Tonight (after the last exam of the first block) I had lots of time, so I looked up advanced directives. Three seconds of research tells me this: "Many Catholic bishops and moralists consider this [living will without healthcare proxy] an unsatisfactory approach, as it does not provide for unforeseen circumstances" (NCBC, ETWN; this page goes into good detail about artificial nutrition and hydration and "extraordinary means").

For reference, here is is a purely Catholic and legally sound healthcare proxy form (designating decision-making authority to another person in the case that you are incapacitated and expressing desires in those cases). It explains very carefully that

the statutory definitions are not always consistent with Catholic moral teaching. For example, the definition of “life-sustaining treatment” under Texas law conflicts with Catholic teaching because the Church considers food and water, even “artificial nutrition and hydration,” as ordinary care, not a “life-sustaining treatment.”

It makes general provisions in accord with Catholic teaching before offering the typical curt "I do wish" or "I do not wish" option.

Please note: these differ according to state. Search for "Catholic advance directive" and your state.

My Companions

Here are the blessed whom I love (hover the cursor over each image for a quote, where available).