Holiday season !!

This time of the year is the holiday season in the United States. It is mainly a family time here. Not having my family with me makes it a difficult time of the year. Also, not having my friends from medical school, and not following up with how things are going with them (it is actually that each of us has their lives and that we are not parts of each others' any more since I am away) makes it more difficult.

Some people say that is great if you have your childhood friends with you. I ask, what if I didn't have that opportunity?? To follow my ambition I had to leave my country, my family and friends of many years!!

I then realized that I actually had the opportunity to be with many great friends who I have made since I came to the USA six years ago. I became involved with their kids as well. Quite a great feeling to be an uncle for those kids. They make things much easier.

So for that part of me who is having those feelings, I would say, I am proud of where I am now, and I am proud of the new family and friends that I became part of. Great friends come during all walks of life. Just keep your eyes open for them.

For my family and friends back in Egypt, I miss all of you. I miss our moments together. I miss going out for a walk by the Nile in Cairo at 3 in the morning, then praying the Dawn prayer in Omar Makram mosque.

And for my new family and friends in the USA, you know who you are (I am not going to put you under the spotlight). Thank you for making my holiday season that rich :-)

Happy holidays for those who celebrate the season.

Till the next post, ... 8-)

Mysteries around us !!

I just came back from watching the movie Interstellar for the second time. The physics is interesting, and the plot is catchy. For me, the music was so moving. One of the things I like about Hans Zimmer's sound tracks (e.g. The Last Samurai, Gladiator, Inception and Interstellar) is the sense of seeking a mystery that I feel filled with when I listen to his music.

His music reminds me of the mysteries all around us. I left the movie with the sense of how it is great to be able to pursue a mystery that is beyond and bigger than ourselves. As I was leaving the movie theater, there were many falling tree leaves. I tried reminding myself how much a complex world there is in each of these leaves. Such a sense of mystery, of something worth of pursuing, of something bigger than myself. And for me, knowing that, as a human, I will never be able to understand fully the Creator and Maintainer of this universe, fills me with awe, sweet sadness, humility, and strong feeling of gratitude that my life means something bigger. All the thanks be to Him.

Good night (New Haven time 8-)).

Inspirations at different levels

When I saw the video about Philae (the probe) I felt inspired. We, as humans, have quite a lot of leverage in this universe. We have the ability to figure out the laws in the universe, and the laws are constant (for the most part at least :-)). That's why we can utilize them to reach places and do what we want, like planning something millions of kilometers away and many years ahead (sometimes the word exploit is used, but my mindset dislikes this word. In my view, humans are not on this earth to exploit it. We were given the tools to make utilize its resources, not to exploit them). 

Another inspiration sat in when I was talking to some of my friends in Egypt. Some of them are neurologists and some are psychiatrists. They are doing their best in order to provide the best care they can for their patients despite how difficult things are in Egypt. Despite the limited resources and the minimal support from people around them, they are still doing what they can. They are doing their best to learn what they can, and apply what they learned. Some have grouped together to make funds available to buy needed devices. I felt humbled by what they do.

Another level of inspiration came when I saw this piece about "Occupied Pleasures", a project by Tanya Habjouqa. Another inspiration towards how resilient people are. I recommend looking at the pics in that piece.  Tanya's webpage is here, and you can know about her here.

Till next post,...  8-)

It has been around 5 years since I last posted on the blog. The last time, I has just started my psychiatry residency at SUNY Downstate medical center in Brooklyn, NY. During the residency, I was also going to do a PhD in the field of computational neuroscience.

Now, I am done with my residency, and I have just started my psychiatry research fellowship in schizophrenia at Yale university, where I will also be working on research in computational neuroscience :-)

I had multiple thoughts to restart blogging again throughout the past years. I didn't because of various reasons. Sometimes I felt that words won't be enough to describe what I wanted to. Sometimes I felt that I don't have anything to say. Other times I felt that it is not going to make anybody's life better, so why do it. On occasions, I felt that I don't want to post once or twice, then stop again for a few more years. As I was coming to the end of my residency, I felt that just like I get inspired by many bloggers, and continue to follow their posts, may be a few people would get some inspirations from my posts; inspirations which would encourage others to continue pursuing their dreams, when they see someone who continues to pursue his dream which started a long time ago (and it is only the beginning). To break it down, the long time started during the last year of high school, the year just before entering into the journey of 7 years of medical school, 3 years of residency in Neurology and Psychiatry in Cairo, Egypt, then 5 years of Psychiatry residency in New York City, and then now at Yale. As I am writing this now, I also realize that it would inspire me as well as I continue in my career. So a confession to make, I am writing these posts for myself before anyone else :)

I decided that I won't promise more than an entry a month :-) This way, I don't make promises that I cannot keep. It is a nice turn of things that I wrote my last blog just after I started my residency, and that I am restarting it after I just started my fellowship at Yale University.

I felt inspired after I heard the news about Philae, the first probe to land on a comet. This twitter feed about Philae has Philae as if tweeting about itself. You can find it here. Cute :)
I also found this video about the mission inspiring as well. I will post my thoughts about that later.

Talk to you next post 8-)

Memories of a resident in USA ! part 2

I am sorry for not posting earlier. Since the last entry, several things happened and I would like to share it with you.

I have finished my first rotation in inpatient psychiatry unit. It was for 3 months. It was a noticeable experience, as it was my first time to deal with the American medical system as a resident. Also, the legal system regarding the mental health profession is very important as we interact with it on daily basis. It was also a full experience in the complete freedom of thought and opinions. You can say your opinion, no matter how strange it is, and you can argue and defend it as long as you have a logic defense.

I also had my PRITE exam. It is an exam that we, as residents in psychiatry in all the 4 years have to attend every year. It was a good chance to study.

Finally, I have just returned from a "pub". This is a place where people would meet after work, drink, eat and talk. Today there was an event in that pub, where one of the famous Irish violinists was going to play there, accompanied by all those who can play and would like to join him. I knew about it through a "meet up" internet group for Celtic music. When I went there, the people were very welcoming, and they introduced me to others there. Also, they were accepting for the fact that I don't drink alcohol, without any comments. I was able to talk with some of the group there, and know something about their lives and their sufferings. They have their really serious problems, so they are not living an easy life as I used to think for any one living in the States.

I also met with 2 of the performers after they finished. They told me that it seems that I was having a good time, as I was swinging my legs and head with the music, and that helped to elevate their morale. I did have a good time, and they were playing in a good way. Some of them were playing on the violins, some on the flutes, and some on some sort of a drum.

I feel that it was a good choice to go to NYC for my residency. The 4 years will be full of interesting and stimulating experiences, and I will meet people from whom I will learn a lot.

Keep all the good work going. Enjoy your day as it might be your last, and feel the blessing of living for one more day.

Memories of a resident in USA !

Thank you all for your feedbacks. It fueled me more, to share as much as I can with you all.

This is part of my diary entry for today. Hope that it might help recharging our motivation to reach our dreams.

"Today, I received my ID for the hospital. The ID in the hospitals here not only allow you to enter the hospital without being questioned by security people, but they also act as keys for different doors in the hospital, as you swipe them through card reading devices. After that I went to the library to activate it, so that I can access most of the library content while I am away from the hospital through the internet.

These words, and the event of obtaining the ID might seem not of that significance to many. But this is one of the biggest days in my life. Yes, it means extra responsibility as this means that now we are responsible for the care delivered to the patients, but it also means a better opportunity to learn and to take care of patients in a better way. It means also that finally I was able to gain access into the educational system in the States, starting with post-graduate training years (PGY). Also gaining access to the library means that finally I reached to the shore of one of the oceans of knowledge that I will not get bored swimming in.

It also looks even more important moment because a year ago, I had obtained an ID with limited access while I was an observer. Yet, now, I am a resident with a full access to the hospital facilities, including the library.

This is an awesome moment for me."

My USMLE CS experience.

My experience with the CS exam was a year ago. This may sound a bit old, I now, yet when I was reading what I wrote on my diary on that day, I found that I wrote my algorithm that I used from the moment that they say "You can now open the doors to your patients", till I finished writing the patient's note. Here it is:

"Wedensday, 23rd of April, 2008. 10:17 am.
Right now I am on the train (Amtrak) heading towards Harrisburg from Philadelphia. Yesterday was my CS exam. I returned to the hotel very tired that I was not able to write anything about the exam. I spent the rest of the day eating, drinking (soda and water), lying in bed and watching TV. Today, I woke up abit later than I was planning, but I was able to make it to the train in time. The train is almost empty. In my car, there are only 3 people. That's nice. I will be able to work on my laptop uninterrupted.

Yesterday, I reached the exam center at 7:15 am. They waited till 7:30 then they brought us inside. They checked our ID, then they lead us to the room where we would put our bags, cell phones, and any electronics in a cupboard, then to put our food on tables assigned to us. They then started an orientation video, that was very similar to the one on the USMLE site. They confirmed several times that nothing should be with us except our white coat and stethoscope. They gave us a board with 12 blue scrap papers on it, and a pen. Then they allowed us few minutes to talk with each other so as to relieve the tension (and that trully worked effectively). The doctor on my left side was an MD, PhD (in neuroscience) and he already has been accepted in an ophthalmology residency. He visited South Africa for sometime doing some ophthalmology work there.

They then lead us to.....(sorry, I feel tired, I will continue later)

8:26 pm.
Now I am in the hotel in Harrisburg. Back to the exam. They then lead us to a hall containing around 22 doors, and each one of us stood in front of a door. We heard an announcement “SP, please be ready”. 30 sec later, we heard “Examinees, you may now begin your first encounter”. These 2 calls were repeated at the beginning of each encounter. We were now allowed to slide the small lid to read the clinical scenario. The first thing that I did is to write down the name of the patient, his age and the complaint. I then wrote down a list of the diagnosis I am suspecting in a column along the left edge of the paper. Then, underneath it, I wrote the systems that I would need to examine, in addition to the “PICKLE”. To the right of the examination column, I wrote a heading “investigations”, then to its left I wrote a heading “Counseling”. This left me the middle part of the page to take the notes I wanted during discussing the patient. I know what you will say, “this will take me a long time”. Well, I took me around 1.5 to 2 minutes, but I believe that it is worthed (I will know for sure after the results of my exam are available :) Then I knocked on the door and introduced myself “Good morning Mr. XYZ. I am Dr. Sherif, (shake hands), nice meeting you. Is every thing alright for you here in the room? (yes Dr, thank you) OK,let me make you more comfortable (and I would drap the patien)”. I then excused the patient to take notes while he speaks “Hope that you don't mind if I took some notes while you speak”. I then would proceed with the patient. The advantage of writing the DD before entering to the patient is that it will make you proceed in your questions without hesitating in front of the patient which makes an impression that you are not confident of yourself.
During the encounter, whenever the patient would tell me about something that would need counselling, I would write it beneath the heading “Counselling” eg smoking, alcohol intake or unsafe sexual practice. I also cleaned my stethoscope with alcohol swab after I wash my hands, before examining the patients.

After we finished the encounter, we would have 10 minutes to write the patient notes. I chose to type because I know that my handwriting would be awful if I wrote rapidly. During the clinical encounters, I didn't have any chance to look at the clock on the wall. And during writing the PN, the clock on the wall was away from me. But what really was of benefit was the 5 minutes and the 2 minutes announcements that they would make. For the PN, I practised to write the HPI and review of systems within 2 minutes, the rest of PAM HUGS FOSS in 2 minutes, then 3 minutes for writing the DD and needed investigations, leaving 3 minutes for writing the examination (in that order).

After we finished our first five encounters we had a 30 minute breaks, during which I uesd the restroom, ate some toast and drank some water. Then we resumed for 4 encounters. Then we had 15 minutes break then the last 3 encounters. The time for the encounters was a bit tight and I was only able to perform focused examination. I was worried that the 2.5 hrs of the first 5 encounters would pass slowly, but actually I did not feel any of them. They passed very rapidly. After the exam I felt that I had made a number of mistakes. I am waiting for the results, hoping for the best."

And for those who are curious, I passed my CS exam on first attempt, thanks be to God.