los anjalis to anjuquerque

Back to blogging, after almost a month. What an adventure the past month has been. Intense! (just the way I like it). During a two week vacation in October, I participated in an inspiring and totally radical Doctors for Global Health gathering in El Salvador (with a few of my close friends from LA and SF) — I liveblogged once from there, and hope to share some more experiences and photos from that inspiring trip.

I flew back to LA just in time to fly out to New York City in order to hang with the ‘rents in NJ and DJ the 10th anniversary of MUTINY, an event that a few other DJs and I put on every month for 6 years. It was HISTORIC to say the least. Again, hope to reflect on that a bit here.

Flew back to LA and started a super intense adrenaline-rush of a 2 week stint working in the hospital with very sick patients. It was a truly rewarding experience, and I spent 16+ hour days in the hospital, taking care of patients, thinking out my clinical management of their diseases, talking to their families, and discussing plans with the subspecialty consult services in our hospital. Outside of the hospital I saw MIA in concert with a few friends, it was an out of control 2 hour visual and aural onslaught! Saw Suzanne Vega in concert the next week, she was amazing too. And now, I’ve completed a week on my new rotation as Resident Clinic Director, where I’m managing the flow of patients in our family medicine clinic as a 3rd year resident in family medicine. I’m also triaging the walk-in/urgent care patients and doing some administrative work too. It’s a fascinating learning experience, and very valuable for me since I’m jonesin’ to start my own clinic someday.

Lastly, this thanksgiving weekend has been filled so far with goooood movies (Syriana, City of God), goooood homecooked vegetarian food, goooood quality time with the bro, and some nice LA exploring (first time at the Eagle on wednesday night, and heading to dinner and maybe some dancing tonight in silverlake or west hollywood). I’m excited about my new resolve to spend some more time in Los Angeles instead of flying around the country and the world, and about figuring out what’s next for me after residency finishes in June. Always an adventure, always an adventure :>

and now, back to near-daily updates here. It’s been a month, and it’s time to get back in the game. I’m reading TOO much and experiencing TOO much that I’m itching to share with others…

I’m back from a two week trip to the state of Chiapas, Mexico!

I travelled there with a few other family medicine doctors to work in Hospital San Carlos in the small town of Altamirano.  We managed adult and pediatric patients’ medical conditions, as well as delivered a few babies along with the young doctors there.  It was truly an amazing experience, and I hope to share some stories and photos from the trip in subsequent posts here.

Every day in Chiapas, we took siestas (afternoon naps) for an hour or two during our long days of work.  Since I’m now back in the US and we don’t do siestas, I’m especially tired tonight, so goodnite!

Ah.  We’re here!  5 residents from our family medicine residency program (Jose, Suganya, Casey, Eva, and myself) arrived in Kansas City, Missouri yesterday for the annual American Academy of Family Practice (AAFP) National Conference of Family Medicine Residents and Medical Students.  We’re accompanied by our wonderful program director, Dr. Castro, and our associate program director, Dr. Sanchez.  Thinking back, this specific conference is what introduced me to my residency program in the first place.  I’m from the east coast — New Jersey and NYC to be specific — and I had no way of knowing what programs in the west coast or midwest fit my interests well.

I remember feeling a little down (and exhausted) after walking by many many display booths at this conference when I was a 3rd year medical student.  After a few long days of talking to many programs, I felt a connection to a few, a handful of them who I felt really walked the walk and did not just talk the talk in regards to broader public health issues, resident-driven change, and sustainable community outreach.  And then — love at first sight.  I glanced over at one table where a slideshow was being shared, and I saw photos of residents rallying with SEIU for healthcare reform; I saw photos of resident-driven international trips;  I saw photos of residents running the show at a resident-founded homeless clinic.  I talked to the residents and faculty at the table, and I heard more of the same, accompanied by a rigorous training, a sense of satisfaction and a sense of humility.  This was exciting!  Long story short, the conference introduced me to my top choice program in the country, and I’m ready to play the role of excitedly sharing the program with medical students.

We set up our display booth, which was quite fun, we’re pretty excited about it.  We’ll have video from our residents and screenshots of our residency blog (first of its kind in the nation, eh?) and our wiki (resident-driven collaborative learning/reflecting) on two laptops at our booth.

The freebies here are interesting.  There are some really fun ones, like the program that brought the portable popcorn maker and another program that brought a smoothie machine.  But it’s quite disappointing to see so many pharmaceutical companies’ huge display booths — very expensive and schmancy ones at that — set up among the family med residency booths.  We’re not quite sure what the purpose of them is…other than blatant blatant marketing of their drugs to physicians and (get ‘em young) medical students.  This is a family medicine conference for medical students and resident doctors, a recruiting conference, this is not a recruiting conference for the latest Merck drug.  sheesh.

Digging in the crates — I was going through some old emails and reread this piece I flagged, from last year around this time, when Dave Chappelle surreptitiously took a break from his show and flew to South Africa to be inside his head.

“I’ve got to check my intentions.”

…”I want to make sure I’m dancing and not shuffling,” he says. “What ever decisions I make right now I’m going to have live with. Your soul is priceless.”

…But Chappelle also says that he must share the blame for the stalled third season. “I’m admittedly a human being,” he says. “I’m a difficult kind of dude.” His earlier walkout during shooting “had a little psychological element to it. I have trust issues, things like that. I saw some stuff in myself that I just didn’t dig. It’s like when I brought a girl home to my mom and it looked as if my mom really didn’t like this girl. And she told me, ‘I like her just fine. I just don’t like you around her.’ That’s how I feel in this situation. There were some things about myself that I didn’t like. People got to take inventory from time to time. That’s what this [coming to South Africa] is for.”

(From TIME.com: On the Beach With Dave Chappelle)

I’m feeling the dancing too.  Checking my intentions for sure.  Reflecting on the past few weeks and my months ahead, really wanting to dance.  Though this past month i’ve been working with the neurology consult team at my hospital, affording me the opportunity to see too many people shuffling along because they have Parkinson’s disease.

I’m joining the Work Less Party, after my family medicine residency is over, that is. 1 year, 6 weeks to go and counting! Check out the article that this below is excerpted from, a fascinating correlation between working more and consuming more/destroying the environment/being more anxious and less happy.

It’s just those kind of values Schmidt has tried to encourage in his Work Less Party. Schmidt, a former computer programmer, started by getting rid of his car and cycling to work, then took advantage of the savings by reducing his workweek, which allowed him enough time to write his book, make two documentaries, and organize a community theater group — all in the last three years.

“People spend so many hours working they have no idea of how much creative potential they have, but you get a taste of mental freedom you want more of it. It’s an explosion of creativity.” says Schmidt, quickly adding, “I’m a workaholic, but it’s the type of work that’s the problem. Our society is focused on work that makes stuff that goes directly into landfills. Essential work such as art, music, creativity, community, the kind necessary to create a healthy society and planet, is being negated in favor of that.”

If there’s any solution to increasing our well-being, as well as the planet’s, Schmidt’s advice flies counter to our driven consumerism. “If you want to protect the environment, you have to consume less, which means you have to produce less, and you have to work less. We have to keep the message positive — our standard of living will improve hugely. I think people are starting to make the connection.”

So who’s with me?

Yes, yes! Tonight! I’ve written about Rupa and the April Fishes previously on this blog. They graced Los Angeles with their presence in March 2007 (part of the Por la Frontera Tour from San Francisco to Tijuana). Here’s a personal quote from Rupa (who’s also a resident physician in internal medicine at UCSF and sees firsthand the struggles of immigrants through their health experiences):

This tour was inspired by several patients i met working at sf general, immigrants who came to health care too late in their disease process for fear of being deported. it struck me as messed up that a policy could alienate someone from their own sense of health so much that they would not seek help when they knew they needed it.

Below and above are two videos I’ve uploaded from the show at Temple Bar, Santa Monica, in March. They’ll make you want to dance all burlesque and stuff. Disclaimer — these videos were taken on an it’s-getting-up-there-in-age digital camera (not a videocamera) and I kept running out of memory so I wasn’t able to capture the whole songs (but nost of them).

Ok, so meet us there! Hotel Cafe, 1623 1/2 North Cahuenga Blvd, Los Angeles. 7pm! We can all hang with the band afterwards, groupie style :>

Want more?

• SUPER fun video from their Extraordinary Rendition cd release party at the Independent in SF.
• Rupa and the April Fishes MySpace page.
• Rupa and the April Fishes website.

We are adaptable creatures, and while that is generally good, sometimes it’s a problem. We have no difficulty taking prompt action when faced with a sudden calamity, like a bleeding head wound, say, or a terrorist attack. But we are not good at moving against the creeping, more insidious threats — whether a slow-growing tumor, waistline or debt.

It’s as true of societies as of individuals. We did not muster the will to reform our long-broken banking system, for example, until it actually collapsed in the Great Depression.

This is, in a nutshell, the trouble with our health care crisis. Our health care system has eroded badly, but it has not collapsed. So we do nothing.

For at least two decades, polls have shown that most consider our health system seriously flawed. With family insurance premiums now averaging $12,000 a year, the insured fear it will become unaffordable, and businesses regard health benefit costs as their single greatest obstacle to competing globally.

People without insurance are proven to be more likely to die, and 28 percent of working-age Americans are now uninsured for at least part of a year. Emergency rooms, required to care for the uninsured, have become so full they turned away 500,000 ambulances last year. As a result, large majorities support the idea of fundamental change…

from Atul Gawande’s commentary “Can this Patient be Saved?” NYTimes May 5,2007. (thanks to Donkey O.D. for sharing the full piece, which is otherwise on the payola-only section of the Times website).

The bolded section above (emphasis mine) is a pet peeve of mine — we’ve put billions and billions into disaster preparedness and bioterrorism work in the past few years, and we’ve taken billions OUT of more insiduous killers like chronic disease programs, integral public health mechanisms, and such basics as housing, food, transportation, etc.

I work at a county hospital and clinic in Los Angeles, where we mostly treat the uninsured, underinsured, or undocumented.  We’re the safety net hospital in the area.  However, we’ve been packed to the brim and have had to say no to ambulances (channel them to other county or non-county emergency rooms) over and over and over again. Now that’s what I call scary.  Spillover from a safety net hospital.
Also — the cost that Gawande mentions for health insurance for a family isn’t overstated.  Even in California, individual health plans are more than $4500 a year, and family plans are definitely more than $12,000 a year.  And what’s minimum wage, in California or in the U.S.?  You do the math.  (Obviously this cost is too high even for middle-class folks!) That’s f***’ed up.  Where’s our revolution?

As the months of my family medicine residency progress (just a bit more than a year to go! yay! and yikes!), I will receive more and more advertising information about specific job opportunities around the country. Various interesting tactics are often employed to attract doctors to these jobs — including ways to entice future applicants to the location, family things to do in the area, an exciting salary, or a unique job description.

Today I received a pamphlet in my mailbox at work — from a clinic and hospital system in Iowa. The job opportunity looks neat — small to midsize town, lots of good primary care, full service family medicine (everything from babies to adults to pregnant women to delivering babies to old people, a good mix of primary care and urgent care, and some work in the hospital also).

The quotes included in the pamphlet though, are eeenteresting.

“One of America’s Great Small Town Getaways” — [some magazine]

“one of the four top places to spend a football weekend in the U.S.” — [hmm...enticing? err...]

“One of the 52 Great American Weekends under $200″ — [ok]

“One of the Top ten places in the U.S. to view folk art” — [ok cooler]

The weirdest are two quotes probably from the same article, from a piece done in the New York Times about this area:

“…northeastern Iowa is our country’s premier rural landscape, as woods and intimate as New England, but with wider horizons and more room to breathe, its sandstone-ridged hills cut by slow tea-colored streams where boys in cutoff denim shorts still fish with cane poles and bobbers, Tom Sawyer style.”

oh but the fun is just BEGINNING:

“…is a town that Disney World ought to buy whole and ship to Florida and populate with smiling lifelike robots who, when a stranger asks them for directions, ask him if he needs a lift as well, which is what happens to me outside the hotel when I mention my interest in a certain local landmark.”

Sweet! I’m moving to plastic robot town that ought to get shipped to even-more-plastic Disneyworld!

But seriously now, who the F*** thought of including this in their advertising materials? On another note, can we fire that NYTimes author too? And while we’re at it, can we sit down with the folks who put this pamphlet together and explain that (1) they should be incensed that some weirdo from the NYTimes would speak so condescendingly about their town, and that (2) this isn’t a compliment to their town and shouldn’t be placed front and center on their pamphlet?

Tomorrow night, a beautiful sound is coming to Los Angeles. It’s called Rupa and the April Fishes, and they’re gracing us with their presence at Temple Bar in Santa Monica. I’ve seen the lead singer Rupa perform solo — just her and her guitar — at a coffeehouse in San Francisco last year, and she’s fun, socially conscious and versatile, to say the least.What’s even more interesting to me (and inspiring!), is that Rupa is a 3rd year Primary Care Internal Medicine resident at UCSF — you know, the job where you work 80 hours a week after medical school for a few years? She’s finagled a way to truly pursue both doctoring and performing music — a way that includes splitting up her residency into a few months on, few months off (to perform) and I hear from my friend Nicole (who’s a resident in that same program) that Rupa comes back to the hospital with a renewed sense of energy for her work and compassion for her patients.

Her experience as a physician shaped the evolution of the group’s current tour called “Por la Frontera”. They’re performing from SF to Tijuana and raising awareness and doing benefits for immigration rights issues. As she explained to me in an email:

This tour was inspired by several patients i met working at sf general, immigrants who came to health care too late in their disease process for fear of being deported. it struck me as messed up that a policy could alienate someone from their own sense of health so much that they would not seek help when they knew they needed it.

Come play! 10pm, Temple Bar. When you’re asked at the door who you’re there to see, say Rupa and the April Fishes! (this way they’ll surely come back to the Temple Bar to perform!) Call or email me if you’re planning on going :>

More info on the band: MySpace page (check out the featured tracks! so beautiful) and TheAprilFishes.com

A snippet from a review:
“They sing and play together with such wonderful ease and gusto, it’s as if they’ve been playing together for years. Their multilingual music draws from cross-cultural influences and source material — Indian ragas, tango, French chanson, bossa nova, jazz, not to mention numerous forms of folk music from around the world — which conjures words like slinky, fevered, hypnotic and intoxicating.”–Aquarius Records Review

Yesterday I worked a long 12 hour shift (yes, there are short 12 hour shifts and long 12 hour shifts) in the pediatrics emergency room at a county hospital as part of my pediatrics experience during my family medicine residency training. I didn’t end up leaving the hospital until a while after my shift ended because I wanted to tie up loose ends and make sure two patients who were being admitted to the hospital wards had their studies (imaging, blood studies) all tucked away.

As a result, I missed the infamous LA Sepia Mutiny blogger meetup, the first blogger meetup I would have attended in my life. I missed my chance to meet some amazing folks (including Sunny who’s visiting from the UK), to see SM writer Abhi before he leaves Los Angeles for H-town, and to check out this eerie venue called Nirvana Lounge in Beverly Hills.

But all is still OK. Why? Because my ER shift was fun. FUN. The kids are the cutest. There are traumas and emergencies that bring us joy (in stabilizing/curing) and sadness (gun shot wounds and freak accidents in kids are the worst). But some of the funniest interactions occur with the less acutely sick patients.

For example, a 10 year old girl with headaches for a week straight gives me more information on these pains — how long they last, what they’re exacerbated by, how they affect her at school, and i rule out the most dangerous causes of headaches with a number of questions. But the first thing she says to me when I walk into the room, introduce myself, and ask her what’s bothering her is — “I’ve been having headaches for a week and I just cannot afford it.” I had to stop myself from busting out laughing during the rest of my interaction with her.

And a 3 year old boy who we think has whooping cough (pertussis) because of his extended coughing pattern (and related symptoms) also had some trauma to his left ear, and there’s a little bit of dried blood in the ear canal, but no damage to the eardrum. Definitely looks like he tried to put something in his ear. But he vehemently denies it, when I ask nicely, and when mom asks nicely. Then the attending doctor (the senior doctor running the ER) comes to see the patient again with me, kneels down in front of him and says in a really sweet voice, “Hi I’m [insert male first name here]. How are you? Did you put something in your ear?”

The child nods his head side to side, motioning “No.”

The doctor whispers, “I won’t tell anyone if you put something in your ear, you won’t get hurt.” And then the doctor repeats, in a cute voice, “Did you put something in your ear?”

and the child nods his head up and down and smiles the cutest smile EVER.

I’m not generally a fan of horoscopes, and i’m not really into signs. But Friendster’s horoscopes are a daily gift to my mind. One day Friendster tells me i’m pretty damn cool, and I feel wonderful all day. Another day Friendster speaks to me in subtle voices about my negative attitude, and I work to improve my attitude (i’d like to think i’m really not that malleable). And now this… what to make of this?

Your ability to predict things border on the psychic right now. Act on your gut.

Remember that you have one of the best guts around (in terms of instinct, that is!). So this recent bout of self-doubt is completely unwarranted and unnecessary. Today you need to trust yourself! This day offers you a big opportunity to try out your new optimistic self-assurance — and the best part of it is that it will be fun and completely risk-free. Consider it training wheels for a healthier ego. Your ability to see the future will grow stronger once you start listening to yourself again.

Well, in a few hours I’ll be switching up my role, to take on managing the inpatient (in hospital) family medicine service at the main hospital where i’m doing my residency training. It’ll be a profoundly different experience from my time catching babies and working with pregnant women this past month. I’m excited about this new responsibility but mad nervous at the same time. Here’s to some healthy confidence and a healthy gut…

I’m finally a second year resident in family medicine (yikes!). 2nd year started off with a bang — I’m on week two of working at a hospital in downtown Los Angeles, doing obstetrics/gynecology. That means I’m triaging women who are possibly in labor early or in labor on time, admitting women to the Labor & Delivery section of the hospital, delivering babies (YAY!), assisting in cesarean-sections, and caring for women for the 1-3 days they’re in the hospital after deliveiring their babies. I’m working with both physicians and midwives, which is a great experience. I’ve got lots of stories from my past week, but yesterday I worked overnight, and my last patient in the early AM hours was a 17 year old girl who came into the hospital to be evaluated because she was having contractions regularly. She was 39 weeks pregnant, so contractions would make sense, she was in active labor and ready to deliver her baby. The only issue? Well, she hadn’t told her parents until that morning that she was even pregnant. They were livid, but calmed down appropriately in time. But what? She lives with them, and they didn’t notice that she had gained weight or looked different. And in the process of not telling anybody, she never got any prenatal care. A social work consult was in the works, and I hope everything ended up going well in her delivery, which happened after my 28 hour shift.

During this month, i’m improving my baby delivering skills but also observing how the senior residents and attending physicians and midwives “coach” laboring women and gain great rapport with them as they’re going through some of the most intense pains any of us may ever feel. Humor during this process really helps, and as we’re crouched in front of a woman’s vagina, coaching her to push as if she’s having a bowel movement (to push the baby out of the vagina), the first bit of the baby we obviously see is his/her hair. So some of the more recent hair comments by the physicians:

“Oh my goodness, your baby has hair! We’re off to a good start”
“Hmm…mommy your baby has black hair, no highlights”
“No way, your baby has a mohawk!”
or “No way, your baby has dreds!”

Day Labor

So moving on from the hospital to the folks who make it run — nurses. Right now a battle is being waged against them by Bush’s National Labor Relations Board:

In a series of pending cases known as Kentucky River, the Bush board could strip what remains of federal labor law protections from hundreds of thousands-perhaps millions-of workers whose jobs include even minor, incidental or occasional supervisory duties. The pending cases involve charge nurses in a hospital and a nursing home and lead workers in a manufacturing plant, but these workers could be just the tip of the iceberg.

The Bush National Labor Relations Board is easily the most anti-worker labor board in history, but even against this sorry backdrop, the scope of what they now are contemplating is breathtaking….

The stakes are high for the public, too. In health care, for example, scholarly research has documented that heart attack survival rates are higher for patients in hospitals where nurses have a union than in hospitals where nurses do not.

Already in 2000, months before George W. Bush was declared president, Human Rights Watch issued a powerful report that found U.S. labor laws were grossly out of compliance with international human rights norms. That organization’s bill of particulars was lengthy, but the first item on their list was the failure of U.S. labor law to cover millions of workers, including among others, managers and supervisors in the private sector…

It is therefore imperative to push back against the Bush board’s assault on workers’ rights. We must, moreover, go beyond good defense; we must win serious protections for workers’ rights. The Employee Free Choice Act (EFCA) is the most significant federal legislative proposal in nearly 30 years to protect the freedom of America’s workers to form unions and bargain collectively. Since its introduction in the 109th Congress by Ted Kennedy, D-Mass., and Arlen Specter, R-Pa., in the Senate (S. 842), and by George Miller, D-Calif., and Peter King, R- N.Y., in the House (H.R. 1696), EFCA has garnered 215 House cosponsors, just three shy of a majority, and 43 in the Senate…

(from Lawless Workplaces by Stewart Acuff and Sheldon Friedman of AFL-CIO

And more from AFL-CIO:

Have you ever shown a co-worker how to perform a task, or been asked to look over someone else’s work? If so, your freedom to form a union and bargain collectively is in danger. The Bush-packed National Labor Relations Board (NLRB) is considering three cases that could alter the definition of supervisor—and that could mean hundreds of thousands of nurses, building trades workers, newspaper and television employees and others could be prohibited from forming unions…

During the week of July 10, hundreds of thousands of union members will take to the streets in a week of action to fight for their right to union membership. Already, some 7,000 nurses and other health care workers at eight New Jersey hospitals threatened to strike to protect nurses’ right to speak out for their patients through their union.

You can send a quick letter to your congresspeople here.

And from the California Nurses Association:

The National Labor Relations Board will soon issue a major ruling that could jeopardize the ability of RNs to receive the protections afforded by CNA/NNOC representation. At the request of healthcare employers and anti-union consultants, the Board is expected to make the absurd ruling that many thousands of RNs are “supervisors” under the law because they make clinical patient care assignments to other staff. Under federal labor law, supervisors have no protection. THEY HAVE NO RIGHT TO UNION REPRESENTATION.

This coming Tuesday, CNA is organizing rallies in Los Angeles and Oakland. More info here.

Art and Labor

On a very related note, I’m hoping to check out the “At Work: the Art of California Labor” exhibit at Pico Gallery, Downtown Los Angeles, sometime in the coming month. Details below and more information here, comment below or email me if you’re interested in joining me or if you’ve already checked it out! Looks good…

The story of labor – which comprises passionate struggles and triumphs as well as dehumanizing forces – has figured largely in the art of our time. At Work: The Art of California Labor exhibition opened at the Pico House Gallery at El Pueblo de Los Angeles Historical Monument on June 13, 2006. It is the first exhibition to explore this important topic through the eyes of artists who witnessed or were inspired by some of the most significant trends and events in the history of the 20th Century…

Many Californians are aware of San Francisco’s 1934 General Strike, but probably few realize to what degree labor movements shaped the state’s political and social climate. Even fewer know of the copious art which both inspired and reflected California’s labor struggles throughout the 20th century. “At one time, the strongest and most important artists in California made art about labor,” explains Mark D. Johnson, Professor of Art at San Francisco State University. A mid-century backlash, however, including the persecution of labor sympathizers in the McCarthy era, has all but erased from public memory the very “vast and compelling” art surrounding the labor movements, he says.

And lastly — Manual Labor

Ending on an upbeat note (pun intended), join me for some manual labor, aka dancing, each of the next 3 thursdays, at the Root Down party at the Little Temple in the silverlake area of Los Angeles. I’ve got each of the next 3 fridays off and I’m working each of the next weekends, so it’s party time each thursday night, and this party/movement is where it’s at.

(cross-posted at To the Teeth)

Natalie Dee is fantabulous, check out her daily cartoons, they make me very happy. I have to share her latest, aptly entitled “all they do is hang around and make pee” — and give a shoutout to my friend Pooja who’ll be doing 3 years of pediatric nephrology after her 3 years of pediatrics training. Maybe she can make this set of kidneys a little more excited about life :>

In my next 2 weeks of my family medicine residency program, I’ll be working at and learning from various community health projects in LA. These are two weeks that other residents tell me are grounding — they awaken us sleepy/agitated/tired/hospital-based first year residents to the community health work around us and inspire us again — THIS is why i went into family medicine, or THIS is community health!

I’ll be going to prison clinics, job corps, a clinic at a high school for pregnant teens (started by one of the faculty members when she was a resident!), and a tattoo-removal clinic — started by one of the former Harbor-UCLA family med residents, in collaboration with Father Greg Boyle and his organization Homeboy Industries, who have been working with former gang-members (with tattoos on their faces and other exposed areas) to help them back into society and into the workforce.

I’m not sure if it’s because i’m rested after a vacation, or because i’m ready for something other than the hospital right now, but i’m pumped about this rotation. On one of the afternoons, I’m going to have to talk to high school kids at one of the local schools about a health-related topic, and I’ve already been thinking about incorporating music into my session, for so many reasons (music is great at breaking the ice, connecting with youth, and helping to convey messages). And really, I just wanna be down with the kids :>

So I was elated when I read about ‘musical cues’. Andy Hilbert is a teacher in Los Angeles who runs a blog where he discusses education, the Los Angeles Unified School District, and teaching, from his perspective — as an 8th grade teacher and chair of the Carson area United Teachers of LA. He’s experimenting with musical cues in the classroom:

On my first attempt I opened the class with a question, “What is a musical cue?”
Usually there was little response.

So, I continued. “What if I could play a sound or a tone or a piece of music and everyone in the class would instantly know what to do? Well that would be a musical cue.”

The class seemed perplexed yet curious.

“I think musical cues work. I’ll play a note or sound or song and everyone will know what to do and start doing it. It works. You’ll see. Let’s try it.”

I walked slowly to the CD player and pushed play on track nine for the song “Hey ya” from which I had lifted the “shake it, shake it, like a Polaroid picture” lyrics. Once my students heard the song, they burst into exclamations of recognition, started singing, smiling, and taking out 8½ by 11 pieces of paper and folding them into word charts. I illuminated the definitions on the screen and everyone started copying the definitions as the song continued to play. When the song finished, the class was in a trance. They could not be bothered. They wanted to complete the word charts quietly by themselves without my instruction. I didn’t have to issue a single instruction, let alone repeat one twenty times. It even took me a little while to bring them back from absolute silence, but I slowly managed to engage the class in discussion about the words.

Now I just have to think of appropriate tunes to cue transitions into group work, silent reading, and clean up time. Hey maybe I can turn my students on to Neil Young, Bob Dylan, Ben Harper, and Victoria Williams. I better not push it; this is supposed to be a job.

Check out the rest of his blog, Horsesense and Nonsense. He’s pretty passionate about his classes *and* about Los Angeles politics and education. Rock on.

(cross posted at To the Teeth)

I’m still quite embarassed at my spanish language skills these days. I’m finding myself confused by the tenses and using the present tense way too often. Working at an LA county hospital affords me the opportunity to work with many spanish-only speaking patients — in the clinic, in the hospital — and I’ve improved my Spanish immensely in the past few months. There’s really nothing like immersion. But i’m just not nearly where I need to be. I used to be a pro — I took 4 years of Spanish in high school and I was a conjugation and vocabulary rockstar, and a pronunciation queen. Then… I forgot everything. And now… it’s coming back to me, but muy despacio.

Yesterday, I met a friend at a bookstore before we grabbed some dinner. I hunted down the Spanish language section, on a mission to find THE BOOK that would help me. Spanish for travelers? No. Spanish for lovers? Hmm, perhaps in the future, but not right now. Latino Slang for Gringos? what’s this? here’s a description:

“ Learn Spanish Slang Now – You Can Use Our
Exclusive Latino Slang 4 Gringos to Understand
What Others Are Saying About You. . .
And Stop Feeling Powerless At The Office,
The Mall Or While On Vacations! ”

I’ll hold off on that item for now. Still lookin’….various spanish-english dictionaries of various mid-range pocket-fitting sizes. Do I want a dictionary? maybe. Do i want a 42,000 word one or a 100,000 word one that would take up my whole pocket? 42,000 words seems like it would be enough for me, really. Oh forget it, maybe i’ll get a dictionary for my PDA instead of stuffing my pockets so much I can’t close my white coat. What i’m looking for right now is a mastery of conjugation, not how to say “pencil sharpener” in spanish (try fitting “sacapuntas” in a conversation with a patient. Let me tell you, I’ve tried. You’ve gotta show you know some spanish, even if it’s “your leg looks like it was eaten by a pencil sharpener. le duele?”)

The various Spanish tenses are way back in the depths of my brain, and sometimes I recall them from my high school days. But the fact of the matter is, I only really have present-tense confidence right now: I’m still past tense shy, present progressive tense anxious and preterit tense scared-out-of-my-mind. I’m tired of using the present tense for everything:

Like: How much does that hurt you yesterday?
Or: I am going to will be in the future drew your blood in 5 minutes.

(ok really i’m not THAT bad). Well, my broken spanish gets me by, but would I want a doctor who talks like that? So anyway…still looking… looking for the right book for me. Thoughts go through my head as I pan my eyes over the rows and rows of Spanish learning tools. Wow, what a great industry, I think to myself. Books, dictionaries, audio CDs to distract you while driving, slang dictionaries, nicely dressed up and durable multi-colored plastic binding travel guides, etc. I even saw a Panjabi audio CD selling here — I can’t even imagine trying to learn Panjabi while driving in my car.

Oh wait, what’s this?!? Complete Medical Spanish! Sweet! WITH tense explanations, vocabulary, AND only 280 small pages. Now I can add to my wealth of medical terminology…

‘Doctora, tengo una enterrada’ = ‘I have an ingrown nail, Doc’

…while learning conjugations again :> Rodillas, pulmones, corazon, picazon, comezon, bring it on!

So here I go, my friends. I bought the book. And it’s so cute, the authors have thrown in cultural references to go with the grammar and vocabulary. I’m hoping they don’t stereotype and make me cringe, but so far so good (as of page 2):

“One should shake hands with everyone to avoid being seen as extremely rude, cold, and uncaring. An even more kind, caring, and warm gesture is to cup your left hand over the hand you are shaking which conveys the feeling of trust (confianza). It is a quite comforting action seen from the Latin American point of view, and it tends to communicate the feeling that “You are in good hands now.” It does not transmit the trite or paternalistic attitude that may be interpreted by U.S. Americans.”

Sounds like a great way to shake hands with everyone, latino or not, paternalistic or not :> Mucho gusto, ‘Complete Medical Spanish’. We’re off to a good start.

(cross-posted at To the Teeth)