I wanted to explore the definition of health, because although this seems like something a kindergarten student would know, its actually not as simple as we seem to think it is. It seems like a lot of people think that being healthy is to have no physical illness or medical condition. However, the World Health Organization has defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (1). This is how I have begun to see health, and I hope to show you why. I view health as a multi-factorial state. I believe that many things fall under health, such as physical health, emotional and mental well being, social well being, and quality of life. These factors are not independent, rather they are extremely dynamic and can influence each other – which is why they are all extremely important. I think that the health care community can and should always address all aspects of a patient’s health and not just their physical health.
I have personally experienced the complex interactions of my own health. I suffer from moderate-to-severe chronic eczema. I have had it for over 4 years without any “remission”, and it can vary from a small patch on my arm to covering the entire back of my legs, arms and back (about 15-20% of my body). My flares worsen with stress, such as during exam time in college or before medical school interviews. My flares have also made me self conscious for situations where my eczema is fully visible to other people, such as in the summer when it’s too hot to wear long sleeves and pants. Its a tough cycle to control, and I am still trying to figure out all the things that make my eczema better or worse. So far, I found that exercise, a healthy diet, and stress reduction practices really influence (but not totally prevent) my flares.
I love sharing stories about different topics, but I also think it is important to dive into more concrete examples of how different facets of health intersect. One area where this has been shown is in cardiovascular disease. Research has shown that patients with coronary heart disease that are also depressed are more likely to have major cardiovascular events such as heart attacks and strokes (2). It is suggested that this is because depressed patients are less physically active (2). Stress levels and social support in the work place has been shown to increase the risk of cardiovascular disease (3). And heart attacks have been linked to a significantly lower quality of life even years after they occur (4). Although these are very specific associations that have been found, I think they provide examples supporting how different facets of health influence each other.
In the future, I hope to be able to address all of these subcategories of health for my patients. Although physical health is the main area that physicians focus on, I believe they should be aware of their patient’s emotional, mental and social health as well. I think that this focus on the entire health of a patient could be extremely influential for a lot of different conditions, and particularly chronic conditions.
When I look back on this year, I see it in distinct snapshots. Some of these memories are extremely happy, others are rather somber, but most reflect the amount of growth that this year has brought about. This year has given me new friends, a new family. It made me both confident and insecure. It would be impossible for me to explain this year in a blog post. Instead, I would like to share some of those snapshots with you.
I have many extremely positive and joyful memories from this year, both within and outside the halls of the hospital. There were lots of summer festivals where I was able to explore my new city: the little Italy festival, Asian night market, and even a garlic festival (haha I loved that one!). I can smell the 12 pounds of baked ziti that my roommate pulled out of the oven for our friendsgiving dinner in November. There was the 20 some hours spent with friends snuggled in my family room as we watched all 8 Harry Potter movies straight in a row. There were weekends spent hiking, biking, boating, and exploring my new home state of Ohio. And probably my proudest moment outside of the hospital this year was completing in my first half marathon! Within the hospital, there are memories of bonding during orientation week. There was the first time I shook a patient’s hand in my white coat. The time when I finally was able to navigate the series of hallways within the hospital so I could get from school to my car without getting caught in the rain. I can still hear the quick clear heartbeat of the few week old infant as I held my stethoscope up to her tiny chest, and the time I was able to comfort a crying patient without feeling helpless. This past year was full of sparkly bright memories that won’t fade for a long time.
There were also many uncomfortable moments that made me think, made me stronger. There were the interview questions where I wasn’t sure if the patient or myself was more uncomfortable. There was the first day in anatomy where the bodies were cold but the blood still oozed (my program uses fresh rather than preserved bodies – a distinction that wasn’t entirely clear to me until after that first day in anatomy). There were the painted fingernails, the scruffy beards, and the hair scrunchies in anatomy that always snapped me away from the edge of frightening comfortability. The biggest darkest memory from last year however was my first direct encounter of mortality. I shadowed in the trauma ER for a short 4 hour shift. I knew it was possible to see a trauma within that time period, but I don’t think I processed that going into the shadowing opportunity. Within an hour of being there, the trauma pagers were going off. I was set up to observe the incoming trauma right inside the room, against the wall and off to the side, but still very much in the room. The man came broken in as many ways as one could image. I watched for almost 2 hours as the team worked together to try to save the man. Unfortunately, he did not make it. I really wasn’t able to process what I saw that day. It was heart wrenching, but I was also inspired by the trauma team. The way they worked together, the way they made decisions and worked tirelessly for this man was inspirational. Seeing death occur for the first time and having both extremely negative and positive emotions left me confused and uncomfortable. I think I sort of just saved that memory to process later rather than really think through it in the moment.
The highs and the lows pushed me to adapt, and some of those highs were a result of my growth. Sometime in the fall I realized I needed to change the way I balanced my life. I was used to undergraduate school where you had your assignments and you could check off what you finished. What I realized though was that in medical school, the check list wasn’t a finite list of seven things you had to do. Rather it was of things you had to understand, and it’s up to your judgment to decide when you know it well enough. Because of this, I had to learn what my limits were, what I wanted to know. I had to adapt how I worked and how I decided I was ‘finished’ with my ‘check list’. Most importantly, I learned how easy it was to get consumed with studies, yet how important it was to maintain a life outside of medicine. If I was to talk to a stranger and tell them who I am, it would be so easy to just say I’m a medical student, but that is not what I want. It is important to me to maintain a balance of my passions, because medicine is just one of them and I don’t want to lose the others.
Overall, I loved my first year of medical school. I learned a lot but I also had a lot of fun and tried new things. I pushed myself out of my comfort zone (think mountain biking and half marathons ) but I balanced it with some home comfort (Harry potter marathons and roommate movie nights). I look back with a smile and I’m excited to move ahead into second year.
Hey there! My name is Caroline Franke and I am a second year medical student! I am starting this blog so that I can document my journey of learning about health and wellness. To me, health is so much more than the absence of disease – it is overall human wellness. This includes physical health, mental health, social health, and emotional health. Health can be discussed on an individual level, a group level, and a global level. My passion is focused on nutrition, mental health, and fitness. I will also this blog to share some of my experiences as a medical student.
A little more about me: I am a huge sport lover. I particularly love basketball, football, and lacrosse. I played D1 lacrosse for four years in college, and I loved every second of it (my teammates were the absolute best). I no longer play lacrosse, but I have found long distance running as my new fitness outlet. I am also a huge lover of dogs and babies. Kids make me so happy, probably because I’m still a huge kid at heart!
Stay tuned for more posts in the near future! Feel free to follow me on instagram @beingfranke
Hi! My name is Caroline Franke and I am a second year medical student in North East Ohio. I love cooking, running, and playing with dogs and kids. I am on a mission to learn as much as I can about nutrition, mental health, and physical well being. Feel free to join along as I try to navigate the world of wellness.
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