Sunday, July 18, 2010

Camp Angel Summer 2010

Wow, looking over this blog, I can see that I have not been writing much. This is not because nothing's happening. Rather, it is the opposite. I will try to do better. Well, July 9 through 11, I was at the summer Camp Angel. To learn more about Camp Angel, visit their website:

Like last year, this camp was held near Three Rivers in northern Wisconsin at Camp Luther ( . Camp Luther is a beautiful facility with several different kinds of camp buildings for the kids: a fort, a tower, an Ark and other wooden, fun architectures that make an adventure out of staying there.

This year there were 24 children, an equal number of boys and girls. As with each year, they were divided into groups according to ages. The 8 and 9 year old girls were called the Bunnies, the 8 and 9 year old boys, the Bears, the 10 through 12 year old girls the Foxes and the 10 through 12 year old boys the Wolves. Each group had 2 to 3 counselors. Every year the groups do fun things with their names like 'the Foxy Ladies' and the boys shouting, "Who Rocks? THE BEARS!"

When the kids get off the bus, one tends to see... kids. But if one sits down and reads their application forms, one sees the heartbreaking stories behind them. One of the children lost his dad to cancer only in April. Others have lost a mom or grandparent. Others have a sibling with cancer. What does this do to a kid? We had one little girl on 2 sleeping pills, something to prevent her wetting her bed and something for acidity. Those of us administering the medications shook our heads in increduility and dismay even as this 8 year old pointed to each tablet and told us why she had to take it. A number of kids were on antacids, ADHD medication or something for chronic headaches. Processing the stress of a close family member with cancer can code in their little bodies as psychosomatic illnesses, behavioral problems or actual physical ailments.

One little girl got off the bus and was brought straight to me: "She threw up the whole way here!" She had a headache and did not feel good. I took her to the medical room and encouraged fluids.

That evening, we had a scavenger hunt with the kids having to find things like a bronze bowling pin, a particular kind of feather, eggs and other items skillfully hidden on the grounds by their counselors. As happens every year, the Northern Wisconsin Harley Davidson group drove in revving up their motors to make a grand entrance. The kids gazed wide-eyed at the shiny motorbikes. Several took pictures sitting on one or more of the bikes. I held onto one 11 year old who had just been dropped off by his parents. He didn't feel like being there and was teary eyed as his family drove away with the admonition: have fun!

The next day was our main day on camp. After a good breakfast, buses of us set out for Three Rivers and Duck Lake, where Captain Steven and his son Steve-O had a pirate ship ready and waiting for us ( Before that however, I made a quick trip into town to pick up some anti-nausea medication for a few kids who, it turned out, had motion sickness. I also stocked up on hydrocortisone for bug bites, Aloe with some lidocaine for bad sunburns and some children's peptobismol. During the pirate ship adventure, most of the kids had fun. Captain Steve showed us a bald eagle's nest with a couple of birds in it. With pirate songs playing in the background ("My name is Roger, and my favorite letter is 'ARRRRHH"), we blew bubbles, and colored white T-shirts with pirate-themed pictures. Counselors and myself looked out for kids that seemed to take themselves out of the fun because of depression or sickness and helped.

In the afternoon after lunch which was a yummy cookout, we all got into the water. Kids jumped off the pier, swung on a rope for a splashy landing in the water, rode on tubes pulled by jet skis and motorboats and went fishing. We had a few sunburns, scrapes and and nausea but nothing major. I stayed in the water and helped kids on and off the tubes. I smiled at one group of 3 8-year olds who had never been tubing and wanted to try it for the first time. As the motorboat pulled them across the lake, I could see the waves and wind cause the tube to skip and bob on the water, causing their little bodies to bounce, and they held on with two hands to little handles on the tubes. When the tube came to shore, their faces were white and eyes wide. They broke into smiles and pleaded "can we go again?" One little girl went 5 times.

Kids took breaks to get their hair braided, face painted, play shuffleboard or paint souvenir rocks to take home.

After cleaning up, we gathered outdoors for DJ Dan and his music. We got almost everyone out on the floor to dance. It was a fun evening. After that, the campers went back to their camps for s'mores, a bonfire and whatever late night activities naughty campers do.

The next morning, after a breakfast, everyone got back on the bus to go home. There were lots of hugs, smiles and some sweet sadness of saying goodbyes.

Camp Angel is magic for these children. For a few days, they get to forget the solemnity of death, hospitals and sickness. They get to be kids. As a camp medical careprovider, I have learned to balance giving attention to illness, treating what needs treatment and otherwise distracting kids from their illness with some magical results. The camps have taught me that sometimes, distraction is much better than a pain reliever or stomach medicine and sometimes validation of a need is more important than treating it with something.

Kids are magic and seeing them have fun is rejuvenating for those of us adults who were there. I got my Camp Angel rock as a souvenir. Mine has a rocket ship on it. Well, I did have a blast!

Sunday, July 04, 2010

MUA - where I went to medical school

I get a fair amount of queries on Facebook and such about MUA -- the Medical University of the Americas and what my experience there was. Many inquirers want to know if the school is 'real' and whether they can succeed and get into residency in the United States or Canada after graduating from there. After writing individual replies (typed these days, painfully, on an iTouch) I decided it might be best to post this and send inquirers a link. I still try to reply with a personal message to each one, but so many people ask so many of the same questions, this just makes sense.

If memory serves me right, I joined MUA in January 2001. The school was (I think) in its second semester on the island. I had flown down to the island to visit several month before when the classrooms were still being constructed, the pool was a hole in the ground, the library building did not exist yet and there were no students. It was scary and I was not sure if I was doing the right thing.

I graduated from MUA in 2005 and began residency that same year. For the two and half years I was on Nevis, I bought took all my classes and taught biochemistry (this is why it took me a little longer to complete the Basic Sciences curriculum).

Okay, so here's the big picture... the things that really matter. MUA graduates have got into many different residency programs -- community to university-based programs in competitive specialties like neurosurgery, radiology emergency medicine, general surgery and practically every available type of residency program. Many were chief residents of their program in their final years. Many have gone on to do subspecialty training in fields like cardiology, endocrinology, nephrology, critical care, oncology and subspecialties in anesthesia like interventional pain management. This is only based on the people I know personally.

Bottom-line: the school delivers. We are proof of that.

Second-years have to do the United States Medical Licensing Exam Step1. There are 2 additional steps. I personlly know MUA students who have gotten in the 97 to 99 percentiles in these exams. These are very good scores.

Caribbean medical schools come in many shapes and sizes and degrees of credibility. I cannot authoritatively comment on any of them except the school I went to. In MUA's case, I can vouch for the school as a product of it who is a licensed physician in internal medicine and pediatrics and a clinical professor of these specialties with the University of Wisconsin.

Because the standards for getting into the schools in the Caribbean are not the same as those in the States, a number of students will get in that will never graduate. Some will never finish the Basic Sciences. Others will complete their time on the island but not pass the USMLE exam(s). Still others will graduate and never get into residency. I think this is because not everyone who gets into medical school is there for the right reasons. Some are there to please their parents and are trying to fulfill their ambitions. Others think that it would be really 'cool' to be a doctor, but have not sat down and counted the cost. Others have underestimated the sacrifice, hard work and years of training it takes to succeed.

Life as a caribbean medical school student is hard. Some people have a prejudice against caribean medical school students and graduates, thinking they are second-rate because they did not get into a U.S. (or Canadian) school. The interesting thing is that once you're in the hospital (third and fourth years), most people evaluate you by your performance and not your label. The Basic Sciences Dean at the time of my graduation from the island gave us this advice:

1. Be the first to arrive and the last to leave
2. Volunteer for everything ('who wants to look this up? Who want to try to start this IV?)
3. Own your patient (know their labs, their care plan, read on their diagnosis, evaluation and management).

I took this advice and did great. It was an honor to be a Chief Resident, to win an award for the Best resident teacher -- an award given by U.S. medical school graduates who were in training in my institute, and to be asked to join the faculty of our residency upon graduation from our program. I owe my school for these opportunities. MUA took me a student and gave me the instruction in the basic sciences, placed me in my third and fourth year clinicals, wrote my Dean's letter, gave me my degree and enabled me to get into residency and get licensed to practice medicine. What more can a school do?

The rest is up to you.