Kiva- A Nobel Idea to end Poverty

I just made a loan to someone in the developing world using a revolutionary new website called Kiva. Kiva is a system based on that developed by Muhammad Yunus, who just won the Nobel Peace Prize.

You can go to Kiva's website and lend to someone in the developing world who needs a loan for their business - like raising goats, selling vegetables at market or making bricks. Each loan has a picture of the entrepreneur, a description of their business and how they plan to use the loan so you know exactly how your money is being spent - and you get updates letting you know how the business is going.

The best part is, when the entrepreneur pays back their loan you get your money back - and Kiva's loans are managed by microfinance institutions on the ground who have a lot of experience doing this, so you can trust that your money is being handled responsibly.

I just made a loan to an entrepreneur named José Solórzano in Ecuador.

It's finally easy to actually do something about poverty - using Kiva I know exactly who my money is loaned to and what they're using it for. And most of all, I know that I'm helping them build a sustainable business that will provide income to feed, clothe, house and educate their family long after my loan is paid back.

Join me in changing the world - one loan at a time at www.kiva.org

Get Fast Food out of Hospitals

As a family doctor, one of my primary duties is to prevent my patients from suffering heart disease and cancer. I spend a lot of time counseling my patients to eat a healthy diet. I tell them to eat lots of fruits and vegetables, whole grains, and to limit sweets, soda, bad fats, and refined carbohydrates.

But then my patients walk through one of my affiliated hospitals, Tufts-New England Medical Center. There they can purchase a Dunkaccino with 11 grams of bad fat at Dunkin Donuts. Then they can head over to Pizza Hut and get pizza with 1240 milligrams of sodium. They can finish off with a Carrot Nut Muffin with 38 grams of sugar from Au Bon Pain. They can eat all of these without ever stepping foot outside the hospital.

I recently conducted a study with the American Medical Student Association, which looked at the prevalence of brand named fast food at academic-affiliated hospitals. The research, published in this month’s Journal of the American Board of Family Medicine (www.jabfm.org) reported that of the 234 hospitals surveyed, 42 percent were selling brand-name fast food on their campuses. These included Krispy Crème, Subway, McDonald’s, and Burger Kings.

But, brand named fast food is not the only problem. If you visit the Harvard hospitals in the Longwood area you can pick up a cheeseburger, fries, and soda. A few years ago, I worked at Children’s Hospital (which has one of the healthiest cafeterias). I wondered how the obese children would fare after we told them sugary drinks are bad, and then saw our cafeteria serving soda.

Hospitals should be promoting a healthy safe eating environment for the communities they serve. The food served should be representative of national dietary recommendations. Hospitals should help educate patients as to what a healthy dietary menu looks like. The best way they can do this is by setting a good example.

The first thing hospitals could do to take the lead would be to provide nutrition information that is easily available. The menu boards that show the price should also show the number of calories and/or amount of bad fats. For instance: Chocolate Frosted Donut, 200 cal, 9g Bad Fat, $0.59. Second, hospitals should make sure that food has no deadly hydrogenated oils.

The hospitals should then look at the food offerings as a whole. If the whole menu was analyzed by food group, would it adhere to national guidelines? Is the majority of the menu whole grains, fruits, and vegetables? If not, hospitals should pressure the food vendors to adopt their menu to be healthy. There is no problem with Dunkin Donuts offering their coffee to fatigued doctors, but why can’t we tell them to sell their donuts somewhere else?

If these franchises or cafeterias cannot change, they should be asked to leave the facility and contracts should end. With the large problem of poor nutrition, someone has to push for change. Hospitals not only have the power to control what food is served, they have the responsibility. Their mission is to improve health. They receive millions of dollars from Medicare to treat people with high blood pressure, high cholesterol, diabetes, and heart disease. Yet they also help create these problems by serving some of the very food that causes these conditions.

The medical profession needs to start practicing what it is preaching. Let’s put words to action and create healthy hospitals which educate patients on a healthy diet inside and outside the examination room.

For more information see: www.amsa.org/cph/healthyhospitals.cfm.

Interns.... Don't be Ants

I can tell already that internship is going to be a bit tough. It's mainly the hours and the increase in responsibility I have for my patients. I was talking to my fellow interns and a lot of us are going through the same struggles in first weeks. Are we really helping our patients? Do we look stupid? Why can't I figure out how to prescribe GasX? The little things can really get you down and wondering.... what the hell am I doing?

I had a chance to see Dave Matthews Band at Fenway park on Friday night. It was a great show in a historic place. His closer was Ants Marching. As he sang, "Take these chances. Place them in a box until a quiter time. Lights down, you up and die," I thought of one of the babies I delivered this week. A first mom, with a new beautiful baby boy. As we put her new baby into her arms, she was crying out of happiness. It was such a great moment with so much joy going around the room.

It's times like these we have cherish during residency. Or else we will just be Ants Marching.... "always doing the same thing."

P.S. There is no reason to shout "Yankees Suck" at a Dave Concert. It's just dumb. I'm a huge Cornell Hockey Fan and love shouting Harvard Sucks, but I wouldn't do it if Dave came and played in historic Lynah Rink. I was trying to like the Red Sox, but it's so hard. Life is not a continuous baseball game.

Trust me I'm a Doctor

After 9 years of post-high school education, I've finally got my MD. It's exciting right now, but I will quickly become humbled when my first patient asks me a question I don't know. But questions are something I like and are ultimately only good. Every time a patient asks me something, I will be pushed to learn more to provide the best care for my patients.

As you can tell by my blog's title, I like to ask questions too. A lot of this came from my undergraduate education in nutrition at Cornell! where we were trained to analyze nutrition research carefully. We learned how to ask questions that develop research to figure out the "truth". To be in medicine, I think you have to be comfortable with questions, as research and policies are always changing with new information.

I questioned a lot of things in medical school: from antibiotics to nutrition policy to evidence based care to changing our health insurance system. I often felt like Patch Adams in medical school, in a sense I was always questioning to make things better. I think my questions and drive for change were often met with encouragement. But, there were many times I got the response Patch got, with resistance from those who don't want change. I'm excited now that I'm further on the path to making my own ideas into reality on how to help to have healthy happy lives.

I want to thank all my friends and family for supporting me on my road to becoming a doctor. I could not have done it without all of you. I'm hoping you will keep me sane as I go through the next stage of my training.

Listen to Elie

Elie Wiesel on the Darfur, Sudan:
It was a direct or indirect consequence of a millennium lecture I had given in the White House on the subject, “The Perils of Indifference”. After I concluded, a woman in the audience rose and said: “I am from Rwanda.” She asked me how I could explain the international community’s indifference to the Rwandan massacres. I turned to the President who sat at my right and said: “Mr. President, you better answer this question. You know as well as we do that the Rwanda tragedy, which cost from 600,000 to 800,000 victims, innocent men, women and children, could have been averted. Why wasn’t it?” His answer was honest and sincere: “It is true, that tragedy could have been averted. That’s why I went there to apologize in my personal name and in the name of the American people. But I promise you: it will not happen again.”

That brutal tragedy is still continuing, now in Sudan’s Darfur region. Now its horrors are shown on television screens and on front pages of influential publications....A million human beings, young and old, have been uprooted, deported. Scores of women are being raped every day, children are dying of disease hunger and violence.

“Lo taamod al dam réakha” is a Biblical commandment. “Thou shall not stand idly by the shedding of the blood of thy fellow man.”

Should the Sudanese victims feel abandoned and neglected, it would be our fault – and perhaps our guilt.
That’s why we must intervene.

If we do, they and their children will be grateful for us. As will be, through them, our own.

Save Darfur.org

Munich and Terrorism

I've been meaning to write for awhile about my thoughts on the movie, "Munich". I thought it was an excellent film and very powerful.
Watching the film, I started to agree with its thesis: Killing terrorists for revenge or for deterrence does not really work. There are always more to fill their gap.
I definitely agree with the revenge issue, as I have been adamantly against the death penalty for many years. I just don't think civil human beings should kill another to prove they are more civilized.
But what about killing terrorists to prevent a terrorist attack? What if they are a direct threat? I think it is easier to argue to kill another individual if they are directly about to kill you. For instance, shooting a person who is about to blow up a bomb. But, in today's world a lot of the threats are more theoretical. Should we kill Osama? Will it really make a difference to KILL him? I definitely believe we should catch him and put him on trial, and if guilty (yes he will be) put him away for ever. And he won't allow us to capture him, I guess we have no choice. But should our goal be to kill all terrorist leaders? According to the premise of the film Munich, they will just be repopulated by new terrorists. We'd end up having to kill a lot of people.
I've always believed we have to fight the root causes of terrorism and hate, which I believe are poverty and lack of freedom.
But should we kill everyone? As I was thinking about this, I read a great quote from Sogyal Rinpoche: "...the natural karmic logic that taking the life of others or harming them will shorten your life, and giving life will lengthen it." As long as we follow the noble path, we will be rewarded, even if it is not in this lifetime.
The balance is just hard to find sometimes.

Becoming a Republican

Funny.
Sad.
Much of it true of the current Republican Leadership.
BECOME REPUBLICAN