Dragon Fighting



After having been a princess all my life, I decided to take up sword-fighting! Or, more precisely, Historical European Martial Arts (HEMA).

Did you know that this was a thing? There are currently thousands of people around the world who have taken to reviving the art of historical fencing, using the manuals left by the masters of the 14th and 15th centuries. The modern iteration of the art is a couple of decades old, and people are starting to become quite decent at it. There are groups practicing in just about every major city. Our group in Reno meets twice a week.

Now, why would a doctor be interested in wielding a sword? For me it’s because, at its core, sword-fighting is a mind game. Mind games are ideally won by smarty-pants like doctors.

I’ve been at this for about six months. Previously, I’d watched my husband pursuing the art for the whole nine years I’ve known him. He’s taught groups in Reno and Vegas, practiced with others all over the west coast, and even trained in Scotland for a year. I had been dragged to practice occasionally, but I was never really interested in swords before… I don’t know, I guess I don’t have a tolerance for standing around holding a sword while someone explains stuff for several minutes at a time. My idea of a workout is sprinting on a treadmill while listening to lectures or memorizing flashcards—a doctor’s got to use her time effectively.

But that all changed when my husband came to a deep understanding of the art and revamped his curriculum for beginning students. All of a sudden I had a really good teacher, and as I started to study, I realized that the same skills I’d picked up in medical school applied to fencing.

Contrary to what movies would have you believe, sword-fighting is much more sophisticated than whacking people with a stick of metal. It boils down to the intellectual task of understanding the principles of Physics and Geometry. (Sound familiar? It’s the same reason that I chose Radiology as a career.) To successfully implement these principles, one must not only train the body, but must also train the mind. It’s a matter of critical reasoning, of correctly assessing the situation and remembering the algorithm for the best response, and especially of doing all of this faster than the opponent. As an intern in Internal Medicine right now, “critical reasoning” and “algorithms” just about sum up what I do in the hospital every day! And as more and more people figure this out and incorporate the thinking game into their HEMA practice, the art will only become more intriguing.

Plus, swords are really photogenic.





As many of you know, last week I graduated from medical school AND officially released my book, Tales of an Ugly Docling. The book is a collection of stories and essays about my experiences working as a medical student in clinical settings, much like the posts I make on my blog. All of the proceeds from sales of physical copies of the book will be donated to medical charities worldwide.

The Kindle version of the book is currently FREE on Amazon (from 5/20 to 5/24)! I am doing this as a “graduation gift” from me to all of you! Please take advantage of this promotion: download the book, rate it, review it, and spread the word!

Also to promote my book, I have a new WordPress site and blog at http://www.uglydocling.com. In the future, I will be posting my medical stories in the new Ugly Docling blog, and I will repurpose Nervous Impulses for things I do outside of medicine, such as traveling, cooking, photography, and music. I encourage you to follow my new blog to continue reading about my adventures in residency and beyond.

I want to thank everyone who has followed me through my journey in medical school over the past four years. The thoughtful feedback and support have really pushed me to continue writing, and the whole experience has made medicine so much more meaningful for me! Let’s have many more adventures together in the coming years!

I’ve decided that every week between now and when I start working as an intern in July, I’m going to try something I’ve never tried before. With graduation on the way and having completed both my clinical rotations and my book, I haven’t been writing a lot about medicine lately. And that clears up a whole ton of time to take on new hobbies! Not the least of my reasons for doing this is that I really, deeply believe in constantly showing myself new facets of life that I suck at.

Two weeks ago, I went snorkeling in Puerto Rico. When we signed up for this, I clarified with my husband, “So in cartoons, when they sneak around underwater and look out through a tube… is that what snorkeling is?” I’ve always been a terrible swimmer, so naturally, I have the floaties to thank for my life.

Last week, I broke out my new camera and made my debut in portrait photography. Not only do I now totally understand why people keep taking unflattering photos of me, but I can also now take my revenge. (Shown here are my husband in his historical fencing gear, my sister before Prom, and my other sister with her date.)



This week, I took up golfing. It is pretty much obligatory for a doctor to play golf, and my family consists entirely of competitive golfers. On day 1, my average drive was an impressive 10 yards. On day 2, my average drive increased to 100 yards. I was SUPER excited for day 3, but I’m sorry to say I did not average 1000 yards.

Of course, now I’m looking for other fun things to add to my list! I will consider all plausible suggestions that comply with my moral standards. =]

Ugly Docling cover copy


Tales of an Ugly Docling, my book of essays about medical school, will be officially released on May 16th (2 weeks from today)! The Artist in Residence program, which funded the materials for the project, will be hosting an artist reception/book signing that day 4-6pm at Sierra Arts in Reno, Nevada.

Not in the Reno area? Most of my readers aren’t, but you guys have really been a huge support in making this happen. So for you, I will be releasing my book on Kindle FREE for the first week! Just as a way of saying thanks for being awesome.

(Note that 100% of the proceeds of the book will be donated to medical charities worldwide, so more people will benefit if you also order a physical copy through my website,www.uglydocling.com)

Ugly Docling cover copy

An update on my upcoming book… Here is my first draft of the cover! I made it with a combination of pencil drawing, scanning, Paint, XnView, and Photoshop (on a Mac and a PC). I’m not too much of an artist, and I’m kind of indecisive about the kerning aspect, so feel free to give me any feedback on how to make this better!

I wondered for a whole year what I was going to title my book, and suddenly, “The Ugly Docling” came to mind. I think it’s fitting on many levels.

For one, the Ugly Duckling is the story of a nerd kid who grows up to be a doctor (or engineer, or astronaut, or member of any profession that draws from the smart kid pool.)

I’ve been a misfit since elementary school. First it was because I was an immigrant, had an odd name, wore different clothes, and didn’t speak the language. But even after I grew accustomed to American culture, I still struggled with being a nerd. I tried so often to dumb myself down so I could be accepted by other kids. I wanted people to know that I was a musician, a poet, and a tennis player, but I would be mortified if anyone found out that I was in MathCounts or Academic Olympics. And though I spent way too much time trying, I never had nice hair. For me, this one was tough; high school is all about the hair.

Fast forward to medical school: Everybody is a smartypants. Everybody is charismatic. Everybody has nice hair. Well, almost. When we tell people that we are going to be doctors, they react with kind words of admiration, appreciation, and respect. (And then they show us skin lesions for diagnosis.) Yet, when I found my old MathCounts roster and pointed out that a couple of my classmates were on it, they were mortified. It really is bittersweet to look back on those years. But hey, let’s face it: doctors don’t just pop out of thin air; they were Mathletes when they were little! Nobody makes fun of a doctor. So why are American kids taught to make fun of nerds? I consider this book to be a big hug for my young self—and for nerd kids everywhere. Nerd kids: It gets better!

But my personal Ugly Duckling story continued even after I met up with the other swans in medical school.

Perhaps because of our common unspoken background as nerds, the culture in medical school is reversed. We admire and compliment each other for knowing the right answer at the right time. We fear being laughed at when we act ignorant or incompetent. Some may brag about how they never study, but they are either lying or willfully endangering lives and mocking the practice of medicine, and the rest of us know in our hearts that we would never refer our own patients to those individuals.

It was in this culture that I realized I may still be a misfit. Yes, of course I have studied my tail off, and of course I want other students to think of me as being a stellar student. But to the degree that I still have gaps in my knowledge, I question my doctoring skills. When I get an answer wrong, I question if all my classmates are smarter than me, if I can be a good doctor, if other doctors will want to refer their patients to me. For the first couple of years, I focused so much on test scores as measures of my doctoring skills. But then, when the exams were over and I was thrown into the real world of hospitals and clinics, I was humbled to learn so many things that were never taught in the medical classroom. These are the things that I felt moved to write about.

I’m ready to let the word out that I am publishing a book this year, thanks to the Artist in Residence program*. The book will be a collection of essays that document the adventures and insights of a medical student, much like the posts I make on G+ and my blog. As part of the graduation festivities, there will be an art show at the Sierra Arts Gallery in Reno on May 16th, where I will have my reading and book signing event. The proceeds of this event will be donated to medical charities locally and world-wide.

Right now I am in need of suggestions for medical charities to benefit. I have been a long-time fan of Doctors Without Borders, and recently heard about Child’s Play (which provides toys to children’s hospitals around the country). I also want to recognize my readers by letting them suggest any medically-related charitable organizations or causes that are close to their hearts. Please post any suggestions in the comments, and include an explanation of why the charity is important to you.

Please feel free to spread the word! I’m very excited about this project, and hope that my messages (and the funds they generate) will reach many people in need.

*The Artist in Residence program is a collaboration of the University of Nevada School of Medicine, Sierra Arts Gallery, and the Healing Arts Foundation at Renown Hospital. Every year, they give awards to graduating medical students for pursuing artistic endeavors related to medicine. It is funded by generous donors in the Reno community.

Have you ever had a doctor break down and cry with you as you received bad news? Sometimes I have to work really hard not to be that doctor.

Each day in Oncology clinic, I see all the stages of grief. Everyone battles cancer completely differently, and I get to experience it all as one giant roller coaster.

One minute an old woman comes in after her last round of chemo left her hospitalized. She absolutely insists on taking another round. Her doctors hesitate to give her more chemo and radiation than she could tolerate, yet she refuses to go to the grave without having pulled out all the guns. The defiance in her eyes is contagious. I want to shout, “Yeah!! Go get ‘em!”

Next thing we see a young man whose cancer had no business interrupting the course of a well-plotted life. He’s already nauseated just worrying over how the treatments will affect his family. He and his wife raise a slew of questions, exploring every crevice of every possibility. Our uncertainty makes them visibly uneasy: Curing cancer is a numbers game, from our perspective. But for each individual patient, we either achieve a cure or we do not—and the side effects are definitely not worth it for a not-cure. I wonder if he might talk himself out of getting any treatment at all.

Then we get a happily oblivious patient, a guy with brain tumors so far gone that he no longer has the capacity to understand his own plight. We try to explain that he needs to take his chemo pills diligently. He smiles pleasantly and agrees, indicating that he clearly won’t do anything of the sort. While this is truly terrifying to me, part of me also thinks that perhaps, for a cancer patient, he is in the best of all worlds.

The tearful patient really gets to me. Someone had given her false hopes about her prognosis, so then it became our job to set the record straight. The doctor apologizes profusely. The patient retreats into heaves and sobs as she begins to mourn her own death all over again. In her mind, we have just killed her. I hand her a box of tissues—inadequate for the gravity of the situation. Yet she smiles briefly as she takes the box from me. We continue the conversation as she empties the box. Pagers ring, and we silence them without answering. Occasionally I stare at the ceiling so the tears won’t crash down.

Where in my medical training was I supposed to learn how to let a patient die? How do I tell the dark news, and then, how do I react? Do I grieve the disease, or do I fight it? What does the patient need to hear? Is it inappropriate to laugh with them? To cry? Is it unprofessional to admit that the cancer, in beating the patient, is also beating the doctors?

What is a good doctor?


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