I’m rushing, I know I’m rushing. I feel the beat of my heart beating throughout my entire body. Underneath my yellow gown, I can feel myself getting sweatier and sweatier. Good thing I remembered to put on deodorant today. My anxiety levels are shooting out of the roof. Why? I got out of class late, and I’m trying my darndest to set up for my medically complex patient in time. I’m under a particularly particular faculty, and I feel nowhere near prepared. I’m getting to the point where I’m so stressed; I’m forgetting the little things. Have I gathered all of the materials I need? Do I even know exactly what I’m doing today? Have I looked up all of my patient’s medications, so I can give that stellar start check? As dental students and young practitioners we’ve all been here. In the journey to become a dentist, it is almost impossible to not experience the stress and anxiety similar to above. For some of us, it may be every single clinical experience, and for others it may be during our competencies and testing situations. No matter what, it would be remiss to ignore the effects that stress has on our work.

It’s in moments like these that we need strategies to deal with this tension. Lucky for us, there is a myriad of methods to prevent stress, anxiety, and other debilitating emotions from taking hold of our lives and our dental careers. My personal favorite is Mindfulness Meditation. You’ve probably heard of it, as it’s a bit of a “hip” topic in the psychology world. This is for good reason, as there are plenty of scientific studies to back it up.                               Photo Credit: http://www.huffingtonpost.com/lisa-firestone/mindfulness-benefits_b_2965648.html

Often, when people think of meditation they think that it is the absence of thoughts and feelings—a spiritual experience that only monks who practice for lifetimes get to go through. They couldn’t be more wrong. Mindfulness is actually being very present in the current moment. It is accepting and not judging your current situation. The very key to mindfulness is not that your mind doesn’t think of things, but that when it does you bring yourself back to the task at hand.

Mindfulness is a skill that can be practiced and honed. You probably won’t be very good at it in the beginning, but being good at it is not the point. The point of mindfulness is to not let your emotions and thoughts control you. Having mindfulness meditation in your “tool box” can take the hectic situation from above and flip it on its head. Mindfulness is most definitely not a cure-all to all stresses in life. However, after practicing mindfulness, when you start to feel those familiar feelings of stress and anxiety creep up on you before a challenging clinic session, you will have a tactic to no longer succumb to those pressures. Rather than freaking out over the things you cannot change, you take on the procedure one step at a time. You will make less mistakes, and most importantly you will provide your patient with the best care possible.

There are four different ways of practicing of mindfulness: breathing meditation, body scan, loving-kindness meditation and observing-thought meditation. The key is finding which one works for you. You can find a myriad of different sources to learn about each type and to get resources to help you out. Those include apps with guided meditations (Headspace is my personal favorite), podcasts, and videos on YouTube. Whether you are a mindfulness expert or simply a beginner, I encourage you to continue down the path to a healthier, happier you and a less stressful, more enriching dental school career.

On January 15th, 2009, US Airways Flight 1549 took off from New York City’s LaGuardia Airport at 3:25 pm. Less than six minutes later, the aircraft crash-landed in the middle of the Hudson River. Everyone onboard survived and few serious injuries resulted. The event known as “The Miracle on the Hudson” immortalized the commander of the plane, Captain Chesley Sullenburger. Somewhat less well known is Sullenburger’s copilot, First Officer Jeffrey Skiles. Flight 1549 was Skiles’ first time flying an Airbus A320 since passing the qualifications to do so. As the keynote speaker at the recent 2017 ASDA Annual Session in Orlando, First Officer Skiles described the systems and protocols that led to the successful crash-landing on the Hudson. When a flock of geese collided with Flight 1549 shortly after takeoff, the airline crew initiated a cascade of emergency procedures. As Captain Sullenburger communicated with the control tower at LaGuardia, First Officer Skiles reached for the Emergency Procedure Book readily found in every airplane cockpit. Although this was Skiles’ first commercial flight on an Airbus A320, he had been trained for this. To simplify training, cockpits are standardized across the airline industry. This minimizes the unfamiliarity of a new aircraft. Other industry standards include seat belts and life jackets for each passenger and crewmember. These environments reduce the possibilities for failure or confusion. The familiar cockpit allowed Skiles to act quickly and confidently with each step of the protocol. Seat belts and life jackets at each passenger’s seat minimized panic and injury. First Officer Skiles sited a large part of his success that day to the standards set in place that diminished the possibility of failure.

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The airline industry is not alone in manipulating an environment to encourage success and influence human behavior. Plants and vegetation in inner-city housing developments reduce crime rates. Parks and trails result in improved community health. Advertisers use color to conjure certain emotions. Thanks to Annual Session being held in Orlando, I was able to make a quick trip to Disney World where I noticed myself being manipulated by the psychological puppeteers of Disney.

Because of ASDA-related activities that took place in the afternoon, my group only had three hours of magic before the park closed at 10pm. Despite our limited timeframe, we decided it would be worth it to jump into a 60-minute line for Space Mountain. To our surprise, just 20 minutes later we could literally see a light at the end of the tunnel! We went from this long, dark tunnel to a large room where we could see people getting on the ride. It looked like we’d be on the ride in no time. This disillusioned sense of progress kept our spirits up until another 20 minutes later when we realized the line had yet to wrap behind a long wall before re-entering the room. We ended up waiting a full 65 minutes!

It turns out Disney spends loads of money on studying the psychology of waiting in a line. To keep thousands of park attendees in good spirits, they design the lines in such a way that repeatedly gives people false hope as they endure the long wait for popular rides. A simple Google search on “Disney World psychology” revealed other ways Disney uses the environment to manipulate emotions and behavior. The walkways throughout the parks are made of black pavement, which encourages park-goers to seek the cool shade provided by nearby shops and eateries. Taking it a step further, some of the shops pump out fragrances that smell like freshly baked goods. Other shops crank the air conditioning to encourage shoppers to buy a hoodie that they would otherwise neglect in the Florida heat. Sections of the park Disney wants to remain hidden are painted in a color referred to as “No-See Green,” a shade of green easily overlooked by the human brain. This is uncanny, as I don’t recall seeing any “No-See Green” in Magic Kingdom…

While shadowing in dental offices during undergrad, I noticed this same use of environmental manipulation. Operatories, countertops, and cabinets were labeled to encourage organization, efficiency and infection control. A printed schedule displayed a morning huddle at the start of the day to confirm plans and review goals. Even switching a patient’s manual toothbrush for an electric one had repeatedly demonstrated a successful outcome in improving oral hygiene. Changing the environment for patients and staff yields real results!

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It’s difficult to invoke change in people who aren’t motivated to change. Being quite stubborn and impulsive myself, I have obsessed over this idea that changing one’s environment will change one’s behavior. As students, we can mold and model our environments to ensure success! The following are some examples of environment adjustments that have worked for me.

During my undergrad, I began every day with my phone. Checking messages, news, and social media consumed precious time that would have been better allocated toward working out and making breakfast. To change this, I set up a charging station outside of my bedroom. Before bed, I put my electronics in a drawer where they are charged out of site. I am not allowed to open that drawer until after breakfast. Hiding the electronics has been a simple change to my environment that has drastically improved my morning routine—just like “No-See Green”.

Other habits can be easily manipulated by simple adjustments. I’m a natural night owl. My nocturnal habits quickly became a problem in dental school, so I committed to going to bed earlier. The commitment fell apart within two days. After repeatedly failing to change my habit of staying up late, I turned to my wife (my copilot, if you will) for help. I told her my plan to set an alarm to go off at 9:00 pm every night, signaling for me to begin getting ready for bed. I asked her to help me stick to that commitment. The nighttime alarm combined with reliance on a copilot has yielded great results. Don’t have a spouse? Find one. Just kidding. Ask a roommate, friend, classmate, significant other, or family member to help you out!

After a decade of trying to set meaningful New Year’s resolutions, I was tired of letting those resolutions slip away by mid-January. All my mentors and role models successfully set goals and resolutions. Why couldn’t I? Did I lack motivation? Did I lack discipline? Yes. And yes. My wife and I decided to write “Weekly Planning” into every Sunday night in our calendars. We don’t let anything get in the way of our weekly planning session. This time is used to review goals, discuss obstacles, adjust our routine, and plan the upcoming week. It was such a simple change! We even took it a step further and laminated a protocol that we follow every time we plan. Excessive? Perhaps. But here we are, mid-March, and I’m still plugging away at the same goals I set in January.

Whether it’s to avoid disaster, maximize efficiency, or encourage a certain behavior, customizing an environment is a powerful psychological tool. As students, we often have so much to worry about that we can’t spare the mental and emotional energy required to constantly motivate ourselves toward success. If you’re struggling to exercise, study effectively, eat healthy, manage relationships, keep track of goals, maintain your sanity, or land a plane, try changing something in your environment that will make it harder for you to fail!

Dental Conferences are like rushing for a sorority; endless small-talk and prattle of where you're from, what school you go to, what year you’re in, and what position you hold. It almost feels like a rapid-fire competition of who can ask the most questions and how quickly someone can fill those awkward silences (my favorite). At this point, I could probably say I’m a small-talk aficionado given that most of my extracurricular activities have involved this sort of interaction with people. However, I have slowly come to the realization that these kinds of conversations, although I do them mindlessly, leave me exhausted and apathetic. One of the beauties of student dental conferences is the myriad of networking opportunities. We have the ability to expand our little black book of contacts in the hopes of making connections with the people that will be in our future professional community.

Networking: “interact with other people to exchange information and develop contacts, especially to further one's career” - Google

That last line has never sat well with me and I doubt anyone would like to be described as an opportunist or a carpetbagger. This type of “you scratch my back I scratch yours” mentality limits ourselves to the facts and figures of conversations instead of digging deeper to who we are as people. It seems that having one insignificant conversation with somebody and handing out our business cards like they’re Halloween candy will automatically put us in a position to ask for favors in the future.

Why does Networking only have to be small talk? Why can’t it also be big talk?

I understand that some people are uncomfortable with getting straight to the big questions right off the bat. But I will argue that you can definitely turn insignificant pleasantries into meaningful dialogue and part of it is getting over our fears of looking too inquisitive or intrusive. We all know what open-ended questions are; we do it with our patients all the time. Why can’t we do the same when networking?

This mentality may be in due part to my ENFP personality and my will to find the deeper meaning in anything and everything (I strongly encourage everyone to know their own Myers Briggs letters). I don't mean I will always try to have existential conversations or discuss the nature of the cosmos with every stranger, but I will absolutely try my best to leave an exchange of dialogue knowing something enticing about a new person. Opening-up and having a moment of feeling listened to will make a person much more likely to “do you a favor,” if that's what you’re looking for in networking. I know it sounds like common sense, but I challenge you to make an effort and skip the small talk when meeting a new person.

I decided to try this out at this year’s ASDA Annual Session with the first person I met, a foreign student who came to the USA at age 12 and also identifies as gay. Right after our exchange of names and schools and right before I asked him what year he was in, I stopped myself and went straight for it: “Tell me about your experience being in the LGBTQ community while going to school in Kentucky”. BOOM! He looked a bit taken aback by the question and I started regretting my decision. He tilted his head to the side, looked at the floor and started rubbing his chin. Suddenly, 30 minutes passed as he was telling me about a horrible but character- defining incident, the people in his life who stuck up for him, and how lucky he is to live in a city where he is much more accepted than the rest of the state and his native country. It was beautiful.

In the days that followed, we would happily run into each other and exchanged our excitement for the day’s itinerary. By the end of our time in Orlando we said our goodbyes, and as he hugged me for the last time he smiled and said, “if you ever need anything or if you’re ever in town, you always have a place to stay.” And that, to me, is real networking.

Annual Session 2017 has come and gone. After five fervent days in Orlando of legislative meetings, resolution debate, emotional elections, and evening festivities, ASDA has launched itself into the year ahead. Here are some highlights from the week:

-Colorado took home the Gold Crown Award for Best Chapter Blog. 

-John Luke Andrew (Colorado '18) was elected District Nine Trustee. He'll oversee the dental schools from Colorado, Texas, and Oklahoma.

-Houston ASDA became the new top dog with their well-deserved win for Ideal ASDA Chapter. Their very own Tanya Sue Maestas also became the new ASDA National President. District Nine continues its prolific reign (Colorado was last year's Ideal ASDA). #D9sofine

-Becky Bye (Colorado '18 and current Colorado Chapter President) authored and defended a resolution to unify all dental schools with one degree (eliminating either the DDS or the DMD). This topic will likely become a major player at future meetings. #1profession1degree

-The continual battle to remodel the licensure exam continues. The new Executive Counsel intends to make great strides in coming up with a system that benefits both the students and is mindful of the patients.

-Dr. Christian Piers (Colorado '16) concluded his influential and devoted service to ASDA with his role as this year's Immediate Past President. I'm sure we haven't seen or heard the last from Dr. Piers (and we certainly hope not).

-Nothing keeps Colorado from going to the beach. Even if it's hurricane-like rain. Worth it? Absolutely.

-Some of our members had the (mis)fortune of being stuck on the Pirates of the Caribbean ride at Disney World. They were rewarded with an extended stay in the park and free rides. I don't think they were too upset...

Thank you to everyone who contributed to The Colorado Quickset over the past year. Colorado truly knows how to make the magic happen.

Cheers!

If the concept of giving local anesthetic injections wasn’t already anxiety producing, the name of the practice lab is sure to create some butterflies in your stomach. At least that is what happened to me. I knew I had the knowledge of where the nerves and the arteries were, how to position the needle, and how far to insert the needle into the tissues, but the idea of performing this procedure on a live patient still seemed a daunting task. As the day of Stab Lab grew closer, I started obsessing over the Local Anesthetic book, asking professors for tips, going over and over oral landmarks to assist in making the injections, even watching YouTube videos. Nothing seemed to make me feel more comfortable with “stabbing” my partner until I got the fact through my head that I will be doing this every day of my professional life! I had better get used to and become efficient at doing injections now so that I can begin to focus on all the other aspects of dentistry that come after the local anesthetic injection.

With this profound realization in my head, I still went into Stab Lab nervous. I was at the brink of being confident that I would do a good job, which showed personal progress compared to where I started. Setting up the clinic chair and talking to my classmates helped diffuse the apparent tension on the fourth floor. Then came the time to perform the injections on my partner. All I can say is that it was AWESOME! After you do your first injection, you get a feel for the needle and how it moves in the soft tissue. You get feedback from your instructor who is by your side the entire time, telling you to do this and do that. The fear slowly melted away and I felt more confident doing my last two injections…finally.

I learned that the anxiety was helpful because it made me slow down and really focus on what I was doing. I was able to pick up on cues my partner was giving, which were subtle but useful in helping me learn how to respond when my future patients react the same way. This is a huge step in becoming a dentist, and I can say with pride that our whole class did a great job in administering local anesthetic for the first time. Overall, it was a great experience and there was no need to be fearful to begin with. By the second semester of your second year, you are ready to learn local anesthetic techniques.

This past weekend I went to California for a college friend’s reunion. After graduating, my four college roommates and I decided that we would get together every year. While this is no small feat, it is extremely high on my priority list. Just as a great romantic relationship requires equal effort, this idea would require equal priority and value amongst all members. The Plan: Back in November, I started a group message to see when the best time would be to meet up. Timing can always be difficult, whether as a student or out in the workforce, but some compromises can go a long way. When deciding on the location, let’s just say that graduates, two years out of college, were not in the financial situation to jet off to Hawaii. We decided we would settle with a weekend in the Sierra Nevada’s at a family member’s cabin.

The Commitment: The two students had to commit to the idea and arrange flights so that we landed in San Francisco at the same time and decided one vehicle would suffice. The next step was to figure out what I would miss in school. I personally have always had a difficult time skipping class, because I often felt that it took about twice as long to catch up. I knew, however, that the value of seeing old friends would be worth the hectic week that lurked upon my return. The final and most important step to having a reunion was the act of getting on the plane or in the car to travel to the meeting spot. This was where one of my friends struggled this year. I texted him at DIA and asked if his flight was on time. His response was, “What?” I reminded him, “Your flight to CA?” Unfortunately, I was a bit too late, as he replied, “I’m at school. I thought the reunion was next weekend!” Needless to say, we were all devastated that this year would be 4 of the 5, but I’m sure this would not be the last time that all five would be able to attend.

The Value: In the few weeks leading up to our trip, I began to struggle focusing on my schoolwork. This was partly because I was getting excited to see friends. One had been in Santiago, Chile for 8 months, and I would be seeing him the day after his return, but also because there was a lot going on in my life. College friends have a special insight to your life. They are the ones that meet you as that semi-awkward and mostly lost 18-year-old. They get to share in your growth as your frontal lobe continues to develop and you become the person that is closer to your 50-year-old self than you might want to imagine. I believe that there is way more to college than a degree. The person that walks away from that institution can be exponentially different than the one that walked into it. Having people in my life that know and have shared in my self-growth can always provide a level of comfort no matter how long it’s been since we’ve seen each other. On a macro level, dental school can be a hedge maze, and as the days go on, the walls grow taller and taller. What is crucial for my pursuit to navigate (and sometimes crawl) my way through the maze is to every now and then get a birds-eye view of what I’m up against. Catching up with old friends and giving my elevator speech as to what dental school is like puts everything back into perspective. When I’m surrounded by other problems independent of how difficult a test was I feel like I am an executive in Westworld watching from above, and I can finally see the small confines of my own hedge maze.

Whether it’s commiserating about dating apps, swapping exciting stories about South America, playing board games while having a beer or two, or simply being able to shred sledding hills, there is some part of my wellbeing that can only be filled with time spent with old friends. They remind me who I really am and why I’m even where I am today. For myself, at no cost, financial, time or otherwise, is dental school and the busyness of a day or month worth the friendship of those that truly understand me.

On Tuesday, November 2^nd (or early the next day), millions of Americans retired to their beds. As they closed their eyes, some felt hopeful and excited; others felt angry, depressed, or even confused. Regardless of the divergent emotions that night, the sun still rose in the morning. Life continued, as it always does. Now that the election frenzy has subsided, we can begin to examine the impact our newly elected leaders, referenda, amendments, and miscellaneous ballot initiatives can have on our personal and professional lives. As a lawyer and self-proclaimed political junkie, I spend a substantial amount of my free time fixated on articles and news commentary about the candidates, the issues, and the future. After countless hours of examining the impact of our new president, the power dynamic within Congress, and my local elections, I must confess that I cannot make any concrete assessments at this point.

However, I can conjecture what the main issues confronting dentistry and health care will be based on my own perspective and that of the ADA. I will continue to examine how the new administration, nationally and locally, will shape the future of these issues.

According to the ADA website, the main issues its advocacy branch monitors include access to dental care (including health insurance coverage), health care reform vis-à-vis the Affordable Care Act, and continuing oral health science and research initiatives at the federal level. Additionally, the ADA routinely reviews regulatory issues that face dentists as employers and business owners—from taxes, workforce safety requirements (i.e. the regulation of amalgam), labor and employment laws, and Medicare coverage for patients.

In addition to the issues that the ADA has identified, I also hypothesize that the general cost of health care and drugs will affect dentistry either directly or indirectly. As many have noted, non-dental insurance premiums have risen significantly and will continue to do so. Many blame the Affordable Care Act as the culprit. Regardless, those who must pay heftier insurance fees may exhaust any allotted funds they had for healthcare in general. Thus, it is possible that those most stretched by increases in insurance will forego dental treatment.

Additionally, the shifting environment of drug regulation may impact dentistry. Over the past year, senators and political candidates have questioned why some life-changing, necessary drugs come with exorbitant price tags, precluding many patients from taking them. The drug companies have responded that the price reflects the cost of investment in research, development, and the countless clinical trials required by the FDA to bring that drug to market. Since dentistry strives for continuous improvements to its techniques and methods, this issue may have an impact on the rate of investment in private oral health-related R&D.

I remain cautiously optimistic that regardless of this year’s election outcome, the dental profession will continue to thrive, and patient care will continue to improve. Members of our profession are passionate about improving dentistry, and will do whatever it takes to make it better. We are also fortunate to have one of the most successful national lobbies in history, which continuously advocates for patient’s interests and our personal interests. With a high percentage of dentists being members of the American Dental Association, the collective voice of dentists is one that lawmakers hear loud and clear.

As members of the dental profession, a profession that has a large health and economic impact on our country, it is imperative for all dentists and dental students to stay apprised of the political landscape. We must proactively work to make oral health care better for our patients and our own livelihood. Otherwise, we might wake up to a political climate that contradicts our profession altogether.

The other day I went on a run for the first time in a long time. When my hands stopped tingling due to a lack of oxygen and I finally caught my breath, I stopped focusing on the simple act of running and, instead, on letting my mind clear. That is my goal with running. I’m not particularly good at it, which is evident by the scar on my knee from falling on dry pavement not once, not twice, but three times. And, unfortunately, I do not have steel-cut abs from it (I like ice cream and beer too much for that). However, in spite of those things I still love to run. It helps me to clear my mind and accomplish new perspectives by seeing past the tunnel vision of dental school. Once I let the thoughts go that were occupying my mind, I took notice of the environment around me. I ran past a house with about 15 feet of sidewalk in front of it, and thought, “What is the point of that?” The sidewalk was not continuous, which basically rendered it useless. The only purpose that sidewalk served was to be stood on when the house owners checked the mail or for a short game of hopscotch for the kids that lived in the house. While those things do serve a small, individualized purpose, they do not serve the purpose for the goal of a sidewalk—to make a continuous path for pedestrians.

The more I thought about it, the more I saw the reflection of my dental school education in that oddly configured sidewalk. My classmates and I establish squares of concrete and temporarily learn as much information as we can about a certain subject. The newfound knowledge is then promptly “brain dumped” after a final. We learn essential details to get us through our most recent assignment in lab, but we fail to understand the big picture. While these segments of sidewalk serve a great and noble purpose for the task at hand, they will not be very useful when it comes to walking around the block.

As we slowly (and I’d like to think gracefully) crawl towards the graduation finish line, we must keep this in mind. Our snippets of knowledge will only get us so far; it is the segments that connect those pieces of knowledge into a contiguous and fluid path that will allow us to smoothly navigate to our endgames. No matter where we are in our dental careers, we need to be sure to construct our sidewalks so the stroll around the block can be as seamless as possible. After all, you can have all the knowledge in the world, but if you can’t see the forest through the trees, then that knowledge simply becomes facts rolling around in your head.

My thought process wouldn't be complete without including this popular and all-too-relevant poem from Shel Silverstein(1.):

1. Silverstein, Shel. Where the Sidewalk Ends: The Poems & Drawings of Shel Silverstein. New York: Harper and Row, 1974.