As I reflect back on my educational experience, I realize that I could not have done this alone. I've been blessed to have people around me who supported me, tolerated my melt-downs and self-doubt, and still remained by my side. They were the flowers in my garden! Graduation is a celebration of my accomplishments but most importantly, it is also a celebration of those who've helped me on this journey.

I hope that you will also remember and recognize those who've stood by your side (and remained there!). I will leave you with a quote about gratitude by William Arthur Ward: "Feeling gratitude and not expressing it is like wrapping a present and not giving it."

On that note, thank you all for reading my blog posts and leaving comments. It always made my day to know that someone took the time to read my words and to leave a comment.  Since I'm no longer a student, this will be my last post, but I hope to continue contributing to ADVANCE for NPs and PAs in other ways. Now, go out there and be thankful!

Some of these mistakes I've made four or five times, but by that fourth exasperated, "OH MAN!  Again!" some synapse in my brain is marred to never ever do that again. Then there's this mistake: When the surgeon asks you, "What's that?" and you say artery, but it's really the thoracodorsal nerve right after he pinched it with a hemostat. Ah, lesson learned.  A guess, or "maybe" is not good enough in the OR. 

I'm pretty good at moving beyond my mistakes and not let them get at my gut. The key is to ask yourself a few key reflective questions: Was anyone seriously harmed?  Did I learn something?  Will this ruin my life forever? Hopefully, for most of you, as it's been true for me, no one has been seriously harmed, I do learn something, and my life isn't ruined forever. Thus, I move on and enjoy being a student. Students make mistakes because students need to learn. 

Clinicals are such a unique opportunity to ask stupid questions and feel less stupid asking them simply because your nametag reads "student." Scrub nurses, surgeons, MDs, experienced NPs and PAs have all been where you've been-clueless and overwhelmed. So stop, take a deep breath, and finish closing that laparoscopic incision. 

My first encounter with homelessness was while living in Ecuador. Homelessness there is pervasive and hard to miss. It is present on most street corners and does not discriminate, affecting both old and young; it is quite merciless and ruthless. I remember seeing kids as young as 3 years old with plastic cups begging on the streets. They had a job to carry out, day after day, regardless of weather, mood or age. Their survival depended on it. Homelessness, however, is not just their personal problem—it’s a social problem with ramifications that extend past these people’s individual lives.

During my clinical rotation in emergency medicine, I got to work with several people who were homeless. I clearly remember one of those patient encounters because it felt so defeating. “HR” was a 62-year old male with schizophrenia, alcohol dependence and a history of narcotics abuse who was living on the streets for many years.

He had presented to the ED with severe tooth pain secondary to untreated cavities. He was quite upset because this had been his third time in the ED for the same problem. Each time he was given pain medications in the ED and sent on his way with instructions to follow up with his dentist. He never made that appointment. He insisted that we “get your act together” so that he can be seen and treated before the shelter closes at 6 p.m. Otherwise, he would be spending his night on the streets.

That day, I did not contribute much to the care of this patient. On exam, there was no sign of infection or abscess formation, so our plan was to continue with pain management. We chose to do a dental block of that tooth to provide the patient with longer pain relief.

After injecting him with the local anesthetic, I realized that we had only temporarily “fixed” his problem. Again, he was discharged with instructions to follow-up with his dentist. This time, an appointment was made for him at a free dental clinic.  

Patients often present to us with psychosocial issues that impact their health or access to healthcare. We’re trained well to address patients’ healthcare needs but more training is needed in how to best address the psychosocial issues that often act as barriers to the provision of quality care.

There is no easy answer. The least we can do is to be aware of the resources available in the community—ranging from free dental care to food shelves—and to provide patients with this information. It is frustrating to both patients and providers, but we need to work together to stop this perpetuating problem. 

For those of you just entering the healthcare world, you may have noticed that any and every field has a conference. Having lived in Orlando for 5 years, I know about conferences (Orlando is probably the conference capital of the east coast). So, why all these conferences? What's the point, besides the CME for actual professionals? Can't you just learn stuff on your own or via webcast without traveling cross-country to get to them? Well, obviously, yes, but perhaps the reason conferences are so abundant and popular is because they work.

Confession: I love conferences. Just last month I went to an amazing OB/GYN conference. Last year, at the same one, I met a preceptor I'll be spending the month of May with. Next month I'm going to a Wilderness Medicine conference in North Carolina and because I'm too cheap for a hotel, I'll be tent camping. 

I know conferences can seem like "death by PowerPoint" but usually there's decent food involved, a new setting and the chance to go out afterwards with cool people you met or traveled with. What's not to like? Some conferences are overpriced but in order to pick the best ones you have to evaluate what you want to get out of them.

This time next year I can earn CME credit, but for now I just look for ones at which I may find future employers or topics that I really want to be up-to-date about. It's not cheap, but I've found ways to make it cheaper by going to places I can get free lodging at. For example, at the AAPA conference this May, I'll be staying with family friends and taking the metro into the city.

The year is young yet so my advice to all you future NPs and PAs, get into the conference groove. You might just learn something. And you PAs, see you in Washington D.C.!

Graduation day is just around the corner (but who is counting?), so I've decided to reflect back on the "lessons learned" during my clinical year of PA school. It has been a challenging and rewarding experience for me. There have been ups and downs; both were very much needed. Live and learn, as they say.

1. Avoid asking questions that start with "Why?" It may seem judgmental. I learned this the hard way.
2. Always check to make sure you have the right patient. I spent 30 minutes interviewing the wrong patient once. How embarrassing.
3. Use your patient's name regularly. They will remember you for it.
4. Remember that it is a privilege to serve patients. We're in the service profession and are not doing anyone a favor.
5. Touch is important, but be aware of circumstances where it might not be appropriate.
6. Always check those medication lists. The answer you're looking for might be there.
7. Provide hope, but be realistic in what you can offer. Honesty is important but it takes practice to deliver it in a sensitive manner.
8. Do not judge. Your attitude will reflect that.
9. Realize that you can't always be in control. Patients will not always follow your recommendations. It's frustrating, but it is their right.
10. Take care of yourself. You can't take care of others when you're not well (physically or mentally).
11. Do not burn any bridges. Some rotations will not be your thing. Come with a good attitude anyway and do your best. There is always a learning opportunity.
12. Do not take things personally. Patients are usually not upset at you but at the system or their illness.
13. Remember that you can't please everyone. Some patients will dislike you for doing the right thing.
14. You might feel incompetent at some point in your training. This is normal; things do get better!
15. Finally, remember to have fun!

An EMT friend of mine warned me that knowledge came with a price. That price came due this week. One of the heroes of the cop procedural drama I use to ease my mind after work was gutshot. As the ambulance rushed her away, her partner was told that she was in critical condition and would be placed in the ICU.

Two scenes later the woman woke up with a nasal cannula and an IV drip apparently attached in her armpit. I was incensed. To add insult to injury she engaged the nurse in conversation. The nurse had time to teach her a life lesson! In the freaking ICU. Then boom! Our hero is up and walking about to solve the case 3days later.

Since then it has been all I have been able to see. People recovering from the flu hooked up to heart monitors. The complete absence of catheters and CNAs. IV Bags hung upside down. I don't get it. These shows know how to talk the talk. I hear about VTAC and sepsis and how it is never lupus. I wonder if this is how lawyers feel when they watch Law &Order SVU.

Final point: I've been working in health care for 3 years now and not one beautiful surgeon has offered to leave her husband for me, even though she is dying of an incurable disease. Get it straight, must-see TV! Otherwise I'll yell at you like I yell at the news.

First, to help our learning, a brief case study:

HPI:

An 8-day-old white male infant presents to your ED with a 4-day history of lethargy and vomiting and the mother complains, "He smells bad even after I bathe him and he won't eat." The infant was full term and weighed 6 lb. 5 oz. At the visit today the infant weighs 5 lb 12 oz. The mother states he has had no wet diapers for 2 days. He is lethargic and vomits twice while in the ER. He will not take a bottle. 

Family and medical history are unremarkable. Child lives at home with two parents and healthy 2-year-old sister. 

PE:

On physical exam, the infant appeared dehydrated with sunken eyes, dry mucous membranes and no fat stores. The infant smells like sweaty feet or rotten cheese. 

Clinical Course:

After a full workup with lab tests, imaging and genetic testing, this patient is admitted to the NICU. You emphasized to the admitting NICU team that they should seek genetic testing as soon as possible because the smell of the child could indicate an underlying genetic disorder. The NICU team follows your suggestion, which helps expedite the patient's diagnosis: isovoleric academia (IVA), a rare autosomal recessive disorder that is pathognomonic for the "sweaty feet, cheese" smell. 

This patient has decreased production of the enzyme that breaks down leucine. Isovoleric acid builds up, resulting in its secretion, which leads to the odor on the skin and other effects of metabolic acidosis such as coma and eventual death. Is there any hope for this baby? Of course. The mother is instructed on a very specific low protein diet to avoid leucine as well as administration of carnitine and glycine, which research has shown will help metabolize the acid. 

After a week-long admission and follow-up with a geneticist and dietitian, the patient returns home. By 1 month, he has returned to his birth weight. This child's life will be extremely complicated by this disease, but misdiagnoses could have been fatal.

Bottom Line:

So, back to Mark's point: smells can save a life. Of course, it was actually all the labs and the genetic testing that proved the diagnosis but there's some support that following your nose as a practitioner may not be a bad idea.  

IVA is very rare. Most diseases pathognomonic with an odor are, but a few interesting ones I came across to complete our "smeducation":

• Nicotine addiction. (Just kidding, but we all know it's true.)
• PKU = Musty, locker room towels
• Maple syrup urine disease = (you'll never guess) maple syrup
• Hypermethioninemia = breath smells like cabbage
• Cystinuria = urine smells like rotten eggs
• Methionine malabsorption = malt or hop
• Cyanide poisoning = breath smells like almonds
• DKA = breath smells fruity
• Kidney failure = breath smells like urine
• Ileus = breath smells like solid human waste
  
• Tuberculosis = reported to smell like beer
• Malignant melanoma = smells like gasoline
  

Smelling down your patients is never a walk in the park to smell the roses because usually sick people don't smell like roses. For example, I came across a study that money could not pay me to participate in: smelling the elderly's incontinence pads to detect bacteriuria. It was only 33% accurate. I wonder if that was just the fault of the researcher's smell fatigue. I can't blame them. 

In medicine, a reality of our jobs is billing: we have to make money and prove stuff with our money-making tests. For this reason, diagnosing based on smell is tricky because our accuracy is rather pathetic if used alone without other costly tests.

Although we humans aren't always the most accurate sniffers, dogs, who have long been known to exceed humanity's abilities in a myriad of skills, prove to be super smellers in medical diagnosing. There's some other interesting research about dogs being able to rat-out a patient with schizophrenia from their smell. A recent Wall Street Journal piece highlighted the role of dogs in pediatric Type I diabetics to assist families in avoiding hypoglycemic emergencies.

These dogs don't come cheap and cost between $18-20K. I'm jealous of our furry cousins because if I could make that kind of money smelling, my student loan debt would be so much less daunting. Dogs are definitely where more researchers are putting their efforts, but don't let this dissuade you from smelling.

This brief post just scratches the surface of all that lies under the power of our noses. I suggest you do some follow-up research, especially with regards to "aroma therapy" for reminiscence. You never can tell what you'll smell along the way.

References

1. Kazushige et. al.  The scent of disease: volatile organic compounds of the human body related to disease and disorder.  Journal of Biochemistry Review: 2011;150(3):257-26.  Available from: http://jb.oxfordjournals.org/content/150/3/257.full.pdf+html
2. Midthun S.J., Paur R., Lindseth G.  Urinary Tract Infections: does the smell really tell?  Journal of Gerontologic Nursing.  2004 Jun;30(6):4-9.
3. Pavlou, AK.  Sniffing out the truth: clinical diagnosis using the electronic nose.  Clinical Chemistry Laboratory Medicine.  2000 Feb;38(2):99-112.  Available at: http://www.ncbi.nlm.nih.gov/pubmed/10834396
4. Rakheja et. al.  A neonate with hyperammonemia.  Lab Medicine.  2005 Jan; 36 (1).  Available at: http://labmed.ascpjournals.org/content/36/5/292.full.pdf
5. Linebaugh, K.  Service Dogs Pick up Scent of Diabetes Danger.  The Wall Street Journal.  2012 Dec 10.  Available from: http://online.wsj.com/article/SB1000142412788732400110457816342312970336.htm

I am a class and a half from graduation. I repeat this to myself often. I am a class and a half from graduation. Sometimes it is helpful, and other times well, other times it seems like I am not any closer to the cap and gown celebration of the end of this journey. 

I had a friend email me this weekend, who is thinking about continuing her education. She values my advice and my opinions and I didn't want to let her down. I was thinking, oh no what a time to ask me when I am feeling so whiny and overwhelmed. A part of me wanted to respond, "Noooo, runnnnn, don't do it, don't do it." I took a deep breath and tried to focus on all the reasons I am taking this journey, found an ember of positivity, and gave her the best advice I could. Yes, it is hard, but it will be worth it, and we like a challenge, right? 

The other day, I came across a poem that was written by an older man who was living in a nursing home.  It is a touching poem, so I've decided to share it with you.  Although the poem addresses nurses specifically, I believe that its message is to everyone, regardless of one's profession. It is a reminder that, despite our age or state of health, we're always human beings deep inside.

Crabby Old Man

What do you see nurses? . . . What do you see?
What are you thinking . . . When you're looking at me?
A crabby old man . . . Not very wise,
Uncertain of habit . . . .With faraway eyes?

Who dribbles his food . . . And makes no reply.
When you say in a loud voice . . . "I do wish you'd try!"
Who seems not to notice . . . The things that you do.
And forever is losing . . . A sock or shoe?

Who, resisting or not . . . Lets you do as you will,
With bathing and feeding . . . The long day to fill?
Is that what you're thinking? . . . Is that what you see?
Then open your eyes, nurse . . . You're not looking at me.

I'll tell you who I am. . . . As I sit here so still,
As I do at your bidding, . . . .As I eat at your will.
I'm a small child of ten . . . With a father and mother,
Brothers and sisters . . . Who love one another.

A young boy of Sixteen . . . With wings on his feet..
Dreaming that soon now . . .  A lover he'll meet.
A groom soon at Twenty . . .  My heart gives a leap.
Remembering, the vows . . . That I promised to keep.

At Twenty-Five, now . . . I have young of my own.
Who need me to guide . . . And a secure happy home.
A man of Thirty . . . My young now grown fast,
Bound to each other . . . With ties that should last.

At Forty, my young sons . . . Have grown and are gone,
But my woman's beside me . . . To see I don't mourn.
At Fifty, once more, babies play 'round my knee,
Again, we know children . . .  My loved one and me.

Dark days are upon me . . . My wife is now dead.
I look at the future . . . Shudder with dread.
For my young are all rearing . . . Young of their own.
And I think of the years . . . And the love that I've known.

I'm now an old man . . . And nature is cruel.
Tis jest to make old age . . . Look like a fool.
The body, it crumbles . . . Grace and vigor, depart.
There is now a stone . . . Where I once had a heart.

But inside this old carcass . . . A young guy still dwells,
And now and again . . .  My battered heart swells.
I remember the joys . . . I remember the pain.
And I'm loving and living . . . Life over again.

I think of the years, all too few . . . Gone too fast.
And accept the stark fact . . . That nothing can last.
So open your eyes, people . . . Open and see.
Not a crabby old man . . . Look closer . . . See ME!!

Many of the nurses in my program got jobs in rehabilitation and skilled care establishments comment that their job is a hectic med pass with long hours after shift doing documentation. They complain that they have too many patients to perform the assessments and care that they would like to. Some feel as if they jeopardize their license with every shift. On the plus side the pharm knowledge and real world execution of care in a full speed environment will serve them well as practitioners.

I did something different. I currently work in a prison health services unit. I serve as a gate keeper for the nurse practitioners. Mine is a job of autonomous assessment, detailed documentation and assisting with procedures.

I triage and assess several patients every day. My work is to funnel the small percentage who need expert medical care through the referral process. The assessment is made harder by the fact that many of my patients are practiced liars and manipulators. The big upside I am finding to correctional work is that I am allowed to take the time necessary to do a proper assessment on every patient. Those who come into the health assessment unit are used to waiting. Corrections work isn't for everyone, but I think it serves as an excellent transitional job for RNs in an accelerated program. 

How will you know if you would make a good corrections nurse? The advice I have been given over and over is that you need to be a confident and independent person who does not seek the approval of others. Also, if you are thinking of going into corrections as a new RN, apply online a month before you take your NCLEX. The wheels of the state move slowly.

If I could give any future medical student advice about the ER, my three most important words would be: Vicks Vapor Rub. When I first entered the ER, I was prepared to be jaded, but I was not prepared for the smells: abscesses, STDs, rotten teeth, body odor, mildewed t-shirts, alcoholics, chain smokers, drug-addicts, and diarrhea diapers, to name a few.

I have worked in a nursing home, so I have smelled my fair share and this month in the ER has added significantly to my repertoire because I've learned to expect the unexpected. I don't mean to sound too facetious, because smells are serious. Science shows that smells can awaken deeply buried memories and I consider my "smeducation" essential to my future as a practitioner. 

Why? Smells offer the perfect context to practice social justice -- every patient gets the same level of care and concern compared to any other. If a patient walks into the ER, they matter, odor and all, and they will get cared for. I didn't think social justice was a reality anywhere until this month. I thought, "Surely at the ER they won't treat everyone the same; healthcare is expensive and I'll bet I'll see subtle discrimination." 

I am pleased to say that I have not, which indicates to me that though the United States healthcare system has gaping flaws, we are still the world's best. For example, last week this precious-yet-noncompliant Jordanian patient presented with a complication from his chronic diabetes. In his broken English he described how in Jordan, "Doctor sends you home with a shot and doesn't fix you. Here, I get help." It was beautiful because in the course of his stay, I noticed a transformation of attitude towards healthcare workers and he even smiled as he left.

Or the time an intoxicated homeless patient who smelled remarkably like the Roanoke River (he had apparently fallen in) received a full work-up for head trauma and an overnight stay, a bill that probably totaled over $3,000. 

I know there's a huge problem with this system, but I'm learning to love the patients through their smells. The chain smoker you can smell down the hall and hear coughing because their COPD resulted in another case of bronchitis isn't easy to genuinely care about. But without your antibiotic therapy, that bronchitis could literally end the patient's life. I knew I would learn a lot about medicine in the ER, and I have, but medicine is constantly changing. The biggest lesson I'm learning won't ever change: treat every patient as you would want to be treated, smells and all. 

After all, the last two semesters were so time consuming and required such concentration that I felt as if I barely made it through. This semester is even more difficult -- barely making it through may become not making it at all. One would think after all these years of nursing education, I would be accustomed to the marathon speed in which nursing students are required to attain and maintain knowledge.

I think people underestimate what it takes to become an advanced practice nurse. I have had people, both in and out of healthcare, ask where I go to school. When I tell them, and they realize the university is four hours away, they seem perplexed until I explain I attend class online. Then they seem to just scoff at me, and not take my education seriously or the time and dedication that is required to complete it. I want to tell them, "Just because I don't go and sit in a class, doesn't me what I am doing isn't hard," but I don't. 

Taking classes online takes a great deal of responsibility, maybe even more so than in traditional learning. It can be tempting at times to shirk some reading or lectures to do something else unrelated to school, assignments are given, and one must keep track of due dates, test dates, and clinical hours. Yes, learning online may be harder in my mind, but I am glad for the opportunity.

If I could not take classes online, I would not be where I am in now. My children are too young and I have other responsibilities that would prevent me from sitting in a class all day. Online learning also gives me the opportunity to attend a school based on merit, not on location.

So, I guess as much as things change, such as how nursing education is delivered, they also stay the same, such as the dedication required to make it through the accelerated nature of nursing learning.

"Mr. Lee" is a 35-year old Asian male with HTN, HLP and DMII who had s/p stent placement in his LAD two years ago. He has stopped taking simvastatin, lisinopril, Metformin and aspirin, does not exercise, continues to smoke, and does not check his blood glucose at home. Despite adequate amounts of patient education (and a psych evaluation), Mr. Lee refuses to adhere to medications or to implement any lifestyle changes to reduce his risk factors. His reason: "I'm tired of popping pills. This is America. I can do whatever I want. If God wants me to live, he'll save me. I don't need your divine intervention. You're not God." Needless to say, this patient encounter did not go well. We did nothing for him...how disappointing.

"Ms. Smith" is a 44-year old female with relapsing remitting multiple sclerosis (RRMS). She stopped taking her medications one month ago. Her reason: "I want to be medication-free. My relapses are rare and the side-effects are terrible. My quality of life is good and I want to keep it that way without being dependent on any medications for it." She is knowledgeable about MS and about its potential to progress and cause disability. Despite this knowledge, however, she has chosen to stop treatment. This patient encounter did not go well either. We did nothing for her...how disappointing.

In clinical practice, we often label Mr. Lee and Ms. Smith as "non-compliant" or "non-adherent." In all honesty, I find these patients to be challenging because they do not let me "fix "or help them.  As students, we're taught to always come up with a plan... a solution of some sort. Patients expect this from us as well. Most do not want to leave their office visit empty-handed. They need something. When patients refuse to follow recommendations, it can be quite frustrating. Sometimes, we're not prepared to handle this. At least, I wasn't.

Are Mr. Lee and Ms. Smith right? Or as my preceptor bluntly put it, "Is it our role/duty to save patients from themselves?" What I've come to understand is that medical-decision making is complex. Patients' illnesses, their reactions and understanding about it change throughout their lives. Chronic disease is, after all, a dynamic process. What is right for one patient may not be right for a different patient. What is right now may not be right ten years from now for the same patient.

Each patient's illness needs to be viewed in the context of his/her life, values and beliefs. This is no easy task, however, because it can challenge evidence-based recommendations. It helps to remember that these recommendations are just that-recommendations or guidelines. After that, the ball is in the patient's court.

"This place is old, lots of stories AND ... it's haunted. HA! Just joshing. But stick together."

Her comment would not have struck my imagination if it had not been repeated, near verbatim, by another instructor. I wonder if it is the start of some elaborate hazing ritual. But this is a serious place. When we reach the part of the training where they wish again to impress upon me the importance of diversity, my mind wanders.

I remember my first end-of-life case as a CNA. The hospice nurse guiding me instructed me in her thick island accent to leave the door open. ... "So the poor dear doesn't get stuck on her way home."

When I was in the Peace Corps, funeral processions were a regular part of life. Children would run ahead of the march, knocking over chairs and covering comfortable rocks and stumps with flowers. The logic was that the spirit was tired from crossing over and would sit if allowed. Lost without the procession, it might become angry and cause mischief.

Then the memory of my uncle telling a gaggle of cousins about the grizzly bear that haunts our farming clan. The story goes that whenever a man in my family is about to die, it can be heard dragging the trap that drove it mad.

I have no truck with spirits one way or the other. My belief in ghosts can be directly related to how dark it is and how alone I am. I like science and studies and rock solid fact. Still, I remember the first time I heard a death rattle. It occupies some of my more primal nightmares.

I thought I would ask, because I will be working some long, lonely RN shifts in this very serious place. Where does our profession, so familiar in the art and science of death, stand on the subject of hauntings? Any thoughts?

Was it losing weight? Spending more time with your family? Dragging your body to the gym? Reading more books? When's the last year you set a new year's resolution? And how far did you get before you broke it? And why are you so discouraged about trying again in 2013?

We students in the medical field are required to study behavior change and learn how to counsel patients. The classic question, "On a scale from one to ten, ten being very motivated, how motivated are you to make ___ change?" allows us as the counselor to gauge how to progress the patient to the next stage of behavior modification. 

Two weeks ago I engaged in this exercise with the 8-10 patients at the free clinic wellness class I teach, encouraging them to at least set a goal for the new year. What can it hurt?  The scientific truth is that it can't. According to a landmark Journal of American Psychology study from 2002, 45% of American's usually make resolutions and 8% of them are successful.

However, the individuals who make explicit result ions are ten times more likely to attain their goals than those who didn't. If you met a patient and said, "I have a FREE weight loss drug but it only works in 8% of patients. Want to try it?" I guarantee that most of your patients would give it a go. Then, if you spent another couple minutes getting an explicit resolution on paper, you're getting somewhere.

I'll just use myself as an example. I am going to run a marathon this year on April 20^th. I have to. I want to run this tough race well. Run a marathon well? What does that mean? Ok. I want to run the Blue Ridge marathon in less than four hours. Better than that, I want to train on the course three times a week and life weights twice a week at the gym. There. There's a resolution. It's realistic, specific, and has short outcomes measurable each week. And of all a sudden, I'm ten times more likely to keep it than if I off-handedly decided that I want to get in shape in 2013. I feel faster already.

We Americans are resolution-weary and pessimistic, yet we still claim to be the nation of undaunted courage and unprecedented innovation. We are the land of the free, the home of the brave. Why would we so casually dismiss resolution-making because of a few decades of failure? This could be it, the BIG YEAR where you, yes you, are the eight percent. Be brave; make a resolution. Get to the gym, call your mom, quit smoking, start cooking, save some money. Remember, it can't hurt, and maybe we can up that decade-old 8% statistic and prove science wrong. If that's not a good reason, I don't know what is.

Feel free to comment below with your resolution or past stories of successes and failures. Remember, the more people you tell, the more likely you are to follow through.

Happy resolving!

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