P's and pig labs

Yesterday was a big day. I took (and passed!) my last anatomy exam. So, I have completed my first medical school class, with a P! Woohoo! Doesn't quite have the same ring as an A, does it? (Or a B+ in a class I was really struggling with...) I think the pass/fail system for medical school is a tricky thing. It messes with my motivations. I thought coming from 17 years of being graded, it would be a relief not to care - but oh wait - I still do. Except I'm also lazy. Ok so anyway, big day yesterday.

In the afternoon, I got to go to an OB/GYN residents' laproscopic surgery training session. I phrase it like that first for all my friends who are animal lovers - yes, we did operate on live pigs under anesthesia. But the instruments were so amazing - they use vibration and heat and other amazing technologies to cut tissue in the least invasive way possible. The residents got to practice tying sutures inside of a body and doing a hysterectomy (I got to hold the camera!). It is also amazing how bloodless the surgery was - you basically only cut through completely avascular tissue to remove the uterus. While standing there observing for three hours, it struck me how different my life will be when I'm an actual doctor. Sometimes I get worried when I am so sick of all the studying and feel like I can't do this anymore - I am so glad I have opportunities to participate in amazing things like this surgery to keep my drive going. I won't be able to make it through if I allow myself to forget the end goal. Or if I simply forget how awesome the end goal is. I won't spend the rest of my life sitting in lecture and reading textbooks. Thank goodness.

honestly

So, I realized that lately I haven't been blogging that much, but everything I've written is super cheerful and hopeful. I think maybe my blogging hasn't been so honest. I tend to do that when I'm struggling - act super cheery and only talk about the positive stuff, and just leave out the stuff I don't really like. To be honest, there's a lot of stuff I don't like:

1) Doing laundry. I know, everybody hates this one, but I am never home. My roommate can attest to it - sometimes we go days without seeing each other because I leave at 8am and tend to get back around 11pm. And the occasional evening I take off, I don't want my vegetative state in front of the television to be interrupted by trips to the laundry machines with the huge amounts of laundry I accumulate. Most weekends I feel guilty if I don't spend the entire afternoon (at minimum) at school studying.

2) My basic science classes. Let's face it - I've never liked biochemistry or histology - but I have always enjoyed physiology, and I even hate that class at my school. The class is taught so poorly that I often can't bear to go to lecture. I feel like I have to teach myself everything and it's really, really hard to motivate myself to do so. Uninteresting, poorly taught material + an enormous amount of said material + friends that are fun to hang out with = Chelsea has trouble concentrating. Which basically makes me feel constantly guilty and like failure is looming over my head unless I get my act together.

3) The fact that everyone is constantly telling me I will forget everything I just bemoaned having to learn in #2. Oh wait, maybe I should just add this to the "why Chelsea is both unmotivated and guilty" equation.

4) The stuff I actually care to learn, stuff I will use in my future life, like physical exam skills, I barely spend any time on. Because the "Practice of Medicine" class is the least intense, I feel like allowing myself the luxury of reading the material for that class means I'm taking away precious studying time from my harder classes. Which is sad, but true.

5) I want so badly to know how to balance everything in my life, but I just can't seem to find a way yet. Hopefully eventually I will, but I know the next few years of my life involve a constantly changing schedule that I don't know whether I'll ever be able to strike the right balance.

So that's what med school is really like for me right now. There are definitely enough times when I do something and get really excited about becoming a doctor. Those moments are what get me through and let me know that medical school will be worth it. I think this year is just more of a struggle because it's not where my strengths lie, but many of my classmates are geniuses at this basic science stuff. Well, that's enough complaining for now. Hopefully it wasn't to painful to read (well you could have stopped reading, no one's making you...)

home visit

Last week, we were required to do a "home visit." We were assigned in groups of three to visit someone who has a chronic illness or cancer. I admit, I was a little anxious about it. We drove out of the city to a nursing home in a small town. We had to go into a woman's home and ask her questions not only about her illnesses, but how she perceives doctors and how she feels about our health care system. 

I am so glad I was required to do this, because otherwise I might not have been able to overcome my anxiety and speak with a lovely 87-year-old woman who was so positive and inspiring. Even with weakness in her legs, she still walks one mile every day. She worked as a minister for a long time, and now she paints and writes and makes sure to help other people. 

Her view of doctors is something I often forget to think about. She spoke about how growing up, doctors would just stop by the house if you fell and thought you hurt yourself. Doctors were her friends. Now, she said, doctors say "I'll meet you at the emergency room." If she calls her doctor the day after an appointment with a question she forgot to ask, the doctor doesn't have time to talk to her. She told us we need to "train our patients" so that they know how to help us help them. 

In some ways, I wanted to say that doctors aren't any better than other people. Doctors are flawed too. But sometimes I think much more is expected of us than other people. I don't really like the idolization that sometimes surrounds doctors. But at the same time, it reminds me of the enormous responsibility I will carry some day. Hopefully, with the advice of this woman and many other people who know much more than I do, I will be able to live up to that responsibility. 

search for a specialty

"I'm a medical student."

"Oh that's so cool! Do you know what specialty you want to do?"

The automatic question. Maybe I could legitimately be annoyed if it wasn't a question I am passively debating myself. Not that I feel any pressure to decide, but it's something I contemplate every time I am exposed to a new medical setting. This week, I shadowed a pediatrician as part of a primary care preceptorship. I'll meet with him two more times this year. The basic point is to expose us to primary care (the majority of medical practice) and to give us an opportunity to practice basic history and physical exam skills. 

I think I am never going to be able to decide my specialty, because I wind up enjoying each specialty I shadow. I thought I would hate general pediatrics, because I like happy kids, but I really don't like crying, sick kids. I was pleasantly surprised by how interesting and challenging I found pediatrics to be. When you take an adult family and social history, you ask almost the same questions for everyone. You do a similar exam on most people. But kids are changing so rapidly - a 15-month-old's physical is different than a 2-year-old's and then different than a 5-year-old's. You have to know developmental milestones for all ages. You have to know how to give parenting advice. You have to be able to diagnose a patient who can't or won't speak to you about their problems. In many ways, pediatric medicine can be more challenging than adult medicine. On the other hand, kids are just pretty awesome. If I become an adult doctor, I'll never get to "listen" to a stuffed giraffe's heart. 

I didn't think I would like it, but I did. I think that may continue to be a problem as I have more experiences with different specialties. This is going to be a harder decision than I thought. Oh well, at least I know that I would enjoy doing many different things, which is the best place to be, really.

playing doctor

In an earlier post I mentioned a professor who said we were officially med students once we'd taken our first exam. I disagree - I think the first time we will be medical students is tomorrow. Tomorrow we have our first "SP" - standardized patient. I know, I know - talking to an actor pretending to be a patient does not make me a real doctor. But I've taken exams before - never before have I walked into a room wearing a white coat, asked someone very personal questions, and then examined them.

I think it will be kind of fun. Although I'm certain watching the video of the whole interaction will not be so fun. Tomorrow I get a glimpse of what my life will be like someday - not a classroom, not studying power point slides - interacting with people on a very personal level to figure out what's happening inside their body. Some of my classmates are freaking out because they labelled this an "exam" on the schedule. I'm just excited about being a little closer to becoming a doctor.

Sorry if anyone found this cheesy. I will try to make fun of my sincerity tomorrow.

midterm rant

I don't even want to write about medical school. I just took four exams in five days and I only started studying for one of the exams before this week. It's over now, but I'm still stressed. I've been trying to watch TV but I keep thinking "Wait should I be studying right now?" Because literally that's all I've done for almost the past 2 weeks. I realized one day I studied from 10:30am-6:30pm straight, only pausing once to microwave a lean cuisine. And then I studied while I ate it.

I passed two exams for sure! I guess I should take solace in that. But even that does not feel like a victory, just a relief. I was petrified the whole week of having to retake them. The point is, I learned the following:

1) I hate cramming
2) I need to balance my life better (meaning increase the studying/fun ratio) so that my next round of tests isn't so hellish
3) You know that line that separates sane from insane? None of us are as far from that border as we imagine.
4) I still like my Macbook Pro
5) If you don't have time to go to the grocery store, you should buy almond milk. It doesn't go bad as quickly. And it's tasty.
6) I'm smarter than I've ever given myself credit for.
7) Medical school isn't supposed to be fun all the time (even during first year, all you second years who gave me nostalgic advice). Why did I believe this lie?

And with that, have a good weekend. I know I will!

long time no blogging

I know it's been a long time since I posted. I'm sorry. I knew this would happen, but I'm trying to prevent it by posting now.

Major updates:

1) I passed my first anatomy exam! Yay. As we were walking out of the exam, one of the professors said "You are now officially medical students." I thought "I want to take a nap."
2) My birthday was awesome. I am now a year older and grateful for my amazing friends and family. I wish I could go on about how much my new medical school friends and my old faithful friends impressed me with their love and generosity, but that would get mushy... Suffice it to say that while medical school/life gets challenging sometimes, my birthday reminded me what an amazing support system I have.
3) I have four exams this week. Monday, Wednesday, Thursday, Friday. And I have procrastinated studying for every single one of them way more than I should have. But what's done is done - I had fun over the past couple of months, and now I will scramble to study for what seems like forever. All I can do is plan to be more forward-thinking in the future. I will still pass (cross your fingers) and I will not have a melt-down (cross your other hand's fingers).

Don't worry, I'm just being (a little) dramatic. P = MD!

little things

Today, two things made me happy: 

1) A bunch of plastic tags labeling body parts.

2) Doing nothing productive after 6pm.

Something made me sad:

1) I can't remember the last time I did nothing productive after 6pm. 

So for anyone who is still hung up on the tagging body parts thing: I like cadaver lab again! One of my anatomy partners had the brilliant idea to order plastic zip-tie labels to identify all the structures we have dissected in our body. Perhaps this sounds disgusting (to non-med people) or "gunner-like" (to med people), but seeing the vasculature of the abdomen as a beautiful labeled web instead of a mess I have to memorize reaffirmed how much the body amazes me. 

Also, I made myself take the night off. I am embarrassed to admit how many times I had to tell myself that I wasn't allowed to go back to school to study. I went to yoga, cooked dinner, read a book, watched Modern Family (oh that show makes me so happy). Now I'm blogging. 

Why don't I do this more often? I got into "busy mode" where it felt odd to do anything but go from one thing to the next. I forgot how sitting around doing nothing centers me. It's amazing how quickly I forgot.  

you know you're in medical school when:

1. Your partner at ballroom club tells you to put your hand on his inferior deltoid.
2. You talk about dissection at dinner and everyone keeps eating.
3. Wearing a white coat makes you feel "pretty."
4. A joke about the protein "map kinase kinase kinase" (I can't make this stuff up) is the best joke you've heard all week.

More to come... I think I'm going to make this an occasionally regular thing. Unfortunately all the things that struck me when I first started seem entirely normal to me now. Med school is making me weirder.

fairy tale

And now, my medical school fairy tale has come to a close. Don't get me wrong, I've been busy up until this point, but busy being social. Every week day has been celebrated by a party at some point (including Monday). I have gone to ballroom club and yoga club. I have "studied" while hanging out with people. I have gone to class (most of the time), learned some interesting things, and met some awesome people.

And now real life sets in. Our first test is in two weeks, so everyone is beginning to gear up for that. Our elective classes are starting, so we have class after 3 pm sometimes (who does that? wow how my view of life changed so quickly after undergrad). Also, I was under the false impression that extra-curricular activities would only occur during lunch. Suddenly we have meetings in the afternoons/evenings almost every day. The happy-go-lucky stage of meeting everyone is over, so now relationships are getting more complicated. I have a cough and some sort of cold (which I can't diagnose in spite of my six-ish weeks of medical education). I can't hear the splitting of the S2 heart sound on myself, or anyone else for that matter. I can't find my point of maximal impulse - which is apparently somewhere under the left breast - and I feel ridiculous trying to feel myself up to find it.

I am tired and a little overwhelmed. Sorry for making you read my self-pity. Well, I guess I didn't make you read it, so sorry if you're sorry you did.

white coats

Yesterday a classmate went to volunteer for a free health screening, where medical students (who know nothing) are allowed to take blood pressure, blood glucose levels, and calculate BMI. While volunteering, he met a woman in the "morbidly obese" category and told her that she should lose some weight. Immediately she began asking him questions like "What should I eat to lose weight?" "What diet should I go on?" etc. He was astounded that when he puts on that white coat, people believe he knows something, and trust him to give good advice. A simple garment creates what they call a "fiduciary relationship" based on mutual respect and trust. Not that the relationship is determined only by the white coat - but there is an inherent difference between being an undergrad, shadowing and "wanting" to be a doctor, and a medical student, who will be a doctor. Somehow suddenly we are different.

The privilege of that power is intimidating. At this point in medical school it feels like all the tangibles matter more - the sequence of the branches off the aorta or how g-protein cascades work - but there are moments when I realize becoming a physician is more about the intangibles. It's more about the unique relationship I will hold with my patients. I hope I continue to hold on to that.

med school is awesome. especially on the weekends.

Sorry it's been a while since I posted. This week was the first week med school required anything out of us, so therefore I was really busy. We had a homework assignment due Tuesday and a "quiz" on Thursday (which really covered an amount of material like a test). And we didn't have a single lunch talk! Now they are making us study harder and they stopped feeding us? What's up with that?

I can't think of anything really clever to say right now, which is perhaps why I haven't posted recently. Med school is really fun and occasionally miserable, but it comes in waves that give me an overall happy impression of my life in med school. For instance, yesterday I wanted to vomit when I cut open my cadaver's stomach because it smelled so bad. Anatomy yesterday was terrible in general. The lecture was really boring and the lab was really smelly. It just put me in a bad mood. Plus I was tired because I hadn't caught up on sleep yet. But after that, I spent the entire rest of the day hanging out with friends, which made me feel happy about life in general. I love the flexibility of my schedule and the amount of time I get to spend socializing (at least at this point). In my view, what I'm learning is important, but establishing relationships and spending time with people is more important to becoming a great doctor. How can you relate to your patients if you've spent your whole life reading a book? Then again, maybe that's just the excuse I'm using to have a fun weekend guilt-free. :)

conundrum

This afternoon I planned on going out to lunch with some of my friends from undergrad. At the same time, there is a TA session for physiology. Our first problem set is due on Tuesday (after the long weekend), so this is the last time to seek help from someone who isn't a classmate. Only I haven't done the problem set yet. So what do I do? Until I left anatomy lab, I was still vaguely undecided and I hadn't cancelled on my friends yet. At this point hunger was my driving force - anatomy lab makes me incredibly hungry - yeah, a little bit distasteful, I know.

So I cancel. My friends are understanding, they say, "Well, you're in med school now, we get it." I eat food, so now it's guilt instead of hunger gnawing away at me. Will the TA session really help me if I haven't done the work? Should I work right now instead because I already cancelled on my friends? 

So I go to the TA session. The first thing the TA says - "I just wanted to start off by reminding you that this year is pass/fail and this homework assignment is worth 3 points of your total grade." 

Wonderful. So now instead of being in the TA session learning or going out to lunch with my friends, I am blogging. Med school is confusing. "There is no right choice. Only what's right for you." That's what everyone keeps saying. Well, sometimes no choice feels right. All I know for sure is that I was really, really hungry. 

The interesting dilemma about not having grades is not that I'm unmotivated - it's that I'm afraid to be worthlessly over-motivated. Now that's a conundrum. 

firsts

This week I took my first patient history (with a real patient, isn't that scary?). At least this time the fourth-year medical student did the interview. We just took notes, but next time we have to come up the questions ourselves - I'm terrified. You would think it would be easy, but just randomly asking a person about how they feel with no medical knowledge is really intimidating. I'm sure I will write more about this later, it's amazingly complex.

My lab group removed the lungs from our cadaver (after sawing open the rib cage, which almost made me faint - and I'm not a queasy person). We also got lectured for not being able to tell the difference between arteries and veins...oops. In fact, they look extremely different. Veins are really thick and dark in cadavers because they don't have the musculature that arteries have, so the blood was never pumped out of the veins after the person died. After the professor showed us what an artery looks like, I felt really dumb. Oh well, now I know.

Other random firsts: I took a tango class for the first time. I made stuffed peppers for the first time. I also tried Peruvian fusion cuisine and Bosnian food, both firsts. I skipped my first medical school class - you might be able to guess it - Histology! (Studying for an hour instead was way more effective, I should add.)

Life is good, though really busy. I think I need to slow down a little bit, but it's hard when life's this exciting, isn't it?

trust me, I'm a med student

A day like today is the reason I'm in medical school. I know I didn't admit it earlier, but last week was pretty draining. A whole bunch of basic science lectures all in a row = super boring. I had trouble sitting still, and as one of my best friends describes the sensation: "I feel like a 5 year-old boy who's told to sit still in Kindergarten, but just can't do it." But today, I experienced my first anatomy dissection and learned how to take blood pressure.

Today I made my first incision into human flesh. Today I was put in charge of my first patient, my cadaver. He donated his body, the place where his "self" once resided, for me to learn and to become a physician. I will learn intimate details about him - details he himself did not even know about his muscles and vasculature. The organization of the human body is impressive. Also, there is a difficult pull between wanting to respect and care for the person who donated their body for you and wanting to distance yourself from the reality of the dead body in front of you. It is easier if you just allow your desire to learn to take over. I think it will take me a while to continue to process this privilege that society has afforded me, a privilege very few are given. It might take me equally as long to remove the smell of formaldehyde from my hands. 

I also learned how to take my classmates' blood pressure. Carrying around my stethoscope, I feel like I'm just "playing doctor." It took less time than I thought to be able to hear the sounds, but my readings are highly inaccurate - don't trust me to diagnose you with hypertension any time soon.

accomplished.

Finished with my first week of classes! This week we had histology three times because we're not starting anatomy until Monday, so I'm really glad this week is over. (Needless to say I don't think histo is going to be my favorite subject.) Although my histo TA is extraordinarily gorgeous. Like, super hot. Today he told me my observation was "astute." Frankly, there's nothing better than a really attractive man saying that you just said something intelligent. At least in my world there isn't. (Maybe this is why I had to come to med school.) Unfortunately, the ring on his left hand indicates that I must admire from afar... Well, he is welcome to come by and look in my microscope any time.

The other really fantastic thing about medical school are the free lunch talks. This week, I had pizza, Chinese food, Jimmy John's, and Indian food. All for free. And all I had to do was sit and listen while eating. At least I know I won't have to worry about feeding myself with my student budget!

learning ahh

Things I have learned in my first three days of medical school:

1. Mast cells, macrophages, and plasma cells all look the same to me under a microscope.

2. In four years, I will have a narcotics license, so apparently this means I have to grow up now.

3. Clown doctors actually do exist. And I can take a class about them.

5. Doctors with beards are actually supposed to wear huge helmets over their heads when an N95 protection mask (in the case of certain infectious diseases) is called for.

6. I am in love with my Macbook Pro. Every time I open my computer I enter this joyful world of bliss where everything makes sense. 

7. Medical students are way more interesting than you'd expect. Maybe too interesting... In general though, I have met some pretty awesome people that I am excited to spend time with over the next four years.

The list could probably go on and on (and begin to include some very boring information) so I'll leave it at that. 

50 percent?

It is the day before my first class and already I am blogging to avoid my reading for class tomorrow - this is probably a good sign for my blog, but not my study habits.

As I began reading about electron microscopes, I was plagued by a quote from a dean during orientation: "By the time you finish your medical training, 50% of what you learn here will be obsolete. I just can't tell you which 50%." It is pretty impressive (and perhaps a little defeating) to think that 50% of the humungous volume of information I will learn in medical school will change in such a short period. It is inspiring to think that medical knowledge is expanding so rapidly, but it's also intimidating that I am beginning my journey into a constantly changing profession.

On the other hand, I hate microscopes so much, I don't think it matters whether or not these particular type of fancy microscopes are still used when I'm old and wrinkly - I doubt I will choose a specialty where I stare at slides all day. Anyway, I'm still excited about my first day of class tomorrow, although I do feel sorry for my histo lab partner. Wish me luck!

cpr certified

Today we had CPR training as part of orientation. Many people complained because they are already certified, but I haven’t learned anything about CPR since a babysitting class at eleven, and my only memory from that class is being petrified of babies dying from SIDS. I think the first few times I babysat after that class, I just watched the babies sleep the whole time, afraid they would randomly die at any moment. Anyway, I am now CPR certified, but I definitely would not be able to just save a random person dying on the street. First of all, I would have to carry my CPR mask around with me all the time… I guess we got the “professional” version of training, which assumes I will only encounter unconscious people in hospitals. Considering I will spend a large portion of the rest of my life in a hospital, I guess this is a fair assumption. My favorite fact I learned today is that compressions should be performed at the pace of the songs “Staying Alive” or “Another One Bites the Dust”, or 100 bpm. I personally prefer “Another One Bites the Dust” because that’s definitely what would happen to the poor unconscious person whom I encounter on the street at this point in my career.

wilderness

My medical school experience started off with just what you’d expect – a wilderness retreat! Being the very outdoorsy girl that I am (not), I secured a spot in the coveted “rustic lodge” (which turned out to be a motel room with a barely functioning shower head), which was still way better than sleeping in a tent. I thought the second years would make us learn something medical, but luckily our survival skills were only tested when it rained while trying to grill burgers.  Even though I got rained on and muddy, I met a bunch of cool people. It is comforting to have a number of familiar faces going into orientation tomorrow.

beginnings

I am starting this blog for a few reasons:

1) I’m blatantly copying off the very inspiring blog agraphia.net, written by a current ER resident who has documented his entire med school experience and beyond.

2) I have trouble keeping in contact with everyone who I would like to tell about my life, because I tend to get a little swept up in studying. Hopefully this will be encouragement for me to communicate little tidbits of my life I might otherwise forget to share with my friends and family, even while I’m sucked into the med school vortex

3) If I can actually keep this up it will be an awesome way to look back

I hope you will find my musings somewhat interesting. I’ll try not to drone on (too much) about the really exciting facts I can’t wait to begin learning.