HPI: Started Medical School in August, 2006...

Less than a week left...

2009-09-23T23:54:00.000-04:00

... till it's time to go back to the "real world"... which in my case would be my 12-week medicine clerkship (thankfully starting with a yummy 4-week surgical-subs elective with mostly 4th years whom I love :oD))

As I sit here nibbling on peeled orange slices (isn't it awesome when you get those? I know, I know, major fiber loss but sooooo much yummier with all the balls of juice just exploding in yoru mouth - okay, major digression) I wonder if I'll still remember how to write a friggin' SOAP note. Eh, worry about it when the time comes.

The worst part about investing your sweat, your blood, your cervical vertebrae (last I checked, my C-spine looked like that of a 65-yo woman; Even the radiologist wanted the tech to double-check to make sure it was mine. I knew I should've listened to dad all those years about posture...)

... is that you FORGET half the shittake mushrooms you worked to hard to learn, absorb, memorize!

Okay, so I rarely memorize. Not that I can't, but a) I usually don't get around to it, b) I hate it, c) I hate it... so I stick to understanding concepts intuitively and in the worst-case scenario where I HAVE to inhale random minutia (i.e. 55% of medicine)... I usually made stupid associations involving anthropomorphizing all the different cells and interactions and blah blah...

You would think I would remember things if I UNDERSTOOD THEM...

Nope.

Definitely easier to re-learn, but I must have a giant gaping hole in the back of my head where stuff just falls out with every step I take... it's just that no one's told me about it yet (kinda like that open fly you spend all day flaunting until you come home or happen to glance at a mirror yourself).

I swapped Neurosurg for ENT... a last-minute deal that I didn't think they'd honor, but did somehow. I love head and neck anatomy, so it isn't much of a downer. I just wanted to save Neurosurg for a later time when I have more surgical experience. I was supposed to have completed OB/GYN by now, but given that Im currently taking that rotation off, I don't see the point of walking into the OR without a single clue on how to even scrub in.

Hard to even IMAGINE where I'll be in about a week and half from my current vantage point... but that's what I love most about life... especially mine.

Met a Physiatrist this afternoon...

2009-09-10T12:54:00.003-04:00

... granted for about 20 minutes and he was relaxed and on vacation, but I was shocked.

I've always wanted to do an executive MBA after graduating, and that's exactly what this guy did - and started a number of sites in under-served areas within the Midwest...

I love working with OT's, PT's, and ET's. They're real, fun, and really know their stuff. I had a 62yo PT lift me up and almost throw me across the room once when I screwed up the answer to "what is the unhappy triad" once. It was awesome.

The integration of Neuro and concepts from sports medicine, as well as snippets from medicine itself due to its wide array of referrals... makes me not have to sacrifice my stetho or, more importantly, my knowledge of anatomy...

The psych? Of course! The patient, the family... it's a long, tough, tedious process... QOL improvement requires more than just moving your left knee into a certain position x-times a day for x amount of weeks.

Been there, done that, bought a t-shirt, scars, chronic pain, and a whole lotta patience.

Did I mention continuity of care? or lack of night-calls? or the fact that the dude I met look positively ecstatic to be alive?

Gonna head to bed before this becomes overwhelming. Maybe I DO need a hit or two of cocaine... er, methylphenidate :oD

Physiatry and Rehabilitation Medicine? Me? Ummmm.... really?

2009-09-09T12:17:00.001-04:00

You would think between stingrays and sharks, I wouldn't be thinking medicine.

I woke up this morning with THE most random idea in the world:

A Physiatry residency in CA.

Huh?

I don't even think I knew what a Physiatrist WAS really when I thought that. I know a classmate of mine has a mom who's a Physiatrist and all I remember is her saying something about "good stuff" in injectable form constantly lying around in the fridge. Hmmm... not sure if I need my future kids getting doped up everytime they make a PB&J, but okay.

I'll admit it - I still don't really know the specifics. But the emphasis isn't on saving lives per se (I'll leave that up to my ER doc dad)... it's about RESTORING lives... saving the QUALITY of a life.

Pain... chronic pain... recovery after stroke.. it ties in mega-well with Neurology and Sports Medicine, the latter which I'm starting to like more and more. I, under no circumstances, want to do orthopedics, but sports medicine is just awesome. Maybe I can shimmy my way in through the back door?

The point of documenting this, I think, was to prove my mother's point of: "[Sweetheart], I don't think you have ANY idea what you're going to do, okay? Just wait and see - every day you will change your mind [and every day your dad and I will pray for the day when you finally decide and we don't have to listen to your wild & wacky contemplations ranging from Neurosurgery to Psychiatry, and now, to Physiatry.]"

The parentheses was implied speech.

::yawn:: If those 30% (?) cuts in Medicare go through though... maybe Child Psych would be the way to go after all...

Yes I took my Concerta/Adderall/Hit of Cocaine today.

Scalpel? DSM IV-TR?

2009-09-05T03:08:00.000-04:00

I think sometimes people think I say it just to see the look on a person's face when I respond to the inevitable, q twice daily question of, "so, do you have any idea what you might want to specialize it?"

"yeah... I initially came to medical school wanting to be a neurosurgeon, but I've actually become quite interested in Psychiatry lately, so I'm not sure... I guess I'll have to wait and see."

Sometimes I get the polite nod of, "yeah, sounds like an intelligent two options you've got there... I hear [bipolar] med students say that all the time."

Sometimes, I get the blatant, "wow, um, those are two VERY different fields you've got there... ::nervous laughter::... [you must be one very confused person.]"

It's okay. You can say it. I get it. I got into medical school didn't I?

Seriously, what is one to do? I know, I know... wait for the rotation (which are BOTH scheduled for next semester, although I did sign up for a surgery elective starting October 5th). Part of me LOVES the hands-on, digging inside, immediate (okay, within 24-hours for most surgeries) gratification (vs. writing 30 Rx's for Lipitor daily and waiting and seeing and waiting and seeing). I remember back to Block II of anatomy when we moved on from the muscles and ligaments (thank GAWD) onto the interior anatomy of all the organ systems. We kinda stood around waiting for our professor to show up, until the only guy at my anatomy table and I, while flipping through our manual, realized we wouldn't be dissecting the uterus and freaked (he wanted to do OB/GYN. i just wanted to dissect anything and everything because i was simply fascinated by the systematic way our bodies worked on the inside)

Lo and behold, we spent the next hour (during which our professor still didn't show up) lifting bowels out of the way, the gallbladder aside ("OMG! it's GREEN! guys, did you see this!? the GALLBLADDER is actually GREEN! just like in the atlas!" - yeah, the simple things excited us back then) searching in vain for the uterus which ended up being about a foot from where we were desperately searching for it (note: this was month two of medical school. we're better now. sort of.)

Our gloves were covered in nonspecific brown goo, we were trying to decipher why there was a "fat pad" in the middle of the abdomen (later turned out to be the Pancreas), and we almost gave each other a splashy, icky high-five when we "found the left kidney!" (turned out to be the spleen).

The point of this isn't to turn anyone off from donating their body because med students obviously have no clue what they're doing (we do. by the end of anatomy. which is exactly why it's so important.) I just always look back on anatomy as the most amazing learning experience of my life... I went in not even KNOWING what side of the body the liver was on (yes, I'm serious), and to be quite honest, I didn't really care. I started off like everyone else: anatomy sucks. get through it alive.

I ended up with a near perfect score on both Block II and Block III (head and neck) exams after pretty much flunking the first one. Not because I was in the lab studying to get a good score, but because I couldn't let go of my awe at the ability to touch and explore the insides of a human body... my body. To hold someone's heart in my hand, to hear the crack of arteries under my fingers when i squeezed thanks to atherosclerotic plaques (i ate reallllly well during anatomy, I will admit), and the best part: to hold the human brain in both hands and feel its weight, connect it to the nerves going into the various foramina and fissues... and just let it sink in exactly what i was doing!

The 3-D nature of head and neck anatomy fascinated me... the routes of nerves and arteries, the variability of it all, and the implications of even the tiniest slip (to go from our dissection skills in Block I, where I think one of us cut the trapezius in half by accident, to Block III, when we actually found, without killing, the ansa cervicalis - totally gets you automatic baller status- was nothing short of miraculous.) were beyond intriguing.

Then, of course, I re-discovered my love of all that psychiatry encompasses (in theory anyway). With my psychology background from college (this is why I had no clue what side of the body the liver was on), I started to see patterns of behaviors that played a huge part in the health of my patients in the family medicine clinic I rotated through during my first two years. Sure, they had diabetes, HTN, the whole schebang, but I liked sitting there taking my "history" and letting my patient with the uncontrolled HTN let her long day's worth of frustration and agony with her job, her family, and her feeling of being "trapped into this life" out... as an MSI, you're not allowed to do much but take a history anyway, so what harm was there in letting her talk it out? What harm was there in a teeennnyyy weeeeeeny bit of some cognitive behavior smidgeons thrown in about why she felt trapped and was she really trapped? What brought that thought on? "Well, okay, I'm not really trapped - I keep feeling that way, but I'm not. I guess that just gets me down even more." Hmmm... let's work on that, shall we?

Obviously it was just pulling stuff out of my ass and more from my own experiences than medical school, but seriously... I saw those patients again and again throughout my two years, and it always warmed my heart to get a hug from them on their way out, or get excited when they saw me walk into the room. And then of course there was the 55yo man I convinced to stop smoking (even after my preceptor had told me it was a lost cause - turns out he was just frustrated about not "getting any" from his wife and didn't wanna approach it with her, so he smoked instead. now he "gets some" and breathes easier too :)) and he REMAINED that way!!

There was the little boy with a buttload of paperwork for speech therapy, OT, psychiatric care, and a grandma who said she had no idea where the patient's mother/her daughter was... who I talked to for about 15 minutes, asking about mom and the pregnancy, only to go up to my preceptor and say, "I think this kid's got fetal alcohol syndrome." And lo and behold, righto I was!

My heart valves tugged on their chordae tendinae when older patients were brought in by their children, not just for the patient, but for the children... and given that as a medical student I had the luxury of time that most PCP's don't, I always turned to the caretaker and asked them how THEY were doing... it wasn't my job, I didn't get brownie points, I just FELT the innate need to do so. What followed never failed to amaze me. These poor, hardworking, guilt-ridden children, wives, nieces/nephews were simply overwhelmed and in desperate need of someone to understand the hardships they faced daily in the care of their older parent or loved one. I cannot begin to count the number of times I've had someone simply burst into tears the minute I asked that question... often sobbing it out because they haven't had a chance to till now. There were times I got extra crucial pieces of history by asking that question, but mostly, I got a LOT of "thank you. thank you SO much for asking. it meant a lot. no one has ever asked before."

Cheesy? Yeah. I know. But true. I was much happier sitting and yapping and listening to my patients than answering pimp-like questions about the significance of the MCHC or RDW on the labs (which I quickly learned was ENTIRELY attending-dependent - some attendings scrutinze each and every lab value much to the horror or the poor medical student working under them, and others couldn't care less about the rest of the lab report as long as certain "golden" values were satisfactory.) I loved procedures, I loved writing scripts (and spelling Omeprazole wrong, so that the attending had to rip up the script and write a new one anyway... I shudder even thinking about it... "Amiprizoll" i think it was... hey, I've come a long way!)

None of the above experiences reflect the true nature of either of the two specialties in question. I realize this. Loving the touchy-feely-awe-inspiring feeling of anatomy is NOT comparable to being in the OR at 4am scrubbed in and unable to scratch your nose on your own (these things matter to me when making life-long career choices, yes). Listening to a genuinely distraught middle-aged woman in an outpatient FM clinic and perhaps being able to prescribe her something to help her cope or help her change her behavior pattern, etc. is not the same as day-in, day-out med management for outpatient Psychiatry and the non-continuity-of-care, often tedious and trial-and-error management of inpatient.

It was also easier to entertain the idea of giving up my stethoscope first year of medical school when I couldn't hear much out of it anyway (other than the static-y rustle of hair on my then-bf's chest as I pretended to check for murmurs and heart sounds - he might as well have had a grade VI mid-diastolic rumble with an opening-snap loud enough to deafen the little robin perched outside the window. I would have written normal S1S2, RRR).

Now that I can hear murmurs in infants, it's a bit harder. Oh, and I've graduated to Grade II's ;)

I think I mostly wrote this out to document my own naivety to chuckle at later when I'm chief of Physiatry in Alaska or something. Life rarely goes and I intend it to, and I've learned that I'm pretty awful at predicting where I'll end up and what I'll be doing at any given time.

One thing's for sure now though (I've discussed it with the parentals and I'm all clear!!): I am saying good-bye to my beloved NYC and headed to SoCal...

There comes a time when you need to shed out of your comfy cozy scrubs-you-wear-everywhere, aka skin, and just go for it.

Right now I'm going to go for some brunch. Sitting by the water typing away makes me hungry.

(That was meant to instigate some slight feelings of jealousy. Someone please feel jealous. Just a little bit. Especially given that the closest I've come to wireless by the water in the past few years is typing up a last-minute, due-in-twenty-minutes patient write-up first year while sitting on the john in my bathroom by the tub. That's probably mega TMI, but sunshine makes people say funny things.. especially when they normally don't get much of THAT either year-round ;o))

Maybe I'm not as worldly as I thought I was...

2009-09-03T10:36:00.003-04:00

My insatiable curiosity apparently isn't enough. I poke my nose into everything.

Everything.

To make matters worse, I am the nosiest, detail-obsessed, and sensitive-to-shifts-in-emotions-and-moods person I know.

It drives me ballistic.

Growing up in Queens and having traveled a lot as a kid (prior to HS where AP's took predominance over my worldly development... much to my travel-loving dad's dismay) I thought I had this shit down.

When my old step-buddy calls while I shop at Wegman's at 11am (high time for 60+ conservative traffic) and I scream "Nigggeerrrrrrr!!! Where has yo ass BEEN?" in the cereal aisle and the entire bazillion-square foot grocery all of a sudden seems reeaallllyyyy quiet... I somehow don't really understand why. Especially when these same 60+ conservatives laugh till their bellies are sore when I see them at AvenueQ where you pay to hear all the racist remarks and stereotypes you're supposedly not allowed to laugh at for free in public.

"Been there, done that" is my motto in life and although med school kinda ate it for the past few years (and will lick the remaining crumbs over the next two I'm sure) I still always thought I'd seen more, done more, knew more...

Then I poked my head out of the U.S. of A. for the first time in a while.

Sure there are some materialistic struggles... and war... and bombs kinda falling like two feet from where you may be standing at any given time... oh, and you might have to give up your "pocket money" to the cop down the street who just feeelllss like a cup of chai but doesn't feel like reaching into his own pocket for the change. There's also this issue of hygiene and lack of seemingly "unlimited" resources. i.e. people don't Purell their hands every 5 seconds (and thus actually possess some form of immunity in their GI tract as opposed to Purell-resistant colonization) ad you can't just grab 30 Taco Bell sauce packets only to throw out the 28 you didn't use. (I am guilty as charged. I used to do it to read all the little messages on top, but after a while, one realizes that a sauce packet saying, "Will you marry me" is really a rather sad accompaniment to one's baja chalupa.)

Yet... people magically seem to have more time. When you come visit, they're not tied up at the hospital or other job, and somehow, it's okay to just "show up" as opposed to making plans 3 weeks in advance, timed to the T. There's no "meet up for lunch" to make the visit efficient and worthwhile (I've actually always hated that innately - hard to connect with someone while you're chewing half the time and a quarter of your vision has a clock in it to keep track of the time so you're not late) You just "meet up" and no matter what time of the day it is, you end up eating something or another anyway (curious how the world connects over food and mood-altering beverages), but the eating is secondary to the meeting... a coninkydink, as opposed to a scheduled simulltaneous activity.

Doctors actually apply their knowledge of nutrition to their own lives and that of their family (not saying there are no pot-bellied docs outside the U.S. - but definitely a rarer breed for sure) which, at least in my experience in the NE U.S. is not encouraged, and even discouraged at times!! Blasphemy! Dude, you spend half your life learning how to help and take care of other people's health... you and your family are people too! If you can't benefit from your own knowledge of your own body, you're depriving yourself of one of the BIGGEST perks of being a physician or other healthcare professional!! It's THIS concept that struck my innards... not saying all docs are unhealthy, and I actually love that the current generation of docs are some of the most active hikers, bikers, skiers, runners, etc. They have passions outside of medical school and stick to them... but will they be able to continue to do that as they move further in their careers?

Bellydancing yesterday was one of the most liberating things I've done in a long time. It's been aaages and I was so ridiculously out of shape and practice... but after the music started and I started to awkwardly remind my transversus abdominis of its existence, I couldn't care less if my tummy poked through between the shirt and skirt of my ghetto outfit... the coins jingled, the skirt flowed, and my arms swished through the air helping me turn and jiggle for a full 2 hours.

I haven't bellydanced since I started medical school in August, 2006.

That thought has stayed with me all day. As I head to bed, I'm making a list in my head of the pieces of myself I've lost along the way over the past three years. Granted, I've gained so much... knowledge (as evidenced somehow by Step 1 - seriously, studying for that *&#%$ somehow helped me make sense out of all those I was SUPPOSED to learn during the preclinical years), maturity (just when I thought I was mature enough, has seen enough, something else would always come up), and stamina to survive through the worst of times (surgery, chemo, car accidents, long-term break-ups... you name it... it all happened... and during med school of all times).

I love what I do. I love what I've gotten myself into. I'm even all for the the wrinkles and dark circles under my eyes that will most definitely ensue before the next year is over... I just don't want to lose all the other loves in my life either... I don't want to blame medicine for that. It's like a partner you're completely engrossed in and in love with but, as a consequence, you lose touch with your family and friends, who comprised a huge part of you before you even met this new man/woman/gorilla/peacock/whatever tickles your spleen tip.

3rd year is, of COURSE, a wonderful wonderful period in my life to realize all this. I'm sure I'll be able to find alllll the time in the world to cook, keep in touch with family & friends, dance, shop at the farmer's market, draw (ok, scribble and doodle), go to all the car shows I've missed, read my Motor Trend as opposed to stacking it on the 80-foot "read later" pile, and test drive maserati's for fun (they're gonna take one look at my haggard, post-call face and call the "Home for the Homeless" hotline)...

One thing's for sure: I didn't give in to the vending machine or cafeteria crap during Peds and I sure as hell am going to continue with at least taking care of my OWN health in the midst of (attempting to) fix everyone else's. I'll wear a diaper if I have to during my forthcoming, obnoxiously long brain surgeries, but I refuse to become a dehydrated wacko with electrolyte abnormalities and vasovagals.

Nu-uh man. I gots waaaaayyy too much to do once I walk that stage with an MD tacked to the end of my name.

Like surviving intern year :)

Helllooooooo 3rd Year!

2009-08-22T11:55:00.006-04:00

I'm not even going to bother looking back on my old posts... most are such obvious products of the anti-med school oppression I lived under for three and and a half long years from my verryyy much EX-SO that it makes me wanna puke all over his constant array of Excel charts... thankfully they, nor him, are in any range to puke over, even if I was a projectile-vomiting firstborn male with pyloric stenosis :)

Here's my original blurb from when I started this blog as a happy, excited-to-be-here medical student:

One day, I came home from my preceptor's office having just performed surgery on a 7-day old infant with an extra digit, taken out sutures from a young woman's back while draining the abscess, convinced a patient who had been smoking for 20 years to quit, and thought, "wow... this is pretty awesome."

After a year and half of medical school, there are things about medical school that strike me as wonderful, and things that make me wish I'd never chosen this career...

I just deleted the current blurb I had up... something about how med school doesn't come with a manual and one has to find their way on their own and blah blah blah... Yeah, you'd start being philosophical too if someone fed you their own philosophical BS 24/7 for over three years ;o)

6 weeks of Pediatrics FLLEEWWWW by... it's been ages since I've functioned on such low levels of sleep and high level of excitement and drive... and I loved (almost) every effin second of it.

Of course my semi-procrastinating ass is STILLL working on her patient write-ups the Saturday after the last day of the rotation. Did you expect anything else? Have I ever handed in anything on time? Obviously this time was 100% legit and to be honest, other than my delway with the write-ups and a day and half missed out of the entire rotation (after the resident said, "Go home!") I've been on track for all 6 weeks :o)

I'm thanking my lucky stars I'm skipping my next rotation, which would have OB/GYN, to traipse around India with my mother so we can both regain our senses of self and take a much-needed, and overdue, break from the need to be doing something. Then again, I'd even take re-studying for Step 1, as 11 people in my class will be doing, over the splishy-splashy-ness of childbirth...

...Or would I? I was supposed to hate Peds too... the kids were supposed to drive me crazy and my blood cultures were supposed to be positive for every type of bacteremia possible for the duration of 6 weeks.

Don't worry, they're still pending... 48 hrs tomorrow. I'm gonna guess I'll be put on Ceftriaxone pending sensitivities like every other kid who popped in with a sepsis work-up to our floor over the past few weeks... I remember thinking in my half-asleep, pre-round state,"whoever the eff invented/discovered that one is probably peeing and pooping mula."

As for the kiddos. I love 'em. I love the lack of thirty billion meds to document and manage (in most)... I love the relatively better hygiene that makes it much more "palatable" to physicially examine them... (although one patient, who was transferred from a long-term care facility, almost made me puke with the amount of candidiasis she was covered in... poor poor thing...)... and the parents, who were supposed to test the limits of my deep breathing exercises, were actually the 2nd best part... the concern is evident, and actually quite-heart-warming. Maybe it was because I was a medical student and they somehow knew most anything that was being done was not my decision, and thus not my fault... or maybe it's because we as students have the luxury of time (and humility) to actually EXPLAIN what's going on and why... (that, I feel, is the most important aspect in any specialty... frustration arises when you have no clue what's being done and what it's being done for, whether it be with you or a loved one)...

I decided a few years ago that I was going to stop pretending I "looovveeeeee kids!!!" like every other female my age and admit that, though I have no hate for them, I'm not one to go out of my way to coochie coo one or fawn all over a ball of pudge that might grow up to be the next serial killer. I'd much rather leave it to someone else and focus on better, more important things like which Audi will be mine post-graduation.

So imagine my surprise (and my family's) when I started coming home... happy... excited... esctatic actually... of course they rolled their eyes when I hesitantly squeaked out that I mightsortakindamaybejustalittlethinkabout doing Peds and attributed it to just the excitement of being out on the wards... but I've HAD tons of clinical exposure... I've done more pap smears and rectal exams and friggin hernia checks than most interns by working in a Family Med outpatient site during my first two years with Docs who were more than willing to let me do whatever... adult medicine never tickled my spleen tip, but peds medicine? Hmmm... who would have thought?

I guess there is still plenty of time to peruse and ponder and flip flop between specialties and career moves... but considering Peds was the 2nd lowest on my future specialty differential (yep, even below Proctology, but definitely above Orthopedic Surgery after the smell of burnt cut bone made me vomit during block 3 of anatomy)... I've decided I had no effin clue what I was talking about over the past few years...

If I go into OB/GYN though, somebody please, please PLEASE for the LOVE OF GOD...

... find me a rich man to pay for my malpractice insurance? :oD

Onward ho!! Two more A/P's with some UptoDate references and I'm settttt to go back home!! :)

C Equals MD

2008-10-30T17:55:00.003-04:00

Random advice from a colleague-physician of my SO.

"Just remember. C= MD. That's something I wish someone had told ME while I was in medical school," he'd said.

Never left my mind since.

Today I've come to realization that I've been setting myself up for failure by expecting a complete turnaround in my attitude after that year off I took. You simply cannot expect to go from a 4.0-GPA, cried-when-I-got-that-A-minus-in-that-one-credit-physics II-lab-sophomore-year-of -college-even-though-it-didn't-change-my-GPA-an-ounce.... to someone who doesn't flinch when she gets asked by a professor to meet to discuss her recent Pulmonary grade of 64.44.

Shrugging your shoulders and telling everyone you don't give a shit doesn't change that gnawing feeling in your gut when you realize your score, or the socked-in-the-stomach feeling when you get e-mailed about scheduling a meeting regarding your "unsatisfactory performance." However, the changes such as apathy going into an exam situation, choosing to do pleasurable activities during a time when everyone else is studying like a MoFo, IS a change and needs to be acknowledged as well.

It's real. It isn't a phase. I really have lost any desire to be a perfectionist or get straight A's in medical school in the PRACTICAL sense - i.e. it doesn't suit my personality or life goals anymore. However, that's is not what is significanly decreasing my quality of life or those of the people around me. It's the fact that as a PERSON, I STILL am that perfectionist who WANTS to perfect and get straight As... more for the sake getting them because she can rather than because of the purpose they serve.

<<< Written last evening before heading out to dinner with SO. Did not end up getting any studying done afterwards, and on the contrary, another fight ensued and neither of us went to bed before 2am. Met with professor today who asked no questions about the situation and instead, just went over the exam, after which I realized I simply goofed because I underestimated my own knowledge.

What does my woman want...

2008-10-30T12:27:00.004-04:00

The age-old saga of men trying to figure women out continues... and not only am I one of those men who cannot figure out women (despite being one myself... I a) cannot for the life of me understand why women can be so irrational and b) cannot figure out why I MYSELF am so irrational and complicated at times! Ugh!

But even worse... not only can I not figure women out, but my professional school has driven me crazy to the point where I want to just scream, "JUST TELL ME WHAT YOU WANT! DO YOU WANT MY SOUL? TAKE IT! DO YOU WANT MY SANITY? IT'S YOURS! WHAT ELSE COULD YOU POSSIBLY WANT? MY FAMILY? FRIENDS? YOU TOOK MOST OF THOSE ALREADY TOO!"

I know the above sounds depressing, but I think that sorta is what it is: depressing. I'm going nuts, playing the game, trying not to care.. but you know what, when you get a letter notifying you you've failed and need to meet with the module coordinator, you feel like crap... because a) you failed with a 64.44 (literally), and b) you DIDN'T fail after they curved the damn test, but the professor still wants to meet with you!

Don't take me the wrong way... I think these professors rock and I really appreciate that they're taking the time out to try and help... but how shitty does that make you feel?

Gone are the days I used to care... I let MY woman (med school) just be and ignore her assaults on my mind, my soul, and the ripping apart of my self-confidence.... after all, what can I do at this point? Lament my fate? My decision to "spend the rest of my life" with her?

Alas... because I AM a woman... it DOES bother me... even when it shouldn't... and so instead of the normal man who would take it with a shrug and move on with his life, I take it as a blow to my heart, which I still have pieces of left...

.. and i have no clue why.

Blurb change..

2008-10-26T09:23:00.004-04:00

I started this blog with the intention of recording all the amazing things that I get to do as a medical student (after coming from from doing a bunch of amazing things)... however, the # of amazing things after that never quite amounted to blog-worthy, and thus I just went with what was actually going on behind the grueling experience that is my career path... Just for purposes, here's the original blurb... and maybe 3rd year, I can use it again.

After a year and half of medical school, there are things about medical school that strike me as wonderful, and things that make me wish I'd never chosen this career...

Wake Up, Brush Teeth, Be Happy ... Crack Open a Book and Learn!

2008-10-26T08:49:00.005-04:00

So that my previous post lasted me about a day... granted it was a good day and had I not "affirmed" that I would happy, it would have been a mega-crappy day... then again, you can't blame me for scoring low on the happy scale right before an exam (which happens to be tomorrow). I mean, at the rate my studying is progressing, I think a more important affirmation is, "I shall not panic! I can always flip burgers!." And I'm not panicking... really.

I've been meaning to hit up the library all semester, and even through the depths of hell during Cardio, I never quite made it... yesterday, I finally did, and with three classmates as well... and that's when I realized how much of that "peer support" I'd been missing out on... studying with your peers really brings with it a new level of confidence, security in your study plan, and the much-needed moral support and drive to keep going when it's been 16 hours and you still need to keep going.

I worry sometimes that my social skills have died since college, and exhuming them may not do any good as I'm in a whole new context with a whole new set of people who respond to different stimuli than normal people (hey, it's true). You may think you do not need social skills to study, but you sure as hell do if you need to make friends with study buddies and use their knowledge to your advantage.

The biggest problem, by the way, with studying in a quiet place with only your notes to distract you is that you get hungry... a LOT. Despite more caffeine in a day than I consume in a week, my "appetite" was huge... despite the fact that I was sitting on my ass all day! Between a container-full of Indian food, a mexican pizza from Taco Bell, Starbucks Oatmeal, a friend's endless supply of salted cashews, and a Cliff bar, I was convinced my body was trying to store fuel away for that I time I head to Cambodia to find a job after I flunk med school (or my exam tomorrow - same thing).

Anyway, my conclusion from yesterday is this: I think "happy" affirmations are the cheesiest things I've ever written up (publicly anyway), but they work! Thus, I think I need daily reminding of yet another fact (and please do note that these are indeed facts - affirmations, as least by my definition [ha! I've reached the age where I can create my own definition of pre-existing terms!] must be reminders of things that actually exist, and thus you cannot affirm something that are not)...

I LIKE TO STUDY!

No seriously... when did studying become a punishment? It's so simple, yet the whole world makes you think they're out there having all the fun and here you are, holed up in a library, reading your life away. Well, in HS, sure, maybe it wasn't the best because I was FORCED to be there, but I CHOSE to go to grad school, didn't I? No one forced me to be doing this... and for crying out loud, screw everyone else, I'm learning about my own body! ! The very stuff that makes me, ME! Okay so maybe I don't have interstitial pneumonia, but you get my gist.

I like learning... it keeps my brain active and aside from the lack of bodily movement involved in studying (which blows in terms of keeping the butt-size down), it's kinda fun... yeah some topics are boring sometimes, but honestly... and no one ever really admits to this, most things are only boring when they're a) repetitive, or b) you do not understand them. Think of all the classes you took in college where the topic initially sucked but you enjoyed cuz you loved the professor (i.e. he taught you a lot).

I think the library, or my new idea of bringing earplugs to louder areas, is going to be my new haven from now on... an escape from everyone, including family, friends, and SO... just me, my work, and my grad school peers. I strong believe, especially after this weekend, that distancing yourself and your work from your loved ones keeps their lives and yours more sane. I don't mean a complete divide, but definitely a wall that should not be crossed very often. However, more on that later... I need to get back to studying and this time, not as a punishment, but rather as an opportunity to learn that few get in this world... especially at the level I'm at...

If you're happy and you know it, clap your hands!!

2008-10-21T13:01:00.006-04:00

That cheery subject line does NOT mean I'm clapping my hands, but it's a reminder of happy times such as the time I went apple picking about a week ago. While my SO and I were downing some upstate-favorite Perry's ice cream, a kids band was chanting the words of that ageless song of clapping and stamping your feet to let everyone within hearing range know of your gleeful state.

More than ever, I think I need to start off my day with some affirmations. Kinda like you are what you eat, you are what you think... and believe it or not, you can modulate your thinking in the most simplest of ways... if you let yourself believe in them that is.

The same things don't work for everyone, but by the same token, you can't expect affirmations to work if you scoff at the list of them that you've prepared for yourself. The same way people wake up and stretch to make themselves loose and nimble, I think it'd be good for me to wake up and stare at a list of good-sounding words and sentences to get my feel-good hormones circulating throughout my brain.

Does this have basis in science? Sure it does! Am I going to cite any studies proving it? Hell no! Do I not have anything better to do with time? Jeez! :)

Man, medical school has been one crazy ride!!!... for me, for my family, and for my SO. Part of it is my intrinsically perfectionist attitude towards life and my career, which undoubtedly is like ASKING for shit to go awry... yet the other part is working towards something your whole life and discovering it to be both not what you expected, and even something that turns you off at times.

I look wistfully towards wedding planners, personal trainers, and marine biologists... what if I had THEIR job? I would be so much happier! And have free time! And love what I do!

The grass is alllllways greener on the other side... but an important thing that a lot of us (medical students that is) tend to lose track of is that... this, what we do in the basic science years, and even in the clinical years, is NOT what we will be doing the rest of our lives. Contrary to most others, our lives are wide open... we can CHOOSE (well, mostly... Step 1 scores aside) if we want to spend the rest of our lives dealing with kids, with dead people and their body parts (pathologists), or even living on a cruise (yes, there is a specialty called "cruise medicine!!")...

Thus, whilst we whine and we moan and we slowly have alllll the humanity and kindness and innocence slowlyyyy sucked out of us by Socrates-loving attendings, and self-loving PhD's who cannot lecture for an an hour on a topic without bringing their research and its importance into it (i.e. now I know aalllll about your research on anteater plasmid research, but WHAT is an adenovirus again?).. we go on... because if this is what our entire lives entailed, God knows we'd revolt and let the stupider folk in to do our job...

No, we're smarter than that (hey, we made it to med school, didn't we?) ... we know this is just the means to an end... an end that we will eventually decide to higher degree than most people have the ability to... an end that, baseline, pays more than your average grad-school-grad's job... an end that gives you the option of either being power-hungry bastard who cuts people open and sews 'em back up (disclaimer: not all surgeons are power-hungry bastards - some are money-hungry too) or a kind, caring family doc who overloads his brain and schedule with little relative monetary ROI...

So I will sit here and download my lectures and stress about how I'm going to get them done and find time to study... I will lament spending my 20's on a laptop listening to lectures about Mycobacterium when my friends are living life and traveling to Ethiopia and Greece...

Yet, I refuse from now on to wake up or go to sleep feeling like I'm not happy, or I'm worthless because after 2 and half years of medical school, I feel like my brain collapsed on itself and isn't worth a damn to anyone... no one deserves to feel like that, ESPECIALLY not someone who is working so hard to achieve something she's dreamed of doing all her life, and genuinely wants to spend each day of her professional career bringing a smile onto someone's face.

With all the talk of rights, no one ever mentions happiness... and yet, it is my strong believe that life does not indeed come down to sex and money (and I believed for most of my adult life)... it comes down to happiness, and the pursuit of it. That explains why we're all so different... and how we can live and survive in such different ways and all be human at the same time... happiness means something different to everyone, and the only people who are not happy are those who either are not able to be where they want to be, or those who fail to realize that they are.

If I'm one of the latter, tomorrow morning, I'm going to wake up with a smile on my face... and that's one more step towards my goal of putting a smile on someone else's.

What am I doing here?

2008-09-01T09:06:00.003-04:00

I've been wanting to vent for the past three days, and I have been doing so in my head constantly. I knew if I took to writing it all down, I would be spending half of this gorgeous weekend in front of a computer when I could be spending it... in front of a computer cramming for my Cardiology midterm...

I'm not complaining about Cardiology (although I can, and I have, and I will continue to do so). I'm not even complaining about the time investment. All I'm wondering is... if I don't really CARE anymore, about my grades, about what I'm studying (with all due respect to my own body, I'm kinda getting sick of looking at picture after picture of something wrong with it)... and the WAY I'm studying it... WHY am I studying it?

Is all this really going to help anyone? Or am I just wasting away my 20's following someone else's idea of how to acquire a doctorate of medicine degree? (To be honest, I don't reallyyyy know what an MD even stands for.)

Everyone says you hit this stage at various points throughout your medical education, and normally I hate being part of the crowd, but in this case, I'm wishing on a wishing star that "they" are right, because I've worked hard and long to get here. I genuinely do enjoy helping people with their medical needs and breaking the mold in many ways by being an empathtic health care provider and person... but I feel like I'm losing everything and gaining nothing.

Nothing breaks the spirit more than to strive your whole life to get somewhere, and then realize the journey was long, hard, and sacrificial, and the end result was actually not what you wanted.

I haven't felt this disheartened about my medical education in a long time. Not only is it sucking away the fun from my life, it's starting to nip at my confidence too.

Of course that could have something to do with the fact that I need a DRASTIC makeover in terms of study habits and techniques (yes, even after two years of this). Apparently I'm a slow learner :oP.

The Chronicles of Nine-to-Five-Nia: The Gossip, the "I'm busy right now," and the Great Escape

2008-07-24T09:12:00.006-04:00

I haven't written in here for a while... mostly because work (i.e. my summer research position) had me down in the dumps so bad that I had myself convinced I wasn't capable nor worthy of writing a blog entry... but also because I had started this "series" of "Nine-to-Five-Nia" (which I thought was damn spiffy... did I just say "spiffy?" Words like that are more telling signs of aging than even wrinkles) and desperately wanted to continue it... except how do you talk about work when you never... um, GO to work?

On the surface it seems like another case of the "medical-student-who-started- his/her -summer -research-project -and- then-gave-up-halfway- due - to- laziness- and-stopped-showing-up"... but in my case, it was absolutely nothing to do with loss of interest or the lack of desire to get up in the morning and learn how to read MRI's... that is shit is COOL man!

No, what I couldn't stand was the environment that doing... no, ATTEMPTING to do this research, put me in. With my PharmD "mentors'" offices on either side of the one shared office that was set aside for research staff (in the sense that we were to squeeze into spaces not taken up by the PharmD's boxes of Christmas decorations and unused dusty coffee makers)... I was privy to all the gossip, name-calling, and endless petty complains about a colleague named "Zoey"... a privilege I would have gladly handed over in exchange for wearing a spiked dog collar around my neck.

All day long, they complained. And complained. And bitched. And bitched some more. Try as I might, I just couldn't drown them out. "Can you BELIEVE what she said to me??" "OHMYGOD That is sooooooo funny!" (In reference to an e-mail forward I've received about 80 times since the 7th grade) "UGH, I have to go see this stupid patient. Why do I have to see patients today?" (Why did you decide to become a clinical pharmacist?)

I tried to drown them out; tried to immerse myself in patient charts and get all caught up in Lipitor doses and whether the patient was put on Plavix post-stroke or pre-stroke. I even took breaks and checked my e-mailed and chatted with my SO for hours on end, doing nothing productive and finding out which cruises I could possibly hop onto mid-semester after my Cardio final. Nothing did the trick and all I could do was not scream from the constant stream of whining and bitching that grated on my nerves like a broken radio trapped inside a hidden wall within your house.

Did I expect to be working in an environment this summer in which people actually did their work and saw patients and acted in a respectable manner? Of course not - I'm not dumb. I know half the work day is nonsense filled up with fluff and no-good. But at least the other half is productive, right? And if you can spend 6 straight hours yapping about your neighbors and your dog and your mortgage payment, you can spare 6 minutes to talk to a student you're supposed to be mentoring, right?

Wrong. And here is where I lost my patience and learned something new about the workplace and the psyche of its human constituents: When it comes to gossip and politics, there is ALWAYS time; It does not matter if a patient has been in the waiting room for over an hour - Petunias and one's latest sob story about their mother-in-law always take precedence.

Furthermore, this applies to medical students working in the midst of PharmD's with egos: When the student approaches the PharmD with a question, the PharmD is immediately concerned with patient care, finding his or her stapler, or responding to an e-mail about Bingo tonight. Ten minutes prior, and up to three hours post-attempted question, the PharmD has all the time in the world to return to more pressing concerns: continuing the day's gossip and spreading the love of hate.

After weeks and weeks of trying to approach my mentors in a way least obtrusive to their gossip schedule (AKA their patient and meetings schedule), including short, to-the-point e-mails (something I as a person find very hard to do), listening closely to wait until they took a water break from their conversation (to alleviate their dry mouths after a lengthy Zoey-trash-talk session), and even scheduling quick meetings to avoid random "pop-ins," I gave up. There's a point you reach where you can no longer attribute completely ignored meeting times (even after several subtle and eventually not-so-subtle reminders), completely ignored e-mails (that require less than a 7-word response), and utterly useless, grunted replies to questions asked during a lull in the day, to just being busy.

I'm not a 5-year old looking up to a 50-year old for advice on painting the fridge green!! I am a medical student working on a project on which my mentors' names come before my own, and thus I deserve at least some sort of guidance as to what the hell I'm doing and some real answers to some very legitimate questions! The excuse of "I'm busy," whether explicitly stated in words or actions, just doesn't apply when you're obviously NOT busy!

Addendum: [It took me a while to be able to declare the above - I thought for almost 4 weeks that I was doing everything wrong and it was entirely my fault that they didn't seem to like me. I still think that it takes two to tango and thus, if I had approached it differently, maybe things would have worked out better, but I can no longer say it is 100% my fault. My mentors truly dislike me for some reason (perhaps being a med student has something to do with it?) and have made it obvious through their obvious disregard of my presence on a day-to-day basis. The only positive thing to come out of this experience is that I feel much more prepared for my 3rd rotations and dealing with physicians who will inevitably dislike me at some point, or at least appear to. The lesson learned: 'Tis better to ask for forgiveness than permission." Just do instead of asking, and people will appreciate your initiative more than they will your desire to do everything the right way.]

And thus I decided I needed to simply escape. It began with escaping to two-hour lunches versus one, and going home to practice some bellydance moves and chatting it up with my mom on my couch before returning to work. Eventually, I added on arriving a half-hour past the hour - just to see if anyone would notice. With no response, I decided to take longer with my make-up, make a Starbucks-stroll before work, and carry my grande-caramel-lightice-soy-iced-coffee in with me along with some hummus and crackers in at 11am (still taking my two-hour lunch from 1pm - 3pm). It saved me from the morning warm-up gossip session that I hated the most, but it still wasn't enough. By the time I came back from lunch, I just wanted to leave again. My productivity, which had been low to begin with, dropped even further, with me doodling and running to the bathroom every five seconds just to stretch my legs and get out of that zone of mind-numbing chatter.

It was when it got to the point where I enjoyed being in the "Summer Garden" scented pink bathroom more than I did in my nook within the office, that I finally decided I had HAD it. Yes I'm being paid upwards of six grand for this summer gig (not by the PharmD's, thank heavens, no, but rather by an independent university program that promotes research within the mental health field) plus an all-expenses-paid trip to San Diego for a weekend. Yet, making myself miserable, even for a few hours a day, during my last-ever summer vacation, is not worth any sum of money to me. After two weeks of a true nine-to-five, and then about two weeks of my modified nine-to-five, I decided to quit. I stopped going in completely, using the excuse that I would come in after-hours when no one was there and do my work in peace - which I did... a few times... for about an hour at a time. Strangely enough, I got more done in that one hour than I often used to get done in a week. I found flaws in the study design that I have no incentive to fix, and decided that the minute I present in San Diego, I am finished, once and for all, with this study.

Now, looking back, this summer was all about beach-house parties in Canada, sleepovers with friends and old Indian movies, weekdays of bike-riding, sitting outside eating sloppy Joe's and watching thunderstorms, cooking random meals, trying Hibachi, weekend trips home for the 4th of July, partying (and nearly dying) in Vegas for four days, road trips to and from a wedding in CT, a day in Ithaca eating crepes at a Farmer's Market, and dedicating a few hours each morning to working out my mind and body.

I still have to present this research in about a week from now (and with about 10% of my data collected and no clue how to analyze it, let's just say I'm somewhat in a bind with that)... but my goal is still to just get SOMETHING done so I can keep my six grand and keep my sanity until school starts up again. And considering my 200-crunches a day now and lengthy stretching routine, maybe I'll have some tighter abs to show for it.

As for what I have prepared as an answer to the remote possibility of someone at work asking me where I've been or what I've been doing the past few weeks... all I plan on telling them is that "I've been busy."

The Chronicles of Nine-to-Five-Nia: The Med Student, the Coffee-Maker, and the Printer

2008-06-16T16:47:00.008-04:00

After two weeks of the 9-5, I decided to finally say, "screw it" and write a post bitching about work... at work.

I mean, isn't that what you're supposed to do? Isn't an account of a beautiful Hawaiian sunset much more plausible when written IN Hawaii, as opposed to when you're back in your cramped little office in the city and staring at a charred brick wall remembering your vacay?

I needed this exposure to the "other side" - for many reasons. Let's start with the fact that I've never worked in a traditional office. In all my ::cringe:: 24 years, I have never seen the "printer hangout" spot, the generic coffee maker with the even more generically labeled canisters of "sugar" and "creamer" (and innumerable extras in the cabinet below - I didn't see them exactly, but I know they're there)... or the parking lot that fills between 8:55 and 9:05am, empties between 12 noon and 1pm, and starts to fill again between 1pm and 2pm, only to become a replica of a paved-out version of the Sahara desert by 4:59pm... oh, and let's not forget the GOSSIP. During my hourly visits to the restroom (thank you caffeine, you potent AVP-inhibitor you), I hear more drama in the 75 feet I walk to my destination than one could possibly ascertain from two talk shows back to back. The Pharmaceutical rep is cozied up next to the "free-food table" right by the coffee maker with an NP, the secretaries are shouting back and forth about some "Biatch" that ruined their night last night, the RPA-C's are running around pretending to be pretentious doctors complaining about their patients, and the neuroimaging fellows reading MRI's are really discussing their night out on the town and who got laid.

It's interesting that all this coincided with me reading Tim Ferriss',"The 4-Hour Workweek," a book I would have NEVER picked up in a million years had I not found it lying in my apartment, left by a friend, during a need to read while eating. The book hones in on the exact problem that has plagued me since I got here: WHY ARE PEOPLE WORKING 9-5??? It is SO arbitrary - 80% of the work done in a given day is done within 20% of the time allotted to it. There is NO NEED t have 8-hour work days... not because Tim Ferriss said so, but because in in all my 8 hours a day I spend in my allotted office, 75-80% of the chatter I hear around me involves NOTHING to do working (unless a clinical pharmacist needs to dish out the scoop on how she bought her mother a kayak right before the store closed and then got pulled over on the way back but got away with it ("HA!") in order to see and evaluate patients).

You would think my experience so far would cause me to roll my eyes and possibly laugh at these idiots throwing their life away in a little basement cubicle staring at pictures of themselves doing what they wish they were doing... except I can't laugh... it's not funny, it's ludicrous!... and exemplifies the lack of thinking people in this world put into their own lives. 9-5 is a cult - a following with no basis in logic. People dedicate their entire lives, no, not just that, work their entire lives AROUND their "9-5"... for what? Cheap generic coffee and the opportunity to compare shoes and talk about your kids with people who only listen to get to their turn to speak faster?

Call this a rant if you wish, but doing things for the sake of doing them, doing things because "someone" decided this was the way to go, is no different from following a religion that tells you to go implement the crusades to eliminate those who do not belong (tell that to a secretary and you're bound to get lynched). You get to work at 9am sharp even though you feel like shit when you wake up, because if you don't, your boss will fire you and you'll be out of a job. Convincing your boss that if you arrive at 11, your productivity won't change, is bound to elicit a stunned look that says, "stop smoking whatever you're on and get back to work." So you keep doing it, keep feeling like shit, and what do you do when you get to the office? You plop on your seat and read the news, drink your coffee, and wait for your brain to wake up so you can start working at 11.

Could you have slept in, dropped the kids off at school, gotten some errands done, and treated yourself to a latte in those two hours you sat in your office because you were supposed to? Sure. But what's the logic in THAT?

Bottom line? (yes there is one... somewhere... I swear) Or... why does this drive me up a wall? Because it reminds me of how I sat in my Clinical Practice of Medicine class one day wondering, "Why am I here?" The lecturer was horrible, I had just had an exam that morning... all I wanted to do was go home and sleep, but here was this 1pm class (mind you the test ended at 10am) and the only reason ANY of us was there was because were required to sign in. REQUIRED TO SIGN-IN.... Read: We are MEDICAL STUDENTS. No elitism there - just the insinuation that we are some of the most driven, type-A, perfectionist, and psychotic people to walk the face of the earth, and every single one of us has faced our college peers in organic chem and caused them to crash and sizzle to the ground. When we want to learn, we learn - we damn sure didn't work this hard to stop now. Why, then, were we being treated like high-schoolers (and where I went to HS, they didn't even flinch when we cut a class to sit right outside the classroom to finish the HW due that day for that class - such was Stuyvesant HS, which I'll yap more about another day)...

This "high-school" concept stuck with me and from then on, I refused, even within the conservative realms of medical school, to do anything for the sake of doing it because someone, akin to your high-school principal or that evil 9th period Chem teacher, decided I "had to." Yet, here we have an entire POPULATION of "9-5'ers" who do exactly that: show up at work at 9 because they have to, leave at 5 because that's when they "can" leave, and make up for their misery by being totally unproductive for more than half the day!!!

Does that NOT strike anyone else as weird? I've got a lot more peeves and I'm sure a lot more to learn (next post: PharmD Elitism - p.s. you guys are NOT physicians. Thank you.)... but wow. To think how conservative our so-called "progressive" society is.

There's an old Indian tradition that says when you've shared something edible with a family or group of people, you have somehow become a part of them, indebted in a way and connected at the same time....

... God knows I ain't drinking ANY of that generic coffee!!!! Daily Starbucks runs? Here I come!

Kaapoooooeeyyyy!!!

2008-05-26T12:58:00.004-04:00

I've been in some weird zone lately... randomly hyper and randomly focused... much like the Type I and Type II muscle fibers I'm learning about... my life resembling one of those H&E preparations with dark-staining type I fibers where I'm working like a squirrel who procrastinated gathering acorns for the winter... and then some type II light staining fibers which symbolize my spurts of dancing around my apartment like a humpback old lady who just learned the cha-cha and downed a case of Red Bull.

Even cramming can be made fun I've learned... you have your panic attack and you spazz and then you enjoy life in the middle and are thankful for the little things... friends... loved ones... good coffee... the loan money to afford good coffee and goodies at the cafe you camp out at...

Confidence is a driving force like no other... where it leads you is yet to be determined... but hey, at least it keeps you going :)

Fingers crossed... I can call myself a 2nd year medical student as of Friday, May 30th, 11am...

Appeasiotomy

2008-05-21T08:58:00.007-04:00

It hit me this morning that my faith and sense of security within the online search system needs to go on a diet.

I was actually looking up the word "pragmatic," after reading it in an e-mail and realizing I had no clue what it means... when the word "episiotomy" randomly popped into my head as well... and so I decided, hey, let's look that up too.

So #1... I don't know what pragmatic means. I don't know why I don't know what it means... people have described me as such numerous times and I'm a well-educated, intelligent individual... so okay, fine, I never bothered to find out what it means but I am now... so better late than never...

Now... #2... episiotomy... this just popped into my head and thus I had absolutely no clue how to spell it, or even if it was a real word or not... so I go back to good 'ol phonics/random guessing and spell it out as "appeaseotomy"... and lo and behold, there it is! It IS a real word! I do a little "I'm so smart" jig in my head and proceed to figure out what it means.

Two things caught me off guard. First of all, there was no Wikipedia entry about it... this is weird for ANY medical procedure/term/etc.... unless it is really THAT obscure... (and even then...) Secondly, all the hits had misspelled "perineum." Aha, proof that I AM a medical student! I know how to spell perineum! So why had everyone spelled it "Paraneum?" Laymen I tell you.

It took me long enough but eventually I figured it out... and boy did I feel like a moron. After trying several variations, Google finally offered me the correct spelling, "Did you mean, 'episiotomy?'"... YES! There it was! Official-looking hits, complete with the token Wikipedia entry... and a good lesson on relying completely on the internet to do the thinking for you.

A Google search is only as good as your knowledge of the words you are entering into it... and as silly as that seems, in a world where the brain often takes a backseat to computerized intelligence, that's a hard fact to come by.

An appeaseotomy for me, then, was the removal of my innate assumption regarding the immediate appeasement of my thirst for knowledge by a Google search...

Next, "Melanoma." Hey, at least I know how to spell it.

Treading the Path... Not Walking It

2008-05-13T08:46:00.005-04:00

Numerous studies have been done, most before the implementation of the lovely IRB, regarding human behavior and obedience. We just somehow function better when we're told what to do. It's true - the majority of us like to be directed and respond to an authority figure, and it is only within that control that we are comfortable stretching our legs and "being ourselves."

In a way, we need it. I mean, try figuring out traffic rules on-the-spur... it just helps to know that you have to stop at red, go on green... yet we get to pick somewhat when we stop at the yellow's and try and race through them. That small freedom is what allows us to not question and complain about the red's and green's.. the strings of the governing power that pull and jerk us like puppets on Avenue Q.

Yet what happens when, one day, you wake up and decide you don't care for the green-yellow-red system. Maybe you're standing still at a pointless red, with no traffic on the other side and thus, no purpose to stop other than the fact that if you do go, you will get a ticket.

Where's the logic behind that? Granted, as a whole, the system is needed to maintain order and create universality... but when you're the 3am-exception-that-really-wants-to-go-home-and-sleep- but-the-light-is-red-so-you-have-to-stand-there-and-wait... you wonder why they can't tweak certain aspects of the rules when they're absolutely ludicrous.

Obviously one ponders such issues and develops a certain cynicism for life when things aren't going right... like myself who's using the red-light-at-3am as a metaphor for my current med school experience...

I've spent the past year fighting the rules... questioning them, dissing them, and even deliberately disobeying them just to prove their futility. Now that I'm nearing the end of my repeat-the-year stint, I've started to formulate my plan of action for next year... when everything will be new and hardcore (we're talking Cardio module here)... with not much room for disobedience. Yet, for whatever reason, life has lead me to the flippant perspective I have now... not jaded, just flippant... an attitude that is almost NEVER applied to medical students...

... and I'm trying to figure out how to use it to my advantage.

If my appt. is at 2pm... why am I still sitting in the waiting room at 2:45?

2008-05-01T15:07:00.002-04:00

Along the years, it has somehow become acceptable, if not the norm, to make it point to arrive at your doctor's office on time... yet... to not expect to be seen until about at least ten minutes later.

Chalk it up to my lack of experience in waiting rooms - either I wake up the doctor at 4am if I problem (the doctor being my dad, of course), or I am a special patient taking part in a special study that is waited on hands and foot by her doctors.

I strangely enough encountered this issue not as a patient, but as a medical student seeking a summer research opportunity, and not even with a physician, but a PharmD.

Granted he apologized for the wait... but THAT isn't the norm either.

So what can we do to prevent it? Obviously all avenues have been tried by all parties involved... and with health being one of those issues stuck in the middle of humanism and capital gain, you can't quite shove your patient out of the office when his or her time is up... yet, you can't help but stare at the clock knowing you might be billing for one less patient if time runs out...

But there has to be SOMETHING... I mean, the punchline is, NOT all offices make you wait. There ARE doctors out there who manage to give their patients the attention they need, yet don't make them wait outside in their plush waiting room for 20-30 minute stints either. Granted it's way harder for a PCP to regulate time versus the specialist, as the complaints can be endless (my foot hurts... my nose hurts.. and my neck is a wee bit red there... and... and) and there are so many various issues to tackle (are you taking your HTN Rx? When was your last mammogram? We should do a colonoscopy)... hence why the waiting time for primary care physicians is so obnoxiously high...

... yet there has to be something?

A med student can hope. And hey, one can always just become a specialist.

Supposedly, I'm supposed to become an adult today...

2008-05-01T09:47:00.001-04:00

Forever Growing
Taurus Daily Horoscope

Your thoughts may be centered on your familial and career stability today. Since you are likely dedicated to ensuring your security and thus thinking about the future in concrete terms, you may feel compelled to take on more responsibility at home or in your workplace. A caring and supportive mood can motivate you to volunteer to do chores or run errands for elderly loved ones. You may also be inspired to begin working harder in order to win a more prestigious professional position. Your efforts can put you in a mature frame of mind that allows you to see how you have changed over the course of your personal history. Today may be the day you feel that you have truly become an adult.

Well, Gee, Golly... finally!

"How long can you keep fresh cornbread out till it spoils?"

2008-05-01T09:35:00.003-04:00

I was rummaging through my pantry (is that what they're still called?) trying to find something to nibble on for a quickie breakfast and I found some cornbread that I'd bought fresh from Wegman's a little more than a week ago. Halfway through eating it however, I noticed a very very slight funky odor that was there one second, and gone the other... and I wondered... should I be eating this?

I can tell you Nephritic versus Nephrotic... I can Tanner Stage like no tomorrow... but I can't tell if any future patient might be having a tummy ache because of poorly preserved food.

G.I. complaints related to food supposedly make up a gazillion office visits a year, but we just treat it and move on... yet does anyone ever talk about prevention? My SO the other day was making fish and decided rinsing his hands with just plain ol' tap water was enough to kill at the germs on his hand so he could handle my little containers of paprika, garlic powder, basil, and the like.

Now, everything from my kitchen towel to my spice jars are probably covered in salmonella... and you know what the saddest part is? The man is actually within the upper ranks of healthcare management. Yeah, you read that right - he's not a carpenter or CS guy... he's actually IN the field.

If that's him, what in the world does a layperson do when he's making fish???

So why can't I be taught such things? So that I can teach my patients? So that I can PREVENT food-borne illnesses before they even happen? The medical equivalent to a flu vaccine for food poisoning... is that really so hard? Yes, wash hands wash hands wash hands... but does anyone FOLLOW the 20-second rule of soaping? No... why? Because they don't UNDERSTAND why it is so important...

... and neither do I. Just like I have no idea why my cornbread smells kinda funny... but while I was typing all this, it's all gone anyway.

Now all I can do is wait.

"Do you want the large? It's only 20 cents more."

2008-04-16T15:29:00.002-04:00

My Goodness... give the fat man a break! Sitting in front of the B&N cafe counter is more educational at times than the actual renal lectures I'm reviewing it seems... I see not only the root of our obesity epidemic, but the perpetuance of it! (And yes I know that isn't a word).

I'm a Starbucks-a-holic... I don't pay $4 for a latte, but I definitely Venti-up my brewed coffee and whenever I see someone ordering a cup of "Tall" (the smallest size available), I do a double-take just seeing a cup so small in their hands. I mean, a Grande is the new "small" and it hit me the most when Starbucks was giving away free samples of its new brew, "Pike's Peak" in teeny-weeny cups... except... those were 80z cups!!

An actual serving of any liquid is 8oz!! And just SEEing an 80z cup of something in Starbucks made me think, "eek, must be a sample," which makes me wonder... um, how much coffee am I REALLY drinking a day?

Granted it's not that big a deal - the myths against moderate amounts of coffee have long been debunked, and as a medical student, an extra cup of Joe is way better than the damage from the stress of not getting something done on time. Yet... our portion sizes as a country are OBNOXIOUS... and I know I'm just singing the same jingle over again, but when you venti-up a Frappuccino, you're adding almost 200 extra calories, which frankly, adds up!

Why are the price margins so narrow? And why can't it be "cool" to get less? We all know if we walked around with giant 7-11-type slurpies in Europe, we'd be labeled as gluttons... so why can't we incorporate something like that into our cultures here?

Hell, that would cut an average PCP's workload in half... wouldn't have to tell every other patient to lose weight, eat less... maybe then there would be enough time in an office visit to actually do a physical exam... or something important like that.

"Do you speak Spanish?"

2008-04-15T15:33:00.003-04:00

I was just leaning over to explain BUN and Creatinine levels to my friend Kari, sympathizing with the complexity of it all and reviewing Hematology jargon... and I noticed the man at the next table over (barely two feet away) listening to my conversation avidly... not unusual since a lot of residents study at B&N and I feel are often on the prowl for a significant other...

When we finished and I turned back to my work, he turned over to me and asked, "Do you speak Spanish?"

What?

"Um, no... sorry," I replied.

He seemed utterly surprised and almost insulted at my answer, saying, "Oh, I could have sworn I just heard you speak Spanish." As I repeated my apology and turned away, I couldn't help but notice him shake his head, as if to say, "people these days - what's the big deal about admitting you speak Spanish?"

Well if that isn't a metaphor for doctor-speak, I don't know what is. This is exactly why doctors need to stop reciting lab results to patients... but more on that some other day :)

Maternity clothes for pregnant Aunt Lucy... Alzheimer's clothes for Grandpa...

2008-04-15T11:58:00.006-04:00

I've been pursuing two researchers for a few weeks to try and get in on a major Alzheimer's research project, but lo and behold, they simply are only a month away from publishing and thus, don't have anything for a full 9 weeks which is what I need... ::sigh::

My parents saw a movie this past weekend depicting a young, 20-something married girl who develops an usual, early-Alzheimers. The movie then focuses on her husband and family who struggle to work around her illness and manage to go on with their own lives.

It's hard... it's heart-breaking. I haven't experienced it personally, but when I hear my mother joke about my father leaving the garage door open or having fits over nothing, it hurts a little inside just thinking about my robust, zealous, active and absolutely engaging father being reduced to this.

What really prompted me to write this blurb was an ad on my gmail account, probably based on my email related to Alzheimer's research, that led to a website of Alzheimer's-friendly clothing: made for adults who suffer from the chronic confusion of being in public and unbuttoning their clothing, leading to embarrassment for both themselves and their family members.

Here's the website: www.clothingsolutions.com

Just the idea that it can go to this level... wow... anyway, back to my Renal lectures I go. I AM just a first-year medical student after all.... yet I still have my fingers crossed for a possible Alzheimer's research opportunity this summer. It really hits me in the gut.

A stupid exam ate my vacation...

2008-04-14T13:35:00.002-04:00

I had done it... scheduled an awesome trip to Virginia Beach the weekend of my birthday... granted the birthday was just an excuse to get away... but lo and behold... the magical schedulers of my Clinical Practice of Medicine class decided early today to place my final clinical exam smack in the middle of it: Monday, May 12th.

Now, granted that is an official day of school and granted I technically should be in class every day of the week, but I have already TAKEN this exam. My re-take of it is purely bureaucratical in nature... yet there it is, an ugly mark on my PDA's calender and quite possibly the force leading to cancellation of our B&B reservation, flight booking, and dreams of kayaking and Busch Gardens...

::sigh::

Preaching Balance... DailyOM-schtyle...

2008-04-14T10:23:00.002-04:00

Once again, my daily words of wisdom... I highly encourage subscribing..

A Bit Of Everything
Taurus Daily Horoscope

Your obligations could seem more like chores than challenges today. You may be feeling torn between a very real desire to tackle your responsibilities and a similarly real need to relax and unwind. These contradictory drives might make you feel that unless you escape you’ll never again have an opportunity to have fun. You can meet your need to be responsible and have fun by learning to find a satisfying balance between work and play. You may need to rework your schedule or make time for only the tasks that are absolutely necessary so you have time to participate in leisure activities. Today can be a great day to gather your loved ones in your home for a round of cards or join an amateur sporting club.

You can be sure that you are devoting your attention wholeheartedly to your tasks when you live a truly balanced life. Often, the pull of responsibility can prevent us from having fun, while having too much fun can impede our ability to fulfill our responsibilities. When you know that you have made time for both, however, and realize that focusing on one will not take time away from the other, you can fully concentrate on each one. By making sure that you have plenty of time for your responsibilities and recreation today, you will find that you have plenty of energy for both.