I was perusing all my posts over the past three years. And I was thinking, "Why on earth has my blog become so negative?" Lots of frustration pouring out all over the place. Very few posts, and most of them make me feel down, not glad. So I have decided to move on to a new blog that does not focus so much on the grind of med school but on the awesomeness (I hope) of a medical career. I will keep this blog online, but I won't be posting here any longer.
The new blog is cheerful, reflects my present mood, will weather well (even if I move out of the Bay Area), and has a skull AND books on top!
Please come with me as I move over to Diary of a Future Doctor-Lady!! And may the adventures continue...
Friday, April 15, 2011
Saturday, February 19, 2011
Career Musings
You may or may not have heard that I'm going to take (another) year "off" between my third and fourth year of medical school. Since I did a master's/MD, I will be doing a 6-year path through med school instead of the 4 years I was originally planning. Ouch. Instead of graduating at 26, I'll be 28. It turns out that on average, 1/3 of the rising MS4 students do this, and last year, almost 50% of the rising class decided to take a year away from their medical education. Most people did research. I am also going to do research. And career discernment, which isn't something you can put on your resume, but is super important in the crafting thereof.
At this point, I'm not really sure what I want to do with the rest of my life. I am feeling a bit behind and discouraged, largely because of my lackluster Step 1 score. I know there were extenuating circumstances, etc, but I've always been a good test-taker, so it's disappointing. I guess at our master's program, nobody ever really emphasized just how important Step 1 is in determining which career path you take -- I mean, people said, "Oh, yeah, it'll be fine," but it's really not. With my score, there are quite a few doors slamming shut. Some of them I really couldn't care less about (like radiology), but some are kind of sad (even OB/GYN and emergency medicine would be competitive for me). Of course, I for years thought about becoming a geriatrician. As far as I can tell, that path is still open to me. I also love developmental biology and genetics, so pediatrics is a natural fit. This year, I've gotten really interested in immune/rheum stuff as well, so I'm going to do research in that area to see if I want to do that clinically or whether it's only the lab work that's neat. Finally, neurology and rehab (especially spine stuff) is super interesting and expanding fast.
The other thing I've been thinking is -- it would be fine to have my Step 1 score if I were free to go anywhere and do anything. If I could literally apply to every single residency in a given specialty across the country and go to Idaho if I so chose. But obviously, that would mean that one of the best things that's ever happened to me (planning to marry B) wouldn't be happening, so I don't actually wish that. Instead, I really want to do my research and choose a specialty where my score isn't held against me too much, because I want to have a strong enough application to get in wherever B ends up also. Residency would be a long time to be apart.
Finally, I have to choose something that gets me up in the morning. Frankly, 3rd year rotations don't tell you a whole lot about what a career in a given field is like. They only give you a feel for the resident culture, which is 3-5 years of a 40+ year career (if you're lucky). You don't really get a nationwide, cross-sectional view of what it's like to be an OB versus a family doc versus a neurologist. I'm hoping to do some clinic days and shadowing during my months away, so that I do get a sense of what I'm getting myself into.
My current top 5:
1. Pediatrics
2. Child neuro
3. Rehab/spine
4. Adult neuro
5. Family or Int'l Med + geriatrics
Since applications happen in September and early applications (like Child Neuro) happen even earlier, I'm not ready to figure out what I want to do with my life and then create a good application for the 2011-2012 match year. The more I talk about the decision to take time off, the more I meet others who are doing the same thing. I'm excited. I think it will be a good move for the future, both career-wise and family-wise. And a little extra time to study for Step 2 is probably a good thing.
If you have thoughts about a gap year, pros/cons/worries/insights, please feel free to post them here!!
At this point, I'm not really sure what I want to do with the rest of my life. I am feeling a bit behind and discouraged, largely because of my lackluster Step 1 score. I know there were extenuating circumstances, etc, but I've always been a good test-taker, so it's disappointing. I guess at our master's program, nobody ever really emphasized just how important Step 1 is in determining which career path you take -- I mean, people said, "Oh, yeah, it'll be fine," but it's really not. With my score, there are quite a few doors slamming shut. Some of them I really couldn't care less about (like radiology), but some are kind of sad (even OB/GYN and emergency medicine would be competitive for me). Of course, I for years thought about becoming a geriatrician. As far as I can tell, that path is still open to me. I also love developmental biology and genetics, so pediatrics is a natural fit. This year, I've gotten really interested in immune/rheum stuff as well, so I'm going to do research in that area to see if I want to do that clinically or whether it's only the lab work that's neat. Finally, neurology and rehab (especially spine stuff) is super interesting and expanding fast.
The other thing I've been thinking is -- it would be fine to have my Step 1 score if I were free to go anywhere and do anything. If I could literally apply to every single residency in a given specialty across the country and go to Idaho if I so chose. But obviously, that would mean that one of the best things that's ever happened to me (planning to marry B) wouldn't be happening, so I don't actually wish that. Instead, I really want to do my research and choose a specialty where my score isn't held against me too much, because I want to have a strong enough application to get in wherever B ends up also. Residency would be a long time to be apart.
Finally, I have to choose something that gets me up in the morning. Frankly, 3rd year rotations don't tell you a whole lot about what a career in a given field is like. They only give you a feel for the resident culture, which is 3-5 years of a 40+ year career (if you're lucky). You don't really get a nationwide, cross-sectional view of what it's like to be an OB versus a family doc versus a neurologist. I'm hoping to do some clinic days and shadowing during my months away, so that I do get a sense of what I'm getting myself into.
My current top 5:
1. Pediatrics
2. Child neuro
3. Rehab/spine
4. Adult neuro
5. Family or Int'l Med + geriatrics
Since applications happen in September and early applications (like Child Neuro) happen even earlier, I'm not ready to figure out what I want to do with my life and then create a good application for the 2011-2012 match year. The more I talk about the decision to take time off, the more I meet others who are doing the same thing. I'm excited. I think it will be a good move for the future, both career-wise and family-wise. And a little extra time to study for Step 2 is probably a good thing.
If you have thoughts about a gap year, pros/cons/worries/insights, please feel free to post them here!!
Surgery Shelf exam fiasco
So the surgery shelf was canceled on the day for which it was scheduled, because the surgery administrator forgot to order the exams. For real. Never has my hallowed, esteemed etc. medical school seen the like in ten years of giving these standardized national surgery shelf exams. We were, to put it gently, royally pissed off. And so the shelf was postponed, and I just took it this morning.
I would sigh a sigh of relief except -- that shelf was a monster. First of all, there was not enough time. The questions were long. And second, when people said it was a medicine shelf, they weren't kidding. Barely anything I studied was on there, and I reviewed all the exam review books. There were random questions on there that had nothing to do with any of the hundreds of topics I read about. I was hoping to do well, and now I'm even doubting if I passed it.
You know, I really wish I hadn't cried wolf all those years ago when I would say to friends or family, "I think I failed!" because back then, I knew I hadn't. These days, sometimes, it's REALLY hard to tell. I used to be a fantastic student. How do I get my groove back??!!
MY GROOVZ. I WANTZ IT! GIVE IT TO ME NOWZ!!!
I would sigh a sigh of relief except -- that shelf was a monster. First of all, there was not enough time. The questions were long. And second, when people said it was a medicine shelf, they weren't kidding. Barely anything I studied was on there, and I reviewed all the exam review books. There were random questions on there that had nothing to do with any of the hundreds of topics I read about. I was hoping to do well, and now I'm even doubting if I passed it.
You know, I really wish I hadn't cried wolf all those years ago when I would say to friends or family, "I think I failed!" because back then, I knew I hadn't. These days, sometimes, it's REALLY hard to tell. I used to be a fantastic student. How do I get my groove back??!!
MY GROOVZ. I WANTZ IT! GIVE IT TO ME NOWZ!!!
Friday, February 4, 2011
Surgery
I'm currently studying for the surgery shelf, which is obviously hard. For some reason, I've been feeling less and less like writing about med school. I don't really want to air my stories about patients to the world. I can see the purpose of keeping a journal about these things, but the digestion required to make it fit for public consumption takes much more time and energy than I currently have to spend on this blog. I think I will record these beautiful and meaningful events and try to write about them when I can, but it's more important for the purposes of being a good future physician to remember them and the lessons I learned from them.
But I'm alive, and trying to balance things, and still enjoying myself in spite of it all. On bad days, it really is the patients who keep me going. The "worst" (ie most stressed, angry, saddening, or whatever) patient out there is soothing compared to dealing with the school part of it. I'm really glad I am taking a research sabbatical. It will give me time to "gather my thoughts and regain my strength." Yes, 3rd year of med school and Clueless is still very relevant. Ah, Amy Heckerling. You have no idea how much you influenced my generation.
I also need to figure out what exactly within medicine I want to do, which a prominent urologist who gave us a lecture yesterday called "absolutely the most important decision you will ever make in your careers. And soon they won't be allowing you to take a paid 2nd residency, so it may be a one-way street." This does seem like a lot of pressure. Which is why I have taken up yoga again. But that is another post for another time.
But I'm alive, and trying to balance things, and still enjoying myself in spite of it all. On bad days, it really is the patients who keep me going. The "worst" (ie most stressed, angry, saddening, or whatever) patient out there is soothing compared to dealing with the school part of it. I'm really glad I am taking a research sabbatical. It will give me time to "gather my thoughts and regain my strength." Yes, 3rd year of med school and Clueless is still very relevant. Ah, Amy Heckerling. You have no idea how much you influenced my generation.
I also need to figure out what exactly within medicine I want to do, which a prominent urologist who gave us a lecture yesterday called "absolutely the most important decision you will ever make in your careers. And soon they won't be allowing you to take a paid 2nd residency, so it may be a one-way street." This does seem like a lot of pressure. Which is why I have taken up yoga again. But that is another post for another time.
Sunday, January 23, 2011
Self-Discipline
A stitch in time saves nine. Never put off for tomorrow what you can do today. Idle hands are the Devil's workshop.
I have been thinking about self-discipline. All my life, I have struggled with procrastination and absent-mindedness. Some people are born with an innate ability to plan ahead, execute that plan, and not forget anything along the way. Unfortunately, not so with me. I have a tendency toward both, which was pretty much indulged throughout my childhood. For instance, I remember when my mother was furious in 7th grade (7th!) when I didn't organize my homework the way the teacher wanted, and had marks deducted from my grade, even though the math was correct. She was furious because the math was correct and so I shouldn't have had marks off, not because I got in trouble with the teacher.
Looking back, what she, and I, failed to realize, was that the discipline of doing your homework neatly and on time is a skill that is in some ways far more important than math. And while elementary school math is easy, college math is impossible if you can't write neatly, keep your notes straight, or remember what's due when. If I forgot my books or projects at home or at school, there was always a doting parent or family member who would help me go fetch it. If I was up against the wall and hadn't done the work necessary for the day, there was always a parent willing to help me with an excuse. I thought it was funny and wonderful at the time, and once or twice it would have been. But the constant message to me was as long as you're smart, you don't need to be self-disciplined.
Don't get me wrong, I learned many important skills growing up: to dream big, to think positive and look for the silver lining, and to never give up. But this is one area in which I still need to help myself out a little bit. By definition, you cannot be nagged or coaxed into self-discipline. You must simply learn by running up against the cold, hard consequences of your decisions. As you get older, the price of doing whatever you want gets higher.
The word "discipline" has come to mean 'punishment'. But in another sense, it means 'practice'. Taken in this way, "self-discipline" actually implies "self-practice" -- the practice of exercising one's will, or self, over the mind. In many different philosophies, people have written that the mind is apart from the self. The mind is something to be trained, like any other muscle in the body :) Power over your mind allows you to make choices that are best for your true self.
For instance, let's take today:
My mind: It's so pleasant just sitting here, typing and drinking tea. Let's not start our work at all! Or we can stay home and just do a little bit at a time. There's still a lot of time until the test.
Self: You have a big exam coming up. Today is a free day, which is a wonderful opportunity to immerse yourself in the material before it becomes urgent and panicky. If you start today, January 23rd, that only gives you three more full study days before the exam, plus whatever time you can fit in during the week. You'll be able to concentrate far better in the library than at home.
In the meantime, off I go. Wish me luck.
Saturday, December 11, 2010
Am. So. Sick. Of. Working.
No matter how much I do, it seems like a tiny drop in the bucket. There are never ending tasks, some of them important, some of them urgent, all of them necessary. It wouldn't be as mind-numbing if the urgent ones and the important ones were the same, but it's like they want to make ABSOLUTELY sure that we do a clinical journal that no-one will ever read, but if we get around to writing up a patient note, whatever. Huh!?
I am so underqualified for my life.
I am so underqualified for my life.
Wednesday, December 8, 2010
Whew.
Things are a little less completely insane now. I have taken the exam, although because it's a national shelf I'm not sure if I passed it yet -- that will take a few weeks. The cat's other end seems to be functional, and she didn't even need an enema. Just a phone consult. We had a clinical skills video evaluation, which I think went well. Unfortunately, of course when things go well they're pass/fail. And then I was on cardiology for four days. My patient was a lady who came in to rule out a heart attack, which she didn't have. Then it was thought maybe she had heart failure (yup) but not due to a common cause (hmmm). So now she has been discharged and is going to see her doctor for many unusual tests which will hopefully solve the riddle of how she is walking around asymptomatic when her heart can only pump 30% of its final volume to her body. Good for her, at 80!
One of my OB patients, whom I had been working with pretty closely, was finally delivered of her girlchild. By me!! I did the entire delivery all by myself, which was the first time ever that I have run a delivery. It was amazing. And because it was the first night of my cardiology call, which was right after the OB shelf, I basically haven't slept well in over a week.
Today we were teaching the MS1s about heart failure. It turns out you do learn something in two years, after all. But they were better at heart medications, having just studied them. Oops. I guess I need to review all of the latest options myself, since on the wards I'm not the one deciding which meds are the best. I also learned today that soon they will come out with a better clot preventer than warfarin (Coumadin), and that whoever wins that particular pharmaceutical race is going to be very rich.
I got my first psychiatry patient today. He's awesome and has depression. Hopefully we can get the poor guy being more awesome and less depressed and back to his old self again. I have had other patients in psychiatry clinic, but this is the first one whose care I'm supposed to be in charge of. Fantastic. I feel behind in psych and need to study it more.
I got all fours (good) on a recent surgery evaluation. I think they evaluated the wrong person. I'm not going to tell them when I have surgery tomorrow.
Finally, I am excited because I think I might get enough sleep tonight. I'm really, really excited. I'm looking forward to it. I've been dreaming about my nice soft cottony plump firm pillow all week long....ahhhh....
One of my OB patients, whom I had been working with pretty closely, was finally delivered of her girlchild. By me!! I did the entire delivery all by myself, which was the first time ever that I have run a delivery. It was amazing. And because it was the first night of my cardiology call, which was right after the OB shelf, I basically haven't slept well in over a week.
Today we were teaching the MS1s about heart failure. It turns out you do learn something in two years, after all. But they were better at heart medications, having just studied them. Oops. I guess I need to review all of the latest options myself, since on the wards I'm not the one deciding which meds are the best. I also learned today that soon they will come out with a better clot preventer than warfarin (Coumadin), and that whoever wins that particular pharmaceutical race is going to be very rich.
I got my first psychiatry patient today. He's awesome and has depression. Hopefully we can get the poor guy being more awesome and less depressed and back to his old self again. I have had other patients in psychiatry clinic, but this is the first one whose care I'm supposed to be in charge of. Fantastic. I feel behind in psych and need to study it more.
I got all fours (good) on a recent surgery evaluation. I think they evaluated the wrong person. I'm not going to tell them when I have surgery tomorrow.
Finally, I am excited because I think I might get enough sleep tonight. I'm really, really excited. I'm looking forward to it. I've been dreaming about my nice soft cottony plump firm pillow all week long....ahhhh....
Thursday, December 2, 2010
A Charming Topic...
So my cat hasn't had a poo, as far as I can tell, since Tuesday night. Now it's Thursday morning. She is otherwise acting well and eating and peeing, so I am now left with this interesting dilemma. Given that our OB/GYN shelf exam is tomorrow morning, at which point do I need to take her to the vet? Pre-exam, or post-exam? Poor little old lady cat. I will let you know how she does (she thinks she's fine). I'm pretty sure there will be an enema in here somewhere before this is resolved.
Sigh. What purrfect timing.
Sigh. What purrfect timing.
Wednesday, December 1, 2010
More Examinating
The next one is OB/GYN. And for anyone out there who thinks that it's all 'natural' and 'simple' and 'what can possibly go wrong with the female reproductive tract and kid production?' The answer is: Way. Too. Much. Please, if you or females you know have symptoms, get over your embarrassment and get your a** to a clinic where they know what they are doing ASAP. Your nether regions are very important.
Ok, back to studying. Guess who has cardiology call right after the OB/GYN exam?! Four days and nights of taking care of people whose hearts are acting up. Both very cool and incredibly scary. Just like med school.
My personal motto: Just keep swimming, swimming, swimming...
Ok, back to studying. Guess who has cardiology call right after the OB/GYN exam?! Four days and nights of taking care of people whose hearts are acting up. Both very cool and incredibly scary. Just like med school.
My personal motto: Just keep swimming, swimming, swimming...
Saturday, November 13, 2010
Still Alive and Kicking
Summer is definitely gone, as has Labor Day, Halloween, and Veteran's Day, and now we're gearing up for Thanksgiving. By 'we' I mean everyone else: my class has three exams next week, plus I have a presentation and two patient consults to do. Yikes. But interesting things have happened since my last post, which I'll briefly summarize before getting back to work:
-- Brother, dad, and I all moved home so all 4 of us are living under one roof. Definitely a full house, but fun!
-- B had an emergent appendectomy & pulmonary edema + ICU stay -- in Holland. I went out there for a bit until he was better.
-- Went to B's high school friend's wedding in NY for Halloween. Was brief but awesome.
-- The Giants (LET'S GO GIANTS!) won the World Series. For the first time in 54 years. All is happy chaos here.
-- I delivered lots of babies on my inpatient OB/GYN week. Again, awesome.
-- I won a free wedding photo album & design session for after we get hitched!
-- Got 2nd evaluation, nothing too scary. Yay.
-- Started freaking out about aforementioned exams
K, back to work. Bye for now!
P.S. If you have called or emailed and I haven't replied, thank you. I still care about you.
-- Brother, dad, and I all moved home so all 4 of us are living under one roof. Definitely a full house, but fun!
-- B had an emergent appendectomy & pulmonary edema + ICU stay -- in Holland. I went out there for a bit until he was better.
-- Went to B's high school friend's wedding in NY for Halloween. Was brief but awesome.
-- The Giants (LET'S GO GIANTS!) won the World Series. For the first time in 54 years. All is happy chaos here.
-- I delivered lots of babies on my inpatient OB/GYN week. Again, awesome.
-- I won a free wedding photo album & design session for after we get hitched!
-- Got 2nd evaluation, nothing too scary. Yay.
-- Started freaking out about aforementioned exams
K, back to work. Bye for now!
P.S. If you have called or emailed and I haven't replied, thank you. I still care about you.
Sunday, August 29, 2010
Summer is Slipping Away...
Hello! Gosh, it's been two months since my last post. There has been a lot going on, so I'd better start at the beginning. Last time I checked in, I had just started my third year of medical school. Now, it's been three months, not three days!!
In May, I was just getting started, going to clinics, and meeting my preceptors. I had only a few patients. Now, I have done 2 weeks of inpatient surgery, during which I got to suture a huge abdominal wound closed using subcuticular stitches, I got to drive the camera during a laparoscopic surgery, I got to ablate (laser out) part of a liver, and I got to talk about poop a lot with some amazing and wonderful patients (it was a colorectal surgery service). There is something convenient and reassuring about being able to be frank about people's bodily functions without them running out the door. It's scary to talk about, but it's so important. I know it can be hard to trust a perfect stranger with information about your body, but it makes a huge, huge difference. And I did find that patients were, for the most part, totally blase about their symptoms.
Then there was my first delivery ever, in mid-July. As in, I helped catch. I was following Mom as one of my patients, and I got paged to the hospital. I stayed up all night while we induced labor due to a liver condition, but still no baby. She came in on Friday, and at the stroke of midnight on Sunday, I helped catch a beautiful baby girl. The mom was so brave and working so hard. And she did it! Normal vaginal delivery. Mom and baby had some trouble at first, but I am happy to report that they are now doing well. The baby is over a month old now! They named her after a Roman goddess. And I got to do her first newborn exam as well, and do mom's postnatal exam (with supervision, of course, don't be scared). Awesome. One of the most awesome experiences ever.
My patient list has grown from six to thirty over the past three months, and I hope to acquire about sixty by December. I am surprised that people do, in fact, contact me with questions. The silly medical center voicemail system is NOT user-friendly, however. Grrrr. I missed a call from a lady who had had a stroke the other day, and I was very displeased. So I have to fix that. But patients email me, too. Especially the pregnant ones! I am supposed to deliver 10 ladies of their babies by the end of the year. Here's hoping!
Speaking of strokes, I was allowed to do a neurology consultation to the ER alone. The ER doc said, "Are you from neuro?" and I realized the answer was yes. I diagnosed and admitted a lady with a stroke! It was somewhat harrowing. My supervising resident was very careful and thorough and checked everything I did, but I was able to do it and that was a huge high. It was a sad story, though -- the lady didn't trust the hospital, and so didn't come in until more than 24 hrs after her stroke. By which time it is too late to stop the symptoms from becoming permanent. It was a small stroke, though, and she will be fine with some care and therapy. She will have a permanent slur to her voice, and a facial droop. But she's alive. And she's such an amazing, brave person. She raised an entire family of children and grandchildren by herself. She is so inspiring.
I love, love, love my life. It is hard, it's stressful, it can make you want to cry. It's scary; it can be daunting every single day, but I wouldn't do anything else for the world.
In other news, B was here all summer. That was very cool, even though we were both working the whole time. We stayed at E's place for two months, which was fun. It was a shame that we couldn't hang out with E & R more, but it was a somewhat family-focused time (my dad is moving back to the US from Japan at long, long last). Now B has gone to The Hague. He will be helping to prosecute international criminals! How incredible. Wedding plans are starting to take shape, and I'm getting excited. We are hoping for next spring. It will be a small wedding (very, very small by Indian standards), but it will be our loved ones watching us start our lives together, and therefore excellent. We are going to have a multicultural ceremony, which I hope will not offend anyone belonging to the respective cultures involved! Hopefully we can have a reception for our friends later on. I have to say that I am very lucky to have such amazing parents, such an amazing brother, and such amazing in-laws-to-be. And then there's B. Who makes me happier than I can write on such a blog.
My school program had a light schedule this past week, so I have been getting chores done. I cut my hair, cleaned my room, played with my cat, and talked with B on the phone a lot. I also did do a little schoolwork, because, as always, there are things to catch up on. Speaking of which, I have to e-mail a patient.
TTYS!
Love,
Niya
In May, I was just getting started, going to clinics, and meeting my preceptors. I had only a few patients. Now, I have done 2 weeks of inpatient surgery, during which I got to suture a huge abdominal wound closed using subcuticular stitches, I got to drive the camera during a laparoscopic surgery, I got to ablate (laser out) part of a liver, and I got to talk about poop a lot with some amazing and wonderful patients (it was a colorectal surgery service). There is something convenient and reassuring about being able to be frank about people's bodily functions without them running out the door. It's scary to talk about, but it's so important. I know it can be hard to trust a perfect stranger with information about your body, but it makes a huge, huge difference. And I did find that patients were, for the most part, totally blase about their symptoms.
Then there was my first delivery ever, in mid-July. As in, I helped catch. I was following Mom as one of my patients, and I got paged to the hospital. I stayed up all night while we induced labor due to a liver condition, but still no baby. She came in on Friday, and at the stroke of midnight on Sunday, I helped catch a beautiful baby girl. The mom was so brave and working so hard. And she did it! Normal vaginal delivery. Mom and baby had some trouble at first, but I am happy to report that they are now doing well. The baby is over a month old now! They named her after a Roman goddess. And I got to do her first newborn exam as well, and do mom's postnatal exam (with supervision, of course, don't be scared). Awesome. One of the most awesome experiences ever.
My patient list has grown from six to thirty over the past three months, and I hope to acquire about sixty by December. I am surprised that people do, in fact, contact me with questions. The silly medical center voicemail system is NOT user-friendly, however. Grrrr. I missed a call from a lady who had had a stroke the other day, and I was very displeased. So I have to fix that. But patients email me, too. Especially the pregnant ones! I am supposed to deliver 10 ladies of their babies by the end of the year. Here's hoping!
Speaking of strokes, I was allowed to do a neurology consultation to the ER alone. The ER doc said, "Are you from neuro?" and I realized the answer was yes. I diagnosed and admitted a lady with a stroke! It was somewhat harrowing. My supervising resident was very careful and thorough and checked everything I did, but I was able to do it and that was a huge high. It was a sad story, though -- the lady didn't trust the hospital, and so didn't come in until more than 24 hrs after her stroke. By which time it is too late to stop the symptoms from becoming permanent. It was a small stroke, though, and she will be fine with some care and therapy. She will have a permanent slur to her voice, and a facial droop. But she's alive. And she's such an amazing, brave person. She raised an entire family of children and grandchildren by herself. She is so inspiring.
I love, love, love my life. It is hard, it's stressful, it can make you want to cry. It's scary; it can be daunting every single day, but I wouldn't do anything else for the world.
In other news, B was here all summer. That was very cool, even though we were both working the whole time. We stayed at E's place for two months, which was fun. It was a shame that we couldn't hang out with E & R more, but it was a somewhat family-focused time (my dad is moving back to the US from Japan at long, long last). Now B has gone to The Hague. He will be helping to prosecute international criminals! How incredible. Wedding plans are starting to take shape, and I'm getting excited. We are hoping for next spring. It will be a small wedding (very, very small by Indian standards), but it will be our loved ones watching us start our lives together, and therefore excellent. We are going to have a multicultural ceremony, which I hope will not offend anyone belonging to the respective cultures involved! Hopefully we can have a reception for our friends later on. I have to say that I am very lucky to have such amazing parents, such an amazing brother, and such amazing in-laws-to-be. And then there's B. Who makes me happier than I can write on such a blog.
My school program had a light schedule this past week, so I have been getting chores done. I cut my hair, cleaned my room, played with my cat, and talked with B on the phone a lot. I also did do a little schoolwork, because, as always, there are things to catch up on. Speaking of which, I have to e-mail a patient.
TTYS!
Love,
Niya
Wednesday, June 9, 2010
Surgery is not a spectator sport
Gosh, I have so much to write that I must think at least 10x a day, "Oh, I wish I could blog about that right now." But of course, nobody ever accused your third year of medical school of being boring and full of free time to blog. So I will have to satisfy myself with just one right now. I've been itching to write about my inpatient surgery rotation. I just finished two weeks on the colorectal surgery service. And -- it was fun! Actually fun! But -- I am exhausted! So exhausted!
I had the most incredible resident, Em, who gave me more responsibility and taught me more in two weeks than a textbook could have taught me in a year. She took me to lunch and had me practice my subcuticular stitches on a Starbucks banana. She stayed hours after she had to just to talk about patients and illnesses. She gave me rides to grand rounds. She let me do things in surgery and stepped out of the way. In short, she was amazing.
She understood that surgery is not a spectator sport. That once you are familiar with the excitement of being in the OR, it is supremely boring to stand at the back of the room and watch other people operate in a field you can't see, when they are speaking behind masks and it's difficult to decipher what they are saying. Knowing this, Em encouraged me to get my hands dirty. I got to see beautiful dissections of organs. I got to check a colon segment (removed) for cancer. I got to hold countless instruments for delicate procedures. I got to see the abdominal aorta pulsing and the shining dark brown lobes of the liver. How many people have held a pancreas? I am so lucky. Em advocated for me to the surgeons, getting them to let me scrub in, teaching me skills, and essentially pushing me to learn more about what it means to become a surgeon. It's tough. You wake up at 4:45 am if you are a resident. You rarely go to sleep before midnight. You do the math. But there they are, tireless and dedicated and liking their work, every day.
I don't know how I will ever thank her, but I know that when I am an intern (a first year doc post-MD), I will be kind to my medical students because of her. She made me think that you don't have to be a jerk to be a surgeon (and so did the rest of the team, who was pretty nice, in fact).
Oops, out of time. Drat.
I had the most incredible resident, Em, who gave me more responsibility and taught me more in two weeks than a textbook could have taught me in a year. She took me to lunch and had me practice my subcuticular stitches on a Starbucks banana. She stayed hours after she had to just to talk about patients and illnesses. She gave me rides to grand rounds. She let me do things in surgery and stepped out of the way. In short, she was amazing.
She understood that surgery is not a spectator sport. That once you are familiar with the excitement of being in the OR, it is supremely boring to stand at the back of the room and watch other people operate in a field you can't see, when they are speaking behind masks and it's difficult to decipher what they are saying. Knowing this, Em encouraged me to get my hands dirty. I got to see beautiful dissections of organs. I got to check a colon segment (removed) for cancer. I got to hold countless instruments for delicate procedures. I got to see the abdominal aorta pulsing and the shining dark brown lobes of the liver. How many people have held a pancreas? I am so lucky. Em advocated for me to the surgeons, getting them to let me scrub in, teaching me skills, and essentially pushing me to learn more about what it means to become a surgeon. It's tough. You wake up at 4:45 am if you are a resident. You rarely go to sleep before midnight. You do the math. But there they are, tireless and dedicated and liking their work, every day.
I don't know how I will ever thank her, but I know that when I am an intern (a first year doc post-MD), I will be kind to my medical students because of her. She made me think that you don't have to be a jerk to be a surgeon (and so did the rest of the team, who was pretty nice, in fact).
Oops, out of time. Drat.
Sunday, May 16, 2010
Fatigue! Honestly come by.
Beginning your third year of medical school while moving out of your old apartment and changing your sleep cycle to an earlier one can be summarized by one word: exhausting. I am exhausted. But this has been one of the coolest things I've ever done, and I can honestly say for the first time I KNOW I made the right choice. I'm so glad I came to medical school.
I have seen patients by myself in a variety of clinics over the past few weeks, and B and I just moved 80% of what remained of my stuff out of my apartment this weekend and put much of it in storage. I have so much extra work to catch up on it's not even funny. And we won't be here next weekend because my cousin is getting married. But it's been amazing. B has sacrificed much of his vacation time in helping me, my mom, and my brother, who just had shoulder surgery. Let's just say there's a lot going on.
More after some sleep. But just wanted to write that I am still alive and kickin'. But not kickin' it.
I have seen patients by myself in a variety of clinics over the past few weeks, and B and I just moved 80% of what remained of my stuff out of my apartment this weekend and put much of it in storage. I have so much extra work to catch up on it's not even funny. And we won't be here next weekend because my cousin is getting married. But it's been amazing. B has sacrificed much of his vacation time in helping me, my mom, and my brother, who just had shoulder surgery. Let's just say there's a lot going on.
More after some sleep. But just wanted to write that I am still alive and kickin'. But not kickin' it.
Thursday, April 29, 2010
The Unwritten Rules
One thing I'm learning is that on the wards, many, many people will let you just put your foot in it. This is not just other medical students who think they're competing with you -- doctors, nurses, staff will let you just make a mistake and then see how you react. This morning was my morning. My attending asked me to check my schedule and tell the patient when I'd be back. Simple, right? Nope. I didn't have my schedule (for the year, not this week) printed out and with me. That was mistake #1. I couldn't log on to the server because I had forgotten which account and password out of five new account/password combinations I was supposed to use. So it locked me out. That was mistake #2. So far, so good.
But the compounding mistake was asking another doctor to log in for me. Apparently that is a big, BIG no-no. But she didn't tell me that. The few other people sitting there didn't say anything. She was just silent, then asked, "Do you have an ID?" and I said yes, but I was locked out. Then she said, "hold on," and left, so I thought maybe she would help me. Meanwhile, I looked up the help number. When she came back, she said, "Are you still locked out?" and made it absolutely clear she was not going to do anything about it. Let me note that she didn't say anything along the lines of, "You know I'm not allowed to do that. Call that number on the screen." She was just silent, as was everyone else.
So at this point, I finally caught on and said, "I'll just call the hotline here." And I picked up my cell phone, spent the next 10 minutes on the phone, and got my schedule off the computer o' doom (it is not a coincidence that the server login screen resembles the Blue Screen of Death). By which time, of course, my patient had departed. I offered a dejected apology to my attending and then swallowed it like a big girl and kept seeing people (who in this case, were very adorable well babies, so this was frankly not too hard). But I lost a patient for my cohort and a chance to look like I actually had my act together.
Lesson learned: Never, never, never, never ask for help if there's a chance you can solve it without putting someone out. Because you are at the bottom of the ladder. Oh, and carry your schedule for the entire year, in case someone asks you what you're doing next July when your patients need shots. Third, always keep an eye out for the Unwritten Rules. The nurses know, just copy them. And never ask a doctor who isn't responsible for you for help. No teaching credit, no time. Oops, I forgot one: learn how to blend invisibly into an overcrowded room without getting in anyone's way or, God forbid, taking a chair (that one I knew: they all 'belong' to someone).
But the compounding mistake was asking another doctor to log in for me. Apparently that is a big, BIG no-no. But she didn't tell me that. The few other people sitting there didn't say anything. She was just silent, then asked, "Do you have an ID?" and I said yes, but I was locked out. Then she said, "hold on," and left, so I thought maybe she would help me. Meanwhile, I looked up the help number. When she came back, she said, "Are you still locked out?" and made it absolutely clear she was not going to do anything about it. Let me note that she didn't say anything along the lines of, "You know I'm not allowed to do that. Call that number on the screen." She was just silent, as was everyone else.
So at this point, I finally caught on and said, "I'll just call the hotline here." And I picked up my cell phone, spent the next 10 minutes on the phone, and got my schedule off the computer o' doom (it is not a coincidence that the server login screen resembles the Blue Screen of Death). By which time, of course, my patient had departed. I offered a dejected apology to my attending and then swallowed it like a big girl and kept seeing people (who in this case, were very adorable well babies, so this was frankly not too hard). But I lost a patient for my cohort and a chance to look like I actually had my act together.
Lesson learned: Never, never, never, never ask for help if there's a chance you can solve it without putting someone out. Because you are at the bottom of the ladder. Oh, and carry your schedule for the entire year, in case someone asks you what you're doing next July when your patients need shots. Third, always keep an eye out for the Unwritten Rules. The nurses know, just copy them. And never ask a doctor who isn't responsible for you for help. No teaching credit, no time. Oops, I forgot one: learn how to blend invisibly into an overcrowded room without getting in anyone's way or, God forbid, taking a chair (that one I knew: they all 'belong' to someone).
Wednesday, April 28, 2010
There but for the grace of God go I...
...where on earth have I been for the last month? Oof. That is truly the million-dollar question, but the answer is pretty much what you'd expect from a medical student in her last two months of her second/third year of a joint MD/MS program: studying. And finishing things. And starting things. With a touch of freaking out underlying it all.
Anyway, today I've got my typewriting skills back, because today was the day I PASSED the USMLE Step 1! Now, I didn't pass 'with flying colors' or streaks of glory or smears of superiority or any such thing. Oh, no. I passed by the very skin of my teeth -- which is not cool nor is it characteristic of my attitude towards exams. I usually like exams and do well at them. But that is another blog for another day. Today, I simply sigh a big sigh of relief. I passed. I passed. Thank the Lord above, I passed.
Which means: I can move forward with rotations. I don't have to call the nice patients in my longitudinal patient panel to tell them that no, I won't be seeing them at their appointments this year after all. I don't have to take time off to retake the test. I can graduate on time, hopefully, and some day be an actual doctor. I can actually enjoy myself (or try to) this year. I can start looking forward to the next set of exams. I can actually make friends with my new classmates/teammates/preceptors/attending doctors. And -- and this is the big and -- I can focus on learning medicine in all its nitty-gritty, terrible beauty.
And: I can help plan a wedding (yay x 1000), find a summer sublet, hang out with friends and B more, and be a less grouchy sister to my younger brother, who has moved home! Good times. Plus, my adorable and slightly plump, middle-aged Siamese cat will get more attention, not to mention my long-suffering parents. Today is honestly one of the most beautiful days I have ever seen. Fluffy white clouds, blue skies, sunshine, eucalyptus trees -- and a passing score.
A passing score, by the skin of my teeth. When I saw it, I felt my heart racing, the same feeling you get when you're hiking and you almost step off a cliff by mistake. Phew. And now, finally, I can say my classroom years have come to a close. I can finally let them go. And I'm mourning them, because I can't remember a time when I wasn't a student in a classroom whose job was to learn. And now I'm a student in the real world, an apprentice-student-doctor, being given real responsibility (with supervision) for real people with real problems who need actual help. The classroom of life.
So far, I'm on my third day of clinical rotations. I have seen two patients entirely on my own, many with my preceptors, and I have six patients who are "mine" -- I will follow them throughout the year and be at any of their appointments I can make it to. My rotation is a longitudinal one, which means I do ALL the core disciplines at once: family, internal, OB/GYN, pediatrics, psychiatry, neurology, surgery, etc. It's been AMAZING. It's been like a dream come true. And my preceptors have been really great teachers so far. And the patients, of course, are the entire point. That's the reason you wake up early (very early!) in the morning. Eventually, the goal is for me to have roughly 60 patients of my "own" for the year -- which is nothing when you realize that the average clinician carries about 1000 patients on a regular basis. But of course, we're just starting out.
I will be blogging more now -- so much to write about, so little time!
But I will never, ever forget, in exams or in life: There but for the grace of God go I.
Anyway, today I've got my typewriting skills back, because today was the day I PASSED the USMLE Step 1! Now, I didn't pass 'with flying colors' or streaks of glory or smears of superiority or any such thing. Oh, no. I passed by the very skin of my teeth -- which is not cool nor is it characteristic of my attitude towards exams. I usually like exams and do well at them. But that is another blog for another day. Today, I simply sigh a big sigh of relief. I passed. I passed. Thank the Lord above, I passed.
Which means: I can move forward with rotations. I don't have to call the nice patients in my longitudinal patient panel to tell them that no, I won't be seeing them at their appointments this year after all. I don't have to take time off to retake the test. I can graduate on time, hopefully, and some day be an actual doctor. I can actually enjoy myself (or try to) this year. I can start looking forward to the next set of exams. I can actually make friends with my new classmates/teammates/preceptors/attending doctors. And -- and this is the big and -- I can focus on learning medicine in all its nitty-gritty, terrible beauty.
And: I can help plan a wedding (yay x 1000), find a summer sublet, hang out with friends and B more, and be a less grouchy sister to my younger brother, who has moved home! Good times. Plus, my adorable and slightly plump, middle-aged Siamese cat will get more attention, not to mention my long-suffering parents. Today is honestly one of the most beautiful days I have ever seen. Fluffy white clouds, blue skies, sunshine, eucalyptus trees -- and a passing score.
A passing score, by the skin of my teeth. When I saw it, I felt my heart racing, the same feeling you get when you're hiking and you almost step off a cliff by mistake. Phew. And now, finally, I can say my classroom years have come to a close. I can finally let them go. And I'm mourning them, because I can't remember a time when I wasn't a student in a classroom whose job was to learn. And now I'm a student in the real world, an apprentice-student-doctor, being given real responsibility (with supervision) for real people with real problems who need actual help. The classroom of life.
So far, I'm on my third day of clinical rotations. I have seen two patients entirely on my own, many with my preceptors, and I have six patients who are "mine" -- I will follow them throughout the year and be at any of their appointments I can make it to. My rotation is a longitudinal one, which means I do ALL the core disciplines at once: family, internal, OB/GYN, pediatrics, psychiatry, neurology, surgery, etc. It's been AMAZING. It's been like a dream come true. And my preceptors have been really great teachers so far. And the patients, of course, are the entire point. That's the reason you wake up early (very early!) in the morning. Eventually, the goal is for me to have roughly 60 patients of my "own" for the year -- which is nothing when you realize that the average clinician carries about 1000 patients on a regular basis. But of course, we're just starting out.
I will be blogging more now -- so much to write about, so little time!
But I will never, ever forget, in exams or in life: There but for the grace of God go I.
Saturday, February 27, 2010
It blows my mind.
It blows my mind that a healthy woman with NO prior health history, on NO medications, who had a baby 5 months ago, could spontaneously develop a dangerous liver abscess from a severe infection. This world is a crazy place.
Luckily, she will be okay. She was my last patient at the JMP! Which is another thing that blows my mind. I can't quite realize that three years have gone by. I am no longer that fresh-faced young person just starting anatomy. Three years older, and dubiously wiser, and slightly sadder, and definitely happier, all at the same time. I've learned a lot, and not all of it has been from a textbook.
1. It's good to be important, but it's more important to be good.
2. A sense of humor will preserve you.
3. Never scoff at love in any form.
4. Remember what it feels like to be sick. Everyone in the hospital feels like that times ten.
5. Be grateful. As often as possible.
That's all the sentimental nonsense I got for now. It's a mellow sunshiny afternoon here after days of rain, and our big clinical exam is tomorrow! I'm a little tired so I may take a quick nap before studying my physical exam stuff. We each get six patients: 20 min. for physical exam, 8 min. written exam, 7 min. feedback from each examiner. They grade you on above, at, or below competency, and there's some magical algorithm to tell them whether you've passed or not. Sigh.
Life is crazy right now. There is too much to remember. I miss B something fierce. I try not to dwell on the fact that I don't really get to see family, hang out with friends, catch up with old friends, or have lots of fun right now. But I'm probably contagious anyway, given this vague pro-dromal feeling, so perhaps it's a blessing in disguise.
I'm listening to The Great River from the LOTR soundtrack, which is beautiful. Wouldn't it be fun to be Howard Shore and compose all the music that went with that movie? Although maybe it would be more fun to be in the orchestra or the choir. Hmm. Either way, it's pretty fabulous stuff.
Luckily, she will be okay. She was my last patient at the JMP! Which is another thing that blows my mind. I can't quite realize that three years have gone by. I am no longer that fresh-faced young person just starting anatomy. Three years older, and dubiously wiser, and slightly sadder, and definitely happier, all at the same time. I've learned a lot, and not all of it has been from a textbook.
1. It's good to be important, but it's more important to be good.
2. A sense of humor will preserve you.
3. Never scoff at love in any form.
4. Remember what it feels like to be sick. Everyone in the hospital feels like that times ten.
5. Be grateful. As often as possible.
That's all the sentimental nonsense I got for now. It's a mellow sunshiny afternoon here after days of rain, and our big clinical exam is tomorrow! I'm a little tired so I may take a quick nap before studying my physical exam stuff. We each get six patients: 20 min. for physical exam, 8 min. written exam, 7 min. feedback from each examiner. They grade you on above, at, or below competency, and there's some magical algorithm to tell them whether you've passed or not. Sigh.
Life is crazy right now. There is too much to remember. I miss B something fierce. I try not to dwell on the fact that I don't really get to see family, hang out with friends, catch up with old friends, or have lots of fun right now. But I'm probably contagious anyway, given this vague pro-dromal feeling, so perhaps it's a blessing in disguise.
I'm listening to The Great River from the LOTR soundtrack, which is beautiful. Wouldn't it be fun to be Howard Shore and compose all the music that went with that movie? Although maybe it would be more fun to be in the orchestra or the choir. Hmm. Either way, it's pretty fabulous stuff.
Thursday, February 25, 2010
The Post Triumphant!!
I have an announcement to make! After 48 hours of incredibly hard work and very little sleep:
A new thesis comes into the worldTo prevent the spread of germs (mine to you), visitors are very welcome after April 2nd.
Wednesday, February 24, 2010
We're Not Alone
And, as proof that others have felt this way since time began (or at least since the first world war):
Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.
Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.
Surely some revelation is at hand;
Surely the Second Coming is at hand.
The Second Coming! Hardly are those words out
When a vast image out of Spiritus Mundi
Troubles my sight: a waste of desert sand;
A shape with lion body and the head of a man,
A gaze blank and pitiless as the sun,
Is moving its slow thighs, while all about it
Wind shadows of the indignant desert birds.
The darkness drops again but now I know
That twenty centuries of stony sleep
Were vexed to nightmare by a rocking cradle,
And what rough beast, its hour come round at last,
Slouches towards Bethlehem to be born?
(Yeats, The Second Coming)
Things Fall Apart
The book by Chinua Achebe describes a man who watches in dismay as his way of life becomes obsolete. The analogy is a pretty good one for 3rd year at the JMP. The first two years, you mosey along, doing PBL like it's a hobby, thinking to yourself how fun medical school has turned out to be. You don't actually bother to remember much from the first year, and you remember a little more from the second. Third year, you begin to realize ways in which some of the common myths passed around the JMP are actually hurting some of its type A procrastinators (hmm, I wonder if I fall into this category).
First, I'm exhausted so please take this post, if you happen to be reading it at the moment, with a grain of salt.
To reiterate: please take this post with a grain of salt. None of these generalizations are subscribed to by everyone, professors and students, in the JMP -- in fact, I think only a few individuals actually believe them. But they have somehow become acceptable to say. I debunk them below.
Top Ten Myths Passed Around the JMP
1. "Don't worry now -- after all, the boards/thesis/exams/wards are a long way away. The best preparation is lots of fun and sleep." This is not true. I cannot even tell you how many times people (including professors) brushed me off instead of helping me find the tools to really learn and make myself a better student. Now, in my 3rd year, I find myself having to correct mid-course. Sleep is important, obviously. But so is taking your work seriously! You're not paying $30,000/year to scrape by.
2. "Oh, whatever -- I barely studied. Who cares, anyway? Screw it." This attitude is addictive. I know I've gotten sucked into it. But really, people? This is not middle school, it's medical school. I realize they both begin with M. But you're still too cool for school?
3. "You'll never know everything, so don't worry about it. Just enjoy it the first time around, it'll be back." Yes, but if you never take the time to understand it when it's fresh and exciting, it'll always be a mystery and eventually you'll develop a mental block, whether it's EKGs, ABG's, or other acronyms that scare you. Better advice would be, "There is a lot to learn, but don't feel anxious. Just take it one step at a time and focus on the task at hand."
4. "Medicine keeps changing. Don't bother to memorize anything." This is something I've heard again and again and again, and truly it does students a disservice. Memorization helps you remember things so that you can understand them the second time around. And glycolysis hasn't changed in my lifetime (or yours, either)! Anatomy? Still the same (evolution isn't that fast). Normal vital signs? Very crucial. So ditch the hippie attitude. It is important and we do need to know it by heart. When it changes, we'll have a basis to understand the change.
5. "In PBL, students call the shots and can learn whatever they want, however they want to learn it." Again, not true. There are standards, they are simply not published. So please, please ditch this myth and the passive-aggressiveness it generates. If you want us to learn something specific, don't use the unit exam to tell us this -- just tell us! Believe me, we won't be offended or crippled by a little spoon-feeding now and then. Getting angry at us when we don't want to 'challenge ourselves' is a failure to recognize a cry for academic, or personal, help. All together, now: 1, 2, 3...HELP!
6. "This is great preparation for the real world." No, this is the real world. I've said this before, and I'll say it again. You don't tell a 5-year-old that learning to write is super easy, so why are they stressing? You don't tell them that a playground fight is no big deal. No, you help them with their writing, even if it takes you three hours, and you clean the wounds from the fight while trying to figure out what's going on with your kids. Here's a secret: medical students are just 5-year-olds who are older. So please accept the fact that for us, life is actually difficult, the demands on our time are perhaps more than we have the skills to deal with, and that yes -- when we're 50 it might be easier for us, but we're still LEARNING. That's why it's called school. So please be patient instead of dismissive when we're stressed or overwhelmed. Of course, that is never an excuse for us to act mean or rude. But realize we're learning more than how to use an iphone app. Some of us are still learning how to keep ourselves clean and clothed.
7. "We have an integrated curriculum." No, we have three arms of the curriculum -- clinical skills, master's thesis, and PBL. They are all vying for our attention (which is very flattering, by the way). They're all useful and exciting. However, they are not integrated. Each arm rarely can describe what's going on with the other two. All of them tend to demand a lot of time and effort. Please don't pretend that you've integrated the curriculum -- you've presented the curriculum to your students, who are integrating it in their studies. But we may as well be taking three entirely different classes in three different departments on three different campuses, because that's how much logistical coordination and effort is required to pull it off. And THAT'S OK. But let's be honest.
8. "We know what you're going through." I appreciate this as what it's meant to be -- a genuine expression of empathy. However, rarely does someone use this when they actually know what I'm going through. Unless you have individually met with a student and figured out how they learn, their academic history, what their home life is like, their level of fatigue, their morals and values, and their other commitments -- then no, you have very little idea of what they're going through. This just sounds dismissive. See #6, above.
9. "Everyone needs a therapist." No. Everyone needs more sleep. Everyone needs food and water and shelter from precipitation in freezing weather. But everyone does not need a therapist. If YOU need a therapist, that's absolutely fine. I like therapists. Hell, I even let them use my bathroom! (That was a joke. Joke. Joke.) But my point is, please, please, please stop telling me I need a therapist. If I've offended you, I'm sorry. Otherwise -- huh? Stress is okay. Sadness is normal. If I feel like I'm sliding, I'll go to a therapist. But it's just rude to assume you know what someone else needs unless you're deliberately trying to stage an intervention. I realize the point of this is to emphasize that MANY medical students go through depression or have other mental health needs, and I think that needs recognition. I just don't need to find a therapist myself to recognize that others might want one! I SUPPORT YOUR DECISION TO GO TO THERAPY. I SUPPORT YOUR DECISION TO GO TO THERAPY. I SUPPORT YOUR DECISION TO GO TO THERAPY. Ahhhh.
10. "If a student doesn't do well on this exam/thesis/final/oral/preceptorship, it must be that there's something wrong in the student's personal life." This is actually not a bad assumption for a professor to make, but it would be a lot easier if they also understood something else: I care about your subject very much. I do not deliberately want to blow it off. But I'm juggling, and sometimes, I cannot prioritize your subject/ball. Sometimes your subject/ball will drop on the ground. I will pick it up, dust it off, and continue to juggle. But until I'm a master juggler, balls are gonna drop. If it belonged to you, I'm truly sorry and will try to do better. But it's really not personal -- it's not about you, and it's not about my personal life. It's purely about my juggling ability.
Wow, that was cathartic. Okay, back to my real life. Which right now involves an emergency nap (we had an exam this morning).
P.S. I just want to say that you rock. That's right, YOU -- mom, dad, brother, friend, partner, unsung professor who really gets it, loved-one-in-some capacity -- you are people I care about, look up to, and try to do well for. Thank you for being there.
First, I'm exhausted so please take this post, if you happen to be reading it at the moment, with a grain of salt.
To reiterate: please take this post with a grain of salt. None of these generalizations are subscribed to by everyone, professors and students, in the JMP -- in fact, I think only a few individuals actually believe them. But they have somehow become acceptable to say. I debunk them below.
Top Ten Myths Passed Around the JMP
1. "Don't worry now -- after all, the boards/thesis/exams/wards are a long way away. The best preparation is lots of fun and sleep." This is not true. I cannot even tell you how many times people (including professors) brushed me off instead of helping me find the tools to really learn and make myself a better student. Now, in my 3rd year, I find myself having to correct mid-course. Sleep is important, obviously. But so is taking your work seriously! You're not paying $30,000/year to scrape by.
2. "Oh, whatever -- I barely studied. Who cares, anyway? Screw it." This attitude is addictive. I know I've gotten sucked into it. But really, people? This is not middle school, it's medical school. I realize they both begin with M. But you're still too cool for school?
3. "You'll never know everything, so don't worry about it. Just enjoy it the first time around, it'll be back." Yes, but if you never take the time to understand it when it's fresh and exciting, it'll always be a mystery and eventually you'll develop a mental block, whether it's EKGs, ABG's, or other acronyms that scare you. Better advice would be, "There is a lot to learn, but don't feel anxious. Just take it one step at a time and focus on the task at hand."
4. "Medicine keeps changing. Don't bother to memorize anything." This is something I've heard again and again and again, and truly it does students a disservice. Memorization helps you remember things so that you can understand them the second time around. And glycolysis hasn't changed in my lifetime (or yours, either)! Anatomy? Still the same (evolution isn't that fast). Normal vital signs? Very crucial. So ditch the hippie attitude. It is important and we do need to know it by heart. When it changes, we'll have a basis to understand the change.
5. "In PBL, students call the shots and can learn whatever they want, however they want to learn it." Again, not true. There are standards, they are simply not published. So please, please ditch this myth and the passive-aggressiveness it generates. If you want us to learn something specific, don't use the unit exam to tell us this -- just tell us! Believe me, we won't be offended or crippled by a little spoon-feeding now and then. Getting angry at us when we don't want to 'challenge ourselves' is a failure to recognize a cry for academic, or personal, help. All together, now: 1, 2, 3...HELP!
6. "This is great preparation for the real world." No, this is the real world. I've said this before, and I'll say it again. You don't tell a 5-year-old that learning to write is super easy, so why are they stressing? You don't tell them that a playground fight is no big deal. No, you help them with their writing, even if it takes you three hours, and you clean the wounds from the fight while trying to figure out what's going on with your kids. Here's a secret: medical students are just 5-year-olds who are older. So please accept the fact that for us, life is actually difficult, the demands on our time are perhaps more than we have the skills to deal with, and that yes -- when we're 50 it might be easier for us, but we're still LEARNING. That's why it's called school. So please be patient instead of dismissive when we're stressed or overwhelmed. Of course, that is never an excuse for us to act mean or rude. But realize we're learning more than how to use an iphone app. Some of us are still learning how to keep ourselves clean and clothed.
7. "We have an integrated curriculum." No, we have three arms of the curriculum -- clinical skills, master's thesis, and PBL. They are all vying for our attention (which is very flattering, by the way). They're all useful and exciting. However, they are not integrated. Each arm rarely can describe what's going on with the other two. All of them tend to demand a lot of time and effort. Please don't pretend that you've integrated the curriculum -- you've presented the curriculum to your students, who are integrating it in their studies. But we may as well be taking three entirely different classes in three different departments on three different campuses, because that's how much logistical coordination and effort is required to pull it off. And THAT'S OK. But let's be honest.
8. "We know what you're going through." I appreciate this as what it's meant to be -- a genuine expression of empathy. However, rarely does someone use this when they actually know what I'm going through. Unless you have individually met with a student and figured out how they learn, their academic history, what their home life is like, their level of fatigue, their morals and values, and their other commitments -- then no, you have very little idea of what they're going through. This just sounds dismissive. See #6, above.
9. "Everyone needs a therapist." No. Everyone needs more sleep. Everyone needs food and water and shelter from precipitation in freezing weather. But everyone does not need a therapist. If YOU need a therapist, that's absolutely fine. I like therapists. Hell, I even let them use my bathroom! (That was a joke. Joke. Joke.) But my point is, please, please, please stop telling me I need a therapist. If I've offended you, I'm sorry. Otherwise -- huh? Stress is okay. Sadness is normal. If I feel like I'm sliding, I'll go to a therapist. But it's just rude to assume you know what someone else needs unless you're deliberately trying to stage an intervention. I realize the point of this is to emphasize that MANY medical students go through depression or have other mental health needs, and I think that needs recognition. I just don't need to find a therapist myself to recognize that others might want one! I SUPPORT YOUR DECISION TO GO TO THERAPY. I SUPPORT YOUR DECISION TO GO TO THERAPY. I SUPPORT YOUR DECISION TO GO TO THERAPY. Ahhhh.
10. "If a student doesn't do well on this exam/thesis/final/oral/preceptorship, it must be that there's something wrong in the student's personal life." This is actually not a bad assumption for a professor to make, but it would be a lot easier if they also understood something else: I care about your subject very much. I do not deliberately want to blow it off. But I'm juggling, and sometimes, I cannot prioritize your subject/ball. Sometimes your subject/ball will drop on the ground. I will pick it up, dust it off, and continue to juggle. But until I'm a master juggler, balls are gonna drop. If it belonged to you, I'm truly sorry and will try to do better. But it's really not personal -- it's not about you, and it's not about my personal life. It's purely about my juggling ability.
Wow, that was cathartic. Okay, back to my real life. Which right now involves an emergency nap (we had an exam this morning).
P.S. I just want to say that you rock. That's right, YOU -- mom, dad, brother, friend, partner, unsung professor who really gets it, loved-one-in-some capacity -- you are people I care about, look up to, and try to do well for. Thank you for being there.
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