Saturday, April 21, 2012

Longing for the Past...

Last night I dreamt I went to camp again. Just like they did every summer when I was younger, my parents dropped me off at the St. Louis airport and when I arrived in the Minneapolis airport, I was instantly surrounded by familiar faces--former campers and counselors and (because it was a dream) friends from undergrad and even a few familiar faces from medical school.

In real life there's a three-hour bus ride that separates camp from the airport, but in the dream I was just suddenly standing in the midst of the familiar-smelling cabin with the mesh windows and perpetually dirty wooden floors and (somewhat uncomfortable) beds that I had not so very long ago called my home away from home. My things had magically unpacked themselves and sorted themselves onto shelves and into my tiny closet. And so I just stood for a moment, letting my eyes wander over the dozens of names and memories that had been carved into the cabin's walls.

When the camp bell rang out I instinctively knew it was the 15-minute warning bell for dinner and my feet began to carry me down the path to the dining hall just as they had done hundreds of times before. As I walked by the cabin where the counselors-in-training slept, one of my friends (who I haven't spoken to in years) called my name and we walked arm-in-arm to the dining hall, talking about who we thought might end up dating that summer and what activities we planned to sign up for for the first two weeks. The rest of the dream was a hodgepodge of camp activities, which I will refrain from describing. Suffice it to say, I was genuinely happy in the dream.

For a moment, when I woke up, in the pitch black of my bedroom I thought I was really in my cabin at camp, but as my eyes adjusted to the dark and my mind cleared, I realized I wasn't anywhere even remotely close to camp. No. It was 5:27am on April 20, 2012, and I was in my apartment. In just two short hours I would be awoken, not by the camp bell, but by my alarm clock. And all too quickly I remembered that instead of having a day of swimming and kayaking and sun-bathing ahead of me, all I had to look forward to was reading First Aid and doing yet another set of USMLE World QBank questions. And that's when I started to sob.

When the tears finally subsided, seeing as it was still only 5:40 in the morning and I figured even my grandma probably wasn't awake yet, I went and grabbed my computer. You see, when I feel anything but happy, I like to look at quotes online. Sometimes I search for quotes on specific topics like "moving on" and sometimes I'll look up quotes by my favorites authors or other well-known people. Usually I keep looking until I find a quote that describes how I'm feeling. I guess it helps me feel less alone to see that, at some point in time, someone else felt just as sad or lost or stressed out as I feel. And so it was that I happened to stumble across a quote by Leonardo da Vinci that said, "Once you have flown, you will walk the earth with your eyes turned skyward; for there you have been, there you long to return."

And, while I didn't literally long to fly or spend my day with my eyes turned skyward, I realized that I longed for the life I had once had. For camp and undergrad and the hours and hours of free time I had prior to medical school. For the time when I was able to spend four hours a day at dance practice. Or six hours making dinner and dessert for my friends. Or an entire day laying in the sun at the beach. Or an evening dancing. Or a morning doing absolutely nothing at all.

My days now consist of anywhere from three to six hours of lecture and small group sessions followed by another eight plus hours of studying and then an hour or so of tossing and turning in bed because I can't get my brain to stop thinking about all the things I still need to do and how I can never seem to remember everything I read and what might happen if I don't pass boards. Some nights I get so stressed out trying to fall asleep that I end up doing things like cleaning my apartment at 2am or baking cookies at 3am--anything to take my mind off my life.

When I talk to family, they sometimes ask me if I'm still sure I want to be in medical school. Part of me almost always wants to reply, "No way--please come help get me out of here as fast as possible!" But I always end up saying, "Yes. I'm sure."

And it's true. Right now, I may long for my old, carefree life. But, deep down, I don't really want to be anywhere but in medical school because I really do want to be a doctor. And I'd like to think that one day I will be able to look back on these years and long for them like I currently long for camp. Because really, my life isn't so very terrible. School is difficult--there's no doubt about that. And I don't have as much time as I'd like to sleep or to do fun things like going dancing or going to the pool. But I have a great group of friends and a loving family who provide me with much-needed words of encouragement when I feel like I giving up.

And, at the end of all this, I get to be a doctor. If I can just survive medical school, I will get to spend the rest of my life making a difference in the lives of those around me. I will get to help patients and their families through the worst moments in their lives. When I go home from work at night, I'll be able to say, "Today I did everything I could to save someone's life." And that is something I truly long for.

And so, for now, I'll leave you with a couple quotes that will hopefully help you feel a little bit better if you, like me, have been feeling a little stressed and/or sad lately:

"Become a possibilitarian. No matter how dark things seem to be or actually are, raise your sights and see possibilities--always see them, for they are always there."
– Norman Vincent Peale

"I am a very old man and have suffered a great many misfortunes, most of which never happened.”
– Mark Twain

"Everyday may not be good, but there's something good in every day."

Until next time.

Friday, November 18, 2011

Letting Go of The Past

Dear Reader,

When I was younger I loved to watch Disney movies. (Just in case you're wondering, I still love to watch them, but that's not really important as far as the story I'm about to tell is concerned.) And I think watching those movies over and over and over may have a lot to do with why, even in high school, I still believed that one day I would meet my "prince" and he would be the first and last and only guy I would ever fall in love with.

I feel it's important for me to mention that when I turned eighteen and graduated from high school I was still more than a little naive. I had never been kissed and the only date I had gone on ended with the guy offering to pay for my dinner and me saying, "Do it and I'll kick you in the throat." (I had had a martial arts lesson earlier that day and the instructor told me a good way to stop someone from doing something you didn't want to do was to kick them in the throat). Perhaps needless to say, we never went out again (although we did become close friends) and I learned it's better to just say "thank you" when a guy offers to pay for you.

In any event, though, at the beginning of the summer before my first year of college, I was still convinced that my perfect prince was out there somewhere, waiting for me to notice him.  And so it was that within a week or two of graduation I went out on my first date with the guy who would become my first boyfriend and who I hoped for two years was my first and last and only love. He was handsome and fun to be around and even my parents liked him and I quickly fell head over heels in love with him, but somewhere around a year and a half later I learned that I was not his first and last and only love. No, as it turned out, I wasn't even his only girlfriend.

I was heart broken when I learned he had been dating someone else for close to the entire time we had been together. But he was such a smooth talker and I was so convinced that he was the man I was going to be with for the rest of my life that I decided to give him a second chance and then a third and then a fourth and oh so many more chances than I should have. By end of the summer after my sophomore year of college I was fighting with my parents because they wanted me to stop seeing him. I cried almost every night for several weeks in a row and yet I couldn't bring myself to give up my dream that my first love would be perfect and would never end. But eventually, with the help of my friends, I came to see that my relationship had to come to an end. And so, just before I left for my junior year of college, I ended things with the guy who was supposed to have been my first and last and only love.

That fall I took a non-fiction writing seminar and, for my final project, I wrote about my failed relationship. When I first started the essay I was hurt and angry and all but convinced that true love didn't exist, but by the time I got to the last paragraph (close to five months after my break up), I found I was once again feeling hopeful. I ended the essay by saying that I would not let one bad relationship rob me of my hope that one day I would meet a wonderful, trustworthy guy who I would be able to spend the rest of my life with.

And so it was that a couple months later I began dating once again. But for the next three years I just couldn't seem to let myself get attached to anyone. I was so scared that they would hurt me again like my first boyfriend had that I would end things with each guy who showed an interest in me before things got too serious.

This past June I unexpectedly began dating once again and after a month or so I came to realize that our relationship was quickly evolving into something more than a summer fling. As the summer drew to a close, I became more and more aware of the fact that I was getting attached to him and the all too familiar feelings of worry and fear began creeping up on me. For a while, on the nights I spent alone,  thoughts like "How can I be sure he won't cheat on me like my ex-boyfriend did?" and "How can I be certain that he wants to be with me and only me?" would sneak unbidden into my head.

As time went on, though, I realized that he (unlike my first boyfriend) truly deserved my trust and the thoughts began to keep me awake less and less. I found I was still terrified to let myself get so attached to someone again because--even though I knew I could trust him--by letting myself get attached to him, I was making myself vulnerable to getting hurt.

I guess what I'm coming to realize, though, is that relationships aren't always perfect like in Disney movies and they aren't always terrible like my first one was either. Sometimes, the first person you fall for just isn't destined to be your first and last and only love like in the movies. And maybe sometimes the second or third or fourth won't turn out to be the one you'll spend the rest of your life with either. But if you don't let go of the past and allow yourself to get attached to someone (even when it means you could get hurt again), you'll never be able to find that special someone who will make you happy and who just might turn out to be your last and only love for the rest of your life.

On that note, I'll leave you with a couple quotes:
  • “When we think we have been hurt by someone in the past, we build up defenses to protect ourselves from being hurt in the future. So the fearful past causes a fearful future and the past and future become one. We cannot love when we feel fear.... When we release the fearful past and forgive everyone, we will experience total love and oneness with all."
  • "When one door of happiness closes, another opens, but often we look so long at the closed door that we do not see the one that has been opened for us."
  • "Sometimes the cards we are dealt are not always fair. However you must keep smiling and moving on."

Until next time.

Wednesday, September 21, 2011

Willingly Trapped in the Dungeon

Dear Reader,

Hello again! Sorry it's been so long since we last "spoke." Time just kind of got away from me.

Sometimes I feel like medical school straight up steals all of my time. I mean, it even invades my sleep and causes me to dream about EKGs and what imaging study should be ordered when and why. But, if I'm going to be honest with you and with myself, medical school really hasn't stolen anything from me. No, everything I've given and everything I will one day be called upon to give to it, I give freely and willingly. Although it took me a while to realize that.

In fact, a few weeks ago I had a dream that our high-heeled-wearing block director was keeping me and a handful of my female classmates locked in the dungeon of her castle. For those of you who aren't a student here with me, "the dungeon" is what we lovingly call the area in the basement of the school of medicine where our small group labs are located our M1 year. There are no windows, the lighting is terrible, the heating/cooling doesn't always work, and some nights when you're studying, a cockroach is your only companion. (Now do you see why we call it "the dungeon?")

In the dream, though, our professor kept each of us in a separate, tiny room and fed us blue mush three times a day through a small hole in the door to our cell. (One girl painted a mural with her mush because she refused to eat it.) Occasionally, our professor would let us out to clean the dungeon, and one day, when she put me back in my cell, she was in a hurry and forgot to lock the door. After she left, I slipped out of my cell and freed my classmates. As we crept through the castle, several guards saw us and forced us to stop by threatening to shoot us with their crossbows. It turned out the guards were M3s and M4s and initially they wanted to escort us back to the dungeon. They said that they had had to serve their time in the dungeon and that we should have to do the same. Being the fearless and charismatic leader that I was in my dream, I convinced the guards that it wasn't necessary for us to suffer just because they had. And, in the end, they let us go. 

Unfortunately I woke up before we made it out of the castle, so I don't know how the story ends. In any event, as I prepared to go to school, my first thought was, "Could my subconscious have been any less subtle?!?" Recently I had begun to feel somewhat trapped by medical school. On days when I wanted to hang out with my friends, I had to go to class. At night, I wanted to be able to go on a date with my boyfriend or go take a dance class, but instead I had to study. I wanted to travel, but I couldn't get away for more than two or three days at a time. In short, it seemed like there was no way to escape even for long enough to do the things I wanted to do without risking failing medical school.

I think I kind of hit rock bottom after talking to some of my friends who aren't in medical school. When they get done with work, they're free to do anything they want. They can make dinner every night with their significant other. They can stay at home and rest for as long as they need to when they get sick. They can spend a nice Saturday at the park or botanical gardens or the zoo. As I talked to them, it hit me that I was more than a little jealous of their lives. And one night, when I was by myself, I found myself once again crying because of medical school.

Now, you're probably thinking to yourself something along the lines of, "Geez, this girl sure does cry a lot...in one blog she said med school makes her cry all the time...in another she had a dream where she cried because she was trapped in a tower...in another she was on the verge of crying. Why doesn't she just quit medical school and be done with all the crying?"

Well, in response to your question, I must say that the thought of dropping out of medical school has crossed my mind. I may have even toyed with the idea of drafting a letter of resignation so I had one handy in case I ever decided to go through with it. However, like I said once before, when I really get to thinking about it and so long as I keep the long-term in mind, there isn't anywhere else I'd rather be.

Yes, medical school may frequently feel like torture right now, but in a few years, everyday I'll have the privilege of working with complete strangers who will trust me completely with their lives and their darkest secrets. I'll have the opportunity to positively impact their lives, not only by providing them with the best possible medical care for physical ailments, but also by providing comfort to those who suffer from non-physical problems and helping to ease their pain during the trying times. And how many people can say that they get to do that?

It would be nice if med school were a little less stressful, but I am determined, more than ever before, to do whatever it takes to become a doctor. And so I will willingly serve out my time in the metaphorical dungeon. Granted, there will be days (probably lots of them), when I will complain and when I will once again wonder if I should just go ahead and give up and run far, far away from med school, but I won't ever do that. No, one day, I will put on that long white coat and in that moment all my time spent down in the dungeon will have been worth it.

With that, I'll leave you with a couple of my favorite inspirational quotes.

"One half of knowing what you want is knowing what you must give up before you get it." -- Sidney Howard

"Success isn't a result of spontaneous combustion.  You must set yourself on fire."  --Arnold H. Glasow

"The rung of a ladder was never meant to rest upon, but only to hold a man's foot long enough to enable him to put the other somewhat higher." --Thomas Henry Huxley

Until next time. 

Tuesday, May 17, 2011

The Reflections of 1/4 of a Doctor

Dear Reader,

Seeing as an entire year of medical school has somehow managed to go by, I thought it would only be appropriate to take a moment to share some of the things I've learned and reflect on my experiences.

Things I've Learned:

1. Each kidney has more than one nephron--approximately one million more to be more precise. Somehow I managed to not pick up on that key fact until the end of my first week studying renal physiology. Afterwards the kidneys made so much more sense.

2. I probably shouldn't walk around outside barefoot any more.

3. I probably shouldn't eat meat unless it has been burnt to a crisp just to be safe.

4. I probably shouldn't eat anything when I go abroad and I definitely shouldn't drink the water.

5. I have probably been exposed to Toxoplasma gondii (my sister jabbed me in the leg with the broom we were using to sweep up around our cat's liter box) and Histoplasma capsulatum (endemic in Missouri). While that may sound somewhat alarming (especially if you haven't studied microbiology), it's actually not a big deal. Unless, of course, I become immunocompromised, but then every pathogen is a big deal.

6. I should probably live in a bubble just to be safe.

7. I can live on much less sleep than I ever realized.

8. Redbull and watermelon sour patch gummies together make a highly satisfying diet.

9. People really do trust you the moment you put on a white coat.

10. Vacuuming spiders up is not a good way of killing them because, if they survive, they can crawl out again or lay eggs in the vacuum.

11. Loads of other "temporary truths" (i.e., things we think are true now that will be disproven in a couple months or years or decades) and (perhaps) some permanent truths, but I see no reason to bore you by attempting to list all of those. If you want to know the more important ones, go get a copy of First Aid for the USMLE Step 1.

12. Speaking of First Aid, I bought a copy of it at the beginning of medical school but didn't open it for weeks because none of our courses were about first aid. It wasn't until our second block that I realized the book does not contain tips on how to care for someone's wound, but instead contains many "high yield" facts on all the topics covered in medical school.

13. Medical students seem to love things that are "high yield" more than they love food.

Things I Still Don't Understand:

1. How my body isn't falling apart.

2. The brain.

3. The immune system.

4. How to interpret a chest x-ray.

5. How to interpret an EKG.

6. Why no one has taught the Office of Medical Education that punctuation goes inside the parentheses. For example the patient described his pain as "worse than being stung by a thousand bees."

7. Why people always say that we have four eight hour exams when the exams are, in fact, closer to nine hours (8 am to 4:45pm = 8 hours and 45 minutes).

8. Men.

Momentous and/or Memorable Moments:

1. Meeting my classmates for the first time and discovering what an amazing class we have.

2. Having my first (and hopefully only) panic attack.

3. Developing the "crush and flush" method of disposing of spiders after learning that it's not enough to just vacuum them up.

4. I was wearing my white coat once when I got out of my car at my apartment and an elderly man nodded respectfully to me. I wanted to tell him, "Oh, no, you don't need to do that--you have no idea how little I know and how useless I would be to you if you were to have a stroke or something right now." But instead I just nodded back and vowed to never wear my white coat in public again until I can actually be of use to people.

5. It was near exam time, and I was shadowing a doctor and kept thinking about all the things I needed to do when I got home. The patient we were seeing started to cry, so I handed her a box of tissues and her daughter turned to me and said, "You're a very nice young lady." That reminded me that there's more to medicine than memorizing as many little details as possible.

6. Social events! Some of my favorites were our Halloween party, karaoke, our trips to the winery, and of course anything that involved dancing.

7. Baking for my classmates--there are honestly few things that I love more in life than feeding people. (And by "feeding people" I mean providing them with food, not literally putting the food in their mouths.) I love seeing them smile and knowing they're happy at least for the few moments that they're eating whatever I made.

8. One of my tutors told us how a child who had undergone an operation explained surgery to a child who was about to have an operation: Men (doctors) in their pijamas (scrubs) come in and they take you away in a red wagon (what they used at the time to take children to the operating room) to a big white bathroom (the OR walls were all tiles) and they have you lie down on a big table and they cover you in a blanket so you don't get cold, and then you disappear.

Med School Nights' Dreams:

1. In our first block I dreamed that I was being followed by two men and then I ran into our possum-loving professor. I gave him our secret signal so that he knew I was in danger, and he went to my house and alerted my dad that, when I got home, there would be two men following me. On my way, however, I ran into one of my male classmates, and the two men stopped following me. When we got to my house, the professor and my father were convinced that the guy with me was trying to harm me and he had to correctly identify several histology slides in order for them to believe he was my friend. Afterwards we all had dinner together.

2. Oftentimes when I studied anatomy before I went to bed, I would have zombie dreams.
  • Particularly Memorable Zombie Dream #1: While we were in the midst of a PBL (Problem-Based Learning) session, the zombie apocalypse hit the United States. However, because our labs are in a basement, my classmates and I all survived. Our professors informed up that we should split up into small groups, gather supplies in the hospital, and find a place to hideout while they contacted the CDC to see how bad the outbreak was. My group was gathering food and found ourselves in a room with a large window. We could see the zombies approaching the hospital and were all afraid that the end was near. Fortunately I woke up.
  • Particularly Memorable Zombie Dream #2: I was visiting friends in Atlanta and decided to borrow a motor cycle and go for a ride through the countryside by myself. (Note: In real life, I have never ridden a motor cycle.) As I was riding, the speed limit suddenly dropped from 60mph to 30mph and I try to slam on the breaks, but couldn't slow down enough. Two cops (also on motor cycles) pulled me over and I noticed that they were walking in a very jerky manner. As they got closer, I could see that their skin was peeling off and they smelled like our anatomy lab (i.e., horrible if you're never been in an anatomy lab). I ran off into the woods and eventually found an abandoned house and barricaded myself in a bedroom. Somehow I managed to fall asleep, and when I awoke I found it was pitch black outside and I was wearing a wedding dress. In the background of the dream, "Hurricane" by 30 Seconds to Mars started playing. A hand broke through the window next to the bed I was on and shattered glass flew everywhere. The hand grabbed me, but I managed to get away. I ran down the hallway and everything proceeded in slow motion. I ran slowly and the veil and dress slowly trailed behind me. I made it out of the house only to find that I was completely surrounded by zombies. I tried to fight my way through them, but eventually I was just too tired to fight any more and I gave in. Only then did I wake up.

    3. On a lighter note, I once was dreaming my way through the urea cycle and when my alarm went off, I thought, "If I don't go back to sleep and finish, I'll get a build up of arginine." So I went back to bed and missed lecture that morning. Later that day I looked up the urea cycle and found there was indeed a point where arginine is involved in the urea cycle.

    4. In our neuroscience, endocrine, and reproduction block, I woke up one morning and thought to myself that I hadn't made enough of some hormone yet and so I went back to bed. I also missed lecture that day.

    5. I've also had a number of dreams where my family members are sick or dying and it's up to me to save them. Initially, I was utterly helpless, but by the end of my first year I was at least able to keep everyone alive for long enough for help to arrive.
    • In one dream, my mom, dad, and I were being help hostage in a hotel room. Three men with machetes demanded that we give it to them. We tried to explain that we had no clue what it was, tried to tell them that they had the wrong family, but they wouldn't believe us. I suddenly realized my sister was missing and asked, "Where's my sister?" One of the men laughed and said, "It's too late for her now." Then he tapped the ceiling in three places with his machete and the ceiling collapsed and my sister with the rubble to the floor. She was coughing up blood and with all the dust and debris I couldn't find where she was injured. I screamed her name in the dream and woke up crying.
    • In another dream, some of my friends and I were at a lake and everyone was jumping into the water. My sister was there but she was only maybe seven or eight years old (much younger than she is in real life). Despite my warnings about checking for rocks, she dove in head first and then slowly floated up to the surface of the water, belly down. I ran into the water and carefully flipped her over and swam her to the shore where she immediately started coughing up water. She had a bump on her forehead but claimed she was fine and that she just wanted to go home and rest. We started walking towards the bridge that lead into the town where we lived in the dream and she stumbled. She said her head suddenly hurt really badly and that she was seeing two of everything. I asked her if she was feeling nauseous and she said yes and vomited and then fainted. I grabbed a Wii remote out of my backpack and hooked her up to it and began pressing the buttons every couple of seconds because, in the dream, that was the best way to keep her intracranial pressure down. I carried her across the bridge, pressing the button the entire time. When we got to a restaurant a man called an ambulance for me and the EMTs were able to make it in time to save her and they took her to the hospital and she lived. The doctor told me, if I hadn't kept her intracranial pressure down, she would not have made it.

    Obviously I've learned more than thirteen things, still don't understand more than eight things, and have had more than eight memorable experiences and five dreams in the last year, but I figured I'd just hit some of the highlights. If I were to tell you everything, we'd be here until this time next year.

    So I suppose I'll close for now, with another of my favorite quotes: "Life's too short to be anything but happy. So love deeply, forgive quickly, take chances, give everything, and live with no regrets. Forget the past, with the exception of what you have learned from it, and remember: everything happens for a reason."

    Until next time.

      Monday, February 14, 2011

      I Love Thee, I Love Thee Not (Part 2)

      Dear Reader,

      After a rousing day of lectures--on the off chance you weren't there we started with the male reproductive system where we learned (among many other things) that men produce approximately 1000 sperm per heartbeat and ended with how to talk to patients about domestic violence--I was faced with the reality that I would be spending the rest of my Valentine's Day studying and as I trudged down to my lab, I had pretty much convinced myself that this day was going to end up on that ever-growing list of bad ones.

      To make matters worse, as I opened my neuroanatomy book, I came to the sad conclusion that not only would I be studying alone tonight, but that I would most likely be alone for--at the bare minimum--the next couple months. You see, I had recently been entertaining the idea of dating someone, but over the weekend had come to the sad conclusion that I just don't have the time or energy to start something new right now. In two weeks we'll be taking our third week-long round of exams and, after making my to-do list, I realized that for the next three weeks I'm barely going to have enough time to average six hours of sleep per night, let alone fit in time to hang out with a guy. Plus, even after exams are over we'll only have one three-day weekend before we begin our fourth block. And I mean, even the most understanding guy would not likely be thrilled if I said to him, "Ok, so we can't see each other for the next three weeks. And really, I don't even have enough time to text or call. But three weeks from now we can maybe spend a day together but then I have to go back to seeing you maybe one night a week for another two months. But once summer rolls around we can totally see each other as often as you'd like except when I'm shadowing..." But the truth is, that's all I can really offer right now.

      And so, at this point in our story, I'm on the verge of tears and feeling incredibly lonely and am just about to add today to that ever-growing list of bad days I mentioned earlier. But then the thought occurred to me: Why does today have to be a bad day? Obviously there are a lot of reasons I could label it as a bad day (such as all the ones I mentioned so far), but really, I'm in medical school at the university that I know--beyond a shadow of a doubt--is the perfect fit for me. I have an amazing group of friends. Despite all of the things I now know of that can go wrong with a body, I'm healthy. And, yes, I may be single, but, on the bright side, that means I really don't have any drama in my life and, when I find myself with free time, I can use it to care for myself and do things like exercising or making myself a nice dinner.

      And, so, in conclusion, I have decided that today is going to go on the list of good days. After all, even though I might sometimes say I'd like to be somewhere else (like on a beach in the French Riviera), the truth is I'm right where I want/need to be. And, in all honesty, I would most likely be miserable if I were out of school and leading a life of leisure--I'm too much of a workaholic to be satisfied with something like that for very long. And so I'm off to study and maybe if I really focus well I'll work out later and make myself a nice dinner.

      Until next time.

      Wednesday, January 26, 2011

      I Love Thee, I Love Thee Not

      Dear Reader,

      I don't know if you already know this or not but I once dated a guy who--before I finally worked up the nerve to end things--managed to make me cry almost every night for months on end. After I got over him, I vowed to never keep anyone in my life who made me cry more often than he made me smile. Because life, I decided, was much too short to be unhappy all the time. But for me to live up to that vow, does that mean I have to break up with medical school?

      This time last year, if you had told me that med school--the thing I knew I wanted more than anything else in the world--would turn my world upside down and inside out, I would've said that you were crazy and informed you that you clearly did not know what you were talking about. I would've told you that nothing was going to stand between me and becoming a doctor. Would've assured you that I could handle anything, was willing to give up whatever it took, in order to reach my goal.

      But now some nights I startle awake (sometimes multiple times in the same night even) and am overcome by a panic that necessitates that I jump out of bed and throw open the blinds to check to make certain it's still night. Because until I look outside and see that it's still dark I can't tell if it's 4:37am or if it's 4:37pm and I've slept through that day's required classes. And then there are the nights I have horrific dreams where I must watch helplessly while those closest to me die from injuries or diseases about which I have yet to learn. Or if I study anatomy before I go to bed all-too-real-looking zombies hunt me down until I am simply too exhausted to fight any more and have no choice but to give into them.

      Other nights I feel so lonely that I am half convinced that, if I were to get up and take a look in the mirror, I would find a gaping hole in my chest where my heart used to reside. But then when the sun rises and I once again return to my schoolwork, I wonder if it is perhaps better for me to just be lonely so I can use all my spare time to study. And when I do occasionally take a break to do something non-academic I am overcome by guilt for doing something emotionally rewarding instead of studying or doing something else that will help ensure I am placed in the residency program of my choosing.

      Lately my emotions have been so out of whack that I can go from feeling ecstatic to sobbing to being completely devoid of emotion all within the space of a day. The night before our multiple choice, knowledge-based exam I am so overcome by an impending sense of doom that I lay awake until my alarm clock calls me up and to arms. And when I get my scores back, my hands--always so steady in undergrad--shake for the hour before I work up the courage to look at my grades. And even when I saw that I passed this time around, I felt no relief but instead immediately began to worry about passing the next block of exams.

      But inevitably something amazing will happen--like in anatomy lab the other day when we got to look at a human brain and hold it in our hands. It was unbelievable to think of all the things it was once capable of doing when its owner was alive despite how seemingly simple it looked lying there in my hands. Or when given an opportunity to shadow a doctor, I will suddenly be reminded of why it was that I wanted to go into medicine in the first place--to be able to help those around me and to make a difference in the lives of others.

      I knew medical school wasn't going to be easy but nothing anyone said could have prepared me for how truly hellish and simultaneously wonderful it has turned out to be. I was told the other day that medical school is like a downhill slope and that, just when you think things can't get any worse, they somehow manage to do just that. But the doctor I was talking to assured me that, if I can only make it to residency--or even third year when we begin to have more clinical experiences--things will start to get better.

      And so, I suppose for now I'll just have to take the good with the bad, and try my hardest to balance school with having a life and hope that the days that make me smile out number the ones that make me cry.

      Until next time.

      Thursday, November 4, 2010

      Medical School: A Heroic Journey

      Dear Reader,


      Thousands upon thousands of yesterdays ago man developed from what had once been nothing more than a single cell and even the face of the earth itself underwent a great many changes until the day finally came when I sat at my computer, nervously debating whether or not I should log in to the Office of Medical Education's website to view my Block One grades.

      Part of my brain insisted that if I didn't look, the grades didn't exist and that really it would just be best if I continued on in ignorant bliss. The logical part of my brain reminded me that what's done is done and that the grades were there, within the website, and whether I looked or not, they existed and were not going to change. But still, I just couldn't bring myself to look.

      And as I sat there with my fingers poised over my keyboard, my mind wandered away from the glowing screen before me and off to a memory of a recurrent dream which I have from time to time (generally when I am about to receive important exam scores or feedback on a story) and which I had had the night before. In the dream I am trapped somewhere way up high in a tower and, like dreamers often do, I somehow know that there is no way for me to escape from this tower and that no one is coming to rescue me. Not then, not that night, not even ever.

      And the thought occurs to me that, if only I had long golden hair like Rapunzel, I could use it like a rope and throw it out through my window. And perhaps if it were heavy enough, it would pass through the earth itself and sink down and down and down and then snake it's way back up and out until it had found my rescuer. And because it was a dream he would somehow know to grab hold of it and he would follow it back and find me and free me.

      But in this dream my hair is neither long nor golden nor capable of doing much of anything, and I know it cannot bring a prince to me or anyone for that matter. And yet in the dream I cannot help but stare out my one small window and dream of my rescuer's arrival. And so I wish and wonder and sigh and try to conjure him up. Try and try and try but still only nothing and nothingness. No knight in shining armor ever bursts through my door and takes me away with him. No, he stays wherever he is, where my hair might find him if this dream were more like a fairytale and not so horribly real. He stays where he is and nothing, not anything, will change that, I slowly begin to realize. Not then, not that night, not soon, and not even ever.

      And so I wrench myself away from the window and sink to the ground at last, a mandolin appearing on my lap as things in dreams sometimes do. And as my hands--suddenly skilled in an art I have never attempted in the world of the waking--unleash a haunting melody, two liquid somethings slide down my face and make a plink-plonk on the strings which, much to my surprise, is followed immediately by a tap-tap on the door to my prison.

      I move to the door at a speed only attainable in dreams, but as I reach for the doorknob I am overcome by a feeling of dread. It occurs to me that the person on the other side of the door might not be who I hope he is. He might not have come to save me but instead to harm me. And as I contemplate the risks and potential benefits of opening the door and learning who or what lies on the other side, my alarm clock erupts into life and I am suddenly myself again, lying in my bed on the morning of the day we are to learn our Block One grades.

      After the memory ended and my mind drifted back to the present, I still was unable to bring myself to type in my username and password and can remember thinking to myself that if life were a fairytale, I would have nothing to worry about. In a fairytale land, every block two satisfactory grades would await me without fail. But just as in the dream, I was painfully aware of the fact that I did not live in a fairytale land and that it could be two unsatisfactories that I would find.

      For a second I wondered if I closed my eyes and wished hard enough, that I might be able to wake up in my bed back in Atlanta, only to find that I was once again a freshman and all of med school to that point had been naught but a dream. But, knowing that that would never happen, I prepared myself for the worst, logged in to OME's website, clicked around until I found my grades, calmly shut my computer, and headed upstairs for lunch.

      Now, before I tell you how I did, I feel I should say one thing: Even as I worked my way through the knowledge-based exam, I could tell that I hadn't studied correctly. I had mastered the basic concepts but hadn't learned any where near enough of the small details we ended up being tested over. When I finished my exam I knew it was going to be a close call, and so it came as no great surprise to me that, while I passed all the other sections with flying colors, I got a 61% on the KBE.

      What did come as a surprise, though, was finding--upon reviewing my exam--that many of the questions that had been eliminated were questions I had answered correctly. After doing a quick calculation, I discovered that, including the eliminated questions, I had answered the same number of questions correctly as someone who had passed. And yet because of the particular set of questions I had answered correctly, I had failed.

      Upon discovering that I was not the only person this had happened to, I decided to meet with one of the deans to discuss my/our predicament. And so that night I prepared my logic-based argument on why I (and the other students in my position) should receive a passing grade and why questions deleted should only be subtracted from the denominator of your score. I practiced and refined my argument with my mom. Practiced with my roommate who played the devil's advocate. Practiced writing it out. Even practiced one last time in anatomy lab.

      But when I met with the dean, despite all my practice, my world came tumbling down. You see, the dean allowed me to work through my argument. She appreciated that I acknowledged the fact that I needed to change my study habits to avoid being so close to passing or failing that the questions chosen to be deleted could decide whether I received that S or U. She agreed with my argument that simply removing points from the denominator of each student's score would take into account the fact that different students were given different tips from different tutors and would even adjust for the fact that different questions do and do not make sense to different students because we all possess different reasoning skills. But in the end, while she agreed with my logic, she said that nothing was likely to change. The system they used had determined that I had failed while other students had passed and that was that.

      Until that moment in the dean's office I suppose I had shut my eyes to the flaws in the medical education system because they had yet to effect me, but when the realization hit that the system was flawed and could have such a profound effect on me it literally took my breath away. And so it was that for the next twenty minutes I sat, crying a little, but mostly just hyperventilating in the the dean's office. And while I could not recognize it at the time, I later came to understand that what had upset me was not the fact that I had failed (in truth, I did much better than I had expected to do). No, what upset me was the fact that what had ultimately decided that I had failed while others who had answered the same number of questions correctly had passed was something out of my control. It was the harsh and unwanted realization that in a perfectly unflawed world, I would have passed as well but that I was living in a human world--full of flaws and bias--where others decided the rules and where there was nothing (or at least very little) I could do to change them.

      After a long talk with my mom--a PhD psychologist who had also come to terms with the fact that graduate school operated on a biased and flawed system--I came to realize that, while it had been a highly unpleasant experience, it was probably for the best that I had had my eyes opened early on so that I could learn to navigate my way around such flaws in the future.

      Towards the end of our talk my mom told me that medical school was going to be much like a heroic journey--full of monsters and obstacles that, at first glance, seem insurmountable. She reminded me that, at some point during their quest, all heroes fall and that the truly great ones are the ones who pick themselves back up, adapt, and continue on their journeys.

      After we got off the phone, I came to the conclusion that failing the knowledge-based portion of my exam had been my first fall and that learning that the medical system is not perfect had revealed the first monster I would have to face again and again during my quest. But I knew I had learned from my mistakes and, more than that, had learned how to avoid future encounters with this particular monster. And I know this may sound cliche but I could feel that I was changing. My fall had been unpleasant to say the least, but in the end it had helped me to become stronger and even more determined to become a truly great doctor.

      To close, I'd like to leave you with one of my favorite quotations:

      "It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs; who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who, at the best, knows in the end the triumph of high achievement, and who, at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat." --Theodore Roosevelt

      Until next time.