Monday, May 23, 2011
Deadrocketcow, MD
I graduated from medical school today, and I can say officially, that I am a doctor. It was a day like any other, but one that I most probably will never forget. My mom, brother, sister, aunt, uncle, cousin and N came and made it even more special. Next stop: residency.
Friday, April 29, 2011
Step 2, you are getting in the way of my relaxation
I have postponed taking Step 2 twice, I think, because my brain was broken. It's currently on the mend, which is good, because I am going to take Step 2 next Friday. Or else.
Four years of undergrad and 3.5 years of medical school culminated in my applying for a residency in Neurosurgery and my matching. I will be leaving New York to go to [Mid-western state] in about a month. Now that that horrid business is over, and I am over my disappointment in not getting my first choice (almost over it, almost...), I am starting to get excited about finally pursuing the career I have dreamed about since time immemorial. I am looking forward to meeting my new co-intern, resident and attending family and exploring the hospital. Before that, I have to learn how to drive, find a place to live and move all my belongings.
For now, it's back to First Aid for the USMLE Step 2 CK and USMLE World.
Four years of undergrad and 3.5 years of medical school culminated in my applying for a residency in Neurosurgery and my matching. I will be leaving New York to go to [Mid-western state] in about a month. Now that that horrid business is over, and I am over my disappointment in not getting my first choice (almost over it, almost...), I am starting to get excited about finally pursuing the career I have dreamed about since time immemorial. I am looking forward to meeting my new co-intern, resident and attending family and exploring the hospital. Before that, I have to learn how to drive, find a place to live and move all my belongings.
For now, it's back to First Aid for the USMLE Step 2 CK and USMLE World.
Monday, March 14, 2011
Sunday, February 27, 2011
Interesting quote
[T]rue gender equality is actually perceived as inequality. A group that is made up of 50% women is perceived as being mostly women. A situation that is perfectly equal between men and women is perceived as being biased in favor of women.
And if you don’t believe me, you’ve never been a married woman who kept her family name. I have had students hold that up as proof of my “sexism.” My own brother told me that he could never marry a woman who kept her name because “everyone would know who ruled that relationship.” Perfect equality – my husband keeps his name and I keep mine – is held as a statement of superiority on my part.
[Lucy, When Worlds Collide: Fandom and Male Privilege.]
And if you don’t believe me, you’ve never been a married woman who kept her family name. I have had students hold that up as proof of my “sexism.” My own brother told me that he could never marry a woman who kept her name because “everyone would know who ruled that relationship.” Perfect equality – my husband keeps his name and I keep mine – is held as a statement of superiority on my part.
[Lucy, When Worlds Collide: Fandom and Male Privilege.]
Wednesday, February 23, 2011
Thursday, February 17, 2011
How to like it
A new favorite:
These are the first days of fall. The wind
at evening smells of roads still to be traveled,
while the sound of leaves blowing across the lawns
is like an unsettled feeling in the blood,
the desire to get in a car and just keep driving.
A man and a dog descend their front steps.
The dog says, Let's go downtown and get crazy drunk.
Let's tip over all the trash cans we can find.
This is how dogs deal with the prospect of change.
But in his sense of the season, the man is struck
by the oppressiveness of his past, how his memories
which were shifting and fluid have grown more solid
until it seems he can see remembered faces
caught up among the dark places in the trees.
The dog says, Let's pick up some girls and just
rip off their clothes. Let's dig holes everywhere.
Above his house, the man notices wisps of cloud
crossing the face of the moon. Like in a movie,
he says to himself, a movie about a person
leaving on a journey. He looks down the street
to the hills outside of town and finds the cut
where the road heads north. He thinks of driving
on that road and the dusty smell of the car
heater, which hasn't been used since last winter.
The dog says, Let's go down to the diner and sniff
people's legs. Let's stuff ourselves on burgers.
In the man's mind, the road is empty and dark.
Pine trees press down to the edge of the shoulder,
where the eyes of animals, fixed in his headlights,
shine like small cautions against the night.
Sometimes a passing truck makes his whole car shake.
The dog says, Let's go to sleep. Let's lie down
by the fire and put our tails over our noses.
But the man wants to drive all night, crossing
one state line after another, and never stop
until the sun creeps into his rearview mirror.
Then he'll pull over and rest awhile before
starting again, and at dusk he'll crest a hill
and there, filling a valley, will be the lights
of a city entirely new to him.
But the dog says, Let's just go back inside.
Let's not do anything tonight. So they
walk back up the sidewalk to the front steps.
How is it possible to want so many things
and still want nothing. The man wants to sleep
and wants to hit his head again and again
against a wall. Why is it all so difficult?
But the dog says, Let's go make a sandwich.
Let's make the tallest sandwich anyone's ever seen.
And that's what they do and that's where the man's
wife finds him, staring into the refrigerator
as if into the place where the answers are kept-
the ones telling why you get up in the morning
and how it is possible to sleep at night,
answers to what comes next and how to like it.
-Stephen Dobyns
These are the first days of fall. The wind
at evening smells of roads still to be traveled,
while the sound of leaves blowing across the lawns
is like an unsettled feeling in the blood,
the desire to get in a car and just keep driving.
A man and a dog descend their front steps.
The dog says, Let's go downtown and get crazy drunk.
Let's tip over all the trash cans we can find.
This is how dogs deal with the prospect of change.
But in his sense of the season, the man is struck
by the oppressiveness of his past, how his memories
which were shifting and fluid have grown more solid
until it seems he can see remembered faces
caught up among the dark places in the trees.
The dog says, Let's pick up some girls and just
rip off their clothes. Let's dig holes everywhere.
Above his house, the man notices wisps of cloud
crossing the face of the moon. Like in a movie,
he says to himself, a movie about a person
leaving on a journey. He looks down the street
to the hills outside of town and finds the cut
where the road heads north. He thinks of driving
on that road and the dusty smell of the car
heater, which hasn't been used since last winter.
The dog says, Let's go down to the diner and sniff
people's legs. Let's stuff ourselves on burgers.
In the man's mind, the road is empty and dark.
Pine trees press down to the edge of the shoulder,
where the eyes of animals, fixed in his headlights,
shine like small cautions against the night.
Sometimes a passing truck makes his whole car shake.
The dog says, Let's go to sleep. Let's lie down
by the fire and put our tails over our noses.
But the man wants to drive all night, crossing
one state line after another, and never stop
until the sun creeps into his rearview mirror.
Then he'll pull over and rest awhile before
starting again, and at dusk he'll crest a hill
and there, filling a valley, will be the lights
of a city entirely new to him.
But the dog says, Let's just go back inside.
Let's not do anything tonight. So they
walk back up the sidewalk to the front steps.
How is it possible to want so many things
and still want nothing. The man wants to sleep
and wants to hit his head again and again
against a wall. Why is it all so difficult?
But the dog says, Let's go make a sandwich.
Let's make the tallest sandwich anyone's ever seen.
And that's what they do and that's where the man's
wife finds him, staring into the refrigerator
as if into the place where the answers are kept-
the ones telling why you get up in the morning
and how it is possible to sleep at night,
answers to what comes next and how to like it.
-Stephen Dobyns
Sunday, February 06, 2011
The power of Good bye
When I was a third year medical student, on my Neurology rotation, I met a young man, about 34 years old, who had been referred to our hospital for further management of his disease. Basically, the hospital that he had just spent four days in getting his diagnosis was not equipped to fully handle his disease and had sent him to a hospital that could. I remember this patient encounter particularly because of how powerless I felt and how I had to "lie" to the patient (and his family's face).
This patient had not been acting like his usual self over the past two months, and without getting into too much identifying information, he had changed from a quiet, soft-spoken man to one who was forgetful, inattentive at work and given to anger outbursts. A CT done at the first hospital revealed a huge mass (read tumor) infiltrating most of his frontal lobes. The frontal lobes are parts of the brain that are responsible for so called executive function: the ability to know when actions are socially acceptable, to understand the consequences of one's behavior, etc. The CT explained why this young man had been exhibiting such bizarre behavior.
I was on call that night and it was my duty to see new patients that had been accepted onto our service and assist the overnight resident in making a plan. After a look at an MRI which had been ordered, a discussion about how this mass was most certainly a GBM (pretty much the worst kind of brain cancer you can get) and the fact that this young man would probably not live beyond the next two years (WITH aggressive treatment), I was dispatched to this young man's room, Neurological tools in hand, with the task to take a "history and physical".
In the room, the young man was sitting on the hospital bed, hair disheveled, but looking composed. His father, his father's brother and his father's brother's wife were sitting at the foot of the bed. I introduced myself, explaining that I was a third year medical student and that while the "real doctor" would be in shortly to see their son/nephew/nephew-in-law, I was here to expedite the whole process by making everyone's life easier and getting this routine stuff out of the way.
I did not realize it then, but I know now I was apologizing for what essentially I came to medical school to do: to learn how to interact with patients, gain pertinent information from their story and physical exam and work towards treatment. I knew this young man was so very sick, that his family must be upset in a way that I could not fully appreciate and yet here I was, learning off their pain. I felt like an intellectual vampire. Most importantly, I felt like a fraud. The family thought I was a contributing member of the team (and you can argue this all the way to the bank that I was, but we shall agree to disagree, for now) and that I was there to help them. In my mind, I was there because it was a required clinical rotation and a part of my curriculum.
Nonetheless, I did what I was there to do. Because I was learning, and because I like to explain things as I do them, it took me about an hour and a half to complete this patient encounter. To compare, on the practical exam I just took January 12th, that uses standardized patients, or patient actors, we are given 15 minutes to gain the same information. Through this 90 minutes, I tried to be professional: calm, methodical, friendly. I included the family in the conversation when I could and asked social questions also - who were they, where were they from, what did they do? I also told them about me - my goals, my background. I cannot remember if I attempted humor, but I think I may have, because at some point, there was laughter. Looking back I am ashamed to think that I was insensitive enough to joke, but I can only assume that I had assessed the situation and decided it was appropriate.
After all this was done, I knew it was time to lie - without lying. To withhold information.
"Is my son/nephew/nephew-in-law going to die soon?"
"Until we get more definitive tests I can't really say" (Yes, probably)
"Why is this happening? Is it genetic?"
"There is some research that shows certain types of tumors run in families. It's hard to say at this point if this is the case, because we are not sure what type of tumor this is" (I don't know, I don't know...I'm only a medical student. I'm...sorry)
"What happens next?"
"The next step is to take a sample of the tumor and perform laboratory tests on it to determine what kind of tumor it is"
"You mean he's going to have brain surgery?!"
"Yes. I know this is difficult. However, the surgeons here do this sort of procedure all the time and your son/nephew/nephew-in-law is in good hands" (Please don't let me say anything wrong, please God, make them stop asking me all these questions, I'm only a medical student!)
And so on.
When I felt I had answered all their questions, I turned to leave. The young man's uncle indicated that he wanted to talk to me outside. I felt afraid and flattered. Did I say something wrong? What is he going to ask me outside? Will I not know and look as stupid as I feel? And also: he wants to talk to me outside? Me? That means he must value my opinion. He actually thinks I'm a professional.
It turned out he wanted to talk more into detail about his nephew's bizarre behavior and what it meant. I was able to answer some questions and for those I could not, I said I would find out.
Over the next week I saw this patient and his family everyday. I listened, I answered their questions. I helped as much as I could. As I was wrapping up my rotation that week, I felt I had to say bye, but I could not. I felt more like an intellectual vampire than ever. I felt they would be angry with me. That they had opened themselves up to me so much and only for me to leave - on to my next rotation - the next week. I could not bring myself to explain that I would be leaving. Friday came and I had still not said bye. I had two competing thoughts all day. Tell them! They deserve to know. Don't tell them! How can you just leave like this?
In the end the decision was made for me. I had to leave for lecture and I had not said bye.
I often think about this young man and his family. I think about them and I feel guilty. I feel guilty because even though I was able to build such strong rapport and advocate for them, ultimately I let them down. I betrayed their trust. I wonder what they thought when the little medical student they could talk to for hours on end, because no one else had the time, about their suffering, their pain...just did not show up the next morning. Did they feel hurt? Confused? Angry? I imagine this must be the case. I wonder often also, where they are now, what they are doing and how he is doing with his disease. I wonder and I regret.
This patient had not been acting like his usual self over the past two months, and without getting into too much identifying information, he had changed from a quiet, soft-spoken man to one who was forgetful, inattentive at work and given to anger outbursts. A CT done at the first hospital revealed a huge mass (read tumor) infiltrating most of his frontal lobes. The frontal lobes are parts of the brain that are responsible for so called executive function: the ability to know when actions are socially acceptable, to understand the consequences of one's behavior, etc. The CT explained why this young man had been exhibiting such bizarre behavior.
I was on call that night and it was my duty to see new patients that had been accepted onto our service and assist the overnight resident in making a plan. After a look at an MRI which had been ordered, a discussion about how this mass was most certainly a GBM (pretty much the worst kind of brain cancer you can get) and the fact that this young man would probably not live beyond the next two years (WITH aggressive treatment), I was dispatched to this young man's room, Neurological tools in hand, with the task to take a "history and physical".
In the room, the young man was sitting on the hospital bed, hair disheveled, but looking composed. His father, his father's brother and his father's brother's wife were sitting at the foot of the bed. I introduced myself, explaining that I was a third year medical student and that while the "real doctor" would be in shortly to see their son/nephew/nephew-in-law, I was here to expedite the whole process by making everyone's life easier and getting this routine stuff out of the way.
I did not realize it then, but I know now I was apologizing for what essentially I came to medical school to do: to learn how to interact with patients, gain pertinent information from their story and physical exam and work towards treatment. I knew this young man was so very sick, that his family must be upset in a way that I could not fully appreciate and yet here I was, learning off their pain. I felt like an intellectual vampire. Most importantly, I felt like a fraud. The family thought I was a contributing member of the team (and you can argue this all the way to the bank that I was, but we shall agree to disagree, for now) and that I was there to help them. In my mind, I was there because it was a required clinical rotation and a part of my curriculum.
Nonetheless, I did what I was there to do. Because I was learning, and because I like to explain things as I do them, it took me about an hour and a half to complete this patient encounter. To compare, on the practical exam I just took January 12th, that uses standardized patients, or patient actors, we are given 15 minutes to gain the same information. Through this 90 minutes, I tried to be professional: calm, methodical, friendly. I included the family in the conversation when I could and asked social questions also - who were they, where were they from, what did they do? I also told them about me - my goals, my background. I cannot remember if I attempted humor, but I think I may have, because at some point, there was laughter. Looking back I am ashamed to think that I was insensitive enough to joke, but I can only assume that I had assessed the situation and decided it was appropriate.
After all this was done, I knew it was time to lie - without lying. To withhold information.
"Is my son/nephew/nephew-in-law going to die soon?"
"Until we get more definitive tests I can't really say" (Yes, probably)
"Why is this happening? Is it genetic?"
"There is some research that shows certain types of tumors run in families. It's hard to say at this point if this is the case, because we are not sure what type of tumor this is" (I don't know, I don't know...I'm only a medical student. I'm...sorry)
"What happens next?"
"The next step is to take a sample of the tumor and perform laboratory tests on it to determine what kind of tumor it is"
"You mean he's going to have brain surgery?!"
"Yes. I know this is difficult. However, the surgeons here do this sort of procedure all the time and your son/nephew/nephew-in-law is in good hands" (Please don't let me say anything wrong, please God, make them stop asking me all these questions, I'm only a medical student!)
And so on.
When I felt I had answered all their questions, I turned to leave. The young man's uncle indicated that he wanted to talk to me outside. I felt afraid and flattered. Did I say something wrong? What is he going to ask me outside? Will I not know and look as stupid as I feel? And also: he wants to talk to me outside? Me? That means he must value my opinion. He actually thinks I'm a professional.
It turned out he wanted to talk more into detail about his nephew's bizarre behavior and what it meant. I was able to answer some questions and for those I could not, I said I would find out.
Over the next week I saw this patient and his family everyday. I listened, I answered their questions. I helped as much as I could. As I was wrapping up my rotation that week, I felt I had to say bye, but I could not. I felt more like an intellectual vampire than ever. I felt they would be angry with me. That they had opened themselves up to me so much and only for me to leave - on to my next rotation - the next week. I could not bring myself to explain that I would be leaving. Friday came and I had still not said bye. I had two competing thoughts all day. Tell them! They deserve to know. Don't tell them! How can you just leave like this?
In the end the decision was made for me. I had to leave for lecture and I had not said bye.
I often think about this young man and his family. I think about them and I feel guilty. I feel guilty because even though I was able to build such strong rapport and advocate for them, ultimately I let them down. I betrayed their trust. I wonder what they thought when the little medical student they could talk to for hours on end, because no one else had the time, about their suffering, their pain...just did not show up the next morning. Did they feel hurt? Confused? Angry? I imagine this must be the case. I wonder often also, where they are now, what they are doing and how he is doing with his disease. I wonder and I regret.
Thursday, January 20, 2011
Reflection
I took my Step 2 CS exam January 12th. This served as chance to reflect on how much I have learned in medical school. I remember getting ready to start third year and memorizing the physical exam and the questions in the history. I thought to myself there was no way I could ever remember each maneuver or remember each part of the history and do it in a manner that pretended to be close to efficient.
Turns out, I did.
I studied about a week for this test (can you say pass/fail?) and only practiced doing a physical once - because even though I have not done much more than a Neuro exam for the past 6 months, once I started, it came back to me easily, flowing out my brain and into my hands like warm syrup on a buttered pancake. I was mostly concerned about making sure if a standardized patient started leading me down the path of HIV/STI's I remembered to ask about safe sex practice...or if another suddenly started coughing uncontrollably, I would offer a tissue, and remember to check for blood in said tissue. All the while coming up with a differential for hemoptysis, which is to say, coughing up blood.
I think I passed. But I'll find out for sure in six - ten weeks.
The next hurdle is Step 2 CK which I have rescheduled to March 28th. I am amazed at how different my state of mind is for this exam compared to Step 1. Perhaps, because I don't feel the fate of a residency position/my career/my happiness/my whole life as I know it rests entirely on this exam as it (sorta) did on Step 1. I have applied, I have interviewed, and hey - by the time I take the exam I will already have matched (or not matched). So take that, residency!
All in a day's work.
Turns out, I did.
I studied about a week for this test (can you say pass/fail?) and only practiced doing a physical once - because even though I have not done much more than a Neuro exam for the past 6 months, once I started, it came back to me easily, flowing out my brain and into my hands like warm syrup on a buttered pancake. I was mostly concerned about making sure if a standardized patient started leading me down the path of HIV/STI's I remembered to ask about safe sex practice...or if another suddenly started coughing uncontrollably, I would offer a tissue, and remember to check for blood in said tissue. All the while coming up with a differential for hemoptysis, which is to say, coughing up blood.
I think I passed. But I'll find out for sure in six - ten weeks.
The next hurdle is Step 2 CK which I have rescheduled to March 28th. I am amazed at how different my state of mind is for this exam compared to Step 1. Perhaps, because I don't feel the fate of a residency position/my career/my happiness/my whole life as I know it rests entirely on this exam as it (sorta) did on Step 1. I have applied, I have interviewed, and hey - by the time I take the exam I will already have matched (or not matched). So take that, residency!
All in a day's work.
Monday, January 10, 2011
Things are back to normal
There are 66 days until Match day. I am almost done interviewing - I have two more and then interviews will be yesterday's headlines. Thinking about the email I will receive on March 14th (the Monday before the match) saying whether or not I have matched, makes me ill now. How will I be on the 13th? *Shudder*
Fourth year is winding down now with rotations such as "the research elective", Primary Care and ethics, where a late day is 6pm, and waking up early, is...well, non-existent. At this rate, residency will be a rude shock. If I match. A ha! Ha. Ha...excuse me while I go cry quietly in the corner.
I feel better now.
I have my Step 2 CS exam Wednesday and thank God it is pass/fail. Really, I just want to get it over with. Surely, I am empathetic and compassionate? Surely, I can ask [fake] patients the right questions in the right tone of voice with just the right amount of eye contact? In any case, this is just another one of those trials that medical school is full of, proving that I am worthy of the future M.D. after my name. Deadrocketcow, M.D. Nice, eh?
You know it.
Fourth year is winding down now with rotations such as "the research elective", Primary Care and ethics, where a late day is 6pm, and waking up early, is...well, non-existent. At this rate, residency will be a rude shock. If I match. A ha! Ha. Ha...excuse me while I go cry quietly in the corner.
I feel better now.
I have my Step 2 CS exam Wednesday and thank God it is pass/fail. Really, I just want to get it over with. Surely, I am empathetic and compassionate? Surely, I can ask [fake] patients the right questions in the right tone of voice with just the right amount of eye contact? In any case, this is just another one of those trials that medical school is full of, proving that I am worthy of the future M.D. after my name. Deadrocketcow, M.D. Nice, eh?
You know it.
Monday, November 08, 2010
Wednesday, October 20, 2010
Long time no post
I am in Houston, Texas, where I have been for the past 3 weeks and 4 days and where I will be for the next 2 weeks and 4 days. What am I doing, you ask? A required medicine "Sub-I". I put Sub-I in quotations because this is not the traditional Sub-I taken during the fourth year of medical school to explore a residency choice. This is something that has been created by my school to torture me. I jest. My school only considers one thing a Sub-I - this required month long Medicine (or Pediatrics) rotation taken during fourth year. This effectively places all my "traditional Sub-I's" in the category of electives - which means I can only receive pass/fail grades on the grueling three months I spent living and breathing Neurosurgery...but that's OK, right? Right?! Right...
...it is most certainly NOT OK. But, moving on...
I decided to come to Houston for my rotation, because this is where the slackers go, and after three months of Neurosurgery, I am definitely a slacker. Also, my sister and the cutest/most adorable/bestest nephew in the world live here, so I get to see them on weekends. Which, is the highlight of my week - yeah, not even the intricacies of high blood pressure and ACE inhibitor management can compare. Unless, of course, said high blood pressure causes a sub-arachnoid hemorrhage via an aneurysm. I'm kidding!! Have three months of Neurosurgery turned me into a cynical, self-absorbed, arrogant Neurosurgeon-to-be-medical student? Perhaps. Which reminds me...
This morning, the medical team that I am on were gathered to round before the attending, who loves to tell humorous stories encountered in his career as a Hematologist. On the way to the punchline on one of his stories, he mentioned casually some attributes about different specialists.
"Nephrologists tend to be very careful, precise people. They do things in a calculated manner."
"Orthopedic surgeons are only interested in driving their cars when they get done in the hospital."
"And Neurosurgeons, well, they are some of the nastiest people around."
Which, the entire team thought was extremely laugh out loud funny, seeing as that is my specialty of choice. He didn't know I am applying into that, which I guess, makes it alright.
A good thing came out of my being in Houston - I have two residency interviews scheduled here before I leave, which makes at least two plane tickets less of an expense during this whole interview season business.
This is my last week at the hospital though, and I get to spend even more time with my sister, nephew and brother-in-law. Awesome!
...it is most certainly NOT OK. But, moving on...
I decided to come to Houston for my rotation, because this is where the slackers go, and after three months of Neurosurgery, I am definitely a slacker. Also, my sister and the cutest/most adorable/bestest nephew in the world live here, so I get to see them on weekends. Which, is the highlight of my week - yeah, not even the intricacies of high blood pressure and ACE inhibitor management can compare. Unless, of course, said high blood pressure causes a sub-arachnoid hemorrhage via an aneurysm. I'm kidding!! Have three months of Neurosurgery turned me into a cynical, self-absorbed, arrogant Neurosurgeon-to-be-medical student? Perhaps. Which reminds me...
This morning, the medical team that I am on were gathered to round before the attending, who loves to tell humorous stories encountered in his career as a Hematologist. On the way to the punchline on one of his stories, he mentioned casually some attributes about different specialists.
"Nephrologists tend to be very careful, precise people. They do things in a calculated manner."
"Orthopedic surgeons are only interested in driving their cars when they get done in the hospital."
"And Neurosurgeons, well, they are some of the nastiest people around."
Which, the entire team thought was extremely laugh out loud funny, seeing as that is my specialty of choice. He didn't know I am applying into that, which I guess, makes it alright.
A good thing came out of my being in Houston - I have two residency interviews scheduled here before I leave, which makes at least two plane tickets less of an expense during this whole interview season business.
This is my last week at the hospital though, and I get to spend even more time with my sister, nephew and brother-in-law. Awesome!
Sunday, August 01, 2010
Status Post Sub-I #1
One Neurosurgery sub-I down, two more to go. I start my second sub-I tomorrow morning at the luxurious hour of 7am. While I am not as frantically excited as I was on that first day one month ago (since I have a fair estimation of what to expect), I am looking forward to exposure to a completely different program than my home institution. I have heard that this next program is as similar to my home program as an apple is to an orange, so this should be interesting. After jumping through the hurdles of obtaining I.D, getting access to the scrub machine and learning everyone's name...I have to learn how to navigate a system that is completely foreign to me and do it fast - a sub-I who does not know how to get things done fast is as good as no sub-I at all. In other words, more hurdles. Another concerning thing is - what will the other sub-I's be like? After a month with the most likable and easy going fellow you could ask for, getting stabbed in the back at every second will take some getting used to. Because the Neurosurgery sub-I is cut throat - every sub-I for him/herself, eat or be eaten...you get the point.
And of course, by the time I am just getting good at figuring things out over there, the month will be over.
Here's to a new month of Neurosurgery.
And of course, by the time I am just getting good at figuring things out over there, the month will be over.
Here's to a new month of Neurosurgery.
Friday, July 23, 2010
10 signs you are sleep deprived on your Sub-I
1. You spend a substantial portion of your day dreaming about how nice it will be to ease into some warm sheets at day's end and scheming how to get the maximum number of hours (start undressing in the elevator, eat dinner with right hand, brush teeth with left...).
2. You have thought about looking online for the possibility of injectable caffeine shots.
3. You have mastered the art of the 30 second power nap - standing up.
4. You have mastered the art of the 30 second power nap, standing up - with your eyes half open.
5. When walking into conference, you dawdle at the door, so there won't be any seats left - because if you sit, you will fall asleep.
6. You have pinched yourself to stay awake.
7. You know all the good places in the hospital to take a quick 15 minute nap (that couch on the dark end of the visitor's lounge, that abandoned stretcher on floor nine...).
8. You've been timing your coffees in order to keep blood levels of caffeine constant, with a gradual decline towards sleeping hours.
9. You've thought to yourself "If I don't sleep for 15 minutes NOW or at least have some caffeine, I will truly die. I will just konk out right here on the floor."
10. You would rather be hungry from 4am to 2pm so you can have that extra half hour of sleep.
2. You have thought about looking online for the possibility of injectable caffeine shots.
3. You have mastered the art of the 30 second power nap - standing up.
4. You have mastered the art of the 30 second power nap, standing up - with your eyes half open.
5. When walking into conference, you dawdle at the door, so there won't be any seats left - because if you sit, you will fall asleep.
6. You have pinched yourself to stay awake.
7. You know all the good places in the hospital to take a quick 15 minute nap (that couch on the dark end of the visitor's lounge, that abandoned stretcher on floor nine...).
8. You've been timing your coffees in order to keep blood levels of caffeine constant, with a gradual decline towards sleeping hours.
9. You've thought to yourself "If I don't sleep for 15 minutes NOW or at least have some caffeine, I will truly die. I will just konk out right here on the floor."
10. You would rather be hungry from 4am to 2pm so you can have that extra half hour of sleep.
Sunday, July 11, 2010
Week One (or how I resolved what I want to spend the rest of my life doing)
I made it through the first week of my sub-I and my first 30 hour overnight call. So far, I am having an incredible experience - each day gets better than the day before. I can now declare that from not being able to sleep that night before my first day, waking up early and being dressed and ready to go 40 minutes before time, to loving every minute of being in the operating room, scrubbed in on the most amazing cases, to sleeping only 3 hours on Friday night, yet staying awake all through Saturday and into Sunday morning constantly on my feet, I am 100% sure that Neurosurgery is the perfect fit for me. Each moment of the day is an occasion to learn something new about Neurosurgery and surgical management, from the pathology behind various illnesses to communication, efficiency and multitasking skills necessary to be a great physician.
Even more fabulous is how wonderful the residents are, from the chief (who is letting me do more and more in the OR as I prove myself) to the interns (who are always ready to answer my questions, no matter how silly, no matter how small, offering advice on the application process).
I have been loving each task given to me, even though the residents will preface them with an apology for giving me "scut". I don't know if they believe me when I say I don't think it IS scut and that even if it were, I would be happy to do it.
All in all, I am having the best time of my medical school experience. Ever. Now on to my second week...
Even more fabulous is how wonderful the residents are, from the chief (who is letting me do more and more in the OR as I prove myself) to the interns (who are always ready to answer my questions, no matter how silly, no matter how small, offering advice on the application process).
I have been loving each task given to me, even though the residents will preface them with an apology for giving me "scut". I don't know if they believe me when I say I don't think it IS scut and that even if it were, I would be happy to do it.
All in all, I am having the best time of my medical school experience. Ever. Now on to my second week...
Monday, July 05, 2010
Tomorrow
I start my first Neurosurgery sub-I tomorrow morning at 5:30am. I feel horribly unprepared and horribly excited. Wish me luck!
Monday, June 21, 2010
Why I [think I] want to be a Neurosurgeon: reason #3
May I just say that I cannot wait for my Neurosurgery sub-I in July? I already have a plan in place for my week off before fourth year begins. Sit down a minute, dear reader, grab a hot cup (or cold, depending on which part of the world you are in) and let me tell you...
Firstly, I have a 10K run to do Sunday the 27th. Training for this has been pitiful, but if I have to walk part of it, then so be it...to think that two years ago I ran a half marathon in just (barely) under 2 hours, at about a 10 minute mile without stopping...it boggles the mind.
Second, I need to read through as much of the Neurosurgery bible as I can, focusing mainly on the chapters that one of the residents mentioned are high yield for the sub-I.
Third, I need to seriously get up to speed on my suturing and knot tying skillz. I have not tied a knot since - I cannot remember. I need to do this non-stop for hours on end, until I can tie perfect square knots, with my eyes closed, one handed, while suturing with the other hand. I will also attempt to perfect the much sought after left handed tie and perhaps achieve immortal-like status as a sub-I in the OR. This is going to be hard with a metacarpal fracture of the 1st finger, but it has to be done.
Fourth, I intend to get myself used to waking up at the crack of dawn and working out for half an hour. Just half an hour, please God? 'K, thanks.
Fifth, I intend to figure out a way that I can eat healthy despite being a sleep deprived, time crunched zombie. This means lots of healthy snacks that can be fit into my white coat or scrub pockets, a filling healthy breakfast to get me as far into the day as is possible and NO junk food. None!
That cup almost done? Come on, now - get yourself a second. You know you want one. Listen a while to my third reason about Neurosurgery. Here, have a seat.
Reason 3: the brain is awesome. When a human fetus is unable to gain the nutrients it requires in utero (for a myriad of reasons, e.g. maternal consumption of alcohol or drugs) and essentially becomes malnourished, it starts to cut back on growth of certain organs and body parts. The liver, usually one of the biggest organs in the human body becomes smaller, the lungs, the kidney and other organs are reduced in size in order to save precious nutrients. This process, however, does not apply to the brain. It continues to use just as much energy for growth as it normally does, at the expense of other vital organs. What mean this, you ask? Yes. The brain is THAT important. The brain makes you you. It guides your movement, creates your thoughts, controls your breathing so you don't have to, keeps your heart beating and protects you from harm. Basically, all other organs exist to keep the brain happy. Injury or insult to the brain comes with devastating consequences and half of Neurosurgery is a surgical emergency with crucial decisions that must be made by reflex. In a nutshell? Awesome. What better way to spend the rest of my life than training to heal and understand this elegant organ?
Firstly, I have a 10K run to do Sunday the 27th. Training for this has been pitiful, but if I have to walk part of it, then so be it...to think that two years ago I ran a half marathon in just (barely) under 2 hours, at about a 10 minute mile without stopping...it boggles the mind.
Second, I need to read through as much of the Neurosurgery bible as I can, focusing mainly on the chapters that one of the residents mentioned are high yield for the sub-I.
Third, I need to seriously get up to speed on my suturing and knot tying skillz. I have not tied a knot since - I cannot remember. I need to do this non-stop for hours on end, until I can tie perfect square knots, with my eyes closed, one handed, while suturing with the other hand. I will also attempt to perfect the much sought after left handed tie and perhaps achieve immortal-like status as a sub-I in the OR. This is going to be hard with a metacarpal fracture of the 1st finger, but it has to be done.
Fourth, I intend to get myself used to waking up at the crack of dawn and working out for half an hour. Just half an hour, please God? 'K, thanks.
Fifth, I intend to figure out a way that I can eat healthy despite being a sleep deprived, time crunched zombie. This means lots of healthy snacks that can be fit into my white coat or scrub pockets, a filling healthy breakfast to get me as far into the day as is possible and NO junk food. None!
That cup almost done? Come on, now - get yourself a second. You know you want one. Listen a while to my third reason about Neurosurgery. Here, have a seat.
Reason 3: the brain is awesome. When a human fetus is unable to gain the nutrients it requires in utero (for a myriad of reasons, e.g. maternal consumption of alcohol or drugs) and essentially becomes malnourished, it starts to cut back on growth of certain organs and body parts. The liver, usually one of the biggest organs in the human body becomes smaller, the lungs, the kidney and other organs are reduced in size in order to save precious nutrients. This process, however, does not apply to the brain. It continues to use just as much energy for growth as it normally does, at the expense of other vital organs. What mean this, you ask? Yes. The brain is THAT important. The brain makes you you. It guides your movement, creates your thoughts, controls your breathing so you don't have to, keeps your heart beating and protects you from harm. Basically, all other organs exist to keep the brain happy. Injury or insult to the brain comes with devastating consequences and half of Neurosurgery is a surgical emergency with crucial decisions that must be made by reflex. In a nutshell? Awesome. What better way to spend the rest of my life than training to heal and understand this elegant organ?
Monday, June 14, 2010
Today, we had a class meeting to discuss the residency application process - from good ol' ERAS to making sure you get good letters of recommendation. These meetings always invoke a mixture of feelings in me. Excitement, worry, fear, anticipation...it's all those and more. On July 1st, 2010, the online application, aka Electronic Residency Application Services will open for applicants to begin entering information. September 1st, 2010 residency programs will start accepting said information for applications. Scary. On top of that scariness, I have sub-I's back to back from July through September and then a required medicine rotation in October. When will I have the time to make sure my application is submitted in full and as early as possible?
In other news...
I fractured the metacarpal of my 1st finger (pinky) on my DOMINANT hand. Yup, just in time for my first Neurosurgery sub-I in July. My arm is gloriously wrapped up in a splint. This should be fun. (Please notice sarcasm here).
Hopefully, it heals enough to gun through tying knots in the OR with hand pain. Or maybe I'll come off like a trooper since I'll be suffering through 16+ hour days with a disability. Ugh, at least I know nothing worse could happen at this point...
...Oh, wait - I have to take the Pediatrics shelf exam next week Friday. I haven't even talked to the course director about the fact that I'm not supposed to be using my right hand. However, like studying for the boards many months ago,
I will take this
one day
at a time.
Goodnight!
In other news...
I fractured the metacarpal of my 1st finger (pinky) on my DOMINANT hand. Yup, just in time for my first Neurosurgery sub-I in July. My arm is gloriously wrapped up in a splint. This should be fun. (Please notice sarcasm here).
Hopefully, it heals enough to gun through tying knots in the OR with hand pain. Or maybe I'll come off like a trooper since I'll be suffering through 16+ hour days with a disability. Ugh, at least I know nothing worse could happen at this point...
...Oh, wait - I have to take the Pediatrics shelf exam next week Friday. I haven't even talked to the course director about the fact that I'm not supposed to be using my right hand. However, like studying for the boards many months ago,
I will take this
one day
at a time.
Goodnight!
Tuesday, May 04, 2010
Just a thought
I just got done with a four week Neurology rotation and began a two week public health rotation (read vacation) this Monday. After that, I will have six weeks of Pediatrics to go through and then third year will be over. How fabulous is that? Quite fabulous indeed, I say. After a 10 day break, the real fun begins with my first Neurosurgery sub-I in July. At this point you can interject with some syrupy sweet baby talk, "Who's an excited med student?" "Who's an excited med student?" To which I will point both my thumbs in a self-ward direction. "This girl".
I am scared, apprehensive and about ready to vomit with excitement. I want it to come NOW.
I am scared, apprehensive and about ready to vomit with excitement. I want it to come NOW.
Wednesday, March 24, 2010
Why I [think I] want to be a Neurosurgeon: reason #2
The day that current 4th year medical students around the US found out about where they would spend the next 3+ years of their lives training during residency happened Thursday, March 18th, 2010. This epic day was excellent for one of my fourth year friends, who got her first choice in General Surgery and good for another one of my fourth year friends, who got her third choice in General Surgery also. Of course, since I am somewhat convinced that Neurosurgery is for me, I eagerly scanned the posted match list for people matching into Neurosurgery. It was both exciting and extremely frightening. These feelings sent me into a frenzy of setting-up-appointments-with-the-Neurosurgery-powers-that-be, in order to frankly assess whether or not I am a good enough candidate to 1)match ANYwhere...you best believe that I will take what I can get and 2)maybe/possibly/hopefully/please God match at my current top choice. One of these meetings happens on Friday. Another, hopefully, next week Tuesday. My resume has been updated and printed on paper watermarked, my goals put in fresh perspective and my fingers appropriately crossed. Which leads me to this post:
Reason 2: the specialized, very technical aspect of Neurosurgery is appealing to me. I enjoy working with my hands and spending time on tasks that require physical manipulation. It gives me an incredible sense of accomplishment and pride when I am able to complete said task, with the involvement of much elbow grease. For example, as an undergrad, I worked part time in one of my school's cafeterias. This job involved sorting plates, cups, cutlery and other dining hall paraphernalia off a rapidly moving conveyor belt, ridding them of the drink and food scraps they had left and placing them onto the car-wash-for-utensils that then cleaned them. At the start of the 4 hour shift, there would be the odd bowl of half eaten cereal and empty juice glass, but eventually, piles upon piles of plates and silverware would be jammed onto the belt. Although a very simplistic example of technical skill, I loved every moment of this job. The manual dexterity required to manipulate forks, knives, cups and glasses of all sizes, odd shaped bowls and plates, stack them together in like piles, remove all traces of solid material from their surfaces, place them into the dishwasher machine on steroids and do it incredibly fast - while hot steam billowed into my face and even more objects jetted in on the belt was insane. (In a very good way). Each shift, I would challenge myself to not drop a single utensil, or allow a plate to pass by unnoticed.
Exciting also, is the idea of being highly specialized in a field, performing complex procedures with meticulous attention to detail, over and over again until I am absolutely amazing at what I do. Could the satisfaction that comes from knowing you spent hours scrupulously dissecting away a tumor/placing screws for spinal fusion/establishing hemostasis with a job well done be greater? I think not.
Reason 2: the specialized, very technical aspect of Neurosurgery is appealing to me. I enjoy working with my hands and spending time on tasks that require physical manipulation. It gives me an incredible sense of accomplishment and pride when I am able to complete said task, with the involvement of much elbow grease. For example, as an undergrad, I worked part time in one of my school's cafeterias. This job involved sorting plates, cups, cutlery and other dining hall paraphernalia off a rapidly moving conveyor belt, ridding them of the drink and food scraps they had left and placing them onto the car-wash-for-utensils that then cleaned them. At the start of the 4 hour shift, there would be the odd bowl of half eaten cereal and empty juice glass, but eventually, piles upon piles of plates and silverware would be jammed onto the belt. Although a very simplistic example of technical skill, I loved every moment of this job. The manual dexterity required to manipulate forks, knives, cups and glasses of all sizes, odd shaped bowls and plates, stack them together in like piles, remove all traces of solid material from their surfaces, place them into the dishwasher machine on steroids and do it incredibly fast - while hot steam billowed into my face and even more objects jetted in on the belt was insane. (In a very good way). Each shift, I would challenge myself to not drop a single utensil, or allow a plate to pass by unnoticed.
Exciting also, is the idea of being highly specialized in a field, performing complex procedures with meticulous attention to detail, over and over again until I am absolutely amazing at what I do. Could the satisfaction that comes from knowing you spent hours scrupulously dissecting away a tumor/placing screws for spinal fusion/establishing hemostasis with a job well done be greater? I think not.
Monday, March 01, 2010
Why I [think I] want to be a Neurosurgeon: reason #1
There are two fourth year medical students on the Psychiatry rotation with me, and, during the shuttle ride home from the hospital today, I was talking to one of these medical students about residency applications, rank lists and match day - this year to be held on March 18th. The conversation, being a good one, fraught with such expressions as "I can't believe it's happening" and "It's out of my hands now" and "Am I really going to be a doctor in 4 months?" got me thinking about my own impending doom/application process, which starts July 6th, on my first Neurosurgery sub-internship. And in the course of my soul searching and deep inner reflection, I decided I needed to put into words why I think I should spend the next 7 years AFTER medical school being sleep deprived and slaving away long hours in the hospital days into months.
Reason 1: Working hard makes me happy. Working extremely hard makes me even happier. This is not to say I do not appreciate a lazy day at home with naught but a book in hand. I do. I just don't feel the need to "have a life outside of Medicine", or "Maintain an active social life" or the many other good reasons that people quote when deciding on a lifestyle vs. (for lack of a better word) non-lifestyle specialty. I want to be consumed by my work. I want to wake up early, spend a substantial portion of my day working hard at what I love, and go home feeling fulfilled, because I brought it all to the table. Will this naive, idealistic and romanticized dream of an honest day's work change as I morph into yet another bitter, overworked and underpaid resident? Maybe. I hope not...but we will see.
Reason 1: Working hard makes me happy. Working extremely hard makes me even happier. This is not to say I do not appreciate a lazy day at home with naught but a book in hand. I do. I just don't feel the need to "have a life outside of Medicine", or "Maintain an active social life" or the many other good reasons that people quote when deciding on a lifestyle vs. (for lack of a better word) non-lifestyle specialty. I want to be consumed by my work. I want to wake up early, spend a substantial portion of my day working hard at what I love, and go home feeling fulfilled, because I brought it all to the table. Will this naive, idealistic and romanticized dream of an honest day's work change as I morph into yet another bitter, overworked and underpaid resident? Maybe. I hope not...but we will see.
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