More Med Student Texting

Me: We just got SOOO lucky! Clinic flooded we are off next week!
Med Student: OMG FO REAL? Buying lotto ticket today!

Me: Hi Dr. Intern. I'm assigned to work with you tommorow. Where and when would you like me to meet you?
Intern: I don't know.
(Silence)
Me: Well I was only given your contact info. Is there an upper level I should contact?
Intern: I don't know. 
Me: Okay, well I guess I'll just show up at 6am and see whats going on?
Intern:( Silence)

Mean Surgeon Resident: lunch
Me: okay, cool. what time are we meeting back?
Her: office
Me: Will meet back at the office after. What time?
Her: lunch
Me: I'm sorry... I'm confused...?
Her: IM TRYING TO TELL YOU DR G BOUGHT US LUNCH AND ITS IN THE OFFICE! JESUS. 

Me: Dude where the eff are you? Resident is ready to kill you. You have the morning note in your pocket and she needs it...
Med Student: Tell her I'm getting Coffee
Me: Are you out of your mind? She's going to kill you. You better come up with a better excuse that that. No way I'm telling her you're getting coffee!
Him: Coffin! Damn I phone! I'm getting Coffin's note from the chart...
Me: You just saved your own ass....

New York City

NYC + Ella = LOVE

Yup, going to a (ah-hem) VERY nice medical school for an EM away rotation this fall. So excited! Plus, one in Northern California, North Carolina, and Arizona. Gonna be away from home till after Christmas. 

Ugh... now to find an apartment in Manhattan. I think I need a Xanax. And I don't take Xanax. 

Med School applications....Its that time....

If you are applying to med school this year, your application should be done or VERY close to it. Just a reminder.

But Ella.... the school says its deadline is Nov 30th. Or Dec 15th. Or whatever.

Yes, you are correct. The school will gladly accept your application all the way until Dec 15th. And your piping hot $150 application fee. And it goes right into a big pile of back up applications that they will look at right about a quarter to never.

Here's how it works. Schools start getting completed applications from students about now. If the application makes the "cut-off" (usually a preset formula determined by the school incorporating your MCAT and GPA)... then it goes to "review". Review is a scan by a committee member who decides if your application is worthy of an interview.

Then you are invited for an interview if you make the cut. Most interview invitations are at the very least decided (albeit privately) by September... some as late as October. Schools vary on when they actually send the invite out.  Now you might say I'm nuts because your best friend received an interview in November or January.... and you would be correct. Tons of people interview late in the year. But they were selected from a pool of candidates that was chosen very early in the game. Exceptions to this are rare. I promise. Unless you are the most stellar candidate on the planet or you have someone influential who has made a call on your behalf.

Most schools participate in rolling admissions... meaning that they admit continuously... AS they find applicants they like. They continue admitting until they have accepted their limit (usually 2 to 4 times the number of spots available in the class)... assuming a large amount of those students will matriculate elsewhere.

So once they admit enough... (which comes from the EARLY applicants)... they stop. And believe me.. they get plenty of qualified, complete applications right off the bat. By October they have so many they don't know WHAT to do with them. Short of all the best medical school candidates spontaneously combusting in a freak pre-med convention, they have absolutely NO REASON to look at applications that come in in December.

So yes, they will accept the application. Technically they say its not too late. But you must understand that admissions applications fees are a HUGE source of revenue (10,000 applications x $150 bucks a pop) for schools... so they will always SAY that October or November or December is not too late.

But it is.

So get your shit submitted. Now.

Went Hiking

It was lovely....

Surgeons

Ok, I figured surgeons out today. After presenting a patients age incorrectly as 54 instead of 56 (oops my bad) to my attending, I got a lecture and this life tip...

"Every person's goal is to be perfect at everything". 

Stated as if it were the most obvious and true thing ever.

And I'm thinking uh... my goals are more like this...

1. Don't kill anyone
2. Graduate med school
3. Catch a redfish this weekend
4. Find a hot pair of $900 Prada boots for $120
....etc.


Do any non-surgeons out there have the goal to "be perfect at everything"?

Lately....

1. Finished Anesthesiology. It was awesome. Tons of fun. But not for me. I did, however, get to intubate 4 patients... all successful on the first try. Yay!

2. Finished 2 weeks of Breast Surgery. Yuck.

3. Started OB today. Oh Dear. We'll see.

4. Got accepted for a couple of EM "away" rotations... So I'm going to New York City for a month, and California for a month.

5. ObamaCare - thrilled for progress... nervous as to what will happen. we will see.

A Little Bit O' Ella

Here... figured it's been a while... here's what I've been doing besides med school...

Cooking!

Baked Brie en Croute with Raspberry Jam

Rosemary Seared Lamb

Tuna and Fennel Salad with Rosemary Olive Bread

Green Lentil Salad with Lemon and Olives

Pretzel Hearts with Sweetened Peanut Butter and Milk Chocolate

Fruit Tart with Homemade Sweet Crust

Decorating My Apartment... no that isn't a real butterfly... relax...

Growing a Garden!!

Loot from my garden....

Jazz in the Neighborhood...

Top 10 Things Heard in the ED

10. Is he dead or DEAD dead?
9. Room Q has an hmm-hmm stuck in his hmm-hmm
8. I dont know who shot me! I was just standing around minding my own bizz-ness!!.
7. Stick your finger up Room C's butt then get yourself some breakfast.
6. Is that guy... Oh god really...yup... he's jerking off....
5. NURSEDOCTORLADY!!!!!!!!! My phone is ringing!!! Reach it for me!?!?!?
4. 210/122? I'm not worried about that.
3. I can't get no motherfucking sleep in this place!
2. Nurse Doctor Lady?? Please tell the po-lice I'm too sick to talk to them??
1. But I'm ALLERGIC to Tylenol, motrin, aspirin, mobic, toredol, Naproxen, celebrex, AND actron!

On Birthin'

Per my very wise brother "watching the birth of your child is like watching someone throw your very favorite toy off the top of the empire state building". Fact.

Pink Nails

Remember that day.... way back my first year of med school when I saw the cadaver with the pink nail polish and I kind of freaked out? Well my last shift was kind of the same. Only the pink nails were mine. And I could see them a tiny bit through my gloves. And I just kept looking at them. While they did CPR. For the first time. On a kid. That died. It was awful. Numbing. And awful. And I just kept remembering the pink fingernail thing. Weird how things sort of come full circle. When I got home I took a pic of my hands to remember the way I felt today.

More Bliss...

Started EM. It's also freaking ridiculously awesome. I'm at a Level I trauma center, and trauma there is. Last shift we got 6 trauma activations. 4 GSW's and 2 stabbings. I got to clean out bullet wounds with a battery powered supersoaker. How freaking cool is that? I can't believe people get paid to do this shit.

Best Moments on Family Medicine on da' Bayoo....

1. EVERY SINGLE patient talks about fishing!
2. EVERY SINGLE weekend I could go fishing! (YAY! See below)

3. I started calling my attending "Doc Awesome"... and it stuck
4. I got to suture, cut out basal cell carcinomas, catch babies, inject trigger fingers, scope, do INDs, drain hematomas, do prostate exams, hernia checks, steroid injections... yada yada. All the stuff somebody should have let me do by now but it hadn't happened until family medicine.
5. I got to see inpatients, outpatients, ICU patients, peeps in the ED, and patients in WalMart. Pretty awesome.
6. My attending is single... so the nurses feel sorry for him and cook for him several times a week. When they found out I am single too... They felt sorry for my by proxy. So I got all kinds of bayou food to take home.... catfish courtbouillon, fried trout, redfish dip, crawfish pasta, venison spaghetti, chicken with lima beans... oh man it was fabulouso!
7. No matter how many times I reminded my patients that I was a med student, they still called me Doc. As did everyone at the gas station, the grocery store, and at the one restaurant in town.

8. The clinic was a 'lil piece of heaven (see above)
9. We discussed making topwater bait just as much as we talked about medicine (example below)

10.  I said it before, and I'll say it again. Family Medicine... practiced rurally.. is the most romantic type of medicine there is. You see babies, peds, adults, and grandparents. ICU patients, mothers giving birth, emergencies, etc. You don't consult cards or psych unless you REALLY need help. You're a cowboy. I absolutely love it. 

More Confused Than Ever

So I'm more confused than ever. Loving Family Medicine. Loving Emergency Medicine. I have no idea what to do. I start my EM rotation next week... so hopefully that will put things into a little better perspective for me.

Here's my PROS/CONS list thus far

EM PROS:
1. Um, everything? It rocks
2. Shift work, flexible schedule, flexibility to pick up more or less shifts.
3. No "practice" to run
4. Fun, amazing, fast paced
5. Diverse pathology
6. No patient follow-up
7. Can move hospitals/cities easily
8. TRAUMA !!!!!
9. Procedures!!!
10. The residency process is awesome

EM CONS:
1. No patient followup... will that bother me eventually??
2. Will I get tired of shiftwork?
3. Possibly more difficult to practice rurally?
4. Only 1 program in the city I live in... so I may need to move... which I REALLY don't want to do.

FM PROS:
1. Diverse pathology
2. Treating all ages, lots of procedures, managing cards, psych, neuro, etc. cases... essentially everything!
3. Can do a general surgery fellowship
4. Continuity of care
5. Day to day life is pretty damn nice
6. Get to do inpatient medicine and be an intensivist
7. Tons of procedures

FM CONS:
1. Responsible for a practice/ difficult to get away, take vacation, etc
2. Might get tired of routine office visits... URIs and UTIs can get boring
3. I don't think I will enjoy the residency process... with tons of months on wards.


Thoughts from Y'all??

Time Flies....

When you are in med school, apparently. I'm officially a 4th year, folks.

Life is good

Perks of rural medicine... Getting greeted with "morning doc!" at the grocery store by people I've treated ♥

The World As I Know It....

Is totally upsidedown. I love EM. I have always loved EM. And its what I want to do. But.... who knew it? I love family medicine just as much. Enough to switch. Or add. I'm not sure. There are apparently 2 Fam Med/EM dual residency programs. One in Louisiana and one in Delaware. Delaware? Ugh. I'm looking into them. I'm so excited! The last 3 weeks have been BLISS! TONS of procedures. Small rural town. Nice people. OMG. I am so excited about work that I hate the weekends. Seriously. I swear.

Best 2 Days Of Med School Thus Far

I almost didn't write about it because I didn't want to jinx myself... but my first two days in family medicine may have been the best 2 days I've had in medicine thus far. In 2 days I saw 60+ patients. No lie. Me and my attending. Fast paced. Rural. Tons of cool stuff to see. I get to see my own patients. No residents. Its awesome.

Side story... I'm seeing a patient in a room, my attending knocks on the door, and he's like "Can you run in those shoes?" We ended up hauling ass across a huge field to the make it to the hospital to catch a baby from a section.

Incidentally, it also doesn't suck that my attending is 32, single, and uber hot.

Second thoughts....

So I'm having MAJOR doubts about moving. Might call the whole thing off. Yes, one neighbor sucks... but I really hate to leave my place. It's perfect y'all. And if you knew how hard it is to find a "perfect" place here. Ugh. Until I sign a lease aren't I legally entitled to my deposit back?


Update! Got my deposit back. Staying put for now.

Things Are Looking Up

I got a new apartment. Which means I'm moving from my lovely, perfect, historic cottage. But which also means there is no more neighbor boy. Which is good. Really good. Sad, however, very sad to leave my place and my other neighbors. And my neighborhood.

Good news is that my new place is pretty kick ass (almost as kick ass as here... but no jacuzzi tub and no gas range... sad face). It is, however almost 3 times the space and architecturally pretty sexy... and only a few blocks away.

Beat that

Got to see a case of Catel Manzke. Only 26 known cases in the world. Which made it a pretty effing cool day, considering my obsession with peds genetics.

Incidentally....

Just 15 more months until I'm a doctor!!!

Heading out...

to rural country for my family medicine clerkship. 50 mile drive each way... but honestly I'm looking forward to it. Coincidentally, its also the same tiny town I've been driving to at nights to work in the ED for fun... so I think I'm going to like it. A little unnerved, however, that my preceptor is younger than I am. Sigh.

PMI WTF

Here's a little convo that took place today between me and my attending in the PICU on rounds today.

Him: Ella, what is the PMI?

Me: The point of maximum impulse?

Him: No

Me: Hmm. The beat of the heart at the apex?

Him: (sigh of frustration) No. Do you even know where it is?

Me: (worried and thinking I'm crazy) I believe that would be the left anterior mid-clavicular line at the fifth intercostal space.

Him: Absolutely not! Ella, you do realize that if you don't know something as elementary as the PMI, BASIC HUMAN ANATOMY (!), that I will have to fail you on this rotation. Its the FOURTH intercostal space!!!!

Me: (gulp holy shit what am I missing????)

Him: Go look it up.

Me: Yes sir.

Him: ( a few minutes later....) Well......? What does it say?

Me: Um, it says the point of maximum impulse is palpated at the left anterior mid-clavicular line at the fifth intercostal space

Him: LET ME SEE THAT!!!

Then, because he was pissed, he pimped me on a bunch of ridiculous shit that nobody in the group knew.

(now to be fair, though the literature does say the 5th intercostal space... I have also seen it as "between the 4th and the 5th")... but for Christ's sake he threatened to fail me over that! And mind you I have no bad history with the guy... it was only my 2nd day working. First day he said "good job"

Decided.

So even though I've known this all along... I'm officially declaring it again. Emergency Medicine is it. It's me. It's final. Its what want more than anything.

Unfortunately, I want to say in the city I'm in just as much as I want to go into EM. If not more. And there is only one program. Which I happen to love.

Not yet sure how that will play out. I'll keep you posted.

I don't agree

So something happened today that pissed me off. And the more I think about it, the more it makes me mad. So I'm all for patient comfort. And I'm all about minimizing disruptions so that patients can sleep. And treating people like people. And doing whatever is necessary to make patients happy. Within reason. Even if it means I'm inconvenienced.

But I'm on Heme/Onc Peds right now. Which of course we have many patients on long term chemotherapy, study regimens, experimental drugs, etc. And a few have simply decided that they don't want to be bothered by medical students. They refuse to let them in their rooms or talk to them or whatever. Even to the point where some patients have put up "no med student" signs. Needless to say, this really bugs the shit out of me.

Why? Lets put aside for a second the UNGODLY amount of money I'm paying in order to be exposed to patients and for clinical learning. But these people came to a TEACHING hospital. Meaning they are getting the benefit of having an entire team mull over their case every day. They get to be in a research hospital where new and better treatments are being investigated. And where they get the benefit of having free treatment in many cases. But when it comes to returning the favor.... by letting others learn to potentially benefit others... they refuse. Stating that it's too bothersome to have multiple people in the room or multiple questions asked every day.

And what really pisses me off is that many attendings simply adhere to these requests and refuse to let us in. Which burns me even more.

On second thought

So I'm liking peds. A lot. Especially peds genetics. Which I have always liked. But until now I hadn't really seriously considered going into peds. I have to admit I'm tempted by the chill lifestyle, the nice people, patients that actually get better, and playing with babies all day.

But today all of that changed.

I saw a 3 year old for worsening asthma. And sick he was. Definitely in respiratory distress. Breathing hard but he wasn't dying in the next 5 minutes. Maybe a couple more days like this and he'd be toast. But not this minute. My attending admitted him and they sent an ambulance for transport. Ok, no big deal.

Let me tell you, folks, you'd have thought that aliens attacked the White House. People in the clinic were excited. Like really excited. Including the attendings. So I asked... "is this considered a lot of excitement for y'all?" To which I was told, "Yeah!!! Thats the most excitement we've had in years."

Hmmm. Maybe it isn't the place for me.

The babies

are making my ovaries do jumping jacks. which is sooooooo not what i need to be thinking about right now.

god. i'm going to be too old for babies soon. ugh.

Foot in Mouth Disease

Friday my attending is taking me to work a juvenile detention center clinic. And today we were discussing logistics. Where to meet, what to bring, etc. And then he said this.

"Just don't wear anything cute or sexy. What you are wearing right now is perfect."

Um?

ADD worse than me....

Holy smokes. So today I was on Peds ID. Which was pretty cool. But my attending, whew. I mean, she is smart. Really smart. But she talks a million miles an hour and is an ADHD mess!

Example one...

She is on phone call A. On a land line.

Her cell rings. She looks at it, hands her cell phone to me, and says "Can you just tell her I'll call her back?"... as if she totally knew the person.

I say "sure", pick up the phone and say to the woman, "Hi this is Dr So-n-so's phone. She asked me to tell you that she'll call you right back. Is that ok?"

Twenty minutes later after she gets off the phone, she looks at me and says "Well? Who was it?"

I'm like "uh, duh, I thought you knew who it was.... duh...."

Happy Place on Earth

Peds. Who knew med school could be... gasp... fun? No one yelling at you or pimping you or making you get to work early and stay late. Excuses are accepted. You can get time off for a wedding. Seriously. I swear.

Started out on NICU which admittedly was a little boring. But then moved to Well-Baby where I got to play with dozens of happy, healthy, newborns. Now I'm on a variety of clinics, including genetics clinic... which is really cool. And next Friday I'm heading out with one of my attendings for a rural juvenile detention center to run a clinic day.

Yay!

WMFS?

This totally non-politically correct conversation took place between me and one of my attendings regarding a patient who was being difficult about a special supplement that she needed for her infant but didn't want to pay literally pennies for.

ME: What was that all about? We're talking about $2.99.

Attending: Oh, she has WMFS syndrome.

ME: WMFS?

Attending: Yeah. "Where's my free shit?" syndrome. Its rampant in these parts if you haven't noticed.

Yes, unfortunately. I've noticed.

Update

So like I said. Last 2 months has been awful. And I don't want to blog about it. I think I'm starting to feel a little better. Maybe. Hopefully.

To catch you up on the med school aspect of my life, Step One is over. Passed. Yay! Currently on my Peds rotation, which is overall a fun and happy place. Got to do some ED work in a rural area with my favorite attending recently, so that was fun.

Lately I have been contemplating life. A lot. I love being in medicine. But that is about the only thing in my life that seems to be good or that makes any sense at all. And sometimes I wonder if its enough.

I miss you too

So it's been a pretty rough month in my personal life. As indicated by my non-blogging self. I'll get back with you all in a couple weeks when I sort it all out and get my head straight.

Love, Ella

*non-school related...

Rural Thoughts

A reader sent me this article from the New York Times. Which prompted me to write on a topic I've been thinking about for the last six months or so. Regarding my plan after medical school. Academic medicine. Private practice. Working for a private hospital. Or saying eff the world and packing it up to some rural county with no doctors for 300 miles. I don't know.

Most of the time I think Academic Medicine is not for me. However... unless you are HIGHLY self motivated.... that teaching element is what keeps you current, fresh and sharp. I just hate so much academic political bs and bureaucracy. The turf wars. The unfair decisions made without regard to merit. Not that that doesn't happen everywhere to some extent. But in academic institutions its the worst.

Then there's the idea of private practice. Ok. Not happening, since I want to do EM and I'm not interested in opening some urgent care center somewhere. Not to mention I don't want the pressure of having to run a business.

Private Hospital. Lots of money. Cushy schedule usually. May or may not have residents to alleviate the workload. Patient disease processes are usually less diverse because the population generally has private insurance, and is a more affluent demographic in general. Which in my opinion is a negative. However, this might not matter as much in EM or Anesthesiology. I mean, sedation is sedation and an emergency is an emergency. Right? Maybe.

So that leaves my rural option. I grew up in a tiny town of less than 4,000 people. My entire life all I could focus on was getting the eff out and doing something bigger and better. I've lived in DC, Boston, Phoenix, Miami, San Diego, and LA since then. Maybe it's time to give up the city. I don't know. I know I would love to stay in or at least near the city I am now. That would be my ultimate dream. But what about living an hour or three out? Working a week rurally and three here? Or six months out, six months in. Would I be happy out there? I have absolutely no idea.

Thoughts?

Best Comment From A Reader ....

Anonymous said...

I can’t believe my luck in finding your blog in such a timely manner. I’m a college freshman, dead set on med school, and I’d already adopted the "pre-med mindset" (all work--no play, major in chemistry, 40 on MCAT or DIE, etc) when I read your “advice to pre-meds” section. Screw my major. I hate chemistry and there’s no way I want to spend four years studying it. Screw all the pre health clubs. Screw it all .I’m majoring in political science because I love it, I’m volunteering at medical clinics in Honduras because I’m passionate about helping people in rural and underserved areas. I’m not going to bust my chops to win a research grant that I couldn’t be less interested in. Hell no. I’m going to spend the next four years learning things I’m interested in, helping in ways I feel count, and not worrying about impressing med schools with things I don’t give a damn about.

I still want to be a doctor more than anything, but I refuse to sacrifice my personal joy and sanity.

Thank you for your insights. Thanks for being honest about your journey. Reading your blog has lifted a load I didn’t know was there.

Wolp...

Tomorrow's the big day. Sink or Swim. Hope it goes well. Incidentally, it is also my nephew's 1st birthday so maybe that will be good luck.

Ugh.

Med Student Texting

(from my resident) Hey sorry you didn't get to eat today. Or yesterday.

(from classmate) FUCK I overslept. Just tell them I'll be there asap ok?

(from me) Are you fucking crazy? i'm not telling them anything. just get here. they don't even know you exist. 7th floor.

(from B1) saw my first C-section today.... nurse got sliced. straight up shanked with a blade

(from classmate) shit! what's the blood supply to the thyroid? no time to look it up. text me asap. Dr. X is going to kick my ass.

(from classmate at 9:45am) hurry up let's get breakfast [cafeteria closes for breakfast at 10:00am]

(from me) he freakin' knows I'm hungry and he's keeping me here

(from me at 10:01) he just let me go

(classmate) ass! totally did that on purpose

(from a classmate) ok seriously, my resident is making me babysit the intern. this is a fucking joke

(from me to my resident) hey i just checked Mr K's labs and his glucose is 35

(from my resident) does he look like he's dying?

(me) well no not really

(resident) .......[no answer]

(from me) hey, Mrs N isn't in her bed!

(from the resident) what? she's 93 and in restraints! she better be there

(me) she's not

(resident) find her!!

(from resident) where are you guys?

(me) we're um.... practicing

(resident) jesus. practicing what?

(me) do you really want to know?

(resident) yes

(me) we're giving each other IV's in the pre-op supply room

(resident) don't tell me that shit!

(from resident) if you get me a cheeseburger from the cafeteria you can go home early

(me) done

(from my attending) you think I'm gay??

(from me) huh?

(attending) the resident said you guys think I'm gay

(from me) oh. um, no that was classmate X

(from me) but just FYI, I'll still like you if you are

(from him) god

Guess the Neurocysticercosis Thing Worked

Got honors in Radiology. Yay!

(though I'm guessing they probs give Honors to anyone breathing in rads) lol

For the First Time in My Life

I am so incredibly lucky to be surrounded by friends. Not friends that live far away. Not childhood friends that I barely talk to. Not friends that I see once in a while and are in reality just acquaintances. Real friends. Classmates, girlfriends, neighbors, mentors, boys to date, and those rare few people that you love with every ounce of your soul. I have quite a few here in this city. And I know that makes me incredibly lucky.

Specifically loving Lolo, Rica, Dr J, neighbor boy and his family, MB, B1, B2, and AMH. I love you all very much and this wouldn't be worth it without you guys.

In Stitches by Dr. Anthony Youn ~ a review

Somehow during my surgery rotation I managed to read a book. So it goes without saying that it was a fun read.

The book is written by a Korean-American, Chicago-based plastic surgeon about his journey in medical school and the uncertainties and pressures he faced throughout the process. While his experience was drastically different than mine, it was fascinating to read about the role that pressure from his family played in shaping his medical career... and really his entire life. This is an issue I've been lucky to escape yet I know many many pre-meds and med students out there deal with these outside factors every day.

Regardless... the book is a riot. They guy spends just as much time trying to get ladies as he does studying... and somehow manages to make the entire process of becoming a physician storyteller worthy.

You can find an excerpt on this link In Stitches (an excerpt) . Check it out.

If you don't believe me...

(about the last post).... try this exercise.

Write down every "bad" thing in your life. All of them. Divorces. Arrests. Losing a loved one. Breakups. Failed classes. Financial Ruin. Whatever you got.

Then systematically eliminate every one of them, and how you wouldn't be where you are today. It might not be intuitively obvious. But really think about it.

For example.... (hypothetically)... if you got pregnant at 15, you might feel trapped or at least held back from some of your goals by having a child so early. But delineate it a bit. Were you promiscuous and having a child slowed you down and helped you focus on more productive things? Did having a child at 16 help you develop a better relationship with your parents? Or maybe it got you away from people who weren't healthy for you? Or maybe its something as simple as having a child that early brought you much needed joy and the motivation to do something better?

If you got arrested for drug possession. Maybe it was a turning point. Maybe it saved you from a life of dependent drug use. Maybe it pushed you to help others.

A failed class? Or failed out of college? Maybe you are cosmically supposed to be focusing your talents elsewhere. Or maybe you had a better, more inspiring professor the next time you took the class.

Divorcing the love of your life? Perhaps you developed other friendships that enriched your life more than your marriage. Or you were free to explore the world or a career you couldn't have otherwise managed.

If you really think about it, you can do this. And if you can't think of any good things that came from the bad experiences, my bet is that you haven't yet learned the lesson.

Connecting the Dots

So I've tried to make this point before. But I've never been able to convey it as eloquently or as effectively as Steve Jobs did in his commencement speech at Stanford. If you haven't seen it, do watch it. He discusses how in life you can retrospectively connect the dots and derive meaning from the sequence of your experiences... though the significance of every event is not able to be seen prospectively. Meaning you can't look forward and see how the event in your life will lead you to your ultimate goal. You just have to TRUST.

Certainly thus far this is 100% true in my life, and I would bet yours as well. If my parents had been richer, I would not have had such a circuitous route to college and med school. Possibly I'd have missed out on work experiences that propelled me towards medicine. If I'd not dropped out of college at 19 I may have never worked as a firefighter and never developed my passion for emergency medicine. If I'd have gotten into med school the first time I'd applied I'd have likely gone to a school that didn't fit my personality... and I certainly wouldn't have gotten my masters degree in tropical medicine.... an aspect of medicine I know I want to incorporate into my career somehow. If I'd married a boy that asked me, or if I'd stayed with one that broke my heart... I wouldn't be here today.

Point being? Relax. Just keep going, keep working towards your goal, and trust that the delays, the failures, and the diversions are all part of the big picture.

Hungry?

Pasta, Peas, and Pesto with home-made pesto and home-made mayonnaise

Belgian Endive with Chevre and Turkish Figs

Blueberry Pie

Peanut Butter Cup Cookies

Broccoli Salad

Grilled Eggplant Sandwiches with Broiled Tomatoes and Feta

My First Patient

Somehow I managed to never write about her...but this story is a must. This happened way back in May on my first day of Internal Medicine.

So....

Scene: 1st day. My resident tells me to go into room 19 in the ED and take a full H&P on Violet. He's smirking a bit to the ER nurse, who (nicely) pulls me aside and gives me a quick heads up on what to expect.

Nurse: (to the side) So she's um sorta naked in there and a bit out of it. Just to warn you.

Me: Ok.

Resident: (laughing)

Me: Ok, seriously, what is the deal?

Resident: Nothing. Just go.

Me : (FML)

So I suck it up and walk in. And I'm met with....

VAGINA. LEGS UP IN THE AIR. NAKED. SPREAD EAGLE.

(and add a few hemorrhoids...)

Add to that she can not even speak.

I mutter an uncomfortable "Oh I forgot something. I'll be right back" to the husband.

Me to my Resident: You know this is my first day, right?

Resident: She's crazy. I'm calling psych. Just go. Do your best.

Round 2: I take the H&P. I do the physical. I ignore the vagina.

After an hour of all that, I actually make my first diagnosis. Which happened to be correct. Hepatic Encephalopathy. The legs up in the air? Posturing. Clinical sign of encephalopathy. She wasn't "crazy" and got better after 2 days of lactulose.

That, folks, was pretty much my one and only day of feeling like a complete rock star. Kinda been downhill from there, lol. But, great none-the-less.

Some VERY nice things my readers have said about my blog. Thank you all for reading and sending me emails! It means a lot!

My one way relationship with your blog has been longer (and arguably better) than my last two serious girlfriends combined. In short, it is a pleasure to read your stories.

I was starting to think that maybe I was getting too old and that it was too late. Thanks for showing me that it can be done with perseverance and strength. I am really excited about the years to come as I continue my goal of getting into medical school.

I just started reading your blog and have managed to read most of it in 1 day...THANK YOU SO MUCH. I'm in the midst of applying to DO schools and I seriously have to hold back vomit when I look at my grades and then compare it to those damn gunners on SDN.

So as I was going through your blog posts, I became more hopeful as I read about your experience and those of the people who shared with you their individual journeys. It reminded me that not all doctors go in with perfect records and applicants who demonstrate substantial life experience will likely be successful once they get accepted.

Thank you for the hard work you put into maintaining a meaninful blog and for helping to re-ignite the spark of hope that was nearly snuffed out by a few early rejections.

I constantly think about the uncertainty and the many failures and successes that will be sprinkled in my path. Sometimes its hard to see past the obstacles. But then reading your blog made me feel less alone in the world. Clearly you are years advanced in your goal then I am, but to know that these struggles are shared throughout the medical community helps ease some of my burden, and I only hope that I can be a medical student in the years to come. I have found your blog insightful, uplifting, truthful and a snapshot into what I will encounter. For that, I deeply thank you.