Christmas at My House!!

A Question From A Reader

Your blog seems to be one of the few that really highlights the positive aspects of med school and the memorable moments. At first, this didn't really bother me, but the more I thought about it, I started to remember the numerous physicians I shadowed who said similar things. It seems like there's this ongoing inside joke between physicians who try to convince pre-meds to head in a different direction.

What's your take on this? Why do a lot of physicians seem bitter of their decision? Is this something you have noticed too? Or have I just met a bunch of unhappy professionals who unfortunately chose the wrong lifestyle. I understand that medical school is difficult and can often wear a student down, but does it do this to one permanently?

Wow. Indeed this is a huge topic to cover. I'll try to answer by hitting the main points.

1. First and foremost, I think there are a lot of people in this world (doctors or not) who have poor social skills and don't know when to keep their mouth shut.... and to not give unsolicited advice. Is there a shitty side to every job on earth? Pretty much. Are there pros and cons to every decision you make? Definitely. Is it your job to be discouraging to those who want to go into the field you happen to be in? Definitely not. By doing so, you are assuming that YOUR reasons for going into medicine are the same as everyone else's reasons to going into medicine. You are also assuming that everyone else has the same criteria as to what a "good life" is, etc. Of course there is nothing wrong with giving your honest opinion... but when asked advice about your field... saying flat out "don't do it" is simply arrogant and immature. If it was THAT bad, those physicians would have likely quit long ago. Additionally, some people just enjoy being miserable... and telling others about how miserable they are.

2. I think there are a lot of older physicians who are indeed miserable. They came into medicine during a time which it was much easier to get into medical school, physicians made huge amounts of money, and never had to deal with much of the bureaucracy docs have to deal with today. They came not because of a unquenchable desire to be a physician, but rather for money, or the "good life", or the prestige, or because it was what was expected of them. As things changed, they didn't like it.... and suddenly the lack of the things mentioned above made medicine less of a draw. These are the people that say "medicine isn't what it used to be". Not true. Medicine is the same and even better. Pay, red tape, competition, etc... those are the things that have changed. All med students today know that very well... since they had to put up with it just to get into med school... so they have a different perspective.

3. Sad as it may seem... there are people who like the eliteness of medicine... and newer, younger, better physicians with new ideas and energy are indeed a threat. They compensate for the fear of the threat by discouraging others. Fortunately I think these are few and far between. Most physicians get pretty stoked at the idea of younger folks being interested in medicine.

4. Here's the one you probably don't want to hear. There is indeed an element of "Oh shit have I wasted my life on medicine?" that tends to poke its way into my consciousness every now and then. While I know that I love medicine and the rigamarole that comes with it... I have lately been having fleeting thoughts of the following...'

• Oh crap I'm 32, a 2nd year med student, and for the most part alone in a world of 10,000 other doctors
• Did I come to med school because I love medicine or because I had something to prove?
• Holy shit, I am going to be working REALLY HARD for the rest of my life. Physically hard. Long hours. Sleep deprived. Stressed. Backaches.
• Did I sacrifice having a family, etc. thinking I wanted medicine more... because now I'm not so sure...
• Can I really do this? Effing acid/base bullshit on a patient without killing them?
• Fuck, can everybody stop bitching about medicine so I can enjoy my day please?
• Wait, you mean for the next 8-20 years I'm going to be disgustingly broke and low man on the totem poll?
• Hold up. When I said I didn't mind being alone in order to be a doctor, I never said anything about being ok with being lonely. This sucks.

I mean... these things definitely hit me at least once a day. But then I have patients and procedures and classes and discussions which immediately give me a sense of clarity that I made the right decision. A sense of feeling like I'm using my talents to the best of my ability and challenging myself, and that I'll never be stuck in a different job wishing I was a doctor. Because I know that if I'd have gotten married and had children years ago at the expense of being a physician, I likely would have had just as much regret or more for NOT following through.

I can't really give a definite answer. I guess I'll have to keep you posted. I can say though, that I've had this exact discussion with physicians who absolutely love their lives in medicine and assure me that I will too. We'll see.

Now She's Even Cooler

After I posted about Dr. R the other day, somebody in my class sent me a text asking if Dr. R on my blog was actually so-n-so. I said yes. And she said "you know she's married to the lead singer of (insert famous band here)."

Seriously, she just got way cooler. If that's possible.

Well, your penis might fall off

Today I had a patient at clinic ask me for medicine that would give him a "boner" for 3 days in a row. He quickly changed his mind when I told him (on command of the attending), that 3 days of continuous erection could cause his penis to fall off.

Funny how the idea of a 3 day boner suddenly didn't seem so appealing.

Dry Socket

I've got one. That's always fun. So far going on 2nd week of excruciating face pain. Totes awesome.

Drinking From A Fire Hydrant

I once heard second year medical school described this way. And its dead on. I am seriously not having fun. I'm overwhelmed. Underprepared. Clueless how to study. And feeling like I'm going to be the worst physician ever. I thought the feeling would pass. But its been going on since September. I don't know what the eff to do.

STEP I

Is coming sooner than I want to acknowledge. I just submitted my app. (Before I only got my Q-bank)

Yesterday

Was the day. The male UG exam. Remember how I said I was nervous? Well I wasn't nervous. I was really really nervous. So nervous I thought there was a grand possibility I might throw up or cry. I don't really know why. Not like I've never seen/touched a naked guy before.. even in the hospital setting. But the SP's make me nervous. And the cameras, and the possibility of getting a jackass for a student partner. Alas, all went well. I was originally assigned to a really irritating guy who was supposed to be my student partner... but the coordinator switched me to be with another girl in my class who seemed almost as nervous as I was. So it worked out well.

I'm not sure what I was worried about exactly. That I'd eff up and hurt the guy? That he would be so hot that I would get nervous and not be able to concentrate? That I would laugh? That he'd get an erection and I'd be embarrassed? I can say this is officially the first time I examined a guy's goods this closely while simultaneously praying he wouldn't get an erection.

Anyway, I survived. Lets just say I didn't have to worry about any of the things I originally thought... as I am fairly confidant my SP had no attraction to women what-so-ever... and when I began the exam without asking him to "bear down", he just shrugged and said "that's ok. I'm an expert at this".

Whew.

Tommorow

Doing my first Male UG exam. Ugh. Not going to lie... a little bit nervous. I just know I'm going to get the (really) old guy.

Today...

I got to see Dr. R (see side for description). She's awesome. I want to be her. And I still love love love love Emergency Medicine. How do I know its for me? This convo took place between her and one of the other chief residents:

Dr. R: So if you really like doing tedious things like calculating osmotic gaps, EM might not be the place for you.

Resident #2 : What's an osmotic gap?

Dr. R: I don't know. I saw it on a research poster in the hallway.

This is so me it's ridic.

How To Keep On Truckin'

I've received a few emails asking how on earth I managed to keep my morale up when I failed as a pre-med. Like failing an exam, bombing an MCAT, hearing disparaging "advice", and whatnot. I guess the answer is that I didn't. I mean everytime something happened, I was distraught. And totally devastated. I started combing through my back up plans, applying to random grad school programs, looking up internships, and fantasizing about running away to the peace corps or becoming a writer or a chef or an FBI agent. It was awful. Awful because I had little perspective or knowledge that the path to becoming a physician is a long journey... marked by failures and successes. I'd see a few classmates or colleagues get right into med school with no sweat, and so I thought it wasn't meant to be for me. And so I'd head in another direction... like research, or public health, or epidemiology.... something that I THOUGHT would make me happy... as these are parallel fields to medicine.

And sure enough, these fields would keep me interested for about 10 months. Then I was bored. Soon I'd find myself back in the med school mode... tagging along with physicians, fantasizing about med school, plotting my next attempt at the MCAT or applying to med school. It was a series of try, fail, hibernate, heal, plot, try, fail, hibernate, heal, plot, try, sort of succeed (YAY!), try harder, fail, blah blah.

So I guess the answer is this.

1) Try to keep "success" in perspective. Know that when you're "up" you should enjoy it while it lasts because there will be "downs" too. And when you are "down" know that it's just temporary until the next "up".

2) After a "down"... don't be too hard on yourself, and don't make any drastic decisions that will alter your med school plans. The feeling of wanting to quit is soooo intense you can often fool yourself into thinking that you don't want to do medicine anymore.... even if you actually do. Give yourself some time to really regroup, re-evaluate, and make a better plan of attack. Immersing yourself in "parallel" fields like public health, etc. are great because they help strengthen your application while you regroup and get your ducks in a row.

From One of Our Profs.... AFTER Thanksgiving :)

PATHOLOGIES RESEMBLING FOOD

FOOD PATHOLOGY	DISEASE	NOTES
Anchovy paste liver	Liver abscess	Amebic
Apple core lesion	Colon cancer
Banana Sign (cardio)	Hypertrophic Cardiomyopathy
Banana Sign (neuro)	Arnold-Chiari malformation	Abnormally shaped midbrain & elongated cerebellum
Bread and Butter	Pericarditis
Café-au-lait spots	Neurofibromatosis (I &II)
Caseous Necrosis	TB, histo, coccidio, crypto	Casesous = Cheese
Cherry Red appearance	Carbon monoxide poisoning
Cherry Red spots	Tay-Sachs, Niemann-Pick, Retinal artery occlusion	Macula
Chocolate cyst	Endometriosis
Coffee ground vomit	Upper GI bleed, PUD
Grape clusters	Hydatidiform mole
Hamburgery Sign	Uncovered vertebral articular facet
Honeycomb lungs	Eosinophilic granuloma, DIP, UIP, interstitial pneumonitis associated with collagen vascular diseases, asbestosis, berylliosis, sarcoidosis, LIP, DAD, recurrent aspiration, allergic alveolitis
Lemon Sign	Spina bifida	Scalloping/overlapping frontal bones
Millet seed appearance	Military TB on CXR
Nutmeg liver	Chronic liver congestion
Olive (sign)	Congenital pyloric stenosis
Onion skin arterioles	atherosclerosis
Onion skin (musculo/skeletal)	osteomyelitis, osteosarcoma, Ewing sarcoma
Peau d’orange	Carcinoma of the breast
Pizza pie	CMV retinitis
Popcorn sign	Fibroadenoma of breast
Port-wine stain	hemangioblastoma
Red-currant jelly	Intussusception, Klebsiella infection (sputum)
Rice grain calcification	Taenia solium infection
Rice water diarrhea	Cholera
Strawberry Tongue	Scarlet fever
Sugar-coated spleen	Chronic serositis

Is it a bad sign

When your ex-boyfriend sends you an article entitled "Who Needs Marriage Anyway? Men, Apparently."

Ok, I'm a cold fish. Sorry. I'm trying to stop.

Reasons Why You SHOULD NEVER Look at SDN

Yes, folks, these are real. Copied verbatim (except the purple.. that's me :). Sad to Say.

HELP!

I went to a community college and then transferred to ucsd. I've got straight a's in all my classes except my 1st semester at the community college was a c in calculus b in chem c in bio and b in English. my mcat score is 34. what are my chances for ucla medical school as well a's other uc med schools?

Am I worried for no reason?????

Stats:

GPA is around 3.85
sGPA is around 3.85
MCAT score was a 36Q
2 Summers of Hospital Volunteering (200+ hours)
2 Semesters as a writer for school paper
2 Semesters working as a team manager
Working at a Pharmacy for 2 summers (unpaid, 75+ hours)

Other EC --> Cultural Club and Intramural sports
-I had no research experience until this year but I currently am doing research and I also have a sports medicine internship (8 hours per week)
-I applied to like 20 schools
-I got 5 interviews so far (Rochester, Penn State, Buffalo, SUNY up and downstate) but I was already rejected from Buffalo and my other interviews are coming up..
-Also I shadowed two doctors in August, one for around 40+ hours and another for around 10, I'll be working with the former again this winter break...

Suggestions????

I am a Florida resident, 3.86 cumulative, 3.83 science & math, 31Q MCAT, majoring in Applied Economics and Biochemistry. I have 2 years of patient volunteering, 1 month of shadowing a rad onc, 2 science research projects, 1 economics research project on price discrimination in the health care system, and lots of leadership (SGA senate 2 terms and world affairs program), and I have worked as a chemistry tutor for 1.5 years. I have 6 letters of rec, 3 from the professors I did research with and took classes with, 1 from the volunteer coordinator of local hospice, and 1 from rad onc shadowed, I know them all pretty personally.

I submitted my secondary to UF on 10/4 and have yet to hear anything. If offered an interview should I provide an update at the interview or after the interview? I am starting a new volunteer experience (tutoring mentally disabled adults and teens for GED), a new research project, and will be submitting 2 papers for publication in the coming months as 1st author. Any general suggestions? THANKS!

PLEASE HELP!!! 3.34 GPA and 39 MCAT!!!

Please help me out here, what do y'all think my chances are? I'm pretty nervous because of my low GPA. Below is a concise 'resume'...if you need more info just ask I am a junior at Duke, so my science GPA is my projected GPA for the end of this semester, presumed that I keep the same grades I have now.
science GPA: 3.34 (Overall: 3.41), with an intended Major in Biomedical Engineering and an already completed Minor in Biology at Duke University. I really screwed up freshman year, but got a 3.4 fall semester sophomore year and have been trending upwards in GPA.
-MCAT: 39, taken only once
Extracurriculars: Leadership positions in 2 major school clubs (1 club sport), worked 7000+ hours (WTF???? 7000 HOURS???) in 2 labs (1 clinical, 1 biochemistry) since high school, published as author on 3 journal articles ( 1 in Nature). 200+ hours clinical volunteering, shadowed 2 physicians for 120+ hours. My summers were spent working full time in labs, volunteering and shadowing.
Michigan resident, Asian background
I have a feeling my GPA will come back to haunt me.

PLEASE LET YOUR HONEST OPINION GUIDE ME!!!!

I started to think about going to medical school in my senior year of college (one year to go, its a five year program). due to an event I experienced.
I jUST WANT TO KNOW my chances through this forum, recommended by many pre-med students I know

my info:
Syracuse University
Major: bioengineering, and Physics
minor : Linguistics
GPA: 3.2, I believe I can pull it up through my electives to 3.4
Science GPA 3.6
I took Kaplan MCAT (free event, it was like a real test scenario but without the writing section). I scored a 35.
Academia awards
Dean list
Honor List
chancellor award (two year consecutively), the highest award you can get in my university
Experience
worked in factory (part time)
Independent study in Darfur, planning to go back again at the end of this summer
Research Assistant
president of Society of Public Health education
President of Syracuse Breakdance Club
public relation of Biomedical engineer society
United Nation Ambassador of good will
Volunteers
Say Yes Education
Amaus Drive
taught refugee kids after school
and many others non related to medical fields
non academic Award
won the redbull Street futbol (as a team) in Germany 2008
competed in the preliminary of Redbull bc one
Langauges
English
Nubian
Portuguese
Arabic
Dutch
(taking spanish courses as of now)
I shadowed a doctor recently (for a week) to see if I really want to be a doctor or not
****I know that I don't any type of clinical experience, research and hospital volunteering.
but I should start to hospital volunteer by next semester, and Hopefully researching.
Please let me know what you think!!!!

SIGH. Lets just all set ourselves on fire. Bleh.

Idiocy of Men Part I

Met a pretty hot older-than-me guy at my favorite wine bar on Thursday. We talked for maybe an hour... mind you very proper and lovely.. (Lolo was there too)... and he gave me his card and asked me to text him later so he'd have my #.. so I did.

The following series of texts resulted.

Ella: Hey thanks for the drinks. It was nice meeting you.

Dumbass: Hey thanks for the fun company! Let's hang out again!

Dumbass: Call or text if you want to meet up tomorrow.

Dumbass: Or we can hang out another day!

Dumbass: Hey your last name is MedStudent, right?

Dumbass: I'll find you on facebook.

Ella: Facebook huh? Ok, lol

Dumbass: Don't laugh at me, I'm older than you. Much older than you.

Ella: Much...?

Dumbass: Guess

Dumbass: Honestly

Dumbass: Ok, I friended you on FB

Dumbass: Gorgeous profile pic btw

Dumbass: Guess

Ella: Ewe. This is a dangerous game. 42? Give or take 2 years?

Dumbass: Pretty good... 45!

Ella: Well, don't be offended. It must be my soon-to-be-doctor side coming out. I'm usually pretty good with age, height and weight. I'm sure another woman would have said 35 :)

Dumbass: I'm not offended at all!

Dumbass: What I really want to know is how you look in just a doctor coat and glasses and high heels.

And that was the end of the conversation until the next morning.

Dumbass: I'm sorry about that last comment. I think it might have been the beer.

Still the end of the conversation.

And then he friended Lolo.

Last night

Was our University's annual grad school party. With everybody. Law School. Med School. Social Work. You name it. It was awesome if not a bit overwhelming as there were easily over 1000 people there. But it was totally fun. It was a cocktail party in a huge venue with dancing and food and extremely cheap drinks. (Champagne for $2, yay!)

Of course...

Steak Cilantro Tacos with Home Made Guacamole

Home Made Mayo

About Boys

Ugh.

That's really all there is to say... it goes downhill from there.

Med School Classes - A Different World Than Other Medical Programs

Somebody asked me... so here it is. Well they specifically asked "how many" classes you take at once... and there is no simple answer.

Two things are simple:

1) All med schools have to incorporate the same minimum course material as dictated by the LCME.

2) All students in each class follow the same curriculum. So you don't "compete" for classes like you did in undergrad. All first year students take anatomy at the same time, etc.

Whats different is that med schools have some freedom in the way their curriculum is designed. Most go by "blocks"... basically little stints on one subject that end with an exam. They can be long blocks... 14 weeks for anatomy with 3 exams... or short ones... 3 weeks for genetics with just one exam at the end. Some do quarters, semesters, etc... but every school is different (and for sure drastically different than the curriculum at a nursing program) First year at my school we got lots of breaks and downtime.

As for how many you take at once? I don't know. Its different all the time. There was a time during first year that I had histology, biochem, and physiology all at once. At the end of the year I only had one class, Neurology. Plus you take a clinical foundations course that is mostly hands on examinations, nutrition, etc.

Suffice it to say, you'll be busy. Some times are definitely less stressful than others... but everything I did was manageable. My school has an online calendar that we are responsible to check everyday. Basically, it is subject to change at any moment. Sometimes little gems pop up and I'm surprised, like "hey! I didn't even know I was in this class".

Just roll with it.

The Best Advice I Have Ever Received...

Ok, maybe not the best ever... but the best career advice I think. I have a fantasy of someday building a self-sustaining clinic in a developing country... that is completely independent of foreign aid or doctors... a project description best left to another post. But.... I know a physician who did just that! And so of course I pester him quite often about how/what/where/and how the heck can I be just like him.

Here's his advice. Write this down. It's like gold.

In order to be a physician and incorporate international projects into your career... here you go!

1. Broadening your horizons with an MPH or the like is very helpful. An MD is for medicine.... but anything you can do to increase your exposure to public health issues is extremely beneficial.

2. Learn languages, and learn them well! Communication is the #1 key to success in every field!

3. If you want to make the world a better place, medicine isn't the only way to do it. Business, politics, research, nursing, economics, environmental conservation, teaching... you can make a huge difference in many fields.

4. Pick a residency that you LIKE. Don't pick something that you assume will be useful internationally. It all will be useful. You'll be happier if you follow your passions.

5. (My personal favorite). Choose a spouse who has compatible goals and who supports your international endeavors. Having a supportive or non-supportive spouse can really make or break you.

It's About That Time

I'm signing up for STEP 1 and buying my Q-bank this week. That and we just had our 3rd/4th year rotation scheduling meeting. Just one question. How the EFF did this happen so damn fast????

And feel free to throw in your advice for scheduling rotations. FYI, my school considers 3rd and 4th year the same... so you can complete rotations in ANY order. Any order, seriously.

More Food.... what else??

Lemon cupcakes via a recipe from the Hummingbird Bakery in London

Blueberry French Toast made with Sourdough from the Fisherman's Wharf in San Francisco

Rock Cornish Hen roasted with citrus and cranberries, braised with port wine and shallot sauce

Moral of the Story? Don't wear a "bump it".

My Nephew Oliver!!

San Francisco, Bodega Bay, Petaluma, Santa Rosa

Just got back from a self-assigned vacation. My BFF got married... and I ditched 10 days of the GI block... opting for a hiatus instead. Wine tasting, pampering, champagne, bachelorette parties, etc. Here's a few shots.

Not So Much Cool as a Cuke

Last night I was a patient. And a freaked out one. So this is probs TMI, but it's my blog and I don't care. So I occasionally get a UTI. Maybe once every few years. But they are always solved within an hour by drinking a couple of big glasses of water. No biggie. But last night it didn't work. It just got worse. And worse. And eventually I started peeing blood. And then I panicked. Like panicked panicked. WTF? I knew I wasn't going to die. Well I kinda felt like it, but I knew logically I wouldn't. And the other thing. I had this horrible realization that I was alone. Like really alone. Who should I call at 2:00am? Lolo had to work in the morning... and what could she do? Dr J was sleeping... and though I called him he didn't pick up. I was seriously in too much pain to go to the ER or urgent care. And Mr. Ex Boyfriend was on vacay with his new girlfriend. Not exactly great options.

An hour later it got worse and I sacked up and called my ex. He called me in an antibiotic and some azo. I'm sure his girlfriend was thrilled that he was doing me favs while on vacation. Oh well. Then I woke up my neighbor to run to Walgreens for me. Which he nicely did. That was pretty major for me actually. I have some crazy psychosis where I am practically physically incapable of asking other people for favors. But I did. And they said yes. So thank you Eli and my neighbor. You saved my ass.

Tonight

I'm going to our block party. Its a "pink" party. Who knew that I do not own one single garment that is pink? Must be a f*&% up on an X chromosome somewhere.

My Lovebug is Here to Stay

My dog Luke, now lives with me on a permanent basis. Ex boyfriend by some miracle agreed to relinquish him... and I am looking for a new place to stay. Not right away, but within a few months where he can have more room to play.

I know it probably isn't the best decision for a med student to make... but right now I am able to take better care of him... and for once in my life I've decided to worry about the future when it comes.

3 Types Of Med Students

I wrote a guest post for Dr. D a few months back describing 3 types of med students and what the "right" reasons are for going to med school. I wanted to repost it here... bc I think it's super relevant to applying to medical school.

So before we get into what the "right reasons" are, let me clarify a couple of things. Medical school is difficult. It takes tons of time. It's stressful. It is a huge commitment. It's competitive. It is also a million other wonderful things. Everyone in medical school has essentially the same base experience.... four years of school plus residency, essentially the same course load, the same time schedule, the same amount of financial aid available for monthly living expenses, etc. Yet, you will hear every different opinion from students about their medical school experience... ranging from "it was the worst time in my life" to "this is easy cake" to "this is so much fun". In my opinion, one of the MAJOR factors that contributes to the differences in student's experiences in medical school is the vast array of reasons why they are there.

Now when I spoke before about the "right" reasons... I guess I should clarify... as who am I to say what the "right" reasons are... But let me describe a pattern I have noticed among medical student. I think there are three main groups of student attitudes about medical school. I'll describe them here.

The happiest students (those who have a balanced perspective, who do well academically, who have reasonable amounts of stress and anxiety, and those who generally "love" medical school) are those who are enjoying the journey. Meaning, they actually love medicine, love the material they are studying, love the lifestyle of continued learning and a high-paced academic environment. Of course, many have other interests and families, but to them medical school is not an obstacle in the way of those things. Med school is an awesome part of their life. Personally, I'm a second year medical student, and I love reading my huge Robbins pathology book with a cup of coffee in the early morning. I love going to lecture and participating in clinical problem solving. I feel a rush everytime I am in the hospital, I talk to my patients for too long, and my brain is always coming up with ideas for projects and research. I look forward to residency and my future career, but I am in no way miserable in school. I certainly think I fall in this category. I absolutely could NOT imagine being anything other than a physician... it took me so much work to get here that I am actually in academic bliss all the time. I know this sounds weird and a bit (ok a lot) over the top... but I know a lot of other people like this. If you ask them about medical school, they will describe it just like I have.

The second group of people are those that like medicine just fine, and it came about as a reasonable choice. They worked hard in undergrad... and are all around strong academic students. To them, medicine is more of "a good field to be in" for them instead of "the most amazing and only possible career on the planet". They are smart kids, but probably had interest in other careers as well... they could have been attorneys or engineers or business entrepreneurs or stock brokers and would have been just as happy. They are happy in medical school not because it is their #1 all time passion... but because they are very strong scholars willing to put in the work in order to be in a field like medicine. They do well academically, but are a bit blase about medicine... often eager to get home, eager to skip extra discussion about a disease or patient, and tend to be a bit disinterested and or frustrated with the rigamarole that comes with medicine. This doesn't make them less of a physician, but they do not enjoy the ride of med school as much as the above group. They are "putting up" with med school... and willing to wait to get out so they can have a family, a paycheck and a steady schedule.

The third group are the miserablites, of which there are two categories. These are the students that don't come to class because they hate medical school. They are barely hanging on by a thread academically, they are socially and academically absent, and they are caught up in the idea that that are in the wrong spot. They've figured out that medicine is a lifestyle that doesn't end after medical school... and they just come to the hard realization that the "misery" of studying, testing, stress and academic/hospital nonsense will be a theme in their lives forever. The first category of miserablites ended up in medical school because of outside pressures. Either from family or society or from within themselves, they felt pressure to do something "worthwhile", to make a choice, any choice,... and medicine seemed like it would be the answer. Their heart wasn't in it... but they either didn't have another readily identifiable passion, or they felt their other passion didn't hold enough weight. A lot of people in this category really wanted to just focus on another less traditional passion, or on family, having kids, being a parent, but got pressured into having a career first... and they are miserable because their heart isn't into med school.

The second category of miserablites came to medical school for the money or the lifestyle, and quickly figured out that those reasons are not sufficient to motivate you through the insanity of medical school. There are a million ways to be rich, that don't involve 8+ years, intense academic work, and a quarter of a million dollars in student loans. And they also figured out (news flash) that being a doctor doesn't make you rich... perhaps a bit too late. Sure you can make a life where you are comfortable financially... but 90% of doctors are not free of financial obligations. Student loans, malpractice insurance, etc. make the life less than glamorous. And frankly, though you can and will make a solid income more than the average American, the goal of being "rich" doesn't seem all that worth it two weeks before Step I when you are sleep deprived, amped up on caffeine, cramming, freaking out, and wishing you'd gotten an MBA or become a real estate agent. The miserablites are those who, as you say regard medical school as "sucking all life out of me, leaving me absolutely passionless, tired and with no ambitions". I can tell you I have NEVER even one day felt this way about medical school.

So, in essence, I think everyone applying to med school has a lot of thinking to do.

Ok No Joke

Again, cardiology is really really awesome. It is just so intuitive. I mean, not to say that I understand everything I'm learning... but the heart is the most amazing organ ever. Not to mention, taking out the heart was the only day of anatomy I even slightly enjoyed.

Kicking Papa Robbins in the Arse

Definitely read some 70 odd pages in Big Daddy Robbins path book in 4 1/2 hours. What now?

More Food (aka Med School Procrastination)!

Bow tie chicken pasta with grape tomatoes broiled in olive oil, and fresh feta and rocket arugula from the farmer's market.

Stuffed Mushrooms

Cilantro Salsa

Quail Stuffed with Port Soaked Raisins, Sage, and Walnuts, served with Brown Sugar Roasted Acorn Squash.

Sesame Crusted Seared Tuna with Floral Peppers

It's Really Too Bad

That you have to do IM before you can be a cardiologist. Cause cardio is totes awesome.

This Week Sucked. TGIO (O=over)

1. Totally missed the memo that we had a TBL on Tuesday

2. Basically love cardio but suck at it as I haven't studied for crap

3. Am considering living with my freakin' parents bc I am so broke

4. Guys suck. Is there a middle ground between those that act totally uninterested and those that won't leave me alone for 5 minutes? That would be new and different.

5. I got a flu shot

6. I have to plan a bachelorette party. Is there anything lamer on earth?

7. My dog is being naughty

8. My landlord is annoying

9. Did I mention I am broke?

10. I have a whole lot of academic catch up to play.

My Nephew Will Be Here Soon!!

When Someone You Love Bombs the MCAT

I've seen several Google searches with the above topic directed to my blog, so I thought I would address it directly. When I tanked the MCAT, the only thing worse than tanking was seeing my parents disappointment. Not that I think they really gave a rats ass about me tanking the MCAT. It was more that they were devastated that I was devastated. So here's my what to do and what not to do list.

1. DO NOT act overly disappointed. Empathize, but if you act like this is a huge fuck-up, the test taker will only feel more like a loser.

2. DO NOT push them about "what are you going to do now?" They have just been through a HUGE amount of work that was essentially wasted (well that's how they feel in the moment anyway)... and it is wayyyy too overwhelming to think about studying and taking the test again. They will get there in their own good time.

3. DO remind them that the MCAT is a nightmare for everyone. If it was easy, everyone would be a doctor.

4. DO remind them that there are many people who take the MCAT many times and still get into great US schools. If you don't know any, you do now. See the profiles on the right.

5. DO support them in their temporary "Plan B" options (like taking a semester off, getting a Masters in pharmacology, taking a research job), but encourage them to keep trying for med school. Try to dissuade them from doing anything drastic (ie. running off to the peace corps or joining the circus). The moments after bombing the MCAT are very fragile, and it is easy to convince yourself you don't want a life of medicine... even if you really do.

6. DO NOT tell others that they took/bombed/etc. the MCAT. They will figure out a way to disclose that information on their own time in their own way.

7. DO NOT undermine the importance of the MCAT score or the difficulty of the test. Tips on how to study better or stories of how you fucked up the SAT II will not go over well.

8. DO just be a friend and invite them out to do something to get their mind off the issue will help. When I bombed the MCAT my best friend brought over a bottle of wine and we got lit.

9. As a preventive measure, DO NOT tell everyone you know that so-n-so's MCAT results are due. That's just asking for trouble if it comes back bad.

10. DO send them a link my blog. At the very least, they will feel better that they didn't eff up the MCAT as many times as I did.

Syphilis... with Crabs

Last night was a great night. I'm in a women's book club (yes, me=big dork), and we all got together at this chef lady's house in historic Algiers. We had wine and food and more wine... and we also had home-made crab dip made from crabs she caught (the kind you want to catch, you know). It was totally great.

Funny thing is that unbeknownst to me, the girl who took my state syphilis epidemiologist job was there. Random coincidence. Small world.

Ok, EFF Being PC. This is lame.

Friday I went to the Standardized Patient Clinic where we were supposed to perform a cardio exam. Instead, we got a 20 minute lecture on gown ethics from an SP who was clearly not comfortable being partially (or even minimally) naked in front of people. I mean, maybe if one of us aggressively pawed at her or touched her inappropriately the lecture would have been merited. But nobody had even touched or said anything.

Look folks, I GET that there is a needed threshold of sensitivity for dealing with patient modesty. And I GET that you don't just walk up to people and put your hands down their pants without introducing yourself. But seriously, I was annoyed. I'd really like to do a cardio exam, and I get a lecture about how you should never ever ever ever expose breast or nipple tissue. How you can listen to the A&P valves from the top of the gown, and the Mitral & Tricuspid from the bottom of the gown by rolling it up carefully. And a femoral pulse requires a delicate "tucking" of the gown up the leg. Then when I went to delicately "tuck" the gown I got yelled at for touching the gown. Apparently I am supposed to ask the patient to tuck her own gown.

The entire time I wanted to yell "Give me a fothermucking break!!!!" I don't have time for this. Personally I am not all that into naked chicks, but I had a very strong desire to rip this woman's gown off, judo chop her ass back to on the exam table and have my way with my stethoscope. Seriously? A quick cardio exam turned into 20 minutes of gown-tucking nonsense?? Right. I can just see me on the wards now. "Ella, why the EFF did it take you half an hour to determine that she had normal rate and rhythm?" Oh, sorry, I had to explain to her the gown folding procedure as to not expose any nipple tissue. That should go over well.

Epigluvula

So my neighbor got strep throat and of course, me playing doctor, wanted to see. Not only did I see all that strepnastiness, but I got another surprise. His epiglottis. Popped right up like a cobra in the back of his throat. I was pretty excited, although I wasn't sure how uncommon that was to actually see an epiglottis, I'd certainly never seen one.

So last night I was out to dinner with some friends (one of which is a resident) and I asked if he'd ever seen an epiglottis while just visualizing the throat. He looked at me like I was the biggest idiot on the planet, and said "Yes, on every patient I see". Well then I started to feel like an idiot, and question my own sanity... but I just said, "Huh, I have never seen one before, I guess I'll look harder from now on".

Then he's like "look, you can see mine... it hangs down in the middle"

Then I'm like, "uh, that's your uvula"

Tonight!

Is the annual History of Medicine Society Wine and Cheese Cocktail party. One of our professors lives in a beautiful historic home in the Garden District, and he lets us throw a party at his house every year. I'm sooo excited. It was awesome last year. My lab group will be there, plus most of my close friends from med school. Our prof likes to tell the story that years ago someone ate his goldfish at this party, so this year we are putting plastic goldfish in all the wineglasses just to tease him.

Med School High

Wow. This weekend may have been overload. I went out with my med student friends every night... which was fun. But it really is like high school. He said, she said, omigod are they hooking up?, she looked at me funny, here have a shot, KEGSTAND!, late night pizza, he's flirting with another girl!, she said what?, what an asshole!.

Still had fun, but it makes me so grateful to not have drama. Well, at least that kind of drama :)