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.

Well I can officially say....

That the absolute WORST time for a GI virus to kick in is 3 minutes before you are supposed to present to a roomful of soon-to-be and current physicians.

THAT SUCKED! But I toughed it out.

An "oh shit" moment

Me, being proactive and interested (and stupid) in my radiology project when most no one else gives a shit and just steals their shit off the internet for an uber easy presentation.

Ella: Hey Dr. P! I'd like to do my project on Neurocysticercosis. Have you seen any images come through in recent years?

Dr. P: Why Sure! I've got some stuff right here.

Ella: Oh wow, you've got books on the topic!

Ella: Oh wow! You actually (gulp) wrote these books.

Ella (in thought): F&@#ing way to go, dumbass!

Surgery is O-V-E-R

Passed my surgery shelf so there is no effing possible way in hell that I will have to do that ever again for even one minute!!!

Ready for every other wonderful specialty in medicine! (ah-hem... EM)

A few Interesting Things

1) a doc i know told me he took the MCAT 4 times. scoring 19, 20, 24, and 28

2) another (different than #1) doc told me he applied to medical school 12 times. 12????? do they even allow that? granted that was a while back 20+ years

3) a VERY coveted fellowship in a top specialty was recently given to an acquaintance of mine. who also failed step I.

4) a doctor god that I know was actually fired from his first residency. he's now head of an ICU in an Ivy League hospital

Point being?

Almost anything is recoverable.

Kimberly

1) Name (fake or real)

Kimberly

2) Age (real age please)

26

3) What's your sign? (curious and contemplating, pre-med, med-student, resident, fellow, god)

med student

4) Briefly describe your career and or academic history. Including your pre-doctor life (if applicable) and bouts of time in between school. What makes you non-trad?

Went to college directly out of high school, was accepted into a joint program between my school and a local medical school. Was on track for the program until the end of my junior year (was required to take the MCAT and score a 24, scored a 20), dropped out of the program. Graduated....studied for the MCAT and took some graduate science classes at a local school. HATED IT. Scored a 20 on the MCAT again. Got frustrated with life, applied to an MPH program and moved to FL. Loved my program, studied for the MCAT AGAIN, went to Ecuador...got scores back... 19. Decided to apply to Caribbean schools...got accepted to Ross University SOM and started January of this year!

5) What propelled you to switch into the medical field?

I've always been interested in medicine...I just took the excruciating route to finally get here.

6) Family status... married? children? how old are they?

Single, no kids!

7) What's your experience with the MCAT? If you are a successful applicant will you share your academic stats and application highlights?

3 times is NOT the charm. Looking back, I did not have the correct study habits for the MCAT...I was used to just knowing things by going over it a few times. It wasn't until I got to med school that I finally understood that I had to put in some serious effort. Wish I had understood that back then.

8) Biggest hurdle getting to med school

SO MANY!!! MCAT scores and finances probably top my list.

9) Are you going MD or DO? Why?

Definately MD. No other reason other than I always practiced writing my name Kimberly, MD, MPH. It looks amazing! :)

10) Best advice to other pre-meds (non-trad or not)?

Don't underestimate yourself. Even if you are not a great test taker, limited on funds...whatever, if you are dedicated and truly want this...there is a way. Also, don't turn your nose down to Carribean schools (like I did at first). The Big 4 (SGU, Ross, AUC, Saba) offer you the opportunity to let your dreams come true.

11) Anything else you'd like to say... or something cool about your story you'd like to share?

Yes, I have the cutest dog ever... (not biased)

Rhonda (sorry I didn't post this before!)

2) Age (real age please)

29

3) What's your sign? (curious and contemplating, pre-med, med-student, resident, fellow, god)

pre-med

4) Briefly describe your career and or academic history. Including your pre-doctor life (if applicable) and bouts of time in between school. What makes you non-trad?

I am a paralegal right now, I got an Associate’s Degree in Legal Studies/Paralegal, and thought I’d follow the path of Law straight into law school, except I don’t like it and I keep being pulled back onto the Pre-Med path. I’ve changed my major about a million times trying to find something that I like and I always end up back on the Pre-Med track. Right now I am like a 8th year Senior at my University majoring in Biology. I’m also getting the credits required to teach Biology, just in case this whole Doctor thing doesn’t work out. My fascination with Biology will probably be helpful in the classroom as well.

5) What propelled you to switch into the medical field?

I’m in love with the thought of being a doctor. I have always been on the line but finally my fiancé of all people told me to just go for it, but to have a back-up plan…just in case.

6) Family status... married? children? how old are they?

Engaged, 1 son he’s 9 (10 this summer)

7) What's your experience with the MCAT? If you are a successful applicant will you share your academic stats and application highlights?

No experience yet.

8) Biggest hurdle getting to med school

What isn’t a hurdle? Time and money mostly. I have to work full time in order to support our household, so I don’t have a lot of free time to volunteer or do things that I normally would, I volunteer as much as I can. I’m just hoping that it’s enough. The money thing well that’s just that school is expensive and even though I get financial aid and loans eventually I will have to pay all of that back and I’m trying to be smart about it. I would love to find a different more flexible job but I wouldn’t make enough money and I have really good benefits for my son and myself. I also have to overcome some black marks on my transcripts, although since I committed to the Pre-Med route I have nothing below a B, and that’s a rare occasion that it’s below an A.

9) Are you going MD or DO? Why?

I’m going to apply to both. There are a few DO schools that I like.

10) Best advice to other pre-meds (non-trad or not)?

Focus on one thing at a time.

11) Anything else you'd like to say... or something cool about your story you'd like to share?

Just stay positive. And keep moving.