Striving to be better.

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When Ernie calls himself a power user just below, he’s not kidding! Relapse during the double-blind phase was defined as the following conditions being met (on three consecutive visits for 1 and 2, cafergot interactions and for visit 3 for condition 3): (1) YBOCS score increased by ≥ 5 points, to a minimum of 20, relative to baseline; (2) CGI-I increased by ≥ one point; and (3) worsening of the patient's condition in the investigator's judgment, to justify alternative treatment! His proposal is based upon a similar study undertaken in Illinois in which an expert found that jurors did. This is often because of the now truly present imbalance in the individual’s brain, commonly a Serotonin deficiency?

Surprise – I’m alive.

But seriously. WHOA. I found a specialty I am truly excited about. I interviewed. I traveled the country. I chose a program. I matched into – wait for it – anesthesia. I became a mother (again). And I survived medical school. But you would never know, because life got in the way of putting my thoughts on paper; the ongoing, daily conversations and deliberations – both externally and internally – were often too overwhelming to attempt to articulate in a meaningful way. And I fell off the blogging bandwagon.

But now, as I struggle through the everyday life of intern year, I find myself longing for a creative outlet that enables me to feel in control. That reminds me of my passion for life, especially a life outside the hospital! That acts as a sounding board for my daily struggles. And that serves as a connection to a great community.

So to that end, I’m alive. I survived. Four years down, four years left to go.

 

 

And Just Like That.

And just like that…

I am a fourth year med student – with so much to do in so little time! I wish the day had more hours and the week more days; or perhaps just more sleep for my eyes and rest for my brain 🙂

With 2 months until applications are due, I am in full swing. I am behind on my thoughts but promise to push through to the end. Watch out for rotations 7-12; the reflections might be short and sweet but I swear there will be More. To. Come.

 

Feeling So Loved.

What an amazing year 26 has been! And after a long weekend full of birthday celebrations with family and friends, I am overcome with happiness and gratitude for this most amazing life that I get to lead.

27th Birthday

So here’s to 27 – may it be a year full of joyfulness, laughter, silliness, thankfulness, and clarity. May it bring new challenges, new adventures, and new memories with the ones I love.

Rotation 6: Family Medicine – Not my Cup of…Coffee.

I knew going into family medicine that it wasn’t the right speciality for me; I like a different pace, a different environment, different patient problems and I like doing procedures. But I approached it with an open mind, making it a point to pay special attention to patient interactions I especially enjoyed. That being said, I found myself gravitating towards all the pregnant patients – I was excited to talk to them about how everything was going, their fears, their excitement, their anxieties; I was eager to answer their questions and felt motivated to advocate on their behalf.

The more I thought about it, the more I realized how perfect ob/gyn might be for me: the combination of surgery, outpatient and hospital-based care as well as the opportunity to care for and advocate on behalf of women across all age groups. So while family medicine was not my favorite rotation by any means, I ended it with excitement for what lays ahead.

Creativity in the Making.

In all his spare time (you know, when he’s not working full-time, traveling internationally, being the world’s self-proclaimed #1 dad or supporting my endeavors unconditionally), my husband manages to also be an amazing photographer and videographer. He recently started his own company and I couldn’t be more proud.

Check out the wedding he captured earlier this month!

Rotation 5: Internal Medicine – The Bane of my Existence.

I write that title in jest – but only just somewhat.

To be completely honest, internal medicine was a true struggle for me – and, even now, I’m not exactly sure why.

It can be overwhelming going into every rotation with an open mind, constantly asking yourself, “is this something I could see myself doing for the rest of my life?” And it can be very frustrating coming out of a rotation not knowing the answer to that question! But one thing’s for sure, somewhere between being on-call every third night and being told I wasn’t helping (eventually interpreted as, it is not my responsibility as a medical student to help but rather to learn), I lost myself. And I lost the balance that I so crave in life.

While I enjoyed working with the adult patient population (more so than I expected), looked forward to participating in morning report, and found myself intrigued by the process of care, internal medicine, as a whole, failed to ‘win me over’. Going forward, I can only hope to learn from this rotation – to better identify why I struggled and how I came to lose myself – with the ultimate hope of finding a speciality that challenges me but allows me to stay true and maintain the balance in life that I desire.

Rotation 4: Pediatric Nephrology – Hello Kid(n)ey.

Keeping this reflection short’n sweet (because life is particularly hectic at the moment):

I genuinely love being around children and I find the kidneys absolutely fascinating. So, overall, I really enjoyed this rotation. I spent the first week in the children’s hospital rounding on patients who required our daily care and expertise. I spent the last two weeks acting as a consultant, covering three different hospitals’ NICUs, PICUs, ICCs and general floors, while spending my afternoons in clinic.

In addition to the varied settings, I was also intrigued by the variety and complexity of patient problems. Despite each problem (quite obviously) revolving around the kidneys, no two patient scenarios were quite the same. Some problems were chronic – infants born with congenitally malformed or seemingly nonfunctional kidneys, children with chemotherapy-induced renal damage, adolescents on dialysis waiting for a kidney transplant – while others were (hopefully) short-lived – minimal change disease, poststreptococcal glomerulonephritis, hemolytic-uremic syndrome. I enjoyed partaking in the lengthy discussion surrounding each patient and I admired the way in which the physicians spoke about their patients. They demonstrated compassion and empathy; they spoke intelligently and confidently, yet frequently consulted each other as well as the literature; and they never once downplayed or spoke ill of another care provider or medical specialty.

If I ended up pursuing pediatrics, I am almost positive I would specialize and at this point, I would seriously have to consider nephrology.

Taking a Breath.

I should be preparing for my final exam right now. It is the last week of my family medicine rotation after all. But instead, I find myself sitting at my desk, staring blankly ahead, trying to thoughtfully process all that has happened.

My nephew, lovingly dubbed “Benny Boyee” by my 3-year-old, was born one day shy of 28 weeks. He weighed just 2lbs 3oz. For the past 17 weeks, he has remained in the NICU with his mother, a NICU nurse herself, by his side. His little lungs just don’t seem to want to work, not even on the oscillator or with his tracheostomy. Six days ago, he was declared a pulmonary non-survivor. So we have spent this week preparing for his death.

—————————–

I usually can figure out complex problems in the shower. During high school and undergrad, I solved many mathematical problems this way. I found that as soon as I let my mind wander, I would arrive at the answer. I have even found this to be true in med school; that’s how I finally figured out how the kidneys work. Something about the distraction allows me to identify the one detail I don’t understand and in doing so enables me to finally understand the larger, more complex whole.

I usually can work through stressful and overwhelming situations by working out; in feeling physical pain, I allow myself to feel, process, and resolve the deeper emotional pain. While studying for step one, I ran 114 miles.

That’s what I do. I process and resolve difficult situations in a thoughtful, purposeful, deliberate manner.

But I can’t process this. No shower, no amount of exercise can touch this. I have no solution; I have no fix. I don’t know why. Why them, why now, why another loss, why another heartache. I don’t know how. How to grieve the loss of someone I barely got the opportunity to know but yet wholly and completely love. How to prepare my son for the loss of his cousin and friend. My son who prays every night for boyee to be healthy, who longs for the day when he can share his love of dinosaurs with him, and who hated to let go of his little hand when he finally got to meet his beloved Benny Boyee for the first time. How to love and support someone who is experiencing a pain that runs so deep. I just don’t know.

So as I sit here, powerless, directionless, with tears streaming down my face, I say that some things cannot be thoughtfully processed – they must only be felt.

Rotation 3: Radiology – The Dark Room.

My very first thought at the end of my very first day of radiology was that if my older brother, an astroparticle physicist, were to go to med school, he would make for an amazing radiologist. That side of me – the side that loves math and kind of digs physics – was actually, quite unexpectedly, fascinated with radiology. Beyond the math- and physics-laden imaging modalities, radiology also offers an intriguing element of art analysis. Sitting in a dark room, with a systematic visual approach and a heavy reliance on the similarities between human anatomy, a radiologist must decipher the delicate difference between disease and the slight variations that make us all uniquely beautiful beings.

I honestly do enjoy looking at images, especially if I know the greater context of the patient’s story. And I value the amount of information imaging modalities can add to patient care. As a result, I have seriously considered pursuing radiology from time-to-time. But when I step back to look at the greater picture, I try to define what “practicing medicine” means to me. While I don’t yet have a complete definition, I know that radiology doesn’t quite fit, as it is not necessarily conducive to the type of impact I want to have, and have always imagined having, on my patients’ lives.

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