Author: Andi Hill

Categories
Medical School

10 Things Vol. 6

Back to our regularly scheduled program, here is number 6 in the 10 Things series. Now that I have a whole, whopping 1 rotation under my belt I thought I’d share my top ten things I love about seeing patients. Sa far…

  1. Hearing and seeing the abnormal- in school we were taught to know what “mom” is. “Mom” is normal. You know everything about “mom”. “Mom” is the way the human body is supposed to be. When something is different with “mom” you immediately know something is wrong. Every exam I practiced on a classmate has been normal and not pathological, but seeing real patients means there is real pathology. I am actually hearing real atrial fibrillation and seeing enlarged adenoids, instead of just reading about it.
  2. Their stories- each patient has a complicated story of what got them to that point. Some visits are more simple than others, but no two cases of strep or heartburn are the same. You learn to listen for key words and subtle nuances that lead you to a diagnosis but it isn’t always cut and dry and though its frustrating, its much better than class 8-5.
  3. Kids- Pediatrics is still an option for me, but I don’t know if I could see kids all day everyday for the rest of my life. Still, whenever there’s a kid I get to go see, especially for a sick visit, I get really excited because they are so sad and vulnerable. They only want one thing- to feel better and its very gratifying that I get to have a small part in doing just that. They aren’t faking or lying or trying to get drugs, they just feel crappy and I can see it right on their face. If I can send them home with a medicine and a sucker to get them there, then I’m a happy girl.
  4. Reading articles- call me crazy but I much prefer a couple relevant 5 page articles every night as homework vs. listening to 17-20 hours of lecture a week ANY DAY!
  5. Families- I like when patients bring their spouse or kids or siblings into the room with them. Sometimes they have very different and helpful perspectives as to what is happening with the patient.
  6. Coming home- I love in the evenings when my roommates and I are all home and we swap stories about the day- in compliance with HIPAA of course! We talk about the cases we saw that day and what we learned and pimp each other on which antibiotics to use and what tests to order.
  7. Procedures- I have a lot easier time understanding when its time to remove a mole, when I actually see multiple kinds of which ones get removed. Medical education in the first two years a lot of times says “You’ll understand later when you need to be concerned.” And we are just kind of left looking at one picture example of a concerning mole. Same goes for a lot of different things, not just moles. Its a lot easier to know when vaginal discharge is concerning when you see (ahem, smell) concerning discharge.
  8. Talking- In the first two years of med school, we see standardized (acting) patients in front of an attending. If that wasn’t intimidating enough, you are also being graded by said patient and said attending. For me anyway, this is not conducive to a nice, easy, free-flowing conversation between a competent future doctor and their patient. For fear of saying something wrong, fumbling with the blood pressure cuff, or being awkward, I often ended up saying things wrong and awkwardly and dropping things in those scary exam rooms. Now, that I am with real patients, sometimes in the room by myself, I see that I have their attention. They are looking to me for the right questions and answers and guidance and I feel like I can rise up to that and say useful things sometimes.
  9. Being accidentally called doctor- Seriously who doesn’t love this pleasant mistake, that will soon be true.
  10. Learning- It won’t be much longer that I can fall back on “Hold on, let me ask my attending.” It is my entire job- in this season of life- to learn. To soak up every last thing. To watch every thing that every physician around me does and to determine what they are doing right and what could be improved. I ask the same questions of myself constantly- what am I doing right and what needs fixing. It is such a rare thing to only be asked that you learn. So I will learn every possible thing from every possible patient on every possible day. I’m trying to do just that, and to enjoy it too, because it won’t be too long from now that I will be called upon to just “know”.
Categories
Life Medical School Medicine

I'm Back– Close Calls, Boards, and the Start of Third Year

My life looks very different now than what it did 5 weeks ago. And, 5 weeks before that, I was in another galaxy. I wouldn’t have thought it possible, but these last couple months have been more of a startling transition than going from college and a summer off to matriculating the first year of medical school. I will say though, this transition has brought much more enjoyable changes.
So let’s start back at the end of April/beginning of May during board exam preparations when I deleted every social media app and other time-sucking things from my life and moved in with my best med school friends; it simultaneously became a huge load off my back having awesome roommates and being in a more nurturing place at home, but then it got a whole lot more stressful because Macy and I needed to buckle down and study. Hard.
This was 6 weeks before my big test, and classes were already over to give us time to study for boards on our own. (Before I go on, for all you non-medical people- passing this test is crucial to moving onto your “clinical” years of medical school and an absolute necessity for getting the big D.O. after my name. Residency programs look at this test score and assess your worthiness, and if getting into medical school isn’t hard enough, I daresay this was about 437 times harder than anything I had to do to get in.) Anyway, I took a practice test that the school required we take to make sure we were ready to take the exam and pass it.
I was not at a passing score at that test, 5 weeks out from D-day. I’ve debated writing about it because it feels like a big deal to talk about scores. This test and the months of preparation leading up to it are such a big part of my life right now and no one shares their scores except with the closest of people. Still, I want to share at least some of my story for the same reasons- because it is such a big part of my life and I learned so much.
I was devastated about this practice test score for days. I curled up in my mom’s lap and cried. My dad bought me a Quiktrip pretzel and told me to take a step back and maybe talk to the school about pushing everything back a few months. I cried to an attending physician in his office- the medical school equivalent to calling your teacher “mom”. Still, I decided to buckle down and move forward as planned and the plan was to pass at all costs.
I knew balance was key and I needed to stay sane with breaks and hobbies, etc, but I also wasn’t stupid. I knew my “studying status quo” of cooking a nice dinner, running 4-6 miles 5 times a week and taking Netflix breaks- even without the social media- wasn’t going to cut it. With a very important deadline, some more sacrifices had to be made.
I think I ran a total of four times in that last month. I watched one 22 minute show at the end of my study days. I started drinking Ensure nutrition shakes for meals. I lost 20 pounds in the 6 months before my boards, which is not a healthy amount for me by the way. I gave my dog back to my mom for a number of weeks. I went to an 8-5 board review class and stayed. awake. for. the. whole. entire. week. I hit the books hard and cried and panicked and learned more than I have ever learned in my entire life. I was also very miserable and alone for the majority of every single day for those six weeks.
I took two more practice tests before my exam, and I surprised myself, getting significantly better each time. I didn’t really know what to expect as far as what kind of progress was possible that close to a test date, but I did it. As well as I was doing, my anxiety lurked in the shadows during every minute I wasn’t studying. I would go get dinner with Dru and inside my heart was pounding, saying “You’re going to fail because you didn’t bring your book with you.” In the shower every night, “You don’t deserve a break with scores this low.” Laying in bed, biting my lips until they bled, texting my family and anyone else that would listen to try to get any sort of 5 second reassurance where I didn’t feel like I was going to vomit my esophagus up into my mouth. The harder I studied, the more I feared I would not pass.
Being naturally high strung, having anxiety, and a having healthy dose of fierce test anxiety to boot, I fully expected to need a dart gun to feel calm on test day. The night before, I took a Benadryl and a melatonin at 6 PM just to cover my bases. I added an ice pack on my head and a heating pad on my feet for good measure. I was out by 7:30PM. I woke up that next day and grabbed my packed lunch and rode with Macy to the testing center as we were taking it on the same day. I felt like everything was going to be okay. I got low on time during the first four hours, and I had never needed extra time before. Still, I didn’t feel nauseous. Even during lunch, when my mind was able to wander,  I didn’t ever feel like it wasn’t going to be okay like I had been feeling for the past 6 weeks. Macy and I finished and went home- together, relieved, overwhelmed and exhausted- where my sweet boyfriend had cleaned my house and got me a couple precious happy gifts. Still, it would be another 6 weeks before I knew for sure I could take a breath.
In that 6 weeks I spent a lot of wonderful, mostly stress-free time with my family, roomies, and Dru. I learned Advanced Cardiac Life Support. Some of us went to the lake and saw lots of med school friends that we hadn’t really been able to let loose with really since orientation before first year. It was sweet, sweet relief to my tired, studied-out soul. Memories were made that I know I’ll cherish forever.
And then we started rotations. Possibly the most daily rewarding thing I’ve ever been privileged to be a part of. This useless noggin full of jumbled up, color-coded notes and random lectures finally has a use and can make heads or tails out of what’s actually wrong with my patients! (most of the time.) It is much easier to read medical things at night and on the weekends while being able to put a real patient’s face to the condition I need to learn more about.
I got my scores back last week and I was mostly pleased with the results. In my Type A hindsight, I like to think I could have done more and gotten an even better score by tweaking some of my preparation, but I do I know I did my best and really got a much needed confidence boost out of finding out that my best was good enough this time. Medical education can be extremely taxing in the self-doubt department and make you feel like you’re failing all around because it is so all-encompassing, all-consuming. This was not one of those times.
If you didn’t want to read the whole thing and scrolled down to the end here; I can really sum it all up by saying how extremely blessed I am to be in a career with these sorts ups and downs. Where the rewards are that much sweeter because of the trials. I can focus now on being the face-to-face, compassionate, knowledgable, doctor now that that pesky test is in my past; thank you Jesus.
I’m also lucky because of everyone that brought me meals (thanks, mom), sent me encouraging texts, cupcakes, edible arrangements, Starbucks, and hugs. My roommates really pulled together and helped me get through, while also studying and working really hard themselves. My family prayed for me and supported me emotionally and financially and recruited others to pray as well. My school faculty and classmates supported me and gave encouragement, resources, advice and kicks in the pants where needed. Dru loved me, taught me a lot of test material, and listened to me whine repeatedly; he did dishes, cooked meals and absolutely knocked his own test out of the park all at the same time.
I don’t remember where I read it or if it popped in my head or where I got it, but somewhere along the line, I told my family that I had a mantra for this seemingly insurmountable test. I started telling myself “You are overestimating the problem and underestimating yourself.” It sounds crazy at this point in my life that I would still be crippled at times with self-doubt and confidence when it comes to my ability to belong to this schooling and eventual career, but I do. Even after I got accepted to medical school, if you had asked me to look at a future hologram snapchat video of me seeing patients competently and happily coasting into the start of third year in July 2016, I would have said an incredulous, dumbfounded, “No, that can’t be me.”
It blows my mind, in the best of ways. 
 

Categories
Blogging Family Friends Life

What I've Learned from Kicking a Bad Social Media Habit

I’ve been on a social media hiatus, but I never said I would quit the blog until boards. It’s been a gradual weaning process to break the habit of checking my instagram, twitter, and facebook every 5 seconds. I hated that I was so dependent on them. I was on my phone way too much, now I lose my phone a lot more without it by my side every minute. I also have a lot more time to study or better yet- relax- now that I’ve logged out of all of them and deleted the apps. Facebook has been the most difficult to kick though, mostly because a good part of my class uses it to communicate with each other. As a result, I’ve been checking it for school updates occasionally. It has been an overwhelmingly good thing for me, and not just for boards studying. I’ve also realized I don’t miss it. My boyfriend always said I scowl my face every time I scroll through my phone for the past couple months. I did it without thinking about it. Its stupid how much time I wasted on things that don’t matter. The people I really need to know about are people I talk I actually talk to on the phone, text, or in person. Best case scenario on social media is me paying very little attention to what I’m looking at or reading, absent-mindedly scrolling through weird, personal details of peoples lives. Its very strange, our interactions online. Worst case scenario I get told to buy something, or I get jealous, down on myself, panicked, sometimes angry even. On Instagram, I can spend hours looking at pretty pictures of people I don’t know, which is another weird thing we do online. People brag online without thinking about their audience of mostly people in similar walks of life struggling to lose weight or make good grades or get their baby to sleep through the night. Even the simplest #humblebrag can make someone else feel like they are failing, and that’s something nobody really thinks about enough. Women are the worst at it, and I’m guilty of it too. My twitter has a lot of anonymous medical students at great schools with blogs and twitter feeds that often make me feel panic-y about studying or feel like a slacker. I pray that this blog never makes any of my peers feel behind or down on themselves. Trust me, I’m more behind than you! Keep doing your best, medical students; I know how hard it is!
Bottom line- social media has a purpose. I’m thankful for the funny articles and pictures of my friends that I don’t see often. I’m glad it makes people realize how blessed they are and gives a platform where people often publicly compliment their friends and be more grateful for their families. I even like when people post about their successes- most of the time. People butt heads and you’re never going to make everyone happy or avoid offending everyone who reads what you post. For me, it became overwhelmingly negative at a time in my life where I am already at the breaking point. I’m stressed and very often, things on social media affected my mood in a very negative way. Not to mention the time suck it was for me when there already aren’t enough hours in the day. Even after boards, I hope to maintain this habit of rarely checking my accounts. I want to choose to focus on real conversations in real life with my loved ones, and save the successes and failures and announcements and life events for the people who are actually there to celebrate or offer a helping hand right there with me.

Categories
Medical School Running

Olympic Years and Boards Fears

You guys. It’s an Olympic year. Rio 2016. I don’t know how many of you know this, but I friggin’ love the Olympics. I’m not really that patriotic any other time, there’s just something about the USA’s best of the best going to compete against the world. And- even better everyone gets to see the runners that I love perform on the world’s stage.
It always surprises me that the best of the best of America’s runners train together. You would think they would hide in their respective corners of the country and conceal their earth-shattering workout times and world class coaches and not let anyone know their secrets. In reality, its quite the opposite. They gather in Flagstaff like Amy Cragg and Shalane Flanagan, or Portland, or Boulder and take training trips up to altitude together. They run their tune up races stride for stride with each other. Its a pretty great example of how no one truly succeeds on their own. They push each other, help each other come back from injuries and pregnancies–yeesh!- faster than anyone would think possible.
Once they make it to the World Champs and Olympics these runners face the reality that they are now competing against their best friends, sometimes roommates, and running partners for the gold metal. But, they all know they never would have qualified without their teammate pushing them there.
My class is freaked out about boards. So freaked out, in fact, that our school cancelled a previously mandatory class this semester to make room for a mandatory board review class. Today, during that class, one of our professors told us how the last class that got a 100% board pass rate managed to pull it off. It was simple. They decided they weren’t going to let anyone fall back. They saw to it that everyone was going to do their practice questions, put in the work. We are eventually going to be competing against each other for residencies- but this is not the time for that. We all have to pass first. Its like making the US Olympic team together before you line up at the start and see which runner has what it takes to take it all the way to gold that day.
We are all starting from different places. Some of us are seasoned marathoners just following our routine that’s always given faithful results.  Some of us are transitioning from really great 10k performances to the almighty marathon- and hoping to be able to manage the mileage. Some of us cough-me-cough-cough are like Kara Goucher when she first went pro, who has been on the elliptical 4 hours a day for months doing no real high-impact work and instead of getting somewhere, got a stress fracture in her femur. Yes, that happens. The point is that we get everyone out there on the roads, putting in miles and hitting their splits.
I want to tell everyone that my class didn’t let anyone bow out of the race early. I want to tell everyone that even though some of my teammates are better than me, that we all helped each other get on Team USA. Those that fell or got injured, were lightly nurtured back onto their feet and shown that they have what it takes to still finish strong.
I’ve found my resolve. Let’s do everything we can to get there.
The Olympic Trials Marathon is February 13th. It determines who’s going to Rio. Our boards are scheduled throughout May and June. That is our qualifying race.
Class of 2018- Let’s take these boards to Rio!
 
 

womenstart1usolyt2012 Source

Categories
Medical School

2nd Year Rut: Revisited

Apparently I scared my mom with my last post. I didn’t mean to be all dark and twisty. In medical school though, the drag on and on is not really a huge negative every single waking minute. We still lead pleasurable lives. To all of us, the huge amount of work is simply a fact of our lives right now. No more depressing than a weather report.
“It’s 14 degrees outside.”
“I have to spend 14 hours studying today, tomorrow and the next day.”
They are one in the same.
After that blog published, several classmates told me they felt the exact same way. We just keep on going. So in that, I find inspiration. We just keep moving forward, trucking on through. I wouldn’t rather do this journey with any other group of people anywhere on earth.
 
Allow me to bring last weeks post into a more positive light. One of runnings’ most fulfilling qualities, to me, is its incessant ability to apply as a versatile metaphor for medical school and life in general.
The semester stretches ahead of me- my last body systems courses, my last months in the classroom, my first board exam, studying for both as much as possible- it all looms ahead like a road race I didn’t train for.
I’m nervous. Scared I won’t be able to finish. Dreading the pain and suffering. The anxiety is enough to make me want to sit this one out. Wait until I’m better prepared. Go back home to my warm bed, and promise myself I will start training for a different race…tomorrow of course.
Suddenly I remember all the other runs I’ve dared. How they empowered me and I always came out stronger on the other side. I remember how sometimes I was cold or uncomfortable. Maybe I was having a hard time breathing or got spooked by a shadow. Sometimes I had other things I wanted to do but I chose to invest in a little run to get my heart rate up and my mind in the right place. This semester stretches ahead about 97 times longer, harder, and more daunting than I would like. Something always keeps me coming back to it though, just like how I do with running. Signing up for road races- and medical school for that matter- seems to be a lot more difficult than I bargain for a lot of the time.
I’ll make it though. I always do. And I always look back at how far I’ve come, amazed, legitimized, privileged and strong.
Will it hurt? Yeah. Could I be doing something else more fun with my time? Probably.
But with my heart already racing, mind full of worries, and soul growing weary with the weight of it all; I can’t help but take a deep breath, put my toe on the starting line, and wait for the gun to go off, so I can give it all I’ve got.

Categories
Family Friends Growing Up Life Medical School

2nd Year Rut

I wanted this blog to be real. Honest. No sugar coating it.
Med school sucks sometimes. There I said it.
Its three days into a new semester and I’ve already hit a wall so hard that I can’t even sleep. Usually when I don’t want to study, I can sleep, or at least binge watch something while simultaneously “candy crushing” until sleep finds me. Here I am, though- its 2 AM and I’m Facebook stalking pictures of myself while I was in college, feeling sorry for myself.
Something is off. And it has been for a while.
I feel happy each day. I wake up, I eat, I laugh, I study, I see my friends, I sleep. Even my family is always close by when I need them.
But, after looking at my own pictures on my feed, I see I’m not even the girl I was a year ago. That girl was “pinch me” happy to be in medical school. That girl lived to go into school each day and learn. That girl was running everyday. She loved going out, even on weeknights- regardless of the sleep she’d lose- just to be with her new friends, gain the life experiences.
I loved my first year of medical school. It changed my life in all aspects for the better.
Shortly after first year started, an older gentleman in a restaurant overheard me using “first year” and “second year” terminology and leaned over and said “You must be in law school, using those words.” I smiled and proudly said, “No sir, I’m in medical school.”
“My mistake,” he smiled, “Congratulations then.” My “thank you” to him was heartfelt and beaming with pride. I was passionate that I was finally where I had wanted to get to all these years.
Last year, it was this all-consuming-love-of-my-life and I couldn’t talk about anything else because I was so enthralled.
Now, I’m this 15lb. heavier zombie, dragging my sedentary body around with my arms in front of me growling and yelling “SLEEP!!!! Where is my sleep?” and feeding on any friends and family nearby, sucking them into my darkness whenever possible.
I don’t want anything to do with going to class or shoving any more knowledge into my haggard, feeble, and engorged brain. Hanging out with friends? Forget about it. The first thing I do after class is come home, throw my jeans on the floor and sit in bed. I study when I have to and do anything else besides school that I can find when I don’t have to.
My best friend asks me how school is going “Horrible,” I say. “can we talk about something else?”
 
 
So tell me, which girl do you want to be your doctor in a few years?
 
 
I’m not the type to squander this opportunity. I truly, deeply want you to know that I know I should be more grateful. I know I am extremely privileged to be able to pursue this profession. I just happen to feel like its costing me a lot in this season of my life. I know these feelings are normal too. I know I’m human, but I hate the fact that I am already this burned out and broken down by my medical education. It’s hard, though. Its hard to go back to the honeymoon phase when you’ve seen medical school in the light of day.
When you’ve had to miss birthday parties.
When you’ve had to tell your nieces that you can’t make it to dinner.
When your jaw is throbbing from clenching it when stressed.
When you miss those concerts with your friends.
When you feel 80 years old for wanting to sleep at 7:30 PM and you are only 23.
When you have to start studying for a $600 test 6 months in advance.
When you want to be active and run and play and shop and dance and stay up until 5AM with your girlfriends.
When you want to be sore and tired from all the things you did that day, but instead you are sore from sitting on your leg too long and you have a hand cramp from writing too much and you are tired from straining your eyes.
All for a potential illness you have not yet learned in a future patient you have not met, in a clinic you cannot picture. There’s no such thing as instant gratification in med school. I have only a far off hope that someday, some rewarding case will instantly make it all worth while. Do you see what I mean?
 
 
In undergrad, I was very wary to not use the term burned out whenever I was frustrated because I knew how much longer I had to go.
But this…there is no other word for this than burn-out. I flailed through last semester and faked it til I made it but three days in to my second semester of my second year and I am having some serious trouble.
The worst part is- I don’t have a solution.
I’m struggling. I’m doing my best. I try to find the good. I don’t let comparisons to my awe-inspiring friends and classmates steal my joy. I stay disciplined to my studies. I keep my head down and work. I just keep swimming.
I guess I know I’m doing something right when I wouldn’t trade this crappy 2nd year rut, for any other experience anywhere else.
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Categories
Health Medical School Medicine

Functional Anxiety

Hopefully by now you have learned not to expect much in the way of blog posts during the school year. It’s a rough time and nearly all relationships, hobbies, and other activities suffer in the thick of it.
I used to worry a lot about where the time went and fret over how little I had done in 3 hours or whatever. Now, I don’t have time for that. Anything that isn’t directly related to studying for my systems course- which right now is hematology- is immediately considered free time and I have promised myself to never regret how I spend my free time. If its free time and I want to sleep, I sleep. If I want to hold one of my babes, I try my hardest to get my sisters to let me hold them. Unfortunately sometimes OMM and DTP eat up my free time with their class requirement, and that is a quick way to get me really cranky.
“Hell Week 2.0” I think is now over. I remember one distinct week in first year that just raked me over the coals. We had back-to-back tests, Anatomy and something else awful like Embryology or something. On top of that, I was sick. I’m sure there was more to it than that, but I have PTSD and can’t remember.
This year’s worst week ever- just happened. I just had a lot going on; there were two tests and I had to do my first full history and physical on a standardized patient. This was all within 6 days but it didn’t fall on an exact calendar week so I had a weekend to study. That made it somewhat less traumatic than last year. Anyway its over and I survived. Somehow I always survive.
This “Hell Week” my sickness came after. A lot of my class and I are still fighting something viral. My nightstand is still cluttered with cough medicines and tissues but I am feeling much better. Sickness always comes with stress for me.
I think it is a part of the remnants left over from when I *cough* didn’t have it all together like I do now. Cough cough. I think all medical students are generally highly motivated, Type A’s who like organized outlines, but I take it to the extreme, and I always have. If I had time to write all my notes in perfect penmanship and white-out all errors, I swear I would.
When I was twelve I had a pack of 64 gel pens and I kid you not, they had to be put back in the box in rainbow order or I would lose it. 64 PENS. Some of us med students are more lax and some of us are more like me. I was WAYYY worse in college when the workload kept piling up and didn’t give me time to hole-punch all my papers into a color-coded, divider-laden binder and neatly outline each chapter of the assigned readings. Seriously. I really do have a problem.
Its called Generalized Anxiety Disorder.
I’ve written a version of this post several times; how I would tell cyberspace that I actually do have really bad anxiety; I could talk about how terrible mental illness is or how I think mental illness rates might be highest among medical students, but the truth is, I know very little about either of those things. All I know is what I’ve experienced.
And what I know from my experience is that I’m not really a victim of mental illness. I live a normal life. Anxiety doesn’t have its grasp on me and pull me under until I can’t breathe. There was a time when I might have said that it did, but honestly, I have a very blessed life, and always have. There were always people around me that knew me and supported me and didn’t let me get too far away before I was shown some perspective. I worried all my life. When I was little, I remember worrying a lot about my family dying, awkward moments, and getting sick when I was away from my mom. Now, pretty much all I worry about comes down to one thing: “Am I good enough?” Am I good enough at school, a good enough friend, am I going to be a good enough doctor, am I a good enough aunt, am I good enough to pass boards.
For the most part, though, its under control. I have functional anxiety. Enough anxiety to keep me working hard and not enough to keep me in bed, too scared of failing to do anything. I have had those days- though not in a long, long time. I call it functional anxiety and it’s livable.  My “anxiety” habits are things that happen to me involuntarily that I didn’t know were pathologic until college. I thought they were normal. I bet a lot of my classmates do the same things because stress does some crazy things.
Functional anxiety means my lower lip will always need chapstick. I bite and peel the skin off of that lip until it bleeds. It means I peel hangnails back, not out of boredom, but because I’m so twitchy. It means I can’t get through a single exam without wiping the sweat off my forehead. It means I have to pee right before a test and then I sit down to take the test and I have to pee again. It means I get really hot and sweaty when I am uncomfortable. It means I have to walk and take deep breaths when I’m really mad. It means I cannot keep my fingernails painted because I pick the polish off as soon as I’m alone with my thoughts.
These things are concealable. Most people wouldn’t know, and don’t know, that I am physically not able to listen as they quiz each other right before the exam because I am in my own head, taking deep breaths. It’s not something that they have to be conscious and courteous of, to spare me the agony of triggering my mental illness. I like that I have to deal with it. We all have our own adversity. It just so happens that mine is diagnosable- and also manageable. It’s my functional anxiety, and I’ll survive it. Just like I always do.
 

Categories
Blogging Life Medical School

Second Verse, Same as the First

I have started my second year of medical school. I’m actually two and a half weeks in.
I’m still in the classroom, but since only years 1 and 2 are done on campus, it gives all of us MS-2’s this false sense of being “top dogs”. We’ve been showing the first years around all summer, and now we can pop backs so we think we are some hot stuff. Then the dream stops and we wake up to the nightmare reality every morning that we still actually only know very little and boards loom on the horizon like that scene in Apollo 13 where the astronauts are all walking toward the space ship dramatically. Will we all just burst into flames and never make it there?! Will we get halfway to the moon and then freeze to death?! Will we make it home to our lives and loved ones triumphantly?!
NOBODY KNOWS!
Sometimes I don’t feel like walking forward towards that spaceship. It seems like too great of a risk. Studying for the MCAT depleted my gumption reserves. It gave me mono and walking pneumonia and insomnia and anxiety and the sweats and nightmares. I always felt like crap, just completely run down for that 6 weeks or so I studied; only surviving by way of coffee and sonic drinks. Now that such conditions are normal for me as a medical student, I wonder how preparing for my tortuous first round of boards will plague me.
Okay, think happy thoughts! That test is not til next June and I am loving school for the most part. The transition back into a routine is always a little rough after a break though. Especially with the added change of living situations.
I moved out from living with my parents back in July. I live much closer to school now, with two classmates. My house turned out just the way I wanted it! (Easy to say when your dad is the contractor.) It’s cute and cozy and it felt like home right away. Though it was still hard to move out permanently- even at 23.
I think I got burned out being at the school all the time last year, so I study at my new house a lot more so far this semester. Since all of my roommates are medical students, (which I highly recommend doing!) noise is never a problem, and I get a lot done at home. Sometimes I think I live by myself, it’s so quiet!
It’s strange how my study habits change so quickly and seamlessly when I’ve been doing this school thing for so many years.
I want to do a study doing a functional MRI on medical students’ brains before first year and then after they graduate. Just to see what the heck goes on up there. I think it probably actually gains mass from sheer info and also probably starts to just fritz out on occasion during important situations especially. It would also be great to do a study on how many words we read a day or some other way to quantify the vast amounts of information that pass through in ear and out the other.
I’m also open to writing a book or piloting a TV show about the medical school experience if anyone with money or power is reading this. Its the most exciting thing I’ve ever been through, which is sort of sad because the majority of what I do is sit there. However, when asked, I bet money that YOU, Regular Joe, would like to see the process of taking a mostly kind and hardworking (but still dumb) person and turning them into a wonderful, knowledgable doctor- I think Regular Joe would want to see that. It’s got everything:
Romance-there IS dating in med school
Roller coaster of emotions- test grades, fake patients, and prostate exams, oh my!
Drama/Tension- “They said we would have 2 full hours, not 1 hour 50 minutes for this test!”
Fun/Action- med students have been known to throw a nice formal ball AND get down in sand volleyball. That’s riveting stuff!
If fishing for crabs in Alaska gets a show, medical school should have a show.
That’s all for now!
Eat, class, study, run, sleep, repeat!

Categories
Health Medicine Uncategorized

Lion Scratches

When I was 15 my legs were itchy. I couldn’t sleep. I writhed in agony, with no rash or bumps or any other symptoms. I went to my pediatrician, urgent cares when I couldn’t stand it, and even the emergency room once. No one could figure it out. I had a whole cabinet full of lotions and creams to numb and soothe. Eventually I got a referral to a dermatologist with a 2 month wait before her next appointment. When I finally saw her, she told me about another over-the-counter lotion and sent me away to come back in 2 weeks. Still no relief. When I went back she found a few goosebump sized bumps on the back of my thigh and she squeezed them until I cried to see what would come out. The best she could figure was that it was some sort of keratosis. She prescribed Triamcinolone acetonide cream- basically what I now know to be the steroid cream of choice for itchy skin. She didn’t just give me the little toothpaste sized tube either. She gave me a 1 lb. tub with two refills on it. I was instructed to rub it all over my legs and butt at night and anytime after I showered.
I followed the instructions; I got less itchy. And then it went away all together. I forgot all about the cream when I quit itching and then the itching would come back, so I used it again every night. The tubs of lotion lasted about six months and I used all of them, along with OTC CeraVe. With three tubs of triamcinolone, I did this for about 2 years. When I got to the end of my last thing of lotion, I went back to see the dermatologist. She gave me another refill and I left. Somewhere after this I started to get deep, purple striae on my legs. They were slight at first, then bigger and bigger. “Finally,” I naively thought, “I have a rash that she can see and get rid of!”
I got an appointment. She looked at my legs and frowned.
“Oh no,” she said, “I am so so sorry.”
She asked me how long I had been on triamcinolone.
“Almost three years,” I said, now age 18.
She asked me where I had been applying it, who prescribed it, how often I used it. These are all questions she should have known the answer to. She then explained to me how I slipped between the cracks for proper treatment. That steroid cream is only used to treat the symptoms for a short time and that I never should have used it that long without us searching for a solid diagnosis and treatment.
I had about six long, purple, shiny trenches on each leg.
Turns out that long term steroid use causes skin atrophy. Skin atrophy from steroids can look different on different people and even be more severe than what I have. Basically, I have skin atrophy much like what happens in stretch marks.
“I’m sorry pretty girl,” she said on my way out. “I like to keep my young girls with beautiful skin.”
I don’t know what happened. I don’t know if the refill number on my script got misread by the pharmacy. I don’t know if she was distracted and forgot to order me a follow-up appointment. Maybe my insurance wouldn’t pay for a biopsy and she forgot to revisit a solution. Maybe everything happened at once. I was ignorant and didn’t know to call and bother her office until a permanent solution was found.
I have since grown out of whatever caused me to itch, and I have never seen another doctor prescribe triamcinolone in excess. I now believe myself to have had keratosis pilaris– a relatively common and straightforward diagnosis. It doesn’t really matter what it was though. It won’t make the marks on my legs go away.
Mine is a cautionary tale of the power of medicine in both its healing and harming, and of the health care system’s shortcomings. Several things went terribly wrong in my care; placing the blame on her alone wouldn’t do anyone any good. It could be a lot worse. I still have my quality of life and no function was lost. I know others who get lost in the system aren’t always so lucky. Though there are steps the doctor could have taken to give me better care, I don’t blame her. I’ve seen her waiting room; I would forget some things too, with that many patients in a day. Having perspective from both patient and provider helps me to be more forgiving too.
The scars have since faded to a light pink, but they are still there- thin-skinned, ugly, and obvious whenever I wear shorts.
My nieces have all asked me about them at various ages. Their age doesn’t really matter because they are still too young to understand this medical mishap. Just the other day Addie asked me what happened when she was sitting in my lap. “Do you have an ow-ie?” The shock of the scars’ size was on her face, worried for me.
“It’s okay, they don’t hurt Addie. Some medicine did it to me.”
When I first got them, my older nieces asked me about them, I didn’t know how to explain it. I told them a bedtime story about how I happened upon a lion, and got scratched as I struggled to outrun and escape it. Then they started telling people their aunt got scratched by a lion.
I’ve seen articles where new mommies affectionately refer to their stretch marks as tiger stripes. Paying homage to their battle wounds from carrying a baby; owning them proudly instead of hiding them away. The scars remind them of the sacrifices they made to bring a life in this world. They will never forget why they are there. I haven’t brought any baby into the world, but my lion scratches still mean something to me. I won’t ever forget why they’re there, and though I’m still not fond of them, they remind me of how I fell between the cracks in an overworked, red-taped, short-on-time health care system- and how I, the patient, ultimately paid the price. Every time I look at them, they tell me never to let a patient of mine have the same kind of consequence in any form- cosmetic or otherwise.

Categories
Life Medical School

First Year of Medical School is Over

and it has been for about a month now. To be honest, I’ve been relaxing without any guilt of not studying, not worrying about extracurriculars, boosting my application, or even getting ready for next year like I was constantly worried about last summer when I was prepping to enter first year. It’s a good feeling. I’ve had time to reflect and reevaluate myself and recognize all the changes that have occurred.
Two weeks ago, I helped with some recruiting events for the medical school where some of my class travelled Oklahoma and taught high schoolers about some of the things you get to learn in medical school. Over and over, my classmates talked about how much we had learned in our first year. Listening to my classmates explain things in such a way that high schoolers understood, gave me a lot of pride in watching the fruits of our labors these last nine months come to life. We have successfully integrated anatomy, foundational biological sciences, and now the physiology of the systems we are going through sequentially; we are able to articulate these concepts into something high schoolers can understand.
I’ve heard it said several times now that medicine involves a lot of teaching and at first I dreaded that thought. Rarely am I able to explain things in a fluid way such that my audience understands my thought process and the little tricks in my mind that help me learn. However, once I was put in front of these students just barely encroaching into the path that is Premed, I felt like for the first time I was able to take what I learned and really present it to this audience where they might be able to take away a deeper understanding of the heart, lung, or whatever we were discussing. Simply because I really, really understood the how it all works- from a molecular level, up to cellular, tissue, organ, and the entire body system through and through. Its taken 17 years of school, but I am finally getting there.
Throughout classes, I always felt like there was too much information- how could it ever all stick? Well, some of it doesn’t. My classmates were always right there for me to ask them about my weak points  in order to figure out a good way to explain it. But for everything I didnt quite feel proficient in, there were 17 other things I could rattle off and say- with some confidence- that were just as pertinent. It was an extremely cool thing to find. This crazy, flawed, difficult system that is medical education is working. I wish I had the stats- how many pages have I read, how many words- some way to quantify what was shoved into my brain. Its astronomical, but somehow, its working.
Against all odds- fighting sleep and skipping workouts and eating junk; feeling like crap, feeling like you’re never going to make it, skipping class, studying at all hours of the day, unsustainably torturing ourselves to fill ourselves to the breaking point with information- it actually really really worked. And medicine is just as amazing as I hoped it would be, and more.
Here’s to you, first year- all your ups and downs, suffering through, and thriving with some of the most wonderful humans I’ve ever met; I’m glad you are over but sad to see you go. I am now an 18th grader!
I’ve got some posts up my sleeves for this summer; some I have been mulling over for over a year when I first started this blog! So stay tuned.
Use the contact form at the top right of the screen to request a post on certain topic, get in touch, ask questions, whatever you need! Summer is the best time for me to do it!
 

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First day of medical school! I thought it would be cute to document just like I did in kindergarten!

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Last day of medical school a bunch of us went bowling to celebrate!