the holidays are at an end…

i do apologize faithful readers (also known as rachie, maybe dave sometimes, and the random web page clicker person), but the holidays are indeed no time to blog.  at least not when my main purpose of this blog is to talk about my experiences throughout medicine, because i don’t do anything medical during that time.

however, starting yesterday (hardly), i began my jaunt on cardiothoracic surgery, henceforth deemed cts.  it was a rough start, but not because of any issues of adjustment. no, no, my friends, it was because i had the beautiful gift of the bubonic plaque compliments of z.  after one week of him pummeling my immune system, all that was left was the occasional t-cell and neutrophil dragging their metaphorical butt across the floor.  thus, the kindly virus quickly had gone to work and i woke up saturday morning with a lovely sore throat, stuffy and runny nose, headache, fatigue and malaise.  no fun.  well, on monday, i was not much better off.  in fact worse off because i was no longer enjoying the luxury of sleeping until noon but still enjoying the “luxury” of waking up every 15 minutes nauseated, tossing and turning in bed.  thus, monday was torture.  i could barely hold my upper body up during our first case of a carotid endarterectomy (  <3 true love), and i became so violently ill i had to sit on a stool until the wave of nausea passed.  the worst part was is it happened again when it was time for me to sew the neck closed.  this would all be bareable, but both events coincided with the best parts of the surgeries!  1. when you scrape the plaque from inside the artery 2. when i finally get to do something!

anyhow, my presence was so pathetic i was sent from the operating room for some much needed r and r.  so there you have it… a pitiful day 1.

diarrhea “cha cha cha”

i don’t remember what that is actually from…probably some stupid commerical from my childhood.  what marketing genius decided to add the “cha cha cha” as though any one that is about to have an explosion of poo from their behind is interested in the samba.

the point… it all starts with the fateful disposal of some very toxic taco bell in the garbage.  being the olfactory-gifted canine she is, delilah promptly sought out these grade z tacos and enjoyed them for an early breakfast, leaving her usual evidence of wrappers strewn about the living room.

fast-forward to several hours later.  dede is now running up and down the hallway as i lay in bed reading.  i had left work because of some pretty mayjah menstrual cramps – something i rarely get (and continually gloat about), so everytime i have them i whine and complain like a big ol’ baby.  so here dede is running up and down the hall doing her air-squeak thing she continually does.  i keep asking her what’s wrong in that obnoxiously high cutsey voice, and of course, she refuses to answer. 

i naturally assume she is upset because diamond and casey are nowhere to be found or that she is looking for chewkie or dom.  afterall, she was scratching at matt’s door.

fastforward – matt comes home.  “i think dede was looking for you today.. she was freaking out this afternoon”.  matt is of course flattered.  and why shouldn’t he be.  delilah is queen b here.  even casey, the only male dog, bows to her huge lipoma, her stinky left ear, and perpetual air leak.   chewkie per his usual routine heads  to his room, and finds dede was so excited to see him she left him a present…some diarrhea…in his bed.

hilarious.

uh

not “uh” but university hospitals.  here is another residency interview update:

uh

i went in thinking it would be terrible – afterall, they interview 25 people per day and have three interview days.  to me, that just screams “we don’t care about you as a person”.  i didn’t leave the interview dinner feeling like it would be any different.  the student to resident ratio was grossly out of proportion, and i was just exceedingly relieved to find one of my classmates there.   we were then able to commandeer a couch, and we had the luxury of talking until people came up to us.  the program director was exceptionally nice, giving us hugs as we left the party early – the food was meh, and the company was average (particularly some of the other candidates).

at the actually interview day, we sat through 1.4 million lectures, but then quickly proceeded to our interviews. 

1: great lady, we had a nice discussion on ethics and morality.  she gave me an honest comparison to metro. i liked her spunk and honesty.

2: residents – pretty cool, although one was a bit timid to me, she was adorable nevertheless.  this was a time my board scores were mentioned by my irritation was mollified by their questions regarding the ccc.  all is forgiven. bonded with the third year resident – he would make an awesome chief.

3. pretty cool generalist who knew the former chair of the ob dept i did my clerkship in.  pretty easy to bond with her over that.  now in retrospect can hardly think of what we talked about.  not that interesting – although this was probably more to do with her velvet tie-dye shirt more than anything.  yikes, it was mesmerizing.  (side note: mesmerizing i think came from some magical dude named mesmer – yes?)

4. the program director’s husband who i had talked to the night before – genuinely a nice guy.  we had a nice discussion about reading, which i am quite fanatical about this year.  i am itching to read something now even though i should already be sleeping.

5. prog director herself – picture this:  middle age lady, maybe early 50s, pretty, likes wearing animal prints, bright colors (esp red!).  she definitely preoccupied with people’s appearances as she commented on it throughout the day – not applicants, but on her co-workers… appropriate time to mutter “awkwaaard” under my breath.

so there you go.   i did like the day overall though.  i’ll definitely be keeping them high on my list – got a good vibe.

time flies

it’s almost frightening how quickly time has passed me by.  only 3 months ago i was panicking over submitting my common application form on eras – what if there is a typo, did i remember all of my extra curriculars, did i properly cite all of my research, etc.  not 1 week later, i was compulsively checking my e-mail and the eras website waiting to hear back from programs.  time went too quickly – i had the opportunity to start interviewing in october, but couldn’t bear the thought of starting that phase of my life.  my first interview did end up beginning in mid-november, but i was grossly unprepared compared to now… i hadn’t really wanted to start.  even now i approach most of my interviews with dread.  i hate even the thought of smiling when i don’t feel like it, or laughing at a joke i don’t think is that funny.  i hate asking questions i don’t care about regarding topics that won’t actually influence my decision to go to a residency.  so, inevitable, my disdain for these actions has led to me 1. not doing them 2. cringing when i see others doing them.

i have also become extremely cynical about the whole process.  there are three areas that are continually commented on in my application: 1. my boards scores (i guess i should have figured – they are very nice) 2. letters of recommendation 3. research.  and while these are nice, why comment on them?  i hate when i feel like they don’t even care about what i have to say, but are salivating for me to come to their program because my score on step 2 is bitchin’.  yes, bitchin’.  but ultimately, i would rather talk about my life, my hobbies, everything except medicine.  it has consumed my life for so long.

and on that same note, i still dread the progression of time.  i think about how i have spent my entire life in school and studying. what will i do when i am responsible for patients.  a real job.  people dependent on me.   no more winter and summer and spring vacations.  today is only one more reminder of those things as my month in the ed comes to a close.  

it has been a pretty entertaining month – although sometimes i am extremely bored and all i can think about is how much i want to leave.  today was not one of those days fortunately.  it was a wonderful way to end the month, especially since i was able to spend tonight’s shift working with my favorite e.d. resident.

step 2 cs

silliness.  i am sure i did just fine. 

what it entails:  12 standardized patient interviews – 15 minutes to see the patient, 10 minutes to write a note, including your assessment and plan. something like 98% of US medical grads pass it without a problem (it is pass/fail).

my only observation was the pattern of all the other students not requiring the full 15 minutes to do a complete history and focused physical exam on the patients.  the very idea of this blows my mind – as a medical student, you should have plenty of questions in your repertoire to take up 15 minutes… but these interviews didn’t just involve doing the aforementioned tasks – you also had to summarize and explain your plan… basically – it should take you 15 minutes unless it’s an unbelieveably easy case.

although i suppose it doesn’t matter.  we’ll all pass, and we’ll all be good doctors regardless of that test.   plus i am pretty sure they are not going to continue administering it next year.  stupid.  not surprised.

grace

it was not too long ago in my religious discussions with z that the topic of grace came up, and i recall inquiring into what grace really meant.  his answer was it’s when you come by something you didn’t necessarily earn, which for some time was sort of inconceiveable to me.  i was always of the mantra that everything you have you should earn…but there are somethings that we all have that we did nothing to attain. 

nothing taught me more about grace than my recent interview at allegheny.  the program director was commending me on all of my positive characteristics and traits, but specifically my intelligence.  it was a nice interview because it was a lot of compliments for me, but when he raved about my “brilliance”, it really struck me on how fortunate i have been. 

i know i have  a very blessed life, but for some reason my epiphany came right then.  how lucky to have two very intelligent parents, with the only factor limiting their going to college was 1. their lack of ambition (my father) 2. three children by age 23 (my mother).  my mother eventually went back, but i just wonder what she would have achieved if she hadn’t married so young.  how lucky for me that she did marry early, because i wouldn’t be here.  how lucky for me that i have such a supportive family that has encouraged me throughout these four years.

and that is a minor sampling of God’s grace in my life.  i pray i never forget to thank Him for all he has given me and all that continues to come my way.

interviews

i have been rather lazy when it comes to update about interviews, so here i am to update about the past four.  i need to keep on this for the rest of time so that when i need to rank, i have yet another source, especially for my earlier interviews.  i need to have something to remember them by.  so my four interviews in order of occurrence:

metrohealth/ccf

when i first went to this interview, i looked back on it more positively than i should have, but that is the problem with a first interview.  you have nothing to compare it to.  if all that mattered to me was my interaction with the residents and the program coordinator, then i would certainly consider going there.  however, the feeling i got from the attendings was completely different.  the program director asked me about the state of summa and the things that dr. f would be getting into, which i thought was inappropriate and irrelevant to my interview.  another attending told me that they came back to metrohealth for the benefits, when i asked why she came back after leaving for two years.  now i am sure that was certainly a reason, but that should not be number one.  then most of the attendings asked, “well why should we take you?”  i just felt like the attitude of the attendings toward the residents was not an environment i would want to be in.  i should note it wasn’t all bad.  there was one attending that was into medical education that i completely bonded with, and i know i would enjoy working with him.  and again, i was interviewed by a resident who i definitely enjoyed talking to.

so overall, it was meh. (which p.s. is now a word in the dictionary!)

aultman

my reception at aultman was certainly a welcoming one.  despite their statement at the dinner and throughout the day that they all get along i was a little skeptical because only 3 showed up to the dinner, 2 of which were interns.  it was a frustrating interview because you would ask the residents one simple question and all three would feel the need to provide an anecdote to answer with none of them telling you something different.  however, it was pretty clear that liked being there and were happy.  as to the attendings, they were all welcoming and kind, and i felt like i would be wanted there. the main downfall?  it’s canton.

musc

loved it, loved it, loved it.  i loved the residents, the musc students, the attendings.  it was like i was at summa – but without having to have been there for 10 weeks.  i was there for a few hours and felt comfortable.  they had some students from the north, so i know they would be willing to take students from there and it was one more way for me to bond.  i liked all of the attendings, and it was a rare occasion that they tried to pimp me on my application.  instead they tried to find out about my life outside of medicine and how i worked to maintain it.  i had very personal conversations with the attendings.  basically, there was nothing after that interview that i could say i didn’t like.  the program director was completely and utterly wonderful.  if i decide i’d like to go out of state (which is definitely a strong possibility), i will be striving to go there.  i may try and go back for a second look if i can get z to go as well.

summa

summa was…summa.  they know how i feel about them, and vice versa.  if i decide to stay in the area, i will certainly be there and loving it.  dr. f is wonderful, the residents are great overall, and i know who the chiefs will be and they are awesome.  the attendings are all incredible, and i know them well.

so right now, the two top contenders are summa and musc.  we’ll see where things go.  i will start trying to make individual posts about interviews.

black friday…

is overrated.

happy thanksgiving

i was recently asked what my favorite holiday is, and after some contemplation, i decided it was thanksgiving.  don’t get me wrong, i love christmas.  however, in my family thanksgiving is the time of year that i see most of my family all at once.  i don’t see my father’s side of the family, but i still love the time i spend.  the other downfall of my christmas experience is that i have to hop around to a million places without much time being spent with any one group.  i look forward to the time when i have a family of my own and have an excuse to spend it at one place for the entire day.

and that is what i love about thanksgiving.  because my mother doesn’t do it here, and my father only does it here, there is only one place i can be for that holiday.  this year, i joined my mother to kill two birds with one stone.  on monday i have my step cs (clinical skills) in atlanta.  why atlanta?  well because the test entails interviewing real patients, they can’t have this test every where like my other boards.  thus it is only in 6 places in the country, and atlanta is one of them.

this year was also special because steve’s family joined us.  i have always gotten along well with them, and as i get older i appreciate the change in the relationship i have with his family – certainly a positive one.  every year, one of my favorite parts of christmas was knowing on christmas eve that i would spending the evening at mike and kathy’s house.  it really is one of my favorite holiday traditions.  this year also offered my the opportunity to talk to sarah a little more than usual.  i don’t know why that hasn’t happened in the past, but i do like her very much, and i hope there are more opportunities to spend time with her.  i loved sitting at dinner next to mike and kathy last night as we talked about all of the places i’d like to go, and places i hadn’t previously considered going.

the remainder of today and tomorrow will now be spent preparing for monday, but there is little i need to do.  i have been technically been preparing for this test for the past 3 years of my life and if i can’t do it without a ton of prep, then i really shouldn’t be a doctor.

crazy awesome

yesterday i had the joy of not only viewing but also actively participating in a “laparoscopic salpingoophorectomy” which is a fancy-schmancy way of saying we’re taking out a tube and ovary.

as the surgery began, i took to my usual post between the patient’s legs to push on a tool that would suspend the uterus in air within the patient’s abdomen.  it’s an easy task, and i have never minded doing it because unlike retracting, it requires no physicial exertion and still affords the opportunity for the medical student to watch the surgery.

yesterday was different though.  as i stood there, the doctor asked if i would like to stand up at the side of the table.  flabbergasted at why this would be an option, i asked him what he would do. 

“i’ll stand there and hold the uterus up while you come down here.”

“why would you do that” – as i start to edge back from my trusty position.

“because i want you to come here for residency you twit.”

well, that was more than enough reason for me as i scurried around the table to my new post.  and there i stood.  my first task was putting in a new trocar, and i managed with no difficulty, both in making the incision and in placing the trocar.  next was helping out by grasping the appropriate structures.  it was a little strange getting used to it at first because you’re obviously watching a tv screen where everything you do is reversed, much like watching it in a mirror.  the rush was unbelieveable, and despite all the pressure and sweaty armpits, i managed to do a good job.  we finished up the case and i helped close the ports as though i were an integral part of the case. 

this is all of what i look forward to.   i will miss it, as tomorrow is my last day.

as an update – today the same doctor asked, “if i let you do an entire vaginal hysterectomy, will you promise to come here for residency”.   fortunately, he doesn’t have any lined up tomorrow so i didn’t have to answer that question.  it’s nice to feel wanted.