Abaton 2015

  

Relationships with patients have always held a special interest with me. It is quite often that I go looking for essays and poems about doctors’ experiences, to learn from them how to be a better physician and how to cope with the things we deal with every day.

Years ago, I stumbled upon a little publication in medical humanities, and I told myself that someday I’d get a piece of my writing published in it. This year marks the third year I’ve had a piece accepted and I’m still as thrilled as the first time. Des Moines University publishes Abaton annually, and I always enjoy reading the pieces they select. The current issue, in addition to the previous issues, can all be found here. 

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Rainbow

  
Internal Medicine: mostly plain black

Surgery: What’s a stethoscope?

Neurology: an even mix of different colors

Pediatrics: “I just got my new stethoscope! It’s rainbow!!” 😀

I’ve loved my first week of outpatient peds. I am, most definitely, a pediatrician at heart.

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Top 12 Posts on in-Training!

I started writing a column for in-Training.org this year called Cherrios and Stethoscopes. My first article made the #4 article on their Top 12 list for 2015! I’m so excited! I only agreed to write because I hoped that maybe my story would help someone else. I’m hoping I can continue that in 2016! 

In-Training link to article! 

Happy New Year, y’all! 

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Looking Forward

It’s that time of year again!

2015 was one heck of a year. I finished my second year of medical school, passed Step 1 of my medical boards, celebrated our daughter’s first birthday, took her on her first long family vacation, moved into a new home, started my third year of med school on the wards, and went on a birthday trip (My first time on a plane since 2005!). As phenomenal as all of that was, it wasn’t without it’s low points. We lost my father-in-law in September, and early this morning, David’s family lost another remember. As excited as I am to ring in the new year tonight, it feels a bit dampened now. However, I’m trying to remember the good times and press forward with hope.

Over the past month, I’ve been thinking about what I’d like to accomplish with this new year, knowing that by this time next year, I’ll likely be done interviewing for residency (more or less), and we’ll be making hard decisions about the first step of my career. I’ve never been good at keeping my New Year’s resolutions. The best thing I’ve ever done to stick to my resolutions is… To start before the new year. 

After my surgery rotation, I started going back to my gym (I mean, I’m paying for it anyway, right?) and I am so proud of myself for losing nearly 20lbs so far. I feel better, my pace time is already improving, and I’m already down a size in my jeans. I usually go for a run super early on my off day or late at night after the Ladybug goes to bed. I really enjoy my time for “just me” at the gym… I don’t think about school, or things I need to finish, or anything…. it’s just me and the distance racking up on the treadmill (and my iPod, to be honest). Since I’ve been able to keep at it for a few months now, I bit the bullet and finally bought a FitBit (it came in the mail today!) to help keep me on track. I’d really like to run two half-marathons this year… if I can keep this up.

Last week, I found this idea: a “7 x 2016”, a prompt for making wishes become goals instead of ‘traditional’ resolutions. I really liked that idea, so here goes mine, with a couple additions:

Learn how to.….. speak in medical Spanish. Back in high school and even college, I was pretty good in speaking Spanish with native speakers. However, it’s true that what you don’t use, you lose. I’ve bought a guide and have already conquered the first chapter. Here’s hoping for better communication with some of my future patients.

Start……. My Year of Kindness. One thing I’ve been noticing lately is a genuine lack of kindness in our community. I’ve got a few ideas on what to target for each month, and I’m really hoping this new venture is a success. More on that soon.

Stop…… Doubting myself. I do it all the time. It’s a hard habit to break, but I realize what a detriment it is to my psyche and my performance as a student, wife, and mom. There is no room for it anymore in this new year.

Travel to.….. This one is my favorite, I think. While I feel like I am overdue for a visit to somewhere outside the USA. It’s been almost 5 years since we went to the Caribbean. However, I think that adventure might still be awhile off. This year, we’re planning on a post-third year pre-Step 2 studying family vacation to Washington, DC and Virginia Beach–three new states for me and the Ladybug’s first trip to a beach. Much slower-paced than we’re used to, but that’s ok! Making memories with my family is a priority this year.

Find…. Two half-marathons to run this year. With rotations, it’s not like I can just pick which ones to do this far ahead of time, so I’m wondering if I should skip the local half-marathon in April (during my OB/GYN rotation… just watch my week of nights in L&D be the same time as the race) and plan for one in summer and another in the fall. Any suggestions for fun ones to run?

Try…… New restaurants in our area. Since there is a great probability that we just may not be living here after The Match, I’ve insisted that instead of always going to the same places (which I love, honestly), that we try some new places that are unique to the Louisville area. We’ve asked friends of ours to go with us to a new restaurant once a month. I’m really excited for this new Double-Date Night!

Be more……. Girly. Since being in med school, I quit dressing nice for class/school in general unless it was absolutely necessary. Then once I became a mom, I put myself last on the list of people to care for. I love dresses but don’t think they look right on me. Since losing so much weight, the brand-new clothes I bought for rotations in July already don’t fit me, which is a blessing and a curse. I hope to actually acquire some style this year, and maybe even keep my nails painted and try new lipstick or something.

And then two I added to make my own “9 x 2016”:

Less….. Screen time/wasted time on my phone. I wonder how much efficient I would be if I transferred all of my phone time to work time. Not that it’s bad to focus on something outside of medicine for awhile, but I find that I scroll through all the social media apps when I’m bored and spend much more time on them then I intend.

More…… Memories/Playtime with my kiddo and hubby. The Ladybug loves for momma to come home and do nothing but play until it’s her bedtime… which sometimes eats up a large amount of my study time, and sometimes makes me worry that I’m not a good medical student. However, I don’t think this is time wasted (such as when I’m on my phone). I always, always, always make sure that I tell her that I am happy to see her and that I love her as soon as I pick her up each day. I want to soak up all of this sweet toddler time as I can.

A friend of mine stuck to her resolution last year to try to bake one new pie/month. I really like that idea, and David has already volunteered for the difficult job of taste-tester! ;)

2016…. another big year for us. I am so excited to see where it leads us, and start the process of finding my first job as a doctor… Sometimes it hardly seems real.

So, friends, I leave you with this: I hope the new year brings you enough obstacles to keep you courageous, enough disappointment to keep you hungry for personal growth, and enough adventures to keep you inspired. Let the following question be your guide:

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Six Years… and Counting

In the hustle and rush of a med student’s schedule, I often don’t get to spend as much time with my friends and family as I’d like. But there’s one person in particular that I feel like I’ve put through a particularly hard ringer in the past two and a half years, and that is David.

When I first met him, he had just moved home from a job in Iowa, was living with his mother, and didn’t have a job here yet. I was particularly miserable when I met him… I felt lost. I had been through a bad breakup earlier in the year, had been rejected after months on the waitlist of my dream medical school, had left behind many friendswas working a job I wasn’t sure I even liked, and enrolled in a graduate program I wasn’t sure I fit into, all while trying to figure out what I was going to do with my life. I’d considered dropping everything I was doing to join the Peace Corps or AmeriCorps… I had the applications filled out but had not had the courage to hit “Send”.  I imagined a life of loneliness, being married to my work, and maybe someday adopting children if I still wanted them. In reality, at that time, I wasn’t even sure I wanted to meet anyone until after I got my own life figured out.

But…. he sure was handsome. And he was kind. He had a sharp wit and understood my science jokes. He had his own science jokes. When I talked about all of the trips I dreamed about taking “someday”, he was the first guy that didn’t balk at me…. but instead, added in his own. And when I rattled on and on about my dream of becoming a doctor, with one unsuccessful application cycle under my belt… he didn’t try to talk me out of it, as others had. He is always encouraging, always supporting, always pushing me to find new horizons. In the past 18 months, he’s had to deal with my insanity of becoming a mom… and endured all the silly songs I have created to make our daughter smile (sometimes, I am sure he thinks I have lost my ever-loving mind).

This year, we celebrated six years of our fairy tale. Things haven’t always been easy. There have been many obstacles that we didn’t foresee: funerals, sick family members, two more unsuccessful medical school application cycles, a successful application cycle, last-minute switch in medical schools, getting pregnant during medical school…. This year alone we’ve dealt with the stress of Step 1, moving, juggling a toddler during a long and draining surgery rotation, an unexpected funeral… In the year to come, we’ll deal with the stresses of the Matching process, together.

In these years, he is unchanged. He continues to surprise me with his thoughtfulness. He has never once told me my dreams were too big… instead, he stretches their boundaries and makes them ours.He has never once told me things were too rough. He lets me vent my frustrations when I need to. He has his own frustrations that sometimes I feel he keeps to himself because he knows I am stressed. However, this life is still pretty sweet, and I love him more each day. I never thought that this life was possible. He is a treasure, and my perfect match. I am so thankful for our  we have built together.

Very often, I remember what life was like pre-David. I remember all of the things that ran through my mind, and I remember that I didn’t like where my life was going. This all makes me realize just how lucky I am that he chose me.

David, my handsome…. I can’t promise white Christmases or always-clear skies…. But I can fuel your adventurous side, and walk those trails hand in hand. Happy anniversary, David. Six years of adventures behind us, and hopefully many more still to come.


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Rotation: Pediatric Surgery

  

Name/Location of Clinical Rotation

Pediatric Surgery at the Children’s Hospital (4 weeks)

What did I like most about this specialty?

Pediatric surgery was a lot of fun. I really liked my team. The attendings here were great, their current Fellow is outstanding, and the residents were pretty cool too, for the most part. I’m convinced that if you like your team, you’ll have a great experience.

What did I like least about this specialty?

The hours on surgery are the longest of any of our rotations this year. A normal day started at 5am or before for prerounding, then rounds at 6am and the first surgeries starting around 7:30am. On a normal day, we were told to go home around 5pm. On a call day, we’d still come in around 5am but not leave until after rounds the next day, typically 8am or later. It made for some really long days, a tired and cranky momma, and a family that missed me.

It didn’t take long to figure out that Surgery is a different kind of beast than Internal Medicine. I found that the personalities were a lot different than mine. On Pediatric Surgery, this wasn’t very evident, but it came to light later on. In general, there was a lot more crankiness on Surgery than on Internal Medicine.

What I liked least about this rotation is that I would get maybe 15min a day with patients when I prerounded, which bummed me out because I love talking to my patients and getting to know their families. I don’t count time in the OR or PACU as time spent with patients.

I was also not thrilled about the oral exam at the end of our rotation. Surgery is the only specialty that still does oral exams, and they included one in our rotation. It was intimidating and to me didn’t really seem to serve much function other than letting the students who are interested in surgery get a feel for it.

Did this clinical rotation give me a good sense of what practice in this specialty would be like?

I felt like I got a good overview of the type of workload an intern/resident is subjected to.

Did my interests, values, kills and personality fit with this specialty? If yes, how did they fit? If not, why might they not be compatible?

No. I found that I value spending more time with my patients than what was offered with Surgery. Time in the OR and PACU with patients wasn’t really what I would call quality time, so surgery is definitely last on my list of potential specialties (keeping in mind that that list is currently two specialties deep).

  
What are the possible practice settings exist for this specialty? Do any of them interest me and do I know enough about them?

I only saw academic hospital-based surgeons.

What info do I still need?

None–I think I have all I need to know to make an informed decision about this specialty.

Has my perception of this specialty changed? If yes, how?

Not really. I’d shadowed in surgery many times before and of course there was always my love of Grey’s Anatomy, but other than thinking that performing surgeries is pretty badass, that was where my perception ended and was accurate based on my feelings by the end of the rotation. I’m fine with leaving Surgery in my past.

Did my clinical rotation experience influence the likelihood of choosing this specialty?

Yes. This clinical rotation definitively put Surgery last on my list of possible specialties.

Right now, how interested am I in this specialty?

Surgery is really cool and really helpful to patients and their families, but I’m not sure that’s how I want to spend my career. I yearned for more time with patients.

What information do I still need to evaluate this specialty? Any other comments or reflections?

Cool cases: Wilms’ tumor, Pheochromocytoma, patients on ECMO; I was surprised that I didn’t get to see a single case of gastroschisis or omphalocele the entire time… even the attendings said it was weird, that usually there’d be several every week. I got to drive the laparoscope plenty of times, put in sutures, practice throwing knots, and even put staples in a kid’s head after an MVA (motor vehicle accident). And as I shared before in a local news article, there was a case of conjoined twins being separated that was AMAZING, to say the least.

Surprises: I was really surprised by how many patients we had that were adopted. It was a lot more common than I htought it would be. Also, we had several Amish patients over the course of the 4 weeks I was here, which was pretty cool too. I really liked getting to know all of these families (and my pediatrician-hopeful self loved being at the children’s hospital anyway!).

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Follow-Up Interview

images

Awhile back, my contacts at Accepted.com asked me if I’d be willing to do a follow-up interview with them since my story of starting a family during medical school resonated with so many of their readers. I’ve learned a lot in the past 18 months not only about medicine, but also about life, hope, parenthood, and how dreams change over time, so I agreed to share a bit about this life. My interview is now live and you can read it here.

*Disclosure: Awhile after completing the interview, Accepted.com did send me a Starbucks gift card as a thank you, and I wouldn’t feel right about it if I didn’t at least share that info.*

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18 Months to Go!

 

Natalie Christmas Charlestown

Guys! I am now on Christmas Break and third year is officially halfway over. How on earth did that happen so quickly?!

If there is one thing that I learned in med school so far, it’s to always be prepared. Today was no exception. My neuro classmates were mixed in with the peds, OB, FM, IM and psych classmates to talk our shelf exam today. Halfway through the shelf, the NBME (the company/organization that makes the shelf tests and Step) servers went down. Over an hour later, we were all finally allowed to finish our exams. By that time, my brain was no longer in “exam mode” and I was starving, so I have this feeling that the neuro shelf will not be my best. But there’s nothing I can do to change that now.

Afterwards, I rushed home to start baking cookies for the annual Americana Winter Festival where ULSOM has hosted a cookie decorating booth for the kids for the past several years. I made 9 dozen sugar cookies and then rushed all the way over to Americana before rushing back home to take the Ladybug on a carriage ride through a local small town to see Christmas lights and displays. Even if the morning didn’t go as planned, the day was still pretty great, and I am now so thankful for a break for two weeks to enjoy the holidays and visit family and friends. I may even get to update this blog a bit.

A friend reminded me a couple days ago that in 18 short months, we’ll be called “Doctor” and have our MDs. That, to me, is so scary! I’ve learned (and re-learned, and forgotten) so much this year already. The Ladybug just turned 18 months old, and that amount of time seemed to go by so quickly!

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Sometimes, There are Just No Words

There has been radio silence on this blog lately. I’ve tried writing this post several times and just can’t seem to do it.

Surgery was a very rough rotation for my family. It wasn’t just the change in schedules because a normal day was 5am to 5pm for me, with call days being 5am on call day through at least 8am the following morning. When I was home, I was exhausted. Part of the required assignments was completion of online video modules; on more than one occasion, I literally fell asleep on top of my laptop doing the modules. That is just the nature of this particular rotation–it was exhausting, but the majority of the time I was still having fun, even if I didn’t see myself going into surgery.

There are just some things that you can’t prepare for. My strategy for the surgery rotation was to keep my head down, work hard, be helpful, and move on. I didn’t think I wanted to go into surgery, but I was looking forward to the experience and learning a lot.

On the night of Memorial Day, David got a phone call. From his mom. Which wasn’t exactly unheard of, but this time things were different. My father-in-law was diagnosed with small cell lung cancer in July, and he was going downhill fast. After a couple of hours of panic at the sudden change in status, the ventilator was withdrawn. With the diagnosis, we knew there wouldn’t be much time, but we were not prepared for this so soon. This happened after midnight and I was due to get up at 4am to be in the hospital before 5am to see my patients. I still went into work that day, because 1) short notice 2) there was nothing I could do for my family as we were all in shock and 3) I deal with grief better when I am busy. That was the first time I have ever thought that I really didn’t want to spend time in the hospital on a particular day, so it was quite unlike me.  I did let my clerkship leadership know, and they did let me take off a day to comfort my family and help with the arrangements. The funeral was on my post-call day, so I didn’t need any extra time off for that. I am not the type that likes to ask for help, or likes to have special arrangements made, but this was one time that it was nice to have supervisors that were understanding. The situation put me into a mental funk that I still don’t think I have recovered from, on top of still having some guilt for missing a day of work–I totally felt like a slacker even after I made up the time and assignments.

The most difficult part, though, was being home. My father-in-law was a good man, and I loved him, but I’ve only known him for 6 years. It was much harder for David, and I didn’t feel like I was doing a good job of comforting him when I spent so much time away. This is why I feel medicine is a tough profession for families–the perception is that time away is weakness (especially in surgery). Many people have asked me how I balance being a mom, wife, and med student. Most of the time, it’s not too bad, because I get to do so many of the things that I love on a daily basis. However, there are plenty of instances where I feel like I have stretched myself too thin. This was one situation where I definitely felt like there just wasn’t enough of me, or enough time, to go around.

There were a few other things that happened during my surgery rotation that were beyond my control, and that are beyond the scope of this post, but I have learned from them and moved on. This particular rotation was Murphy’s Law for me… everything bad that could have happened, did happen, and happened at the worst possible time. I haven’t really felt much like writing/blogging since, especially about this topic. After several weeks, I am just now getting back to feeling like I know what I’m doing again, and with that, comes the need to write.

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Recent News from Our Children’s Hospital

This past month, I’ve been on elective in our children’s hospital. I’ve spent a week each in heme/onc, wards, PICU and currently, ID. I love this hospital! I love all of the good we can do for children–which is why I think I’ve always wanted to be a pediatrician. Then this article was released this week:
Children’s Hospital Separates Conjoined Twins

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