My First Diagnosis

…and it’s not what you think.

The memory of that day has haunted me ever since.

My grandma called on a Sunday afternoon, which used to be fairly normal. I talked to her for a few minutes, then handed the phone off to dad, since that was who grandma wanted to talk to on Sundays when she called. (I was still in high school, so yes, I lived at home.)

Once dad took the phone, I turned to mom. “Grandma has Alzheimer’s,” I said.

Mom looked at me, startled. “What did you just say?”

I told her about the conversation. In the few minutes I had been on the phone, Grandma had asked me several questions and each one she repeated multiple times, even after repeating my answer back to me.

My Grandpa had Parkinson’s, and later developed Alzheimer’s. Grandma was a retired RN, and took care of him in the home they lived in for ~50 years. He never spent a single day in a nursing home or hospital. I was quite familiar with what these issues looked like. During those few minutes on the phone with my Grandma, I knew. My blood ran cold and my stomach churned. A few years later, an actual doctor diagnosed her with Alzheimer’s (presumptively of course, since plaques and tangles can’t be confirmed until autopsy, if one is performed). We lost her tragically on Thanksgiving during my first year of grad school.

This week we’ve started our final new course, Clinical Neuroscience, and we started the week with neuropathology. Learning more about cognitive disorders has kinda freaked me out this week, and awoken some memories I guess I had repressed. I think what scares me most is wondering. I have no idea if maybe I carry the ApoE4 gene… And I do not want to know.

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Registering for Step 1

Over summer, while I was on bedrest to prevent preeclampsia, I spent some time researching how to register for Step 1 and how to build a study scheudule (mostly because I was so bored while on bedrest and had the free time). From what I found, it looked like I didn’t need to worry about that until at least November, which seemed forever away at the time.

Right before the Block 2 exam, my class got an email about how to register for the exam. Being so close to block week, I put that on the backburner. It wasn’t until a week and a half before Block 3 that I finally went through and looked at the email we got from school about how to register for it.

I was officially registered for my test date by early November. Most people don’t register so early for the exam, and it’s really not necessary to do so, but I had my reasons for wanting it done and out of the way.

Over that previous summer, we were told the date we needed to take the exam by (June 23rd or 24th) so that we have it done before third year orientation. My daughter’s birthday is in mid-June, and we wanted to have a few weeks between my Step 1 date and orientation for a family vacation. Knowing this, and knowing how many weeks I wanted to take for dedicated study time, and factoring in days off for special events (my brother’s college graduation ceremony, running my second half marathon, etc), I knew the target date that I wanted to take the exam. I also knew which testing site I wanted (the one where I took the MCAT, a very small testing center close to home). Since the testing site was really small, and since I still had plenty of funds from my loan disbursement (this test is more than $500 to take), and knowing that I HAD to have that exam over with before my daughter’s birthday, I knew I wanted to register as soon as possible.

It was actually a really easy process. I went to the NBME website, logged in, and selected my three month window of when I wanted to take the exam. I then could print off the form I needed school to sign saying that I was eligible to take the test (gotta love security measures, right?). Luckily, I still had extra copies of my last passport photo, so I could use that for the form (again, gotta love security). Then I had our academic affairs staff sign the form and add the school seal (security…). I then had the letter sent overnight mail that required a signature so I could track it, and so that I knew without a doubt that my sensitive information was received (it was only a couple of bucks, so I didn’t really care about the extra cost). When the NBME received my paperwork, I got an email saying that it would probably take 3 weeks to get my official testing permit sent to me; I needed the testing permit before I could log back in to the website and look for a testing center and select a date (the security on this exam is nuts!).

It didn’t take three weeks. I had my testing permit in less than three days. I immediately logged into the NBME site, chose my testing center, and they still had plenty of seats open on my target test date. It was so easy, and so quick to get it done by registering so early. Everyone’s situation is different, but doing things this way made it a lot less stressful, and I didn’t have to think about the registration process anymore. If there’s any advice I could give about registering for the exam, it would be to register early to get it out of the way.

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Stagnant

To say that this blog has been a bit stagnant lately is an understatement.

I know every med student blogger goes through this phase of long stretches without posting, but that doesn’t mean that I have to like it. What have I been doing since the new year? Mostly, focusing on family and doing well in classes while gearing up for Step 1 prep. But there’s plenty of other stuff too.

One of the reasons that there hasn’t been much posted here is because of how I’ve been writing for other sources. I agreed to be one of the Class of 2017 bloggers for the new ULSOM blog that I shared earlier on this post, but I also have been working on a piece of writing that was very personal. My editors at in-Training have liked my work so much that they asked me to write a column. I mulled it over for awhile and agreed. They’ve been waiting on my first post for the column since around Thanksgiving. I don’t like that I took so much time to write the first piece, but I wanted to make sure I got it absolutely perfect.

The first piece is about my experience of being pregnant while in medical school. In all of the blogs that I have followed over the years, I’ve stumbled upon some really good ones of both moms and dads in med school, but they already had kids before starting. I hadn’t found ANY that actually talked about being pregnant while being in school–so last year, I really did feel like I was isolated. So when the editors approached me about a column and I pitched my ideas to them, I was ecstatic that they thought these experiences would be valuable to others.

And so, I wrote. And wrote and wrote and wrote. Then deleted. And deleted some more. Then took a break from it all.

Pregnancy was much harder on me than I had imagined it would be. I did have a few hormonal breakdowns, usually on mornings where I was running behind to get to school on time, my clothes didn’t fit, I couldn’t even bend over to tie my shoes, I was always sick, but yet the only thing I wanted to do was study. I didn’t really feel like there was anyone I could talk to about it, either. None of my close friends understood what it was like to be pregnant and be a medical student. David tried his best to be a great husband, but he still didn’t really understand. Not every day was that horrible; in fact, there was quite a lot of excitement and joy, but the feelings of inadequacy and doubting myself took a serious psychological toll on me after awhile, especially since there really wasn’t anyone to talk to about it.

When I reflected on my experience, I realized that I didn’t want anyone else to feel the way I did. So I wrote about the truth of my experience. And I wrote and wrote and wrote some more. And I hesitated on submitting the piece for a long time, because I wanted to make sure I got it just right. Because this is important. In this day and age where there is still a glass ceiling, and there are still some who would criticize a woman physician’s right to start a family when and how she chooses during her training. I wanted to make sure that I conveyed how difficult it was to try to pursue my dream of being a mom and my dream of being a doctor simultaneously, and yet also give hope that both can be done, and can be done well. It wasn’t easy for several reasons: for the undue stress I put on myself, for being much more sick than I had ever imagined, for finding mentors, for figuring out how to budget for a baby and figure out my school schedule and daycare… the list goes on. There were many things that I wish I had known before we made the decision to start a family, but as it turned out, first year wound up being a great time to welcome a baby into our family.

So early last week, I decided enough was enough, and I needed to pull the trigger and submit the darn thing. So when I did, I left a note for the editors explaining why it took me so long. Not long thereafter, I got a very nice email from my editor saying that it was a great piece and they can’t wait to publish it, which should be sometime this week. I am so excited that they liked it already, and I’ve got the “go-ahead” to write more pieces for the column (hopefully without taking so long this time).

That piece of writing took up a good deal of my time, and the blog was neglected. I also wrote a few pieces for journals, and of course the entry for the ULSOM blog. It didn’t feel right to C&P those into this blog, so it’s been sitting and pretty much off of my radar. For now, though, I hope I can get back into the habit of sharing what medical school is like from a second year’s perspective.

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Spring Semester Commences

Hello all,

Spring semester is in full gear now, and with it, Step 1 prep mania has ensued. Our first week back to classes after winter break (which already feels like a lifetime ago), we had three days in a row of exam prep companies trying to get us to buy their products–which led to the (hopefully unintended, yet still unfortunate) phenomenon I was dreading…. white noise and seemingly mild panic. Now what I wanted to return to in the new year. But, it happened. And now a lot of what I’m hearing in passing is “DIT, Kaplan, Step 1, Boards, prep, blah blah blah…”, and it’s really, really getting old. We are +/- 5 months out from taking this exam, and the last thing we need to is start psyching ourselves out already.

But I digress.

We are now a little over a week and a half out from our Block 5 exam, and there are only 7 block exams this year (plus too “shelf” exams, which are more like cumulative, standardized exams, that we take and are must pass for Microbiology and Pathology). Basically, we are in the home stretch of being done with second year.

This is nuts.

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Of Bookstores and Past Lives

I miss the smell of a bookstore.

I haven’t been inside a bookstore since before school started in July of 2013.

This is really more devastating than it sounds, it really is.

Last night, after a wonderful dinner with my in-laws, lots of playtime for the little one, and then getting little one into bed, I didn’t know what to do with myself. Friday was our Block 5 exam, which means this is a truly “golden” weekend. So I opened a book, a book I’ve been trying to finish reading since last summer and my ‘maternity leave’. There was also a basketball game on tv… I haven’t sat down to watch a basketball game in so long. And I started thinking about bookstores and basketball and traveling, of my past life before school started.

When we used to live in Indy, I spent a lot of time in bookstores. We had a Barnes & Noble a few minutes away from where we lived, and we also had a Half Price Books. When I had my first job and was miserable, buying (and then reading/basically consuming) books was my retail therapy. Stacks and stacks of books are my remnants from that first job.

I adore stories. I always have, and always will. While I just knew that I was meant to be a doctor, I also knew that my desire for reading novels would draw the short straw once that dream commenced. There are so many days where I’d like to just curl up in my recliner with a stack of books and my favorite hot chocolate and leave medicine alone for a day. This isn’t to say that I’m ungrateful for my opportunities, just that sometimes I miss the things that make me “me”, and reading has always been a part of that.

It also didn’t help that the book I was reading was all about hiking, adventure, and work-life balance.

It’s also true that I knew ahead of time that my traveling days would be markedly reduced once school started, and then with the baby even more so. But I didn’t expect to feel so cabin-feverish so frequently. It also doesn’t help that we live in the midwest, and Louisville is particularly flat and dull. David and I have such a love for the outdoors and hiking and there is just nothing to even look at here. I’m afraid the west has turned us into mountain-snobs; if there isn’t even a treeline, it’s not really a mountain. So when I read about someone climbing the four-thousand-footer’s on the east coast when we’re used to the 10-12 thousand-footers in the west… I’m like, huh? What fun is that?

I’ve thought about doing a wilderness medicine elective during fourth year. I think that would be so cool, and get me out into the west again (bonus being that I’d be “required” for school, right?). Fourth year just sounds like fun. And it’s actually kind of scary how close it already is; we’re on the downhill slide of second year, Step 1 becomes closer every day, then we start clerkships, and then it’s fourth year and we interview for jobs and then we’re DONE. Four years of medical school in a flash. I’d be lying if I said that traveling during 4th year wasn’t one of the things I am most excited about. Having a variety of possibilities is exciting–we could literally go anywhere for residency. While we’d be leaving behind family and friends here, I think we’d both like some adventure for a few years, especially while Ladybug is young enough that she’s not in school yet. When I do have free time from school, the things that we like to do–like hike in Yellowstone or Glacier–are a good two days of driving away, just to get there.

Work-life balance in medicine can be tricky. It can be tricky in any profession, but it seems like medicine enjoys being so consuming. I love studying medicine. I love finally being able to pursue this dream of mine. But sometimes, I still want to do things that remind me of me. I miss those days where I ran the lab, taught other labs, learned new research techniques and felt like a valuable team member. Hopefully someday I will feel like a valuable team member again; I still feel like I will never know enough to be as good of a doc as some of my mentors. I would love to sit down and reread the entire Song of Ice and Fire series again–but that won’t happen for a long time. We try to read to Ladybug every day (she is currently being read The Hobbit), but I know she’d get more stories if I had more free time. Where we live, we don’t get a lot of time outdoors, especially when we’re at home–I want Ladybug to have a big backyard and lots of fun outside. Not being able to do that stuff now is disappointing, and not helped by my impatience for the days ahead. I’m supposed to be “enjoying the ride”, right?

This morning is gloomy and full of rain–it’s not helping my mood or my desire for something more. It’s strange that I’m wanting to read a book, when during the week I get so tired of reading books and notes. It’s hard not to daydream about warm weather and being outside. We haven’t even had any real snow this year, so I’ve had no excuse to pull on my hiking boots. There’s a piece of me missing, I feel.

I know this morning my thoughts are jumbled and this is probably the worst flow-of-consciousness posts I’ve ever penned. There is just something that I need that is missing from my current big picture, and I’m hoping that someday, maybe with the opportunity of moving for residency, that all of my hobbies, interests, and passions can all be indulged….

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Compilation of Summer Research Programs for Premeds

One of the highlights of my undergrad career was the summer research program I participated in after my sophomore year; this experience gave me a background in pediatric oncology drug development, established friendships, and ultimately was a great stepping stone for my previous career in biomedical research. In other words, it was invaluable.

Finding programs to apply to was a challenge. A database was not available then. It look a lot of online researching and tracking down specific universities that I was interested in. In the end, I applied to 6 programs and got my top choice. It was a paid experience, and it was also the first time I had to find housing on my own and live in a new city without knowing anyone. It was such a great experience on so many levels, and of course it looks good on your CV when you go to apply for medical school. Also, my first scientific publication came out of my work in my summer program.

The newest blog post by Accepted.com has a convenient listing of program opportunities for premeds. If you’re interested in research but don’t know how to get involved or where to start, this could be a great source of information for you!

http://blog.accepted.com/2015/01/26/pre-med-summer-undergraduate-research-programs/

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ULSOM’s New Medical Student Blog

My first entry for the University of Louisville School of Medicine student blog went live today. For anyone who would like to check out what it’s like to be a medical student at UofL, please head on over to check it out! It’s brand-spanking new and will feature contributors from all four years of training, so there’s bound to be a wide variety of experiences, backgrounds, and viewpoints presented. There may not be many entries yet, but it’s finally up and running and there should be a lot more content coming soon! If you’re wondering what it’s like to be a medical student at ULSOM, this is a great way to get insight from multiple sources!

http://ulsomstudent.wordpress.com/

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Quote of the Day

“I have to work in an underserved area for three years as a requirement for my visa. That’s not a long time. Three years is nothing. If you can do med school for four years, you can do ANYTHING for three years.”

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Back to It

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Break was wonderful–an entire 16 days of forgetting (well, not entirely) that I’m a med student and being able to relax, sleep in, see family, go to a movie, remind my husband that I love him, play nonstop with our baby girl, and overall just having a good time.

Although, there were 4-5 days that were not so great… as the stomach bug, or the “plague” as I’ve been calling it, hit all three of us and we were pretty miserable. I lost 10lbs in 2 days, and not really on purpose… although a great kick-start to my New Year’s resolutions.

Yesterday, we walked the Big Four bridge as a family, had a great lunch at our local Cheesecake Factory, took care of some friends, and totally rearranged our living space (MUCH more room–I am LOVING it!). My pantry is stocked and my freezer is full of prepped meals and prepped ingredients… everything in med school is about efficiency, so it was worth the time I took on break to get organized so I can free up time in the semester.

To welcome us back to the semester, winter decided it was actually going to show up this year. It was a brisk 18 degree F when I got to the parking garage this morning, and now I know what to bring with me to school tomorrow so I can stay warm on campus… for instance, I forgot my earmuffs and my CuddleDuds today… whoops.

Since this is spring semester of second year, I am now focusing A LOT more on Boards in June. The countdown begins, so to speak. So while the stress level may go up a lot, it’s my goal to keep spreading smiles. Happy Monday, everyone!

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Year in Review: 2014

Following the sappy trend of reflecting upon the wonderful year that was 2014, below are my responses to 50 questions about the last year and looking ahead to the next:

YOUR 2014

1. What one event, big or small, are you going to tell your grandchildren about?

This was the year we welcomed our firstborn. This is the year we will never forget.

2. If you had to describe your 2014 in 3 words, what would they be?

Studying, sleepless, blessed.

3. What new things did you discover about yourself?

That I am capable of much more than I imagined, but also that I need to scale back some things…. sure, I can kill myself through working too hard, or I can relax a bit and be much happier and much more fulfilled. I’ve discovered that I rather like the latter these days.

4. What single achievement are you most proud of?

I am really excited that my writing is seeming to take off. I’m excited to see where that trail leads. That was always a huge dream of mine, and to have an outlet like in-Training to share my work, and even have an article picked up by Student Doctor Network was a huge accomplishment.

5. What was the best news you received?

That Ladybug is healthy. 100%, perfectly healthy. Having to go through both Medical Embryology and Biochemistry/Genetics while pregnant is not the best idea… you learn absolutely every tiny thing that can possibly go wrong. It turns out that hearing about such awful things like holoprosencephaly and the mucopolysaccharidoses makes you think that it’s inevitable that your growing baby will likely have one of those horrid things.

6.What was your favourite place that you visited in 2014?

When we went on our road trip to Galveston in April so I could present my research at the UTMB conference, we side-tracked on our way home to visit, for the first time, our long-lost friends who live in Louisiana. That has to be at the top of my favorites list, since we didn’t get to travel as much as we’d hoped, and this was a bonus state and bonus layover with great friends (who selflessly gave this 8-month pregnant lady a warm, comfortable bed for a great night’s sleep).

7.Which of your personal qualities turned out to be the most helpful this year?

Hands down… perseverance.

8.Who was your number one go-to person that you could always rely on?

David is my hero when I need one, my comedian on occasion, my travel buddy, my partner in crime, my co-daydreamer… my other half.

9.Which new skills did you learn?

I learned how to really use my stethoscope, and I’ve been practicing with heart sounds. I know this sounds extremely nerdy and not very useful in the long run, but since the sounds are difficult for me to hear correctly, to me, it’s a big accomplishment to gain this skill.

I am also much, much better about keeping my mouth shut these days. It’s really hard to do around friends who are anti-vaxxers or when friends and family members ask me questions about their health, but I’m learning discretion in my remarks. I have a feeling that this will be a very valuable skill.

10.What, or who, are you most thankful for?

I can’t just say one person and do justice to anyone who has helped me through the past year. David was my hero every day of my pregnancy, and my parents help us out so much now so that I can continue to pursue my dream. Dr. H, Dr. F, Dr. B-C, Dr. T, G, A, and Dr. C were all instrumental in helping me finish my first year strong. I couldn’t have done it without all of these lovely people.

11.If someone wrote a book about your life in 2014, what kind of genre would it be? A comedy, love story, drama, film noir or something else?

It would have to be a comedy. Me, waddling everywhere for half the year. Me, sleep deprived ^1000th degree. All of my mishaps in first year and the first few weeks of Ladybug’s life. Yep, a comedy.

12.What was the most important lesson you learnt in 2014?

How much I value calm, relaxed days at home. I used to be such a busy-body. Now I value my time to relax, regroup, focus, and rejuvenate so much more. I realize that I have to make time for myself, and it’s ok to ask for help–even if I just need a morning to sleep in and have one of the “aunts” come over to babysit. Calmness, the need for less “stuff” and more memories, is something that I have appreciated even more this year, and I’m ready to start downsizing and enjoying life more than stuff and clutter and tasks. Downsizing will be good for the long run as well… looking ahead to moving for residency.

13.Which mental block(s) did you overcome?

There were several times where I thought that I couldn’t do this…. “this” being, being pregnant and a student. When I got to the point where I got overwhelmed when I was slow to get ready in the morning, couldn’t tie my own shoes, and had trouble with getting winded just walking to class, I wanted to give up. That was really tough. I’m so glad that phase is over.

14.What 5 people did you most enjoy spending time with?

Aunt Sherry and Uncle Mike; David; Ladybug; and the other Aunt Sherry. All people I either take for granted, don’t get to see often, or enjoy down-time with.

15.What was your biggest break-through moment career-wise?

When I realized that I really was made for this. Every time I get to see a patient that really sticks with me, I am so glad that I chose this path, and this path seemed to also choose me. I am always amazed by how many things there are to do with a medical degree, and I am encouraged that all the things I want to do, eventually, I will be able to with all of these skills.

16. How did your relationship to your family evolve?

It became much stronger. I am ever so amazed by the intense love my parents feel for my child, and we have grown much closer with her arrival.

17. What book or movie affected your life in a profound way?

I grew up watching the 1980’s cartoon version of The Hobbit. When I was a bit older, I read the Tolkien books. And now, the cinematic adaptations have come to an end. While they’re not dead set on the book plot, I love all of them, all 6. But seeing the last Hobbit movie, The Hobbit: Battle of the Five Armies, was harder on me than I had predicted. Now that they are over and there are no more to look forward to seeing, it feels like a bit of my childhood has died, and this makes me immensely sad.

18. What was your favourite compliment that you received this year?

That my daughter is a great baby. I know this sounds totally cliche, but it’s true. The whole time I was pregnant, I was hoping she would be a happy and healthy baby. The first 8 weeks were the hardest part about being a mom, because I’m learning how she likes things, and she’s learning to cope with being on the outside. It was really, really rough for what seemed to be a long time. But in all honesty, she’s a great baby. She hardly ever cries; she gets fussy when she’s hungry, or sleepy, or needs changed. That’s it. We’ve gone out to dinner with family and friends, and no one can believe she is already as well-behaved as she is. I prayed so hard during my pregnancy that she wouldn’t have colic and that she’d be a calm, happy baby.

19. What little things did you most enjoy during your day-to-day life?

Once Ladybug goes to bed and I can have some quiet time with David. Everything is always so busy… and I’m of the frame of mind to “quit glorifying busy-ness”. It’s nice at the end of the day to relax and remember who we are as a couple, not as parents or employees or students, but as “just us.”

20. What cool things did you create this year?

I am working on a project for Ladybug’s room: a travel map of everywhere she’s been. It’s not done yet, but I love this little project and I hope we instill a love of traveling and adventure in her as she grows up.

21. What was your most common mental state this year (e.g. excited, curious, stressed)?

Worried. Ever so worried. Worried about how I’d survive the semester pregnant… worried that what if I had to repeat the year, or needed to take a leave of absence… worried that maybe she wouldn’t be healthy…. worried about how my relationship with my husband would change… worried about how I would juggle school with being a mom… worried that I’d made the wrong decision and should have taken the year off… worried that I wouldn’t be a good wife/mom/student. Always so worried, with no need to be!

22.Was there anything you did for the very first time in your life this year?

Of all the things I could choose, I’m going with this one: observing an autopsy. Hats off to the pathologists who have a stomach for this endeavor. While I was fine with the physical work that was involved, as I learned more about the case from the coroner, the more I did NOT want to know… and I think the “knowing” about these cases, and having to testify for cases as part of my job, would wear down my soul. I firmly believe that forensic pathology is out of the question for me. I cried on the way home that day–the case was just too overwhelming.

23. What was your favourite moment spent with your friends?

Taking Ladybug to see one of my best friends for the first time. This friend likes her dogs more than she likes kids, but she took right to Ladybug and I’m pretty sure the love was mutual.

24. What major goal did you lay the foundations for?

For a long time, I’ve wanted to be a runner. Even when I was in the best shape of my life in high school running track, I was mostly a thrower–discus and shot put–and running has always been a challenge for me. I do not have the hips of a runner… but I’ve wanted to overcome that and start to actually enjoy running. While we lived in Indianapolis, I convinced (conned?) David into running a 5k with me (The Color Run), which was tons of fun, but my goal was to run a mini marathon. My dad started running several years ago, and has run 7 mini’s. If he could do it, I could too. So we trained, and we finished! That medal is something that I’m extremely proud of. But it’s not enough. Not long after, I started school, got pregnant, and couldn’t run the second mini I had already signed up for. (Dad couldn’t run it that year. So I wanted to finish it, 7 months pregnant, with a shirt I made that said “For my Dad… (and my grandpa!)” and present him with the medal. But this was not to be. At 7 months pregnant, I could barely waddle from the parking garage to campus, less than a mile.) So my goal is to run the Derby City Mini Marathon in April of 2015, with hopes to keep running after that. I’ve recently found out about the St. Jude Children’s Research Hospital mini marathon, and a series of races in the national parks that I really want to participate in, in the future.

25. Which worries turned out to be completely unnecessary?

Worries are always, always, always unnecessary.

26. What experience would you love to do all over again?

The holidays with Ladybug for the first time. Sure, she won’t remember it, but since she means so much to all of her family members, their reaction to her was my favorite thing about the holidays so far, and I’ve really relished it.

27. What was the best gift you received?

I don’t want everything to tie into having a baby, but she is definitely the greatest gift… I am also so thankful for our health, insurance, family and friends…. but if I have to pick just one gift that someone gave to me this year, I would have to say that the luggage tag that David made for me, custom with one of his photos from our roadtrip vacation to Glacier National Park, is probably my favorite.

28. How did your overall outlook on life evolve?

I have discovered what I want my long-term life to look like. It seems like so much of my life has been working toward just getting to the “next step”… high school, college, med school…. or just making it from exam to exam. Now, though, I’m learning what I want my life to look like when I am–finally–working. (I miss working.) I don’t want my child to feel neglected. I don’t want to keep my focus on the “next step” of climbing rungs on a ladder. I’m the type that is a badass at her job, uses all of my vacation days to their fullest, and strives to be happy. I don’t think I would do well in hospital administration or any type of work where climbing the ladder is expected.

29. What was the biggest problem you solved?

The biggest problem that I needed help with, especially once the semester began, was how to manage my time most effectively so I could save time, be less stressed, and make as much time as possible to spend with family. It was a learning process, and took awhile with trial and error to get down to a science… Now that we have our routine, I can study effectively when I need to focus, and once I come home I can relax and not worry.

30. What was the funniest moment of your year, one that still makes it hard not to burst out laughing when you think about it?

David made the mistake of telling me that his mind is a colander, and this has definitely came back to bite him on several occasions. This has made me burst out laughing many times, but I guess the story is only funny if you were there at the time.

31. What idea turned out to be the best decision ever?

Using my “last summer ever” as my maternity leave. I was uncertain about what this would mean for my career, but I’m glad I had that time at home to recover and focus on myself and my family instead of worrying about how a few weeks would affect my entire, decades-long career.

32. What one thing would you do differently and why?

I would not listen to the hospital staff about breastfeeding. The best advice I got came from another OB in the group practice that came to see me when mine had the day off–and he was male! I stressed out so much over breastfeeding in the beginning, something that is supposed to be natural. In the long run though, I think it’ll make me a better doctor because I know what it’s like to be in a tough situation as a brand-spanking-new mom with a brand-spanking new baby who are both learning how to fill those new roles. And, note to self: if I’m ever in a private practice pediatrician’s office, hire a full-time lactation consultant, and don’t rely on nurses for such services.

33. What do you deserve a pat on the back for?

Continuing with M2 without taking time off. I’ve wondered if I made the right decision many times, but pursuing this so I can graduate on time and move on with life has been a great decision for us, even though it has been much, much more difficult than I had imagined.

34. What activities made you lose track of time?

Showing Ladybug the world… reading to her, watching her learn and play. She’s such a smart baby already, and curious about everything. The days of breaks go by so quickly now that we have her.

35. What did you think about more than anything else?

Vacations and trips. I have had intense travel fever for about a year. When I was working full time, I could go about three months before I needed a trip somewhere to clear my head–even if it was only an extended weekend. I tend to feel better about myself and am able to focus better if I have had a trip somewhere new.

36. What topics did you most enjoy learning about?

Over the past several years, I’ve started following blogs written by medical students all over the world: Canada, South Africa, the UK, Australia, the Philippines, etc. I love learning about all styles of healthcare and medical education. What I find to be endearing is that even though the countries are different, the systems are different and the curricula vary dramatically, is that we are all going through a lot of the same things as we grow as physicians-in-training. It’s nice to see other students’ lives and how we manage all of the stress, the unknowns, and life outside of medicine.

37.What new habits did you cultivate?

I am not an optimist by nature. I tend to always think about worse-case-scenario first… and my lifelong motto has been “always be prepared.” So this year I have made a conscious effort to be an encourager. This academic year is stressful by nature, with the constant reminder that Step 1 is just around the corner. I don’t like seeing people so overly stressed when we are already pushed to our limits. Simple things, such as a smile or a hello or a complement, can really turn someone’s day around. I try to do that for everyone, every day. It’s made a difference in me as well; I’m not nearly as pessimistic as I have been in the past.

38.What advice would you give your early-2014 self if you could)?

I would tell myself not to worry so much. Lord knows I worried way too much about how things would turn out with having the baby and then going back to school. It all has worked out far better than we imagined.

39. Did any parts of your self or your life do a complete 180 this year?

The things that I worry about, and even worrying itself. There are some things that I used to care a lot about that now, I simply don’t have the time for, and letting them go has made me a lot more stress-free.

40. What or who had the biggest positive impact on your life this year?

Dr. T has played a huge role in my school life, and she’s been a key player in formulating what I want my future career to look like. She also has a family, so she is a great mentor.  I hope I can adopt her outlook on life. I have never, ever seen anything but a smile on her face. Her husband is actually in the first year class this year, so she understands a lot about what is going on in the lives of students.

YOUR 2015

41.What do you want the overarching theme for your 2015 to be?

Learning/Leading/Random Acts of Kindness

42.What do you want to see, discover, explore?

I am dying to get back to the mountains. Being in nature and not thinking about school or work does a wonder for my mind. I can’t wait to go back.

43.Who do you want to spend more time with in 2015?

My baby girl. I love her so much. She is growing so quickly and let me tell you, this kiddo is already so smart. I cannot wait to take her to the Smoky Mountains for her first birthday, to teach her all about hiking and exploring. I can’t wait to see how much she continues to grow and learn from now til then.

44.What skills do you want to learn, improve or master?

I still want to learn medical Spanish so I can optimize my time with patients. I’d still like to get better with suturing. I really, really hope that I can work my way up to being an avid runner. I want to be a great mom. I hope I grow in Christ, and love my husband well. I want to get back into yoga again, and improve my own health overall. I hope to start reading more for fun instead of just studying or avoiding fun reading. Improving my SOAP notes and clinical knowledge and experience are always high on my list.

45.Which personal quality do you want to develop or strengthen?

I want to continue to strengthen my generosity. Since moving home, I’ve had less opportunity to serve the homeless in my community like I did in Indianapolis.

46.What do you want your everyday life to be like?

Happier. Sure we’re more stressed because Step 1 is approaching, but there is no reason we shouldn’t still be having fun while in the preclinical portion of our medical education, the very last year that we’ll ever be in a classroom.

47.Which habits do you want to change, cultivate or get rid of?

My laziness. I’ve been so lazy this year. The habits that I cultivated while pregnant (take it easy!) have persisted and I’m working on getting back to the before-pregnancy mindset and being more active.

48.What do you want to achieve career-wise?

  1. Get a great score on the USMLE Step 1 so that when it comes time to Match, I don’t go without a job, and hopefully we wind up somewhere that all 3 of us love.
  2. Solidify my global health research project.
  3. Spend more time in the NICU–I really miss those tiny babies. I have much to learn from them.

49. How do you want to remember the year 2015 when you look back on it 10/20/50 years from now?

It is my hope that 2015 will be the year I gain more confidence in my clinical skills, and sets me up well for my first job, residency after graduation.

50.What is your number one goal for 2015?

KILL STEP 1. This “silly summer quiz” has taken over so much of my life and my friends’ lives, and it has such a huge influence on what we can do for our careers and where we can train, that I cannot wait to get it over with… and hopefully have a score that reflects competence, hard work, and dedication.

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