The Correct Answers

“Have you ever seen….. ?”  NO

“Do you want to see…. / Do you want to do….” YES

Just do it! You’ll get to do and learn so much more if you stay open to all options. Even if you’re tired. Even if you’re bored. Even if you’ve seen/done whatever it is already. Even if it’s the end of a call day. 

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Full Disclosure

I love being a mom in med school. It’s not easy. Lots of people have told me that they are proud of me for making all of these facets of my life work together so smoothly. But that’s not always the case…. far from it. So here’s my full disclosure.

Yesterday, our little Ladybug got sick at daycare. Kids get sick, not a big deal, right?

Since third year has started, I’ve had a really hard time balancing working + studying + “me” time + husband time + baby time + family time….. a really hard time. I’m behind in studying. I’m behind in UWorld questions. We still aren’t fully unpacked yet. I have a mountain of stuff to donate/sell/trash since we are downsizing (basically because I don’t want to move all of this stuff again when we move for residency). And no energy to do any of those things once I get home. It doesn’t help that we won’t have wifi until this coming weekend–and I wasn’t going to watch a 3 hour Tegrity over how to work AllScripts over my phone’s hotspot. All of these things have been weighing on me, even if I haven’t really been thinking about it.

Yesterday after getting out of my rotation, I really wanted to knock out some work and catch up a bit. So naturally, the Ladybug got sick. When we got home, we cuddled on the couch. And we watched Despicable Me 2 for the millionth time (it’s her favorite movie… she adores the Minions). My plans were derailed, I was disappointed that I couldn’t get much done, but everything was just fine.

Today we also had clinic after seeing our inpatients, so I got home a lot later than I usually have so far into this rotation. The Ladybug is still having belly issues so she is taking a nap. My first thought: I should study! My second thought: I could take a nap! My third thought: I could veg out and watch a movie and do whatever I want to do!

What really happens? A mix of things. Last night I held her while the movie played, and I read a few cases out of Case Files: Internal Medicine. Once she finally went to sleep, I spent the night in her room on the inflatable bed (not my favorite way to sleep, but she needed me and I wanted to be close)–I had no more energy to study, and I could barely keep my eyes open. We ran late this morning getting to daycare but I still managed to preround and be prepared for work rounds with my attending (who forgot to tell me we also had clinic this afternoon). She had a good day at daycare, didn’t eat much, and fell asleep on the way home.

Now, I am using my ten minutes of “me” time to write this blog post while I eat dinner. I hope to get a few cases knocked out before Ladybug’s nap is over, because I know she will want more cuddle time (totally fine by me!). I feel like a bad student because I am so far behind in my goals for studying and knocking out cases, but my daughter needed me and of course I was going to be there for her.

There are a lot of times where I feel like I’m not good at anything…. that I’m not a good mom, a good wife, med student, etc. It probably happens at least once a day. I still have not prepped freezer meals so I can enjoy family time when I get home. I still have yet to make it to the gym this week. Last year, I was almost sick over whether or not I should take a leave of absence for the first year of my daughter’s life because I didn’t think I could handle everything, all at once, and still be functional and sane. Personally, I feel like I would be a happier, better person/friend/wife/mom if I could get a 5 minute neck and foot rub every day. However, I am so glad that I didn’t postpone my education for a year, and I am ever so thankful that we decided to try for a family three years before we had originally thought. She’s made life so much fuller and richer in ways I had never expected–I really thought that when people told me how much babies change your life was just a bunch of blah, blah, blah…. but they were right. It isn’t always rosy, but most of the time it is pretty fun. I doubt myself all of the time. I don’t have my life put in order, not at all. But it’s a pretty happy life, even if I am behind in studying.

My ten minutes are up…. Back to working cases.

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What Motherhood in Med School is Really Like 

When you’ve had a great day on the wards, and leave feeling inspired and motivated to knock out a bunch of work when you get home….

… to arrive at daycare just in time to see three children, including your own, projectile vomit all over the place.

It’s going to be a long night. 

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We’ve Moved!

so in the midst of studying for Boards, gearing up for third year, and leaving on vacation… We found a new place to live. The old place, despite it’s convenient location, was getting smaller by the day with a mobile toddler and didn’t have any room outside for her to run. So we found a place a few miles away that was nearly twice the square footage for less rent, and sat on 4 acres in the country with a gorgeous view of the hills at sunset. So we were sold. We moved over the weekend between orientation and my first day on the wards. It’s been an adjustment but I really like it so far! Even with the longer drive to daycare, it takes no time to get from home to the hospitals. 

The past two weeks have been really rainy, and early this morning we were walloped by a pretty nasty storm. Our backyard was transformed into lakefront property fairly quickly. 

  
All in all, I’m loving the new place and we plan on staying til I graduate & (hopefully!) we get to move again to someplace awesome.

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It Can’t Be Found in These Pages

In the first week of M3, I have already learned that this year will be MUCH different than the previous two years of medical school. At the end of each rotation we take a “shelf” exam over common topics in that rotation, so while we might not be sitting in a classroom, we do still need to read and study.

When a patient comes in, I go take a history and physical, report to the team, and write a note. THIS is why I came to medical school! I am loving third year so far! 

However, what has become blatantly obvious in the past few days is that no book or lecture can teach compassion, empathy, or the right words for a suffering family. That comes strictly from spending time with your patients.  There is SO much to learn this year.

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Autopsy

(Don’t worry, no graphic descriptions or pictures, just details about the procedure.)

For our pathology class, we had to attend an autopsy at the coroner’s office. I was really not looking forward to this assignment; I had a hard enough time with Gross Anatomy lab and the Fresh Tissue lab during first year (and to be honest, just thinking about it makes me nauseated, because I remember having morning sickness while having to go to those labs… yuck!). So I, along with some friends, scheduled our date to go early in the year to get the assignment out of the way since second year is so busy.

We arrived at the Office of the Chief Medical Examiner bright and early at 7:30. We signed in and donned our gear, gowns, gloves, masks, bouffants, and booties, while we waited to be called into the autopsy room. While we were getting ready, the pathologists were setting up and taking pictures of the body. It’s important to document any lesions, bruising, or anything else that may be of importance later, especially if there’s a chance the pathologists will need to testify in court if need be.

When we were called in, I noticed that the room was really cold, and it didn’t smell anything like the anatomy labs we’d had before, not even the fresh tissue labs. It looked a lot like the autopsy room on Dr. G, Medical Examiner (so, no surprise there). The body was on the autopsy table in the supine (or anatomical) position.

The pathologists follow a systematic approach. We observed how they opened the body and examined the internal organs, taking them out one by one, weighing them, and placing them on the table for the attending. The most senior member of the team was standing on a platform at the foot of the table, on a raised stand, that had a flat top to work on. She would take an organ, like the heart, and make consecutive linear cuts with her scalpel through the muscle and along the coronary arteries. (I heard the residents call it “breadloafing”.) This way, she can see if there are any lesions and if so, how it changes or how extensive it is through the tissue. (We could actually see plaque buildup in the coronary arteries of this particular heart.) pieces of tissues were saved to go to the pathology lab, and notes were taken about damaged organs or any other findings. 

I have always thought surgery was awesome because you can open someone up, fix a problem, and restore them. I think what jarred me so much about anatomy lab was that we couldn’t restore the person’s structures. Autopsies, for me, are nearly the same–it still doesn’t appeal to me because there is no way to restore, although pathologists do provide a valuable service to patients and families.

I think it would have been fine if the coroner wouldn’t have shared the details of the case with us. The more he spoke, the more I didn’t want to know. The case was complicated and heartbreaking, and I wound up crying on the drive home. I’ve thought about that case many times since then, and it still breaks my heart.

What I was surprised by most is that this was yet another version of death that felt different than any of the others I had experienced. Being with a patient when they die, attending a funeral, dissecting in anatomy lab, observing an autopsy… each has had its own, different effects on me. I’m fairly confident that I can forego pathology (or at least forensic) off of my specialty list.

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On the Road Again

With Step 1 behind me and the first birthday celebrated with family and friends, it was time for another adventure. 

It wasn’t necessarily planned to be a great adventure like our previous trips to Yellowstone National Park or the Grand Canyon, but it was planned to be special for another reason: we were taking the sweet Ladybug to Asheville, North Carolina (where David proposed 5 years ago on the Biltmore Estate) and Gatlinburg, Tennessee (where we spent a few days after the wedding 4 years ago, since our original honeymoon plans were scrapped due to moving and immediately starting new jobs) for hiking and to visit the Ripley’s aquarium. The Ladybug got to add a 6th state to her list, and even though we’d been there before, we got to try some new things too.

It may not have been the mountains I was really longing for, but they have soothed my soul anyway. 

So instead of boring you with more words, here are some pictures from the first part of our trip, since I am currently the copilot as we push on to TN today:

   
                       

  

   

   

   

   

   

  

  

   

  

  

  

  

  

  

  

  

  

  

  

         

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To the Mom at the Pool

To the mom at the pool today in the bikini, with the rounded yet sagging stomach and faded stretch marks… I commend you for being far braver than I am in my postpartum body that I refuse to accept so comfortably. 

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A Chance to Breathe

It’s over.

Over, over, over.

Friday was the big day. The day itself went fairly smoothly. I used all of the allotted time, I used my breaks to completely de-stress and start fresh for the next blocks of questions. At the end, though, I had no clue how to feel about the exam as a whole. There were a good amount of questions that were easy (what’s the diagnosis based on this picture) and then there were a good amount that seemed to come out of left field and I had no clue. I took several practice exams in the weeks leading up to the exam, and my ‘scores’ on those tests were around my goal score…. but I felt like those NBME exams were SO MUCH EASIER than the real thing. All I can think now is that I just really, really want to pass, and even if worse comes to worst my score is lower than I hope then I’ll just deal with it and work on crafting my CV and residency application to show off my better strengths… I just never want to have to take Step 1 again.

I don’t mind having to take a comprehensive exam after finishing half of my medical school education. What I haven’t liked, however, is the undo stress that has been building up all year on me and my classmates and friends. Even though there are other Step exams before we can become licensed, this one carries the most weight and is what everyone stresses out so much over. When you take a bunch of Type A perfectionists, make everything a competition, pair it with insane educational debt, and then hinge our future careers on a single 8-hour exam… it’s a pressure-cooker. It is unpleasant.

Thank God it is over.

People were talking afterward about crying in their cars. I don’t know if it was metaphorically, because it was such a difficult exam, or if it was a stress-release mechanism. But once it was over, I didn’t cry. I didn’t feel like I had been hit by a bus (but I probably looked like it). All I could say on the way home was, “…. I hope I passed. ….”

Studying for Step 1 has been controlled by Murphy and his Law, if you know what I mean. Everything that could have happened did happen. On Monday, as I’m starting to get panicked about my upcoming exam and I am reviewing the highest-yield topics just one more time to have it solidly memorized, I get a call from daycare at 8:30am… the Ladybug was breaking out into a rash over her entire body. Which meant she couldn’t stay at daycare until it went away–meaning that I had to find a babysitter for the last few days before my exam, or submit myself to not studying for the entire four days before Boards. I was panicked, but it all worked out. David took off work, my mom took off a day of work, my mother-in-law came to visit, and my brother babysat the day of my exam. This was the second time Ladybug got sick in the 7 weeks I took to study for the exam. I took a bit longer than was recommended (most people say 5-6 weeks maximum), but I knew I would lose a few days here and there for unforeseen reasons. I was also sick with a bad case of sinusitis. And then there was the accident right around the time school let out. So it was actually rather funny to call my weeks of study time “dedicated” study time.

But, it’s over. I found out if I passed/what my score is sometime next month. Murphy and his Law couldn’t stop June 5th from coming (and I refused to change my test date), and now that day has come and gone and I get a few days of “summer vacation” until I have to report for third year orientation.

Did you see that? Third year orientation. Is this real life? How is it that I am now ready to be set loose on the wards?

In speaking of which… I got my first rotation schedule the week before the exam. I can’t remember if I wrote that in the last post or not, but it’s true–I have a tentative schedule for my first rotation of third year. My first rotation is Internal Medicine, which is split into a month of wards and a month of two specialties. I start out with the specialties–two weeks of Cardiology at the VA and two weeks of Infectious Disease at the VA. Then a month of ward work at University. I am so excited! Real patients to learn from, and real H&Ps and SOAP notes to write. As much as I always wanted to study the medical textbooks before I came to medical school, the real reason I came to medical school was to be trained to take care of real patients. It’s about time!

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One Week to Go!

I take Step 1 in one week. In all honesty, I will be so thankful to have it over with. Seven weeks in study isolation with my falling-apart copy of First Aid (minus my time spent on DIT videos… that’s social interaction, right?) have nearly driven me mad. Especially when we have had some gorgeous weather (so I’ve been told…) and I haven’t left my study area in that timeframe. When I do get a quick chance to run to the store, I feel like I don’t know how to interact with society….

I did take one day to get all of my paperwork done for the VA (I was hoping that my old VA paperwork would transfer from Indianapolis to Louisville, but I was out of luck there and had to redo all of it), even though I didn’t know if I would even be spending any time there on rotations, not having our schedules yet…. which turned out to be a good thing, because this week I got a very short list of my schedule for my first rotation! I will be starting my Internal Medicine rotation at the VA, two weeks on Cardiology and two weeks Infectious Disease! Those were my top choices for the elective month of my Internal Medicine rotation, so I’m pretty excited. The second month of my IM rotation is at University Hospital where I’ll be on wards (I’m not even 100% sure what that means). My first rotation starts one month from today! I’m really hoping for great experiences on this first rotation as a third year medical student, as I figure out how medicine works in a real setting, all day every day. How is it possible that my first two years went by so quickly?!

So that is a quick update from me. One week til Step 1, one week and two days until we celebrate a special girl’s first birthday, and less than 3 weeks until we take our longest family vacation ever. I cannot even tell you how excited I am that this is almost over and I get to spend some time with my family in the mountains again.

Back to studying. #CrunchTime #FinalPush #JustKeepSwimming

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