Long Time No See

The last time I posted, I had just found out that I matched into one of the programs on my Rank Order List for a residency in pediatrics, accomplishing a goal I’ve had since I was 14.


It has been such a long time since then, and I haven’t written about it. After Match Day, there was so much to do, and it felt like we had no time. It all went by so quickly.

We immediately went on the hunt for a house. On one Saturday, we toured 19 properties, put in an offer, and bought our first home.


My brother got married with my Ladybug as the flower girl:


I finished my final med school rotation in the NICU, which I absolutely loved.


We had to find a new daycare and it completely broke my heart to leave the one we’d used since the Ladybug was 8 weeks old.

I GRADUATED!


We took a family vacation to Key West, FL, Dry Tortugas National Park, and Savannah, GA.


We spent two weekends painting the house and moving in, with the help of the best family and friends.

Then the fun started. Mountains of paperwork and training and licensing and certifications before even starting orientation.

And now they call me Doctor. Paging Dr. Allie. It is real, and no longer a fantasy or far off in the future. It doesn’t feel like it at all. I’m currently on my second rotation, which means I have “survived” July of intern year, but not without rubbing one of the children’s hospital’s ladybugs for luck on my first day.

129 Days


Today I was reminded that even though I’ve learned so much in med school, there is still SO MUCH I don’t know and need to learn, practice and repeat. The answers don’t always come from textbooks. I am so thankful that as an intern, there will still be several layers of supervision as I learn to navigate the responsibility of making medical decisions. 129 days! Tonight’s agenda, though, is learning about QI & peds EKGs as well as reviewing some articles & brushing up on sedation meds. (And NO, I’m not hardcore studying for Step 3 yet, but I ALWAYS keep reading material & a To Do list on me!)

On a separate note, my ROL (rank order list, the list of my preferred residency programs in the order of my preference) is certified and will be locked in tomorrow night at 9pm. Match Day is LESS THAN A MONTH AWAY and I am so excited. I just want to KNOW already. I’m itching to start the house hunting, moving, moving on with my life, etc!

Rotation: Psychiatry


Psych wasn’t a bad rotation… I got out early a few times, including the day of the daycare Family Fun Night where we were the first to play in the bubbles! 

Name/Location of Clinical Rotation

Child Psych inpatient with Child Psych clinic, Addiction Clinic and Bipolar Clinic, with two Emergency Psych Services shifts

What did I like most about this specialty?

I learned a lot on this specialty about all of the services that we could offer that didn’t necessarily restrict the patient to the inpatient setting. We had a large variety of clinic settings, inpatient, outpatient, and emergency psych services. For child psych, we had an inpatient unit that included school sessions for elementary students and junior high/high school students. There were also group activities and art and music therapies. It was pretty interesting to see those sorts of things in the hospital setting. We even had federal services available for girls who we thought might be trafficked.

What did I like least about this specialty?

I came across a lot of patients that were violent. I knew it was a possibility with this service, but I didn’t expect it to be so frequent. This was the first time I’ve ever been threatened, so that was fun. 

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

I believe so. We got a very broad view of the different types of psychological illnesses and a variety of practice subspecialties and clinic settings.

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?

I really like finding community services that benefit patients, and I honestly think this specialty had the most available services out in the community. That being said, I really don’t think this type of practice suits me very much. Psychological issues are usually fraught with social issues as well, and it is so hard to treat not only the illness per se, but also the home environment and lots of other issues. If the home environment is the root cause, and then you send them back to the same environment, what are the odds of them getting better? 

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

Inpatient, outpatient, and a mix of both. It was pretty interesting to see so many different practice types, including the Emergency Psych service at our adult university hospital.

What info do I still need?

None–this was a very enlightening rotation.

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

I learned so much about this specialty that I didn’t know beforehand. I didn’t really think that psych would be a good fit for me, and even with being selected for the pediatric version of psych, it wasn’t a good fit. I really admire the people that go into psych and especially child psych. In the child psych unit, I heard some of the most disturbing, horrifying, unbelievable stories I’ve ever heard in my life. 

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

It cemented for me that this is not my future specialty although I do find the resources to be very valuable for pediatric patients that I will definitely use in the future.

Right now, how interested am I in this specialty?

Pretty far down the list.

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

There are a bunch of patients that I met on this rotation that have shaped how I practice with other patients. That has been very valuable and formative for me.

Life These Days

Here is just a glimpse of what 4th year has looked like for me since late August/early September:

Please pardon the language on this picture, but I laughed at it because I recently completed a two-week EKG interpretation course and my ACLS training! Lets just hope that I don’t forget everything I learned in that elective because it was fun and useful but now I won’t see it again for a while.

There has been much more free time in fourth year, and you can bet that I am taking full advantage of it. The Ladybug and I hit the local parks for fun as often as I can muster with rotations, studying, ERAS-app production, etc.

I had my ACLS training early in the year, around the time that our ERAS applications were due. I wanted to get it out of the way before interview season started. This was a fun 2 day course with hands-on training (And I passed! Always a relief!); even though the EM residents running it told me they were sorry that I’d have to take it again–Pediatrics has a separate ACLS-style training course that I’ll take in the spring summer, either on my own or in coordination with my residency program.

Downsizing. Since we’re moving next year (either away to a new city/state or even just into a house if I match into our home program), I do NOT want to move all of this stuff, yet again. So we are downsizing and minimizing, which included our movie collection. I took a ton of books and movies to Half Price Books, and the movies that we did keep we transferred to a DVD case and threw away all of these cases. SO MUCH MORE SPACE!! I am so, so pleased with getting rid of all of that.

On the first day of Step 2 studying way back in July, I found the back of my earring caught in my hair but the actual earring itself was nowhere to be found. I panicked. These earring were a wedding anniversary gift from my grandma’s late husband, given to me on my wedding day. I not only wore them the day I got married, but also for every medical school interview, the day I got my first med school acceptance, every day of gross anatomy, the day I learned I was expecting, the day we learned she was the Ladybug, the day we met her and brought her home, the day I took Step 1… So they were beyond special to me. I love you Jed everywhere and retraced every step I had taken that morning. I had been to daycare, the gym, and all over campus. It was nowhere to be found. I have ugly-cried so many times since then, and I couldn’t bear to tell my grandma. I even had the thought of someday taking the remaining earring to a jeweler and having a replica pair made. It has been over 11 weeks since this happened, and I had given up all hope of finding it, took Step 2 without them, and put the remaining one safely in a jewelry box. One night this past week, the Ladybug was fighting sleep and crystal nf for a certain bedtime toy. I looked under her bed and GUESS WHAT I FOUND! How many times have I walked right by it without noticing it?! How many times have I swept that carpet and yet, there it was! I am so relieved! (And I never had to tell grandma that I lost it!)

I also passed Step 2 CK (total relief, I can never tell how I performed on those things) and updated my ERAS application before the September 15th deadline/release date. Now I only have Step 2 CS (the in-person part where we take care of a dozen standardized patients in the course of a day) and then I am totally done with exams (minus the AI, acting internship, elective shelf exam that I take in late October) until after I graduate and get my MD!

Minimalism and the Weight of Stuff

We have now been in the new apartment for a year. We moved because we needed more space with the baby starting to walk (and getting into literally everything), plus there was no room whatsoever outside in a yard that we could take her to play. There was also an incident with the upstairs neighbor’s water heater flooding our place and leaving behind mold–which they tried to cover up with a thin layer of white paint over half of it… and then their new water heater leaked, and we got another dose of mold. No thank you. So we were looking for a new place, a place with more square footage for the baby to roam with a yard or outside space. Bonus if it was in the country and quiet.

Then we found the new place: nearly double the square footage, huge windows, high ceilings, in the country on 4 acres and a grand total of six apartments in the building so it’s super quiet. It also affords us sunsets like this:


However, there was one thing that I didn’t like about having to move: hauling all the crap from one place to another. I didn’t realize just how much stuff we had accumulated. Frankly, I was embarrassed by how much stuff we had to move, and all the boxes and the stuff that just kept coming. By having the baby we gained a third person to our happy home and all of the stuff that comes with adding a third person to our family… but it was still way too much, and it just kept coming. Babies have a way of making anyone and everyone super generous, which can be nice, but can also add up quickly.

So here we have been, in this new spacious apartment… and it’s got two closets. Not even a coat closet. So lots of stuff got pushed into the closet space we did have.

And then came the third year of medical school with work hours and patient logs and call days with 30+ hour shifts on top of studying and assignments. I kept thinking that I needed to “go through stuff”when I finally got a day off or on post-call. Well…. guess what. When I did get time off, the last thing I wanted to do was go through stuff and sort out piles of trash, donate, sell, or return to owner. Ever so slowly, those piles did form and items started to disappear. The problem was, there was still…. stuff. Everywhere.

I kept having thoughts roll around in my mind about how to best get rid of the excess we had accumulated. Little by little those same piles started to reform. If I did find myself with some free time and if something was bugging me, I’d settle into a heated, angry, cleaning frenzy (hello cluttered sink that drove me nuts for months…).

In November I came up with an idea for a donation project. I worked through my school to set up a donation drive for the local refugee center, which was a huge hit! We wound up taking over 13 carloads of household goods to the local centers. So not only did we do some good for the local community, but I also got to donate a ton of men’s, women’s and children’s clothing that needed to find a good home.


And even then… we still had excess. And it was driving me nuts. How on earth did just three people accumulate so much stuff? We’re not hoarders by any means, but my goodness, there is just stuff everywhere. When I helped with the dropoffs for the donation drive, I can’t even begin to tell you how much of a relief it was to give away bags and bags worth of stuff that could find new life in a new home. I felt a huge weight lifted from my shoulders, and a lot of the stuff I dropped off was NOT mine/ours.

I had no idea just how much mental weight all of that stuff was putting onto me.

Months later, my husband preordered us tickets to a limited-screening documentary held here in town: Minimalism: A Documentary about the Important Things. That is the kind of people we are: we preorder tickets to documentaries. I was so happy he did this–not only because it meant a weeknight date night after a busy clinic day, but also because sometimes my husband just gets me, and it feeds my soul.

I gotta say, I love this documentary. What Joshua and Ryan say is simple and clean, and made so much sense to me. Stuff and consumerism isn’t what makes us happy. How much of the stuff that we have we bought or kept because we thought we had to, or we thought that it held the memories or was the source of our happiness? And it was then that I realized that…. it wasn’t.

Let me tell you about the stuff that I have that is weighing me down. I still have clothes in my closet from high school, back when I was a muscular, slender athlete with big dreams for what was to come. Add in the grad school weight, the married life happy weight, the baby weight… I have a closet full of clothes that I am keeping for the day when I slim down and I hope my old favorites can fit again. It’s massive. My favorite jeans, shirts, even a couple dresses. The thought of letting most of it go makes me uneasy. My closet is full of stuff that I cannot wear. But… having seen the documentary, and having thought about it for months while I finish up the third year of medical school, the time had come to clean it all out.

The closet was actually one of the last things to be tackled. First was the bookshelves. I love my books. I still have some old textbooks from college, but over the years I have been so happy to use the Amazon Trade-In program to give back some of my textbooks in exchange for funds for the next batch of books I need for school (thank goodness I am entering the last year of school and the textbooks will slow down–maybe–for a bit). Books that I didn’t want/need anymore that Amazon wouldn’t take were donated to libraries or children’s programs. Also, when I’ve been published, the publisher sends me multiple copies of the journal. Do I really need four copies of the exact same issue of the journal?? No. Away they went.


Then we tackled the movie collection. When we got married, we had so many duplicate movies. I thought we had gone through them all and found the duplicates, but I found a few more. Then there was a pile that we haven’t watched since the first viewing. Out they went. Then went (some) of the movies that are unopened (like the entire Saturday Night Live collection still pristine, wrapped in plastic).

The next thing we tackled: all the old paperwork we have kept for a rainy day or just in case. I went through it all and majorly cleaned out all that paper clutter, shredding what needed to be shredded and recycling what I could. Then out went the magazines, after one more time of reading them. Bye bye, paper clutter.

One more thing we found: at my favorite local coffee shop, there was an advertisement for a shoe collection/donation that went to making playgrounds for schools and providing clean water in resource-limited areas. After going through all of our shoes, we donated seven pairs of tennis shoes to that program.

Out went the bags of trash. Out went the bags of donations. Out went the paper and the clothes with holes and all the things that we kept that every time I looked at it I thought, I hate you. Why do I still have you?

One of the things that we do for fun in the summer is go to local home shows. I love seeing how different homes are set up as I daydream about our future home. But what I think I like most about touring this homes is just how crisp, clean and decluttered they are. I know it’s all staging and set up to be that way, but what draws me to that style is the minimalism of it all.

After the first round of attempting to be minimalists, we still had a lot of stuff. But, we have much less. I feel like a huge weight has been lifted. When we end up moving early next year after I match into a residency program, I don’t want to have that same anxiety-provoking, overwhelming nightmare occur when we move for the (hopefully) final time.

An unexpected way we’ve been able to minimize: using up what we already have.  I haven’t been to Bath & Body Works in over a year. I’ve been gifted so much that I do not need anything from there until I use up what I have.

Which means my pocketbook is happier too. I collect Starbucks mugs in their Cities collection from all of our trips. Lately, on two of our trips, I have intended to buy a mug but left without them. And I’m not remorseful about it. They’d just be collecting dust until they have their own home once we move into a house next year. For now, they’d just be clutter. And who needs that? Why organize so much when you can downsize? Less stuff = no need to organize. That makes me so much more…. free…. now that I have let go of so much stuff and the need to have so much stuff.

This weekend, we tackled the most dreaded of all tasks… the baby’s room. Holy moly, so much stuff.

We are far from done with cleaning out and adjusting to be minimalists. I still have plenty of books, as they are my first love. I still have some old jeans that I hope to once again wear. Because minimalism isn’t about never having any materialistic thing, but about knowing that things and stuff do not bring happiness. We have a long way to go, but we are trying.

 

Rotation: Inpatient Neurology

Name/Location of Clinical Rotation

Inpatient stroke at our local stroke center/Inpatient General Neurology

What did I like most about this specialty?

It was pretty relaxed. I got to spend a lot of time with my patients, and there was a lot of time to think and research things for my patients.

What did I like least about this specialty?

There were some really sad stories, and what I didn’t like about Neuro was that a lot of the time, the patients never got better; at best, we might halt or slow a disease process, but we didn’t really fix anything.

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

I was on inpatient stroke/neuro consult and had my ED experience, which gave me a lot of unique experiences. I enjoyed that part, and I feel like I got a view of a large scope of that sort of practice.

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?

I liked that I got so much time with my patients, but it isn’t the right specialty for me. It did not click at all.

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

There’s inpatient, outpatient, and subspecialties in stroke and lots of things that I didn’t know about prior to this rotation! I feel like I got a good view of them, but I don’t see myself pursuing neurology. Right now my list is: IM>Neuro>Surgery, but I’m only on my third rotation!

What info do I still need?

None–I feel like I saw enough and got a good enough feel of it to know that I am interested in looking elsewhere for my specialty selection.

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

I learned a lot on this service. I really sucked at localizing lesions in the beginning, and with the neuro exam encompassing so many steps, I was always nervous performing a total neuro exam in front of my attending and residents. I felt like I had a good relationship with many of my patients. I still wonder about some of them, how they are doing. I do have a much higher respect for the specialty now.

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

Now that I’ve gotten a chance to really see what working in neurology is like, I do not think I will be selecting it, but it has been a positive experience.

Right now, how interested am I in this specialty?

IM>Neuro>Surgery at this point.

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

Some of these patients were so sad. I tried to give my patients plenty of time to complete the MMSE exam, but it was frustrating to them as well as me when they tried so hard on this silly set of tests and sometimes could just not do them no matter how hard they tried.

Psych so far

My last rotation of 3rd year is Child Psych, and let me tell you, it is so much different than everything else I’ve done this year, in good ways and¬† not so good ways.

The unit is a locked unit, with multiple doors and multiple keys. All trash bags in the unit are paper bags, not plastic. Most rooms with showers don’t have shower curtains. Since most of the kids are school-aged, there are school sessions throughout the day so that they aren’t counted as truant. There is art and music therapy. There is a schedule that is followed every day so the kids have to get up at a certain time, have showered by a certain time, etc.

We start out the day with table rounds at 8am (no pre-rounding). We then go see the kids before art/music/school/drama/the daily activity and go to any family sessions that are scheduled. I think write my notes and we’re usually done by noon or so. Lectures/Grand Rounds/Journal Club is in early afternoon, sometimes from 11-3, depending on the day. In the afternoons, three times a week, we have a clinic. We are either in the child clinic, the suboxone clinic, or the bipolar clinic. Those days can stretch out for a really long time.

During this rotation, we also have three “on call” days in EPS, Emergency Psych Services, and I’ve done all three of my calls. It is so much different than what I’m used to seeing in the day.

There are now only two weeks of third year left. Just two. I don’t feel like I know enough to be a 4th year medical student, but it is coming soon regardless.