Nightmares

I had my first big anatomy exam a week ago today. It takes quite a bit of stamina to spend all morning doing the practical and still have the energy and willpower to get through the written in the afternoon. Studying for med school is tough at the best of times, and I can tell you that dealing with chronic pain doesn't make it any easier - more so when the pain is aggravated by stress. I finally managed to get into full study mode for the week of the test, which is why when I looked at my grade yesterday I actually saw two passing grades (high pass on the practical, actually - completely shocked me). We had such a long stretch without a break, that I was feeling quite burnt out and unmotivated most of this unit, so I had fully expected to perform poorly, but somehow I managed to pull it out. Having something to look forward to really put in that motivation toward the end- December 20th was one of my best friend's wedding, and I got a really pretty bridesmaid dress for it and everything.

Unfortunately, this particular friend has a history with being the embodiment of Murphy's Law. So I don't know why I was so surprised to hear friday afternoon of the horrible blizzard on the east coast. I saw the next day that my flight was cancelled, and after 45 minutes on the phone with northwest having been told the earliest they could get me in was monday, I was determined to nevertheless get there somehow. I had promised, and it just couldn't be real if I wasn't there. Amtrak was sold out, so I bought a ticket on a bus. It was scheduled to get in early in the morning, but I figured it was okay because the wedding was in the afternoon, and maybe the snow would be cleared up by morning. Sadly, I arrived in Cleveland to discover I couldn't take a bus anywhere past Pittsburgh, and the Baltimore station was closed until further notice. I luckily had some med school friends in Cleveland and so had a place to spend the night; We were up until 2 am trying to find alternate routes. No buses would get there in time, and when i decided to take a flight and get there Sunday night so I could make it to monday night sheva brachos, the flight got cancelled before I could even get the ticket.

I took a bus from Cleveland Sunday afternoon - back to Toledo. Wishing desperately to be going the other direction, to be able to walk into the wedding, even in my sweatshirt and sweatpants and be there for any part of it, I would have given anything. It absolutely kills me that I did everything I could and still failed. It never occurred to me this could happen and I wouldn't be there at all. It was inconceivable, and yet there I was, on a bus, going the wrong direction. Every song on my ipod was about friendship or love, or even weddings, and would bring it all back again.

I came back to a cold empty house, on the night I really needed a literal shoulder to cry on, but of course the people I normally call to talk when everything is going wrong - at the wedding. I know I did everything I could, and that she'd do the same for me, but I still feel like a failure and a horrible friend since even everything wasn't enough. Already physically and mentally exhausted from the anatomy exam, I was now emotionally exhausted, too, I couldn't even manage to cry anymore.

And now, I'm home with my family, where I still feel rather alone. Alone by myself, and still alone in a crowd seems to be the story of my life.

one plus - I gots a Kitty! :)

Wrong Side of the Bed

First, a big congratulations to Nathan upon achieving his black belt, to Jason for promoting his first black belt, and to Rachel for finally outranking me again.

Second, I am sick again. Apparently I have the flu. I was not in fact tested, so no one is sure if it's the usual seasonal flu, H1N1 or just a really nasty cold. however, this puts me on the patient's side of the table, which reveals to me a great many things.
Among them:
1) When I am a doctor, I won't show up 45 minutes late without at least apologizing and giving an explanation
2) I will listen to my patients. I may want to avoid catching whatever it is, but if i think it's flu, I'll test for it before prescribing tamiflu.
3) Making that connection is important. I feel awful and miserable, I'd like my doctor to be comforting and not just tell me I can't go back to class until the fever is gone.

I'm supposed to start gross lab on friday, and do my first dissection. I'm hoping I'm better enough by then. Feeling this miserable has meant that I haven't been able to study so I am terribly behind.

Only Time Will Tell

I'm 3 units in to the 4 unit Biochemistry Block and I'm feeling the pressure but at the same time I feel like I'm finding out how to deal with everything, even with it all coming at me all at once.

I find which subjects and professors need more time and effort to work on or understand, and that I don't need to sweat small group CDM because it's okay that I have no idea what's going on - we're not supposed to! It can be frustrating to hear that it's all about the process, and no, you don't get the answer, but it's a reminder that I'm going into a profession that doesn't have definitive answers like we do on our lecture exams. It doesn't replicate a real patient experience but it certainly breaks up the monotony of lectures; it gets pretty sickening sitting in that same lecture hall day after day, in the same row, with that same malfunctioning light just off to the left.

I'll take the time to hang out post-exam or on weekends, talk on the phone, or go to karate, because I'd rather miss out on a couple of hours of sleep than lose that sense of personal connection with actual humans. It goes a long way in keeping me sane. however, with relationships comes drama, and nothing shows that more than my relationships with my friends from high school and college. Once you don't see people everyday, it really takes effort to keep up the contact and for some it's easier than others. Even if we got along really well when we lived close by, if both sides aren't making the same effort, the relationship degenerates over time.
My ex-roommates have lost all contact, and I haven't heard from either for quite some time. When my college roommate stopped replying to my emails in January, I began to wonder about the nature of our relationship through college and how much of it was real or if it somehow wasn't as close as I had thought. It was shocking to see our relationship go from "let me know when you get back to the country so we can have a reunion/combo b-day party/etc. to not even an occasional single line email.
Close friends from high school have pretty much the same pattern - very little real contact until we find we're both back in Denver at the same time, meet up once or twice, catch up, see you next time. It can be amazing to see how much people have changed and what hasn't. People living out dreams, or doing things none of us would have even imagined - fashion design, TV writing, living in Antarctica, medical school, grad school, or marriage.
Friends from college have different patterns - many have become just facebook friends, a few have had occasional contact - an email or phone call once in a while, and some really feel like friends for life having really gone the distance to keep up, care about what's going on in my life and have me on the list of the first to know what's going on in theirs. Two of my best friends from college I still consider best friends now, and I can't imagine life without them. Though we've gone very different directions, we've each done a lot to keep in touch and visit each other. Now one of my besties is waiting anxiously to hear from grad schools in california and the other just got engaged!
Wow.
I look back and can barely believe how we all got here, but it's been an amazing ride so far.

Confronting the tiger

When I was a volunteer at the Denver Zoo, I had the opportunity to meet Inga, the Siberian tiger. I and two other teen volunteers had just finishing raking the tiger yard and the keeper asked if we'd like to meet her tiger. Having never met a tiger before, we all agreed. Before she took us over,the keeper taught us 'tiger etiquette' so that we wouldn't offend or upset Inga. Tiger etiquette mostly involves not showing your teeth or maintaining prolonged eye contact, both seen as signs of aggression. The she flipped the switch to open the door to the passage between the indoor and outdoor enclosure, and so Inga came through and sat down on the floor of the passage. When I went up to get closer and say hi, I was pretty nervous. I blinked every five seconds or so, just in case any longer might indicate I was hostile. Even knowing I was perfectly safe with the bars between us, I really didn't want to piss off a tiger. Of course, nothing bad happened that day, and Inga politely blinked back (far less often than I did, of course), but that day was one of the more exhilarating experiences in my time at the zoo.

I confronted a new tiger this week in the form of my first standardized patient in my CDM class. He was an actor, the symptoms were fake, and there was no danger of misdiagnosing or hurting anyone, but I was nervous as hell, knowing that someday my ability to interview a patient could in fact mean the difference between life or death.

Overall, it went okay. My nerves made me forget several of the questions I should have, (and meant to) ask, but I managed to get most of the pertinent information for his Chief Complaint and History. The best part about it was after the interview, during the feedback portion, where the facilitator helped us understand the interaction better and how to figure out what sort of questions should be asked, and how to ask them.

Today is my birthday, and my gnomes celebrated by installing a porcupine in my throat and developed a cough, my professors celebrated by making me attend class for 6 hours and I am celebrating by eating Pad Thai and Birthday cake, and studying for Monday's exam.
Pad Thai and studying for an exam is becoming a birtday tradition - I did the exact same thing for my 21st birthday.

Reality Sets In

Orientation is over and today was day 3 of classes and the real mass of the workload is really hitting me.

We have a two inch thick syllabus, and that's just for the first two weeks! Our first test is the tuesday after labor day. Hmm, I seem to remember I've got something else around then. Oh yeah, I'm flying back to Denver for my brother's wedding. Oh boy, this is going to be tough.

Just three days of notes is a lot of content to know, and it doesn't feel like it's sticking. Even though most of the material so far isn't really new, the pace and the amount mean that it's difficult to get the material back to the level of understanding. We're essentially doing a semester's worth of material every two weeks and having that cumulative exam in that time.
Well, it's scary.

Today we were introduced to 2 new classes, Clinical Decision Making, and Microanatomy Lab. Clinical Decision Making is the Integrated (integration is the key word, they said it a lot) curriculum that introduces clinical reasoning and skills paired with the content we're learning in the regular lectures. It's got its own syllabus, which is in addition to the amount we need to know for lecture, but this is the part where we learn what being a doctor is all about, and one of the reasons I chose to apply to this school. Learning to do a differential diagnosis and a physical exam, and to develop bedside manner and communication skills early was important to me. I learn best when learning in context, and learning to be a doctor would have to mean putting the content from lecture into a clinical setting and learning application of that knowledge.

Microanatomy Lab, unfortunately, isn't nearly so exciting. Very poorly designed and organized,the material wasn't the hardest thing about today's class. I can only assume the professors were playing a game titled "how many computers on the network does it take to crash the server?" With 176 computers on the virtual slides site, things took quite some time to load. Having to muddle through the slides trying to find the structures was difficult enough without having to deal with technical difficulties.
Luckily, I had my Macbook Pro, who has now been dubbed Alexander, for both Lyta Alexander of Babylon 5 and Alexander the Great, because I managed to get through the class with the only technical issue being slow loading, while I watched people (with PCs) around me get frustrated with all sorts of problems trying to access the site, copy the slides, zoom, etc.
I really don't understand why they couldn't put the slides on a powerpoint with the structures labelled. How are we expected to find things when we have no idea what we're looking for?

Into my fourth week of living in Ohio, second week of UTCOM,and first week of classes, I'm looking back and feeling nostalgic about all the good things from Undergrad and this pat year in Denver

Top 10 Things I Miss About Brandeis
1. Late night trips to the c-store for ice cream
2. Classes started only as early as I wanted them to
3. Pad Thai in Waltham
4. Going Places- Brookline, Boston, Joann's for knitting and arts supplies, and the treacherous trek down the hill at East to get to the car
5. Surprise parties for everyone’s birthdays
6. Dinner with everyone, followed by Sherman shopping
7. The 'only at Brandeis' stories, like Bonnie's trip back from Newton-Wellesley, and tales of BranVan drivers gone crazy
8. Thursday night TV with Adi – Ugly Betty and Grey’s Anatomy just aren’t the same anymore
9. Episodes of “Bonnie’s World” are much better in person
10. Having all my friends just down the hall from me

Top 10 Things I Miss About Denver
1. “Guess what I learned in Jewish Home today?”
2. Living a mile high - the lack of oxygen, the extra blood cells, all of it
3. The mountains always mean west
4. Missing out on the Museum’s genetics of taste and smell study (at least I got to find out I'm a Taster!)
5. It’s been HOME for my entire life
6. The weather – 300 days of sunshine!
7. Free room and board
8. Alana’s baking
9. Mom’s cooking
10. My family

The Anatomist: A True Story of Gray's Anatomy by Bill Hayes

This book is two stories told in parallel. The first is that of the author, who's fascination with anatomy took him on a journey of discovery of the human body, but also one of history. His interest in anatomy was coupled with a specific interest in Gray's Anatomy, possibly the most famous of medical texts. This led him to wonder about the history of Gray's Anatomy itself, and that of its author and illustrator, Henry Gray and Henry Vandyke Carter, respectively. The book switches back between Bill's story of the anatomy courses he takes as well as his research into the two Henrys' lives, and the story he uncovers behind it all, and recreates through the diary entries of Henry Carter.

A well-written and fascinating book, I really enjoyed the way the two stories were woven together. As someone who hasn't taken any anatomy courses as of yet, I can say with some confidence that even at its most scientific is written in such a way that a layman can understand it. However, much of the book comes at you from a more personal level. Details of the lives of the two Henrys are revealed, such as Carter's struggle with faith and tragedy in the family, the context in which Gray's anatomy first came to be written. The author himself, too, reveals much of himself, his past, his apprehensions, and his curiosity to the ready. The vulnerability really helps draw you in as a ready, to relate and sympathize with the (yes, somewhat morbid) fascination felt by the author and the two Henrys in each of their journeys into the structure of the human body.

Since my own foray into human anatomy is inching closer each day, this book really struck a chord in me, and I'm finding myself more and more excited about the vast amount of knowledge I will get to attain soon, and am looking forward to my own experiences in the anatomy lab.

Cyborg Name

I have discovered my cyborg name. Unfortunately, the application only allows 10 letters, so I have to be Karatesock. I have no problem with exploration and scientific observation, but I'm a little worried what the ceaseless killing indicates. I hope it is not indicative of my future medical career.

Get Your Cyborg Name

What's next

I got the packet with my official acceptance letter in the mail on Saturday. I know it's real because most of the packet is about financial aid, filing for FAFSA, having proof that I've had all my vaccinations and don't have any communicable diseases. As it's memorial day weekend, I won't be able to send out my acceptance of the acceptance until Tuesday.

I had thought that once I got an acceptance letter, I wouldn't feel so stressed, but my anxiety level has just shot through the roof. now having to worry about moving to Ohio, not having much of a support system outside of school and being up to my ears in debt are the things I cannot get out of my mind. I assume at least part of that anxiety comes from The Headache and a nasty sinus infection. I feel absolutely miserable right about now. Maybe I've read too many blogs about how med school sucks, but I'm finding it difficult not to panic right now. Underlying it all is the fear that the admissions committee made a mistake and that I don't have what it takes. I'm telling myself that I asked for a challenge and a chance to prove to myself that I could do better, that for once good enough isn't good enough and that I will be doing something that pushes me to really do my best.I applied to medical school knowing I couldn't coast through like I did high school, and that like many of my courses in college, I will probably have to try my hardest just to me average in this environment. I can take this one thing at a time, and have help figuring stuff out, but right now, I'm terrified.

Hurts so good

I have to say today has definitely been a good day.

I went to what seems to be the millionth specialist - a physical therapist who specializes in headaches. For the first time, someone really made sense - put it all together like a puzzle and said this is what's wrong and this is how i intend to fix it. She used a dry needling technique I've never heard of before - she used acupuncture needles to get into the knots in my muscles - the trigger points, or gnomes,as I call them. That's right, for the first time someone really acknowledged the gnomes!. I could really feel the needles doing their work - the muscles sort of seized up around the needle and I could feel the pain travel up to my jaw and my head, and the headache slowly relaxed away. it's not gone entirely, and there's a point on my left shoulder that's still extremely sore, but for the first time in over a year the pain is a good pain - and I'm really hopeful that something will finally work.
And speaking of good pain...
After all that waiting I finally have an answer, and I find this one acceptance letter has really made up for all the NOs I've gotten. It is slowly sinking in what it all means. After all that work, frustration, and the horrible, horrible waiting, that pain is gone. it has been replaced by a whole list of new ones - moving to Ohio, finding an apartment and a roommate, living on my own, all the work, paying for tuition and living expenses and more. Yet all these things are about moving forward and all these worries are troubling, but feel so much better than the stationary constant pain of waiting and hoping.

Here's me on my interview day

Stuck in my Head

Don't you hate it when a song lyric gets stuck in your head, just playing over and over?

I've had a bunch of these recently, including, but not limited to:

Defying Gravity from Wicked
Beyonce's Single Ladies
the prince and princess line from Taylor Swift's song

and weirdest of all, a song i learned in high school french that popped into my head randomly and now won't leave
goes something like this
I apologize for what is undoubtedly poor grammar and butchering the lyrics, but please consider I haven't spoken a word of french in over 4 years

Dis t'en moi porquoi la vie est belle
Dis t'en moi prquoi la vie est gaie
Dis t'en moi porquoi, chere mademoiselle
Est ce que par ce que tu m'aimer?

I have no idea where this came from or exactly how wrong the writing is, only that it is currently playing incessantly in my head.

Unfortunately, I gain appreciation for these ear worms when frequently the alternatives playing over and over in my head are my interviews and every single mistake, slip-up, possibility of misunderstanding, or stupid moment that occurred at each one. Once entirely freaked about maybe hearing light and fluffy lyrics aren't so bad?

I need to stop thinking right about now.