Your Ad Here

Archive for the 'medical school' Category

one step forward, three steps back…

Published
by
mylifemypace
1 day, 20 hours ago
in lab/graduate school and medical school
. 2 Comments

The good news (I think): I’m finally almost done with my dissertation revision. I could have it done by the end of this week if my thoughts didn’t keep fluctuating and then focusing on how ephemeral life is. That and the fact that all I have left to finish is the discussion. One section doesn’t sound tough, but it is the section that needs the most work and the one that is the most difficult for me to write.

The bad news (or maybe not so bad if you really think about it): I’ve been asked to consider stopping my clinical work (read: my third year) and starting up again with next year’s class so that I would have my dissertation completely behind me and be able to start completely fresh instead of jumping back in with now super-experienced third years with only psychiatry under my belt. I have mixed feelings about this particular strategy. On the one hand, I do need that extra time to “prepare” myself as best I can by reviewing things like the physical exam and clinical reasoning, which I never was very good at in the first place. Also, since I’ve already done one rotation, I can take my last block off and study for Step 2, which I need to do well on since I’m going after Radiology. Oh yeah, and if I were to really return on rotation 5 as planned, I would be so far behind that I would not have any time to do any away rotations during my fourth year before having to apply to programs. I really believe that this extra year will be advantageous to me in helping me become the best possible Radiology applicant I can be. And, of course, I’ll have no more dissertation hanging over my head. On the other hand, now I’m going to be yet another year behind. One more year of not being done. Of not moving on with my life. Of not earning enough money to afford as many Chanel handbags as I want (though, really, in the grand scheme of things, I realize that life is far too short to spend coveting overpriced designer handbags). Oh yeah, as if it wasn’t hard enough to join the current class I’m in, I’ll have to do it all over again with a new batch of people. Not to mention that I’ll have to start the warm-and-fuzzy doctoring class all over again. I suppose I’ll just make sure to take on an early case since I’ll know what they’re all about.

Hmm…now that I’ve listed out all the pros and cons, it’s perfectly clear that taking the rest of this year off and starting again next year really is the best thing for me to do. Now, it’s not set in stone yet. There’s going to be some headbutting between bigwigs over this plan, but we’ll see where it goes. Until it’s decided, I’m sure as hell going to enjoy my carefree days. There’s nothing like tasting just a tiny bit of the third year of medical school to make me appreciate the finer points of doing nothing 10,000% more than I ever did before.

i took the plunge!

Published
by
mylifemypace
2 weeks ago
in medical school
. 0 Comments

So part of our third year curriculum includes the much-loved warm-and-fuzzy doctoring class that kicks my ass because I’m so not warm and fuzzy.

I’ve been trying to not be super quiet, but it’s been hard because my group consists of people I don’t know who all seem to know each other so well and because there are a couple of extraverted people who tend to dominate the discussion. But I am thankful that there are only about 2 extraverts instead of 6 when I got screwed during my second year.

Well, the other day, our session was about dealing with family members of someone in the ICU who isn’t going to make it. The discussion centered on how difficult it is to handle such a tough, emotional situation in a way that makes the family feel better. And, of course, just to make things hard on us, there was going to be a standardized patient interview. We decided to fly by the seat of our pants early in the course, with the interviewer volunteering on the day of the interview instead of pre-assigning days to people. Of course, I did not volunteer. Not because I was afraid of it being too emotionally draining or heartbreaking or whatever. But because this case required loads of empathy, which I severely lack and I didn’t want to be evaluated doing the thing that I am weakest at (these stupid mock interview evaluations go into our Dean’s Letter to residency programs!). Someone else volunteered, so it was okay.

But after learning the heartbreaking details of this particular case, the volunteer interviewer chickened out, saying that she knew she would break down during the interview (which I thought was lame because we all know that this is fake!). She did break down right after making that statement and left the room in tears. Somebody apparently has too much empathy. So with her out of the picture, we had to procure another volunteer. And no one else volunteered. Like I said earlier, I wasn’t about to volunteer either. But after two prolonged awkward silences, I knew that I was ripe for being picked on because I hadn’t talked much in any of the prior sessions. So before I could be forced to “volunteer,” I volunteered.

And the interview was hard. Our standardized patients were an irate father and a hysterical mother. The mother I could deal with. The father…not so much. But I eventually muddled my way through and it wasn’t an utter disaster (as has happened to me before in my second year warm-and-fuzzy doctoring class). I actually got pretty good marks, which I’m happy about.

What I’m proudest of though is the fact that I volunteered and that I wasn’t as self-conscious and nervous as I usually am about these things. Maybe it’s because I don’t know these people and don’t care what they think of me. Who knows. But it was a really big step for me. This case was hard for me, but not in the same way as it was for other people. Everyone else’s heart breaks over the case itself and they fear that they cannot stay unemotional while talking to the patient’s family. I have the opposite problem: I don’t really care and I’m not very good at pretending that I care. Which one is harder to deal with? Well, I think that less people would fault an overly emotional doctor than they would fault one who just didn’t seem to care. There is such value placed on empathy that it makes me feel that I fail at being a doctor just because I lack in that area. Forget my smarts. I’m screwed because I don’t have empathy.

Well, at least I was able to fake it until I made it this time.

in response to my dear reader post…

Published
by
mylifemypace
1 month, 3 weeks ago
in medical school
. 2 Comments

Ages ago, I noticed an onslaught of new user registrations without much in the way of comment-posting, so I wrote a post requesting that readers give me some input about what they want to see on this blog. I am now finally getting around to responding to loyal (I hope so still…) reader 314’s questions listed below.

1. Did you ever have any dream careers as a child?

When I was in elementary school, I wanted to be a scientist. I even went so far as to draw a picture of myself in a labcoat working with chemicals at a lab bench when I was in second grade or so. So I’ve always been interested in the sciences. In high school, I wanted to be an astronomer until my mom told me that I’d never find a job (she was probably right). Not very interesting, huh?

2. What did you think being a doctor meant when you first decided to go to med school?

I lived a pretty sheltered life until my mom passed away when I was in high school. Even afterwards, I remained pretty sheltered (thanks to a psycho possessive ex-boyfriend). I had never really been exposed to what it is that doctors actually do except for what I saw whenever I went to my own doctor, who was invariably either a family practician or a pediatrician. So I thought that being a doctor meant having my own general practice and that was what I wanted to do. I thought that being a doctor meant seeing sick people and making them better, even after watching doctors fail to cure my mom. To put it simply, I was pretty naive and idealistic about the whole thing.

3. How/why has that changed as time passed?

Well, the first thing I learned when I started med school was that there were all these different specialties that I could choose from that I had absolutely no idea existed before. Then I learned that I do not, under any circumstance, want to go into a general field of medicine (e.g., family practice, internal medicine, pediatrics). Then along the way, I learned that being a doctor isn’t all that it’s cracked up to be. I don’t like seeing sick people. I don’t want to see people die under my watch. I don’t like the long hours and being treated like crap. I’ve been lucky to have pretty pleasant patients so far, but I’m sure the day will come when I get abused by a patient who thinks that I’m not good enough for them (and they would probably be right). I haven’t yet been yelled at either, but I hate living each day in fear of the time when I will finally get yelled at. I’ve also learned that a large part of medicine is about how well you get along with people, which I utterly fail at. I make do and plenty of patients like me, but when you put me next to Mr./Ms. Extrovert, I look like an utter failure. So what’s changed from my idealistic vision of everything is that med school is full of abuse and that the long, hard road is seldom worth it. And that contrary to what I had hoped, I cannot change who I am and be good with people. Which means that I have to hide in the shadows in Radiology instead of becoming a brilliant diagnostician (because, unlike TV, I’m pretty sure I can’t be an ass like House and still have a job).

Wow. How utterly demoralizing. But you introverts might as well know that med school and being a doctor is 100x harder if you’re an introvert before you jump in.

update: of puppies, chanel, and iphones

Published
by
mylifemypace
2 months, 3 weeks ago
in lab/graduate school, married life and medical school
. 1 Comment

Yes, I’ve been MIA again. It’s really hard to write when I’m too busy being a blob.

I deferred my second rotation because the ghost of my dissertation just would not stop haunting me. Translation: my asshole major professor kept demanding a draft from me despite the fact that no one really expects us to pump out a dissertation during our third year of med school. It was a tough decision, but it was just something I had to do in order to make sure that I could focus completely on my rotations so that I don’t fail. One can skate by with only half a mind on Psych, but not while on Peds or Medicine. And I’ve been making good progress so far.

This whole deferment has allowed me to enjoy life a bit more, which is good because I’ve learned to appreciate the little things, like watching my adorable corgi puppy sleep in my lap all day long. It’s also bad because I will have to learn to live a shadow of a life once I return in August. I’m not yet sure how I’ll deal with that yet, but my preliminary plan involves large amounts of Prozac.* Speaking of my puppy, he is absolutely awesome! He’s the cutest thing ever! I always thought that I would miss him having a tail (my other dog has a really fluffy tail that has a tendency to knock things over quite often), but I now find my puppy’s little nubbin to be quite adequate at expressing his emotions and quite cute to boot. From behind, he looks like a bunny hopping when he runs. He’s a handful, but nothing compared to the horror stories I’ve heard about other breeds. I definitely cannot imagine my life without him and can see why Queen Elizabeth II has a bunch of corgis.

What else is new? Well, say hello to my new acquisition:

Isn’t it pretty? It better be because it costed $1000 more than our 52″ LCD TV. I could also have bought the Macbook Air with the amount of money I spent on this purse. Or that Canon 40D DSLR that I’ve been coveting for a year now. But, no, because I am a woman after all, I instead blow my money on a Chanel purse. And all because it’s purple and shiny and super-limited-edition. It was supposed to be my reward for finishing my first draft of my dissertation. I was just at the boutique to try it on so that my husband could then later buy it for me when I fulfilled my end of the bargain, but we ended up buying it because Chanel newbie that I am didn’t realize what incredible good fortune I had to even be able to find it at this late juncture, but at least had the good sense to know that I would forever kick myself if I passed it up. So I possess this purse that I wasn’t planning to buy for another 10 years now and I am quite broke. It is also still all boxed up (my husband was kind enough to let me take it out for a few hours to take pictures of it) waiting for me to finish that draft before it can come out and play. And now you know why I’ve been so productive as of late.

And lastly, somehow beyond all reason, my husband was able to convince me to wake up at 4:30 am the morning of July 11th to head out to our local Apple store to wait in line for the iPhone 3G. Because, of course, I just had to have it. So that’s what we did. And it was quite the interesting experience. We were, of course, not the only crazies as there were already 50ish people there by the time we got there and the line grew to well over 100 people by the time the Apple store opened. I thought I would feel really lame about waiting in line for a phone, but I have to say that I was glad to have experienced it. Of course, my shiny new iPhone 3G was defective and I had to go back a week later to get it replaced, but at least I have one now. By the way, it’s also all sorts of awesome.

*I kid. Sort of.

speaking of psych hospitals…

Published
by
mylifemypace
3 months, 1 week ago
in medical school
. 1 Comment

So I’ve been done with my psych clerkship for awhile now. I’ve just been too lazy to write. But this article about a woman collapsing then dying in the waiting room of a psych hospital and then going unnoticed despite the activity there for an hour or so is appalling enough to make me break my silence.

You see, I was at a psych hospital myself for the last four weeks of the rotation. It was made out to be quite a scary place, what with all the warnings of, “always watch your back” and “take staff with you to interview your patients.” Not to mention the crazy long self-defense class they forced us to sit through on orientation where all I retained was to always yell, “STAFF!” if I got in trouble. Thankfully, I survived my four-week stint there unscathed and quite intrigued by these patients.  Sure, some of them are pretty manic and psychotic (at the same time, an awesome combination) and others have quite scary histories of assaulting family and staff, but I grew to be fond of most of them. Except for my super antisocial patient for whom I always made sure to have staff present. And except for the manic guy (who wasn’t even my patient) who had an Asian fetish and managed to trap me in a room (thankfully, I was able to shut the door on him before he got in, but then I had no way out). This same guy then made friends with another psychotic patient who also had a thing for women (not just Asian, but all women) and they teamed up to harass me. But I wasn’t groped or assaulted, so I was happy.

But back to the article that brought me out of hiding. From the rest of the story, it seems that this particular psych hospital has a history of not treating patients so well. This latest incident seems to be a sad and extreme example of the type of behavior that can occur at psych hospitals. I was always amazed that fewer incidents are reported of things happening between patients because they’re all allowed to mingle with each other. You would think that putting a bunch of psychotic/manic/depressed/personality disordered people together would not be a good idea. But it seems to work. For the most part. Things do happen. Patients do get into it with each other. But it works remarkably well. And in the case of the hospital mentioned in this article, what happened to this patient was not a result of other patients, but of lack of concern from the staff.

Even though nothing even remotely close to what happened in the hospital mentioned in the article happened at the facility I was at, I can see how things can deteriorate to such a point. There are not enough staff members to provide the kind of attention these patients often need. Staff is spread quite thin and many of these patients are not exactly easy to work with. They take a lot out of a person. I was always happy to retreat back into the residents’ room after spending just 15 minutes or so out in the patient area. Staff members cannot retreat. They must be out there all of the time, dealing with these patients. They also have their share of difficult patients. And, unfortunately, their dealings with these few difficult patients color how they deal with everyone else. They have to stick to strict regimens, such as not giving patients snacks if they miss snack time so that patients will adhere to their snack schedules. I understand that. But at the same time, there are patients that come into the facility on legal holds who are not psychotic and who are pretty reasonable who just happen to miss snack time or need an extra snack. It breaks my heart when these patients go ask for a snack and get sternly turned down when they could have been denied more gently. That kind of treatment of these relatively reasonable patients causes them to feel that they are not being treated as fellow human beings, which then leads them to become irritated and possibly get into altercations with other patients, even though they are not normally violent people.

I do not blame these staff members for how they approach their patients. Of course, I’m not out there everyday dealing with all of these patients, so who am I to tell them how to do their jobs? But what I can say is that the system is not perfect. Our resources are spread thin and patient care suffers. Perhaps, if there were more staff members, they would not need to be so limiting to everyone just because of a few bad apples and would be able to get to know their patients well enough to decide which ones are reasonable and which are not in order to better customize how their care. Oh, if only we lived in a perfect world…

i am so going into radiology

Published
by
mylifemypace
5 months ago
in medical school
. 0 Comments

After 1 week of psych consult, I learned that I do not, under any circumstance, want to go into Internal Medicine. How anyone can stand the smell of someone else’s diarrhea is completely beyond me. And I’m from psych consult! I probably had to smell it for, what, five minutes? Yeah, well, five minutes is far too long. I cannot imagine being on Medicine and actually having to do a physical on someone who stinks of poo. Let’s just say that I was actually glad I hadn’t eaten before seeing this patient because I would have surely vomited otherwise.

We get a lot of consult requests from the various Medicine teams in the hospital. So I’ve had the distinct pleasure of visiting many Medicine areas in the hospital. And they all have that distinct hospital smell that I have now grown quite sick of. Sometimes, this smell is intermingled with the distinct smell of poo. The people in these areas tend to be pretty sick with multiple problems. And MRSA. I guess I should be glad I’ve learned how to gown up for such situations. But, really, I just don’t like it.

At the end of my second week, I learned that I don’t like talking to patients. Or their family. Or anyone else, really. Sure, I already knew that, but I thought it would change when I started wards. That something inside of me would magically change and I all of a sudden wouldn’t be socially awkward anymore or hate talking with people. No such luck. There’s nothing like knowing nothing to really make you not want to open your mouth when speaking to patients. Patients who expect you to know everything.

By the end of my third week, I decided that I’m going into Radiology. Over the weekend, I debated whether it was really what I wanted because I never really liked what little Radiology I had been exposed to in my first two years of med school. And it’s also 4 years on top of an internship year. Plus I’d want to either do a Neuro or Interventional fellowship, which would add another 1-2 years, making it 6-7 years total, far too long a time for someone who has already wasted 4 years on a PhD that she’ll likely never use. So I had my doubts.

Then, yesterday, my attending insisted on watching me interview a patient. These kinds of situations are particularly painful for me because of my social awkwardness and nervousness when being watched by other people. Of course, I get a psychotic patient. Which I’ve never seen before. So I really concentrated on making sure I asked the right questions on the timecourse of his symptoms as well as things to rule out depression and mania and the like. And because I was being watched and didn’t want to waste the attending’s precious time, I directed the interview more than I usually do, sometimes cutting off the patient’s rambling answers to interject my own questions, but never too brazenly. I also took this approach because I’ve gotten quite a few delirious/talkative patients who would talk and talk and talk without making much sense, making for really long pointless interviews and I was kind of tired of it. Also, I was modeling the interview style of the other attending, who I’ve worked with more than this particular one, who keeps things nice and short. Well, at the end of it all, this attending called me an unempathetic information gatherer. Now that might sound painful to those who aren’t used to hearing themselves being described that way. But it didn’t surprise me at all. I actually wanted to respond by saying, “Tell me something I don’t already know” because I didn’t find that assessment particularly useful. I know that I suck at empathy. That’s because I suck at social interactions, period. Sometimes, I think I have Asperger’s. And the sad thing is that I was actually trying during this interview. Though not as much as with unwatched interviews because I always feel so fake doing such things and didn’t want the attending to call me out on it. Yeah, that plan worked out well.

So, that’s how I’ve come to decide that Radiology is for me after just 3.5 weeks on rotations. The only thing that might change my mind is Surgery. But I doubt it. And I’m sure my attendings will be glad to know that I won’t be spreading my unempatheticness wide and far.

one week down, 47 more to go

Published
by
mylifemypace
5 months, 2 weeks ago
in medical school
. 5 Comments

So I’m done with my first official week of third year. And it sucks. I don’t know if I’m supposed to feel this way, but I kind of hate it. Maybe it’s because I’m on psychiatry adult consult and all I’ve seen this week is malingering, delirium, and dementia, all of which involve pretty hard to interview patients. I suppose my malingering patient wasn’t that difficult, except for the fact that he was a prison inmate and kind of scared the crap out of me. But I definitely didn’t figure out the malingering part, which makes me an idiot. I’m so tired that even 10+ hours of sleep last night wasn’t enough to make me not feel dead tired today. And this is just psych. It’s not medicine or surgery. I wake up at 5 in the morning so that I have plenty of time to preround on my one patient (I have two now, so I’m not quite sure how I’m going to pull it off on Monday). That’s how slow I am. At this rate, I might as well not leave the hospital when I’m on medicine and surgery because there’s no point when I’ll probably have to come back in an hour or so since I’m so slow. Not only am I slow, but I don’t know shit. My fellow psych consult-ees all claim they don’t know anything either, but it sure doesn’t sound that way when they present their patients. I’m just waiting to get yelled at because I’m so incompetent. In fact, I’m surprised I haven’t been yelled at yet. I figure they’re just holding it all in until next week, when they can safely assume that we should know what we’re doing.

I know I complained to no end about grad school sucking, but I think I almost prefer that now. At least I’ll have plenty of sleep and not be exposed to people with Hepatitis B and C every damn day. Nor will I be living in constant fear of getting yelled at. I hear it’s inevitable. My fellow psych consult-ees have all already gotten yelled at. It’s just a matter of time before it’s my turn.

like a prisoner being given his last meal

Published
by
mylifemypace
5 months, 3 weeks ago
in married life and medical school
. 2 Comments

That’s what I’ve felt like these past couple of weeks. Everyone keeps telling me to enjoy everything while I still can as if I’m some prisoner enjoying my last meal before my execution. Sad how that statement is pretty much true. It is so unbelievably hard for me to accept that I’m going to have to give up everything that I enjoy indefinitely. Simple things like lounging around the house with my dog, playing Rock Band, cooking, blogging, sewing, tennis…all the things that make me me. All those things will no longer have any place in my life as I enter the abyss that is the third year of med school. Having these things then having to give them up again makes me almost wish I’d never done a PhD so that I would never have tasted such freedom because it is now so hard to let it all go. Well, I think you get my point. Enough whining.

I’ve been MIA for quite awhile now because I’ve been enjoying my last meal to the fullest extent possible and was on a last-minute vacation. It was fun, but the spectre of third year was never far behind so it wasn’t quite as fun as it could have been. But at least I won’t regret not taking a vacation later. I don’t do much on vacations besides eat and shop and this one was no exception. And for some reason, I was obsessed with finding a perfectly functional handbag because I was finally tired of my small yet not-so-functional collection. Not one to cheap out on such things, my husband insisted that I only look at designer bags. I had a Marc by Marc Jacobs in mind, but it ended up looking way better online than in person. I guess handbags just can’t be functional and fashionable at the same time. I then found a Burberry one that I could live with and had settled on it (and was planning to buy it once I got back home) when my husband insisted we check out the Louis Vuitton store on the way out. Now I don’t like LV stuff because I don’t like the monogram and how it’s everywhere, but I decided to humor him since he had already humored me way more than he had to with my great handbag search of 2008 and I figured he deserved it. I really hate going to these high-end stores because the people are just so snobby and act like I don’t even deserve to be in their store. One day, I swear, I’ll stroll in in my scrubs and white coat just to see if I get treated differently. Suffice it to say, I was trying to get in and out of there as quickly as possible, but my husband made me look at their bags, theorizing that maybe so many people have them because they’re functional. Well, he was wrong. But he also found the perfect bag for me while he was at it. And even though I don’t like LV stuff, I caved in and bought it.

There was no way I was going to be able to resist my special shade of purple. And besides, it’s a really nice bag. And it doesn’t have that ostentatious LV monogram all over it. And I’m now $900 poorer. I figure I won’t be shopping much once I start rotations again, so it’ll be okay.

So I start tomorrow bright and early. I still wish I could freeze time and be a slacker forever…or at least until I master every instrument on Rock Band on expert, but I have no choice but to forge ahead. I might disappear for extended periods of time, but not forever. You’re just going to have to be patient and you’ll be rewarded with stories aplenty, I’m sure.

And to those who responded to my Dear Reader post awhile ago, I haven’t forgotten you and will be getting responses up as soon as I stop admiring my new LV bag find the time.