Wednesday, May 30, 2012

Pediatric Ponderings

Today was my first day in inpatient pediatrics. My love for pediatrics was reconfirmed, as I enjoyed all of the patients, was able to handle the parents, and preferred the illnesses/chief complaints over those of the usual adult inpatient setting. With this being said, here are the extremely important, life-changing points that I am left pondering at the end of the day:

1. If I have a stuffed animal wrapped around my stethoscope, at what age is it inappropriate to have the patient guess what animal it is or name the color? I think seven could be a good cut off (obviously taking development into consideration). Pretty sure the eight-year-old thought it was lame.

2. What kind of stuffed animal am I going to buy for my stethoscope!? Tigers are my favorite. But, a monkey could be cute. (Sidenote: I hope you can tell I am writing this with sarcastic tones... mostly...)



3. Do I have to ask patients if there are "monkeys in their bellies" or "potatoes in their ears"? I like the monkey idea... maybe... but, I am pretty sure half of the kids under three didn't know what a potato was yet. Could be a problem. Maybe I'll say "cookie."

Adorbs!!! http://swell247.com/baby-doctor-gift-set.html

4. Apparently, I need to borrow my friends' kids and practice changing their clothes. Did not realize I'd have to do that... very awkward, need some skills.

5. Definitely will enjoy a subspecialty over general peds. Something a little more hands on... and when a parent asks what my job is, I don't want to respond with "I'm here to monitor how much your kid eats, pees, and poops." Gen peds is great for being the hub of information and consultation, but I want my daily skills set to go beyond the basic physical exam. Also, I prefer what's going down inside the body, as opposed to what's coming out of the body.

6. I think physicians are either drawn towards peds or drawn towards adults, and there is only a select few that can thoroughly enjoy both categories. Yesterday, an elderly patient was hacking up a storm and I was legitimately scared - had to make a conscious effort not to slowly back out of the room. Lots of things flashed through my mind... getting puked on, dentures falling out, patient falling out of bed, patient dying. None of these are good things (May I point out that I excel at stating the obvious?). In comparison, today, a pediatric patient was hacking up a storm and I was legitimately in doctor mode, immediately consoling the patient and helping him through the fit. Who cares if I get puked on? It will be a smaller amount. The bed is three times the size of this kid, and the kid isn't obese... not gonna fall out of bed.

For some reason, I see kids as more resilient than adults. I appreciate their innocence and potential, and I have more internal faith and belief in them, which is probably the main reason I'm drawn towards peds. Interestingly, my fellow med student friend feels exactly the opposite. She's terrified of kids, I'm terrified of old people. She views pediatric patients as fragile and scary, I tip toe around everyone over 65. She prefers adult puke, I prefer kid puke (again... smaller quantity, yo!). She prefers black and white, I prefer colors and animation.

Edinburg Children's Hospital in Texas. Seriously!?!?! How could you not be happy working here!?!?

7. If I have nightmares tonight, I know exactly who to blame. I've seen students/interns/residents get yelled at and reemed out by attendings before, but only on TV. Today, I witnessed an attending open the gates of hell and unleash 1,000 furies on an intern, and for literally NO REASON! She was walking by as he was explaining why a particular patient was unable to receive oral medication to me. The attending heard only the words  "use oral meds" and flipped out on the intern, telling him how he was "only a first year resident and knows nothing and shouldn't be telling people information that you have no clue about." She then went on to yell how it was "inappropriate for this patient to be on oral medication, so why are you talking about using oral meds? That's wrong. You are wrong." Which, as you can see, he was not wrong, as this was exactly the point he was trying to make, that this patient shouldn't be on oral meds. He literally had to chase her down the hall and try to politely interrupt her rant to defend himself, and then report back to his attending and tell her about the misunderstanding. I literally feared for my life and I was just standing there. Can't wait until it's my turn!

Monday, May 28, 2012

Professional Sunscreen Applier? Sign Me Up

The first time I felt like a "doctor" was September of my M1 year when I signed up to help with the Special Olympics. First of all, this was an amazing experience and I plan on joining the Special Olympics medical team every chance I get - highly recommended! Second of all, at the time I signed up, I had only been in medical school for three weeks, and therefore knew absolutely nothing. So, I show up to volunteer, introduce myself as a "medical student," and they hand me a Med Team shirt and point me in the direction of the other health care professionals. I'm feeling pretty badass in my shirt, strolling over towards the make-shift exam rooms. I am told that I will be running exam room 1. It's at this point that I have a minor freakout because WTH DO I DO IN AN EXAM ROOM!? Oh God, oh God, these people think that I know how to do stuff! Crap. Thankfully, quite a few M4s show up, and they ask if anyone would like to partner up. I immediately find myself a partner who is actually qualified to do physical exams. This day turns into a fabulous experience. My M4 teaches me how to test reflexes and how to administer musculoskeletal exams. By our third patient, we develop a routine where the M4 performs the cardiovascular and pulmonary exams and let's me do the neuro and musculoskeletal exams. I hit it off with an athlete who has cerebral palsy and when his mom asks to take a picture of us together, it really hits home for me. After spending only 15 minutes with this family, I helped improve their day and make their experience memorable. Experiences like this are why I entered medicine. 

Throughout the school year, I signed up for numerous other volunteer experiences, eager to feel like I was making some kind of difference. Working with real patients is a wonderful reminder of why we kill ourselves during the week studying. Some of my experiences involved teaching physical exam skills to Girl Scouts and high school students interested in health care, speaking to undergrads and high school students about life in medical school, teaching anatomy to elementary school students, and skills clinics on phlebotomy and suturing. Each of these experiences again reminded me why I chose this profession.

Yesterday, I signed up for the medical team at a sprint triathlon. Basically, I will be working with Sports Medicine and Emergency Medicine physicians and other medical students to ensure the safety of the participating athletes. By now, I know how to do a complete physical examination and I won't be so shocked if they give me my own station. This will be a new environment for me, and hopefully a great learning experience. I was pretty excited about it, again thinking of how much I enjoy these experiences and how they always reinforce the fact that I am in the right field.

 And then today happened.

Today, a bunch of my classmates and I were celebrating Memorial Day at a local lake. Quite a few of the gentleman in our class are pretty buff, so when they asked me to apply their sun screen, it was not the worst of experiences. It was during this tedious task that I found out, much to my dismay, that I am clearly entering the wrong profession. Apparently, I should not be on the triathlon medical team, as there is another position even more glorious. Apparently, there are people that wait at the end of the swim and their sole job is to rip off the athletes' wet suits and apply sun tan lotion on them as fast as they can. Is it too late to change my mind about med school? Where can I get an application? Profession Sunscreen Applier!? SIGN. ME. UP. 


And, since this is a "medical" blog, I suppose I shall leave you with this:

1. Skin cancer is the most common form of cancer in the US.
2. One in five Americans will develop skin cancer.
3. There are three types of ultraviolet radiation, classified by wavelength. UVA usually makes you tan, especially since many sunscreens don't protect against UVA; UVB usually makes you burn; and UVC usually doesn't have an affect on you, since it is absorbed by the ozone layer.
4. Your skin has molecules called chromophores, which absorb specific wavelengths of UV. When a chromophore absorbs a photon of UV light, it becomes excited and must release its energy. Sometimes it does this through a photochemical reaction.
5. Photochemical reactions lead to visual biologic responses: tan, sunburn, dermatoheliosis (chronic photodamage, skin appears aged and wrinkly), and carcinogenesis (development of skin cancer).
6. Melanin is produced by specialized skin cells (melanocytes) to help protect the body from UV damage.
7. Wear sunscreen, limit time in the sun, and for gosh sakes, stay outta dem cancer coffins!!!!

Friday, May 25, 2012

"What's the grossest thing you've ever seen?"

Emergency Department, five years ago.

Curious Me: Dr. J, what's the grossest thing you've ever seen?

Dr. J: Easy. Maggots. My intern year and I will never forget it. Homeless woman comes into the ED holding her side. She has a huge abscess. I need to drain it. Cut it open, and out spills hundreds of maggots. I want to gag just thinking about it.

Shocked Me: No way. Really? That happens? Maggots?

This morning.

At 2 am I get an email from my mentor saying, "Hey! Why don't you come in tomorrow? 8 am?"
A serious Night Owl, I am wide awake at this hour and think, "CRAP! I can only get 5 hours of sleep!? What is this?! It's summer! I haven't functioned on less than ten hours of sleep in two weeks!"

I wake up at 7am, jump in the shower, and turn around to see a seriously large and thick massive black spider flying through the air to attack me. I scream and attack back. I win. At this point, I can't decide if this is a really good start to a day (up early, going to be productive, kill a spider) or a really bad start to a day (dang, I'm up early, a massive spider just attacked me). I get my answer when I pull my white coat out of the dryer and spill orange pop on it less than ten minutes later. Then, I realize I've lost my ID. Twenty minutes later, I find it, and I realize it's too late to walk to the hospital, so I jump in my car. I figure I will drive as far as I can and park on the curb where I do not have to pay millions to park. I notice all these signs on the sides of the street, forbidding me to park there. I turn around and drive until the signs stop. I park. I realize I am only five blocks from my house. I get out, walk to hospital, trip on curb, hurt my toe. I start to get nervous about what this day has in store for me.

I walk into the team room and read the board. "Maggs."

Mentor: Want to see something gross?
Me: Ummm... Sure?
Mentor: Ever see maggots?
Me (actually getting excited): OMG! No! But, I want to! I have probably asked 5-6 doctors what the grossest thing they've ever seen is, and the answer is always maggots!
Mentor: Oh crap, patient's already in surgery. (Gives me brief patient history) But, I can show you the pictures.
Me: Yeah!!!!!!! Awesome.
Me (looking at image one): WHAT? Oh my God, that is the grossest thing I have ever seen.
Me (looking at image two): OMG, I think I might throw up just looking at these. I can feel them crawling on me! There are thousands! How does this happen!?!?!?!?!?!???!!?!?


Even though I did not see these in real life, I saw enough to deter me from ever being excited about maggots again. I did not describe what it was like in good detail, because truthfully, it was the grossest thing I've ever seen and I want to save you from having any type of mental image. All I'm saying, is when I snuck into the staff meeting to steal some free Chinese food, I looked down at my fried rice and saw maggots. Appetite killed.

Good luck to everybody in healthcare. May none of us ever have to deal with maggots, and if we do, may we have the strongest of stomachs and a really bad cold at the time so we can't smell.


Diagnosis: Pigeons

I signed up for a mentor at the beginning of my M1 year, and Irish Luck was ever on my side that day. I hit the jackpot! My mentor is an internist and one of the coolest physicians I have ever had the pleasure of meeting. She's chill, realistic, amazing at her job, well-connected, and passionate about teaching med students - basically the perfect combination of mentor traits.  This morning, I walked into the team room and began perusing the boards, looking for something interesting. What do I see?

Patient: fever, pigeons

Pigeons? What kind of diagnosis is this? How does it present? Is this person sprouting wings and living in the streets, following close at a passerby's heels for spare food? Did I learn about this in biochem? Is there a pathway? Pigeons?

I contemplate asking the residents about it, but then decide they look exhausted, busy, and potentially very grouchy. So, I shuffle around awkwardly and sign on to a computer. I google a few other items on the board so I am semi-in-the-loop during presentations, and then I google "pigeons." Obviously, you know what comes up.
https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRCTpvDI9rQKxci8KVE3lDirJSkJDbKTYLffN8vmzZmSn3V6pQr9E4fDH1KP4zi911tdNXuFVxxzGovFbaanRugqva1828s_XJU6jKg5t9WRLWrG6pVg3osKMTD5LpVFi6E7kUNHdVzGo/s1600/pigeons.jpg
Google fail.

Thursday, May 24, 2012

Get Your Game Face On


For those of you who have never played Loaded Questions, it is arguably one of the best board games. It never fails to be hilarious, entertaining, and surprising. For those of you who have never played Loaded Questions with med students, beware. Five of us were playing, four med students and one significant other (poor chap, he will eventually join the med school clan, but for now, he's still sane). 

Rules: Question Asker picks a card and reads a question. Everyone else answers it. Reader reads the answers and the Question Asker has to try to match the responses to each player. However many matches the Asker gets correct is how many spaces the Asker gets to move on the board. 

I have played this game many times before, but never with other medical students. Just like the other times I've played, I thought this was just a normal, funny game. Until this happened:

Question: If someone were to stare up your nostrils, what would they think?

Answers:

1. Cool! It's a deviated septum!

At this point, we all laughed and looked at each other, wondering which med student put that (I had my poker face on, because it was secretly my answer).

2. Dayquil... STAT.

Another legit answer. Again, we looked around and giggled, sizing each other up to see who presented with a cough, cold or flu-like symptoms.

3. Nasal septum... pink and moist.  

First thought: Textbook description of a healthy septum. Great answer!
Second thought: Who ARE we!?! We are playing a game and these are the answers we generate? Med students. Smh.

4. Oh, what a glorious nostril this is that I have happened upon.

We all gazed off with small smiles on our faces, envisioning a perfect, booger-free nasal cavity, pink and moist, with no septal perforations or deviations. And then we snapped back to reality and wished the non-med student good luck as he tried to match us with our answers.

 This round piqued my interest and I started paying attention to our other answers. Use your imagination for the questions, but here are some of the responses recorded throughout the game:

Med Student 1: killed a patient, anatomy lab cadaver after the dissection, killed a patient, Alzheimer's, dead conjoined fetus stuck on head, highly neurotic

Med Student 2: not killing a patient, have a baby, sleep too much, maxillary sinuses, congestive heart failure, missing teeth, all the gunners having questions after lectures

Med Student 3: how to not kill a patient, that weird kid in our class, Alzheimer's, 400 lbs of fat, I take nice notes

Med Student 4: kill a simulated patient, locked-in syndrome*, pharmacy


Medical school changes people. I am certain that these would not have been answers that we would have written a year ago, prior to our M1 year. A year ago, we knew we were going to be doctors, we knew of some diseases, and we knew that medical school would be hard. But, if we were asked "What is the worst thing that could happen to you?" our answers would not have been "Alzheimer's" and "locked-in syndrome." If we were asked "What would you like to know more about?" we would not have responded with "how to not kill a patient." If we were asked "Who would you not want in your bed?" our answers certainly would not have included "anatomy lab cadaver after the dissection." Today, we think like doctors and that manifests itself in almost all that we do. It is quickly becoming second nature and we don't even notice it. 

For example, I can't help that my first thought when I see the following picture, is "Wow! Serratus anterior!" 

Thank you, Carly Rae Jepsen. http://data.whicdn.com/images/26359192/Holden-Nowell-18_large.jpg 




Compliments of good ole' Wikipedia.




That's the glory of medical school. Med school consumes our time, so that eventually it consumes our minds. No matter what's going on, somewhere, deep down inside our brains' gyri, we are thinking about something that has to do with medicine and the human body. It might be annoying to play games with us, or maybe you'd find it entertaining. But, when it comes down to it, we are trained to always have our game faces on. I don't know about you, but I want my doctor to be the best in the game.


*Clinical Correlation: Locked-in syndrome is generally caused by damage to the ventral pons, which is a part of the brainstem. Patients with locked-in syndrome are fully conscious (awake, alert, aware), but completely paralyzed. Some patients retain the ability to move their eyes. Most patients can still feel pain and their cognitive function is still intact. Currently, there is not a cure for locked-in syndrome.


Wednesday, May 23, 2012

You're a M2... You know everything (you know this is NOT true, but your non-med school friends don't)

For the non-med school people out there, let me break down the common medical education system for you.

Undergrad: Complete pre-med requisites, which include: two semesters of Bio, Chem, Organic Chem, Physics and the corresponding labs, two semesters of English, math (this varies depending on the school), and that is IT! Anatomy, not required. Pathology, nope. Micro-what!? Definitely not required. Sure, a lot of med students major in Bio, Anatomy and Physiology, or something science-y, but even then, in most cases, they know more about a plant or a frog at this point in their education than the human body. A lot of medical students do not even major in a science, myself included. Therefore, don't let us fool you. If we are undergrads, even if we know we will someday be doctors, we probably don't know anything about that weird spot on your inner thigh or why sometimes when you have a sinus infection it mysteriously switches sides in your nose.

Acceptance/Pre-M1: Yay! We are officially going to med school. This does not make us smarter than when we were in undergrad, in fact, most of us are still in undergrad at this point. We can tell people "I'm in med school," and it's technically not a lie, but we still can't tell you what that weird spot is or why your sinus drainage changes.

M1: The first year of medical school, in a traditional curriculum (this curriculum style is changing at many schools, so I am speaking from my experience alone), teaches the student about the normal function of the human body. Normal anatomy, biochemistry, cell biology, genetics. Normal human organ system function. For the most part, the only class full of pathology is neuroscience, and that feels theoretical anyway (there are how many pathways in brainstem? they cross? what? I thought nuclei were cell control centers?!). Sure, we learned about diabetes and obesity and MIs, and maybe at this point we could at least remember what lecture we could refer back to about that weird spot on your leg, but we had like 60 other derm terms to cram and all those pictures looked relatively the same. Oh! And we did learn about maxillary sinus drainage, so if you wanted, I could explain to you the anatomy about why that switch happens. But, trust me, even though we memorized over 5,000 pages of notes, attended 400+ lectures, contributed to more than 70 small group sessions, spent over 120 hours with cadavers, passed at least 30 exams, and spent countless hours studying, we still are pretty clueless when it comes to correctly diagnosing/treating something. We understand the normal, and therefore how to recognize abnormal, but not necessarily how to classify and treat it.

The one thing my Mom wanted me to learn in medical school was why her stuffy nose would switch sides sometimes. A late night study session led me to this profound answer. I called my mom at 3 am to tell her, and then I drew her a picture similar to this the next time I saw her. Guess the rest of med school isn't important! :-)
M2: This is the year spent on pathology, aka the study and diagnosis of disease. We learn how to identify it, and thanks to pharmacology, we learn thousands of potential drugs to treat it. We are totally getting closer to being a real doctor. Time is spent studying infectious disease, pathology, abnormal histology, pharmacology, and clinical case studies. By now, we should be able to recognize that vesicle on the medial side of your thigh, because we know immediately that a fluid-filled blister less than a centimeter in diameter is classified as a "vesicle." We also might be able to tell you exactly what treatment to use to help that sinus infection, and exactly why it works. Maybe there will be a pathway we can draw for you!

The Dreaded Step 1: In between the M2 and M3 year, we have 3-5 weeks to study everything we've ever learned to take the USMLE Step 1. The first of many board exams we will have to pass to continue our medical education. Are we ready to see real patients? Will we survive the wards? Fingers crossed.
Finally! First Aid in COLOR!!!
M3: This is the year we have all been eagerly awaiting! Boards are over and Hellllll Yeahhhh we get to see REAL PEOPLE! One lady even called us "Doctors" today. We couldn't stop smiling. And then our attending pimped us, crushed our souls, and "forgot" to release us until we'd been there for 13 hours, four of which we had nothing to do, so we tried really hard to look busy and avoid the questioning. Anyway, it is during this year that we do most of our core rotations, which means we spend 2-8 weeks in various specialties, and then have to take shelf exams in each area before moving on.

M4: The year of interviews. As we continue to rotate through various fields, we also have to start thinking about what we want to spend the rest of our lives doing. We apply for residency, and hopefully, we match. Right now, Match Day feels like worlds away for me. I was at the bar when the recent M4s matched, and wow, it was like they were party animals who had been chained down, buried, kicked, and left for dead, and then all of a sudden, they drank the Elixir of Life and were floating on top of the world. There were more shots taken, more attempts at swing dancing, and more yelling than any frat party or celebration I've ever witnessed (not that frat parties were my scene, one of my freshman partners-in-crime thought it was awesome to pull the fire alarm when she was drunk... needless to say, there were quite a few places we didn't feel like frequenting again).

Bring it on, Match Day! http://ezbartending.net/drink_recipes.php



























































































Intern. Resident. Fellow. Attending. Since I'm not there, I really can't claim to know a lot about these stages, except this is the order they go in, and they supposedly get "easier" as you progress through the stages, though the responsibility increases. But, once we are here, we can legitimately be referred to as "Doctors" and we are as close to knowing "everything" as we will ever get, and if we don't know it, we know someone who does, or at least we know how to appropriately research it.

I'm an M2... I know everything (I know this is FAR from the truth, but apparently, my friends don't... and you know what? I don't mind one bit). I guess, like most med students, I have always been the "responsible" one and the "smart" one, in my group of friends, though they, better than anyone else, can definitely name times where this would be called into question. I was the one that my high school friends would name-drop if their parents weren't going to let them go somewhere. Of course, I never minded filling this role, and it still gives my ego a boost :-) Once I got accepted to med school, my friends immediately started calling me "Doc" and giving me a hard time about it - lovingly, of course. But, they also started texting me weird pictures of their body parts and asking "is this normal?" My first reaction is like "WTF, dude! Gross! Holy crap, what happened!?" But, my second reaction quickly kicks in, and I'm like, "Yay! Let me tell you all the possible diseases you could have (because I have no clue what it actually is) and all the ways you could potentially treat it! Oh, and do you want me to draw the pathway out for you (because that's about all I know at this point in my education)?" And if all else fails, I can just say "diabetes" - the M1's answer for everything. (If you are a current med student and have not seen the M1 Patient Diagnosis, worth two minutes of your time.)

Example 1: Best friend texts me a picture of right upper quadrant that looks severely bruised and injured from blunt trauma.
Me: Holy crap! What happened!?
BFF: I don't remember!
Me: WHAT!? How can you not remember that!? It looks like it hurt like hell.
BFF: Well what should I do about it? Can I still run ten miles a day?
Me: Tell me about your pain (haha, thank you clinical education course)
BFF: Well, it hurts really bad. I think I fell down on something (No, really!??!?!)
Me: When did it happen? Did you take anything to alleviate the pain? Have you tried running since your injury?
BFF: I think late Saturday night. I tried Tylenol, still hurts like a b!tch. Yeah, tried running and I cried.
Me: Well, I recommend you stop running (genius, right? Just hand me that MD right now). I know you're in training, so try some static lifting or exercises that don't involve your core. Or, go for a walk. Just take a week off so you stop agitating it.
BFF: Thanks, Doc.
Me: Or, you could go to a real doctor.
BFF: Nope, I trust you (Good choice!?!?!)

Note: BFF is okay, and completed first half marathon with flying colors. Proud.

Example 2: BFF texts me a pic of really bloody big toe with this caption "Ouch. What should I do?"
Me: Try cleaning it. Add some neosporin. BOOM.

Example 3: 
BFF 2: What's the real name for knee cap?
Me: Patella.
BFF 2: YES! Crossword complete.  

Example 4: This morning, hence the inspiration for this blog, BFF 2 texts me.
BFF 2: You can have white stuff on your tonsils and not necessarily have strep throat right?
Me: Yep.
BFF 2: It's gross.
Me: A lot of times it's just calcium build up. Maybe try increasing your water intake. (Will this help? Not sure, but I can reason it out in my head about why it might help, plus, she doesn't drink enough water anyway. Solid advice)
BFF 2: So I should wait it out? Not bother making a doc appt? Even if my throat is sore? (I give her credit for contemplating seeing a real MD)
Me: If you have a fever and your throat hurts like strep, make an appt. If you don't have strep symptoms, wait it out. Pain may be from build up irritating your tonsils.
BFF 2: Okie dokie, thanks Doc.

Moral: Since I just finished my M1 year, I know a lot about nothing and a little bit about everything. 
A few notes from M1 year.
Even though I am years away from being a physician, I still take pride in the fact that my friends contact me about their injuries or questions, no matter how weird or insignificant. Currently, I appreciate this. They have confidence in me and trust my advice, even though, I don't know if I would trust my advice at this point. I have heard a lot of physicians complain about this. They get frustrated when their fourth cousin twice removed phones them in the middle of the night asking what they think their cough means. Hopefully, I don't ever become one of these physicians. Yes, I can understand where it gets annoying. But, as physicians, we are choosing to fulfill a simple role in society: to help people. People put their trust and their confidence in us. They tell us weird things, personal things, scary things, secret things. And they trust in us to help them. To fix them. To heal them. In med school, we are all taught about social responsibility from day one. So, even if I'm an M2, and I don't know everything, it is still my social responsibility to help out my friends, even if it's only on the daily crossword.



Monday, May 21, 2012

Pre-Med Advice 1: If you want to be a doctor, make sure you want to be a doctor.

So today, in continuing my trend of being a bum since it's summer, I spent a good hour flipping through facebook pictures. My journey took me through engagements, weddings, births, etc. Now, I am still getting used to the fact that these three things are happening to people my age and younger, and it still slightly freaks me out. Sure, there is a good number of people in medical school that are non-traditional and begin medical school married, a few even have kids. Three people in my class are getting married this summer. But, for most of us, the concepts of marriage and babies are slightly terrifying and distant. For the most part, we all want to get married and have babies, but DUDE, NOT YET! It's hard enough to take care of yourself in medical school, let along juggle a significant other and a family. Sometimes, I will be studying for ten hours straight and think, "OMG, I haven't peed or eaten all day. I should probably do both of these things." Then, I do them as fast as I can, so I can return to the books. Imagine that mentality with a baby - not prime parenting. In no way am I saying it can't be done - I see people do it very successfully everyday, especially with the relatively new decelerated programs being offered. This is just a generalization. Anyway, back to facebook. These weddings and babies make me smile and feel happy for everyone else who is at this point in life. Great for them! Adorable. Part of me wishes I was there, almost. But, like I said, most of me is pretty terrified by the concept and just wants to focus on the MD. 

So, then I get to my college roomie's albums. She got married our senior year and she and her husband basically took off to travel and explore the world. Jerusalem, Panama, Egypt, Italy, Spain, you name it. They've been gone for over two years doing this. At first, the Sensible Me was flipping through these pictures thinking "How do they afford this?" and then the Inner Wild Child Me thought "Why the hell am I in medical school when I could be DOING THIS!? I want to travel! I want to use my language skills! I want to eat real pizza and pasta and food that I have no clue what it is! I want a mud bath! I want that watermelon-shaped popsicle!"

The point being: the most important part of the pre-med years is to make sure, with 110% confidence, that medicine is what you want to do. Life as a physician is not full of watermelon-shaped popsicles (unless you are an awesome pediatrician and make a point to hand these out). Life as a physician comes with sacrifices, and those start in medical school. Those wedding albums? I was only able to make it to one of the weddings, and only because it was my best friend's and she would have shot me had I not been there. It's hard. A lot of people do not understand why you can't fly across the country for their big day. They don't get the concept of weekly exams, catching up on sleep during the weekends, and 70K/year in loans. You need to be okay with the fact that someday you will get to see the world, have that mud bath, and eat those popsicles because someday you will be able to afford it, but in most cases, that isn't going to be anytime soon. 

I made the decision to become a physician after I spent quite a bit of time as a patient during my youth. At 13, I knew I would become a subspecialized pediatrician, and that still holds true.  Even though I have never been interested in anything else, I still explored other opportunities. I made sure I spent a lot of time in the hospitals during undergrad (~10 hours/week) and I applied for medical summer internships, landing one in organ transplant. I made sure that medicine was the career path I wanted to take. I even took a year off after undergrad to save up some cash and experience "real life." I taught high school science and coached, and it was an experience that I wouldn't trade for anything. Even if you are sure you want to be a doctor, I still recommend taking time off, as it will not only help you mature and further solidify your decision, but it will strengthen your application, and admissions committees usually eat it up.

It may seem cliche that my first piece of Pre-Med Advice is "If you want to be a doctor, make sure you want to be a doctor," but truly, it is the most important piece of advice out there. There are many other options for those interested in healthcare that are not as demanding as being a physician. After completing the first year of med school, I see firsthand how bad it sucks for my friends/classmates who did not make sure, with absolute certainty, that medicine was the life for them. Here they are - some of them because their parents pressured them, others because they thought the lifestyle would be glamorous - thousands of dollars in debt, unhappy, frustrated and confused. Don't let it happen to you. If you cannot imagine doing anything else in life but being a physician, then it probably is the right career path for you. I remember at the end of every day I was teaching I thought, "Wow, teaching is a lot of fun and hard work... Boy, teachers do not get enough credit... Fun for now, could not do this forever... I cannot WAIT to be a doctor." Get exposure. Get experience. Get confident that this is the right choice. 

Here is a great website for Pre-Med and Medical Internships: 

 Click HERE for a list of awesome Pre-Med and Medical Internships!

http://www.sirinthada.com/post/12586040084/a-little-public-service-announcement-today


Thursday, May 17, 2012

The Product of Free Time

My first year of medical school has officially ended, leaving me dazed and confused with the sudden appearance of - whoa! - free time. Not only have I watched three seasons of "The Game," one season of "Game of Thrones," cleaned my car, done seven loads of forgotten laundry, and actually cooked a real meal, I have googled the hell out of USMLE study guides and compiled a comprehensive study plan - all in the four days since my last final. Oh wait, I am sorry, five days. I have no clue what day it actually is (my roomie just confirmed it was Wednesday)- and that fact alone is pretty awesome. Why am I looking up Step 1 study guides when I am not taking it for another year? I don't know. Probably because I, like every other type A medical student, JUST CAN'T GET ENOUGH OF MED SCHOOL! Yeah, right. It's a serious sickness. Last night, I went on my first date in over ten months with someone who was NOT in medical school. What did I do? Talk about medical school. It was kind of embarrassing actually, once I realized that every other sentence out of my mouth had to do with studying, exams, patients, hospitals, or drinking ourselves into a post-exam stupor (although those stories turn out pretty entertaining). Don't get me wrong, I absolutely love medical school and I love to talk about it, dream about it (only because I feel like I am "studying"), think about it, breath it (literally, random whiffs of cadaver lab hit my olfactory receptors weekly, and anatomy ended 5 months ago...), etc. So, when I say "serious sickness," I say that with love.

Anyway, in my extreme state of boredom, I found myself perusing other blogs by medical students, when I noticed most of them (at least the ones I came across) had ended prior to 2009. So, in case anyone happens across this, here is the beginning of a current medical student's blog. Throughout these next few months of freedom, I will attempt to catch up - you know, give my quick and dirty opinion of the pre-med years, application process, and an overview of the first year.