doc w/ pen

a journalist becomes a doctor before your eyes

Month: December, 2016

Crafty

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The arts and crafts bug really struck me during my vacation. Here are a few more pieces I made over the last week. As you can tell, I love working with colors, shapes, and textures. Here’s hoping I can find a way to better incorporate this kind of creativity in my medical school life!

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Inspiration via interruption

Regina likes to keep me company when I'm writing.

Regina likes to keep me company when I’m writing.

When I’m in a good mood, I write. When I’m in a bad mood, I write. When I discover something new, I write. You get the idea.

Putting amorphous thoughts into words, sentences, and paragraphs helps me interpret and understand my daily life. It helps me reach deep inside, to locate and process ideas and feelings I didn’t even know were there.

Usually, writing is a solitary task. This week though, I’ve had help from my dad’s cat Regina, as you can see. When I’m on the couch in the morning, computer in my lap, she quietly slips beside me and gingerly steps, one paw at a time, onto the keyboard. Soon her rump is on the black keys, her front paws on the track pad. Typing becomes a lost cause.

But I’m ok with this interruption. Regina stares up at me with her hazel eyes, and I don’t care about finishing my work. I scratch her head, stroke her back, and she purrs with contentment. I’m contented too, happy to have this warm, furry creature sitting with me and basking in my company. Writing can wait.

Unless I take allergy medicine, I get sneezy and snuffly around my dad’s cats. So felines are not likely in my own future. But the joy of having Regina and her brother, Ismael, sidling up next to me has gotten me thinking about what it would be like to have my own animal distraction.

I do like living by myself. I find solace in the peace and quiet. But it gets lonely, especially when I’m studying for hours on end. Maybe having another warm body around, even a little one that can’t talk, would help. Living in a little apartment, pets are tricky — and often not allowed at all. So perhaps this is something for my life beyond medical school. But it’s something to ponder.

The writing process helps me think. Apparently, this is the case even when that process is interrupted. It just goes to show that sometimes, interruptions — in the form of cats, or otherwise — are the best inspiration.

Under the glass roof

Who loves a garden, loves a green-house too.
Unconscious of a less propitious clime
There blooms exotic beauty, warm and snug,
While the winds whistle and the snows descend.
— William Cowper, “The Task,” 1785

I read that verse on a placard at the Garfield Park Conservatory earlier this week. My family and I have been visiting this incredible Chicago greenhouse since I was little, especially during winter holidays. Under that glass roof, you’re transported to tropical and desert climates, despite the frigid temperatures outside. This year’s visit was especially special to me this year, as a New Yorker, with so little greenery around me. (And obviously, no backyard garden.) Here are some photos I took during our visit. Click on any image to enlarge.

What do I want to do when I “grow up”?

In a recent comment on my blog, someone posed a question to me. She asked whether I have a specialty in mind for the future. It’s a common question for medical students. So I’m used to fielding it. I think it’s worth explaining my thought process here.

The short answer is that I don’t really know what I want to do when I “grow up.” I’ll become a doctor of course, but what kind of doctor? I’m not sure yet. I think that’s the case for most medical students at my stage, pre-clerkships. We haven’t had real exposure to what doctoring is like. We’ve all shadowed various physicians, sure, and spent some time in the hospital practicing our physical exam and history-taking skills. But we’ve never been a true part of the medical team.

And that’s what clerkships are about. They’re an introduction to several medical specialties, a chance to try on the different branches of medicine, to see which one fits best. In order of my own rotations that start Feb. 13: ob/gyn, primary care (adult outpatient medicine), psychiatry, surgery, anesthesiology/critical care, neurology, internal medicine (adult inpatient medicine), and pediatrics. During clerkships at Cornell, we also get a 2-week elective block where we can try a field not represented in this list.

Part of choosing a specialty is finding the kind of medicine that interests you most. This is pretty obvious. Do you want a procedure-based specialty like general surgery or urology? Which patient population do you want to work with — kids, adults, pregnant women? Clerkships are designed to help answer questions like these.

I’ve also heard that part of choosing a specialty involves finding your kind of people. I’ve been told that different fields attract different personalities. Finding the right fit means finding where you fit in.

Clerkships still lie ahead of me. So I’m decidedly undecided at this point. My goal in the next year is to remain open minded. And there is so much overlap between the different specialties that no matter what I choose, having some experience with the other fields will benefit me — and my patients.

That’s my attitude. I hope that approaching clerkships this way will help me learn the most from each one.

Be in the moment

This morning, my dad's cat Regina reminded me how important it is to just be.

This morning, my dad’s cat Regina reminded me how important it is to just be.

I had the most incredible experience this morning. It didn’t involve leaving the house. It didn’t cost anything. I didn’t even have to change out of my pajamas. For an entire hour, I sat on the couch petting my dad’s cat Regina.

My dad’s two cats are friendly, and love attention. But neither has ever sat still that long for me. So the encounter itself was a pleasant surprise. Even more surprising, though, was how amazing it felt just to be for that time. Just to exist in the moment.

I don’t often take the time for anything like that. It always seems like there is so much to do. If I’m not doing something, anything, then surely I’m falling behind. But maybe the sense of peace I got from this simple 60 minutes is a lesson to me. A lesson that no matter how much is going on, taking even a few minutes to ground myself, for serenity’s sake, is worth it. I think this is especially important as I approach my Step 1 study period and my clerkships. During both of these experiences, I’m bound to feel more harried than ever. Which means I’m bound to need a moment of tranquility more than ever.

If only I had a purring, furry friend like Regina who could remind me of that every day. I’ll just have to remind myself.

Preparing for what’s next

Being unprepared is one of my worst nightmares. Literally.

The dream takes different forms. Usually, I’m at school. I discover there’s a huge test I didn’t know about (and so didn’t study for). Or there’s a big assignment due, and I completely forgot about it.

I wake up from these dreams unsettled, because in real life, I make a point of being prepared. I know that in general, there are all kinds of things that I can’t control. So the things that are within my power, I try to manage as best as I can.

Nowhere is that more true than with my upcoming clerkships. So much in that realm is out of my hands. I recognize that. But certain aspects, I can prepare for. Like having everything I need in advance.

Living in New York City without a car, shopping can be a challenge. So I’ve tried to get some of that done more conveniently (and more cheaply) while here in Chicago visiting my family.

Jeans aren’t exactly appropriate for the hospital, so I needed more professional attire. And to take a patient’s heart and respiration rates, I needed a wrist watch. Thankfully, I think I’ve gotten everything I needed. Christmas sales made it all relatively affordable — certainly more so than in New York.

I did roll my eyes when my mom explained our shopping trip to a sales clerk at the local mall:

“My daughter came all the way from New York City to go shopping here in Chicago!”

But really, she was right.

I came here to see my family, of course. That’s my main priority. But I also came here to get ready for what’s next. To get in the right mindset for studying for Step 1, and to get what I need for clerkships.

At this point, I’m prepared for what I can prepare for. And the rest? I’ll handle that as it comes.

Reconnecting with my creativity

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Coming home to Chicago means I’ve reconnected with my family. It also means I’ve reconnected with my creativity.

Ever since I was a kid, I’ve loved creating things with my hands. Beads, wire, glass, and paper have all been my mediums, at one time or another. Before starting medical school, I even sold some of my work at arts and crafts shows. But creating takes space. That’s something I lack at my New York City apartment. So the few supplies I didn’t get rid of, I left at my mom’s place.

This morning, I zipped open the red duffel bag that sat on a shelf in her musty basement for the last year. Inside the bag are clear tubs of beads and spools of colored wire. A velcro-secured pouch holds my wire cutters and other tools. In another box are pieces of second-hand silverware that I’d bought at resale shops. Take all those supplies, add some personal inspiration, and what you see in these photos is what you get.

Watching something take form before your eyes, something you have designed and created, is a good feeling. I’ve missed it.

Winter reflections

Looking out my mom's living room window this morning, through the frosted glass.

Looking out my mom’s living room window this morning, through the frosted glass.

My long-awaited winter break has arrived. And boy, is it winter here in Chicago. I’d avoided donning my down coat in New York until last Friday, when the temperature dipped to 18 degrees. I decided at that point, I could deny the cold weather no longer. Here, that denial is impossible. My iPhone weather widget tells me it’s 7 degrees this morning,  but feels like -7. That’s pretty damn cold, no matter how you spin it. Thankfully though, my internal Midwest thermostat seems intact, and I’m weathering the weather just fine, thank you very much.

Sarah and I were beyond excited about the alleged end of the frigid U.P. winter.

Sarah (on the right) and I were beyond excited about the alleged end of the frigid U.P. winter.

Flipping through an old family scrapbook this morning, I was reminded that even as a kid I had a high tolerance for cold. We lived in the Upper Peninsula of Michigan for a couple years when I was little. There, winter pretty much runs from October through April. Summer feels more like spring. But my sister Sarah and I had no trouble romping in the waves of Lake Michigan while my mom huddled in her jacket on the beach. One of the stories that my parents like to tell about our time in the U.P. was that in 1987, on the first day of spring, Sarah and I were so happy that winter was (supposedly) ending that we put on our bathing suits and ran outside, barefoot, yelling “It’s spring! It’s spring!” We did this in spite of the patchy snow still on the ground.

Looking back, that seems like such a crazy thing to do. Bare feet, bathing suits, and snow? Seriously? But then again, I think a lot of life is like that. In the midst of doing something, no matter how difficult, it seems completely natural. In retrospect though, you wonder how you survived. I wonder if that’s how I’ll feel about medical school. It’s certainly possible. There’s been plenty of craziness involved, and I’m only 3/8 through. But right now, medical school feels like the most natural thing to be doing. Just like running through our snowy lawn, barefoot and in my bathing suit, almost 30 years ago.

Always more to learn

What we know is less than what we don’t know.

That’s a quote from one of our infectious disease lecturers. She was talking about viruses. But her words describe so many vantage points, including my own right now.

I’m done sitting in a classroom. Not just for the semester, but for medical school. Next semester, after I take my board exam, I go straight to the hospital to start applying all I’ve learned. And to learn so much more.

It’s been a jam-packed three semesters. I absorbed more information than I thought possible when this all began. Attending medical school is compared to drinking from a fire hose. It’s an apt analogy. What we endure is intense.

Even so, what I’ve got now is book knowledge. A tangle of facts. (And even that needs a great deal of solidifying during my five weeks of studying for boards.) Having that knowledge at my fingertips, and understanding how to use it in clinical practice — those are skills I don’t yet have. And while I know the steps of a physical exam, interpreting the findings, what they mean in the context of my patient, is something I need to practice too. I also need to listen to hundreds of hearts and lungs and bowels so I can learn what normal is — and what abnormal is. Right now, it’s all a bit of a jumble.

I have learned so, so much since starting medical school in August of 2015. But I have more to learn in the next two and a half years while I’m in the hospital. Then more yet in residency. And even more once I’m an attending physician. In medicine, the learning and growing never stop. That’s intimidating sometimes, but it’s also exciting. It keeps things interesting.

Right now though, I’m ready for my two-week winter vacation. All this learning is hard work.

Building trust, one patient at a time

Sneaky.

That’s what my patient called me yesterday.

He meant it as a compliment. I took it as one.

I’ll back up, and explain the context of this clinical encounter. Yesterday was our final OSCE of the semester. OSCE stands for Objective Structured Clinical Examination. That’s a long way of saying we get videotaped interacting with a standardized patient, an actor who’s trained to play a certain role and then provide us with feedback about how we did. It’s a required part of our medical school curriculum. It’s how they assess our developing clinical skills. We’ve had several OSCEs since starting medical school, but yesterday was the culmination of our three semesters thus far. Up until this point, we’d only done bits and pieces of the standard history and physical exam. This time, we had an hour for the whole thing, from the chief complaint (why are you here?) and history to a head-to-toe physical exam.

I was nervous. In part because being filmed intrinsically makes me nervous. But also because this was a lot to remember. It matters, and I wanted to do well, to take the exercise seriously. Because in a couple of months, I’ll be doing it for real.

But once I settled in with my patient, I was fine. While taking his social history, I learned he was from Chicago. So I delved into that a little more. We talked about the differences between New York and Chicago. We joked about particularities of the Upper East Side. And then I attempted to gracefully move on to the TED questions — tobacco, ethanol (alcohol), and drugs. Sexual history was next. These two groups of questions are some of the most touchy. My feeling is that if you have the time, it’s a good idea to get to know the patient a little before asking those questions. Not only that, I simply enjoy hearing other people’s stories. What is someone else’s life like? Where have they been? How do they approach the world? It’s the curious reporter in me.

And that, my patient told me, was sneaky. In a good way. We were talking about Chicago and then all of a sudden you were smoothly on to more history questions, he said. By talking about his life, he told me, I’d developed a rapport that made him feel comfortable answering those delicate questions.

Not everything went so smoothly. I have lots of room for improvement. I need to find the right balance between spending time on those life-questions and spending time on the rest of the physical exam (which I didn’t quite finish within the hour).

But I’ll get faster. I’ll become more efficient. Those are skills I can learn, and will learn as I make my way through clerkships in the hospital. That I know how to earn someone’s trust — I think that’s more important at this stage. At least for me. The rest will come.