Living the much updated and better life!

Well, being now the beginning of October - WHERE HAVE I BEEN? So many stories to tell! I have heard though from family that I really need to update my blog. Just letting all know that I am back and will be slowly updating what I have been up to lately.

Now being in the research department, I will have ample time to start where I left off and bring everyone to the present! :) Stay tuned, coming up next: Step 2CS, pediatrics and the end of Saginaw!

Draggin' & Doubt...

Well radiology is over and it was a nice relaxing two weeks compared to the worst I have seen. While I saw the appeal as in every specialty, I know it isn't for me. Lately in fact, I wonder if anything is for me... While these past months have been stressful, I can't help but reflect back over the last time I was truly happy with medicine. Honestly, the last time I could think of was January, my trauma surgery month. Even though it was so very busy, it has been rough since it seems. Surely you all know of my infamous countdown to come home in about 5 weeks for good and I am truly hoping this is the reason for my lack of interest in what I am doing.

I find myself not as eager to study, to see patients or even to drive to the hospital! The best way I can explain it is - remember if you didn't want to go somewhere but your mom made you go, kickin' and screaming? Yeah that is me, except it is kinda in my head. I wake up thinking, "I don't want to go in at all" while I am getting ready. I get in my car and say to myself while I am driving into the hospital "Just turn the car around or better yet hit the highway home!" I am kicking and screaming in my head yet I am constantly forcing myself into each day. It sounds terrible I know... I have definitely hit some low points and constant thoughts of doubt. If this is how it is going to be, should I do this? Is it only because I am so SO fed up with being away from home? Could it just be the constant stress of presenting patients and getting critiqued by every preceptor - not because you aren't doing it the right way but you aren't doing it THEIR way? There are so many things bothing me as of late that overall, well, I truly feel like I have lost my passion... and I can't find it.

What happened to me? I used to be so invigorated by it all... Sigh, I'm not saying I am quitting or anything. I really don't think there is a way out even if I wanted. I mean it is so much easier said than done. What am I just going to NOT show up for clinicals tomorrow and drive home only to realize I am nearing $200K in debt? Oh no problem, I can work that off in - psh - well whatever other career I would choose would go off to paying off my $200K mistake. Ok, so obviously I have thought of it... I just keep wondering it is because I am away that I am feeling this way. I felt so good rotating at home and being able to live my life. Maybe that is what is missing? Maybe then I'll get that passion back? Okay, let's think positive and say that will happen. I run into another issue... Say I make it through this crazy last year and actually obtain my M.D. degree, lol. I still am not sure what specialty I would want.

Truth or dare: Truth. What specialties have lingered in my mind for more than 10 seconds? IM, OB/GYN, FM and to a lesser extent ER. Why? Don't get me wrong, I loved my month in it but something gets to me everytime I hear an ambulance or when we'd have to take care of a drunk moron for driving his snowmobile into a tree at 3am. I know it must sound so cruel but I don't want to spend my days taking care of people that don't minimally take care of themselves. Yes, you could make that argument with IM or FM for people not managing their hypertension or diabetes but to me that is different at least. So ok, what to do now with my final 3? Well, I truly love them all but I decided to look into where residents do their curriculum rotations. To be truthful (and I think that I will mean this more when I find that passion again lol) IM is the best. They get the IM floor, cardiology, respiratory, heme/onc, pulmonary, GI and so much more that all strike my interest. FM has many of the same rotations but it seems in shorter amounts of time. Sigh, so much to choose from but I think I know the direction I am bound to take. Just ready to know for sure!

Life in a box...

Well, radiology is not as awful as I had thought. I am with a very nice doc that while he doesn't teach a whole lot, is not making these two weeks difficult either. Don't get me wrong, I love a challenge, but these two weeks were supposed to be vacation anyway ;). I cannot tell you how many films we have reviewed in only 3 days but I am enjoying it. I am not sure if it is going back to my anatomy roots, sitting in a dark room and getting all cozy or taking a break from endless H&Ps but it is a more relaxing way of spending these two weeks. I can see the appeal of this specialty though. It has to rank high on the lifestyle list with the hours they work, 8-4:30pm. Again too, I can see the appeal of being in a room alone just to get your work done and go home, but it totally is the opposite of what I saw my career to be like. I always wanted that patient contact. Although these past couple days, I don't have much sense of dread going to the hospital. Maybe because I know I just have to look at a screen and not worry about my interview or exam skills... Like I said though, for these two weeks it works just fine with me, a much needed relaxing rotation and hey - this is 2 weeks more of fourth year (now being a month total) that I have completed and will have that much extra time off early next year! Breaking it down, if I took no breaks for the Step and interviews, my medical school rotations end in the middle of February! How awesome would that be? Heck, graduation isn't until May and internship isn't until July!

I am not anticipating alot of time to study for the Step (planning on taking during my outpatient month of IM) and interviews - well, a topic for another post but I have I think about 12-15 programs I am looking to apply. After speaking with my medical education coordinator here in Saginaw, I supposedly should be applying to 60-150 programs... I can tell you now that will not happen. There are ~15 programs in Michigan and 2 in Ohio that I am looking to apply as I am not interested in doing a residency away from home. Yes, I know what that means. What if I don't match? What if I only get one interview? Well, I may be crapping my pants until the match - but if I don't match, then I don't. I had heard that people apply for 150 programs and only interview at a grand total of 7! I don't know if that was for a surgical residency or what but it really didn't push me anymore to go looking into out-of-state programs. I think that I will have a good shot especially if I can prove myself in my core this summer in Detroit. More of this to come in later posts but I just know how I feel about this situation and feel that I do understand the risks of such a choice.

Anyway, I better get going... I have more sitting around to do tonight (ok maybe some reading too). I just can't wait until the weekend arrives - home!

Finding a balance?

I'm troubled tonight thinking of what is to become of my life. To me, I know it will be everything I ever wanted and perfect. I will be a wife, mother and physician just to name a few...

I guess what has got me thinking more is just planning my final year and learning from the experiences of others. Tomorrow begins my attempt at securing more rotation spots to finish up medical school and it is completely exhausting to worry about finding places near home. Nothing else I can really comment on that now but I will keep you posted on how things go in that regard. Though tonight I watched a show on NOVA, "Doctor's Diaries". All were great physicians, all dedicated and all seemingly consumed by work. The men physician would get divorced or have wives that would stay home with the children and the women physicians would have no social life at all.

So two ends of the spectrum. My life as like the rest of the world will be indeed wonderful but not perfect. On the other side, I am not looking to be consumed by this career. I love it so much but there is point that I an not looking to cross. I know eventually, sometime in my career -years after residency ends - I will not be looking for a full-time job (in med terms, what like 60ish hours?). Whatever it is, I know I want to be there for my children. While I know I won't be able to be a full time stay-at-home mom, but I have no interest in sacrificing that aspect of my life for medicine. Reading that back to myself it sounded kind of harsh but what does that mean? Why do I feel like this awful person for not feeling different? Truthfully, when I am set in my career I feel fine about that statement. It is just this stupid 4th year I have to plan that is making this so difficult. I have the option of staying in Saginaw for the rest of my education - to have it all planned out and set for graduation. Yet, I am opting for making it more difficult on myself and planning it on my own to be near home. On the one hand I think I am an idiot. On the other, I think it is long overdue and I should do what is in my heart. Head vs. heart is what we have going on here people... The eternal battle. Wait no, that is good and evil... anyway...

Just what am I to do. At this point, it is April and I still have some time to figure this out. Hopefully some luck will strike me and I can work closer to home. The thing of it is, I just don't miss being around home - I am physically starting to feel it. Mentally, oh please that has been around for what probably is years, for which I have slapped myself out of many, MANY times. I am honestly physically feeling sick when I leave home. As I have told my own mother, my heart literally aches everytime as I begin my drive away from my home. It's just like, exactly like, I am just leaving a part of me there and without that piece I cannot fully engage myself in the tasks that are at hand. Again, on the one hand I feel so good having this thought, because I know my upcoming wedding is just so right, it is that piece of comfort and peace that I will have in my life forever. On the other hand, I want to yell at myself for not being tougher and sticking through this like other students - as I am not the only one to have sacrificed for this path chosen. All the years I have worked, I feel like wanting that comfort and peace is giving up or wrong. Again, in my eyes this is just another case of head vs. heart.

I am not expecting to come to a conclusion tonight. Haha, even if I wanted to - it wouldn't happen anyway. All I know is maybe I just need to ingore them both and go with another alternative - my gut. Tonight? My gut is telling me to start listening to my heart and pray. The rest will fall into place... at least I hope for that and maybe in my own heart my life will become maybe not a perfect life to all - but the perfect life for me.

*~Spring has sprung!~*

Guess who? Yes, I know I haven't been around in a long while. Lately this has been a hard thing to remedy. Like I always say, after my day is done it is hard to go back and relive the whole day so I had started to forget to write. Maybe that has been my problem too because my bitterness as of late has increased. So much has happened though since I have last written and all I intend to write about. First of all surgery is over!!! I had gotten through my last week with my second surgeon and could not wait for it to end. He gave me some constructive criticism for my last day, shook my hand and went on his way. I ran in the completely opposite direction, haha! See ya! I must say that my month with him was the hardest month in medical school for me. I have always been dreading my surgery rotation and for the exact reason for the month of February! I learned though - mostly to speak with confidence more and get thicker skin. Since that month has ended our program has our last month in the ER.

Let me tell you that I went in that month scared to ask a single question or to do anything wrong. I was like a neglected puppy that was placed in a new warm and educationally encouraging environment, and I felt... relief! I felt like I could be myself and actually enjoy being a student again. This was the whole month of March and I had 10 shifts of 10 hours. Shifts were either 6am-4pm, 1pm-11pm or 10pm-8am. The ER was full of encouragement and praise on my end. I felt like I went from being the stupidest student on earth to... well, someone that could actually pass as a physician next spring! For those looking for a great rotation before USMLE Step 2 CS - do ER! (Yes, in my absence from this blog I have taken my CS - don't worry I will talk about it too!!!) The ER gave me so much autonomy - freedom to take the reins of my own clinical experience. I was able to do my own H&Ps, differentials, workups (granted it was the resident ordering the tests but I was always asked what my differential was and what tests I would like to order). You guys - that's CS right there. A perfect month of preparation! :) That being said, if I fail my exam, my story will change. Since I just took this exam recently, I will save that for another entry but all in all it felt good and dare I say - kinda fun!

So, what is on my plate now? I just went home for two weeks after my surgery rotation completed and spent it planning the wedding, enjoying my time with family and friends and of course getting yet another glimpse of what life will be like in a matter of weeks (not months anymore!) when I move home for ever after with my Tony and puppy Maggie. Soon my time of travel will be over. No more island, no more living out of a suitcase in a hotel or a one-person apartment. Yes folks, after nearing 3 years I officially feel like my dues are paid and it is time to pick up where I left off. The summer will be spent in Detroit, which is very close to my home and I can only wish that I make a great enough impression to hopefully get the opportunity to interview there and obtain a residency! I can't wait. My homecoming has been long awaited and the emotions that I am sure will come over me will be something I have never seen. I appreciate all the opportunities that I have been given and the blessings I have had for being this close, but the time has come and I am at my limit for what my career is worth - and it calls for home... Having this without my family and friends is just less worth it as of late and it cannot come at a more perfect time. When I am home and working - it is the best of both worlds. To come home to my fiance and puppy (just turned a year old, so I guess not a puppy anymore right? :)), is just the best feeling ever. Knowing I can be with them all night long and go to work the next day only to return right back will be the best blessing ever after being through all I have these past years.

As for now, I have returned this morning to Saginaw to begin my radiology rotation which will be two weeks long. I really believe that this rotation is so valuable to any student. While they aren't the most stimulating days, maybe that is what I need now since I am kinda "checked out". After this on April 24th, I start my pediatric rotation which ends June 5th - the last day in Saginaw! I am sure I will be writing more as my countdown quickens and I just can't contain myself anymore! Well, I am sure I have some holes in my stories and have more to talk about but I will get to it soon. Today my day was 8am-3:30pm and with all that time I should have ample time to blog, hmm? :) I'm gonna read and relax but I will catch you all soon.

Nobody said it was easy...

Time is surely ticking down on surgery and I couldn't be more thrilled! I really wanted to post more on this rotation but when I take the time to write, it is like I have to relive it all over again. Usually when the day is over - it is the last thing I want to think about, unfortunately for you. Well, fortunately for you I am stuck here in Saginaw, as my attending as asked me to come in and round in the morning. Afterwards, I will have the rest of Saturday and Sunday off and plan on heading back home. So, here I am bored and realize what a perfect time to update people on my rotation ;)!

So this was the third week with my second attending and it was a better one. I don't know what it was but I have been getting most questions right, doing much better on my notes as far as my plans go and overall just getting along better with him. After last week, I really thought about how his work ethic affected me and how others (staff, students, residents, etc.) really had similar experiences as me. I know that it isn't just me. Being strict, unrelenting and at times condescending is just his way and maybe not even how he'd see it. I have felt like over this past week he has the military "break 'em down and build 'em up" style. I say that because my first two weeks were brutal. I mean to the point of crying most days and leaving the hospital feeling lower than dirt. Nothing I could do would please him and it was just a fight that I could not win. It is still somewhat to that point but he is seemingly more happy with my work, praising me more, joking with me more and generally a more pleasant man to be around.

I hate (really) to admit it and I am sure this happens with many students. When you are getting to the end of a rotation that you really did not like, you are sooooo happy but then have a sense of hindsight. I do not like the phrase "hindsight is 20/20", because well... duh. It's the same thing as finding something lost "in the last place you look". Anyway, I am slowly seeing how I have learned this month. While I am not learning ICU management or a plethora of information, I know I have become just that much tougher. Sure, I have gained some knowledge too, of course - but I think the majority of what I have learned is to work up a better plan, thinking to read up on patient's conditions while I have them and becoming more confident. My plans are improving, patient conditions I try to read on but when you never know where questions are coming from you just get sidetracked and completely are oblivious to thinking ahead to what the next day's questions might bring. Confidence is still something majorly in the works. It is coming along though.

Today, I had rounded and found out there was nothing else much to do for the day. Hoping I would get a break and allowed the weekend off, I was told to come in tomorrow morning to round and couldn't be happier about it (ahhemmm). Anyway, so tomorrow I will round and head home for a day or so. Next week? My last week of surgery baby! Well, there is still a month of ER to go in my rotation but it is completely different. No calls, no rounding, no lectures. Just 10 hour shifts. So next week marks a huge point for me in my medical education. As always, it hasn't and probably will not hit me for a while but I hope it does. There is a Hawaiian Ball next Friday that I cannot wait to attend for our local firefighters at home. It is dinner, dancing and... open bar! Also, it is on the same day that my surgery months end and I am sure I will be partying it up! I have really started to work on my diet (less junk and such) and began my workout regimen again that I have ignored for about 3 weeks. I am slowly getting back to my old self and can only hope that I see more of this. I know I will appreciate it as well as others who have heard me yabbering on about how stressed I have been.

Well, I am going to do some reading and relax a bit before heading to bed. I can't wait to head home in the morning!

Oh surgery, how I love thee - let me count the ways (not).

As you all probably know, I am sorry for my lack of posts over the past couple of weeks. Surgery is ... well, surgery. Overall I am sure that I will be getting a positive overall experience but I truly feel that I learned much more out of my first month than this one.

To start off, my first month ended spectacular. I found a wonderful book on the ICU call "The ICU Book" (haha). I really haven't had much time to read it since I started my new month of surgery but I can't wait to get to it once it is over! I truly loved trauma surgery and mostly I guess it was for the ICU patients. I think that I have determined that IM is the way that I am going to go in residency. Not 100% sure yet, but pretty darn close to that! I am thinking of specializing as well and at the top of my list is oncology but we will have to see. Anyway, at the end of trauma, I have learned so much, done procedures (PEGs, art line, femoral triple lumen, pulling chest tubes, etc), closed in surgery, done countless H&Ps (which I think I am kinda getting the point of *wink*) on top of learning so much in rounds! I was never criticized for having the wrong answer, sometimes told to check up on some things but for the most part having my attendings take the time to teach me. I left that month, feeling like I worked as hard as I could have and got nothing but good reviews of my performance. Who knows if that will translate into an 'A' but if not it is ok. Truly I am just trying to get through it.

So... this month. Yeah. Much different. Let me tell you, I would rather be on the trauma service for another month of 80-90 hours a week than what I am doing now. While my attending gives off a nice vibe, it is the majority of these last two weeks with him that I have felt just as how I thought the "typical surgical student" would feel. I am criticized quite often, rarely praised and pretty much nothing can please the man. When I get things wrong, I am given a good talk about how I need to read more (if I am even reading in the first place to him). If I am right, just more questions come until I get something wrong most likely. If I try to ask a question to clarify after I do something wrong, it is taken as trying to justify myself. I have already been told to shut my mouth when he is trying to make a point and to speak when he asks questions. It goes on and on. I know he has so much to teach and is a smart guy but I haven't learned 25% of what I did last month. Everyday I go in thinking that I will get SOMETHING out of this month - even to be more thick-skinned or quicker in responding to questions with more definite answers - but it usually comes out as a flop at the end of the day. I really am trying hard but I must admit that the constant comments and criticism of my work - to the point where he thinks I go home and just watch tv, MAKES me want to just go home and do that. If he will not believe that I am actually studying no matter how hard I try - why should I? What's the point?

We were in surgery for a total thyroidectomy and I read up good on it. I will admit I get super nervous when questions come. This is diminishing because for the 1/2 of the questions I get wrong (if not more) I am just getting used to that "oh shit" feeling in the pit of my stomach. So I read up on the thyroid well and in the 2 hour procedure I get 4 questions - 4! Out of the whole thyroid. Of course in the book I am reading it breaks down anatomy, physiology, diseases, surgical points in preventing complications, etc. Notta one question on what I read. So automatically, I must not have read because I answered 1/2 of the questions wrong. This was not the first time this has happened. At the end of the surgery when I was getting lectured, I was tired of it and told him that I did in fact read and he didn't ask anything about what I covered. I don't know what he thought of that but he told me to go ahead and tell him what I studied. So I spend a couple minutes telling him of anatomy, things to watch out for in surgeries, etc. Who knows if he was satisfied or more upset but I was tired of it. Some of his questions are just too advanced it seems for me - but I take it in stride hoping that I will learn even more. When I was asked to what I would like the D5 0.9%NS maintanence fluid rate to be set at for the patient post-op, well thank goodness I was wearing my mask because I was like whaaaatttt... Positive note? I now know how to do that. When I didn't know however it was shocking to him. His favorite line of this month is, "You have had a month of trauma surgery and you don't know how to do this/know this?"... sigh. What can I say, I am trying and furthermore... Only 2 more weeks! Less than that actually, as he is on vacation until Tuesday (so I am with his partners) and of course I have lectures to attend, conferences, meetings and still one more call. Only one more on-call in surgery!

I truly cannot wait until this month is over. Again, I will be in the ER next month for what is now 10 shifts of 10 hours thoughout the month. Umm, sweet!??? Plently of time to study for my shelf exam and Step 2 CS! Oy, but surgery just needs to end and I don't see why Ross has such a long surgical rotation. I was with a MSU student yesterday and he just had 4 weeks. Lucky duck. Anyway, I have made it this far and am currently finishing up the part of medical school I have been dreading for 3 years. It is almost over and to me, everything will be downhill from here. I have no idea what my grade will be in this rotation and as long as I pass... whatever!

Whew, felt good to get that off my chest. I still have a bunch more to talk about with other things but I will save it for another day soon to come. I am sure once this month ends (last day is February 27th) I will have so much more time to post! :)

Well, I am post-call and it is time to get ready to see my sweetie who is coming up to see me for Valentines Day! We are thinking of maybe going out to a comedy club which would be great. I could really use some comedy in my life at the moment ;)!

HAPPY VALENTINE'S DAY (or Happy Hallmark Holiday - whichever you prefer!)

Onward to week 3...

My one free weekend of the month - and what a relaxing weekend it was! It was so good to be home and to rest up a little. I had one trauma during call Thursday night, otherwise pretty much uneventful. Alas, here I am about to begin week three of surgery. Two calls left this month, one being tomorrow and my last on Friday. At the end of next week, I will be done with my trauma service, my time with the trauma team and be half way done with surgery. Whew. I can't wait. Once I start my 2nd month and get that underway, I will be so thrilled to start saying, "Only 3 more weeks!". Seems so far away but it is coming. Of course, after these two months I will still have 4 weeks of ER but from everyone I have talked to, it is alot of fun. Out of 31 days in March, I will have 16 shifts of 10 hours. Much more time off, no call and truly the start of a much better life as a medical student. The hardest part mentally and physically of medical school will be over and done with and I will be able to focus on all the great things to come afterwards.

Just on the drive back up to Saginaw, I was just thinking of how long this saga has been going. Since August of 2006 I have been away from friends and family, living out of a suitcase, moving from apartment, hotel, another apartment, etc. Granted I have been able to drive home many weekends and at times come home during a scheduling hiatus - but soon, June of 2009, it is finally over. I find myself so excited I can barely contain myself thinking of how strange it will be to use my suitcases for trips instead of another move back to a city that isn't my own. Also how strange will it be to be home with Tony and Maggie, to wake up knowing while my days are still going to be long, I will always be coming home to them each and every night. Just to be back home living life again, getting ready for my wedding, to be a wife, to take spring and summer trips to the cabin, gosh so much...

It is hard when so much stands in the way of getting to that point. Truly though, going back to August 2006 and looking forward to such things would be a bit far-fetched. Now, nearly February 2009 - it is really not so absurb to think of such things. I guess it is all in perspective. Heck even after this month of trauma, my 2nd month could be even better. I know my next attending has earlier hours but as far as weekends and times when the day is finished might be better at times that this month. How wonderful it would be to be an improvement from this month, considering this month thus far has been, dare I say, a pleasure.

As you can see, so much is on my mind tonight as it usually is when I have to pack up my car Sunday afternoon, say goodbye to my man and puppy, only to see them hopefully within the next 2-3 weeks... Luckily, my mind is in a good place tonight which traditionally has not been the norm when I have to leave home. I am hoping in this whole change of mentality, I am seeing the bright, bright light at the end of the tunnel. After 16 months on the island, 5th semester, the Comp (twice), the USMLE Step 1, FM, Psychiatry, OB/GYN, and my ENT elective - and in the near future to be surgery and a quick rotation in peds - collectively nearing 3 years (from August 2006-June 2009), I will be living the life that I have been dreaming of ever since the very day I left on that plane for Dominica. I'm holding on for that day and when it comes, life will just never be the same!

Pushing forward - Second call over...

Time just keeps on tickin' and a good thought for all of you out there dreading surgery - days go by quickly. Seriously, hours just fly and before you know it you are mid-afternoon so close to getting home. Of course, some days drag on but the majority of the time it goes fast - especially if you keep yourself busy as much as possible. Here is a BIG tip in surviving surgery (while I know I am nearing only 2 weeks into it):

1.) CHANGE YOUR MENTALITY!!! I had to very much so. Not so much physically but I thought that I would seriously die from this rotation out of exhaustion and harassment from the surgery team. Things truly now (at least for this month) could not be further from the truth. It is so hard for me not to say, "Three months to go.". It made me sad and cry everyday before I just came to change my mentality. I don't even count my 3rd month now because it is 16 shifts of 10 hours in the ER. Not bad, no call. So now from 12, I am down to 8 weeks, 2 of which are nearly over. Changing your mentality! It is hard for me to take it one day at a time but really, with the trauma team I am on, I do feel like I am a wee bit useful with my getting up way before the crack of dawn to pre-round on as many patients as I can to lighten the load for the rest of the team. Of course, I hope it impresses them, hope that it is appreciated and noticed - but above all I have changed my mentality. I now tell myself, "The more you do in pre-rounding, the quicker you can get to relax before rounds, finish rounds and get back to the apartment."

I cannot even explain how much of this is a mental game to convince yourself to push onward one day at a time. I resisted so hard to change the way I thought. I still will have hard days and some of the hardest are when my perspective is lost, in that I WILL be done with soon. It is just another hurdle and the best time of my life is yet to come when I move back home, get married and more! In this rotation though, getting up in the morning is still the worst part of my day, but knowing I will be in the hospital within the hour pre-rounding and getting the job done makes me happy because that probably the one time of the day I can truly shine and show that I am up for the challenge. Questions you can get wrong, procedures you can do and be talked though, but here is the one time you can show true initiative.

2.) Surgery cannot - I repeat - cannot take away your "me" time!!! I have a strict schedule (kinda). I need my time and I will have it - even if it means that I get less sleep. I shower before bed, have my clothes laid out so when I roll out of bed I get dressed and walk about the door (without breakfast (I can get some food in the resident on-call room), I can do it in 10 minutes!) I finish my day (12-13 hour days when I am not on call lol) - but then? Well, I workout! Something I refuse to compromise on. Before surgery I did 5 days a week. That is a bit too much I think to handle for me, so I count my on-call days as "workout days" even though it isn't much of a workout. Just the mental stress and physical stamina it takes is enough. So technically, with that I still get my 5 days a week. What else? I get in a bubble bath when I feel like I need one, have a cocktail or two (;D), watch TV (while looking up things I jotted down thoughout the day during rounds that I didn't understand) and do some leisure reading (reading "Marley and Me" right now). Whatever you would like to do - DO IT. There is time, even if it is cut short you don't come home to dread another day because you "don't have a life". Sure you are in the hospital 6 days a week - well that day off will be FAB-u-lous!

Can you see this post is really for me still, too? Haha, okay - I have more tips I am sure to come but those are so far up on the list, I had to talk about them. If anyone ever feels that dread or worry for what lies ahead - I am here if you need it. These past 2 weeks have really hit home for me and while I know I am here for those who need it, being able to talk about this here makes me feel that I am not alone either...

As my family says, stop and look back on all you have accomplished! Look at all the steps it took for you to get where you are! Be proud of yourself and know you have the strength in you to reach your dream. Stay as focused as you can, try your best to avoid the wrong mentality and always make time for the one of great importance - YOU! Everyone needs to be reminded of this from time to time... even me....

I'll be writing soon so stay tuned :)...

So begins surgery...

Well, good news? I will never have to do my first week of surgery ever again. Surgery began on January 5th with our orientation. It was so funny because with all my other rotations it was very welcoming. Surgery? Not so much. It was pretty much like, "This is your schedule, get used to it and just deal with it.". Interesting to say the very least. After talking with the last group that went though who the good attendings were and had the best of the worst hours. I've been told the two people I have are the worst hours but it seems like we all kind of have the same situation.

Anyway, my first day I was on call. I went in at 6am Tuesday (since it was my first day I didn't start rounding until the day after so I got to come in later), had office and hospital hours until 5pm, went on call at 5pm and stayed until 2pm the following day. 32 hours... Sigh. Luckily call was uneventful as there were barely any pages for trauma, so I got to sleep for about 4 or 5 hours. Call is technically over at noon but being my first day in, I was timid in any way asking for a break or to go home. So I stayed for 5 surgeries in the morning and went home at 2pm. The rest of the week comprised of me coming in to pre-round (on the floor at 5am) before rounds and staying to about 5-6pm at night. I am still pretty slow at seeing people and can see am trying to improve my efficiency. In FM or OB/GYN, notes were short and sweet. TICU/NICU (trauma/neuro ICU) notes are longer and full of detail. Right now I am seeing 3-4 patients before I see any resident or attending. By the end who knows how many I will see.

This rotation is full of the unknown. To me, this is my first seemingly medical rotation in terms of fully comprehending basic physiology to formulate treatment plans. I guess maybe its the ICU and not really surgery that makes me think this way. Even yesterday, the attending, resident, PA and myself sat to talk about hemodynamic profiles with a Swan catheter. I think I have never felt more unprepared for a talk. I have not even looked at that in months and months and here I am getting 90% of the questions wrong. I was getting so embarrassed. Truly on this rotation, I am sure I will learn a great deal but really in no way am I expecting an A. Of course, I will try for it but, really I do not hear alot of students getting that on this rotation.

So, the rest of the week basically was rounding and procedures. As far as my first week goes I have already gotten to help close up patients in surgery, pull a chest tube and place a PEG (or G-tube). I really enjoy the hands on aspect of it and really have no time to be nervous because once they say "glove up" you are pretty much commited to do the procedure. Overall the trauma team is very nice and I hope they don't think I am the worst student to ever work with them. After asking the resident what I can do for next week better, he told me to just work on suturing but as far as my availability and notes to just keep doing what I am doing. Hmm, not too sure what to make of that but ok. My resident is a real sweet guy though and pretty fun to spend the day with. So with all of us together it is a total of 6 people - attending, resident, ER resident, PA, med and PA student. Truly the days as of yet do not drag on because they are so jammed with work to be done. One thing I think is that time will go fast in this rotation. Days went by fast this week and I can only hope my energy stays how it is and time continues to roll how it has. Now that I am thinking about it more, it is probably better that I am doing this rotation in the wintertime. I thought it would make me more depressed but really, if I was doing this in the spring or summer and missing out, I would be alot worse. At least the rest of Michigan is semi-kinda where I am right now. I just am trying to keep things in perspective. I won't have to miss the opening of the cabin up north this May to go for great weekend trips, I will be home forever June 5th, I will get to have summer at home, etc. Overall, I am glad at the timing of this rotation now. All I have to do is get through it...

Tomorrow I am back on call but then I will be done by around noon on Monday. Since I have to go in early tomorrow I wasn't able to see any family or friends this weekend from home but next weekend is supposed to be my "full weekend off". We will see how that goes later in the week. Anyhoo, I suppose it is time to close this entry and start relaxing a bit and getting some reading done.

What IS Jessica Up To?

I cannot believe how fast time flies and I apologize for not posting for the past while. There is so much that I would like to talk about so I think I will probably break it down over the next couple of posts. When I last left off I was about to do my weekend call for OB/GYN. Of course, being there for about 16 hours pretty much nothing happened! Call was from 8am-midnight and not one delivery. Only by around 5pm were there any screeners at all! Luckily, my resident let me out at like 10:45pm and I was able to get some rest. I had one more call on Wednesday but the big news came in the last few days of L&D. All I wanted was to get in there for the deliveries and be involved in it. Days past and all that happened were C-sections. Oy. Well the time finally came! My first delivery (which I was able to actually deliver the baby) and the next day I was able to deliver yet another! After that week, we had our final shelf exam and I went on home. Ah, how the days flew by...

I know it has been so long since my last post but on vacation - posting or talking about medicine for me isn't really on my priority list, so I hope you understand! It was such a wonderful vacation. I had a week off before starting my ENT elective rotation to start off my 4th year a bit early. This was a more specific rotation in laryngology (the voice box). It was a wonderful way to see more specific areas of medicine and I had a wondeful time with my attending and residents. I really was bummed when it was over because I learned so much in two weeks and was welcomed so warmly by the staff. I will post more on that possibly soon if anyone wants to know more about it! Alas, it was time for vacation. 3 weeks of it. It was so great to be back home with my Tony and Maggie. We did so much with the house - painting, carpeting, new furniture, getting ready for our 2nd annual New Year's party, etc. Christmas was fabulous too and very busy. I can't believe it is already over and here I am waiting to start my surgery rotation tomorrow.

I think I will have to wait until tomorrow to tell you all how I feel about that. Everyone has to do it and I'll get through it somehow but I am not happy about being back. Practically bitter and very emotional about it (what do you know - again). I think if I was doing this at home near Tony and family it would be 1000x better. It is so much harder coming back here to an empty, quiet and cold apartment. I am just so sad again and know where this is headed, back to feeling low and I don't think I can take it again. But what is there to do? Quit or keep going. Man, I wish there was a middle ground. Taking a break though only puts me behind and really just prolongs the inevitable of finishing rotations if not here most likely further away. I hate this funk. After this rotation, I have a month off where I will be taking my USMLE Step 2 CS in Chicago and maybe squeezing in a radiology rotation if I feel up for it. If not - 3 weeks off after my exam then back to Saginaw for my last rotation here: pediatrics. Finally, I will be back to no call, no weekends which will be a great way to finish. Then on June 5th, I am done in Saginaw and back home FOREVER. I will beg whoever I have to in order to stay home for my 4th year and don't really see it as a hard thing to accomplish as compared to 3rd year. After nearly 3 years of my medical education, I can finally finish and start my career back at home. That is all that I want! Please God, that is all that I want.

I am sorry for the delay in my posts but am ready to start off 2009 and keep you all filled in as I go along! Prayers welcomed tomorrow and I am not looking forward to it in the least and can only hope I am kept so busy these three months fly by. Or just fly by without the work (either way!). Here goes nothing...