See it for Yourself

My wise hair dresser once told me that life was all about perspective. While some of the things that man said were far fetched, Howard did hit the nail on the head (or the split ends with the scissors, as it were) with that one.

Earlier this week after a conversation with a friend who is starting the medical school interviewing process (So so so so so glad that is OVER), I was feeling a little blue. My friend has an interview at the school that I desperately wanted to attend, but after interviewing there, was not accepted. The chronological (and emotional) distance I've had since that gut wrenching email has helped. And I have faith that I am exactly where I am supposed to be right now. But giving her advice for her interview and answering her questions about when she could expect to hear back from Dream School was tough. Don't get me wrong, I love my friend and want amazing things to happen to her! It just brought back a lot of feelings I thought had long since been put to rest. But later this week, when I was studying about the differences between secretory diarrhea and bloody diarrhea (Ahhhh, microbiology), I had an epiphany.

Five years ago if you were to ask me what I wanted to do after college I would have told you that my dream was to to go to medical school and become a doctor. People frequently used to ask me where I wanted to go to school and I remember answering (I can still hear the younger and more fit me saying it right now): "I don't care where I go. I'll go wherever I get in." And that was the truth. When it came right down to it, my dream was not to go to a school, it was to become a doctor. And in less than three years (wait, what?!) I'll have two letters after my name that will allow me to do just that. Be a doctor. Practice medicine. Help people.

If I hadn't ended up at the school I am at now, I wouldn't have met the amazing people I'm lucky enough to have by my side on this crazy adventure that is medical school. I wouldn't have learned that I can live a more than four hours away from my dad. Or that I can (barely) survive snow. The thing is, sometimes when our dreams come true, they look different than what we had imagined. But that doesn't make them any less beautiful or perfect for us. And I hope that I can remember that the next time I lose my perspective.

AND, in case you haven't laughed yet today, Sage Howard gave me that advice while he was putting TWO INCH blonde streaks into my hair, as per my request. Eeeshk. Talk about perspective. ;)

When You Come Back Down

You were in sixth grade when you announced that you wanted to go to West Point. Dad had given you a book he had just read, The Long Gray Line, and for you, that was it. You read about a class that graduated in war times from an institution charged with educating some of our military's greatest leaders. An institution whose history department proudly claims, "the history we teach was created by those we taught." From that moment every baseball practice you went to, every accelerated math class you studied for, every trumpet solo you perfected, was all for one purpose: to get you into West Point.

Along the way, you turned into a pretty great kid. I remember when you called to tell me that you had done it. That John McCain had given you his primary nomination to the academy and you were finally going to be a part of that Long Gray Line.  Back then I didn't think it was possible for me to be any more proud of you than I already was. I was wrong. Since you started West Point three years ago you have learned a new language, won awards for leadership, and are ranked in the top ten percent of your class. You have traveled the world and passionately learned about cultures different than your own. You've competed in international military competitions and have trained with those blokes across the pond. You've learned about sacrifice and how to take care of people. And now you have a symbol of that hard work. Of that bond you share with your classmates, and those who have gone before you and will go after you.

What has always inspired me was your ability to create goals for yourself and work tirelessly, relentlessly, and fiercely until you achieve them. You don't stop until the job is done. And even then, you're on to the next one. I know I'm the older sister, so really this should be the other way around, but watching you go after your dreams, has given me the courage to chase my own.

At the age of eleven, you set a goal for yourself and in 271 days, you will accomplish that goal. It seems like a long time, and yet I know it will fly by. So I'm going to try and cherish those 271 days. During which you'll still be here and safe, unburdened by the difficult choices and tasks your future career will inevitably ask of you.

But when they are up and all of this becomes real, my prayers for you won't change much. I will pray for your safety. I will pray for your protection. I will pray for those you lead and for those who lead you. I will pray that you always know how very much you are loved; and that wherever you are, whatever you're doing, your family will be waiting to welcome you home.

Bats on Ice

You know that Beyoncé song, "Cigars on Ice?" According to the Beyoncé dictionary, because that's a thing, Cigars on Ice (n.) is defined as "the practice of drinking alcohol on the rocks while smoking cigars, two luxury status symbols at the same time." This post has absolutely nothing to do with that song, other than I had it stuck in my head while I was writing this post. And because this post tells the tale of how I put a bat on ice. Minor point. 

Monday morning, I was awoken by the following texts from my roommate:

I think a bat got inside our house and is outside our [bedroom] door. We're kinda trapped.
Jack saved us. 

I detected a hint of urgency/emotional trauma in her texts (I am a doctor in training, after all) so I decided to drag myself out of bed and head downstairs to investigate.

Apparently, when she woke up that morning, my roommate heard a commotion coming from our kitchen. When she opened her bedroom door, to her horror, she was greeted by a bat flying straight toward her face. As she slammed the door, she noticed my cat (Jack), deep in the throws of the hunt, leaping after our uninvited house guest. While she and her boyfriend were in her room trying to figure out what to do, Jack tracked down the bat and killed it. I at first found this part of the story difficult to believe, since normally Jack can't be bothered to kill stink bugs, let alone winged vermin. But I guess he realized his moment to achieve glory had finally arrived and he leapt for it. Pun intended.

I didn't think much of the whole incident. My dad is a retired game warden and growing up, I saw my fair share of dead things. Needless to say, my threshold for "ick" is pretty high. So, with the bat securely tied in a trash bag and in the basement awaiting garbage removal, I thought the story was pretty much over.

Incidentally, Jack had a check up appointment at the vet scheduled for Tuesday afternoon. While we were at the vet, I mentioned that he had killed a bat in my house the day before. One rabies booster later, we were on our way out of the office when the vet poked her head back in and told me that I might consider calling the Public Health Department so they could come pick up the bat and test it for rabies, just in case.

Once we got home, and after giving Jack the appropriate amount of treats earned for the thorough ear washing and shots he had bravely endured at the vet (9 treats, by my calculations), I dialed up the local public health department, for what I thought would be a brief call.

It was not a brief call.

Twenty minutes later, I was half way through filling out an incident report form with a lovely woman named Diane who needed to know how many people were in the home at the time of the bat incident, how old said residents were, what said residents cell phone numbers were, and whether or not said residents had:
Noticed any small bite marks on our person
Woken up in the middle of the night to a bat flying around the room
Felt a bat fly by our face
Touched the bat
Touched the carcass of a dead bat with bare hands
Touched anything the bat might have touched
Touched any bat feces
Seen a small child touch the bat
Seen a small child in a room with the bat

When Diane had extrapolated all of the pertinent information regarding the bat incident, I was told to wait for her supervisor to call me. Apparently, this was going straight to the top.

So, 4 minutes later, Supervisor Maureen called and pretty much repeated the same conversation I had with Diane minutes earlier. Except Maureen wanted me to take the bat to get tested for rabies. (For future reference, the public health department does not make house calls to pick up dead, potentially rabid wildlife.) Maureen then instructed me to put the bat in "coolants." When I asked her if she meant antifreeze, she was slightly exacerbated by my "silliness" because she meant ice. After I put the bat in coolants/ice, I was to put the bat in the refrigerator and label it to make sure no one would eat it (Welcome to "Pensiltucky," everyone) and bring it in to the Public Health Department first thing Wednesday morning.

I mentioned my threshold for ick was pretty high. This is also largely in part because I grew up in a family that hunts, so dead animals next to my frozen foods was not new territory. My roommate, however, was not used this particular method of storage. So the bat spent the night in the basement in a Tupperware dish on ice. Hence, bats on ice... 

This morning I woke up and took our furry deceased friend to the local Public Health Department Office where Diane and Nurse Dave were waiting for me. Our bat will be shipped to the lab today and hopefully we'll have the results tomorrow morning. Fingers crossed the bat is rabies free. 

As for the hero of our story, he is still walking around his castle (AKA my house) like a soldier home from Nam.

He is also getting used to his new anthem, nah nah nah nah nah nah nah nah Bat Cat. 

UPDATE: The Public Health Department called, and the bat tested negative for rabies. Hallelujah. 

Patch

I guess this wouldn't be a true "medical student blog" if I didn't mention a medical show/movie that inspired me. So, I'm gonna tear off the band aid and do it. Deep breaths, everyone. Here is how Grey's Anatomy changed my life...

KIDDING! Man. That would be terrible. Okay. For real now, I just finished watching Patch Adams. I know, I know. It's the epitome of cliche. But c'mon, gang. I can't NOT write about how much I love this movie. It's just the best. 

In the light of Robin William's death, my friends and I were talking about how much we loved his movies and how we wanted to watch one in memoriam of him. Since we're all bright eyed, bushy tailed, medical students who will finish our didactic training at the school year's end, it seemed fitting to watch a movie where Robin William's plays a man who breaks the typical white coated doctor mold of his era.  Cue Patch Adams. 

My favorite line of the move is this:

"You treat a disease, you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome."

It is undoubtedly one of the most often quoted lines of the entire film. But it encompasses such a vital component of practicing medicine. One that I hope all of us doctor wanna-be's remember when we are out next year seeing patients, and putting all of our hard earned book smarts to good use. 

I also hope that enema bulbs are still bright red. Because they sure do make terrific clown noses. 

The Distance

I have learned that the path to becoming a doctor is not linear. Which drives the Type A, OCD, perfectionist individuals attempting to do just that, a little crazy. The problem with learning almost everything there is to know about the human body, is that you're learning almost every little thing there is to know about the human body. Which means that for most of us, it's impossible to do in one pass. So instead of taking a linear path from point A to point B, it's more like you're running a path that twists and turns back onto itself. You're exposed to the same material different ways at different times. Each time you pick up a little more.

My school's curriculum is problem based, and instead of learning in lectures, we learn in small groups where we're presented with a case. Most of the time it feels a lot like House. With less snarkiness and condescension. (Usually.) Our cases consist of a "patient" presenting with various symptoms. Then we work through the case, getting patient histories, coming up with differential diagnoses and ordering lab work, etc. We finally get to a diagnosis and then we pick readings from our text books about whatever pathology or disease our patient had.

These cases used to take forever. Our first case we ever did, a pediatric case where the kiddo had trisomy 21, my group took four two hour sessions to work through. And that case was relatively straight forward. The reason it took so long was because we didn't know anything. We spent hours looking up what blood test and urinalysis results meant. Deciphering an abnormal physical exam from a normal physical exam. Trying to figure out exactly what we were looking at on imaging studies. Learning the difference between respiratory and metabolic acidosis and alkalosis and whether or not they were being compensated. It was tough.

Today, we got through a pretty complicated case - our patient ended up having HIV, fungal infections, herpatic lesions, exposure to tuberculosis and a host of other problems - in one hour. Now we know what to do. We know how to take a history. What we're looking for on a physical exam. What tests to order (most of the time). What a list of legitimate differential diagnoses looks like (pretty much).

If medical school was linear it would be easy to mark your progress. To check off the boxes of things you knew when you learned them and then give yourself a gold star for being super. But it's not. And sometimes, it's easy to forget how far you've come because you're focused on how much farther you've still got to go. But today as I overheard the first years arguing about what different lab tests meant, I felt happy and thankful to be doing what I am doing. And grateful for the reminder that while I've still got a lot to learn, it's less than it was a year ago.

There's Your Trouble

"So what's going to be your toughest class this semester?" 

It was a familiar question. My dad had asked me the same thing a couple days before asking my brother. The two of them launched into a discussion about electrical engineering (I think ?) and we continued our drive through the Arizona desert up to Payson. 

As my summer came to an end, most people asked me what I'd miss most about being home, or what I was most excited to get back to. But my dad asked what would be my biggest challenge. Not because he was trying to bum me out or kill my blissfully school-free summer buzz. But because that's how my dad deals with challenges. Head on. And that's how he is still teaching me to handle them. 

My dad is someone I can always count on. For support, for financial advice, for comedic relief. For everything and anything. He is the person I call when things are great. And he is the person I call when things aren't so great. And throughout my childhood (and early adulthood), he has taught me that challenges are just that. Challenges. Not impasses. Not impossibilities. But obstacles to overcome. I've learned that there is power in realizing what my faults and weaknesses are. By recognizing where I've stumbled before, I can catch myself before I fall next time. 

So, here I sit, on the eve of my first day as a second year medical student. I'm gonna trust my dad again on this one and tackle this beast head on, one day at a time. It's worked this far. :)