Wednesday, January 28, 2009

Monday, January 26, 2009

You're a Honda - not a Mercedes.

Today was our midterm evaluations and, while they didn't go badly, I feel like the good ol' balloon of self-esteem sprung another leak and continues to deflate. My clinical skills preceptor has this to say as a way of summarizing his feedback for me:

It's as if you are a car. Let's say you're a Honda. This means that you're a good car and certainly not deficient in any way. But, you're not a Mercedes.

Well, maybe I like Hondas! Not every doctor-to-be aspires to own a fancy, gas-guzzling car with leather seats and loud stereo, you know. Ok. Maybe I want my future vehicle to have a loud stereo... ideally, though, it would be an 80s ghetto-blaster strapped onto the back of my very classy European bicycle. Harumph.

In other news, I have acquired a new rabbit. Hoyle and I drove to the Center of the Universe to adopt her from Despair's cavern. She's a sweet, timid dutch cross and while it wasn't love at first sight, they certainly were snuggling by the time we made it back to the Tundra. This has been quite a relief since I had braced myself for months of bonding hell.

The new bunny's name is Jazz (really!) and she's still learning to come out of her shell. When you go to pet her, she'll pancake to the floor and pretend to be a turtle. It's awfully pitiful while still being very cute. Also, because she lived her whole life in a tiny cage, she hasn't developed the coordination to run, yet. Instead, when she wants Hoyle to play, she'll shake her head and hop around a bit, but sometimes she loses her balance and trips over her own feet. Hoyle stares at her like she's gone mad when this happens and, while it might mean that I'm a horrible person, this form of rabbit interlocution always makes me giggle.

Lastly, I would like to mention that I have discovered where the Herald of Spring winters. Today, I was confronted by a giant flock of them in the tree outside my building. It was a very odd feeling to be met with so many rosy breasts in the middle of January. I was also struck by the irony that this means that I conduct their migratory route once a month to go visit Penguin in the Far North. Who says that names don't define us, anyway?

Fruit-on-the-Bottom Yogurt Drought Persists, Day 3.

Wednesday, January 21, 2009

Yell help, Wednesday night, ugly.

At Starbucks, I smell
like a cadaver - not coffee.
No one notices.

(Thank goodness!)

Sunday, January 18, 2009

There was a moth caught in the soap dish, laminated in lye...

Hi ho, Audience of One!

So, after months of silence, I have once again returned to blogging. I apologize for my prolonged literary absence, despite Penguin's significant effort to encourage me to put fingers to keyboard. To put things lightly, the first semester of medical school was an uphill battle. I've certainly learned many things during this time but, unfortunately, the lessons did not come easily and so there was little time (and honestly, little inclination) to start this blog off with 3 months of pessimistic prose. So, to sum it up for you, I have written this haiku:

Bunny!! But sick for
Three months; three funerals- God!
Homework never ends.

With the new year, however, come new enlightened intentions. Here are a few pieces of wisdom I have accrued since September and intend to implement from now on...

I didn't want to get into med school to learn about biochemical reactions, biomechanical physics, or other cutting edge scientific whatnot. I applied to med school because I find meaning and satisfaction in helping people who are in trouble. It's cliche but it's the truth. If I had wanted to learn the in's and out's of the most current health science, I would have gone into research. And we all know that I'd rather swallow a live mouse than do that.

Unfortunately, our education thus far has been strictly textbook. The result has been that my motivation went from 100% to nil as soon as the tough got going and my immune system packed up and went to Hawaii without me. Usually, I use school as an escape from the rest of my life- but for the last 3 months, I've been using the rest of my life as an escape from school.

Thank god for our class on the Art of Medicine, though, or I would probably have dropped out by now. After returning from Winter Break, we had a class that focused on the characteristics of a good medical student. Two phrases stuck with me from this class: 'competency is crucial' and 'striving for excellence'.

The competency statement reminded me that even if I'm not particularly interested in, let's say, the pancreas, I still need to know about it in order to provide my future patients with the standard of care that they deserve. It terrifies me to think that, one day, I might be treating a patient and have to step back and tell a colleague: "Do you know anything about the pancreas? I've got a patient and I think there is something wrong with their's but I skimmed that chapter back in first year and don't know jack about it." Gulp. Of course, I'd rather a doctor that owns up to the limits of their knowledge (after all, you can't know everything!) but I'd also like to have a doctor who has the fundamental knowledge required of them by their training and profession. Thus, whenever I'm up late on a Tuesday night trying to sort my way through the pentose phosphate pathway and its relevance to the metabolism of carbohydrates in diabetes mellitus, I remind myself that it's important to be a competent doctor.

Often, with that mental note in mind, I can squeeze out another 15 min of good studying before droopy eyelids and my fragile attention span once again tempt me to pack up the books and head to bed. At that point in time, I often find myself thinking - "I've done just enough to fake it through the next tutorial without anyone realizing that I actually don't have a clue about what's going on here. I'm sure I'll figure the rest out later." First of all, let me tell you, there is no "later" in med school. If you don't get it now, you're not going to have time go back and look it up later... the curriculum moves forward as inexorably as a glacier advancing on you, a tiny, insignificant ant, in its path. And just like the ant, you are expected to carry 10x your own weight in knowledge by the end of it all. 

Thus, I now have a second mental note in my arsenal to keep the concentration juices flowing until the job gets done satisfactorily and that is: a good medical student strives for excellence. It's just not enough to say: that's good enough. Can you imagine a surgeon cutting a 6 hr surgery short and, as he's sewing up the patient, mutter to himself: "I'm sure that's good enough." (Btw, did you know the pun? smirks) This is exactly the scenario I think of when that second wave of sleepiness hits and usually it'll bolster me to hit the books for a little longer until I get the job is truly done.

Like I said at the beginning of this rant, though - I didn't strive to get into med school because I'm fascinated by the science. So what else is there to being a doctor than knowing the specific enzymes that your pancreas pumps out when you eat a delicious dinner? Answer: a lot. And it's more than just the doctor-patient, doctor-doctor, doctor-nurse, doctor-whomever relationships that we all keep harping about... it's about what is a doctor? Does that definition change if you move to a different part of the world? What does a doctor do that is unique to that profession and what does a doctor do that, despite the fact that they might pretend to have to monopoly on a particular service, they actually aren't the only one (or even the best ones) to approach about certain problems? Doctors don't save the world, social workers do. Doctors don't take care of you when you're sick, nurses do. Doctors don't just cure disease, sometimes they create them. Doctors don't just heal, sometimes they maime, or even kill. Why do the people who talk about this vital message feel the need to espouse it as such verbose pedagogy that the recipients of this vital knowledge are left retching from the forced feeding or simply comatose? And why, knowing all this, do I still want to be a doctor?

To be honest, I'm not as sure as when I first got into med school. I am confident, however, that this self-doubt is going to be beneficial in the end. I would be much more worried if I just cruised through this experience and didn't think twice about any of it.

For the last 3 months, I've been afraid of writing about this self doubt and lack of direction. Clearly, however, my aim now is to embrace it and learn from it. A good blog reflects both sides of the coin that is reality: on one side there are the fun, whimsical stories of daily life and on the other is the profound drama of struggle and hardship. Recording both sides, as I experience them, is my commitment to you, my dedicated reader, and to myself. So please look forward to many more posts in the upcoming weeks. 
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