Category Archives: everything else

How Badly Do You Want It?

I remember being an undergrad and moving back home to save on expenses. Not exactly what I was expecting to be doing when in my 40s, that’s for sure! But I discovered I was willing to do what it took to do well in all those crazy pre-med classes I was completely unprepared for, and a great deal of that “doing well” simply required lots and lots of time. Living at home allowed me to focus exclusively on my studies.

Fast forward a few years, and I’m once again needing to make an adjustment. Sadly, the intervening years brought a house fire that completely destroyed my family’s home, so that’s no longer an option. So I’ve been snooping around looking for a much smaller place that will accommodate me, an adult child, and three German Shepherd dogs.

Its a dream-switch that is a bit uncomfortable actually. Rather than building always toward home ownership again (following divorce and life-stuff), in some ways I’m going backwards in order to go forwards.

Because I want medicine more than anything.

When you’re passionate about a goal, you’re willing to do absolutely whatever it takes. In my case, I have the amazing privilege of attending a medical school that doesn’t allow me to go into debt; that means I have a monthly payment on top of living expenses. So stress-reduction means limiting the expenses I can control by seriously downsizing. And quite honestly, once the decision was made, a whole heap of angst was lifted off my shoulders.

Do you have a thing you’re willing to pursue no matter what? Have you chosen to make sacrifices in the pursuit of that goal? I’m discovering that those sacrifices are nothing compared to the gift of being able to walk boldly forward, knowing that this is another big step in the right direction.

Now, back to the books!

When Grief Hits Home

The medical profession is all about giving – serving those who are hurting and helping find medical solutions.

We’re not so good at receiving.

Yesterday morning I got a text message from my sister. My big sister is a doc herself and has been part of my ‘cheering section’ as I’ve pursued my own medical career. But this message hit me hard.

“I’m writing to tell you that Al passed away this morning.”

There’s nothing that can prepare you for such news. And while I feel like my sister holds half of my heart, I know that the sadness I feel is minuscule compared to hers. She found her true soul-mate late in life, and Al was one of those priceless men who treated my sister like a queen. Their life together was a beautiful testament to how wonderful a marriage is supposed to be. And my only thought was, I need to get to her. I need to help get our mother to her. We need to be together and wrap her up in our love and support.

As messages of condolences roll in, I’m watching how different folks deal with grief in another’s life. Some don’t say much but their “I’m with you” message is clear. Some offer prayers, some share a similar situation in their own lives. And some ask what they can do to help. With the help of friends, we set up a gofundme account to help us siblings and our mother travel so we can just be with. 

The most priceless messages we’ve received are those who say something like this:

Its okay to be sad. Its okay to cry. You don’t need to pretend you’re alright. I understand.

I hope I always remember this, as I continue to reach out to suffering patients. While there is a limit to medicine’s ability to ‘fix’ things, there is no limit to the power of compassion.

And often, just saying, “we’re with you” is enough.

Your contributions will be used to help us travel to be with my sis, and anything beyond travel costs will go to help with all those ‘little’ things for my sister. May blessings continue to flow into your life as you give, and receive, compassion.

The Others

I’m convinced that its never too early to begin establishing habits of acknowledging those “others” – the ones who so heavily contribute to student doctors and physicians being able to effectively do their jobs.

Last night, I spent late hours at my local hospital Emergency Department. It wasn’t exactly a busy night, but there was a steady stream of patients. The little boy with a croupy cough – not bad enough for admission, but I spent quite awhile reassuring his exhausted parents. The dad in the middle of a custody fight concerned about possible abuse to his 2 year old daughter. The confused young man high on ‘something’ and his mom who tried to cope…

As I watched the night play out, I paid attention to those “others”. Here’s a few of the lessons I learned.

  • Take time. In a busy setting like an emergency room, everyone is focused on doing their job. But I’m finding it so important to create time to interact with those “others”, even if just for a moment. The nurse who seemed relieved to share how her own son is doing with his medical challenges. The front desk folks who’s faces light up when I stop to ask them how their night is going. Don’t be so busy “doing your job” that you forget to take time.
  • Make eye contact. Its not enough to throw out a fast “how the heck are ya?” as you dash past the tech, or housekeeper, or student nurse. Stop walking for just a moment and make eye contact. Its important.
  • Say thank you. Last night I watched as patients were collected by Radiology for a fast CT scan, blood draws and X-rays quietly just “happened” after the doc checked that box in the EMR… Saying Thank You is huge. It doesn’t happen often enough. Its important.
  • Intentionally acknowledge people. Sure, often those “others” are just doing their jobs. And they’ll most often brush off your acknowledgement. Do it anyway.

It was after midnight when I finally said good bye to a mostly empty ER and walked out the door. I said good night to security and walked out into the drizzle – after all, I was parked close, under a light, and I didn’t feel any need of an escort. As I started up my car I looked out my rear view mirror and saw the security guy standing on the sidewalk. I hadn’t asked him to, but he had followed me out and was watching. Just to be sure.

I jumped out of my car and jogged back to where he was standing.

“Thank you,” I said, reaching out to shake his hand. “I didn’t think to ask you to watch, but I feel safer having you here.”

He acted a bit embarrassed actually as he dropped his eyes. “Just doing my job ma’am”. But I saw the smile lifting the corners of his mouth as I turned around to leave again.

Acknowledge people. Everyone. ALL are important.

The Myth of Multitasking

Its not real you know.

Whether you’re a man or a woman, there truly is no such thing as actual multitasking – literally doing more than one thing simultaneously. Researchers have proven time and again that what happens is a fast switch between multiple activities or mental exercises instead of actual simultaneous action.

But I’ve got to tell you, I come as close as humanly possible to that illusion. And one of the most frequent questions I get is some version of: “How in the world can you do everything you do and still be successful in medical school?!”

Well, consider this. There are about 18 hours of productive time in every day (while I may not like the interruption of productivity, I do need my six hours of sleep every night in order to keep up with all my super cool activities the rest of the time). I routinely study 12 hours daily, this includes lecture hours, seven days a week.

So what about the rest of the time?

Aha! This is where some folks fall down on the job. They’ll feel exhausted from their major tasks and think that what will serve them best is to just “veg” for awhile. Those six hours, usually in the evenings, are typically filled with mindless tv watching and socializing. And weekends are usually filled with many hours of “rest” that accomplish little.

Now please don’t misunderstand. I’m not one to advocate activity just for activity’s sake. I’m perfectly content to be still, to rest, and to connect with friends. I’m a human being, not a human doing.

Yet I’m also super creative.

Along with being in med school, I’m also a business and parenting coach, a social media marketing manager for a doc’s practice, and a ghost writer for various other businesses. I’m working on setting up an independent lab research project for a potential PhD program in Biology (because, well, I want that degree too). And I’ve always got several home-improvement projects going.

I guess the best advice given to me on this subject was one I heard back a few years when a friend was encouraging me not to give up on my dream. He said this: “Just make sure that you don’t put the rest of your life on hold while you’re pursuing your education. Education is a big deal, and you’ll get there. But its not the only deal.”

So how about you? Besides your ‘main thing’, what are you multitasking about? What other projects do you have going? How do you fill your time and days and weeks and weekends? I don’t know about you, but I am reveling in the soul-enriching process of multitasking, being more than the educational process!

Four Upsides To Being a Non-Traditional Med Student

“Non-traditional” is the word most often used to describe medical students who took a different route besides going straight from highschool to college to med school. Those of us determined to pursue this dream when over the age of about 25 are lumped together as “outlyers”. Admission committees juggle our commitment against the economic reality of the expense of our medical education and our life expectancy. If we do achieve acceptance, our colleagues don’t quite know how to relate. Often we’re older than our professors, and the less secure among them may (subconsciously?) lash out in their need to maintain the upper hand. Residency programs aren’t sure if the time they’ll put into training us will pay off in the long run – after all, someone like me will begin actual practice at about the age many docs are looking at retirement.

But even with the jaded eyes of one who fought long and hard against prejudice and sometimes outright discrimination, I maintain that there are huge upsides to being an older student in medical training. Here are my top four.

  1. We’ve lived. We’ve lived long enough to find balance, know self motivation, and have proven commitment in real-life experiences. We don’t need to be taught compassion. We understand at a visceral level what it takes to keep going when things get tough. We don’t need hand-holding. All those “real life” lessons not yet learned by someone spending their first 25 years of life in an academic setting have already been experienced and assimilated. We’ve lived.
  2. We don’t take abuse. This is a biggie. With much focus these days on creating a medical education experience less dominated by an autocratic mentality,  I confidently say that I don’t take abuse. Its not an entitlement thing. Its a real life emotionally healthy thing. And the icing on this particular cake is that this all happens in reality – you can try to bully me. But it will have absolutely no affect on my psyche.
  3. We can relate. Having lived, having carved out our own emotionally healthy well-grounded life in the real world, we can relate deeply and authentically with our patients. We understand the fatigue of a new parent. We never forget the ending of a marriage or the time we couldn’t pay the light bill. We know the fear of a medical mystery, teenagers in trouble, and aging parents. All that life stuff our patients live with every day, we can relate with having lived rather than from reading a textbook or listening to a continuing ed guru. All that relating makes us much more effective physicians.
  4. We’re in touch. There’s a pretty good chance that we’re in touch with our weaknesses as well as our strengths. We know where our biases are and how to work around them. We know how and where to reach out for help when we get stuck. And having lived just a little longer, we’re a whole heap less swayed by the latest push to fulfill someone else’s idea of our dream. We’re in touch with our insides, our outsides, and stay fairly well in balance even when life stuff kicks our backsides.

If you’re a person with the dream of being a doctor one day, never feel like you’re “too old”, or that its “too late”.

If you’re a “non-traditional” medical student, embrace who you are and keep going. The medical profession needs you!

If you’re sitting on a medical school admissions committee, mentoring a potential med student, a med school professor or clinical director or attending, please remember that we will learn from you whether you make the process easy or hard. We will pursue our dream whether you support it or throw up every possible roadblock. And we will bring compassion and competence to our practice of medicine whether or not you see our value.

No matter what path you’ve followed in your pursuit of medicine, if you’re a “non-traditional student”, we need you. Medicine needs you. Patients need you. You’re in the right place.

I Am More

There’s a lot of focus lately on things like physician and student doctor “burnout” – that demoralizing realization that the grind of the job isn’t worth the price paid. That crisis can show up as everything from mild depression to a major job or life change to suicide attempts. While some are lobbying strongly for major changes in both medical education and medical practice, I’m thinking more how this works at the individual level.

From my position as an “older” medical student, I ache for the students and practicing physicians who experience such crises and believe they have no options. But its not just about empathy.

Its far more than that.

Over the few decades I’ve been an adult, I’ve had a few crises of my own. Having dealt with severe depression in my 20s, I know intimately what depression feels like and what it takes to move forward. I also know how insidious depression can be. And with the perspective of experience, I’d like to share a few things I know.

Its kinda like being halfway up Mt Everest, reaching back to the climbers following to share the potential pitfalls they’ll encounter and how best to keep climbing.

  1. I know that horrified moment of waking up realizing I’m in an abusive relationship – both an abusive personal relationship, and an abusive academic / work relationship. When I was younger, I would just “take it” for awhile. As I got older, I got to know my insides a whole lot better. I learned to stick up for myself, and I learned when it was important to walk away. You’ve got to be willing to walk. (Having done that – walked away from an abusive med school – I can absolutely promise you that it doesn’t have to be that way. Your dream of medicine is not over if you walk away from an abusive academic situation or an abusive practice situation.)
  2. Tough is fine. Abuse is not. Wherever you are on this hike up Mt Everest, you’ve put in the time to know that its a hard climb. Long hours. Not always warm-and-fuzzy colleagues. Unrealistic expectations. But here’s the thing. We expected tough. We knew it would be tough. We prepared for tough, and even with that preparation we get blindsided now and then. But abuse is NEVER okay.
  3. The law of attraction… with a twist. The field of medicine doesn’t just attract those of us who want to make a positive impact or heal suffering. It also attracts narcissists. There are a few other fields that have a higher than ‘normal’ percentage of self-centered jerks, but oh boy howdy medicine – both academic and practice – sometimes seems to only rarely attract those able to keep their gentle altruism intact through the training process. Remember that when you’re struggling, and don’t expect your colleagues to necessarily be the best people to lean on.
  4. You MUST have people. By that I mean, people you absolutely feel safe with and can lean on. People you can share your horrid day with an awful professor or attending or colleague without them judging you or walking on eggshells. People who will really hear you when you question your sanity or want to just throw in the towel. For me, this always means someone I pay for their ‘friendship’. Maybe that sounds a little cold, and I do have a wonderful family and great friends. But the only place I let my heart feel completely safe to be that real is with a therapist.
  5. I expect myself to lose perspective. For instance, I know ahead of time that right after an exam, I’m sure I failed. When I say “I don’t know” to my clinical supervisor, I’m sure he is fed up with me and wishes I would stop wasting his time. Your triggers will be different, but you must take time to understand what they are and anticipate them.
  6. Protect your career / reputation while you’re saving your life. I considered not even including this point, but what the heck, I’ve lived through this one. Its a reality that many within the field of medicine / academia have little patience with or understanding of the inherent soul-shriveling nature of the field for many. When you run into a professor or supervisor or colleague who’s own wounds mean they lash out to wound you, protect yourself. Until the culture changes, if you’re feeling overwhelmed or unsupported or abused, just remember that your school / boss / supervisor is likely not the place to go for help. Remember #4, you must have people. Choose your people wisely.
  7. Turn left. There is always a different option. No matter where in the process you are, there is always a different path than the one you find yourself on if it isn’t working for you. This isn’t about some weird entitlement attitude – you’re not entitled to always feel giddy with happiness in this grand field we have chosen. But serious ‘burnout’ – hitting the wall and hating your life – is entirely different. Don’t be embarrassed to admit you feel stuck, or overwhelmed, or exhausted, or depressed.

I’m tough. I’ve put a lot of energy and a few decades into becoming very good friends with my insides and understanding what it takes to keep my soul intact even in super hard circumstances. What I’ve discovered is that I AM MORE.

I’m more than my chosen profession.

I’m more than my job.

I’m more than what others think I am.

I’m most definitely more than what I DO.

And I will continue to protect WHO I REALLY AM with every fiber of my being while I strive to keep climbing up this grand mountain we’ve chosen.

If you’re in that place of feeling overwhelmed, realize you’re losing perspective, or just ‘can’t stand it anymore’, reach out. Please. There is always hope. And WHO YOU ARE is so much more important.

The Importance of Sprinkles

Its Christmas break – a few weeks to breathe, sleep, and eat between Block 2 and Block 3 of medical school.

(I won’t hear officially if I passed Block 2 finals until after Christmas. Typical of me, I’m trying hard not to stress / think about i!)

Downtime is precious. No stack of flashcards. No lineup of lectures coming up tomorrow. No countdown to the next midterm. No alarm clock set for 5am to make certain I get in enough study hours.

Its a little funny-feeling actually.

Because I live my life intentionally, I’ve decided to use this down time to choose JOY. Here’s some of the ways I’m doing that.

  • This year, I’m not leaving Christmas family time to chance, and I’m determined to excise all stress-factors from the experience. We’re keeping it simple. Except for a few immediate family members, we’re not doing gifts. Instead, we’re intentionally spending time with each other. Because that is what’s most precious to us about Christmas.
  • I have a year-old white German Shepherd who’s still very much a puppy, and who looked a bit confused sometimes during the last term when I had time for little more interaction with her than to make sure she had clean water and food and a place to curl up beside me when it was sleep time. So I’m using this time to play with her more. Puppies are awesome for giving immediate positive reinforcement for giving them attention.
  • Sprinkles. What is so magical about sprinkles? Next time you make a batch of cookies, slather on a healthy layer of icing, then generously add tons of sprinkles. Let those sprinkles make a mess on the counter. When you take a bite, let those sprinkles float down to your lap, stick to your fingers, even fall to the floor.

With all the little things I’m doing this year to keep the holidays stress-free and to intentionally fill back up, I’m lovin’ the sprinkles. Sprinkles are like JOY. Start using them, and they start getting into everything.

Exactly as they should.

From my home to yours, here’s sending you sprinkles of JOY for this holiday time. Merry Christmas!

An ER Argument (or The Strep Conundrum)

Last night I got into an argument. It started out as a 2-way argument (me and the hospital’s medical director who I was working with at the ER), then turned into a 3-way argument when my mentor Dr. J joined in. It wasn’t about who was right and who was wrong, not at all. But three intense personalities had intense opinions, and all three of us had no problem expressing those opinions.

Its sometimes a bit weird, being a “mature” medical student. I’m older than both of the docs I argued with last night – not that age per se has anything to do with it, but I do think my age / generation has its own particular viewpoints on doctors and treatments and the sweeping changes affecting medicine. I have, after all, half a lifetime of experiences with real life, being a patient and the mother of four kids who were often patients. And over the last 30+ years, medicine has changed a whole lot.

We’ve gone from “the doctor is god” mentality, to a collaborative effort between doctors and patients. With the advent of the internet, patients now often Google their symptoms and potential treatments before they ever show up at their doctor’s office or the Emergency Department, and are sometimes quite adamant about what they have and what they need or want.

The last 30+ years has also seen a huge shift in use of antibiotics. Growing up in the 60s, I had more than my fair share of strep throat infections, and for whatever reason my parents chose not to have my tonsils removed. They simply called the family doc (who made house calls and always made me feel so well cared for) who would peer at my pus-pocketed ginormous tonsils, then routinely prescribe me a round of Penicillin. In fact, I had it so often as a child (and quite frequently didn’t complete the regimen) that Penicillin simply doesn’t work for me anymore.

With that background, I was stunned the first time I heard my mentor, Dr. J, tell a patient that there was no need to prescribe an antibiotic for their strep infection – that the current research showed it simply wouldn’t help much, and that their body would most often clear the infection on its own. That was a couple of weeks ago, and I of course went and did my own research.

While many docs still prescribe antibiotics following a positive strep test, just as many don’t. And the latest research does indeed seem to indicate that the body will clear a strep infection without the use of antibiotics.

Enter my “position” – my opinion based on personal experience.

Turns out my mentor Dr. J had frequent strep infections while working in his medical residency program, and experienced fast symptom relief each time he began an antibiotic regimen. But notwithstanding his personal experience, he will give his patients the latest research findings, that strep infections most often don’t need an antibiotic.

Dr. U, the hospital medical director and I, had a rousing “discussion” last night about this. He is adamant about not over-using antibiotics. And I see his point – in an up-close-and-personal way. After all, the list of antibiotics that I can effectively take is growing smaller.

Could it be that this is part of a greater problem? Our society has long wallowed in the “fix-me-fast” mentality. A pill for everything, and that pill is expected to fix symptoms from a sore throat to a headache to indigestion to STDs to insomnia to high blood pressure to pain to depression to …. well, just about everything. I’ve been saying for years that it really is okay to have a fever, or a cold, or pain, or whatever, without needing to grab a pill for a quick fix.

So I was rather surprised at how resentful I felt during the “argument” last night. The double standard (I want a pill to fix a sore throat no matter what the research says, but to be a good doc I need to not give a pill to my patients with a sore throat) was glaring.

How about you? Did you grow up knowing there was pretty much a pill for whatever ailed you? Did you take “too many” antibiotics and now have a smaller list of those that are effective? How do you feel about the wind-shift among physicians to prescribing less antibiotics, and educating patients more on allowing their bodies to heal themselves (even if that means a few more days of discomfort)?

When Life Happens

Life happens. Even when I’m in med school. Funny, that.

Tonight, partway into a major study session, memorizing long lists of Immuno / Micro / Pharm stuff that is slowly coming together, I got a message from my Ma.

Now understand, my Ma is an amazing woman. At nearly 80, she still works full time as a medical social worker, does incredible pottery and sculpture in her “spare time”, and keeps up with 30 acres and a charming little cabin about 20 minutes outside of town. My Ma is also my biggest cheerleader who’s most frequent phrase these days is: “Don’t worry about that – go STUDY!!”

Tonight when Ma was driving home, a deer came out of nowhere and smashed right into the driver’s side of her vehicle, doing extensive damage. I jumped in my car to go help, and was amazed. Her car looked like it had been in a major wreck, side widow and door panel completely smashed, front fender dented, windshield looking like she’d just been in a major head-on collision.

And, my Ma is okay. Shook up, but okay.

I’ve been thinking tonight. Life keeps happening. Even when I’m in medical school. Priorities still need to be adjusted, choices made, a little juggling… One of the most powerful things one of my professors keeps saying is, “It is absolutely vital that you stay in balance. You are MORE than a study-machine. You are a person. Stay in balance. Eat well. Sleep enough. Stay connected with family.”

Tonight, I’m grateful. I’m grateful my Ma is okay. I’m grateful I was here to help. I’m grateful I’m flexible  I’m SO grateful I’ve got my priorities right.

Are you staying in balance?

Three Things I Wish I’d Known As A Premed

I’ve got to admit, my journey to medical school has been ridiculously convoluted in some ways. When I returned to complete my college degree, I was in my 40s, with exactly zero foundation for the science courses I needed. While I have (finally!) been successful in achieving acceptance (three times – wowie – see my About page for details), there are a few things I really wish I’d known at the time.

Things that might make your journey a little easier.

With the clear vision of hindsight, I’d like to share the top three things I wish I’d known as a pre-med student. A caveat on my experience and my three things…. if you’re a 20-something student with a 4.0 GPA, tons of family resources to help fund the process, and no additional responsibilities besides ‘do-well-in-undergrad-and-apply-widely’, you can completely ignore this post. If, on the other hand, you’re a non-traditional student and have lived long enough to show your humanity on your application, read on.

1. Stop listening to advice that doesn’t apply to you.

I don’t know how to stress this point enough. There’s the advice that pretty much applies to everyone: get good grades, get your shadowing time documented, do great on the MCAT, apply broadly. Okay, that’s fine as far as it goes. But that is not sufficient if you’re a non-traditional student vying for one of those precious seats in an entering class.

Don’t read student forums (truly, they’re not helpful). Don’t hobnob with students ten years younger than you and hope to glean nuggets you can use to gain medical school acceptance. Don’t bother sending messages to other successful applicants asking something like, “Here’s my grades, what are my chances?”

Getting rid of all that noise will free you up to create your stand-out experience and application. Trust me, you do NOT want to look like everyone else out there.

2. Practice whatever you’re not good at, until you change that.

Practice everything. Practice a 30-second version of your story. Practice explaining your research. Practice test taking (seriously, until you’re very good at it). Find people who will ask tough questions and practice your response.

I remember a medical school interview I had about halfway through my nine years of application cycles. I was nervous. Intimidated even. And my interviewer did nothing to put me at ease (at least it seemed so at the time). Part of my application included molecular Biology research, and it was apparent that he had carefully read my Personal Statement when he asked me, “And what is the normal function of the RBR gene?” My mind went absolutely blank. Not only could I not pull up a smooth response, I couldn’t remember a single detail of the research I had spent two years working on. Finally, in a pathetically squeaky voice, I said, “I have absolutely no idea”.

Obviously, I did not get an acceptance after that interview.

My brother (who is a neurosurgeon) suggested I write out my experiences. Write down a concise explanation of my research work. Write down a concise explanation of my unique story. Write it down. Then start by reading it aloud (to the mirror at first, then to other people). He had given me that advice before the disastrous interview, and I had ignored it. (After all, I was a ‘more mature’ student and didn’t need it). Obviously, I changed that, fast.

3. Find a mentor (or two).

I don’t mean your undergrad pre-med advisor, although pre-med advisors can be wonderfully helpful as you navigate through the mechanics of the application cycle(s). But I’m referring more to real-life people with real life experiences who can relate to you, call you on your BS, and give you solid and practical suggestions.

You’re not looking for a cheering section (although encouragers are super important, that’s not what I’m talking about here). You’re looking for someone who KNOWS what its like. Do you struggle to find a way to afford all the application expenses? Talk to someone who didn’t have deep pockets as a premed. Do you battle test anxiety? Talk with someone who has struggled with the same thing and has found solutions. Do you have career and family responsibilities and wonder how the heck to add medical school responsibly into the mix? Talk to someone who was a parent or career person before they reached medical school. Do you have time-management issues? Talk to someone who successfully worked through those same issues.

It won’t always be easy, finding these folks who will help. However, I am convinced that their value cannot be too highly stated.

Obviously, all of the above is something we provide with Second Chance Mentor. But there are many different ways to find your champions – those who will go to bat for and with you, giving you feedback even when you don’t want it, and who won’t give up on you when you mess up (because you will).

This discussion wouldn’t be complete without this: Consider, when you have your own success story, becoming one of those mentors for someone else. One of the greatest gifts you can give is the gift of helping someone else succeed.

And yes, through every challenge, failure, and heartache of my convoluted journey to medicine, it was all overwhelmingly worth it!