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!

 

 

My First REAL Patient

Sometimes I just sit very still and let the wonder of this whole process roll over me. After all, I worked toward THIS for nine years.

I guess I kind of figured I’d spend the first two years cramming information into my brain, then the second two years learning how to actually use all that info in practice. My experience has been very different than that, and that more than anything is what daily blows me away.

As I’ve written about previously, a big part of my medical school experience is spending 20 hours a month with my mentor from the very beginning of year one – a practicing physician who has agreed to let me follow him while he sees patients. Theoretically, this is considered “an observership”, one tiny step up from the shadowing I did as an undergrad. However, it very quickly turned into much more.

This past Tuesday, I arrived at a small university health clinic and almost immediately my mentor and I were moving from room to room, addressing headaches and plantar warts and completing study-abroad papers. My ‘job’ was to complete the EMR note, and I’m getting better at listening to my mentor rattle off the diagnosis and medication / dosage without having to say, “could you repeat that please?” Thirteen patients seen in a little over two hours.

And then it happened.

As we were with the last patient, freezing a particularly recalcitrant plantar wart on the foot of a determined soccer player, the nurse stuck her head in. “Any possible chance you could see one more patient? He just walked in and looks really miserable…” 

And the doc looked at the nurse, smiled, and said, “My student can see him.”

I cannot begin to describe my moment of panic. I’m a first year student. That means I say “I don’t know” a whole lot. I follow, look over my mentor’s shoulder, ask questions. I’m partway through learning long lists of bacteria and viruses.

I’m sure my panic was written all over my face as my mentor reassured me, “I’ll double check once you’re done – just think, you are going to be SO PREPARED by the time you hit clinicals! Here, use my stethoscope…”

And just like that I found myself knocking on the next exam room and reaching out to shake the hand of a miserable-looking young man who didn’t care in the slightest when I introduced myself: “My name is R, I’m a medical student. How can I help you today?”

I pulled up the EMR record, glanced at vitals the nurse had entered, then started right in. The patient was complaining of a sore throat for the last four days. No fever, no nausea or vomiting, no headache. Just the sore throat.

I tried to remember the ‘right’ order of things. Check the eyes, ears, nose. Look in the throat (yikes that looks really painful!), check sinus pressure, feel for swollen lymph nodes, listen to heart and lung sounds (so nervous I truly couldn’t hear a thing omg I’m messing this up so bad!), then have a brief conversation with the patient.

I’m a student so Dr. J will come in to confirm. But at this point it looks like you’ve got viral pharyngitis, basically a sore throat. Since its a virus, it won’t respond to antibiotics, but I know its super uncomfortable. You’ll want to drink plenty of fluids, get lots of rest, treat the discomfort with over-the-counter meds like Ibuprofen and maybe a throat numbing spray like Chloraseptic. Do you have any questions?

(I’m secretly praying he doesn’t. Don’t ask me anything! I promise I don’t know anything!!) But he asks how long before he feels better, and I reassure him that his body should fight off the infection in another 3-5 days. If he starts feeling a lot worse, or develops a fever or other symptoms, please come back to the clinic.

My visit with this patient took less time than it just took me to write about it, although at the time it felt like I was taking way too long. Then back to my mentor to report what I knew. Try to remember those TV shows I used to watch (back when I had time for TV),  students reporting on a patient to their Attending. Run through the patient’s complaint, my exam, try to describe the throat (it doesn’t look like the strep or mono sore throats we’ve been seeing – more like areas of ulceration or something) and then the doc is peering in my patient’s throat, glancing at my SOAP note, then leaning back against the counter while he confirms everything I just told my patient.

And now I know what a coxsackie virus throat infection looks like.

Once the patient is gone, my mentor looks at me. “Two things”, he said.

First, get your own stethoscope.

Second, make peace with the fact that most often (both now and for your entire career), you’ll feel like you’re operating more from life experience than from your med school information. Trust what you know. You’re really good at this.

I could have hugged him. But I didn’t… enough to know I’m on the right path. This is a “first” I’ll remember … for the rest of my life.

Hobnobery and ADD

Balanced against the growing stack of immunology and microbiology flashcards, the looming holiday Events are coming quickly. Events where I have the opportunity to “hobnob” with Important People – those who have already achieved a few more letters after their name than I, and who can potentially help me achieve my own.

Yesterday’s eight hours in the hospital was invigorating – spending time in my small-town emergency department with the steady trickle of fevers, bowel blockages, and stupid teenagers once again reminded me of what is most important about being a physician: Service.

Yet there is more to this preparation process than memorizing lists of parasites and clocking hours with my mentor. No one thing is of more importance, yet at times I find myself intentionally practicing a bit of ADD… that multi-tasking skill I’ve honed pretty close to perfection over the years.

Starting out the day in jeans, changing to scrubs for the hospital, and donning a little black dress and heels and putting on makeup for the evening gala can be a bit frantic-feeling if one isn’t mentally prepared.

But its all part of the process.

That “hobnobery” is important. Time spent networking with other medical professionals, practicing my “elevator speech” of who I am and what school I’m attending and why the heck I’m pursuing the study of medicine at my age (seemingly the most interesting part of my story) is all part of the big picture.

I’ll admit though, last night one case was my all time favorite so far. A teenage boy was brought in by his parents after he decided to take a bite out of a sidewalk plant. (Seriously? What were you thinking?!) My mentor took a picture of the plant and started an internet search trying to figure out what it was (and why the kid was saying his mouth felt like it was being attacked by needles on fire). I grabbed my phone and – thinking like a parent instead of like a doc – did my own internet search. And learned tons about plants that kids somehow decide to take a bite of, that also contain oxalic acid crystals and leave the biter feeling like they just chewed on ground glass. Best part? The remedy is to thoroughly wash the affected area with soap and water (who knew “washing your mouth out with soap” was a medical ‘thing’?!). It was just icing on the cake to hear my mentor let the parents know that “my med student solved the mystery”…

Now to get ready for a little hobnobery tonight… and convince myself that I really do not need to bring along my flashcards. On second thought, I think a small stack just might fit in my purse hmmm…

STAMINA

STAMINA.
 
I’ve learned a thing or two about stamina – that quality of ‘just keep going’ that often defines a person’s ultimate success.
 
Stamina means you start from where you are. Whether you’re building a skyscraper or for an Olympic championship, you must begin where you are. Athletes had their DAY ONE – the first step around the track, the first weight lifted, the first attempt at a basket. Successful business owners had their first risk, their first partnership, their first failure. Professionals in any field had their first class, their first internship, their first job.
 
Stamina isn’t glamorous. There’s no cheerleaders beside the track at 5am. There’s no band playing when mom decides to return to school. There’s no celebration for the sore muscles, the frustration feeling like you’ll never get “it” right, or the emotional overload of unstoppable effort. In fact, pretty much people don’t want to hear about the study marathons, day-in-day-out practices, or quiet determination of that ‘thing’ you’re working toward.
 
Stamina takes daily effort, over and over and over and…. well, you get the picture. That’s what it IS. Daily effort toward a goal. Regardless of if anyone else gets it, understands you, or joins you. Its the part of life that highlights the glaring difference between those who spend a lifetime wishing, complaining, settling… and those who are willing to just shut up and do what it takes. Stamina is NOT the same thing as loud shouting about how successful you’re gonna be any minute now, or how dumb anyone is who hasn’t embraced your particular goal. In fact, those who realize the greatest success in whatever area tend to be the most quiet about it.
 
Finally, building stamina can sometimes feel lonely. At least if you’re the sort of person who wants/wishes for acknowledgement and support (however you define that). When its past midnight and I’m still studying… when I’m stupid tired and I exercise anyway… when I’m emotionally hitting the wall and I keep building toward my goals not because I feel like it but because that’s my commitment and that’s what’s next…
 
So here’s my invitation to YOU.
 
Choose something. Some goal that means something to YOU.
 
Take a step forward. Then another.
 
Let go of your need for a ticker-tape parade to celebrate with you. That’ll come later.
 
Get used to moving forward every single day whether you feel like it or not.
 
Embrace the fact that while others may give their support and encouragement, ultimately this is YOUR goal, YOUR mountain to climb, YOUR habit to break or establish, YOUR ‘thing’. YOU are the only cheering section that will be right there with you through thick and thin.
 
Then, shut up about it and JUST DO IT.
 
If you’re still with me, awesome. Funny how ya gotta live long enough to find a little wisdom along the way AND be willing to act on it.
 
STAMINA. That super cool quality of being willing to do what it takes, daily, because you’re just like that. And yes, overwhelmingly yes, it is so completely worth it.