Archive for the 'medical school' Category

i am an ms4, now hear me roar!

Behold! I have returned at long last and I am an MS4! Yes, I thought I would never make it. And I’m sure many of you thought I wouldn’t either. But here I am, 1000x more weary and none the wiser after having gone through the many levels of hell that was MS3. I think I may have a touch of PTSD, but that’s nothing a little Prozac won’t fix!

Oh the stories I have to tell!

But we’ll start small. Let’s just go with worst experience of MS3. Two words: Internal Medicine. I have never been actively suicidal in my life, but I swear I was during this rotation. The hours suck. The busy-work sucks. The fact that you’re just a peon chasing after coat-tails sucks. But what really killed me was the constant humiliation. A typical day of rounds went something like this:

Dr. Know-it-all: MS3s, go listen to this patient’s heart.
[MS3s proceed to listen to patient's heart]
Dr. Know-it-all: What did you hear?
Fellow MS3: I heard a murmur.
Dr. Know-it-all: Wrong! What about you?
Me: Er…um…A holosystolic murmur.
Dr. Know-it-all: Wrong! It went whoosh-whoosh, not whoooosh-whoooosh or swoosh-swoosh. Therefore, it was a crescendo-decrescendo murmur. And that’s aortic stenosis! [self-satisfactory grin]

And as if that wasn’t bad enough…being humiliated by the attending on a daily basis, we got a good share of it from our senior resident as well.

R2: What drugs reduce mortality in CHF?
Me: Um… (yes, I should have known this, but I didn’t at the time)
R2: Dig…
Me: Oh, digoxin? (which I totally thought it wasn’t because I vaguely remembered reading that somewhere)
R2: NO! I tricked you! I was testing you and you were wrong!
Me [to self]: WTF! [to R2]: Oh, okay. Sorry I didn’t know. I will go read up on it now.

My last example happened on a call night at around 11pm, when the R2 demanded that us MS3s give her a presentation on heart failure. Her comment was, “Because I’m sick of all this passive learning!” WTF! We would learn if we actually had the time to! And 11pm on a call night is NOT the time to be making MS3s give presentations! She then proceeded to put my poor fellow MS3 on the spot throughout her entire presentation. Luckily for me, I was a much better bullshitter than she. The semi-photographic memory also helped.

And those are just a few of the lowlights from my time on Internal Medicine. More stories to come now that I am an MS4 and have a semblance of a life again!

med school sucks

And that is why I’ve been gone for I-can’t-even-remember-how-long. I’m always thinking to myself throughout pretty much everyday of my third year so far: “Wow! I should really blog about this!” But by the time I get home and eat dinner, it’s time to go to sleep to start the whole crappy routine all over again.

Oh the stories I have to tell!

Third year is sucking the life out of me. My brain works so hard everyday that when I finally get to stop, all I want to do is sit around and not think. I was at the airport one day waiting to board a plane and was staring at my brightly-printed Tokidoki bag when my husband asked me, “Uh, what are you doing?” “Staring at my bag,” I replied. He thought I was crazy. But I just need to turn my brain off sometimes! It’s perpetually on and running, running, running everyday all day long. “Today sucks. I can’t believe I’m here. Oh wait. Don’t look bored. Look interested. You love this! Oh crap. Where should I stand? Did I say that right? Well, that was a stupid thing to say! Am I being empathetic enough? But I don’t know how to do what you’re telling me to do! Gotta pretend like I do anyway! Nod yes. Crap I hope they don’t figure out I don’t understand what the hell they’re talking about. Please don’t yell at me. Please don’t yell at me. Fuck my life.” Even when I get home, it doesn’t stop. “What do I have to do tonight so I don’t look like an idiot tomorrow? Crap, I really gotta study. Crap rounds are at 6?!” You’re lucky I’m even writing a post!

So I’ve done surgery. I’m on pediatrics now. I know I’m not going to be a surgeon. I actually like kids a lot more than I ever thought I would. But it’s early. We’ll see. And now I must shut down my brain. Stories from surgery hell next time I post.

it’s just a job

That’s what I’m trying to tell myself so that I’ll stop having anxiety attacks about it. It’s just third year. Everyone else goes through it and survives. And yet I can’t help but be unreasonably nervous about it. I guess too many years of being told I’m an unempathetic robot can do that to a person.

But it’s not just that. I kind of liked being a bum for the past six months or so. Staying up till 2am and waking up at noon was nice. Too nice. I think I’m addicted. I feel like my life is going to end. I’ve been sulking about it for awhile.

But I finally realized that it’s just like having a job (a really crappy one, but still…). Truthfully, I’ve never had a real 8-5 kind of job before. Sure, there was lab, but that doesn’t count at all. I’ve never had to actually do work for eight hours a day. I’ve never not been free to eat lunch whenever I want or take vacations whenever I feel like it. I never had to accept that the weekend is my only respite.  But now here I am having to do that. And more. After having been spoiled for so long. Not only do I have to accept that weekends will be my only time off, I have to accept that most of the time, I won’t even have weekends. That I won’t be home some nights.

Here I am boohooing about it when my peers (those who did not go to med school) have been living like this since they graduated from college. How silly of me! And yet I can’t help it. My life will likely never be the same again. But at least I managed to delay real life for this long. That’s what I’m telling myself. How long until I listen?

better late than never?

Tada! She’s alive! Ugh. I’m so bad. If I can’t blog when I have all the time in the world, what’s going to happen when I’m back on the wards and have no time at all? Well, we’ll see. Maybe I’ll have more to write about since everyday will be a new adventure. Yay.

What have I been up to? Absolutely nothing. Seriously. Nothing at all. Which sucks because when I decided to lengthen my break from school, it was so that I could do some clinical review work to make myself feel more confident when I return. Well, the powers-that-be made it sound so awesome…like they were going to totally hook it up…but when the time came, all I got was nothing. Don’t they know how hard it was for me even to ask for help in the first place? Why must they make me fight for it every step of the way? Well, I didn’t fight hard enough because *gasp* I thought they were actually going to keep the lofty promises they made me, so I ended up doing shit during my time off. What a waste of my time! I’m not getting any younger here!

Well, I’m not that dumb. I didn’t sit on my ass and twiddle my thumbs while I waited. I got cracking on studying. Big time. I’ve lost count of how many books I’ve read, but I’ve read at least one book for each rotation, plus Bates, plus Step 2 Secrets, plus others in the time I had off. I don’t know if I retained much. I probably still can’t tell you the difference between croup, bronchiolitis, and epiglottitis, but at least I can make some wrong guesses that don’t sound completely stupid. I got ambitious and tried to set up Step 2 at the last minute, but without having done third year first, I wasn’t going to be able to study enough to do well enough for my standards in less than 60 days, so I gave up on that. If only I’d come up with that idea say 6 months ago? That would definitely have been enough time. But silly me, I was still waiting on my miracle from the administration. Stupid. Stupid. Stupid. Me.

I’m not whining. I don’t care anymore. I’m just trying to finish it all up now. No more breaks. No matter how scared or overwhelmed I feel. It’s time to just plow through. I’ve got more Chanels to buy, dammit and I can’t afford them with my stipend money! Just a word of caution to other MD/PhDs out there: don’t expect any help returning to your clinical years. Actually, you should expect sabotage. They will do everything in their power to make it harder for you than for everyone else. I guess it’s punishment for being such overachievers. So if you want anything from them, demand it and don’t stop until you get it. There is no being meek or being afraid of seeming too demanding. If you don’t get in their faces, you just get totally and utterly screwed. Like me. Don’t be like me. You deserve better.

twitter and site maintenance

I’ve been meaning to post, but I’ve been quite busy lately. In the meantime, I’ve finally joined Twitter, so you can find me there as mylifemypace. I’ll be posting shorter updates there when I don’t have time to write a full post. Feel free to find me there and ask me any questions you might have. I’ll try to answer in 140 characters or less. :P

In other news, the site appears funky right now because I’m upgrading my blogging software and it messed things up. I’m working on fixing it, so please forgive the strange appearance until I get everything worked out. I’ll be back soon with some new material.

one step forward, three steps back…

The good news (I think): I’m finally almost done with my dissertation revision. I could have it done by the end of this week if my thoughts didn’t keep fluctuating and then focusing on how ephemeral life is. That and the fact that all I have left to finish is the discussion. One section doesn’t sound tough, but it is the section that needs the most work and the one that is the most difficult for me to write.

The bad news (or maybe not so bad if you really think about it): I’ve been asked to consider stopping my clinical work (read: my third year) and starting up again with next year’s class so that I would have my dissertation completely behind me and be able to start completely fresh instead of jumping back in with now super-experienced third years with only psychiatry under my belt. I have mixed feelings about this particular strategy. On the one hand, I do need that extra time to “prepare” myself as best I can by reviewing things like the physical exam and clinical reasoning, which I never was very good at in the first place. Also, since I’ve already done one rotation, I can take my last block off and study for Step 2, which I need to do well on since I’m going after Radiology. Oh yeah, and if I were to really return on rotation 5 as planned, I would be so far behind that I would not have any time to do any away rotations during my fourth year before having to apply to programs. I really believe that this extra year will be advantageous to me in helping me become the best possible Radiology applicant I can be. And, of course, I’ll have no more dissertation hanging over my head. On the other hand, now I’m going to be yet another year behind. One more year of not being done. Of not moving on with my life. Of not earning enough money to afford as many Chanel handbags as I want (though, really, in the grand scheme of things, I realize that life is far too short to spend coveting overpriced designer handbags). Oh yeah, as if it wasn’t hard enough to join the current class I’m in, I’ll have to do it all over again with a new batch of people. Not to mention that I’ll have to start the warm-and-fuzzy doctoring class all over again. I suppose I’ll just make sure to take on an early case since I’ll know what they’re all about.

Hmm…now that I’ve listed out all the pros and cons, it’s perfectly clear that taking the rest of this year off and starting again next year really is the best thing for me to do. Now, it’s not set in stone yet. There’s going to be some headbutting between bigwigs over this plan, but we’ll see where it goes. Until it’s decided, I’m sure as hell going to enjoy my carefree days. There’s nothing like tasting just a tiny bit of the third year of medical school to make me appreciate the finer points of doing nothing 10,000% more than I ever did before.

i took the plunge!

So part of our third year curriculum includes the much-loved warm-and-fuzzy doctoring class that kicks my ass because I’m so not warm and fuzzy.

I’ve been trying to not be super quiet, but it’s been hard because my group consists of people I don’t know who all seem to know each other so well and because there are a couple of extraverted people who tend to dominate the discussion. But I am thankful that there are only about 2 extraverts instead of 6 when I got screwed during my second year.

Well, the other day, our session was about dealing with family members of someone in the ICU who isn’t going to make it. The discussion centered on how difficult it is to handle such a tough, emotional situation in a way that makes the family feel better. And, of course, just to make things hard on us, there was going to be a standardized patient interview. We decided to fly by the seat of our pants early in the course, with the interviewer volunteering on the day of the interview instead of pre-assigning days to people. Of course, I did not volunteer. Not because I was afraid of it being too emotionally draining or heartbreaking or whatever. But because this case required loads of empathy, which I severely lack and I didn’t want to be evaluated doing the thing that I am weakest at (these stupid mock interview evaluations go into our Dean’s Letter to residency programs!). Someone else volunteered, so it was okay.

But after learning the heartbreaking details of this particular case, the volunteer interviewer chickened out, saying that she knew she would break down during the interview (which I thought was lame because we all know that this is fake!). She did break down right after making that statement and left the room in tears. Somebody apparently has too much empathy. So with her out of the picture, we had to procure another volunteer. And no one else volunteered. Like I said earlier, I wasn’t about to volunteer either. But after two prolonged awkward silences, I knew that I was ripe for being picked on because I hadn’t talked much in any of the prior sessions. So before I could be forced to “volunteer,” I volunteered.

And the interview was hard. Our standardized patients were an irate father and a hysterical mother. The mother I could deal with. The father…not so much. But I eventually muddled my way through and it wasn’t an utter disaster (as has happened to me before in my second year warm-and-fuzzy doctoring class). I actually got pretty good marks, which I’m happy about.

What I’m proudest of though is the fact that I volunteered and that I wasn’t as self-conscious and nervous as I usually am about these things. Maybe it’s because I don’t know these people and don’t care what they think of me. Who knows. But it was a really big step for me. This case was hard for me, but not in the same way as it was for other people. Everyone else’s heart breaks over the case itself and they fear that they cannot stay unemotional while talking to the patient’s family. I have the opposite problem: I don’t really care and I’m not very good at pretending that I care. Which one is harder to deal with? Well, I think that less people would fault an overly emotional doctor than they would fault one who just didn’t seem to care. There is such value placed on empathy that it makes me feel that I fail at being a doctor just because I lack in that area. Forget my smarts. I’m screwed because I don’t have empathy.

Well, at least I was able to fake it until I made it this time.

in response to my dear reader post…

Ages ago, I noticed an onslaught of new user registrations without much in the way of comment-posting, so I wrote a post requesting that readers give me some input about what they want to see on this blog. I am now finally getting around to responding to loyal (I hope so still…) reader 314’s questions listed below.

1. Did you ever have any dream careers as a child?

When I was in elementary school, I wanted to be a scientist. I even went so far as to draw a picture of myself in a labcoat working with chemicals at a lab bench when I was in second grade or so. So I’ve always been interested in the sciences. In high school, I wanted to be an astronomer until my mom told me that I’d never find a job (she was probably right). Not very interesting, huh?

2. What did you think being a doctor meant when you first decided to go to med school?

I lived a pretty sheltered life until my mom passed away when I was in high school. Even afterwards, I remained pretty sheltered (thanks to a psycho possessive ex-boyfriend). I had never really been exposed to what it is that doctors actually do except for what I saw whenever I went to my own doctor, who was invariably either a family practician or a pediatrician. So I thought that being a doctor meant having my own general practice and that was what I wanted to do. I thought that being a doctor meant seeing sick people and making them better, even after watching doctors fail to cure my mom. To put it simply, I was pretty naive and idealistic about the whole thing.

3. How/why has that changed as time passed?

Well, the first thing I learned when I started med school was that there were all these different specialties that I could choose from that I had absolutely no idea existed before. Then I learned that I do not, under any circumstance, want to go into a general field of medicine (e.g., family practice, internal medicine, pediatrics). Then along the way, I learned that being a doctor isn’t all that it’s cracked up to be. I don’t like seeing sick people. I don’t want to see people die under my watch. I don’t like the long hours and being treated like crap. I’ve been lucky to have pretty pleasant patients so far, but I’m sure the day will come when I get abused by a patient who thinks that I’m not good enough for them (and they would probably be right). I haven’t yet been yelled at either, but I hate living each day in fear of the time when I will finally get yelled at. I’ve also learned that a large part of medicine is about how well you get along with people, which I utterly fail at. I make do and plenty of patients like me, but when you put me next to Mr./Ms. Extrovert, I look like an utter failure. So what’s changed from my idealistic vision of everything is that med school is full of abuse and that the long, hard road is seldom worth it. And that contrary to what I had hoped, I cannot change who I am and be good with people. Which means that I have to hide in the shadows in Radiology instead of becoming a brilliant diagnostician (because, unlike TV, I’m pretty sure I can’t be an ass like House and still have a job).

Wow. How utterly demoralizing. But you introverts might as well know that med school and being a doctor is 100x harder if you’re an introvert before you jump in.