Tag Archive for 'medical student'

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?

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.

update: of puppies, chanel, and iphones

Yes, I’ve been MIA again. It’s really hard to write when I’m too busy being a blob.

I deferred my second rotation because the ghost of my dissertation just would not stop haunting me. Translation: my asshole major professor kept demanding a draft from me despite the fact that no one really expects us to pump out a dissertation during our third year of med school. It was a tough decision, but it was just something I had to do in order to make sure that I could focus completely on my rotations so that I don’t fail. One can skate by with only half a mind on Psych, but not while on Peds or Medicine. And I’ve been making good progress so far.

This whole deferment has allowed me to enjoy life a bit more, which is good because I’ve learned to appreciate the little things, like watching my adorable corgi puppy sleep in my lap all day long. It’s also bad because I will have to learn to live a shadow of a life once I return in August. I’m not yet sure how I’ll deal with that yet, but my preliminary plan involves large amounts of Prozac.* Speaking of my puppy, he is absolutely awesome! He’s the cutest thing ever! I always thought that I would miss him having a tail (my other dog has a really fluffy tail that has a tendency to knock things over quite often), but I now find my puppy’s little nubbin to be quite adequate at expressing his emotions and quite cute to boot. From behind, he looks like a bunny hopping when he runs. He’s a handful, but nothing compared to the horror stories I’ve heard about other breeds. I definitely cannot imagine my life without him and can see why Queen Elizabeth II has a bunch of corgis.

What else is new? Well, say hello to my new acquisition:

Isn’t it pretty? It better be because it costed $1000 more than our 52″ LCD TV. I could also have bought the Macbook Air with the amount of money I spent on this purse. Or that Canon 40D DSLR that I’ve been coveting for a year now. But, no, because I am a woman after all, I instead blow my money on a Chanel purse. And all because it’s purple and shiny and super-limited-edition. It was supposed to be my reward for finishing my first draft of my dissertation. I was just at the boutique to try it on so that my husband could then later buy it for me when I fulfilled my end of the bargain, but we ended up buying it because Chanel newbie that I am didn’t realize what incredible good fortune I had to even be able to find it at this late juncture, but at least had the good sense to know that I would forever kick myself if I passed it up. So I possess this purse that I wasn’t planning to buy for another 10 years now and I am quite broke. It is also still all boxed up (my husband was kind enough to let me take it out for a few hours to take pictures of it) waiting for me to finish that draft before it can come out and play. And now you know why I’ve been so productive as of late.

And lastly, somehow beyond all reason, my husband was able to convince me to wake up at 4:30 am the morning of July 11th to head out to our local Apple store to wait in line for the iPhone 3G. Because, of course, I just had to have it. So that’s what we did. And it was quite the interesting experience. We were, of course, not the only crazies as there were already 50ish people there by the time we got there and the line grew to well over 100 people by the time the Apple store opened. I thought I would feel really lame about waiting in line for a phone, but I have to say that I was glad to have experienced it. Of course, my shiny new iPhone 3G was defective and I had to go back a week later to get it replaced, but at least I have one now. By the way, it’s also all sorts of awesome.

*I kid. Sort of.

i am so going into radiology

After 1 week of psych consult, I learned that I do not, under any circumstance, want to go into Internal Medicine. How anyone can stand the smell of someone else’s diarrhea is completely beyond me. And I’m from psych consult! I probably had to smell it for, what, five minutes? Yeah, well, five minutes is far too long. I cannot imagine being on Medicine and actually having to do a physical on someone who stinks of poo. Let’s just say that I was actually glad I hadn’t eaten before seeing this patient because I would have surely vomited otherwise.

We get a lot of consult requests from the various Medicine teams in the hospital. So I’ve had the distinct pleasure of visiting many Medicine areas in the hospital. And they all have that distinct hospital smell that I have now grown quite sick of. Sometimes, this smell is intermingled with the distinct smell of poo. The people in these areas tend to be pretty sick with multiple problems. And MRSA. I guess I should be glad I’ve learned how to gown up for such situations. But, really, I just don’t like it.

At the end of my second week, I learned that I don’t like talking to patients. Or their family. Or anyone else, really. Sure, I already knew that, but I thought it would change when I started wards. That something inside of me would magically change and I all of a sudden wouldn’t be socially awkward anymore or hate talking with people. No such luck. There’s nothing like knowing nothing to really make you not want to open your mouth when speaking to patients. Patients who expect you to know everything.

By the end of my third week, I decided that I’m going into Radiology. Over the weekend, I debated whether it was really what I wanted because I never really liked what little Radiology I had been exposed to in my first two years of med school. And it’s also 4 years on top of an internship year. Plus I’d want to either do a Neuro or Interventional fellowship, which would add another 1-2 years, making it 6-7 years total, far too long a time for someone who has already wasted 4 years on a PhD that she’ll likely never use. So I had my doubts.

Then, yesterday, my attending insisted on watching me interview a patient. These kinds of situations are particularly painful for me because of my social awkwardness and nervousness when being watched by other people. Of course, I get a psychotic patient. Which I’ve never seen before. So I really concentrated on making sure I asked the right questions on the timecourse of his symptoms as well as things to rule out depression and mania and the like. And because I was being watched and didn’t want to waste the attending’s precious time, I directed the interview more than I usually do, sometimes cutting off the patient’s rambling answers to interject my own questions, but never too brazenly. I also took this approach because I’ve gotten quite a few delirious/talkative patients who would talk and talk and talk without making much sense, making for really long pointless interviews and I was kind of tired of it. Also, I was modeling the interview style of the other attending, who I’ve worked with more than this particular one, who keeps things nice and short. Well, at the end of it all, this attending called me an unempathetic information gatherer. Now that might sound painful to those who aren’t used to hearing themselves being described that way. But it didn’t surprise me at all. I actually wanted to respond by saying, “Tell me something I don’t already know” because I didn’t find that assessment particularly useful. I know that I suck at empathy. That’s because I suck at social interactions, period. Sometimes, I think I have Asperger’s. And the sad thing is that I was actually trying during this interview. Though not as much as with unwatched interviews because I always feel so fake doing such things and didn’t want the attending to call me out on it. Yeah, that plan worked out well.

So, that’s how I’ve come to decide that Radiology is for me after just 3.5 weeks on rotations. The only thing that might change my mind is Surgery. But I doubt it. And I’m sure my attendings will be glad to know that I won’t be spreading my unempatheticness wide and far.

inspirational music for the medical student 2.8

Starting med school is like starting a new life…you have to learn to study extremely efficiently, deal with slightly crazy classmates, and fumble your way through your first physical exams and patient interviews. Along the way, you’re going to make mistakes, many embarrassing ones. You’re going to be scared that you’re never going to be good enough. And you’re going to be happy that you’re pursuing your dream. So in honor of new beginnings, my song for this week is Yael Naim – New Soul.

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Send song suggestions here.

inspirational music for the medical student 2.5

Med school is synonymous with information overload.  There’s just way more to learn than we can possibly ever learn.  No matter how much we memorize, there’s always something that we just can’t remember.  And that didn’t sit well with me when I started out because I had never before had trouble memorizing every single detail about something.  So, eventually, I learned to accept that there are just some things that I couldn’t memorize and to be happy with what I did memorize.  So, okay, I don’t know all 16 possible side effects of furosemide, but I know the important ones.  I’m fine with that now.  Because when you’re trying to memorize the mechanisms of actions of these drugs, their side effects, along with more than you ever wanted to know about your kidneys on top of also trying to become an expert on the gastrointestinal tract and the inner workings of the mind, you learn to take what you can get.  And if that means you know 14 of 16 possible side effects of furosemide, then so be it.  Which brings me to my song for this week: Dashboard Confessional – Tonight I’ll Take What I Can Get.  Because that’s just what we have to do sometimes.

As usual, feel free to send me song suggestions here.