Perspective

23 more days until Christmas.
3 more weeks until the end of finals.
13 more days until the start of finals.
9 more days of class.
4 more sleeps until the baking extravaganza with my cousins.
Just a few more hours until the gingerbread house competition.

9 more months until I start clerkship and need to know all this material.

A few months until Niece's second birthday.

The world will manage if I need to take a day to myself.

Perspective is a brilliant thing.

I'm a terrible patient

I've had the flu and a cold for the past 7 days. I hate it. I'm crabby and taking it out on everyone around me. Why we didn't think of feeding me DayQuil until yesterday is beyond me. It bothers me that when I meet patients in observerships who are crabby because they are unwell, I am patient and kind, but with myself, I am impatient and unkind.

And you've been warned - stay away from me when I'm ill!

Do what you love and the rest will follow

'Do what you love and the rest will follow' is advice that I have passed on to anyone wishing to apply to Medical School. It really doesn't get more simple than that. I love swinging in the park, hanging out with my brother's kids, eating chocolate and drinking coffee, hitting the gym and cooking. I loved my jobs, the volunteering I did before I got here and the degree I was studying. That shone through on my essays and in my interview. If I had done everything by the book and volunteered in an emergency room or done a degree in biomedical sciences, I'm not sure I would have been admitted. That's the selfish side of doing what you love.

The practical side is that it makes everything you do easier. When we're little and have to go somewhere we don't want to, we dawdle. I'm sure it drove our parents nuts. It takes forever to get a kid that doesn't want to go somewhere out the door. Putting on shoes, finding coats and remembering to go pee can take an hour. I wonder if it's fair to assume that when I'm taking forever to get to my early morning meetings with faculty and administration if it's just that I don't want to go there. The days that we have early morning clinical methods however, I'm out the door like a shot.

I'll try to pay attention next year during clerkship to find out what gets my feet moving in the morning and what will make it easier to leave the house. That might finally let me know which specialty is calling my name!

Here is a set of links to advice from the women at 'Mothers in Medicine'. They are what these women would have wanted to know upon their acceptance to med school. Things like don't lose yourself, don't do it for the money, you will miss and love the classmates you currently want to throttle, the happiest med students are in their mid twenties, all the crap will be worth it, take a calcium supplement, don't let yourself get too fat, write in the school paper, it will all work out, you're never alone.

Game Face

My GI exam is coming up. I have a lot of studying left to do. I still love this block and I'm still not going to be a gastro enterologist.

I took a mental health day today and it was fantastic. Most of the day was watching "How I met your mother". Not exactly ideal study conditions, but wonderful for making me smile and lose track of my stresses. And there was chocolate. Far too much chocolate. Tasty tasty chocolate.

But I digress.

There are many students in my class who are focusing on studies alone, leaving all the organization and advocacy to other people. That's fine, I respect that. I just wish they wouldn't rub my nose in it.

I know that I am just as smart and able to succeed in school as well as advocate for my fellow students.

I am currently giving myself a pep talk. One that will allow me to get to work and learn everything I could ever want to know about the pancreas and liver (and more). I'm putting on my game face and being the strong woman I know I can be.

Driven to Drink

My partner and I have been incredibly social over the past few days. It's unusual for us. Both of us find being in socially heavy situations to be difficult. I know there's irony there, the woman who is going to be a doctor is uncomfortable talking to people. I think that situation will be different though since my patients will be coming to me with an agenda, and unlike our sneaky standardized patients, they will let me know what it is they want from me.

I've been asked at each of these events what I want to specialize in. I DON'T KNOW!! Family medicine looks good because there are so many options available for me. If I learned nothing else this summer it's that family docs can have a wide breadth of practice. It would help my attention deficit ways.

I've also been asked about my children. Someone has been telling people in the first year class that I have kids. This amuses me but also upsets me. I hate gossip...when it's about me. It really is amazing how quickly gossip spreads around and between the classes.

In other news, I passed Endo!! Yay! I've really got to start studying for the final so I can maintain my pass. Even though we have a saying in this pass-fail program (six-oh and go) I'd still like to learn the material well before heading into clerkship and having to attempt to diagnose a real live prolactinoma. Or at least put it on the differential.

I'm still enjoying digestion, but think that I've fallen further behind in it than I would have liked. What's new. More studying is definitely on the agenda for this week.

Thanksgiving

Thanksgiving can be such a great way to stop and take stock of everything that is going right in my life. I have a very bright future in a field that I love (LOVE!!) helping people and learning every day of my life. That alone makes me one of the luckiest people I know. We can move to wherever we choose to embark on this fantastic adventure and the people there will make it easy for me to settle in. I can travel for 1 week out of 6-8 to the north to see an entirely different patient population. Within my career I can specialize as much or as little as I would like. Maybe I'm a little too glow-y, but I don't care.

I have a partner who loves me and whom I love.

I have 2 adorable cats who know when the time is right to snuggle.

I have a family that (touch wood) is free of illness and who despite our arguments love the heck out of each other.

And I get my choice of 4 types of pie for dessert tonight!!

Mini Vacation

We've been given 4 days off. I might be in heaven. There's definitely a huge list of things that I need to get done, but knowing that I have 4 whole days to fit them into is lovely. Plus there's no one else around so I'm not expected to show up for meetings anywhere. Pretty much divine.

I had my first large scale mistake last week. No one got dead, but an entire class of students was subjected to my idiocy. It really threw me because I was just starting to feel as though I had things together (well, non academic things). It's surprising to me how important it was that I get praise rather than chastisement for the effort I'd put into the project. I think it's indicative of a mindset I need to change for next year. I will be making more mistakes than a kid learning how to walk and I need to be ready to listen to the criticism. Now to make that magically happen...

We've moved on to the Gastro Intestinal tract and nutrition. I love it. Apparently I'm the only one in the class that does. Their loss.

I don't think I'll ever specialize in GI, but the anatomy and physiology is so interesting that I love it. There are so many mechanisms set up that make sure that we get all nutrients from our food - it's fascinating. The anatomy is simple and logical. What else could you ask for in a block??

RIP

Before it was the fashionable thing to do, Paul Newman donated buckets of money to charity. He was a good man, a fantastic actor, an important part of what I consider to be important pop culture and incredibly sexy.

I hope you have peace.

I Love Fall

It may be because it's when my birthday is, the smell of dirt, changing leaves, starting school or the change in weather. I think mostly it's the feeling of not being here or there but a magical place in between. We still get delicious warm days like today, but also chilly 3 sweater days like last week.

I slept last night for eight hours, almost in a row. It was glorious.

We're learning about type 2 diabetes right now. It's a fascinating disease and one that I know that no matter what speciality we choose we'll be helping patients who suffer from it. Except maybe radiology. I can't think of how T2DM would show up on film.

Metamorphosis

"Be who you are and say what you feel, because those who mind don't matter, and those who matter don't mind. - Dr. Seuss"

We're heading to Point Pelee today to see the Butterfly Migration. I'm hoping for a zen kind of day.

All that has been going on has made me cranky and not a good person to be around. It's time to become the person I really want to be.

Up to my eyeballs

I feel like I'm running a million miles an hour. It's safe to say that I've bitten off way more than I can chew this year. I feel like I'm back in high school running between meetings and not doing my homework.

It's unfortunate since this block is really interesting. Endocrinology is one of the parts of medicine that I find most attractive - push part of the system here and watch what happens over there. It's a very elegant, logical science that I'm looking forward to spending the weekend learning more about.

There's been so much on the go that most of my socializing is done between classes. Or over coffee at a coffee pub while working on a paediatric assignment.

I've been in contact with a couple of women I want to speak to about being an older than average student at school. Mostly I want to know how they dealt with being married and in clerkship, though my lack of sleep now can only be helping me prepare.

O Week

Holy cats. What an O Week this is turning out to be. The biggest 2 parties are still coming up so the coordinators in their infinite wisdom gave the 2012s last night off to recoup and recover, they weren't quite ready for the partying force that is the 2011s.

Tonight's party involves us dressing up as our favourite 80s movie. Since most of my group doesn't know many 80s movies, we've decided to do a "concept" team costume instead. We will be ever so Pretty in Pink. Last night we hit a thrift store looking for pink clothes - so fun seeing the guys in pink dresses. My dress is a bit more revealing than I would normally wear. It seems likely I'll have a shirt on underneath.

In other news, endocrinology is like death from a thousand paper cuts. They jumped in with both feet, skipping the pesky "what does each hormone do" lecture and moved directly into the tumours and crazy diseases associated with them. Thank goodness I have all this extra time to cover them on my own - no sarcasm. Well, not much.

Oh, and I may have pissed off the academic dean in a recent meeting so I've got to make sure that I don't need his help. So off to figuring out what's happening with these hormones.

What Med School is Like

It seems like whenever I get overwhelmed with what is happening at school, someone asks me how school is going. They mean well. I love that they care, I really do, but I have no way of explaining how I'm feeling without sounding like I'm whining.

The blogger "The Rumours were True" compared med school to eating 5 pancakes every day. He has something there, and it's definitely worth a read.

The idea was made into a short film.

Why do we put ourselves through it?

Dr. Unnecessarily Angry Surgeon comes to in to teach at least once a month

I've been able to get to know the entire class. Really. I know everyone's name and at least 2 bits of interesting information about them. Even the ones who never come to class.


OK, too many videos on one page, I'll start actually writing now.

I love school, it's a great experience. What gets to be stressful though is how absolutely impossible it is to do everything I want to. My undergrad style of note keeping went out the window within a few weeks of starting class - there just isn't time and it just keeps coming. There are "interest group" lectures about absolutely everything. It's a great way to learn what I want to do when I'm done school and I want to hit every one, again, can't.

There are a million committees and community interaction groups, councils and academic events that I want to take part in but again, just no time.

Not to mention the weekly (at least) party.

I'm constantly feeling guilty that I'm not getting to everything and doing as much as I possibly can. It's a bizarre thing. I'm getting used to the fact that I can't do everything but I don't like it. You know I'm pouting.

Maya Inspiration

It's so easy to be caught up in the every day, noting how difficult our lives are. Or maybe that's just me. I know that I need to give my head a shake and notice how much is going on for me when so many have such a difficult time. I was reminded this morning when I saw this clip. I haven't heard Maya Angelou read "I Rise" for quite a while and it was long over due.



In the same vein, the words to Phenomenal Woman also by Maya Angelou. It's who we are not what we look like.

Pretty women wonder where my secret lies.
I'm not cute or built to suit a fashion model's size
But when I start to tell them,
They think I'm telling lies.
I say,
It's in the reach of my arms
The span of my hips,
The stride of my step,
The curl of my lips.
I'm a woman
Phenomenally.
Phenomenal woman,
That's me.

I walk into a room
Just as cool as you please,
And to a man,
The fellows stand or
Fall down on their knees.
Then they swarm around me,
A hive of honey bees.
I say,
It's the fire in my eyes,
And the flash of my teeth,
The swing in my waist,
And the joy in my feet.
I'm a woman
Phenomenally.
Phenomenal woman,
That's me.

Men themselves have wondered
What they see in me.
They try so much
But they can't touch
My inner mystery.
When I try to show them
They say they still can't see.
I say,
It's in the arch of my back,
The sun of my smile,
The ride of my breasts,
The grace of my style.
I'm a woman

Phenomenally.
Phenomenal woman,
That's me.

Now you understand
Just why my head's not bowed.
I don't shout or jump about
Or have to talk real loud.
When you see me passing
It ought to make you proud.
I say,
It's in the click of my heels,
The bend of my hair,
the palm of my hand,
The need of my care,
'Cause I'm a woman
Phenomenally.
Phenomenal woman,
That's me.

This is how I procrastinate

A parody of the Dark Knight that's a little less intense than the original.


What can I say, I love pancakes.



Can't get enough of turtle boy.



I'm "working" on course development for the med school, but finding it difficult to stay focused. Currently I have a vibrating foot stool aka Fat Cat, a strong cup of coffee and it's wonderfully cool outside so I really have no excuse. Back to work I go.

Who am I kidding?

It wasn't just being older than my class mates that I was worried about, it was being so much fatter. It was justified. Anytime a slide was shown with an MRI, an X-ray or surgery that showed a fat person, there was a chorus of "ew! Gross!" from behind me. At one point, a google image photo was used to demonstrate a risk factor for gout, excess weight. That got a giggle from the class. I was roughly the same BMI as the woman in the picture. That was upsetting, but not as upsetting as when someone put the photo into her profile pic on Facebook because he "thought it would be funny".

I recognize the hypocrisy in a medical student who is obese learning about how to counsel her patients on losing weight, I'm fat not stupid, but I can also recognize the difficulty in losing weight while under the pressures of medical school.

I'm actively trying to lose weight, joined an online weight loss program, have been working out at the gym a lot. I've lost 10 lbs in 5 weeks, and 10 cm off my waist. I was hoping to have more off before heading back to school so that it will be obvious, but that doesn't look like it will happen.

end confession

An American Swimmer Inspires Me

Have you been paying attention to this woman? Holy Moley! Dara Torres is an American swimmer (why I hadn't noticed her before this morning). She's the oldest woman competing in the Olympics. What an inspiration, especially considering how young this field is.


There isn't an age limit on any of the changes we want to make in our lives. Don't say you would do something if you only x years younger. I call your B.S. and tell you to just do it!


I was actually in tears this morning while I was watching the news reports posted above. I was so scared when I first hit my med school class last year, afraid of what they would think of me as so much older than them. Listening to what Phelps said about Torres (mom) made me think that he was being a bit immature. It's so much easier to slough off comments made about Dara than they are about me. What a great lesson. Someone in the class called me Mom once this year b/c I was giving him a hard time when he came to my house (pardon me if I want my kitchen left in one piece). I snapped. I too would prefer to be thought of as an older sister - it makes sense to me since my little brothers are the same age as the class. Either way, I hope I can remember how proud I feel right now of going into med school at my age.

In an unrelated topic, profs/administration/tutors need to back off students. Either they're creeping our Facebook, or complaining that we don't get to class often enough, or bitching about our work ethic. It makes me absolutely crazy. I spent a significant amount of time and energy this week trying to calm down the teachers in the course I'm helping develop - it's ridiculous.

Brainstem!

I'm pretty excited that this year we'll be looking at Neuroanatomy. It was fun in undergrad, I'm hoping it will be fun in med school too. It's good to have high expectations, right?


Most of the blocks this year will be interesting to me: Endo/metabolism, Digestive system and nutrition, genitourinary system, reproductive system, neuroscience/eyes/ears, Psych and behavioural sciences, Emergency care. Yay!

What I did on my summer vacation

I still owe you a list of the loveliness that I witnessed during my elective.

• breast reduction surgery - this was one of the most amazing things I've ever seen. The tissue went from looking like a train wreck to a perfectly shaped breast. Wow.
• removal of a congenital defect from someone's tendon, a huge connective tissue chunk. Again, wow. Plastic surgery is looking less like something ridiculous
• colonoscopy - ew
• emergency ectopic pregnancy surgery - so much blood
  
• 2 deliveries, both were natural and no tearing on either
• I presented 2 cases to the internal medicine preceptor
• witnessed a respiratory code
• saw a passionate doctor calm the coding patient down with only a few words
• saw an amputated toe
• listened to a billion hearts and lungs, give or take a million
• surgically assisted on a vasectomy
• saw toe nails removed **always cut your toe nails straight across**
• heard a patient scream at an emergency physician because she wanted to be treated immediately. She went on to compare the US EDs to Canadian "over there you're served in 29 minutes or it's free, they're proud of it", "like a pizza?" " ya". Witnessed Doc storming from room. What drama.
• was asked by a 4 year old if I would give his mom a foot massage too when I dropped off a warm blanket
  

Forensic psychiatry

We were camping last week when the news broke about the decapitation in Manitoba so I was surprised when my physician friend mentioned it off hand. He is pushing me to consider specializing in forensic psychiatry since this guy clearly needs help and the courts will need a hand understanding why he lost it. I'm not sure I have the gumption to entire that field, but I couldn't agree more that one should come in to help out. This is a horrific event and I'm interested in seeing how it plays out.

PETA has compared this event to animal slaughter and I'm not sure how to take that. While I can see why they consider the murder analogous to the mass meat industry, it's way too soon. There's been a lot that PETA has done that I have found to be tacky, but this is the worst campaign yet.

When I brought this up with an extremely paranoid religious person I know, I was told that it was the result of satanism. It's not a psychiatric illness, the devil made him do it. I guess that saves me several months of studying next year, the right answer for the underlying biological causes of schizophrenia? Satanism. Depressed? You're not praying enough. Thank goodness no one we know has any sort of mental illness like depression or other psychosis (said dripping with sarcasm). It was a short conversation because no one deserves to be shot on their birthday.

Another Pointless Post

I'll update on my elective experiences soon. Well, soonish. Until there, here's a baby moose playing in a sprinkler.

Apparently I would Fail as a 30's Wife

Quelle suprise.

-2 As a 1930s wife, I am Very Poor (Failure) Take the test!

Bone Tired

I get that a lot of docs feel a strong need to let lesser people (aka nurses, med students, patients) know that they are not as worthy of oxygen as they are. It's absolutely exhausting though. I was yelled at by a surgeon the other day, in front of the patient and his family, which was humiliating for me and uncomfortable for them. I can appreciate that she was having a rough day and knows a million more things than I do, but it's hard to remember that when I'm too busy looking for a hole to crawl into.

I can't wait for clerkship when I have to deal with this all the time. Yay.

Dancing makes me happy

This new generation of med students

We're a generation who knows what it means to be without a physician. After almost 20 years of looking for doctor I ended up going to med school - it would be faster. We're disillusioned with the health care system, concerned that it will fail us and our families in our times of need. During some group discussions we have covered the concept of allowing our family to jump the queue of diagnostic testing to ensure that they are seen and treated while the disease is still manageable.

It boggles my mind that physicians of previous generations don't recognize that we don't put as much faith in the system as they do. Neither do our future patients.

The internet and poor availability of health care have made doctors less important. On more than one occasion over the past two weeks I've seen patients bring in pages they've printed off the net and question the doctor's decision regarding tests to the point of getting a second opinion on the same day. The patients are assuming that they know more than the physician who has been studying the material for years. Granted, this is how we are taught to approach the physician - patient encounter, always ask the patient what they think the problem is since they'll have a good grasp of what's going on since it's happening to them. Some patients take this as the doctor not knowing what is happening. In reality it's often the doc fishing for a fact that the patient has hidden as though this is an episode of CSI.

When I was growing up, my family doc knew all. The man was a brilliant diagnostician and a terrific doctor. Our community loved him and held him in the highest esteem. Who could blame him for wanting to be a doctor 24-7?

When your patients aren't providing you with that love and support, I think it's easy to see why many of my generation of doctors feel a strong need to make sure their life outside of work satisfies their well being. Docs that are now entering the work force are choosing to work fewer hours and spend more time with their families, hobbies and life outside of work. Macleans magazine misinterpreted this as female docs choosing to leave their profession to raise their families, but it's the men as well. The "pink ghetto" is a concept that many older, male docs choose to believe is true. I've had several docs over the past few weeks say things to me like "female doctors should be sterilized before entering med school", "women doctors are the reason we have a shortage right now" and my favourite who said both, "white males are discriminated against in the admissions process" and "there are more women than men in med schools now which is just going to make the doctor shortage greater as we move forward". Wow.

I don't deal with incorrect, inflammatory statements in an acceptable way - i.e. nodding and smiling. It's bull shit.

I'm not done ranting, more on this soon.

Pessaries and Circumcision

This week was a bit more dull than last - probably because I wasn't in the OR at all. I spent most of the week with family docs plus some time in the ER and with an internist at the hospital. My list for this week:

• performed a 6 month well baby check up with the cutest baby ever
• met a born again Christian/recovering alcoholic
• danced with a delirious geriatric patient to try to keep her in her room in the ED
• heard the distinctive tinkling of someone with a bowel obstruction
• met someone who had been hit by a train and survived
• learned what shifting dullness was and how to properly check for pitting edema
• saw a stress test in action
• heard COPD, emphysema and chronic bronchitis
• saw a woman with shifting pain that the doc didn't know what to do with - not sure why she wasn't referred to rheumatology, even though it wasn't in the joints, it may have been fibromyalgia
  
• speaking of rheumatology, why are none of these docs on top of management??? Tylenol for RA?? wtf?
• was lectured endlessly on the woes of the Canadian family doctor and how we'll never make any money
• saw a woman with scleroderma and pronounced sclerodactyly
• she was happy to let me feel her fingers and skin to get an idea of what to expect
• there are support groups for those with scleroderma
• I think the doc was dissapointed - I'm pretty sure he was hoping to stump me with that one ;)
• watched moles and skin tags be burned off
• closely followed with the first time I've almost fainted (no lunch + burning flesh = syncope)
• saw a circumcision - uck - how can you do that to your baby??
• met a man who takes 72 pain pills a day for his chronic pain
• my first question - do you still have room to eat food? Apparently his appetite is still strong
• heard a pan systolic murmur
• found a melanoma spot in an elderly woman's mouth
• wrote the admission notes for a patient who was unconscious - or at least attempted to, I wasn't that great at it - this is how we learn though
• saw a uterine prolapse and a pessary insertion
• examined a few pregnant bellies
• saw several cervixes (cervi?)
• met "that guy", the one who thinks that because he's on lipid lowering meds that he can eat whatever he wants and as a result his blood sample was 1/2 fat so the lab couldn't do cardiac enzymes - those guys actually exist!
  

Still freaking out a bit about finals but I this week has been busy enough that I haven't really noticed. I'm doing a 5 week "elective" at a large centre away from med schools. It means I get to see a lot and I'm the first in line to watch it all happen/learn how to do it myself.

It's been great to see a team of doctors, nurses and nurse practitioners that work together so well. It makes me want to work at least part of the time in a hospital. So far this week I have seen:

• carpal tunnel release surgery
• the suturing was so neat and close to invisible I'd be surprised if there was any scarring
  
• laparoscopic cholecystectomy
• I will never consider eating beluga caviar again

• C section, double ovary removal, tubal ligation
• aortic aneurysm
• cranial fracture
• very sick people
• drug seeking people
• intubated 2 people
• put a peripheral IV line in one
  
• took close to 20 histories
• did abdominal, respiratory, cardio and MSK exams
• missed a fracture
• got to hang out in the OR, ER, family doc's office

All together, it was a great experience for a first week!!

Still waiting for the hook

When I got back to town yesterday there was a notice from Purolator on the window. My heart sunk into my toes. Not anatomically possible, I know, but it sure felt like it. I've been in a total panic since exams were over that I wouldn't get the 30%s I needed in my exams to pass the courses. It doesn't help that many of my classmates also feel the same way and came to me to make themselves feel better.

As much as I like being able to help people, I need to have my own space. One day I was having a hard enough time getting my own studying done but ended up talking classmates off the ledge. It's weird that I seem to give off an aura of someone who is on top of their studies to some people in the class, but others treat me like I'm an imbecile.

Toward the end of the year I was growing very weary of my classmates and was looking forward to summer. I'm hoping I can stay relaxed enough until the final marks are posted that I'm actually able to enjoy my summer!!

Procrastination

So far today, instead of studying for my last 2 exams (Cardio and Resp/ENT) I have:

Gone for sushi with friends (2 hours)
Checking emails, Facebook and favourite bookmarks (1 hour)
Eating lemon pie and ice cream (15 minutes)
Napping (2 hours)
Watching Hot Fuzz (I'll let you know when it's done)

Writing so many exams in a row is eating my brain!

Drowning not Waving

Final exams start in 9 days.

Nine.

Days.

7 exams.

I probably should start to study.

Talk about surreal

I think I've made it pretty clear that one of my biggest concerns about coming to med school was getting along with my classmates. I was treated like an alien by most of the people in my program during my undergrad. I thought this time would be different.

I spent quite a bit of time last summer researching cultural norms of the average 23 year old, hoping to acquire a language that we could all speak. Imagine my surprise when "Don't Stop Believing" by Journey became our class anthem. It comes up every time we go out as a class and everyone who is out has their rock finger in the air pointing and singing at the top of their voice. We're insane. A woman in the class who doesn't go out to many events came out to a recent one and witnessed the insanity that is our class. We act like fools and really get into whatever it is we're currently doing, singing, dancing, stripping... and none of us judge each other while we're at it. She said "I know completely understand something I previously didn't know existed. When are we going out again?"

Other classes think we're mental/immature but we're having a lot of fun and frankly don't care.

Guitar Hero had a huge impact on the music my classmates listen to since it's how they spend so much free time. It's amusing to me since I remember when most of those songs came out on video and they just think of them as something that happened way back in the eighties.

Our last day of school is in 38 days (YIKES!!) and we're planning a trip away to someone's farm to camp out. The weekend will be named after an eighties band that I was fond of during high school. This is what I bring to the class, an ability to pull from my huge repertoire of eighties trivia to make the year more colourful. And I don't need to do anymore homework to fill this role!

Expectations

It's time for another rant. I'm in a terrible head space right now because my mother laid a wicked guilt trip on me last night. The family came to town for Easter Vigil Mass and I chose to go with them rather than skip it or go to a much closer (and as it turns out, 2 hour shorter) service. But I went. And I went to communion. Then in front of the church, she told me that I shouldn't have gone to communion, that living with my partner means that I'm not allowed to go to communion. She loves me, but needs me to know that it's not OK that I think that I'm eligible to go to communion. She wants me to annul my previous marriage and get married and make everything legal and perfect. Since weddings are so cheap, and med school is practically paying me to attend, of course I'll do that. I'll do it tomorrow. And then everything will be absolutely perfect and she'll love me.

But wait. I don't want to have children. Oh, well, you can't be a good Catholic and not procreate like little bunnies. Ok, so what if I'm biologically incapable? Well that's fine then.

But wait. You're willing to counsel women in making their own choices? You will help a person through their last moments on earth with pain relief that may hasten their death as a side effect of alleviating their pain?

I don't know why I'm trying so hard to be a good child. She's already picked the perfect one. It's the one that drinks almost every night, always assumes she can have the car, lies to both my parents, isn't planning on a future education and will likely be married and pregnant and married by the time she's 25. That's the perfect daughter.

The one who never drank through high school, worked her ass off at home and outside of home to provide for herself and family, who got into effing medical school but lives with her boyfriend...well that one's just plain evil.

I'm so incredibly jealous of friends and class mates who have a safe home and haven with their families. It's hard to imagine a place where you know that everyone will love you, even if you decide you want to be a doctor.

Oops.

I've gotten myself so far behind with 6 projects that I can barely breath. How did I let this happen? Too much T.V. probably. Stupid T.V. Plus I've definitely stretched myself beyond the real capacity I have for working.

Very little real work got done this weekend, but I did get into the habit of going to the gym every day, so I suppose that's something. I ended up counselling a couple people too - how is that possible? I'm on break fer cryin' out loud!

After doing 2 years residency in Family Medicine, we have the option of adding on a third year in whatever we'd like. I spent quite a bit of time looking at my options this week and am quite confused about what to do. Palliative care has been calling to me, so has psychotherapy, obstetrics and paeds.

Thank goodness I've got another 5 years before I need to make that decision.

Palliative care seems a bit out there right? It's not. One of the things that really drew me to medicine was the way my uncle was treated by the docs caring for him during end stage pancreatic cancer. They were patient and compassionate with his family as they explained the options and what quality of life he could expect if they continued treatment. They allowed us to have a mini - family reunion/going away party for him in his hospital room. To me, they gave him a good death. There's something really noble about giving people a good death.

To me a good death is on the terms of the patient. They deserve to spend their last days in the way that their well - self would have liked. Their family also deserves to spend time with their loved one in a way that is hopefully not entirely clouded by pain meds/end of life delerium. The family and patient need to be heard. This is a pivotal moment in their lives and they deserve to be able to talk about it and celebrate/mourn.

I was lucky enough to get to hang out with a palliative care doc a month ago. In the hospitals here, there's a palliative team working with the docs to provide a comfortable end of life experience. Social workers in particular are available to the patients and their family as they work through what will be happening next. Tests and medications that don't have short term effects are discontinued so that the last moments aren't spent being poked and prodded.

Maybe when I hang out with a psychotherapist though, I'll feel just as passionate.

So much snow!

We're into March Break now - so great. And well timed since I'm 4 weeks behind in classes and have 3 extra curricular projects that need to be wrapped up, not to mention that I still don't have summer plans....I can do all that in a week right?

There's something about snow though that makes me want to not do any work. We can barely see the houses across the street right now. I tried to get out and make it to an even earlier today but it literally took me 20 minutes to get around the block. Safety first boys and girls! So rather than catching up on my Cases of the Week, I'm watching TV. In particular In Treatment.

I was turned onto by someone in my clinical methods group since it mimics some of the problems we go through in our advanced interviewing skills classes. Yikes.

In case I get the "patient who hits on you", I thought I should know if they're nuts or not. Apparently not.

My strengths

When I first came to med school I was incredibly concerned about being so much older than my colleagues. My student advisor told me that it was unlikely to be a problem and that I would find that my fellow students would be coming to me for advice and help with their social problems. She was right

I'm used to being the one that people turn to with academic problems, so having this shift in perceived ability is a bit strange.

So far I've chatted with class mates about misunderstanding partners, working too many hours, family discord and now divorce. It's like I have a neon sign suggesting that they come discuss this stuff with me, or maybe it's that advisor telling them to come see me, either way, I'm finding the new role to be sometimes overwhelming.

Since I'm older than these guys I can see my younger self in them. This is pulling up a lot of things that I hadn't considered in some time and many mistakes I've made but was happy to "forget". It's a bit exhausting.

While it's incredibly gratifying to know that I do have a helping role within the class, I should maybe consider investing in a chaise...

Shoulda' bought shares in Starbucks

We bit the bullet and bought me a car. I think it's about time since it was taking an extra-ordinary amount of time to take the bus to school and every person who comes to visit my home feels they've left the county. But I think they may be slightly exaggerating.

The car has been lovely, I can make it to meetings and observerships without any worries. I can stay late at night and study with my colleagues. I can get tasty Starbucks whenever I like.

Have I defined observership yet? Partner o'mine hates it when I use words he doesn't understand. An observership is when a kind doc lets me come and watch what he/she does. These are usually a few hours long, and aren't repeated unless I'm very lucky. I've seen an osteoporosis clinic, a rehab ward in a hospital and an outreach program between a psychiatrist and community GPs. Pretty cool.

But about this car. It means that I'm suddenly spending a lot of money on gas (well, not a lot I guess relatively speaking since it's such a tiny car), but it's not cheap. Plus there's insurance and maintenance etc, and my sudden car induced craving for Starbucks.

I'm pretty sure that where ever I decide to practise, there needs to be a Starbucks nearby.