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.

Waffles; they're not just for breakfast anymore!

I keep waffling back and forth between feeling as though I am going to be the best doctor ever and expecting the big Gong Show cane t.m. to pull me off the stage. My class nominated me for an award. I'm in awe - partly because I'm pretty sure other people deserve it more, partly because I didn't think anyone noticed that I was there. There's a dollar amount attached to the award, so it would be fantastic if I actually win the thing.

I've decided that observerships are the best thing a med student can possibly do. I arranged to shadow a rheumatologist this week for an afternoon in her Osteoarthritis clinic. Her nurse was confused about my qualifications (thought I was a resident i.e. already an MD) and started barking orders at me about what I was to be doing all day. Given that I've covered OA in school already and feel comfortable taking patient histories from all the clinical methods training I've had (6 weeks) I was OK with it. When the doc showed up, she knew I was still in first year and didn't give me anything I couldn't handle. I was essentially catching patients' files up since their last visit by getting their histories (solo), interpreting x rays and learning a heck of a lot. Don't worry, the patients all knew that I'm just a student.

I left the OA clinic feeling like I could be a doctor right then and there!

Then I started studying again.

How is it possible that I can be so far behind when I work so much? I think I set my expectations for studying way too high. Re-writing every single lecture is too far. Ignoring weeks of material because I had the prof isn't far enough. Where is the balance they talked about in our first week?

Something I haven't mentioned yet is what I have going on in the background. I find it to be a struggle to keep up with what is going on in my home life and my school life. My partner has bipolar disorder. It's type II which means it's a mild version of the disorder, but that's not reassuring when I never know what to expect when I come home. I don't have the support here that I wish I did. It's not something that I advertise either, I don't want people to know what I'm dealing with. I'm not sure why I think it matters - probably just that I'm not ready to expose my weaknesses until I really get to know my classmates. He's on meds which is fantastic and tries really hard to be stable for me. No extra pressure at all. But if I can get through med school while dealing with his insanity (literally) I deserve then M.D. I'm given.

I guess I'll just keep trudging through until the cane pulls me off the stage.

Lots of information, not enough neurons

AHHHHHHHHHHHHHHHHHHH!!!!

Midterm is next Monday, Finals start the week before Christmas. The first final will be fine but the next 3 I haven't begun to prepare for.

I'm still going to do observerships because that's where I feel I learn more about medicine than I ever do in lecture.

My last was with a hospitalist who let me do rounds with his residents. I was taught to do some tests and was included in conversations about the patients' care. I can't believe it's taken me so long to do these!

My next is a psych observership which I'm really looking forward to. I'm not sure if I want to be a psychiatrist - in fact I'm not at all sure I know what I want to be, but it will be great to learn what they do. I think that no matter what practice I end up taking up, there will be a psych component to it. Same as regardless of which practice we choose, we're all going to be geriatritians. As I go through my class material, I try to think about how what I'm learning is different if the patient is old. Should be good practice right?

One of my finals is MSK (musculoskeletal) so I've arranged for my observership before finals to be in the osteoporosis clinic. It'll be like review for the final right??

The more I think about finals, the more I freak out. It's a lot of information for me to have in my head and be able to apply clinically. Clinical application is fun but requires that I really own the material.

Which means I better get back to work and stop watching Bones.

Prejudice is a four letter word. No really, count again.

Prejudice is live and well in the medical community
:: waits for the shocked gasp ::

One of my tutors firmly believes that everyone has equal access to health care and that Americans are well off with respect to wait times and ability to get care. I get so angry. Then I blather on and on about other things because I know if I don't change the subject I'm going to punch her in the mouth. She goes on and on about the 350lb man with a donut in hand who comes in complaining of >insert whatever illness we're discussing that week<

She also assumes that people who work blue collar jobs are a) idiots that aren't capable of understanding a treatment plan and b) don't care about their health.

If Canadians, rich and poor, have equal access to health providing opportunities, then why are babies born to teen aged moms significantly smaller? If it's not the reduced counselling about prenatal nutrition received compared to women in their 20s and 30s, and the lack of medical support for this demographic, then I just don't know what it would be.

I recently came across this blog called "First, Do No Harm"
It's terrific, horrifying and well written. Fat people who have been treated like garbage talk about their experience accessing health care in the US. I know it's the same here just listening to my tutor.

Checking in

After being so worried about my first block exam (and the gong-show of disasters that surrounded it) I ended up doing OK. I had set the bar low, aiming for a 75% but got a 77%. I can live with that! I had 3 weeks of classes for which I barely picked up a book.

When I'm at home, I feel like I should be available to my partner (who is admittedly, quite needy) rather than studying for school. I've been talking to other people in the class who have partners/spouses at home. The common theme seems to be that they really really don't understand how much work there is to do in med school. It's as though they sincerely believe that we're just having fun all the time. When I'm discussing my day, I try to focus on the positive aspects rather than the negative - why would I ruin his day with my crap? That may seem to put a weird spin on things.

Part of the problem is how much I need to censor myself at home.

Talking about neat specialities I can pursue in the future leads him to be 1) depressed that he hasn't got a dream of his own to pursue or 2) point out that I can't do everything. Surprisingly, I do know that I can't do everything but having the idea that I could pursue a speciality keeps me focused and working on whatever subject I'm currently knee deep in.

Nothing gross. Unfortunately the definition of this changes daily. Last night it was extended to include a cleanly broken bone. Seriously. I get no puss or tumour talk, but a broken bone???

Discussing the MD/PhDs in the class is strictly forbidden as they act as a reminder of his unpursued potential. If he really wanted to use his PhD in Biostatistics, I'm sure he could!!

All this censoring makes regular conversation difficult, especially when it comes to the tough topics like money. Argh with the money!! /end rant

I have finally been brave enough to ask for observerships. I don't know how my classmates have been so quick to find them! I felt like I was asking for a favour and that's hard for me to do. It's really exciting to get an opportunity to see what the "real world" of medicine will be like! My first is set up in geriatrics, the next in child psychiatry. I'm 95% sure I'll be a family doc, but I want to check out the specialities too so that I can be confident in that choice and so that I can be the best family doc ever.

How did I become this person?

My first block exam is soon. I'm not remotely ready despite promising myself that wouldn't be me. I'm terrified of failing out of med school.

I'd go to church but I don't like the wine

I keep waiting for someone in a white coat waving a cane to come running into the classroom, pointing at me and yelling that I'm not supposed to be there. So far this hasn't happened. It's only been 5 weeks though, there's plenty of time for that.

Before coming to school I was incredibly torn about what I was going to do for orientation week. Here I am, significantly older than my classmates, not able to hold my liquour (as a lovely going away party proved) but still wanting to make connections with my classmates. These are the people I'll be working beside, not only for the next few years but as my colleagues for the rest of my life. I want to make a good impression. I want to be someone that people will study with. But mostly, I want to be liked. Whoever said that med school is just high school, take two, wasn't exaggerating. The class is quite clearly divided, not just physically into front vs. back, left vs. right but also the partiers, the jocks, the book smart, the religious and me. I don't fit into any of the groups but seem to have been adopted by the religious.

It's weird. It's not that I don't like like religion. Many of the best religions serve wine at service which I can't help but endorse. It's just that it's not me. It's not just Christians in this group, there are Muslims as well. What will they all do to me when they realise I don't go to church? Will they wave a cane and kick me out as well? What will happen when even the religious nerds don't want me?

Due to logistical issues (I was commuting from another city) I didn't hit the major parties in O-week, especially toga. This meant that I missed out on a huge opportunity to meet a large portion of the class. I wanted them to get to know me before making judgements about me based on my age and my non-athletic nature. They will know soon enough that I've only got an average intelligence, that I'm not very quick on my feet and speaking of feet, mine spend most of their time in my mouth. I wanted them to get to know the fun me first.

As long as I can keep my mouth shut for the next few weeks, there's always Hallowe'en.