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.

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.