Wednesday, October 31, 2007

Trick?

Well, it certainly wasn't a treat.

Not two hours ago, I had two police officers, with guns drawn, at my apartment door asking me to come out with my hands up.

What's your name?

DC Med Student--I'm the tenant in this apartment.

Is there anyone else in there with you?

No.

Were you aware that your door was open?

No.


At this point, my landlord shows up from upstairs and confirms my identity. Apparently, he had heard movement and something drop upstairs when he arrived home from work. He called the police and had them come over to check things out. It doesn't look like anyone was in the house, and there certainly wasn't anyone in my apartment (on the ground floor), though it was kinda weird that my door wasn't locked and fully closed. Needless to say, I haven't been able to fully concentrate on studying since the police were here, but I can't find fault with my landlord's actions.

I live in a neighborhood that is experiencing growing pains from gentrification. And, as has happened in other neighborhoods (and there are many in DC) that have or are going through gentrification, there has been an increase in crime. For example, just last month, the new corner-store across the street which I frequent, was held up at gunpoint -- the two gunmen clearly taking advantage of the fact that this corner-store didn't have bulletproof plexiglass around the counter.

I love my apartment, but lately I've been thinking that it will probably be better to move to a safer area once my lease expires next year. This time, no windows or doors with security bars.

Hope you had a happy and safe Halloween.

Tuesday, October 30, 2007

Order

I need some order in my life.

While studying this past week, I felt like I was scrambling up a gravel slope, slipping two steps back with every step forward. I had an insane amount of material to go over for my three examinations. It was impossible for me to get through all of it since I had taken some time off (mental health days) to have some fun. My preparation strategy was to first get through the "big lectures," those in a series with multiple parts, and, if I had time, I quickly reviewed the small topic lectures. I also hit First Aid for the USMLE Step 1 HARD.

I didn't like feeling so behind on my studying. The stress was too much. At times, it was paralyzing. I would just look at my long "To Do" list and my stomach would turn. Life became so disorganized. My eating habits were horrible (I haven't had so much McDonald's in years) my sleep schedule was all messed up, and I took to studying in bed, which I'd rarely, if ever, done before. But, that's how bad it was. The stress and panic had lead me to believe that staying in bed would somehow save me valuable time. I slept very little, and when I would wake up, surrounded by my laptop and books and notes, I would just continue working. Insane.

Although I didn't get through all of the material, I still think I came out with a descent grade on these exams (knock-on-wood). It's not that they were easy, but I knew enough of the major diseases and concepts to work my way through the exam. I should get my grades by the end of the week. No matter what, it was worth the good times in NYC.

For this next unit, however, I think I'm going to take the advice of the education counselors and stick to a schedule. Every day, I'll either be in class or studying from 8AM to 5PM, I'll take an hour break for dinner, then continue studying until 10PM, and finally break for the rest of the night. After 10PM, I'll either exercise or prepare meals or catch up on my favorite TV shows. Or-- I almost forgot -- I'll post a new reflection.

We'll see how well I can stick to this schedule. I'm hoping it will lessen some of the stress and cramming that comes along with studying in the days leading up to exams. I'm also hoping that it will allow for guilt-free mental health days when I need them.

Tuesday, October 23, 2007

NYC

As you know, I was feeling a bit stir-crazy the past couple of weeks, so I decided to take a little trip to the Big Apple. It was the best thing I could have done for myself.

A friend from college met me at Penn Station around 1PM on Saturday, we dropped off my bags
at her place, and then hit the city. We spent the majority of the afternoon and evening at the Top of the Rock (Rockefeller Center). The sunset and views from the observation decks are gorgeous! Unfortunately, I forgot my camera, but my friend had her camera and took over 100 beautiful pictures (two shown in this post).

At 8PM, we met up with another friend from college, who treated us to dinner and a night of bar hopping with his friends. We started off at Coffee Shop (Union Square) for dinner and drinks, made our way to Merc Bar (SoHo) for more drinks, and ended the night at Pegu Club (Village/SoHo) for some of the best cocktails I've ever had.

Without realizing it, we stayed out really late. It was past 4AM by the time we left the last bar. NYC is crazy like that. There are tons of people out and about at all hours. You can't help but lose track of time. I can see how it would be very easy to stay up all night.
I love New York City!

Now that I'm back in DC, the stress level is slowing rising once again.
I have an exam this week and two on Monday. Yes, I've come back to reality -- I'm a med student -- and it's not pretty.

The good news is that I don't think I'm going to be as stressed as I would be had I not made the trip to see my friends. Instead of feeling like I never get to go out and have fun, I have great memories and pictures from this weekend to look back on. I can't help but smile when I think of all the great moments. It makes it easier for me to now focus my energy on studying.

I played hard all weekend and now it's time to work hard.

Friday, October 19, 2007

SNAP!

[WARNING: Grey's Anatomy spoiler ahead]

OK, I just finished watching last night's episode of Grey's Anatomy: The Heart of the Matter. Callie (played by Sara Ramirez) was AWESOME!! She finally let Izzie have it. It was a beautiful thing. Seriously.


You feel terrible? You took advantage -- He was your best friend -- I tried to trust you. So much, I'd convinced myself that it was all in my head -- that I was crazy -- but I wasn't, was I? And then you pulled that thing in the cafeteria today -- It's not bad enough that you humiliate me by getting in bed with my husband, you have to humiliate me at work too. George may be the one who broke his vows, but you. . . We're women, Izzie; you did this to another woman. You took something from me. You stole something from me like a petty little thief. You are the one who should be humiliated. You are the one who should be ashamed. You are the one who should. . .


[Wait for it]



Don't you dare come to me for forgiveness, you traitorous bitch.

Thursday, October 18, 2007

Shots

I could have used a couple shots (lemon drops, preferably) before going to the student health center for Tdap and Hep B vaccinations today. I'm such a baby when it comes to shots! I get all nervous and sweaty, and I feel like I have to get to know the nurse a little better before I let her stick me.

I'm sorry, What was your name again?

Oh! Are those pictures of your family?

Those eyeglass frames are great! Are they new?

Oh, yes, I'm sorry, I'm sure you're very busy.

OK, so my arm is going to be sore for a few days with the Tdap?

I'm right-handed, so, yes, let's put that one in my left arm.

OK. . . Yes, I'm ready.

That wasn't so ba-- The other arm, right.

It's so embarrassing, but I can't help it. I can't even look at the injections! I wonder how this is going to play out when I have to administer a shot. I've yet to be in that situation, but I don't think I have a problem giving other people shots. Just keep the needles away from me.

What can I say, I like my shots in a one ounce glass, not a syringe.

Monday, October 15, 2007

Consistency

I received the results for one of my exams from last week. The hard work payed off -- I got the H! It will be another week or so before I get the results for the customized NBME exam, but I'm pretty sure I got the H on that one as well.

Why can't I be more consistent? Why does it seem like I'm always on some sort of roller coaster?

My wish is to find that right balance that allows me to perform well in school, yet feel like I'm still participating in life. Currently, I'm either in multi-slacking (a la Seth Rogen in Knocked Up) or crazed-gunner (a la Hermione Granger in the Harry Potter series) mode. I need to find that sweet spot -- that Tiger Woods setting.

I wish I could, but I can't study non-stop week after week because after a week or two of crazed-gunner mode, I don't want to look at anything related to medical school. And then I fall behind and I'm playing major catch up. However, crazed-gunner mode seems to be the only way for me to get grades in the Honors range.

Friends have suggested a modified crazed-gunner mode, where I still study hard, but take a break every other weekend or so. On these weekends I don't study as much, but meet up with friends and get out for a while. That way I don't feel so isolated or like I'm missing out on life. I think they may be right.

So, on Saturday, I'm off to NYC to visit a friend for the weekend. That means I'm going to have to study hard all week because I'll lose some study time on the weekend. Hopefully, having "scheduled distractions" such as this will help me to feel more balanced and to perform more consistently.

Friday, October 12, 2007

Stir-Crazy

I need to get out! I am so sick of my apartment, my school, the local coffeehouse (which is not so local). I need a change of scenery. I need a change of pace.

Possible getaways before winter break:
  • NYC next weekend
  • London the week of Thanksgiving
  • NYC next weekend
I think I'm leaning toward NYC next weekend. Heck, maybe I'll do both. I've been meaning to visit a college friend in London for 4 (5?) years now. It would be a great-crazy-fun thing to do.

Thursday, October 11, 2007

Out

Twenty years ago today, the first National March on Washington for Lesbian and Gay Rights was held. That day is probably best remembered for the inaugural display of the NAMES Project AIDS Memorial Quilt. One year later, October 11, 1988, the first National Coming Out day was observed to celebrate the March one year earlier. I was just a toddler at time.

For me, coming out has been an ongoing process since my junior year of college. It wasn't difficult for me to accept, but I found it hard to tell that first person. How was one of my best friends going to react? The fear of rejection was strong, but I knew that if I was going to continue in these friendships, I needed to be completely honest and open. I needed to be my whole self. Thankfully, that whole process was very positive.

My experience as an LGBT medical student has been mixed. I was out on my medical school applications and was asked about an LGBT group I was involved with in undergrad during one of my interviews. Some LGBT students choose to hide this kind of information on their applications, but I decided I didn't want to be at a school that didn't want me.

Once I decided to attend my current medical school, I set up a meeting with a faculty member to address some of my concerns about being an LGBT medical student. Did the medical school have an LGBT group? What were LGBT students' experiences like during the clinical years? Was being openly LGBT going to negatively affect my medical education experience? The faculty member's advice was, "It shouldn't matter, but I would just keep it a secret -- like don't ask, don't tell."

I've had several uncomfortable experiences during lectures, where a professor will tell a joke at the expense of the LGBT community. Most in my class laugh, some have no visible response, and some, like me, have that "I can't believe they just said that" look. Do I say something then? Do I confront the professor after class? Do I send them an email telling them I thought their joke was inappropriate? I end up not saying anything because (1) I don't want to come off as hypersensitive and (2) I don't want to be singled out. I already feel like I don't really belong, so why add to that feeling.

I'm out to all of my friends at school, which was a must. I don't believe you can really know and trust someone if you're hiding something. You're always going to keep some distance, which is not what I want in my friendships. As for others in my class? Some have asked me and I've answered affirmatively, but it's not like I've made an announcement. There's no need for that.

Basically, I'm just trying to live an open, genuine, authentic life. I've been doing it since my junior year in college, 7 years ago, and I don't see why I should have to stop now.

Tuesday, October 9, 2007

Time

If there's something everyone can relate to, it's not having enough time. In medical school, I've found that there's never enough time for sleep; never enough time for exercise; never enough time for grocery shopping; never enough time for errands in general; never enough time for friends; never enough time for family; never enough time to do all the required reading; never enough time for study and review. Yet, somehow, I manage to keep up this blog. . .

Today, I barely had enough time to finish the Customized NBME Exam. We were told that the clock in the upper right hand corner of our screen would not be the official amount of time we had. They, the professors, were giving us 30 additional minutes.

Uh huh. Right.

I was so nervous about this exam, I wasn't taking any chances. I would finish the exam before the clock read 0:00:00. I was slow at first. It took me a good half hour to adjust to looking at the monitor instead of having a paper exam that I could take notes on or circle/underline "buzz words." But I picked up some time on some easy questions and finished the exam with 0:02:17 to spare.

Unfortunately, many of my classmates didn't finish before the "unofficial time" ran out. When the clock read 0:00:00, it locked them out of the exam and they could not finish. Minor technical difficulty. The professors and IT people were working over the phone with the NBME people, but they couldn't come up with a solution.

So, what happens to those who couldn't finish? It's unclear. Of course, the rumor mill is working overtime. I've heard everything from "I'm sure they'll get to finish sometime later this week" to "They'll just have to eat those points" to "They'll have to take the whole exam over again" to "Everyone is going to have to take a NEW exam."

Thanks to my mad studying, I think I did OK -- I don't want to take another exam. But bottom line: I don't have time for this . . . nonsense.

Sunday, October 7, 2007

Wave

I lost control of bowel movement this morning. Squeeze your external anal sphincter tight and take a look at this article from CNN.com. That is one GIANT wave. Something I never want to see in real life.

And here I was, dreading my upcoming exams as if they were giant waves about to crash upon me. Chil' please! People are losing their homes, their businesses, their schools, their communities, their lives.

I will continue to work hard over the next two days and will gladly take the fourth set of second year medical school examinations. It's a privilege, not a natural disaster.

Saturday, October 6, 2007

Dr. E

Erotic. From the moment she walked onto the stage, you knew that Dr. E was going to have some fun. She was all smiles and had a bounce in her step.

"Good morning, y'all!"

[Students half awake] Good morning.

"How many of you know about spoken-word? . . . Well, I'm a poet -- Oh, you want to hear one of my poems before we begin? OK, we're all adults here, so I can share."

Clearly, Dr. E wanted to share one of her poems with us. And, as soon as we heard the "we're all adults" line, we knew it was going to be good.

Dr. E proceeded to share with us one of her poems. I don't remember the words exactly (and I'm not about to go back to the audio), but she mentioned heat, desire, seduction, biceps, hamstrings, gastrocnemius, a king and a queen -- and I think there was something about crawling on all fours. Dr. E needs some sexual healing -- stat! (Stat. Is that word ever really used?)

The poem was hot! OK, so it really wasn't that hot -- I mean, who wants to know about their professors sexual fantasies? But, she got our attention and gave a good lecture.

And besides, nerds need love too.

Friday, October 5, 2007

NBME

The acronym has been thrown around a lot during my second year of medical school: "You have to study hard for your NBMEs," "Forget about the LCME, it's the NBME you should worry about."

So, what is the NBME?

The NBME is the National Board of Medical Examiners. Founded in 1915, it's the independent, not-for-profit organization that provides nationwide examinations so that medical licensing authorities have a standard they can use to judge candidates for, well, medical licensure. They're the nice folks that make second year hell. How? With administration of the USMLE (United States Medical Licensing Examination) Step 1 at the end of the second year of medical school. This sole exam determines whether you have the option of going into competitive specialties such as Plastic Surgery, Dermatology and Radiology, or are limited to a primary care specialty such as Family Medicine, Pediatrics, and Internal Medicine. Believe me, I'll be writing about Step 1 hell come April.

So, why am I bringing up the NBME now?

On Tuesday, I will be taking the first of six "Customized NBME Examinations." Beginning this school year, the NBME is offering 40 medical schools the opportunity to administer these web-based examinations to their students. My medical school choose to participate, making each Customized NBME Exam count for roughly 40% of my grade each unit. Since this has never been done before, I'm a bit nervous.

The process is as follows: (1) faculty sends NBME list of topics, (2) NBME sends faculty pool of questions related to topics, (3) faculty selects questions from pool, (4) NBME produces examination, (5) faculty reviews examination and makes any changes, (6) final examination produced. About a week later, students take the examination either in the computer lab or a lecture hall (a program has been installed on our laptops). Each student will get the same 100 or so questions, but in a unique, random order.

I'm looking at these new exams as a positive change. Clearly, the major benefit is that I will be very familiar with the format of Step 1 by the time June rolls around. I'll also be familiar with the style of questions asked on Step 1. Another clear benefit is that I won't have to deal with poorly worded questions written by faculty, or questions with multiple answers that are subsequently dropped. Also, I think it will be good for the faculty because they'll actually see what topics they should be focusing on in lecture. The pool of questions sent by the NBME will make it evident. If there are a lot of questions on Topic A and few on Topic B, but Dr. B spent most of his time on Topic B, then maybe he'll change that next year. (One can dream, can't they?)

Grades may dip on this first Customized NBME Exam because of the new online format and vignette-style questions with images and lab reports -- not to mention possible problems with computers and the internet connection -- but my hope is that overall we'll do well. And come June, when I break 240 on Step 1, I think I'll be grateful for these NBMEs.

Tuesday, October 2, 2007

Stay

One week from today, I have my second exam for the unit. Since I failed the first exam, I've been working my butt off, not just to pass this exam, but to get honors.

Around midnight last night, I decided to take a break and treat myself to some television (a.k.a abc.com episode player). I could have used some sleep, but I knew that watching the season premiers of Grey's Anatomy and Ugly Betty and the series premier of Private Practice would lift my spirits. And, for the most part, my shows didn't let me down.

[Warning: spoilers follow.] Grey's Anatomy had the weakest episode. What was up with Izzie and the deer? Stupid. Disappointing. Ugly Betty got me, though. I was like, "What? Santos didn't die at the end of last season?" But alas, at the end of the episode we find Hilda alone in her bedroom. Sadness. Private Practice was the winner. That cast is so easy on the eyes! And I just love Addison. Overall, a good TV fix.

I love the drama of the relationships on these shows. (Probably due to the lack of a relationship here.) Whenever there's a "Pick me! Choose me! Love me!" scene I always hear Bette Midler singing "Stay With Me" in my head. Throughout the seasons it could have been Izzie singing to George; Callie to George; Meredith to McDreamy; Addison to McDreamy; McSteamy to Addison; Preston to Christina; Christina to Preston; Betty to Henry; Hilda to Santos...

In case you don't know the song, I give you the Divine Miss M, Bette Midler, performing "Stay With Me." If you aren't feeling Miss M in this performance, check your pulse.

Monday, October 1, 2007

Reverence

Sometimes you just need to step back and look at your situation from a different perspective.

Last weekend I saw a fantastic film:
In the Shadow of the Moon. I highly recommend that you go see it if you haven't already. It's a documentary about the Apollo space missions, launched by NASA between 1968 and 1972. The never-before-seen footage was amazing -- incredible!

Alongside the NASA footage were stories directly from the astronauts. I truly enjoyed watching and listening to them as they described what the experience was like for them. One of my favorite astronauts was the eloquent Jim Lovell. He was able to express with such clarity the epiphany he had in space -- that of connection to everything in existence. We're all just a bunch of atoms, after all. He added:
Just from the distance of the Moon you can hide the Earth behind your thumb, everything that you have ever known; your loved ones, your business, the problems of the Earth itself, all behind your thumb; it makes you consider how insignificant we really are; but then how fortunate we are to have this body and to be able to enjoy living here amongst the beauty of the Earth itself.
What Lovell said struck a cord in me because I had a similar experience during college. The more I learned about biochemistry and molecular biology, the more I grew in awe of Life.

[Leap]

During this Sunday's sermon, "The Practice of Reverence," Rev. H, defined reverence as "fundamentally, a deep respect; an attitude of awe and wonder and gratitude for something of high or ultimate value." As soon as he said this, I realized that this is partly what lead me to medicine.

The complexities of the body (how it develops, how its organ systems function, how it processes food, how it fights infection and disease, how it can turn against itself, etc.) are fascinating to me. I know I like to complain at times about the lack of sleep and social life during medical school, but when I really dive into the work and I'm "making the connections," I feel fortunate. I get to see and understand a whole other world that allows me to feel connected, on some level, to everyone around me. We're all the same; our bodies are all made up of the same stuff.

Rev. H, closed his sermon with the following quote by Henry David Thoreau: "Pursue some path, however narrow and crooked, in which you can walk with love and reverence." I believe that medicine is that path for me.