Silence

Three o'clock to five o'clock in the morning. This has become my favorite time of the day. It is so peaceful. The only sounds are the occasional humming of my refrigerator and laptop cooling fan.

It's rare to find peace and quiet in the city during normal business or weekend hours. I've found few oases that offer relief from the city's cacophony produced by rush-hour traffic, drag-race wannabes, police car sirens, ambulance sirens, fire truck sirens, speeding metro buses, speeding presidential and dignitary motorcades, military helicopters, emergency response helicopters, low-flying airplanes -- you get the picture.

The end of the 3-to-5 a.m. silence brings with it a slow but steady rise in those cursed traffic sounds. However, it also brings with it a gift: sunrise. Watching the colorful 2-hour transformation of the sky from a deep black to shades of purple and subsequent pinks and yellows and finally a brilliant blue is really rather quite spiritual.

Failed

Despite being caffeinated and drinking lots of water, I failed in my attempt to stay up all night studying. I'm getting old folks. Actually, I'm just out of practice. During college, I pulled many an all-nighter. In fact, on two separate occasions I pulled back-to-back all-nighters. And back then, I only used water! Surely I still have this stay-up-all-night ability in me.

As I've heard many medical school professors say, "Sleep is for the weak." Although I only had four hours of sleep, I'm feeling a bit weak for not being able to pull off the all-nighter. Two-thirty a.m. hit and my eyes just wouldn't stay open and I had a horrible headache. Perhaps I'm tough for being able to withstand the "big, bad buzz" of the Monster energy drink?

Sorry to disappoint if you thought this post was going to be about failing in medical school. I'll make it up to you in the near future -- hopefully not because I failed my upcoming exams!

Disconnect

Only a few weeks into the school year and already I've experienced my first discouraging moment: a less than satisfactory quiz score.

I am discouraged because I had put a lot of time and effort into preparing for this first quiz. I pre-read for every class, I attended all but one lecture (8 a.m. came early that day), and I reviewed all of the lectures as well as my notes. It's a blow to my confidence that all of that work went unrewarded.

So what went wrong? Where was the disconnect? Well, I think the problem was twofold.

Lesson #1: Do not believe professors when they say that they are not going to ask a question about "X" enzyme or gene or chromosome; you need to know the details! We were told by the faculty to focus our attention on the concepts rather than the details. I don't know why I believed them because professors love to ask questions about the details.

Lesson #2: Stick with the method of studying that works best for you. Because I didn't think I had to know the details, I didn't write anything out by hand. I did not follow my own advice, the same advice I had just given to my mentee! Usually my preparation would have consisted of drawing flow charts on my white board and writing notes and charts by hand. There is just something about putting pen to paper that really makes the details stick.

The quiz is not worth much of my overall grade for this section, so I'm just going to brush myself off and keep it moving. Besides, I have two exams in the next week that are worth a significant portion of my overall grade for this section. This time I'll be prepared for whatever Dr.A & Co. decide to throw my way.

Diet

Last year, I fell in love with Papa John. Well, not Papa John himself, but rather his online pizza, chicken tender and chicken wing delivery service. How could I not fall in love with Papa John's? The food was good, ordering online was a snap and the food arrived hot in about 30 minutes. And what did I like best about PJ's? Well, two things: 1) I didn't have to make the trek to the grocery store and 2) no clean-up!

One evening over the summer, I got home from work and went to the fridge to see what I could make for dinner. Nada! My fridge was empty. My options were to either (a) make the 20-minute trek by foot to the grocery store and get stuff to restock my fridge, (b) run across to the street to the sketchy corner store and get some 5-year-old canned soup or instant ramen, or (c) go to papajohns.com, click on "Repeat last order" and relax in the comfort of my apartment until food arrived. This wasn't neuroanatomy; I chose (c).

I logged onto the site and received a message that I had not seen before: "Store closed." What do they mean "Store closed," it's 6:30 on a weeknight? I tried logging in again. "Stored closed." How could they do this to me without any notice? It felt like the end of my first relationship.

While I was on vacation, I made a pledge to myself to be healthier this school year. I would start eating right and exercising more. So far, so good. My new love is the Giant, a relatively new grocery store about 20 minutes away. I count the trek as exercise -- no, really, the bags can be quite heavy sometimes! -- and I'm eating more fruits and vegetables. Yes, I'm doing the things that doctors are always telling their patients to do. I've also started doing some resistance training, and I can already see my body changing for the better. Best of all, I feel better.

Hopefully, I can keep up with this new healthy lifestyle. I know how easy it can be to slip back to my old habits, especially under the stressful condition of medical school. But, I think I can do it this time. Otherwise, how am I ever going to fulfill my dream of becoming a hot, sexy M.D.? ;o)

Patience

Medical school is slowly draining me of patience. This concerns me as I believe that patience is a quality required of all physicians wishing to provide compassionate care.

Dictionary.com provides the following definitions (showing only the first three) for this virtue:

1. the quality of being patient, as the bearing of provocation, annoyance, misfortune, or pain, without complaint, loss of temper, irritation, or the like.
2. an ability or willingness to suppress restlessness or annoyance when confronted with delay: to have patience with a slow learner.
3. quiet, steady perseverance; even-tempered care; diligence: to work with patience.

Pre-medical school, I was an extremely patient person. For instance, my job prior to medical school sometimes required me to go to the post office to mail documents to clients. DC postal workers move at a glacial pace, and there can only be one -- two at the most -- postal workers at the counter at any given time, no matter how long the line of customers. I did not mind. I would bring my iPod and listen to music until it was my turn to be served. It was a nice break, to be honest. Even on weekends, when I would buy stamps or send packages to friends and family, I did not mind the wait.

Today, I would never set foot inside the post office. Standing in line is no longer something I can do without becoming irritated. Instead I do everything online: buy stamps, ship packages, etc.

I am still a patient person. If you could ask some of my friends, they would tell you that I am probably one of the most composed people they know. However, as I look back at some of my previous posts (specifically, Backpacks and "Question!") and reflect on my reactions to a couple of poor lecturers these past couple of weeks, it is clear to me that I am no longer as "willing to suppress restlessness or annoyance."

Time Lack of time is a major factor in this slow erosion. I constantly feel like I don't have time for anything but studying. I need to study to perform well, and I need to do well to have options when it comes time to choose a residency. Therefore, anything that is seen as taking time away from studying had better be important. Of course, friends, family, and eating always make the cut.

Becoming a good, competent physician is very important to me. I know for sure that it will require a lot of patience if I am to remain calm, cool, and collected through this education process and beyond. Finding myself an irritable person at the end of this journey would be a huge disappointment.