Lessons

I’ve been thinking about what to do with this blog – I’d like to move away from posts that just comment on the day-to-day and try to write about something more interesting, but I’m not sure how to go about it. I want to create something that will help other students, but not with the condescending, holier-than-thou sort of tone that many of the upper termers take with us newbies. I’ll probably start working on this in earnest over the summer, but for now, I’ve got to focus on getting through these next three weeks alive. I’m teetering on the edge of my goal, which is to get into the IEA Honor Society, and I need to put every effort into finishing strong.

I attended a seminar about reiki yesterday for my Integrative Medicine selective, which is an extra course you can take in addition to your core medicine studies if you wish to enrich your education with focused, elective coursework on a variety of medically relevant topics. This particular selective is one of two that is open to first term students, and it requires attendance at 16 one-hour lectures/seminars on various integrative (aka holistic or alternative) medicine topics over the course of my two years at SGU. Anyway, I found these five “spiritual principles” of reiki to be heartening, and I will try to integrate them into my current mindset.

Today, I shall not get angry.
Today, I shall not worry about anything.
Today, I shall have mutual respect for all.
Today, I shall do an honest day’s work.
Today, I shall appreciate my blessings.

On the subject of blessings, I wanted to take a moment for myself to realize just what a blessing it is that I ended up going to medical school here in Grenada. No matter what people have to say about attending a foreign medical school, my experience is my own, and it’s truly been a life-changing one. I’ve been going through a really hard time for the past month or so since Kevin has been gone, especially with the added stress of medical school and some health issues that have really been adversely affecting my quality of life. Still, I will always make an effort to stay positive, no matter what the situation. I haven’t dealt with real depression in a long time, and I refuse to ever let myself feel that way again.

To be continued…

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Plateaus

“Quit and you might as well be dead. If you always put limits on what you can do, physical or anything else, it’ll spread over into the rest of your life. It’ll spread into your work, into your morality, into your entire being. There are no limits. There are plateaus, but you must not stay there; you must go beyond them. If it kills you, it kills you. A man must constantly exceed his level.” -Bruce Lee

These past few weeks have tested my strength like never before. I thought I would be okay with Kevin leaving – I wasn’t. The first few days after he left for Albuquerque, I barely ate, slept, or paid attention to anything we learned in class. I couldn’t stop crying, and I didn’t want to see or talk to anyone. It’s been over two weeks now, and we’re down to 49 days until we see each other again. I’m still counting down the seconds, but it’s slightly more bearable now that we’ve gotten used to being without each other. Of course, FaceTime and constantly texting makes the distance seem smaller, and I can already feel our relationship growing stronger despite these hard times. Kevin started working on the ambulance again last week and has already racked up plenty of overtime hours. I’m so appreciative and proud of him for working so hard to support us both while I’m finishing up this grueling first term, and making sure that we’re able to afford the beautiful wedding that I’m dreaming of.

I took my MSK exam last Thursday, along with the lab practical exam on Friday, and enjoyed a weekend of fun activities and a little relaxation – I had a blast bowling at Lavo Lanes, the brand new bowling alley on the island with a distinctly American feel that made me feel a little homesick but in a good way. I actually went out the brewery with my friends for once. I participated in the One Health, One Medicine Fair in Victoria, St. Mark, Grenada’s poorest parish in the northwest of the island, and ran in the Women In Medicine Pink Run 5K for breast cancer awareness. I even saw Beauty and the Beast at the movie theater with everyone on Sunday night (AMAZING!!) and enjoyed the nostalgia of one of the oldest movies I can remember from my childhood.

But yesterday was back to the grind as we start our CPR module on cardiac, pulmonary and renal anatomy and physiology. I’m excited for this module as we will finally start learning some important clinical features of major diseases such as coronary artery disease and diabetes, and begin training for our OSCE clinical skills exams at the end of April. We’re finally starting to think and act like little doctors! I’m impressed with the steadfastness of my colleagues thus far – we’ve gone through some demanding and complex material in a matter of only 10 weeks, and we’ve only lost about 60 of our classmates, who either dropped out completely, chose to repeat the term in the fall, or enrolled in IAP, a supplementary education program offered to students performing below a 70% GPA who need a little extra individualized attention, which gives them the opportunity to move on with the rest of the class provided they pass the next two exams. I didn’t receive the grade I wanted on the MSK exam or practical, but my GPA is still high enough to reach my goals of teaching DES (student-led tutoring) and being inducted into IEA (medical honor society) next term, and I will continue to strive to keep my A through the final two exams.

Until I see Kevin again in 49 days (I arrive at midnight on his 25th birthday!), I’ll be here studying hard, getting in amazing shape for the wedding, watching Grey’s Anatomy (didn’t mean to get obsessed with that one!) and involving myself in as many extracurriculars as my schedule will allow – these next six weeks are going to fly!

This article showed up on my Facebook feed at the perfect time last week – take a look for some inspiration to improve your attitude. It makes all the difference.

Heavy Weight

I realized yesterday that we’re exactly halfway through our first semester of medical school. It really seems like we just started last week, and I still have random moments of disbelief while I’m sitting in lecture listening to the professor tell us, “When your patient comes to you with [disease X] and you prescribe them [drug Y]…” or during small group when I sanitize my hands and introduce myself to my standardized patient as a first year medical student – disbelief that I’m actually here, doing this medical school thing, becoming a doctor. It still doesn’t seem real. It also makes the weight of what we’re learning so much greater, knowing that everything we’re studying now will almost certainly become applicable at one time or another during our medical career. For that reason, I’m pleased that my grades are reflecting how much work I’ve been putting into my studies, and that my nights spent in the study halls instead of at the bars have certainly paid off.

This MSK (Musculoskeletal) module has been kicking my ass, so I now have less and less time to revel in the wonder of attending medical school. We’ve dispensed with the biochemistry and genetics for now, and are finally focusing on the human body and all of its parts – literally, all of them. In just under a month, we are responsible for learning each and every muscle in the body, along with its major functions, arterial circulation, venous and lymph drainage, and nerve supply. As if that’s not enough, we’re also studying muscle physiology, histology of bone, cartilage, muscles and nerves, and the autonomic nervous system along with a host of drugs that we must memorize.

To top it all off, Kevin is flying home on Monday to recertify his paramedic license and return to work at AMR. We talked about this at the beginning of the semester, and I thought I would be much more okay with it when it came time for him to leave, but I’ve felt incredibly depressed this week knowing that I’m going to face the last 8 weeks of the semester on my own. I feel almost physically weighed down by this sadness, and it’s put me in a funk that I’m fighting to get out of so that my attention to my studies doesn’t suffer. I’m really going to miss having my husband here with me, keeping me company and supporting me when I feel like I’m not doing my best. I know that support will be just as strong from across the sea, but it’s going to be hard all the same. I’m so fortunate to have had him here with me for this long, as many others I know have to deal with missing their significant other every day while they’re on the island. I’m going to really focus on school work and schedule myself as rigidly as possible for the next two weeks preceding our MSK exam, and hopefully that will make the time pass by more quickly. I’ll be flying back to New Mexico on May 16th, the day before Kevin’s birthday, and I’m sure we’ll have a great time getting to know each other again. Keeping a positive mindset is going to be key in this transition, and I know I can do it.

Learning Curve

Well, it’s becoming increasingly clear that I have significantly less time to blog than last semester. I have significantly less time to do anything, really, aside from study, work out, eat, and sleep. “Eat when you can, sleep when you can” is the advice I received pretty consistently from my physician friends before embarking on this journey, and I think that pretty much says it all.

I’ve been on this medical school grind for over a month now, and I have had to completely transform the way that I approach learning. Kevin sometimes makes fun of me because I’m literally “learning how to learn” which he thinks is adorable somehow. During my undergraduate years at UNM, I realize now that I never actually had to study to get good grades – “study” means a lot of different things to a lot of different people, and there’s a ton of argument about quantity vs. quality of study techniques, but when I think of studying, it all boils down to putting in the time. I never really put in the time during undergrad, which is evidenced by my excellent grades in classes that I could essentially “bullshit” if necessary, and my not-so-stellar marks in the courses that really required a time commitment for any sort of fundamental understanding (i.e. physics, quantitative chemistry, biochem). My attitude in undergrad was basically this – if I decided I didn’t like a subject, I stopped caring about it and just wouldn’t spend any more time on it than was absolutely necessary. Of course, there were topics I found fascinating (forensic anthropology! also genetics and evolutionary biology) and I poured my time and effort into these courses. But those subjects that didn’t truly interest me, the ones that were simply stepping stones toward the end-goal of getting my bachelor’s degree, I neglected. This now seems like a pretty shitty attitude toward learning, and incidentally, it probably explains my lackluster MCAT scores as well.

Flash forward to the first term of medical school, where EVERYTHING COUNTS and EVERYTHING MATTERS, and there are actual real-world consequences for not knowing the material, like becoming a bad physician or making an incorrect diagnosis or treating a patient with the wrong drug or KILLING SOMEONE and ruining a family. A little dramatic, sure, but all real possibilities. So yeah, now I’m paying a bit more attention to the material, even though topics composing the first module – basically a review of everything we did in undergrad, like biochemistry, genetics, histology, cell biology, and some rudimentary pharmacology, but in far more mind-numbing detail – is admittedly bone-dry at times, but with interspersed clinical correlates and mechanisms of disease that provide just enough meaningfulness to get through the long hours of studying. I’m truly finding myself interested in all of it, mainly because I now have the gift of time that I never had in undergrad. I was obsessed with working and making money then, partly because I had to, but mostly because it was rewarding and satisfying in the short-term. Now I’m being forced to think long-term, and not having to work while in school has become the greatest gift in my years of education. I feel like I’ve earned this.

Learning how to study here seems to be a difficult adjustment for most students. Obviously, no one is going to scrape by here like they did in college, and many of their tried-and-true methods from those years have become obsolete as we try to drink in as much as we can from this firehose of information being blasted at us every day. I’ve been to several study workshops put on by the Department of Educational Services (DES) –  a free tutoring service provided by the school that we are so lucky to have – with topics ranging from test-taking strategies for multiple choice exams, test anxiety, study skills, time management, etc. All of the information and suggestions have been extremely helpful, and as we move into the week before our second exam, I feel quite confident that I have found my magical studying “groove” that the upper-termers tell us about.

We have four hour-long lectures each day from Monday through Friday, excluding a few days that we have IMCQ (Interactive Multiple Choice Questions) sessions in place of lectures, usually in preparation for an upcoming exam. According to DES learning strategists, students should spend 10-15 minutes previewing each lecture, one hour during lecture taking “active notes,” and 90 minutes reviewing the lecture within 24 hours to seal in the material. Multiple choice questions are stressed as an imperative daily tool to be used for self-testing during the week and reviewing on the weekend, which helps you confront your shortcomings and identify weak points that need further review. Saturday and Sunday are days to review, integrate concepts, and prep for the following week’s lab/small group sessions.

There is only one rule in medical school – whatever you do, DON’T FALL BEHIND. So far, I’ve managed to keep up with all of my lectures by using my laptop to highlight and annotate powerpoints during lectures, then take extensive hand-written notes for my review, and finally, transcribe these notes into neat, concise one-page outlines as a final review that can be quickly accessed at any time, along with countless multiple choice questions to test my knowledge. I like math, so let’s see how many hours I’ve spent studying just the lecture material for this first module, WITHOUT including any weekend review time:

80 lectures x (15 mins preview + 60 minutes lecture + 90 minutes review) = 13,200 minutes = 220 hours

More than 220 hours of studying in the first six weeks of medical school. And I still wouldn’t trade it for anything.

White Coat

A woman in medicine is lucky enough to get two special days on which she gets dressed all in white, stands up before her family and friends, and pledges her eternal devotion to the love of her life – once at her wedding, and once at her White Coat Ceremony.”

I’ve made it through the first two weeks of medical school alive, and absolutely thriving in the environment of non-stop learning and activities – there is always something to do, someplace to be, and I wouldn’t have it any other way. My mom visited Grenada for the first time (like me, this was her first time being outside the US) from Monday to Sunday, and she had a great time exploring the beautiful beaches of the island while I slaved away with my studies. However, I was able to take a small break over the weekend for my White Coat Ceremony celebration on Friday, as well as a fun tour of the island on Saturday.

The White Coat Ceremony is a momentous occasion for a medical student, especially one like me who has been fighting for this chance to study medicine for quite a few years. It really meant a lot to me to have my husband and mom there to watch me receive my coat, and to hear the inspiring words of the speakers at the ceremony. Dr. Bruce Bonnano, an emergency physician who gave a talk to the Emergency Medicine Club earlier in the week, told us that some of us may have come down to Grenada with a “chip on our shoulder,” alluding to the obvious fact that SGU is probably not everyone’s first choice school, and that as foreign medical graduates, we may face some real challenges in the world of medicine in the United States, particularly when fighting for limited residency positions. He said, “They’re going to tell you that you can’t do it. Do it anyway.” Those words resonated strongly with me, and I realized that all of the struggles of my past have been worth it, as they have led me to this exact moment in time where my dreams are literally coming true. I sat with all of my MPH friends during the ceremony, and I felt so incredibly lucky to be there with them, to have their friendship to look forward to during my time here on the island. I felt a wave of emotion come over me as I recited the School of Medicine professional oath, a derivative of the outdated but traditional Hippocratic oath that was recited at White Coat Ceremonies many years ago. I have pledged my life to the study of medicine and to my patients, and one day, I hope to make them proud to call me Doctor.

First Day

Yesterday was my first day of medical school. It still hasn’t quite sunk in yet. Of course, I promptly got sick two days before school started. I still have a sore throat, cough, runny nose, aches and fatigue, which made it a bit hard to concentrate during lecture, but I was able to pull through. We started our day with a professionalism session in which we sat with our “small groups” (6-8 students) and facilitators and talked our way through several scenarios involving the various ways that a medical student can breach their professionalism. We will meet with these same small groups once or twice per week for the entire term for lab and discussion sessions for anatomy, histology, physiology, genetics, etc. In addition to these sessions and four hours of lecture per day, I can already tell that I’m in for an exhausting (but exciting!) ride.

I woke up bright and early at 0600 yesterday, made it on the first bus to campus at 0715, and arrived 20 minutes early for the professionalism workshop, which ended at about 0930. I used the long break before lecture at 1300 to go to the gym, eat lunch with my hubby and some friends, and then arrived early enough to get a third row seat for lecture alongside all of my MPH friends, who are equally stoked to finally begin studying medicine. We sat through four hour-long lectures, each led by a different instructor, which involved an introduction to the Foundations of Medicine module, basics of histology (the study of cells under the microscope), homeostasis, and cellular organization. I left lecture at 1700 feeling absolutely awful, even after taking some cold/flu medicine I found in my backpack, but this was soon remedied by our first sunset yoga practice of the term. I look forward to this one hour of “me time” every Monday, and it was the perfect end to a long first day. After yoga, I caught the bus back home, ate a quick dinner, and hit the books until 2300, which is going to be the official cutoff point to my studies every day. It’s going to be vital to set limits for myself so that I don’t go overboard and forget about the important things, like spending a little time with Kevin before bed. My aim is to be in bed and asleep no later than midnight each night, which will allow me to get 6-7 hours of sleep so that I have plenty of energy for the busy days ahead.

Today is the 40th anniversary celebration for SGU and they are having a massive parade in the street leading to the school, so campus closed at noon and our classes were cancelled for the day. I spent the morning on campus working out and watching last week’s Saturday Night Live episode while Kevin worked in the SIM Lab, and now that we’re back home with the rest of the day off, it’s study time for me and relaxation time for him. I love our new apartment – there’s so much more room here than the tiny dorm room that we shared last term, and it’s a great place to study because we each have a big desk, not to mention a great view from the third floor! I’ll post pictures soon. Gotta be a responsible medical student and start studying those boring histology slides 😉

 

 

Go With the Flow

Yesterday was not the best day. I wouldn’t go so far as to call it a bad day, but it was definitely not one of my favorites. I woke up bright and early to go get my silks set up at Sandals Resort in preparation for the Halloween show that night. The venue, called the “Living Room,” is a gorgeous covered outdoor bar/lounge area with dozens of oversized cushioned beach chairs, hammocks and suspended bench seats surrounding an open floor in the middle, topped with a 50 foot ceiling adorned with a giant chandelier in the middle. As an aerialist, I’m obsessed with high ceilings and am constantly looking for exposed beams to hang from, so this venue was absolutely perfect in that regard. Still, I was getting more and more nervous as the hours went by, thinking about how I hadn’t practiced silks at all for the past three months since I haven’t been able to find a high enough place to rig from that’s accessible without a ladder. I got to mess around for a few minutes after the maintenance crew rigged my apparatus to the ceiling beams, and I realized that the humidity in Grenada made me incredibly sticky – the silks were sticking to every bit of exposed skin on my ankles and feet, making lots of simple moves a lot more difficult and further shaking my confidence. I had a routine planned in my head consisting of the simplest moves I know so at least I knew I could do them, and I had been going over the steps incessantly in my head the past few days trying to mentally work out the kinks, which is definitely not how I like to prep for this sort of thing. The only thing that makes routines better is by doing them, over and over and over again until you get it right. That was clearly not an option here, so my only choice was to hope for the best and wing it if it all went wrong.

The stress of my impending performance and the addition of some petty social nonsense going on in my MPH class made it hard to concentrate in class that morning, and I started to feel really bad. I barely ate anything all day, and it took everything I had to sit for my Concepts, Practice and Leadership final with full concentration. I managed to do it, and I got to reward myself with a great yoga practice afterward. It was my last Monday sunset yoga session with my favorite instructor until we come back in January, so I wanted to make it a good one. I was finally able to clear my mind of all the negativity from the day and just go with the flow, and it was a great feeling. Not to mention I got a killer stretch just before my performance.

When 9pm rolled around and I left the waiting area at Sandals with the other performers to wait “backstage,” I was feeling ready. I didn’t have my most comfortable performance leotard and tights, and I didn’t have the confidence that I would have liked, but I made myself relax and try to have fun with it. After all, doing aerials brings me more joy than anything else, so it really shouldn’t be such a stressful process. Between my trial run in the morning and show time that night, the Sandals staff had decked out the performance space for Halloween with lots of cobwebs, decorations, spooky lighting and fog machines, and the seats were packed with guests who looked like they were having a great time. I watched from offstage as several talented groups of traditional Grenadian dancers, a fire twirler, a singer, and breakdancers took the stage before me with a contagious energy, and when I heard my music start to play, I did my thing. My performance went nothing like I had imagined, and I basically had to improvise most of it because certain movements didn’t work like I wanted due to the stickiness of my hands (damn humidity!!!). Still, I got wild applause throughout the performance, and although I knew that I had “messed up,” I also knew that no one in the audience could tell, and they probably didn’t care anyway. I made it work, and I’m really proud of myself for that.

The event coordinators told me that Sandals hosts events for pretty much every holiday, so I will likely be coming back next year for many more performances, as well as other events they host around the island. I love sharing my passion for aerial arts with others, and even though living in Grenada is not ideal for being able to practice, I will work hard to make it happen, even during the busy first semester of med school that awaits me in January. In the meantime, I go home next week and then immediately head down to Las Cruces for a five-day intensive aerial workshop where I get to work with three professional trainers and choreographers to develop a routine under their direction. My perfect reward for a semester well done! Two courses down, three to go…