Quarter Century Update: Writing, CPR, Neuroscience, and Finding a Balance

This might sound silly, but I am destined to do something great with life. Perhaps we should all feel this way to some degree. It drives my intrinsic motivation haywire and might explain my joining the military to be a physician. This might also explain why I feel a lurking presence telling me I should be doing more. I want to do something great, but I cannot tell you what that is yet. If it’s not medicine, I want it to be a book.

My greatest goal in life is to write a novel. Nothing like the ramblings in this blog, mind you, but something more legitimate. There’s a story I have been wanting to tell for quite some time. Still cannot figure out how I want it to end though. Maybe I’ll figure it out as I put the pieces together and start letting my stream of consciousness take over into something of substance.

An unfortunate thing about creative writing: I am most motivated in times of emotional despair. Words come easily when my amygdala is on fire. Probably related to why the most amazing artists have the most tragic backgrounds. I will use that as one of my explanations for the gaps in my blog posts during medical school: I am having a great time and do not feel the need for writing to be an outlet for negative energy anymore. I think I need a new approach: channeling my positive energy into writing as much as I use it as an emotional outlet.

In other news, I turned 25 on Friday. Celebrated at the Cheesecake Factory (my fave) and received warm wishes from friends and family all over. Birthdays 23 and 24 don’t feel like too long ago, yet so much has happened in the past couple years, let alone the past few months. For one, my first-author manuscript about hippocampal volume changes in childhood-onset schizophrenia has been accepted for publication in Psychological Medicine! Achieving a first-author publication has been a dream since I first looked into working at NIH. I have experienced my fair share of projects falling through last minute, as is the case with medical research. I am lucky to have a few co-authorships, but achieving that first-author was a battle and great success.

For anyone curious about post-winter break USU curriculum, CPR (cardio-pulmonary-renal) and Neuroscience modules have certainly lived up to their reputations. Most organized modules but also the most difficult. Rumor has it that school is much easier during GI module, which seems like a break in comparison. Honestly though, in CPR I began relaxing more and successfully struck a balance in this work-life business that people say you lose during medical school.

Medical school is about balancing priorities. Mine are academics, mental wellness, physical health, and family/friends (I show up to the important things)… with my priorities in that order on a normal school day. Others likely have a different order, especially if they have children, focus on extracurricular organizations, or are social butterflies. We all have our own methods of studying and we all have our own methods of decompressing. You do you.

CPR was a great opportunity to find that balance, and I have kept it up in Neuroscience. The module directors in both of these modules are beyond accessible and approachable; faculty members genuinely want their students to succeed. I watch a lot of television these days, but I feel my time spent studying is more high quality (I will let you know if I am singing a new tune after Tuesday’s midterms). CPR and Neuroscience have Dean’s Time galore (2-3 free afternoons a week), making it easier to keep up with the material. I find this is the case more so with Neuroscience because CPR had dozens of assignments due (plus I was not a huge fan of the graded small group sessions), but the nice thing in CPR was having a full week dedicated to both midterms and finals. My preferred study style is old school: by myself, with papers and notebooks. Some other classmates prefer the group style and/or computers/tablets.

Our combat medical skills classes have been pretty cool the past few rounds. Military Medicine is an overarching module we have interspersed in our curriculum. We’ve learned how to intubate and other methods of establishing an airway, how to appropriately assess a patient at a scene and safely transport them, and we’ve done basic IVs on each other. Later this week, we will be doing more advanced IV techniques (still on each other) that involve injecting local anesthetics. I’m both excited and terrified! [Note: no one is pressured to perform the procedures or to have IVs done on them, but most people do. The goal is that we know the process and are familiar with these techniques during our preclerkship years].

Life has been treating me well. Today is actually the first day in two months that I have not had a low-grade fever, and I am finally recovering from an unfortunate bout of pneumonia. Oh right, my other explanation for not updating my blog… The Saturday after our CPR midterms, I went on a 7-hour GoRuck event romping around DC with some Air Force buddies. I had a sore throat before the event, which likely predisposed me to catching something more serious. I progressed to full-blown “I have never felt so awful in my entire life” within 24 hours and lost 8 pounds in the first week. Don’t worry, I got my appetite back pretty quickly and found those pounds again. All that matters is I am finally feeling well and got my much-needed energy back, hence motivation to write 🙂

Well, that’s all I have for now. Neuroscience is certainly my favorite module thus far — coming from a Neuroscience major who wants to specialize in something related to Neurology/Psychiatry. No matter your interests, opening a human skull and dissecting brains are surreal and truly amazing.

Stay tuned for an up-to-date COT packing list for those of you heading to Alabama this summer. TBA in a future blog post.

Happy Spring!

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Beginning the 2015 Chapter

2014 came and went, and along with it a plethora of emotional highlights I felt along the way: unadulterated happiness and relief with my unconditional acceptance into USUHS, excitement visiting close friends around the world, mixed feelings saying goodbye to the NIH, joy traveling to Brazil for the World Cup with childhood friends, stress when I hastily submitted my research paper for publication, anxiety due to sleep deprivation at Commissioned Officer Training, and passion, resolve, plus occasional fits of overwhelming despair during my medical training.

The MSK module ended on a solid note. I beasted during finals and redeemed myself from a post-midterm funk when I felt beyond burnt out for a few weeks. Without a doubt, winter break was well-welcomed. I spent the better half of our two weeks off in San Diego with my mom – we figured out Uber and adventured the city together. First day consisted of decompressing, food, and a lovely walk in her neighborhood where we could see the ocean and appreciate the great weather. Just what I needed after my first four months in medical school.

My family never really celebrated Christmas when I grew up, so lo and behold, I was in for a treat this year. I woke up to a breakfast feast – filet mignon, eggs, yogurt, and tea. My mom is the best cook ever, and I have been missing out since she’s moved to the west coast! After the necessary time needed to digest, most of Christmas Eve consisted of pool time and me appreciating warm weather galore. As for the evening, we were graciously invited to dinner with the Mormon President’s family and some other church-goers. My mom has become a regular attendee at a Mormon church near her and entered this network of lovely individuals I enjoyed meeting during my trip. [Note: I myself am a little confused about the role of the President, but I knew that he is a trained lawyer by profession. I learned a great deal about Mormonism from my mom, who’s working on a project comparing the Book of Mormon in English to the Persian translation to see if the translations are appropriate in Farsi.] Dinner was delish – ham, cheesy hash browns, green beans, followed by pumpkin and banana cream pies (everything home-made, the President literally whipped cream just before dessert).

Our Christmas Eve festivities were unlike anything I had imagined. After we ate, we all sat together and sang Christmas hymns. I had expected this to be uncomfortable, but I was pleasantly surprised. We all sat in a circle and picked our favorite songs (thankfully there were books for lyrics) while the President or his daughter played the piano. As a first-generation Persian American, it almost felt like one of those perfect families featured in the end of a Christmas movie. It didn’t feel like real life, but I certainly enjoyed it. The Elders joined for hymns later in the night to; this is when I learned that “Elders” are missionaries, with all the ones I met recently out of high school.

After singing hymns, we all dressed up in costumes the President’s wife had made to re-enact the nativity scene. My mom volunteered herself to be the Virgin Mary, and I played two roles: an angel and a wise man. Truly one of the most fun and memorable Christmases.

Virgin Mary (mom in the middle), three wise men, and Joseph on the right.

Virgin Mary (mom in the middle), three wise men, and Joseph on the right.

On Christmas day itself (with more steak and eggs for breakfast), my mom and I went to Seaport Village and Coronado Island, enjoying seafood, the warm weather, beautiful views of water, shopping, and a festive evening at Coronado Hotel.

In Seaport Village

In Seaport Village

After Christmas, I spent a good amount of time with family friends in the area, some of whom I hadn’t seen in nearly ten years! It’s amazing how at home you can feel with certain people, picking up just where you left off no matter how many years have passed. My ‘cousin’ took me to La Mer, so I got some face time with the ocean.

My last full day in San Diego was truly beautiful and my favorite day of the trip. My mom and I gallivanted all over La Jolla, which seemed to have all the fun activities packed into one area – with the beach, the lounging sea lions, an outdoorsy picnic area, shops, and restaurants. We showered each other with some much-needed love and attention before we parted ways the following day, when I returned to the real world of Virginia.

The week before classes began consisted of working on my NIH paper and seeing friends in the area, but mostly working on my paper revision. After recently catching up with some friends/former coworkers from NIH, I realized how much easier medical school feels in comparison! It’s nice to be a professional student. I enjoyed the longest lunch ever with my fellow genetics IRTA the other week and had this epiphany that she (along with Andrew and the IRTA she replaced) was one of the few people who were intimately a part of my post-graduation transformation. I don’t know how to describe that post-graduation phase I know many of us experience… It was certainly a time of figuring out my priorities in life and what I wanted from myself, others, and my environment. Few people in the world know you on that deeper level, and seeing her felt like this unexpected reminder of the younger Afsoon before she grew up.

So here we are. Break has come and gone, and classes are in full force. Despite the cold, which generally arrests my sense of productivity as my body and mind become increasingly lethargic, I have been faring pretty well this winter (knock on wood). Somehow I anticipated the cold to be much more gripping coming back from San Diego than it turned out to be. Warm weather was paradoxically a cure to my cold-weather loathing simply because I expected the cold weather to be so much worse.

The CPR (Cardio-Pulmonary-Renal) module has been more unrelenting than others, and yet, I feel like I am managing time better. Maybe I needed that positive encouragement on the first day back to school when I was awarded a free Gray’s Anatomy textbook for getting a 100% on my anatomy exam in MSK [I hate to be the nerd that says good grades are motivating, but they are.] I felt like I was trudging through medical school for a few weeks last module, and I finally have the energy and motivation to manage a better work-life balance that I didn’t have before. Maybe it’s because I started Crossfit too – something about lifting heavy weights and my muscles hurting 24/7 has helped me focus more and take the necessary breaks away from school and thinking too hard about science and medicine. Then again, Crossfit is also pretty intimidating, so maybe med school has simply become less intimidating.

Midterms are in a week, and I need to pick up the pace for our big exams coming up. I went overboard and bought prep books galore – including BRS (board review series is amazing) physiology, BRS pharmacology (pharm is a subject area I need to work on), First Aid Organ Systems, and a book on how to read EKGs. Granted, this might have been a response to well-deserved me-time rather than study-time. Andrew and I celebrated our two-year anniversary last week! Our second celebration at L’Auberge Chez François in Great Falls, where the ambiance and food make the experience worthwhile. I’m lucky our anniversary falls on a three-day weekend so I can carve out time from studying with zero guilt or anxiety. We spent a fabulous Saturday watching Breaking Bad and enjoying our fancy meal at L’Auberge. Grateful for Andrew who’s supported me from pre-MCAT NIH days to military medical school today. He’s the best fake patient for all my practice medical interviews/physical exams.

December and January have been good months to me. I addressed a few long-standing goals of my life. I bought a tablet (feeling pretty fancy as I get with the ages). I learned how to study (it’s an ongoing process, but I think I finally figured it out…for now). I began reading regularly (for fun, nothing with too much intellectual substance). I sleep more than I used to and still make time for Netflix. I think I understand how blood flows in the body and might even identify some murmurs accurately. Most importantly, I got to spend much-needed quality time with my mom.

A Tragic Reality Check

Alas, the further I fall into the abyss of medical science, the less I have been writing. Balancing passions of life is quite the challenge, but we shall carry on.

I could talk endlessly about this module, Musculoskeletal, and about the countless hours of dissection, labs, lectures, and feeling legit in scrubs. I could talk about all the work that has gone into clinical exams and our first [terrifying] Integrated Clinical Skills assessment. I could discuss the struggles of the average medical school student. Maybe I will talk about those later, and maybe I won’t.

The reason I wanted to post on a late Saturday night [when I originally wrote this] is because I need to talk about some grave reminders we get when we experience serious reality checks: 1) we’re human, 2) we don’t live forever, and 3) there are more important things in life.

At 12:36am Friday morning (I know because I looked straight at the clock when I was abruptly shaken awake), my boyfriend told me his former roommate and close friend attempted to commit suicide. I was shocked but not surprised. I know that might not make sense to others, but it’s certainly a distinction to me. At that very moment, it was like my mind went clear. Looking back, I would have expected my response to include panic and tears. But it didn’t.  I remained quiet as Andrew described how his night progressed, how he walked from a bar to visit his friend, how his friend’s current roommate broke the news, and how he drove to a nearby hospital in a panic.

Lying in bed that night, vigilance had taken over. I felt alert as if an emergency had taken hold, as if my fight or flight response was in full gear. I knew I had to do something. Both Andrew and I knew that we had to wait until the morning, when he figured out exactly which psychiatric facility we could find our friend and when we could visit.

Navigating rush hour traffic that evening frustrated me as we headed to a hospital nearly an hour away. With a gallon of fruit punch in Andrew’s hand and a box of chocolates in mine, we were armed for some loving and ultimately enjoyed our visit, all things considered. After signing in and dropping our belongings in a locker, a kind employee escorted us inside to a room filled with grey foldable tables, rectangles lined against the wall by the window, with fold-out chairs tucked under. The only individuals in the room were exactly who we expected: the man himself and their other former roommate with his girlfriend. The following hour and a half was full of laughter, nostalgia, and light-hearted talk regarding grave circumstances.

I kept looking at the wall of art made by the patients, abstract colors, sketches, landscapes, quotes both deep and snarky accompanied by illustrations. I desperately wanted (and still want) a one-on-one talk with him. He’s one of my favorite people. I get how his mind works. I see where he’s coming from. And I desperately wish I could help. Way back, he helped me in a dire family situation when I had nobody else I could call – I knew he would help with no reservations or judgment.

I came to a realization a couple months back when William and Mary had their most recent suicide – there is a stark polarity in decision-making when it comes to the choice to live. Because, when you think about it, every day you live is your choice. To a certain extent, that is quite empowering, whether or not it seems like a decision you would ever consider.

I graduated from an amazing institution that has been criticized as the “suicide school” in Virginia, the College of William and Mary. I can’t say I know all the statistics, and I can’t vouch for one side or the other. Certain people believe this to be a horrible misperception of our university, and others think the title reflects a greater problem that needs to be addressed. The facts I know are the following: there were 3 suicides during my 4 years at W&M and one this past August. If anything is for sure, these unfortunate tragedies reflect the vulnerability of our college years and the need to support one another.

In the William and Mary community, if you didn’t know the person, you knew a friend, a classmate, a hall mate, a professor. The campus went quiet a day or so before the shock wore away. Quickly thereafter, we fell victims to the same stress and runabouts of daily activity, until we would hear horrible news again, this time a new name, a new story.

My heart goes out to those with depression. It’s a crippling disorder that makes you consider your options in ways that most people don’t. For now, I am grateful my friend is alive and has not been permanently harmed from the event, physically at least. The mere thought of losing him hurts my soul, a reality check that both curbs my frivolous complaints and inspires me to move forward in my career. Right now, I want to be a psychiatrist so badly, more than I have every wanted something in my life. I want to help people like my friend, like my lost members of the Tribe, like the countless individuals out there struggling from severe depression, as well as other individuals suffering with mental health illnesses.

If there’s anything I wish for humanity, it’s compassion. Unconditional compassion, for our friends, neighbors, and strangers. I am convinced this world would be a far different place if we listened to compassion as a paramount factor in decision-making. Maybe then it would be easier to seek mental help. Maybe then we could save precious lives.

There are some great articles out there on the subject, and just a few suggestions for anyone’s interest:
-The challenges of suicide prevention on campus after three suicides within a year: http://www.washingtonpost.com/wp-dyn/content/article/2010/11/12/AR2010111202853.html
-About Tracy L. Cross’s research on suicide in the gifted: http://www.wm.edu/news/stories/2013/cross-book-explores-suicide-among-the-gifted123.php
-Blog post of a Tribe member’s own struggles, written after the most recent suicide at W&M: http://wmblogs.wm.edu/skyler/one-tribe/

To Pandakar and Back

It’s time to break my longest hiatus from the blog. Alas, I’ve officially succumbed to the hectic life of being a medical student. I often choose the pleasures of sleep, food, and an occasional Netflix or Hulu episode over writing. I might need to reevaluate my priorities.

Fundamentals proved fruitful. Unlike the other modules, it’s a hodgepodge of information, and I personally liked the variety of subject material (most of my fellow classmates probably disagree and prefer the focused content of most modules). We were graded on more classical methods of class work (lab quizzes, weekend quizzes, NBME midterm, NBME final, practical final, faculty exam final) and some more society-centered studies (medical interviewing of patients, full physical examination, and humanities essays on medical history and emotion processing after seeing patients). I actually enjoyed myself during Fundamentals. Despite the stress and long days, I enjoyed the information and had a decent time on the weekends, not so social, but I at least managed to get relaxing time in, which I desperately need to recharge.

Within 20 hours of my last Fundamentals final, I found myself on a bus to Pandakar, our patient role-play destination where the four-year USU med students used first-year students as well as volunteers as guinea pigs for a mock deployment scenario of patient health care. We stayed in barracks, which were much nicer than I anticipated. Likewise, all the porta-potties around Pandakar were surprisingly well-maintained. It’s the simple pleasures that keep you going.

We began our first day by taking an emotion intelligence test, personality test, and by learning how to play patients (which included an understanding of various medical abnormalities, how to act them out, and how the fourth-years should be treating our conditions). The next few days in Pandakar were quite epic and exhausting with more or less moulage involved. We played patients in combat scenarios as well as in sick call scenarios to give the fourth-years a plethora of presenting conditions to treat.

I will have more on what the MSIVs do in a few years for their side of the story of Bushmaster (Bushmaster was this doctor-patient role-play experience in fake-country Pandakar/real-world Fort Indiantown Gap in Pennsylvania). They had several roles to play, including security, surgery, ATL, CSC (for mental health), medic, litter carry, and a few more I either cannot remember or never learned myself. The poor fourth-years seemed exhausted by the end and were organized by platoons into different clinical teams by helmet color. I happened to see the Red platoon all the time, and I also happened to play a couple of hilarious patients, one of which was an “odd person”. For the respect of not showing us goof off with fake injuries, we can’t share our photos from Bushmaster, but it was an awesome/exhausting/educational experience for both the patients and the physicians – an experience no other medical school gets!

After Bushmaster, we had our own military training experience as MSIs within our platoons that included M9 shooting/safety training, LRC (leadership reaction course – my COT training served me well), land navigation, preventive medicine, ultrasound, CBRNE (training for chemical, biological, radiological and nuclear defense), combatives (thanks to a West Point graduate I partnered up with, I learned way more and definitely enjoyed myself…slash we sparred in pairs at the end, which I found terrifying to watch but fun/painful to do myself), Health Service Support (strategy of establishing medical/military posts during combat), casualty evacuation, and movie nights to watch clips of videos/documentaries and listen to panels/speakers ultimately illustrating the realities of military medicine [besides my parenthetical insertions, I promise this sentence/paragraph wasn’t a run-on].

And thus, we reached the end of our time in Pandakar. I bonded with the members of Alpha company (the half of MSIs that did Bushmaster before MSI training), and it was nice to go home and have a few days off before classes started up again. Unfortunately, on my last day in Pandakar, I woke up with the world spinning around me. I basically crawled to the bathroom to vomit from dizziness. Luckily I found two kind classmates to take me to the medic who diagnosed me with vertigo due to a viral infection. Fun times. The next few days were mostly spent at home recovering and relaxing, with some occasional activities within the scope of my ability to sit and walk slowly.

This past weekend before classes started, I went to a pumpkin patch with some Air Force friends and had my first experience pumpkin-carving at my parents’ place with Andrew. Also got to catch up with a few local friends and family before classes began yesterday. After organizing my calendar and planner for this next module, MSK (musculoskeletal), I am both excited and terrified to hit the books again.

Here we go again.

Medical School: Round 1

It’s official: I completed my first exam of medical school today (terrifying). I finally have a chance to write a brief update. Now I know what real academic volume is. I especially sympathize with my classmates who have children because I can barely manage myself these days. Graduating from William and Mary, I feel adequately prepared in terms of my undergraduate education, but being two years out of the classroom came with challenges. Bright side: I don’t find it horribly difficult to sit eight straight hours studying on a Saturday. I have averaged about 11 hours a day of school/study time in the past three weeks (weekends included). Granted, I am a slow reader, but I feel like my schedule is probably reflective for most of my classmates as well.

Our first module, Fundamentals, highlights biochemistry, histology, pathology, epidemiology/biostatistics, microbiology, and immunology. It is a good introductory review of science as well as getting the basics of histology and pathology down (we have computer-based labs for these courses too). It’s a nice way to level the playing field in terms of everybody’s background education in science.

In terms of patient experience, we are already learning how to conduct medical interviews and how to perform a full-body physical examination. These take up our Tuesday and Thursday afternoons. I was incredibly anxious at first, but all of our preceptors are amazing and approachable. These sessions are opportunities to begin developing specific skill sets in physician-patient communication and the ins and outs of performing an examination. Medical interviews are done with standardized patients (actors) or real patients at Walter Reed. We practice the physical exam with other classmates in small groups.

Thus far, I am excited about the USU medical school curriculum. They instituted a recent change that bumped up Step 1 scores remarkably, and the layout seems well-thought out and organized. Each module usually lasting 7-8 weeks has a major theme: Fundamentals, Musculoskeletal (MSK), Cardiopulmonary-Renal (CPR), Neuroscience, GI/Hepat/Nutrition/Metabolism, Reproduction/Endocrinology, and Multi-System/Complex Disease. Between Fundamentals and MSK, we’ll be heading out to Fort Indiantown Gap in Pennsylvania for 10 days of leadership/teamwork training and some patient role-playing for the fourth years.

All in all, I am enjoying medical school despite not seeing my friends/family in the area very much. I definitely have my moments where I feel like I am riding the struggle bus to downtown struggle city. But don’t we all?

Stay tuned. I might be changing the blog up a little bit because med school talk cannot stay interesting on its own.

From Montgomery to Nashville to USU Orientation

As a COT-graduate, I had been entirely too sleep deprived. Right after the graduation festivities on Friday, everything still felt rushed with the campus bustling and people all over Morehouse Hall exchanging goodbyes and luggage. Andrew and my dad helped me pack my belongings into my dad’s car (well, the car that said “Distinguished Visitor” on the license plate – I learned from one of the administrators that the Air Force views SES as equivalent to 3-Star Generals and the Army generally views them as the civilian equivalent to 2-Star Generals. Makes me proud!). 

I had the opportunity to show my dad and Andrew downtown Montgomery when we grabbed lunch in The Alley near the Riverwalk. I scarfed down a bacon cheeseburger like nobody’s business. My dad bought wine, and we celebrated my accomplishments/survival. I mostly celebrated the ability to see my family and go home and sleep (you’ll notice this theme of SLEEP will come up frequently). After lunch, we picked up Charlie (my 2006 Honda Accord) from the shop with her new battery. McGriff’s Auto Shop proved to be a great spot right next to Maxwell AFB (suggestions for future COT-goers who have their batteries die…I heard of a number of individuals with this problem, probably because we had to leave our cars unattended for a few weeks). Beware of politics if you mention you’re in the Air Force though. The guy working at the auto shop certainly had his opinions about “Barack Obama negotiating with terrorists” and I prefer to steer clear of such conversations with strangers, namely to avoid political affiliations with the military. Remember: whoever the President is, he/she is your Commander in Chief!

Once we got back to base (I’m beginning to rock the car salute), we all decided to take a power nap in the Fairchild suite my dad and Andrew were staying at. Originally, Andrew and I planned on driving to Nashville after dinner as a pit-stop on the way home – we both have friends in Nashville and have never been to Tennessee. However, this power nap turned into a 4+ hour affair. Neither my dad nor Andrew wanted to wake me up, and I am grateful they didn’t! After waking up, showering, and having a cup of coffee, I was finally ready for dinner. At this point, it was sometime after 9pm, and we set out back to The Alley. My dad and Andrew were both very impressed by Montgomery, and I attribute that to my tour guide skills of downtown. Enjoyed some Mexican food, some margaritas, and some good old-fashioned conversation.

Blurry photo of Andrew at El Barrio in Birmingham, Alabama

Blurry photo of Andrew at El Barrio in Birmingham, Alabama

My dad’s flight went out Saturday morning, and Andrew and I headed for Nashville a couple hours after. Because of traffic, our 4-hour drive turned into an 8-hour drive (somehow there were 4 accidents on the one highway we were taking). We managed a pit-stop in Birmingham, Alabama, and to the suggestion of my Alabammer flight mate, we went to El Barrio, a fantastic Mexican food place in the downtown area that had A+ breakfast burritos. Very cool ambiance. Several hours later, we made it to Nashville! Andrew treated me to the Marriott with a view of Vanderbilt Stadium. 

View from our hotel room

View from our hotel room

Soon after, Ben – a William and Mary friend who I knew through Project Phoenix (a tutoring/mentoring organization), APO (a community service organization), and math/science classes, currently getting his education degree at Vanderbilt – picked us up for a driving tour of Nashville and dinner at Five Points Pizza. If I was a Yelper, I would have given fabulous ratings. I never realized what a small city Nashville was, and it has so much Southern character. After dinner, the three of us went to Andrew’s friend’s place. His friend is managing a band in Nashville, a great city to kick start a music career. His friend, also named Andrew, took us bar hopping and gave us a variety of scenes – from underground bars to Broadway street. Music was everywhere. The streets were absolutely packed. I have never seen so many bachelorette parties in one location! 

Broadway Street in Nashville, Tennessee

Broadway Street in Nashville, Tennessee

After our half-day in Nashville, Andrew and I had to make the drive back home Sunday morning, which was really painful due to traffic and poor pit-stop experiences, including a gas pump in Knoxville that kept going after my tank was full, resulting in gas spilling over onto my feet. Eating at Cracker Barrel eased our hanger – don’t judge, I’m a huge Cracker Barrel fan.

Once we made it back to Northern Virginia, I had this brief existential moment when I realized I had changed. COT definitely had a greater impact on me than I expected. I have this huge appreciation for being home as well as being with the individuals I care about. I also appreciate time to sleep (which I should hold dear to my heart before medical school really picks up). It’s time to prioritize what I value most in life. Spend less time on the things that don’t matter and more time on the things that do. I’ll try to maintain the school-life balance to the best of my ability, but I want to be a qualified physician and will do what it takes to get there. Wish me luck 🙂

I have been attending USU orientation for the past three weeks, the first two designated for Military/Brigade Orientation and the latter week for Academic Orientation. Military Orientation was a little like COT 2.0 with more direction and without the screaming. We had some lectures relevant to the military and mostly filled out paperwork and completed online training programs. Orientation provided ample free time to get life in order. It was a fabulous time to catch up on my social quota with friends and family in the area and to catch up on much-needed sleep. Academic Orientation this past week introduced us to the USUHS curriculum, mostly focusing on the pre-clerkship period in the next year and a half. We had a lecture for our first module, Fundamentals, which basically provides a foundation for the rest of the modules and is Pass/Fail (no honors, unlike the other modules).

I’ve been spending lots of time with my fellow USUHS Bravos and the one amazing USUHS Alpha (I’m clearly still in COT-speak. We have been staying in touch with our fellow Bravos – a few of us went out to U Street when a Bravo from Philly visited last weekend. And our flight commander sent us a final Bravo Bombers morale memo to motivate us for the next stage of our careers). All in all, my classmates seem awesome. Everybody is friendly and always willing to help each other out. Faculty members thus far seem fabulous, both engaging and caring for their students. I am a balance between excited and terrified to embark on the next stage of the journey. Somehow I am already swamped with readings, an essay, online quizzes, and a massive to-do list. First day of medical school is tomorrow! Although I feel quite unqualified, I see my first patient this week and am doing a home visit with a classmate on Wednesday. And so it begins. Ready, set, gooooo!

The COT Finale: Weeks 4-5

It’s been three weeks since my last post, and oh my, a lot has certainly happened. I had been so chronically sleep deprived that I never managed to set enough time aside to write a coherent post of what had been going on. So let’s give this a try.

The fourth week of COT was a jumble of events and emotions. We all anxiously awaited graduation, which was the Friday of Week 5. I have no idea how the BOT, ROTC, or BMT trainees do it because 5 weeks for COT already felt like eternity. I have the utmost respect for everybody who successfully completes these intense training programs.

WEEK FOUR
Monday
The day was quite busy, beginning with our final PT exam and the CWT #2, followed by lectures galore (not gonna lie, it was the first time I straight up passed out in the big red pillows. I am quite grateful I was sly and not caught by any instructors. You’re supposed to stand up in the back of the room if you’re falling asleep.) In other news, I finally got my ranks sewn onto my uniform and it feels GOOD. Now I see what OTS staff members mean by having pride in your uniform. My name and rank are looking pretty beautiful.

Some happy times in Boyd Auditorium

Some happy times in Boyd Auditorium

PT test: earned a 98.4 of 100 on the test. I have never run so quickly, smashed so many push-ups, or whipped out that many sit-ups. For the first mile of my 1.5mi, I ran a 7:28 (if you know me, this is a miracle). Ran the full deal in 11:34. Did 43 push-ups in a minute and 57 sit-ups in a minute. KILLING IT. Did not think it was possible to improve on my original score, but I did. Everybody in my flight improved across the board for all three elements of the PT exam. In retrospect, it’s funny that I stressed so much about PT before COT when it turned out to be my strongest aspect.

CWT #2 (our final academic test): solid score, felt good to be done with the academic portion of COT. Done done done done done and time to celebrate!

Tuesday-Wednesday
LRC: Leadership Reaction Course (not to be confused with the Learning Resource Center at USU)

The LRC was a continuation of Project X from the previous week where staff members graded us on leadership skills in a series of (mildly dangerous) obstacles. Playing out Navy Seal-type missions with zero prior outdoor leadership experience, we dealt with heights, climbing walls, building tripods (oh hey, that’s my claim to fame), maneuvering in water, utilizing given resources, relying on the leader, planning the mission before execution, etc. LRC was a great learning experience because it was one of the first opportunities everybody could get leadership training. I might have preferred a crash course beforehand in field activities and outdoor safety though (I was never a girl scout and have never been privy to climbing things). Bravo Bombers beat the record for one of the obstacles when we happened to have only athletic guys grouped for one of the teams.

After the LRC events, we were phased up! Ironic timing too because we were granted phase 3 privileges before our mock deployment began (called Blue Thunder), meaning we could only truly exercise phase 3 status over the weekend. It was nice in theory, but man you have no idea what it meant to be given phase 3 privileges. No more tight meals and we could leave the base outside of duty hours. Sweet sweet freedom was in grasp. Freedom tastes so good.

Anyway, we were phased up before heading to our overnight mock deployment. The tents were air conditioned even though the bunks hurt my back. Awesome Air Force planes were taking off like they were right in front of us (same with on OTS campus but the view was much better here). Luckily we were so ravenous during the events that eating MREs weren’t so bad. [[In case I didn’t mention it before, MREs are almost space-type meals with way too much sodium and interesting methods of chemistry to heat food. I am bringing a few of these meals home that I didn’t finish so Andrew can have an MRE-picnic with me.]]

Our mock deployment base

Our mock deployment base

Inside the girls' tent for Alpha and Bravo

Inside the girls’ tent for Alpha and Bravo

Thursday
Beware of the trains that you hear passing in the middle of the night and the 4:30am wake-up call to rock music. Didn’t get too much sleep at Blue Thunder before beginning our long day of the Ropes Course and Litter Carry during Black Flag weather.

Ready to embark on the day

Ready to embark on the day

The ropes course consisted of a 40 ft rock wall, the tooth pick (the second worst), a repel wall, and an actual ropes course (which was the worst). I have this massive fear of heights; despite lots of crying, I got through it. I received endless support from my Bravos and the Alphas who came after us as well as OTS staff (the OTS staff members helping on the ropes course were fantastic). I was grateful to have the most adventurous Bravo female in our group come behind me to help out emotionally along the way. Completing the ropes course events in its entirety was a big accomplishment for me but I cannot say I will ever do it again voluntarily. It was pure torture. Good to know I can accept a challenge and see it through.

Featuring the wall and the toothpick

Featuring the wall and the toothpick

I assure you, that was not a real smile

I assure you, that was not a real smile. Also, the picture is misleading; I am not walking on ground.

Who knew there were so many things involved in carrying stretchers (ie litters) in the military? So many commands. I was pretty unhappy to discover that carrying a 113 lb flight mate on the litter was painful although most of the guys didn’t have a problem. Here I thought I was a strong, capable woman, but I guess I should hit the gym some more. Luckily, black flag conditions meant we didn’t have to do the litter carry course with an actual person on the litter. A highlight of the course was when OTS staff threw sand on us (“blood and guts”) as we crawled underneath wire that got progressively narrow as we proceeded. Fun times at COT.

Sleepy during litter carry break

Sleepy during litter carry break

Friday
As part of the Blue Thunder mock deployment experience, MRIC (Medical Readiness Indoctrination Course) consisted of two portions with a massive tent set up as a combat field hospital, the first part testing response to patients with minor injuries and the second part testing response to a mass casualty event due to a bombing. Trainees had a variety of positions, including hospital administration, security, manpower, ICU, OR, patients, moulage, etc.

The Bravo moulage crew

The Bravo moulage crew

I signed up for mental health originally, but only 1-2 individuals got the slot. I was assigned the role of a patient, which ended up being ridiculously fun. First scenario, I was a marine who got hit by an IED while chasing car bomb suspects. Despite my minor injury (which was never treated), I was sedated for being so belligerent (I was trying to stick with my devil dog, aka my chaplain roommate, who was severely burned. Also security took my rifle away. You don’t take a marine’s rifle away.) I was almost sent to the morgue due to confusion about my sedation records. That was exciting. Second scenario, I had shell shock, and the team had a much more appropriate response to my clinical condition than the first round. Very interesting experience from a learning standpoint of what should be done in a mass casualty scenario.

Coming back from MRIC, we had our usual Hall Call to end the week, which is basically one big pep rally. Bravos won flight of the week within our squadron and our overall class. Within Bravo, I won the award for flight member of the week, which was exciting recognition for building flight morale and challenging myself during all the field events. In other news, my Falcon squadron rocked the drill competition (with Bravos leading the way as element leaders, guidon bearer, and flight leader for the superflight and made it #1). As per usual, Bravos REPRESENT.
FORWARD HARCH.

Getting our flight of the week award

Getting our flight of the week award

OUR GUIDON

OUR GUIDON

Falcon Superflight

Falcon Superflight

Saturday
The morning was short but eventful. We wore dress blues for the commandant inspection, consisting of open ranks (basically a fancy drill/uniform/military inspection) and room inspection. Only thing the Bravos needed to learn was folding hospital corners in our beds, which was something we had not been taught before so we were pretty proud of ourselves.

As for the rest of the day, we got to feel like normal people again, wear civvies, watch a movie (got a military discount for the first time!), eat out, and go shopping. I was a little bit of a chauffeur but I missed my Charlie baby so that was alright. One day to almost feel like a real person, despite our imposed squadron curfew at 2230 (aka 10:30pm).

Sunday
A little back to the COT world – errands galore for dining centerpieces, plus a summer camp feel when we were doing art for it, plus the ultimate Frisbee tournament. One of our Bravo’s dorm rooms had electrical issues that caused a fire alarm to go off, which added extra spice to our weekend because we weren’t allowed to go to Morehouse dorms for a solid chunk of Sunday.

WEEK FIVE
Monday
Our day mostly consisted of random lectures galore. They were actually pretty useful topics for the future. However, I had still been struggling with sleep debt and thus paying full attention was not the easiest. We spent the evening at Mellow Mushroom (deliciousness) for our flight commander dinner, where we invited Capt Warren, his wife, niece, and seven children out for a meal. They were such a lovely, happy family. His wife and kids decorated rollos to look like dynamites in honor of the Bravo “Bombers”. Adorbs.

Dinner crew at Mellow Mushroom

Dinner crew at Mellow Mushroom

Tuesday
The highlight of Tuesday was the Dining In, which was a formal event (despite wearing our ABUs, not blues) at the Officer’s Club. The military traditions were a-plenty and oh so odd. If you broke any rules, you could be sent to the grog, which was a hodgepodge of mixed drinks that apparently tasted really good (with both alcoholic and nonalcoholic options). There was a certain way of doing everything. So many rules to remember, which they cover pretty extensively and include in the red packet they leave on your table. So many little quirks about the meal; for example, instead of clapping, you tap the table with the round part of your spoon. The best part was the comedy skit coordinated by our class – absolutely hilarious and pointed out all the silly idiosyncrasies of COT. The night ended with a DJ event in the basement bar area of the Officer’s Club.

At the Officer's Club

At the Officer’s Club

The beautiful centerpieces!

The beautiful centerpieces!

Wednesday
We did our last PT with a fun run around campus, learning about the history of Maxwell AFB. At the conclusion, we got our wings! It was quite ceremonial.

Family started pouring in (so we were phased up to phase 4 privileges) and made me wish I could fast forward to Friday when my dad and Andrew were coming into town. We had the USAA dinner that evening, which included a delicious buffet. It turned out to be a huge advertisement event with bankers and USAA insurance agents at the ready while speakers were giving out random prizes and presenting certain aspects of financial opportunities with USAA. Congrats to me: USAA approved me for a career starter loan (at 2.99% interest!) so I can pay off my credit cards and my higher interest student loans. Afterwards, some of us hit the town near the Riverwalk area in the Alley (basically the only place to go out in Montgomery, Alabama).

Thursday
The last full day of COT. Falcons won Honor Squadron at the awards ceremony, and unfortunately, Bravo came in 2nd place for Honor Flight (we lost by 0.2%). In my heart, Bravo will always be #1. Even though my car battery died and needed replacing, I absolutely enjoyed my last day and night with these fabulous officers.

Friday
Thanks to an active duty meeting first thing in the morning, a few of us were late to our graduation ceremony – whoops – in the COT conference room (it was actually supposed to be in our flight room but we had too many guests to fit). When I walked in, the very first faces I saw were my dad’s and Andrew’s. So much happiness in the world when your home comes to you! Our flight commander shared funny tales about each of us while giving out certificates and coins. Great success! As per usual, we rushed to get to the graduation parade after. Because my dad was one of the few distinguished visitors (as an SES in the Army), I knew exactly where he and Andrew would be sitting and watched them with my peripheral vision during the entire parade – you’d be surprised how much you can see using peripheral vision by the end of COT. After graduation was over, I exchanged hugs and photos with my Bravos as we said our goodbyes.

Graduation

As a conclusion to this post, I have to put the cherry on top of my Bravo-loving. We’re a bunch of goofballs. I wish I could list all the things I love about each and every individual in my flight if I had the time and could dish out details of their private lives. I am grateful that I contributed to this group, with zero drama and 100% support. I am grateful we didn’t crack the whip on each other and could courteously make corrections when necessary. I am grateful we kept up good spirits while getting through such a challenging training experience together. Finally, I am grateful to have 3 Bravos in USUHS with me, 1 Alpha, and a Bravo dentist close by at Andrews AFB. I love being surrounded by good people, and COT encouraged me that we are recruiting some amazing people as officers of the U.S. Air Force.

As always,
Peace, Love, and Bravo