The MSI Finale, Summer, and Beginning MSII

I have been living with a new motto recently: learn to enjoy the moment. That being said, I will blame said motto for the extended hiatus between blog posts. This past year has flown by, and I cannot believe I am already in the second year of medical school. It’s been an amazing journey, and I am truly grateful!

GI Module
Neuroscience module came at a great time after spring break and was extremely well-organized, fun, informative, and the easiest module for me. Granted, I was a neuroscience major at William and Mary, so it came in handy. GI module (let me clarify: Gastrointestinal Tract, Hepatobiliary System, Hematology, Oncology, Metabolism and Nutrition Module) was pretty horribly timed. As the last module of first year with no more than Saturday/Sunday to de-stress after our last final, I was burnt out and didn’t even realize it. The first couple weeks of school were killed in terms of productivity because the lottery to determine third year rotations took place throughout the school day and really distracted from learning – especially for the few lecture-goers like myself who found ourselves checking our lottery statuses instead of paying attention and taking notes.

Because the first two weeks of GI module were lottery weeks and the next weekend after that was Memorial Day weekend spent catching up with family/friends, including a lazy tubing adventure in West Virginia, I focused all of my energy studying like mad for the next couple of weeks before midterms. I thought I had appropriate catch-up time studying and actually felt prepared for my midterm exams. At this point, I have learned that feeling prepared for an exam is a major red flag. When I feel prepared – as I was for both MSK and GI midterms – I do far worse than when I have a mini-freak-out the night before an exam. Anywho, my midterm scores motivated me to kick it into high gear, so finals were fantastic. They were redemption for my bruised academic ego. I think I might be more interested in Heme/Onc/Nutrition, so that likely played a part as well. For current USUHS classmates, beware that the GI midterms were a dud across the board for our class and the class before, but I hear that the module directors are working on improvements to see how to fix that trend from the past couple years. Ultimately, it was my worst module academically, but I still passed and feel confident about the information we learned!

The Lottery: Third-Year Rotations
The lottery is quite the system. In the end, it all works out. Basically everyone was happy in the end, and we are getting a great experience at all of the locations. We started out with 100 points, and at least 1 point had to be used for each of the 9 rotations. You can prioritize based on the order you want to do your rotations or the places you want to go. I knew I wanted to get the surgical rotations over with, and being local to northern Virginia, I wanted to stay in the area as much as possible. My order of rotations was definitely not how I originally planned, and I am not going to Hawaii at all despite putting it #1 almost every time. However, I feel particularly lucky and am ecstatic at how my rotations came out.

We had two options: go homestead or go singles. Homesteads group three rotations together in one location. It’s a pretty great deal. It’s less stressful in terms of moving between rotations and less stressful in terms of time towards the lottery during GI module. I am doing my first set of three rotations in San Diego and my last set of three rotations at Walter Reed.

Local locations became vastly more popular this year than previous years because the system for housing at rotation locations changed. Now, we have housing provided for us at rotation locations rather than having an allowance for housing. I myself prefer this, but it was not a pleasant surprise for the folks with families who planned on bringing their kids to different locations. We were told that our lodging is comfortable for a spouse or significant other to stay, so I am excited for Andrew to visit while I am in San Diego!

Stay tuned in 2016 for rotation updates. My schedule is as follows:
– San Diego for Ob/Gyn, Surgical Subspecialties, and General Surgery, January – April [where my mom lives]
– Walter Reed in Bethesda for Pediatrics, May – June
– Offut Air Force Base in Omaha, Nebraska for Family Medicine, June – July [believe it or not, I’m actually excited for this one too]
– Fort Belvoir, VA for Psychiatry: Addiction, July – August [my selective rotation]
– Walter Reed for Internal Medicine (Outpatient and Inpatient) and my favorite for last, Psychiatry, August – December

AMP101
I had four days off after the end of the school year to run errands galore before leaving for my summer operational experience. All Air Force students go to the Aerospace Medicine Primary 101 (AMP101) course, the first of three required courses to become a flight surgeon/medicine doctor. I road tripped up to Wright-Patterson AFB in Dayton, OH with a few other USU students and was happy to see my fellow classmates as well as familiar HPSP students’ faces. Of the 70 attendees at our July 6-17 AMP session, the majority were USUHS kids, about 20 were HPSP, and four non-2nd-lieutenants were doctors and reservists who were given the responsibility for accountability. Our AMP session was booked to max capacity. The two June sessions were majority HPSP students and the July session after ours was reserved for mostly physicians rather than students.

First week at AMP101 was death by powerpoint, but I enjoyed the presentations in the sense that I have a much better idea of real life operational Air Force now. The weekend of AMP I attended my first friend wedding at the Alumni House in Williamsburg, VA. It was a blast to my college past, and I was glad to have Andrew meet the fabulous bride and groom – two of my friends from William and Mary. It was a mess of stress to coordinate this. I had been emailing the AMP higher-ups as well as up my own chain of command for a few months to get permission because I needed to take leave and plan my flight back to Virginia – – note that on the Thursday afternoon of the first week, students had the opportunity to switch schedules around with other students to allow for personal trips. We were given three days off that were different based on your group, and I am happy I did all the work and coordination in advance because I would have originally been scheduled for a fly day on the same day as the wedding and would not have wanted to wait until last minute for scheduling.

Reunion of friends at William and Mary for the #LizGoesPro wedding

Reunion of friends at William and Mary for the #LizGoesPro wedding

That being said, I also was at the mercy of weather. For such a large AMP session, we had three groups scheduled to fly on Saturday, Sunday, and Monday. Unfortunately, Saturday had the best weather and not enough pilots scheduled, so a few students were pushed to Monday fly day when it rained in the afternoon. I was among 8 students who had to go in for a chunk of our Wednesday off to fly. If I had lounged around Ohio all weekend like most folks did, I wouldn’t have minded. However, I was beyond exhausted and sleep deprived. I do not regret going to the wedding, but it most definitely put a damper on some fun activities during the second week of AMP festivities, the highlights for me including the tour of the Air Force museum, flight simulators, and flying the SR-22 Cirrus with a pilot. We had to present a safety brief and study for the final exam, both of which were not difficult at all but involved time and energy I was horribly lacking.

Heads up for those afraid of heights, flying is an incredible experience and not-at-all scary because of how exhilarating it is. It helps that there was a seasoned pilot manning the controls in the passenger seat like driver’s ed.

About to fly the Cirrus SR-22

About to fly the Cirrus SR-22

Summertime Off
After coming back from AMP, I finally had time to catch up with friends and family in the area. It was so very necessary to see the important people in my life that I had trouble keeping in touch with over the past year. As an INFJ often mistaken for an ENFJ, I recuperate by becoming a bit of a hermit and organizing my life. I had to balance my excessive social life with scrubbing the bathroom and trashing random items I hoarded as mementos for my past or references for the future. And of course, there was lots of HGTV/Netflix.

Andrew and I attended a wedding in Long Island that should have been on MTV (it reminded me of those crazy impressive super sweet 16 parties). We also spent several days at Sebago Lake in Maine. I spent the first rainy day reading Go, Set a Watchman. The rest of the days were gorgeous and sunny, so they were filled with paddle boarding, paddle boating, canoeing, swimming, speed boating, and being lazy. It was lovely. We went to Portland for our last full day to shop, eat, and be merry. Lobsters all day, every day.

ACME: TCCC, BLS, ACLS, Antietam March
All the acronyms.
ACME – Advanced Combat Medical Experience, part of MFP 102 (Military Field Practicum)
TCCC – Tactical Combat Casualty Care
BLS – Basic Life Support
ACLS – Advanced Cardiovascular Life Support

We were split into two groups. One group started with TCCC (i.e. “TC3” or “T triple C”) and the other started with BLS/ACLS. I was happy to start with TCCC – we had longer days, but they included fun activities and were reflective of our combat medicine classes during first-year medical school. All we had to do to pass was to study TC3 guidelines and learn the primary/secondary assessment sequences for patient encounters. TC3 was especially fun because we had paintball guns, ran into the forest to save patients, and got to see ourselves on camera to realize we weren’t as much as a mess as we felt during the experience. We also learned medical skills like cricothyroidotomies and chest tubes.

Ready to save some lives!

Ready to save some lives!

In the weekend of ACME, Andrew and I attended our third wedding of the summer and saw two of our friends get married!

In the weekend of ACME, Andrew and I attended our third wedding of the summer and saw two of our friends get married!

BLS and ACLS were more fun for the emergency medicine/ICU personality types. It involved a lot more studying for folks like myself who did not have the background for it, but it was a worthwhile experience. BLS was the simple CPR and defibrillation sequences. ACLS involved leading a megacode team (and being part of a megacode team). It involved a team leader, time keeper, CPR, maintaining the airway, defibrillation, and medications. There was a practical where we could use the all-mighty ACLS card and a written exam based on classroom material (it helps to do the practice questions we were given as well as reading the book/supplementary packet).

I had been looking forward to the Antietam March. It was a 6.5 mile walk/trail/hike that is easy when you aren’t falling behind schedule and basically jogging it with all your gear on. Also, I didn’t mind the rain much because it cooled us down, but rain + jogging = blisters (and here I thought my boots were the most comfortable shoes I owned!). It was a fun way to end ACME and to allow us to compare military medicine from the days of the bloodiest battle of the Civil War to today.

The Official End of Summer
This past weekend consisted of a fun MSI/MSII mixer and an impromptu beach trip to Dewey Beach (the waves were so aggressive!), so I have definitely had some laughter and sun before hitting the books hard again. Cheers to this past year and making it to Reproduction and Endocrinology Module!

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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/

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.

Personal Statement Throwback

I’ve been reading through personal statements for friends applying in the upcoming medical school cycle and decided to look back on my own. Best of luck to current applicants, and congratulations to matriculants! …

I grew up in a family of philosophers and poets, free-thinkers and political activists, intellectuals and athletes. My upbringing framed limitless goals for the future, which were as expansive as my interests. I wish I could say that my love for science and the desire to be a physician run deep in my blood, but my relationship with medicine began in college. In high school I had said, “I can see myself as anything but a doctor.” The universe only heard ‘doctor’, and my goals for the future shifted dramatically.

My first semester freshman year, I completed the physical science requirement with General Chemistry 103, thereby eliminating any future obligations to science. My chemistry professor shared his philosophies of life to the 100-person audience consisting of mostly pre-medical students. Occasionally, he paused from writing on the blackboard, turned to the large lecture hall, and broke into poetry. Reciting memorized works or thoughts of his own, he often began with, “Science is beauty, and there is beauty in science.” My introductory chemistry course taught me more than the art of balancing reduction-oxidation equations; I learned how to approach the unfamiliar world of science with my background in humanities. Medicine became a marriage between the disciplines of science and humanities, and I see now why my professor found it so beautiful.

Benefiting from an undergraduate liberal arts education, my interests adapted from humanities to the sciences. By the semester of Spring 2010, I declared my major in neuroscience for an interdisciplinary exposure to science and declared a minor in mathematics with a focus on mathematical modeling of biological phenomena. I appreciated the complexities of brain activity determining how we sense, perceive, behave, and function; thus my fascination with molecular networking in the human body began.

The transition into science felt surprisingly natural. My parents and non-nuclear family fostered an environment of self-reflection and independence, giving me the opportunity to grow in any field of my choosing. As my pursuit for a pre-medical education continued, my mother, already diagnosed with bipolar disorder, began to decompensate in mental and cognitive function. The impact of disease goes beyond the biology of the affected person and alters one’s abilities, lifestyle, and relationships. Her battle with mental illness reaffirmed my desire to become a clinician and inspired me to combine compassion, intellect, and curiosity into a career.

My proclivity towards psychiatry brought me to the Child Psychiatry Branch at the National Institute of Mental Health (NIMH) in July 2012. After settling into my research position, I remember meeting an 11-year-old patient in a wheelchair admitted for our childhood-onset schizophrenia study. Dark circles under her eyes, thin, and clearly agitated, this little girl was lost in her own world and could not register my “hello”. About three months later, when I walked into the unit, she jumped into my arms for a hug. Hand in hand, we paced down the hallway to calm her and to talk about the day. At rounds before the girl’s discharge, our team members reflected on her hospital stay. Her father smiled with tears in his eyes as he thanked us for bringing his daughter to life. With careful observation, diagnosis, and treatment, the psychiatry team prescribed her the right dose of antipsychotics that improved her functioning, and to some degree, saved her life.

The girl reminded me that although the human body functions remarkably, we are naturally flawed in biology. Perfect health is nonexistent, and physicians play an integral role in nurturing well-being. The responsibility of physicians goes beyond addressing immediate clinical presentation; they also provide hope for patients to think beyond their conditions and enjoy a better quality of life. I embrace the challenge of a clinician to address patient health within my community, no matter what specialty I ultimately practice.

The distinguishing factors between a good doctor and a great doctor elucidate traits that determine the success of one physician over another. A good doctor is quick-thinking and intelligent. A good doctor is highly organized and dedicated to medicine. A good doctor effectively diagnoses and treats patients. However, a great doctor executes the roles of a good doctor in addition to fostering interpersonal relationships with patients, colleagues, and fellow health professionals. A great doctor builds trust, fundamental for the success of a clinician. Beyond the academic traits necessary to be a good doctor, I believe I have the personal characteristics from my experiences to become a great doctor. In the pathway to becoming a qualified physician, medical school provides the necessary skill sets through relevant coursework, exposure to specialties, and actual clinical practice.

I aspire for a career in medicine, an ambition that feels true to my character. My foundation as a pre-medical student is strong, and I would appreciate consideration to attend your institution. I guarantee that I will be a valuable asset to the medical community, and medical school is the next step of my journey to becoming a qualified physician.