Hiatus: depression

I am taking a short hiatus from this blog, due to trying to get my depression under control.

I am still in medical school, and doing well there overall, but the past month has really taken a toll on me, and while I will blog about this experience later on, I can only juggle so many things at once.

See you on the flip side.

Willed Body Memorial Speech

Medicine is full of sacrifices. Physicians and nurses give up time with their families to help a last minute patient. Medical students give up a good portion of time, money and youth to study. We have blood donations and bone marrow donations and even full organ donations. However, donating your body to the Willed Body Memorial program requires a special kind of trust and sacrifice because the benefits aren’t as tangible. If someone decides to donate a kidney, there’s an immediate payoff – you know right away that you helped to save someone’s life. Donating your body, and conversely, honoring a loved one’s wish to donate their body, to a medical school program requires patience and understanding and trust, and most importantly, the ability to see the big picture. It’s a sacrifice bigger than most people are willing to make, so thank you.

I thank you and your loved ones, our donors, for that patience and trust. I’m thanking you not only because that kind of selflessness is imperative to my education as a doctor, but because 25 years ago, my family was in the exact same place.

25 years ago, my great grandmother donated her body to the University of Michigan Anatomical Donations Program.

My great-grandmother, Anna Cora Tretchler Babcock, was first and foremost a teacher. She started teaching when she was 18, at a one room school house. She taught until she got married and was forced to give up her job – at that time, married women weren’t permitted to work. Despite not being able to teach in a classroom setting, she was still a teacher at heart. She raised 7 children and taught them how to read and sew and cook and run a farm. When my great-grandfather, Gordon Babcock, died of Mustard Gas Poisoning from WWI, she allowed a full autopsy to be performed because she hoped that the doctors would be able to learn something from his case, and be able to help other young veterans in the future. She imparted on my grandfather a healthy curiosity for medicine and science, which he passed down to my mother and me, and is probably the main reason I decided to become a doctor. She had so much respect for the medical community that she made the decision to donate her own body – if death was inevitable, as she well knew it was, she wanted to make sure somebody could learn something from it.

I never got to meet my great-grandmother…she died a few years before I was born. But I am living proof of her legacy – I have her love of sewing, and I know the secret ingredient in her blueberry dessert. I have her independence and her love of medicine, so much that I am the first person in my family to go to medical school. But more importantly, she left a legacy to about a hundred other students. There are doctors, practicing medicine as we speak, that are able to do what they do because my great-grandmother wanted to give one final lesson.

This is the same legacy that your loved ones have passed on to this generation of future doctors.

We have learned so much from your loved ones – and yet we know so little about them. It’s a caveat of medical school that the more you know, the more you realize you don’t know, and that can be a little scary at times.

I can tell you the size and shape of someone’s heart – but I can’t tell you what made it stir. I can describe the path of a nerve as it exits the spinal cord and weaves its way done to the fingertips – but I don’t know the last thing they touched. I can name every single part of their brain, but I can’t tell you what made them laugh or smile or what their favorite TV show was. I know so little about these people, these people who donated their bodies so that I could learn to become a physician, and yet….

I know they were brave. I know they were brave because death can be scary. We don’t like talking about it, even us in the medical profession who deal with it every day. But these brave people not only accepted that they were going to die someday, but they chose to make a plan.

I know they were selfless. I know they were selfless because it requires a selfless act to donate to a cause that they will never reap any direct benefits from.

I know they had faith. I know they had faith, because they entrusted a generation of medical students that they had never met. They trusted us that we would not only respect their bodies and take care of them, but that we would learn from them.

And that’s the greatest and most terrifying demonstration of trust I’ve ever known. There’s been a lot of negative press for my generation – we’re self absorbed, we spend too much time on the internet, we don’t know how to communicate, the list goes on and on. So the fact that these wonderful people trusted us enough with their body, with their last legacy – it gives me hope, and it makes me shoulder my responsibilities a little more carefully.

It’s a wonderful burden to live with every day, because the donors are really our first patients. We may not be able to heal them, but we are still entrusted with their care. It’s a reminder of all the patients I have yet to meet, who will also be placing their trust in me. And it’s inspiring: if these unknown donors can have such blind faith in me, then maybe I can have a little more faith in others too. 

So once again, thank you. Thank you for trusting us with your loved ones. Thank you for your patience. Thank you for understanding that we literally could not become the doctors we are hoping to be without these donors. From the time my great-grandmother decided to donate her body to today, life has a funny way of coming full circle, and I am so honored to be a part of that legacy.

Thank you.  

So far, so good....

Well, I have my first (and almost second) round of exams done, and the results are in: so far, I'm rocking this semester.

(I mean, I SHOULD be - I really only have a few classes, so I better be acing them.)

Biochemistry I'm the most proud of. After suffering through it last year, it's finally making sense this year. Granted, I think this year's exam was written MUCH more fairly (big idea issues instead of nitty-gritty detail hidden within the coursepack), but I got a 97% on the first exam, and have been doing pretty well on the quizzes as well. The 2nd exam is coming up in a week - the topics for this section are the ones that gave me the most trouble last year, so we'll see what happens, but at the very least I have a nice little grade buffer in case things don't go as well as I want.

However, since I'm sticking to my main goal of "sticking to the man", I foresee the exam going well :)

Ethics and Physiology are going well too. Physiology I'm not really attending classes; just reorganizing my notes in prep for the exams, but I'm remember things more and some of the more complex ideas are easier to understand the second time around. I got a 94% on the first exam, and am waiting on the results of the 2nd exam from today, but I felt pretty good about it.

I really enjoy my ethics group. Our preceptor is a geneticist and very laid back, so she just lets us TALK, instead of leading us down one path or another. I subbed in on another group last week, and their group was not nearly as good as mine.

Which brings me to the other cool thing I did last week: I got to speak at the Willed Body Memorial for MSU. See, my great-grandmother donated her body to a similar program, so I was able to talk about her love of teaching and why donating her body to a medical school was so important to her. I got a lot of compliments on my speech, and - small world- got to speak to the Zussmans afterward. J's brother in law donated his body and was honored that year, so it was just  another funny way of things coming full circle.

I also (in news of my own health) have started running again and am signed up for the Ugly Sweater Run on December 1st. That seems like a long ways away, but since I can barely run more than 6 minutes without having to stop for a walk, I think it will give me JUST enough time to be able to run the full distance.

Wish me luck!

Death

An older brother of a high school friend was tragically killed this last week, and it's left me with some psychological grumblings. I hadn't actually talked to this friend in quite a while - we went to the same university after high school, but ended up on very different tracks and had just naturally grown apart. We kept in contact on facebook, but that was about it.

I think the reason his brother's death is hitting me so hard (besides my own issues with death) is that I had been sort of gossiping about him just a few days before his brother died. I was out drinking with another high school friend, and we were talking about everyone who had gotten married, who had kids, who had kids and didn't get married, who was already divorced - the usual small town gossip. The aforementioned friend had just had a kid, and we were commenting on how....(not unlikely....surprising?) that was.

And then his brother died.

Can you imagine how awful that must be, to be celebrating the birth of your child one day, and mourning the loss of your sibling the next?

I sent a short message to my friend, and am planning on going to the funeral, but the whole thing is leaving me feeling just a little bit guilty. And of course, my own issues are resurfacing a bit more.

I'm still dealing with my depression and PTSD regarding Tori's death. Thankfully, the PTSD symptoms have mostly lessened over the past 2 years - the "wake up in the middle of the night screaming because she is drowning and just out of reach" nightmares happen only a few times a year now, and I don't get panic attacks from discussing pediatric death cases. I still have "triggers" of course, but I think they're more related to the general depression.

We talked a lot about death in my ethics class this week - specifically, if patients have the right to refuse treatment and consequently, the right to die. We watched and discussed the infamous Dax case - to be quite frank, it made me ANGRY. For me, death can be awful, but not nearly as awful as some other outcomes. I think there's a very important reason we wish our dead to "rest in peace".

It's also not helping that my grandfather is in the hospital again, and my mother doesn't seem to feel the need to tell me until several days after the fact. This is now the 3rd time he's had to go in for various reasons, and I've asked her to tell me when it happens, and she didn't bother to tell me until 3 days after the fact - and at my brother's football game.

My issues with my family right now are a whole other story, but I'm just at a bit of a loss right now. Thankfully school is going well and I've got some fun projects coming up to keep me distracted. I just really hope death doesn't come in threes this time.

Back to the Grindstone: Year 1.5

Well, I just completed my second "first week" of medical school.

Because I am extended, this semester, and really this year, is a blend of Block I and Block II classes. It's been a little hairy this week, trying to figure out exactly what classes I have to go to and which classes am I auditing and exactly which of these "required" events do I actually have to sign in for. The joys of the real world, I suppose.

My class load for this semester is:

Biochemistry (which I'm going to Master just to spite Mr. A)
SCCD (Basically, ethics)
Epidemiology II
**Auditing Physiology
**Auditing Genetics

I'm also (most likely) presenting a couple of lectures at Teslacon this year on Victorian Medicine and The Science and Sociology of Victorian 'Freak Shows'. I'm pretty excited about it - still waiting to hear back for the official schedule, but it would be a great way for me to legitimize all of this steampunk stuff I've been doing. One of my advisers also wants me to present these at the History of Medicine Interest Group.

I'm also *slowly* working on my paper from my internship this summer. If all goes as planned, I'll have another publication before the school year is out. Oh! I'm also taking a medical business elective, just for kicks and giggles.

It's both good and weird to be back. I really missed my classmates - more than I think I even realized. And now that I live closer to the school, it's easier to get up and walk to class in the morning. But dealing with some of the aforementioned bureaucracy triggered some of my depressions issues, so I almost feel like I've relapsed a bit.

We'll see.

Sexism in the Workplace

This may be the first time I'm writing about this on my medical blog, but I'm sure it won't be the last.

Dr. Orthochick just wrote up an experience with a patient of hers on A Cartoon Guide to Becoming a Doctor. For those that don't want to read it, she has an encounter with a patient who asks her multiple times to have sex. She ignores it, and the patient is discharged. However, when she complains to a male co-worker, his response is "I'm jealous - my patients never want to have sex with me!"

...

Really? One of your coworkers was just sexually harassed by a patient, and instead of sympathizing with with YOUR FELLOW DOCTOR, you validate the sexual harassment?! The privilege and ignorance in that response just confounds me, and I know it happens all the time.

Men Everyone: when your coworker says that s/he was put into an uncomfortable position, your response should always be along the lines of "Wow, what a jerk. Are you okay? Is there anything I can do to help you or the situation?"

This is why I sometimes hate that I want to go into orthopaedics. Medicine in general is becoming more woman-friendly, but there are still some specialties that are stuck in the good ol' boys' club. The worst part of it is that most of the sexism (at least from what I've seen) comes from the medical community itself. You're always going to have to deal with "idiot" patients who don't know any better, but when the sexism and harassment comes from supposedly highly educated compassionate professionals? It stings.

For example...one of the interns this summer was very....patronizing. I kept quiet about it for a while, because I couldn't quite determine if he was only doing it with me (I was the only female medical intern), or if he was doing with everybody. Part of the problem was I started about 3 weeks later than him, so I did have to come to him with a lot of questions about where we were supposed to be and the protocols for each of the different hospitals we scrubbed in at. Some people are just naturally patronizing, so I tried not to overreact.

Unfortunately, it seemed that he was one of the dreaded combinations: a "well-meaning" sexist.

My first week there, I was asking about the wet lab (for cadaver demonstrations). Instead of answering any of the questions I asked, he turned to the other intern and said "Oh, don't tell her about the bodies, we don't want to scare the little woman!"

Dude, I'm in medical school, just like you. I literally JUST told you yesterday how much I loved my anatomy lab.

It wasn't just medically related things either. A few weeks in, I was telling one of the other interns that I went and saw The Conjuring and how much I loved it. He butted in, asking me what movie I had seen.

Me: "The Conjuring."

Him: You mean the Wolverine?

Me: No, I went and saw The Conjuring.

Him: No, you mean the Wolverine.

Me: Uh, no, I mean the Conjuring.

Him: The Wolverine?

Me: No, DUDE, I saw the Conjuring. You know, the scary movie? I'm going to see the Wolverine next week but -

Him: Haha, I know, I just think you should have seen the Wolverine first.


Many of our interactions were like this. Frustrating beyond belief, and what was even more frustrating was that the rest of the office loved him.

"Oh, he's such a sweetheart!"

"Oh he's so nice!"

"Oh, he's just joking around."

The attending physician loved him too. Thankfully there wasn't any blatant favoritism, but you could definitely tell he was the golden child.

Ugh. Thankfully, him starting earlier than me meant he left earlier than me, so the last few weeks without him around have been great.

First Day of my Internship

(taken from my travel blog)

Today was my first day of my orthopaedics internship. Overall it was pretty fun - the main doctor is on vacation this week, so no shadowing and I'm not getting assigned my "big" project yet, but I am currently working on two "in progress" articles that need to be cleaned up, re-researched, and rewritten.

I've done a lot of this type of research work before (aka, grunt work), but it's much more fun when I actually know more of what I'm reading/doing. Once again, I'm surprised at how much I actually did learn in medical school this past year.

I'm working with two other interns: another 2nd year medical student, and a pre-medical student, both from the area.

It's been a little weird - I'm the only one not from the area, and everyone knows that I'm staying at Mr. K's house. Like, "This is B. She's the medical student that Mr. K recruited from Michigan - she's staying at his house." Like I'm some big deal. And maybe I am? But it is a bit weird.

Other than work, it was a pretty quiet day. I got lunch in Cos Cob at this cute little deli. The clinic is right near the marina, so I chatted with some fishermen. I took a new way home and saw a statue of Jackie Robinson.

Anyway, off to bed so I can be extra prepared for tomorrow! I'm trying to cut out caffeine (read: soda), so we'll see how it goes.

Semester Wrap Up

FINALLY.

FINALLY had my *last* exam this morning. What was supposed to be a two week break turned into about a half week because of this stupid neurology exam.

Long story short, I missed the real final, my makeup got delayed for a full week, I had a sort of panic attack the night before and walked into the exam in a sort of calm-deluded-denial state and consequently mixed up some very, very basic things on the exam and failed. This led to the remediation exam this morning, which I think (and I pray) I did well on, so I am FINALLY on break.

I am tired. This semester was a drain on me in more than a few ways. The good news is, summer is looking great, and I'm in the process of finding a new, closer therapist so I can take care of some lingering PTSD and depression issues.

CHM is big on mental health and mental wellbeing, but it's one thing to say you're going to take care of yourself and another thing when you've got 3 exams and you haven't looked at the material in weeks and you didn't do well on the practice exam so instead of seeking out help you lie in a pathetic heap in your unmade bed because you don't even have the motivation to tuck some sheets down in the corners or eat a proper meal besides yogurt and garlic bread and you're grinding your teeth because you can't find your bite splint so you wake up with a headache no matter how much or little you sleep, and the pills only work if you have some caffeine, which keeps you up late and makes your sleep even worse.

"Physician, heal thyself" is not always an easy thing. Luckily, I've got some good friends and coworkers who are (lovingly) on my case about getting what I need, even if what I need is just a simple bonfire and some drinks.

And I am really excited about this summer. Besides going to NYC and (theoretically) having an easier/more interesting class load, I am going to be piloting an Art and the Physician program. Basically, I'll be looking into ways that studying and making art can make someone a better doctor. I have some fun ideas up my sleeve, and I also plan on entering Artprize this year.

BUT, in the meantime, I have a few precious, guilt-free days off, so I planning on visiting some friends up north, drinking some wine, dressing up the Great Gatsby premiere, and catching up on some much needed rest.

New York Bound!!!!!!!!!

Guess who got a freaking amazing orthopedic research internship in NYC this summer!

ME!

Okay, so it's actually in Greenwich, CT, but it's close enough to NYC that I'm just going to keep saying NYC. I'm not a New Yorker, so sue me.

I'm pretty geeked - I will be doing a combination of research (hopefully getting published to boot) and general shadowing/clinical work in orthopedics. I don't know what project in particular I'm working on  yet, but everything the program director told me about sounds really cool.

This foundation has worked with various Olympic sports teams and does FDA trial research, as well as a decent amount of community service (including working with vets), so I'm sure I'll be able to do something really amazing.

There's also the added bonus of living in a billionaire's house this summer. I won't have ANY fun with that...

:)

Clinical Skillz

I am officially done with Clinical Skills II, and am "certified" to do a complete head to toe exam on a patient. Of course, I don't know how to actually interpret anything (except blood pressure), but hey, it's a start, right?

It's kind of a relief. I actually like being able to do a full physical exam, but the exam portion of it was kind of annoying, as we had to articulate everything we were doing to our preceptor.

"I am now inspecting your skin."
"I am now looking in all four quadrants of your eyes."

I now just have neurology, and all the excitement for Med Ball! Just a few more weeks until the semester is over.....crazy!

March Updates

Sorry for the lack of posting...things have been either been super busy with no time to write, or actually very quiet with not much to update on.

I'm officially done with Physiology and Epidemiology (biostats), which means I only have Neurology and Clinical Skills to worry about through the end of the semester. Grade-wise I'm doing much better this semester, mastering nearly all of my classes - not sure if it's the lighter class load, the lack of biochemistry, just getting used to the work load, or some combination thereof. Probably the combination - the lighter class load certainly helps me not feel overwhelmed in general, but I'm finding I'm learning a lot more with the same amount or even less studying.

Spring break was a much needed and very fun break - check out brittneytakesontheworld.blogspot.com for my updates on that. It was my first trip with all just friends, and I had a really good time :)

I found out I didn't get accepted into the Auschwitz fellowship, which is pretty disappointing. I knew it would be a long shot, but I had heard good feedback from Dr. Walker, and I guess I was really hoping for that tangible, "this-is-why-I'm-extended, so I experience this" moment. Getting into that fellowship was going to be the moment I was officially okay with failing biochemistry and having to extend. Now that it's not, I just feel kind of lost.

Other things are going well though. A and I are looking at apartments for next year, and I'm having super fun planning Med Ball and creating follies with everyone. Now I'm just trying to figure out what I'm going to do  this summer - I kind of got the traveling bug from spring break and I'd like to do something out of the country, but I'm not sure if that's going to be best, or if I should save some money, stay at home, and maybe get some more physical experience working at a clinic.

Harrumph.

Suturing!

As part of the Surgery Interest Group e-board, I'm unofficially taking the surgery elective this semester. We've just had two sessions so far: basic knot tying and basic suturing. This is my first real suturing experience. Not too shabby, eh? It's very similar to embroidery, just, you know, with pig skin instead of fabric.

Exciting News!

I just found out my stained glass mosaic "All Heart" is going to be published on the cover of the Medical Student Research Journal!!!!!!

This is one of my unfinished pictures, and of course the published photo will be sans laundry on the floor, but this gives a pretty decent overview of the art.

Basically, this piece represents the heart of the physician: we take all of our experiences, good and bad, and use those to connect to our patients.

Study Buddies

File this under the random fun things at CHM.

Our histology lab is all computer based - rather than staining cells ourselves or looking at tissue samples under a microscope, we have pre-selected images on a computer program that we use to learn the difference between Kupffer cells and Ito cells, for example.

Because the things we are identifying can be quite tiny, and because CHM doesn't want fingerprints all over the computer screen, we use these little pointers.

We also have stuffed turtles, so if anyone has a question, they can simply place the turtle on top of the computer and continue on with the lab, rather than waiting forever with a hand up for a professor to come over and help.

This inevitably leads to my lab partner and I posing the turtles in various positions throughout lab.

January Updates

Wow, it's been a while since my last post. Considering I pretty much hibernated for most of winter break, I guess it's not too surprising, but still.

Some updates:

I am now extended. Biochemistry, once again, was my death knell. I did great in all of my other classes (was JUUUST shy of mastering Genetics and Anatomy), but biochemistry continues to haunt me, and will continue to haunt me for another year. I blame my parents: I have the same initials as the class, BMB. Thanks a bunch, mum and dad! Ah well.

So what does extension mean? It means I will be taking five years to complete my medical degree -spreading classes from the two pre-clinical years into three and then I'm back on track for the rest of my education. It's not all bad. Right now it means I'm not taking three exams a week and generally have more time to do non-medical school things. Except for me that means I'm filling it up with more medical school things, which brings me to my next update....

I just got elected to the Emergency Medicine Interest Group e-board! This means I'm now on three committees...four if you count my unofficial-but-official involvement with Health and Wellness. It's fun though. Rumor has is that EMIG board members get to apply to the ride-along program for Aero Med. Whatever happens, it means I'll get to help set up fun activities like suture clinics, casting clinics, and intubation labs.

I'm also applying to some great summer programs: ethics fellowship at Auschwitz, clinical skills in Turkey, Orthopedic clinics in NY...the possibilities are endless. I'll keep you all posted as I find out!

We've also started "real" clinical skills this semester. Last week I learned how to take a blood pressure and perform a basic eye/ear exam. Right now we're just focusing on how to use the equipment and connect with our patient; we'll learn how to actually utilize the knowledge we gain next year and the years beyond. It was pretty fun. Thankfully my partner is very patient with me, so I was able to get a good look in her eyes, by far the most difficult part of the exam.

We also had a one-day patient education exam, where we were assigned a subject that we had to educate a simulated patient on. I had to teach this adorable older gentleman how to use an epi pen. Mine was relatively straight-forward and allowed me lots of time to just talk with my patient, but a lot of my classmates had more involved subjects (low-sodium diets, TLC diets, etc) that were much more complicated to teach in 15 minutes or less. When we got together as a group to review them, it was interesting to see the different reactions from all the actors. It kind of puts it back in to perspective: we can learn all we want, but if we can't teach it to our patients in a way that they will understand, we can't really help anybody.

Last quick update: I'm the GR committee chair for Med Ball, and we just picked our theme: James Bond! I'm super excited to start planning it :)

Back to the books.....