Match Day!

I am beyond ecstatic!!!!!!

I matched into one of my top programs in Family Medicine, and will be moving to St. Petersburg Florida!!!!

The journey has been crazy, and it's still not over, but I am over the moon with the results. Bayfront had my favorite fellow residents, lots of great community medicine opportunities, an alumni that runs a LGBTQ clinic, and, best of all, the BEACH ;)

The next few months are going to be crazy - I've got a research elective, preparations for graduation, trying to find an apartment, and (gulp) trying to figure out how to move all of my stuff far, far south.

Block III First semester Wrap Up

The road thus far:

Pediatrics:

I LOVED pediatrics. I was actually surprised by how much I loved pediatrics. At least some of it was due to just general excitement about being in the hospital working with REAL patients, but even 4 months out, I still really enjoyed it - to the point where I am seriously considering pediatrics as a career choice. 

Favorite moments: They all revolve around really getting to help a patient. We had a suicidal teenager that I was just really able to connect to, who felt comfortable enough talking to me to reveal the reason she tried to commit suicide. There was another baby with a pretty serious and rare genetic condition whose mom I was able to give a pamphlet explaining the condition (she was VERY young, and no one had really explained the "future" of her child's condition). I was able to bond with a lot of different kids, which was pretty damn amazing, considering I have never really been "into" kids before. 

Things I loved: pediatric ER shifts (I got to do a lot of diagnosing, and got to suture and set broken bones), nursery (seriously, can I just snuggle babies all day???), working in the outpatient clinics, and working with teenagers. I really felt like I was part of a community, and there were some GREAT mentors. 

Things I didn't love:  ICU was kind of hard for me - I learned a lot, and had some great mentors, but I definitely had a personality clash with one of the visiting residents, and didn't feel like I had as much to do there as I did on other services. 

Surgery

Surgery was a bit of a roller coaster for me. While my time at one hospital was very tiring, I learned a lot, and had great relationships with the residents. At the other hospital, I did not have a great experience - mostly related to some serious personality conflicts, and generally just feeling like medical students were unwanted. I enjoyed a lot of the patient care and definitely enjoyed the trauma side of things, but overall, I don't think the surgeon lifestyle is for me. 

Things I liked: getting to suture a lot in the trauma bay (lots of motorcycle accidents = lots of superficial wounds that need stitches), vascular surgery (they let me amputate toes!!!), follow up patient care during my vascular week, and getting to help admit patients from the ED. 

Things I didn't like: having to stand in one place for several hours, and the stereotypical surgeon ego (and the resulting conflicts) - I felt like you were really at the whim of how the head surgeon felt that day. If he was friendly, it was a good day. If he didn't like you or was in a bad mood, NO ONE had a good day. I felt like there really wasn't as much as a team aspect as I would have liked. I also had a patient ask me to "please don't let them kill me" right before going into emergency surgery, which was very tough emotionally. 

Internal Medicine

Overall, this was a great experience. The residents and physicians were AMAZING - great teachers, good team players, and very eager to work with  medical students. I got to see a lot of patients, and I did very well grade-wise in this rotation. However, I enjoyed admitting patients from the ED or seeing them in clinic a lot more than I did rounding - I don't think 10 minutes a patient when you round with the team is enough for what I want to do, at least if I am doing long-term care. 

Things I liked; working in the free clinic, being able to explain a lot of complicated medical jargon in a way that patients understood, getting really good at coming up with plans for patients coming in with chest pain, working with a team. 

Things I didn't like: Rounding. I know, I know....it's good, its a good way to see all the patients and still teach, but I just found it.....too much, and not enough? I liked rounding during peds and surgery, but for some reason it just seemed to draaagggggg on during internal med, and I felt like we really didn't see much of the patients during this time. 

So, overall, my favorite moments have been in the ER or in the clinic, and usually with pediatric patients or with patients that I get to explain things to. 

Right now, I am mostly torn between pediatrics or emergency medicine. I've been utilizing my break time to research different residency programs and find out which I am eligible to apply for. I have to start making a decision in....8 short months (HOLY COW), so I figure that more information now is better. 

I have another full week of break, and then I start back up with Neurology, followed by Psych, Family Med, and OB/GYN. My schedule is *theoretically* a little less hectic, at least for the next 4 months, so I will hopefully have more time to document things as I go along. 

Step 1 Score and my first week of Block III!

First of all, I'm writing this from the first floor of my 3 story rental house in Flint - that's right, I am all moved in and (mostly) settled into my clinical setting. My student ID card doesn't even work in GR anymore!

I got my Step 1 score this past Wednesday. I passed!!!! My score is much lower than I wanted it to be, and lower even than my practice exam, but I passed. It's a relief to have it over with, and to know that I can just beef up my medical CV with clinical skills, honors grades, research, volunteering, and a better Step 2 score, which I was planning on anyway :)

I have already survived 2 weeks of Block III, although one week was orientation so I'm not sure that counts. My first rotation is pediatrics, and the rest of my schedule is as follows:

Pediatrics

Jr. Surgery

Internal Medicine

Elective (Neurology)

Psychology

Family Medicine

Ob/Gyn

I'm pretty excited. My year is definitely front loaded, which I'm a little nervous about in terms of burnout, but so far it's going well, and that means I will have a pretty easy spring semester. 

So far, pediatrics is amazing. I'm liking it a lot more than I thought that I would. I mean, I like kids, but after my stint as a camp counselor I haven't always been 100% comfortable around small screaming people. However, I have been having a blast and learning a TON. I've mostly worked with the two extreme of pediatrics - small, small babies, and older adolescents. I love working with babies and their parents - the parents are very tired, and definitely appreciate my ability to reduce what the attending/residents are saying into non-medical jargon. And babies: OMG tiny fat babies with their little grasping hands and their kicking legs and their sucking reflex - LOVE. I also like working with teens: they are definitely challenging patients, but I like being able to talk to them about depression and sexual activity, and being able to treat them like adults, especially when they are sensitive to their parents helicoptering a bit. 

It's not all perfection - I got to admit a not quite so fun case today. The kid will be absolutely fine, but they were in quite a bit of pain, so getting a physical exam was rough on everyone involved. There's just no explaining to an under-5-year-old that you HAVE to poke and prod at the things that hurt, and a crying child tugs on everyone's heartstrings. 

I also have great residents and a great attending to work with this week. Dr R is a fantastic teacher, asking questions that are appropriate for my level of training and never making anyone feel dumb for not knowing something - just encouraging them to look it up in an article, and then share with the group. I also really like my residents. The 1st years are just starting too, so it helps to not feel as out of place. 

My favorite things so far (in list form):

1. BAABBIES

2. Listening to heartbeats

3. Feeling a sucking reflex

4. Getting to work as a true team with a resident - them teaching me, and me even sometimes teaching and helping them

My goals for this rotation:

1. Never lose my compassion for my patients - this includes staying behind to explain things a bit more, being an advocate for the more challenging patients and parents, and always introducing myself by name before I perform a physical on a patient. 

2. Honors the non-exam portion of this domain. I would like to honors the entire thing, but I am trying to be realistic, since I am not sure about the extent of the shelf exam. 

3. Get extremely comfortable doing full physical exams on all age groups. 

Pelvic exam

Today was one of my final clinical skills experiences - learning how to do a pelvic exam!

Being a woman, I can tell you there is not much worse in this world than a poorly done pelvic exam, so I was anxious to learn how to do this exam FAST and WELL - I didn't want to inflict any more discomfort on our practice patients than I had to!

There's 2 parts to the pelvic exam - the first part involves the speculum, which sort of spread the vaginal canal so the doctor can look at and/or get a cell sample of the cervix. I was able to locate the cervix on the 2nd try on my first patient, and on the first try on my 2nd patient - I felt super accomplished!

The second part of the exam is called "the bimanual exam", and essentially involves inserting your fingers into the patient's vagina, and then using your other hand to press down on the patient's abdomen and sort of "smush" all the soft tissue together, so you can feel the outline of the uterus and the ovaries. This is much trickier, although I was able to at least palpate one ovary. It feels sort of like a little marble!

My mentor for this session was an ER doc I've worked with before, and this time I especially appreciated her style, both as a doctor and as a teacher. She was efficient but not cold, and got the job done quickly - something both myself and the patient appreciated. I asked her how many pelvic exams she does as an ER doc, and she said that if she wanted to, she could do 10 or more a day - lots of pregnant patients and people coming in for STD checks at the ER.

To me, that's really cool. I wasn't interested in OB/GYN because I don't think I would want to do this sort of thing all the time, but its definitely an interesting procedure, and one that I could feel comfortable doing as an ER doc.

Just 2 more clinical skills experiences this year - phlebotomy, and our Gateway exam!!!!

60 days left!!!!

Holy cow. I have 60 days until my Step 1 exam. 2 months, people. TWO MONTHS.

I am 76% done with my first run of QBANK - if I do at least 20 per day for the next 25/30 days, I will have completed all 2200+ questions before my final domain exam, and can start anew on my first day of ISP. Piece of cake, right?

I am excited and nervous and just READY.

Counting Down....

Wrapped up Cardiology, finally. Spring break in the middle was nice (actually, really nice. The best, even. Myrtle Beach with mom was exactly what I needed), but 4 week domains are kind of a beast to begin with, and the extra week just meant that I am SICK about learning about the heart!!!

Thankfully, I MASTERED the exam, and can move on to my next domain, Metabolism/Endocrinology/Reproductive.

We started today off with a bang, and had a HILARIOUS German professor. Okay, so she wasn't actually that funny, but her accent just made the entire lecture hilarious (***she was really a great lecturer...just hearing about testosterone in a foreign accent makes it a *little* hard to pay attention early in the morning!)

By they way, did I mention I have 6 weeks exactly until I am done with preclinical exams? I had my Flint campus meeting yesterday, and while I am SUPER excited to move on to the next part of my medical life, I cannot believe how fast this semester is going.

6 weeks. 40 days. 2 domain exams. 3 clinical skill sessions. That's all the separates me from my Intensive Study Period.

And, oh, by today's count, I have 70 days until I take my Step 1 exam. And that means like, 75 days until I move to Flint.

AHHH!!!!!!!!*****





*****(this is a scream of excitement. Can't you tell???)

2015 Updates

Gosh this year has been going by fast. Fall semester was here and gone in a blink of an eye, and even though my winter break was an extra week longer than usual, it still wasn't long enough. I've already been back in school for a month and it feels like it might as well have been just a week!

The renal domain was a bit tough. I got my lowest score on any exam in the past year, but considering that a friend attempted suicide and I was sick with the flu for about a week during this domain, I was happy just to pass. It was still frustrating because I don't think the exam really reflected the knowledge that I gained and because my goal is to master every exam, but at least it is over.

Pulmonary seems to be going well so far, but I admit it's been a bit tough to find my groove this semester. I know part of it is due to the aforementioned events of my friend's hospitalization and my illness, but my depression seems to be rearing its ugly head and throwing things out of balance.

I tried reducing my medication dose over winter break (with permission/supervision from my therapist) -- BIG MISTAKE. I did fine at first, but after about 3 weeks of the reduced medication I kept wondering why I was feeling more anxious and panicky and lashing out at people and then it hit me - duh, I should probably go back on the dose I know that works. Since then, things have been *better*, but I still feel out of sorts. My sun lamp helps when I am studying, but I just overall have been feeling lower than I would like. Hopefully this changes soon.

I added a countdown clock to my first licensing exam - 121 days as of today. I am about 30% through my first run of my question bank. I was hoping to be at around 50% by now, but the way the domain schedule works there are a lot more questions related to school stuff in the spring semester, so hopefully I will be more on track soon. I am remembering a decent amount of things from last semester, or at least remembering enough to at least be familiar with what the test is asking, so I'm feeling pretty good about having a good intensive study period in May.

I also can't believe that beside my test being in 4 months, I also move to Flint in 4 months. I've got my apartment search narrowed down to two places, possibly plus or minus a few (there are a few condos/lofts downtown that don't really advertise online that I'm going to check out in the next few weeks). K and I were going to try to live in one apartment together, but due to some family stuff, that probably isn't happening. However, we are going to try to live in the same complex, just to have someone nearby.

Countdown to Step 1!

Fall average: MASTER

Got my overall grade average for the fall semester: 87%

My highest grade was 92, and my lowest grade was 84.

While I was hoping that all of my exams would be above 85, I am thrilled with my performance this semester. I am exactly where I want to be - mastering the subjects, and still having time to do all the costuming things I want to do.

This, according to CHM's studies, puts me in a great place for Step 1. The reason they set mastery at 85% is because if you "master", you are almost guaranteed to pass Step 1 on your first try, with an average of 225 for you score.

Woohoo!

Medical School or Art School?

"Gosh golly, Dr. Brit! We haven't heard from you in a long time. What have you been up to???"

I'm glad you asked, gentle reader. 

This. Lots of this:

 And a lot of this:

And even some of this:

Now, what do pro-wrestling, silly looking dinosaurs, and Clint Eastwood have in common?

They're all part of my story pneumonics to help me learn and memorize some odd-hundreds of drugs, their use, and their side effects.

Now, medical school may look like just a bunch of fun drawings, but this is just a small portion of what I've had to learn. I am 3 days away from completing my third medical domain of the semester. I already finished with Neurology and Infectious Disease, and I am just wrapping up Musculoskeletal.

So far, things are going GREAT. I have really found my groove this year - so much that doctors I have literally just met are telling me the same thing. My grades are in the mastery range - I actually got an "official commendation" from the school on how high my last exam grade was. Clinical skills is making much more sense as we dive into more specific physical exams, and I just feel like this is my year.

It's about damn time.

Last Aeromed Shift!

Today is my last aeromed shift! I am going to miss it very much, but it has been a great experience, and has confirmed my interest in emergency medicine.

I'll talk more about my experience later, but here is a fun selfie of me in my flight suit for good measure.

Flight

Today I helped bring a patient to the same room where Tori died.

I noticed, and remembered, and I *cared*, but it did not bother me.

I think I have made some progress.

There was the potential for a lot of triggers today - my first medical flight, lots of coworkers talking about drowning rates over holiday weekends, bringing a patient to the children's hospital....

However, instead of feeling triggered, I felt POWERFUL. I enjoyed the actual flying, of course. But I really felt like "a doctor" - I knew most of what the actual medical people were talking about, I knew what was going on when the physician was intubating, I knew what to say to the parents to help explain what was going on, I knew how to read the CT. I felt on top of the world (literally, especially when I was standing on the helicopter pad).

I was able to take some sweet photos while I was in the air - I will post them later, but for now, I just feel GOOD. And that's pretty damn awesome.

Awesome new shadowing/volunteering gig....

Sculpture in hospital

For my Art Saves Lives elective, we had to find a piece of art in our daily lives and sketch it/form questions about it over the course of 5 days. This is the sculpture I choose, which can be found in a Grand Rapids hospital. 

Photos from my "Art Saves Lifes" elective

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.