Day 1 of 2 done

I just finished my first day of the Step 3 exam. It sucked... 8 hours straight answering questions.

I strolled back to my hotel afterward and walked into my room to find flowers waiting for me.

NotMexican sent them.

Don't you wish you were dating him?

I sent him an I Love You text. Seriously, who have I become?

He replied:
I love you Roxy. Very much in love with you and I like it. Every day I realize I would give the world for you and pray to God about it. Corny maybe... but true.

Don't you all just wanna vomit? (try not to though as it'll result in hypokalemia)

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M.D.

I graduated yesterday. It was kind of a surreal moment. The past 4 years were quite possibly the worst years of my life. I have felt very little aside from anger, and I just couldn't find a way to diffuse it.

Yesterday, after I received my poster-size diploma I think I finally felt some relief. Though I have many fears about my future, this gigantic piece of paper is Tufts telling me they believe in me.

I wish my parents believed in me though. I think that's where a lot of my anger is sourced. My mom wanted to meet the president of the hospital at the graduation because she was "the person who got me in." That night at a dinner party, my father thanked the chief of radiology for "letting me into their residency program."

My parents are pretty pissed with me at the moment because I've been doing a lot of things without telling them. I secured my apartment in Denver without telling them. I keep making plans in Boston without telling them.

I bought my ticket to Denver for June 1st. I don't even have to be there until June 15th. When my mom asked me why, I lied and said it was to get to know the area. She knows the reality is I can't get away from them fast enough.

I'm trying to channel all of this negative energy into something positive, though. For one, I'm refreshing my memory like crazy to do well for my patients because I get my first patient on June 22nd. Second, I am going to learn spanish. In Peru, I realized I understand the language a lot more than I realized, so it's time to be able to speak back.

Every end has it's new beginning, which will hopefully be better.

Medical school is over. I know I already feel better.

Thank. You. God.

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TOMORROW

The day has finally come. I'm trying not to flip out, but clearly I am.

I pray to God that all my studying pays off. I hope I trust my brain. I will try not to change answers (since I'm sure that is what screwed me over with the first exam).

I will try to relax and eat well. I will hopefully maintain a strong drive and stay alert.

If I must guess, I hope I can narrow my choices enough to let eenie meenie miney moe work in my favor.

It's all in God's hands right now. I hope He helps me succeed.

280 280 280 280 280... Keep chanting!

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Unfortunate Break

I'm on lock-down for exam studying. 

Everybody please put out the number 260 into the universe. That's the score I'm hoping (need) to get.

If you really love me... push for 280.

Thanks!

I'll be back at the beginning of October. 

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Formal Writing

I don't know how many people know this, but I HATE writing... I'm not kidding.

I'm an engineer for pete's sake. I don't write or memorize. I calculate and do.

I love blogging, but it's totally different. Sure you might be judging me, but my future does NOT depend on what I write in this blog.

Basically I blog almost exactly the way I speak... plus what I'm actually thinking when I speak.

So this formal personal statement, personal essay... whatever the hell my residency application requires... takes me FOREVER.

And then it ends up being a piece of crap... and my only salvation is DruHil.

I once asked DruHil to proof-read a 5 sentence essay I wrote explaining why I wanted to study abroad in Paris. I thought it was pretty darn good... straightforward and succinct.

DruHil replied by email 3 minutes later with a one page essay explaining why I wanted to go to Paris. In that essay, my 5 sentences had been coherently scattered throughout.

To this day, I ask DruHil to help me out... and I just sent her TWO personal statements. One for pediatrics.... the other for radiology.

Thanks Dru! You got me to Paris... to med school... and i'm confident to Residency... and don't go anywhere because I've got fellowship to follow ;)

YOU ARE THE BEST!

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Sucked In

I started my new rotation on Monday, pediatric radiology. It was the compromise I reached with my mom since she desperately wants me to become a radiologist... and I like genetics.

Since Monday, I have had several radiologists sit me down and tell me why I need to go into radiology. The pediatric radiologist went on and on about how great pedi rads is and how there's a desperate need for pedi radiologists and how I would make bank in private practice.

The neuroradiologist told me how she was just like me... not a memorizer, engineer, etc... I would totally understand the brain and how it would look when diseased (let me tell you, I still don't know what a normal brain looks like on imaging).

And then there is O. O did his residency and fellowship at my mom's hospital. O tracks me down everyday with a new reason why I should do radiology. Yesterday was only day 3 and he dragged me around a cocktail party to introduce me to all the important department chairs and heads.... and the residency director.

I'll admit I'm getting sucked in. I may not get the patient contact I love as a radiologist, but I have seen some really cool cases. My favorite (yet painful for the patient) was the story of the kid who got testicular torsion after his friend chucked an onion at his package... and well... his balls twisted from the impact.

Ok reality check. I have kept my step 1 board score a secret because I'm embarrassed by it. I am tired of being judged by a number every four years. I know a major reason I have avoided radiology is because many hospitals have a cut off board score... and mine is way below it. I don't have the confidence in my application to get a residency in that field, so I found genetics... an up and coming field that will accept me because they "need" me more than I need them.

Last night I reached a new compromise with my mom. She will talk to the chief of the department and ask him what he thinks my chances are. If he says I may apply to my mom's hospital, I will and rank it first... but the rest of my applications are for genetics.

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5 years later

Somehow in my drunken stupor on Friday evening I had the sense to wash the make-up off my face, but when I woke up Saturday morning the fake eyelashes were still superglued to my eyes and really uncomfortable.

I couldn't believe I wasn't hungover... ok I sorta was. I spent the day in this odd sort of haze. Druhil and I sauntered over to Newbury St for brunch/lunch at Trident, then we went to RedSox's place to hang out. That afternoon, Dru had been invited to a bbq out in Brookline and I tagged along.

The bbq was full of random Tufts people from undergrad. None were my friends, but I was happy to see them nonetheless. I also started drinking again.

We spent several hours there, one hour stuck in sox traffic and 2 hours stuck in a restaurant that couldn't handle a wedding party on the same weekend as graduation... even tho there were plenty of empty tables. (Sam, you woulda *loved* this. Snarf)

When we finally made it to Vox for the reunion, we were greeted by a line. Let me remind you that I'm not a big fan of Vox, especially because it is never packed. I found the line to be ridiculous.

Anyways, right away I knew the kid standing in front of me... except we didn't go to Tufts together. We went to high school together. So we chatted, and then the Tufts people started to pop up everywhere. I forgot I knew a lot of people from undergrad. I'm not surprised I only remembered the men.

I broke out into hives when I got upstairs. People started approaching me from every direction to hug and say hi. Many I recognized, but overall it was overwhelming and I had to run to the ladies room to calm down. I knew I partied a lot in college, but somehow I thought I always saw the same people.

Miraculously, I didn't see a single ex-sorority sister. Either they never showed or left early. Regardless, I had an amazing time. I saw all my former roommates, a bunch of ChemE's, pretty much everyone I wanted to see and then some.

RedSox met up with me, and I introduced him to everyone. There were plenty of whispers of awe as I was known as the quintessential single gal... *the* predator.

I found it all amusing... and I look forward to our next reunion... imagine 10 years later.

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Quirky Genes

My first week of genetics has been pretty awesome. I have seen people with all kinds of genetic disorders. It's pretty amazing, though occasionally sad.

I love telling a woman that she does NOT have the breast cancer gene.

I love telling new parents that their baby may have tested positive for cystic fibrosis, but in reality they DON'T have the disease.

I love the symptoms some of these patients come in with, my favorite being a girl who suffered from rage anytime she ate certain foods.

I hate the sad stories, though, like REALLY hate them. Today I met the brightest, coolest 7 year-old. She likely won't live very long due to her disease. She has two parents who love her dearly, who allegedly found her in a trash can at a restaurant in Cambodia when she was a newborn.

Then there was the little boy adopted from Russia who beats people up, hurts animals, has even killed a dog. His biological mother was a drug-addicted, alcoholic prostitute who fed him vodka as a baby to shut him up and physically, verbally and even sexually abused him along with her MANY MANY other children. I know he doesn't have a genetic disorder... poor thing is just broken.

With all the good and the bad, it still seems like I will be going for genetics. I love it and I know there will only be bigger and better advancements by the time I get there.

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4th and Final

Well surprise... I'm sick.

I'm hoping it's because I worked so hard studying for my Ob/Gyn exam today that I just let my immune system go... and therefore it's only fair that the universe give me an AMAZING score.

When I walked out of my exam I realized that I'm actually done with my 3rd year. The medical school doesn't allow me to say that officially, because they have their stupid rules about starting 4th year in July. (I know it's just to guarantee my tuition for an entire year).

But as far as I am concerned, I am starting my 4th year of medical school on Monday.

I wish I could say I can finally relax. The truth is next month and for 5-6 months afterwards, I will be working my tushy off to get recommendations, write a personal statement and apply to residency programs.

I'm excited, scared, nervous... but for now, I'm not gonna let my emotions get the best of me.

For now, I'll just try to get over being sick.

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Cuss & Gossip

I don't like to swear. I do it, just like anyone else. It usually happens in an angry moment or it can go on continuously when drunk, but all in all I don't like it. I do love gossip, not gonna lie... but I try my darndest NOT to do it. I don't want people talking about me, so I'll do my best not to talk about others.

I don't mind, though, when others cuss... unless they sound extremely uneducated. I don't mind when others gossip because I get all the dirt.

What I'm finding is that Ob/Gyn docs drop the F bomb like it's a standard medical term and they gossip about each other like the latest US magazine.

The whole atmosphere really isn't me, yet I fit. Because I get along with just about everyone, the Ob/Gyns have taken a liking to me. Since I remain quiet, they treat me like an untainted child. It's weird, but cool.

I'm just worried that a few more weeks of this and I'll be one of them.

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Life Can't Wait

The other night I couldn't fall asleep. I hadn't yet been able to handle a full meal. I hadn't yet worked the outpatient clinic. I couldn't keep my mind off residency and impending exams. I was freaking out about my meeting with the Dean in a couple weeks, and my headache since vomit-rama wouldn't go away.

I didn't know what to do, so I prayed. It had been a while. I prayed and begged for help, for forgiveness, for answers. I told God I was tired of everything. I hate how much 3rd year dissapoints me. I hate how difficult studying is. I hate that I'm tired all the time and can barely concentrate. I hate that I hate.

I cried, and got upset that I was crying because my lack of fluids was probably the main cause of the headache. But something happened when I let it all out. When I let myself admit my own vulnerability, my headache went away. I instantly started feeling better, and I made a decision to change my attitude. Then I fell asleep.

The next morning I felt refreshed. I checked my email as usual and saw a banner stating "Life Can't Wait." It turned out to be a contest where people enter their story about how life can't wait. I read entries about surviving divorce and abuse, living with chronic disease and never giving up on dreams.

I realized that I had my own "Life Can't Wait" moment when I cried at 2am, so I entered my own story in the contest. I talked about how much med school was weighing on me, but that I could and WOULD triumph because in the end it's not about me.

Yesterday I received an email from a woman who read my entry. She told me she was rooting for me because it was clear from my entry that I was going into medicine for the right reasons. She told me her story, which is a link to the right of my blog called Julianne's Journey. I felt further encouraged and inspired... and even more sure that genetics is right for me.

I hope in a few weeks, I will continue to feel this way. Then I can hold my head high as the dean lays down the cold truth. I wil tell her that I'll show her what I can do... and then I will do it.

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Easing into cardiology

So I was dreading my cardiology rotation because the last two classmates who went through it found it to be brutal. Long hours, crazy days, scary attendings... but a fantastic education.

I gotta say that although I could do without the hours, I've been having a pretty fun time on my service. I haven't had scary attendings persay... but definitely some intimidating moments.

This week I've been a little nervous around my attending. He jokes around a lot with every other word a curse word... but today my fears subsided.

First he told me to call him by his first name. Then when I told him about the sleep studies discussed in grand rounds, he made a comment that got me to laugh out loud (something I haven't done in a long time).

Me: "Yeah apparently you need to get 7 hours of undisturbed sleep to avoid developing insulin resistance"

Doc: "The last time I got 7 hours of sleep was in utero... Sh!t... F*ck that."

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Drinking on a work night

So I'm on my cardiology rotation. It's tough but a lot more interesting and fun than my last 2 blocks have been. People are calling me a white cloud because there are only 4 patients total on the service and they're used to upwards of 25.

Unfortunately I still have to get in early enough to round by 6:30am. I generally get to the hospital at 5:30am to give myself time to pre-round and read all the extra notes and stuff of happenings over 24 hours.

This weekend I have a black weekend. It sucks because I have to work until 9pm saturday and come in for a half-day on Sunday. Having done this before I know that we start rounds a little bit later than usual. I asked my resident what time and she told me not to pre-round and to be in by 8am.

8am? That's so late! That's awesome! I can drink tonight!

Yup... that was the exact sequence of my thoughts... and yes I will be drinking tonight on my valentine's date with RedSox at Ruth's Chris.

Hope everyone has someone to love and someone who loves them more back.

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Time Off

Though I know I probably won't do this, I wonder if dropping back to the class of 2010 would boost my application for residency. I was in the education office the other day for a meeting and I saw the average for the Renal Exam. It was a 72%. Last year for my class, the average was a 92%.

I think I got a 90% on the exam, which means the majority of 2009 did better than me. BUT I did better than the majority of 2010. Interesting.

When we had our big class meeting a couple weeks ago, we learned a lot more about the Dean's Letter. We're ranked and sorted in 5 categories. I'm sure I'm in the Good category for 2009... but I might bump way up to Superior if I joined 2010.

In doing all this math, Sister told me that in the end it doesn't really matter. My class is full of lunatics and stressballs, and I shouldn't get caught up in it. I should in fact make connections, which I've already been doing and work on getting good recommendations.

The right words from the right people prevail in the end. I've always known this, but sometimes I forget. So I need to remind myself how I got into Tufts Med in the first place... off the waitlist... thanks to knowing a Dean who loves my mom.

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Is it time to change?

The following day, we all rounded as usual. There was a point where it was just me and my intern. I asked her if she could give me some feedback on how i've been doing.

She said I've been doing really well. Everyone likes working with me. I've contributed a lot to the team. I've even brought up stuff that she never thought of, or come up with answers when the rest were stumped.

Since people sometimes mask the truth, I wanted to be extra sure. I told her what had happened in the computer room, and her mouth dropped to the floor. She asked who the resident was that said those things and I tried to describe him for her.

According to my intern, I don't suck at all. The resident who said that must have known I was the med student and said it on purpose as a joke.

Later that morning I presented a paper on acute kidney injury, then went off to med student conference as usual. That afternoon, my resident complimented me on my presentation.

I wonder if my intern told them what had happened.

Either way, I'm glad I asked. The only way I could change is to know exactly what needed to change. Sounds like I don't need to change a thing.

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when I'm the conversation piece

When people talk about you behind your back, do you ever get enraged and say something along the lines of "they should say that to my face!!!"?

I don't.

I'd rather people talk behind my back and then smile and wave... heck even be my friend to my face. (This is probably why Los Angeles is such a refresher)

I really don't want to know what peoples' personal opinions of me are unless they bear any weight on grades and money. Why?

Well there are a couple of reasons. 1. It most likely will not inspire me to change my behavior. 2. It will really hurt my feelings, probably leading to paranoia.

Today I was sitting in the computer room looking up some stuff to present on morning rounds because I've been having a pretty crappy experience on my latest block and really wanted to impress tomorrow.

Last week, the attending completely ignored me. He even cut off a funny (medically relevant) story I was telling. This week I've been suffering from some form of laryngitis, and I'm purposefully trying NOT to talk too much because it hurts... plus overall I'm just exhausted.

But I pushed myself today. I know I haven't been an "honors" student, but I really want to be. So I looked up a ton of stuff today and I'll be making three presentations tomorrow.

I was pumping myself up in that computer room, getting really excited when I hear "So, I hear your med student sucks." This was immediately followed by a high-pitched "Oh my God she's right there!!" and subsequent uncontrollable laughter from my resident.

I didn't look up right away. I don't think it registered. Then I turned around. My resident was laughing and making some gestures towards me which I'm hoping were the "it's not true" gestures. The guy who made the comment was calmly sitting at a table writing his note.

I turned back around, choosing to focus on what I was doing. But as the day wore on, I couldn't help but wonder if my team really does think I suck.

I know I don't answer every question correctly, but sometimes I've nailed some toughies.

I wonder if they can tell how high my anxiety level is when I'm talking.

I wonder if they think I'm lazy because I'm only carrying 2 patients (when the resident told me right off the bat that she only wants me to have 2).

I wondered a lot of things... but nothing struck as strong of a chord as wondering if I suck.

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The Major Con of Internal Medicine

Maybe I lucked out for the past 6 months. Maybe 2008 is a bad year for the rooster. One thing is for sure. This has not been the best start to the new year.

I couldn't believe how nice people were on medicine, like SUPER nice.... the anti-surgery. What I sorta knew but didn't want to believe was how hard internal medicine doctors work. Now I have to live it.

I worked 13 hours last saturday, 5 hours on Sunday and 16 hours just two days ago. I could not wait for the weekend. RedSox was on vacation with his family. He is back today and I just wanted to be with him all weekend, watching dvds and relaxing.

I spent majority of the afternoon waiting to be dismissed. At around 5:30 my intern told me to go home. I did the obligatory and fake "are you sure there's nothing else I can do?" Ready to bolt, I just needed to hear the ok when she said "Nope, I'll see you Sunday."

I didn't move. Sunday? What? Are you freaking kidding me? I just had a black weekend!! My classmate hasn't worked a single weekend day, nor has she stayed passed 7pm on a regular workday!!!!

I calmly questioned the Sunday bit, and she said med students follow the intern schedule. She has to work on Sunday and be prepared because it's going to be another 13 hour day. Faking enthusiasm, I told her I'd see her Sunday.

Then I cried the entire walk home... and because it's raining, no one noticed.

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How would you describe youself?

Anytime I've written or responded to a craigslist ad, I've always desribed myself as petite, fit, fun, cute and outgoing. It just rolls off my fingers as I type. Never would I have written aggressive (possibly sadistic), self-confident (borderline narcissistic), dramatic, and conscientious (a tad OCD).

Well those were the top 4 peaks on my personality self-portrait graph.

I went into work yesterday, and Dr. R said he felt bad that he hadn't taught us much. We went back to his office and he started blabbering away. He might have been trying to apologize for his passive-aggressive behavior through patient examples. This man may either be really clever or just not know when to shut up. (After today, I'm pretty sure it's the latter).

Anyways, in his dramatic speech about how he may be deemed passive-aggressive with us med students he side-tracked to talk about personalities and handed me a comprehensive personality test. I'm talking over 100 questions to be followed by calculations, plots and graphs.

It was my task to take this personality test, so I spent a good hour doing the thing. When finished I had no idea what the numbers or graph meant, but I did notice aggressive was a peak on the graph towering above all the rest.

I took my finished assignment back to Dr. R. He commented on the aggressive peak and said "yeah, I can see that."

What the hell does that mean? I'm not aggressive. At least I didn't think I was. So I took the book and read the chapter on aggressive.

Hmm wow, ok so umm... yeah, I guess I can be pretty aggressive. And geez yeah, people have said some of the exact words to me in the chapter, especially after a night of drinking.

Well the good thing about this book is that not only does it describe the various aspects of personalities, but it gives us 2 very important sections: How to deal with these people and exercises these people can do to tone things down.

In some ways I need to tone down the aggression, but in other ways I need to embrace it. Aggression is the reason I compete so well. Aggression is the reason I have CEO potential. Aggression is the reason I have succeeded in most of what I've done. Aggression is the reason some men can't get enough of me... sadism is the reason I keep these men around ;)

I'll do what I can to avoid the progression towards sadistic personality disorder, but for now I think I'll be myself.

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Surgery Flashback

"I told Dr.K I didn't want medical students, but he's making me take you guys." - Dr. R

That's how my classmate and I were greeted this morning as we started our first day of adolescent psychiatry. Not exactly welcoming, but I chose to ignore that statement. My last two weeks of psych have been awesome, and every psychiatrist I met has involved us med students.

Right after Dr. R said that to us, he went on to teach us quite a bit about adolescents. It didn't seem at all like he didn't want us there, so I actually felt quite comfortable when the time came to see patients.

Our first teenager had run away from home. Through her interview we learned a bit about past sexual and physical abuse, anger towards a parent, trouble with school... the typical profile for a teen psych patient.

When Dr. R finished, he asked the social worker if she had any more questions for the patient. She had a couple. Afterwards, she looked up towards my classmate and me. I wanted some more details on the patient's siblings and home life, so I went ahead and asked questions.

Through my questioning, we discovered some intense physical abuse toward the patient and her siblings. After I finished and the patient left, Dr. R turned towards me and my classmate (but more specifically me) and bitched us out.

"I ask a very specific set of questions. These are MY patients. I don't need a PCP running her mouth asking a whole bunch of questions. It reveals a whole bunch of problems that may need to be addressed, and I've already decided what I want to handle. Asking more questions adds MORE WORK that I DON'T want to do."

I felt like I was back on my surgery rotation. I was flabbergasted and immediately retreated... just like I did on surgery. My classmate, too, was in awe of what just happened. He shut up too.

But I don't regret what I did. The only extra "WORK" I added to his workload was a 2 second phone call to DHS to investigate the situation. How dare anyone complain about something as important as keeping a child safe?

I am beyond shocked at what happens to children that brings them into the psychiatry unit, so there is no way in hell I'm going to shut up when help is available.

Fuck You, Dr. R.

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Suicidal... and Hot

On the way into the conference room to admit a new patient, he walked out. He was in scrubs and really hot. Since all rational thought goes out the window in my gaga state, I assumed he was a male nurse or an orthopedic surgeon.

He had that scruffy look going, appeared to be in shape. He had those nice, dark, brooding eyes. I didn't get a chance to look him over further, but I hoped to see him again.

A couple hours later, the attending called in his next patient. It happened to be the aforementioned hottie. It turns out he tried to kill himself last night. I missed the bandage around his wrist initially, instead focusing on his perfect hair. He decided he didn't want to be in the world anymore, and he was perfectly nonchalant about it.

Oddly enough, I found that incredibly sexy.

He said he almost jumped off the roof, but realized 3 stories was more likely to paralyze him. So he climbed back down.

How smart.

After he left, the attending turned to me and said the hottie was schizophrenic with comorbid alcoholism.

I love to drink too.

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