Sunday, August 26, 2012

Inpatient Hem/Onc

I honestly don't know where the time went, but my two weeks on inpatient hematology & oncology are up. It has been a really great experience; I just wish it would have been a four week rotation rather than two!

One subject which kept coming up while on inpatient is sickle cell crisis. About half of our inpatients are people with sickle cell disease who need to be in the hospital for pain management during an acute sickle cell crisis. It is horrible to see people in such overt pain. We do our best to manage the pain with all of our best pain medications, we push IV fluids in an attempt to minimize the sickling, we give oxygen, we give transfusions...but it is still difficult to see people in such agony. It's really such a horrible disease; I am more affirmed in my opinion of the importance of genetic screening for diseases, such as sickle cell trait, prior to a couple choosing to procreate. A lifelong battle against pain just seems so difficult, when it can possibly be prevented by proper screening of potential carriers and providing useful education.

I did see a couple of really interesting cases, which I am thrilled to have been a part of the management team in these instances. I'm working on a couple of case reports at the minute, and who knows? maybe I'll be able to publish one.

For now, it's back to putting together my residency application before I begin my next clerkship tomorrow - I'll be on internal medicine for four weeks! :)

Sunday, August 19, 2012

Home

Since it has been nearly two months since I have been home, I decided to finish editing a few photos I took when I was last at home.


My sister received a cute little cockapoo for her birthday in May, and he is just about the most adorable little pup ever! Our dog, Marley, loves to play with little Wrigley, and they are so much fun to watch.
































My niece, Katelyn:



On the farm:














Thursday, August 16, 2012

Hematology & Oncology

I have really enjoyed the last four days I've spent in the hospital. 

My patients are really interesting. We've actually been quite busy, and we've had some fairly uncommon complications in the past few days. I'm learning so much, every day. 

I love working on this service. I would love to do this for the rest of my life!

Today, I overheard one of my female patients refer to me as "Dr. Barbie"; I'm going to go ahead and take that as a compliment (please just disregard the "Dumb Blonde" jokes that have just popped up in your head). 

I'm working really hard, and I am treating the patient's as if they were my own responsibility. So I'm constantly checking up on them, refreshing their current laboratory work waiting for "pending results" to switch to "available results". I get to actually talk with the patients without feeling pulled in a million different directions. I love it. 


Monday, August 13, 2012

Medical Monday: Link-Up!




Today, I will be linking up with a few of my favorite bloggers over at Your Doctor's Wife and From A Doctor's Wife.

As a fourth year medical student, it may be easy to forget what exactly drew you to medicine in the first place. As I fill in my paperwork/CV/Personal Statements/Requests for Letters of Rec/etc etc etc for my residency applications, I am finding myself trying to make some sense of how I have evolved into who I am today from the girl I was when I entered Medical School three long years ago.

I was drawn to medicine in a fashion likely similar to most people: I have an innate, deep desire to help people. Generic, I know, but I have come across a few medical professionals who I sincerely question this seemingly ordinary characteristic's validity. I discovered this need to help others while a nursing aide at an extended care facility. Helping others with such seemingly mundane tasks - such as eating dinner, combing hair, brushing teeth - fulfilled a part of me that I didn't realize was previously empty. Hearing the stories from times past, joking around to put a smile on another's face, learning invaluable life lessons from those with long-term perspective - I absolutely loved it. So I decided to enter into medical school, knowing that there could be nothing else in the world that would make me as happy as serving others as a physician.

During the second week of my first year as a medical student (a few days after my very first exam), my mom called to tell me that my cousin had been diagnosed with Stage IV Colon Cancer. This disease has a long history in my family, having claimed the young lives of my grandmother and aunt. As a medical student, having a small grasp of what that diagnosis truly means, I feared the grave reality of the unfortunate diagnosis. As I continued life as a medical student, my cousin's diagnosis never strayed far from my mind, and I had an inclination that I would someday pursue work in the world of oncology. Cancer has impacted my personal life, and I have always found it frighteningly fascinating. In fact, my 8th grade science-fair project involving the effects of beta carotene on the growth of cancer had foreshadowed the inevitable development of my career. I have taken courses such as molecular genetics and cancer biology in an attempt to better understand the intricate disaster of life gone awry, of the morphology of the deranged cellular replication cycle which causes uncontrollable and insatiable growth of particular cell lineages which we lump into the broadly encompassing term of "cancer".

As chance would have it, my second rotation of third year was surgical oncology. This was when I discovered that the inclination of my desire to work in the world of oncology became an obviously clear choice of work for me. I knew that I was drawn to the mechanisms of cancer, of the complexities of such derangement in normal human function, but it wasn't until this clerkship that I discovered that I also really and truly love the patients. I'm not sure if it's because of my personal connections with cancer, my sincere interest in cancer, or if it is because the patients are strikingly different to those cared for in other services, all I know is that I enjoy the opportunity to participate in their care, to somehow assist them in their battle against cancer.

The final portion of my progression during medical school will finish in June of 2013. Undoubtedly, I will continue to grow through this year of training, and solidify the decision to pursue a career in medical oncology.

Saturday, August 11, 2012

Final Thoughts: Third Year of Medical School

Third Year of medical school is now well and truly finished. For those who might be interested in what one's schedule may look like during the most rigorous year of medical school, I've compiled a few statistics from my third year:
  • 50 of 52 weeks were spent working in various clerkships, including the mandatory Surgery, Pediatrics, OB/GYN, Internal Medicine, Neurology, Psychiatry, and Family Medicine as well as my chosen elective of Radiation Oncology.
  • Throughout the year, I averaged working 48.4hours per week (this is a bit lower than I expected!). The most time-consuming clerkship was surgery (about 70hours/week); the least time-consuming clerkship was psychiatry (33hours/week).
  • I enjoyed one week free from clinical duties during Christmas/New Year season, as well as a week off during my elective rotation (which I didn't actually take, as I worked several days that week because - what can I say? - I love it).
  • Throughout the year, I had 69 out of 351 days off (1.37 days off per week, including holidays and weekends).
What I LOVED about Third Year:
  • You gain invaluable knowledge through experiences with patients. It's one thing to understand a concept and apply it to a written examination, but it is quite another thing to apply that knowledge to real-life, clinical situations
  • The amount of understanding which comes during third year is nothing short of amazing. You learn so much so quickly.
  • You get to see patients. Every day. 
  • Often, you are one of the first people in the team of doctors to interview the patient for your service. That allows you the freedom to learn the best approaches, appropriate questions, and useful clinical examination skills while still maintaining the patient's well being as a first priority. It also allows you to think through the clinical scenario and suggest subsequent tests to order and medications to prescribe. 
  • Your responsibility is to learn as much as you possibly can. You can make mistakes, suggest ridiculous plans that are quickly rejected, and give a differential that is totally off-the-wall - and all of that is okay. You're here to learn, learn, learn.
  • You aren't stuck behind a stack of books for the entire year - you actually get to interact with real people! That in itself makes third year pretty great! ;)
What I DIDN'T love about Third Year:
  • The whole life:work balance is a difficult thing to master. I reckon it might take a lifetime before one could properly achieve the perfect balance. At times, it is hard to realize all that you're missing out on in your life outside of work - but most of the time, the work is so fulfilling and rewarding that the work is worth the sacrifices. On a very important side note, it is absolutely imperative that those you love understand how demanding life can be for a physician. The life:work balance will always be a significant struggle for the family of a physician. (I am so incredibly lucky to have such an unbelievably supportive, loving, and understanding fiance and family, and I wouldn't be here without all that they continually do for me).
  • There are definitely moments when will be overwhelmed by the amount of things you don't yet know, or haven't quite mastered. That's the beauty of medicine - it is always evolving, and you have to do your best to keep up. 
  • Studying for a shelf exam is not something I loved doing when I had patients that I want to help care for to the best of my ability. Fourth year is full of taking care of patients without the worry of an impending examination!

Before my first day of medical school, a recently-graduated doctor passed on her perspective of the four years spent in medical school, and it has really stuck with me as I have progressed through the course work. "I can't say that it's going to be easy, or that you're always going to love what you're doing, but I can tell you this: each year is better than the last."

And with that: BRING ON FOURTH YEAR!!!!!!!!!! :)

Friday, August 3, 2012

Step 2 CK - Check!

Well, everyone: it's over!!!!!!!!!

What a long day!

Nine hours of difficult examination is surely a form of torture in some places of the world; it was borderline unbearable! My ADHD self had one difficult time sitting and staring and concentrating and interpreting and determining and narrowing down and selecting an answer for each question! 356 questions? Or something like that? I don't even know. It all just has already been kind of wiped from my memory...

I feel like I should sit and really contemplate what it means to have just finished this exam. I know it's a huge deal, and it's the last difficult thing that stood between me and my MD. It's hard to even fathom how much a person can grow, how much someone can learn, how anyone can change in so many (hopefully) positive ways in such a short amount of time. I still can't believe how far I have come on my journey to living the life of my dreams.


Life is good.

And I am blessed enough to have an amazing man by my side, through it all.

Oh, and PS: Not a single question on Lynch Syndrome (is that too much to ask?!haha); however, there were a few that kinda/sorta linked to Lynch in a round-about way, which was ok. I made a point to thank my cousin/aunt/grandmother/great aunt a few times throughout the exam for their unbeknownst but significant contributions they have had on my education.

Right. Now I'm off to do a few things I've been neglecting for the past 5 weeks! That's right, I'm not going out celebrating tonight - I will instead be cleaning/cooking/laundry all night (with a glass of wine in hand, of course!). Tomorrow is all about taking it easy.


Enjoy your weekend, friends! Thank you for all of your unending love & unwavering support. :)

Wednesday, August 1, 2012

48 Hours from Freedom

Okay, things are getting serious.

In less than 48 hours, I will have completed my final written exam of my medical school career. Crazy, right? It feels like just yesterday I was sitting in the lecture hall, nervous and excited and scared out of my skin taking my very first exam of my medical school career. Here I am today, two days from the final major exam of my medical school education. I still cannot believe how far I have come on this journey to becoming something better than I ever dreamed imaginable - I will become a doctor.

Seriously. How cool is it that I will be directly involved in saving lives? This is the best job in the entire world. I cannot WAIT to continue on this amazing journey, pursuing my wildest dreams and truly changing the world.

I'm kind of freaking out; after taking hundreds of practice exams, I looked into what my predicted Step2 score is - and it's out of the ballpark. Seriously, I could never in a million years actually perform that well. According to the predictors, the score could be 297 (+/-11). I refuse to believe that I could actually do so well. But maybe this is a sign that I should have a bit more confidence - I will do just fine. I'm not expecting a 297, that's for sure!

Anyway, it's not like I'm trying to get into Derm or Ortho or something at Johns Hopkins! Geesh! ;) I just aim to do my best; its the best I can hope for - and I won't complain, no matter the outcome, because I will have truly done.my.very.best on this exam.


After 5 weeks of 10-12 hours/day of studying, everything starts to look a little fuzzy!