And Breathe

Just a brief look into the life of a crazy shoe-a-holic, dog-loving, hair-braiding, nail-painting, life-embracing, medical student
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So much to do, yet so little desire to actually do it 😞

To all of my MS1 followers just starting out, this is some pretty solid advice. It also made me think what I would tell my MS1 self. It seems like so long ago that I was a scared/excited/optimistic girl sitting on the plane to a developing country to start my first semester of medical school. I thought I would be like college, just a little harder. Try a lot harder. With our 2-years-in-16-months curriculum, you got it the first time or you were lost. I had to learn how to really study for the first time in my life—it didn’t “just come to me” like everything had in high school or college. I had to really work. I stressed, I cried, I contemplated quitting and just going to work at a zoo the rest of my life (still my back-up plan, by the way, because I love the gorillas) on at least a weekly basis. I guess if I could go and tell my MS1 self anything, it would be to stop trying to be perfect! Work hard, yes. Do your best, yes. But don’t stress yourself out trying to always get an A. Don’t beat yourself up because you didn’t understand that biochem pathway, or had to go to the tutor (just go get the help you need!), or endocrine still makes your head spin. You’ve got this, you’re capable of so much more than you think, and you WILL succeed. So chin up, MS1 self, put in the work, believe in yourself, and go kick some ass!

Well I had the worst day of rotations to date…

This morning started out on a good note with Grand Rounds. Apparently I didn’t have to show up until 10am, but I got there at 9am. No big deal because I learned about paying back student loans (not really the pick-me-up you’re looking for in the morning, lol). One of my colleagues surprised me by bringing me coffee (yay!) to celebrate my anniversary that was over the weekend! Today’s actual presentation was on alcoholism and DTs, which everyone gets to see at one point, so it was very helpful and informative. The medical student portion actually ended by 11am, so I was able to go home, spend some time with my dog, and eat lunch before having to be to the office by 1pm.

Tuesdays at the office are a little different because it’s OB day, and a resident is there. Therefore, I really don’t get to see patients. I got to see one patient in 3 and a half hours…and I didn’t get to see them on my own. It was a follow-up visit so it took all of 5 minutes…With follow up visits I’m basically a fly on the wall, listening to the conversation between my attending and the patient, and not even allowed to participate in the physical exam…It’s frustrating. So I did a whole bunch of nothing with patients today.

But what truly made my day terrible was giving the presentation I prepared for my attending. The only information she gave me was “I want you to do a presentation on asthma.” Nothing was said about her expectations for my presentation. So I followed the set up of the presentation I gave during OB/GYN—very detail oriented, going into all of the pathophysiology, the mechanisms behind each treatment, etc. I prepared a powerpoint that was 34 slides—enough to get me through a half hour to 45 minute presentation. Apparently this was not what she wanted. She stopped me 3/4 of the way through my presentation to inform me that what I was delivering was what she would expect out of a 1st or 2nd year medical student…That alone just crushed me. I am very Type A, and am definitely a perfectionist. I take pride in my work and put a lot of time and effort into everything I do. For her to insult my presentation and my intelligence was too much for me…She continued into how my presentation was sub-par and I tried so hard, but I could feel my face getting red and my eyes watering.

I am NOT a crier in front of people, but the frustration about this rotation for the past 2 and a half weeks just came to the surface and spilled over. I was so embarrassed and I felt stupid and weak for allowing it to happen. When she asked why I was tearing up, I could only get out that I felt like I failed…All I can think of is what a terrible evaluation she’s going to give me, especially now. I excused myself and had to go to the bathroom to just cry it out…

Thankfully it was the end of the day and there were no more patients to see. She then told me not to be embarrassed, but to learn to control it because I should never allow myself to get emotional in internal medicine or surgery because they would not be understanding, and that I would need a thicker skin to be in this business…Then she told me to redo my entire presentation as well as prepare another presentation about acute pancreatitis outpatient management by tomorrow…

I am just dreading going back tomorrow…I hate complaining like this…I want to like Family Medicine so badly because I’m really thinking of going into it, but I have disliked this rotation so much thus far! I like the patients, but I feel like my attending hates me, which makes me anxious and nervous every day…I know I need to just get over it because there will be attendings like this for the rest of my life; no one said it was going to be easy. I just hate that I let her get to me and that I let her see me like that because now I DO feel weak. I am done at this location this week, so I just need to get through the next few days; hopefully the next location will be a better experience for me…

Went to go buy some low black pumps (yay for more professional shoes) and walked out with the shoes, 3 new professional grown-up dresses, plus king-size sheets…Worth it? I think so :)

So this was my first week of family medicine. I want to like family med so much because in the back of my mind I would love to be that small down primary care doctor that knows everyone in town…Honestly, right now I’m just feeling overwhelmed…You literally need to know EVERYTHING because the family med doctors are typically the first to see everything from pneumonia to pregnancy to depression to alcoholism…and so on. 

So my night on call was fortunately (for me) and unfortunately (for y’all) very calm. There were no pressing matters during the night, so I actually got a full night of sleep! Well, as much of a full night as you can get on the super uncomfortable on call room beds, lol. The patients were pretty interesting though. There was a man that was withdrawing from alcohol—thankfully no seizures through the night! There was also a man that we did not know what he had—there was redness spreading over his body, but it didn’t LOOK like cellulitis. I believe when I left the infectious disease team was throwing around the ideas of Toxic Shock Syndrome and Scalded Skin Syndrome. There was also a girl, one week postpartum, that possibly had post-partum depression so we were calling for a psych consult. Our last guy just had a LOT of problems, but was in such good spirits…I guess ignorance truly is bliss because he didn’t seem to realize just how bad off he was. He was just happy to have us all checking in on him. 

I have a bunch to look up and research on patients from last week…I have 3 SOAP notes to write, one that has to have a “very good differential list and work up plan.” I also have to do cases, log patients, and do cases. 

Ever have so much to do that you just want to crawl under the blankets and say “forget it, I’m staying here.” Yeah, that’s me right now. I have so much to do that I literally don’t want to do any of it, though I know I need to. I feel like I always freak out for the first week though…deep breath…and just get it all done tomorrow :)

I have to remember this in all aspects of my life—it’s not about being perfect, it’s about working to be a better YOU every day!

And so begins my first night on call for family medicine! My resident seems chill, and it should be a slow night according to him—let’s just hope that is accurate because I’m not sure I can handle too much excitement my first night lol. I’m here until morning rounds tomorrow morning, which begin at 8:30. I’ll be sure to write up how my night goes for y’all! Wish me luck!

And so begins my first night on call for family medicine! My resident seems chill, and it should be a slow night according to him—let’s just hope that is accurate because I’m not sure I can handle too much excitement my first night lol. I’m here until morning rounds tomorrow morning, which begin at 8:30. I’ll be sure to write up how my night goes for y’all! Wish me luck!

If you know yourself, you’ll not be harmed by what is said about you.
Arab Proverb (via caffeinatedcranium)

(via medisane)

Soooo I’ve been MIA lately with studying and this rotation coming to an end. I started writing this post when I took this picture—Saturday, or day 3/4 on call. Thankfully it was a very calm on call weekend. Thank goodness because my shelf exam is tomorrow (positive vibes, please!). The last thing I needed before studying like crazy was another ridiculous on call weekend (just go back a few posts!). It ended up with the way my colleague and I split up the patients that I got almost all of the males. For some reason all of the males were more or less stable with little to no problems—I definitely lucked out.

I had one “hostile” patient that wasn’t fond of speaking, telling me that he would only speak when he was getting discharged (Monday). He had no interest in getting better because he didn’t think there was anything wrong with him. He came in for depressive symptoms, but I would suspect there to be some antisocial personality disorder in there somewhere. When most people hear antisocial, they think of the people in the corners at parties. That isn’t what we mean by antisocial in psychiatry, however. In psychiatry, it is meant for someone who has no regard for rules, places blame on others, has trouble with the law/authority in general, and shows no remorse—pretty much think of serial killers. If people show these traits before 18 years old, they cannot be labeled as antisocial personality disorder, because personality disorders are diagnosed in people >18 years old; instead they would be labeled as either oppositional defiant disorder (disregard for authority) or conduct disorder (theft, hurts others, escalated from ODD). If you think of them on a timeline, a child would first have ODD—without treatment and intervention this would then continue into conduct disorder. Once they celebrate their 18th birthday without any treatment or intervention, they are then labeled as antisocial personality disorder.

I had another patient who is transgendered, or gender identity disorder. She had been born a male, but feels she is a woman trapped inside a male body. She began hormone treatments to begin her transformation into a woman. She came in for suicidal ideations, and has had problems like this in the past. She was very nice to talk to, very polite, and very kind. We augmented her medication regimen with another mood stabilizer to hopefully help with her depressive symptoms and suicidal ideations. It was a little weird though because when we talked, she did not address being transgender at all—the admitting nurse informed me that she liked to be referred to as a woman and some of her history. Without that information, I wouldn’t have known. She was androgynous, so I wouldn’t have been able to tell by how she looked either. The conflict she is feeling with being trapped in the wrong body may be adding to her symptoms, so I hope she talks to her outpatient psychiatrist about it…

This past week has just been study mode for me…my test is tomorrow, so I know as much as I’m going to know now lol. I’m just reviewing some history of psych and some theories, as there were practice questions on these topics. Let me just say—I don’t know about other medical schools, but at mine, we never went over that. They just mentioned Freud in passing pretty much. The only time I learned about child psych, psych theories or the history of psych was in high school (so long ago!) and my sophomore and junior years in college when I would have minored in psych if that was available. That seems like forever ago, so I’m pretty much happy that I even recognize some names and theories let alone understand and remember each one! Why, psych shelf, do you want to give me anxiety?! Please be kind and just ask me to diagnose and treat, preferably with SSRIs since those are the go-to. As you can see, I am in need of positive vibes tomorrow, lol. 

Well study break is now over 😞 back to the grind. As always, any questions, feel free to ask!

Soooo I’ve been MIA lately with studying and this rotation coming to an end. I started writing this post when I took this picture—Saturday, or day 3/4 on call. Thankfully it was a very calm on call weekend. Thank goodness because my shelf exam is tomorrow (positive vibes, please!). The last thing I needed before studying like crazy was another ridiculous on call weekend (just go back a few posts!). It ended up with the way my colleague and I split up the patients that I got almost all of the males. For some reason all of the males were more or less stable with little to no problems—I definitely lucked out.

I had one “hostile” patient that wasn’t fond of speaking, telling me that he would only speak when he was getting discharged (Monday). He had no interest in getting better because he didn’t think there was anything wrong with him. He came in for depressive symptoms, but I would suspect there to be some antisocial personality disorder in there somewhere. When most people hear antisocial, they think of the people in the corners at parties. That isn’t what we mean by antisocial in psychiatry, however. In psychiatry, it is meant for someone who has no regard for rules, places blame on others, has trouble with the law/authority in general, and shows no remorse—pretty much think of serial killers. If people show these traits before 18 years old, they cannot be labeled as antisocial personality disorder, because personality disorders are diagnosed in people >18 years old; instead they would be labeled as either oppositional defiant disorder (disregard for authority) or conduct disorder (theft, hurts others, escalated from ODD). If you think of them on a timeline, a child would first have ODD—without treatment and intervention this would then continue into conduct disorder. Once they celebrate their 18th birthday without any treatment or intervention, they are then labeled as antisocial personality disorder.

I had another patient who is transgendered, or gender identity disorder. She had been born a male, but feels she is a woman trapped inside a male body. She began hormone treatments to begin her transformation into a woman. She came in for suicidal ideations, and has had problems like this in the past. She was very nice to talk to, very polite, and very kind. We augmented her medication regimen with another mood stabilizer to hopefully help with her depressive symptoms and suicidal ideations. It was a little weird though because when we talked, she did not address being transgender at all—the admitting nurse informed me that she liked to be referred to as a woman and some of her history. Without that information, I wouldn’t have known. She was androgynous, so I wouldn’t have been able to tell by how she looked either. The conflict she is feeling with being trapped in the wrong body may be adding to her symptoms, so I hope she talks to her outpatient psychiatrist about it…

This past week has just been study mode for me…my test is tomorrow, so I know as much as I’m going to know now lol. I’m just reviewing some history of psych and some theories, as there were practice questions on these topics. Let me just say—I don’t know about other medical schools, but at mine, we never went over that. They just mentioned Freud in passing pretty much. The only time I learned about child psych, psych theories or the history of psych was in high school (so long ago!) and my sophomore and junior years in college when I would have minored in psych if that was available. That seems like forever ago, so I’m pretty much happy that I even recognize some names and theories let alone understand and remember each one! Why, psych shelf, do you want to give me anxiety?! Please be kind and just ask me to diagnose and treat, preferably with SSRIs since those are the go-to. As you can see, I am in need of positive vibes tomorrow, lol.

Well study break is now over 😞 back to the grind. As always, any questions, feel free to ask!

Made some yummy (and healthier) blueberry muffins for Joseph coming home! #healthier #blueberry #yum