Friday, April 17, 2009...24 hours...1440 minutes later...

it seems almost surreal that this day has come...and gone! i was expecting a shift, a pause, a break in time and space, a moment, something that would make April 17th feel different than April 18th.

i arrived in the lecture hall the same time as I always did, entered through the back doors and made my way down the center aisle towards my usual seat. i have sat in the the same seat to take exams for almost two years, which seems perfectly normal to me, but clearly not everybody follows that same pattern. so as I enter the back of the lecture hall, the last time I will enter the lecture hall for an exam, I glance to my left to insure MY seat is there. it is, BUT someone is in the seat right next to mine! so, I know it’s surprisingly, but that’s one of my idiosyncrasies, Can you believe that I have more than one...don’t answer that. I don’t like having someone sitting right next to me. Well, thankfully he moved and now all is right in my world. I settle into my routine, take out my two mechanical pencils (have to be prepared in case one runs out of lead), my eraser and open my protein bar (don’t want to disturb my classmates by fumbling with my wrapper in the middle of the exam) and get ready for what will be my last exam as a second year medical student. my last exam in this lecture hall. CRAZY!! oh, of course, like clockwork he arrives 15 minutes late for the exam! what makes one person hypervigilent about being on time and another seemingly hypervigilent about being late, FOR EVERY SINGLE EXAM! he, as usual, casually walks into the lecture, shoulders hunched, almost shuffling, just like he has done for every exam. gives the odd half smile or smirk and saunters to a seat, directly behind me! this has got to be my punishment, my test upon a test, to have to deal with what is possibly one of the most irritating people in my class. none the less I try to put it out of my mind, telling myself to focus on my exams and slowly will myself to return to the task of getting focused for my exams.

throughout the coarse of the exam, he gets up 3 times to go to the bathroom. who does that? how could he possibly have to pee that many times? I guess one would say “why am I even concerned with him”, good question? I wish I could let it go, not have it register with me, but I find it so difficult. he has managed to snowball our class into believing he is an upstanding, honest, self-less individual when I know first hand that he is everything but that. I have personally watched him be dishonest, undermining, self-serving and manipulative. I keep telling myself that he will get what is coming to him, but it still doesn’t prevent me from being disgusted by the very sight of him. even now, I should be focusing on my exam and yet I’m watching him saunter through the lecture hall to go to the bathroom for the 3rd time in 2 hours!! seems suspicious to me, especially since I know exactly what he is capable of. FOCUS!!!

four exams and a little over 3 hours later I double check all my exams and scantrons. I quietly gather my pencils and eraser, slowly rise from my chair insuring it doesn’t swivel and slam into the desk, quietly zip up my back pack and begin the walk towards the front of the lecture hall. wow, am I really done? two years of medical school over. I remember vividly the first day of orientation. I sat in a different seat then. oddly enough I maintained that seat for actual lecture time but had a different one for exams. you think I’m too rigid, too predictable? my anatomy professor would say so. In passing, he mentioned “you probably sit in the same seat for exams don’t you”, and this was almost one year after I had finished his course. sadly enough he was right. I wonder if that is a window into what specialty I will decide to pursue? wouldn’t it be great to correlate one’s seat choice, and whether it remained consistent, with what specialty a student decided to pursue. that would certainly ease some of the angst I have right now. probably not likely.

anyway, backpack slung over my right shoulder, I slowly walk down the lecture hall steps and advance towards the front of the lecture hall. I openly smile, very rare for me on exam days, and hand in my exams and scantrons. my professor returns my smile, congratulates me and I slowly head towards the door. I gently ease the door open, catch the handle on the other side and insure it closes slowly. Done!

I always imagined this day would generate more emotions. figured it would feel like sprinting the last 1/4 mile of a race or digging deep to finish the last 1 minuter / round of a tkd fight but it wasn’t. there was no big weight taken off my shoulder, no big sigh of relief, no breakdown or major revelation and I certainly didn’t fell like I had amassed all this knowledge that now I was “ready” to enter my 3rd year of medical school. I passed my classmates in the hall comparing answers, “what did you put for X”, “I put X” and walked up the back stairs to the Library. I had made plans to meet friends, not just classmates but friends, in front of the lecture after the exam. we were going to celebrate!!

April 17, 2009...24 hours...1440 minutes later...I’m now an OMS III.

Now what?!

like clockwork...

one week before my M2 year is scheduled to start and the sleepless nights have begun. sometimes i have such a hard time stilling my mind and my thoughts? i’ve had a good summer...a great summer, with no regrets. i had the chance to relax, spend some quiet time with myself and make much needed and overdue road trips to see my family and friends. spent a few days with my grandmother...she is so cute! I went out to dinner with my cousin and when i got back to her apartment she had made the pull-out couch for me and put out an extra pair of bedroom slippers...pink and comfy ones! at almost 90 years old, she is my hero. so strong, so committed to family, a mother and nurturer in every sense of the word. i hope to be half the woman, mother and grandmother that she has been. i’m going to surprise her at the end of august for her 90th birthday party...i can’t wait. i love my gran! i got to visit two college friends in PA..truly a blessing to see them! it was as if no time had passed. they are genuinely good people...loving to the core. they have stood by me, held my hand, hugged me and cried with me through some crazy, trying times...thank you for always being there! i love you guys! if you happen to read this...get a facebook page :). it was so mentally and emotionally rejuvenating to sit and enjoy stories and laughs with family and friends. that time can not be replaced and I wouldn’t trade it for the world. you know, as last year was winding down i struggled with how and what to do with my summer. do something medically related, get a job just to make money, do research, etc...turns out the best decision i made was to do “nothing”. this is exactly the summer that i needed. will it come back to haunt me, i don’t know, i guess only time will tell...although i really doubt it. I got to watch my boy swim, run around off-leash, chase tennis balls...his summer has been just as priceless as mine. thank you to the cape cod natives for a fabulous weekend...enjoying the beach, relaxing in the backyard, and sharing stories. anyway, back to my sleepless nights..as usual i digressed. maybe that’s why i can’t sleep...from one thought process to the next. what keeps me up at night? financial aid..will my loans be funded on time? i’ve been told by my lender that funding is delayed by 10-15 days and then my school needs time to process and cut a check. will i have it in time for september rent? what about other financial obligations that are coming due within the next two weeks? what about my tuition and fees? will my school give me an extension? what about work study? i need to fill out the appropriate paperwork and get them back to my financial aid office. oh yeah, i cant forget to bill for the hours that i worked over the summer that will come out of my fall work study hours. what do we need to get done for the outreach program that my classmate and I are trying to start? who do we need to follow-up with? we need to get student volunteers? we need to complete the grant application? books...i haven’t bought my books yet because i didn’t want to make the same mistake as last year. i bought all the books and i never even used some of them. when will i be able to afford / buy books? how far along into the semester will that be? how is this going to affect me? what 4th year electives do i want to do? i read somewhere that you should work backwards from your residency choice...what residency do i want to do? when will i know? if i wait until 3rd year, will that be too late to secure the 4th year electives that i want? how do i go about deciding which residency i want? a good friend of mine, suggested first to decide if i want to do medicine, surgery or a bit of both. once i know that, then decide on the lifestyle that i want. from there narrow the field. in the end, she recommends letting my lifestyle be the determining factor. can i really do that now? will my grandmother live to see me graduate? will she live to see my white coat ceremony? what would my mother say? what would my sister say? what advice would they give me when trying to make these decisions? the thoughts quickly run through my mind...i don’t seem to linger long enough to fully explore them...and i’m off on another thought. in spite of all this, its as if i can hear the clock ticking in the background...click. what time is it? how long have i been up? i have so much to do tomorrow and at this rate i’m going to be exhausted. where is my dog? is he in the room or the hallway. well i have to go to the bathroom, so i’ll see where he is. he’s downstairs...enjoying the cool breeze coming into the living room. its 4am! i have got to get some sleep. lets hope i get to sleep soon. more so, lets hope this doesn’t happen tomorrow night. classes start on monday, august 18th...unbelievable...its already here. i need to get some sleep...but i can still here the minute hand...click.

sunday, september 14, 2008

the annual new york city race for the cure is sunday, september 14, 2008. i have formed a team in memory of my sister, steppin' for sabrina! my family and friends have walked in the race the last two years in memory of nina and we will be in central park again on september 14th.

you may know that one in seven women will be diagnosed with breast cancer in her lifetime. you can help these women and thousands of others in the fight against breast cancer. join the fight against breast cancer by registering (as part of my team - Steppin' for Sabrina) or by supporting my efforts with a pledge contribution. the money raised through the Race will fund vital education, screening and treatment programs for underserved women in our own community and support the national search for a cure.

i need your support! every step counts and all contributions are appreciated, no matter how small!

thank you and help me reach my fundraising goal of $5,000!!

Join or make donations at Steppin' for Sabrina.

Thank you!!

is first year really over...

now that summer is here, i have the opportunity to reflect on what the last year has meant, what i’ve learned (or was supposed to have learned) and where do i go from here. i have been asked countless times, while catching up with friends and family, “so, how was medical school”? i have attempted to answer that question, but am i doing the experience justice? it has been a roller coaster ride and i’ve tried to take small victories where i can and learn from the defeats. when i look back, can i say that i am satisfied with my performance and accomplishments? what is the measure of success? is that measure realistic? if i say that it isn’t realistic, is that because I didn’t accomplish my goal(s) or was my expectation truly something i could accomplish? i still don’t know the answer to these questions. so in the meantime i try to enjoy the free time….i stroll through the park with my dog, lay in the park reading a book or writing in my journal, and most importantly i’ve started running and training again! in between these moments of rest, i think about these questions and try to do some self-reflection and analysis. most, if not all of my friends, would say “just relax”...why am i using my free time to think about school and rehash the emotions and actions of my first year? my response would be, growth only comes from honest self-reflection. imagine going through life, making choices, establishing and ending relationships without ever reflecting on those decisions. were they really the best decision at that time and for the circumstance? could you have made a better, smarter choice? could you have applied a different set of principles, a different strategy? so at the end of the day i’m left with more questions than i have answers. i guess not much has changed since the beginning of the year. i’ve got some academic / review goals for the summer, but i’m truly trying to give myself a mental break. next year will be difficult, whether some of that is self-induced i’ll let you decide, so i want to be prepared. i already feel like step 1’s are staring me in the face...gosh that seems so strange…i still haven’t gotten my arms around the fact that i’m in medical school, much less done with my first year and thinking about step 1’s. i am so blessed...this privilege is more than i could have imagined it would be and i work diligently to insure that i don’t squander this opportunity. i don’t want to be average / mediocre / just pass...i want to be exceptional, i want to feel confident that when i’m placed in a medical situation i have the knowledge, skills and confidence to make the hard / necessary choices...choices that will be made with empathy, concern, and in the best interest of my future patients and their families. i think i might have gone off on a tangent…

anyway, back to summer...rest, relax, travel, visit family and friends, review, prepare the appropriate study space in my apartment, start investigating board prep courses and review schedules and try to schedule in some time for exercise next year! seems fairly do-able...off to board my flight back to new york...didn’t believe that i was actually going to rest and take some time off did you ?!

something to think about...

“It doesn’t interest me what you do for a living, I want to know what you ache for, and if you dare to dream of meeting your heart’s longing.

It doesn’t interest me how old you are. I want to know if you will risk looking like a fool for love, for your dream, for the adventure of being alive.

It doesn’t interest me what planets are squaring your moon. I want to know if you have touched the center of your own sorrow, if you have been opened by life’s betrayals or have become shriveled and closed from fear of further pain. I want to know if you can sit with pain, mine or your own, without moving to hide it or fade it or fix it.

I want to know if you can be with joy, mine or your own, if you can dance with wildness and let the ecstasy fill you to the tips of your fingers and toes without cautioning us to be careful, to be realistic, to remember the limitations of being human.

It doesn’t matter to me if the story you are telling me is true. I want to know if you can disappoint another to be to yourself; if you can bear the accusation of betrayal and not betray your own soul; if you can be faithless and therefore trustworthy.

I want to know if you can see beauty, even when it’s not pretty, every day, and if you can source your own life from its presence.

I want to know if you can live with failure, yours and mine, and still stand on the edge of the lake and shout to the silver of the full moon, “Yes!”

It doesn’t interest me to know where you live or how much money you have. I want to know if you can get up, after the night of grief and despair, weary and bruised to the bone, and do what needs to be done to feed the children.

It doesn’t matter to me who you know or how you came to be here. I want to know if you will stand in the center of the fire with me and not shrink back.

It doesn’t matter to me where or what or with whom you have studied. I want to now what sustains you, from the inside, when all else falls away.

I want to know if you can be alone with yourself and if you truly like the company you keep in the empty moments.”
-Oriah

does faith and religion have a place in medicine?

i say absolutely yes! a recent study, as presented in our clinical medicine course, showed the effects that prayer has on patient outcome. beyond that, maybe it hasn't been shown through scientific research, but i think we all would agree that "complete" health comes from being mentally, emotionally, physically and i would add spiritually healthy. can we as physicians ignore the role that faith and religion play in our patient's lives? do we need to agree with their choice of religion, or is more important to acknowledge the role that it plays in their lives? should we respect our patients rights to pray and the prayer schedule that they must adhere to? as stated in class, we as physicians don't have a problem asking our patients about their sexual habits yet we won't ask them if they pray...why is that?

A Physician's Prayer

Dear Lord, thou Great Physician, I kneel before Thee. Since every good and perfect gift must come from Thee I pray, give skill to my hand, clear vision to my mind, kindness and sympathy to my heart.

Give me singleness of purpose, strength to lift at least a part of the burden of my suffering fellowmen and a true realization of the privilege that is mine.

Take from my heart all Guile and Worldliness that with the simple faith of a child I may rely on Thee.

AT Still

practice what you preach

pet peeve of mine...i have so many...

so you say you want to be a doctor. you want to help others be healthy...granted this may be my definition. but none the less, we will be tasked with the responsibility of helping our patients achieve health and counseling them on diet, nutrition, exercise, etc. so pray tell why you're eating mcdonalds, hotdogs, kentucky fried chicken, and / or popeyes for lunch? how do you dissect an obese cadever and see up close and personal the effects of poor nutrition and still continue to throw crap down your throat? how can you tell your patients they need to lose weight because it represents an increased risk for hypertension, high cholesterol, diabetes and you yourself are just as unhealthy. where is nutrition and it's impact on health in the medical school curriculum? i think it should be mandatory. how does the administration say "it's important for each of you to remain healthy and to exercise while you're in school" and the vending machines in school have nothing but processed chips, m&m's and candy? am i missing something? am i being too harsh? i have that tendency, so it wouldn't surprise me.

now i have room for improvement...i eat way more chocolate than i should and i went from doing vigorous exercise 6 days a week to moderate exercise 2 days a week. so right here and now, i'll be the first to practice what i preach...i can't realistically say i'll be able to go back to 6x/week of vigorous training, but i WILL do a minimum of 3x/week!!

you heard it hear first. if no one reads this, does that mean i have to do it?