Back to the start, yet moving forward.

As I sit in yet another airport awaiting my connecting flight, I'm embarrassed to see I've only posted 7 times this year... but I will stop with the apologies and just accept it. I hope to continue my sporadic posts (and replies to comments) as I start yet another journey.

The Pediatric rotation finished! Looking back, long hours were spent with adorable, but screaming children.
After this rotation I really felt that my history taking skills have improved. Seeing 50+ patients per day gave me an opportunity to fine tune the questions I posed to parents and the patients (a technique that I'm sure I will be forever perfecting). I realized that it is such a fundamental part of any exam as it can drastically alter an assessment and treatment plan. Patients and parents tend to forget/ not divulge details if they do not think them significant and as a medical student we have the privilege to spend a fair amount of time questioning patients before the doctor sees them. The questions you ask and the flow of the interview not only sets the atmosphere of the appointment (especially in pediatrics) but it also shows the supervising doctor your train of thought. Each question should be directed in such a way that it either 'rules in' or 'rules out' a diagnosis on your continually forming mental differential diagnosis list.... and trust me that list is a long one when the answer to "what brings you in today?" is "my child has been coughing".
So, with that said, I do love kids; I like observing their different personalities and how they surface at such a young age. I like making them laugh and feel comfortable in the doctor's office. I am grateful for the opportunity to have had such a large amount of time interacting with patients during the peds rotation but my heart is with the field of obstetrics and gynecology :) ... and will make sure to enjoy the simple fact that my patients will be able to express their pain and describe it!

Being home meant I got to spend time with this "little" guy. :)

For the past 5 weeks I took a much needed 'break'. And the word break is in quotes because it consisted of being home and studying for the canadian equivalency exam as well as working on 4th year elective applications.
I was definitely burned out when I got home. Sleep, eating and doing nothing all day had never felt better... every now and then we all need a lazy, lounging day ( or week) spent in the confines of our home ...  Although, as I sit here waiting my plane, I am excited to be returning to my role as a medical student. I guess I missed having a structured day. I really shouldn't be surprised; I am the type of person that will choose white water rafting and camping as my vacation rather than an all-inclusive resort.

Friends supporting friends. Being in medical school doesn't mean your hobbies are put on hold. 

the never ending swarm of runners was such an amazing view.

mile 11.

I also went to support a friend running the NYC Marathon (I hope to write a short post on that alone) but I do want to encourage all of you to attend a big city marathon if you ever have the chance. It truly is an inspiring atmosphere!

So what's next?

I'm going back to the start! That is I will be returning to Sheppard Pratt for a 3 week clerkship in female adolescent psychiatry before returning to Florida for 3 months of Trauma Surgery to complete my third year.
I'm excited to return to Pratt as I will be going back changed; a more experienced medical student. With Ob/Gyn in mind, the female adolescent psych elective will be a nice complement. During my core Ob/Gyn clerkship we dealt with a surprising number of pregnancy complications related to drug addictions and mental health. I will try to keep you posted.

To end this overdue and long update I'm also happy to share I will be partaking in the Color Run in support of Global Citizen. Click on the links to find out more about them and see when they will be hosting an event near you :) It's a fun and interactive way to get everyone involved and spread awareness.


PS. Personal goal of running a marathon has been set... and now it is public which means I have to do it

On to the next one...

I wrote my last post almost a month ago - I can't seem to keep up with the blogging.

Third year seems to be becoming a blur.

As much as it is exciting to be in the hospital, you rotate through each specialty so quickly.  As I am getting comfortable and familiar with my surroundings, the rotation is over and I am thrown into another. Sometimes it seems I just need to keep my head above water long enough for my next day off to come. Working 6 days a week since February with a total of 3 weekends off has taken a toll. Might I add that the "day off" is spent guiltily sleeping in and then franticly studying for the next exam.
Needless, to say it can/has been frustrating and exhausting to feel lost most of the time - while trying to keep an external calm and having the classic "medical student enthusiasm".

I have already finished my first week of paediatrics.
Here is peds in a nut shell: adorably cute kids that are ALWAYS screaming/ crying and come in with full blown colds that get you sick (and give you headaches!). Lessons learned so far? new found respect for parenting!
... but I'd rather tell you about the last little while in florida.

I finished 6 weeks of Obstetrics and Gynaecology (Ob/Gyn) and LOVED it. I think I may have found my specialty. The rotation was mostly an inpatient experience as I only spent 2 days in the outpatient clinic, however it was my choice as I wanted to get as much hands on learning as I could. I became a sponge for wanting to learn too much in very little time. I couldn't help myself, I took two 26 hour calls that were voluntary and worked 12+ hours/day. I may have over-indulged! But I had great attendings teach and trust me to perform procedures on patients. To give you a little glimpse... I learned to actually deliver babies with my own two hands (what an incredible experience! To hold someone in their first moments of life and be part of that new family), I was taught how to close fascia and skin, admit patients on my own, read and interpret fetal and maternal monitoring strips, make first incisions, drain cysts and scrubbed in/assist on numerous surgical cases.... the list can keep going but I'm afraid I will start using too much medical lingo ... then I would lose my readers for sure.

If you can't tell that I am excited then here is a picture to prove it. This was taken on one of my last days working with a doctor that I have grown to look up to (she truly invested her time in teaching and showing me everything she could). This was taken after she had let me close fascia and skin after a c-section and perform a quick surgical procedure called marsupialization on my own (with her guidance of course!). Such a rush.

I found ob/gyn to be the perfect combination of primary care in which you can develop a relationship with your patients, hands-on work that is not too time demanding in the OR (most procedures are < 2 hours) and a specialty which I can take the skills I learn and contribute elsewhere, where maternal health resources are needed. This specialty would allow me to continue pursuing my interest in international health (and even link my undergrad genetics studies). There are so many (too many?) possibilities.

Hollywood beach boardwalk

Other than rotations I have not had much time to explore Florida, unfortunately. But I hope to do so in the coming weeks... I am however a 5 min drive to the beach and boardwalk which has become my new running route as soon as I get used to the humidity here - you'd think I would be used to it from Saba, no?

mom and I at the beach after our 17 hour road trip!
Obviously this is the first place we would go to :)

Dinner with friends before they left for their next rotation.

My new favourite study spot.
Poolside studying can work...sometimes

One thing I find is hard to get used to is all the moving around. As much as it is exciting and amazing to have all this opportunity to travel and temporarily live in places I would never think of going, my friends and I have Skype friendships now. Sometimes we even Skype if we are in the same city doing different rotations. Everyone has such a different (and hectic) schedule that it is hard to find to maintain those friendships in person... unless we meet up for study sessions!
I look at all this moving around as travel opportunities and times of adventure... but sometimes, just sometimes, I feel like a lot of people my age are starting their life. "settling down" so to speak which seems like a comforting idea. Being away from close friends and family can be isolating. Moving from place to place with no real 'home' can also be isolating. Always studying can become lonely.

Just some thoughts.

To end off on a more positive (and super cool!) note, here is something I found today :)

If you want to follow his adventure here is the link to his blog: http://www.hankboughtabus.com

midnight thoughts

I went to my first hot yoga class in a very very long time. Before starting clinical rotations I become an avid yogi - I will even admit I became addicted to the 'high' of relaxation and clearing your mind... and the excessive sweating of course. Something about it just cleanses you.

Recently I have been more tired than usual. I guess that's what happens when you work 6 days a week for 6 months, move from city to city trying to temporarily settle down and call the place your home - oh, study and write exams in your spare time as well. I have not had a break from clinical rotations and my mind/ body are taking the toll. Don't get me wrong! I am loving clerkships. Being in the hospital and interacting with patients is inexplicably amazing. I always leave with a smile on my face at the end of the day - even if I grumble getting out of bed at 5:30am everyday.
My point is this: rotations are tiring.
Learning is on overload all day, every day. And your body needs more than 5 hours of sleep at some point. Right?

So I decided it was time for yoga again. The class I went to was amazing and challenging. Not just on my body but on my mind. You reach a point in that hour and a half where you regret going... not because you are not enjoying it but because you start thinking I could've done so much more with the time I spent in this class. I noticed myself constantly having to push these thoughts out of my head and put effort into 'being in the moment'. At the end of the class the teacher ended with something that really resonated with me so I thought I'd pass the message along.

She said: "Take the time to think back to this past hour and a half. Think about what the others in the class have accomplished. Send the praise and compliments to the centre of the room so that everyone can feel the positive energy.... breathe. Now, take a moment and think about your own practice. Pay attention to what first comes to mind. Now push those thoughts of 'I could've tried harder. I could've done better. I could've stood stiller.' out of your head. Why is it that when we think of our own practice we criticize but when we think of the others around us we praise them on their hard work. We should treat ourselves with the same kindness that we allow ourself to treat others."

She was right. My first thought was I should've been more mentally present during the practice. I should've stopped thinking about what I need to study...
We are our own toughest critic. I have always noticed that about myself. So from now on I will be (trying) setting a goal to be content with my results or performances, because, at that particular time, I know I gave it my all.

So, please, take the time to stop and think. Think about how you would praise others for their efforts. Now say that about yourself. Be happy with your accomplishments.

namaste.

"The" one.

Choosing a specialty is like finding the one person you want to spend the rest of your life with...at least I consider it with as much importance. It will dictate your career, lifestyle and opportunities. It will send your life in a certain direction ... surgery versus family medicine will make a difference. It is not just about deciding whether to be a doctor because that was an easy decision, it is now time to really define the rest of my life.

Like I have mentioned before, the follow up question I always get to "what do you do?" is "what kind of doctor do you want to become?"

As  I have always had a passion for surgery, I have been going back and forth on it being my top choice because I am also trying to consider the lifestyle I want to lead further down the road, thatis, one of balance (traveling, keeping active, research, family etc.) Should I choose something I am truly passionate about or a path that would guarantee me more free time away from the hospital? Is there a way to do both?

In the last few days I've had the opportunity to scrub in on a short surgical procedure for one of the patients I was following on the internal medicine floor. I am enjoying the internal medicine rotation, however in the past month and a half I have spent in it I have to confess that I have never been so excited to come back to the hospital (after a full 12 hour shift, mind you) to scrub in for that procedure! It was exhilarating and inspiring...I got those butterflies in my stomach and I couldn't wipe the smile off of my face, even if it was after an 18 hour day. It made me think why not do both? Why can't it be both? I have worked hard at becoming a doctor thus far and chose to take this path with no reservations - which does come with sacrifices - so should I settle for something I would like or something I would love? I figure if I am loving what I do, I can (eventually) take charge and make time for how I want to live my life as well... it might take a while before I am able to reach that point in my career but wouldn't it be worth it?
I don't yet have the answer yet but I thought I would share my thoughts and would love to hear some feedback from you!

the new life: psychiatry in a NUTshell, IM and this new thing called a social life :)

Much has happened since the last time I wrote. I finished my review paper, got it approved, received some of my clinical rotation schedule, already finished the psychiatry rotation at Sheppard Pratt and am 2 weeks into the internal medicine rotation at Harbor hospital.

So let's start with psychiatry!

Sheppard Pratt Psychiatric Hospital

6 weeks at Sheppard Pratt psychiatric hospital flew by. It was overwhelming at first - as you can imagine we had information overload...hospital protocols, new schedule, new patients, learning not to get lost in the hospital (trust me, the last one was harder than you think!). Being in a hospital with real patients is completely different than just reading about suicidal behaviour. It was very surreal in the first week when you sit with a patient and ask about suicidal thoughts, homicidal thoughts and severe depression. I was surprised at how comfortable patients were discussing such personal issues. Overall I actually enjoyed psychiatry more than I had thought. I really liked getting to know patients, their stories and by that I mean not just their 'medical history'. Psychiatry is one of the few specialties which really relies on knowing the full picture; social aspects of a patients life is just as important as their medical symptoms of depression. Assessing and managing a patient includes psycho-social evaluations. I loved sitting down with the treatment nurse, the social worker and the psychiatrist to check-in on patients daily. Once the patient would leave everyone would say their impression of the story we had just heard, we'd call a patients family to get another perspective and include both their and the patient's request on how to manage them. Are they safe to be out in the real world? that was the golden question, the one that decided if they needed to stay in the inpatient program or can continue as outpatient treatment. The down sides to psychiatry? there was no practicing of hands-on medicine and I feel like I would miss that. Most of the management of a patient was medications and therapy... the therapy portion I liked, the medication monitoring not so much. The pros of psychiatry was definitely the amazing schedule and lifestyle it allows. It is a specialty in which you can choose to do research in your free time and that is something I will be pursuing no matter what field I end up going into.

My friend from Saba and I looking all professional
on our first day of internal medicine 

Suffice to say I liked the rotation and will most likely going back in november to do an elective in adolescent/child psychiatry :)

Internal medicine is a totally different basket of eggs! I have only started 2 weeks ago and I find myself going to take a history of present illness report from the patient and asking them more questions about their social situation than I probably should. Although it is important, IM deals with emergent cases at times (especially [and obviously!] when we are doing admissions from the emergency department!). I need to stop thinking like a psychiatrist!! haha. So far I am in the overwhelming stage of IM... long hours (12 hr shifts are the norm and we have night call as well as long call 7am-9pm. Oh, did I mention we work 6 of the 7 days a week?). So yes, still adjusting to the schedule and the early start time! But all in all I like the patient interaction and the fact that we get to use our physical exam skills everyday. Something about hearing the patient talk about their symptoms and then confirming it with palpation or auscultation is very thrilling! :)

6:30am sunrise from the Harbor hospital parking lot.

As far as I am in my clinical rotations I can say one thing for sure: people are truly sick. I know this is such a general statement but when you read about stage III kidney failure, or about pancreatitis, or about anaphylactic shock it doest not sink in until YOU see it. I am starting to link all my book knowledge with the corresponding patient and it is a great way to build information. I find that I am learning so much more, so much faster than at Saba!

Oh and for those of you reading this and are preparing to start rotations, get ready to feel like you do not know anything all over again! We are once again merely medical students trying to stay afloat and catch our breath... its going to be a great ride.

Accepting the inevitable

I haven't posted in a while, but I would like to get back into it very soon. I am almost done my psychiatry rotation... much has happened so with a little more motivation and time management I will stop to reflect in the next couple of days.

...For now I wanted to share this particular video by Dr. Alejandro Jadad (with whom I've had the great pleasure of working with). He touches on such a simple idea, yet it is unbelievably thought provoking. I took the time to watch and then spent a good portion of my night trying to wrap my mind around it. Mortality. Yes, we all know that we do not live forever but do we take life for granted if/when we are younger? Can we ever reach that state of acceptance he talks about? Are we ever going to be completely happy that we have done everything we wanted to?



Dr. Alejandro Jadad | Acceptance from Maysie on Vimeo.


Just some food for thought to start the week off right :)

PS. sorry to those who have posted comments recently. I will get to answering them this week... promise!

A self-reminder

2013 has started out strong, for a lack of a better word, for my family... It has shown me how we can always pull through when we think we cannot and that we are always there for each other during difficult times. In light of this I would like to post a poem by Octavian Paler. (a Romanian writer and poet). My mom introduced me to this poem after my grandmother passed away a couple years ago. Although its quite lengthy, it helped me stay grounded and remind myself of the important things in life.
I hope it touches someone else too.



We have timeby Octavian Paler

We have time for everything:to sleep, to run from one place to another,
to regret having mistaken and to mistake again,
to judge the others and to forgive ourselves,
we have time for reading and writing, for making corrections to our texts, to regret ever having written,
we have time to make plans and never respect them, we have time to make illusions and gamble through their ashes later on.

We have time for ambitions and illnesses, to blame it all on fate and details,

we have time to watch the clouds, advertisements or some ordinary accident,

we have time to chase our wonders away and to postpone the answers,

we have time to break a dream to pieces and then to reinvent it,

we have time to make friends - and lose them,we have time to learn our lessons and then forget them quickly afterwards, 

we have time to be given gifts and not understand them.

We have time for them all.

But there is no time for just a drop of tenderness.

When we are about to get to that too – we die.

I have learned some things during my lifetime, experiences that I am now sharing with you.

I have learned that you cannot make somebody love you;

All you can do is be the beloved one.

Everything else, depends on the others.

I have learned that no matter how much I might care,

Others might not care at all.

I have learned that it could take years to earn somebody’s confidence

And only a few seconds to lose it.

I have learned that it is not WHAT you have in life,

But WHO is there for you to have.

I have learned that charm could be of use for only about 15 minutes,

Afterwards, you better know something.

I have learned that you should never compare yourself to what others can do better than you, 

but with what you can do yourself;

I have learned that what happens to the others is not as important as what I can do to help;

I have learned that in whatever way you might cut things,

They will always turn out to have two sides;

I have learned that when you have to depart from your dearest ones, you should do it with the warmest words;

It could be the last time you see them.

I have learned that you could carry on for a long time

After stating you cannot take it any longer;

I have learned that heroes are those who do what is right, when they ought to, regardless of the consequences;

I have learned that there are people who love you

But do not know how to show it;

I have learned that when I am upset I have the RIGHT to be so

But I do not have the right to be mean as well;

I have learned that true friendship continues to exist even when great distances are involved

And that goes for true love too.

I have learned that, if somebody does not love you the way you might want to be loved,

It does not mean they do not love you with all their heart.

I have learned that no matter how good a friend might be to you,

They will inevitably hurt you from time to time

And you will have to forgive;

I have learned that it is not always enough to be forgiven by others,

Sometimes you must learn how to forgive your own self;

I have learned that, regardless of how much you might suffer,

The world will never cease running because of your pain.

I have learned that the past and circumstances could alter your personality,

But it is certainly YOU to be held responsible for what you become;

I have learned that, if two people argue, it does not mean they do not love each other,

As well as their arguing would not prove that they are not in love.

I have learned that you should sometimes put a person in first place

And not their deeds;

I have learned that two persons could be watching the very same thing

And perceive two totally different meanings;

I have learned that, in spite of any consequences,

Those who are fair and honest with themselves reach higher peaks in life;

I have learned that one’s life could be changed in only a few hours’ time

By people who might have never even known them;

I have learned that when you believe there is nothing more you could offer,

You will always find the strength to help a friend who is in need.

I have learned that writing,

Just like speaking,

Could soothe your inner pain.

I have learned that the ones you hold dearest

Are taken away from you far too soon…

I have learned that it is far too difficult to realize

Where to draw the borders between kindness, not hurting the other and firmly sustaining your ideas.

I have learned to love

In order to be loved in my turn.

A Good Start :)

The holiday season wraps up and 2013 begins...

Oh how I have missed spending time with family and being able to fully relax. I wrote the USMLE Step 1 a month ago, received my mark last week ( I PASSED :) ) and then proceeded to sleep 16 hours straight! I didn't realize how anxious and stressed I was until I had finally got the much anticipated email. The studying paid off and I am happy to have started 2013 on such a good note! 

I am currently working on a research paper (one of Saba's new requirements before starting clinical rotations) - the only thing standing in the way of me being in the hospital.

Being home is great, seeing family was wonderful but I noticed everyone has the same question for me "what type of doctor do you want to be?". Such a hard question to answer. If you asked me this 2 years ago I would've said one of two things: Surgeon or ophthalmologist. It was an easy answer. Now? not so much. Ophthalmology is ridiculously competitive, and I'm trying to be realistic. Surgery still sounds appealing - except for those dreaded hours and the fact that I would be spending the rest of my life in the hospital. The one thing I realized about myself in the last two years living on Saba was that I love to live a balanced life. I love to be outdoors, to hike, to go diving, to enjoy a nice meal. I love to always be active. I was never happy when I had to study 24/7 and never leave my house. Of course, there is always a trade off and there are times where you need to do it. I was alway more productive after a workout. So to sum up my ramblings... I don't know if the surgery lifestyle would fit with what I know makes me happy. I'm still going to keep an open mind to surgery because I think I will still like it but I think I will also be interested in Obsetrics/gynecology and paediatrics. 

My friend found a medical specialty aptitude test from Virginia School of Medicine (click here to try it).  It's based off of 130 questions relating to your personality. Below are my top 20 ... I think there was something wrong with the 1st choice. Radiology? me? No thanks, I like being around people. Other than that the choices were interesting :)

Hope everyone had a great christmas and new year celebration! Good luck to those going back/starting Saba! Looking forward to being an active blogger once again with the upcoming excitement of clinical rotations.