A little inspiration to get the wheels turning for this evening.
I just watched this TedTalk tonight and funny enough I have been thinking about this topic a lot lately with applications to residency around the corner.
There has always been that question lingering in the air when I talk to others about what residency specialty I have picked; that question? It is the one I always expect to get asked. "how hectic is the lifestyle?". Yet what they really want to ask is "will you have time for a family?" Unfortunately I have noticed that question gets asked a lot more toward the female medical students rather than the male - especially when their answer consists of a surgical specialty. I understand the concern but if you listened to the above talk you will already know what I am trying to get at...
Unless.
Why can't it be a package where you have a great career working alongside what you are passionate of rather than having to chose between lifestyle and career? Im not saying it is easy. But if life was easy and decision making was straightforward, what would be the point in having interests and passions?
Can it be done?
Can you have a great career AND be a great parent AND a great friend AND a great spouse?
No.
Unless you find your passion and try to not be afraid.
Thank you, Larry Smith, for being so blunt.
would love to hear anyone else's thoughts on this....
The moving has begun, again! If it was not yet apparent, as a caribbean med student we do not have a 'home' hospital like the students that attend an american school in the US. Thus all our clerkship rotations are at school affiliated hospitals found throughout the states - mostly the east coast, the south and some central states such as Georgia, where I am currently residing for a month. The third year core clerkship rotations, those that are required by every medical school to be completed, can usually be done in one if not two places so the student can decide if and how much they would like to travel. I went between Florida and Maryland if you recall. Talking to other caribbean students this has been a common path.
The 4th year is completely different.
It is the year when you try and narrow down your interests if you have not picked a specialty already. These clerkships are called elective rotations and each individual is responsible to make up their own schedule based on their interests. For us, that usually means we move around to different hospitals depending on what they offer, their availability and scheduling... I will not get into the stress of making up that said schedule because that's besides the point. Yet, I will say that it is not an easy feat!
I will say that I finally have my 4th year scheduled!
Since my last post I have finished two one month electives, one in Michigan and one in Baltimore, MD. I am currently in Atlanta, GA doing a family medicine elective and will be heading off to New York for two months and then Louisiana for the last two months of my medical school clerkships. It seems I have so little left before I get to have that status as an MD. Looking back I can see how the process has shaped who I have become as a senior medical student. Last month I went back to Harbor hospital, where I completed the required 3 month Internal Medicine rotation last year. I worked with a Hospitalist doctor as a senior student. During my stay a new group students started their third year - including some friendly faces from Saba! I have to admit that I noticed a significant difference. By which I mean that there was a comfort level of navigating around the hospital, approaching patients, speaking up during rounds etc. For me, there was an evident difference in the level of knowledge between myself and the starting third years... Now! Let me explain myself before you jump to any conclusions. What I mean is this: I now realized how much information I have absorbed in the past year (and of course, there is a ton I still have yet to learn). It is really astounding to see the difference in which I approach certain problems, diagnoses and questions thrown at me. I find myself not overwhelmed like I first felt in third year. The knowledge seems to have become a second nature sort-of response. Anyways, ignoring my ramblings, what I mean to say is that I have surprised myself at how far I have come in just one year. The process is gruelling and pushes you to your limits but it really does work! I have no doubt those third year students will go through the same realization when they reach 4th year.
Where am I now?
Applications to residency programs are a month away! Yes, you read that correctly. One month. If you have been following my journey from the beginning, can you believe it's been 4 years?!
All the required board tests have been taken - and passed!! I am now finalizing the programs I am applying to, which has become a very time consuming task, albeit important. The personal statement is written; but it may be re-written over and over again in the next month. As a blogger and a person who enjoys writing, the personal statement has been something so difficult to be 100% pleased with because it forces me to summarize my passions, goals and direction in life in just one page. One page?! I am almost tempted to write one line: "Dear Program Director, please read my blog".
In any case, the end is in sight! Although it won't be smooth sailing until next March (when we find out to which program we matched) I can say I will try to make the most out of my travels and experiences.
Here are some pictures of Atlanta so far. Never did I expect it to be such an 'artsy' place!
This is going to be a tremendously difficult one to write.
On Losing...
What becomes of a person when they are gone? Their memories stay within those lives they have touched. The life around them, that, unfortunately, does not stop. Everything keeps going. The bed is made. The night table holds their glass of water. Their reading glasses atop that unfinished crossword puzzle; the one they set their mind on finishing later that night. Only, now, it is two nights later. The crossword puzzle remains unfinished and the glass of water, is half full. Yes, half full, because half empty is too much to handle for right now... My glass will always try and be half full... The one bedroom apartment looks exactly like I remembered it. The bookcase of classic novels, poetry and art books. Pictures, neatly, splattered on the shelves as proof of their travels. Familiar faces all smiling back at me. It all felt the same, like they were about to walk in the door. Only that didn't happen; it really didn't feel the same because the people who walked in were in fact family, but there were no smiles. Only sadness and disbelief in their eyes reflecting back my own emotions. The hugs were never-ending, the conversations began with "remember when...." and there was never a shortage of food because that was their way of taking care of us. And it was nice to be taken care of when other things were on my mind. I looked over at my family and how we had come together once again, how nice it was to see everyone in Romania after 10 years of being away - although I would've given anything to not see them under these circumstances. I had flashbacks on the strength and resilience of my grandmother and the calmness wisdom of my grandfather and pushed through the emotions. A strong link to keep pulling my family forward towards a new day... one that seems so far away, one that I am sure has sunshine and smiling faces, one that I do not want to come just yet because that means all of this - the passing of my grandparents - is in fact reality. And yet we have no choice but to move on. I want time to stand still. To stand still last summer, when I was home for a weekend from clerkships and they were in Canada. The last time I hugged them, the last time I experienced my grandmother's amazing cooking and the last time I sat down with my grandfather and showed him how to work his new laptop. Those memories are the ones that bring an ever slight curve back on my lips.
It has been 3 months since I've been back and life has hurriedly put me back on course. I am finishing up my 4th year elective clerkships and am writing my last exams before applications for residency begins. I cannot believe that the time has almost come and graduation is around the corner. Although I feel that this has been a long enough road. I will write on my elective experiences and application process soon.
I needed the time off to gather my thoughts.
Time to find my way back from Romania, time to find my way back from the loss. I cherish to have been so lucky to be close to all four of my grandparents and am unfortunate to have to experience their loss all within a couple years.
I've been thinking about my reflection on the psychiatry elective I finished over 2 months ago for a while now. In my last post I was just about to start it ...For 3 weeks I worked in the adolescent female inpatient unit and it was definitely an unexpected experience. I went there with the thought that it will be a nice break from the rigorous clerkship rotations I have been through and a nice transition from studying at home to my current trauma surgery rotation in Florida.
I was wrong and realized something about myself in the process.
I enjoyed my 6 week rotation last year which is why I decided to come back and work in another unit. Adolescent girls I thought would be a great fit - I can relate and it will help in my long term goal to work and advocate for women's health. I fit into the treatment team right away. The social workers, unit staff and my supervising attending all cared for their work and put in long hours. There was no real structure for me to follow which is great because it let me explore working with different people on the unit - from social workers holding family meetings to art and musical therapists. It was really up to me how much I wanted to invest. As I've said before, I learn best by experiencing, so I got involved as much as possible. I started getting to know the girls, their histories, their personalities, how they interact, their families … it was interesting in terms of psychiatry and applying the things we learn in books to real life situations… but also heart breaking to read about their life experiences at just 12 years old. By my second week, the attending doctor encouraged me to take time and talk to some of the girls one-on-one. I did.
I was taught how important 'active listening' is as a skill. We were told about it in my 4th semester on Saba but not until now do I really understand what our prof was trying to tell us. Daily one-on-one sessions with some of the girls were amazing. They began sharing and opening up about their past; stories that weren't even in their social work reports. I was so happy to be able to have an honest discussion … to hear them out, never judging, that's really what they were looking for...but emotionally it was hard. Very hard. The movies about street kids from broken families surrounded by drugs, abuse and prostitution; girls being bullied because of their appearance to the point of harming themselves - unfortunately they are true. These girls have experienced life's hardships at such a young age that they grew up. Fast. What did surprise me was their strength, and resilience - two things that were not obvious when I participated in the group sessions. Most of the girls seemed so different talking to me than in the group. I learnt about their dreams and aspirations and then, in a split second, heard them shutting down those ideas because "it's not possible". That was difficult to swallow. As a person, I am an optimist (if you haven't figured that out yet!); so I asked "why?, why can't you?". their answer was even harder to understand, but it was the truth… "I have no support." " No one cares." "I have to take care of my siblings." "I have to provide for my family." Now, I am generalizing as not all the girls were in the same situations… but these were some of the answers I did hear.
I realized how important a nurturing, supportive environment is as a child. Having a family that cares enough to ask about getting homework done, to insert those (sometimes annoying) reminders to clean.. we've experienced them, and they come from our loved ones. But that is support; support that most of these girls were missing.
This elective made my final decision to not apply to psychiatry. NOT because I didn't like it. It's actually the complete opposite. I had the hardest time separating my emotions from acting as their doctor. We are taught about professionalism in the oath we take. As doctors, we are not a patient's friend and I completely understand that. In all my other rotations it is a clear line. In psychiatry, it became very blurred for me. I emotionally invested in my one-on-one sessions. Came up with ideas and ways to talk about difficult topics… and they worked. Great! But I went home and took their stories to heart. I could not separate the medicine from myself. At the end of my rotation, the attending pulled me aside and said I would become a great psychiatrist one day.
I'm sure, in time, I'd learn how to draw that line but I don't want to go through 2, 3 or 4 years bearing all that emotional turmoil with me when I get home. This may sound selfish but I think its the best thing for my own health and my ability to treat my patients.
As medical students we've either said it or heard it: psychiatry is not 'real' medicine. There are never clear cut answers; everything meshes together to provide an emotional response. And, as students, we all have that one thing which we cannot deal with in medicine - whether it be skin rashes, broken bones, surgery or delivering babies. For me, mental health is where it becomes the hardest. I can stand in the OR for 6 hours. I can deal with stabilizing a trauma patient after they got shot. I can stay up for 30+ hours without coffee. I can look at an open abdomen and see the medical complexity and not the patient. Yet, talking to someone through their emotional turmoil, hearing about their past, yes, I can do it. Yes, I can be good at it. Yes, it's very natural for me to just listen. But it's been one of the hardest things for me to go through.
Hats off to anyone who works in the mental health system, I now partially understand the hardships you experience.
Part of a letter I received from one of the girls on my last day of the elective. It's in a safe place to always remind me of my experience and how much they taught me.
PS. the video is a spoken word poem by Sarah Kay. I found it a great way to reach out and discuss those difficult topics. Needless to say I learnt a lot more amazing poetry slams from the girls… they were very familiar with it!
