"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.

What would you do?

Came across this video today and got me thinking how a society would change if money wasn't a controlling factor in being able to survive...

Take some time out of your day, watch the video and then ask yourself: would you be working towards the same goal as you are now? Would you spend your day doing the same thing? if not, is there some way to incorporate that passion into your life now?

I know it isn't that simple, but just think about it.

Rumors

I haven't been back online in a while because of studying for Step 1 but I do continue to follow the activity on the blog as best as I can. Unfortunately, recent comments on this blog seem to be focused more on Saba's credibility rather than responses to my journey. This has led me to make the decision to monitor comments. I've been trying to let this space be an open forum and not delete any comments received however, this blog is supposed to be about sharing my experiences on going to medical school in the caribbean and hopefully help those who are in the same predicament I was two years ago. I do not want to be spending my time debating which rumors are true or how good of a school Saba really is.
I have decided that I will be deleting any comments regarding the credibility of Saba University or of any rumors going around... Everyone has their own opinion and experience. Sometimes a caribbean medical school is the only option you have left. And if that is the only way to do what you have dreamt of doing all your life, then that is the road you will have to take.

So, please, for any discussions on credibility, rumors, attrition rates etc go to medical school forums like valuemd.

I will still be happily answering questions about Saba, if they are appropriate. I'm sorry that it has come to this but I hope those of you who have been following my adventure continue to do so.

To end on a more positive note, here is a little inspiration for the rest of the week...

Conversations with myself.

How do you keep studying when all you have been doing for the past month is study 14hrs a day?

I find that by the time I get home I am exhausted. Drained of energy; my brain forgets the simplest things. I know it is time for a break. But how do I take a break without feeling guilty? without staring at the clock, without realizing I could have just read another 5 pages in the last 20 minutes I spent eating and catching up with the world around me. It becomes a viscous cycle. I want to study. No, I need to study. I must reach my goal. What happens if I don't? Have I failed? failed what? myself? I am not sure.  I know putting this much pressure isn't healthy. After-all it's JUST a test, but then I am reminded by my subconscious: it's THE test. If I don't get the score I want on the test would all my sacrifices count for nothing? All the energy spent, money consumed, shutting out my friends (and sometimes my family - I am sorry.)... All this for what?

A dream.
Is it worth it? ...Yes. It will be.

-----------------

I felt like sharing this self-battle as I hope I am not the only one whose felt so strongly about something, someone, a dream....or anything. It's not supposed to be a pessimistic post, just a glimpse of reality.


PS. Thank you to everyone who has been endlessly supporting me with this crazy dream without questioning it - especially my family.

Haaave you met TED?

Well, have you?

I'm talking about TED talks (but I am also a fan of the show How I Met Your Mother :) ). I was home for thanksgiving this weekend -- it was amazing by the way. nothing feels better than to be surrounded by family and food :) --- and my brother & his wife brought up a TED talk they recently watched on "power posing".
Sooo apparently 2 minute of power posing a day can boost your self confidence (via an increase in testosterone), lower stress hormones (like cortisol) and change they way you are portrayed by others... Although a little skeptical on how well this actually works, the idea of changing outward behaviour to shift the way your body works is still fascinating.
watch the talk below and next time you go on a date, go for an interview or take a test, try it ...it can't hurt!

Change

a little change in scenery on my new running route; at least the sunsets are still beautiful... although I don't know how I feel about running in the colder weather. I already miss not having to worry about what to wear when I go outside. The caribbean weather was always predictable: 30 degrees, sunny with scattered showers.

In other news my intense study schedule seems to be getting the best of me. It's been hard to be so focused all day, all the time - especially when I'm trying to fight off this cold that seems to be going around. Wish I could just take a day off to recuperate, read and not think/ feel guilty about not studying. Alright, I think I'm done venting, for now.  Ugh, back to work...

PS. Grey's Anatomy is back tonight. I'm a little excited even though I know thats not what real world 'doctor life' is like. At least I can make myself think that I am being somewhat productive since the show is about medicine; I'm sure I can learn something useful from it.