Heaven and Hell

Survived third year!! A brief montage and summary of the past week. 

Monday was the long answer written exam (3h, 10 questions) and the extended matching exam (150 questions). I know some people run marathons without food, and most people write exams without food. I could not imagine either. When my blood sugar gets low (i.e. below 6) I get hangry and my brain function ceases. I was certainly not taking chances with finals. Photo below was taken with my sweaty pre-exam hands before we were strip searched for electronics.

 

After the incredulous feelings of did they really have an immunization schedule long answer question? along with seriously? gynecology emergencies? dissipated, Margaret and I noted that the sun was shining outside and we had two days of studying still ahead of us. 

So we took something beautiful (her parent's backyard)...and made it ugly.

 

We spent Tuesday and Thursday hammering for the clinical exams. 

 It has been so long since I've had to use sunscreen I thought I ought to take a photo. 

One of the really stressful things about the clinical exams is that they were a different format than the previous 2 years, where we had OSCE's. This year our long case was a patient with real pathology who we had 30 mins to examine and take a history from (the cases ranged from things like a post-op orthopedics case to diabetes). Then the examiners questioned us for 20 mins. 

My patient was a good historian and had a very straightforward presentation which I had prepared well for. I am usually rubbish at presenting (you have to be detail oriented and well-organized) but somehow the planets aligned and I actually did my best case presentation ever! What are the odds? 

There were no questions that stumped me and the absolute best part was after the examiners walked out I turned to the patient and she said to me I hope I am never in the hospital again, but if I am I really hope you are my doctor! I was completely bowled over and honored. 

The short cases went quite well too. They were all very barn-door spot diagnoses and exams. Though I did manage to stutter out some random statements and completely forget basic things (which I would never forget in an actual hospital, i.e taking a blood pressure from a patient in atrial fibrillation). Yeesh. The highlight was one of my surgical case patients yelling to the examiners as they left the room GIVE HER AN A.  

Awesome and awkward. 

So there you have it. Third year, done and dusted. I also just received some rather big news. But that deserves its own post. Heh. A little suspense to keep all of you coming back. In the meantime, it is sleep time. Sweet, sweet sleep.

One...Week...Left...ughhhhh

Cottage Love

I have been commanded by my friend Ryan to update the blog (so he can get Guns and Roses out of his head). I figure I need to make the few people that still check in on me happy, so here's a quick post!

I am in the final stretch of 3rd year. I spent the last 4 days holed up in a classmate's cottage, attempting to cut myself off from the world and bury myself in the books. Amazing how much more productive I am when the only internet I have access to is an intermittent flickering of 3G on my burner when the planets align.

I had planned to go just for the night but the fireplace and views were too lovely to tear myself away from. So I burned home, picked up the rest of my books (oh, Toronto Notes, you monkey on my back...you) some tinned mackerel, instant coffee, and returned.

A week from today final exams will all be behind me. And two weeks from today I'll be on a plane back to Canada. I am mentally composing my ode to the Irish countryside already. Some questions that will remain...Year three, where did you go?? Did I squeeze every last drop out of my year on the wild west coast?

Welcome To the Jungle - 2012

Things are starting to pick up momentum here on the wild west coast of Ireland. Exams are exactly two short weeks away (eep, why I am I still typing this blog post instead of memorizing differentials for fatigue??)

A brief look at life for the next few months:

May
-exams
-pack up house
-move things / car into storage
-fly home

June
-start pediatric emergency elective in Alberta (4 weeks)

July
-have a week 'off' (see below for what will actually be happening during 'off' days)
-start gastroenterology elective in Nova Scotia
-start CaRMS application process (Canadian post-graduate application)
-have 10 days holiday to study for MCCEE (Canadian board exam)
-fly back to Ireland, find place to live / move in / start psyche rotation

August
-study for boards while doing psyche rotation while working on CaRMS

September
**Canadian Board Exam**

October
-CaRMS and obs/gyne rotation

November
-Submit CaRMS
-collapse from exhaustion

December
-hit 'refresh' on email inbox until residency programs start emailing
-possibly decide that I'll stay across the Atlantic for post-graduate training

Just typing all of that gave me a facial tic. I may have to start playing this song everyday when I get out of bed.


 

Ding! Ding! Round Two.

Today I bought:

-Toronto Notes, 2011. Yes. All 1400 pages. I think it's officially in the lead as most expensive (135 Euro) and heaviest textbook of my collection. Yet it is light compared to the weight of worry which is post graduate training....dun....dun....dunnnnnn. It is basically the study guide for our Canadian boards, known as the "EE"'s because there are too many letters ahead of that, so even the acronym gets shortened.

I've held off until now because I thought it was a bit much in every sense of the word.  But, I've realised that if I don't get 99% on the EE's I'll either be staying in Ireland to train or working as an RN in Canada, with M.D. after my name. And almost half a mil of debt. Sub-awesome. So the Toronto Notes are now becoming my new BFF.

It's true though. The fourth years in my program have just found out their Canadian interview offers and two (of 13 Canadians applying to get back) didn't even get an interview. Nada. The shopping spree continues...

I also bought the kindle version of First Aid Cases for Step 2. Mostly just as a way to structure some of my studying using cases instead of just reams of multiple choice questions. Which brings me to my next purchase...

Access to the Canadian MCCEE's Question bank for the next 9 months.

And then I accidentally bought USMLE Secrets For Step 1 for my ipad kindle. Yeah. I already have written step one. I meant to buy step 2. [Hits head on self-assembled desk.]

After reading dozens of reviews on step 2 study guides I opted for Step Up to Step 2.  It will also be arriving shortly via the postman.

Then I bought some pens. You know the ones. Because there is a lot of writing looming on the horizon, and that writing is going to be done nicely in blue-black 0.3mm point style, dammit. We have the technology, people.

It's only a short matter of time until I also cave on a USMLE q-bank but I just can't decide on USMLE-World or Kaplan. Kaplan is cheaper (wow, I can't believe I just typed that phrase!) but everyone seems to say U-World is tougher and prepares you better. In the same way getting hit repeatedly with a hammer makes getting hit with a hockey stick almost seem gentle.

I need to give my visa some time to stop shaking before I use it again. It was an expensive day. I am not even allowing myself a mental tally at this stage.

As always, any thoughts, experiences, frustrations, or treasured methods of study for the EE's or step 2 welcome.

And so, round two of studying for a life-and-career-path-altering exam begins!! Ding! Ding!

Clinical Exam Follies and Triumphs

This week I had the opportunity to invigilate a licensing exam for doctors here in Ireland. Though no one actually said anything to us about confidentiality I am very certain that I am not able to blab about any sort of details. However, I will say that it was a fantastic learning experience to see how different people perform under pressure, how examiners basically set out to shred you to pieces, and how little things can really affect one's rapport with the examiners.

One thing I will take with me for when it come to be my turn on the sharp end of the short-case examination:  if you are told "examine body part [x]" then EXAMINE BODY PART X!!!!!

I was stunned to see people being told specifically to examine one organ or anatomical location to find them faffing around with other systems, only to the irritation of the examiners. The examiners would sometimes have to repeat themselves several times, "stop, examine x!"

There was one candidate who was my hero. She (somehow) remained calm, did very methodical and well organized physical exams, could rattle off differential diagnosis like a champ, answered all the examiners questions clearly and precisely, and was really personable to the patients. I was mentally cheering her on the whole time and wishing I was her. I also felt devastated for the people who started floundering, crashing and burning, knowing all too well the negative spiral of

stressed

mind blank

higher stress

flustered

adrenaline injection

mind completely barren of thought

fear of failure

despair

quavering voice

certainty of failure 

despair

despair

despair.

It was somewhat reassuring (or depressing, not actually sure which) to see that even people who have been doctors for years still get stressed and fumble during clinical exams, it is not just we doclings. 

Please Note

Please note the countdown that is on lower right sidebar.

Accepting all forms of incantations, wishes, prayers, vibes, energy beams, sacrificial offerings, blessings, final thoughts, advice, good-will, and major credit cards. 

That is all.

Two Clues...

Looking around my study room today I couldn't help but notice two clues that I am back in Alberta.

Oh how I've missed the Old Country. Heheh.

Can't complain, though...my brother-in-law has kindly let me take over the Man Room for the next four weeks--sweet view, fireplace, and couple of bear skins included. Woot!

---

Update! As per OMDG's comment... :)

Can't believe I didn't think of that! hahah

Study Chuckle of the Day

Just going over a few practice questions today while waiting for din din to be ready.

Came across this explanation in my gunner training which made me chuckle, and love gunner just a little bit more...

After reading answer explanations for over an hour I almost missed it. Seriously, it makes me want to write a textbook just so I can surreptitiously add commentary to the content.

Soon, Grasshopper...Soon.

Two of four core homegirls.

What gets me through the dark study hours is knowing that I will once again be on the other side of a beer with those ladies in a few short weeks.

Le sigh.

Week of Lasts

It has certainly been a week of "lasts" as my 2 years of basic medical book learnin' draws to a close. As someone said in my PBL today, it has been kind of anti-climactic. Which, to a certain degree, it has. Mostly I think it is because the crushing stress of finals coupled with the looming USMLE has most of the Canadians in my group nervously fidgeting and mumbling, "yeah, great...er...it feels great?"

Regardless I am seeing that these two years have whipped by at almost criminal speed and on Aug 2nd I will finally be able to set foot in a hospital again. With nurses, and doctors, and receptionists, lab techs, and....wait for it...real patients!!! I actually like the smell of hospitals. I like the throb of controlled chaos. I like making terrible tasting coffee at 3am. So naturally I am looking forward to heading back into the fold, as a lowly medical student.

To start, last Friday was our last clinical skills session. I capped the session by letting one of the girls start an IV on me and I am pleased to discover (again) that IV's actually aren't that bad (though I know I am blessed with my non-sliding-minimal-valve-garden-hoses).

Now turn your head and cough. Er...no wait...

Next up was our last lecture. The school kindly decided to round out our two years in pre-clinical work with a 2h afternoon stats lecture on SPSS. If I ever have to go through something like that again, can someone please just take me out back and slowly stab me to death with a 24G needle. That would be more enjoyable. To be fair, though, I actually greatly admire our stats prof. She is a brilliant statistician, for starters, and a big supporter of the medical research here at the University. She knows we hate statistics and that we are rubbish at it, so she's designed the course very specifically to make us critical interpreters of medical articles. WIN. That is all this girl wants!

'Twas the night before collaboration

Last night I didn't quite finish all the homework for our last PBL session. I figured it just wouldn't be right to break from tradition and not scramble at 0630h the next morning to get all my prep work done. [To the uninitiated PBL is problem based learning which means as a small group we work through case studies together each week, come up with what we don't know, and learn it on our own (or as one prof put it, PBL means if you don't understand a concept it's your problem, not mine). Then we reconvene 3 days later and the group discusses all the unknowns. It is a great way to learn, I think, but at this stage of the game everything feels like a scald. Give us patients!! ]

The thing I have found very challenging is not remarking everyday, "one time...in the hospital..." because for almost every case we've done I've had some experience in the ED with the exact condition. Sometimes I've cursed not doing a more specialized type of nursing so that I'd be going in with a deeper understanding of...something...ANYTHING!! But I must say, the ED background is good for being able to think, "yeah, I have seen cases of [malaria, spousal abuse, anti-freeze poisoning, full thickness burns, heart attacks, bulimia, insect bites,  allergic reactions, amputations, strokes, sore throats, intussusception, gout]...once and..." I may not know much about anything, but at least I have a vague notion about how condition's look when they rock up to the emergency department's sliding doors.  I tried hard (and failed many times, I am sure) to not be the annoying person in the group who had an anecdote for every medical condition that came up. Patients faces are still so fresh in my mind though, especially for certain things...it was hard to not reminisce.

Bubbly + Learning = awesome

There was cause for a celebration this morning I tell ya. As we wrapped up the last case I popped the cork and went about divvying up a small toast of bubbly for everyone. Normal people would have probably gone our for beers at the end of an era like this, but students who are facing final exams and boards are not normal people. The real cork popping is 2 weeks away still (for some) and 8 weeks away for others (like myself who doesn't really get to shake it up until the USMLE is in my rear-view mirror). That said, I will be sending up a few woots on the 10th of June.

Workin' in a coal mine...goin' on down down...

So this was our final clock-out. Yeah, you read me right: clock out. Due to some major truancy issues in the year ahead of us the school implemented a biometric clock in system, wherein we'd have to clock in and out for every clinical skill lab and PBL class. Only 4 clinical skills or 6 PBL classes could be missed for the entire year. Needless to say the whole process was met with major resistance. The thing that killed people was that if you forgot to clock in, even if your tutor told the school that you were indeed there, you were marked as absent. I avoided the town-hall-pitchfork-esque meetings on the whole issue and just went to class. I figured the schools solution was a bit extreme, if people are skipping tutorials it is their problem. Hospital reality will come crashing down upon them soon enough.

Ryan sticking it to the man with his compliance.

I wish I could say something profound or touching about where I am at today, but to be honest I am just feeling sleep deprived, stressed, and very inarticulate. Classroom work has just started to feel like a distraction from the pressing volume of information I have to review from the past two years. TWO YEARS. It is cruel and unusual to test someone on curriculum from that far back, as far as I am concerned. Especially us old folks, our brains are hard and crusty...information just doesn't stay in there like it used to.

Bottom line: nearly there. Pre-clinical years will be behind me soon enough, and a whole new set of hoops shall appear. 

Back to the books for me.

Flash Cards

My brother Russ gave me an iPad for Christmas (thanks Bro!!) which I have hardly had a chance to use/play with, but this week I finally did a little shopping trip to the app store.

I bought a flash cards app, I know, I know...."why buy an app for something you can do on paper for free?"

See the thing is, I have hundreds of handmade flashcards lying around in these crazy disorganized piles, written in my chicken scratch/shorthand which makes ME the only person that can decipher them.

The beauty of this app is:

-I can put images with the cards, which is the BEST thing about them, because it means I don't have to try and describe the histological differences between an osteoblast and an osteoclast--I can just upload an image from Wheater's on the card
-I can organize them into sets
-it keeps them in one place, not randomly strewn throughout my school bags, gym bag, purse, desk, couch crevasses 
-it keeps stats on which ones I get right, wrong, and sorta-right-but-want-to-go-back-to
-I can select to just go through my 'wrong' piles or my 'review again maybe' piles
-they are typed, not in ABB hieroglyphics, making it easier for another person to quiz me (well, slightly easier).

Anyway, I've only just started making cards but if any of you nerds out there have an iPad/iPhone/iTouch you can download my sets for your learning pleasure. I'll be adding to them every week. I know they are kind of specific to my course, and that making flashcards is a big part of the learning, but hey...you just might LOVE them and become more brilliant for having them (please excuse my occasional mnemonic or loose association technique in the answers).

My page is here. If the link doesn't work let me know and I'll fiddle with it.

Happy studies!

Sample:

Obviously, the images are larger and look way cooler on the iPad.

Experimenting

In an effort to wean myself off music (no earphones allowed during relay race in June) I have decided to try running to the not-so-dulcet tones of Edward Goljan's pathology lectures.

I think it is safe to say that most medical students know about Lord Goljan or G Pac as he is lovingly referred to on his FB fan site. You could say he wrote the book on pathology, because he did. THE BEST book on it IMHO: Rapid Review Pathology.

I usually need some heavy beats to get me up the hill outside campus gates but tonight I had [insert hard American G.I accent here]:

"look at that...what IS that...NUTMEG...does that look anything like a NUTMEG LIVER?? NO!! I don't know who decided that NUTMEG liver looked like NUTMEG. Must have been someone with CATARACTS...someone with corticosteroid use induced CATARACTS...did you know that corticosteroids can cause CATARACTS?? Not glaucoma. Anyway..."

But, it worked! Ok my pace was slower than usual, because he's good but he's no black eyed pea. I was surprised though at how having my brain engaged actually let me forget my usual, "I hate running, ow, ow, ow, remember to smile" mantra. I have been feeling guilty lately about taking time out to exercise what with my study and review for school plus study and review for USMLE schedule. But now--huzzah! I can cram and run at the same time! I do realise that maybe it is a bad thing to combine recreation with studying so I am still keeping up my yoga in a Goljan-free zone.

Path domination here I come!!

Biochem Anyone?

I had been out of university for about 6 years when I decided to go back and take the missing, magical pre-requisites that would be my ticket to passing the MCAT and getting into medical school.

It was a full year and a half of inorganic chem, organic chem, physics, microbiology, and health sciences. It sucked. For a lot of reasons.

Once I was done that I was able to apply to several schools in Canada/abroad and had enough of my bases covered to write the MCAT so I opted to not go back in the fall for another full year of calculus, stats, and biochem--doing that would have given me the pre-reqs to apply to U of Alberta and UBC. But I was getting close to 30 for crying out loud! How many more 1st year courses did I have to endure??

I was living in my friends' parents basement doing o-chem when my 10 year high school reunion rolled around--which I obviously skipped. What was I going to say? Yeah, things are going well...I am in the process of getting dumped, I am doing a second year chem course, unemployed, and keeping my fingers crossed on getting into med? Riiiiiiggghhhhhht.

I just couldn't face it. I'd drained my RRSP's and my relationship. I thought that if I couldn't get in somewhere with what I had then I'd figure out a plan B.

Turns out maybe a little biochem would have come in handy after all.

They barely touch on it in my program, yet the USMLE seems to care if you know what a g-coupled protein receptor is.

I took the kaplan diagnostic test last week and found that my (major) areas of weakness are medical genetics, biochem, and molecular biology. Shocker! I never have taken any classes in those areas!

When we did our little kaplan pep talk a couple weeks back the lecturer said that wherever we have weakness we should spend 30 mins a day from NOW until the exam chipping away at it, "If your weakest area today is your weakest area on exam day then you aren't studying correctly".

Taken at face value it's pretty basic/obvious, but I think it was absolutely sound advice.

I've plowed through the first few chapters in the review book of medical genetics. Tomorrow the autodidact begins biochem.

This is going to be an interesting little educational diversion.

Wish me luck.

All Quiet

I needed a couple of days away from my computer screen and away from the confines of my office. Now that I've read a few hundred pages of my book, slept in, gone for walks, talked to my family, prepared a turkey feast for 10 people (on one hours notice), and worn my housecoat for >5h straight...I feel like I can sit in here and stare at my computer screen again.

It's been wholly up-and-downish since my last exam (anatomy spotter of doom) on Wednesday afternoon. If you want a more detailed account of how those exams work I linked to my previous explanations in the last post. A quick and dirty version: there are 25 desks, 50 questions. 1 minute per question. When the buzzer goes, after two minutes, you get up and move to the next desk. Everyone starts at a different point on the exam, this time I started at question #15.

I was flying! Remember, these exams are designed to make grown men cry (and they do). This semester I opted for a different study tack, and I think I cracked the code. Our anatomy prof gives us about 15-25 images each week with our learning objectives for the case. That is what most people study on because often it is these images that turn up on the exams. Now that we've been in school for a year and a half this means the amount of slides that could be chosen from are >600. Instead of madly trying to go through all the slides from the past I picked the concepts that keep coming up and looked at as many images of those things, from different sources--especially imaging atlases (because I am really trying to train myself to visualize the 3D version of x-rays, CT, MRI). I spent time reading up on hernias, embryology of the face, cardiac circulation, head injuries, lung pathologies, etc. in general and avoided my notes all together.

It totally worked. The first 10 questions seemed almost laughably easy. I was trying not to grin at how well prepared I felt and how much I was ROCKING THIS EXAM!! Oh what a feeling.

Hang on. 

I am supposed to be at question 26. But I am at question 25 on my bubble sheet? BUZZZZZZZZZZ!!! (i.e. move to the next station)

NOOOOOOOOOOOOOOOooooooooooooooooooooooooooooooooooooooo. 

Yep. Somehow I got out of sync with the numbers, I missed filling in a bubble somewhere. Somewhere between the vagus nerve question and the head injury one.

Oh God. I am going to vomit. What question am I looking at now. Yes, ok fine common fibular nerve question...ok should I try and figure out where I made the mistake? Should I flag my prof down? I thought for sure that vagus question the answer was "D" but it looks like I put "E", maybe that is where I screwed up, maybe...BUZZZZZZZZZZZZZZ!!!

Ok I am going to be sick. No, don't be sick. Forget it. Move on. Finish this exam as well as possible. FINISH in STYLE. Don't have a meltdown now. Don't vomit now.

Head in the game. Game face. Bring it.

I finished the exam. Told my prof on the way out that I'd gotten out of sync somewhere between 15 (where I started) and 26. He just said "Oh, ABB!" with genuine empathy and disappointment for me. He said he'd look through my answers and try to rectify the situation if he could.

It was actually too much. He's a real hard ass, so getting his very kind response brought on wave of nausea number three--I bolted.

Home, called my mother. Cried. Composed myself and called my prof. I told him I didn't expect he could really fix anything but that I'd told him only because my ego/vanity couldn't handle the thought that he wouldn't see the mark that I had been on my way to getting. I know, I lost prob max 10-12% in the mistake (and maybe a smattering more due to the momentary panic), but that I passed overal. Thing is, I don't obsess about grades. I want to learn this stuff for the sake of being an excellent, safe, competent physician. I can't even tell you what I got last year because I looked at my marks and then forgot about them. But for once, and for the first time in medical school I felt like everything came together during an exam!

He told me not to worry, the exam was only worth 14% of my total marks for the year and that it would in no way compromise my academic standing overall. We wished each other a Merry Christmas and hung up.

I changed from my nervous-sweat-soaked t-shirt and headed to the pub. I suddenly missed my friends and classmates and I wanted nothing more than to be getting "yay we're done!" hugs and drinking a Guinness. It was over, I was past it, and I wanted to reclaim the celebratory feeling that I deserved.

I reclaimed it and it has been a sweet, sunny, quiet few days since.

The Fear

It's really starting to set in.

Since we get our curriculum delivered via case-studies (PBL) and our exams are cumulative for years 1 and 2 that means I have to memorize/learn/understand/regurgitate 48 cases from the last year and a half for my exams. Which start in 8 days.

Each case has an anatomy component (these weekly mini-case studies we have to know around all the differentials, embryology, etc--usually about 20 slides), a histology component (usually about 30 slides), pharmacology, physiology, pathology, stats, and of course all the psycho-social stuff (which has yet to ever show up on an exam).

So I thought I'd get through all the cardiac cases today (as a treat to myself, since I like cardiac).

Yeah, I got through 2 cases. TWO. And I have cranked out a solid 10-11h of focused study. This is not good. I think I will have to abandon all plans for actually going through cases properly and go into a take-no-prisoners mode. I don't know what that last statement means but...first, I will have to start flying through the anatomy sheets...basically ignoring most of the details and skimming though the cases.

I really never thought I'd have to
know so much about the larynx...
next slide! 

Then I'll throw my eyes over each diagnosis in Medicine at a Glance (the book that every patient hopes their doctor never used in medical school). Burn through about 1300 histology slides. (Thank goodness that pink stain never starts to blur into one image after a while...)

Next I'll somehow read through the learning objectives from all a handful of the cases and hope to hell it's those ones that show up on the long answer. Not like last year where 10% of the written marks came from if you knew what a P-value was or not. Really glad I spent all that time memorizing, oh, everything but stats.

Wow. There were a lot of numbers in the preceding paragraphs. Am I perseverating on irrelevant details? Trying to somehow strategize how I can cram all of those numbers into the number "7" which is how many days I have left to study?


In other, more interesting, non-medical-school-meltdown news, I think I'm going to abandon my attempt to read 100 Years of Solitude unless someone from the blogoland can convince me that it's worth sticking with it. I am about 100 pages in now, and it just hasn't grabbed me. I thought I'd give Gabriel García Márquez another shot after Love in the Time of Cholera became an anvil in my backpack two years ago on my Himalayan trip (one of the few books I brought with me so I felt I had to keep reading it). 


The other reason I am feeling tempted is Freedom by Johnathan Franzen is sitting on my bedside table waiting to be read. Well, it was supposed to be for my Christmas break (but then, so was Into the Wild which I accidentally started reading and finished last week). I remember loving The Corrections so I have been wanting to get into Freedom ever since I saw it at the bookstore.

I just like staring at the cover and thinking "December 15th, late afternoon...sigh" I'll get my own little taste of freedom for a few sweet weeks.

Breaks over! Back to it...

The Only Accurate Thing About Grey's Anatomy

I used to watch Grey's about 3 years ago when I had gone back to do my pre-req courses for medical school. I'd spend a lot of time yelling at the screen when seriously inaccurate events were depicted (several times per episode) but yet I couldn't tear my eyes away. Yes, it was my television version of a train wreck.

The only thing they got right was the baking. Izzie used to bake when she was stressed and for me, that is bang on. Only I rarely bake, I cook.

action shot

Hence yesterday being rather therapeutic.

It was Ryan's birthday on Thursday so I offered him a birthday dinner as his present from me. I love cooking for people anyway, so it's like a double-edged gift sword of goodness (poor mixed metaphor? Whatever, I like it).

So out of the menu options he chose Hearty Wine and Beef Stew with Dumplings, I deviated slightly from the recipe because I loathe parsley, so the dumplings had green onion and basil in them instead. There was garlic bread and home made ceasar salad to start, and for dessert this berry custard and ginger cookie bowl of yumminess. And, naturally some mulled wine--hey, it is almost December. We have a farmers market here on campus I was able to get all organic veggies and even local organic meat (a.k.a happy meat) for a decent price.

Since I started making the stew at 1400h, it was great to study and breathe in the aromatherapy all afternoon. Somehow the different types of collagen and epithelial adhesion mechanisms just weren't that hard to bear.

By the time dinner was on the table I had been able to shake off the horrible feeling that had been churning my stomach all week. This was also in part due to the comments and emails of encouragement from the blogosphere---thank you! I definitely needed that pick-me-up.

School is hard, and most days yes, all encompassing. But somehow when there are people around that you love, delicious stew on the table, and mulled wine in your glass, life seems more than ok.

Caught with a mouthful of Ceasar. 

Medical School Makes You Haggard

I often end up turfing or just writing private posts about how much I loathe medical school somedays. I guess I don't want this blog to turn into a whiney drone about stress levels, lack of sleep, nil free time, and nostalgia for Canada. I am sure if I was back in my pre-med shoes again I and I came across posts like that I'd grind my teeth and think about how much I wanted to be in medical school while the world seemed full of undeserving, unappreciative little snots who did nothing but complain about being in medical school.

But let's be honest. I am not feeling the love right now.

I know that it is partly because finals are looming and that just brings my baseline cortisol levels up a notch, but it's also this sinking feeling that I made the wrong decision by quitting my life and coming here to do this.

I've been ruminating on the reasons I seem to have been hard-wired into pursuing medicine and wonder if there would have been any way I could have re-wired myself before I got tangled up in this.

I remember the exact moment that I decided I was going to be a doctor and after that, nothing else even seemed to be a possibility. The problem is that it was my complete awe and admiration for an astounding physician that made me want to pursue medicine. Where my reasoning may have been flawed is that it was the man (my grandfather) that was astounding, not the career. He would have touched hundreds of lives and made a positive impact on the plantet if he'd been a used book seller, or a languages professor, or a farmer, or a school janitor. When you are eight years old though you can't grasp that part of the equation. You just see a wonderful human and think the best way to somehow be like them is to do what they did with their life.

I should be feeling good, I did well on the anatomy spotter. But I just feel, obligated. Obligated to constantly study, review, test myself. Surely it is natural, when something seems to take up your entire existence, to feel resentful towards it from time to time?

I am actually grinding my teeth even when I am AWAKE these days. That is a new one. Can't sleep, can't eat, can't relax. Ugh.

So I apologize to the premeds that might stumble upon this post. But right now I'd rather be anywhere than here.

How Much Is Enough

I feel like 2nd year really started like a bucket of cold water to the face. I was still reeling from almost 2 months of full-time plus in the hospital, jet lagged, bleary eyed...and BAM!

Hypertension!

CHF!

Rheumatic heart disease!

Acute astma exacerbation!

Lung cancer!

I feel like I am drowning this year*.

I made all sorts of vows to keep up a strong training regime, to play mandolin every day, to spend quality time with Tobie, to get a good nights sleep, to eat well...

It seems that I am constantly trying to patch together work for the weeks PBL, cram anatomy from last year, review all of our cases from last year, prep for the weeks "line of fire" anatomy session, and learn the new material being thrown at us.

I am tired of the 'drinking from a fire hose' analogy. Drinking would mean there might be some satiety involved, some resolution of thirst. But I honestly feel like the I am just running after the bus which is belching exhaust (and lung cancer causing hydrocarbons!) at me.

It is just hard knowing when enough is enough. When have I read something enough, when do I understand something enough, when have I gotten enough detail. It is impossible to know and it is that nagging uncertainty that I am sure is now fueling my insomnia. Oh, hey thanks for returning with a vengeance sleep thieves!

Sigh.

So blogosphere...how do you structure your time? How do you know when to stop? How do keep your sanity (relationships, hobbies, life) in medical school?

*Ok maybe there is something to that stupid fire hose analogy. Damn.

Study Cloud

A firm believer in every cloud having a silver lining...I was trying to think of a positive spin on studying until it feels like my ears are bleeding.

Then I looked up and saw the wind whipping through the giant trees outside the library window.

I decided the silver lining is that as a trade off for not having a real job right now I get to sit in a quiet room and contemplate the human body for hours and hours.*

This is my attempt. Weak? Maybe.




*I also get to wear the same clothes everyday, cut off most contact to the outside world, and note-take my hand into a tendinitis. Ok, those are the 'downsidey' parts of aforementioned contemplation.