Bride Day!

As any med student can tell you, losing a full day of studying can feel horrible... Losing multiple partial days can feel worse.  Most brides will tell you the bachelorette party is probably one of the best parts of the wedding festivities, and bridal showers are a great way to spend time with your nearest and dearest. Because I have finals and boards coming up, I couldn't spare multiple weekends so I had my shower, a wedding dress fitting all in one day. It was exhausting but such a fun day!! It was great too because my sister, who lives on the west coast was able to be there for all of the festivities.  My friends rented a sic room at the Dream downtown hotel in the city.  It was awesome- great photo ops, delicious cocktails, and morning after poolside basking. 

Spring Break!

This week has been spring break, which translates to a week and a half of uninterrupted study time.  With my fiancé in Mexico for the past three days, you'd think I would get in a ton of study time.  Well, it's good to make plans.  Work has gotten done, but there have definitely been a few days were instead of working the 10 hours a day I intended, the hours add up more to a modest 5.  One day I spent the entire time on the couch watching House.  It turns out that the house writers in season 1 LOVE vasculitis…. apparently its in the differential for everything.  Also caught a pretty blazing error in the first season, they refer to Toxoplasma (Toxoplasma gondii) as a fungus.  It most definitely is not a fungus, and in fact is a protozoa that spreads through cat feces.  It's generally not a problem unless you are pregnant or immunosuppressed.

In other news, my mom, brother, and sister (who flew in from Oregon) are driving up from DC for my bridal shower/bachelorette party tomorrow.  I decided to put them both in the same day because 1) I couldn't afford to lose two study weekend this close to finals/Step I and 2) My sister/maid of honor lives in Oregon and I wanted her to be able to attend both without breaking the bank of air fare.  Because the wedding is so close to my Step I date (5 days after), I couldn't put the events in the wedding week due to fear of being massively hungover on my wedding day.

3rd Year Clerkship Order

We got our clerkship order for next year yesterday. Our school assigns clerkship with a computerized lottery system. First everyone ranks 90 different scheduling possibilities from 1 to 90 then a computer works some magic and assigns everyone their own schedule. Generally, if there is something that you think you might want to pursue, you want it in the middle. There is some other general wisdom, like having Internal Medicine first prepares you for the rest of the year, but having it last is really great for Step 2. My schedule is near perfect. 

The only thing I would change is to have Neurology between Surgery and Medicine. Those are two pretty intense rotations, and at 8 weeks each, having them back to back can be rough. I'm SUPER happy I have my electives last. Either I will pick really easy ones sonOncan study for Step 2 or I'll pick something in OBGYN so I can get more letters. Peds is first which is excellent- have absolutely no interest in Peds and I'm not a huge kid person so will be glad to get that out of the way. OBGYN is situated dead center which is awesome. Next up is rotation location lottery. 

Home Stretch

It's almost April. I have 11 weeks and 3 days until I take Step I.  I'm in that strange place where I really want time to slow down because I have so much stuff to do between now and then, but I also want time to continue to go by quickly because I can feel the familiar twinge of burn out.  Second year has been rough. First year, I was extremely good at school. I was near the top of my class in all classes except biochem and I still felt that excited twinge of competition that drove me to succeed and perform well on my exams. Now I'm just tired.  All I want to do is pass. I've been dragging all year.  I'd like to say its because I've been distracted by the wedding but I really haven't.  I'm just exhausted, and sick of sitting in a chair memorizing information, 80% of which I will most likely forget and never use in my career.  There are days when the only thing preventing me from quitting is my massive student loan debt.

All of that said, I'm really excited to start third year.  I know the hours will be long for some rotations,  but I do best when I actually get to interact with people.  I love interacting and building relationships with patients.  I recognize the relationship building is limited in 3rd year because of the rotation schedule, but even getting to see the same person a few times and working with them is really what I look forward to. This is probably why I'm leaning more toward OB/GYN and less toward surgery.  I do enjoy operating- the precision, the physicality, the ability to actually be able to "do something" for a patient.  I also really like building relationships.  Enter OB/GYN a nice blend of the two.  It's also a relatively positive specialty.  But I digress.... All of this is literally MONTHS away. Now at the end of second year it feels almost like the light at the end of the tunnel that just keeps moving.

The highlight of my week was picking my "grid" for the order of my rotations next year. Basically we  rank various orders of rotations by preference then some computer algorithm tries to give everyone their highest ranked choice.  In the next step, we will pick WHERE we rotate. Which I'm also very excited for. Anything that involves looking forward is exciting. Anything that involves doing the work I still need to do to get there is torture.

Recovery

I always feel like it takes several days to recover from a big exam. Our most recent one was on Friday. Since it was match day, they decided to make our exams be one hour earlier so we wouldn't have to listen to all of the commotion being made by people in a far happier place than we were. We started at 8 am and ended at noon. 4 hours, 255 questions. It was awful. So awful that by the time you get to the last 20 questions, you don't even care anymore. You just want to bubble in all C's and be done. Add to that the 2 week run of chronic sleep deprivation and you end up with a severe post exam hangover. 

Luckily for me, I decided the weekend needed to be full of activities:

-Friday: after the exam, went home, had a strong cocktail and passed out. Woke up, showered and drove into the city to Brooklyn for my friend's birthday party. My fiancé met me there, we had a lovely time and were home in bed by around 2am. 

-Saturday: Woke up at 7:30 so I could wash off the stench of hipster cocktails before the F and I left for our 9:30 am appointment to see an apartment.  The apartment sucked. Next, I went to school to teach science to some middle school kids in the STEP program.  F picked me up at 2:30, we took our dog to the dog park then went home. I promptly passed out. Woke up to eat dinner then went back to bed. 

-Sunday: had another apartment appointment at 11, home by 12. Worked on catching up on emails and wedding things until we left around 4. Drove into the city to go wedding suit shopping then met another old friend for dinner in the east village. Home by 11, went immediately to bed. 

Needless to say I'm still recovering, while also trying to learn GI pathology. 

Test Week Truth #4

Sometimes you have to chose not to worry about the small stuff.

Due to the facts that I am getting married in 3 months and my fiancé and I have been in a bit of a back and forth with our landlord (who has decided she wants to sell the apartment we are living in and therefore would like to be showing the apartment in April… 2 months before my boards/ finals/ wedding), there are some issues that come up that need solutions. I tend to ruminate over problems and after I spend half a day ruminating over them, I talk them to death once my fiancé gets home or with whoever will pick up the phone and listen to me.  This is clearly not a good way to handle things so I came up with a little flow chart for problem solving wherein the end task is always to remove the problem from my head, at least for the time being.

1) Does this problem have a solution that is within my control?
     -NO --> let it go, there is nothing that can be done
     -YES --> Question 2

2) Will waiting X days to deal with this problem change the outcome?
     -YES --> Outsource problem to fiancé/parent/friend
     -NO -->  Set a date (usually the day after exams) to handle problem, until then, don't think about it.             Nothing you do now is going to change the outcome.

3) It's impossible to stop thinking about this problem, I'm super pissed/stressed and can't get it out of my mind.
     -Set at timer- 30 minutes to come up with some kind of solution that is satisfactory.  Decide to re-visit this solution after the exam or outsource executing the solution to someone else.


Per our apartment issue, I decided a decent solution that I could control would be for us to give our one month notice and just move over a weekend.  We'd hire movers, I would go stay at my in-laws during the process so study time would be minimally affected.  I found one of those corporate apartment companies, called to see if they had vacancies, and scheduled an appointment for Saturday morning.  Are we actually going to move?  I have no idea, but I do have a plan that is acceptable, and haven't thought about it since (aside from writing about it on this blog post).

Test Week Truth #3

Getting creative with white board surfaces is a always a good idea. 

Test week truth #2

Things I've withheld from myself in order to increase productivity (ie no X until you finish Y):

-Breakfast

-Shower

-Chocolate

-Sex

-Sleep

-Exercise (only works because I like to exercise)

-Booze

-Changing in to comfortable clothes

-Coffee (diminishing returns)

-Internet access

-My Facebook password (requires the help of my fiancé) 

-My cell phone

Test Week Truth #1

I have been a bad poster, but we have now entered test week. In an effort to remedy this problem- I present to you- Test Week Truths. 

When trying to decide if you want to spend the time to take a shower (instead of studying), if you can't remember whether or not you showered the day before, you should probably shower. 

Also: Study Puppy Picture Bonus

"Pharmacology? Le Sigh...." 

Sensitive

We learn the "sensitive" exams in the second year at my med school.  By "sensitive exams" I mean Male GU (kidneys, penis, testicles, hernia, and rectal exams) and female breast and gyn exam (speculum, bimanual, and rectal-vaginal exam).  The way it works is that we go to a clinical site where several professionals act as highly trained standardized patients (SPs).  They first demonstrate these exams, and then talk us through doing the exams on themselves.  To a non-medical person, it probably sounds kind of odd, but it was one of the most valuable experiences I've had in my medical school career.  The SPs not only teach us the mechanics of how to perform the exam, but help us to develop our technique of sensitively explaining what is going on in the exam and avoiding any pitfalls like saying "I'm now going to feel your breast" (as opposed to "I'm not going to examine your breast") and help us to learn how to make the patient feel as comfortable as humanly possible.

A few weeks ago, I had just learned the male GU exam and was later telling a few non-medical friends about it while we were visiting (I would never divulge any of the details, but just shared that I had learned the exam, how it was taught, and what a great learning experience it was).  I was genuinely really proud of myself for having gotten through that hurdle, and was excited to share my experience because it was such a major part of my education.  While I didn't expect them to want to hear all of the details (which I wouldn't share anyway out of respect to my SP), I was surprised by their response.  They were a bit disgusted and shocked (in a really negative way) to hear that there were people who would voluntarily submit themselves to the experience of being an SP.  Now I know that there are things in medicine that most people would rather not hear about, but I was really disappointed in their reaction.  I have so so much respect for the SPs who were our teachers and am so incredibly grateful for what they did for my education.  These are people who are incredibly comfortable in their bodies, are extremely knowledgable, and who must work tirelessly to develop their teaching skills.  They truly deserve nothing but the highest level of respect and gratitude from anyone who has ever been on the receiving end of one of these exams.  The fact that anyone could feel differently (even if they are a little weirded out) completely blows my mind.  I think they were also uncomfortable with how comfortable I was with the whole experience, which also defys logic.  Does anyone honestly think that physicians who perform those exams are uncomfortable while performing them?  That would be a disaster, and a disservice to the patent.  I left the conversation feeling offended and frustrated that none of them respected or recognized the significance of the experience.

Today, I learned how to do the GYN exam.  The woman who taught us was amazing.  She was so incredibly thorough in working with us on every aspect of the exam, from how we place our body relative to the patient to how to describe what we see and feel during the exam.  Words can't express how grateful I am to have had her at my teacher.  I left the experience more confident in my current interest to pursue OB/GYN as my specialty.  I like the challenge of making a patient comfortable in a situation that is incredibly uncomfortable for most.  There is a certain level of frankness coupled with warmth that you have to find, and that suits me, I think.

We are doing the lottery for our 3rd year rotations this month, and I should know the order and where all of my rotations will be by the end of the month.  I'm definitely going to make sure OB/GYN is in the middle so I can do my best and hopefully get a good letter for residency applications.

Study Snack!

Lately I've switched to being the student who never goes to class and studies from home.  This is partially due to the fact that my med school FINALLY agreed to camtasia (where they record the powerpoint/smartboard slides with voiceover and post the videos to the internet) all lectures and partially because I've completely lost my ability to pay attention to 3 hours straight of lecture (or more accurately, I never had the ability, and finally recognized that not paying attention in lecture for 2 hours was a waste of 2 hours).

My new system is to watch lectures from home on camtasia.  It takes me a little bit longer because I pause to take notes, go to the bathroom, search Facebook, slam my head into the desk…. but overall I think it's a time saver because I only have to watch/read (via transcription) the lecture once.  Added bonus, my dog is SUPER happy about the situation.

Another bonus of studying from home is I save a ton of money because I don't have to worry about forgetting/not having time to pack my lunch.  I have a pretty fast metabolism, so I usually get hungry around 10:30-11ish and need a snack.  Today I'm trying spin on a recipe I found somewhere on Pinterest- Roasted Chick Peas.  They are super healthy, a great source of protein, and take a minimum amount of time to make.  Plus, in the winter (especially this polar vortex fueled winter from hell) I find myself craving something warm.

Here is the recipe I went with today (The nice thing is when you get tired of one flavor, you can change it up!!):

Roasted Spicy Chick Peas:  Active time: less than 5 minutes
-1 can chick peas drained (I use canned organic chickpeas from TJs)
-Olive oil (just drizzle it all over)
-pinch of salt
-1/2 Teaspoon each of curry powder, cumin, and chili powder
-dash of cayenne pepper

Toss all ingredients in the colander that you drained your chickpeas in (I imagine you could do the same with the can and save a dish)

Throw onto a baking sheet lined with tinfoil (I didn't do the tinfoil this time, but it makes the cleanup even faster)

Bake at 425 for about 30 minutes and VOILA!!

Chow

Something I've realized is how important it has been for me to know how to cook well. If all else is gone to hell, and I haven't showered in days, and have been pulling 12 hour study marathons day in and day out, the least I can do for myself is to have some good healthy food on hand. 

I generally prefer to cook in bulk so I can spend 30mins to an hour on food prep one day and then microwave for the rest of the week. 

This week I picked 2 meats and 2 sides all from Trader Joes. 

Monday: 

-I took my whole chicken out to thaw

-thawed my TJs Alaskan coho salmon the baked it: layers both filets out skin side down on tin foil in a 13x9 baking dish and seasoned with salt and TJ's lemon pepper then did a generous coating of creme fraiche. Baked at 450 for 10 minutes

-cooked 2 cups of TJs multicolored quinoa per package instructions

-made 2 bags of TJs Kale: 3 frozen garlic cubes in pan with olive oil, continuously add kale until it all fits in the big skillet or wok. Add a little bit of water. Cover and steam until salmon is done. 

The salmon lasted Monday night and Monday lunch for both my fiancé and me. 

Wednesday I baked my chicken (seasoning it with the remainder of my cocktail mixing ingredients):

-rinse out chicken and set on roasting pan

-in a bowl combine half a stick of butter, 2 table spoons olive oil, zest from 3 lemons, 2 sprigs rosemary chopped, salt, pepper. Rub the mixture all over the chicken (including under skin and in cavity)

-squeeze juice of 2 lemons over chicken

-slice the remaining lemon into quarters and slice a small onion into chunks- stuff the lemon, onion and one more rosemary sprig into cavity

-Bake at 425until temperature reaches 165 when measured at the thigh. 

-check your chicken after about 30minutes. If it looks pretty brown, cover it with some tin foil. 

The chicken took about 20 minutes of prep time (just long enough to watch modern family). Tomorrow is Friday and we will be at the end of the chicken, Kale, and quinoa. Two people fed dinner and lunch for one week (plus salmon skin for the dog), about an hour of prep time, total cost: $40. Great success. 

Let Me Entertain You

This past Saturday was my 27th birthday.  Because a birthday that falls on a weekend and is not overshadowed by work or impending exam doom is super rare, I thought I should throw a party for myself.  My parents and brother came up to visit, and my best friend from college came early came so I had a ton of help.  I love my fiancé to pieces, but he isn't exactly a planner, nor is he much of a cook, so he wasn't especially helpful in the planning phase.  He was, however, a superstar in the cleanup department before and after the party and did a great job following instructions with food prep. 

When it was all said and done, we had about 20 guests- my family, fiancé's family, some friends from med school, friends from college, and a few of my fiancé's friends.  Because I've been struggling a lot with wedding guest list because there are so many people I "should" invite encroaching on the people I truly want to invite, I was super brutal with my birthday.  I only invited people who I truly enjoyed spending time with and completely, and selfishly, ignored any feelings of should or obligation.  The result?  An amazing diverse group of people who got along splendidly and had a great time.

Since I'm southern, I feel anytime people come to my home I need to feed them.  I was especially proud of my food and cocktail menu, which I cultivated on Pinterest over several weeks:

Food:
-Smoked salmon, creme fraiche, and chive on savory crisp
-Toasted french bread with warm goat cheese and fig butter (huge hit)
- Crudite platter with 3 types of hummus
-Cheese plate: white cheddar, brie, and blue cheese with water crackers and raisin rosemary crisps
-North Carolina pulled pork sliders
-Sweet and spicy chicken wrapped in bacon bites
-prosciutto wrapped melon bites
-spinach artichoke dip

-birthday cake!!

Cocktails
-plain vodka
-gin
-whiskey
-rye

-beer

-wine
-assortment of mixers and garnish: tonic water, seltzer water, cucumber, basil, mint, rosemary simple syrup, mint simple syrup, maraschino cherries, orange, lime, lemon, and sugar cubes.

-I posted 3 ideas for cocktails and encouraged everyone to get creative!! 

I had the food on our dining room table and the bar in the kitchen, which kept people moving in between spaces.  I felt like the fun cocktail mixers provided a fun adult activity for everyone and gave people a common conversation starter. All in all the party was a great success!! 

Here is a picture of the bar set up

The Fall of Snow Days

I live in the Northeast, which means this winter we have experienced snow storm after snow storm.  Because most people (not students, 80-90% of med students live on campus) that don't live at my school must drive to get there, they were pretty liberal with snow days (especially because last year, several students got into car accidents on the way to our biochem mini board).  From what I can tell, the rule of thumb has been: if it is actively snowing, and the roads have snow on them- cancel school.  We get a delay if they think perhaps the extra time will allow the salt to work its magic.  I'm pretty sure the administration (or whoever makes the snow calls) is starting to regret their decision and has thus changed the snow day rules to something along the lines of: "If a four wheel drive vehicle can make it to school, everyone else must suck it up."  I drive a Honda Civic.   

Today it was actively snowing, all major roads had snow on them, and the weather was expected to get better in a couple hours.  Seems like a a 2 hour delay to me.  Right?  WRONG!!  I don't go to class, but we had a Community and Preventative Medicine Exam this morning at 9 so I got up early to study, and hoped that the snow would at least give me a couple more hours at home.  I held out for as long as I possibly could, convinced they would post a delay.  I left for school only when I knew I would have just enough time to de-snow my car and drive to school at a moderate pace (assuming the roads would be decent since we didn't have a delay).  Decent roads what not what greeted me.  I drove my butt to  school in full snow fall, rolling through stop signs on the hills out of fear that my car would not continue to move forward if I came to a complete stop. When I arrived at school (15 minutes late for the exam), I saw a herd of other commuters who were late as well.  You would think they would at least wait 15 minutes before starting the exam right?  NOPE!!  Or perhaps, recognize that the people walking in with snow in their boots and car keys still in hand might need say an extra 15 minutes for the exam (we only had 30 minutes to take the test).  WRONG AGAIN!!  I'm now convinced our CPM course director either lives in his office or teleports to school.

Recommitting to Yoga

Before my med student life, I was a dancer, avid yoga practitioner, and "yoga teacher" (I put this in quotes because while I did get certified and have taught classes, I did not commit to becoming a full time teacher before plunging into the world of medicine.)  Over the last almost two years, my physical activity has gone down the toilet.  Around this time last year, I decided to join a gym as cardio physiology had me convinced I needed to be doing more cardio (I HATE cardio), and I thought "maybe I can try to work up to training for a half marathon again."  Well, the result was spotty at best gym attendance.  I would have a week or two of going multiple times per week followed by a week or two of no attendance due to an encroaching exam followed by a week long shame spiral at the end of  which I finally managed to get my ass back to the gym.  The net gym attendance was about two weeks go consistent gym going followed by three weeks of being sedentary.  The result- my body continued to feel like crap, I went to a series of disappointing gym yoga classes, and I wasted about $70/month on my gym dues.

A couple weeks ago, I was craving a yoga class.  My body felt like ass and I was going stir crazy in my snow prison of an apartment.  Even though I was trained to teach yoga, I generally don't like giving myself yoga class unless I come up with it before hand.  Trying to come up with a sequence that will feel good and then remember the sequence while also practicing takes away from my ability to empty my mind and enjoy the moving meditation that is my yoga practice.  My solution was to turn to youtube.  The first class I found was ok.  It wasn't amazing, but was probably on par with any gym class I would take.  Two weeks later, I've found an iPhone app and a couple youtube channels that are pretty solid.  (I'll post my favorites at a later date).  I've managed to get between 20 minutes to an hour of yoga in each day and feel amazing.  My mind is clear, my body doesn't hurt, and I feel like I carve out a little wedge of me time every day.  I think the best part of rekindling my practice at home is that it sets me up to be more disciplined and conscious for the rest of the day.  I find that I procrastinate on the internet less, I'm more conscious of how I sit while studying, I make better choices in what I eat, and I tend to be in a nicer mood.

Grownup Clothes: On The Waist:Ass Problem and Being Poor

I realized recently that I would need to start stocking up on adult clothes so that by the time third year starts, I'll have more than one pair of work pants.

My problem is this: in all of my previous professions, I've never needed to wear "work" attire.  Let's take a look:
1) Medical assistant- scrubs
2) Yoga instructor- yoga pants (which I have worn as dress pants in a pinch)
3) Dancer- booty shorts, sports bra and tank top + sweat pants
4) Contortionist- whatever combination of costume/body paint/elaborate head piece I was supplied with

The first two years of med school, at least at my school, I could get away with wearing pretty much any of the items listed above (except for the contortion outfit… that would get some looks).  Because as a med student, I'm poor, buying work clothes has been a pretty low priority because they are expensive. If one is wearing business clothes, it's generally assumed that the wearer has a job and is not, in fact, making negative money.

My plan for next year is to buy a bunch of black pants, shirts that work with black pants, and a pair of black Dansko clogs.  This will streamline my ability to get dressed in the morning (which is going to be absolutely necessary during rotations where I'm expected to show up at work before the sun does.)

Yesterday I started this wardrobe mission by purchasing my first and only pair of work-appropriate black pants.  This was easier said than done.  I am thin and tall, but my ass is one size larger than my waist.  The ass problem is a direct result of over a decade of dancing/yogaing, and while I generally like my muscular booty, it hampers my ability to find pants.

I went to Express, Gap, and J.Crew with no luck.  Finally, I went to Banana Republic, defeated, almost ready to go up to the food court and eat my feelings (probably further contributing to the waist/ass ratio problem).  I walked in and told the sales associate what I needed: a pair of pants that would fit both my ass and waist, were a little stretchy, machine washable, and would work with a pair of Danskos.  She knew exactly what I needed: The Sloane Black Trousers.  Technically they are dry clean only, but in looking at the fabric content, I don't see why they can't be washed normally.  Great success!!

Beer O'Clock

It's the night before the night before an exam at about one in the morning.  My brain hurts- you know that feeling when you've been forcing yourself to learn for so long that you start to have a physical sensation inside your skull?  I'm not tired due to the cappuccino I made fore myself around 7.  The sum of this is that I'm too tired to study, but too awake to go to bed.  The solution? Beer.  Beer and maybe one more hour spent learning about the endocrine system is the answer.  Sometimes you just have to know when to indulge.

Med School Tap Out, Wedding Tap In; Med School Wedding Planning Rule #2

Well I'm day 3 of medschool back after break.  I have many to-dos but at least got many of them checked off of my list over break.

Initially I planned on using break to review micro (which I am terrible at) but by then end of the semester I was so burnt out that I wasn't even stressed about my inability to motivate myself to study for finals.  Not the greatest place to be.  With that in mind, I decided I needed a serious break.  I didn't look at any school related email, didn't touch my computer, and most importantly, didn't crack a single book.  Would there have been a benefit to me doing some studying over break?  Sure, but it probably would have come with the greater cost of being totally and utterly burnt out by the end of second semester, i.e.: Step I prep time so I opted to take a much needed vacation from school.

I did not take a vacation from wedding things.  My fiancé came down after Christmas and we jumped head first into wedding planning.  My goal was to, by the end of break, be in a place with all of my vendors (and my mother) where everyone knew what I wanted and we could essentially run on autopilot with little to no input from me.  I'm happy to say, we got there.  Aside from finalizing the guest list and sending out save the dates, everything is pretty much under control.  This would be my second major tip to anyone who is busy and planning a wedding:

Med School Wedding Planning Rule #2: Pick vendors that you trust to do a good job, then let them do what you are paying them to do.

I am very fortunate to have wonderful vendors (and a wonderful mom).  The intention was to use this trip to make sure they understand my vision.  I did this mainly with Pinterest (discussion for a later post).  My planner showed me some great pictures that improved on my initial ideas (some pulled from my Pinterest, some from her archives), the florist seemed to "get" what I was going for, the tasting with the caterer was a home run, the wedding venue was as nice as I remembered, and the rehearsal dinner venue got a full approval from the fiancé.  Mission accomplished.  I think the main indicator that my major work on the planning front is done is that I haven't looked at a single wedding idea themed image on the internet since our return.