Inspired by a couple of Buddhist monks
This idea of… presence… the idea that one has to consider the person sitting across from them and not just the pathology. It’s damn difficult to be sure – the experienced clinicians seamlessly switch between seeing a person they’re having a conversation with and seeing the list of pathology of the patient. It’s difficult to be both personable and coldly rational simultaneously. The person in front of you is having the worst day of their life and is allowing you in in their most vulnerable moment. The patient has signs and symptoms and a diagnosis and a treatment plan.
Also inspired by the talk the monks gave: “Armor dents. Clay molds.” – by armoring yourself you’ll just take hit after hit until eventually the armor shatters, and you along with it. Molding to situations, adapting to them, being with the people you’re caring for improves resiliency.
A thought about duty
I’m a big fan of the movie 300. It’s not the highest aspiration of cinema but it’s entertaining. One thing said in the movie that’s stuck with me , which I’m paraphrasing a bit, is the following: “In (whatever), the most important thing someone has is the person next to them. Show respect and honor to them and it will be returned to you.” – I think this is quite applicable, especially in light of what we new interns are about to undertake.
I add to this my own thoughts, namely that it takes a certain type of person who can go to someone and without pretense or expectation say: “I will be your shield. I will keep you safe. I will protect you.” – words easily said, but not-so-easily meant.
A half-remembered dream
You know those nights where you remember your dreams? I had one of those several nights ago: I’m on the beach in Grenada standing with others, whose faces I can’t discern, in front of a large bonfire. For a few minutes only the sound of waves and fire washes over us.
Until the mystic in front of us speaks: a voice boring straight into my soul.
“Listen to your heartbeat: The engine which drives you. That which gives you strength in your darkest hour and that which those you care for will call on in their time of need.”
She starts to beat a drum. The rest of us sway along with the bass in our chests, smoke and heat and salt air and now the thump-thump-thump of the drum.
“This is your heart.” She says.
She starts chanting – some incantation in some strange language, lilting and musical in comparison to her voice. For the next I-don’t-know-how-long we persist in this way.
Until finally she speaks again.
“This is your rebirth. Your cleansing by fire and smoke and sea and sound. Use it well.”
At this point the dream degrades. I have no idea what to make of it.
A reboot…
As is often the case with ventures of the Web variety, in conjunction with a busy schedule and a lack of discipline… I forgot about this blog, until now. A colleague of mine took a look at a few of my rantings and ravings and suggested that I start putting them up somewhere. Well, here we are!
A couple posts of some old stuff to follow, and I’ll try to update as best I can. Residency’s like that 🙂
My Match Story
Who I am: US IMG.
My background: BA psychology/neuroscience concentration. Didn’t have the GPA or the MCAT scores to get into a US medical school. Applied Caribbean.
- Did not get into SGU straight away – they put me in their Charter Foundation Program: passed.
- Withdrew from anatomy first term – ex-girlfriend passed away.
- Retook anatomy next term – passed.
- Passed all other classes.
- Step 1: 22x
- Did well in clinicals – very strong LORs.
- Step 2 CS: Pass, first attempt
- Step 2 CK: 21x
- Applied broadly – for neurology and internal medicine.
- 9 total interviews: 1 prelim, 4 IM, 4 neurology (3 categorical, 1 advanced) – Interviewed well (IMO, hehe)
- Partially matched on March 14 – Advanced without prelim.
- SOAP begins: send out the 45. No calls first day.
- Day 2 of SOAP: One call from transitional year program in FL, very nice conversation (14 slots up for grabs). Radio silence the rest of the day. Late evening – email for a facetime interview with MI transitional year program the following morning (8 slots up for grabs), also a call from a NY IM-Prelim program (4 slots up for grabs).
- Phone interview evening of Day 2 with NY IM-prelim PD: “You have fantastic letters of rec.” Hook, line, sinker… or so I thought.
- Day 3 of SOAP, AM: Pleasant facetime interview with PD of MI program (8 slots up for grabs). A few hours of anxious waiting.
- Round 1 of SOAP: NOT A SINGLE OFFER. ZERO. MI program fills completely in round one. FL program fills all but 3 slots. NY program fills all but 1 slot.
- PD’s start calling, FL program first: “anything?” “negative” “OK, putting you back in.” Then NY: “Anything?” “nope.” “hmm, really…” (obvious shock in voice) “Dr. XX I’m devastated.” “I know, I know. Just relax.”
– 3PM rolls around (Round 2): 2 offers pop up (THANK THE GODS!!!!!) – FL and NY. Accept NY, reject FL after consulting with deans. Wanted NY anyway.
And here I am today: matched to a university neuro program, of which I am the only IMG they took in their entering class of 3. Prelim at a well-regarded NY hospital.
Moral: Someone like me, with all my bumps and bruises and middling performance still made it out. Uphill battle, but battle still won. Never say die.
Future applicants: feel free to message me if you need a pep talk or a sympathetic ear 🙂
Pardon the interruption…
I know, I know. In my oft-repeated style I forgot about this blog. I’ll try and update soon when I can catch a breath (and there aren’t many of those in Term 4).
Pro tips
Another term is (almost) done.
The last final for this term was yesterday morning. The grades for the other major final of this term were posted yesterday afternoon (success! w00T!) and I have no “love letters” from the University. Life is good.
I say that this term is “almost” done because this Sunday we have this thing called the “Basic Sciences Comprehensive Examination I”. The funny thing about this BSCE I is that it’s been listed on the master schedule for forever but we were given no information about it. I have no idea what it’s going to be like even though I have some idea of what it will contain. The word in the wings is all that’s required for the BSCE I is a passing mark. Furthermore, if one does not get a passing mark, it’s rumored that one isn’t allowed to sit the USMLE I (scary!!!) That being said, this is an exam you can’t prepare for: there’s no conceivable way to review two terms worth of material in… 48 hours, now?Â
Anyway, all that being said for those SGU Term 1 students who are playing along and following my inane ramblings here are a few tips for Term 2:
- LEARN YOUR CYTOKINES FOR IMMUNOLOGY OVER THE BREAK. I know Immunology is a 2 credit class but honestly you’ll work harder for these two credits than you ever have. Lecture is not helpful because the professor assumes you already know what she’s talking about. A lot of people will recommend Lippincott’s Immunology or Problem-Based Immunology (an out of print book written by the professor. Copies can be found on SGU Post) but I had both of these books and didn’t use them. For as much as people swore by Problem-Based Immunology I didn’t find it helpful because there were questions but no solutions, so I couldn’t verify my thought process. To that end, find a term 2 friend and get the Immuno notes from them. Read it all over the break. All of it. Especially your cytokines.Â
- BRS is your friend. BRS Physiology (Costanzo), specifically. If you don’t have a copy, get a copy. Unlike Term 1, the Physiology & Neuroscience departments provide summary notes for you but the drawback is that these summary notes are comprehensive (close to 100 pages in length sometimes). You don’t have time to read it all, so BRS Physio is a good place to start. BRS Neuroanatomy is also good to have on hand but it’s not ordered the same as the Neuroscience class so you’ll have to hunt for the relevant bits.
- The only other book you really need in paper format is the Haines Neuroanatomy Atlas. Spend the money for the latest edition (It’s like a $5 difference between old and new on Amazon) OR find a quality second-hand copy.
- Don’t sweat CPM or Parasitology.
- Genetics is well taught.
- You can skip or Sonic most of the classes. I personally would recommend not doing so, but it’s possible to do well without ever setting foot in the lecture hall.
- Get a FULL PD kit. I know people will say “oh, you don’t need a blood pressure cuff” because you only use it once in Physio lab but a new question they’re trying to phase in on the OSPE II is being able to take a blood pressure and pulse in 2.5 minutes. I didn’t have a BP cuff so I had to borrow one from an upper termer, but I know I’m going to need one for this upcoming term.
- Your PD kit doesn’t have to be top-of-the-line, and in point of fact it shouldn’t because once you leave the island you’ll never use it again. The only thing I would suggest spending any bit of money on is the stethoscope because that will be yours for a long time =). The rest, go cheap if you must OR try and score some secondhand equipment.
- Try and enjoy your break. Term 2 is draining.
I can’t think of anything else right now, either school related or personally-related. Although I am excited to finally get off this rock for a few weeks…. and then I’m stuck here for SIX MONTHS….
From dormancy to action…
(Long overdue update)
Remember back in grade school where Assignment Number One in English class after returning from break was the obligatory “How I Spent My Summer Vacation” essay? I can write my essay in two words: at home.
My original plan for the summer was to travel with SGU to India to participate in the medical selective which is offered there. In a nutshell, SGU students shadow physicians around a hospital and observe how they practice. Students are also permitted some hands-on experience such as performing routine blood draws. In my case, this didn’t happen. There were no blood draws, no crazy 3AM surgery calls, no assisting the OB-GYN, and no real (read: true-to-form, Delhi-belly real) Indian food.
Just me. And my brother. Stuck at home. All. Summer. (OK, that’s  a bit of a lie – explained below)
My younger brother tore his ACL in a soccer match and after his repair surgery needed me around to get things done (hence, no India selective). Once his physical therapy/physical rehabilitation started I was increasingly less needed, which was a welcome breath of fresh air. I spent the remainder of the summer volunteering with Habitat For Humanity which was something I’d never done before. I really enjoyed volunteering for Habitat. There’s something extremely satisfying about physically demanding work, especially when medicine has me clearly tracking to become a desk jockey.
Summer went quickly between Habitat volunteering, lifting, doing little bits of studying for Term 2 here and there, and of course the obligatory gaming sessions. Hilariously, for my birthday, my parents got the bright idea to take a family vacation to Jamaica. I protested this idea: I mean, come on I spend most of my time in the tropics anyway! Despite this, it was nice to spend time with my family all of us together before we all went off in different directions: my little brother heading off to college, I heading to Grenada, leaving only my parents and my little sister at home.
And then Term 2 started…
Term 2 can best be described as a hurricane: it starts off slowly and deceptively simply and then all of a sudden slams you with a ton of complex material. I’ll go through some pointers in my next update… but for now, I have my midterms starting Monday, so this very-disjointed update will have to do.
Updates
So I’ve been dormant a while….
The anatomy final came, the anatomy final went. I ended up doing worse on the final than on the midterm, a fact I chalk up to it being comprised of material I’ve never seen before, as well as this apathy that reared its ugly head and prevented me from studying at full capacity. Never mind the fact that I got sick with pneumonia for almost two weeks, that took the wind out of my sails, and I quit going to the gym soon after my little tussle with the bug, which only served, I think, to further deflate my weary ego.
At the very least, I passed.
End-of-term is, well, as end of term should be. Even in a sunny place like Grenada gloom and doom and misery settles on the campus, blankets the place in this thick fog that sucks up all the joy. You’ll see people change. Visibly change. Whatever muscle tone they had from working out before soon converts to rolls of fat. People become winded walking up stairs. Eyes become sunken, faces become gaunt, and people keep to themselves more and more. When your livelihood’s on the line and visions of home dance just out of reach, you too would become feral when trying to defend what little honor you have left. Medical school rips your honor from your soul, chews it to pieces, and spits it out at you. Perhaps that’s why the caduceus was mistakenly chosen as the healer’s emblem… no honor amongst thieves. The Thief being school itself. Never mind that medical school is akin to tiptoeing through a minefield. One misstep… Essentially it’s like battling a giant in a ring of Claymores with nothing but a rusted penknife to protect yourself.
Maybe it was these thoughts that inspired the following, scribbled on a Post-It note at some dead hour of the night… machinations of my mind.
“I will drape you in crimson, protect your soul, keep you safe from harm.
Promise safety in the storm, light in the darkness, strength to move the earth.”
Yes, I completed Term One after much pain and suffering and tears and curses. Yes, I am moving on into Term Two. Yes, I have three months at my disposal to do as I please… but then sentences like these come up.
… This needed to be said. Vented. Maybe the fact that it’s been raining the last two days where I am has put me in this mood. A more positive update to follow soon.
Synaptic Misfires 