long weekend

Most of this weekend I've spent in bed, but not even remotely in a good way. Looks like my good luck could only hold out so long, because I finally got sick. Of course, getting sick is always the making of a perfect storm. I suspect the agents to blame are: absurd 180 change in weather (went from 80s to 40s), spring allergies, examination time and exam-related stress.

We had a histology exam on Friday morning at the ungodly hour of 8AM, and I tried my best not to hack my lungs out in front of the computer during the exam. Fortunately, I was sitting in the front of the computer lab so I probably missed my classmates' many death glares.

Which leads me to my next epiphany about medicine and medical students. Medical students hate getting sick. We dread it. We pray it won't happen to us. We avoid it, well... like the plague.

Imagine the following scenario, which I've seen go down countless times since October:

Student #1: Hey! How are you doing?

Student #2: Oh you know, I'm doing okay. Well actually not so good. I think I'm getting sick. *sniffle or cough*

Student #1: (Taking a GIANT, indecent step backwards.) Oh really? That's... really awful. (Still moving away.) Well... hope you feel better soon! (Disappears around the corner.)

(The funniest thing is when this exchange happens in an elevator!)

Okay, so I have been both Student #1 and Student #2 in these scenarios, and each time I feel perversely guilty for being either character. As the sick person I feel bad showing up for class and potentially getting others sick. As the healthy person, I feel bad for running away from a sick classmate. Okay, so maybe my friend doesn't need me to nurse them back to health, but surely I can do the decent thing and stick around to talk with them and offer some help?

The worst case of this pathetic scenario I've experienced happened a few months ago. I have a med student friend who comes over every single week for a weekly lab meeting. This one particular week, I was in rapid recovery from a bad sore throat. It was an acute sore throat, with no other associated symptoms.

This particular afternoon as my friend entered the living room, Andrei also came out of our room and asked me if my throat was feeling any better and if he could get me some tea. My friend was in the middle of putting down her backpack when she heard this, and she literally froze. Then she wheeled around and snapped, "Xu! Why didn't you tell me you were sick!"

I think my mouth must have fallen open. It's just a sore throat, and I feel better, I stammered meekly. "Well still," she said, "you should have told me!"

I was a bit in disbelief. Should I now phone everyone I plan to see the next time my throat hurts? So that they can... take some prophylactic Vitamin C before seeing me? Or avoid me entirely? I was not only confused, but totally offended by this reaction. Suddenly I felt like I was the inconsiderate one.

So here is my bottom line:
We are training to be DOCTORS one day. As in, people who are routinely exposed to microbes of every kind! Bacteria, viruses, fungi, parasites, MRSA, VRSA, VRE -- we will see all of these AND MORE at the hospitals we will be working.

But most importantly, we will be doctors who (get this!) will be interacting with sick people every single day! Wow, brilliant. So while I understand trying to avoid sick people and attempting to save yourself from a potentially time- and energy-draining recovery from being sick... realize that sick people are people too.

And besides, you'll look like a total asshole to the sick friend or patient you're running away from.

can i be just like you when i grow up?

Remember in my last post when I mentioned medical students geeking out and going fan-crazy for Dr. Tao Le and Dr. Goljan? Well I had my own little fanfest yesterday when some medical students and I went to see Dr. Atul Gawande speak.

His name is probably well known among health science circles, but probably not super recognizable to the lay public. He's a general and endocrine surgeon at Mass General (impressive enough), an author of three books (one of which was a finalist for the National Book Award in 2002), a senior health policy advisor for the WHO, and also --ALSO!-- a staff writer for The New Yorker. Pretty darn impressive!

The two-hour talk was hosted in SMG (the School of Management building), and good lord I forgot how swanky SMG is! When I try to imagine the same bar service and waiters carrying trays of hors d'oeurves in the medical school lobby, my mind just draws a big, impossible blank.

The venue made a lot of sense, since the topic was using management tools (read: checklists) to transform healthcare and its practice. Half of the audience consisted of idealistic, doe-eyed medical students with huge crushes on Dr. Gawande, and the other half consisted of older, fatter, and better-dressed businessmen/SMG alumni. You could tell some of them were big donors to the School of Management Health Sector Management Program by all the schmoozing, handshaking, and Oh-Hey-There's! It was a very odd environment, needless to say.

The topic was incredibly interesting, and unbelievably I walked away feeling pretty interested in healthcare management. Me, get an MBA? Does this seem completely out of character?

This reminds me of a conversation that I had with a friend last month:

My friend (who is MD/PhD): Hey are you planning to get any other degrees besides your MD?


Me: Uh... well maybe an MPH at some point... (Thinking to myself: As if this MD isn't enough schooling to try my sanity...)


My amused friend: Hahaha, you would get an MPH, Xu!

Ugh, I don't even want to go there with MPH stereotypes. I own not one pair of Birkenstocks, do you hear me? Nor have I ever volunteered abroad to irrigate farmland or deworm children. (Also, Dr. Gawande is an MPH and NOT an MBA, so what does that tell you? Well, he probably has done some of those things.)

Long story short, I sidled up to Dr. Awesome after the talk and asked very nicely for an autograph in my copy of his book. Before the words were even out of my mouth, he kindly interrupted, "Do you want me to sign something?"

Just imagine going to work and doing a couple of life-saving surgeries and then doing a talk where every person in the audience is hanging onto your every last word... and then coming out to sign a couple autographs for your WORLD-FAMOUS books.

Unfortunately what stands between me and that kind of success is...

1. medical school
   
   and
   
   
2. becoming an actual badass and not just little ole me :)
   

april is the cruellest month...

I'm sure almost every April in my eight years of blogging I've made a post entitled "April is the cruellest month," because, well, April sucks hard. (Sorry T.S. Eliot, I have not your way with words.)

Yes, April is the perfect, opportune, most SADISTIC time for professors to lay one last awful hell week on you before the hell week of all hell weeks: May finals. It's like clockwork.

I was looking at a text doc of things I had wanted to blog about nearly 2 months ago, and unfortunately half of them don't make sense to me anymore:

1. med school formal
   
2. valentine's day
3. hell week for studying (...which one???)
4. got the job i wanted** (I put two stars next to this one because it probably merits more than a few skimpy sentences.)
5. a word on healer's art
6. spring break -- home and california**
   
7. flight delay
8. the white tiger
9. sam adams brewery
10. starting at project trust 4 hrs/week**

Let's just say for numbers 1 and 2 that they happened, they were lovely, and they involved brilliant views of the Boston skyline (no. 1) and heart-shaped pancakes (no. 2).

Nos. 3, 5, 6, 7, and 9 are too long to hash out entirely, but they did involve Disneyland, an unplanned overnight stay in DC that I spent sleeping at the airport (thank you, United!), some beer with AMSA pals, and "fuzzy hearts" from old Jewish folks, though not entirely in that order of events.

But in all seriousness, Spring Break was an incredible mash-up of seeing my family, bringing Andrei to KC again, celebrating my 21st birthday (no I don't feel any wiser nor do I drink any more alcohol than I did before I was 21, sadly?), and lying poolside in sunny California in-between medical talks. (Sign me up for the next conference!) And no, I have not yet posted pictures. Just thinking about it gives me a headache.

Sidenote: At the national AMSA conference I did get a chance to meet and chat with Dr. Tao Le and Dr. Goljan, of First Aid and Rapid Review Pathology fame, respectively. Like, seriously, students were GEEKING OUT and asking for autographs and photos with these two docs. It was surreal, and slightly--no, tremendously--pathetic. In just one year, will I also be worshipping USMLE Step 1 review book editors? (!!!!) I shudder to think of it.

Other thoughts: The White Tiger by Aravind Adiga. Just read it and you'll be glad you did. You'll like this if you liked Slumdog Millionaire or any type of tongue-in-cheek social commentary. One spoiler: the first person narrator tells his story entirely in letters addressed to the Chinese Premier, Wen Jiabao. Good, no? It is hilarious and heart-breaking at the same time, and well worth anyone's time. (Also the winner of the 2008 Man Booker Prize, if you like that kind of thing.)

More details on the starred ** items for next time, hopefully soon.

(I have been THIS close to opening a Twitter account because usually my thoughts need to be put down immediately or they get sucked into the black hole of forgetfulness... but I'm still super Twitter-wary and for good reason, so I'm still not convinced.)

healer's art

I mentioned a few posts ago that I'm currently taking an elective class called Healer's Art, and I don't know if I like it or not. The reason why I'm on the fence is because of the touchy-feelingness of the class. It's a "course" that only meets five times over the next two months, there are no reading assignments, and they gave every student in the course a free book written by the woman who started the course many years ago. I have yet to look at the book, but I get the feeling it doesn't fit my type of reading; I'm just not into inspirational, life-affirming non-fiction. And I kinda wonder what type of person is.... the big Mitch Album fan or religious Oprah-watching type, I suspect.

The first time the class met was last week, and it's a HUGE class. I think a lot of first-years signed up not knowing what to expect and feeling curious about a course that has no expectations of you other than asking that you show up. We sat in a circle of chairs, did some deep breathing, some calming exercises.... and then the course director asked us to grab a pack of crayons and a sheet of construction paper from the pile in the middle of the room.

He asked us to draw things that we feel have gotten "out of balance" in our lives since medical school started, i.e. things that we missed or had to push aside to deal with our more immediate education. People drew mountains and beaches to represent travel, other people drew pictures of their family, and one guy drew this REALLY BIG, elaborate four-poster bed with luxurious-looking sheets that took up the entire size of his sheet of paper. This made me laugh, even though I've been sleeping plenty in medical school because I'm an old lady who loves her sleep. But I can appreciate the humor in it.

Later we broke up into small groups of six or seven to talk about what we drew, and it felt like elementary show-and-tell all over again, except now we were sharing the most meaningful things we've given up in the last semester. It was actually really nice to get to know and talk with classmates that I hadn't exchanged more than a few sentences with prior to the class, but I felt pretty awkward telling near strangers about my family and friends and my personal life. It's probably something I'll get more used to as the course goes on, but right now I'm still on the fence about the class because it seems more like a therapy group than a learning experience. Or, I guess the course philosophy is that learning can come from introspection and sharing of stories, feelings, and mush you wouldn't even admit to your mother.

For the next two times we meet, the theme of the class will be "Sharing Grief and Honoring Loss." I'm anticipating lots of tearing up and stories about death and dying. I'll update about the class as the weeks go on.

the art of breaking bad news

As of Sunday I've been a Massachusetts Dept of Public Health certified HIV counselor and tester, which was pretty gratifying after nearly 2.5 full days of training. It was a long process, but mostly fun (talking about sex in an academic setting is always awesome, right?). Over the next few weeks we're going to do some shadowing on the wards with current counselors/testers and then we'll be cleared to do the counseling and testing by ourselves.

We did some role-playing at the end of the day yesterday, and I was to deliver a positive HIV test result to my "client," who was being acted out by a girl in my class. It was definitely one of the hardest things I've ever had to say to anyone, and it wasn't even a real situation....

It could have gone a lot worse (this girl in my class didn't ham it up and go over the top with grief; actually, if anything, she was pretty muted in her response), but it was still a terrible scenario that I hope I'll never encounter in real life. Apparently one of the 2nd year counselors has gotten FOUR HIV-reactive test results since he started volunteering last year. I can't even imagine that.

It's experiences like this that make me think that medicine is more about knowing how to talk to people and deliver bad news than finding a cure. That's more along the philosophy of the "Healer's Art" class that I'm taking as an elective for this semester. I'm a little skeptical of the class, but more on that in the next post since I really need to go practice for VagMo, unless I want to look like a complete fool on stage tomorrow.

back to the grind

So after an incredible weekend of doing whatever I pleased, it's back to the grind again.

Today we started histology and physiology, and the day went by like a blur. I'm definitely feeling most unexcited about histo--seems to me like another rather useless bunch of information to learn with no real practical application. ...Unless of course you're my mother, or any other pathologist who is happy to sit in their dimly lit office staring down a microscope all day. But as my mother (and anyone who will listen to me) already knows, I am not going to be a pathologist. Or a neurologist. Or a psychologist. Or really any doctor who uses any specific body of knowledge that we've covered so far in the first year of medical school (histo, neuro, human behavior in medicine... hmm).

To balance out the depressing academic side of our studies, we start our clinical part of the semester this week. I'm shadowing a family medicine doc each week for the rest of the semester, and I'm not sure it bodes well: this afternoon I called her office to confirm our meeting time later this week (after I had sent a very politely, meticulously spell-checked email earlier last week), and was told by the secretary that the doc was with a patient and that she would print out my email and show it to the doc, who would call me back.

So I hung up the phone, feeling relieved that I had Made Contact and All Was Well, and waited patiently by the phone like a pre-pubescent girl waiting to hear back from a boy from school. (And like a pre-pubescent girl, I did some cyber-stalking of my doc with Google.)

I noted the time when I hung up with her secretary: 3.13PM. Okay, I thought, it should take her about 15 minutes to call me back and confirm the time since primary care appointments usually only last like 15 minutes, right? Well I sit there waiting, waiting, staring at the phone.... Then I turn on the TV and zone out for a while.... and 30 minutes later and she hasn't called, so I go and lie down in bed, but not before checking five times that my ringer is on LOUD AND SHRILL so that I won't miss the call if I doze off.

Well, of course I did doze off and she never called and now I don't know if it's because she was with that patient for a long time and forgot, or if being a primary care doc is really as hellish and busy as they say. So busy and hellish that you don't even have time to call back a perfectly earnest and fervent first-year med student, who will HANG ON YOUR EVERY WORD because you're a REAL-LIFE doctor?!?!? (And more importantly, not the type of boring doctor her mother is.)

Perhaps my time would have been better spent pre-reading. (Always a BIG bonus when you're already "behind" after the very first day of class. Hell, I was behind before I even got to class.)

what i do when i'm not studying

After a few failed starts to Ye Olde Medical School Blog, hopefully I've managed to settle down on this one. It turns out that I'm no good at starting a story from the beginning at all. I tried to write about my white coat ceremony, I really did. I tried to start from Day One and recount the sweaty-palmed anxiety of marching at the ceremony, feeling like I was about to ooze out of existence because of the unbearable heat of midday August in Boston. But to be honest, it really wasn't very interesting stuff to remember.

And even more amazingly, all of my previous attempts to entertain myself with the story of that one time in lab when my anatomy partner threw a human heart at me with a mean spiral because "it sorta looked like a nerf ball" -- well even that was a bust. So I'm going to start this story 23 weeks and 6 days into the semester, and try my best to forget that image of a projectile human heart.

***

Thursday morning was our dreaded Neuroscience final, and we all emerged bleary-eyed from the auditorium four hours later with grand hopes of two things we had forgone all week: eating and sleeping. I went out for lunch with two classmates to a place that I've already forgotten the name of (in my food- and sleep-deprived stupor, remember?) For the majority of lunch we talked about what we'd do with our "Free Time" now that Neuro was over and now that we had a three-day weekend ahead of us. Talking about our plans for the weekend buoyed us up even more than our good meal, and we walked out of the restaurant high on our freedom from ever having to remember the ventral amygdalofugal pathway again.

The rest of the day Thursday I spent in long overdue meetings for clubs that hadn't corralled its members since before winter break, and I finally got home around 5pm and threw myself in bed. But within 15 minutes of getting into bed I pulled myself out from under the covers and mewled piteously to Andrei in the next room: "I have all this free time to do whatever I want--whatever the hell I want--and I'm choosing to stay in bed?"

So we went out to the Coolidge Corner Theatre to see Up in the Air, which was a movie that I had meant to see after our FIRST neuro exam in December, but never got around to doing. On second thought, I think the reason I didn't see it after the last neuro exam was because I DID succumb to staying in bed for the rest of that night. Carpe diem doesn't always apply to med students, obviously. Yup, sometimes seize the sleep is my only motto.

The movie was good. The cast was magnificent, especially the female actors Vera Farmiga and Anna Kendrick (whose role in the movie was apparently conceived just for her, and you could tell). Andrei liked it, but I thought it was totally hyped up (much like I thought Garden State was hyped up in high school). It was a funny movie and maybe "representative of our times," but I couldn't help but think that it was trying too hard in some places. It was a little unapologetically emo, and George Clooney acting emo, doe-eyed, and lost was not really that interesting to watch.

Friday I spent all morning doing chores (i.e. watering our plants and tackling all the laundry I had not-so-judiciously avoided in the two weeks before the exam) and waterproofing the tan riding boots my mom bought for me over winter break. Before I knew it (or, alternatively, three CSI re-runs later) Andrei was home and we left for the Prudential Center to do some window shopping. Ironically, the only window display that caught my eye was a display of boardgames in the window of Barnes and Noble, and I made a fabulous purchase. It's something I've always wanted! More so than a Gucci bag (Andrei likes to pronounce it "Guck-y") or a Free People dress (Andrei always jokes about the name "Free People").

As expected, we ended the night at Trident, my favorite bookshop in Boston. I love their cafe, especially their teas and carrot cake! It's a ridiculously cozy place and it wasn't too crowded (guess not too many college students spend their Friday nights in bookstores). We caught the tail-end of Trivia Night at Trident and had some fun playing Scrabble. A perfect night in my book.

Saturday I felt equally as ambitious to get out of the house, and so we spent most of the day in the Coolidge Corner area. We had lunch at Dok Bua, my favorite Thai place in a one-mile radius. On the way home I did some shopping at the Gap. I made off with some yellow and teal opaque tights, a striped turtleneck sweater, and a charming grandpa sweater. It was a good haul, worthy of a critical Asian mother's eye :o)

Saturday night Andrei made chicken curry from scratch (there's no argument that he's the better cook between us), and the rest of the afternoon was awesome because Titanic was on, followed by the SAG Awards. Later Lijo and Anna G. came over to hang out and watch movies and do the whole catching up thing.

Today we're doing more catch-up: pho with med school friends in Harvard Square, and a visit from Anna S. later tonight. I really miss that girl! In the meantime I've got to put the finishing touches on this new blog, clean my desk out, finish the book of short stories I started Friday, and pre-read for class tomorrow.

Okay, maybe pre-read.