Humanism in Medicine (Probably just part one)

I started my "post-decision" volunteering by volunteering in an ER. It was a small, local hospital in the suburbs and for the most part, I felt like I was in the way. I was only there for about two months before I had to take a leave of absence for classes, but the experience was such that I did not elect to go back.

Instead, I decided to become a certified EMT and volunteer with a local ambulance service. This experience has been much more productive, I don't feel like I'm in the way, and I'm learning a ton of stuff. In fact, I generally can't wait until EMS-day and wish I could find a way to fit it in more than once a week.

Much as I really enjoy my volunteer experience, I had a call the other day that really drove home a significant point for me. I've literally spent years watching medical dramas, reading med-student books, blogs, etc, and I've always thought the same thing... "Gee, some of them really dehumanize their patients and catalogue them as nothing more than procedures... that's totally not going to happen to me!"

Well. It did. It's hard not to get caught up in the moment. It's extremely difficult not to get excited that I got to perform such and such a procedure for the first time. And the capstone on all of that is that it's even harder to remember that this is someone's father, mother, grandmother, sister, loved one... that is going through a very scary medical crisis.

I know that I cannot allow every single patient experience to affect me so profoundly or access my emotional bank... but I'm going to have to find a way to keep the human aspect within sight. I also understand that learning procedures today will help me become a better clinician, will help me save people down the line, and will ultimately be good for me and everyone I come in contact with... but that doesn't mean that I have to reduce people down to an intubation, or a successful blood pressure check.

This experience is uniquely mine, but it is not mine uniquely. I imagine the vast majority of clinicians ahead of me (and those who will come after) have struggled with this issue and found a way to muddle through. I'm going to have to do the same thing.

I am nearly ashamed to admit that I didn't think this would be an issue for me. I honestly thought that because I was thoughtfully considering the human aspect of medicine that I wouldn't have to have this little heart-to-heart with myself. Turns out this was just one more thing I was going to have to experience before I'd truly know how I'd react.

Shadowing

So, this may come as a bit of a surprise to some people, but I can be a bit shy from time to time. Not, say, in everyday life or in normal circumstances that plague regular people, no. But in unfamiliar situations, well then yes.

Case in point: shadowing. I need/want to shadow some doctors. I'm not even picky, and I kind of want to shadow all different kinds. I work in a hospital that is chock full of doctors. This seems like it would be easy. Walk up to doctor, say 'hey, can I shadow you?', he says yes, boom, done.

But it isn't that easy for me. I mean, is that what you actually do? Is there a form that needs filled out? How do I get him to see me as a real person and not a stretcher-monkey? What if he says no? That's generally my biggest concern. If he says no then I will be embarassed every time I see him and will feel silly having asked.

Do doctors like having med school hopefulls following them around? Or is it annoying? I just don't know. So here we are. I'm swimming around in a sea full of the resource I need, but scared to take a sip.

Today I'm meeting with my med student mentor, so hopefully she has some insight into the process and maybe, just maybe, a little bit of what I like to call "the hookup". I mean, it couldn't hurt, right?

Everest is a big mountain...

So, while I was project managing, one of my favorite stories was how when you climb everest, you have to keep going down, then going back up, then going back down again, in order to acclimate yourself to the lower atmospheric pressure (and thus lower O2 pressure). It was basically a story about how getting there sometimes requires going in the opposite direction.

So anyways...here we are in the "new" version of my life and I find the same to be true. Over the summer I learned that we shouldn't over-schedule ourselves if we want to be successful. Now I'm learning that if you didn't get everything you needed in "First Semester of Subject" you won't actually understand anything in "Second Semester of Subject".

This seems like a no-brainer, right? The only problem being that my first degree, while progressive, did not have a linear progression to it. If I didn't like Practices in Human Resources, I only had to suffer for fifteen weeks, memorize enough to pass, and then it was over. With science, if you don't understand acid/base chemistry, there is no escape. It will keep coming up again and again over and over until you just hunker down and actually learn the differences between pKa, K, and pH.

So. What does all this mean? It means getting a "C" in Organic Chemistry I is not enough to prosper in Organic Chemistry II. So here I am again, in OChem I...

...and yes, I feel a bit "fail-y". But I also learned that true failure isn't retracing your steps, but in ceasing the journey altogether. And quite frankly, I'm not giving up. I'm trying again, this time with more focus.

Besides, this gives me a great way to segue into examples of my perseverance and show proof that I don't give up. I'm shooting for an A+ because I think it makes the point all the more poignant.

(And looks good. Let's not ignore the fact that I'm a weaselly pre-med student...)

(By the way, if you are also pre-med, or post-med, or interested in the life of the med student, or medicine, or hey, just happen to like funny things, cruise on over to this blog.

and check out the funny cartoons. And then, if you really like 'em, you can get them in book form!)

Yay Doctor Fizzy! :)

New Year...

We're closing in on the last day of the year, a situation which tends to make me reflective. It's been quite a year, 2011. This was the year that I started putting dreams to action, the year that things started to gel together and form a path forward. October 14, 2010 was the day I decided to go to med school. 2011 was the year it started to happen.

I started the year with a brand new plan, a chemistry and biology book, and a lot of hope. I learned early on that science was going to take more than what I'd always done. I studied, I cried, I lamented that I was supposed to be one of the smart kids. I memorized constants and equations. I bit off more than I could chew. I passed organic chemistry.

I tried volunteering in a hospital emergency room. The suburban campus was a bit too slow for me, and I felt like I was always in the way. So I tried a new approach and signed up for an EMT class.

I tried using my network of contacts and informants to secure a research position, but eventually just tossed my hat in the ring for someone looking for a "highly motivated undergrad" who decided I was the one.

I killed millions of yeast. I became so good at PCR that my PI decided I would be carrying out her PCR reactions from now on. I applied for my first NIH grant. I realized there are a lot of hoops to jump through, t's to cross, and i's to dot. The struggle continues on that one.

I fell in love with quiet little moments stolen between study sessions. I realized focus was more important than doing a thousand things at once. I withdrew from my first course - calculus - and realized that just redoubling my efforts was not always the way to succeed. Sometimes you had to go back down to base camp and try another ascent.

I rejoined the workforce in an entry-level position in a hospital. I fell in love with patient contact, and realized the power I had in just holding someone's hand. I worked on small talk, something at which I've never been very good. The weather, where are you from, what do you do, how about them 'stillers, all became di rigeur. The struggle continues still.

I came to appreciate people I had taken for granted. I fell in love with my husband again. My quirky little professor who brought me coffee while I toiled, who cheered me on from the side lines, who told me that yes, I could, even when I didn't think so. Who let me take his vital signs a bazillion times until I finally got the blood pressure thing.

I was more frustrated than I can ever recall being. Chemistry books became my constant companion, and people rarely saw my face outside of them. But even with this, I did not study enough. I did not commit enough time, and I did not do enough problems. So, for 2012, I resolve to study in a different way. I'm trying some new tactics, recording lectures, transcribing notes, focusing more, doing more problems. Less relaxation and tv, more actual work.

2011 was the year where I turned my life 180 degrees and committed all my actions towards one goal. 2012 will be the year where we move, full speed ahead, toward that distant horizon.

And all I can be right now is just thankful. Thankful that I'm here. Thankful that I get this chance. Thankful that I have this opportunity. Thankful for all those people who support me, who keep me going, who read my frantic texts about equations, who laugh with me, cry with me, mix chemicals and distill things with me, and let me borrow their notes.

Thank You.

The joy for me is in the journey AND the eventual destination. So thank you for all those people with me along the way, and for those people who believe I'll eventually get there. You all mean the world to me, and I could not possibly be doing this without you.

Happy new year!

the dream

Passed my EMT practical exam, and in a few short hours, will pass the written. It's like throwing gasoline on a fire... exposure to medicine enhances my desire to practice it. The art of the patient history exam is like playing detective and problem solver all in one.

I've been working at the hospital now for a little over a month. I just work weekends, and while I come home exhausted, I often find myself looking forward to going to work. I even love the smell of the hand soap. I feel like a dry sponge, looking to soak up everything I possibly can, learn everything thrown my way, and talk to everyone who'll talk to me.

I still need to figure out shadowing. It's intimidating, trying to conjure up the cahones to talk to a doctor and ask. Who do I ask? What do I say? How does it work? The thing is, I really want to do it. I want to see what it's like. I want to spend a day shadowing as many different kinds of doctors as I possibly can. If there's something to be seen about medicine, I want to see it.

It's become an obsession, really. I wish I could say the same about organic chemistry. ;)

organic chemistry - midterm

So it's a little later than mid-term in Ochem, but I thought I'd provide a "how its going" post so I can come back once its all over ... and be thankful its all over. Yes, it's interesting stuff. Yes, it's probably important that I know what's going to react with what and how. But holy crapsticks batman. There's a lot of material here. And it's intimidating material. And they tend to ask you the most difficult questions when it comes time to answer questions.

There are people in my class who are doing exceptionally well. I have no idea how they are pulling that off. This all seems like a "cross-class skill" (D&D reference for the nerds in the audience) for me, and I have to spend twice as much XP to get it. OChem lab tho? I totally have that. My lab reports dance and sing and have figures and tables... and regularly receive 96% A+'s... I can swirl things that don't mix together into a chromatography column without spilling a drop, work with 10M acid without getting nervous, and distill with the best of them.

Apparently, I can apply things into practice, but I have trouble visualizing them abstractly. It's just that... well, sure, I understand how and when an SN1 reaction will take place, but... I personally think I don't study enough. If I could study five hours a day, I'd probably understand everything and be able to perform better on the exams.

But gosh darnit, pre-med involves a lot of "other" stuff... stuff that takes up all that time that I could be studying. And I'm not talking about tv or other such related pursuits. I literally work my butt off every single day of the week. Saturday and Sunday I work at the hospital as a transporter, gaining valuable patient contact experience and paying the mortgage. All week I have classes, Tuesday and Wednesday classes are all day. Thursday and Friday I work in the research lab for most of the day. Monday I only have one class, but that's also the day I write lab reports, do laundry, go grocery shopping, make phone calls, pay bills...

I'm not whining. Well, ok, I guess I am. A little bit. I'm just saying I wish I had more time. Or that I could somehow go without sleep like most of my colleagues. All-nighters are not a good idea at this stage in the game... I can't just sleep all day the next day, I need to stay sharp every single day so I can do my best.

Anyways. I guess my point is that I can do one or two things brilliantly, a bunch of things pretty well, and a lot of things kinda crappy. That being said, I'm doing pretty ok at Organic Chemistry, wishing I could do better. Three more weeks of this term, after which I'll be a certified EMT, which will open up some really cool volunteer opportunities. The only thing left to figure out is shadowing, and hopefully I'll meet some docs in my job or volunteer experiences.

research

I may or may not have updated that I was accepted as an undergraduate researcher into a cancer research lab, but hey! I was accepted as an undergraduate researcher in a cancer research lab! My PI specifically studies how double DNA breaks are repaired, created, etc, and how this relates to cancer. Pretty wicked cool stuff.

Since I have virtually no lab experience (besides what I learned in Bio & Chem Lab) it was incredibly cool of her to take me on since, with my arrival, there are now three people in the lab including her, me, and her tech. There's also a guy who moonlights during the summer. Anyways, I'm very appreciative for the chance to learn about the research process and get to learn awesome science along the way.

My first project is to genotypically identify 800+ strains of yeast for the gene of interest using PCR. For those of you without a science background, here's a fairly good approximation of what I'm doing using a metaphor:

We have 800+ cookbooks. We need to figure out which cookbooks contain recipes for stew. Of the ones that contain recipes for stew, some of them are vegetarian and some of them are not. Unfortunately, we can't just open the cookbooks and look for the recipes. So, we're using a "find" command that looks for the word "Stew". When it finds the word "stew" it then displays whether or not meat is called for in the recipe. If meat is called for, it's considered "normal" or, "wild type" and if no meat is present, it's considered "not normal" or "mutant" (no offense to my vegetarian friends.)

For those of you with a science background, it's giving me a chance to really work on basic research skills - breaking out strains, pipetting, PCR, enzyme digestion, running gels, reporting results, etc. In addition, we also sometimes get to help with the research grants. (Ok, we get to help come up with titles to the research grants, but hey, that's still helping.)

I genuinely enjoy the experience and look forward to lab days. It's also given me a chance to work on "thinking scientifically" which, as I'm learning, I've been doing all along. Well, at least as long as I was a technical project manager. Science and project management are somewhat similar... at least theoretically speaking. Both have to solve problems that don't have clear answers. Both involve testing a variety of methods before finding the best way (or one of the best ways) to accomplish the goals. Both involve the agony of things not working, and the ecstasy of things working. However, the environments are vastly different...if things didn't work at "work" I was chased around with torches and pitchforks... If things don't work in lab, I sit down with the tech or the PI and we discuss what might have gone wrong, and additional things we can do to improve the results...

It's a nice environment to work in while you're fretting about organic chemistry. And in that vein... off to study.