Sometimes You Just Have to Put on Lip Gloss and Pretend to Be Psyched

Friday, August 29, 2014

I must confess that I have never watched "The Mindy Project," nor have I read Mindy Kaling's book, Is Everyone Hanging Out Without Me? But I hear that "The Mindy Project" is a hoot (yes, a hoot) and her book is on my Goodreads, and getting started it half the battle, right? Okay. Anyway, sometimes you just have to pretend to be psyched. I've been doing a lot of that lately, because on some level, if I pretend that I'm totally stoked to study histology for 4 hours maybe it will actually be fun...?

That's totally a lie, studying anything for 4 hours isn't fun. Unless you're studying a really hot guy's abs. Or his face. His face is probably more interesting. I hope.

ANYWAY, you can tell that it's almost Friday because my brain is doing that thing where someone seems to have put out the "FREE ASSOCIATION TIME" sign, so I just randomly bounce from one topic to another. Now Alison, you might be saying, you do that on the regs, so how is this different? It's not, really, I guess. Just go with me, here.

So you have to pretend to be psyched. I pretend to be psyched that I've gotten 4 hours of sleep and that my coffee has too much creamer and that I have to sit through four hours of lecture, have a lunch meeting, and then sit through 3 more hours of lecture, only so I can go home and study for 3 hours. I pretend to be psyched about the fact that in the next ::stops to count:: 181-ish hours, I have to cram an unreal volume of information into my head about biochemistry, genetics, histology, and cell physiology. Then I get to brain-vomit it all over a 4 hour combined exam before I'm free to vegetate for the weekend. YOU GUYS, I'M TOTALLY STOKED!

(Spoiler alert: I am not stoked.)

But I'm pretending. Don't ruin my fake-excited reality. It's all I have to get me through this giant pile of information in front of me. That, and wine.

The struggle is real, you guys.

How-so-ever...  I am legitimately excited for a few things coming up soon, which is what I'm going to talk about today for the "Oh Hey, Friday!" link up with Karli and Amy! Without further ado, 5 things for which I am actually psyched. Get ready for some serious exclamation point overusage, you guys.

1. Going to Maryland!
After 2 hours of histology lab, during which I may very well want to stab myself in the eye with a spork, Ken and I are getting in the car and driving to Havre de Grace, MD to visit this guy!

This handsome fella is Constantine, and he is currently being fostered in Maryland as part of the Siamese Cat Rescue Center. He is almost 2 and oh my God, just look at that face!! I have wanted to adopt a Siamese (or Balinese, in this dude's case) for a long time because I love their personalities, so when we moved I bothered the crap out of Ken eventually convinced Ken that having a third cat would not, in fact, make us crazy or hoarders. The application process is pretty intense and required 2 references, a vet reference, vet records, an application (with short answer questions!) and an hour long interview. These people are serious about their cats (just like me!) Anyway, we've been approved to adopt, and Constantine is the first kitty we're meeting. We aren't definitely adopting him, but tomorrow we'll see how he is in person (in cat?) and whether we think he'd fit into our household. And no, Gersh and Luna have no idea that they might be getting a new sibling. Shhh.

Also, I am totally a crazy cat lady who happened to get married, so don't lose hope, ladies. It can be done.

After our kitty play-date, we're driving to Columbia, MD to have dinner with my favorite aunt and her husband, which will be nice. Then we're coming back home.

2. Farmer's Market Date! With a Baby!

Then on Saturday, I have a date with these lovely ladies!

That's my friend Jen, and her sweet baby, (my honorary niece) Fiora Sage, and it was Fiora's first time in the ocean. I wish I was that excited about... anything. Maybe sleep. She's far less excited about sleep, sadly. Anyway, we're heading to the Collingswood Farmer's Market from 8-12 on Saturday morning, and it's actually my first time going, so I'm looking forward to it (even if I have to get up before 10 am). Then we'll probably grab lunch and catch up for a bit. I mean, how could I not be excited about getting some face-time with that adorable little girl!? (And Jen too, haha.)

3. NYC Lunch Date with Our Wedding Photographer!

Sunday, Ken and I are taking the train up to NYC to meet up with Katie Jane, the photographer who shot our wedding in 2012, and her husband, John. We haven't seen them since our wedding, and now Katie is pregnant with identical girls! Surprise! I got a little gift for the babies and I can't wait to catch up with Katie and see how life has been! Our wedding was the last "big wedding" she shot, and she's been shooting elopements only ever since. Her business seems to be growing by leaps and bounds, and I am just so overjoyed because she is the kind of person you want by your side on your wedding day. She takes gorgeous photos and is so easy to be around. She's obviously taking some time off to have the babies and be a mom to twins (yikes!) but she'll be back in the game eventually and I suggest that you work with her if you need a photographer! She's also super sweet and I wish she lived closer because I feel like we'd hang out a lot, haha.

4. My First Blate!
It's finally happening! Also on Sunday, after our lunch date, I'm meeting up with Marcie from On the Needles for my first ever blate (blogger date!) I met Marcie through... some random internet blog link-up and I seriously think we were sisters separated at birth. The internet is a weird and wonderful place, my friends. Marcie actually lives in Indiana, but she's visiting her younger sister in NYC for the long weekend so we decided to set up a time to meet and hang out! We don't have any crazy plans, but I'm sure they'll involve vortexing time while chatting about knitting, work, relationships, babies, and God knows what else. Oh, and food. There will definitely be food. And WINE. I'll be sure to take a ton of pictures (sorry Marcie, it's happening... for blogging purposes, of course) and will fully update you all on our adventures.

5. I Have Off on Monday!
It's Labor Day on Monday, so we don't have class. Hallelujah, praise the the deity of your choice. I will be spending the day studying for my first exam (cue sad trombone noise) but I also plan to have lunch with my brother and/or mom, and at least I can spend the day in comfy clothes, drinking coffee, and not wearing shoes. I'm sure at some point, I'll have to wear real pants because I like to study in public places, but while I'm home, it's totally pants optional. So that's what I'll be doing with my Monday. WHOO!

So there we have it. The things I'm actually psyched about, the things I'm pretending to be psyched about, and everything in between. As for now, I'm going to pack up my stuff from this Starbucks so I can head to a dinner date with my friend David. Yes, I was blogging in a Starbucks. As Helene would say, #TBM. After dinner, it's back to the books for me (PSYCHED!) and life resumes. Hope you all have a lovely weekend! 

Exclamation point count: 27! (Okay, now it's 28.)

- A

A Weekend Away

Wednesday, August 27, 2014

Good morning and happy Wednesday to all of you! I'm up bright and early today, ready for 4 hours of genetics lectures, followed by an emergency medicine club lunch meeting, and then 4 more hours of clinical lecturing. ::twirls finger in air:: After the heaviness of yesterday's post, I decided it was time for something a bit lighter and more fun, so get ready for some photos and stories from our weekend away in North Carolina for Mike and Jen's wedding!

The journey started on August 7th at the unholy hour of 4 am. Ken and I piled into the car and drove to the Trenton-Mercer "airport", a term that I use loosely. Very loosely. In the loosest sense of the word. As in... yes, there were airplanes there and you could theoretically get from one location to another utilizing said airplane, but it was not a real airport. We figured that at 5 am, this tiny airport would be a ghost town. 


The entry area of the "terminal" was packed. Wall to wall with confused people with too many bags, small children, and not a clue of where to go. There was one desk to check in and check bags, so Ken and I figured that since we had already printed our boarding passes and paid for our checked bag that we could just throw our bag at someone and be on our way. 

Wrong again.

It took us almost an hour of standing in this painfully long and disorganized line to throw our bag at someone. There was a remarkably unhelpful agent who seemed intent on yelling at people, and plenty of angry travelers who were more than happy to yell back at her. There was also a completely inept family in front of us with 2 kids, a boy about 4 and an infant girl in a carrier. The father had completely checked out and was leaving the mom to wrangle both kids, and the poor 4 year old was having a meltdown because it was 5 am and he was 4. I partially felt bad for them, but I mostly felt like I wanted to punch them in the face. 

Once we got through the check-in line, we went to security, where the inept family followed us and mucked up the entire process by bringing what appeared to be every liquid they owned. Then a random guy tried to walk through security to give something to his family, because apparently he's been living in a cave and it's no longer 1965, so he almost got himself arrested. It was probably the most excitement that has ever occurred at the Trenton-Mercer airport. Ever. We got through security and went to our gate... which was one of 2 gates. TWO. There was nowhere to get anything to eat, really, but there was a bar (priorities, people) and a fridge case with some drinks, yogurt, and sandwiches. After a haphazard boarding, we packed into the plane and I promptly fell asleep before the plane even taxied down the runway.

A little over an hour later, we touched down in Raleigh-Durham and headed to the rental car place. Then, since we had been up since 4 am and it was now 9 am and we hadn't yet eaten, we headed to Elmo's Diner for breakfast. Jen had been telling us about it for years, and we knew we had to go at least once while we were down there. It certainly did not disappoint! I had the most amazing apple cinnamon French toast that basically melted in my mouth, and the coffee was amazing. So good. 

Why is there greenery on my French toast? Get that out of here.
After breakfast, we headed to the house where we were staying in Chapel Hill, which was about 25 minutes from Durham itself. We were fortunate to be able to stay at a family friend's house, which saved us a ton of money (and had bonus kitties!) Essentially, we got to the house and passed the hell out for four hours. It was glorious.

That night, we were able to meet up with Mike and Jen at one of their favorite hangouts, Satisfaction's, for dinner and drinks. It was so good to get them to ourselves for a couple of hours before the craziness of the rehearsal and the wedding set in. Also, as a life-long North Easterner, I was highly skeptical of pizza in NC, but I trusted Mike and Jen to not lead us astray. (I can think of few things worse than bad pizza.) Fortunately, the pizza was AWESOME, and we had a great time relaxing, talking about marriage, and playing with the camcorder that their videographer had given them to document their weekend. (Seriously can't wait to see that one!)

Ken with our cider and beer!
Jen, with her "something blue" cocktail
Mike and me! Friends since we were awkward 11 year olds. Now we're older and... still awkward.

Friday started with manicures and pedicures for the ladies of the bridal party, which was super relaxing. I seriously think I almost fell asleep. Afterwards, Ken and I grabbed brunch (where I ate more French toast... because I have a problem) and then headed back home to get ready for the rehearsal and rehearsal dinner later that evening. Despite some rain, the rehearsal went well and the MOH, Anne, and I realized that if we were getting teary during the fake vows that the actual wedding day was going to be... full of tissues.

Anne, me, Jen, Jen's sister Sarah, and Jen's momma!
Duke Chapel in all of its glory!
Mike and me, again!
Saturday morning, we hit the ground running. Ken and I abducted picked Mike up from the hotel for coffee and pastries for breakfast, and then Ken left me at the hotel to get hair and make-up done with the ladies. I spent most of the day in the bridesmaid room, with a fair bit of running down the hall to Mike's room once hair and make-up were done. The girls' room was a lot of fun. Disney music (with sing-alongs, of course), lunch, giggling, and lots of silly pictures.

Jen, me, Lee, and Anne (MOH) in various stages of readiness!

Card delivery!
Hair stylists are magical. So are bobby pins.
Anne is working hard on her MOH speech, while Connie was working on her MBA readings, haha
Garter time! Complicated process.
Delivering superglue for broken cuff links... the best groomsmaid is on it!
Mike made us all cry when he read his card from Jen. Thank God for waterproof make-up.
Lacing her up!
After we were all ready, it was time for the first look! Sadly, it was raining, so we couldn't go outside to the grounds of the Washington Duke Inn, but the inside of the hotel is quite lovely, so the wedding planner and photographer picked out a great spot. As most first looks are, it was incredibly sweet. Cue more tears.

Then we piled into the limos and away we went! We took some more photos at the church, during which my grandmother's pearls totally broke and I nearly had a meltdown. Fortunately, the wedding planner swooped in and performed some magic using floral wire, and my pearls were individually knotted, so I threw the one that had escaped from the strand into my bag and the day went on. WHEW. Before we knew it, it was time for the ceremony! 

It. Was. GORGEOUS. They had an organist, as well as a trumpet player. Jen was escorted by her adorable father down the aisle to Trumpet Voluntary, and from the first note, I had tears. Thank God I had shoved tissues into my bouquet, because I was very close to ugly-crying, haha. It was just so romantic and grand and beautiful, and Jen was simply glowing. I loved watching Mike's face as his bride came down the aisle, and Anne and I were basically a mess. Not a dry eye among us! Jen and Mike are both fabulous musicians, and they met during high school while doing the musical. Jen went to Duke and sang in the chapel choir for 4 years, and so they had a portion of the choir there for their ceremony, which was just so lovely. They picked beautiful hymns and readings, and the priest they chose was from a program that Jen had volunteered with for a year after graduation, so he knew both her and Mike really well. Everything went off without a hitch, I didn't drop the rings, and there were plenty of happy tears.

They're so married!
Look at that smile. <3

After the ceremony, Anne and I signed the marriage license (official!) and then the bridal party headed to the cocktail hour while Mike, Jen, and their families took some more photos. The reception started right on time with fun entrances by the bridal party (Anne and I walked into together and "vogued" our way into the reception) and then Mike and Jen shared their first dance to "Bless the Broken Road". They surprised everyone with an amazingly fun and beautifully choreographed dance, and they just looked so happy. 

After some parent dances, we had dinner, which was lovely, and then the dance party started! There may or may not have been a shot taken by... the entire reception... and there was a s'mores bar! I was too busy eating s'mores to take photos, but trust me, it was amazing. Every event should have a s'mores bar, in my opinion. I might need to look into that for my next party...

Some scenes from the reception:

Monogrammed cookie with ice cream, because more desserts are always better!
These two little kids were on the dance floor constantly. Adorable!
Beautiful centerpieces!
Mike and me in the limo on our way to the reception!
The adorable and thoughtful clutch that Mike gave me for being his Best Groomsmaid :)

Disney magic and delicious cake!
Right before my Best Groomsmaid speech! Fortunately, I ended it right before I started crying uncontrollably.

After the reception, which ended around midnight, Mike and Jen invited Anne, Ken, and myself to Cook-Out, a local fast-food joint, for milkshakes! It was really fun... and delicious. (And no, calories so don't count when you're on vacation.... right?)

Anne, Jen, Mike, and me!
And then... we went home and I took 947 bobby pins out of my hair, took a shower, and collapsed into bed. We had another early morning the next day for our flight back to the fabulous Trenton airport, and I wanted to soak up all the sleep I could get. I can honestly say that it was one of the most fun weddings I have been to, and I am so glad that I could be there for Mike and Jen!

As expected, Trenton was a hot mess and even though we landed on time, we had to sit in the plane because "baggage claim" was over-capacity. That's probably because their "baggage claim" area was literally a trailer, and there wasn't even a baggage carousel, just a loading dock through which bags were unceremoniously tossed. Ken and I were not impressed:

Thank the Lord, our bag came to us in one piece and we were on our way. Home sweet home. 

The rest of that Sunday, I was out running errands to get prepped for the week, which meant Target, grocery shopping, and Staples (for school supplies!) I love buying school supplies. #nerdstatus

So that was the wedding weekend. There are so many things that I can't put into words that made the weekend wonderful. There was a warmth and love that was palpable, and Mike and Jen were sent into their married life with so much joy. I truly felt blessed to be a part of their special day, and it made me realize just how fortunate I am to have such long-lasting friendships as a part of my life. It was also great to get away for a long weekend, even if it was packed with activity. Sometimes, you just need a change of scenery and a few days to eat, laugh, and celebrate love. I hope you all have time to do that sometime soon. It's nice to remember that life can be sweet.

- A

Why Am I Doing This?

Tuesday, August 26, 2014

Before I go any further, what the heck, 200 posts? ::parade::

Okay then.

At least 27 times a day, I say to myself, "What am I doing?" or some permutation of the phrase. Not going to lie, it's usually, "What the balls am I doing?" or "What the balls is going on here?" If I'm feeling especially dramatic, I might take it to, "What is happening to the world?" because everyone knows that I can't resist a good Mean Girls quote. But as I've been studying the intricacies of the translation of DNA to proteins, 462 seemingly-unrelated genetics disorders, cramming hundreds of slide images of various tissues into my brain, and trying to memorize 628 things about muscle physiology, I found myself thinking...


Well, obviously, I'm doing this because there is currently one way in this country in which to become a physician, and this is it. So there's that. I'm doing this because I have no choice. 

Hrmph. Depressing. 

And yes, there's the whole, "I can't imagine anything else giving my life meaning the way that being a physician will give my life meaning, and it's basically like oxygen, and if you asked me if I'd rather someday have kids or someday be a doctor, I'd pick being a doctor every time," thing. But that isn't something you can just say to someone on the street and have them think you're a sane and rational human.

However, over the past few days, I was reminded with glaring clarity why I am doing this. I was reminded by my own health situation and my own doctors. I wasn't always as fortunate as I am right now with the kinds of physicians I have on my team. I first got sick in 2005, and it took almost 9  years for me to get any kind of reasonable treatment. I saw more than 6 doctors, three of whom were specialists in various fields, all of whom basically ran a bunch of tests and then told me that there was nothing they could do for me because my diagnosis didn't fit into one of their neat little boxes. My debilitating symptoms of joint pain, fatigue, migraines, fevers, and rashes were pushed aside because my blood work was "normal" and I was told that it was "all in my head" and that if I were "less stressed out" I wouldn't feel so ill.

Okay, true. Stress, the completely vague term that holds sway over our entire society, can and does affect physical and mental health, but telling me to "be less stressed" doesn't solve my problems. Neither does throwing a ton of SSRI's at them, in case you were wondering. There is totally a time and place for SSRI's or other mood-altering or mood-stabilizing drugs. I rely heavily on mine to keep me even-keeled and functional. I am Team SSRI, for sure. This just wasn't a problem that could be solved by their usage. I had random diagnoses made, including Lyme Disease (with no positive Lyme titer... go figure that one out) and fibromyalgia (because they ran out of things to tell me?) At various points, my symptoms went away, so whoever was in charge of my health at that time declared me a success and decided I was no longer their problem. Then when the symptoms inevitably came back, as they always did, I moved on to another physician, since clearly the last one had no interest in figuring out the actual problem.

Fortunately, starting in 2009, I started gathering my current team of physicians. I found a good primary care doctor through a friend, and his office is extremely easy to work with, especially with referrals. He and his associates have evening and weekend hours, and it's easy to get an appointment at the last minute. He also understands that basically, he's there for when I'm acutely ill and to coordinate my 900 specialists. He doesn't really try to step in and micro-manage on top of my other doctors, which I really appreciate. 

Then I found my PCOS doctor, thanks to my life-saving therapist. She's also a primary care doctor, so my insurance gets complicated because I can't see my NJ primary care doc in the same 30 day period that I see my PCOS doctor, which leads to all kinds of schedule finagling, but it's totally worth it. She was the only doctor who listened to me when I was freaking out because I had somehow gained 40 pounds in about 3 months for no apparent reason. Meanwhile, my regular gynecologist was telling me to try Weight Watchers and the endocrinologist I was sent to had decided that I definitely didn't have Cushing's, so I needed to go see someone else since she only saw people with neuro-endocrine problems. By the time I landed in Dr. Sherif's office, I was a disaster. I hated my body, I was disgustingly depressed, my hair was falling out, and I basically hated my entire life because I felt like a crazy person. That first appointment with her took almost an hour, and it was worth every second. She just kept asking, "And what else? Tell me more," as if she had all the time in the world. She made me feel like I wasn't crazy, and she apologized for the fact that no other physicians had listened to me when clearly, something was very wrong. She explained all of the medications she wanted me to try and why, and wrote down the studies she had recently read that backed them up. And then, when my insurance didn't cover the Byetta (an injectable medication used for blood sugar control) because I wasn't actually diabetic, she made sure that I got my medication, free of charge, from her office. I am not kidding when I say that this woman saved my life.
That was in 2011, and I actually went almost an entire year without seeing her, until today, when I had a follow-up appointment because I had changed some meds and wanted to talk about what was going on with all of that. I was seen by a completely wonderful resident, first, who was not only kind and friendly, but asked a lot of questions and made sure she understood everything I was trying to say. When I went out of order or back-tracked, she followed and wasn't annoyed. When Dr. Sherif came in, she immediately got right to my questions that I had brought up with the resident, and we went through my more recent medical history and medication changes. She spoke to me like I knew what was going on, but answered my questions when I had them. She made me laugh and put me at ease. When I brought up the 40 pounds weight loss, she practically threw a parade. She asked me how my life was going, and when I told her that I had gotten married and bought a house and started medical school, her face lit up and she said, "Life is really working out for you now, isn't it?" And she meant it. She was so happy for me, and I could tell it was completely genuine. When we were wrapping up, she asked again, "What else?" Never at any point did she have her hand on the door, waiting to dash to her next patient. She wanted to make sure I had her full and undivided attention for as long as I needed it, and I felt a complete connection with her for the entire time I was in the office. When we left, she gave me a real hug, and I felt like I was leaving the presence of someone who really and truly cared about my health and my life. It was wonderful. 

That is why I'm doing this. So I can be that physician for someone.

In 2013, I met my current rheumatologist, Dr. Chen. He stepped in when the rheumatologist I had been referred to by my allergist (yeah, I have a lot of doctors) left the practice. I was nervous, because even though I had only seen the first rheumatologist twice, she seemed nice and was actually willing to listen to me, so I was worried that the new guy would laugh me out of  his office (like so many others had in the past). It turned out that Dr. Chen was even better than the physician I had originally seen, which was a huge relief to me. As expected, all of my blood work was "totally normal" with the exception of one extremely vague marker, but according to my symptoms, there was something definitely wrong. 

It was July and Ken and I had just moved into our condo and were painting 2 of the bedrooms. After a few days of painting, my hands were so stiff and swollen that I could barely hold my toothbrush or drive my car, and they hurt all the time. I was practically non-functional, between the pain and the fatigue, and the NSAID that I was on was doing essentially nothing to relieve the symptoms. It was then that Dr. Chen decided it was time for methotrexate, which was terrifying to me because I only knew it as an anti-cancer therapy. He walked me through starting it and was there while I dealt with side effects, and before long, I was feeling like a human again! When the methotrexate started to not work so well, he counseled me on starting a biologic immunosuppressant; again, scary, but he gave me all of the information I needed to make my decision about which drug to start, and he answered my myriad questions I had about side effects and dosages and pharmacological functioning. I knew that I could call his office with any questions, and he always called me back, generally within the hour. I never felt like he was trying to run out of the office or hang up the phone. Again, a geniune, human, connection.

More recently, I called him a few weeks ago to talk to him about the whole "not being able to breathe" problem. Kind of serious, I suppose. He listened to my symptoms and surmised that it was pleuritis and possibly pericarditis, which means the lining of my lungs and heart were inflamed. He called me in a prescription for a Medrol dosepack (a steroid taper) and put a refill on it, mentioning that I "might need the second pack". The first pack got me through the wedding weekend and I thought I might be okay. Then a week later, my symptoms were back, so I filled the second dosepack. That was this past Wednesday. This past Friday, I woke up and felt pretty horrible, but chalked it up to not getting enough sleep. I missed my first hour of class because I overslept, and the entire time I was sitting in lecture from 9-12, I felt like I could feel my lungs straining to work. It wasn't pleasant.

When I stood up to leave, I got extremely lightheaded and thought I might pass out, but again, decided that was because I was dehydrated and tired. I drove to the harp store in Haddonfield to pick up some music for an upcoming wedding that I'm playing in September, but after 10 minutes or so of browsing, I essentially ran out of the harp store because I was pretty sure that I was going to pass out if I didn't lie down very quickly. I laid in my car for about 20 minutes, focusing on breathing, which was getting increasingly difficult and painful. I called Ken and told him that I was coming home, and then I called my mom and asked her what heart palpitations felt like... because those were happening and I didn't know what to do. I called Dr. Chen and left a message with his office staff, and then I drove home and spent the next hour lying in bed, crying because I was entirely unsure what was happening. I went back and forth about going to the emergency room, but knew that the moment I walked in there and complained of shortness of breath and chest pain that I wasn't getting out of there any time soon. I was also worried about what Dr. Chen would say when he called back, because somewhere in my mind, I am still scared of being told that my problems and my symptoms are "legitimate" because my diagnosis isn't completely nailed down. 

Fortunately, Dr. Chen called and spent about 15 minutes on the phone with me, talking with me about my symptoms, what had gotten worse, what had worked, and what we wanted to do next. He told me when I absolutely had to go to the ER, and he told me that he thought that it was still pericarditis and pleuritis. He said that because of this, he was now leaning towards my diagnosis being more of a lupus-like connective tissue disease (versus RA), and that if I didn't get better, that I needed to see a pulmonologist or cardiologist to make sure there wasn't anything else going on. He upped my dose of prednisone and set up a longer taper, and said to move my appointment up from the end of October to the middle of September. I still wasn't feeling physically better at this point, but the fact that he took the time to listen to me, make me feel less crazy, and agree that yes, this was not normal and something was wrong and no, it wasn't in my head, made me feel like I could at least get through the situation without having a total meltdown.

That is why I'm doing this. So I can be that physician for someone.

So yes, as I sit here and stare into the void of epithelial and muscle tissue, or try to remember which enzymes do what with regards to DNA synthesis and replication, I have to remember that at the end of this weird and convoluted road are patients who need me. I don't know who they are yet, and they might not even exist at this point in time (especially if I decide to go into pediatrics!) but they need me. They need someone to listen to them and to hear them, to give them a voice when they don't have one, and to remind them that even when it feels crazy, it probably isn't. I have to remember that this may feel silly and useless, but it has to start somewhere. 

I have a lot of medical experience, not just from shadowing and volunteering and working in healthcare, but from being a patient. From being passed through the system, navigating insurance kerfuffles and dealing with getting my physicians to talk to one another. It is a freaking full-time job, let me tell you. Honestly, being a patient has only made me want to be a doctor even more. I know that I deserve quality physicians who make me feel like a human who has worth beyond what they can bill to my insurance, and I know that I can be a physician like that for my patients. They deserve that, and they need that.

And yes, this is worth it.

- A

PS: Remind me this in a week when I'm studying for my first big exam and want to hide under my kitchen table, kay? 

Lost in a Book

Monday, August 25, 2014

So, I shamelessly stole this from Making Melissa. Yes, I know I have yet to post about the move and the wedding, but my brain is on overload, so this is all I've got. I love books. I wish I could read more books. By that I mean, I wish I could read more books that didn't have titles like Lippincott's Illustrated Review's: Biochemistry or Histology: A Text and Atlas. I am an avid Goodreads user, but now my Goodreads list is really more of a depressing litany of novels and non-fiction books that I'll get to reading around... 2018. Maybe. Alas, I continue adding things to my "to-read" list and adding things to my Kindle, and they continue to pile up. And yeah, I'm always taking recommendations! (I never learn, do I??)

Author you've read the most books from:
Hm. If we go back to childhood, probably Ann M. Martin or Christopher Pike, because Babysitter's Club and teen horror novels were my jam. Yeah, I was a weird kid. As an adult, I think Douglas Adams takes that title.

Best sequel ever?Hm. I loved The Restaurant at the End of the Universe, which is one of the sequels to The Hitchhiker's Guide to the Galaxy. I tend not to read things that have sequels, now that I think of it. I had been really excited for The Years of the Flood, the sequel to Oryx and Crake, which is one of my favorite Atwood novels, but I didn't love it. :-\

Currently reading:
I randomly downloaded some free YA-dystopian fiction, so right now I'm reading Born. It... isn't great. I don't know why I keep trying to read YA fiction, the writing style always bores and irritates me, and I find myself wishing I could just get to the end so I could put the damn thing down. This is a post-apocalyptic-zombie-virus type novel, but so far, the main character hasn't done anything useful, really. Meh. I have some non-fiction on my Kindle to start, but most of it is about depression, and since I just finished The Noonday Demon, I am kind of tapped out on depression.

Drink of choice while reading:
Hm, good question. Coffee... a mocha... caramel apple cider... tea. Unless it's summer. In that case, hand me an unsweetened iced tea with a lime!

E-reader or physical book?
Oh, physical book, hands down. I resisted getting a Kindle for so long, but I finally broke down because I wanted to be able to carry more than one book at a time and also have something that would serve some tablet-type functions. I love my Kindle, but I still buy real books and can lose an entire day in a library or a bookstore. 

Fictional character you would have probably dated in high school:
Hm. I have no idea, actually. I haven't read anything with any redeemable male characters lately, haha. Most of them are psychopaths or whiny. Perhaps I need to read different books.

Glad you gave this book a chance:
The Great Gatbsy. We had to read this for summer reading the summer before 10th grade honors English, and I wasn't thrilled because the summer reading books were notoriously horrible. However, I read it and fell in love with it and now it's one of my favorites that I'll read over and over again. 

Hidden gem book:
Middlesex. This was one of those books that I picked up 93 times in an airport bookstore but never bought it. I finally read it and I think I binge-read the entire thing in a weekend. SO GOOD.

Important moment in your reading life:
Discovering that I liked non-fiction. I love that I can learn something and be entertained, simultaneously! Some of my favorite non-fiction authors are A.J. Jacobs, Mary Roach, Matt Ridley, and Andrew Solomon.

Just finished:
The Noonday Demon: An Atlas of Depression  by Andrew Solomon. Good read, but a bit self-indulgent at times.

Kinds of books you won't read:
Chick-lit/romance novels.

Longest book you've ever read:
Atlas Shrugged  by Ayn Rand (ugh, never again... so long)

Major book hangover because of... 
Cutting for Stone  by Abraham Verghese. I wanted to start over and read it again right then because I missed the characters. What a story.

Number of bookcases you own. 
2, but we're buying at least one more for the third bedroom because we got rid of a big bookshelf when we moved and now we are sadly lacking. 

One book you have read multiple times.
The Hitchhiker's Guide to the Galaxy by Douglas Adams

Preferred place to read:
Bed, or curled up in the nook of the sectional. If I had my druthers though, (whatever those are), I'd be on a lounge chair by the beach in southern FL, thank you very much!

Quote from a book you've read that inspires you:
Oh... so many. The first one that came to my head is "You save yourself or remain unsaved," which is from Alice Sebold's memoir, Lucky. Not even one of my favorite books, but the quote stuck with me.

Reading regret:
I definitely wish I hadn't spent so much time reading A Separate Peace in high school. It was SO bad and I hated it and I should have just given up and read the Sparknotes.

Series you started and need to finish:
The MaddAddam trilogy by Margaret Atwood. I read the first two, but didn't ever finish MaddAddam. 

Three of your all-time favorite books
American Gods  by Neil Gaiman
The Hitchhiker's Guide to the Galaxy by Douglas Adams
Middlesex by Jeffrey Eugenides

Unapologetic fangirl for... 
Margaret Atwood, Douglas Adams, Mary Roach, A.J. Jacobs

Very excited for this release more than all the others:
I honestly have no idea what is being released soon. I am a terrible book-reader. I guess Jenny Lawson's next book, whenever that comes out. Her first one, Let's Pretend This Never Happened, was amazing and I laughed so hard I thought I might choke. She's amazing.

Worst bookish habit: 
I get too many books from the library and they sit around and I don't read them and then owe fines on them. Whoops. At least I'm supporting the library?

Your latest book purchase:
Some lame textbook. My latest "fun" book purchase was The Depths: The Evolutionary Origins of Depression by Jonathan Rottenburg. As you can imagine, this isn't exactly thrilling, and as I said before, I have a depression hangover from The Noonday Demon, so I haven't started it yet.

Zzz-snatcher book (the last book that kept you up way late):
Gone Girl  by Gillian Flynn. SO. FREAKING. GOOD. (Related: I actually liked Sharp Objects even better, though!)

So that's what I have for you today. Books. What are some of your "must-reads"? What about the book you started but wanted to throw out a window because you couldn't stand it? Tell me in the comments!

- A

What Does Friday Even Mean Anymore?

Friday, August 22, 2014

So, back when I worked a 9-5, I lived for Friday afternoon. It meant that I was free for the weekend to do whatever I wanted, whether that meant laying in bed all day, cleaning the house, meeting up with a girlfriend, binge-watching something on Netflix, or whatever. The weekends were work-free and meant I could recover from the work week. Even though I've only been a med student for a grand total of 2 weeks now, I already feel like Friday might as well be Monday, which might as well be Tuesday or Saturday or any day, really. The only real difference is that on the weekends, I might choose to sleep in, but twice a week, we don't have class until 1, so I get to sleep in then if I want to as well. Granted, I should be getting up and studying or getting life things done, but... sometimes I can sleep in. Anyway, it's Friday, which means it's time to link up with Amy and Karli for Oh Hey, Friday!

So for this week's link-up, I've decided to go with the five artists I've discovered recently thanks to listening to Sirius satellite radio!

1. Vance Joy
Song you need to check out: Riptide

 2.Andrew Allen
Song you need to check out: Loving You Tonight

3. Sara Haze
Song you need to check out: Lovely

4. Jon McLaughlan

 Song you need to check out: Summer is Over (featuring Sara Bareilles!)
5. Hozier
Song you need to check out: Take Me to Church

And one last song, that is a total guilty pleasure?

Someone send help. And wine. Or at least come over here and dance with me! Side note, I totally want her haircut, and can someone teach me how to wear a red lip? #totallyinept

Have a good weekend, all, and I'll see you back here on Monday if I can crawl out from under my notes and textbooks! 

- A

Tuesday Chaos, Wednesday Confessions

Wednesday, August 20, 2014

Well, yesterday was a day. One of those days. One of those days where you hit your snooze button and wake up not 10, but 30 minutes later. One of those days where you get dressed and then realize that you got God knows what kind of hair product on your shirt, so you have to change. One of those days where you try to go downstairs not once, not twice, but three times, before successfully making it down without forgetting something. One of those days where, when you have to go back upstairs for what feels like the 93rd time, you trip and almost smack your head on the hardwood, because clearly, you can't handle stairs at 28. One of those days where your lunch is yogurt with granola and grapes because you didn't get it together and pack your lunch the night before. One of those days where you put on your make-up in the car. And your deodorant.

Just one of those days. And man, was it long.

So far, I've learned the the fastest way to freak out 162 med students is to:

A. Not post slides before the lecture
B. Skip slides that are in the lecture, or talk about slides that aren't in the ones on the website
C. Have conflicting information on various schedules
Basically, we're a bunch of Type-A, overly obsessive, control freaks who don't want to look stupid and need to know what's going on at all times, or we all have meltdowns. At least... that's how I am, and how it seems a majority of the medical students that I've met (both here and elsewhere) react to situations like this. However, this situation did create a pretty hysterical conversation among some classmates and myself. Our online schedule said that today, we had small group work from 1-2:30 and a patient panel from 2:30-3:30, but it also said we were splitting into two lab groups (one from 2-3:30 and one from 3:30-5) and meeting in the lab. For patient panels, we have to wear our white coats, but for lab we have to wear gym clothes. Insert mass chaos here.

Someone had asked if anyone knew what was going on for class and the responses included guesses at interpretations of the schedule, which were helpful, as well as the far less helpful but far more amusing answers:

"To clarify, no one knows if we have to wear loose-fitting clothing tomorrow?"
"Wear all the layers you can."
"Patient panel, lab time, group work... FOLLOW ALL THE PROTOCOLS!"
"I think the conclusion drawn so far... no one is 100% sure that we have lab tomorrow."
"TLDR; mass chaos will ensue tomorrow from 1-5. Plan accordingly."
"Gym clothes under your dress clothes under your white coat, right?"
"I thought white coat underneath?"
"We have some of the 161 of the smartest minds in the country in this group... how do we not know what to wear!?"
"When in doubt, just the coat."
"Coat only? How scandalous."
"Well, that would make OMM easier..."

Because I am a neurotic disaster, I actually broke down and emailed one of the professors because I was tired of not knowing, haha. I never got a response, but it turned out that (not surprisingly) it was way less complicated than we thought it would be, our professors gave us directions as we went along, and no one was drawn and quartered for not having their white coat for the day's patient panel. 

Other chaos that has begun ensuing is my frantic attempts to organize my studying. I had to study in my post-bacc, but there obviously was a smaller volume of information to be assimilated at one time. I know the phrase "drinking from a fire hose" is overused in this arena and some people don't like it, but I still think it's an incredibly apt metaphor to describe how med school feels from day 1. I've also heard it described as "finals week, every week" which also is pretty close to the intensity one feels while attempting this crazy experience. Basically... it's hard. Really hard. (Duh.)

Monday was the first night I realized how my health might affect my ability to study. I've studied while tired before. I've even studied while acutely ill before, with a fever and in between laying on the bathroom floor from vomiting. Monday was the first time I was attempting to study with pericarditis and pleuritis. I say "attempting to study" because I really wasn't getting very far. The only way I found myself able to breathe deeply was to bend forward at the waist, which, as you may imagine, is not exactly optimal positioning for reading, typing, or writing. I also felt like I couldn't catch my breath, so every few minutes, I started to feel light-headed, which led to me laying my head on my desk and waiting for the spots before my eyes to go away. Then I started coughing and felt like the lining of my lungs was going to be ejected onto my notes, which wasn't going to help anyone. Add to that the bonus of my hip bursitis having returned with a vengeance and I was one unhappy camper med student.

Sidenote: If campers are so unhappy, why does anyone go camping? I can't remember when I've ever said that something made me a "happy camper". Perhaps there are campers out there that are simply overjoyed, but I am not one of them. Camping makes me itchy. 

Okay, anyway... Monday night, not fun, no bueno, called it a night at 11:30, self-medicated with prednisone that I had on hand, refilled my Medrol dose-pack, and went to bed. Laying down and going to sleep was hell, but eventually, I fell asleep... probably around the time that the prednisone kicked in. No lie, when I woke up Tuesday, the first thing I said was, "You know what's awesome? PREDNISONE," because I could breathe without pain. I have an unfortunate feeling that there is going to be a lot more prednisone in my future. Ugh. By the way, take a moment and thank your lungs and your heart for functioning optimally and without pain. Do it, I'll wait.


Right, so, Tuesdays are the only day we have class at 8 am (thus far) and into the afternoon, although we're usually finished by 4ish. We started with a thrilling 2 hours of genetics, during which we somehow blew through 90+ slides on clinical cytogenetics. The only thing it succeeded in doing was making me pine for Kristin (my CHOP officemate), who basically taught me everything I know about genetics and genetic testing. Subsequently, I pined for the days of my 9-5 and the office Keurig and having any number of delicious (and unhealthy) food options outside of my office door... but then I remembered that the job itself kind of made me want to punch people... but I still missed Kristin. We followed that up with 2 hours of rapid-fire biochemistry, where an excitable Chinese man shouted about TATA boxes and TTGACA boxes and promoters and who knows what else. Have I mentioned how much I really hate molecular bio? Because seriously? Molecular bio can blow me.

Then I did the lunch thing and sat at the Student Pediatric Medical Association Table to sign people up for the flag football tournament that's happening on Saturday (for charity!), talked to a second year in peds club about how not to fail the first biochem exam (whee) and tried to answer 94 questions about what the hell was going on that afternoon in OMM, because apparently, I look like I know what's going on. (Spoiler alert: I do not, I just pretend.) Then we had OMM... and then I got derailed by a patient panel.

This is the story of how I started crying during a med school lecture, and not because I thought that I would never remember the enzymes used in the tricarboxylic acid cycle or because I failed an exam. No, I cried because, as per usual, I just have a lot of feelings.

Today's patient panel was made up of patients who are seen in the OMM clinic here at the Neuromuscular Institute, which also houses pain management, a headache center, and orthopedics (I think?) They're all treated for chronic pain, either from injury or long-standing issues. There were two particular patients that really sent me over the edge. The first was a young woman, only a few years older than I am, who woke up one morning with intractable back pain. She went through doctor after doctor, treatment after treatment, never getting answers or a diagnosis or relief. She was told over and over again that there was nothing wrong with her and that there was nothing that could be done for her. A physiatrist even told her that what she was feeling (she reported that her entire body hurt) was impossible. How much more dismissive can you get??? Her story mirrored my own experience with chronic illness (and whatever this autoimmune disease is) that I just got very overwhelmed. Fortunately, this patient found a great team of doctors here at the university and she feels like she's finally on the right track to getting well again. 

The second patient was a woman in her mid-30's who had a few injuries from car accidents that started her pain. She also went from specialist to specialist, dealt with the haze of narcotic pain killers, and lost 3 jobs due to her inability to work through or with the pain. She was admitted to a psychiatric hospital because she was suicidal. She talked about how physical pain, day in and day out, can and does lead to depression. Life feels meaningless because the life you had before is over and this new life doesn't have much going for it. Another patient said, "Either come here and kill me, or do something about this pain. Who wants to live like that?" She started to talk about how one of the physicians here helped to save her life, and at that point, I lost it. I managed to not ugly-cry, but it certainly looked like my face was leaking. I guess that makes sense, because it was.

The patient also mentioned that people don't understand chronic pain, because it's not like the patient is always outwardly exhibiting signs of injury or illness. Instead, many of us look "totally normal" and can have what appear to be normal jobs and normal lives. What the world doesn't see is that every step we take from the car to the door feels like a mile, or the pain patches hiding under sleeves, or the haze of narcotics or the cloudiness of brain fog, either from pain or the disease itself. They don't see the depression, the anxiety, the grief over a life changed by pain. They don't see the 17 or 20 pills you might take every day to manage symptoms. What they see is a carefully choreographed routine of how to do things so that they hurt less, and how to hide it when it does hurt. What they do see is that someone might have a handicapped placard, or take the elevator one floor, and when they make a snide remark about laziness, they don't see how much it hurts and how much you want to shake them and tell them that they have no idea what it's like.

I don't know why, but I was just overwhelmed with emotions. I was sorry for the pain these two women had endured, both physiologically and emotionally, because no one wanted to help them until years after the needed it. I felt anger and sadness for myself, because I am still fighting to have my concerns met, and I routinely feel that my pain and other symptoms are illegitimate because I can go to school and work and go out with my husband or my friends. Like in order to deserve treatment, that I must act sicker and frailer. I refuse to give up the life that I have fought so hard to obtain; I refuse to lay down and let my life go on without me. After all, better living through chemistry, right?

And at the same time, I felt inspired. I felt hopeful. I felt right. I felt like if I can be a physician for patients who feel unheard and unseen, then I am doing my job. If I can help navigate the waters of vague diagnostic tests and symptoms that greatly affect a life but don't add up to a diagnosis that we can put into a nice, little, box with an ICD-10 code, then I am doing my job. If I can help someone realize that life is not meaningless, and that there is life beyond daily pain, then I am doing my job. I want to teach patients to advocate for themselves, to take responsibility for their own health, and to become a partner with their physicians in their healthcare. I want to be one of the physicians that these patients talked about, who take care of their patients in body, mind, and spirit. And yes, I realize this all sounds incredibly cheesy, but I really wasn't lying when I wrote my personal statement. Hand to God.

I hope that in 2 weeks, when I'm up to my eyeballs in studying, probably having a meltdown of some kind, wishing that I was back in my quiet office with my IRB amendments and my consent documents, that I can remember the reason I'm doing this. Someone remind me, okay? Good.

And since it's been awhile, let's throw some Wednesday confessions with Kathy of Vodka and Soda in there for good measure.

Vodka and Soda

So what am I confessing this week?

- I don't hate studying. Yet. That will probably change. But I really like using my brain. Who knew?

- A classmate hugged me today and it was awesome. Thanks, classmate.

- I am meeting new people every day and I guarantee that I won't remember half of their names. Sorry, guys. Nothing personal. (But I promise I won't call you Anfernee.)

- I have been pleasantly surprised by the reactions and reception that I've gotten when I tell classmates that I've done the med school thing before. So far, no one has looked at me like I'm some kind of zoo animal, although who knows what they're thinking once they walk away. In any case, they all seem to be totally cool with it, so... hurrah for people being reasonable humans for once.

- I already confessed this, but I totally cried during lecture today. Also, I am a big sap who, when she lets herself, really does feel like this is a good choice. "This" being medical school. That it makes me feel warm and fuzzy to think about doing this for the rest of my life.

And now that I've expressed my many feeling sin the form of Mean Girls and Easy A gifs, I am going to go take some more prednisone and... study? I guess? There's always something else to read and attempt to cram into my brain now. Tomorrow we have 2 hours of histo and then 4 hours of "On Doctoring," which is our clinical course. I don't have class until 10, but I absolutely must get up and attempt to renew my license at the DMV tomorrow before lecture.

So yeah, maybe I'll just take my plethora of feelings and go to bed. I'll leave you with this quote from Pam, because it makes me laugh.

"How can such a tiny woman have so many feelings?! Did they take the water out of you to make room?"

All good questions, Pam. All good questions.

- A

And the Winner Is....

Friday, August 15, 2014

Looks like you all want to hear about med school! Also, I'm kind of impressed that 30 of you actually answered my poll, so thanks for that! And don't worry, I'll be filling in the details of the wedding and moving as well, but all in good time, my friends, all in good time.

So, med school. The night before my white coat ceremony, I definitely was excited/nervous, although I wasn't really sure why because nothing really happens at your white coat ceremony (other than getting a white coat, of course). No one asks you to do anything difficult and they spend most of the day telling you how awesome you are and how wonderful it is that you're going to be a physician. We had to be at school 8:30 for some stupid reason, and I was tired. However, I think I managed to look like a human being:

Once we got there, it was pretty much organized chaos and a lot of hurry-up-and-wait. Eventually, we started the whole ceremony and after much speechifying by various Deans, class presidents, and the guy who is currently heading up the National Board of Osteopathic Medical Examiners (barf, boards...) we got our coats! I was pretty excited because I was "coated" by one of our OMM (Osteopathic Medical Manipulation) professors, who also happened to be the doctor who diagnosed and treated my herniated discs, essentially giving me my life back. She's awesome.

Pretend that I'm blurry because of the excitement and not because I can't hold a phone, kay?
After the coats, there was more chaos and we escaped outside to take some photos and then left to get lunch.

And then the real fun started. Okay, no, not really. Then it was orientation, which is about the most boring and hellacious thing I can imagine. When I started at NSU, it was 5 FULL days of stupid, so at least this was only 3 full days of stupid. It was, as all orientations seem to be, full of people talking at us about how important their particular role at the university was to our well-being. (Spoiler alert: Not actually important.) We also learned that, shocking no one, academic technology departments are inept everywhere. We were all supposed to have our exam taking software loaded onto our school-issued laptops, which of course didn't happen, and the interactive ResponseWare app that we're supposed to be able to use for answering questions in class/taking attendance was also non-functional for many people. Oh, and they managed to mess up all of our email addresses, so there was that. 

I did get to meet some people, which was fun, and I got to meet my "big", as all incoming first years are assigned a second year "big brother or big sister" for the year. This happened on Tuesday, and within minutes of meeting my big, we were shuffled off to a house party in his car, which led to me drinking Reisling out of a purple Solo cup before noon.

Huh, I just realized that the cup matches the walls in this person's dining room. It was definitely overwhelming to be there, as there were approximately eleventy-billion people in the house and it was 937 degrees outside (and no, I never exaggerate, clearly.) I met more people though, ate pizza, and hey, no one was lecturing us about the importance of our alumni association or whatever, so it was a win-win situation, I think.

On the last day of orientation, we had a bunch of presentations (zzzzzz....), including one from the student wellness people. I am all for student wellness, given my last experience with med school, but this slide made me laugh.

I'm sorry, isn't that... all med students? Didn't we all get here by exhibiting most of, if not all of those traits at one time or another? And really, excluding the "suppression of feelings" (because we all know that I have a lot of feelings), those traits describe my personality pretty well. (See also: Why Alison is in therapy.)

Anyway, that was orientation, and having being oriented x3 (ha, medical puns are funny), we all went on our merry ways. There were a bunch of orientation events that I didn't go to, mainly because they involved bars and/or bowling, and I don't like trying to get to know people who are in various states of intoxication or when I'm making a fool of myself trying (and failing, miserably, might I add) to bowl. I'm sure it would have been nice to meet more people, but at the same time, I was already on overload from having to be around so many people for 8 hours a day for three days that I needed a break. 

Fast forward through Thursday, Friday, Saturday, and Sunday morning, and here we are, ready to start med school for real! We got home from North Carolina on Sunday (more on that trip later, I promise!) and I spent the rest of the day running errands and picking up school supplies. I had some trouble sleeping on Sunday night, although I think that had more to do with the fact that I somehow managed to get pericarditis and pleuritis at the end of the prior week, so lying down was uncomfortable. (Thanks, autoimmune disease. You're awesome. Not.)

And so, on Monday at 12:30, I walked into the lecture hall where I'll be spending half of my natural life and started med school at 1 pm. First up was biochem, which is... a trip. The professor is Chinese and seems very nice, but I am definitely having flashbacks to my Public Health Epidemiology class with Dr. Liu, where I spent 90% of the time wondering what the hell the poor man was trying to tell me. I was sure that it was important, I just had no idea what it was. THEN I had flashbacks to one of our anatomy professors at Nova, who may have actually been speaking Chinese while lecturing us about the pelvis. (Sidenote: The pelvis is a disaster. I am not looking forward to that mess again. Ugh.)

After 2 hours of biochem, we moved on to two hours of histology, which if you're not familiar with it, is the study of tissues. This is now the third time I've taken histology, and thank God cells and tissues don't change very much because all of this is familiar. The biochem is familiar too, but I am much less certain about all of that material and it's way less clinical, so I find it rather boring. Histology wasn't always a favorite of mine, but I've been fortunate to have 2 great professors, and I think this one is also going to be wonderful. Everyone else seemed to be freaking out about it, and rightfully so, because yes, everything does look the same under the microscope at first. It gets better... although I definitely will need to brush up on my reproductive system histology because the last time I took that was a disaster. (Uteruses and ovaries, man... always messing things up for people.)

After class, which on Mondays is only from 1-5, I got a massage and I think I may have fallen asleep on the table. Whoops.

Tuesdays seem to be our long days. We started at 8 with two hours of physio, followed by an hour of biochem, and then a 2 hour break before settling in for what was supposed to be four hours of OMM. 


In case you are unfamiliar with OMM, let's do a Reader's Digest Condensed Version of that. 

OMM is awesome. The end.

Okay, not that condensed. So, OMM, or Osteopathic Manipulative Medicine (AKA: OMT, or Osteopathic Manipulative Treatment) is a special set of techniques that DOs learn, on top of learning all of the "regular" med school stuff. If you've seen a physical therapist or chiropractor, you may have experienced similar therapeutic techniques that manipulate the bones and muscles to restore optimal function. Yes, part of this is "cracking" or high-velocity, low-amplitude (HVLA) but it is so much more than that. It's a hands-on diagnostic tool, and it can provide a lot of relief to people who are suffering from back or joint pain, as well as many other issues. Is it going to cure everything? No, and plenty of DOs don't use it in their practices at all. And yes, DOs still use medication, surgery, and other "traditional" medical techniques, but OMM is just an added bonus. When I started learning OMM, I was fascinated by it, and I think it's really fun. Also, if you can fix someone's back or neck pain, they'll probably love you forever, so that's a bonus for sure. I always recommend that people see a DO who practices OMM over a chiropractor, but that's just my personal preference. I'm sure there are plenty of non-crazy chiropractors out there who won't try and cure your allergies with HVLA or color therapy, but... yeah. ANYWAY... 

Now back to our regularly scheduled blog post.

Our four hours of OMM ended about 90 minutes early (thank the Lord) so I headed to a therapy appointment where I brain-vomited all over my therapist and then had dinner with Patricia. That was Tuesday.

Wednesday, we only had genetics from 10-12, which was lovely. The professor was a bit boring and tended to just read off of his slides, but I find genetics to be interesting all by itself, so I don't really need someone to entertain me while they're lecturing. I felt pretty good about the genetics stuff, not only because it's easier to begin with, but because working at CHOP for the last two years and sharing my office with Kristin, genetic counselor extraordinaire, taught me a lot about rare and interesting genetic diseases and their treatment. (I also laughed to myself because I reminded of the time that Kristin was learning to use new pedigree-making software on her iPad and she accidentally "killed" some people in the pedigree, and then consanguineously married two others. Whoops.)

Today was another afternoon of lectures; this time, physio and histology. I had intended to go to the DMV this morning to renew my license, but I got there and realized that I didn't have proof of my new address, so I have to go back on Monday. Sigh. Tomorrow, we have class from 9-12 and then we're free! Free to go and... study. 

So how am I feeling? I thought you'd never ask.

I'm tired, and it's only been 4 days. I haven't been sleeping well, but that is getting better (I think). I haven't found "my people" yet, and I miss Constance and Michelle, who were really the only good parts of med school the last time I did this. I feel like everyone is bonding about freaking out about med school, and I'm standing over here going, "Hey, it's not that bad yet. Wait until the fun really starts." I am trying not to come off as a condescending crazy person, because really, I don't know much more than anyone else about how med school is supposed to work. Just because I (barely) finished a semester once before doesn't make me an expert... but I guess I do know a little bit more about what to expect. 

So far, the material isn't making me want to shoot myself, which is a change from the last time I did this. I think that's largely because we haven't started anatomy or microbiology yet. Biochem is going to be the hardest course for me, I think. Histology shouldn't be too bad; it's just a LOT to memorize, and physio is tricky, but it's also my favorite of the subjects we're learning. We're only 3 days in and people are already studying the stuff we've done thus far, which is a good sign. There are some people who are already totally losing their minds, and I want to just hug them and make them tea and tell them that it will be okay. Or really, that they better figure out a way to make it okay, or they're going to be walking into traffic on Route 30 before Thanksgiving.

I'm also afraid. I'm afraid that even though things feel okay now, that they won't feel okay tomorrow or in a week or in a month. That one morning, I'll wake up and not know what is going on or how I got here, and that I'll start to feel the horrible creep of depression edge its way into my brain. I feel it now, every now and again. The sleep troubles, the appetite problems, the sheer feeling of being overwhelmed by being upright.. it's uneasy and I don't like it. I'm afraid I won't find "my people" and that I'll go through this alone. At the same time, I kind of wish I could just do it by myself, because sometimes, other people stress me out more, and we all know that is the absolute last thing that I need. 

I feel like I can do well here, but I felt like I could do well at NSU, and look what happened. I am going into this telling myself that I just need to pass, but I know that I need to do better than that, especially since the powers that be are predicting that 2 years before we graduate, there will be more graduates than residency spots which... is bad.


I am trying to focus on what is directly in front of me. I can't freak out about potential residency issues before I've even finished my first week of my first year. I mean, I can... I am more than capable of doing that, but I need to not do that. I am trying to remember the things I've learned since the last time.

Do the best you can, and sometimes, the best is just passing.
They expect you to know it all, but there is simply no way. Accept this now.
Don't forget to eat and sleep.
Get up, dress up, show up, and never give up.
You're not the only one who doesn't get it. Go ask the professor.
No one knows what's going on, you're all winging it.
Insanity is inherent in this endeavor.

As one of our professors said this week:

"Most of medicine is not hard. Some things are, but most of it is not. It is the volume of information that is difficult. Nothing about this process is reasonable. This is medical school."

The entire time I was applying, I kept saying to Danna, "This entire thing just feels insane," and it was. And it still is.When I was freaking out before starting, Danna reminded me that I could not spend the entire first mile of the marathon going, "Oh my God, I'm running a marathon, this is the worst decision ever, this is horrible and stupid and insane." I responded that this is why I'd never run a marathon. Her reply? 

"Well, you're about to."

And she's right. This first week is a blip on the radar of my medical education, and it's going to be hard. And painful. And protracted. And exhausting. And insane. But one thing would be more insane than going to medical school, and that would be for me to not go to medical school. I'm afraid, but you can be afraid and you can do it anyway, right? Right.

I plan to do a weekly update about my med school journey, although I make no promises because med school is kind of a full time job (or three). If you have anything you'd like to hear about, let me know and I'll do my best to feature it. 

For now, it's back to the books for me. 

Here we go.

- A

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