Interview Hopping

I missed the last Medical Monday because I was desperately trying to get to Richmond, Virginia before my interview at VCU. But lets back up a bit to get you up to speed about what has been going on for the last few months.

In January, I received interview invitations for 3 different schools in a span of three days. One for VCU on Feb 4th (my top US choice), one for Michigan State on Mar 28 (second choice), and one for Northern Ontario School of Medicine on Mar 29th (that one was a shocker). In that same week, I received an invitation to write the subject test for the Neuroscience MSc/PhD program in Göttingen, Germany. 7 days later I received an invitation for THE interview that I really wanted, which was at my home school, the University of Calgary.

February 3rd I left the frozen Canadian waste land to fly to Richmond, Virginia for my interview at VCU. Except, my flight out of Calgary was delayed an hour and half due to a mysterious light being on. When we landed in Minneapolis I abandoned my Canadian manners and full out sprinted about 2km from gate A to gate F where my flight to Richmond was departing from. I got to the gate, and the women in Delta colours told me the plane had just closed its doors, and wouldn't re-open them, and that I had been rebooked on a flight that would get me to Richmond at 12:30pm the next day. I had to be at VCU by 11am for the interview.

Me: "But I have to be there at 11!."
Delta woman: "Well, you won't be."
Me: "This is literally my future we are talking about, the results of tomorrow may very well dictate the rest of my life."
Delta woman: Fake smile
Me: "What about a flight to DC tonight?"
Delta woman: "Oh, yes. We could do that. The last flight closes its doors in 7 minutes. Its back at gate A."

So, I full out sprinted back to the exact same place I had just come from, but managed to sequester a nice man driving a Delta cart to get me there a little faster. I get to the gate just on time, and I get handed a boarding pass which indicates a 1st class seat (score!). I hurried on to the plane (nobody checked my passport by the way...I guess flights to DC aren't as secure as we thought), I was sweating buckets, clearly didn't belong in first class, and when I arrived at my seat, I noticed it was a window seat....right next to a very nicely dressed US Senator. I have never gotten such a severe death stare in my life. Upon arriving in DC (which is the scariest runway ever, it looks like you are going directly into the river), I was provided with a $300 taxi voucher to get me to Richmond, Virginia. I made it to my hotel by 1 am, after having to spend half of the taxi ride on the phone with the driver's daughter in order to get directions to my hotel because my taxi driver didn't know where he was going. End of story, I made it, I think my interview went well, and VCU blew my mind. I didn't think such amazing schools even existed. As an aside, if Delta had waited 3 minutes, they would have saved them approximately $700, and reduced my cortisol levels about 2 fold...this is why we Canadians love Westjet...they wait for everybody.

This past Saturday I did my interview for Calgary, I think I nailed 9/12 MMI stations, completely blew 1 (had an awkward 2 minutes of silence because you can't leave the room until the 7 minutes are up and I was totally done discussing the question), and 2 stations that I am a little unsure about. I hope it evens out...on to May 15th!

Next up on the interview schedule is Göttingen, Germany next Monday. I didn't study for the subject test, and figured my chances of getting an interview were pretty much 0 as I guessed my way through the 40 physics and chemistry questions. But apparently not...or I just failed less than the other 300 people who wrote the test. The program is paying for my travel and accommodation, which is awesome, worst case scenario is that I have a free trip to Germany :).

But here is my dilemma. The only reason I applied to the program in Germany is because I thought I had no chance of getting into any medical schools that I actually wanted to go to after not hearing from VCU, Michigan and being rejected from UBC. Now I am worried that I will get into a top choice medical school (or any at all), plus the program in Germany. I was hoping to not have to make any decisions. It will be hard to turn down a 3 year PhD program at one of the top scientific institutes in the world (and in Germany), but I also don't know how I could possibly turn down medical school. Best case scenario, I get to defer for 2 years and do an MSc in Germany and come back to a medical school spot. But, its pretty rare to get more than a 1 year deferral.

Also, my thesis is due in 18 days and I am no where near finished. I don't have time for Germany...but I can't not go...

Side note: check our Waves for Women blog, which my friend Caryn and myself will be chronicling our training and fundraising journey for our 35km open water ocean swim in July to raise money for Women's Cancer Research.

The Floor

Today I spent a long time on the floor of an emergency room. You know those pictures you see of sub-par Canadian hospitals in American media propaganda about how bad universal healthcare is? Well, today I flat out was lying on the floor of the emergency room, creating one of those pictures

I have a spinal headache from the procedure that I talked about here. If you have ever had a spinal headache, you will know it to be one of the worst headaches of your life, when you are sitting or standing up that is. When you lie down though, it is gone completely - hence the floor.

You know what? I actually don't even mind that I had to lie on the floor. There was a chair I could have sat on, but it wasn't quite as horizontal as the floor. I am not unhappy with the care I received. I ended up being seen by my own doctor (a specialist) to set up a follow up appointment for Thursday and a team of anesthetists who offered me the choice of doing a blood patch today, or later in the week if my headaches cannot be managed with the pain meds they gave me. I am happy with that. They gave me choices. I chose the conservative route of trying pain medication and then going back directly to anesthesia for a blood patch (skipping the emerg line up) if I feel like I can't take the headache anymore. I think that is awesome. I am not above lying on the floor. I don't have a life threatening emergency, just a painful complication, other patients who are sicker need the bed more than I do.

Even though I am Canadian, and I believe I have the right to healthcare, I also believe in equitable healthcare. I think, despite the lying on the floor thing, that I received equitable and quality care today. I have the right to healthcare, but not the right to take it away from others.

Is this just the inbred Canadian niceness coming through, or do I have point here? I am willing to sacrifice my own comfort and not complain about it because I know that resources are being used to help the people who need it most.

Being in a hallway doesn't mean they aren't receiving the best care possible.

The first week of the end of my degree

I think title says it all, but this is the first week of classes of the last semester of my undergrad degree. Come June I will be happily not walking across the stage to receive my degree in Health Sciences because I will likely still be in Tanzania. (Who would want to sit in stuffy gymnasium for three hours when they could be deep in the Maasai region of Tanzania at a field camp with giraffes walking around?) Needless to say, I am pretty excited that this is the end of my first degree and that I get to finish off with a pretty awesome global health research studentship to Tanzania.

The unfortunate part is that I will be starting yet another semester with post-concussion syndrome. You may remember this post from October, well the saga continues. I still have daily headaches, yet they are mainly orthostatic (I get them when I sit up or stand up, but if I lie down they go away). This has led the concussion specialist physiatrist that I am seeing to suspect I may have a CSF leak (which is what I asked about a week after my concussion when I threw up every time I stood up and the ER doc told me it was impossible to occur unless there was a skull fracture). Soo... I have to do a radionucleotide cisternogram (say that thee times fast) in two weeks, which essentially involves a lumbar puncture, an injection of some radioactive nucleotides and me lying on a table in the angiogram suit for 6 hours. I'm not excited...and I think that if it shows I don't have a CSF leak, I likely will have one after this procedure (every time a needle goes into my epidural space I end up with a CSF leak that doesn't resolve its own). From what I am told, this the best test to check for a CSF leak, and apparently they can't do a blood patch (the procedure done to stop CSF leaks) unless there is indication of leak, which there will be no matter what after this procedure because I am 100% certain (based on past experience) that I will end up with one. Some rules and systems don't make any sense and in this case will likely cause unnecessary patient suffering. This procedure seems pointlessly expensive (to taxpayers of course, GO CANADA) and I am fairly certain I will end up needing a blood patch in the end regardless of the test outcome.

And for further updates, I got wait-listed at Wayne State SOM (which was better than I though based on the strangeness of my interview) and rejected pre-interview by UBC by 0.5 (they give you your application score and the cutoff score for interviews). The UBC thing really upset me because BC has a huge shortage of doctors in rural areas, yet they reject rural applicants at higher rates than those from urban areas (they publish these stats). It has to be recognized that opportunities to build up extracurricular activities in a small town are limited (like there are none), I made some of my own, but even that was a struggle. Anyway, if i don't get in anywhere this year, I know my GPA will be high enough to put me above the interview cutoff for next year for UBC.

On another note I spontaneously decided to apply for graduate school in Gottingen, Germany. But sadly if they like me I essentially have to repeat the a German version of the MCAT (in English thankfully) so now I have go back to studying plant ecology, physics and chemistry.

Who wouldn't want to get a MSc or PhD from here? 

Despite all of these emotional up and downs, and headaches caused by the physical ups and downs, I'm excited for what 2014 has in store. This year represents a void of the unknown and not knowing what is going to happen is always exciting. It also represents long hours in the lab trying to finish my honours thesis on time (so I can actually graduate) and the challenge of fulfilling these 10 goals. 

I hope your 2014 is filled with moments of joy but also full challenges that help you realize its okay to not be in control, and of course, many Medical Mondays (12 to be exact).

Thanks for stopping by!!

(I should also share that I get to snag link up spot 1 because I am in a different time zone,  so technically it is still Sunday here. There are some perks of living in mountain time, in addition to the mountains and -20°C weather.) 

The Wounded Healer

I am taking a class called "Psychosocial Oncology" and today's lecture was about palliative care. The two instructors giving the lecture were what most people would consider in medicine to have opposing jobs. One had a doctorate and was a member of the spiritual care team, the other was a physician and the director of the acute-intensive palliative care unit. Together, they helped me to redefine my notions of adult palliative care, and I was astounded by their abilities to interconnect their roles. Needless to say, I learned a lot about the process of dying, both from a medical perspective and spiritual one. 

5 things I learned today about dying:
1. 93% of palliative care patients ranked maintaining a sense of humour to the end as one of the most important things
2. 0.5% of people in Oregon choose physician assisted suicide despite it being a readily available option
3. Palliative Care physicians are often more influential and important in the life of a person who is dying than any of their "active treatment" physicians
4. Palliative Care medicine actually involves a lot of "real medicine," its not just about pain control
5. Most people who are dying have little desire to confess their sins or wrongdoings  at the end, people do not consider them to be important to them any more.


When we were discussing the importance of physicians and members of the palliative care team to let down their barriers, show their emotions and connect with patients, this quote was on the slide:

"The doctor is effective only when he himself is affected. Only the wounded physician heals." - Carl Jung

I'm not sure how I have made it almost 21 years now with out ever seeing this quote from Carl Jung. I have been beginning to doubt whether or not I can make other well if I am not entirely free of illness myself. But I now feel again that strong sense of purpose, and what I guess you could label as "my calling" to medicine. I don't believe that everything happens for a reason, but I am grateful that this quote was on the slide today, it was exactly what I needed. Perhaps me being in pain, will allow me to heal somebody that others cannot. 

I will someday be a Wounder Healer.

Still Concussed

My last Medical Monday's post was back in August, and it was about the "little" crash I had at a local bike race.

I still have symptoms of an "acute concussion." I don't quite understand how it can be considered "acute" when it is over 2 months past the date of injury. But I'm not a doctor (yet). I can't ride a bike, or do any form of exercise, and school is more challenging than it should be. (Although, I think I did pretty well on my anatomy peripatetic today.) This is a really bad way to be starting off my final year of undergrad, with applications to finish, scholarships to apply for, 4.0s to maintain, a conference to plan and oh yeah, this thing called an Honour's Thesis.

Its going to be a long semester of headaches, concussion physio (I didn't even know that was a thing, and you think with this being my 6th concussion, somebody would have told me about this by now) and trips to the sport medicine clinic. I have a referral to "complex concussion physiatrist," I didn't even know that was a specialty. (Look all the things I am learning about medicine by having a concussion!!) The not exercising part is the worst because exercises is how I deal with pain, no exercise, worse pain, worse pain, worse grades. Apparently physiatrists have solutions for these kinds of dilemmas? I'm not sure if I will ever race a bike again...but I have other plans if I can't.

I hope you are all having a bettter Medical Monday than I am, one not filled with headaches and cadavers with pins in them and pages of anatomy questions. Now back to studying for the written portion of my anatomy exam which is on Wednesday (don't y'all just miss school??).

This is almost exactly what my concussion looked like (but with a helmet), conveniently thanks to Anatomy class I can identify all the structures in this diagram. Yipee!

I think I want to be a Surgeon.

To Spencer,

For a long time I have wanted to be a surgeon, probably since I watch the first season of Grey's Anatomy when I was 12. While Grey's Anatomy is pretty unrealistic (but a girl can dream right?), I still had difficulty wrapping my mind around how a person could operate for 10-12 hours straight. How is it possible to focus for that long without eating or going to the bathroom? I feel like I need to eat every 37 seconds and go pee at least once every 3 hours.  (Lets just say I find exams challenging...)

But this week I had to do 20 sciatic nerve crush surgeries on mice, and each one takes about an hour. For two days I did 10 hours straight of surgeries without eating or going to the bathroom. I got the lab at 8 am on Tuesday and left at 9pm, and on Wednesday I got there at 8am and left after 10pm. I have the new record for longest time a summer student has ever spent in the lab. I'm pretty sick of looking at mice and I still have to inject them until the 8th of July.

This experience has showed me that I actually might be able to be a surgeon. I really quite enjoy the tedious and fine motor skills aspect of doing surgeries on mice. I am the only one in the lab able to do it without aid of a microscope. I can see details that others can't see with a naked eye. Perhaps surgery is in my future.

This post is dedicated to Dr. Spencer McLean., who sadly passed away on June 24 from kidney cancer. He had just completed his orthopedic surgery residency and passed his boards two weeks prior to his death. He was my ski coach for 3 years as a child, and every year I hoped that I would be assigned to his group. Spencer was my absolute favourite coach, and he always will be for he taught me a lot more than just how to be fast on a pair of skis. He taught me that skiing makes you one with the mountain, it makes you a part of something magnificent. He taught me that you must first love what you do, be passionate about what  you do, and then you must work hard in order to become great.

From what I have heard, he became an amazing surgeon, dedicated to his patients in every way. He loved what he did, he was passionate about it and he was great at it. I think I have always wanted to "be like Spencer," he was the perfect mentor. He is a person I will never forget and who I will think of often as I begin my journey to becoming a physician, and hopefully a surgeon.

Thank you Spencer for inspiring me to reach high, work hard and to enjoy the ride.

Sincerely,

A Yiper

Shadowing

I had a pretty impressive morning of shadowing last Wednesday, followed by a somewhat less exciting afternoon of looking at mice in square boxes, cleaning up their excretions and testing their grip strength. But I am sure, you don't want to hear about what I do with mice...back to shadowing.

I shadowed my PI in the neuromuscular clinic, and it was needless to say a really great learning experience. I wasn't too sure how good of a teacher he would be, but he turned out to be pretty great. He explained all the cases to me, what each part of the neuro-exam looks for, the EMG results, and patient histories (some which were more complicated than mine). The first patient we saw was a younger women (early 40's) who had massive file and extensive history. I empathized with her because it seemed like she had been through a similar experience as me when I first got sick. She has seen pretty much every specialist in the city (a neuroimmunologist? I didn't even know that existed), has had extensive testing, has been "combative" towards doctors demanding tests/medications, and at one point wanted to go to the Mayo clinic. Her story seems kinda like mine (I was never combative though, but definitely frustrated). I almost wanted to just give her a hug, and I really wanted to tell her that I truly understood what she was going through, but alas, I was but a mere shadow.

The last patient we saw was a woman in her 50s who had an ethanol induced neuropathy. She doesn't take the vitamins that she needs (B1) which can reverse the neuropathy, she continues to consume alcohol, won't go to physiotherapy and doesn't have a family doctor. She had so much muscle wasting that she looked like a person with muscular dystrophy, and she can no longer straighten her legs so she is wheelchair bound. Non-compliance has committed her to a death sentence from a curable disease. Because of her, I witnessed for the first time what it is like to tell somebody that they will die, and soon, from a condition that is in fact reversible.

It is going to be interesting when I finally become a doctor, I think I am going to see myself reflected back to me in the experience of patients. In almost every patient we saw, I recognized something of my own story in the story of the patients. I empathized with the frustrations of one, the research tenacity of another, the ability of one patient to push through the pain, and realization of a grim future of another. I hope I never lose this empathy. At the same time though, I would give anything for my condition to just disappear by taking some vitamins, most people would, so I don't know how I am going to react when I encounter non-compliant patients. I see non-compliance as selfish, and I feel it makes the role of a doctor almost meaningless.


Needless to say, shadowing was an enlightening experience, which motivated me to submit my AMCAS application on Friday (even though I am still waiting for one transcript to arrive at AMCAS). I also started my application for UBC and the rest of the Canadian applications open up in a couple of weeks. The ball is rolling, and I have started to have nightmares since I submitted my AMCAS application. Looks like it is going to be a long wait until May 15, 2014....


PS Happy Canada Day!!!

The AMCAS Dilemma

On Wednesday, May 8th, just two days from now, I will be able to start my AMCAS application. This is the summer where I officially apply to donate the rest of my life to the practice of medicine, to the art of healing. I'm almost more scared of what will happen if I do get in than if I don't, and if I get into an American school, and not a Canadian one.

Most Canadian schools (or the ones I am applying to at least) drop your worst academic year. The University of Calgary drops your worst year if you have completed 3 full time years (yippee for me!), and UBC will drop your worst year if you have 120 credits (ie, you have completed 4 years). This is where the problem begins. I am in third year, so uCalgary will drop my worst year, but UBC will not. My best chances for admission are at UBC (if I had my worst year dropped, ie the year I spent in the hospital), which would only happen if I applied in the NEXT cycle, not this one.

So, if I complete my AMCAS application, and I apply to the 10-12 schools I have a chance at in the US, and I get into one of them, but not a Canadian school, do I go, or do I wait a year and reapply? If I wait a year, UBC will drop my first year and my GPA will increase (likely) to above admission averages, but my GPA alone won't guarantee me admission. But UBC has a large rural assessment component to the application (which is very much in my favour as I grew up in a town of less than 4000 people), and my extra curricular activities will only improve with the addition of one more year on my application. So, my application, if I were to apply in the 2014/2015 cycle would likely be much stronger, and my chances for admission are higher.

Back to the dilemma, do I submit an AMCAS application? If I get in only to an American school, do I go? My intentions for the past year was that I would apply to US schools, but that was on the thought that UBC would be dropping my worst year, and now that they won't be, I am second guessing. I want to cover all of my bases in Canada, and ensure I have the strongest application possible submitted to Canadian schools before I hop across our southern border.

I want the best chance possible at becoming a doctor and I don't want to miss an opportunity to fulfill my dream, but waiting one more year and getting in to a Canadian school would mean that I would be at least $200,000 less in debt and be able to get a residency spot in Canada. (Plus, I don't have to write step 1, or go through the silly basic science courses that US medical schools force you to go through.)

WHAT DO I DO??? I just want to be a doctor! (Preferably in Canada, and if not Canada, Washington or Oregon state because they are the most similar places to Canada other than of course Canada itself and New Zealand.)

Pain and Sleep

I am a very high functioning young adult with chronic pain. Seriously, how many people do you know with straight A's, who volunteer 10 hours per week, and ride a bike 16 hours a week who have chronic neurological pain? (If you do actually know somebody, please let me know, I would like to meet a this person.) I somehow manage to do things that most normal people, let alone people with chronic pain, can't do. To be honest, I have no idea how I can ride a bike, but somehow I do.

When you have chronic pain, you struggle to sleep, some people struggle to fall asleep, and some struggle to stay asleep. I am a member of the later group, I usually fall asleep within seconds of hitting the pillow, but I wake up about 4 hours later. My pain gets worse when my leg is still, so when I am awake my leg is in constant motion, but when I am in a deep sleep I don't move (like a normal human) and then my pain gets worse and I wake up in a grip of pain. On occasion, I actually sleep through the night, which means I get 9 hours of sleep. I usually go to bed around 10:30 and get up around 6:30-7:30 in order to maximize the potential amount of time I might be able to sleep. This tactic works pretty well because usually out of the 9 hours I spend in bed, I am asleep for 7 of them, meaning on average I get more sleep than my peers. So, strangely, chronic pain probably makes it so I actually sleep more....weird, huh?

My idea to write this post came from this article: "Extended Sleep Reduces Pain Sensitivity" And, as the title suggests, sleeping more means less pain. So, maybe the reason I am able to do all this stuff is that I actually experience less pain than my fellow nerve pain suffers because I sleep more? It is a possibility.  And, even if you don't have chronic pain, sleeping more may help you recover faster from that flu shot, dental procedure or surgery pending in your life. In the world of cycling, those who train hard and sleep a lot are generally the fastest. So if you don't have chronic pain, and are not predicting pain, sleeping might in the very least make you a faster cyclist.

On another note, I crashed riding in the ice/snow yesterday on a corner and sprained my thumb pretty badly. It isn't broken, but I think there is some ligament damage, hopefully the doctor will give me the verdict tomorrow. The worst part is that exams start next week, and it is my dominant hand. Maybe sleep will make it hurt less?

I learned how to tape it via youTube...it worked!

Advantage of Being a Woman in Science

I went to an amazing lecture yesterday given by Dr. Jeffrey Mogil, a pain scientist from McGill. He lecture was titled "Mice are People too: Social Modulation of and by Pain in Rodents and Humans."

As you can imagine, the lecture was about mice, and how they perceive pain. Turns out that they actually have similar facial expressions that infants do (eye narrowing and cheek bulge) and then of course things like wiggling their whiskers and ears which we has tiny humans either do not have or cannot do. He then went to on to divulge the social interactions of pain, when we are in pain with the presence of somebody we do not know, we experience an analgesic effect, or the stranger effect. This hold true for both mice and humans apparently. Conversely  when we experience pain with the presence of a friend, there is increase in the amount of pain we experience, which is known as the empathy effect. This was all pretty interesting, and actually made sense for me. I definitely feel less pain when I am in socially new or uncomfortable environments  which I suppose goes back evolutionary to the feeling that this new person might try to eat you, and you do not want to show any weakness in front of them. 

The most interesting part of that lecture though was the fact that Dr. Mogil's group found that men, or the smell of males (any species other than mice) also exerted a analgesic effect. This means that the presence of a man, or a man's T-shirt in the room will cause mice to become stressed out of fear of predation. This effect only lasts for about 30 mins, but during that 30 minutes these mice show lower amounts of pain, and then after 30 minutes they apparently realize that the male is not a threat and the effect wears off. It hasn't been proven in humans yet, but the effect was shown stronger in female mice than in male mice, and there is a good likelihood that it is also true in humans.

So how does this relate to the title of my post? Well, if the presence of a male stresses out the mice, then it actually throws off the accuracy of a lot of our experiments. Even when we euthanize a mouse to harvest its DRG neurons for analysis, if there is a male doing the euthanasia or in the room at the time, it could skew our results. This is even more pertinent when we do behaviour testing, especially for sensitivity and pain perception testing. Basically, in this one circumstance  it is better to be female scientist than a male scientist. 

If Dr. Mogil's theories also hold true for humans, this gives us a unique perspective for medicine. Perhaps, women truly do make better doctors or more perform more accurate patient assessment because the patient's pain would not be skewed by the examiner ..unless of course the doctor has never met the patient before and then you would have the stranger effect take place. 

Global Health

Welcome to my Medical Mondays Post!

I'm pretty exhausted today after spending my entire day at the Children's Hospital and then going to class...I don't understand how doctors actually make through the day. I guess now is as good a time as any to start improving my stamina and work on looking enthusiastic about everything and my all day happy face.

Anyway, in two weeks time, I will be heading over to Montreal to attend MonWHO, a World Health Organization Simulation conference. I went last year with my previous university, and this year I obtained funding for myself and 5 other students from Calgary to fly out to Montreal to spend 3 days debating, learning and sometimes fighting about global health issues. The theme of this year's conference is "Corruption in Health Care Systems," and I am the Transparency International delegate, which should prove to be a very interesting and involved role. I am also pretty excited about being able to see some of my friends from Guelph who are going and whom I haven't seen in almost year.

The main reason that I was actually able to get funding to go, is because next fall, we will be hosting the first conference of its kind in Western Canada. We are calling it CalWHO, which coincidentally sounds like "Yahoo" which is actually the traditional Calgary Stampede exclamatory phrase (it is not "yehaw" like everybody thinks). Myself and my friend U are the co-Executive Directors, founders and first ever presidents of CalWHO. Before Christmas we had an application process to select 4 more students to form our core secretariat responsible for putting on CalWHO next fall. So while we are headed to Montreal to attend the conference (and eat awesome food, potentially go shopping and maybe hit up one of Montreal's famous night clubs), we are mostly there to learn everything about the conference so that we can recreate it here in Calgary.

This is a massive under taking, as it will be the first student led conference in my faculty and one of two in the entire university (the other is hosted by the faculty of education students, most of whom already have at least 1 degree). I am a bit scared....but at this moment,  I am just really excited to go to Montreal and spend a weekend trying to solve problems that affect the health of people world wide.

Also, happy March from Calgary! I love Canadian weather! (Said no one ever.)

Highs and Lows

In my first year of university I was part of a bible study that we called "DG" (discipleship group), and its where I met most of my really good friends, and a few of them became my room-mates in second year. We met once a week, tucked our selves away in a corner, ate a lot of candy, and talked about God. At the beginning of our meetings we always did "Highs and Lows" where we would each say what a high was for the week and what a low was for the week. It really helped to put things into perspective when you were having a bad week because it forced you to also find the good things that happened.

So, I'm linking up with "happies and crappies" again this week, because I feel like this a helpful exercise when I am feeling a bit glum.

Happies:

- I met with my PI to discuss summer studentship funding, and I am almost done my applications

- I made it to all of my training sessions this week

- I finally got an MRI of my ankle on Monday

- I went home last weekend (because of said MRI) and got to spend some time with my family. Because I went to boarding school when I was in the 10th grade, and then did my first 2 year of  university thousands of km from home, it was the first time I had gone home on a non-holiday weekend since the 9th grade.

- I made my grandmother very happy on Monday when I brought her flowers, which in turn made me happy to see her so happy (and surprised).

Crappies:

- I haven't slept very well in a few weeks. I keep waking up throughout the night (usually at 1 am, 2:30 am, 3:30 am and 4 am) because my leg hurts. I wake up after I have a dream about something happening to my leg, like it gets cut off or like last night, when I dreamed I was shot in the leg. 

- I'm super tired of doing spin pyramids at training

- I almost died driving to my MRI on Monday due to black ice and a freak snow storm, thankfully the big guy was looking out for me.

- Because I went home I got less work done on the weekend

- While this probably doesn't seem like a "crappie," I was disappointed that I only got 91% on my cardiovascular exam in physiology. One question that was marked wrong, is in fact correct based on our lecture notes, so now I have to argue with my prof which I hate doing. I don't like grade grubbers, but when things are marked incorrect when they are actually correct, it makes me upset. 

That is all! Have a good weekend!

"Do not let the pain make you hate"

I wish I had the strength to follow these simple rules.

"Do not let the pain make you hate." This is a really hard thing to do, for me, its more a physical pain that makes me hate, but I know that is not the case for everybody. I hate that I have to deal with things that everybody else deals with, and deal with the pain. My life would be so much easier if I could just sleep through the night, not spend most of the day feeling nauseous from the pain and not spend huge amounts of time faking to the world that nothing is wrong. I hate that I can't do anything about these things, and I hate that the pain makes me hate things.

I don't know why I have this idea in my head, but I feel like if I ever get into med school that my worries will just disappear. I have no idea why I think this will happen, because likely my worries will triple once in med school. Maybe its because my goal of trying to get into medical school has been the only thing that makes me keep on going despite the pain. What will happen if I don't get in? Well, I think my pain will make me hate the world even more than I already do.

I need to go see my family doctor about sleeping pills....I hate asking for drugs (and there we go again with my pain making me hate things).

5 for 5

I decided to join this link up:

I think it's pretty self explanatory, so here it goes.

Happies

1. My mice arrived! 

2. I am starting a conference at school, it will be the first student lead conference in my program

3. I had an awesome time in Tucson riding bikes with Team Alberta a few weeks ago

4. I got an A+ in pharmacology last semester (its the only one semester course I have, so it is my only grade from last semester). 

5. I like most of my classes this semester

Crappies

1. I don't have access to get my mice out of animal care My PI just had a grant proposal emergancy and needed the mice, so now I have no mice.

2. My schedule is so full I am starting to panic

3. Reading a stats text book is horrible

4. I'm too busy to study

5. One of my prof's is a bit of a bigget from Georgia (no offence to anyone from Georgia, but this particular individual from Georgia is rather sexist and racist). 

Looming Medical School Applications

On Christmas eve we had some family friends from the US come for our Christmas dinner (they are originally from Poland, but the used to live in our small town about fifteen years ago). Both of their kids are in medical school (one is in OD school I believe) and they told me that there are a fair number of Canadian students in their class. This gives me hope, because I will be applying to the US (lets face it, I only really have any chance at 3/11 Canadian schools, and that doesn't leave for many options).

It was interesting talking to them about the application process and I was surprised to learn that they both applied to about 30 schools! We don't even have 30 schools in Canada! My plan was to apply to 10 US schools and 6 Canadian schools, which would total to 16 applications. Basically, I will be spending what ever I earn this summer on medical school applications. I also found out that in the US, you might receive offers of admission before the end of October!! Our applications don't even close until October. 

I wouldn't mind going to an American school, it would be better than the Caribbean...I will just be paying student loans until I die....and health insurance might be a bit of an issue for me.

I feel like I am steadily starting to build up my application though, even if I am about a year too late. I was just accepted in a program called PEMRAP - Pediatric Emergency Medicine Research Associates Program. After I go through training all of this month and next month I will be enrolling patients in emergency medicine related studies. I'm pretty excited about it, but it does mean I will be spending 8 hours of every Monday at the Children's Hospital. Good times!

Cycling also going pretty good too, I just spent the last week in Tucson at a provincial team training camp. We rode a lot...and I'm exhausted, but ready for the first day of classes tomorrow. For some reason we start the semester on a Tuesday...but I'm all for it! I spent the entire day yesterday travelling, and I haven't unpacked my bike yet...I hope it still resembles a bike after the whatever trauma United Air inflicted upon it.

Team photo on the last day at Colossal Cave Park

Will they see it?

I feel like I am constantly working my tush off to try an impress people I don't know and likely will never meet. I study as hard as I can for everything, 10% tests get as much attention as a 30% test would because everything counts, there is no room for error. I don't skip a training session for any reason, not for pain and not for school because maybe, just maybe tomorrow will be the day that will mean the difference between 3rd and 4th. I try to balance my family, friends, volunteering and goals with my own sanity, but the scales always seemed to be slanted this way or that.

Is this what the rest of my life will be like? Yes I realize that I am trying to get into medical school in the very near yet distant future, but will it always be like this? Once, or if, I am in medical school I know I will be doing everything possible to match into the residency spot that I want, and then I will be trying to match into the fellowship that I want, and the secure a job, and then publish amazing papers....it doesn't end!!!

Right now, my concern is that my medical school applications won't show how hard I have been working. My first year of university shows a GPA that is less than stellar, but an admission committee won't see that I spent all day everyday in hospitals, clinics, doctor appointments, dressing changes, pharmacy line ups, on buses and trains trying to get to far off specialists to prevent my right leg from being amputated. I didn't go to class because I couldn't, so I stayed up every night until the wee hours of the morning copying out notes from my friends and studying for quizzes, midterms, and exams. I worked harder than I have ever worked before, but my GPA doesn't reflect that, and I wasn't involved in the community because I was completely absorbed with trying to save my leg without sacrificing my life. Will the admission committee see that? My guess is not, and if I talk it about, it will seem like I am making up excuses for my grades or trying to seek pity. 

I have for the past 2 tests in  human physiology gotten 96%, which you might be thinking is impressive, and normally I would also think that, however, my school only puts letter grades on your transcript. In the Faculty of Medicine, and A is 90-96 and an A+ is 97-100. When I apply to UBC school of medicine next year, they will see my A, and translate it to 87%. Which is almost 10% lower than my actual grade, so I might as well study less, put less effort in and get 90%. Or if I study that much harder (which when you have chronic pain, there is a distinct line which you cannot cross because your mind doesn't function after a while) and get 97%, and achieve that A+ (which UBC translates to a 95). The whole grading system makes me angry, I work as hard as I possibly can, and nobody will see that.

Is this the life I am choosing? Work yourself until you bleed and nobody even notices that you are bleeding? I know you will say that they will notice, but I disagree, nobody will see how much I achieved in the face of the challenges I have overcome or am still struggling with. They will see my grades, ones that don't even reflect my actual grades, they will see I had no extra-curricular activities for two years and they will judge me against other students who haven't gone through what I have.

I am choosing a life that is against me in every way.

The First Cut

Today I preformed my first surgery, I made my first cut through skin, isolated my first structure and sutured my first wound. It was amazing, and I thought my hands would begin to shake, or that I would falter or feel faint, but I didn't. Probably because this surgery was on a rat, but on Monday when I watched the demo of the surgery, I felt pretty sick. But there is definitely a big difference between watching somebody cut the skin and actually putting the scalpel blade through the skin your self. Even though his heart was beating and he was breathing (and anesthetized), it wasn't as hard as I thought it would be when I made that first cut. 

I completed my animal surgery certificate course today, I assisted my partner with a surgery on Monday, we did post-op together on Tuesday and today was my time to be in the spot light. All I had to do was isolate the jugular vein, which really wasn't that difficult. And those veins are surprisingly stretchy and resilient. The hard part was the suturing, doing the inner layer of tissue was just fine as it was a discontinuous stitch, but doing a continuous buried stitch on the outer layer of skin was really tricky. I kinda suck at it...but it was my first attempt at ever stitching anything ever!!! I'm pretty stoked on life right now though, mostly because I didn't know if  could ever handle doing surgery. I like it, I'm not good at it right now, but I like it.

After my rat was euthanized (I'm not totally okay with shoving a needle full of anesthetic into a rat's heart yet...) I got to isolate the sciatic nerve. Honestly, it was the first nerve that I have ever really seen. Maybe on day I will get to repair one.

I'm pumped to keep studying, get on with my research project (mice officially ordered) and become a doctor! Surgery might still be in my cards, but I need to practice suturing, so, I bought this:

My first suture kit

 The only problem is that I only have 2 packs of sutures, one for fascia and one for skin. So if you know anywhere I can buy sutures, let me know!!

Laughter

The best thing about volunteering at a Children's Hospital is laughter. Its my job, to make the kids, nurses, parents and doctors laugh. When you are volunteering in a respite/palliative setting and with children, the best thing that  I can do for them is to make them laugh. Today I played Uno Jenga with a patient, a nurse, a nursing aid and a doctor. We were having so much fun that we even drew a couple of parents and other patients out of their rooms to see what was going on. I left my shift today and walked out of the door with everybody laughing and smiling. I can only hope that when I am a doctor, I will be able to do the same, to go home everyday knowing that the last person I talked to was either laughing or smiling when I walk out the door. 

Medical Monday 1

Hey everybody! So this my first Medical Monday, and it is also my first Monday not being a teenager! Yup, I turned 20 yesterday, so I am officially old. I know a lot of people reading this are probably older than me, but I just joined the club.

Today's Medical Monday is going to be about hands. We can do a lot with our hands, we can make things, we can use them as a musical instrument and among other things, we can use them to comfort somebody. I will never forget the moment when my GP put his hand on my back to help me sit up after an exam a few years ago when I was dealing with a pretty severe illness. It was a simple gesture, but that moment he went from being a doctor to being a friend, from being the person with the prescription pad to being a comforting presence. Its a pretty incredible thing that we can do with our hands.

On Friday, I went to my volunteer shift at the Children's Hospital. For about an hour, I just held this four year old boy (he was about the size of a two year old, and developmentally a year). We read stories, but mostly we just cuddled, and he would smile and giggle. There was an other girl, B, and she has her good days and her bad days. Friday was a bad day and on bad days, B doesn't stop yelling, screaming and crying (she is a non-verbal communicator). The morning was actually going pretty good until music therapy...then it all went down hill. So I took her to the sun-room, where she continued to scream until I started to gently rub her back, and then she stopped. As soon as I removed my had, she would start crying again, so I kept rubbing her back until she fell asleep, and then once she was asleep I wheeled her back to her room as quiet as humanly possible.

People seem to have this notion that medicine is about learning about diseases and treatments, and that patients are their disease. I am even guilty of this thinking and I'm not even in medical school yet, but there is something more to medicine than just that. People say that their doctor is amazing because they not only make correct diagnosis but they actually listen, and don't get me wrong, that definitely adds up to some respect points in my book. I think though, that we easily forget that sometimes all people really need from medicine is a comforting hand.

I encourage you, if you are a doctor, want to be a doctor or have anything remotely do with the lives of people who are ill, terminal or are just having a crappy day to extend your hand to them and bring them a sense of comfort that drugs and other treatments cannot. That is real medicine.

Life of a Kid

I had to attend a palliative care training course today, it was depressing, but also opened my eyes to how important the role of a volunteer can be for an individual at the end of life and for my volunteer situation, a family. I volunteer at a pediatric hospice, but its 80% respite care and 20% end of life. I haven't actually been there yet when there was a kid and family there for end of life care, I have just played games and done fun things with kids who have pretty severe and disabling conditions. Every kid that comes through the door (unless they are a sibling) are technically considered to be palliative meaning that they have shortened life spans, but are not necessarily actively dying.

Today also happens to be the anniversary of a pretty tragic death in my own hometown. On this day, 8 years ago, a boy named Chris, who was a year older than me, passed away from a quading accident. We used to play on the same soccer team every year and went to the same school. He was an amazing athlete and would have gone far in life. He was airlifted to Calgary, and stayed overnight in the ICU, and I can remember our principal the next morning going around to each classroom telling us what had happened. It was hard, at 11 years old, to wrap my head around somebody my own age dying from something that kids do everyday in my town, from something so simple as quading at the ski hill with some friends after school. Its hard not to think of who he would have become if the accident didn't happen.

I wish that these kids I play with on Friday mornings could have the chance to grow up to be something amazing, that they would be able to fulfill their dreams.Today was the kind of day that really makes you think about life, and instead of thinking about why bad things happen to people, I am thinking about why they didn't happen to me. Why am I so lucky to be celebrating my 20th birthday in a week when some kids don't even make it to their 5th, 10th, or 16th birthday?

I just need to focus on giving it 110% everyday on behalf of those who cannot.

Peace Like a River.