A Quarter Century

So, it looks like the quarter and I have something in common now: 25.

You know, I’ve always enjoyed my birthday. Smack in the middle of January, it caps off the holidays without getting caught in the middle. Not a bad deal, if I do say so myself. It’s also not too far off from New Year’s, which means it is another excuse to reflect on all the ways I can achieve all my goals and live another fulfilling, crazy, happy year of my life.

It’s been awhile since I last wrote here, so naturally the question is: why now? I came across a couple of my old blog posts the other day and I cracked a smile reading through them, reliving all the emotions I felt as I wrote them (a little cringing now and then was involved). And then there’s the fact that I recently recommended journalling to someone, so I thought: why not take my own advice and give it a quick spin?

There are a million things on my mind now, but I thought I’d share a quick sentiment that framed my new year’s resolutions this year. The big question of what I want to do with my life is still up in the air, but now that the third year of medical school is nearly 3/4 complete, I have some ideas (we’ll save that for later when it becomes a little more clear…)

I’ve recently fallen in love with an Eleanor Roosevelt quote (*among my new year’s resolutions is to learn a little more about her because I swear I’ve fallen in love with tons of her quotes):

To be mature you have to realize what you value most … not to arrive at a clear understanding of one’s own values is a tragic waste. You have missed the whole point of what life is for.

Happiness is definitely an inward experience and it’s tough to be truly happy if you don’t know what makes you happy. That seems utterly obvious, right? But, I think I’ve discovered that happiness comes in different flavors: the sugar rush of frosting, the warm bitterness of dark chocolate, the shock of cold ice cream, the tangy sweetness of a kiwi, the comfort of homemade food, etc. Forgive my corny food metaphor that is making me hungry as I write, but the point is: I think it’s important to realize that we have lots of “happiness receptors”. Needless to say, overdoing (or rather “over-saturating”) it isn’t fulfilling because all the flavors get mixed/muddled and you end up with a less sweet, less happy ending.

Coming across this quote resonated with what I think I/we already know: the real trick is to “arrive at a clear understanding” of what flavors/types of happiness you value. And then, make sure you get a dose each day! In my mind, it’s really that simple.

…so with that, I’m off to fire some more happiness receptors! Hope to take some time to jot down some more thoughts soon.

The Dating Game

Ok, I admit. I almost forget this blog existed. Almost. And then we had our hundredth talk about digital professionalism (OK, maybe it was like the fourth or fifth time, but it sure felt like the hundredth) and how important it was not to post patient identifiers on Facebook and how anything and everything we say over social media will come back to haunt us. Forever.

(Not to worry. My Facebook updates are only slightly less sparse than my blog updates.)

But getting to the relevant point here – this conversation reminded me of this blog I finally get the chance to dust off. Admittedly, I share a lot on this blog, both personal and academic. But one of my classmates said something in our third year tutorial that really struck me. It was something to the effect of, “I don’t really use social media because I don’t want anything I say to ever be used against me.”

Fair, I suppose. But, I also think there is incredible value in using social media for the right reasons in the right way. This blog I’d like to think is an example of that. Yes, I’m sharing personal vignettes with you, but I am conscientious of the specifics and I tell you things to give you the basic idea of what it’s like to be a doe-eyed medical student (and person).

The truth is, everything has a dark side. Take ER medicine, for example. The adrenaline rush of saving a trauma victim or diagnosing appendicitis is an amazing feeling. Having someone sue you for missing viral myocarditis? Not so great. And so ensues the costly lab and imaging tests that create a triaging service* in the ER instead of a diagnostic service (*some might argue this is the purpose of the ER, but should it be?).

But, the bottom line is this: I don’t disagree with my classmate, but 99.9% of the time I truly believe that if you are truly honest, genuine, and responsible about your actions, you get what you give. And it’s as simple as that.

So, here comes a belated update: welcome to third year of medical school.

I’ve decided the best metaphor I could think of is that third year is kind of like speed dating. Admittedly, I’ve never been speed dating, but I imagine it would be something like this: an energetic mix of personalities, scrubs, and white coats in 2-3 week intervals. And then, when you think you’ve made a connection (or not)…time’s up! Move onto the next rotation.

It’s the speed dating night that never ends. So, how does one learn how to love speed dating?

Here are 5 golden rules I’ve come to live by while navigating what might possibly be the best (and hectic) year of medical school so far:

Rule #1: Smile. Even when the retractor in the OR is giving your arm a muscle spasm and you’re wearing a mask, smile with your eyes (it’s a thing). But all joking aside, smiling can never hurt. And if you frown, you might never meet the specialty of your dreams (because who really and truly knows what they want to do before third year is over!? Maybe this dating metaphor isn’t so far off after all…).

Rule #2: Stay calm. Sometimes it feels like there are endless expectations required of you. You have to be in clinic at 1 pm, but the lecturer for your 12-1 pm didactic lecture is running late. To stay or not to stay? Or, someone tells you to suture up a laceration in the ER, but you have actually never done one by yourself. How do you appropriately ask for help without sounding incompetent? Or, my favorite: you are so tired and hungry at the end of the day that you can’t decide what to do first. Staying calm is easier said than done, but sometimes you just have to accept the chaos (and, more importantly, accept that people really aren’t judging you as much as you think they are) before you can successfully navigate it all.

Rule #3: Have a thick skin. This is probably the one I’ve struggled the most with. It’s hard when you’re chastised for breaking the sterile field or (wrongly) compare yourself to residents and think to yourself, “…how am I so stupid?” It happens every day. Stay calm (rule #2), poised, and patient. Time passes far more quickly than I imagined. Which of course, is a blessing and a curse. Because if you do fall in love, you still have to walk away. For now, at least. Fourth year is a whole different story.

Rule #4: Dress to impress. I couldn’t help cracking up up when one of my surgical textbooks reads in its first chapter, “dress to inspire confidence.” But the truth is, it definitely makes a difference. I think I learn the most (and give the best patient care) when patients view me as a competent and knowledgeable member of the team. So, despite how valuable those precious minutes of sleep at 4 or 5 in the morning are, dressing the part can never hurt.

Rule #5: It’s okay to say no. I don’t know what it is, but I feel this jerk to nod and smile to every command or suggestion ever offered to me. Even if it is an internal, silent “no”, it’s important to remember who you are amidst all the various personalities and opinions. And it is also okay to SAY “no thanks” if, using your situational awareness, you feel it genuinely isn’t a good learning opportunity. Just make sure to take advantage of everything you do end up engaging with.

—

Here’s to the last 4 weeks of my surgery rotation! And then off to medicine, neurology, psych, radiology, pediatrics, and OB/GYN…

Like I said…

Third Year = The speed dating night that never ends.

Living the dream

Clearly, the elephant in the room here is that I haven’t updated this blog for AGES (read: 5 months). But, then, two oddly coincidental events happened within the past several days that reminded me how much I truly miss writing, and, well, here I am. So about those two events…

Last Friday, I was reminded that I’d submitted an article to an alumni magazine about my video-making experience at Khan Academy last summer (I somehow ended up talking more about my frustrations-turned-into-thoughtful-criticism of medical education, but that’s for another time…) when I received an e-mail about putting the finishing touches on it. So, I started reading through it (simultaneously trying hard to recall myself writing it since it was really THAT long ago…) and I was overcome with a nostalgic feeling of writing all those blog posts I’d gotten through my first year of medical school with. Not nearly as polished as that article, of course. But that all-too-familiar raw, spirited, and creative tone (if I do say so) was still there.

Since boards’ studying quickly resumed its hold on my life after that transient revelation, I didn’t think about it again until I happened to find myself on Michelle Au’s blog. And to my surprise, there was a massive addition of new entries – surprising, I say, because, she self-admittedly hadn’t updated her blog in nearly half a year. So, I made the next logical conclusion: if she can make a blogging comeback after half a year, maybe I’ll follow suit. No pressure or anything.

For this entry, I actually got a little inspiration from one of Michelle Au’s old blog posts (read: from her medical school days). This blog post caught my eye because I vaguely remembered learning about the Tredelenburg gait way back in Ortho, but not enough to remember what it actually was (reassuringly, she didn’t either). And then I read her post and couldn’t stop cracking up. Experiencing the “blurred lines” between medical school and real life must be some rite of passage because I’m pretty sure I have an endless bucket list of stories along those lines that sum up second year quite well…

1. Hematology & Oncology Microscope Lab

Classmate: “Whoa, my red blood cells look weird…”

Me: “Really! Let me see [looking under microscope]. Those kind of look like spur cells…”

Classmate: “What are spur cells?”

Me: “You know, um…” [picturing the textbook photo in my mind without remembering the caption – typical – as I pull out my smartphone] “…like these!” [pulling up a Wiki page for “spur cells“]

Classmate: “What? It says I have liver problems. Wait [look of terror], what?”

Me: “Um, I’m sure it’s just a coincidence…”

Classmate: “Well, maybe it’s because…”

Me: “No, I’m pretty sure it’s just…”

Classmate: “So basically, I have liver disease. Good to know.”

Being the detective she is, my friend and I ultimately concluded that it could have been (was) an artifact. Also, the fact that our lab instructor wasn’t at all concerned should have clued us into our complete ridiculousness. Moral of the story: don’t self-diagnose. It’s a scary path. Especially when you’re sleep-deprived and know more about names of diseases than actual pathophysiology.

2. Patient-Doctor II

I’ve lucked out with pretty friendly patients this year. They’ve all been accommodating to my “evolving” physical exam skills. Especially the time when I went to take the blood pressure and couldn’t hear Korotkoff sounds. Feeling too embarrassed to ask my patient to take his blood pressure for the third time, I smiled awkwardly, saying how my stethoscope wasn’t working or something and continued with the exam only to realize later that I WAS WEARING MY STETHESCOPE EAR PIECE THE WRONG WAY. Which, apparently, does matter. And I’m pretty sure my patient knew, too. He was just being nice.

3. The daily ominous feeling about not being prepared for STEP 1…

I felt somewhat relieved today when our renal course director broke out into a goofy version of “Sweet Caroline” with lyrics about the kidney and tangentially mentioned how she took a practice STEP 1 exam and it “blew her mind” or something along the lines of “I feel you”. But, that doesn’t change the fact that it is a required “rite of passage” into the world of medicine and that it is in less than THREE months away. Which means, my blogging comeback will be a very, VERY slow endeavor indeed — but I digress.

Returning to this theme of feeling incompetent for a large part of the time, I’ll be the first to acknowledge that studying for the boards is a daily practice of feeling really incompetent. Now, don’t get me wrong, I’ve come to this conclusion with optimism (look how much I’m learning! …followed by an encouraging “a journey of a thousand miles starts with a single step” self pep talk) vs. pessimism (how the HELL will I remember all of this?), but sometimes in the never-ending hours of turbo-charged studying, I, too, wonder in the words of medical student M. Au:

Do I even have a real life outside of my school life?  I go to school.  I live at school.  Not a day passes that I don’t spend the majority of my time doing something school related.  And it’s starting to grate on me.  It makes me feel like I’m becoming a boring person.  I feel like all the reasons that I’d been accepted to this medical school, all the interesting, unique things about me, are becoming totally whitewashed in this all-consuming quest to learn all the things I’m going to need to know to be a doctor.  And it bugs me.  It bugged me that I couldn’t spend one night out and relax without being reminded about having to go home and study my ass off anew.

But, you know what the funny part is? I’ve also come to the conclusion that we all have selective amnesia. The stressors of first year are worlds away even though it felt like a mountain of stress a year ago. “It will pass…” is the sentiment that many of us are using to propel ourselves through this final stretch of our pre-clinical lives. And, though corny as it is, I think we all have each other to know that our “boring selves” are not that boring if we can still put up with each other (and, as a side note that probably deserves its own blog post — the great part about feeling a certain level of incompetence (I think) is that I end up forcing myself to go outside my comfort zone, to ask more questions, and, usually, end up learning a thing or two…).

I’m glad I took a break to write that all down because…who knows? Maybe some random medical student in the future will be comforted by the unspoken feeling of incompetency (which I hope that I have self-evidently left unspoken no more) that makes every medical student question their sanity once in a while. Until, of course, we are constantly re-charged by those moments of “aha” understanding, application, and camaraderie that make it all worth it.

As I said (invoking a legendary phrase from one of my good Wellesley friends) to the casual “what’s up” of a hall mate today – “Oh you know. Just living the dream.” To which my hall mate responded sarcastically, “Right, because studying in the late hours of the night is ‘living the dream’ …” Though I wouldn’t put it past myself to say that I do enjoy studying to some degree…maybe it is. Albeit, in a sometimes unapparent and slowly self-revealing way, I am living the dream. One day at a time.

Summer 2013

“It’s your last summer ever!”

I mean, not literally. But, yes. Technically it’s the last span of eight weeks I will have “nothing” to do. And it went by, as always, in a blink of an eye (…sorry for the blog MIAness). Here’s a quick rundown of what I’ve been up to this summer.

Summer 2013 Top Five:

5. Do not violate HIPAA. Get approval from Scientific Review. Write an entire IRB proposal. Get it approved. Start collecting data. In a whirlwind of “learning how the system works” I’ve learned that patience is not only a virtue when it comes to bench research…it pretty much applies to all kinds of research. After filling out my first-ever IRB protocol, I will be continuing to work on a quality improvement project throughout the school year…fingers crossed!

4. Ghirardelli’s vs. Burdick’s. Is that even a question? In a surprising visit to San Francisco (see #2), I went to Ghirardelli square twice – not for their hot chocolate (although, this place might give Burdick’s a run for its money…but Burdick’s still wins – obviously) – and experienced the chocolate bliss that was their ice cream sundae (the chocolate sauce is AMAZING). OK, so when it comes to chocolate other than hot chocolate, I’m WILLING to branch out. Maybe. And since we’re on the topic of guilty pleasures, I had my first-ever wine tasting in NAPA (!) and had, quite possibly, one of the best meals in my entire life at this restaurant.

3. “The Art of Choosing” by Sheena Iyengar and Atul Gawande’s latest for the New Yorker are my favorite summer reads. This article’s take on obesity was fascinating, too. So much to read, so little time…!

2. I had the amazing opportunity to work with other amazing graduate/med students on creating content for the 2015 MCAT through a collaboration with Khan Academy (they flew me out to San Francisco, too!). I feel like this deserves an entire blog post, but to sum it all up, I’ve realized just how much I enjoy teaching and how, even though I know there is still so much for me to learn, I find myself consistently attracted toward education, teaching, and the like. Can’t wait to see where this goes. Keep your eyes out for the content videos, which will be posted throughout the year on Khan Academy’s website as well as the AAMC website, especially if you’re studying for the MCAT. It’s free and I am already floored at how the content is turning out…I hope everyone will enjoy these resources as much as we are all having fun making them!

1. I had a wonderful sunny week in Seattle with my amazing family, which included: fried chicken (my guilty guilty pleasure), wild mushroom risotto, Bollywood, Scattergories, BBQ, and having my old room back for a week! I miss home, but I’m so glad I got to be back home for a bit. Here’s to more adventures inside and outside of the classroom in year TWO of medical school. Woo!

SAN FRANCISCO…

Guess what my brilliant friend getting a Ph.D. in Chemistry gets to wake up to every morning? Fate.

Golden Gate Bridge Reunion!

Sal Khan’s recording studio at Khan Academy! #kidinacandystore

Napa. Sunshine. California. Beauty.

Finally had my first Sprinkles cupcake!

Happy 4th!

Summer is going by so quickly! I’ve been spending my time at Boston Children’s Hospital on a summer project and, of course, trying to enjoy every second of summer…

This was the second time I’ve seen the fireworks by the Charles — we found a spot next to one of the speakers. It wasn’t crowded at all and we were beginning to think we lucked out until the fireworks started…and there was a massive tree blocking half the view in front of us. Whoops. But it was still wonderful. And, Boston’s skyline pre-fireworks couldn’t have been more gorgeous…

This past week I also had the opportunity to tour some high school students around HMS part of this program called NYLF. They were fantastic — it was refreshing to see how excited they were to tour our mini-skills labs and the hospitals and reminded me how 1) truly lucky I am to have all these amazing experiences and 2) that you can never dream too big. I think my favorite part of the day was when I was leading a session on patient interviewing and I heard one kid ask his mock patient, “From a scale of 1-10, how would rank your pain?” Did he somehow sneak into our PD-1 class?

…Here’s to more summer adventures!

 

 

Obligatory Last Exam Post!

…and first year is (unofficially) OVER! We just took our final exam of the year and just have a couple days of integration next week. It feels strangely amazing to be done. I have grown so much personally, academically, and emotionally this past year and I’m so excited for all that’s up ahead. But mostly I am so thankful to my family, friends, and classmates for all their support and friendship.

P.S.

I’m also in love with this new TSwift music video. Kids, cookies, costumes, and a reckless imagination? That’s why I’m never going to grow up…

Top Five

…Highlights of Memorial Day Weekend

1. Star Trek Into the Darkness in 3D!  I came to the conclusion that Spock and I have uncanny similarities:

• We are incapable of lying (including white lies)
• We are (kind of awkwardly) emotional
• We are overly rational

2. Chocolate Chip Muffins (with miniature chocolate chips, of course)

3. Banana Bread (which is SUPER EASY to make AND, to my surprise, called for NO butter…I guess that’s what the oil was for instead. Everything in moderation, right?)

4. I have mixed feelings about this article – on one hand, I appreciate the ability to watch recorded lectures at HMS, but it is truly not the same as interacting with peers and faculty. Maybe it’s my liberal arts blood, but I think technology should be used to make learning better in the classroom. Wellesley has joined the MOOC movement, though, so I look forward to seeing how it plays out (and, I’m not going to lie…I really wanted to sign up for some of the courses!).

5. Michelle Au (who is a fantastic blogger herself, and, perhaps, more importantly a Wellesley alum) gave a commencement speech at a Wright State University Medical School! Hippo (officially the “Hippocratic Society”), Wellesley’s Pre-Med Society, was lucky enough to have her as our WIM (Women In Medicine) speaker in the spring of 2012. “Be ready for everything you think you know now to change. Be open to new experiences. But always remember who you are in this moment,” were some of her words of wisdom. Even though I’m not graduating from medical school, I think I’m going to take her advice, too (it can’t hurt).

Two more weeks of medical school? Let’s do this.

Sustainable and Filling

This weekend I had a “someday is today” moment. Let me explain: there are THREE MORE WEEKS left of my first year of medical school. When did that happen? But, really, the bigger looming thought in my mind is that I will be seeing patients in LESS than a year. Real people. Not just textbooks or endless lectures with overly busy PowerPoint slides, but diseases with people, or, perhaps more appropriately, people with diseases.

Honestly, my first year of medical school has been filled with personal growth more than anything else. Having been gifted a weekend free of schoolwork after our virology/parasitology exam last Friday, I discovered that many of the non-schoolwork related thoughts I’ve had throughout this past year were eloquently narrated in the novel “Lean In” by Sheryl Sandberg.

My mom (who I am honestly convinced knows me better than I do sometimes) shipped me the book and I admittedly hadn’t heard much about it (I just saw her TEDTalk today, which is a nice abbreviated version of her book). But I am so glad I read it. The writing may not be earth-shattering and what she says isn’t arguably novel (it’s more of a story told quite well), but it struck a chord for me as a young twenty-three-year-old women who has believed in “perfection” for pretty much my entire life. “Instead of perfect,” writes Sandberg as if she can read my mind, “we should aim for sustainable and fulfilling.”

I couldn’t agree more.

I have a confession to make that I’m inspired to share after reading “Lean In” — maybe it’s my very tiny way of leaning in, too: when I started medical school, the grass looked A LOT greener everywhere else. Rationally, it didn’t make any sense to me: I had achieved more than I ever imagined. And yet, somehow I was envious of everyone who was traveling the world and entering the workforce. I knew I was where I wanted to be, but there was a voice inside of me that hesitated: “I’m never going to have it all,” it said. “It’s too hard and maybe…maybe it’s not worth it.”

Suffice to say, I’ve come a long way from that sentiment. In fact, I’ve done a full 360: I don’t want it “all”. That’s not sustainable and it won’t be filling. Sixty years from now, I might be able to connect the dots and say that “I had it all,” but from where I’m standing right now, I have what is the most important to me, including an education that is intellectually stimulating and the most alluring of all: the opportunity to make a difference in the world (cliché, perhaps, but true).

…And you know what? I’m realizing everyday that it’s better to prioritize than to have superficial “slices” of everything. At the end of the day, it’s all about priorities. And everything else? The rest of the “all” stuff? Well, I’ve decided to let it be a surprise. Because a) there are (unfortunately) things that truly are not in our control and b) it’s so much more fun that way.

If I had one complaint about the book, it would be that I really think it applies to men and women equally. Everyone should lean in to their dreams, their priorities, etc. I was happy that Sandberg recognized that empowering women alone won’t make a difference – men need to encourage this as well. In fact, I think men – of any age – might benefit from reading this book more than women who are all too familiar with many of the “choices” that many men might take for granted.

Moral of the story? A world run by men and women – equally represented – is going to be a better world for everyone. Cheers to that.

Dear mom,

Thanks for inspiring me to dream bigger than I ever thought I could, to never give up when I wanted to, and to be the best every single day – even when no one was looking.

You’re my biggest fan and I can’t thank you enough.

I love you, mom!

– Jas

Society Olympics!

Five societies. 200 competitive medical/dental students. And a crazy week of friendly competition.

…2013 HMS/HSDM SOCIETY OLYMPICS

I’m a proud Peabodian/Peabuddy (“Peabody Society”) and we ROCKED society Olympics. What we may have lacked in talent we made up for with incredible participation and serious group bonding. Go PEABODY!!

…check out the procession/banners/dances of all the fantastic societies: