anna in med school

They have a refreshing lack of pretentiousness and bullshit about them.  Guess it makes sense that I’m married to one.

This group has been commenting on an article written about our old high school: The new Thomas Jefferson? It includes remedial math.

Many of us were humanities kids who happened to be good at math and science, and we quickly re-shifted our focus in college.  The required advanced math and AP courses I groaned about in high school allowed me to not have take a single one in college…that didn’t look too great when I was applying to post-bac programs.  However, never once during the process were my science and math skills questioned, “Oh!  You went to TJ?  You can definitely handle premed.”  Mildly ridiculous, and a poor assumption.  And then there was the time I was told by a physician in Boston that my TJ diploma would be more helpful than my UVA diplomas in getting me into a good med school.

So, I have mixed feelings on the opportunities (real or imagined) that TJ has provided for me.  Nevertheless, as has been mentioned by several others of the y’s and hmc, attending this high school was one of the best decisions of my life.  There was significant personal sadness during my high school life, but I still believe that mine was a happier, more fulfilling high school experience than that of many of my colleagues.  Beyond the academic rigor that was fostered more by the students than the faculty, I’m one of the few people I know that still has 20+ close friends from high school, let alone still goes to the beach with them for a week every summer.  (Less than a month until Beach Week XI!)

I don’t really have specifics from the article on which I’d like to comment (this is not meant to be a persuasive editorial, just a splatter of unorganized thoughts), but I’m not sure this kind of change is one for the better.  The best part of TJ, in my mind, was the community of eager students with varied strengths but similar aptitudes it brought together.  Am I being closed-minded by not seeing the benefit of a fracture in the foundation of that community?

The mango noticeably moved/kicked for the first time last night!  I think it might have been a little pissed.  John jabbed at my uterus a couple times after we thought we might have felt a little nudge.  The kid is probably like, “Okay!  Stop shaking my home now!  I’d like to continue my organogenesis in peace, please!”  A little preview of the probably 18+ years of annoyance our offspring will feel toward us.

John and I had a date night yesterday.  If you’re in Wayne, PA, we recommend Matador.  Try the octopus.

I was going to include this next bit in my last post, but I didn’t want my sometimes displeasure with my current career state to detract from John’s accomplishments.  That said, from talking with colleagues, I think this is a fairly common situation for med students who are partnered with others (or have close friends) who play more the part of the successful adult career guy/gal in the relationship, while we are still in our 20+ year of schooling.  I thought it important to at least make mention.

Sometimes when I see all the wonderful ways he contributes to his profession and our family (being our family’s breadwinner and fixing all the appliances I break due to either clumsiness or ineptitude, to name a couple), I can’t help but ask (mostly in jest), “What are you doing with me?  What do I bring to this relationship?”

And without pause, “You bring happiness.”

He’s good, isn’t he?

I don’t mean to be self-deprecating here.  I get called out for being too self-deprecating.  Yes, it’s important for young women to be confident, I get that.  But isn’t it also a marker of confidence to not conceal our insecurities?  To make them public so we can actively address and conquer them?

I feel like a theme of this week has been the conflict between loving being a student (all the privileges and opportunities, protected time to learn and soak in so much) and hating being a student (the frustrations that come with feeling like you’re spending some of your best years n0t creating anything).  I know it’s an investment; I know I need to do the training.  And right now I’m sort of limiting my scope to my professional, not personal, contributions.  But, every now and then, I really just want to be of immediate use.

John wrote a book during residency.  Who does that, anyway?  His passion, innovation, brilliance, and work ethic astound me daily.  And I’m so happy and proud that this 368-page labor of love will be published this August!  Available for purchase here and here.

I kind of feel like I married a rock star or something, only without the substance abuse and, of course, this is way better!

Yesterday was my first shift in the ED.  I performed an ultrasound-guided peripheral IV cannulation with an 18-gauge needle (for the record, that’s pretty thick…thickness increases as the number decreases) on a man with disseminated intravascular coagulation (this is not a condition you want to have; it makes you bleed a lot…so it’s a little scary for the person prodding you with needles).  We use ultrasound to guide IV access in patients who tend to be pretty sick, either in shock or have a disease process that will make access to their veins tricky.  It’s not brain surgery, but it requires some coordination–if you’ve seen me walk (heaven help you if you’ve seen me attempt a dance), you know that coordination is not my forte, so you can imagine my relief/exhilaration at having pulled this off!

Have I ever mentioned that I have a processing issue?  John diagnosed me (sketchy, to be sure).  He reassured me, “Don’t worry…I don’t think there’s anything wrong with your ears.  Just your brain!”

Basically, this is just a more medically way of saying that I don’t do well with competing noise.  Multiple conversations going on around me at once is my personal ninth circle of hell.  For the life of me, each voice sounds like it’s the same volume as the next.  Don’t even try to have an important conversation with the radio or TV playing.  For this reason, John unabashedly tells family, friends, colleagues, bums on the street: “Anna would be horrible at Emergency Medicine.”  He softens the blow slightly by saying, “But that, of course, is the reason behind her musical ear…subtle harmonies stand out clear as day.”  See how he (successfully) butters me up?  It’s been going on for years…

But in the last couple weeks, he’s changed his tune.  The idea of me doing a seven-year residency in surgery is unappealing to both of us and, frankly, though I enjoyed surgery more than medicine, I wouldn’t say I was absolutely head-over-heels in love with the OR and nothing else.  As my ED rotation approached, he would periodically tell me, “You know, it’s okay if you like the ED.”

Well, this might be a problem.  It sounds trivial, but I would have some serious concerns entering the same field as my husband, seven years behind him.  I love that we’re both in medicine…that we both have similar loves of exotic foods, good music, bioethics, travel, and literature…that we both want children, pets, a broad definition of family, life-long friends, and adventures far and near.  But I kind of also want our own respective little corners of our careers that are our own.  And, I’m revealing a new depth to my insecurities here, I think it might make me happier to be in a field where I wasn’t always going to be seven years behind him.  In a career where you’re constantly learning, I would have difficulty always being the one who benefited from his experience and expertise yet could given little in return.  It’s petty, but it’s where I am now.

Now I’m just getting way ahead of myself, as we’ve only had orientation to the ED.  I could hate it.  (I don’t think I will.)

In lighter news, today I successfully inserted my first 20-gauge peripheral IV line into a consenting classmate.

In the last two weeks, I feel like my belly has quadrupled in size.  Must be all the peanut butter, bananas, and frozen yogurt–can one make a healthy fetus on PB&B & fro-yo?  I’m now at 18 weeks, +8.7 pounds (but it feels/looks like I’ve gained much more), and into a new wardrobe.  John, best husband on the planet that he is and having far better taste than I, went shopping with me (a.k.a. practically kidnapped me) this afternoon.  (I was/am too lazy and preoccupied to go on my own…I hate shopping.)  I am so happy that I went.  I had forgotten what it felt like to be comfortable in clothing.

We are dying to know the sex, but in the midst of crazy clinic schedules (mine and John’s), I was unable to schedule the anatomy scan until 22 weeks.  One of my college roommates (who’s due about a month before me) commented on the up side: imagine how much more developed he/she’s going to be!  So much more human-like!  It’ll be such a trip to compare him/her to our last snapshot at 13 weeks.

My week of night float ended 10 days ago, but I feel like it took me this entire week to recover.  Going into it, I was concerned.  16+-hour shifts don’t sound so bad, but factoring in an hour on each end for commuting, getting a max of six hours of sleep (if I ate in the car both ways) times five days seemed a little daunting given my recent need for more sleep–building organs is tough stuff!  Looking back, though, it was one of my best weeks of med school.

Every night I saw and participated in the most awesome medicine and surgeries.  I was on my feet virtually non-stop, hence these as a result.  I felt like an active participant in the trauma team and in the care of the patients.  Several of our patients made the news.  And we actually successfully resuscitated someone who coded and was brought in with EMS performing chest compressions (for the record, if you require CPR, your chances of making it are only about 4%).  On my last night, we  got so many traumas that we had to close the bay.  Pretty fantastic for me, less so for the poor senior resident on call.  I’m a black cloud.

Also, a bit of a surprise: I like surgery more than internal medicine…kind of by a long shot.  Who would have seen that coming?  Of course, my experience in both is so limited (and I should definitely factor in that the first trimester might have affected my first pass on the wards).  On Monday I start Emergency, and I’m so curious to see how I like it…

I would say the cause is 60% week of 16-hour night float shifts on trauma surgery (where all the shit hits the fan), 30% 17-week fetus wreaking havoc on previously healthy 20-something body, and 10% boring old venous insufficiency.

I recently told John that I didn’t think I was not going to be one of those gorgeous pregnant women who spent their 40 weeks “glowing”–and I know they exist.  Heidi Klum, for example.  She looked pretty fantastic hosting Project Runway at nine months.  Well, comparing myself to Heidi Klum is a recipe for depression on all accounts but, still, I doubt she ever rocked the ankles-the-size-of-her-neck look.

To conclude positively, if this is part of the price of a healthy fetus, of course I’m happy with my 1+ pitting edema.  Now I just need to find socks that don’t cut off circulation.