anna in med school

I don’t need an alarm clock anymore.  Starting around 5:20am, I hear her chanting, “Ahhhh, dada, dah-dadada,” through the monitor.  She entertains herself for 10-15 minutes, but I know to rescue her while she’s still happy, just after I’ve splashed some water on my face, gotten dressed, and turned the coffee machine on, because our little crawler (in our death trap of a house) will hardly let me do any of the above once I’ve extracted her from her crib.  These days, I find her sitting upright in her crib in expectation, flapping her arms excitedly as the door to “her room” (our study) creeks open.

“She’s got blue eyes deep like the sea that roll back when she’s laughing at me…” (Plain White T’s, our cheesy-as-all-get-out morning jam…whatever works, right?)

Apologies for the radio silence.  I’ve been getting into a tricky new routine: medical boards prep (USMLE Step 1).  I’ve been trying to use Ari’s daycare hours as distinct time-markers for studying but, today being my eighth day of studying, I have yet to complete my scheduled topics of review/reading/study questions in that time period…or any time, for that matter.  And my poor girl has been the first to arrive and the last to leave daycare for several days, then she returns utterly exhausted, falling asleep in her highchair as she smashes a slice of avocado onto her tongue and the left side of her face.  We haven’t quite hit our stride.

One physician who spoke to us at orientation to med school, God, almost three years ago, said that it took him until just recently in his career to not feel like a total fraud.  It was a relief to hear that, but it didn’t make me any less convinced that, no really, I am a fraud; I’m not really supposed to be here.  The funny thing is, I also considered that maybe 80, 90% of my classmates felt similarly.  Med school is hard and, in large part, it’s the intense fear of failure that keeps even the smartest, most outwardly confident among us going.  At least that’s my impression.

I don’t believe it even has that much to do with us not feeling like we’ll be capable physicians, when the time comes.  It’s more the constant struggle of learning test nuances so that you pick the right answer when two (or three) of the answers truly seem like “the next best step” (because, come on, in an emergency, wouldn’t they all be happening simultaneously?).  It’s the anxiety of guessing exactly how much detail this attending you’re only just meeting will want in your patient presentations, the first impression likely being the only one he’ll remember.  Oh, unless you cry during rounds after vomiting in a patient’s bathroom while trying to conceal a pregnancy–he’ll remember that too.

I’m being circumstantial.  To the point: I feel like I owe it to myself to do well on this exam.  And I’m willing to try unconventional solutions in order to go into the boards feeling, knowing that I’m gonna kick the shit out of it.  Right now I’m experimenting with body language.  It’s fascinating.  I know it’s different than an interview setting, but I find myself placing my hands on my neck frequently as I churn through the question bank.  Wouldn’t it be a fun experiment to treat the test almost like an interview, presenting myself as confident, creative, and capable?

And an Aurelia update: the summer solstice is her new favorite holiday.  Cool, dewy grass and crisp, sweet watermelon–does it get any better?

Such a daddy’s girl already!

I know the video’s a bit longer than I like to post.  Feel free to scoot ahead to my favorite part around second 19 when Ari goes, “Kee!” in excitement and you can see a little positive Babinski action in her right foot, a quick flex of her right fingers, followed by a soft, elated giggle.

No surprise about John’s favorite part, starting shortly  after second 34…my heart melts to watch her so adoringly stroke his hair.

Currently memorizing:

• Amok: sudden, unprovoked outbursts of violence of which the person has no recollection; person often commits suicide afterwards (Malaysia).
• Brain fag: headache, fatigue, and visual disturbances in male students (Africa).
• Dhat: anxiety regarding the discharge of semen (India).
• Taijin-kyofusho: belief that one’s body is offensive to others (Japan).
• Koro: sudden (as opposed to insidious?) anxiety that the penis (or vulva) will recede into the body and cause death (Malaysia).  NOT to be confused with Kuru, the prion disease of Papua New Guinea transmitted via cannibalism.

Believe it or not, these are some of things I’ll be tested on tomorrow for my LAST SHELF EXAM!  I cannot believe I’m less than 26 hours away from being done with my psychiatry rotation and my core clerkships.

More bizarre is that this is my first full night away from Ari since she was born.  I wonder if this will be the best night sleep ever or if I’m now programmed to wake up at around 2am.  Hoping for a delusion-free night.

Ari is currently in Virginia with her father for Rachel’s graduation from high school!  I cannot believe that the third grader I met when John and I started dating is going to be in college in a couple months.  SO proud of my sister-in-law!

John wins.

Also, no judgment that we’ve shoved our daughter’s crib into the study…one day she’ll have a room of her own, promise.

From the brave and illuminating Elyn Saks (take 14:53 minutes to watch her TED talk):

Someone I’ll call just ‘The Doctor,’ and his whole team of goons swooped down, grabbed me, lifted me out of the chair and slammed me down on a nearby bed with such force that I saw stars. Then they bound both my legs and arms to the metal bed, with thick leather straps.

A sound came out of my mouth that I’d never heard before. Half-groan, half-scream, barely human, and pure terror. Then the sound came again, forced from somewhere deep inside my belly and scraping my throat raw.

This incident resulted in my involuntary hospitalization. One reason the doctors gave for holding me against my will was that I was gravely disabled. Supporting this view, they wrote in my chart that I was not able to do my Yale Law School homework. I wonder what that meant for most of the rest of New Haven.

During the next year, I would spend five months in psychiatric hospitals on the East Coast. At times, I spent up to 20 hours a day in restraints — hands tied, hands and feet tied down, hands and feet tied down with a net tied tightly across my chest. I never struck anyone, I never harmed anyone, I never made any direct threats to anyone.

I was lucky I wasn’t one of the one to three people who die in restraints each week.

Some people still hold [the] view that restraints help psychiatric patients feel safe. I’ve never met a psychiatric patient who agreed.

Today, I am pro-psychiatry and anti-force. I don’t think force is effective as a treatment. And I think using force is a terrible thing to do to another human being with a terrible illness.

Last week I received the email with my score of my neuro shelf, and I got an all too familiar knot in the pit of my stomach.  The score was not outstanding, though also not an embarrassment.  This tends to be where I fall for many exams, which gets to me sometimes.  I think about how much I fixated on scores prior to med school.  And then, more importantly, I think about competency: do my grades reflect the quality of doctor I’ll be?  Medical education is serious business, and it should be taken seriously.  I do take it seriously.  But then I also rationalize that a few points better or worse on a standardized exam probably does not reflect my competency…or am I being flippant?

This was still my internal dialogue as we returned from Nashville for our second wedding weekend in a row.  Despite best intentions, I’m a little stressed about two weekends of studying lost, especially since I study hardly at all during the week with our current Ari-routine.

So I’m trying to focus on the short-term list we have hanging in the study/Ari’s room.  Earlier this year, John and I sat down to create a list of short-term (0-3 years) and a list of long-term goals (3-15 years), which include everything from financial (pay off student loans) to personal (get a dog) to friend/relationship-focused (attend as many beach weeks as possible).  Not far down on the short-term list is: “Attend as many weddings as possible.”  Nowhere is there mention, “Score honors on the neuro and psych shelf exam.”

This weekend, Jess (our friend from John’s med school days, who I look to often for career and parenthood inspiration/advice) could not for the life of her remember her performance on her shelf exams.  While I do not want to wish the time away, I look forward to when this marker of competency/achievement will be a memory I struggle/fail to keep.

To me, this portrait of Ari just screams the advent of the new season: the off-the-shoulder tank; tousled hair; blueberry eyes; flushed cheeks; relaxed lips with the small bead of saliva rolling down her chin.  I look at her and still can’t believe I get to keep her!

Oh little girl, how quickly you go from happily being scanned through security to full-on meltdown in daddy’s arms.

We cannot blame you.  We’ve put you through some serious travel in your first 7.5 months.  We understand your resistance to sleep when there is so much new stuff surrounding you.  Our friends Jess and Matt–Callie’s parents, the ones who generously let us stay with them in Nashville and allowed you access to every last berry and sausage in the house–call this phenomenon “FOMO” (Fear of Missing Out).  You suffer from it acutely, my love.

Then again, you might just be missing your new friends.  We do too.