anna in med school

My friend was kind enough to send this TED talk out, and I’ve been reposting it on facebook walls, pasting it in emails ever since.  It simply rings true.

This spring I had a conversation with a close girlfriend of mine who is also a new mother.  We were discussing the first few months, and she responded to something I had said about the difficulties, “But you were so lonely and unhappy.  I never experienced any of that.”  Immediately I felt shut down.  This woman is supportive, sensitive, and kind, and I’m sure her words wouldn’t have troubled me if I hadn’t been already so self-conscious of my feelings of isolation, the feelings I was never supposed to have.  New mothers are supposed to be elated, joyful, and so connected–but 58% of mothers report feelings of loneliness.

For my part, my isolation was not due to lack of support.  Sure, we don’t live near family, but we were fortunate to have many make the trek to visit us, to check in, to bring food.  My classmates in the city were generous, very consistently checking up on things in the middle of their own very chaotic schedules.  And a neighbor, with whom I hadn’t exchanged more than a few sentences prior to the birth of my daughter, left me all her contact information right before Hurricane Sandy hit, so that I and the one-week-old Ari could easily reach out for what we needed while John was at work.  I think it’s just normal, and very much okay, especially while we’re still struggling to find solutions like Jholabhari in India.

And I love Rufus and Alisa’s manner of speaking/presenting.  I would really like to learn how to come off as so articulate, yet also casual, funny, and genuinely sincere.

Looks like 13 months of parenting has bought me a half page of step 2 knowledge.  Just 485.5 more pages to embed on my brain…

On a more positive note, getting to the peds section of First Aid for USMLE Step 2 CK is getting me way excited to start electives and my peds sub-i this winter.  I’m already fretting over the days when I won’t see the babe, but I could not be more thankful for the education/work to which I am returning.

It’s been over five months since she mastered “dadda.”  Since then there have been many moments when she so lovingly gazes into John’s face and repeats the name appropriately toward him, over and over.  It’s like 94% adorable/6% heartbreaking when, after being coached “mmma-mma” repeatedly by friends and family, Ari gleefully smiles and says knowingly, “DADADADA!”

John’s tried to console me: “Honey, when she’s really upset, she calls for you.”  Yeah, but that’s the remnants of a muffled sob; I feel like we’re grasping at any potential m’s coming out of her.

But this weekend she has been all about the “mamamamamamama,” babbling constantly.  I know it’s not real, but it feels so good.  And it just took John leaving us for nine days!  (Oh John, please come home.)

Next up: reading to my daughter.  It’s been something to which I’ve looked forward since I think my dad first read me the Boxcar Children series.  But while she’s found books mildly entertaining, Aurelia mostly prefers eating (destroying) them, and they definitely haven’t made it into any family rituals.

Now I think she’s starting to get it, maybe having a little more patience with the pattern and rhythm required of even the simplest book.  Ari’s been clumsily clutching a book half in her mouth, half in one of her little paws, and climbing into my lap for me to read to her.  LOVE it!  Her favorite right now is Wet Pet, Dry Pet, especially the page with the fuzzy blue-haired pet–I’m starting to learn a lot of the rhymes by heart (oh that they don’t push out of Ranson’s criteria for acute pancreatitis that I just attempted to ingrain).

A few snaps of our girls weekend, first out for a walk with Melissa and Ellie, then at brunch with Ellen and Allison:

That’s the face of a pumpkin donut-induced coma.

So, if you’re a parent out there (or really a roommate, partner, someone who helps care for someone else), when did you stop feeling like a total baller every time you successfully leave the house?  Because my child is almost 13 months old, and I am still pretty damn pleased with myself if we both leave the house in one piece.

Yesterday was one of those days that I actually prepped for the night before (maybe something I should make a habit).  I had everything ready by the front door: my backpack with my study materials + manuscript draft (I had a meeting with a professor with whom I’m doing research) + bioethics assignments; a diaper bag complete with extra diapers, change of clothes, sippy cup, afternoon snack, pajamas; a bag for daycare with the requested diaper cream; a bottle of wine and some cookies for my friend who was kind enough to sit for the little one after daycare so I could go to class.  I even scrounged around for some old train tokens and threw them in my backpack.

Aurelia was up by six and we made it out of the house by seven.  I even put on make-up and managed to pick up most of the oatmeal that she threw around the kitchen.  The radio in the car said that there would be rain in the afternoon–an umbrella was already under my seat.  I left Ari happily playing at daycare, sped off to the train station, and got to school 40 minutes later.  Things were awesome.  I was on top of my shit.

I stopped in a 7-eleven to use the ATM so I could buy train fare for the return trip.  I opened up my backpack: no wallet.  It would be in the diaper bag, parked at the train station.  Hunh.  And I was starting to get hungry.

Change of plan: went to Starbucks instead of the library so I could take advantage of the $6.11 I had on my Starbucks card app.  Then I took advantage of the overly kind, overly generous Eric, who insisted on biking over to give me tokens + a little extra cash for safety.  God, it’s good to be friend with kind people..

After my meeting, I rushed back in time to get Ari from daycare and swing her over to Steph’s house (her children said she was their adopted cousin–love!).  Unfortunately, it was snack time at daycare, but I was already going to be late for class.  As soon as I unclipped the table from Ari’s chair, she let out a tortured scream and did not relent until I gave her the special snack I had packed for her the night before.  Not sure how the parenting fail and win balance out in this case.  Luckily, she was completely back toward the angelic side of the spectrum by the time we reached Steph’s, and enjoyed being doted on by her three older “cousins.”

I trudged back into the city, strolled clumsily jogged into class less than five minutes late.  We were discussing portrayals of Alzheimer’s in television media.

On my way to pick up Ari, as I turned left onto Steph’s street, I felt a huge wave of appreciation: for the trouble some people will go to so that my day can simply resume as planned; for the many times families have welcomed my daughter into their homes with open arms so I can be a student; for starting to have friends in my neighborhood and having a life in the suburbs, as opposed to being isolated from my life in the city.  My thanks was only magnified when I entered Steph’s house to find an exceedingly happy Ari, who was fed, bathed, and in her pajamas.

Getting ready for the day ahead:

Let’s be real, I don’t hold a candle to John when it comes to bathtime shenanigans.  I can tell she’s disappointed.  She tolerates me.  Trust me, she’s way more exuberant when John’s the bath administrator.

John’s been not so gently urging me to send him pictures multiple times a day while he’s away, and everyday proves more challenging.  Our girl is literally never still, and I almost get dizzy watching my iPhone continually refocus.  I’m happy to have a few snaps of her clearly smiling, as opposed to blinking in a weird way that makes her look mildly intoxicated.

Day three of step 2 studying was frustrating, but leaps and bounds better step 1.  I’m trying not to stress (trying).  Studying is broken up by papers that still need writing (one of which might have been “due” yesterday), but still going slower than anticipated.  You would have thought that, by my 30th birthday (coming up), I would be able to better estimate the time required to complete a task.  Unlikely.  I’m on page 75 of over 500 in First Aid, and I can’t tell you much about what I’ve read so far in this slightly glorified outline of the clinics greatest hits.

I really rely on bathtime to make the day better.

The last two months have been blissful!  I’m a full-time mom and part-time student.  I have class two evenings a week when I venture into the city by myself and get to discuss and debate with fellow med students, physicians, professors, lawyers, nurses, other grad students–makes me feel like a grown up.  I even dress pretty (by comparison).  Aurelia’s in daycare twice a week so I can work and she can play and learn with friends her own size.  She absolutely loves it–starts panting when she sees the purple door!

Then I’m with my daughter for five days without guilt about the work I’m not doing.  I keep comparing it to my time with her in the first few months.  I was trying to get a paper published and, though I loved having something else to think about, I should have just hired a sometimes babysitter months before I did.  Trying to get work done in 10- to 20-minute increments is not a happy way to work, and it kind of made me feel like I was failing on both mom and med student fronts.  In summary, life now is better.

That all changes tomorrow.  Ari goes back to daycare full-time so I can study for step 2 of the boards.  We’re both ready, but I’ll miss this time with her.  It’s been a good balance of the things I love.  But this preparation for step 2 I think will be an needed ramp-up for when I start back full-time at school in January, a commitment that spans beyond daycare hours (yeah…we’ll be looking for a babysitter from 5am-7:30am; let me know if you know anyone who might be interested!).

To add twist to this turn of plot, John is leaving town for the next nine days.  Bah, Dallas, bah!  On the one hand, I actually feel like my work load is lessened a bit when John’s away, since I don’t spend very much effort on things like dinner (Ari and I are pleased as punch to just have paleo pancakes, thanks).  But I miss him already, and I know Aurelia will be a little crushed when she intently whispers “Da!  Dada!” as we round the corner to the bedroom, and he’s not there.  Wish us luck!

I admit it.  I go online and see blogs and facebook pictures of folks making full-out dragon costumes (probably with some device to let their children really breath fire), and I get in a little tizzy about what I might be able to sew together with the old surgical suture kits I stole on the wards.  And then I remember: Aurelia is one, and she’s not reading these blogs.  She screams bloody murder when I try to slip a onesie over her head, do you think she’s going to let me stuff her into an overly hot, itchy costume?  (To the moms and dads out there who effortlessly throw together said costumes without breaking a sweat [and the babies who are chill enough to tolerate them], seriously, more power to you!  And thank you–it’s a delight to see all the cute little critters out on Halloween!)

Oh. My. Goodness.  I know I’m biased, but I think my daughter makes the sweetest Harry Potter.  And the costume was made all the easier because one of my best friends did all the legwork (thank you so much, Aunt Kathleen!).  And the costume was comfortable!  When she’s older and cares, I’ll let her make herself slightly miserable by wearing something impractical but trendy.  For now, I’m grateful for the cozy Gryffindor leggings that she’ll sport throughout the winter.

Mischief Managed!  Happy Halloween!

Kind of loving this article maybe more than I should.  Whenever we had lectures on nutrition and health management in med school, it was always a little mirky because, in the past, the medical profession has been pretty poor at pinpointing exactly what foods help you maintain/improve health (yeah, turns out that mimicking the healthy Asian population by eating low-fat, high-carb isn’t the best diet).

And of course, there are so many measurements beyond pounds, waistlines, and cholesterol–it’s tough to get a good assessment of health.  John and I are currently on week three of the Paleo Challenge at our crossfit box (made considerably more easy by the fact that I can indulge with brownies and nutella).  I like the lifestyle, but the one thing I can’t get behind is the encouragement that we get pre- and post-challenge blood work, which includes such measurements as c-reactive protein, a non-specific measure of inflammation.  Any change made by the challenge seems arbitrary, but what do I know, right?

This short piece succinctly summarizes with a pop culture twist a lot of what I’ve learned.  My favorite debunked myth is rightfully number 1; makes me feel better about consuming 3-4 eggs daily and feeding my daughter an over-easy (which she promptly destroys/devours) every morning:

kathleen and isaac’s chickens’ eggs

1. Eggs Are Bad For Your Health

Eggs are so incredibly nutritious that they’re often called “nature’s multivitamin.”

The nutrients in them are enough to turn a single cell into an entire baby chicken.

However, eggs have been demonized in the past because they contain a large amount of cholesterol, which was believed to increase the risk of heart disease.

But the truth is that despite being high in cholesterol, eggs don’t really raise the bad cholesterol in the blood. In fact, eggs primarily raise the “good” cholesterol (1, 2, 3, 4).

Despite all the warnings about eggs in the past few decades, studies show that they are NOT associated with heart disease (5, 6, 7).

If anything, eggs are pretty much a perfect food for humans. They’re loaded with protein, healthy fats, vitamins, minerals and unique antioxidants that protect the eyes (8, 9).

They are also an excellent source of Choline, a nutrient that is very important for the health of the brain and about 90% of people aren’t getting enough of (10, 11).

Despite being a “high fat” food, eating eggs for breakfast is proven to cause significant weight loss compared to a breakfast of bagels (12, 13).

Bottom Line: Eggs are among the most nutritious foods on the planet and do not raise your risk of heart disease. Eggs for breakfast can help you lose weight.

In our psych rotation, we have the option of getting out of a weekend call by engaging in a quick book club.  We read a book chosen by the clerkship director, then get together with a handful of psych interns to discuss it over pizza.  I don’t know the details, but the book club was started shortly after an intern at Penn committed suicide for unknown reasons.  This collective reading and discussion serves many purposes: it sheds light on mental illness, something that we as a society are painfully poor at acknowledging; it gives that illness a face, not so unlike you or me, or those we hold dear; it allows us to appreciate what we learn on the wards in a different forum, thereby deepening our understanding; it recognizes those, like the young intern, who perhaps wasn’t fortunate enough to find comfort and aid, to receive treatment, and calls for us to do better, to not let other colleagues slip through the cracks.

My cohort read Brain on Fire: My Month of Madness by Susannah Cahalan.  Cahalan was in her mid-twenties, an up-and-coming reporter for the New York Post when she developed hallucinations, seizures, behavioral changes, and delusions before entering a catatonic state.  She had been seen by a number of physicians in a variety of specialties, spent weeks in different inpatient units, and when she woke up, strapped to a bed, her head covered in electrodes, she had little memory of any of it.  Through the use of hospital records, a journal kept by her father, and other first-hand accounts, Cahalan pieced together her story.

My colleagues were most disparaging about the last third of so of the book, which Cahalan devotes to describing her recovery.  Many of her critics hold the same complaint: the puzzle had been solved, and she had been “cured”; she spent too many pages going on about her painful and frustrating recovery.  I admit, it wasn’t as gripping, but in many respects I think it was the most important part for me, as a med student, to read.  We’re all health twenty- or thirty-somethings.  Very few of us have had to endure a long recovery, let alone one that involves your mind.  The exciting part of patient care is the diagnosis and finding a treatment that works, not managing side effects and trudging through the long road that we can’t expedite.  It’s important for me to be reminded that the patient’s journey is many times just starting when she’s discharged from the hospital.  And Susannah was one of the lucky ones.  Many don’t fully recover from this kind of brain insult, and some die, even after treatment.

By no means one of her most traumatic moment, but a time that sticks out in my head during her recovery is when she attended a wedding, several months out.  It was to be her big comeback.  She, Susannah, had returned to being the person she once was.  She and her boyfriend would be that cool hipster couple with whom others want to talk.  Sure, she was bloated and swollen from the steroids, her speech and movements weren’t fully back, or even fluid.  But she bought a great new, pink I believe, dress, and got a new haircut.  Only months later, looking at video and photographs, did she realize that she actually looked like a deranged robot, with her mechanical, broken movements on the dance floor.

My heart, I think, skipped a beat when I watched this video.  (Seriously, watch it–your day will be brighter.)  And of course I could not be more proud to get to learn at the same institution as these physician-scientists.  It really is a magical place…

I am not a scientist.  If anything, science is probably my weakest subject, something I’ve really struggled with while being in med school.  My hat is off to my fellow colleagues who possess not only the type of raw talent needed to be leaders in modern medical science (to think, infecting healthy cells with the HIV virus to kill cancer!), but also the passion.  It’s not a glamorous life but, every now and then, you get to do something like this.