anna in med school

I’m the youngest of four siblings and the only one not baptized.  As the story goes, by the time my parents got to me, there was a new minister at the church.  Knowing that my parents didn’t attend, the minister said something to the effect of, “I will baptize this one was long as you promise to raise her in a Christian home and attend church regularly.”  My parents chose instead to keep me as the family heathen.

I was grateful that my parents only ever encouraged me to learn about other religions and attend services with my classmates.  Now with kids of our own, John and I have often talked about how we can give our children access to different faiths so that they can make a choice if they so feel.  There is so much faith can offer humanity.

But could it be okay, beneficial even, to be raised without religion?  This recent article in the LA Times by Phil Zuckerman, a professor of sociology and secular studies at Pitzer College, makes some interesting observations:

My own ongoing research among secular Americans — as well as that of a handful of other social scientists who have only recently turned their gaze on secular culture — confirms that nonreligious family life is replete with its own sustaining moral values and enriching ethical precepts.  Chief among those: rational problem solving, personal autonomy, independence of thought, avoidance of corporal punishment, a spirit of “questioning everything” and, far above all, empathy.

*****

The results of such secular child-rearing are encouraging.  Studies have found that secular teenagers are far less likely to care what the “cool kids” think, or express a need to fit in with them, than their religious peers.  When these teens mature into “godless” adults, they exhibit less racism than their religious counterparts, according to a 2010 Duke University study.  Many psychological studies show that secular grownups tend to be less vengeful, less nationalistic, less militaristic, less authoritarian and more tolerant, on average, than religious adults.

As for my so-far secular children, today had its ups and downs.  They’re both stuffy and congested enough to make sleep mildly miserable, with low-grade fevers that make them more likely to throw a tantrum if given the wrong “special fork” to eat breakfast chickpeas (why not?).  So this afternoon we stayed in and used all the stickers.  (Yes, that is my infant daughter playing with a pipe cleaner…*sigh*)

When asked what color Valentine she wanted to make for Daddy, Ari replied with conviction, “Black,” grabbed a piece of construction paper, and started sticking.  We eventually compromised on her second choice of yellow (though I noticed her unstick several hearts disgruntledly).  I hate to curtail Ari’s artistic expression, but the prospect of our two-year-old handing John a black heart felt a little morbid.

Happy Valentine’s from our family to yours 🙂

My best friend is a writer.  An excellent writer.  He is one of the screenwriters for “The Slap,” the NBC miniseries that premieres in less than 5 minutes!!

The trailer alone is polarizing, and I admit I’ve already sort of chosen a side…and I cannot wait for this series to tear apart what I think I know, make me question the characters and, in doing so, myself.  This is going to be good!

https://www.youtube.com/watch?v=Ui1YlTPlW_8

Over the last year, I’ve struggled to describe the match, the process by which medical students are assigned a residency position.  I’ve likened it to sorority rush, only it takes many months and thousands of dollars.

A good friend posted this article for me, and I think it provides a helpful explanation of how things roll, in case you’re wondering.  And then, with regards to cost:

The conventional wisdom is that students who list more potential residencies have a better chance at a match, since the lists of students who do match average twice the length of those who don’t.  Students are adding more and more residency programs to their lists; the average number of programs listed by students who ended up with a match has grown to 10.3 from 7.4 over the last decade.  Students can send up to 20 applications for the baseline fee. Many send double that, and can end up going on a dozen interviews, paying for a hotel and flight for each.  The costs add up quickly.  (Sallie Mae, the country’s largest lender of student loans, offers medical students loans up to $20,000 specifically to cover the costs of interviews and relocation in the case of a match.)

These statistics surprise me a little, because I’m not sure I know anyone who applied to fewer than 10 programs (granted, sampling bias).  I know plenty of individuals who, due to academic background, competitiveness of the specialty, or entry into the couples match, have applied to 70+ programs.

Along the application process, I often felt lucky to be going into pediatrics.  Although this year is the first (I believe) where there are more applicants than residency positions (terrifying), the chances of matching are higher than many specialties, as the table in the article above shows.  (I was counseled to apply to 10-15 programs and ended up applying to 12.)  Furthermore, I’d like to stay happily married to the father of my children, so where I applied was geographically limited and I didn’t need to take a dozen flights to the other side of the continent; I certainly saved some money there.

37 days ’til Match Day…sounds actually not so far away now!

* * * * *

On one of our past weekend days, the high temp was tolerable.  In our precarious balance of keeping the kids out of the house as long as possible so John can sleep after a night shift while keeping everyone happy, fed, and well-rested, we lasted a short time at a local playground.  This winter hasn’t been the dirge I feared, but still ready for the days when I don’t have to surprise attack my daughters with Aquaphor.

It’s yellow and big and mostly surrounds her.  In her eyes, it’s basically a flying boat.

Between you and me, I have spent (wasted?) hours (possibly amounting to days) in the last couple weeks reading (fuming) over every single vaccine-related post on my facebook feed, then checking in compulsively to sift through all the comments.  Every now and then–I wish I could pin point what makes me do it–I can’t help it, and I engage.  I try to be respectful; I hope I’m successful.  There have literally been studies showing that I won’t change anyone’s mind, so the least I can do is try not to alienate anyone.

I recently finished Dr. Paul Offit‘s Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases.  I think it should be required reading for any physician who will treat children.  It’s a great read, describing the fascinating history of many modern vaccines, including the recent conflicts regarding their supposed risks.  At this moment, I’m thinking of Offit’s description of parents, when the mumps vaccine was in development, coming out in throngs to sign their kids up for the trials.

I don’t have anything pithy to add to the discussion.  (But if you have any questions or concerns about the safety of thimerosal, thanks to Dr. Offit, I feel adequately prepared to at least begin to address them.)  I wanted to link my most recent favorites in the commentaries:

The succinct prose of Dr. Sanjay Gupta (I’ll admit it–and I don’t think I’m alone here–but he’s kind of a celebrity crush of mine; right up there with Dr. James Hamlin): “The anti-vaccination argument is often snugly wrapped in the “I love my kids” sentiment.  And, I find it, well, a little insulting.  To suggest that anyone who vaccinates their kids doesn’t love them is a whole new level of lunacy.  But here is the fact of the matter, for me.  It’s not just because I love my kids that I vaccinated them — it’s because I love your kids as well.”

This opinion piece by Professor Art Caplan: “That is why medical speech is subject to scrutiny by a doctor’s peers and can be curtailed by state licensing boards.  My home state of New York, for instance, warns doctors that they may not use speech that is ‘false, fraudulent, deceptive, misleading’ or relies on the use of ‘testimonials.’  Violations may be punished by revoking a medical license.  Those whose misinformation leads to harm can be charged by a patient, doctor or other health-care professional; investigated by the medical board; and found guilty by a hearing panel composed of doctors and a member of the public.  I have testified in many court and licensing hearings about physicians who abjure the standard of care for their own pet theories.  Many of them are now ex-doctors.  The vaccine crisis has introduced several worthy candidates — proponents of distrust and dishonesty — for dismissal from the ranks of doctors, and the rules in their states provide the mechanism.”

I wonder how Hamblin would handle a segment on vaccines…

In a taxi:

Felt so crazy unsafe, but also exhilarating!  The first picture almost captures the expression Ari gave me when I first helped her into the cab and asked her to scoot over (Uh, no carseat?  What is this nonsense?).  We had a big, burly cab driver who was also incredibly sweet.  He would gently stop at yellow lights, and he apologized profusely for startling Ari when he honked the horn (“You guys must not be from New York, right?”).

Look mom!  Trying this standing thing with just one hand:

John was out of town anyway, so on Friday afternoon I decided that I would pack up the girls and take a flying trip to NYC the following day.  I considered it practice for our upcoming trip to France, minus the jet lag (which, fingers crossed, will be more manageable because we’ll be two parents-on-two children?).

I had literally just put the pack-n-play in the car and was patting myself on the back for getting us all packed and Evie nursed during one episode of Daniel Tiger, when I got the text from my NYC brother. “Full disclosure, strong possibility M has pink eye…She is on meds.”  Unfortunately, pink eye is often viral, and incredibly contagious.  As John counseled, one or both of our kids would most likely get it if I chose to continue with our travel plans.  The budding pediatrician in me knew going along with the trip was a bad idea.  But the parent in me…I mean, the car was already packed; we were going.  (If my brother had texted, “We have gastro,” I would have had the car unpacked in a New York minute.)

The trip, realistically, could not have gone better.  Sleep over the first night was a complete disaster, but we expected as much, and the next night was 100x better (hope that we might survive the trip to France).  All the kids (mine and my NYC niece and nephew) seemed genuinely so happy, though it was sad to have to police M a little so she didn’t touch other kids (ugh, it sucks–we owe her huge!).  And it just feels good to be with family.  I feel like I need to take advantage of these small road trips before residency, when a two-day weekend becomes the rare coveted “Golden Weekend.”

We braved the cold to visit the Met.  It was fun to think back on our visit almost exactly two years ago, when Ari was little more than 3 months old!  In similar fashion, we also dragged our great friend Kristen into Manhattan…during the super bowl, in a small blizzard no less (lack of pictures due to engagement in adult conversation while trying to prevent Ari from smashing popcorn kernels too deep into my brother’s carpet).

Although we cherish the fort-making potential of all homes, it felt good to return to our own yesterday:

Interviews are over.  CS is *hopefully* behind me.  And now I’m chipping away at papers left to be completed, but also soaking in my time with the girls.  What’s the saying?  The days are long but the years are short?  Trite and true.  Suddenly it’s almost February and Evie is 8+ months old (and I still haven’t lost the last of the baby weight–ugh!).  While I am so excited/anxious for the Match, I know it will be here in a blink, and then residency.

I feel like we’re trying to strike that balance between doing kind of interesting (a snow day trip to the Outside In exhibition), even outlandish (we’re taking the kids to France in a little over three weeks to see my family there!!) adventures, with the seemingly mundane but made slightly magical by the presence of fun-sized humans (a evening walk).  I intended to write a separate post for each of these picture sets but, well, the days blew by.  No other excuse.

The Academy of Natural Sciences (my daughter had no trouble petting a rat, but terrified of small turtles):

(and, yes, those are coffee stains…:/)

Girl after my own heart, willing summer to happen by insisting on wearing her beloved fedora and the thinnest excuse for a jacket imaginable:

Forts!!!  (Cannot seem to get my girls smiling in the same picture.)

One-eye; she reminds me of this dog from Lady and the Tramp:

It’s been seventy years since the liberation of the Auschwitz-Birkenau concentration camp.

My mother was born in 1943 in Czechoslovakia.  She and her family were significantly altered by the war for years, lifetimes even.  I remember as a small child listening to some of her stories in an otherwise quiet, still house–a bedtime routine that would inadvertently turn to questions, which sometimes inevitably unveiled macabre memories.

May we remember, respect the victims and those who fought and continue to fight for the protection of all men, women, and children, and promote peace.

It means preserving places like Auschwitz so people can always see for themselves how hateful ideologies can become tangible acts of murder.  It means sharing and sustaining the testimonies of witnesses so that they can endure for teachers and students around the world their testimonies give to each survivor everlasting life and give to all of us everlasting value. (Steven Spielberg)

Additional images here.

In case you’re wondering how I’m feeling after taking (hopefully, pending a passing score) my last exam of medical school, this picture sums it up:

If only we all wore our enthusiasm so overtly!

It was a long-ish day.  12 standardized patient encounters in rapid fire.  We had 15 minutes to conduct a focused history and physical exam on each patient, then 10 minutes to write the note, including a brief differential and plan.  I actually kind of enjoyed the note-writing part.  Since the time and character limit forced brevity, it was fun to bang out quick, hopefully appropriate differentials without worrying a ton about the quality of writing, as long as the point was conveyed.

And, of course, since many of the encounters were adult patients, it only reinforced my love of pediatrics.

For my last two interviews, I got to stay with my good friend Lisa.  She’s a fellow in pediatric hospital medicine and medical education.  Since day 1, when I first decided I wanted to go into medicine, she has been a tremendous source of support and guidance.  There was a nice symmetry with ending my interview trail (and celebrating that small milestone) with her.

But then there was also this…

On the bus to and from D.C.  While pumping during interview days.  Or, rather pleasantly, nestled at The Coupe.

Tomorrow I take part in this insanely expensive exercise that’s required for me to practice medicine.  I am ready, but I still have random moments of panic when I’ll run down the stairs and bark at John, “What’s that physical exam finding I’m supposed to illicit, you know, for that wrist thing that’s not carpal tunnel??”

If there are any prospective med students, MS1s, MS2s, or MS3s still reading and you’re not too bombarded by so, so much advice…may I?  If I could do this again, I would have scheduled this exam within a month or two of completing clerkships, before diving into mostly pediatric electives and sub-Is.  Don’t get me wrong, it’s been fun to read up on things like giant cell arteritis, which I haven’t given as much thought to in the last year or so, but I think CS would be slightly less stressful if taken fresh out of third-year rotations.  In addition, more and more programs are requiring scores for CS earlier, and this exam is a nightmare to schedule.

To end on a sweet note before I call it a night:

In comparison with her more easy-going sister, Ari has been assigned the role of more temperamental of the sisters.  While probably accurate, I wanted to share just one example of her profound ability to empathize, perhaps to a fault.  Tonight I got Evie down first and Ari and I had a little one-on-one time during our book-bed routine.  She asked to take a book to bed with her.  Fine.  I tucked her in, sang our song, said our goodnights and I-love-yous.  A few minutes later, I wasn’t surprised by the sound of pages turning and a high-pitched voice practicing words.  Then quiet.

After 10 minutes, I heard bloodcurdling, persistent screaming, and I knew immediately what had happened.  When I opened the door, Ari was standing up in her crib, tears in her eyes, pointing at the ground and repeating, “Book fall!  Book fall!”  I hugged her for a moment to console her, repeated her statement so she knew I understood, and assured her that I could get the book back for her.  She then said something else that I had a hard time understanding at first, but when she repeated, it was clearer.  “Sorry, book.”

Oh, sweet one.  Her affect was so similar to what she exhibits when she accidentally (or, let’s be honest, sometimes purposefully) upsets Evie in some way, and she is so quick to apologize.  (For Evie, she’ll apologize for the slightest infraction.  For her parents, forget it.)

And now I really should call it a night…

It’s been a big week!