tnqd

The "Why Can't I?" Mentality

When I first applied to my medical school I called them and asked if I could simultaneously do an MPH and MD degree.  I was told “No.”  Within 6 months I was enrolled in both the MPH and MD programs.

I always hear friends, family and peers saying things like “I wish I could do x,” or “I could never be good at y.”  Those types of statements confuse me.  I often wish I could do x or be better at y too, but then I follow that up with a critical question:

“Why can’t I?”

I think in almost every situation that is an honest question to ask.  You may not like the answer, but you should always ask the question.  For example, I sometimes wish I could be in the NBA.  Then I ask, “why can’t I?” and the answer becomes clear - because I am 5'8" and a terrible shooter.  Had I began practicing at the age of 5 the situation might be different, but no amount of practice now (at 26) could get me to the point I could be in the NBA.  That’s ok; that’s called being a realist.

But let’s go back to my original example.  I was told I couldn’t be simultaneously enrolled in both the MPH and MD programs at my school, so naturally I asked, “why can’t I?”  I went through many scenarios: I could fail at one, I could fail at both, etc.  But really those weren’t reasons I couldn’t do it, they were fears.  Could they kick me out of medical school?  If I failed all of my classes yes, but that wasn’t likely to happen.  Certainly they couldn’t kick me out just for enrolling in more classes.  So I tested the waters, got through my first semester of medical school and decided I probably could handle double enrollment. 

If I hadn’t thought to ask “why can’t I?” I never would have dual enrolled and I would have missed out on a lot of opportunities.  This question has led to a lot of successes in my life.  "Why can’t I start a blog for pre-med and medical students?“  "Why can’t I serve on my state medical society’s reference committee?”  "Why can’t I publish an opinion piece in a medical journal?“

This may be the single most important question I have ever asked.

Like I said, sometimes you come up against a real reason you can’t pursue or succeed at what you want.  "Why can’t I fly?”  Well because you don’t have physiologic properties that allow you to do so.  "Why can’t I ride across my state on a bike?“  To that question there may not be a good answer, which is why I rode 500+ miles across my state a couple summers back.  

My point is this: most people quit before they think about trying, let alone before they try.  Many people are content to be corralled by the limitations their peers place on them.  Even more people are corralled by the limitations they place on themselves.  You probably can’t cure cancer.  But you can make a living being an artist, pursue a second career, run a marathon, become a great doctor, etc.

What ever you want to do, just ask, "why can’t I?”

You may be pleasantly surprised at the answer.

-TNQD

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If the road to being a doctor were a disney musical….

The Untold Life of a Med Student

It’s 6:30.  I have eaten dinner – a microwavable meal – and have half a pot of coffee to get me through the night.  I have been up since about 6 am studying, with bouts of lecture punctuating my day.  I will study until roughly midnight, go to bed, then do it all again tomorrow.

This is my life.  This is the glamour of being a 2nd year med student. 

Some days it really sucks.

I recently caught up with a buddy who goes to another medical school.  We talked about our experiences and the perception people have when they learn we are in medical school.  Non-medical personal might as well be the muggles of our world.  They look in with curiosity and the assumption that, like Grey’s Anatomy, my life is awash in beautiful women, drama, and the type of lifelong friendships one always dreams of.  Unfortunately that couldn’t be further from the truth.  Right now most of my life is spent reading medical texts.

The constant studying would be forgivable if we only studied the interesting parts of medicine.  But on this particular night I have spent an hour reading about different types of transfusion reactions.  Before that I dove into the intricacies of different psychiatric medications, teasing out which double as sedatives, which help with neuropathic pains, and which I can use for an incontinent patient.  The truth is that a good portion of medicine is, well… boring.  Unfortunately most diseases we learn about are not House-like medical mysteries.   

What about the patients I do get to see?  They are far from the idealized patients displayed on T.V.  Many are elderly or in poor health with multiple comorbid conditions.  For every rare presentation there are 20 pneumonias, 15 heart failures, and 10 COPDs (that is probably an understatement).  On T.V. patients appear composed; in real life they are likely to have multiple orifices with fluids coming out.  Needless to say, most patients do not appear like they just got done with their Glamour Shots.  

I love medicine, I honestly and truly do.  But sometimes I hate how much it controls my life.  I have a stack of books that are awaiting my attention, half written stories that need to be finished, and tons of bicycling adventures needing to be had.  Not to mention all of the travel opportunities, friends and family that have been neglected over the last years.       

I don’t mean to complain.  I am extremely lucky to be where I am.  I really do feel fortunate to be on a career path I love, especially when so many don’t end up in medical school.  But sometimes I am frustrated by the completely inaccurate portrayal of medicine.  I feel like these unfortunate stereotypes are only getting worse as people see healthcare costs rising and vilify doctors as the cause.  Half of my Thanksgiving was spent justifying a system that I am not even a part of yet.  

In all honesty, being a doctor isn’t like what’s on T.V.  It is hard work, day in and day out, as is the road to get there.  But for every complaint above there are ten more reasons that I love it.  I am proud to be on this road and I can’t wait to one day help patients.  This is a rewarding path filled with excitement and daily revelations.  

But I’ll be damned if it doesn’t suck sometimes.

Caring for Refugee Populations: A PMTH Monday Morning Report by TNQD

*Clears throat*

Is this thing on? Can you hear me? Fantastic. Oh by the way, y'all may want to steer clear of those donuts in the back…we just had the local Krispy Kreme manager admitted to the ID ward with a nasty case of mystery gastroenteritis.

As part of PMTH’s commitment to turning you young whippersnappers into worldly and empathetic docs, I recently petitioned Dr. Wayfaring and Dr. Cranquis with a “cultural immersion” educational program, which might have involved kidnapping all the interns and med students whilst they slept in the on call rooms and then air dropping them into the middle of a developing country.

However, our legal department had a few very miniscule qualms with that plan….

So instead we’re just going to have a brief chat this morning on global health and caring for refugee populations!

Most refugees arriving in the U.S. hail from Cuba, the former USSR, Somalia, former Yugoslavia and Burma (according to 2000-2009 data from the Office of Refugee Resettlement) and typically settle in locations where there either already is an established community of refugees with common cultural and/or national background or where refugee ministries and services are located. In the past decade, over 600,000 refugees from over 60 different countries have immigrated to the U.S. (Eckstein 2011). 

So by a show of hands who out there remembers their first few days at PMTH? Were you a bit confused? Did you lose your way in the hallways and end up in the pillowfort? Was it obnoxious to have mounds upon mounds of paperwork to fill out before you were allowed within 500 feet of a patient? (for liability purposes, of course). Now imagine being in a new country, possibly not speaking the language, now having to enter the halls of a hospital like PMTH (sans pillowfort and donuts) with your sick kiddo in tow and trying to find somebody to help you (who probably won’t understand you or may even look at you funny). Sounds kinda scary if you ask me. 

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First Week of Med School Nearly Complete!

I feel like I’m just poking my head out of the fox hole to glance around at the outside world for a moment. I wanted to give you guys an update on how things are going, but I’m pretty overwhelmed at the moment. Once I get into a solid studying pattern and schedule I’ll hopefully have more time to blog about life as a M1. They certainly waste no time. At orientation, one of our anatomy professors told us not to worry, we were only already 2 weeks behind on studying at the outset of the semester. We thought he was kidding. For the past 4 days I’ve done nothing but go to class, study, eat, shower, and sleep. Studying in groups has helped since you definitely need to be around other people who understand this lifestyle in order to commiserate and get through. The M2s say it gets easier, and I’m hoping they’re right, because anatomy lab is rough. The smell is the worst, and it clings to you all day, sometimes even after showering. We have a 200+ lbs. cadaver that we’re rolling back and forth every day…that hurts your shoulders and back at the end of lab, which are suffering enough abuse from hauling your life (text books, Netters atlas, iPad, 20 snacks for the formaldehyde munchies, various chargers, notebooks, markers, water bottle, wallet, etc.) around with you in a bag all day. Also yesterday I had to be the lead dissector on our lady’s face/neck when looking for the brachial plexus and a bunch of other nerves above the clavicle, so that was a little shiver-inducing. Eventually you learn to distance yourself I guess.

The first day was by far the worst in lab since our cadaver seemed so, well, human. She has pastel pink toe nails and underwent a unilateral mastectomy sometime in the past. Our group calls her Lucy to remind us that she once had a name, and loved ones, and should be treated with respect and care. Sometimes when I’m near hurling and feel disgusted about what we’re doing, I try to remember what our professor said: “This is what they wanted and chose to do with their earthly remains. They want you to learn from them so you can save others. Make their selfless sacrifice worth it.” And I thank her. Not verbally but I just think, “Thank you, Lucy.” And I try to make sure she’s covered properly. The other day I brushed a bunch of flecks of fascia from her hair before re-covering her head. I felt like it was the least that I could do for her, after all she is doing for us.

All Good Things...

I am writing to say goodbye.

Almost 3 years ago I started this blog with no idea what it would turn in to.  Since then I have shared some of my greatest victories and toughest losses.  But due to life circumstances my reign as TNQD is coming to an end.

Don’t worry though, TheNotQuiteDoctor is not going anywhere.  As a blog this will continue.  In fact, the last few months I have been gathering writers to contribute.  It is their hard work that has kept this blog afloat.  Upon my request, one has offered to take my spot.  She will be the next iteration of TNQD and serve as a source of pre-med/med wisdom.  She, and the other writers who have been contributing, will ensure that this blog lives on. 

My life has gotten more complex in the last year as I have begun writing for news outlets and larger medical blogs.  My research has been advancing and I am being pulled into larger projects.  Plus the ever present step 1 looms over all that I do.  This all has happened while I continue to balance being a medical student and graduate student.  There are times in life where you reach your limits - and this is mine.

This also feels like a natural time for me to step down.  I have overcome many of the problems I came here to vent about.  My love life seems in perfect order.  I am satisfied with my schoolwork and I have been exercising regularly.  I honestly feel happy, healthy, and balanced.    

My replacement will be transitioning into the blog throughout March (more likely closer to the end, and I will be around until then).  I know you will show her the same kindness you have shown me.  We have created a supportive community here, for students of all fields and all walks of life.  I sincerely hope you continue to participate and grow this blog in the years to come.

Thank you all for all the support you have given me.  Honestly, you, my faithful readers, have provided some of the kindest words and sincerest well wishes.  I am thankful for each of you.  

All the best in everything you do,

TNQD

What Med School Isn't

Insights from a second week med student

You’re here.  It’s everything you’ve wanted for the past four years (or more).  Now what?  Isn’t there an aura that should be following me around?  When do people call me doctor?  When do I get to save lives?  Most importantly where is the cool musical montage of me studying and acing the exam?

Unfortunately those things aren’t what happens when you start medical school.

So what does happen?

Everything you have ever heard about from your med school/doctor friends.  You know those times they said it would be more information than you’ve ever experienced?  I bet you were like me and brushed it off.  "Pshh, I’m a studying machine, I can handle some tough classes.“  Or how about those times you were told about how broke you would be, and how scary it is signing for so many loans.  "How could that be scary?  I will be making bank some day.”

Well let me burst your pre-med bubbles: the information comes at you faster than Usain Bolt running the 100 meter.  It’s like learning to swim in the kiddie pool and then being dropped in the ocean.  It’s all of undergrad biochem in 5 lectures and half histology in two, at least that’s what my last week has been like.     

Med school isn’t glamorous like you imagine.  It’s late nights and rice for every meal.  It’s copious amounts of coffee and losing your social life.  It’s self-doubt and fear.  It’s everything you’ve trained for.

It’s amazing.

Med school is bonding with people in a way you never expected.  It’s gratification from a job well done.  It’s falling asleep knowing you accomplished something.  It’s learning in a way you never knew you could.

Medical school will never be what you hope and believe it is.  But I promise it will be exactly what you need.

At least that’s what I have concluded in the last two weeks.