I am Murphey's Law...

A couple things from today:

I despise:

   - chief complaints of low back pain

   - when people refuse to let me examine them because I'm a female that "looks like I'm 15"

   - grumpy doctors

I love:

   - people that are active participants in improving their health

   - nice secretaries

   - docs that help me learn, rather than already expecting me to know everything (does anyone            ever know everything????

Today was going awesome until I decided to practice my surgitron ( mole removing tool, wire loop-esque) skills on a piece of meat. Doc was in a better mood today after I made him stay 20 mins past his quitting time to see a patient (God forbid). Well he was somewhat pleasant until I broke the stupid surgitron! I shoudl've known, I have such bad luck. I was cutting away...and the thing died!! Of course! As if he doens't already hate me, I made him stay late yesterday, and now I broke an expensive piece of his equipment. Granted, its like 600 years old (as is everything in his building), but it just figures I would be the last one to use it when it craps out. I wouldn't expect anything less...such is the story of my life. Even more awesome is that my eval is sitting on his desk waiting to be filled out!! Eek! 

By far my favorite pics from the Tour!

These are some of the BEST pics of the Tour that I've found so far...i love them! It makes me really want to travel to Europe AND get more serious into cycling and photography...all at the same time! I really need to rediscover my camera and take some shots really soon! Pictures of AZ are coming!

I watched the bachelorette finale tonight....and part of me wants to be all bubbly and girly and really believe that stuff like that really happens....and the other part of me wants to throw up all over the place! It's very fabricated love, mostly fake...but I still watch it and hope that some aspect of that "love" they find is real, maybe. Either way, its good entertainment haha. But in all seriousness, i'm not sure if i'm a total believer of the whole "true love" thing, not yet anyway. I'm sure the bachelorette would've been in "love" with someone else had that guy not gone on the show. Maybe that's just me being my usual cynical self...who knows. I guess i think everything happens for a reason, but that doesn't mean we can't alter outcomes ourselves. 

Anyway, today i realized the difference between a medical student/new doctor and a seasoned doctor. The new doctor/med student will accept appointments at 4:50 pm (day ending at 5:00pm) and stay later with no complaints. The seasoned doctor (or maybe just my preceptor) yells at the stupid student for taking appointments after 4:00pm and refuses to stay a minute after 5:00pm on the dot! Nonetheless, I took the patient and we were done at 5:25...i was not a popular girl today with the staff. But i don't really care...I hope I never get so desensitized to the point where I turn away patients because they take up 15 more minutes of my time than I had planned. Besides, isn't that the whole reason we signed up for this? 

Lazy weekend...boring post

It's sunday afternoon and I've enjoyed a rather relaxed weekend. I should have been more productive I'm sure, but I really wanted to see what being a "couch potato" really felt like. And I have to admit it makes me feel guilty. I've watched a couple movies, gone to bed early, and just basically mimicked what my abbey does all day. It's nice to relax...but I don't think I could ever be a couch potato. One weekend was good enough for me! 

Saw (500) Days of Summer yesterday....loved it!!! It was very creative yet simple and had a great story. There is only one place in Scottsdale that shows independent films so it was really packed. 

I got my bike re-fitted yesterday and what a difference! It feels like a new bike! I ended up not putting my aerobars on the bike because my frame is a weird height for them and unless I buy a new handlebar stem, the aerobars will be too high...bummer. Oh well, i can ride just as good without them, I just really like them. Maybe when I have money i can buy a sweet bike! For now, she does just fine for me. Coach and my dad are really trying to talk me into getting into track racing. I think I"d really love it. I actually might give it a shot come october when coach starts the season back up again. My limiting factor will always be time and money, so we'll see!

This next week is my last week at this FP rotation. I'm very excited to get out of there and be with a doc that enjoys teaching students. I have learned some, but it has been a rather frustrating month. It almost feels like I've been on an extended vacation. 1 more week!

Back to my couch potatoing...

 

"Hey Marvin, can u pass me the brain?"

Autopsy viewings were pretty cool today. I used to want to be a medical examiner when I was in high school. I love the mystery aspect of the job and how you have to solve the puzzle. But after seeing it today and how it all goes down....yea...I would never want that to be my daily job. At first it was a little shocking to see an empty chest just cracked open with organs sitting in a steel bucket the doc just slicing and dicing the liver, or whatever organ he was on. But after the first body, you kind of get used to it. We saw a couple of decomposing bodies and that just adds a whole other element of ghastliness, with the whole rotting flesh smell. They say you get used to it, but I'm pretty sure i don't want to be in any situations where I "get used to" the smell of rotten flesh and death, not so much, thanks. I guess my days of wanting to be Dana Scully from the x-files were a little far fetched lol. I just thought she was so cool and smart...AND her hair looked awesome during all of her autopsies. Knowing me, i'd get dead people blood all over my face cuz i had an itch in my eye haha. It is very interesting, to say the least, how the docs and forensic techs sort of dissociate themselved from the bodies. They joke and laugh and try to guess how people died or make up "alternative endigs" so to speak. And really, its no disrespect to the dead, they just have to find a way to not get bogged down with the death they see everyday. I can imagine if you don't lighten up, you won't make it very long.  

Total today, we saw 2 decomposing bodies that were found in the desert, a suspected drowning, a MVA, and a man found dead in a drop house, suspected overdose. I was actually a little sad, to my own surprise, to see the drowning. It was an old man who looked like he was such a sweet guy. He could've been anybody's grandpa, just went for a swim, but ended up getting tired in the deep end and drowning, really sad. It still is somewhat shocking to see how they just manhandle these bodies around so rough. I guess its the job, but i just kept picturing my grandma or somebody on that table being cut open and eviscerated like that...unfortunately i'm a very visual person lol. I visualize everything, even the bad things. The lighter side of that case was that as  they were making the classic "Y" cut...we saw a "cyst" near the bladder. As the bowels and everything were being removed the tech popped the cyst and it ended up being a penis pump! It was actually pretty entertaining cuz we were all trying to figure out how that exactly works. I guess you work with what you have to lighten the mood of this poor old man who drowned. It was an interesting day that's for sure. Glad I got to go and observe!

In other news, i'm sad lance is in 4th in the tour. I really wanted him to get it this year, but its not over. I just really really hope he comes back. I don't like Contador, he's a little jerk. In my own training news...i'm going to start getting really really serious starting friday. No more every other, when i'm not tired, workouts. I HAVE to make myself run outside, swim more often, and ride like there's no tomorrow. I need to take on the heat and just do it. I know if i don't, i'll just look back and say "i should've done more with the time off I had." Not that I don't have time off...i still work all day everyday, just a short day...like 8 hours...instead of 14 or 15 like i'm going to have here in a couple of months. So no excuses, I have to get in gear!

Makes you wonder about doctors....

So today I had the great opportunity to sit in a required 8-5 meeting of the Arizona board of osteopathic examiners. All I have to say is...wow.  The board basically reviews case complaints against physicians by either patients, other physicians, or anybody else for that matter and determines if action should be taken against the physician, i.e put on probation, suspension, writing letter of concern, etc. It's different than appearing for a malpractice case, this is of no monetary gain/loss to anyone, it's just a BAD thing for a doctor to go through.  We saw cases ranging from physicians over prescribing opiates (maintaining people's addictions), writing narcotics for themselves, poor charting, and my personal favorite, telling patient her shot is not a steroid, but rather it's actually MAGIC. (I just want to mention that this doctor also wears his best jack sparrow costume in to work, lies on the floor on his belly to read patients charts, and wore a suit with sandals and red socks to his meeting before the board today!) So, although some claims were funny, some were unfounded, most of them were scary...really scary.  We're always taught the importance of charting correctly and documenting EVERYTHING but after today...I'm seriously thinking about writing down my patients' outfits at the time of their visit, not really, but almost. It really put in perspective how important being thorough really is. I mean, of course we shouldn't half ass anything when it comes to patients...but it's incredible how much you have to think about as not to miss anything. They always say if you really are attentive and really focusing on the entire patient and the patient's best interest, rather than just thinking about covering yourself...you won't miss anything. But it's almost like you need to find a balance between the two things.  But then again, doctors are human, they make mistakes, and unfortunately unhappy patients these days like to find the smallest thing to file a law suit. So it's kind of daunting right now trying to just learn how to think like a doctor and having to keep the thought in the back of your mind that on any given day, with any given patient, if you forget one thing, if you don't write it down, or even fail to mention it...you can be in trouble. And knowing all of that....there are hundreds of doctors out there just doing a crappy job at caring for people, failing to do even the basics, and just plain being jerks to their patients. It made me really think/worry about all these doctors my family and friends go to.  How do more people not die?!?! I'm afraid of killing a patient just about on a weekly basis, it's crazy the pressure. But i suppose it comes with the territory.  Somebody once told me that if you picture every patient to be your mom, dad, sister, brother, grandmother, etc...and you treat them the way you'd want your family to be treated, you'll be great. I hope so :-)  

And just a tip to my family/friends in the non-medical field: write down EVERYTHING that relates to your healthcare, hold your doctor accountable for giving you the BEST care you can find, ask questions...and don't stop until they are answered. Be that annoying patient who asks too many questions, it's a good thing! Doctors aren't immune to mistakes and after all, it's YOUR life, who better than to know everything about it than you! (ok i'm done preaching now)

K i'm off to enjoy my free sat night on the town in scottsdale! 

p.s. if your doc ever tells u a drug works by magic...RUN!

Make the most of your life!

Our very last patient today was one that I don't think I'll ever forget. She was a 29 y/o female diagnosed with Acute Disseminated Encephalomyelitis (ADEM)....a very very rare demyelinating disease. It's pretty devastating and causes progressive loss of muscle function, cognitive function, hearing, bladder function. But despite her condition, she was so happy with her life and just lit up the room with her spirit I was pretty in awe of her. So as I'm doing a annual physical on her we're talking and I was struck by how much her personality reminded me of my cousin casey that passed away years ago from Lupus. She too was very sick...but she was always so happy and bright that you would never know it.  Despite my patients condition, she was so smart and inspiring. She was very interested in whether or not I had a boyfriend, which was kind of funny. But she went on to tell me that I was very pretty and that I would meet the love of my life if I was just patient. Another thing that really moved me was how her husband cared for her. Like my cousins husband who was always by her side through all her illnesses, my patients husband seemed to be her angel as well.  She walked very slowly with a walker but he carried her to the bathroom and cared for her like she was his most precious possession. Sounds silly, but i really got emotional just seeing them and how it reminded me of casey.  So after she left the office I read her entire chart and just couldn't believe what this woman has been through, and still had a smile on her face. She told me that despite her disease, she was determined to walk alone on her 30th birthday...it meant more to her than anything and she was going to do it, no matter what the doctors said. Although its unlikely, I think she can do it. I only met her once, but she seemed like one of the strongest women I've ever met and I'm very happy I met her. 

Just seeing her and the struggles she goes through just to stand upright really moved me. I was going to take the day off but she made me really see how lucky I am.  I came home, swam, ran, and lifted at the gym. I just know that she would give anything to be able to walk, much less exercise...so that inspires me to get out there and make the most of my abilities and the awesome life I've been blessed with. I and i think we all often forget how lucky we really are. It's good to take a step back and realize that no matter how unfair, difficult, or stressful our lives seem....it can always be worse...and our attitude towards life is extremely powerful. It was a great end to the day and I'm really going to try to  smile through even the toughest times and make the most of my life...like my amazing patient and beautiful Casey.  

Do what you love...

So today we got our scores back from the USMLE step 1 (my first set of boards that I took this summer) and I did not do so hot.  I was going to put off checking my score report for a couple of days just because I know my track record for taking standardized tests....IT SUCKS. I'm willing to bet that I'm the worst test-taker you've ever met, seriously, I am.  I've never known myself to do "well" on any standardized test....even after taking it a couple of times. I used to get very discouraged because I felt like I was dumb and didn't know the material...but after making it to medical school, doing fine in the 1st 2 years of medical school, I think i've proved to myself that i'm not a complete idiot. I JUST CAN'T TAKE STANDARDIZED TESTS!!! It is reallly ridiculous how I can know the material well enough to explain it to other classmates...but still freeze up during the test, or convince myself to change my choice to the wrong answer. Or my favorite, I have a gut feeling of the answer...but of course I pick the choice that i've never heard of for some reason that I will never understand. You'd think that after knowing how terrible of a test taker I am I'd be able to fix it or at least improve it. I thought so too, but after this test score, I don't know what else I can do. I'm pretty convinced that some people are just great test takers, and some just suck at it (like me)...and that its not a useful tool to measure one's knowledge. I appreciate the purpose of the tests but I still think less emphasis should be placed on them. The good thing is that I'm not sure what I got on my COMLEX, the set of boards that matters the most.  But if these tests follow the pattern that is my life, I'll retake them (making my life more complicated) and do fine and just keep on going, like I always do.  I'm not complaining, but nothing in my life has ever gone as planned really or without hard work. I know everyone says "nothing worth doing is easy"...yea, but seriously, can I not work twice as hard as everyone else for once? please? Can I be like normal students and take tests just one time and do ok....too easy, i love to make my life difficult.

So I was pretty upset earlier today and had a hypertensive episode and near anxiety attack (good thing i was in a docs office) that lasted like 10 mins. But then I got a call from a patient that called specifically for me. I'm thinking, "why do they want to talk to me, the student, and not the doctor...weird." I had seen her earlier in the morning for persistent diarrhea related to celiac dx and lab follow up. She was actually an awesome patient because she took such awesome notes and asked all the right questions, really making us (me and doc) explain everything about her dx that she didn't understand. I really like it when patients hold their doctors accountable and basically make us do our job. Not to mention, she's very well informed about all of her health conditions. Anyway, I spent almost 30 mins (i can do this b/c we see very few pts at our clinic) explaining her labs to her and what everything meant. So she was calling me to thank me and pretty much tell me that she really appreciated me taking time to explain things on her level, not being annoyed with her list of questions, and that I was going to be a great doctor. She also told me she didn't quite like the doc (he couldn't answer some of her questions and found her annoying) because he somewhat blew off her questions. 

So after stupidly looking at my exam score at work and getting upset....her call really put things into perspective for me...I must be doing something right. (hopefully)  I can answer every question a patient has about labs and her 5 different diseases...but I can't do well on my boards, i don't get it.  So I'm over being mad about my exam because despite how tough and frustrating things get, whether its stupid exams, crazy patients, ridiculous hours, inconsiderate people...the awesome patients and gratification that I am actually helping people makes it all worthwhile. I know there will always be something to get frustrated/upset about...but as long as we don't lose sight of why we do things in the first place, we won't go wrong. And today, my sweet patient reminded me of why I take tests over and over until I pass, why I sacrifice so much time for studying and, why I've put so many things on hold while in school....medicine and helping people is what I love.  I'm so grateful that she reminded me of that today, it was exactly what I needed.       

So I'm just waiting on my next set of scores, hoping for the best, but somewhat mentally preparing for the worst. I'm doing better at learning to accept things I can't change and move forward. It's kind of cheesy but it really is true that no matter how hard things seem, doing what you love and loving what you do really is a great philosophy. 

p.s. i can't wait for lance to win the tour!

It's been a while!!!!!!

So, It's been over a month since my last post...crazy! I have been crazy the past few weeks. I took boards (hopefully passed), got completely settled into the Arizona life, and I've started my first rotation as a third year medical student! 

I LOVE it here! It is HOT, today it got up to 116, but i'm not complaining. I am meeting tons of people, getting some awesome riding in with Team Strada, swimming like crazy and really getting in to the best shape of my life. I'm finally acclimating to the dry heat and my lungs don't feel like they're going to explode anymore after 3 miles. 

I'm working in a Family practice clinic this month in Mesa. It's been somewhat interesting this first week for several reasons. My doc is one of those docs that is very old school (he's like 75) and isn't really keen on change. He's a good doctor, but he's also doing things the same way they were done 30 years ago when he started practicing. So, I've been struggling to find my grove with him and really get a great experience out of it. The awesome thing is that 80% of the people we see are spanish speaking only. Awesome because I get to practice my spanish a lot, which is a big reason I came out here. But aside from the spanish, i'm working with my admin to possibly get switched. I'm really not getting the experience I should be getting as a 3rd year student in this clinic. So I'm trying to learn as much as I can without getting frustrated. After all, I'm with another guy at another clinic in 3 weeks. 

Although I'm not really practicing my physical doctor skills really yet, I have learned a lot about people. When I say people, I'm talking about the low income population of patients that we see. Most of the people are at least well informed about their health and are actively trying to remain healthy or get healthier. But a small percentage just don't care. Most of the time, they only come see us because they hurt and want meds. No matter how many times you tell them that a pill won't fix the pain, the only thing that will make them better is a complete life style change, they don't listen. They don't want to listen. I was surprised by the number of patients that don't listen to anything we say, they just want to walk out of the office with some form of prescription, for anything because they think it will fix their problem. Of course not all are that way, but a larger number than I was expecting. I've had to tell patients that they might as well save themselves the copay if they're not willing to listen and try to understand what the docs are really saying to them. Of course I'm compassionate and try to see their side and realize how difficult it is...but some patients admit they just want pills. Not even narcotics, its a psychological thing. They feel they will actually get better with a pill, even if we both know it won't help them much. I'm quickly learning that people think differently when they get "sick".  Maybe its the way the healthcare system works in this country and the expectations put on doctors and medicine. But it is something I don't think we'll ever understand. People are funny, weird, mean, awesome, rude, and then some. Sometimes you just have to laugh to stop yourself from going crazy trying to keep up with all of them.

But I'm def enjoying life right now and working out a ton to balance out the crazies at work :-)