Time flies when you're [in med school]

At 10am this morning, by handing in my psych self exam, I officially completed my 3rd year of medical school.  I am now 3/4 of the way to my MD!

However, I am also officially taking a year off to do research next year, which means I'm on the 5 year medical school path.  So I guess I'm really just 3/5 of the way to my MD.  I'm really excited about the research I'll be doing and the city I'll be living in.  I'm a bit relived that I now have a little more time, and will have more exposure, before having to faithfully decide on obgyn.  Plus, it is allowing me to feel like I'm doing everything in my power to make up for my [first attempt] failed step 1 score.  I'll never actually know if it'll make a difference in my life path, but at the same time I can't imagine that it'll hurt anything! A year to re-learn spanish, exercise, sleep regular hours, travel, cook/eat healthy, socialize with friends, be close to family, ....  what is not to love?! 

I can't believe it has already been a year since I started on the wards!  A year since I wrote this post.  A year later, I still struggle with empathy, compassion, and time management.  While I still feel like I know nothing, I can also tell that I've become more proficient in presenting patients and writing progress notes.  I am better at answering questions.  I have learned to suture, catch a baby, drive a laproscopic camera, do complete neurological and psychological exams, and so much more.  I am also learning to forgive myself when I make a mistake, make an idiot out of myself, and when I have a visceral emotional response to my surroundings.  One year down on the wards and a life time to go.  Every day I spend with patients, I become more and more excited that this is my life!

Sundowning

According to wikipedia: "sundowning, also known as sundown syndrome, is a syndrome involving the occurrence or increase of one or more abnormal behaviors in a circadian rhythm. Sundowning typically occurs during the late afternoon, evening, and night, hence the name. It occurs in persons with certain forms of dementia and psychosis, such as seen in Alzheimer's disease. Although not widely surveyed, sundowning has been estimated to occur in 45% of persons diagnosed with Alzheimer's disease"

I feel like my current emotions reflect a sundowning effect.  I seem to get more frustrated, more teary, and more depressed as the night wears on.  My guess is it relates to the point in the evening where I used to trade in studying to video chat with the [now ex-]girlfriend.   I have cried more the last few nights then I have over the entire past year combined.  I have even succumb to sending desperation text messages to her before I could think better of it.  Thankfully my lovely roommate has agreed to take my phone away before I belligerently text her again.  My emotions are unyielding as my new reality begins to sink in.  I'm nearly as emotionally liable as my patients on the inpatient, locked, psych ward. 


The hardest paradigm shift to accept relates to my future.  I no longer have a magnetic force pulling me towards residency in a specific geographic location.  I no longer have a built in support system that will accompany me to wherever I happen to match.  It is both a relief and a curse.  It takes some pressure off of the decision to take next year off.  However, I used to be able to tell people that I was hoping for certain residency programs because it would allow my partner to have a job though I also used to worry that I'm not competitive enough for the state she is BARed in.  Now I worry that I wont match in a location with a viable singles community, a community with dating options.  How many cities are there that have large, intellectual, activist, queer, Jewish, communities?  When ever I would freak out about not matching, and ramble about some crazy scenario of scrambling into some super conservative [and boring] location, she would affirmatively respond that "we'll be okay there", "we'll make it work".   I don't know that I can do it on my own.  


At the conference last weekend, when I was asked over and over again where I was hoping to go for residency, I fought back tears while trying to explain that my perspective was recently flipped and I no longer know.  I'm pretty sure that all 1000+ conference participants were exposed to my verbal vomit about recently being dumped.  I sincerely hope that I can pull off a slightly more composed persona at the conference I'm going to this coming weekend, though I'm not holding out much hope.  When my current psych patients respond like I have been, they get dinged for over-sharing and missing social ques.   At least I still have my insight and perspective intact.  I am learning first hand that a very fine line divides the process for accepting a major life change and the diagnosis of a mental illness.

Full circle

Pesach is over.  How did that happen?  I blinked (and cried) and the week flew by.  Clinical duties, studying, break ups, and the rest of life very much got in the way of observing the holiday with true kavaneh this year.  Instead of "next year in Jerusalem", this year I'm saying "next year with more kavenah and ruach."

This weekend I'm presenting at an activist reproductive rights conference. This annual conference is where I got my start.  This is the place where I decided I wanted to be a doctor and an abortion provider and where I learned to be an activist and advocate for the whole complex plethora of women's health issues.  It is somewhat surreal being back here, surrounded by old familiar faces and young bright-eyed budding activists, coming full circle with my roots.  It is also re-energizing.  I'm filling my senses with everything reproductive health related.  Currently I'm fixated on unpacking an amazing workshop I went to this afternoon on "pink boys": how to break down gender binaries in education, how to parent non-conforming children, the importance of media literacy, and so much more.  Hopefully, if I successfully process all that I learned in those 2 hours, I'll be able to post more about. 

In the meantime I'm going to do a few psych questions and then crash for the night.   Life as a medical student: studying trumps all, even when I'm away at a conference, even when I'm reliving my good ol' college days.

And life marches on

Break-ups suck.
Trying to keep it together, so I don't look all teary like my psych patients, is hard.
Life keeps marching on.
Is this a clue that I'm supposed to give up my dreams of having a family to throw myself into medicine entirely?
On the upside, at least my roommate & friends are amazing.

VSAS,

Why do you have to be so confusing?  In this age of technology I would have appreciated an easier, streamlined, and transparent way to apply for audition electives.  Alas, you are overly complicated and frustrating, just like everything else in medical school.

Love,
me

Maybe pathology?

Me to my roommate, while asking questions about psych pharm: "Becoming a doctor is hard." 

What else is new?

Maybe I should go into pathology so I wont have to deal with pharmacology.  I wonder if I could match in path.  Pretty sure I'd fail at proving interest and dedication to the specialty... oh well.

On the upside, day 1 of the psych rotation was very enjoyable!  It should be a good month.