Ob/Gyn.

Ob/Gyn.

  • How did I feel when I got home?

Ugh.

  • Did I feel excited to look up the illnesses and diseases in the patients I was caring for, or to study for the shelf exam? Was there diversity in the conditions being treated?

No. So many no’s.

  • What were the main feelings I encountered while working with the patients? The medical team?

“Why can’t they just push for a couple hours instead of us pushing more Ptocin to speed things along?”

“Why is the team doing a poll on whether Snape was Harry’s father or not?”

“Oh, look- another low transverse incision.”

“Oh, look- another shelf question about a pregnant woman with bleeding. Still no idea.”

  • How much direct patient contact was there? 

So much. Too much vagina.

  • What were the humdrum aspects in the patient population or workflow that would have to be tolerated for the rest of your life?

Oh dear god where do I begin.

  • Does this specialty address one of the leading causes of death in the world?

Probably.

  • How easily can motivational impact be integrated into a career in this specialty?

Meh.

  • Does this specialty focus on preventing problems or fixing problems?

Both, I guess. But truthfully, Ob/Gyn was like nails on a chalkboard to me. It was the first and only rotation I have disliked during medical school so far- and I’m okay with that. Maybe it’s my lack of personal experience with childbirth, differences in personalities with those who chose to pursue the specialty, or maybe a lack of a lot of exposure to newborns as I was growing up. Or, maybe, my soul spirit was in medicine in a past life and my allergy to Ob/Gyn stems from a deeply-rooted fire that spans through time and space. Whatever the reason may be, I am so blissfully okay with plopping Ob/Gyn onto the pile beside Radiology and Pathology of specialties I can safely cross off my list (and possibly burn later).

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Photographic evidence of my one good day on Ob/Gyn.

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Ice Cream Sandwich Socks.

She was the most terrifying surgeon in the hospital.

In an age where white coats were to be worn only by men, she walked fiercely into medicine anyway. She took the sneers and barking from senior physicians but she held her chin held steady. Back then, medicine was not a woman’s game. With each step she climbed, she tacked on another piece of armor and she grew stronger. It toughened and polished her, and she was built into the indestructible surgeon she is famous for today.

I have watched chief resident’s fingers tremble beside her. I have watched fellow surgeons, renowned and respected in their own right, fall silent as she stepped into the room. Scrub nurses, usually bustling and preparing while chatting with the circulator,  stand alert with fingers poised and eyes glued her hands, anticipating her next move. Medical teams in the hospital, young doctors visiting from out of state, senior doctors trailing the end of their careers – they all know her name.

For weeks, we had stood shoulder-to-shoulder in silence as she performed many of the biggest surgeries known to medicine. The infamous Whipple procedure – a grueling 8 hour minimum- was her favorite. Her fingers seamlessly twirled around the surgical instruments, and I longingly watched as she carefully cut open the belly, clamped arteries, and unsheathed the pancreas. I stood perfectly still, often for over 10 hours, with my hands carefully planted on a corner of sterile draping. Others had warned me: “She prefers medical students to simply observe. Whatever you do – don’t grab anything.”

Yet something in me resonated with her. There was the smallest hint of a smile in the corners of her mouth under her mask when her eyes met mine. I recited my patient presentations I had spent hours memorizing for her clinic and could see a flash of approval in her stone cold expression before she spun on her heel to enter the patient’s room. Then one day, she handed me her suture. That day in the OR, I was taught the sacred ritual. She began to signal for me to cut her sutures with the slightest flicker of her fingers. One day, I nearly tripped over my own feet in shock as she stepped back from the operating table and silently waved for me to assist the chief resident in stapling the bowel in half.

She was like no one I have ever met. During my last day on her service, she unwrapped the ice cream sandwich socks I had bought for her and she squeezed the breath out of my ribcage. And I will never forget the words she told me:

“Hailey, you are a surgeon. I can see it in you. Do what you are.”

I remember you.

I remember you were embarrassed but you let me help you anyway. You joked that you could be my mother and I joked that I could just pick you up but you wouldn’t let me you wanted to do yourself you said you could do it you said. Every day you were weaker as you disappeared into the bed around you but your spirit never did, I remember that. You said you could do it and I was right behind you, watching your legs flail under you and your white knuckles on those bars and you scared me half to death so when your legs crumpled and you fell in my arms we both laid on the cold tile and you said it’s okay I’m okay and you laughed but we cried anyway. You wrote me a note and I still have it on my wall and I think about you all the time so when I heard his cold voice in our lecture say the disease that riddled your bones, I thought of you and your note and how you’re always right there.

And then you, I can’t forget you even though I knew nothing about you except that you were from Wyoming. I remember that because they said that’s where your children where and that someone came into your house with a baseball bat and that’s why your skull is caved in like that so they flew you here and found a fungus growing in your brain and I didn’t even know that was possible but then again I didn’t know anything about you. They unplugged you and left you and no one ever came for you, your children never came but your breath held on and all the nurses kept waiting, waiting for the room for the next patient but you kept holding on and I was so nervous to be alone with you because I didn’t know what to say god please help me so I washed your skin and moisturized the cracks in your lips and you had a tattoo on your wrist and I don’t know what it was or what it meant to you but you had a childhood and stories, so many stories, and I know you heard me because your eyelashes moved. Can you hear me? Everyone is here. Your children are here and telling you they love you, they love you so much, we’re here, we’re all here and its okay now. When I left you, you stopped waiting. Because the nurse went in and you were gone and they rolled you to the basement but no one ever came for you.

But for the life of me, I can’t remember what brought you. I remember your mother telling me you were an angel and how you would spend your weekends pulling weeds and helping people move but for the life of me I can’t remember what shattered your skull like that. They said the clear fluid dripping from your nose was from your brain and it wasn’t going to stop and there was silence and I listened to it drip, drip, drip, because your skull was like a broken eggshell and they couldn’t piece it back together, can’t you see. And even though I looked away, her voice has stayed with me anyway because I could hear her heart was breaking as the hallways echoed she can’t lose you, she won’t lose you, why won’t you DO SOMETHING doctor, but we can’t fix you we can’t fix you. So they left and she looked at me but this time I couldn’t look away yes I’ll stay with you yes I’ll pray with you and we cried in the dark and in the morning I left and so did you. But when I got home I still smelled like you and the water was so hot but I couldn’t get rid of you. I’m right behind you I knew nothing about you they never came for you we’re all here for you I can’t lose you we can’t fix you so the water dripped, dripped, dripped.

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Read This When,


You think life is hard.

Penny danced along the edge of life for the first few months of her life, her diagnosis remained a mystery until he pieced all of her puzzling pieces together. “She can’t get sugar into her blood,” her mother was told finally. “You’re going to have to do it for her.” This angel wore deep, dark circles in her sallow skin, but her daughter Penny was radiant and beautiful – impeccably dressed and smiling at all the stiff white coats before her. “People tell me, ‘She looks so healthy!’. But they don’t understand.”

She told us how Penny doesn’t know how to chew because she gets fed through a tube, and how she vomits – a lot. She told us how every single night for the past 4 years, she had to set 5-7 alarms so she could wake up and stumble into her daughter’s room and pump corn starch into the tube in her belly while Penny slept. She told us how she had to keep hiding her alarm clock throughout the night, because her exhaustion wouldn’t let her wake up. She could not afford to hit snooze, like so many of us do. Her daughter’s life depended on her. They finally scrounged up enough money to buy an IV pump for Penny while she slept – until the night God awoke her to find Penny’s pump had become clogged. Her daughter’s life was too precious. The alarms continued.

They were told the odds of their second child having the same disease was very small, but when their son was born, he beat the odds. Her strength crumbled and her shoulders shook as she cried. “I never knew I could love something as much as I love them. I would do absolutely anything for them. I have given up everything for them – my dream job I had worked for so many years to get, my life, my sleep, my sanity,” She choked a laugh and looked at her two little ones, smiling cheeks glistening. There was a long silence before she looked back at us and said, “But you know what’s funny? That physician who saved Penny’s life and finally solved the puzzle for us that night in the Emergency Department, I didn’t even learn his name. He was only in our lives for the blink of an eye before he sent us off to her specialist. I think of him sometimes, like when I’m in the middle of the grocery store covered in Penny’s spontaneous vomit, and I think to myself, ‘He has no idea what happened after he handed us that diagnosis’. He has no idea how my life got flipped upside down after he said those 3 short words – Von Gierke’s Disease.'”

You think you know something. 

Lupus is an enigma that insidiously sneaks past it’s diagnosis until a keen physician comes along. For Rose, that took 15 long years. “I feel like those years it took to get diagnosed with lupus – feeling constant pain and crippling fatigue and getting treated like I was crazy – those years were robbed from me.” Her symptoms appeared slowly, as most with her disease do, and were shrugged off or ignored by herself and physicians. When she became so fatigued she couldn’t get out of bed and her joints were too swollen to move, she finally started aggressively searching for answers. “I felt like no one was really listening to me. I even remember being diagnosed with a mood disorder at one point, can you believe that?” Her eyes moved from our faces to the floor, and the reel I’ve seen played one thousand times since starting medical school followed: her gaze returned to us as she said, “If you remember nothing at all about me or lupus or how to test for it, just remember this: Challenge your assumptions.”

You’re facing the impossible. 

I noticed his hands trembling while he shuffled his papers that were packed with tiny scribbles. He had beads of sweat collecting at his perfectly groomed hairline. He had worn his finest tweed suit and he used a cane – just like the SketchyMicro videos used to symbolize his disease. “This is my first time speaking in public, and the first time I have told anyone about my condition. I’m very nervous, please forgive me,” he said to us, avoiding eye contact. He took a deep breath and began.

“This sentence is the hardest I have ever written. But just like that, I have done it, and although it wasn’t the best it could have been – as is life.” The most beautiful words began flowing from his mouth as he read his notes, each sentence becoming less shaky than the last. He congratulated us on our progress thus far in medical school, he asked us to keep an open mind as he shared his story, and to forgive his lack of medical literacy. “I get my hands on any medical things I can,” he told us, eyes sparkling as he scanned the room for the first time. “I envy you.”

It had taken him eight years to share his story with anyone – with us. He lived in seclusion, without a single friendship or relationship, too ashamed of his diagnosis and  disowned from his family after they found out. “Don’t think I haven’t tried, though,” he offered. “I would have it all planned – clothes ironed and laid out, shoes polished, teeth brushed. I would get all ready and dressed, walk to the door, stand there for fifteen minutes trying to get myself to grab the handle, and then turn around, get undressed, and go to bed. This went on for years.” He began needing an oxygen tank at work, and when people would ask him about it he would simply reply, “lung problems”. “I never knew what it truly felt like to be alone before this,” he told us. He spoke about how everyone makes mistakes when they’re younger – hundreds of them. Petty theft from a gas station, experimentation with drugs or alcohol, reckless decisions that make you wonder how you ever made it out of those years alive. “But you can never press the reset button. Not even once.”

He told us that he was reminded of his mistake every day – from the moment he opened his eyes until his head hit the pillow again. His life had morphed into a living countdown timer, ruled by a virus that was ripping out his immune system one day at a time. “You don’t know what you’re made of until you’re up against it.”

After finishing his last page of notes, he stood back and looked up at the hundred fledgling doctors sitting before him. Then he said, “Oh! I almost forgot!” and he reached in his pocket and pulled out a small sheet of paper. He carefully unfolded it, cleared his throat and said, “First they ignore you, then they laugh at you, then they fight you, then you win. Ghandi.”

 

 

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You Will Stumble, You Will Fall.

It took medical school 259 days to knock me down.

At some point in the 4 years of medical school education, you will step into The Pit. I’m not talking about feeling down after a poor test score or being discouraged by a heavy course load. I’m talking about the suffocating blunt force that slams you flat on your back with the wind knocked out of you. It may be your first week of Year 1, or halfway through your Year 3 clinical rotations. But it will happen.

I honestly never really expected to arrive in this dark place myself. I thought my deeply-rooted passion and joy for medicine would steer me safely from it’s boundaries. But I have come to realize – no one is immune to this process. I have lost my joy for studying. I find myself wanting to sleep all day and night. I have found myself interacting with others less and less. I can’t even open my emails because of the heavy boulder it places in my gut: just one more deadline, assignment, expectation.

It is incredible we successfully float through this at all. How is anyone supposed to study such an immense amount of lecture material, while integrating additional material from STEP1 resources, working on research publications and submissions, spending countless hours finding research conferences to present your work at, volunteering and organizing clubs – all the while trying to balance family and spouses and real-life responsibilities like filing your taxes or FAFSA or paying bills or getting your oil changed? I have lost all sight of any hobbies I once embraced, and instead I have evolved into a human machine engraving and regurgitating facts and numbers. I am watching days roll by with something very crucial missing in those hours I am watching: me.

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Thorny Weed.

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More than anything else, medical school is a mind game.

The design is not incidental, but instead it is erected to test you. You are placed statistically with the top 6% of students, all equally as competitive and scrambling for the top just as you are. The tests they hand you are not to see what you can memorize. They are a stress test, repeatedly eliminating the weak. Because this is not a sport for fragile hearts or still minds. For months you will feel inferior, defeated, humiliated and humbled. But it’s only a hoop.

Some are angered by the process – ultimately leading up to the holy STEP1 at the end of your second year. A single test, only a single shot, determining your worth and the future of your career in medicine. But as I was reminded yesterday by my beautiful mother, this is not about tests. Even STEP1 isn’t about the test.

It’s about how you handle the pressure.

Because when the time comes, and you are the person standing over the table with someone’s life resting in your hands, they want to know – Will you be able to handle the pressure? Will you place steady hands on their skin, or unwavering fingers on a scalpel? Or will you crumble?

Medicine is everything I’ve ever imagined it to be. Every day it’s like putting on a soft, familiar sweater – a confirmation of my belonging and purpose. It is mind-blowing. It is perception-shifting. It is jaw-droppingly beautiful and astounding. But medicine has two faces. It’s a lot like loving someone who is everything you’ve ever wanted, but on the turn of a dime, they can become a cold-hearted monster.

The key is to dig your roots, and refuse to let it tear you apart when it turns. Because in the end it is the resilient weeds that remain. They rise stronger and taller before, standing proudly – ready to love medicine at the next turn.

Be a thorny weed.

 

 

Lighter in the Wind.

I.           Am.           Doing.           IT!

 

Medical school has been like being tossed into a drying machine. I’ve been thrown around, trying to figure out which way is up or down, continuously adapting and revising my schedule and study technique. When I finally did get my legs under me, they wobbled and threatened to collapse at any given moment.

 

It has been the most challenging thing I have ever tackled. Not only because of the intensity of the course load and the heavy responsibility that is always hanging on the back of my mind, but also the emotional and psychological battle. Every day, I have to garden my thoughts – pull out the negative weeds that sprout, and nurture those seeds of passion and inspiration and confidence.

 

It took me 13 months,

 

but I am finally steady on my feet

 

and running.

  

“It’s not the load that breaks you down,

it’s the way you carry it.”

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