A Shocking Experience

As we stand around the bedside of our patient, the family anxiously tells us that he was found that morning with vomit and blood around him. The bells are going off in my mind that this man is in hypovolemic shock. The sounds of machines taking his vital signs continue to beep. I see his blood pressure dropping lower and lower before my eyes. With only a year and four months of medical school under my belt, my team and I feel incredibly inadequate to take this man’s treatment into our hands. We quickly begin to realize that we do not have much time to simply stand there, so we begin fulfilling our roles taking a history, physical exam, and ordering tests and treatments that we have only read about. I got on the phone with the pharmacy to order normal saline to replace his fluid loss. The pharmacist asked me how much I wanted to order. My mind went blank. I looked at my teammate who looked back equally as unsure. With some unsteadiness, I replied back that we wanted one liter of normal saline. As I watched his vitals to see what effect this would take, I quickly knew that we were going to need much more. With each time that I called the pharmacy for blood, fluids, or antiemetics, I became increasingly more confident in what I was ordering. Over the course of a few minutes as we gained more information, ran more tests, and administered more aggressive therapy, we began to watch his vital signs improve. We were about ready to send him to endoscopy to look for ruptured esophageal varices when all of a sudden, a voice came across the loudspeaker saying that the next team was up. Before you get too concerned about patient safety at Loma Linda, I should probably let you know that this was just a learning experience in our Simulation Lab that combined our knowledge of pathophysiology and pharmacology into an afternoon of anaphylactic, hypovolemic, and cardiogenic shock.

My team and I with our assigned roles.

In the few hours that we spent working together in lab, each team took turns getting to be the physicians. Those who were not actively participating sat on the sidelines, stopping the situation if there was a treatment that they felt was unsafe for the patient, conferring with others about the best course of action, or being entertained by the flurry of activity in the room. Although there was a mutual tone of anxiety throughout the room because of the unknown, there was also a lot of fun, learning, and laughter that came with it as we watched each other have a “deer-in-the-headlights” kind of experience. For those of us who are kinesthetic learners and/or adrenaline junkies, this was one of the highlights of medical school thus far. It was exciting to be thrown into a situation that might take surprising twists and turns, yet where you were challenged to maintain some semblance of calm in order to think clearly through the chaos. It was encouraging to see both the practicality of the information that we are learning and how much we are actually retaining. Most of all, it was inspiring to catch a glimpse of what it is like to walk in the shoes of the physician. When most of my days seem to be a blur of sleep, study, go to class, exercise, study, eat, study some more, and repeat the next day, this experience was just what I needed to inspire me to keep moving forward.

 

5 Things M2s Want for Christmas

Done with test cycle 3! It was one of the hardest test cycles of medical school so far (first year test cycle 6 still takes the cake though). In the spirit of the Christmas season, I wanted to share a few things that second year medical students would love to have.

1. A “Pass” in Neuroscience and Psychopathology

We start these classes halfway through first year and end them halfway through second year. Thus, we have to be in passing range in both classes after test cycle 3 to avoid retaking a class during the summer or repeating the entire year. It’s not as easy as it sounds! If we pass these two classes, then we can truly celebrate winter break.

So many UWORLD questions to do before STEP1!

2. Free access to UWorld, First Aid, Pathoma, Picmonic, Sketchy Micro, and STEP 1

If you’re having difficulty finding the perfect gift for that M2 niece or nephew, offer to pay for one of these essential subscriptions/registrations. Altogether, depending on the length of the subscription, they can cost close to $1000 (STEP 1 alone is $605). You’ll be sure to bring a smile to your beloved student’s face.

3. Home cooked meals with no pasta or canned vegetables

When we can’t afford time to visit a grocery store, pasta and preserved veggies become our staple foods. Either that or we make frequent trips to the hospital and student cafeterias. Or attend on-campus events with free food. Sometimes I wish I could come home to fresh bread, fried rice with spicy tofu, anything with eggplant, stuffed peppers, hummus, and other non-pasta foods. I speak for myself though as some of my classmates are expert cooks on a budget.

When mom brings over tofu 🙂

4. Consistently folded laundry

Washing and drying laundry isn’t too bad since I have machines at home. I can study while I wait. It’s the folding that takes time. I tend to wait to do laundry until I absolutely can’t go outside without people staring, so I always have a gigantic load to fold. There are days I wear clothes from my pile of unfolded laundry and hope the wrinkles will smooth out over the course of the day.

5. More sleep

Even though studying involves sitting for long periods of time, it’s still tiring. By the end of the day (around 10 p.m. for me), I can’t wait to jump into bed. Ironically, once I’m actually in bed, it’s hard for me to fall asleep. I keep replaying my day and all the things I’ve studied. I think about the day that is about to start and all I have to accomplish. After running almost non-stop all day, my mind needs extra time to slow down. There are nights when I’m happy to get 6 hours of sleep and other nights when 8 hours doesn’t seem like enough. Having more peaceful sleep would be a blessing.

Although I may not have all of these things (I did pass all my tests though, yay!), I’m still grateful that I’ve made it this far and that I have the family, friends, and materials I have now. Yes, medical school is a lot of work, but I know that someday it’ll all be worth it. Half-way through year two! Happy new year 2017!

With Thanksgiving

The holiday season always puts me in a state of reflection. Maybe it’s a result of my annual ten slices of pumpkin pie. Since Thanksgiving is still a recent memory, I wanted to write about a few things for which I am grateful:

A controllable thermostat in the Alumni Hall classroom. When nearly everyone has vacated our lecture hall, and the faithful few remain, I am so thankful that we can turn the temperature up to the 70s and be nice and toasty while we study for eight hours or until our eyelids become too heavy to lift (whichever comes later).

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I’m dreaming of a sunny Christmas…

Wednesday/Thursday $3 burritos. I find it hard to prepare meals for myself throughout the week. There are some weeks when I survive on free food given at events and kind friends who love to cook. But when all my containers are empty and nothing in the community fridge has my name on it, LLU Church UReach $3 burritos save the day.

California sunshine. After experiencing seven Midwest/East winters and enjoying the “winters” here in SoCal, I would be reluctant to go back to a white Christmas, no matter how romantic and song-worthy it sounds.

Tutors and big sibs. At every session, material that would normally take me five hours to digest is compacted into two glorious hours of epiphanies. My tutors are brilliant and funny, and they deserve a lot of credit for helping me succeed in medical school. Meanwhile, my big sib (student mentor) gives me hugs and food, and who wouldn’t be grateful for that?!

friendsgivingFriends. They help make the med school life worth living. In just a few short years, these amazing people will be changing the world, one patient at a time.

Jesus. The author and finisher of my faith. When the world seems to be crumbling from within and more eyes grow cataracts of anxiety and fear, I continually look forward to His promise of a perfect world, where there will be no need for doctors (Revelation 21:1-4).

After three more tests and two mock board subject exams in less than three weeks, we’ll be home for Christmas! I can’t wait!

Why Loma Linda? – Spirituality in Wholeness

We just finished our 2nd round of exams (praise God!). As usual, leading up to the test week, I felt bogged down by my studies. I was definitely out of balance; it often felt like I had to choose between spending time with God or spending time with my lecture notes.

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Textbooks vs. Bible…which will win?!

But the struggle made me all the more grateful to be where I am now. Countless people have asked me, “Why Loma Linda?” especially after finding out I attended a public university in Michigan and a grad institution in Pennsylvania. Aside from the fact that Loma Linda University (LLU) is the school of my dreams, its location in the city of my upbringing, and the opportunities to serve locally and abroad, one reason stands out: LLU makes man whole. I felt that my experiences during this test cycle can attest to that. I’d particularly like to point out how LLU addressed the spiritual aspect of my wholeness:

1. Week of Prayer and Chapelimg_4602

Every Wednesday, students gather in the University Church for 50 minutes to sing praises, share testimonies, and hear from the Word of God. After three hours of packed-to-the brim lectures prior to chapel, it’s uplifting to listen to words of encouragement and be challenged to live better lives for Christ. Having weekly worship with the whole school like this is such a privilege. I would not be able to have this kind of experience at many other institutions.

LLU has a Week of Prayer once a semester. The theme of the most recent one was “togetherness.” Every day for one week, I was reminded to see others through Jesus’s eyes and was given practical ways to show love to people who are different from me. At the end of the week, we all stood close, held hands, and prayed together. That sense of unity among everyone regardless of religious and cultural background felt like a piece of heaven on earth.

2. Religion Classes

Every Tuesday and Thursday, I attend a class called Art and Science of Whole Person Care. In this class, I learn how to meet the needs of patients at the bedside — how to see them as people with dynamic stories instead of living textbook examples. The class consistently reminds me that there is so much more to medicine than just cramming tons of information into my already-saturated brain. In addition to sharing this information, I have the opportunity to show genuine care and treat a patient as a whole person.

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Animal vespers at LLU Church!

3. Vesper and Church Services

On weekends, it always feels like a million things are going on at the same time. But that just means more options for students to gather with other believers, eat, enjoy nature, or just relax. Throughout the weekend, students can attend various worship services at school, at people’s homes, or in different churches. On Saturdays, I can finally see people who aren’t in my class and have my attention fixed on something other than pathophysiology. This valuable time of rest is like a breath of fresh air in the smog of the week and helps me to re-energize for the next week.

4. Dedicated Alumni

Right after exams, some of my img_4638-2classmates and I spent the golden weekend in Indian Wells, CA, for the annual Adventist Medical Evangelism Network (AMEN) Conference (free of charge for med students!). There I met other LLU students and alumni who were eager to learn how to be better medical missionaries in their practice. Several physicians shared stories of talking about Jesus with their patients. I was inspired by the physicians’ dedication to their work, community, the next generation of physicians, and God.

No place is perfect, but there is definitely something special about this place. On to test cycle 3!

Sights and Sounds of Second Year

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For many of us students, the key to coping with the load of medical school is by following a highly predictable schedule that gets repeated day in and day out. It took a few weeks for me to establish the routine as I adjusted to second year, but quickly, I found myself in the rhythm – waking up at the same time, eating the same food for lunch, wearing the same flip flops, studying in the same desk, and walking the same route on study breaks. In some ways, I find myself getting desensitized to the little joys and unique experiences of each day because I get so caught up in my same routine. However, I’ve recently been trying to let me eyes and ears perk up to the little things that make each day of second year special, and I thought I would share six of those little sights and sounds with you.

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  1. Outside of Alumni Hall is a nice loop of sidewalk that is often inhabited by MS2s like me who like to get some fresh air, increased venous return, sunlight, and exercise as we review over notes.

2. The other day as I sat in my study carrel, getting in the last few minutes of studying before Sabbath, through the walls I could hear someone singing with great fervor, “Deliver Us,” from the Prince of Egypt sound track. I found myself laughing hysterically as I saw the similarities between us, the second year medical students and the children of Israel held captive in Egypt.
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3. You can learn just about anything on YouTube, including how to draw blood. So that’s exactly what we did 🙂 Thankfully, my partner and I both got the “flash of blood” on our first try. We received a complete blood count and looked at our blood smears under the microscope.

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4. How do you spend your Saturday night? I spent mine listening to music as I made a super sized table to organize the details of lymphomas and leukemias. If you must study on a Saturday night because you’re a little behind in classes, good music always makes the process much more enjoyable!

5. The study carrels are indeed as they are named, used for studying. They are a cozy little place that provide the quietness needed for focus, but also the company of others that you need in order to keep from feeling too isolated. The carrel that I am in is often pretty quiet, but every few hours someone will say something and before you know it, everyone has abandoned whatever they were doing to join in on the conversation. It’s in these conversations where we have shared great laughs, told stories, and bonded with each other. These are moments and sounds that I savor. After a few minutes of chatting, there will be a collective sigh, and everyone quietly makes their way back to whatever task it was that they were working on before.

6. One of my favorite sights of second year has been the amount of sunrises and sunsets that I have been able to watch. Following in the footsteps of some of the other MS2 bloggers, I also have shifted my sleeping schedule to fit in study time early in the morning where I am more efficient and focused, allowing me to see the sunrise every single day. Each evening, I often walk home around sunset or I get to watch it from the window of my study carrel as the day draws to a close. There is something really special about truly seeing the day from start to finish in the unique and beautiful ways that the Creator paints the sky. It helps remind me of His new mercies that begin afresh each morning, and of His faithfulness that gets me through each day.

It might not be the most exciting life that we live, but these are a few of the little wonderful moments in each day that provide just enough joy to the routine that keep us happily moving forward from one day to the next.