Mile 22

Ever since I was young, I have had a passion for running. Early on in my running career, I realized I was not always the fastest, but I did learn that I had a well-established base of endurance that allowed me to run for miles and miles. During my senior year of college, I decided that it was finally time to run a marathon. For five months, I awoke early on cold, Tennessee mornings for long, training runs. After months of training, my friends and I made our way out to the starting line at 6:30 in the morning in the pouring rain of Atlanta, Georgia. The elements were not at all cooperating, but nevertheless, we were determined to run the race that we had been preparing for despite being completely soaked in water and sweat. Somewhere along the way, my friends and I got separated by our different paces and I found myself running alone. I remember getting to the twenty-two mile marker and feeling completely and utterly exhausted. My shoes and clothes were soaked, my muscles were screaming for a break, and my optimistic outlook was beginning to wane as the miles droned on and on. To say the least, mile twenty-two was filled with a lot of doubt in my training and feelings as if the finish line would never come. It was also in mile twenty-two that I met a fellow marathoner who was feeling about the same way. We began commiserating about the experience and we encouraged each other to keep running. When we saw the sign for mile twenty-three, it was as if a second-wind hit and we knew that the end was just a little ways away. Before we knew it, we crossed the finish line with the greatest sense of accomplishment.

In many ways, second year of medical school has brought up so many parallels to the experience of training for and running a marathon. I awake before the sun has come up to study for a few hours before campus becomes abuzz with activity. Each day I sit down to answer a block of at forty UWorld questions as I try to train my mind to the discipline of focusing and answering questions well for such a long duration of time. I now find myself at what feels like mile twenty-two of the marathon. My mind is tired, the to-study list seems to be ever-growing, the sleep and exercise seem to be decreasing, but I have to keep pushing forward one day at a time. Similar to my marathon race, I find myself surrounded by classmates who are experiencing the exact same situation. Although we each feel discouraged, exhausted, and stressed, I am daily amazed to see what endurance, abilities, and passion each of my classmates possesses that causes them to give this medical school life their absolute best day after day. We encourage each other daily, we laugh and cry together in the misery, and ultimately we will soon round the corner of USMLE Step 1 and be third-year medical students. Oh how I cannot wait to cross the finish line!

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.

 

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.

Keep Your Head Up

This week I found myself with my head down a lot. As I was walking to class, my head was down previewing notes for that day’s lectures. As I sat in class, my head was often down scanning my notes and seeing what I needed to write down, underline, or highlight. As I sat in lab for Microbiology, my head was down as I worked on culturing bacteria onto blood agar. As I would eat my meals, I had my head down as I caught up on my friends’ latest Instagram posts or checked items off of my ever growing to-do list. As I would sit at my desk for most of the afternoon and evening, my head was down learning about bacterial endocarditis, loading doses of medications, and the life cycles of tapeworms that I was imagining were inhabiting my GI tract. At the end of each day, I would kneel by my bedside as I had my head down to pray, relieved that I had made it through yet another day of second year, yet exhausted by its activities. Everywhere I seemed to look with my head down was something that I had to do, needed to learn, or should have already accomplished. To say the least, it was a bit discouraging.

However, on Wednesday morning, as I had my head down reading my Bible, something began to change. I had been studying the book of Hebrews during my devotional time and I had finally arrived at chapter 11 ー the faith chapter. As I poured over each verse, I was enamored with these Biblical icons like Moses, Abraham, Jacob and Noah who, in great faith, lifted their heads up above their circumstances to find strength and hope in something much greater their own. I was reminded of the fact that leading the children of Israel through the desert or building a giant boat for your family and lots of animals was only manageable and possible by keeping their heads up, focused on the promise that God was providing them with something better than what this world could offer. Mostly, I was convicted that in the midst of all this time that I had spent with my head down, I had not looked up enough to see the ultimate strength and joy that is found in Jesus.

As the week progressed, I began to keep my head up a little more. When I did this, I was able to see evidence of my Savior. I saw the beauty of community as I ate lunch with friends in the sunshine, catching up on each other’s lives. I saw camaraderie in my classmates as they encouraged one another to keep working hard. I saw the sunset on Friday evening, bringing His promise of rest.

It is my prayer that we keep our heads up as we progress throughout the journey of medical school. God has great things for us to see.