Closer Than Ever Before

white coat class (2)Last year, as I stood in front of adoring parents and friends during the White Coat Ceremony, I paid no attention to my white-clad classmates surrounding me. To me at that time, that was all they were — classmates. I knew I would sit with them in class and study with them. But I didn’t know that I would get much, much closer.

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Hiding away our bacteria

This past week, we had our 2nd microbiology lab, and for this lab, we were required to obtain samples from a classmate and streak them onto agar plates. Sounds simple enough…except that they were samples from our classmates’ throats and noses. Yes, we had to lift up the front of someone’s nose, stick a long wire into a nostril, twist the wire around a bit, and smear the contents. Afterwards, we sat with our mouths wide open as a classmate stuck a long Q-tip inside. I gagged (literally, as my tonsillar pillars were swabbed). But this wasn’t where we all started.

It all began in first year, when we had physical diagnosis labs. We learned physical exam techniques and practiced them on each other in small groups. Coming into our first lab on measuring blood pressure, we didn’t know what to expect. The least we knew was not to measure over clothes. Since men were required to wear professional long-sleeve, button-up shirts for lab, they had to take their shirts off to expose their arms. This was the start.

Later that year, for physio lab, we placed EKG leads on a classmate’s bare chest and watched his heart rhythms get recorded. For our cardiac and lung labs, we donned hospital gowns to practice ultrasound techniques, chest auscultation, and lung percussion on each other. For abdomen lab, we pressed deep into each others’ livers and spleens to check for enlargement. For ENT lab, we looked into each others noses, mouths, and ears and massaged each others’ necks to look for enlarged lymph nodes. For eye lab, classmates were close enough for our noses to nearly touch as they leaned in with their ophthalmoscope to look at my retina.

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In many ways and after every day, I get closer to my classmates. We sit almost shoulder to shoulder in class, share many fears and tears, lend sweaters and scarves in AC-cold classrooms, and save extra burritos for each other. We’ve come so far from our first day in our white coats. My classmates aren’t just classmates anymore. They’re my friends, confidantes, colleagues, and fellow practicing physicians-to-be. And they’re going to be taking great care of people like me.

 

Secrets to Preserving One’s Sanity in Med School

Victoria-headerWow! It’s been a LONG time since I last posted anything. My excuse? Medical school got in the way!

I feel as though I need to recap everything that has happened since, but I’ll try to be somewhat concise. Two of the most important were my first two exam sets of medical school. Now, for all you out there who have not yet had the distinct pleasure of enduring a LLUSM exam, let me set the scene.

You have been taught a plethora of information from your different classes over the course of about six weeks.

Below are the core classes you are currently taking:

  • Gross Anatomy
  • Embryology
  • Medical Physiology
  • Cell Structure & Function
  • Physical Diagnosis
  • Evidence-Based Medicine
  • Medical Biochemistry
  • Genetics

The various questions, from each lecture (of each subject), are mixed up and compiled into a single test. This test is then broken up into three separate exams to be administered over a course of three consecutive days. This format forces each student to really integrate the information from each class. In addition, one must be able to quickly switch his/her mindset from one subject (or class) to another. To top it off, the last day of the week is dedicated to lab practicums, usually anatomy and cell.

Needless to say, test week causes some anxiety! By the end of the week, students are relieved to be finished. In fact, the weekend following a test week has been dubbed, and will forever be called, a “golden weekend”! Golden weekends are the few times during the school year where LLU medical students can relax without worrying about studying or falling behind. That being said, one has to make the most out of them! My favorite golden weekend activities include sleeping, hanging out with friends, shopping, watching movies – basically, doing whatever makes me happy! After all, when Monday rolls back around, it is time to get serious again!

Anyway, now that you have some background, let’s get back to my actual experience. I was very nervous when the first test week arrived because I wasn’t quite sure what to expect. To my surprise, I survived and actually did just fine! It was hard (especially due to the volume of information), but definitely doable. That golden weekend was our School of Medicine retreat at Pine Springs Ranch. Overall, it was a fun experience getting to know fellow classmates (and faculty) outside of lectures and labs. My favorite part was probably Saturday night’s talent show. It was a blast and everyone who participated was so talented!

Six weeks later, we had our second test week. I was anxious all over again, but in the end I didn’t do too bad!

Lessons I have learned while in medical school:

  • Cling to God because He is the only One who can get you through this!
  • Relearn how to study and then study hard!
  • Previewing lectures before class is incredibly helpful.
  • Don’t be afraid to ask questions.
  • Learn from your mistakes, and don’t repeat them.
  • Take breaks as necessary, but not too many!
  • Collaborate and share with your classmates. (Besides, they’re the only ones who know your struggle!)
  • Preserve your sanity!

That last nugget of wisdom is essential to EVERY medical student! Medical school can be very stressful, but each person must find a way to stay sane. This may involve taking a day of rest, listening to music, exercising, finding a hobby, or even going home for Thanksgiving. Sometimes, you just need to escape for a little while. For me, I knew I had to take a break and get away. When I found out that two of my friends from college were getting married, I decided that I had to go! About a month in advance, I bought my plane ticket so that I could attend their wedding in Alabama. It was one of the best decisions that I could have made!

I flew to Alabama that Friday and attended church on Saturday. Since my family only lived a few hours away, they were able to drive down and visit me. It was such a blessing to spend quality time with my family, and it didn’t hurt that they had cooked! The following day, I attended the wedding with my three best friends (who had also flown down). We were able to witness two of our friends committing themselves to each other for life. It was such a beautiful ceremony and reception. Needless to say, it was a rejuvenating experience to take a weekend off from school and go out of town. When I got back to LLU, I went right back to studying with a renewed mindset and refreshed spirit.

Bottom line: Take care of yourself!

Anyway, here a few pictures from my weekend off!

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My family!!! Aren’t they just gorgeous! 🙂

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Sabbath – REUNITED with my best friends!

Post-wedding shenanigans!

Post-wedding shenanigans!

Picture with the bride!

Picture with the bride!

Thanks for reading!

Until next time…

VM

Of Marathons and Water Faucets

Michelle, First Year Medical Student

Being in med school isn’t a sprint. It’s a marathon, and those who succeed are those who can endure.

This shouldn’t have been a surprise for me, but it was. I’d heard medical school compared to “drinking out of a fire hydrant.” The comparison assumes that the sheer volume of information, thrown at us all at once, was what made it so hard.

Spoiler alert: that’s not what makes medical school hard.

5K

Me at the Holiday Classic Loma Linda Loper’s 5K — their 25th anniversary!

Well, at least not directly. That factor alone isn’t what makes medical school hard (make sure to do your multivariate analysis! Thumbs up for EBM!*). I like the analogy I heard from a fellow medical student: medical school isn’t so much like a fire hydrant as it is a water faucet turned on full-flow. . . that never stops. What makes it hard isn’t just the amount of information, it’s the amount of time we have to sustain such a high level of performance.

But I didn’t realize that at the beginning of school. I still thought the hardest thing about medical school was the large amount of material we had to learn in a short amount of time. So I was pleasantly surprised when I found that the demands of med school were very doable. Yes, we had to learn a lot, and there wasn’t much time to do it, but learning it all was far from impossible. It would just require a not-insurmountable step up from my studying habits in undergrad.

And that’s what I did. It started out well enough. I scouted around campus to find quiet study spots, fine-tuned my study methods and chose what resources to focus on for each class, and soon my days fell into a rhythm. Go to class, study. Go to class, study. Go to class, study. . . It sounds heart-rendingly dreary, but it didn’t seem so at the time. It felt good to stretch and exercise my academic capabilities, the way the endless activity of putting one foot in front of the other can be invigorating to runners.

Studying

How studious! Just like a good little medical student.

(And I admit, I exaggerate — I took plenty of time out to have fun — watercoloring, baking, playing music, going on walks with my eight-year-old cousin, taking weekends off to go on church camping trips, visiting Disneyland. . .)

At any rate, I felt prepared when the first week of exams** rolled around. And it was nice to change things up from the grind of morning lectures-afternoon labs-evening studying. During exam week, there were no lectures to go to, no labs to do, no new material to study.

But then the second test cycle began. After a week of relative relaxation, I felt like I couldn’t go back to the reality of med school. Go to class, study, go to class, study, go to class. . . let me do something with my day that’s not studying.

There’s a word in Tagalog, sawá, that describes the feeling you get when you’ve been doing the same thing for a while and you’re tired of it, like when you eat a lot of something and you get tired of the taste. If you’re not careful, that can happen in medical school. The material every day is new, but the monotony of

wake up

go to class

go to lab

study

go to sleep

. . . and doing it all over again can get, well, boring. It doesn’t help that I tend to fall into routines — studying in the same place, in the same way, at the same time.

Then before I knew it, our second set of exams was before me. And like magic, new motivation to study suddenly appeared! The week before exams I studied harder than I had since before our first test week. But there’s only so much you can stuff into your brain in even a week, before everything starts to merge together into a muddled mess.

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The Yerkes-Dodson law states that that level of performance — whether school-related, work-related, or whatever — increases with increasing stress up to a point, at which increasing stress will decrease performance. This is part of the basis for procrastination. There’s always a willpower-barrier to getting any task done, and sometimes it takes the stress of an approaching deadline to get over that barrier.

The Yerkes-Dodson law: increasing stress increases performance up to a point, after which performance falls

The Yerkes-Dodson law: increasing stress increases performance up to a point, after which performance falls

Liken it to a reaction’s activation energy: stress is the catalyst that shrinks the mountain in the middle, allowing the reaction to proceed to completion. Unfortunately, the longer I’m in school, the bigger that hump seems to be.

Activation energy is the energy barrier to completing a reaction. A catalyst reduces the activation energy and allows a reaction to proceed more easily.

Activation energy is the energy barrier to completing a reaction. A catalyst reduces the activation energy and allows a reaction to proceed more easily.

So, what’s the end of this story? The hump will get bigger and bigger, and the stress will have to be higher and higher for me to get over it, leading to greater and greater procrastination? (Insert hyperventilation here)

I don’t think so. I’m going to be optimistic and say this is just a temporary setback. I may have “hit the wall” now, but that’s nothing a little rest, some stretching, maybe a massage, and — most importantly — not giving up can conquer (marathoners will relate to this!). In the words of Dory from Finding Nemo, “Just keep swimming, just keep swimming, just keep swimming, swimming, swimming. What do we do? We swim, swim, swim.”

I’ll give you one more analogy, but the Bible says it better than I would. Galatians 6:9 says, “Let us not lose heart in doing good, for in due time we will reap if we do not grow weary.” We just have to keep doing it, and God will reward us. Even if we start to grow weary, never fear! Isaiah 40:29-31 tells us,

“He gives strength to the weary,

And to him who lacks might He increases power.

Though youths grow weary and tired,

And vigorous young men stumble badly,

Yet those who wait for the Lord

Will gain new strength;

They will mount up with wings like eagles,

They will run and not get tired,

They will walk and not become weary.”

 

*EBM stands for Evidence-Based Medicine, which is like a research class for continued medical education. Even after we’ve finished medical school, we won’t know everything (hard to believe, I know!), but we should have the skills we need to find the correct answers to questions we and our patients will have.

**For those of you who may not know how our schedule works, we take our classes in blocks of four to five weeks, after which follows a week of exams. Each day’s exam is an amalgamation of questions from all our subjects; this helps simulate the experience of the national boards exams.

A Warning to the New Med Students

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I was flying back to California, and my third year of medical school awaited. The sunset lingered a little longer as I watched it from the cheaper wing seat on my flight west. I didn’t know how much the speed of the plane and speed of the earth’s rotation added up to the lengthening of the sunset’s colors, but just two weeks ago I had taken the monster of the test that was the Step 1 medical licensing exam, and even a brief summoning of whatever critical thinking I had left was the last thing I wanted. It was just nice to romanticize that my mini-summer break was holding on to me a little longer.

Medical school has been hard. Because of undergrad experiences, I figured the frantic cramming I did during finals week all-nighters would simply be a more frequent occurrence in medical school. It turned out that the first two years of medical school however, were when I got the most regular sleep, healthy food, and exercise that I had had for a long time. Mind you, the academic challenge was significant, but there was another kind of difficult learning to be done.

You see, I went to many different public schools since moving to America as a child, and held strongly to my Christian beliefs as I stood at each new lunch room and stared out at dozens of unknown faces. I like to say that my faith gave me roots and allowed me to branch out to meet and love all new and different kinds of people, many times over. I became confident in my faith, confident that having lived among secular lives for a long time had whipped me up into a mature and understanding Christian with most of the answers figured out. I fully expected Loma Linda to be a place where I would indulge in a sort of faith oasis, where I could sit back and be spiritually satiated while working hard on the doctor thing.

Looking back always gives us the most complete perspective. Though I probably would not have paid attention, a bigger warning should be considered for the incoming freshmen: studying the science of medicine while taking religious courses on ethics and human suffering could be a catalyst for major spiritual upheaval.

Let me explain. If you too were brought up in a deeply religious Christian setting, or even many kinds of traditional religious settings, you are also aware of a certain kind of mindset, one that is afraid to look at the unholy for too long because of what I’ll call the exposure effect: your subconscious shapes you and before you know it, you too will be jetting off to France with someone you just met because you watched a little too many episodes of The Bachelorette, or you too will be using heroin if you hang out with the fringe of your college social circles. We all know there is a certain amount of truth to that fear, and so here I stand, telling you to beware of the dangers of medical school.

You’ll see that if you spend most of your waking hours practicing the rational rhythms of science and rational thought, you will be at a significantly higher risk of applying such skills to your ethical and spiritual questions. Maybe your previous life, like mine, allowed you to keep your religion and my academia separate, but such is no more! You see, endless days of studying and complete dedication to medical science resulted in break times that became filled with philosophy and religiously-inclined talks with friends. That’s how I found myself going to a professor at the end of an ethics class and asking where I could find a similar church or bible study group. After all, a school that has a building full of science-appreciating religion professors must have some sort of meeting space where the messy subjects are tackled. It turns out that that very building where our science classes take place during the week turns into a weekend full of PhDs of history, ethics, religion, psychology, anthropology, and any other “-ology” you would need. This building that brings us all anxiety and fear as we fail to know everything turns into a space of free exploration guided by minds filled with expertise in other parts of the human experience.

I won’t bother to tell you the conclusions I have come to; I like to save that for those long dinners or late-night bonfire musings. All I can say is that Loma Linda has allowed my first two years of medical school to make some sense. I have been able to finally bring my mind and spiritual heart closer to synchrony, and it has made all the difference.

As my window became dark, only lit up by the subdued stars above and tired city lights below, I made a new decision: I wanted the sun to set faster, and third year to begin sooner. If first and second year were any indication, I wanted to see what improved version of myself that these clinical years would bring. So far, third year has been an interesting ride. It has included being splattered on the face with some unsightly patient bodily fluids, but then also partaking in important conversations of end-of-life decisions with patients’ families. While it’s too soon to tell, I’m at least wise enough to know I will be changed in significant ways, and I welcome it all with open arms (all while wearing as much protective equipment as possible).