A New Kind of Hard – 3rd Year

I’m finishing my last week of psychiatry rotation. Like whaa?! I know. I’m a 3rd year. It’s surreal. The challenges of 2nd year and Step 1 is all behind me now, and there’s no turning back.

Ooo, is that my name?! Hehe…umm…do I really know what I’m doing?!

If I could sum up my 3rd year experiences so far in one word, I would say it is “moving.” Definitions (per Google, not in particular order):

  1. Producing strong emotion, especially sadness or sympathy.
  2. Influence or prompt (someone) to do something.
  3. In motion.
  4. Change the place or position of.
  5. Make progress; develop in a particular manner or direction.

Interacting with patients, reinforcing knowledge, and working with a multi-disciplinary team…they all present a new kind of challenge. It’s the kind that drives me to tears not because I got a low score or fear the next set of exams. It drives me to tears because I realize medicine can only go so far. No matter how well the anti-depressants or anti-anxiety meds we prescribe work, we can’t erase childhood abuse or violence in the home. Although we have great plans to transfer patients to a board and care facility for further care, we can’t keep them off the streets if they choose to leave or if they cannot afford it.

I realize, too, the necessary humility physicians must possess to show love and care to patients who may insult us, ignore us, and distrust us. Humility is also needed to admit when we’re wrong, to respond to constructive feedback, to ask for help when we don’t know the answers, and to respectfully listen to people who strongly disagree with us.

Lastly, I learn every day about my own personal limitations. How many emotions from the day can I manage without feeling completely drained by 5 p.m.? How do I keep a healthy boundary between empathy for the patient and my own health? What is the best way to organize all the things – the papers, the emails, the assignments, the sign-offs?!

In the end, I’m human. I make mistakes, I feel hurt when I’m threatened or not appreciated, I feel frustrated when the same patient keeps coming back to the hospital for the same reason, I want to go back to sleep when the alarm clock goes off. But knowing I’m human and knowing that my patients are human too helps me to connect with them in moving ways. Knowing the impact that I can make on someone’s life –  knowing that my hard work is making a difference – makes this new kind of hard totally worth it.


I didn’t realize how little outside exposure I would get during the first two years of medical school. I’m inside practically all day and only go home to sleep (which is still indoors!). As Step 1 nears, the atrophy of my social skills has become all the more apparent, and in many situations, I end up being very…well, awkward.

A few examples to illustrate:

On one normal Sabbath day, I was merrily singing my heart out during song service. Then the congregation started singing, “All Hail the Power of Jesus’ Name.” For the first verse, I sang, “All hail the power of Jesus’ name! Let angels prostate fall!” I immediately stopped, incredulous and amused. Did I really just sing out the word “prostate”?

Spending time in crowded areas, even grocery stores, lately feels new and exciting. When I’m out in public, I can’t help but stare at people. I think, his face and arms are very edematous – I wonder if he has superior vena cava obstruction? I would have to look at his JVP, check for pitting, and rule out a heart or liver issue. Or her right eyelid is drooping – I wonder if she has Horner’s? Or maybe Bell’s palsy? That man is walking with a shuffle gait. I wonder if he also has a Parkinsonian resting tremor. I stare long enough until some people catch my eye. Of course, my instinct is to smile and totally give away that I’ve been coming up with a dozen review of system questions to ask them.

I have become great at not maintaining eye contact. Whenever I start talking to someone, my eyes get confused and dart everywhere, looking for words to read. Talking to people who are interested in things outside of school has also become unfamiliar. What do I say? Am I saying the right things? Why does he think I know anything about TV shows and fun? Responses have become reflex, like “That’s so cool that you went cliff jumping and waterfall swimming in a lake! I just learned what microbes swim in places like those!”

Lately, I’ve been fumbling with words and staying silent because I don’t know how to say something. What’s the word for putting fruit into a blender and mixing them together? Oh right, blend. I’ve forgotten how to speak English. I’ve also forgotten essential information like names. Whenever I see an acquaintance, my usual greeting has become, “Oh, hi there….you! *awkward pause* How’s it going?” I can only hope that in a few minutes, my hippocampus catches up, and I can finally recall his/her name. Or else I end up asking the same person multiple times in multiple occasions, “I’m so sorry. What was your name again?”

Let’s just say, I can’t wait to be done with Step 1.

New year!

Janna, First Year Medical Student

It’s a new year and time for new things! We received our first official final grades for a science course- biochemistry/genetics, and now have new classes: neuroscience, human behavioral science, and (for me) a medical ethics religion class. Within the first week, we have already covered the gross anatomy of the brain, learned how to empathize and encourage patients to adhere to a treatment, and faced the ethics of medicine in a documentary about a boy who became a girl and later went back to being a boy because his penis was burned off when he was 2 months old.

I also saw my first “patient” named Harvey in the Harvey Stimulation Lab for Physical Diagnosis. However, Harvey isn’t quite like the normal patient; he’s a robotic head and torso lacking limbs but complete with heart murmurs, pulses, and JVPs. His abdomen even rises when he “breathes”. He helped integrate the information we learned from lecture.

Fellow blogger Lauren (second from left) and her classmates practicing on Harvey when they were freshmen.

Fellow blogger Lauren (second from left) and classmates practicing on Harvey when they were freshmen.

Lastly of my new experiences, this week I also joined some of my classmates and co-blogger Abby at the BATs (buns, abs, and thighs) class at Drayson Center. We jumped, punched, and kicked for an hour! My muscles, used to sitting around all day, are still in shock. But, the class was a great de-stresser and fun opportunity to hang out with friends. I can’t wait to go this week!

Communication Convention

To and back from the sunshine state, specifically Orlando. This past weekend I took a brief break from my med school studies––sort of, I still studied on the flights and in the airports––to revisit my college major, Communication: Public Relations and Journalism. Part of my course work included conducting a quantitative research study which I was now going to present at the National Communication Association 98th Annual Convention.

My co-author and I had been invited to a panel under Lambda Pi Eta (the National Communication Association’s honor society for four year colleges and universities). We had submitted our paper last spring not expecting a response since only a handful of papers are selected from the worldwide submissions. But, our paper was accepted! Upon arrival, we were even more pleasantly surprised to find our paper had made it into the top four papers for Lambda Pi Eta, along with another research group from our class at Pacific Union College (PUC). Our professor, Dr. McGuire, also presented her own research paper at the conference, so she was able to come personally support us at our presentation.

We presented our research on a panel for 8-10 minutes, listened to a respondent, and ended with Q&A. The experience of presenting was very educational, as well as the exposure to the other various communication research studies. I even attended panels on health communication. The studies in these categories looked at improving physician communication in the context of end-of-life care and health care websites.

So, I’m probably a bit behind on my studies, but this experience was definitely worth the extra time I’ll put in over Thanksgiving break. I stopped off in numerous states and Disney park shuttle stations, reconvened with old friends, and furthered my communication knowledge. I was even offered a full ride to a communication university. And, while the thought of no debt is intriguing, the reason for my interest in communication is to facilitate better healthcare and patient interaction, so I’ll stick with pushing through med school. 🙂

In Real Life

It seems like just a moment ago I wrote my last post about my experience with USMLE Step 1 & 2 and here we are 2 months later.

Fortunately you’ve had a ton of great new bloggers sharing all kinds of experiences.

So in my real life recently here’s the quick update:

Things I’ve Been Doing

Thing 1: Sub-Internship. During the month of July I had my Sub-I on Pediatrics Team G. Pediatrics does not mess around. Don’t think that just because you get to work with kids it’s all naps and snacks. I know you didn’t think that. Truth though: It was the absolute best time I’ve had so far in medical school career. It was plenty of hard work, but I loved it and it was very encouraging that I’m applying to the right specialty. And hello to our Team G third years – you were great!

Thing 2: I got married. In the midst of the Sub-I, I was also going home at night and sorting out details for my wedding, because on Aug 4 this happened:

And so I’m happily married. If you want, you can see more pictures at our photographer’s blog here.

Thing 3: Travel. Then we went to Mexico for a honeymoon. I got wicked sunburnt but of course it was great.

Thing 4: Moving. I moved in with my new husband, which is always a hassle – the moving, not the new husband – and we furnished our apartment.

Thing 5: Step 2 CS, I’ll write a separate post on that.

Thing 6: Away elective. I took off to Ohio, from which I write, for a 4 week away elective in Pediatric Infectious Disease at Dayton Children’s Medical Center through Wright State University. While I’m here I get to live with my sister, who just got a new dog. We named him Dobby. I mean look at those little house-elf ears.

To put it plainly, it’s been a busy couple months and my head’s spinning a bit.

I’ve been in Ohio a week, and I feel like I’m finally settled enough that I can take a deep breath. This is important, because in just a couple weeks, it’s time to submit a residency application.

It never stops. I think that’s great.