Settling In

It has rained, literally every day for over a week. It's Summer time in Florida. I guess that's to be expected. Personally, I find the rain a little bit depressing. BUT, the temperature has dropped and that has been absolutely lovely. Autumn in Florida is always a little touch and go. I say we have 2 seasons here: Summer, and not quite Summer. While the leaves don't change, sometimes the temperature does shift, and it eventually stops raining.

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Sunrise in the middle of the showers - Coffee Pot Bayou

We're getting back into the swing of things after boards, and settling into the tri. It's so weird not having classes. Part of me feels like I must be skipping things, or somehow not showing up -- that I should be studying for a quiz or doing a project or presentation -- but I don't have any to do. It's just bizarre.

Of course I still have work to do for the Master's program, but that's a lot less involved than going to classes all day, every day. Speaking of the Master's...I just finished finals for another quarter there. I have only 2 left; 2 quarters left, and less than 2 trimesters left here. I honestly can't believe it. I'm not sure whether I believed it would never happen, or that it just seemed so far away that it was out of my realm of comprehension.

Our 10th trimester mentor, Jen, is making plans for graduation. Yesterday we were talking about hotels and plane tickets and how soon graduation is. It was a bit of a wake-up call.

A bunch of us have been doing some outreach with the clinic. SPC has had a blood pressure initiative going. They're installing automated blood pressure cuffs in many of their facilities. It's helpful for people to keep track of their blood pressure. We've been explaining normal ranges and what people can do to not only keep track, but also to improve.

Julia, Dave, Ricky, Leslie, and Jen have gone, some twice, and given a talk and been on hand to help. I'm excited. I get to go in 2 weeks. We'll see what happens. There's been some good feedback.

Everyone is talking about where we go from here. People are making plans for shadowing, extra seminars, special licensure requirements, etc. Events are taking place. It's really exciting.

Have a great week Everybody!

Fueled by Caffeine and Dreams

I'm recovering from near brain-death. In case you missed it, last weekend (Friday, Saturday, and Sunday) a group of us took boards: Physiotherapy, Part II, and Part III. I wish I could say it was 3 days full of fun-filled magical awesomeness, but I think you guys know me well enough to know I'd be lying through my teeth.

We all survived the weekend, in large part due to the support we gave each other. Julia was my right-hand this weekend. She made me study when I didn't want to, go over questions, and made sure I got out of the hotel room on time (and didn't get lost too badly getting back and forth from the hotel). Ricky and Alid were the humor for the weekend. The four of us (including Julia) and two of Alid's friends from Palmer, went for dinner after PT. I honestly thought we would be kicked out of the restaurant, we were laughing so hard. It was just what I needed to keep me going another day.

It was great to see the smiling faces of people we've taken tests with before from other schools, and also of each other. Kind words of encouragement were given by so many. Leslie, Bryan, Julia, Alid, Theresa, Ricky, Roshaun, and Dave: My huge thanks to you guys for keeping me going this past weekend -- even if you didn't realize that's what you were doing.

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It was a weekend fueled by caffeine and lack of sleep. We learned how little sleep we could survive on, how many questions we could answer in a short period of time, and how much caffeine was required to take an exam at 7:00 a.m. We were laughing at each other and our test-taking strategies, how long it took to finish certain exams, and how much we were stressing about something really and truly out of our control.

Boards are interesting, because you've been studying for them all along. There's really nothing to "cram" for, and yet we cram every time. Of course, it doesn't hurt to refresh memory on what we've not seen for a couple of years even. Part I, last year, was a test of the basic sciences. While these were more clinical, the basic science stuff just doesn't go away. There's always something that didn't get covered, that we haven't heard before, or that we've never seen. There are questions on every test that make no sense, and like all standardized test, more than enough opportunities to overthink something. I've always been baffled at how any exam in medicine can be made into a "Multiple Guess" test -- when everything we do in medicine is completely essay.

But, we survive. No! We endure. And however the scores come out, they come out. We'll take them as they come.

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In other news, clinic is in full swing. At the HEC NUHS Student Clinic, we are BUSY. We've been seeing sports physicals and regular patients -- several every day. As the term gets underway for the SPC students, we'll be seeing less of some sports physicals, and more of others. I believe we're serving at least 3 different sports teams now -- so there will be no shortage there.

I'm finishing up a quarter for the Master's program at UWS. Finals are this week. Hard to come back and tackle that after last week. But I'm SO looking forward to two weeks off with no pressing studies. Next quarter with them starts in a few weeks with Sports Nutrition and Fitness, Gastrointestinal Imbalances, and Oxidative/Reductive Dynamics and Energy Production. Sounds like a party.

Have a Great week, Everybody!!!!

Welcome Back Everyone

Photo of colored pencils"Don't you love New York in the fall? It makes me wanna buy school supplies. I would send you a bouquet of newly sharpened pencils if I knew your name and address. On the other hand, this not knowing has its charms." -- You've Got Mail

I always loved this quote. It reminds me of growing up and going to get school supplies in the fall. Things were a WHOLE lot different then. The seasons changed; things got a little crisper, a little clearer, and somehow a bit calmer.

Welcome Back, Everyone!!!!

I must admit, the last 5+ weeks have absolutely flown by. I honestly don't know where the time went. Between break and the first two weeks of clinic, it just kind of vanished. *poof!* I learned something new over break: singular tasking. I know; you must be asking yourselves. "What is she talking about?" I am a notorious multi-tasker. It annoys people to no end how I'm always doing multiple things at once. But, I made a concerted effort, to simply sit and do one thing at a time over break. It was weird; I will admit. But it was also interesting. I tried to relax, focus on what I was doing (or not focus on what I was doing), and it almost became meditative for me -- no matter what task I was involved in. I'm hoping to do more of that in the future.

We're back in clinic and we've got a new classmate that's joined us from Lombard. (Your loss, Lombard -- Leslie is great!) And we've also been joined by a new crop of now 8th trimester students -- some of which started out in our original class, but have been 5-track students. It's good to be back together again. I'd forgotten what a good crew we were. Next week will be the first week that we're all seeing patients together, but during the preliminary workshops and orientation, I can tell that they're all going to be amazing!

Our students have separated into the two different clinics. For those that aren't familiar, we have two clinics in Florida -- a more student-based clinic at the Caruth Health Education Center, and a more public-based clinic in Pinellas Park. Our student-based clinic treats students, faculty, and staff for NUHS and St. Pete College. Our public-based clinic treats people from the public, but also some faculty from NUHS and students and faculty from St. Pete College. We're BUSY!!!!! It's been really odd having lost half of our classmates. It's a lot quieter when the 8th trimester students aren't in the office, but also, everyone that we've been around, every day for the last 2+ years (depending on when they joined us), isn't around any longer. It's been very different.

That having been said, I LOVE the crew that's I'm at the clinic with now. Everyone is fantastic. They work VERY hard, and we all seem to work very well together. Even though we've already been here for 4 months, it's still a period of adjustment, especially as we get more and more responsibility. I'm looking forward to seeing how things go.

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While we've been working in clinic, we've also been trying to study for boards. Most of us are taking Parts II, III, and Physiotherapy this coming weekend. It's a LOT to study. This is the first time that I've felt extremely unprepared for boards. I think it's because too much of a good thing is just too much. I've got more board study materials than I had for Part I -- probably triple the amount of materials. We were told that there is such a thing as over-studying for boards. I don't feel like I'm there yet; I have quite a ways to go. Here's hoping I make more headway before Friday. I'm pretty nervous.

But, we will go, and we will fill in bubbles and say prayers and hopefully things will work out.

As things get closer and more boxes are checked and things crossed out, I get more excited, and a little bit more scared. But it's all a great adventure.

Have a great week, everyone!

Going, Going...

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.

                               -- Dylan Thomas

Boy, did the end of this tri sneak up on me. I'm not kidding. I looked up and it was Week 13 and I had to start scrambling to get everything done. Now, here we are in Week 14 and the scrambling continues. It's the end of Tri 8. The End. Of Tri 8. These are the last finals that I have to take for this program. We're all to the point where we're fed up, tired, and so over all of the projects and papers and quizzes and exams and practicals. I've heard talk from a few people about giving up. I really have. It's not out of the realm of comprehension to just throw your hands up in the air, take a different path, and just go quietly into the night. But we won't, because we've come too far and done too much work. We can't quit now. It's just not an option.

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In Doctor-Patient Relationship class today, we were talking about lobbying, the ACA, the ACC, and a few other organizations. We were talking, not just about what we're doing here, but what we're hoping to accomplish -- the bigger picture. We've been tasked with writing down where we want to be in 5 years -- not just what we want to be doing professionally, but personally. I can't imagine what life will be like in 5 years -- where I'll be, what I'll be doing. It seems so far away, and yet I know time will fly (just like this Tri did). I wonder if the face of medicine will change -- whether our scope will change across the board, whether we'll have prescribing rights in more states, or whether we'll continue to be segregated like we have been. A lot can change in 5 years -- 5 years ago my life looked dramatically different. I never thought I'd be where I am now, doing what I'm doing. It's pretty amazing how things can change.

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I know, though, what I'll be doing for the next 9 days: studying. So with that in mind, I'll keep this brief and to the point. Study hard, boys and girls. Get your work done; finish your projects. Check the check boxes and fill in those dots. Share some gratitude and compassion with your classmates and even your instructors. This is the last time we go down this Path.

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As a "going away" for this Tri, I found another little park tucked back somewhere in Gulfport while Grey and I were driving around. Photos in this post courtesy of Grey.

Good luck on exams everyone. Have an amazing and restful break.

Life's Kaleidoscope

The trimester is coming to a close, and I can honestly say it's flown by. We're all scrambling to meet deadlines in the clinic: this many of this, that many of that. It hardly seems that about 12 weeks ago we were terrified we'd be horrible at this. Truth be told, I didn't think anything about deadlines and numbers and paperwork (OK, well I did think about paperwork a little bit). That's probably why I'm scrambling now.

The last couple of weeks have been discussions about who is transitioning to the other clinic, and some talks about where we'll end up. Half of our crew is moving to the other clinic. It's unlikely that I'll see them very often. Perhaps we'll have seminars or training sessions of some sort, or get together outside of school (although we don't do that now). But in a few weeks, there will be another big transition for all of us. Some of us have been together, nearly every day, for about 3 years. This will be something really new.

Newness. It reminds me of my theory about Maslow's Hierarchy from last week. Incidentally, I've been working some more on that, but I'll spare you all the details. I had the pleasure to discuss it with two of my fellow interns today, the concept of new ideas. We were talking about my theory, and about other theories -- things in medicine and science that seem to have been left behind. We were discussing the idea that there are no new ideas.

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Mark Twain said:

"There is no such thing as a new idea. It is impossible. We simply take a lot of old ideas and put them into a sort of mental kaleidoscope. We give them a turn and they make new and curious combinations. We keep on turning and making new combinations indefinitely, but they are the same old pieces of colored glass that have been in use through all the ages."

I grew up not far from good ol' Mark Twain's stomping grounds, but between you and me, his writing always made me crazy. No matter how much I tried, I couldn't understand the dialect he wrote. I'm not sure that I agree with Mark; it seems we're discovering new things all the time. From god particles to medicines, we strive and learn how to change, adapt, and understand the world around us.

If the last 12 weeks in the clinic have taught me anything, it's that we have no standard approach to treating anything. We have to be willing to come up with new ideas, or at the very least, new applications for old ideas. For every patient that comes in, even if they have the "same" diagnosis, what works for each one of them is likely to be something completely different.

I'm fairly certain that our discussion today came to the conclusion that there has to be something new. There has to be a pursuit of Science that crosses boundaries into new territories, that bypasses the need for a randomized controlled trial of everything, and simply embraces discovery for the sake of discovery, and implementation for the benefit of the whole. Perhaps we're all idealists. I see no problem with that. Being idealistic just promotes my love of the field and my hope for making a difference.

Neil deGrasse Tyson, in his series "Cosmos" said:

"To make this journey, we'll need imagination, but imagination alone is not enough because the reality of nature is far more wondrous than anything we can imagine."

OK, Neil. I'll take that one to heart. The greatest theories come from crazy idealists.

I wish you all many great new discoveries. May your kaleidoscope always look just a little bit different.