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Reaching the End of M2

Happy New Year! It’s 2017, and the M2s are quickly wrapping up with our preclinical curriculum. In six weeks, we will bid goodbye to the lecture halls and anatomy labs for good, don our short white coats, and step into the hospital. I can’t wait! Between now and then, we have a two-week Hematology/Oncology unit (our last unit of new material!), a two-week review period, and a two-week vacation. The vacation is a particularly nice and unexpected gift; it will be wonderful to take a break to relax and fill our sleep reserves before hitting the wards.

Our clinical rotations (these are traditionally done during the M3 year, but we’re getting a head start due to Michigan’s updated curriculum) include blocks spent working with Internal Medicine, Surgery, Pediatrics, Family Medicine, Obstetrics & Gynecology, Neurology, and Psychiatry. We’ll be working in clinic six days a week, though the specific hours will vary depending on which service we are with. I’ve been told I’ll be very busy, but that I’ll also feel more engaged and enjoy clinic more than lectures. Hopefully it works out that way! I start on Pediatrics, and I’m excited to simply dive in and see what working in the hospital and clinics is all about. That, after all, is what I came to medical school to do! Most of my classmates feel the same way: somewhat nervous since there are so many unknowns about working on the wards, but also excited to get started. As much as we’ve learned thus far, I know we’ll learn even more during our clinical time, adding real life experience to what we’ve memorized from our text books and lectures.

Last week we had a short Rheumatology unit, in which we learned about autoimmune conditions affecting the joints. Now that we are reaching the end of our preclinical material, a lot of this unit was review of concepts we’ve seen before. It was nice to see things a second time; while I definitely needed the review, things were a bit easier to remember this time around.

 

The Botanical Gardens had an exhibit of “botanical clothing.”

 

I managed to take the test on Friday (we have from Friday afternoon until Sunday night to take our weekly quizzes or exams), which meant I had an entire weekend to enjoy! My free days allowed me to take full advantage of some of Ann Arbor’s many great things to do. On Saturday I went to a movie at the beautiful historic Michigan Theater and had coffee downtown with my parents. Sunday was very cold but beautifully sunny, so I bundled up and went for a run by the Huron River – one of my favorite things to do here whether winter or summer! I spent the afternoon at the UM Matthaei Botanical Gardens, enjoying the warm steamy air and many-colored plants, and finished up the weekend with a game night featuring Settlers of Catan. School keeps me busy, so I always appreciate free time and try to make the most of it.

Stay warm out there!

 

Life Outside Medicine

What if I told you there was life outside medicine? Cheesy, I know, but I’d like you to take a second to imagine the possibilities that await you when you attend a university such as Michigan—one that fosters exploration of all your talents. Well, if your imagination is still dulled from overindulgence this holiday season, I’ll try to paint a vivid, tropical picture for you.

The JerkxJollof team is a diverse group of past and present University of Michigan students with (or earning) degrees in medicine, engineering, social work and music.

Though romantic, I sought to examine this problem similarly to how we are taught medicine: holistically and sometimes seemingly paradoxically. But like any medication hoping to breach the market, this theory had to be explored before being put into practice. Michigan’s flextime quizzing gave me the opportunity I needed by allowing me additional time to frequent Toronto, a flourishing, unapologetically diverse international city that nurtured the concept of promoting diversity through celebration.

Realizing the need for such untraveled avenues, my friends and I set out to address the theme of celebration by creating a space where individuals could rejoice and learn about rich African and Caribbean culture. Borrowing the name from a past graduation event, JerkXJollof (pronounced Jerk and Jollof) was born. The name embodies both the Caribbean and African diaspora respectively through two native dishes: Jerk, a fiery Jamaican cooking style, and Jollof, a spicy West African rice dish. Through Soca/Afrobeat-themed parties we call “experiences,” we pride ourselves in sparking discourse with culture, cuisine and nightlife.

These community outreach initiatives are just one of the many endeavors I’ve been able and encouraged to pursue far outside the boundaries of traditional medicine. I can confidently say that here at Michigan, we’re not just cultivating doctors, but nurturing people because we are encouraged to explore the fringes of our curiosity and passions alike. It is these experiences and adventures trailing humanity, independent of the hospital, that often guides and provides the inspiration required to solve complex medical anomalies. Just like healing is more than physical, and life is busier than a single lane highway, there is more life outside medicine.

The team standing in the heart of downtown Detroit in business wear depicting the dichotomy between work and play.

Attracting more than 800 people, New Year’s Eve proved to be the largest experience yet. This stage view captures the crowd’s excitement as patrons anticipate the midnight countdown.

Happy New Year! A team of drummers is seen playing traditional African beats at the stroke of midnight.

JxJ rule number one: come as you are. While some patrons wear traditional outfits, others prefer a more casual look.

Guests are encouraged to bring flags, like the Ghanaian one pictured above, to represent the wide array of ethnic and cultural identities present at the event.

 

And Then There Was (Rogue) One

I had a somewhat eye-opening experience yesterday. I had just gotten back into Ann Arbor the night before and, in typical fashion, already had the day booked solid with appointments, errands, visits, etc. A good chunk of those things were at the hospital, and so I found myself there despite not formally starting back to work until Monday. I initially felt kind of bummed to be back in all honesty. I wouldn’t go so far as to call myself “burned out,” but it really is exhausting having to be “on” all the time (at least for a closet introvert such as myself). The truth of the matter is that, as medical students, we’re constantly being evaluated by our superiors. At best, it can get a little old. At worst, it can drive you into a neurotic frenzy. I find myself somewhere in the middle ground between the two, perhaps a smidge closer to the frenzy end. Even so, simply being in the hospital felt more like coming home than it ever has. It felt like a reminder that all this grading hullabaloo is only temporary and worth enduring.

It ALMOST made me forget about the 2000 dollars I just spent registering for Step 2 examinations. Almost.

I’m getting ready to start the last of the M3 core rotations: Pediatrics. I’ve got a lot of things to mentally prepare myself for, such as catching every upper respiratory infection known to man, having the fact that I have no idea how babies work exposed in front of a bunch of experienced parents, not absolutely embarrassing myself should I run into someone in a Star Wars costume, and so on. It’s going to be rough.

omgomgomgomgomg (Play it cool, Stef, PLAY. IT. COOL.)

I am, however, very much looking forward to having an excuse to act like a total goober while on the job. (I’m building rapport with the patient, DUH.) I’m hoping to get some reticent tweenage boys and win them over with talk of video games. I’m also hoping that I’ll manage to finish out strong rather than succumbing to the finish line effect because wow is it difficult to focus when such a huge milestone is within reach.

Since I last wrote, I’ve decided that I definitely want to do a research year and I’m currently working on finding myself a lab. It sort of feels like a blast from the past, harkening back to my M1 experience trying to find an SBRP mentor for my summer research. Of course, this time the stakes are a wee bit higher. Aside from the obvious difference of duration, I’ve really got to be able to show something for my time (read: get published, preferably more than once) and I also need someone who is going to be ok with my schedule being a little flexible to allow for clinical exploration. It’s not exactly the easiest thing to ask: “Hi, I need you to get me into fancy journals and also let me do what I want. Kay thanks!” It’s also not ideal that the first chance I really had to sit down and start contacting people was over the holidays, when said people were likely off doing things other than obsessively checking their email. (I was playing video games AND obsessively checking my email.) Things worked out wonderfully in the case of my SBRP mentor; I just have to believe that it will happen again and keep plugging away!

Hurray for 2017!

Well, 2016 is finally over! It was definitely a tumultuous year, with the highest of highs and the lowest of lows (and I’m not just talking about Michigan Football). I think everyone had a collective sigh of relief when the clock finally ticked over to 2017 with hopes for a much better year.

For me, 2016 was similarly a time of upheaval. I earned a master’s in bioinformatics and returned to third-year core rotations. Working with patients and helping them heal have been thoroughly enjoyable experiences, but I’m very grateful for the three-week break during the holidays. It was wonderful to sleep more (especially coming off labor & delivery nights…), spend time with family, complete the miscellaneous tasks that build up when busy, catch up on favorite TV shows, and, in general, do nothing. It was amazing.

The best part – I finally managed to finish embroidering and constructing my grandma’s Christmas present, a snowglobe pillow. I had been planning its creation since September but didn’t get around to actually embroidering it until mid-December. Thankfully, I managed to finish it with time to spare.

My time on OB/GYN is dwindling with only a week of clinical duties left before the shelf when we return. I have enjoyed my time here, especially the opportunity to see mainly young, healthy women without the laundry list of comorbidities that was standard on Internal Medicine. Next up, I’ll be on Psychiatry before we begin M4 electives in March and April. M3 year seems like it is flying by now!

Happy 2017, everyone! May your New Year’s resolutions last more than two days, and may you be happy and healthy in the coming year!

Waking Up

On six out of seven days every week for the past few weeks, I woke up and headed to the VA (Veterans Affairs) hospital before the sun came up. I generally didn’t mind, though some mornings were harder than others. I arrived at the hospital, checked on the charts of the patients I was following, talked to their nurses about any overnight events, and went to see and examine the patients every morning. I then prepared for morning rounds, rounded with the team, and then worked on notes or other things that the patients needed. Then there were teaching sessions, tending to more patient needs, and making one final “tuck in” check on my patients before I left the hospital at the end of the day. This is the rhythm of Internal Medicine (IM). It has become my daily rhythm, and I love it.

Self-care winter break edition: mani/pedis and lunch

I admit that I had been feeling very burnt out prior to starting this rotation. The summer and fall were difficult for me, and it was one of those times where several events in my life made me stop and remember that I am a person, not just a medical student. I was hurting, but I pushed the feelings aside in my drive to be an excellent student. As I continued to push, I felt my compassion and empathy toward the patients I cared for slipping away. I hated how I felt, but I had no idea how to make it better.

This is the mood in which I began IM. I was trudging through a day early in the rotation when an intern (first-year resident) on the team made a simple request: provide him with one fun fact that was completely unrelated to medicine about each of the patients I was following. At first, I scoffed at the exercise. It was a simple task, but I was burnt out and cranky, so at the time, it seemed pointless. However, being the obedient med student that I am, I did what he requested and asked the patients questions about their lives outside of the hospital. I was transported down a rabbit hole into my patients’ lives. I learned of their struggles and successes, the things they enjoyed and their dreams. For the first time since the summer, I felt like I was coming alive again after sleepwalking through my days for so long. I was connecting with my patients, and I suddenly remembered all of the reasons why I decided to pursue medicine in the first place. I empathized with them in their struggles, and I also got to experience the small victories with them. I cared about them and was willing to fight for them. For the first time in a while, I felt like myself again, and I can’t thank that intern enough for a simple suggestion that completely changed my attitude and perspective.

Thus, I am happy to say once again that I feel very involved with the patients that I’ve been following at the VA. They have been an overwhelmingly pleasant group despite a variety of ailments and conditions. One of my favorites would greet me with a hearty “hello” every morning before we began our chat of how the night went and concerns for the new day. Usually these morning meetings are relatively brief, but this particular patient always liked to chat. The Type A part of me really wanted to be efficient, check in, and move on to see my other patients, but the human side of me always won over, and I spent many mornings chatting about anything and everything with this particular patient. These visits and my afternoon check-ins soon became one of the best parts of my day. Yes, I love the medicine, but this inpatient service has also provided me with the human element that I was missing.

Unlike residents or attendings, med students have pretty much infinite time because we follow far fewer patients than the residents and have much less responsibility. We are allowed and encouraged to get to know our patients better. Sometimes the things that we learn while talking to them help improve their care. Other times, getting to know the patients is simply for our benefit. They teach us about life, not just medicine. It’s a really beautiful thing.

When I started Internal Medicine, I was convinced that I would dislike it. I was wrong. I love the thought process of IM—it’s like the best form of mental gymnastics. I am pulling together every piece of medical knowledge I’ve learned and applying it. The attending, resident, and interns on my team pushed and challenged me in so many ways, and I love it. I really do. My brain feels like it’s going to explode every day, but in the best way possible. The medicine is amazing, the patients are wonderful, and this is what I always dreamed that medical school would be like. Also, the VA system itself allowed us to take more ownership of our patients and start to practice what it’s like to be an intern (interns and residents do not get nearly enough credit for the sheer amount of work that they do by the way).

I am happy to say that I am once again feeling well-adjusted. I was so excited to go to work every day and see my patients. I was excited to learn how to diagnose and treat them and to get to know them as people. I am compassionate and caring again. It’s amazing how one interaction can shake us to our cores and change our entire trajectory. I’m glad that happened to me because I really needed to be shaken awake. That said, burnout is real and is something that should not be taken lightly. It can harm patients, but it can also harm those in training, so if you have the chance, show a little kindness to the med students, interns, residents, fellows, and attendings you meet (I promise that they’re all working their tails off behind the scenes, and kind words or actions can alter the course of a day).

“Helping” me wrap presents. About 15 seconds later, both the bow and wrapping paper met an untimely demise.

Now, I have reached winter break. I am in the middle of three weeks off, and I am using the much-needed time off to recharge my batteries and reconnect with the people I care about. It has been a difficult year, but I am always optimistic for what the future brings. I have been pushed and stretched in many ways in the past year, and I feel like a different person because of it. This is how a future doctor is made, and I promise that it is quite the ride.

As always, thanks for reading. I hope that your holiday season is a wonderful one. See you in 2017.

Winter Solstice Reflections

Another semester of medical school in the books! It’s hard to believe that my class will be on the wards in just over two months! I really felt like I hit a studying groove in M2 year more so than last year, but it will be great to switch over to taking care of patients rather than minding the many tabs of lectures, notes, and pdfs on my computer.

The two weeks we have off now are a wonderful chance for reflection, and I’m here now at Songbird (one of my favorite cafés in Ann Arbor—you have to try the triple grilled cheese) thinking about challenges and accomplishments of the last semester. It’s amazing to have time to just sit and think, truly a luxury that can be hard to squeeze in during busy weeks. Many experiences have been meaningful in the past few months; I’ll focus on a few to share.

Surgery Olympics Team Waljee: Tim, Hannah, Tony, Shaina, Nonie

Surgery Olympics Team Waljee: Tim, Hannah, Tony, Shaina, Nonie

This past month my team competed in the “Surgery Olympics,” a program established by our surgery student interest group (SCRUBS) leaders. You might wonder what exactly a Surgery Olympics entails. I did too. We worked on surgical skills over the summer, and then competed in teams to see who could perform them most quickly and accurately in a competition. Personally, I found the laparoscopic skills (like the bean drop!) to be far easier than the knot tying and suturing: I have some work to do before my surgery rotation.

In addition to the skills contest, each team presented on a research project they had worked on with their mentor at Surgery Grand Rounds. I had the honor of presenting our team’s work. It was exciting to share our results regarding post-operative opioid prescribing, and especially to hear what all the other teams had worked on, too. Overall, it was awesome to be part of a supportive and collaborative team with the best mentor, Dr. Jennifer Waljee. We took home silver!

The second meaningful experience has been more of a shift in attitude rather than a singular event: medical school has changed my mindset on the division between work and play. Before medical school, I had more of the mindset that if there was a big deadline or exam coming up that I should really focus on that and then find time for relaxation or other projects only after it was completed. But I’ve changed. I’m so glad to now be able to turn the “work” part of my brain off even when there’s more to be done because in medical school (and life in general) there is always more to be doing.

Someone told me at the beginning of M1 that every minute you’re not studying is another minute you’re falling behind, but that’s no way to live! So instead, I’ve rejoiced in the moments I’ve spent at yoga class, or at a coffeeshop with a friend, or salsa dancing, even with an exam coming up! Luckily, Ann Arbor has many places to unwind and relax no matter your style. Flex-time quizzing and our pass-fail grading system have definitely contributed to this change, but I’m hopeful that the mindset shift will stick beyond this phase of training.

Finding time for relaxation at our Doctoring potluck. So grateful for this team (including everyone not pictured)!

Finding time for relaxation at our Doctoring potluck. So grateful for this team (including everyone not pictured)!

There’s so much to look forward to in 2017. Most of all, I can’t wait to be on the wards!