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Arrivederci, Ann Arbor!

And, in the words of Oprah…it is done!

Of course, I believe she was referring to the end of her talk show empire and not her last few days in Ann Arbor, but nonetheless it rings true in both cases.  My bags are packed, I’m ready to go, and after several days of waiting for the movers with bated breath, I am told that tomorrow is the day I will finally be heading East.

Although this week has been a frenzy of packing (I fear that I could have been featured on an episode of Hoarders if the producers of the A&E show had happened across my apartment in the past few days), I spent last week in a paradise of incredible food, art, and beauty (and did I mention food?) in Italy.  We started off in Rome, where we toured the Vatican, marveled at the Sistine Chapel, and pretended to be Russell Crowe-like gladiators at the Colosseum, before heading to beautiful Florence and seeing the incredible David (one of the highlights for me) and countless rows of leather and gold shops that all looked pretty much identical to each other and yet all somehow manage to stay in business.  Our tour ended in Venice, which was perhaps my favorite of all—I loved getting lost in the streets of Venice, wandering over bridges with a cone of gelato and stopping to eat at tiny cafés on the side of the road that seemed to pop out of nowhere.  Everywhere, the same three staples were readily available: pizza, pasta, and vino!  And I did not disappoint—I had red wine with dinner almost every night, ate more spaghetti than resides in the aisles of Kroger, was serenaded on a gondola ride through the canals of Venice (granted, by a larger gentleman who almost tipped the boat with every movement), and had one of the best meals of my life (not to mention imagination) on a Tuscan vineyard.  The days of 4 AM wake-ups and shelf exams seemed a million miles away, and I just completely relaxed and enjoyed myself.

On the same token, however, by the time the end of my vacation rolled around, I was ready to come home.  Just beyond the incredible arduous task of packing and moving is a new start, and one that I’ve spent the last 4 years preparing for: residency.  Although I will still be outfitted in a short white coat (interns at MGH, Brigham and Women’s and Beth Israel traditionally wear short white coats), I am, somewhat unbelievably, finally a doctor.  I feel incredibly lucky to get to do what I really love doing, and to be near the people in the world who mean the most to me (with the exception of the wonderful friends I have been fortunate enough to make here in Ann Arbor, some of whom will be staying in the Midwest next year).   

I’ve been asked many times throughout my time in Michigan what brought me, an East Coast girl who had never so much stepped foot in the state of Michigan prior to medical school and had attended high school and college in Massachusetts and New Jersey, respectively, here for medical school.  Around 4 years ago, I had to make the choice between staying in Boston for medical school, heading all the way west to California, or going just some of the way west to Michigan.  I respond, though usually with an abbreviated version, that every important decision I have ever made in my life has been based on a gut feeling.  On my visit to Princeton as a high schooler, I was overwhelmed with a feeling of belonging and wanting to be among the people I met there.  And when I came to Michigan for my interview, despite never having so much as watched a Michigan football game on TV, I once again had this feeling that this was where I belonged.  The medical students, faculty, admissions team, and campus just drew me in, and I decided to take a chance and move far away from my family and everything that I’d known to come to school here.

The result of taking this chance has been beyond anything that I ever could have imagined.  It was here in Michigan that I found a group of the most wonderful people, from all across the country, who had felt the same way about this place that I had.  It was here that I found friendship, and love, and a mom away from home (Renee!), and a career that I cannot wait to embark upon.  It was here that I lost a dear furry friend, but then later met another who will be coming with me to Boston.  It was here that I struggled through many a biochemistry exam, then physical exam, then board exam, then shelf exam…but somehow came out on the other side.  It was here that I learned to become a doctor.

And now as I leave here, I know the following to be true: I could not have asked for a better education, a better group of classmates and friends, a better place to grow and learn, a better group of faculty and residents to learn from, or a better family.  As I head back to the East Coast, I will be forever grateful for the time I had here, and I will always be proud to say that I came from the University of Michigan.

It has been such a pleasure to have the opportunity to record my experiences of the everyday life of a medical student here—4 years’ worth!—in this blog.  If you have any questions about Michigan, medical school, or the final season of Lost (or the other way around—I have lots of questions for you about it), I am always available at lkehrlic@umich.edu.

Signing off for the last time, and thanking you for taking this journey with me—

Lauren

In-Doctor-inated!

For many, Friday the 13th is a much-dreaded occasion. For the University of Michigan Medical School Class of 2011, however, this day was perhaps the most highly anticipated date of the last 4 years. For rather than being a day of avoiding crossing paths with black cats or maneuvering around ladders, this Friday the 13th marked the day when each of us was declared to be a doctor for the first time. In other words, it was certainly the luckiest Friday the 13th I have ever experienced. 

Graduation Day was truly one of the most wonderful and fulfilling days of my life. I was fortunate enough to have 9 of my family members, including my mother and stepfather, father and stepmother, brother Brad, Grandma Bevy and Artie, and of course (faithful blog reader) Rhonnie and Doug, come to Ann Arbor to celebrate with me. We were treated to two wonderful speeches, the first a hilarious and clever discussion by our classmate Stephanie Sherman about how medical school is not unlike the “Choose Your Own Adventure” books many of us perused as children. She closed with an incredibly witty re-imagination of the Hippocratic Oath, which had us all laughing hysterically. 

Our second speaker, former Wolverine head football coach Lloyd Carr, started off by saying that while some may question his credentials as a medical school commencement speaker since he is not actually a doctor, he in fact has been to many doctors himself–not to mention that he has seen quite a few patients in his day, as well. Coach Carr gave a rousing speech in which he underscored the importance of preparation and willingness to serve wholeheartedly in whatever it is that you do. Whereas a football coach who does not adequately prepare for a competition may lose the game, he pointed out, a doctor who does not adequately prepare to take care of one’s patients may just lose a life. This resonated quite a bit with me, as I have often thought throughout the past four years how similar medical school–and, in particular, surgery–is to athletics: the level of commitment and preparation required in training, the excitement and anticipation of performing at a high level, the dedication to constantly improving one’s skills, not to mention suiting up in a special uniform for the big event.  The difference is, of course, that in medicine, the stakes are quite a bit higher (although some die-hard sports fans may disagree with me here…). Mr. Carr closed by reminding us to always faithfully represent and remember where we came from: Michigan.

By far the most emotional portion of the ceremony, however, was the honoring of our classmate, Sujal Parikh, who passed away tragically last fall in Uganda, where he was spending the year conducting HIV/AIDS research. His parents came up on stage to receive a special award bestowed upon him by his classmates, as well as his AOA certificate and medical school diploma. There was a huge rush of emotion that reverberated throughout Rackham Hall as we all stood in his honor, remembering our brilliant and incredibly passionate classmate and mourning the loss of his extraordinary life.  

Unfortunately, it appears that I was not the only one who was ready to be done with medical school: after 4 solid years, my trusty computer broke down this morning and sadly I am unable to post a graduation photo at this time due to an intractable blue screen. I will work on this…right after I return from Italy in a week! As an incredible graduation gift, my family is sending me on a tour through Rome, Florence, and Venice before I get ready to finish (or, more accurately, begin) packing up to head out to Boston. I will check in one last time when I return…but until then, Ciao! (which is unfortunately pretty much the only word of Italian i know).

And the envelope says…

March 17, 2011 (known to graduating medical students across the country this year as St. Patrick’s Day, yes, but mostly as…Match Day!)  has, somewhat unbelievably, come and gone.  I will not keep you in suspense too long, but I will set the stage a bit for the day…

In past years, medical students had been called up randomly to come on stage in front of an audience composed of the whole class, along with their friends and families, to open the envelope containing their fate for the next 3-7 years (depending on the length of their chosen residency) and share it with everyone present.  In the past couple years, the format has been changed slightly so that students receive their envelopes prior to coming on stage and then have the option to either open it on their own and then share the news in front of everyone, or to open it for the first time on stage.  My original plan had been to do the latter, but when one of my best friends, Andrea, opened her envelope and saw that she would be headed to her first choice (the Children’s Hospital of Pennsylvania, or CHOP), I became so excited that my plan was foiled and I decided to open my envelope right then and there as well.  And it said…

…that I will be doing my residency at the Harvard Combined Orthopaedic Surgery Residency Program!!  I could not have been more thrilled, as evidenced by the fact that I (apparently) began crying/jumping up and down (I was told by my classmates later on; the whole moment is a bit blurry at this point) and was just overcome with emotion at the realization that I had not only matched at my first choice, but would also be heading back to my hometown for the first time in almost a decade.  I will be rotating at four different hospitals during the next 5 years of my residency: Massachusetts General Hospital, Brigham and Women’s Hospital, Beth Israel Deaconess, and Children’s Hospital of Boston.  Which means that I’d better start working on both my sense of direction as well as my knowledge of Boston sports, which has been substantially reduced from childhood.

I feel incredibly happy, blessed, thankful, and excited.  Getting to share this moment with my mother, my classmates, our deans and counselors, many of our favorite teachers and physicians from throughout the 4 years of medical school, and so many other people who have just made a huge difference in our lives here at Michigan (such as Robert Ruiz and Dr. Gay from the admissions office, who were responsible for us all being there in the first place!) was just so special.  It truly was one of the best days of my life, and I could not be more grateful to the University of Michigan Medical School for preparing me to end up at such a wonderful program.

After sharing my match results on stage and placing a pin on the map (see above; this, by the way, was quite a difficult feat due to the fact that my hands were so sweaty and shaky from excitement that I could barely manage to find the state of Massachusetts, let alone stick a pin through it), I got to sit back and listen to my classmates share their results as well.  In a class of 170, you get to know each other pretty well over the years, and as everyone went up on stage I was flooded with memories of being in histology lab with them as M1s, or on seemingly endless internal medicine rounds during 3rd year, or playing in late-night broomball games…and it was just such a wonderful day.  In the midst of all the celebrations after the ceremony, I received calls from my new chairman, as well as many of the current residents and my fellow incoming residents, welcoming me to the program and encouraging me to contact them with any questions.  And of course, as a sign of the times, all of us suddenly had a lot new Facebook friends as our respective program directors e-mailed us our new lists of colleagues.

As wonderful as it was to have so many of our classmates and loved ones with us, there was one individual who was notably absent.  We observed a moment of silence prior to reading our match results as we remembered our late classmate, Sujal.  He was also honored with a special award named for another former University of Michigan medical student who passed on too soon, the description of which fit Sujal’s spirit and work ethic to a tee.  Without so much as a single word being spoken, there was very much the sense that he was smiling down on all of us, his former classmates, as we celebrated this milestone marking the first day of the rest of our lives.  He was in all of our hearts that day, as he is every day.

Congratulations to the Class of 2011–it was such an honor to share this day with all of you!  And now, to get started on the giant package of paperwork that contains our contracts, medical licensing information, etc. that has just come our way…looks like the honeymoon period may be coming to an end!

March Match-Ness

 

Ryan, Jeremy, Rachel, and Steph on hand to celebrate Andrea’s birthday! Unclear what exactly Jeremy is doing in this photo…

Greetings from behind the scenes of the 2011 Galens’ Smoker, Spleen Girls (a take off of my personal favorite film, Mean Girls)!  We are two days away from the opening of the show, and I thought I’d use the several hours of wait time before my scene’s practice to say hello—I am fulfilling a life-long dream—and by that I mean nightmare—of participating in a public dance performance alongside my fellow fourth-year female med students called The Babe Dance.  

After months of traveling from New York City to San Francisco to Boston to Louisville to Los Angeles to Connecticut, I am finally back in Ann Arbor and have spent the past three weeks in the Surgical Intensive Care Unit, or SICU.  I would be lying if I said it hasn’t been difficult to get back in the groove of being a medical student and actually working after two months of putting on a suit morning after morning, taking tours, eating more pastries than I care to remember, and responding to the question, “So, why do you want to go into orthopaedic surgery?” approximately 6 times per day.  I had gotten so excited about starting residency that I almost forgot about the last three months of medical school: pre-rounding, scavenging for labs, and 30-hour call shifts.  What makes fourth year great, however, is that you can finally see the light at the end of the tunnel—we will find out where we match on March 17! 

Interview season was largely a blur, and a rather expensive one at that.  I remember being remarkably nervous before my first interview, but by the time I got to #3 or so I started to fall into a routine—and became an expert in the art of packing a suitcase for a two-day trip.  I had thought that it would be prudent to spend some time reading up on health care reform and such prior to interview season, but as it turned out (perhaps as a product of the field I am entering into), the only current event I was actually asked about was the current state of Michigan football and my thoughts on whether Rich Rodriguez would be with fired following the bowl game loss.  Some places required us to perform manual tasks, such as constructing structures out of clay based on two different two-dimensional views while being asked questions rapid-fire style by interviewers, suturing wet hot dogs back together (after being told that they had gotten into a nasty bar fight the night before), drilling a screw through a Styrofoam ball and into a loop of wire using a fluoroscopy machine to guide so, and so on.  The one constant on all these interviews, though, was that no matter where in the country I went, I was greeted with some variation of, “So you’re at the University of Michigan…what a fantastic place!” 

Another unexpected perk of interviews was getting to meet some really great people.  Women are still very much a minority in the field of orthopaedic surgery, and it was not uncommon to go to interviews and be either the only female amongst a large collection of men.  After a few interviews, I started to see the same group of people again and again, and it was nice to compare notes on programs and hear their insights, especially as the deadline for rank lists drew near and I realized just how much many of the programs blended together.  

So, much like the thousands of other fourth-year medical students across the country who have likewise submitted their rank lists, I am now counting down the days until March 17.  Until then, there is much to be excited about—this weekend’s Smoker being at the top of that list, as well as the lack of call in the musculoskeletal anatomy course I will be taking next month!  I am also looking forward to getting back to the guitar lessons I took during my first and second years, as well as even some cooking lessons.  I have lived in the same apartment for four years, and I figure that it’s about time I actually made use of my stove and gave the microwave a break! 

I will keep you posted on the events of Match/St. Patrick’s Day—countdown is now at 2 weeks!

New Resolve

In memory of two very special souls who have passed on: Tess and Sujal, photographed here in December 2008.

New Year’s Resolution: Blog more often.

Fortunately, I have not set the bar for this task very high!

Happy Holidays and Happy New Year to all.  A quick perusal of my most recent blog shows that it was still fall when I last updated, which means that even in Michigan the snow had yet to arrive.  A couple of blizzards, near-blizzards, and friendly dustings later, it is already January 2, 2011.  I have waited for this year for many years–from the moment my fellow classmates and I first put on our shiny new white coats (which, by the way, is currently in a sad state at the bottom of my closet) and were introduced to our friends and families at the White Coat Ceremony as the Class of 2011, this year has had a special ring to it and yet has always seemed so far away.  Until now.  As I rang in the New Year a couple of days ago (or at least came close…it seems my ability to stay up until midnight has diminished in recent years, especially when combined with champagne), it struck me–it’s finally here!  Board exams are done, shelf exams are done, and though there are still multiple challenges ahead in the form of a full month of interviews, an online course called Advanced Medical Therapeutics, a month in the Surgical Intensive Care Unit (SICU), an elective month of orthopaedic anatomy, and a hospitalist month in internal medicine, the end is finally in sight.

I last left you on the eve of my away rotation in orthopaedic surgery in Boston.  What was originally to be one month ended up as two, as I had the opportunity to rotate at both Tufts University and then Brigham and Women’s Hospital, which is part of the Harvard Combined Orthopaedic Surgery residency program.  These two months were a blast.  Tufts and Harvard both have wonderful programs, and it was great to spend time with my family and be back in my hometown.  Although the first couple days of working at a new institution can be somewhat of a frenzied experience between getting lost (multiple times) en route to the OR, clinics, and conferences (although I did seem to have a knack for finding the cafeteria), as well as figuring out new computer systems and adjusting to minor-to-major differences in the way things are done at different hospitals (apparently Michigan is quite unique in our practice of always gloving  the non-dominant hand first before surgery), residents and attendings at both places were great in terms of showing me the ropes and helping me get settled.

I rotated in hand surgery during my month at Tufts, and then did a week of joint replacement surgery, a week of spine surgery, and two weeks of orthopaedic trauma surgery at Brigham and Women’s.  One unexpected surprise of rotating at the latter hospital was the opportunity to reunite with a bunch of University of Michigan Medical School alumni who are currently in residency there–between the ER, the cafeteria, and the hallways I saw old friends who are now in the midst of general surgery, orthopaedic surgery, OB/GYN, and ER residencies.  We occasionally celebrated (but more often bemoaned) our football team’s performance and traded updates on mutual friends.

Sometime in the middle of my month at Tufts, I learned that one of our beloved classmates, Sujal, had been involved in a motor vehicle accident in Uganda.  Suj, who was without a doubt one of the most hard-working, passionate, enthusiastic members of our class–and probably any medical school class you could find anywhere–had been in Kampala for the year conducting HIV/AIDS research as a Fogarty International Clinical Research Scholar when he sustained life-threatening injuries.  Our Dean’s office kept us in close contact with daily updates on his status, and within days we were informed that his injuries were too severe for him to be saved.  On October 12, 2010, Suj passed away.

It is impossibly difficult to fathom how something so horrible could befall a person so wonderful.  If you were to ask any member of our class who had the most drive, energy, spirit, compassion, knowledge of world events (including everything from politics to education to health care reform), dedication to global health care, and love of his fellow man, I think you would be hard-pressed to find anyone who would respond with a name other than Sujal.  Besides earning the universal respect and admiration of all his classmates, deans, and professors, he was also just incredibly fun to be around.  Not to mention the fact that he was always impeccably well-dressed–it seems like yesterday that I was sitting across from him in his signature sweater-and-button down shirt during the pathology elective we took together in June.

Suj possessed every quality one would ever hope for in a friend, colleague, and physician.  During the pre-clinical years as well as our weekly M3 Seminars in Medicine, he would blow us all away on a near-daily basis by asking such intelligent and insightful questions of our professors and seminar speakers that I often wondered how someone could be so informed and well-read as he was while getting through the same medical school courses and rotations as the rest of us.  During the annual Dr. Med School Pageant as M2s, I was planning a skit in which I portrayed a University of Michigan Medical School version of the classic SNL character Mary Katherine Gallagher.  I immediately thought of Sujal as the perfect addition to my act, as I knew he was a terrific public speaker and would have a great stage presence. Without skipping a beat or asking any details about my rather random request, he agreed to participate.  And although I was not to be crowned Dr. Med School, Suj was hilarious in his role and stole the show.  He threw himself entirely into everything he did, and this somewhat ridiculous five-minute skit was no exception.

Suj, you are–and will continue to be–greatly missed.  Even before your passing, you were a great inspiration to all those around you by virtue of your tireless dedication to health and human rights, both at home and abroad, and your unparalleled drive to make the world around you a better place.  And as hard as you worked, I always admired your ability to find balance in your life and be such a source of joy and love to those around you.  We are all better in every way for having known you.