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Finding a New Normal

I have to apologize for my lengthy writing hiatus these past couple months—turns out it can take a little while to adjust to the pace and demands of medical school life! It’s my hope that I can write much more regularly from this point forward.

I’ve been thinking about a lot recently about the word “normal,” a topic that my FCE (Family Centered Experience) instructor brought up in our small group way back in September. Dr. Rodgers urged us to take note of how physicians use the word “normal” in their daily interactions with patients, as the word could be both reassuring and stigmatizing depending on the circumstances. He emphasized just how important the idea of what constitutes “normal” can play in patients’ attitudes towards themselves and their illness, and how patients often struggle with adapting to new levels of “normal” as their lives are irrevocably altered by their changing health needs.

I recently spoke with a patient (whom I’ll call Ms. A) who was very ill and had chosen to pursue palliative care as she ventured into the twilight of her life. Ms. A had volunteered time out of her schedule to speak with medical students and educate us about the multiple diseases to which she will ultimately succumb—all of this in spite of doctors telling her that she had 18-24 months left to live, a timeline she has now far exceeded. She had every reason to distrust the medical profession; from botched diagnoses to conflicting strategies for her care to impersonal interactions with physicians, it was miraculous to me that Ms. A would volunteer to give up her time to teach medical students like myself. It was truly inspiring and remarkable to see someone maintain her sense of humor, optimism, and general life vigor in the face of such dire circumstances.

I couldn’t help but think, “How does she do it? How can she keep a positive attitude in the face of such a massive amount of adversity?” I was able to catch up with Ms. A after our group session, and she graciously gave me her answers. She told me that she tries to stay positive because she has no other choice—while she didn’t choose to be inflicted with her terminal condition, she has the ability to choose her attitude towards dying and her outlook on the remaining time she has left in her life. She also admitted that not every day was a happy one, and she spoke of days where she couldn’t help but cry her eyes out, wondering why she had been given such a tragic fate. But after the tears dried, her face puffy and nose clogged, she would move forward because she had to. In her mind, there was just no other way. Ms. A told me she didn’t have to be at peace with her condition, but that she couldn’t reject or deny it either.

I likely won’t ever see Ms. A again, and I don’t know that I’ll even find out if and when she passes on from this life. But she reminded me of a very important lesson, and it’s that we have to work with the cards that we’re dealt. Throughout our lives we will always be faced with changing life circumstances, and it’s not always easy to adapt to a new level of normal. Even if we think we know what to expect, the truth can come out of left field like cold brick wall, leaving us feeling lost, exposed, and worst of all, hopeless. I know that I have much to learn over the course of my medical career, but I hope that I can remember to stay grounded and compassionate when working with my future patients, no matter how busy or tired I may be. As I gain more clinical exposure and encounter patients with all types of medical issues, I can imagine it will be easy to slide behind the veil of facts and science and forget just how much a particular illness or condition can affect any one patient and his/her family. And if I don’t take the time to exercise the more “human” portion of medicine with my future patients and help them adapt to the new normals that will be thrown their way, then I will have at least partially failed my job as their physician.

There is far more to being a doctor than making a diagnoses, setting a course of treatment, and managing symptoms as they come up. These softer skills are often scoffed at and their importance downplayed as the medical world pushes for efficiency and results grounded in hard science and facts. But Ms. A reminded me that even the most strong-willed and optimistic of people need support outside of what many consider “traditional healthcare,” and that physicians are in an incredibly unique and powerful position to help provide that support. Even if we can’t perform a life-saving operation or prevent a deadly cancer from spreading throughout one’s body, we can care, we can connect, and we can love.

Ms. A’s final piece of life advice to me was to be passionate about whatever it is that I do. It’s simple advice, but a very good reminder during a time when it’s easy to be looking forward to the next vacation from school. While medical school has been incredibly busy thus far (and will only get busier), I am having some of the best times of my life in Ann Arbor. With that said, here are some photos of some of memorable moments from the past couple months – getting a tour of the Flight for Life helicopter during Emergency Medicine Day, a group photo from a home football game, a Friendsgiving celebration, and our Cinderella M1 broomball team, who made an unlikely playoff push but fell to some experienced undergrads who might’ve been professionals in disguise…

Until next time, Go Blue!

“Kid, It Ain’t About You Anymore”

Before I jump into my first rambling tale of a blog post, it’s probably best that I introduce myself. I grew up in Colorado Springs, Colorado and am a proud 2010 graduate of a small liberal arts school in Maine called Bowdoin College. After graduating, I taught and coached for two years at a boarding school in western Massachusetts before deciding to pursue medical school. I then spent two years completing an MS in Medical Sciences at Boston University and worked for a research group that examines the long-term effects of repetitive head trauma and concussions in athletes. As an untraditional medical student (and Economics major in college), my road to U of M was a bit windy, but I believe I’m much better off because of it. Okay, enough about life pre-UMMS and on to life in Ann Arbor!

Our white coat ceremony was quite an amazing way to kick off our entrance into medical school. While Dean Wooliscroft, Dean Gay, and others spoke, all I could think about was how amazing it was to be joining the Maize and Blue family. The journey to medical school is filled with so many “I’s”: How can I get a good score on the MCAT? What can I do to impress admissions committees? How the heck can I actually get into medical school? It was a very welcome change of pace to start hearing about how our class was joining a huge and supportive medical school family, how we were now at the beginning of a lifelong journey of serving others, and how it was our responsibility as a collective whole to become the best doctors we could possibly be. This is no longer about the pronoun “I.” It’s about us, our future patients, colleagues, mentors, teachers, and so much more. I kept imagining an old, wise doctor casually dropping some advice on me and saying, “Kid, it ain’t about you anymore.” And that’s the most wonderful, fantastic part of finally becoming a medical student!

Orientation was a complete blur (and seems so long ago!) and I can’t highlight enough just how impressive each and every one of my classmates is. With vastly diverse backgrounds (including tons of non-science majors), even more unique extracurricular interests, and a common nerdiness for health sciences, it’s very exciting to think about how much we will all contribute towards bettering each other as future doctors. Our first weekend together was highlighted by a huge tubing trip down the Huron River. I can’t imagine many kayakers were super excited about navigating blobs of 20+ happy-go-lucky medical students tied together. Maybe we were simply helping them develop their paddling skills…

Lectures so far have been varied in pace (from drinking out of a trickling faucet to drinking out of a fire hose), but the patient presentation lectures have been by far and away my favorite parts of our academic schedule. So far we’ve had patients and their family members come in and talk to us about their experiences with Down’s Syndrome and Huntington’s Disease, and we have one on colon cancer coming up next week. I cannot express enough how powerful these sessions are – each lecture has been both deeply touching and incredibly invigorating. As much as you can learn about illness and health conditions from standard lectures, hearing stories from real patients who actually deal with the ramifications of these health issues both A) makes everything instantly more relevant and B) reminds us all why we signed up for this 4+ year journey in the first place.

If I have one takeaway message from my short time in Ann Arbor, it would be that the word “family” is not used lightly here at U of M. In fact, proud alumni, faculty, staff, and other members of the Michigan family sponsored the white coats and stethoscopes that our entire class received at the beginning of the school year. The faculty and staff here are as friendly and supportive as advertised, and I’m incredibly proud to call myself a Wolverine. Hopefully in a couple more weeks I’ll be a little more acclimated to the daily rigors of medical school – until then, thanks for reading and Go Blue!