Goodbye's Are Always Hard

So, to give a bit of background information on this post, I was born and grew up in a fairly large city, so I had a really great university to go to that was right inside my own community. As such, I'm one of the select few who have never had to move away from home for undergrad or for medical school. I suppose many people who had to move away for their first degrees may have experienced friends leaving or having to leave themselves, but I haven't really had to experience that thus far.

I suppose I am coming to the age where instead of moving away for university, friends are beginning to move away for work (after having graduated). I just recently had to say goodbye to a long term friend of mine and it was hard for me to do. We had met each other back in high school and have been friends ever since. It's crazy to think of all that we have went through together, and how much we've both changed since then.

What makes me sad is that I realized although we would try and keep in touch and that we would always be friends, time would make us grow apart.

My friend would go off to a brand new city and become a different person. He will go through hardships and joys that I will no longer be a part of, or perhaps only remotely, and make new friendships and experience new things. Maybe he'll even meet the woman of his dreams there and get married and start a family. Likewise, I'll be stuck here and going through clerkship and residency will also make me a different person. Even if he decides to come back and visit home a couple years into the future, will it be as easy to talk as before? Or will it seem like we've spent a lifetime apart, and that really there is little for us to connect to each other with again.

So I sit here wondering if that's whats meant to be? Do people just move on and leave their old lives behind? As the next few years pass, more and more of my friends from long ago are going to be moving on, to get jobs perhaps even in different countries much less different parts of the country. Where will the future take my friendships? Will I grow closer to only my medical friends and lose touch with all the friendships that have been dear to me since my childhood?

What in the World do Med Students Do During Summers?

So, as I'm sitting bored in my lab and browsing around random websites with not a thing to do (but hours to kill), I decided to write an article on what in the world medical students do during the summer!

1) Research - We're all still keeners and the most hardcore of us can't get away from the idea that we have to make our summers productive and useful to our careers. Best way to do so? Do research. The most hardcore medical students will get themselves into clinical research and then some will do benchtop research.

2) Volunteering - So all those who decided research wasn't for them but were still hardcore will volunteer overseas on medical trips. They get medical experience and get to see the world, what could be better?

3) Shadowing - Some people just decided to ditch any formal jobs or arrangements and just spend all summer shadowing doctors instead. Great ways to build connections and gain clinical experience. Unfortunately not the best way to make money.

4) Working at high paying jobs - We all know research pays crap. Tons of us decide to just make a huge sum of money to tackle the debt. Often these jobs have nothing to do with medicine and are construction, serving jobs.

5) Travel for Kicks and Giggles - While there are still a lot of us that are hardcore, tons of people just decided to 'screw it' and see the world, not to volunteer or to be keen, but just for fun. It's one of the last summers you will ever get so why spend it working?

6) Nothing - Couch, beer, chips, tv.

Hallmarks of a College Student

It's 'that' time again. Things are starting to get tough and exam/school-related stress is beginning to heap up. Without further ado, I introduce to you the hallmarks of a successful college procrastinator:

1) The value of a nap is contrary to popular belief, not measured by the amount of time you spent in REM sleep, rather the amount of textbook pages that your drool managed to seep through.

2) Friends or study buddies are for chumps. Everyone knows the social area of the library isn't where it's at. It's that deep dark quiet corner in the top-most floors that's the place to study. You hope that once you have annexed your seat, not a soul will walk onto your floor, and since it's about 6-7 flights of stairs up, nobody ever does.

3) F**k facebook. Why-o-why must you tempt me to spend meaningless hours scouring through random people's pages?

4) Nobody uses pens anymore for notes. We all use the pretty little Staedtler fine liners so we can color code our notes (neurotic anyone?)

5) Tim Horton's is for posers, we all know the best way to stay awake is a direct IV drip of caffeine (this one is a joke, please don't try this at home, you will probably kill yourself :P ).

6) The extra weight you gain from eating unhealthily during exams and forgetting to go to the gym isn't something to be ashamed of. It is a trophy and testament to your ability to sit in a library study for hours on end and eat McDonalds, microwave burritos, and drink coffee.

... Written exams are driving me nuts. I hate studying, I can't wait till clerkship!

We Work Hard, Party Hard. Friends, Booze, and Good Times

So, it's no mystery that med students are generally ranked as some of the most caffeine-fueled, sleep-deprived, and crazy stressed students on campus. But what may not be known is the social life of med students!

With the amount of parties and conferences that we have (practically one a week minimum) it's not hard to meet a group of really good friends. I think I've grown closer to my group of friends in the last several months than to most of my friends I met in my entire undergrad degree.

Aside from that med parties are perhaps some of the best ones on campus, rivaling that of fraternity/residence parties. You usually have a party every week and there's probably at least 50 people at attendance at any one of these parties. Perhaps it's because we all get so close through the year, but med students get crazy wild and there's at least one good story to tell from every single one of the parties. By the way, the picture just looks hilarious.

Of course boozing parties aren't the only ones that happen. There's tons of people who also organize other types of gathering such as potlucks, movies, and board game nights for those that are less inclined to go out boozing.

First Cadaver Day

As medical students, we are given many privileges over normal students. While I remember learning anatomy from a textbook in undergrad (often times with drawn rather than real pictures), we are given the unique opportunity to learn anatomy from actual bodies.

We started off by discussing dissections in general and talking about conduct around the laboratory. We were told the sacrifice and altruism the donors had when they donated their bodies. They were in full knowledge of what would happen to them and agreed to donate themselves after death to train a new generation of doctors.

We headed downstairs towards the basement, where our labs were situated and were given a chance to group up and find our cadavers we would be working with. Each station was equipped with a hand washing station and a monitor with which we could observe our instructors and the dissections they were doing.

Anticipating seeing a dead body for the first time, I was feeling a bit queasy and uneasy; however, what I found was that the cadaver was fairly far removed from what a human looks like when alive. The skin is hardened and frozen in place from the formaldehyde and the skin is just a shade of grey. The face is covered up and the only exposed areas were the torso.

Overall, I think today was a very humbling experience, to see the body of a deceased person, and also a very unique experience, one that only a few members of society will ever experience.

To end this post, I would like to post a thank-you to all those who donated their bodies and to the families of these people. Not only to my cadaver, but also to all the people out there, the medical schools cross-Canada and also internationally, that have made the altruistic sacrifice to help us learn.

Journeys

Have any of you ever worked like hell for something and when you finally get it, you realize the end-product isn't as important as you thought? But in self-reflection you find that the journey itself is what was truly important?

Let me take you through my experiences. Of course for the past few years, I've dedicated every waking moment to making it into medicine, to get that letter in the mail affirming my end goal of becoming a doctor. But in reflection, what was really important? Was it the piece of paper with patterns of black ink on it? Or was it rather the journey towards it, the experiences you had, the growth your character has experienced, and who you have become as a result of the journey that matters?

My journey towards my letter has hardly been a easy one. I've experienced crushing failures, gotten up from them, and learned from my mistakes. I still remember applying for my first time and receiving the letter of rejection. I had poured my blood, sweat, and tears into making it into medicine and having a letter telling me I wasn't good enough felt like being hit with a sack of bricks. While I moped and cried for a while, I realized that I could not give up, I needed to get up and try again. Looking back to this experience, I'm glad I was rejected, the failure (while it hurt) was one of the most useful experiences I could ever have had. I took a long hard look at myself and improved myself, made myself into a better person, and a better future doctor.

I sincerely believe that due to the journey, whether I had made it into medicine or not, I would have become a better person.

Now, I'm walking along another path, one where I know the outcome, but the path is hardly going to be easy. I've already hit obstacles already. I know that the next 6-9 years (residency + med school) will be tough, that I will stumble, and I will fall, but I know that after these years, I'm going to be a different person. A better person, and perhaps one that is equipped with the character to help make a difference in the world. And this time I know that it isn't just the MD that is important, but the experiences and the lessons that lead me to that MD.

From Science to Emotion

Throughout my undergraduate program medical school so far, I learned about human physiology and (to some extent) disease. I found the material interesting, but nevertheless bookish and abstract. It was intriguing to learn about masses growing in the brain, to read about case studies of patients in far away places and what behavioral deficits it resulted in. For instance the famous cases of HM (seizure patient, surgical intervention, leading to permanent loss of long term memory formation) and Phineas Gage (pole through the frontal lobes leading to a complete change in personality) that have probably been written about in every brain-related textbook in the past few decades.

But reading about these cases is so completely different than approaching a patient. It's so easy to sit in a room, discussing amongst doctors about an interesting brain tumor they find on a patient. But walking up to a human being, sitting down, and telling someone that they have brain cancer is a completely different story. As doctors have a multiplicity of times told me, you learn to separate yourself from the emotions, from the patient. But how do you do that, is it possible to completely distance yourself? I have thus far been lucky not to have seen someone get bad news and am far too early in the game to have given someone bad news, but how do you completely emotionally distance yourself from a situation like that? Back to the brain cancer example, you probably have sat down and given the person and maybe even the family, the worst news that they have ever heard in their lives. How do you not emotionally respond, how do you not empathize with that person?

But by the same token, we can't. Everyday, especially if you work in a hospital, you will be surrounded by people like this. You'll be walking from cancer patients to trauma patients to coma patients etc. If a doctor empathesized and felt the sorrow from every single person they saw, well they probably wouldn't last for too long...

Med School is a Little Like High School

So, as promised my next blog is about med school.

Med school is actually a lot like high school, you don't notice it at first, but if you are separated from it for a little amount of time (like the holidays where you go back home) looking back at it, it's a lot different than undergrad and a lot like high school.

You have the group of popular beautiful people, various other cliques, the few people that nobody really knows and who just go in/out of classes and all the wonderous associated drama that happens.

Really, in undergrad, I had kind of gotten used to being away from this whole high school social thing. My classes were always huge, and my program didn't have my entire schedule set out for me, so really, the people in my classes differed all the time. I would rarely even sit next to the same person. I had close friends I met along the way in undergrad and I would hang out with them, but really there was no popularity contests or social stresses inside school itself.

Residual Stress and the Mysterious CARMs

So, my next blog post will be about the "stress" that I've been experiencing lately. Really, the pre-clinical years in a Canadian Med School should be pretty chill. Your not on rotations or clinical work yet, and for the most part a lot of the pressure to get a A+ (since it doesn't exist anymore) is gone. You get either a H, P, F or a P, F (H: Honors, P: Pass, F: Fail) depending on which Canadian school you go to.

However, I think that I still have some of that residual pre-med keener still roaring inside of me, and I can't help but stress about small things. One of the things that I have been stressing about is the CARMs match I will have to undergo in 4 years time (it's a program in Canada that matches a MD graduate to the residency/specialty that they want) and how I am supposed to prepare for it. The only problem with this is that I have no idea what I even want to do yet, aside from the fact that I want to work with patients (so probably no to radiology, pathology, and the laboratory-based specialties). And if you don't really even know what you want to do, there really is not much of a way to prepare for it (aside from basic stuff like get involved in activities and trying not to fail a course).

The one aspect of CARMs that really does stress me out is my lack of knowledge concerning the weighting of the different components of the application. Does research count for a lot of your evaluation? How much research is enough research? Is it really the reference letters/clinical rotations in the latter bit of my MD that matters?

We're at 8% MD, how time flies!

http://www.youtube.com/watch?v=xk57tmbFKsQ&feature=player_embedded

Random video I found on another medblogger's site (this guy's graduated and that was his commencement speech, if you want to see his original blog, visit here)

The speech gives one the impression of the enormous amount of memories and of the learning that we are all going to do throughout our years. Although my class has just started med school, we've already had various moments that will live long in the classes' memories and there has already been much bonding amongst classmates. We're all going through an adventure together (we're stuck for 8 grueling hours a day together - by the end of this I will have adopted a severe addiction to all types of caffeinated beverages), as a tight knit group and I think we can't help but make some of the closest friends we ever will have here. There is so much culture, and so many great people in our class that I'm excited to see where life is going to take us!

Med school is a completely different environment then undergrad (well at least my undergrad experience). In undergraduate, I was one of the 500 students in an Organic Chemistry course. I wouldn't even get the same seat every time and the people around me would change every single day. I got to meet a few friends, but in science there really was no culture or any real memories at all. You were just one straw in the haystack and nobody knew who you were.

The Beginning of my Journey through Medicine and Medical School

The lifechanging moment: Acceptance May 15 2009 ~9:00 am

Although a bit late in starting this blog, through the past few months, inspired by bloggers such as vitum medicinus and my experiences, I realized that I needed a place to anonymously talk about my experiences, to document and chart my way to becoming a MD and beyond. To share my sorrows, joys, frustrations, and accomplishments in the journey of medicine. Let me start off the blog with the happiest day of my life so far: May 15, 2009.

The start of a new life: the morning of May 15, 2009:

Pre-med in Canada is perhaps one of the most tumultuous experiences imaginable. To re-cap quickly, I realized in high school that I wanted to dedicate my life to changing the lives of others, to die with the knowledge that I spent my life changing the things I saw unfit in the world, and making a difference in the lives of the people around me.

I considered a variety of careers, including law, politics, business, computer engineering (my favorite subjects in high school didn't include only biology but I really enjoyed social studies and computer science as well). However, after a few more experiences, I settled on medicine halfway through high school. At that point, everything I did all had some relationship to medicine (not that the volunteering/leadership I had wasn't for other reasons as well such as enjoyment or interest, but at least part of the motivation for doing these things was because of a wish to get into medicine). I gave up moving away to a cool new university and opted for my hometown university because I believed it would keep me from the temptation of residence partying and allowed me to have the familiarity of living at home (thus increasing the chance of my success in undergrad). I labored for 5 hard years, endured many sleepless nights, all with the focus on medicine. I still remember the envy I would have whenever I saw someone with the ever-so coveted med school backpack (every student in Canada gets a free backpack from the CMA - they give each year a certain color and design that helps identify someone from that year. For example, the Medical Students entering in 2009 all have Red High Sierra backpacks, whether they go to University of British Columbia or the University of Western Ontario).

The worst part of it was the uncertainty, all the effort I put into the pursuit of medical school could be completely wasted. A realistic assessment of the situation showed the competitiveness of getting in and that statistics were against me, I didn't know whether I was good enough, and often times I doubted it, and thought of dropping out, applying to pharmacy, or just finding a good paying job and living an ordinary life. Continually, I would quash these feelings, and remind myself that anything was possible, that if I worked hard enough, if I believed in myself, I could do it. That every year someone had to be accepted, and nothing was stopping me from being that 'someone' except for my uncertainties and doubts.

Throughout my application year, I balanced writing applications, midterms, extra-curriculars, practicing for interviews, doing interviews and honestly, I spent at least 10% of my nights sleepless. Having worked like a dog throughout the process, I remember the crushing feeling I would get whenever I got a pre-interview rejection from schools and also the accomplishment I felt when I got my first interview invite (Interviewed 3/7 Applications). Throughout the process, I kept on asking myself the question "what if... what if I get rejected, what will I do, will I have the strength to try again?"

Then came the big day, May 15 2009. All my doubts about my future washed away with the one fateful e-mail. My heart was racing all morning, waiting for the vibrations on my cellphone (e-mails) that would signal the receipt of a life-changing message. Bringing out my phone and debating whether I should look at it, the e-mail that would give me the biggest news of my life, the e-mail that could either crush me or give me the greatest gift imaginable: the chance to fulfill my dreams. I remember staring dumbfounded at the phone when I read the e-mail titled "Congradulations" and realizing that the next step in my journey was about to begin.

So here I am, ready to continue working for my dreams, and 4 years away from the two golden letters M.D.