“What fiyu cyaan bi unfiyu” (old Jamaican saying). Translation: What is meant for you will be yours.

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“In their hearts humans plan their course, but the Lord establishes their steps.” Proverbs 16:9

When God blessed me with the opportunity to enter medical school, I entered with tunnel vision on becoming either a plastic surgeon or neurosurgeon (my childhood dream after deciding that Little House on the Prairie life probably wouldn’t cut it).  I mean what little child reading Ben Carson’s story doesn’t want to be a surgeon? For years I wrote essays for school about the complexity of the brain because nothing else excited me.  I didn’t want to be open! This is what I had planned to do for God, and this is what I would do.  I planned on being that woman who came into medical school with a plan, and left accomplishing that same plan.  I wanted to be set and have no surprises.

But then there was that little voice. You know the one that tells you to keep your options open although you already have a plan?  While on the short clinical rotations experiences during first and second year, treacherous thoughts came into my head.  Why was I beginning to find the beauty in other fields of medicine? How could this be possible? This was NOT supposed to happen to me:

I was not supposed to melt over the children in the pediatric wing, want to cry over the stories of the kids in the psych ward, or feel helpless beside the old woman with 5 fatal diagnoses.  I wasn’t supposed to have fun while playing “video games” on robotic surgery at the OB/GYN interest meeting.  I wasn’t supposed to laugh with the internal medicine doctor and an old war veteran at the V.A. hospital, or watch with interest in the neurology clinic as a mother with occipital neuralgia received injections.  I was not supposed to feel excited as the physical medicine and rehabilitation doctors talked about their plans to make a fake downtown city to help their PT patients acclimate back into society.

I was not supposed to enjoy talking with the old couple at the ophthalmology clinic about how sight isn’t really appreciated until it’s gone, nor was I supposed to be fascinated as I stared into the eye of a man who had received cataract surgery.  I really was not supposed to be interested as I watched a doctor calm the fears of a teenager braving a long needle into her eyelid to treat a chalazion.

My eyes had been opened. There was no turning back. Could I still become a plastic surgeon or neurosurgeon? Sure! But as painful as it was to come to the conclusion, I was beginning to realize that going down a slightly different path than originally planned does not always alter the outcome. It does not always change the dream.  My dream was ultimately to become a Christian doctor that not only enjoyed what she did, but could also put the passion of her enjoyment into the caring of her patients.

On the bright side, I am just about to finish my first week of third year.  This means that I have a little time to settle in my mind which field is for me.  It is always good to have a plan, and it is even better to be able to stick with that plan. However, sometimes it is the unexpected twists and turns in life that make it fun (at least when we look back on it), that help us to grow, and that help us to become the people we always wanted to be.  In the end with an open mind and willingness to make mistakes, what was always meant for us will be ours.

I get to be a sorta-kinda-almost doctor now!

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Well, it’s here, that moment we’ve all been waiting for when we are unleashed up onto the hospital wards and allowed to actually take care of patients. No, we’re not doctors yet…but we are 3rd years and with that new title comes the time to close (most of) our books, leave the lecture halls and learn, quite literally, on the job.

This week I began my 6 week rotation on OB/GYN. With my crisp, clean, new white coat with personalized embroidery and blast-from-the-past beeper in hand, I looked like a doctor but sure didn’t feel like one! I would be lying if I didn’t say that I am quite literally terrified of what this year has in store.

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In my past 18 years of education I have mastered the art of having teachers present material to me and then regurgitating it back to them on exams. Classrooms, books, and tests have defined my entire life. But now I have a new set of teachers, my patients, and the final exam is no longer a set of multiple-choice questions, but instead involves the health, well-being, and wholeness of a person.

Today I scrubbed into my first surgery, a vaginal hysterectomy/cystocele & rectocele repair/sling placement, and it was awesome!!! I felt completely incompetent wandering around the halls of the OR suites and mostly just tried to do my best to stay out of everyone’s way. It’s terrifying to feel like I have no clue what I’m doing, but at the same time I know that I’m doing my best to learn fast.

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Despite my best efforts, I know that I will make mistakes. My hope for this year is that I will not lose sight of the fact that each decision I make and the effort that I put into learning during the next 2 years of clinical training will have an impact on countless people either for the good or for the bad. I hope and pray that I will be able to honor the patients that put their lives in my care by learning absolutely everything that they have to teach. I also desire to learn from my residents and attending physicians who have an infinitely more advanced depth of knowledge and experience. I hope that I will not take one moment of this next year for granted for the formative power that it has on my training to be a caring, compassionate, and knowledgeable physician. Despite the apprehension and uncertainty that I feel when thinking about beginning this new year, I am also excited for the new experiences that will come my way!

Saying Goodbye to 2nd Year

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Many people have said that the second year of medical school is the hardest and most grueling year of all.  I’ve heard countless people tell stories of how busy, exhausting, and completely consuming 3rd year is, but it is always followed up by the statement, “But I’d take just about anything, including getting hit by bus, over 2nd year.”

To be completely honest, this was in fact one of the most challenging years of my life for reasons that extended far beyond the rigorous course work that we were faced with each and every day and the ever-looming presence of Step 1 (the exam that makes even other medical licensing exams cry themselves to sleep out of fear).

HOWEVER, I can honestly say that despite the challenges that we faced this year, I will look back on 2nd year with fond memories and a never stronger sense of the presence of God’s guiding hand in my life.  Let me take you through a quick whirlwind tour of what the end of this year was like and what made it so challenging, but I promise there’s a light at the end of the tunnel so keep reading!

From January on, the only thing that 2nd year medical students across America have on their minds is Step 1. This is the mother of all exams; it is 8 hours long and covers all of the content that we have learned in the first 2 years of medical school – anatomy, physiology, cell & molecular biology, immunology, behavioral science, biostatistics, preventive medicine, biochemistry, pharmacology, pathology, pathophysiology, psychiatry, and neurology.  Now this test wouldn’t be such a big deal if it didn’t have so much weight toward which field of medicine we will ultimately be able to enter.  It’s basically the MCAT of residencies and our scores will either make us eligible for competitive specialties like surgery, ophthalmology, radiology, or not.  The saddest part, in my opinion, is that students who may excel in those fields because of their clinical skills and passions may not have the chance to experience those professions because this exam holds so much weight in residency applications.  This was one of the things that I struggled with the most near the end of the year.  I watched countless classmates, who I know will be incredible healers struggle beneath the weight of the pressure that this exam places on students.  The tensions were certainly high and at times the morale was low, however, I can say that the silver lining through it all was learning to trust more in the fact that God has called us to this place to serve in a profession that he will placed us in.  If he has gotten us all this far, then surely he will see us through to the end.

Despite the challenges that we faced during 2nd year, I promised that there would be a light at the end of the tunnel.  Medical school is a process that is so much more than simply learning how to be a doctor; it is a process that challenges people at the very core of who they are and I can honestly say that I have enjoyed that challenge.  I’ve been stretched and forced to grow in ways that I could have never imagined.  I have been required to search for the true reasons why I chose to enter this profession.  I have made the best friends of my life because of the common struggles that we have faced together.  I have been inspired to grow in my walk with God.  I have learned more than I ever thought was possible.  And I have been humbled by the realization that I will never be able to learn everything there is to know about the workings of the human body.  Although the process has been challenging, frustrating, and seemingly impossible at times, I now stand on the other side of the first two years of medical school and can say with confidence that I wouldn’t change anything and would do it all over again in a heartbeat.

 

I would be remiss if I did not take a moment to thank the incredible people who helped make this year both meaningful and enjoyable!:

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My study buddies, Scott and Justin.  We met both years for 2 hours almost every night, 6 hours every Sunday, and ran through at least 45,000 flashcards – about 15,000 cards times a minimum of 3 repetitions. I couldn’t be more blessed or more thankful to have had them by my side through this journey.

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My fellow “Carrelers,” Keri, Krisalyn, Melissa, Stephen, James, David, Linden, Casey (not all of whom are in this picture). I spent my afternoons studying with these wonderful friends in the Study Carrels of Alumni Hall throughout 2nd year.  I have been continuously inspired by each and every one of them and have been spiritually and emotionally uplifted by each of their friendships.

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Dr. Werner, our famed professor of Pathophysiology and the Dean for Medical Student Education to whom we owe our gratitude for continuously inspiring us to never stop learning and to be the absolute best physicians we can possibly be.

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And my classmates, who I love with all my heart!  Coming to Loma Linda and joining these incredible, talented, brilliant, God-fearing, and all-around absolutely wonderful people was the best decision of my life!

I have a pager and a white coat with my name on it???

Kristina, Third Year Medical Student

First year – check. Second year – check. Step 1 – check. Orientation week – check. Tomorrow, with white coat on and pager in hand, I step onto the wards.

It’s both exciting and scary that these mile markers for medical school have passed already. For so many years I have been learning from behind a desk, and now it is time to actually do things.

As I look back on the last two years, it is pretty incredible to see how I’ve changed and been molded to face the changes of medical school. The experience has enabled me to get to know myself in a more raw and vulnerable way. I’ve discovered strengths and weaknesses that I didn’t realize during my college years. If this has only happened in the first two years, I cannot even begin to imagine the changes I will experience in the last two years!

With Step 1 (part one of three board exams that dot the path to becoming an MD) behind us, it’s so interesting to even see the changes my classmates went through in such intense stress. I saw some burning out, some are peaking just at the right time, some in a panic to get the highest score possible, and some at peace with just getting it over with. I realize that we have all come to this point in order to become physicians by mostly studying, studying, occasional OSCE…studying, studying, …and more studying. Yet this is one of the first mile markers of many that REALLY stays with us significantly into the future. I really try not to think of that too much as I wait for my score to arrive sometime in July.

Although it has been draining, I have gained some of the valuable things this year. One of the best things I have experienced is making new friendships and strengthening existing friendships like never before in my life. My friends that I have made in medical school are definitely ones that I will keep for the rest of my life. This is one thing that I have absolutely loved about second year of medical school. In college, I had a harder time getting and maintaining friendships. I’m not sure why. Maybe I spent too much time in the chemistry lab, or maybe I just wasn’t a friendly person! But this year, the hardships have made friendships stronger, and that is something that I will always treasure. Because it’s these friendships that get you through the rough times, and it’s these friendships that make the good times even MORE awesome.

Another thing I’ve really learned this year that has been VERY important for me to “turn off the chatter”. There are always people around you suggesting the newest and best resource for preparing for classes and step 1. The class nearly goes into a panic at the beginning of second year trying to find the best books and notes and flashcards and dropbox pdfs in order to succeed in classes/boards. Early on, I found that this kind of talk reallllly gets to my head. And even though I managed to turn the chatter off first year, I had to do it all over again second year. As a result, my days grew to be spent entirely at home with studying from 6am to 11am, working out, eating lunch, studying from 1pm-6pm (with an occasional 20 minute power nap thrown in), dinner break, then studying from 7pm till about 10pm. Repeat the next day. Yes, it did get a bit lonely at times, but I was MUCH more at peace and much more focused.

This past week we had orientation, which was…..interesting. We had a lot of lectures about smoking cessation, preventive medicine, ethics, and some about how to succeed on the wards. There were ups and downs in my attention span, I will admit.

Thursday night was the clinical commencement dinner for our class at Castaways restaurant. It was so awesome to see everyone in nice outfits, all done up for the occasion! But what I think I loved the most was seeing how relaxed everyone was. Seriously, I don’t think I’ve seen such relief on our faces in all my time here. Now, come our first presentation to our attendings in a few days, I don’t think that will be the case! But, I loved seeing so much happiness then.

The program consisted of a vocal rendition of “Let it go” by some of my classmates (Hans, Ben, Vincent, Jackson, Vanessa) and I along with an encouraging and educational speech given by Dr. Werner on how to succeed in third year (probably the most informative speech of all orientation week). It was an awesome evening of no studying, good food, awesome friends, and a gorgeous sunset.

So in short…third year starts tomorrow. Without a doubt, I am SO happy second year will be over and behind me. But about third year, I’m not going to even pretend like I know what is going to happen, because frankly, I have no idea! I’m sure I will miss the days that I could completely control my schedule and plan my fun activities around my studying. However, at the same time, I so appreciate the first two years of molding me into being a better doctor and a better friend. I have grown in my solitude of prayer and study this year, and now I’m ready to continue growing around patients, attendings, residents, and nurses.

And the saga continues…

Sincerely,

Kristina…now MS3

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My First Delivery

Ryan, Third Year Medical StudentIt was early Monday morning, my first day working in Labor & Delivery while on my OBGYN rotation. After my last clinical experience, Family Medicine, when the workday began at 9 AM, waking up at 4:30 AM to finish responsibilities before rounds in the postpartum unit had me yawning and rubbing my tired eyes quite often. I was pretty excited to start L&D after hearing stories my wife, an L&D nurse, would excitedly tell from time to time. But in those first few moments, nothing seemed to shake the fatigue of an early morning. That is, until my attending’s pager started crying for attention.

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My Wife & I, Team L&D!

I was warned that between all the students and interns, the opportunity to participate in a delivery might not present itself very often. But there I was, not 2 hours into my first shift and Loma Linda’s newest life didn’t want to wait for rounds to finish before making a sudden appearance. My attending took off, and not wanting to miss an opportunity, I followed, leaving the rest of our team behind in the postpartum unit. “Do you mind if I come too?” I asked, trying to catch up, “I’ve never seen a delivery before!” She motioned for me to follow, not slowing a bit.

Walking into the patient’s room, I discovered a very busy scene. To some, the room might have looked like chaos, what with the 4 family members crowded around the head of the soon-to-be mommy’s bed, a husband helping one of the nurses hold up his wife’s legs as she pushed, and 10 or so other individuals busy with something. But at this point in my medical education, I didn’t see chaos; I saw a well-oiled machine, each health care member working together as a team, covering every need. A senior resident, already gowned up and prepared to deliver the newborn, was standing at the foot of the bed, counting to 10, and telling his patient when to push. There was a small team of NICU pediatricians, ready to assess the newborn (there was some concern for fetal distress). And there were several nurses monitoring vitals and ferrying items to and from mom.

Taking it all in, I was suddenly surprised as a surgical gown package was smacked into my chest. “Better hurry and gown up,” my attending was telling me, “you don’t want to miss this! What’s your glove size?” Wait, she expected me to do more than just watch? Seeing the question on my face, she spoke up again as she pointed toward the senior resident, “You did well on this in the simulation lab, Dr. Brown* will do it with you now.” She smiled a warm look of reassurance. “Now get that gown on or you’ll miss it!”

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Suit up! Typical Delivery Attire

Just as I had learned earlier in the year (à la My Laparoscopic Camera), I had no time to question. I put on surgical boots and a mask, and then carefully and quickly self-gowned and gloved, making sure my outfit stayed sterile. A nurse came up behind me to help tie my gown, quickly followed by the inevitable jokes about my height and how hard it was to reach the Velcro tie at the nape of my neck. But I barely even heard, I was too busy going over the steps of delivery in my head.

As I approached the foot of the table, the senior resident acknowledged my presence and stepped to the side. Now, from here on out, I won’t go into too much detail; as most of you moms already know, some could consider birth a gory experience! At the point I joined the delivery, you could already see the very top of baby’s head, and two or three more good pushes would have us celebrating a birthday. Dr. Brown took my hands, positioned them over baby’s head, then placed his own over top of mine as he helped me guide baby into a new world. “Alright, give me one more good push!” Dr. Brown instructed, looking up at mom with encouragement.

Next thing I knew, a tiny face was staring up at me, looking surprisingly peaceful. We checked to see if there was an umbilical cord around her neck, then delivered each shoulder, one after the other. With one more push and a gush of fluid, I was suddenly holding a baby girl! For a moment, time froze; it was the most disgusting and yet beautiful thing I had every seen. She was perfect, with her tiny fingers, eyes, ears, nose… “Clamp!” I snapped out of the brief moment and held baby as her cord was clamped in two spots, daddy coming over to cut. He was a brawn looking man, and I could tell he was trying pretty hard, and pretty unsuccessfully, not to cry.

Normally, baby would have immediately gone to her mommy’s chest. The practice of immediate “skin-to-skin” helps with bonding, provides warm, and eases baby into easier breast-feeding (among other things), but in our case, the NICU team wanted to assess the newborn due to some meconium present during labor (meconium is baby poo while in the womb; it can indicate distress). As I handed baby to the NICU team, she gave out a hearty, strong cry, and I knew everything was going to be ok. After a quick check, the NICU team confirmed my relief by smiling and bringing baby over for some of that important skin-to-skin time. At this point, dad had pretty much lost his composure as he and his wife embraced their brand new daughter. It’s tough finding words to describe the moment that was in front of me. 100%, unadulterated love. Pure joy.

For me, there was no time to get caught up in the emotion of it all as we still had to do some stuff you never really hear about after a delivery. The placenta still needed to be delivered and inspected, mom’s uterus had to be massaged to help stop postpartum bleeding, and any lacerations from delivery needed sutures. This happened without problem, and because I mentioned my plans of specializing in emergency medicine, I even got to do the suturing! As I took off my soiled gown, Dr. Brown and my attending both affirmed I had done a good job, which frankly, felt pretty awesome. I then washed my hands, gave congratulations to the new family (along with receiving a grip-crushing handshake from dad), and stepped outside the room.

Me with Some of the Coolest Nurses in the Hospital

That’s when it hit me. Oh my goodness, I just pulled a new life into the world!! Pretty cool. I’m so grateful that even though I’ve less than a month left to go in my third year, even with another huge board exam looming over my head, I’m still finding moments like these.  Not to mention in 17 short weeks I’ll be doing this again as the dad!

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My Son at 22 Weeks. 3D Ultrasounds are Amazing!

Even though I thought I couldn’t have any more respect for my mom, I certainly do after participating in that first delivery. Props to my mom and all the moms out there that have the strength to carry us and the patience to raise us into respectable men and women. And with that, there’s less than two weeks to go until I’m a 4th year medical student! Stay tuned!!

*Name changed to protect privacy.