“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.

When the Going Gets Tough, the Tough Get Carried

Paige, Second Year Medical Student

There are few things in this life that are more valuable than the love and support of friends and family.  I have once again been blessed by this reality in the first few weeks of this New Year.

I am not good at letting people help me.  I like to be in control of every situation, this need comes from a deep-seeded belief that everything that I do must always be perfect.  The fear is that if I let someone do something for me, they won’t do it the way I would and thus it wouldn’t meet my perfectionistic criteria (however skewed those criteria may be).  Fear of failure and the lack of ability to control a situation are in fact my biggest fears in life.  This is why I don’t like swimming in the ocean; the power of the uncontrollable waves literally terrifies me.  This is why I work so hard to get good grades and feel so horrible when things don’t always work out according to plans.  This is why I seldom ask for help, even when I know that it would make my life a million times easier.  And this is also why I struggle in my walk with God, because I am constantly resisting complete submission to His will in my life.

Over the past several years, there have been several situations that I have not been able to control: illness strikes a family member, school becomes overwhelming, relationships go awry.  Each time one of these uncontrollable waves crashes, I am flooded with my deepest fear…that I can’t handle the situation.  It has been times like these when I am thankfully reminded by the loved ones around me that I don’t have to do everything alone, that they can be there to help shoulder the burden and get me through even the toughest situations.

Last week was Week of Renewal on our campus.  It is a week when we have daily chapel services that serve to re-invigorate our spiritual journeys with Christ.  Randy Roberts, senior pastor of the Loma Linda University Church, spoke and shared the story in Mark 2 of the paralytic man that was brought to Jesus by 4 of his friends.  He shared the story to illustrate the importance of having friends who would be willing to go to any length to support you in your times of greatest need.  I resonated with this story and thought about the people in my life who have recently “lowered me through the roof to Jesus.”  Phone calls came from my sister, my Aunt, and my cousins, loving hugs and wise words came from my parents and my grandpa, and I have had several encouraging, spiritually uplifting conversations with friends.  All of these incredible people have shown me that sometimes it takes having a wave knock us off our feet to help us learn that we can let others carry us to Jesus so that He can then say, “take up your mat and walk.”

2nd Year…A Pause to Remember a Sacred Oath

Paige, Second Year Medical StudentAs is evident by the fact that this is my first blog post since the summer before year 2 of medical school commenced, 2nd year is BUSY!  Last year, we heard the 2nd year students grumble about how much they missed 1st year and how busy and completely consuming the ominous 2nd year was.  However, as a 1st year student, it was hard to believe that things could really be that much more difficult.  Little did I know, all the grumblings about 2nd year being one of the most difficult years of my academic life would indeed be indeed prove to be true.  In addition to a heavy academic load that includes: Pathophysiology, Pathology, Microbiology, Pharmacology, Neurology, Psychopathology, Preventive Medicine, and Biochemistry there are the additional requirements of labs, self-study lectures, continuity clinics, medical simulation labs, clinical skills OSCEs, and the ever-looming Step 1 test that will basically determine which residency programs we will be eligible for upon completing medical school.  Throw in extracurricular service activities, time to eat (cooking optional), exercise, spending time with loved ones, and devoting time to building a relationship with God and needless to say, there are never enough hours in the day to accomplish everything with the type of perfectionistic approach that we medical students desire.

If you have read my blog posts prior to this, you must be thinking, “Wow, this girl has suddenly become quite the Debbie Downer!”  I hope that you will continue to read however, because it has been this process of fully realizing the difficulty and challenges of medicine that has shown me even more of the immense value of this profession that I have chosen to pursue.  Moreover, it has shown me that even when things get tough—which they do—if you have the right support system, priorities, and determination, it can be done!

As I sit here on my last weekend of Christmas break and reflect over the past few months since beginning this year, I can honestly say that there have been many times, in fact, the majority of times when I have not had my priorities straight.  Relationships with family, friends, and God have all been stretched to the limit as I have put school again and again at the top of my priority list.  I have always had to work hard in school, but I have always been up for the challenge and have always truly enjoyed the process of learning.  Yet, at the beginning of this Christmas break I was exhausted, burnt out, and dreading the thought of once again immersing myself in the firehose of information that never gets turned off.  As far as I was concerned, the challenge was starting to look like it was a bit more than I could handle.

However, God showed me once again in a most unsuspecting way that He was the one guiding and sustaining me down this career path.  On New Year’s Eve my family had the opportunity to visit the Reagan National Library near my sister’s house in Ventura, California.  There are thousands of quotes scattered throughout this exhibition of President Reagan’s life story and accomplishments, and it would take days to read all of the information provided about the life of this incredible man.  We only had a few hours to walk the museum so we casually perused the information, taking note of just the main highlights.  One quote, tucked away in the volumes of information, stood out to me immediately.  It was spoken by President Reagan on his inauguration day and read, “I consider the trust that you have placed in me sacred, and I give you my sacred oath that I will do my utmost to justify your faith.”

Upon reading this quote, I was immediately struck with awe at the relevance it had in my own life.  It reminded me of that day a year and half ago when I recited a sacred oath “To Make Man Whole” and received a white coat that would signify the sacred trust of many patients that I would soon encounter.  I have no doubt that God used this quote to remind me of the reasons why I am currently working so diligently to conquer this difficult 2nd year of medical school.  As I look to begin this last 6 months of year 2, I am reinvigorated by this reminder of the sacred trust that has been placed in us as healthcare providers, and our sacred oath to be the best physicians that we can be in order to justify the faith that our future patients will have in us.

Fancy Advice

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Since my last blog post, the last several weeks have been pretty ridiculous. As my third year finished up with ten weeks of surgery, USMLE Step 2, and the beginning of the residency application process, I swept immediately into fourth year ER and preventative medicine rotations, watched a person die for the first time, and have been planning my wedding (I’m getting married in two days from writing this post!). Sometimes I get all Descartes-ish and wonder if I really even exist. I’m pretty sure I do.

Anywho, now that I am a wizened old fourth year I feel as if I should give some piece of advice, and so I will. Partly because I feel obliged to – nearly every first and second year I’ve come into contact with over the past few months has a slew of questions for me and I do my best to answer them. And partly because I want to – medical school is one of the craziest tasks anyone can consider undertaking, and the better prepared you are for it, well, the better.

1. Emotions, whether positive or negative, will come.

Like I mentioned earlier, I watched a patient die just recently. I’ve seen many patients on the threshold of death’s door, patients who have passed away overnight when I came back to the hospital in the morning, but no one has gone from life to death under my hands – literally. Unfortunately, a young woman in her forties came into the ER with very mild chest pain. Other than her age, every single risk factor for a heart attack was there, and that’s just what happened. A code was called and a nurse and I rotated doing chest compressions for 45 minutes. In a solemn, surreal moment, I was handed the defibrillator paddles. The four shocks were fruitless and she was pronounced dead as I stood there, the gel for the paddles smudged on my wrist. That whole experience could be a whole blog post in its own right.

Our team went to tell the extensive group of family members; also a first for me. As I drove home that evening I had a million feelings to be sorted out: frustration that the laxity in this lady’s lifestyle had lead to a very untimely death, sorrow in imagining myself in what it would’ve liked to be one of her family members, and admiration at the efficiency, calmness, and wisdom of the ER code team.

The odd fact of the matter is that at the end of the day, you learn medical facts and intuition during your fourth year of medical school. You don’t learn how to keep your voice from cracking as you look a husband in the eye and tell him his wife didn’t make it – the senior resident in charge of that task could not even do it. There are classes that help us to have better people skills, better listening skills, etc – but unfortunately, knowing how to deal with your emotions well only comes with experience. I would be surprised if there were more than a handful of people who did not agree that some of the strongest emotions that they’ve had, whether positive or negative, were directly tied to their experience in medical school. And, medical school not only has a direct effect on your emotions, but also indirectly through the sacrifices you must learn to make with your family, friends, and hobbies, and through the rewards it offers through fulfilling some of the first steps of one of your life’s greatest dreams.

2. Surprises, whether good or bad, will come

Close to Christmas of my first year of medical school, I was experiencing a very intense week of studying for finals and finally plopped into bed around 1am. As I rearranged my sheets and turned to my side, I found myself face to face with a small, very much alive lizard in my bed. After panicking and flailing to the point of falling out of bed, I collected my senses and escorted him outside – he looked very hungry and thirsty.

3. Your first year performance does not have to dictate the rest of your time in medical school

You may have had the highest of the high grades possible in college, graduating with honors and fancy Latin words framing your name. Whatever you did to earn those grades, that now needs to be multiplied ten-fold, maybe more, to score decent grades in medical school. About halfway through my first year (jeez, that seems ages ago!) I looked at my mediocre exam scores and realized I needed to change my study pattern. First year ended; my grades were a little better. Second year; substantially better. Third year I was blessed (I mean that literally; I very honestly feel God gave me the strength to study and sacrifice in other areas of my life) with excellent scores and evaluations.

The purpose of me telling about all this isn’t to toot my own horn and show how far I’ve come, although I am proud of that. Oddly enough, in retrospect, first year was the hardest year of medical school, for it required major adjusting from pre-medical school life and adoption of a lifestyle pretty darn foreign to most 20-somethings. I want to encourage all those freshman and sophomore who are looking at the academic workload in confusion. You’re not alone. Third year eventually rolls around, and you still feel lost when you get on the wards, but with each month you start to gain more and more confidence, and at you realize that you’ve actually been learning a lot, and that what you’ve been learning has very direct and rewarding applications to the hours and hours you spend in the hospital.

Basically, don’t give up, and don’t concede to any thought that you are just not going to do as well as you hoped. Second year is drastically more interesting than first year, and third year, while still difficult, is very rewarding and has many moments of You know, I think I can actually do this. Assuming that you are studying efficiently and have a passion for what you are doing (these two assumptions are extremely important!), you have an excellent chance of not just “getting by” in medical school but actually seeing yourself as a physician eventually, and succeeding in areas in which you apply yourself.

4. Don’t believe every piece of advice you’re told, such as:

Eat whenever you can on your surgery rotation. FALSE.
Coming home at 8pm after a 16-hour day of vascular surgery greatly increases your chances of devouring 3,200 calories worth of whatever is in the fridge in less than 10 minutes. Most likely those calories will be in the form of fried foods and cookie dough. I would recommend not even having those foods in your fridge during your surgery rotation. Don’t even go into a grocery store on your way home from your surgery shift, because all of a sudden you may believe that you could eat an entire frozen pizza.

Another thing you have to watch out for is snack breaks. Free snacks in the resident room are bad news for emotionally and physically exhausted residents and med students. Nutrigrain bars may have a picture of a strawberry on them, but they are like 98% sugar.

Buy all the recommended textbooks. FALSE.
I have three text books, each weighing about 20lbs, that I have read about 16 pages from each. In addition, a vast amount of smaller textbooks scattered throughout my bookshelves as well. I know I will use them more eventually, but right now your best bets for easy to access information about medicine in general are:

  • UpToDate
  • Anything off of eMedicine
  • Review books specific to your rotation (Pre-Test and Case Files are the way to go with most, plus High Yield for OB-GYN), which have the added benefit of fitting in your white coat pocket, which your Harrison’s Principles of Internal Medicine will certainly not
  • I know some people will disagree with me in regards to buying textbooks, so I would say take each rotation and class on an individual basis, and ask the med students ahead of you which were actually used and which were not. For starters, I can tell you that you do NOT need four anatomy textbooks. Your time and money are extremely valuable – the rotations fly by quickly and more efficiently you can prepare for both practical, in-hospital questions and standardized test questions, the better.

Well, time to go get married and stuff! As fourth year is definitely a more relaxed year, hopefully I’ll be blogging much more often.

Also, here is a picture of my irresistibly cute bunny who always is up for keeping me company at the end of a long day:

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First Few Weeks as a Med Student

James, First Year Medical Student“What is it like to be a medical student?” “What does a typical day look like?” “How do you balance between school and having a life?”–these are questions that I often wondered and asked when I was still a pre-med student. Unsurprisingly, I still cannot answer these questions myself at this point. In fact, sometimes I have to remind myself that I am already a medical student and I marvel at the thought that I will (almost certainly) become a physician in a couple of years. In the past three weeks, there have been times when I felt overwhelmed with what is expected of me and there have been times when I felt motivated by other students, doctors and patients. A fellow first-year student told me today that we are so fortunate to be here in medical school and I couldn’t agree more. For this reason, I will try my best to share some empowering as well as memorable moments from these past weeks.

Freshman Picnic: Entering A Christian Community

I have been in Loma Linda two times in my life. The first time was for the application interview and my girlfriend’s family brought me here. The second time is when I flew into Ontario International Airport the morning before orientation day. I was in a strange place and part of me felt excited to be independent. I pride myself on being independent at a young age since I lived away from my family about one third of my life. I was eager to explore the neighborhood around me, find out the best place to get groceries, and meet new friends.

Later that day, I went to school to try on my white coat and attended the freshman picnic. When the picnic started with a prayer, I felt a sense of peace and familiarity knowing that I am in a Seventh-Day Adventist community. It was a bit of a shock to me because I did not know that praying in an unfamiliar place with a large group of unfamiliar people actually gives me a sense of belonging. This feeling tells me that I am in a unique medical school and it is such a blessing to be spiritually connected to my peers and the faculty.

The White Coat Ceremony

During the first day of orientation, we were introduced to policies and other logistics in the student handbook as well as the numerous clubs and organizations on campus. Once again, I felt like I was back in college freshman year when I had to learn the structure of a curriculum, what was required to obtain a degree, and all the resources available to make the best out of my education.

When the day came to an end, I was excited about the White Coat Ceremony in the evening. I had already told my family that the ceremony would be online so they could watch it even when they were in Taiwan. I also told my girlfriend and my best friend who are in Washington about the live stream and I was really happy to receive texts from them saying that they were watching the ceremony.

As we lined up on the sides of the chapel and waited for our names to be called, I trembled from excitement and nervousness. I even reminded myself to walk really carefully so I wouldn’t trip on the stage! When Dr. Hadley helped me put on my coat, I struggled a little, but fortunately it did not take a significant amount of time. As I looked into the crowd, I started to wish that my family in Taiwan was looking at me on the live stream. Unfortunately, they had just moved into a new apartment and did not have internet available yet. When we returned to the stage to take the Physician’s Oath, parents started taking pictures of the students on stage and I started imagining the proud and smiling faces of each of my family members, grandparents, girlfriend, and best friend. When I saw parents and siblings waving and smiling at us, I felt like I was seeing my own family waving at me. It sounds strange but it’s true!

Symbolically, the White Coat Ceremony is the beginning of our medical professional. It helps us realize that we have chosen a career path that requires tremendous dedication and our utmost moral standards. As we all solemnly recited the oath, I felt our vigor and enthusiasm radiate across the entire chapel. Our voices said “This is the moment we have been waiting for. Starting now, we go from being cared for to taking care of others. Our hands will heal others and our words will guide the lives of many. We joyfully take on the responsibilities bestowed upon us and we will follow the example of our teachers. We will exemplify a Christ-like character in our practice and minister to all those around us with compassion and humility.”

Ward Experience: Patient-Centered Care

For the next two weeks, I spent the morning at Riverside County Region Medical Center shadowing an internal medicine team. I was amazed by how much 3rd year medical students know and how fast they learn in their rotations. They were given a number of patients that they were in charge of and they worked up the patients during pre-rounds. Part of me looks forward to the day when I am as knowledgeable and skilled as them but part of me also wonders how I will get there. Nonetheless, my partner first-year student and I tried to be as helpful as we could by grabbing charts, getting order forms, printing patient notes out, offering to help, and by staying out of the way.

Oftentimes, we could help with patients’ needs just by noticing their requests or asking them. One time, a patient wanted to have the nurse help him turn over to the other side because he was getting uncomfortable. After I spoke to a nurse, I went back and told the patient that a nurse should be coming soon. He was quite happy and thanked me for me. A small amount of gratitude such as that made me so ecstatic and I just can’t wait to do more for patients.

One assignment we had was to interview patients, listen to their feelings, and find out how their illnesses influenced them. My partner and I spoke with two patients and prayed for them. Ever since the interview, we always greeted them when we had a chance. Before we left, my partner gave one of the patients a small stuffed teddy bear in a praying posture because she said she likes to pray. She smiled was so brightly that it warmed both of our hearts.

During the pre-rounds, I also saw a medical student on our team chat with his patient and I was able to see the patient in a completely different light. She usually seemed unwilling to talk because of her discomfort. However, in the pre-rounds, the medical student joked around and laughed with the patient and I found that she is actually quite humorous. She jokingly complained about things and swore in front of us, which I find very amusing. The medical student demonstrated that physicians can definitely ease the discomfort of patients and make sure their thoughts are heard. It also helps with their cooperation. I learned a lot from the Blue (ninja) team and have added a few more people to my list of role model physicians.

Special thanks to members of the Blue Team: Dr. Chitsazan, Dr. Lewis, Vu, Kenley, Genoveva, Juan, Tiffany, Marly, and Stewart.

Medical Strategic Network Practicum: Power of Listening

On the Friday of the second week, I attended the Medical Strategic Network practicum and I was able to begin learning how to practice whole person by listening to the spiritual well-being of two patients. As I sat in a dim room on the bedside of a patient, listening to him talk about his faith, I felt the light shining on him grew brighter and warmer. I noticed the times when his eyes grew misty and his voice seemed to almost choke up. Here is a man whose faith has carried him through difficult times and given him strength when he thought he would not make it. He expressed graciousness and thankfulness to God, and I realized that he was my teacher and I was his pupil. As I sat with him, he taught me the importance of having faith despite the circumstances, the power of being listened to, and the need for me to be humble and listen to what he had to say. It was an incredible experience and the deepest conversation I have had with a person who I do not know anything about. This speaks to the unique privilege that health care providers have and the incredible effect it has on people when we truly listen to thoughts that are otherwise never told to complete strangers.

Gross Anatomy: Bodies With Stories

Just this week, actual classes have started and the gross anatomy class has always been something that I had looked forward to early this summer. When it came time for anatomy lab, we were showed something during the orientation that always came up in my mind every time I see our cadaver. We were shown letters written by the donors and one of it read:

“I want you to know that am making my final gift to mankind and leaving it to you to ensure it is delivered. Please know that the bones, muscle, the tubes, cords, and organs within me did know love, pain, hardship, and joy. My eyes have seen the beauty of this world and my feet have crossed only a small portion of its mountains and streams. My hands both gentle and strong have tried to impart comfort to the world. I revel in the memories my mind has stored and I wish I would have used my lips to smile at a stranger or a loved one a bit more often…”

Upon reading this letter, I felt sad, as if I was the donor and the hands that I used to touch my loved ones and my feet that took me to places are to be reduced to cold anatomical terms. During the lab when I studied the muscles in the suboccipital region, I spent a few seconds each looking at the arms that are still slightly pink, her shoulder that is freckled and aged, and her scalp that was shaved. I remembered that she once was alive and her body still holds her life story. She is not just a cadaver, but a teacher who has dedicated herself in a way more than all my other teachers had and I am very grateful for that.

There are a lot of thoughts to be shared because being a “student physician” requires me to see people and lives so differently. This level of involvement is unprecedented, personally, and it makes me constantly evaluate myself and think about the kind of physician I want to be. So, after being a Loma Linda medical student for three weeks, I have felt a wide spectrum of emotions from admiration and enthusiasm to feeling overwhelmed and insignificant. As far as I can tell, each of these emotions is going to feel more intense down the road! But for now, first week of classes, check!