A Good Day

It's been a good day.

1. I finally had an adult patient with a "fix-able" disease. He had pseudogout, which is readily cured with medication. I called the rheum consult and happened to be there when they came by to examine the patient. So I went in with them to see what I could learn. I had forgotten how much I liked rheumatology, haha.

2. I was able to answer most of my attending's questions without sounding/feeling stupid. This feels like an achievement for me because sometimes I feel like no matter how much I read, I fail to recall what the attending determines to be the most salient points. But today I was prepared (or at least phrased my answer in an acceptable way if I didn't exactly know the answer).

3. My attending gave me feedback on my performance. She told me how proud she was of my progress from day 1 to today. I went from an unsure and kind of shell-shocked student to someone who's confident and proactive in taking responsibility in my patient care. And I do feel like a different person since day 1 last week (I almost can't believe I've been doing this for 2 weeks already!). I chose the hospitalist service precisely because I knew my attending would throw me into the fray and force me to be an independent learner without training wheels, and I got what I wanted.

4. As such, my attending offered to write me a letter of recommendation for residency later! She told me how she's written LORs and how she's called residency programs to give her former students an extra edge. Now, when an attending offers to write a LOR, that means that the attending truly regarded you highly. I hope I can continue this momentum with future attendings on rotations down the road.

5. I met the city's oldest woman cop/detective! She quickly became my favorite patient (though she wasn't technically my patient). She was great to talk to. :-)
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Yesterday I hung out with Drew a bit. I picked him up from his house and we went to a coffee shop. We sat down and chatted and people-watched. He kept pointing out all the cute guys and guessing which were likely gay. Btw, I still don't get what people see in asses/what they notice about it; it's simply a body part that I rarely pay attention to. Someone enlighten me?

Anyway we had some good convo. He told me about this guy he likes and likes him back, but they both agreed that neither were in any position to date the other. I suppose that keeps the window open for me a bit, but Drew alluded to the fact that he just got comfortable being single again and would like to stay that way for a bit longer. I'll respect that . . . and also I couldn't get the right words I had wanted to say out of my mouth, lol. And I still couldn't get a feel if I even have a shot. Fail.

I did, however, manage to get him to take his shirt off in front of me. But I assure you it's for a legit reason. He had this rather nasty cough on and off as well as some sinus issues. I just so happened (unplanned, I assure you) to have my white coat and stethoscope in the back seat of my car. So he humored me in allowing me to listen to his lungs and heart. His heart sounded good but his upper lungs did sound a bit congested to me.

All in all, it's always great to hang out with him when we manage to align our schedules.

Mixed Feelings

Today was a day full of mixed feelings.
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I got my Step 1 USMLE Board Exam score. I passed . . . but I didn't do nearly as well as I was hoping or expecting. In fact, I did almost 20 points worse than estimated. T.T I really have no choice but to accept my score because once you pass this exam, you can't re-take it. I did solidly below average for all medical specialties, even pediatrics and internal medicine.

For a few hours I had some serious doubts about my aptitude and ability to just know/remember medical knowledge. I had doubts on whether or not I really "belong" here. Then I remind myself that it's just one test, just one number. I have chances to redeem myself on my residency application in a couple years - I've already done a lot my first two years, I've held quite a number of leadership positions, I'll have an MPH behind my name as well. All I need to do now is obtain amazing letters of rec and rock Step 2 next summer . . .

It's not over quite yet. I may still have a shot at a top 10-15 pediatric residency spot (I just have to work even harder for it)!!
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And for the past couple days I've been taking care of a patient who's been getting increasingly agitated. Last night he refused all medical treatment. When I read this in the nurses' progress notes I went to his room to talk to him. I explained to him why he's here, what we're trying to do, that his meds are working, etc. He didn't believe me. So I asked him what he thought his problems were and how we could better help him. I wanted his perspective of his health. But he snapped back that "I'm not the doctor! Don't ask me! I don't care about no perspective."

I reported all of this to my attending, who then went with me to see the patient again. He was judged "decisional" and he just wanted to go home. He left a few hours later AMA (against medical advice). In a way it felt like a "loss" because there was nothing I/we could do to improve his medical problem, because we can't force care upon someone who doesn't want it and is competent to make his/her own decisions.

Later I recounted this to my pharmacist friend, and here's a snippet of our convo that followed:

Her: "Awww. But wow, [Aek], I am seriously impressed. You're going to make an awesome doctor."
Me: "Lol, impressed by what?"
Her: "I've seen attendings handle difficult patients like that. But not residents. And definitely not med students."
Me: "But isn't that what we're supposed to do? . . . Like, that's part of the job description, lol, to talk to patients and see what's going on."
Her: "Yes, lol."
Me: "And try to help."
Her: "But you seem to have said all the right things. Even though they didn't work. Some people are better at it than others."

I'm glad that she has faith in me. I'm glad that my attending seems to be giving me some positive encouragement/feedback, even when I feel like a dumbass some days when I can't answer her questions as satisfactorily as I think she would like. All I can do is try my best and do what's best for my patients. Knowledge isn't everything, but knowing how to find and utilize knowledge is. Perhaps there is hope.

The One to Make Me Dance?

The dance by *klairy on deviantART

Today I drove about 4 hours to make it to my friend's wedding. In fact, my best friend from undergrad and my roommate freshman year. But more about that later when I've returned home and had time to process the pics I took a bit more.

I can't remember if I've mentioned this, but I always have mixed feelings during every wedding I attend. On the one hand, I'm really happy for the new couple and the potential of their lives together. But on the other hand, I'm also rather sad for myself and still being so so single. This is only accented during the dancing portion of the reception, which I utterly dread.

First all, I feel rather awkward with/in my own body (hands aside - years of playing the piano and cello have mediated that, lol). And second, I usually don't have anyone to dance with because I attend most of the wedding solo too; and if I did have someone to dance with, I'm also not sure what to do. It's all just a really awkward moment for me unless I've had 4+ shots of alcohol within the last 30 minutes or so, haha.

I'm still looking for that one person who can make me dance and not feel like an utter fool. Where is this person who can motivate me onto the dance floor and dance with them (or at all)? A part of me is sick of just sitting on the sidelines waiting. And a part of me is just too comfortable not exposing myself like that on the dance floor. I mean, I even feel embarrassed attempting to dance in the privacy of my own apartment!
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Anyway, on an unrelated note, Drew is now single. Again. Things didn't work out between him and his boyfriend and they broke up on friendly terms. It's been about 2 weeks since the break-up. In the intervening time, at least 3-4 guys have asked him out on dates, all of whom he had soundly rejected. For good reason! They should've given him at least 2 weeks to get over his last boyfriend - such quick rebound is good for no one.

But now 2 weeks are up. I don't know if I should make any kind of move while this window is still temporarily open. I don't want to be yet another guy asking him out on a date as I think that'd hurt our friendship (or at least make things a tad awkward in the future).

What I really want to do is just ask him if he'd ever consider dating me. And depending on his response I'd then ask him out (or not). But I also feel like it's cheesy to do that. Yet again, I don't want to be "yet another guy." Argh. What to do?!

I may ask him if he's free to hang out this coming Thursday afternoon/evening (because that's the earliest time during this week that I know I have some time off from rotations). I could ask him on the spot then. If he said yes things would actually work out nicely because I get my Step 1 board exam score this Wednesday, so he'd be either celebrating or commiserating with me depending on my score, lol.

He's one of the few people I've met who doesn't fail to make me smile and laugh when we hang out. I really enjoy spending time with him even as just friends. He may be one who can make me dance, lol. Argh, I don't want to mess this up. What should I do? Would things work out anyway since we're both so busy? :-/

Survived my First Week

. . . of my medicine rotation.

It's actually not too bad. I'm on the hospitalist team, so it's just me, a physician's assistant (PA), and an attending physician. There are no other med students, interns, or residents on my team. And the hours are surprisingly nice - 8am until whenever I finish (usually between 3pm and 4:30pm) and no call. But man, talk about throwing you out to the wolves! On day 1 I had to do an independent history & physical (H&P) on a newly admitted patient. On day 2 I had to follow-up with the patient (now "my" patient), write a medical note complete with non-retarded assessment and plan for his treatment while he was in the hospital.

And on day 4 I had two newly admitted patients for which I had to do H&P's, write their medical notes, call consulting services, write orders for labs and meds, get consent, and learned how to write an admission note. I've learned and done a lot in this short week - possibly more than I had all of M1 and M2 years combined (or so it feels, lol).

It's been a great experience so far. I've really had to take responsibility and ownership over "my" 3 patients, and I'm slowly figuring out the system. I know I have friends with me on our medicine rotation at different locations who've done less for each of their patients. I've been so busy that I don't even notice how hungry and tired I am until I leave each day - I've just been in this kind of hyper-focused state to do what I can for my patients (if that makes any sense at all, lol). I hope at the end of each day I truly did something to help them and contribute to their care while in the hospital.

Time for bed. I've been granted the weekend off so I can make it to my friend's wedding.

Let . . .

Breathe by ~theflickerees on deviantART

Come here, lay with me,
Inhaling our breathes
together
On this lazy summer day.

Let the sun
caress us
in its warm embrace,
Let the breeze
fill us
with the breath of life.

And we may gaze
at the clouds
And imagine
sweet dreams of tomorrow.

Let us enjoy this day
together;
Nothing to do,
Nowhere to go,
Just lounging around
in each other's company.

Let us close our eyes
and pretend,
Just for a moment,
That the world
stopped turning
And that time
gave pause.

That it is just
you and me -
Whoever you are,
Wherever you are,
Exhaling with me
the breath of yesterday.

Epic Wedding

This post is long overdue. A couple weeks ago I drove down to St. Louis, MO with Michelle for a mutual friend's wedding. Michelle has a relative who lives near St. Louis, so we crashed at his place for the first night we were there.

That first night, we went to the Mehendi ceremony where the women got henna done. The bride's henna was really cool all over her hands.

The following morning was the Christian ceremony (groom's side) at Graham Chapel at Washington University. Though we left early so we could get there early, the universe didn't want that to happen. The highway I took narrowed down to one lane at one point and we were stuck in pretty much stand-still traffic for a good 15-20 minutes. I took the first exit I could find only to find the bridge I had to cross was demolished. I just went back on the highway and surprisingly it was fine after that blockade.

The Christian wedding was pretty sweet and short. After that wedding and taking a few pics, we went to the hotel where the rest of the events were held to attend the luncheon. By the way, almost every meal was provided buffet style with Americano and Indian options. Both were delicious and I was stuffed after every meal without fail. Probably gained like 10 lbs from all that food . . .

Anyway, after the luncheon there was a couple hours' lull as they set up for the Hindi ceremony later that afternoon. Unlike the Christian ceremony, which was about 40-45 minutes long, the Hindi ceremony was about 1.5 hours long. It was really cool though as I had never attended an Indian wedding before.

Finally, after the Hindi ceremony came the reception, which was really nice. Throughout the 2 days, the bride wore a total of 3 dresses, 2 of them being saris. She looked so good in all her dresses! I was so stuffed from the food that I couldn't finish a small slice of cake and attempting to dance was painful. Oh well.

The following morning, Michelle and I checked out of the hotel and decided to see some stuff around in St. Louis before heading back. We first went to the Shaw Botanical Garden where a really awesome tour guide gave us a most excellent tour of the gardens. It was such a beautiful place.

After that, we headed for The Hill area for lunch. But being Sunday and in a heavy Italian district, most places were closed. We did find a pizza place that was open (which was delicious) and then topped that off by going to a gelato place afterwards.

Finally before heading out, we had to see the Gateway Arch, probably the most iconic symbol of St. Louis. We didn't go up to the top but we took plenty of pics around it. All in all, it was a great trip with a couple of minor bumps along the way.

I Have Return from Death

Okay, so I took my USMLE Step 1 exam last Thursday. It was a beast. 15-minute tutorial followed by 7 one-hour blocks of 46 questions and a 45-minute break that can be divided up however one wants. It was going alright until I encountered a heart sound question that required audio and . . . the audio on my computer didn't work. T.T That threw me for a loop. Good thing there was only 2 questions that required audio.

Overall I think I did alright. Hopefully, with some luck, I met my target of getting a score of 225+ (national average is usually between 220 and 223). There was a moment in the middle of the exam that I wondered whether or not I'd pass it, but apparently that's pretty much how most people feel coming out of that exam.

And with that, walking out of the exam dazed, I have returned from Death!
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On Saturday I met up with Drew for coffee. I had promised that I'd get him coffee for his birthday that was about a week earlier. We chatted for a few hours before heading back to his house. His mom and dad were home, which was just a tad awkward for me. We went down into his basement where he proceeded to show me all the music compositions he had written (most of them fragments of would-be melodies).

Then we listened to some classical music on YouTube while I gave him a back rub. For almost an hour. I didn't know that a person could get such knots in their back (I could clearly feel that his muscles had knotted up in ways it shouldn't)! This guy has clearly been under some stress and his boyfriend terribly sucks at giving back rubs.

Man, it sucks that I still like him in a way that's potentially more than just friends. And he's quite happy with his boyfriend, crappy back rubs notwithstanding, lol.
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I've been a bum for most of this week and it's great, haha. I had intended to do a bunch of things but I simply haven't gotten to them. Not sure if I will or not. Tomorrow I'm on my way to a friend's wedding in St. Louis. Going to drive down there with another friend. Hopefully everything goes smoothly!