Otolaryngology!

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I never thought I’d say this… but guys, I matched into my top specialty and at my top institution. Starting in July 2016, I will be studying to become an otolaryngologist – head and neck surgeon (do we have the longest specialty name?)!

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I was literally in tears on Monday of Match Week when I got my email. My best friend CT and I wanted to open our emails together… but my phone wasn’t ping-ing emails to me, so I tried to refresh… and lo and behold, the first words I saw were “Congratulations!” before I started bawling uncontrollably. Now that I’ve matched I feel a little more cavalier about discussing my application process, but basically, if otomatch means anything, I was severely below average for just about everything (my Step scores, my grades/AOA status, my research, my # of interviews). Going into Monday, I had already met with my faculty advisors several times to discuss what to do next year if I didn’t match, and I had mentally prepared myself to participate in the SOAP (scramble). Thankfully, I didn’t need to! And honestly, that news on Monday was enough for me. :)

The days leading up to Friday, I was in a state of anxious calm. Mostly calm but occasionally irrationally thinking that maybe the email was a fluke. My school randomly calls up students, and when I finally held the envelope in my hands, I felt like I really knew that Everything was going to be okay. Match Day was emotional overall; I ended up getting not only my top choice but also the same institution that CT will be going to, as well as a couple of my other classmates. I can’t believe my luck.

Since Match, I have been on a surgery “bootcamp” class that my school offers to help prepare us for intern year. I’ve learned so much from how to respond to a page, how to do pre-op and post-op orders, “palming” a needle driver, and more. The last week of the class, we were gifted the opportunity to be primary surgeon on a simple operation for three days related to our specialty. I got to perform a rhomboid flap reconstruction for a cheek defect with the plastic surgery team, a tracheostomy with the OHNS team, and a neck dissection with a thyroid surgeon. I honestly cannot wait for intern year to begin. I know it will be busy, but I feel so blessed to be where I am, getting to do a specialty I love and finally having the power to take care of others and hopefully make their lives better.

scribbles in scrubs

scribbles

Mini-stories, all under 150 words, from the wards. Always true but some details may be left out to protect patient privacy.

tongue.

My hand is in her mouth pressing gauze against her tongue. She’s been coughing up blood for hours since her surgical wound opened up. The man who accompanied her leaves to go to the bathroom once she’s stabilized. “Who’s he?” I ask because I’m standing so close to her she can see down my scrub top, and her blood is on my neck. She says he’s a guy she just started dating. This is their second date, actually. “I’m going to have to marry him after thus, huh?” she jokes. I smile. A hospital date doesn’t sound so bad to me.

no longer with us.

“Where’s Mr. [x]?” I ask the night team resident.

“He’s no longer with us,” he calmly replies.

My team startles as I burst out “What?! How?!”

“By the time I got here, he had full-on ST elevation. We barely got him to the cath lab on time…”

“But then what happened?”

A pause. “Oh, he got transferred to another hospital.”

We breathe a sigh of relief. He snickers, “This is what happens when you don’t trend trops before transferring to another team.”

you’re not on my team.

She walks into our rooms for rounds with a poster that’s been scribbled all over. “This is my team, and this is my sister’s team. Which team are YOU on?” she asks, her blue eyes flashing wildly at me as she takes a seat at the table, flipping the poster to demonstrate the names written on each side or “team”.

We ask her typical morning rounds questions — how much did she manage to sleep last night? Were the meds helping? Did she still think she needed to escape from her burning house? She answers with the pressured speech and disjointed thoughts characteristic of mania. We try to steer her back but she storms up, grabs her poster, and glares at us. “You’re not on my team. KA CHING, KA CHING, KA CHING!” She points a trigger finger at each of us for each “ka ching” before slamming the door.

My cat is getting surgery!

My playful lovable kitty dearest!

My playful lovable kitty dearest!

My little love bug kitty has to have surgery this coming Monday! :( She’s been having what we thought was a UTI for a while now until the vet did an ultrasound. Apparently, she has a super inflamed bladder plus this ginormous stone. I mean, even I could tell what it was. Poor girl… no wonder she’s been so lethargic lately. So she’s going to have to have surgery this Monday and then probably run around in a cone of shame for a while too. Wish her luck!

Last rotation!

Amazingly, I’ve managed to not post here for almost all of third year. I think that speaks to the nature of this year vs. the other years of med school….

Finally had time to wash my white coat over the weekend, and this is what came out of it! Oops!

As I am currently on my last rotation (!!!), here are some things running through my mind as of late:

1) It really is tiring. – I don’t claim to be the most physically fit person ever, but I know even my running-every-day-and-I-love-crossfit classmates are pooped out. Last Sunday, I literally slept all day. The last time I did this was when I had swine flu in my first year of college, and then before then it was when I was still acutely ill! You really do get pushed to your physical limit, I think. Weeks/months of the minimal amount of sleep, eating at odd times (and sometimes not eating at all), working weird hours and thus messing up that circadian rhythm that I spent a year of my life researching, always having to be on your A-game… yep. Those things take a toll, for sure.

2) “Being a human” becomes harder and harder. – This is what I call any attempts a med student tries to be normal and assimilate into the “real world”. Prior to winter break, a bunch of us were at dinner and reflecting on how we all use medical jargon (and I wouldn’t even call it jargon) in our daily speak now. Just a few weeks ago, we were talking about how people can have benign vs. malignant personalities. I don’t think the #normal person speaks that way. I’ve also found it harder to communicate with my family about what I do and my non-med school friends (example: I’ve sent a ton of snapchats while dallying around in the OR waiting for room turnovers, and I get responses from “I hear you” [other med school friends] to “OMG I can’t believe you’re on your phone in the OR, that’s so not sterile!” [hon, not everything is sterile in the OR, and obviously I am not texting you if I am scrubbed in] to “why are you awake so early?”). I’ve also turned into one of those people I swore I would not become – people who only seem to be able to talk about medicine. *sigh*

3) I seriously can’t believe how fast time is flying. – Second years are asking me about Step 1 advice, which still feels like something that only happened a few months ago. In one year, I’ll be done with interviewing for my future job and career. In one year and a few months, I’ll know what I am doing with my life and where it’ll be. And soon after that, I’ll be “Dr LV”. And then… I’ll be making decisions that I have no qualification to make. I’ll somehow know all these things about proper dosage of medications, running a code, being able to talk to family because they’re requesting to speak to an MD, etc. I mentioned before that I thought that once I got into med school, it’d be like boarding a train that just keeps going without stops, and it feels truer every day. As much as I love what I’m doing, sometimes I do wonder if I’m missing out on something (esp. with #2). I keep finding all these books I wish I had time to read. I pin shamelessly all the places I wish I had time and money to go to (I’ve had to turn down family trips to so many places while in school that I want to cry). I just feel so YOUNG to almost be a doctor. It’s mind-boggling.

4) I’m so lucky I knew myself going into med school. – This is a lot harder for me to write about here since some of my friends might think I’m judging them. I’m not. I think everyone deserves to make their own choices. But third year especially has separated those that I think really got what medicine was and those who didn’t. Thankfully, most of them are in the former group, but I know of at least a few people who are now thinking that they may not even want to do residency after graduating because they don’t want to practice medicine at all. Or those who are willing to do so only because they have this humongous debt to pay off but actually derive no satisfaction in it. I find that all so sad, partially because I was very close to not being accepted into med school, and it’s hard for me to think that there are folks who were lucky enough to get in and then aren’t planning on actually being doctors anymore. I also feel sad for my classmates because they really did have to work their butts off to get here and then to find out that they aren’t happy with this choice… what a nightmare.

I’m so happy I picked the right thing for myself, though. I knew all the downsides of medicine going in, and even though I’ve realized more and more of them while being a third year, they’ve never deterred me from still loving what I do almost obsessively. Literally one of my friends just texted me, and I told him that I had a day off. He responded with: “What? A day off for you? On surgery??? Are you feeling okay?” I mean, I really live and breathe this stuff (read: I’ve lost two relationships with significant others that I thought could be my partner-in-crime-future-husband because I’ve loved/prioritized medicine more than them) so I guess his suggestion wasn’t THAT surprising. So yeah, it’s almost the end of the hardest year in med school, and I’m still getting that reaction, and I’m still taking extra hours just cause I feel so privileged I get to.

On that similar note, I also called it from day 1 what I was going to do with my life! I always knew I wanted to be a surgeon. I think initially, I was, like everyone else, drawn to the glamour of being The Surgeon, but even in my premed years I discovered real reasons why I liked surgery. And yet I still went into med school and especially third year trying to be open to other possibilities because (1) I didn’t want to be the person who was so narrow-minded and pissed everyone else off, and (2) I didn’t want to maybe pass up on something that could be my actual life’s passion. I’m really glad I did that because I really did enjoy my inpatient pediatric, EM, and cardiology rotations (in fact, cards made me really question the surgery path for a very long time). However, now that I am finally in my surgery block, it’s like coming home to your long lost lover. It just feels so right and makes me so happy. Yes, there are totally mean attendings. Yes, the hours suck. Yes, I’m tired and hungry all the time. But I love the OR. When I’m stressed, tired, sad, the only thing that can ALWAYS cheer me up is being in the operating room. I dig beautiful dissections. I love putting my hands on organs. I derive huge satisfaction by being in the right fascial plane. Blood bursting everywhere only excites me, not stresses me. Watching the surgeons sew is like watching magic. There’s only one place where you can literally hold a beating heart, feel the tremendous pressure of the cardiac output gushing against your hand as you block a hole in an artery, look and experience what makes humans Work. A patient was watching his laryngoscopy and said something along the lines of how gross the inner human body was. He asked how we all dealt with it. The attending and resident were like, oh, you get used to it. But I told him that I honestly thought that the inside of the human body is prettier than the outside. And it’s true. Because why would you ever want to look at the neck and not look instead at lovely vocal cords that are touching each other and vibrating perfectly to produce something as magical and precise as voice and language?

So anyway, yes, I’ll be going into surgery, I hope! A particular kind of surgery. ;) But I won’t reveal it here just yet. Let’s just say that if you read between the lines in my paragraph above, you could probably figure it out.

I still have a few more weeks of gen surg, but … fourth year, here we come!

6/20: Complications by Atul Gawande

Complications: A Surgeon’s Notes on an Imperfect Science by Atul Gawande
Category: NF
Rating: 4/5
Date finished: February 21, 2012

Summary: Written by Gawande in his residency, he writes of exactly what his title says — the imperfect science of medicine. He explores several cases of “imperfect science” in his three categories: fallibility, mystery, uncertainty.

My thoughts: It was pretty good. I read Gawande’s Better and really enjoyed it because I felt very inspired to push myself not just in medicine but in life. Then I attempted to read his Checklist Manifesto, and I just couldn’t get through it. So I didn’t know what to expect out of this book. Thankfully, I enjoyed it. :)

I don’t know how to describe what I thought about the book since it was all over the place. I’ll just go over the stuff that stood out to me. I didn’t like the discussion about doctors making mistakes, esp. the one about the EKGs, because as someone going into the medical field, I don’t like hearing about how someday computers will take over our jobs. I don’t believe that’ll happen; it might to some degree but I think in the end, people who are sick would rather have the comfort of a human than a robot. Just a thought. The chapter about good doctors going bad was really scary, but it’s good to know that there are options in case a doctor burns out. I experienced burn-out in high school, and I’d like to think I learned from that experience hoping that it won’t happen again. But it’s possible, so I’m glad that there is some room for making mistakes (although not as flexible as I’d like).

The chapter on pain was really cool. I especially liked the comment he stuck in about how surgeons could keep their hands in the cold water the entire duration and what that said about the profession. The necrotizing fasciitis chapter really scared me. I think it’ll forever keep me a hypochondriac, and it stood out enough to me that I think it’ll keep me hypervigilant as a doctor (which could be good and bad?). By and far the obesity chapter scared me the most. Even though I am underweight (thanks, disease), I felt so scared about everything I was eating after reading it that I began to actively watch what I eat, think about exercising more often, and probably the most concrete change was that I started to spend more time chewing everything I eat.

Overall, it was a pretty good read. I wouldn’t say it’s one of the greatest books I’ve read, but it did give me some good stories and insight into the medical field that I think will help me as a person and a doctor (which is what I enjoyed about Gawande’s other book). Perhaps the Better was better (har) because it was more general (not everything was focused on medicine) so I felt like I could apply its principles to things outside of my career.

In other news it’s clear I’m making major headway in my 2012 resolutions! I’m already very ahead for my reading/book goal. However, I’m about to return to reading A Storm of Swords by GRRM, which anyone who has ever seen or heard of the book should know that it’s both fat and a long read (even though it’s pretty good). So that might set me back a few books, possibly pulling me back on track.