I MATCHED

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I never gave an update! I ended up ranking pediatrics over anesthesiology. It was a tough decision- one that involved many sleepless nights and hundreds of convos with friends, family, and the hubs.. but ultimately, I made the right decision for me and my happiness.

And I’m happy to say that I matched to my #1 choice: Tulsa Pediatrics at Oklahoma State!

While it pains my little Sooner heart a little to think of wearing black & orange, I am THRILLED to be moving close to my family and in-laws and friends, especially while bringing a baby into the world!

 

I started adult neurology this week… I’ll give an update soon because it’s super interesting stuff!!

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The Match

I wanted to write a quick post to capture how I’m feeling at this moment, these last few hours before The Match happens.

The Match (in caps because it’s THAT big of a deal) is tomorrow. ((The Match is when medical students are “matched” to a residency program. So, after all of the audition rotations & interviews, each student submits a rank list of the programs they liked in the order they liked them… And residencies do the same- they rank the medical students who interviewed with them in the order they liked us. Then the data goes into a computer and BAM- each medical student gets matched to exactly one program. Think sorority rush Bid Day or Harry Potter’s sorting hat.)) To me, tomorrow is more important than any other day of my med school has been. You could argue the day we all passed boards or the day we got accepted were bigger deals, but I really believe The Match is bigger. Some people even think it’s a bigger event than graduation.

There are so many emotions. I am all at once so nervous! And excited! And scared. And thrilled for my future. And my classmates’ futures. And worried people won’t end up where they want to. It is one of the strangest feelings I have ever had to know my entire last 8 years of education and training and sweat and tears and motivations and pep talks from family and friends has led up to this point, to tomorrow, when I find out where I matched and where I get to complete my medical training.

And for me, this news will have an added element of surprise and excitement. Not only is this where I get to learn the specific ins and outs of being a doctor, but I’ll get to raise my new baby wherever we end up matching! We get to buy our first house where I match! We get to put together our baby’s nursery in the city I match! It adds so much more anxiety and fulfillment knowing that tomorrow I’ll get to know where my baby will spend his or her first few years. Tomorrow’s news is literally life-changing!

Luckily I have next week off of work. The physician I am currently following is going on vacay and couldn’t have timed it better! I imagine the week will include some early packing of things we won’t need before the move, house searching, realtor calls, and excited/nervous planning!

This weekend to distract myself, and because we have the companion pass & David flies free with me for a year (and honestly just because), we went to Seattle. It was David’s sister’s birthday so we were able to celebrate with her. We got to see one of my sorority sisters & a friend of David’s who lives up here. We were also able to see the Ballard locks, tour Seattle Center and the Chihuly glass garden (David blows glass so this was especially fun), enjoy several breweries, indulge in way too much delicious food (all of the seafood I consumed was safe and not raw, don’t worry), and spend some quality time with my mom’s side of the family who live in Seattle! It was a wonderful quick weekend trip, and just what I needed as a distraction before The Match… Otherwise I imagine I would’ve been pacing the house waiting around all weekend for the big news!

Anyway, I am anxiously awaiting the (somewhat anticlimactic) email that is to arrive tomorrow morning. Several of my classmates & I have a dinner planned to celebrate. I will update more tomorrow! Wish me luck!!

 

Ignorance isn’t always bliss

Not knowing is sometimes worse.

Every week in my small band’s music rehearsal, we hear announcements. These are usually “pay your dues,” or “we’re meeting for dinner next week, come if you want!” But tonight a woman got up and told about her significant other being diagnosed with thyroid cancer, and having to undergo intensive radioactive ablation therapy. She was in tears describing that they can’t sleep in the same bed for 5 days and then have certain precautions to follow due to the intensity of the radiation. She started to cry, and everyone around her was soon tearing up too.

I knew all of this clinically. How many patients’ thyroid replacement medications have I adjusted? How many people have I examined with a horizontal slice mark across their neck or a flat area where their thyroid had once been? How many people with palpitations, night sweats, brittle hair and nails, and a smattering of other symptoms have I helped by finding that perfect balance of thyroid hormone and tweaking their replacement medicine?

But I know all of this. I know the outcomes. I’ve seen the successes and the hardships after radiation to the thyroid. Because I was taught to know it. Because I was tested on it. And because soon, I’ll be paid to know it. And I find comfort in the knowing. I like being able to hear a diagnosis and see multiple examples of success stories & envision what the road ahead looks like. I have a complete picture.

But most people don’t. For most people, diagnoses like these are earth-shaking. They’re life-ruining. Because they only have one small piece of the complete picture. And I feel for them.

Tonight I realized how sometimes the burden of knowing the complete picture is heartbreaking. But sometimes it’s reassuring. And not everyone has that advantage. So I will keep this in mind next time I hear a diagnosis that a patient or family member is struggling with. I won’t dismiss it with “eh, they’ll be fine,” or “come on, just some treatments and meds and they’ll be good as new.” Because it’s a scary world we live in. Big medical words are intimidating. Physicians acting like a huge, life-changing diagnosis isn’t a big deal won’t help anyone. And sometimes ignorance isn’t bliss.

Frustrated excitement

imageSince my last post, I’ve been traveling & flying all over the place (i flew so much that I earned the Southwest Airlines “companion pass,” so someone of my choice gets to fly free for a year with me). I’ve been interviewing & doing audition rotations & deciding what things I want out of my residency training while balancing other aspects of the programs like location and lifestyle. It’s been an interesting couple of months. Among my classmates I’ve heard many similar sentiments recently. Fourth year isn’t the “expensive vacation” we were told it would be. It’s a frustrating, convoluted mess of traveling often & traveling alone while attempting to put your best foot forward and make every program believe they’re your top choice. It’s showing up early and staying late and finding time after work to research something interesting and different enough that it will set you apart from your peers as a good residency candidate. It’s putting on your suit and pep-talking yourself into believing you’re exactly what they’re looking for. It’s learning your limits physically and emotionally for let-downs and “constructive criticism.” It’s constantly being compared to other people with higher board scores, or more community service, or a family member on the medical board at that hospital. It’s holding your head high when you feel like you have nothing left to give and just want to go home. And, for me, it’s all while dealing with pregnancy hormones and physiology shifts that take the whole experience to a whole new level. The small exciting things like feeling the baby kick & my bump finally showing have to be kept hidden from my interviewers because-gasp! god forbid a woman has a child AND a career. It’s exhausting.

Lest I sound disheartened, It’s also really, really exciting. Fourth year is 110% different than third year. Physicians trust you more. You’re only months away from being a RD (REAL doctor!). It’s more interesting because the Attendings teach on a deeper level, and they teach more than clinical knowledge. I’ve learned so much more this year about what it truly means physically, financially, emotionally, & spiritually to choose this line of work and be a physician. And the exciting parts of my pregnancy- David can feel the bumblebee kick now! Even the bulkiest of my sweaters doesn’t hide my bump now! I completed my baby registry & am nesting in my own way by prepping & reading tons of books!- I get to share it all with my family and close friends. Even if my interviewees don’t know, all of the people in my life who matter do- and that makes a huge difference. I wasn’t sure if all of the cool things about being pregnant would be overshadowed by the excitement of graduation coming up and the residency Match being soon. But I can happily say they aren’t! It just makes this season of my life that much more exciting and full of change.

Right now I’m taking a 2-week online pharmacology elective, which conveniently lined up with a family ski trip. I’m sitting in the warm lodge, sipping my hot cocoa & looking out at the beautiful snow-covered pine trees. In 4 short months I will have a baby, graduate, and be a physician! Despite the hardships and drawbacks and uncertainties and sleepless nights, the dreams I had when I was a little girl of becoming a doctor and being a mom will come true. How amazing I get to do them together! On difficult days, and even on the good ones like today, I think it’s important to remind myself of the privilege I have to be pursuing this career & the blessings I have of having a healthy pregnancy. It is so exciting!

I’ll end this post with a quote from a physician’s wife. Our class heard this quote during a lecture second year & it has really stuck with me. “Tell them how lucky they are. Tell them that they will impact the lives of people in ways most can only dream about. Tell them not to listen to the cynics and critics, that the work they will do everyday is of value. TELL THEM THEY WILL BE PHYSICIANS.”

Pediatric Orthopedic surgery

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Peds Ortho surgery was not what I expected. I think when I chose Phoenix for my 3rd & 4th year rotation site, I really didn’t appreciate the huge variety of pathology I would see, simply because it’s a huge city with tons of specialists. It has been phenomenal!!

My Ortho rotation was… Interesting. The stereotype for orthopedic surgeons (as shown in the cartoon above) is that they are jocks and basically carpenters who like to use power tools & brute force. My doctor didn’t fill any of the stereotypes at all!

Some rare things I saw: a baby born with a glycosylation defect (something we med students only read about for boards!). A real case of Ricketts. Cri du chat syndrome (again, a boards question). Klippel-Fiel anomaly. 62° scoliosis. A mitochondrial disorder resulting in scoliosis and dysmotility. Muscular dystrophy. Junctional kyphosis with a myelomeningocele. Killian syndrome, podocki-lupski syndrome, & Biount’s disease (all so rare we DIDN’T learn about them for boards).

We also saw the common “run of the mill” Ortho cases: supracondylar fractures. Mild to moderate scoliosis managed with bracing. Broken femurs. Fractures of ulna + radius. Club feet. Osteomyelitis. Osgood-schlatter disease. Slipped capital femoral epiphysis. Trigger finger. Marfan syndrome. Hand and digit fractures. Olecranon fractures.

We casted tons of kids and removed casts. We put pins and plates and screws into multiple broken elbows and arms and legs. My favorite surgery I got to see was the scoliosis rodding surgery, which had amazing results but looked really brutal/barbaric in the OR. He even let me put screws into the vertebrae and tighten the rods to align the spine!

The most interesting part of my rotation, besides the crazy and rare cases I saw, was how my doctor interacted with his patients. He didn’t seem like he enjoyed working with kids. So why he chose to specialize in pediatric orthopedics, I’m not exactly sure. For example, he would literally huff and puff if a child was playing on his rolling chair when we walked into a room. He would tell me how disrespectful a child was and how terrible the parenting was if the disposable paper on the exam table was torn by a toddler. He hated when the magazines were out of order in his exam rooms, and if the blinds had been moved at all, he threw a fit. He was a terrible mumbler, and when parents would ask him to repeat what he said, he would get really irritated and short with them. He would also try to give away children’s toys to his teenage patients who were clearly uninterested. One time he offered dessert that he brought to the clinic to a patient who had a G tube (i.e. Didn’t eat by mouth, but instead by a tube into his stomach). He was even a little offended when the patient’s mom said “thanks, but no thanks.” We had one patient’s mom who brought in her child’s MRI CD, and in her rush to get to the office on time, the CD had broken in half. She handed it to him & realized it was broken and was really embarrassed & apologetic… And he left the room and said to come back when they had something he could work with. He talked about how rude and disrespectful that mom was for the rest of the day! Over a simple mistake!! He had the benefit of being very “white male privilege,” so at times he would get really judgey about things that he probably shouldn’t have, like parents who didn’t have access to the most resources… And he would interpret that as them not caring about their children. It was so strange!!

At the end of my time with him, he had unexpectedly grown on me, and maybe that’s what his patients experienced too. I chalked his weird practice style up to just being a little odd/not exactly how I would do things. All of his patients seemed to really love him and his work. He was a great physician and his outcomes were some of the top in Phoenix for patient recovery & long-term healing. And he really loved the work he did. Like I said, most of his patients loved him and didn’t seem to mind. Maybe I was just hyper aware of his communication since I wrote my senior capstone on Doctor/patient communication in undergrad… Who knows!

Some weird encounters I had while on this rotation…
We did a special clinic one day a week for children with multiple defects- similar to my Peds plastic surgery rotation. There was a nurse practitioner who worked there as well. She told me she didn’t think I should see patients without my doctor with me since I was “just a student” & “wasn’t far enough in my training”. She knew I was a 4th year & graduating in May, so I’m not sure why she said that. I tried not to take it personally, but these hormones really betray me some days, haha! I also learned that when you break a femur, it actually will grow longer than the other femur when it heals! Most people are concerned it’ll be shorter, but it’s the opposite! Also, Pilates helps Peds Ortho cases more than other rehab modalities, which I found really interesting.

From the weird “zebra” cases I saw during this rotation, including tons of congenital anomalies, I got super nervous that something was wrong with my own baby. When all you see is rare defects, it’s difficult to remember they are in the minority & most babies are born healthy! My doctor also was really nice about me being pregnant- he even kicked me out of a surgery case because he didn’t want to chance exposing my little bumblebee to radiation! One morning he took me out to breakfast & told me all about his path to Ortho & how much he loves his work. Despite my initial impression, he was a very thoughtful physician. Overall, it was an interesting and educational experience, with a doctor who was more of an ‘acquired taste’ than an instant hit with me.