Moment of Clarity

And just like that, another week has flown by! Chai!! *in my best Nigerian accent*

I think I’m already starting to get used to this third-year lifestyle. In between the early mornings, long yet satisfying days at the hospital, lessons I’ve been learning from my upper-levels on my teams, nights of forced studying, and patients I’ve helped treat, I’ve been getting closer to establishing a steady routine. Granted, it’s kind of tough to fully establish one since I’m going to be switching services all the time (I’m starting my Renal service this week), but with each passing day I’ve been getting a better and better sense of how things flow. I’ve also been noticing fast improvements with my information gathering, physical exam and presenting skills, although I still have a ways to go. And last but not least, I’ve noticed how awesome all the people I’ve worked with so far in Internal Medicine are! Both of the teams I’ve worked with so far have been very willing to help teach my classmate and I major keys for success as we continue to acclimate ourselves as newly minted third-year students.

This past week was my second (and last) week of working on the Cardiology unit. But this time, I was on the General Cardiology service, as opposed to the Cardiac Care Unit (CCU). This meant that the patients that we cared for weren’t in as critical of a condition as the ones in the CCU, but they were still quite sick. I ended up following four patients overall while on this service, who all had various conditions that required remarkable treatments. I had a good time getting to know to each of them, and they all showed appreciation for their care and for me taking the time to just chat with them, which touched me quite a bit.

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As for the team I worked with duing this week, they were simply fantastic. I had such a great time working with them that I found myself looking forward to going to the hospital each morning (after making myself crawl out of my bed) just so I could learn from them! The interns were so kind and were willing to explain to us practical things about being a third-year student that we didn’t understand yet. Both the resident and the fellow on the team were geniuses who actually carved time out of their schedules to give us valuable information about Cardiology while making sure we understood what they were telling us by continuously prodding (pimping) us with questions along the way. And the attending we worked with was just incredible. She was highly personable with everyone she interacted with and was incredibly kind to the team as well as to her patients (Her bedside manner is absolutely stunning!). She also was a very effective teacher who forced us to think through the questions that she shot at us routinely so that we would better remember the information that we were learning. I really appreciated that because although I was put on the spot numerous times, I found myself better remembering the things that I was asked and I also found myself more engaged in learning about the various conditions that the patients had, along with their respective treatments. To sum her all up, she’s just the type of person who makes you smile whenever you see her, which is the type of doctor that I aspire to be!

Out of all the lessons that I learned this past week from my team, there was one that really stuck with me and will continue to be with me throughout the rest of my student years as well as my professional career. I had wanted go and talk to a patient we had checked on earlier in the day about a specific issue that was concerning to me, but I didn’t know if I had the authority to do so. So I asked the fellow on the team about how I was feeling, and what he told me truly inspired me and completely shifted the way I perceived my current position as a third-year medical student. He told me that I should not only go for it and talk to the patient, but that I should aspire to take ownership of all the patients I follow from here on out and really feel as though I’m the doctor caring for them. I should never feel as if I’m not in a position to talk with them about certain issues because I’m “only a third-year student”. With that mindset, I’ll feel much more compelled to do what I feel that I need to do for my patients, allowing me to establish more solid connections with them and ultimately allowing me to become an exponentially better care provider at a much faster rate. I instantly had a moment of clarity as soon as I heard that answer. I had heard variations of that answer many times before from other people, but it wasn’t until that moment that I finally and truly understood the incredible power that I had as a third-year. I may still be a student, but I’m here to learn how to become an effective physician. In order to become an effective physician, I need to learn how to do what effective physicans do. And the best way for me to learn how to do these things is to do them myself. I don’t have to merely be a chronically unsure errand-boy constantly doubting my own thought processes. I already have the power to really help change lives through conversation and decision-making. All I had to do was believe that I possessed this power and then act upon this mentality. So I did and I went to talk to the patient, who was actually quite appreciative that I did so. This is definitely a mentality that I plan on fully upholding from here on out!

Overall, I had another great week in this Internal Medicine clerkship. I actually had forgotten that Memorial Day weekend was coming up, so now I’m here on a three-day weekend without any plans except to chill for a bit, complete tasks I hadn’t been able to do during the week, and prepare myself for my upcoming service on the Renal unit. I actually have weekend days to work during this upcoming service as well, so that’ll be quite interesting…😅😅😅.

Have a great Memorial Day weekend and a magnificent week! Make sure to take some time to give gratitude to all the soldiers who have sacrificed their lives over the decades in order to continue keeping us and our country safe from harm!

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, and fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people will not feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It is not just in some of us; it is in everyone and as we let our own light shine, we unconsciously give others permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.” – Marriane Williamson

– Black Man, M.D.

Beginning A New Lifestyle

I’m a week deep into my Internal Medicine clerkship and I’m happy to report that I’m loving it so far! Sure the days have been long, but there has been virtually ZERO instances of boredom within these past few days. Plus, the interns and residents I worked with this past week have been gracious enough to let my classmate and I out at least a couple hours early each day. (I’m supposed to be at the hospital from 6AM-7PM. Lol, yeah.) I’ve been learning so much new & pertinent information so far and have been able to watch that information be applied on real patients. I was in the CCU (Cardiac Care Unit) this past week, so the patients that I saw were those who had critical heart issues and who needed to be monitored on a constant basis. It was an intense environment full of healthcare workers who had to be attentive at all times to all the patients there. There was also a death on my first day there and a couple of other patients who were transferred to hospice care to prepare for their own passings. Way to start off my third-year. But on the other hand, there was a good number of patients who were adequately treated and discharged from the unit! Also, the team that I worked with all week was full of pretty awesome people!

But before I get too deep into my experience at the CCU, let me step back real quick and touch on what I did on the day before I started working in the CCU. On Monday of last week, we (we as in the 30-or-so of us in the IM clerkship) had an orientation session specific to the Internal Medicine clerkship. Because I had flown in late the previous night from Miami and had gone to sleep around 2 AM, I was TIIYYAAD all day on Monday. But I was able to stay awake long enough to glean the important information given to us that day. We finally began to understand the sub-rotations that we were assigned to within the overall IM clerkship and we made our call schedules for specific sub-rotations that necessitated them. (I’ll be working four weekend days and a week of nights during this clerkship. Say it ain’t so! 😅) My IM schedule consists of:

  • 1 week of Cardiac Care Unit
  • 1 week of General Cardiology
  • 2 weeks of Renal
  • 1 month of Transitional Care
  • 1 month of General Medicine

So as you can see, third-year is quite complicated to understand. I’m here still trying to figure out how all of this works, and I’m the one living through it! However, we got a better understanding of what to expect during this clerkship and we were handed a bunch of papers to better supplement our knowledge. We then attended a few sessions, which included a Geriatric interactive presentation where we talked about different ways to properly care for the elderly, an ultrasound activity where we practiced how to perform a transthoracic echocardiogram, and a trip to the Crisis Control center where we participated in a simulation that enabled us to consider what living in relative poverty felt like and how powerful the concept of “generational poverty” can be on underserved populations. ‘Twas an interesting & busy day but by the time the last session (Ultrasound) rolled around, all I could think about was how nice it would be to collapse on my bed. I ended up crashing around 9 PM…only to wake up at 4:30 AM to start my first day on the CCU.

My first day up there was not really what I expected it to be. Then again, I had absolutely no idea what to expect in the first place. I walked up to the unit dressed up in a shirt and bowtie, only to be notified that I was supposed to be wearing scrubs. Go figure. After changing into scrubs, my classmate and I got assigned patients, which surprised us because we were previously told that we were going to be merely observing today. So we researched our patients and went to meet them. My patient had suffered a heart attack and was scheduled to have stents placed in his heart to open his occluded coronary arteries. He was a pleasant man to take care of, and I was actually able to watch the procedure he needed (Percutaneous Coronary Intervention) the next day! After getting the information I needed for my patient, the team and I all began our morning rounds, where we presented our patients to the attending (head doctor in charge) and visited our respective patients as a group. This took almost FOUR hours. FOUR. HOURS. It turned out that this was a particularly busy morning and that rounding this long was unusual, which relieved me. The experience was really cool though and having to present to the attending on my first day was quite challenging, to say the least. Especially since I wasn’t aware that we would have to do so. But she was understanding and gave both me and my classmate some useful advice for presenting patients, something that she continued to do throughout the week. After that marathon morning of rounding, we were notified about a patient who was not recovering from his acute condition and who would end up passing away that day since there was nothing that the team could do for him anymore. My classmate and I joined the Cardiology fellow on our team as he sat with the patient’s family to discuss the unfortunate circumstances that he was in. The conversation was a heavy and sad one where the whole family was in tears, but they were also understanding of the situation. The fellow handled the conversation very well and I’m grateful to have been able to witness that conversation, because I’ll definitely have to have those conversations with the families of patients that I will be helping to treat in the future.

The afternoon consisted of a third-year med student conference that we were required to attend (we have these conferences almost every day), following up on our respective patients, writing notes on them, sitting in on an impromptu lesson from the fellow, and talking with the team about a variety of things. I was actually surprised as to how flexible our time in the afternoon was. I found that I could actually get quite a lot of stuff done in that time, which is very good to know moving forward. We were free to leave around 5 PM and I immediately felt the fatigue hit me once I got back home. Crazy thing is, I needed to study and review material that I had forgotten during my post-Step vacation. I also realized that my mind was still in vacation mode, so I had to force myself to snap out of that mentality. I got a little studying in, but ended up crashing again around 9 PM, only to do it all over again the next day.

I won’t go into length on what I did each day because then I’ll be sitting here typing this forever. But it’s worth noting that each day had a similar schedule and although it has been a busy week, it certainly beats having to watch a lecture in the classroom. Even the whole “having way less free time” thing hasn’t bothered me that much (yet). I think my body is quickly adjusting to this new lifestyle of waking up before dawn and going to sleep at the same bedtime I used to have when I was like 10. In addition, I was able pick up a new patient on my second day, but I struggled on my presentation because he had multiple co-morbidities that needed to be addressed in addition to his chief complaint of chest pain. Turns out he had a stomach bleed that I was able to see via an esophagogastroduodenoscopy. (EGD) (Try saying that five times fast.) We had to take care of that before getting to the chest pain he had, which hadn’t bothered him ever since his stay in the hospital. I stayed with this patient until I left the unit on Friday and as for my first patient, he was discharged on Thursday. As the week progressed, I found that I was getting better at giving presentations, I was getting more accustomed to the flow of rounds, I was learning a lot more about asking pertinent questions & performing pertinent physical exams, I was bonding quite a bit with my patients, and I was running around with my classmate trying to watch various procedures being done on multiple patients. We were able to watch a Foley catheter being put in as well as two heart stents being placed in the cath lab, but we missed two arterial lines and a thoracentesis. Darn. The team was also very gracious to us in answering any questions we had, chatting with us on the topic of choosing specialties and in giving us very helpful tips on necessary third-year skills. They were also getting a laugh at how enthusiastic we were about this new lifestyle. Before I knew it, it was Friday afternoon and we were leaving the team that we had befriended pretty quickly. My classmate and I were legitimately sad to have to leave them because we had been having such a great time with them. But alas, we must continue to expand our medical horizons!

Overall, my first week of third-year has been a great one! I’ve already learned so much and I was made aware of just how much more information I need to learn. I also found myself thinking about various things like how much medicine has changed over time and how amazing procedures such as PCIs can save someone from heart damage in 20 minutes while a heart attack 100 years ago was, as far as I know, pretty much a death sentence. I also noticed myself often thinking about both the patient and their family’s perspective in the hospital in parallel with my own perspective as a third-year medical student and just how different our worlds were in the moments that I saw them during rounds. No wonder many doctors have written countless books about their experiences in the hospital…this type of stuff really gets you into deep thought. I could personally write a narrative on the thoughts I had while helping to take care of the two patients I was assigned to this past week. And that’s just after a week of being in the hospital. Who knows what I’ll come across these next twelve months and in the foreseeable future as I continue my medical education.

But as for now, I’m done with this post. I gotta review some Cardiology for this upcoming week lol. I hope you enjoyed reading this! Have a wonderful week!

“One can choose to go back toward safety or forward toward growth. Growth must be chosen again and again; fear must be overcome again and again.” – Abraham Maslow

– Black Man, M.D.

P.S. – Today is the two-year anniversary of my one and only acceptance to medical school! Shoutout to the Wake Forest School of Medicine for taking good care of me! I’ll be forced to (literally) repay the favor to the government for temporarily funding my education, but this is one investment that I’ll voluntarily (though quite begrudingly) go into debt for!

Christel Wekon-Kemeni, (1/2) M.D.

Boy does it feel good to see the “1/2” in front of the M.D. in my name.

I guess I’ve technically been a 1/2 M.D. ever since I took my Step exam, considering the fact that it was the monumental milestone that effectively ended my second year of medical school. All I’ve really been doing ever since then is going on vacations and attending third-year orientation sessions. So pretty much, I’ve been straight chillin’. But I found it fitting to officially call myself a 1/2 M.D. only after officially becoming a third-year med student, which to me meant completing all my orientation sessions. So here I am, a third-year medical student who has conquered both Step 1 and the required basic science coursework necessary to continue on to the clinical wards in order to begin my clinical rotations this week. Although I may be halfway done with my formal medical education (*GAAASSSPPP*), I sure don’t feel anywhere near ready to become a practicing physician. But I’m sure that all the looming long days in the hospital will work to effectively change that. Lol. Not really laughing though.

This past week was been an excellent one, to say the least! I started off my week at a day-long session on how to effectively use the Electronic Medical Record, which we had lowkey already went over the prior week. However, I did learn how to use the system a lot better this time around. It was still painfully boring though. The next day, I attended a Pharmacology lecture and was inundated with drugs and drug classes that we were expected to be familiar with once we got on the wards. Again, my eyes glazed over during this session. This ended up being the last session of third-year orientation, meaning that I was free to do whatever I wanted the rest of the week! Take a guess as to what I ended up doing? Yuuuuup, I was off to Miami for the last time in a long time in order to watch my girlfriend as well as my other close friends walk the stage for graduation! I flew out late Tuesday night and am just now returning to North Carolina after about five days of non-stop festivities. It was such a great time! As always, it was an absolute pleasure to link up with fraternity brothers, old friends, and my girlfriend + her family. I also haven’t had so much good, free food in such a long time! Shoutout to my girl’s parents for taking care of me the whole time I was in Miami! In between going to dinners, helping her pack her room up, going to graduation ceremonies, catching up with old friends, and trying to keep up with my emails, I was kept pretty busy the whole time and lost some precious sleep as a result lol. But it was an awesome and unforgettable time and I’m so thankful that I was able to attend UM’s graduation this year!

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With the completion of this trip unfortunately (or fortunately, depends on how you wanna look at it) comes the end of my post-Step vacation. It was an amazing vacation overall and am grateful that I was able to enjoy the whole experience. Now it’s finally time to apply the knowledge that I’ve accumulated over these past couple of years to real-life patients. Can’t believe that this time has finally come….I’m sure that it’s about to be a very interesting ride!

I hope that you have an outstanding week! Happy Mothers’ Day to all of you mothers out there, you are very much appreciated! And a huge congrats to everyone graduating from their respective institutions this month! You’re making all of your loved ones extremely proud!

“All the concepts about stepping out of your comfort zone mean nothing until you decide that your essential purpose, vision and goals are more important than your self-imposed limitations.” – Robert White

– Black Man, M.D.

Closing Of A Chapter

Only a week left until I finally start my clinical rotations!

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The closer I get to my first day on the wards, the more excited I’m becoming! I’ve also noticed that I’m feeling much lower levels of apprehension about this shift in my life than I was feeling just last week. Much of that has to do with these orientation (third-year boot camp) sessions that I’ve been attending as of late. We’ve gotten repeated exposure to our clerkship directors, who’ve made themselves available to us for any questions that we may have of this next step in our medical careers. We have also listened to multiple student panels made up of rising 4th-years, who’ve worked to appease our anxieties by giving us the rundown as to how third-year works and on what to expect going in. We also have been led on tours of the hospital and have been instructed on how to utilize the Electronic Medical Record (EMR) that we will be using throughout not only this upcoming year, but for the rest of our careers. As a matter of fact, this past Monday was dedicated to learning how to use that system….it was not the most fun thing I’ve ever done. And it wasn’t easy to use. Hell, I still don’t know how to effectively use it. It’s one of those things that you gotta continuously play with until you get into your groove with it. Just one more thing to add to the steep learning curve that I’m already facing starting next week.

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Along with “learning” how to use the EMR, we learned how to electronically track our patients & procedures that we’re expected to do. We also listened to presentations about communicating bad news with patients, making the most out of the countless opportunities that will be available to us during third year, tips for studying for our shelf exams and performing successfully on them, conflicts of interest, and how to stay professional while caring for our patients. On Wednesday, I got to know my third-year team some more via a group exercise where we shared our personal stories with each other. I’m glad that we were able to do that because although I knew who each of these people were (I’ve been in the same class as all but one of them for the past couple of years), I realized how little I actually KNEW of most of them until I listened to each of their stories. I’m looking forward to working with them for the next year and I hope that we all manage to continue getting along throughout our rotations!

On that same day, I FINALLY got my Step score back.

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There was actually an annoyingly dramatic sequence of events that preceded my viewing of my score. I got the email notification that my score could now be viewed as I was getting out of the group exercise session that I previously mentioned. I then proceeded to go home, place my free chicken salad on my kitchen counter (I managed to lose my appetite, even though I was starving just 10 minutes ago), plop on my (roommate’s) couch with my roommate, stare at my phone for a good 20 seconds, take a few deep breaths, and finally open my email…..only to realize that I needed to click a link in the email to see my actual score. I rolled my eyes as my roommate chuckled and clicked the link after a couple more deep breaths. I was then led to a sign-in screen, which annoyed the hell out of me. I then signed in and was led to another screen that informed me to click on ANOTHER link, which held my score via PDF format.

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Now I was getting extremely annoyed and nervous at the same time. I stared at my screen for another 30 seconds while my roommate repeatedly told me that I did fine and coaxed me to click and get it over with. I then held my breath and clicked the link, only for my phone to tell me to disable my pop-up blocker! Seriously??? Now I was getting mad while my roommate just busted out laughing at me. After a few more futile attempts to open the PDF on my phone after trying to disable my pop-up blocker, I gave up and logged onto my laptop in order to view my score. This process took an additional (and painful) three minutes. When I finally got to the PDF link again, I stared at my screen for what seemed like an eternity before holding my breath again and FINALLY clicking on the link. It led me to the score that served as the culmination of all the strenuous studying I had put towards preparing for that exam. When I ultimately laid my eyes on my score, I paused for a couple of seconds before exclaiming, “I’lllllll TAKE IT!!”  Granted, it wasn’t as high of a score as I was aiming for…but I am perfectly content with the score, especially since I had absolutely no idea how I did after taking that test. It really could have been potentially A LOT worse. Plus, my score still keeps all the specialty options that I’m considering relatively open, which is what my true end-goal was. So with that said, I’ve officially closed the Step 1 chapter of my life! However, it’s just incredible to see how I still wasn’t able to get that close to the score that I aimed for even after all the hard work and long hours I put into preparing for that exam. That test really is something else man. Although I didn’t make it to the stars, I sure as hell landed on the clouds!

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Thursday and Friday consisted of other useful sessions including personal wellness during third-year, financial aid, and a session called “What I Wished I Knew Before Third Year”. The main points I gleaned from that last session were to be assertive with my learning, to appreciate the growth that I will experience as I get comfortable with procedures and coming up with plans for the patients, to be unafraid of being wrong because I still will have relatively fewer responsibilities than my upper levels, to look at every day as an opportunity to do something that I’ll probably never be able to do again, to have very few expectations of going home early, to inquire what my upper levels expect of me as and to use “pimping” questions as a method of learning. Friday’s day-long session centered around inter-professionalism and working in teams with healthcare providers in other career paths such as physician assistants and CRNAs. In this session, we listened to a number of presentations regarding the importance of teamwork and got into smaller groups that included medical students, PA students and CRNA students, where we worked through a patient case and used root cause analysis to improve the quality of patient care. It was a long, yet interesting day!

And last but not least, I was invited to both a scholarship dinner for the Wake Forest School of Medicine Class of 1967 last night (it was their 50th reunion!) and a scholarship brunch this morning for all scholarship donors and students on scholarship. I was invited to the former dinner because I was awarded a scholarship this year from a late member of the Class of 1967. I’m still not entirely sure why I was blessed with the scholarship, but I’m not about to start asking any questions 😊😊😊. At the dinner, I found myself in a friendly room of elderly physicians and their spouses, all of whom were very excited to see the product (me) of their donation to their scholarship fund. As they shared stories of the man whom my scholarship is named after, I found myself feeling even more honored to have been selected to receive this scholarship because it was very obvious how much it meant to these physicians, for everyone I spoke to had very fond memories of this man. As for the actual food, I found myself eating the salad with a fork and knife lol. I also thoroughly enjoyed the free salmon, steak and mashed potatoes + vegetables that made up the dinner! As for the dessert, I took a bite of it and decided that I didn’t vibe with it. The dinner reception was marvelous overall and I had a blast this morning at the scholarship brunch as well! I’m really making it a mission of mine to provide scholarships to deserving students in the future, for these generous gifts of money have been changing my life ever since I received the Ronald A. Hammond Scholarship that allowed me to attend the University of Miami.

Alright, my word vomit has finally ended. Be sure to have an exceptional week! And congratulations to all of you graduating from your respective universities! That’s a major accomplishment that you should be extremely proud of! I’ll be in Miami this week to watch my girlfriend cross the stage and officially become a UM Alumni! 😆

“A dream is your creative vision for your life in the future. You must break out of your current comfort zone and become comfortable with the unfamiliar and the unknown.” – Denis Waitley

– Black Man, M.D.