Rude Awakening

You know, it’s hilarious just how pumped and bright-eyed I ALWAYS seem to be right after a break from school, only to be brutally reminded about what’s really good when I get slammed with work to do as soon as my first week back starts. And I’m not even necessarily talking about the work I do in the hospital; yeah it was a very busy week and I was taking care of multiple patients with various neurologic conditions, but I’m used to all that. I’m more so talking about all the extraneous tasks I told myself that I had to complete within a certain time frame, getting my fourth-year schedule in order, having to study for the Shelf exam that I’m taking this Friday (I swear that test crept up on me SO fast), and finding the time (and energy) to do all of those things in the couple hours of free time I have each day after a 11+ hour shift at the hospital. Oh, and how can I forget about the oh-so-pleasant feeling of being SNATCHED out of sleep at 4:45 AM each morning? I was up and running on Monday morning with a pep in my step, but it only took until Tuesday morning for me to remember why waking up so early sucked so much. All I could do that morning was groan, lay there in bed for a couple of minutes, chuckle randomly, roll my eyes, take a deep breath and throw myself out of bed to start another day in my General Neurology inpatient week.

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The actual experience on the inpatient service was pretty dope, especially since everyone on my team were such great people! From the interns all the way up to the attendings, everyone was just so nice. There were plenty of good vibes to go around and I learned quite a bit through their fantastic teaching. We as a team also rounded on an interesting array of patients, some of which had rare enough conditions deserving of a case report. In addition, I was able to sit in on a family meeting with my team and further appreciate the humanity of this side of medicine. The time just seemed to fly by while in the hospital, especially in the mornings when we pre-rounded and rounded on patients before going off to lunch. My afternoons consisted of additional patient care, meetings and required lectures on multiple topics in neurology. I would leave around 5 PM each day and try to summon the strength to study and complete little tasks before eating dinner and crashing onto my bed…only to be abducted from my dreams again the next morning. Although the days were filled with long hours, the week seemed to fly by pretty quick overall!

Earlier, I mentioned having to get my fourth-year schedule in order. You may be like, “Wow, you’re scheduling your fourth-year already? Why? It’s only January!” Well yeah I agree, it is quite early. But then again, it’s not that early because if I’ve learned anything in med school, it’s that time literally flashes before your eyes on a constant basis. So with that said, some members of the current fourth-year class went out of their way to give us a presentation regarding fourth-year scheduling. God bless their hearts. Turns out that there is SO much that I have to figure out between now and the start of my final year of medical school in late May. This includes figuring out if I want to do away rotations or not, deciding which acting internships and ICU rotation I want to complete, what electives I want to take, what to do with my “flex” blocks, where I want to apply for residency, when I want to take both parts of Step 2 (I literally just registered this exam a couple days ago…here we go AGAIN 😒), who to ask for letters of recommendations, yadda, yadda, yadda. Decisions, decisions. And I gotta really start figuring this out sooner rather than later.

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Quite a bit of pressure, don’t you think? Luckily, I have a good amount of people to talk to, including an assigned career advising counselor, who can help me figure all of this out. And I’m most definitely going to be hitting them up, believe that.

Remember that meeting that I had to set up for my “Less Than Satisfactory” performance on the rapid-style CPX that I told you about back in my Stroke of Misfortune post? Well I finally had it a few days ago with the clinical skills course director and we talked about how I did and what I could do to improve my performance for the next CPX in May. The main thing that I need to work on is quickly coming up with an accurate assessment and plan while writing up the patient note in less than ten minutes. So with that said, I’ll be specifically focusing on that skill between now and May, because I’ll be damned if I can’t move onto fourth year due to another “Less Than Satisfactory” performance with some standardized patients. Also, I plan to ace the Step 2 Clinical Skills portion. Sooo yeah, I got some work to do in order to transform this temporary setback into a major comeback!

On that note, I’m gonna go ahead and sign off for today! Have a fantastic week and be sure to take some time to reflect on what Dr. Martin Luther King, Jr. and the rest of the civil rights activists sacrificed in order to make our lives and this country a better place! And wish me luck on this Neurology shelf exam! 😄

“If you can’t fly, then run: if you can’t run, then walk; if you can’t walk, then crawl; but whatever you do, you have to keep moving forward.” – Dr. Martin Luther King, Jr.

– Black Man, M.D.

Starting Off Strong!

Well would you look at that, it has already been a week into the New Year!

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My first week of 2018 was spent in Atlanta, where I enjoyed a fantastic week full of relaxation, goal-setting, and brainstorming. New Year’s Eve was a blast, and New Year’s Day was full of some spectacular college football games. The other days of the week seemed to blend together, all the way up until yesterday when I returned here to good ol’ Winston. Within those days, I FINALLY watched Girls Trip, Bright (wasn’t a bad movie at all, despite what the movie critics say), the new season of Black Mirror (shoulda seen my face when I realized there were only six new episodes), the new Dave Chappelle Netflix specials, the series premiere of Grown-ish, and some other stuff I can’t think of at the moment. I can’t remember the last time I watched that much TV. I also ate a lot of good food from multiple restaurants, met a few of my girlfriend’s old friends and went ice skating for the second time in my life (first time was as a first-semester college freshman and my dumbass had decided to wear a v-neck t-shirt with some cargo shorts back then…I wasn’t so dumb this time 😊). I was wobbling about 97% of the time….buuuutttt I DID NOT FALL!!!

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It was a fun and restful week overall, and an awesome way to finish up my two-week long break from my clinical rotations. I honestly don’t even know when I’ll have that much time off from school again. Probably sometime deep within my fourth-year. Who knows. All I know is that I made the most of my break and I feel more than ready to return to the grind and knock out these last two weeks of my Neurology experience! Then comes my eight-week Surgery rotation, and I’ll be ready for that too, belieeeve that! I’m not letting anything stop me, scare me or slow me down man! Remember, a positive mindset = positive results!

Lol can you tell I’m pumped up? This holiday break really invigorated me, just like pretty much all my breaks in the past have done. Also, I just feel so grateful for where I am in my life and where I’m headed, Lord willing. There are hundreds of millions of people in this world who would kill to be living the life I’m living, so why wouldn’t I be pumped up about being able to continue my medical journey? I know how hard I’ve worked to get this far, how hard I’m willing to work to reach and surpass the goals I’ve set for myself and how much support I’ve been blessed to receive along the way, so what reason do I have to complain or become discouraged? As you can see, when you take some time to put things into perspective, you realize just how great your life is and how much worse off you could be! Perspective is key, never forget that!

That’s all I got for you today, short and sweet! I have a really good feeling that 2018 is going to be such a dope year; I hope that you feel the same about this year as well! Let us continue to prosper and reach our desired goals as we move further into this year!

“I am not a product of my circumstances. I am a product of my decisions.” – Stephen Covey

– Black Man, M.D.

Reflections.

I want to start this post off by giving a shoutout to each of us for making it to the end of this crazy year! By the grace of God, we’ve survived a year full of unpredictability, uncertainty, ridiculousness, and insanity. But at the same time, as President Obama has beautifully summed up in a series of tweets, there are countless stories of people that did amazing things throughout the year even though our collective consciousness has been dominated by endless reports of bad news. Through the good and the bad though, we’ve all grown in our own respective ways this year, and we should definitely take a moment to reflect on our experiences of 2017. With that said though, I’m sure that we are all ready to start off 2018 with a BANG!!

tracee ellis ross dancing GIF by HULU

Personally, 2018 is going to be a HUGE year in my life. Not only will I be taking both parts of Step 2, I’ll also be applying to residency programs throughout the country and will have to make the ultimate decision as to what specialty I would like to devote my life to. In addition, I’ll be finishing my third year and will be starting my final year of medical school.

I gotta say that again because I don’t think I understood that well enough the first time.

I’LL BE STARTING MY FINAL YEAR OF MEDICAL SCHOOL.

scared kevin hart GIF by Kevin Hart: What Now?

Final year of medical school?? It doesn’t feel like that long ago that I was just starting this blog and my first weeks of LAUNCH and Anatomy as a new first-year student. Hell, my senior year of college is still a fresh memory to me! What’s even more wild is that in just another year, I’ll be the recipient of a medical degree! I’ll actually be Christel Wekon-Kemeni, M.D.! That’s so exciting and terrifying at the same time 😅. Exciting because I’ll have something tangible to show for all the prayers that have been sent my way coupled with all the sacrifices and work I put into this journey. Plus, I’ll finally be doing something that I truly enjoy doing on a daily basis, and I’ll be getting paid to do it! Terrifying because I currently do NOT trust myself to be fully responsible for another person’s life, and I don’t know if I’ll feel much better about it when I graduate. The silver lining is that as a resident, I actually will have other residents and attendings with much more experience than me looking out for me. THANK GOD. But let’s not get ahead of ourselves; I haven’t even entered 2018 yet lol. It’s going to be a dynamic year, and with the midterm elections happening later on in the year, there will hopefully be some major changes in the current government as well.

As for 2017, it has been a very active and productive year for me. Like, VERY active. And VERY productive. I went from studying kidney pathophysiology as a second-year student in my Renal block at the beginning of the year to caring for stroke victims in my Neurology rotation as a third-year student at the end of the year. In addition, I became much more aware and active in this country’s political scene. I survived the Step Study Period and succeeded in completing my Step 1 exam. I’ve transitioned successfully from my basic sciences curriculum into my clinical rotations. I’ve seen and done things in my rotations that I’ve never done before in my life and have had experiences with patients that I will never forget. I attended the SNMA’s Annual Medical Education Conference for the first time, and had an awesome time there even with my disastrous performance at running for the position of Regional Community Service Liaison for my region. I was one of ten medical students in the nation to be selected for the SNMA’s National Future Leadership Program. I’ve traveled to several other high-quality conferences this year and met a number of influential people while at these conferences. I traveled to Mexico for the first time in my life and had an unforgettable experience there with some great friends of mine. I helped deliver a set of twins via C-section on my 24th birthday. I’ve continued to expand this blog throughout the year and am working on plans to further extend its reach to an even larger amount of people. I lost the only grandparent I had left in this world. I’ve been reminded of the strength and resilience of my family. I witnessed the best football season that the Miami Hurricanes have had since the early 2000’s, ranking up to as high as the #2 team in the nation at one point before our dramatic fall from the top with the losses of our last three games. I’ve had a major potential shift in my career goals. My girlfriend was accepted in a highly competitive MSPH/PhD program at UNC and is now much closer to me in distance. And in an unbelievable twist of events, she is now practicing her FIFA skills to one day beat me in the video game that I’m best at. These are just a few of the many highlights of my year, with some lowlights sprinkled in between.

It has been a hell of a year, and this past week of relaxation was a calming end to such a wild year. I didn’t do much last week other than spend a lot of time with my family, play a ton of FIFA with my brother, work on my blog, toy around with ideas that I would like to implement in the near future, and catch up with some old buddies. I flew to Atlanta last Friday to spend time with my girl and her family, and that’s where I currently am right now. I have a whole ‘nother week to chill here before I get back to the third-year grind, and best believe I’m absolutely going to be making the most of it.

Congratulations to you on surviving another year on this Earth, and CHEERS to a fruitul and prosperous New Year!!!

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“New Year – a new chapter, a new verse, or just the same old story? Ultimately we write it. The choice is ours.” – Alex Morritt

– Black Man, M.D.

Dashing Thru Neuro

Shhhh…..do you hear that?

No? Really??

Listen closer…..now I KNOW you can hear them bells ringing!

That’s right! Santa Claus is coming to town!!

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It’s the most wonderful tiiiiime of the year, where the brisk & chilly winter air (if you live in the Northern Hemisphere) reminds you that you belong indoors with your family drinking some hot cocoa while listening to holiday music and laughing about stories that are being shared, half of which you’ve probably already heard like ten times. Christmas dinner is beginning to be prepared, extended family is arriving, and your parents are telling you to run last-minute errands before Christmas day. Then as Christmas Eve starts drawing closer and closer to an end, the anticipation of Christmas morning overcomes everyone, especially the younger children in the family and everyone in the house entertains one another in a merry fashion. Then Christmas morning arrives and just like magic, there’s a ton of presents under the tree and everyone is all smiles and just happy to be in each other’s company! It’s a wonderful experience every year and being able to see everyone all together happy and healthy is enough of a gift for me every year. I wouldn’t have said this same thing 10+ years ago, back when Christmas meant getting the newest toys and gadgets to entertain myself with. But alas, we all grow and mature and eventually realize the true meaning of Christmas and the holiday season in general!

I love this season as much as anyone else, but I didn’t come here to write up a Christmas novel or memoir. Y’all know the real reason why I’m here. So let me get straight to it.

My experiences at the various outpatient clinics I visited last week were overall positive ones! The atmosphere at the clinics was very calm, laid-back, and educational. The patients that we treated were very nice and appreciative as well. I was at five different clinics throughout the week, most of which were general neurology clinics. So with that said, I ended up seeing several cases of myasthenia gravis, peripheral neuropathy, and headaches. I was even able to witness a case of newly diagnosed ALS, a diagnosis that was not easy for the patient and his family to accept. In addition, I did get the opportunity to observe procedures involving electromyography in one of the clinics, which was pretty cool the first couple of times I saw it. It actually looked quite uncomfortable for the patients, for they were getting pricked by needles in various parts of their body so that we could study the muscle activity in those areas. And it wasn’t a quick procedure either. On average, it took maybe about 20-30 minutes to complete. After the second time around, I had pretty much gotten the gist of the procedure. Hopefully I never need an EMG study done on me. 😅

At some point during the week, my rotation group and I all participated in a coma simulation lab, where we were divided into two different groups by a Neuro ICU attending and were assigned the task of managing a dummy who came into the ER in a comatose state. You know, it’s always funny realizing how much you don’t know when you’re thrown in a situation that you thought you knew how to handle. After managing the ABC’s (airway, breathing, circulation) of the “patient”, my group was at a loss at what to do next. We threw out different ideas and acted on them, but none of us really had a structured plan in place for a situation like this. After exhausting all of the options we could think of as a group, including asking for a CT scan that came back normal, I sure as hell had no idea what to do next. So I just kept sternal rubbing the dummy and calling out “Mr. Jones”! (That’s the name I made up for him on the spot lol.) After both groups had their turn, we critiqued each other and learned some valuable lessons from the attending about managing a comatose patient. It was a cool learning experience and it further proved the point that there is a very clear difference in reading about doing something and actually performing the task in real life. I’m absolutely sure that I’ll get the opportunity to learn more about emergency care later on in the year during my Emergency Medicine rotation.

Speaking of emergency care, I was participating in just that during my night shift last Thursday. Boooyyy, was it busy. Soon after arriving for my shift, we were literally bombarded with pages about the patients that we were covering and about new patients coming into the emergency department. There were several patients who came into the hospital with active strokes and it was fascinating to watch how all the residents in differing specialties worked together in concert in the ED. The neurology residents would perform a patient interview and neuro exam while the patient was being wheeled to the CT scanner, and after being scanned the neurology resident would continue the exam while another neurology resident would assess the CT scan with a neurosurgery resident in order to decide if the patient needed immediate surgery or not. Everything would happen so fast, and all my classmate and I could do is watch and try our best not to get in the way, which we managed to fail at on several occasions. It’s almost impossible to get out of the way in a cramped place like the emergency department, just saying. Apart from answering pages from the ED, we checked on other patients in the hospital who were suffering from other conditions such as seizures and headaches. I definitely learned a lot that night from the awesome residents who were very willing to help us learn things, no matter how busy they were!

The final thing I want to touch on is the mid-rotation feedback session that I had with my clerkship director. It was a very helpful session filled with comments about my strengths and practical feedback that I can utilize in the second half of my rotation when I get back from winter break. I also got my quiz grade back (the one that counted for 30% of my grade) and I must say, I was quite pleased with my score. 😄 The director and I discussed several things, but the main lessons I took from the session included: 1) developing a mindset of thinking in which I’m actively looking to figure out what important lessons and/or techniques I will be taking away from each rotation and 2) focusing my history-taking and neuro physical exam performance on what the patient is complaining most about. She told me that her main goal for me and the other students in this rotation is to have us really learn and appreciate the neuro physical exam so that we are able to use it comfortably in not only our future rotations but also throughout our careers. So guess what I’m going to do? Yup you guessed it; adequately learn and appreciate the neuro physical exam so that I can comfortably use it whenever I feel that it’s necessary to do so!

With two weeks of a solid performance in Neurology behind me and another two weeks of relaxation in front of me, I’m in a fantastic spot mentally, physically and spiritually. I’m planning on this winter break to be an amazing one!

Have a very Merry Christmas and a strong finish to 2017!

“Learn to enjoy every minute of your life. Be happy now. Don’t wait for something outside of yourself to make you happy in the future. Think how really precious is the time you have to spend, whether it’s at work or with your family. Every minute should be enjoyed and savored.” – Earl Nightingale

– Black Man, M.D.

Stroke of Misfortune

Last week was absolutely one of the busiest weeks I’ve had in a while.

It was my first week of Neurology and I was on the Stroke service helping to care for patients who were suffering from symptoms concerning for, well you know, stroke. My classmate and I were put to work right away as soon as we came in at 6 A.M. for our first shift on Tuesday morning. (Monday was reserved for Neurology Orientation, where we were told what to expect from the rotation and what was expected of us. We were also given free Chick-Fil-A lunch and reflex hammers to borrow, which was nice. 😊) From then on, we were expected to closely follow the patients that were assigned to us (I was assigned about 7 or so patients throughout the week), pick up new patients as they came in, think through their problems & try to come up with solutions to them, try our best to read their MRI and CT scans, follow through with the tasks assigned to us by the residents on the team, go to the required lectures that the attending physicians were giving to us, and some other things I can’t think of off the top of my head. Sure, most of this stuff are things that I’ve already been doing in other rotations and aren’t new to me.

But the fact that I had been thrown in a very busy service in a specialty that I hadn’t had much exposure to ever since Step Study Period made it harder to keep up with everything I had to do. It didn’t help that the last time I had conducted a full Neurology exam was well over a year ago. 😅 My multiple gaps of knowledge were exposed by the questions that I was peppered with by my attending, who also was gracious enough to fill those same gaps with very valuable information regarding strokes and how to efficiently assess brain imaging. In addition, I saw firsthand how debilitating brain damage could be, how it can completely change how a person functions physicially and mentally, the unbelievable findings that can be elicited on a physical exam and how much it could affect the families of the patients who were suffering from the damage. I definitely learned a lot last week from the medical team and the patients on that service, and with all the tasks that I had to complete for my patients (who were all really friendly!), I really felt like an indispensible part of the team! Okaaayyy, I’m stretching it with indispensible. But I sure did feel useful!

On the other hand though, I barely had any time to study new neuro material. Clinical duties and attending lectures are heavily stressed on this rotation, so I was ending my shifts around 5 PM or so, and getting back home pretty tired. I got some studying in and reviewed the conditions that my patients had but then before I knew it, it was time for me to go to bed in order to start the process all over again the next day. It was like the inpatient units of Internal Medicine all over again…except that I’m more than halfway done with third-year at this point and it’s really freakin’ cold outside at 5:30 in the morning these days. I did do some studying of the lecture material this past couple days for this quiz we have tomorrow that is worth 30% of our grade. 😂😂😂 I had to laugh because I’ve never heard of a quiz being worth so much of someone’s grade before. It’s wild as hell…but it’s also not supposed to be a tough quiz. Plus, we have to complete a bedside clinical exam at some point during our rotation and we actually have the option to subsitute that grade for our quiz grade if we would like to. And the clinical bedside exam isn’t known to be a hard thing to do great on in this rotation. So hopefully, this 30% will work heavily in my favor and not the other way around!

By the way, y’all remember the Clinical Practice Exam I talked to you about back in my Back To Basics post in October? You know, the CPX where I had to zip through 6 patients in 15-minute intervals and write up clinic notes on them on the spot? Well I know I had said that I thought that I did alright on it and that my performance was far from perfect. I FINALLY got my evaluation back from it and turns out that my evaluators thought the same thing! Well, except for the “doing alright” part. They absolutely agreed that my overall performance was far from perfect. As a matter of fact, they believed that it was so far from it that it was “Less Than Satisfactory”.

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Well damn! Less than satisfactory though?!? Can’t say that I was expecting that kind of feedback. On the documentation side, they seemed to think my history-taking and physical examination skills were okay, but they did NOT seem to like what they saw when it came to my diagnoses and workup plans.

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As for my actual encounters with the standardized patients, they weren’t big fans of my history-taking and my physical examination skills.

Confused Tituss Burgess GIF by The Late Late Show with James Corden

Confused? Yeah, me too. But hey on the bright side, I scored above average on my communication and interpersonal skills, so I did something right!! But overall, I didn’t do as well as they would have liked for me to do, so now I need to set up an appointment with the director of this clinical skills course in order to review my performance. Thankfully, it doesn’t have any impact on any of my grades and I’m glad that my flaws are being exposed now so that I have more than enough time to fix them before my second Clinical Practice Examination and Step 2 Clinical Skills comes about. And by looking at the averages and ranges of the class scores, I’m absolutely certain that I’m not the only one who’s performance was viewed as less than satisfactory. Plus, it was the first time that any one of us ever had a clinical exam in that format. Regardless though, it’s annoying as hell that I’m not considered up to par clinically. Looks like I still got a lot of work to do before Step 2 Clinical Skills rolls around.

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Well, that’s all I got for you today! I start outpatient clinic tomorrow at 8 A.M., which means I get to sleep in this week! Yay me! And after my night shift on Thursday night, I’m free for winter break!! TURN UUUPPPP!!!

Have a marvelous week and continue to enjoy the glory of the holiday season!

“You don’t need to be perfect to inspire others. Let people get inspired by how you deal with your imperfection.” – Wilson Kanadi

– Black Man, M.D.

Time Stops For No One

Welp, here we are again. The beginning of yet another rotation.

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I start my Neurology rotation tomorrow and judging by the email I received over the weekend regarding scheduling and the expectations of this new rotation, it’s going to be a really busy four weeks. Well, technically I’ll be in this clerkship for six weeks thanks to our two-week long Winter Break. So in all honesty, this rotation is going to be very manageable and I’ll have ample study time to dedicate to the upcoming shelf exam. However, in an interesting turn of events, the shelf exam isn’t worth as much in this rotation (only 10% of grade) as it usually is in the other ones (usually about 20-25%). Instead, there is apparently a quiz or set of quizzes based on lectures that will be given to us during the rotation that is worth 30% of our overall grade. Yeah you read that right.  THIRTY PERCENT!!! Why this is the case, I haven’t a clue. Kind of reminds me of the first couple of years of med school, with the lectures and tests and all. I guess I’ll have a better sense of what this strange curriculum is all about during Orientation tomorrow. I’m also going to be going back to a 6 AM starting time starting on Tuesday for the inpatient service this week…I literally haven’t started a shift at 6 AM since the beginning of October during my first week in Pediatrics. That’s going to be fun.

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But then I work in the outpatient setting next week, where I’ll be starting around 8 AM! And then I’ll go back to a 6 AM start time the week after break and then alternate yet again to an outpatient setting the final week of the rotation. So as you can see, there’s going to be quite a bit of hustle and bustle in these upcoming weeks. Hopefully I don’t show up in the wrong place at the wrong time at any point during the rotation! I’ve definitely done that before in the past, and it wasn’t a fun experience. 😅😂

The Psychiatry shelf exam I took this past Friday to finish up my Psych rotation wasn’t too bad of an exam overall, although it was a bit more challenging than I was expecting. Actually, let me rephrase that. There were some tough questions asked that seemed to have come from nowhere. Tough as in I would not have ever known to review that specific material, because it was random as hell. But for the vast majority of the test, I did feel adequately prepared and I ended up having a very generous amount of time leftover to review the few questions that gave me trouble. As for the week leading up to exam day, I spent it observing psychiatric interviews in the outpatient setting in the mornings and helping out in the Emergency Department in the afternoons/evenings. Both of those settings made way for some valuable learning experiences, and I was reminded about the fact that you just never know what people around you are going through on an everyday basis.

During one of the afternoons last week, my whole class had to attend a mandatory meeting in order to discuss what scheduling for fourth-year rotations, residency interviews and Step 2 is going to look like.

Wait a minute. Hollll’ up.

FOURTH year?!? Step TWO???

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Like, how?? I’ve just recently gotten the hang of the third-year lifestyle; ain’t no way in hell I’m ready for residency applications yet! And Step 1 may have been like eight months, but that doesn’t mean that I’m all gung-ho about taking another one of them marathon exams! I don’t even know when I should take Step 2 yet, but the time is already ticking to register for both the Clinical Knowledge and the Clinical Skills parts! 😰Thankfully, the true purpose of the meeting was to just make us aware about the timeline of events that will be taking place soon and was not intended to make us nervous or anything. Regardless, I am now acutely aware that time is starting to move a bit too fast for my liking…

Speaking of time moving fast, I’m going to go ahead and wrap up this post because I need to eat dinner and enjoy the rest of my night before diving headfirst into my next rotation. One quick sidenote before I finish though. Believe it or not, I saw the Nutcracker for the first time this past weekend! To be honest, I only went because my girlfriend wanted to see it, so I got us tickets as an early birthday present for her. I literally didn’t know it was a ballet until I was on the site about to purchase the tickets lol. The show definitely exceeded my expectations, and I didn’t realize how many Christmas anthems came from this one production! I was really impressed at the choreography of the dancers, and at just how well they synced with the music of the orchestra throughout the whole show. I didn’t think that I would ever appreciate a ballet as much as I did last night, but that’s exactly what happened. We then got some hot chocolate at a nearby bakery and “enjoyed” the winter wonderland that we were left with after this weekend’s snowfall.

Be sure to have a ravishing week! And get yourself ready for the holiday season! 😄😄😄

“That which we persist in doing becomes easier, not that the task itself has become easier, but that our ability to perform it has improved.” – Ralph Waldo Emerson

– Black Man, M.D.

You Think You Got It Bad?

And just like that, it’s shelf week.

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Even with the week-long break in the middle of the rotation, time managed to fly by really fast. Like, it’s already December! We’ll literally be in 2018 at this time next month! Hopefully it proves to be a better year than this one has been. However, we gotta finish 2017 off on a strong note! With that said, I plan on perfoming as well as I can on Friday’s upcoming exam and on marching through the first two weeks of my Neurology rotation on solid footing. Speaking of the exam, I’ve come to realize that there’s only so much that can be tested on the Psychiatry shelf exam due to the fact that the specialty itself isn’t as broad as something like Internal Medicine or Pediatrics. But on the other hand, there are a TON of guidelines that are used to diagnosis the pathologic conditions within Psychiatry, so it’s important to make sure that I keep them all straight in my head. Also definitely can’t forget the various drug classes and specific drugs that are used to treat these psychiatric pathologies. As always, I just hope my study efforts allow me to do as well as I would like to do on the test!

I was on the Psych consult service this past week and our main task was to answer the questions of healthcare providers on other services in the hospital who called us to see if we thought that their patients needed psychiatric help. There were instances where we helped manage patients with conditions such as bipolar disorder or major depressive disorder, but a good amount of the calls we received were usually because of an offhand comment that a patient would make relating to suicide. In those instances, the patient tended to become annoyed that we were asked to talk to them and usually insisted that they weren’t really suicidal after we would explain that we took comments like that very seriously. Being on this service allowed me to appreciate the routine frequency of which psychiatry is consulted, commonly for reasons that we would fix with a simple conversation with the patient. I’ll be sure to keep this in mind when I work to treat patients in an inpatient setting in the future and will think twice before consulting psychiatry for something that I could probably take care of on my own.

On one of the mornings during the week, I was given the opportunity to take part in treating patients via ECT (Electroconvulsive Therapy)! You know, just like what you see in the movies where we shock people in the head with electricity! Just like FRANKENSTEIN!!!

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Okay I’m just kidding lol. It’s not really what you would expect. Yes, we did shock people with electric currents in order to induce seizures, which in turn would work to help treat severe psychiatric conditions. However, these people being shocked would lay perfectly still while the current zapped through their brain. The only thing that would move would be one of their feet, which was made possible by tightening a blood pressure cuff around their ankle. The rest of their body would be paralyzed by medications. Pretty nifty huh? We performed ECT on about 5-7 people that morning (the whole procedure would take about 20 minutes max) and I actually was asked to press the button to zap electricity into someone’s head! Guess you can call me a MAD SCIENTIST NOW!!! MUUUUAHAHAHAHAHAHAHAHAHAHAHAHAHA!!!!!!!!!!!!!

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Something else that I was able to appreciate this week was the unbelievable power that addiction has on the lives of people. We participated in a discussion about the topic during a lunch session at some point last week, where the paradigm of “Use, Abuse, & Addiction” regarding drug use was reinforced. Interesting fact alert: If someone mentions that they could quit using whatever substance they’re routinely using or doing whatever activity they’re routinely doing at any time they want but just choose not to, they’re probably addicted. We were also taught that an addiction is almost impossible to control and that the first step in recovering from addiction is to understand that one is powerless in trying to control an addiction. A day after that talk was given, I had the opportunity to actually sit in on a group therapy session for recovering addicts. It was part of an intensive outpatient program that served as a bridge between the inpatient unit and outpatient 12-step programs such as Alcoholics Anonymous. While at the group therapy session, I directly witnessed the incredible power that this type of treatment had on these people and watched as they displayed a wide range of emotions while describing their personal experiences with the destructive force of addiction. It was such a powerful, eye-opening experience. The disease of addiction is very real. I really appreciate being able to learn from that experience and the people at the session also expressed gratitude about the fact that we as medical students are able to attend their sessions, because it forces us to understand the reality of addiction and it will help influence how we treat our future patients. I was also asked by one of the group members to check out “The Big Book“, which I’ll look into at some point in the future.

One more thing and then I’m done. Promise!

Right before writing this post, I was volunteering with the H.O.P.E. (Help Our People Eat) organization of Winston-Salem. Me and a few other classmates helped out by delivering lunches and fresh produce to the kids and adults of some low-income neighborhoods in the city. The food was stored in a big green van that we followed around in our own car and as it blasted the same New Orleans-influenced “When The Saints Come Marching In” song over and over again, kids would come running from all directions to pick up food for themselves and their families. It was like they were running to the ice cream truck…except that it was nutritious food that many of them relied on each and every week. For some of the kids, these lunch bags were the only things that they would be able to eat on the weekends before going back to school for lunch! That is so wild to wrap my head around. It’s just unbelievable that without an initiative such as this one, these kids could very well starve on the weekends. Participating in this organization for an afternoon is a required part of our longitudinal Health Equity curriculum throughout third-year, and I’m very happy about that. Requiring us to interact with the appreciative residents of these lower socioeconomic communities certainly allows for us to gain appreciation for what we have in our own lives and also shows us a perspective that some of my classmates have probably never appreciated before in real life. It also ties into the physician-patient relationship in that we’ll be able to better understand the circumstances that some of our future patients will be living in. Overall, I’m sure that the H.O.P.E organization has made a critical difference in the lives that it has touched, both volunteers and food recipients.

Alright, I’m all done now. Gotta get prepared for this last week of my Psychiatry clerkship! Y’all have a magnificent week!

“Let us rise up and be thankful, for if we didn’t learn a lot today, at least we learned a little, and if we didn’t learn a little, at least we didn’t get sick, and if we got sick, at least we didn’t die; so, let us all be thankful.” – Buddha

– Black Man, M.D.

P.S. – You probably realized that I hadn’t mentioned the Clemson-Miami ACC championship game that I witnessed in real life with my own eyes yesterday in Charlotte. It’s because I’m still grieving about the annihilation that we suffered through. It was so, so, soooo sad. Smh. Welp, at least we’re playing in the Orange Bowl. It was a good season overall. We’ll come back even stronger next year!

Full Speed Ahead!

Alright, I’m back from my week-long Thanksgiving break and am ready to cruise right on through the last two weeks of my Psychiatry experience! Then after that comes my Neurology rotation, where I’ll be working for two weeks before shimmying right into my two-week-long winter break!

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This is such a great time of the year because I always come from Thanksgiving break refreshed and ready to take on anything in my path, only to get to some rest again after powering through my work like a madman for about a month lol. Plus, everything is so festive and delightful! Only thing that irritates me during this time of the year is the cold weather that just keeps getting colder as we march into the winter months. It’s times like this where I miss the wonderful, comfortable “winter” weather of Miami. But on the other hand, the holiday season always feels more authentic to me when you can actually see your breath while walking outside! Ain’t nothing like sitting on your living room couch all snuggled up in warm pajamas with some hot chocolate in between your hands and flashy holiday decorations set up all around you as the snow drizzles outside your frosted window. (Try saying that whole run-on sentence in one breath. Bet you can’t…..and if you did, I’m still taking pleasure in the fact that I just made you talk out aloud to yourself. Hehehehe)

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Just take a second to appreciate the beauty of this deliciousness. Makes you want some right now huh? Yeah, me too 😓

Overall, I had a very restful and moderately productive break! I spent some of it with my girlfriend and the rest of it with my family and friends back at home. As always, it was a bunch of laughs, catching up, good food, FIFA and Monopoly all bundled up together in a week of fun. The Thanksgiving feast was amazing, to say the least! I cannot emphasize enough on how CLUTCH free, homemade food is man. I swear food tastes so much better when it’s free 😂. I also am proud of the fact that I got through a good amount of study questions during the break, something I told myself that I was going to do during the break but wasn’t sure if I would stick to it. I’m so glad I stuck to the plan because it only makes my life easier as I kick everything back into full gear in order to perform to the best of my ability on next Friday’s shelf exam!

Oh and one other thing before I wrap up this short post. I finally had the chance to help give a presentation to local high school students about the process of successfully getting from high school to medical school/any other health-related grad schools! As of late, I’ve been facilitating the execution of this outreach program (WCBD Ambassador Program, created by the White Coats, Black Doctors organization) here at Wake and have been setting up times for students to go to local schools in order to talk with the kids there. I hadn’t been able to go give a presentation yet because of my schedule but with the break last week, I finally had the opportunity to do so. It was a great discussion! The high school students were being interactive (although it took some effort on our part at first) and they had some excellent questions to ask us about our own experiences regarding the process of getting to where we currently are in our lives. It really was refreshing to share some useful knowledge that I take for granted with these kids and it forced me to put the experiences in my life so far into perspective, something that I recommend people do every once in a while. The teacher emailed me later on to tell me that the kids were talking about us and our presentation after we left and were excited that we came to talk to them! It was so dope to hear that! If we could help positively influence and inspire at least one person during our presentation, my trip from Chapel Hill back to Winston just to give the presentation would have been totally worth it.

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I hope that your Thanksgiving was a fulfilling and memorable one, and that you didn’t spend all your savings on Black Friday shopping! Have a fantastic week! And be sure to remain thankful for everything that you have in your life, as well as for the things that you don’t have that you wouldn’t want! 😊🙏

“Some people are always grumbling because roses have thorns; I am thankful that thorns have roses.” – Alphonse Karr

– Black Man, M.D.

P.S. – Yeah yeah, I know Miami’s winning streak just got snapped and all…but we still going to the ACC Championship this upcoming weekend!! We just gotta beat Clemson now, and our season can still (hopefully) be saved! Best believe I’ll be at the championship game cheering on my ‘Canes!!

Mind Trip

You know, if I was asked to describe what I thought about my Psychiatry experience so far in one word, the word I would use is peculiar. I would use this word because it essentially describes not only the patient population I dealt with this past week, but my interactions with them as well. As a matter of fact, I’ve had some of the most peculiar moments of my medical school experience within this past week. Although I had learned all about various personality disorders and mental illnesses in the past, I had never really seen any of them in real life until now.

Witnessing people with conditions such as schizophrenia, mania, borderline personality disorder, and bipolar disorder in real life was just as interesting as it was bizarre. I had to keep reminding myself that I was in a Psychiatric ward whenever I interacted with my patients because they acted so abnormally. I had a patient who literally screamed at me in anger at one point, but then had a cheerful conversation with me about ten minutes later.

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There was another patient who was pleasant to chat with, but was also actively hearing voices in her head at the same time.

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And let me not forget about the person who seemed to be disgusted with me from the moment I met her and made it hard for me to help care for her until her last day when she suddenly warmed up to me and actually laughed with me at one point.

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These are just a few of the many strange encounters that I experienced while on the inpatient adult Psychiatric unit this week. Although I was dealing with people who could prove to be very unpredictable at times, I never really felt unsafe or bothered. If anything, I was quite perplexed as to how these patients ended up the way they were. But there were times where I did get annoyed about how the patients were acting towards my team and I, and those were the moments that I really needed to remember that I was in a psychiatric ward.

Because the patients here usually had more control over their own fates than the kids in the Child Psych unit did, we were able to do more for them than we could do for the latter, which made the experience a less depressing one overall. It was also cool to see how the patients on the unit were able to participate in group therapy, where they were encouraged to create and execute their own goals daily just like the kids in the Psych unit were able to a couple of weeks ago. And last but not least, I can’t forget about how awesome my team was! We ended up having a great time with each other, and the residents were so thankful for having us medical students there to help out because according to them, it was a rougher week than usual on the unit. I totally believe them…some of the patients did not make it easy for us to do our jobs lol. Overall, I had quite an interesting time while on this unit.

Whenever I wasn’t directly participating in patient care, I was either studying shelf-related material or attending lectures on topics that included antidepressants, psychotherapy, psychosis and opiate addiction. I even randomly attended a dinner presentation on financial investements on my own volition, because learning about money is also important! Some of the takeaway points I could appreciate from these lectures included: questioning why certain treatment protocols exist and determining where they come from, putting more emphasis & focus on the positive qualities of patients while interacting with them as opposed to strictly focusing on the problems that they have, and being more aware about the financial options that I have when it comes to investing for my future. Each of these takeaway points are things that I plan on making more of an effort to become better at as time goes on!

With this past week over, I’m now halfway done with this rotation! In addition, I get a whole week off for Thanksgiving! I’m SO going to take advantage of this time off and spend the majority of it with my family. I hope that you enjoy your Thanksgiving holiday and that you remain thankful for the blessings that you have in your life!

“Train your mind to see the good in everything. Positivity is a choice. The happiness of your life depends on the quality of your thoughts.” – Unknown

– Black Man, M.D.

P.S. – MIAMI IS 10-0!! WE STILL UNDEFEATED BABY!!!

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Shattered Hope

Remember when I said last week that my experience in Psychiatry would surely be a unique one? Turns out I’ve been right so far. Like, VERRRY right. I knew that this rotation was going to be unlike any of the ones that I’ve experienced so far….but DAMN!

I definitely wasn’t fully prepared for what I saw this past week. Many of the patients who came in had such depressing and traumatizing stories, thus either creating their mental ilnesses or exacerbating the mental illnesses that they already had. What made it worse was that all the patients that we saw were under the age of 18! I literally couldn’t (and still can’t) believe the things that some of those kids had to go through. I can see how easy it would be to become very dispirited while working in a field such as inpatient Child Psychiatry. It’s some emotionally draining work man. Like, I only was on that service for a week and I found myself having to put more mental effort than usual into keeping my positive vibes up while trying to not become demoralized everytime I learned about a new patient’s story. It made me wonder just how people working in this field could function effectively on an everyday basis while living happy lives. I eventually realized that it all came down to using various forms of coping mechanisms. The members of my team must have learned how to utilize their own coping mechanisms successfully, because we were all still able to keep things light-hearted and have as good as a time as we could, given the serious nature of the conditions that we were treating.

Something else that I noticed while on this service this past week was the high level of interdisclipinary teamwork that occurred on an everyday basis. We worked very closely with not only the nursing staff, but also with the social workers and the PAs from the Emergency Room. Because of the fact that the vast majority of these young patients lived in the midst of dreary social situations, it was very necessary to have multiple realms of patient care involved, especially social work. As a matter of fact, it felt like just as much of our energy was geared towards trying to help improve the social conditions that the patients lived in as it was towards stabilizing the acute conditon(s) that these kids came in with in the first place. There were multiple family meetings that took place during the week and both the Department of Social Services & Child Protective Services were contacted on a regular basis. Having witnessed all of this, I can see how social aspects could make providing adequate care for this patient population frustrating, especially since it’s usually not the kid’s fault for being thrown into the situation that they’re trapped into. There’s only so much that medicine and social work can do in some of these situations. It was an eye-opening experience overall, and it really made me appreciate the life that I’ve been blessed to live so far. It has also given me all the more reason to appreciate the field of Psychiatry and the very important work that the people in this field of medicine do for their patients. However with all of that said, I’m not entirely sure if Psychiatry is necessarily for me. I still got a good three weeks to go though, so my mind is still open!

I’ll be working on the inpatient Adult Psychiatry service this week, which is quite of a big deal for me. Why is that, you may ask? Well if you think about it, I’ve been dealing with children exclusively for the past seven weeks….which means that I literally have not had an adult patient ever since ending my Ob/Gyn rotation back in September. Kinda trippy huh? To tell the truth, it’s going to be pretty strange having to transition back into adult care. It just won’t be the same. 😔

That’s pretty much all I have to share with you this week! And oh yeah, MIAMI IS 9-0 BABY!!! Last time that happened was back in the early 2000s! That UMiami-Notre Dame game last night was a spectacular sight, to say the least! We also clinched a spot in the ACC Championship game! Best believe I’m gonna be there rooting for the home team! 🙌

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Make sure to have an outstanding week!

“If you are feeling low or trampled, unappreciated or forgotten and you are reading this, realize it is an illusion. The hope is real, you are valued, and what lies ahead is brilliance.”Tom Althouse

– Black Man, M.D.