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!

Tori’s Spirit

This past week, I was painfully reminded about just how fragile life could be.

About half of my overall class and I were in the middle of our Health Systems & Policy (HSP) class early Monday afternoon. The other half of my overall class were in the Medicine and Patients in Society class (MAPS) at the same time. I had just come from a Kaplan lunch talk not too long before, where a representative was talking about how great the Kaplan Question Bank was in preparing students for Step 1. My thoughts were drifting back and forth between how I was going to use the Kaplan Question Bank to supplement my ongoing studies, how to make sure that I had the best fantasy football team in the class draft that I had just been invited to, and the financing & distribution of Medicaid in North Carolina, which is what we were currently being lectured to about. It was your typical, sunny Monday afternoon.

Then around 1:30 PM or so, the Associate Dean of Academic Affairs opened the door of the classroom as the professor was in mid-sentence and motioned for him to come over to her with her finger. Puzzled, he looked at her for a couple of seconds and exited the classroom with her. All of us in the class were quiet for a few seconds, and then indistinct chatter started to fill the room. My friend and I started joking around about what the professor must have been thinking as the Associate Dean, of all people, abruptly interrupted his class. After about a couple of minutes, the professor walked back in looking pretty shocked, along with the Associate Dean and about five other faculty members. I suddenly did not like the look of what was happening. I heard my friend behind me whispering “Oh no, this doesn’t look good. This looks like bad news. This is going to be bad.” The Associate Dean got to the podium as the other faculty stood in line facing us and started to break the devastating news that our classmate, and my friend, Tori McLean, had just passed away due to complications from the bone marrow transplant that was supposed to have saved her from her diagnosis of Acute Myelogenous Leukemia. As she said Tori’s name, my jaw dropped. I could hear gasps around the room. As the dean continued to speak, I began to hear my classmates sobbing across the room. A couple of my friends I was sitting at my table with began to sob as well. I was completely dumbfounded. My jaw just hung open for what felt like an eternity as I stared in disbelief at the dean. I don’t even remember most of what was said after hearing the initial news. Just before she finished speaking, she said we were free to take the afternoon off to collect our thoughts and to mourn. I then sat back in my chair and numbly stared at the ground. I had just entered one hell of a daze. I must have sat there like that for about five minutes or so as others around me packed up their belongings and left the room. I then somehow managed to get up, walk out of the classroom, and walk back to my apartment complex where I met up with a few friends in their apartment. I walked in the apartment, set my bag down on the floor, sunk in the couch, looked up at the ceiling and proceeded to stare blankly at it for almost an hour.

As I type this post almost a week later, I still find it hard to believe that she’s really passed on. Like, I’ll never see her on this Earth again. It’s an unreal feeling. I keep thinking about how her closest friends and her family must be taking the gravity of her loss. That thought alone saddens me. The fact that she won’t ever get the chance to become the incredible doctor that she had the potential to be, or to start her very own family, or to just continue with life in general as a 24-year old woman is very difficult to accept. She had been fighting so hard against this cancer that she has been diagnosed with since mid-March, right as we were about to take our first Neuroscience exam. It was so unfortunate, but we all figured, including her, that it was a terrible phase that she would get through before returning to her regular life. It’s terribly unfair that her life on Earth had to end this way, because she was such a great person…she went out of her way to make others feel better, even while she was fighting against the cancer wearing on her body. While I was checking in on her this past summer, she told me that she truly believed that I was not only wise beyond my years, but that she was confident that I would grow into an amazing doctor, especially now that she’s experienced the patient side of things. She said all this after stating how much it meant to her that I was reaching out to check on her when she could only imagine how busy I was. Lol, that was just how she was man, so humbling and appreciative of everything. I had to tell her that I was never too busy to check in on her and that I had been praying for her and her family every day. She also told me that she still had been reading my blog every week throughout her treatment, which really moved me. As a matter of fact, Tori had been a huge supporter of Black Man, M.D. since day one. She was always “liking” my blog posts on Facebook and had told me several times in the past how much she enjoyed reading it as well as how appreciative she was of the quotes I put up every week. When I spotted her at the school back in early August after school had started up again, I tore myself apart from the group I had been chatting with, shouted her name, and gave her such a big hug that I may have lowkey scared her now that I think back on it. My last interaction with her was when she wished me a Happy Birthday a few weeks ago and had hoped that my day was just as wonderful as I was. Man, I’m gonna miss her.

This past week has been a rough one, with losing Tori and simultaneously having to study for our Cardiology exam that we’re taking tomorrow. However, the school has been absolutely wonderful in responding to the tragedy. In a matter of less than five days, many emails were sent to our class from various faculty members, including from the Dean of the Medical Center himself, the medical class under us worked to console us by providing us snacks and a memory tree for Tori where we can write & hang our memories with Tori from the tree, a memory book for Tori’s family was purchased, and a memorial was planned to honor Tori’s life. This memorial service took place this past Friday in an auditorium at the former medical center next to the hospital. I’m happy to say that the auditorium was packed to the brim and that the service was phenomenal. Her whole family was present as well as many of the faculty, our classmates, and others that either knew her personally or knew of her. There were songs sung & played on the violin/cello/piano, prayers given, stories shared by her friends and family, tears dropped, and laughs shared between the people present. It’s incredible to realize that even after her time in this world had ended, she was able to bring so many people from all walks of life together in one place. I felt, and continue to feel, honored to have been friends with such an angel who has touched the lives of many.

There were many organizations on campus that Tori was a part of, but one thing she was absolutely passionate about was Project Teach, a program within the Student National Medical Association (SNMA) here at Wake where we help to tutor both middle and high-school students from the community around us on Tuesday nights. We had both been very involved in this program last year, but it was very obvious to me how important the program was to her. Her love for the kids shined so bright that she was made the Community Service Co-Chair alongside me so that she would have full control of how the program was run. Sadly, soon after obtaining that position, she received her diagnosis. She then reached out to me a couple of weeks after her diagnosis and asked for the “big favor” of temporarily assuming control over the program as she began to fight off the cancer threatening her life. Of course I obliged and began to do so alongside another friend who was also invested in the program who also happened to be the new Vice-President of SNMA. Her and Tori had been working to expand the program to high-school students in the community, for at that time only middle-school students were coming for tutoring. When this school year started, my friend and I continued to work on expanding the program and eventually got a nearby high school on board to participate. This past Tuesday was the very first day of Project Teach for the year and I’m happy to say that it was a phenomenal success! We had about 25-30 volunteers and just as many middle & high school students show up. And the number of students is expected to increase for this Tuesday as well! I really wish Tori was able to have seen how well the first day went and how much bigger the program is going to get this year. But I know she’s watching from high up above and smiling down proudly on all of us.

Life can be very rewarding and at times you may feel invincible. But life can also be just as fragile, for one moment you’re on top of the world and in the very next moment you can be on the ground suffering. If there’s one thing I’ve learned from this unfortunate event and from medical school in general, it’s that nobody is invincible. Disease & Tragedy can strike any one of us at anytime, even if we mean well and do our best to stay healthy. However, as the late and great Maya Angelou once said, “people will never forget how you made them feel”. I’m sure that just about everyone who has been touched by Tori’s presence can comfortably say that they will never forget how she made them feel, and that although she’s physically gone, her spirit will continue to live on in them forever. Her spirit will surely continue to live on in me. We all only have one life to live, so let’s shape our lives the way we want to shape them. Believe it or not, we have the power to do so. And while we work on shaping it, let’s find a way to make a positive difference in someone else’s life. It can be as big as funding a full scholarship for somebody or as simple as genuinely telling someone that they are beautiful. Even something as small as giving someone a smile can do wonders for another person. You just never know.

Victoria “Tori” McLean

January 6, 1992 – September 12, 2016

May your phenomenal soul rest in eternal peace.

“To live is the rarest thing in the world. Most people exist, that is all.” – Oscar Wilde

– Black Man, M.D.

Testing My Brain on a Test on the Brain

First off, Happy Easter to each of you who celebrate this glorious day!

And if not, Happy Sunday to you!

I woke up this morning half-expecting the sun to be shining radiantly in the blue sky, birds to be chirping, sunflowers to be sprouting, bunnies to be hopping around, etc. You know, your typical PBSkids-looking sunny spring day. I got dressed and walked outside into a dreary forecast of clouds, fog, mist, and coldness. You know, the kind of thing you see in a graveyard in a scary movie. What an Easter.

That didn’t screw up my mood tho! Then again, now that I think about it, what if this dreary weather is a grim reminder of my first Neuroscience exam I have…tomorrow???

 

 

Yup that’s right, I got my first Neuroscience exam tomorrow. You would think that Ola Ray’s reaction above would be precisely how I feel right now. But if you know me well enough or have been following this blog for a while, you would also know that I’m not one to really ever freak out…unless I just witnessed Michael Jackson transform into a werewolf and was about to slaughter me in the middle of the woods. Then yeah, I would be screeching like there’s no tomorrow. I like to keep my cool and to believe that I can trust myself to do well after all the long hours of studying I’ve subjected myself to. Honestly, I know I probably don’t share the same view of this block as a great portion of my classmates but I’m actually finding this material to be highly interesting. It’s almost as if I’m enjoying studying about the central nervous system (brain & spinal cord), everything that can go wrong with it and how to fix different pathologies relating to it via surgery procedures and drugs. I know, I know, I’m not smoking anything. I swear. Maybe I like it so much because it’s extremely relevant to what I’m going to be seeing as a doctor. Or maybe because the brain is literally the cornerstone of the human body and it has so much power over what we do in our daily lives. Or I could just be a straight-up nerd. It’s okay, you can point at me and yell out, “NEEERRRRDDD!!!” I’ve come to accept that title a long time ago. 😂 Regardless, it’s been nice to actually understand how strokes work, how the brain coordinates movement/pain/sensation/emotion/homeostasis/yadda yadda yadda and what the drug commercials are advertising as well as how those drugs work in the body. Don’t get me wrong, this ish ain’t easy. It’s actually SO MUCH information…like I’ve been having study-thons these past couple of weeks. But the material has definitely been capturing my interest. So with all that said, I’m ready to take on this test tomorrow, rain or shine!

Also, I FINALLY found out what I will be doing this summer. Turns out I’m going to be a Teaching Assistant for the wonderful Minority Students In Health Careers Motivation Program, run by the Office of Diversity and Multicultural Affairs at the Miller School of Medicine in Miami! (Talk about a mouthful.) I just can’t seem to stay away from South Florida 😅. I’m looking forward to meeting the students in the program as well as sharing my first-year experiences with them as they are looking to pave their way into the medical field. I’m just glad I was given the opportunity to make something out of my summer; Lord knows I don’t know how to sit idle. I also wasn’t landing any of the paid research positions I was applying to, so I really wasn’t sure what I was about to occupy myself with this summer. As a matter of fact, one program still hasn’t hit me back up yet now that I think about it…not that it matters anymore anyway. I’m more than happy with this TA position I was blessed with.

There’s a couple more things I wanna touch on before I wrap up. First, in our medical ethics class for the past couple of weeks, we’ve been talking about death, the complicated feelings associated with it, and how to deal with it as doctors both on a patient and an individual level.Yeah…it was pretty depressing. We delved into what our visions were on a “good” death, what our visions of death were based on, the moral significance of death, and how American culture views it. We also touched on why it’s still very difficult for physicians to deal with mortality even when we all understand that everyone has an end to their life. It wasn’t a fun topic to have, but it did get me thinking on how much power a society has on influencing the way we think about things, including mortality. On another note, we had a nationally known speaker named Robyn Ochs come speak to our class on the topic of bisexuality. She was funny man. I ended up learning a ton from her presentation; things I really never considered at all when it comes to the LGBTQ population. I’m glad I was able to attend and further diminish any ignorance I may have had for the population. Ignorance is bliss y’all…it truly is a danger in this world.I’ll be sure to think back to Mrs. Ochs whenever I have patients in the future that identify themselves in that group.

That about does it! Have a lovely week!

A change in your life can only come from a change within yourself.

– Black Man, M.D.

P.S: I’m still salty I didn’t get to go to the SNMA conference this past weekend…and that my bracket is completely busted after Kansas’s loss last night. Way to go Jayhawks.