Ready Or Not

Y’all, I have about a month until my residency application is due. A month. That’s like no time at all, especially if you live in my world where time insists on zipping by like a shooting star. I remember first learning about the ERAS (Electronic Residency Application Service)  and the whole timeline of fourth-year like it was yesterday. I also remember feeling like I had so much time left during that fourth-year information session back in the late fall of last year. Back then, I was more concerned about powering on through my Psychiatry and Neurology rotations so that I could get to winter break. Fourth year seemed like a mile away…..but here I am now, about to start the last week of my third rotation of my final year of medical school, only about a month out until the application is due.

hm wow GIF

Luckily for me, my school ensures that we are prepared to submit our application well in advance by not only making us go to information sessions throughout the year, but also allowing us to pair with residency advisors during the summer in order to review the various elements of our application. Because I had to have drafts of my personal statement, CV and MSPE characteristics completed before my advisor meeting, I’ve already done all the hard work. I’ve even gotten a few people to review my personal statement already. All I need to do now to complete my application is to finish revising my personal statement, ensure that the people I’ve asked to write a letter of recommendation for me do so before the deadline, and complete the other fill-in-the-blank sections of my application. Then I’ll be pretty much set to submit! Oh wait, I also have to come to a final decision on which programs I’m actually going to apply to. 😅 Whittling my list down to about twenty-or-so programs is still a work in progress and is actually harder than I had anticipated, especially when there are so many fantastic pediatric programs across the East Coast. But I assure you, it’s getting done!

This past week was another one that went by in a blur. I woke up on Monday morning ready to start my week and before I knew it, I was leaving the hospital on Thursday afternoon wondering how the heck I was already approaching Friday. Carrying up to four patients at a time most of the week kept me pretty busy, which at the same time also helped make time fly by. By being responsible for this many patients, I felt like I was getting a taste of what being an intern was going to be like. I was writing notes for my patients, presenting them on rounds, assisting in coming up with plans of care for them, assisting in procedures (I helped perform a couple more of those 15-minute head taps that I wrote about last week lol) and even helping write orders for them. I really was feeling like the doctor that I’m going to become in less than a year!

Barack Obama Swag GIF

Overall, this past week in the NICU was another solid one. I even had a baby smile at me multiple times as I played with him! 😄 That about made my week, especially because of the straight-up sad nature of the NICU. These babies are literally the sickest infants that I’ve ever seen. Some of them fortunately end up getting better and going home, but many of them have been there for an extended period of time, with some of them having spent their entire lives in the hospital. It’s pretty depressing man. As a healthcare provider for these infants though, it’s extremely important that you don’t let your feelings cloud your judgment, no matter how sad and unfortunate the patients’ circumstances are. Of course you need to be able to emphasize with these patients and their families, but you also have to ensure that you’re not letting their circumstances affect your life in a negative and destructive way. It’s a much harder rule of thumb to follow than you may expect. Or maybe you actually do expect it to be a hard thing to do because, well you know, sick babies are naturally a sad sight to see.

While I feel like I’ve been able to emphasize with the patients and their families in an appropriate manner, I’ve found my mind frequently drifting off to what this experience in the NICU must be like for the families that come to visit their loved ones. Whereas each day in the NICU is just another day of school to me, it’s surely an emotional and unforgettable experience for each of the parents whose children are recieving care there. During these times of reflection, I tend to be brought back to the times I volunteered in the Ronald McDonald House’s Brenner’s Family Room in the hospital (located on the same floor as the PICU and the NICU), which is a place where families of the hospital’s pediatric patients can get together in a comfortable place close to their loved ones and rest while having access to free food and coffee. I remember witnessing how distressed and hopeful these families were about their loved ones, and being reminded that there was another world outside of the hospital that was full of the worried relatives and friends of each patient. It’s pretty terrifying how easy it is to go about your daily routine in the NICU without even taking a moment to seriously consider the perspective of the families who are scared to death about their loved ones. I hope to continue this habit of making time to consider the perspectives of others so that I can be that much more of an empathetic, caring and effective physician.

Well that’s it for today! Go on and live your best life this week!

“The question isn’t who’s going to let me; it’s who’s going to stop me.” – Ayn Rand

– Black Man, M.D.

Lessons In The NICU

This week flew by so fast man.

And I’m already at the halfway point of my NICU rotation.

Like, how??

kevin hart jokes GIF by Kevin Hart: What Now?

Between the long hours at the hospital each day and the great learning experiences that I’ve been fortunate enough to enjoy, I guess it’s easy to see why time has seemed to pass by so quickly. My mornings are primarily spent pre-rounding, pre-charting, rounding with Radiology, rounding on patients with my regular team, and finishing my notes. I’ve learned so much about routine care in the NICU just by paying attention to other providers during rounds and keeping up-to-date with my assigned patients. Although I had an idea of what day-to-day patient care looked like, it amazed me just how many calculations need to be done on a daily basis in order to adequately maintain the status of these infants.

After eating whatever I manage to come across for lunch, I typically spend my afternoons checking on my patients, finishing up whatever notes I have left, attending various learning sessions, and/or observing/participating in various procedures. As a matter of fact, my colleague and I actually performed a ventricular tap on an infant who was suffering from brain swelling and increased cranial pressure due to her overproduction of cerebrospinal fluid. The Nurse Practitioner supervising us walked us through the procedure, but we were literally the ones doing it. Can you believe that I actually stuck a needle into the baby’s fontanelle (“soft spot”) so that my partner could draw fluid from her brain? Wild man, just wild. Can’t lie though, it was pretty cool…..until I realized that I had to be immobile with the needle for about 15 minutes as my partner SLOWLY drew the fluid out of the baby’s head at a rate of about 1 mL a minute. We had to draw out 15 mL.

Sad Music Video GIF

The little kid took it like a champ though! What a soldier.

I spent part of another afternoon with a Neurologist and a group of third-year med students who were learning how to perform an effective neurological exam on a newborn at the bedside. That ended up being a really good review, and I also learned about the 5 S’s for the first time. Best believe I took notes on that. And speaking of third-years, I got the chance to orient another group of them to their Pediatrics rotation earlier on in the week. Like, I was one of the people giving them tours and tips during their rotation orientation! Talk about having things come full circle!

There were other various afternoon learning sessions that I attended during the week such as lectures on antibiotics and ventilators, interdisciplinary meetings about the next steps for our patients’ care, and my partner’s talk about abdominal wall defects. I even gave my own presentation about the development and usage of the HeRO score in a clinical setting! (The link lets you download my powerpoint, in case you were interested in the topic for whatever reason. It’s pretty interesting, but then again I’m biased. 🤷🏿‍♂️) However, the two sessions that I’ll probably take the most away from were the Medical Improv session and the Brenner Schwartz rounds. The Medical Improv session was actually a fun group activity that took the idea of improvisation and applied it to clinical settings. All the various healthcare providers in the room practiced using affirmative phrases such as “I appreciate you said that” & “yes, and” on each other in order to get an idea of how much more effective conversations can be. We also used negative statements such as “yes, but” and “no” to capture the feelings that patients can get when providers use them without thinking twice about it. We all had a good amount of laughs from the activity, and it made us more aware of the different ways that we can build rapport with patients as well as with our colleagues and other people in general.

The Brenner Schwartz rounds was a multidisciplinary forum that focused on discussing the experiences that various healthcare providers have gone through. There was a panel made up of two nurses and a Neonatologist, all of whom talked about various “best days of their lives” in their careers. It was neat to hear each of their stories and how much of an impact some of their patients have had on their lives and careers. Listening to their stories also motivated me to begin documenting my best experiences with patients so that I can look back on them whenever I’m having a tough day in the future. But then I quickly reminded myself that I have a whole blog to look back on whenever I’m having a tough day lol. But still, having a place where I have my patient encounters documented wouldn’t hurt. There are a good number of experiences that I just haven’t written about, simply because I don’t have the time to write them all out in the manner that I would like to write them out in. But even with that said, I’ve been able to touch on many of my experiences at one point or another in prior posts. Who knows, maybe I’ll end up creating a separate section on the blog dedicated to patient encounters at some point in the future…

That’s all I got for this post! Even though I don’t have to spend my time studying for a Shelf exam, I still managed to find a way to keep myself busier than I would’ve liked to be…so with that said, I’m gonna go and get some work done.

You all be sure to have a spectacular week!

“Opportunity is missed by most people because it is dressed in overalls and looks like work.” – Thomas Edison

– Black Man, M.D.

A Smaller World

You know, waking up at 5:20-ish AM this past week hasn’t been so bad at all. Yeah I know, sounds kind of absurd, doesn’t it? Here I was thinking that I was going to be struggling to wake up before sunrise, especially since it had been a number of months since I’ve had to do that. (It’s hard to believe that I was consistently waking up at 4:15 AM for three weeks of my Surgery rotation…now THAT was a struggle. 😩) I didn’t really mind waking up so early this past week because it turns out that I had a very positive first week in the Neonatal ICU!

happy best gif GIF

Now I’m not entirely sure what I was expecting when I first started. I just figured that because it was such a high-stakes environment, all the health providers on the floor would be very serious. I also thought that seeing all of the sick babies would bring about a somber atmosphere and that I would be the only student on the service working with residents, fellows, attendings and all of the other people on the team who worked in various specialties. Plus, the ICU literally stands for Intensive Care Unit, so I assumed that it was about to be an intense experience in a world that I had no familarity with.

Booooy was I wrong.

Okay, I wasn’t totally wrong. There definitely were a lot of sick babies on the floor, with some of them being as premature as 24-26 weeks. It was sad to see these babies suffering from the medical conditions that they have been unfairly afflicted with and to see them with multiple IVs, tracheostomy tubes, and dialysis ports, amongst other things. We tried to help alleviate their suffering by talking to them and playing with them whenever we were pre-rounding or visiting them throughout the day. Also, of course everyone was very serious about taking proper care of the patients. However, although they were serious in delivering excellent care to the babies, the atmosphere of the NICU was actually much lighter than I had anticipated. The team that I was working with was full of laid-back people who liked to laugh and have fun while at work (probably to help process the emotional turmoil that the NICU can bring), which surprised me a bit. It probably shouldn’t have though, because this is literally what the field of Pediatrics is all about. Plus, to my total surprise, I wasn’t the only student who showed up on the first day of the rotation. There was a PA student starting at the same time as me who was going to be working with me for the duration of the rotation, which was a relief to me. I can definitely handle being the only student on a service (I’ve done it numerous times before), but I’ve always had an even better time whenever I’ve been paired with other students!

With everyone on the team being really nice, likeable and compassionate, my first week in the NICU has been a wonderful experience. And of course they’re all really intelligent, so I’ve learned a ton of information as well, especially from the fellows who have given my colleague and I some useful presentations regarding both the maintenance care of infants and the various pathologies that affect infants. And what’s probably the best part of the experience so far is that I don’t have to worry about having to study for a Shelf exam! I can literally learn whatever I want without worrying about the fact that I need to answer study questions and learn high-yield things!

Happy Ftw GIF

Because I don’t have to focus on learning specific topics, I’ve been able to learn more about maintenance care of these patients, about the various machines that are helping these babies survive, about the psychosocial factors regarding the care of these patients and their families, and about all the random things that I come across while exploring this new world of medicine. The only assignments that I have are to deliver two separate presentations on topics of my choosing, but otherwise I’m free to learn whatever I want! I’ve also found myself thinking about what the futures of these patients are going to look like and if they would eventually end up going to camps like Victory Junction when they were older. Overall, I’ve had an awesome time so far and I hope that these next three weeks are just as awesome!

In addition to starting my NICU rotation, I had the “pleasure” of finally taking my Step 2 Clinical Skills exam in Atlanta on Friday. I literally had to drive straight from the hospital to ATL on Thursday afternoon, but I ended up getting there at a decent time thanks to my team allowing me to leave from the hospital earlier than usual. Being able to stay with my girlfriend’s parents at their house was also VERY clutch. I got a good night’s sleep and was fed very well both before and after my exam. The actual exam itself was pretty similar to the clinical practice exams that I had taken on two separate occasions throughout this past year, so I thankfully wasn’t blindsided by anything. It was pretty long (I interviewed and wrote notes for 12 standardized patients) but the day honestly flew by very quickly. Plus, we were fed lunch during one of our breaks at the testing site, which ended up coming in pretty clutch. (I had forgotten to pack snacks for whatever reason 🤦🏿‍♂️).

Even though my school had given me good preparation for the exam and I’ve repeatedly heard that Step 2 CS was a exam that pretty much just tests your English proficiency and your communication skills with another person, I didn’t want to blow it off as something not to take seriously. Plus, I had already been recently burned by my Step 2 CK score, so with that in mind I took the time a few weeks leading up to the exam to review various standardized cases in order to review all the different diagnoses and workup plans that could come in handy on test day. I also visited the USMLE site a week in advance to make sure that I knew all the information regarding the test and even watched the video on the site to ensure that I was familiar with everything on test day. I wasn’t about to give myself any chances to drop the ball! Although there are a few things that I could have done better throughout the test, I want to say that I feel satisfied with my performance overall. But I’m gonna just wait and see what my score is looking like before I proceed to jinx myself. 🤞🏿

After a very easy drive back from ATL, I’m now back in Winston, all ready to focus on learning some more in the NICU this week!

Let’s all make this week an extraordinary one!

“It is not how much we do, but how much love we put in the doing. It is not how much we give, but how much love we put in the giving.” – Mother Teresa

– Black Man, M.D.

Unforgettable Memories

I had to take a step back a few days ago to fully process the fact that it’s already been three years since I first created this blog.

Three years!

Oh My God Wow GIF

That’s crazy man. Three years of typing out weekly posts about my experiences as a medical student. I didn’t know how possible that would be when I first started, but I remember telling myself that if I just focused on making a habit of typing up one post at a time on a weekly basis, things would eventually work themselves out. And look what happened; things really did work themselves out! Now I can’t fathom not typing up an update on my life each week lol. I’m so glad that I had the foresight to do this and am grateful of all the love and support that I have recieved as I’ve worked to expand this blog. I’m also very grateful for all the people across the nation that I have met over the years as a result of my blog and my growing online presence. I literally wouldn’t know about a quarter of the people I know now if I hadn’t started blogging! It’s so wild just how much this hobby has expanded my network, which just continues to grow more and more with each passing day!

And to think that this whole project was birthed from the fact that I couldn’t find a blog that I could fully relate to while I was transitioning from college to medical school. Who knew that it would become the cathartic and inspiring entity that it is today? I sure didn’t. I thought that I would just be scribbling down my thoughts on a routine basis. I had absolutely no idea that I was going to add sections such as Med School 101, Useful Blogs or the popular Health Career Spotlight Series further down the road. I didn’t know that I would teach myself basic HTML and CSS code simply to design parts of my website in a particular way. And the thought of this blog being a potential talking point on my residency interviews never once crossed my mind until one of the physicians that I look up to suggested that I put it on my CV! Overall, it really has been an honor to serve as a source of inspiration for those of you who are motivated by the content in this blog, and I hope that I’ve been able to adequately fill the void that inspired me to start all of this in the first place as a rising first-year medical student.

Now onto my last week at Victory Junction. 😭

I spent my final week at camp working as a medical volunteer again, but this time I was given the opportunity to float around different units to maximize my exposure to as many medical conditions as possible. Because I was able to do this, I ended up interacting with a lot of the kids at camp, all of whom ranged from ages 6 to 16. Having this kind of exposure also allowed me to connect various conditions (some of which I had never even heard of) to their presentation in children, which was very helpful to me. The campers this week all had some sort of past or present disorder involving either their hearts, lungs and/or kidneys, so you can only imagine the variety of illnesses that were present in this group of kids. Also, because some of these children were immunosuppressed, there were A TON of medications to sort through and distribute. Like, I literally spent 30 minutes on accurately sorting out one camper’s 15+ different medications. Can you imagine having to take 15 medications every single day of your life? Or even having to accurately distribute 15 medications to your kid at specific times throughout the day? I had many experiences like this throughout my time at camp that gave me some perspective on the lives that these kids live on a daily basis. For example, I witnessed a couple of kids get a 4+ hour session of hemodialysis while at camp. They get these types of sessions about three times a week, every week. I was also with a couple of other kids who had to get peritoneal dialysis on a daily basis as well as very frequent dressing changes on their catheter site.

I remember the many kids with sickle cell the week prior who needed to take many extra precautions such as keeping warm and staying hydrated constantly to ensure that they wouldn’t suffer from a sickle cell crisis. Yet, they will still have medical complications down the road and will need to have access to pain medications to alleviate their chronic pain while trying to avoid being unfairly categorized as “pain medication-seeking patients”. And I can’t forget those kids living with ostomy bags that needed frequent changes throughout the day, or the kids with various levels of neurological impairment that I helped care for as a camp counselor. Yet, even though all of these young people have either faced or are currently facing challenges that would potentially cripple you and I, they seemed to just treat them as an everyday thing as they had the times of their lives at camp. I was especially blown away at their stage day (talent show), where one of the teenagers performed various acrobatics such as back handsprings and backflips, and couple of other teens performed songs that they composed themselves. I was equally touched during one of our nightly “cabin chats”, where a few of the teens shared some very personal details about their lives with a small group of their peers, counselors & us medical volunteers. Witnessing all of the great memories that these kids were creating gave me great strength and further reaffirmed my decision to dedicate my career towards helping young people like them live the best lives that they possibly can.

I’m bummed that my time at camp has all come to an end. I’m really going to miss many of the aspects of it, especially the positive & laid-back atmosphere, and the connections that I made with the many kids, counselors and medical volunteers. And I can’t lie, I’m really going to miss having three free and filling meals a day. 😭 The good news is that I can always go back to work as a medical volunteer after I recieve my medical degree!

With my second rotation coming to an end, I now have my upcoming NICU experience to look forward to. I haven’t worked in the hospital ever since I finished my Emergency Medicine rotation a couple of months ago, so I’m going to have to quickly calibrate myself back to the hospital environment and to waking up at like 5 AM. 😅 I’m interested to see how this next month is going to turn out, and am so looking forward to finally taking my Step 2 Clinical Skills exam in Atlanta this Friday and getting it over with! 🙏🏿

I hope that you all have an outstanding week!

“Do you really want to look back on your life and see how wonderful it could have been had you not been afraid to live it?” – Caroline Myss

– Black Man, M.D.