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.

Back To Basics

It’s hard to believe that I’m already a month into my Pediatrics rotation…but then again, I’m always finding things hard to believe. I’ve come to accept it as a recurring theme in my life lol. Having a month of Pediatrics behind me means that I only have two more weeks to soak this rotation all in before I go on to my next one, Psychiatry.

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I’m definitely not ready to end this experience any time soon; I’ve been having such a great time! I was afforded the opportunity to work in a private practice clinic last week, where I participated in handling the bread-and-butter of outpatient pediatrics: well-child visits, immunizations, upper respiratory infections and a WHOLE LOT of reassurance to worried parents. The clinic was very busy and the pediatrician I was working with was always darting from room to room, which meant I was getting a ton of steps in. But even with the speedy nature of the clinic, she was very willing to teach me many things about outpatient pediatrics that I never knew, allowed me to go into her patients’ rooms to gather histories & perform pertinent physical exams, and went out of her way to discuss important concepts that I needed to know for my shelf exam. I was also struck by how nice she was, and by how happy and kind everyone else in the clinic was as well. I really felt welcomed there from the minute I first walked in on Monday morning (after having showed up at the wrong clinic first 😂)! In addition, I truly appreciated the amazing level of rapport that she had for her patients and I could literally feel her passion for children radiating from her while she interacted with them. She would ask them what they were wearing for Halloween, joke around with them, hold and bounce the babies to calm them down, and let the little kids play with the toys she had in her handybag, just to name a few of the things she did. Overall, I had a fantastic experience at the clinic! It was only made better by the fact that I avoided getting sick 😄. Now excuse me as I proceed to knock on some wood and plead to God that I don’t catch a cold.

Because I was in an outpatient clinic last week, I had quite a bit more “free” time to work with than I had while I was on my inpatient weeks. Due to this, I got a ton of studying in and was able to fulfill a number of tasks that I had been pushing off for a while. Oh yeah, before I forget, lemme tell y’all about the clinical practice exam that I had to take on Monday afternoon. You know, the one I mentioned to you at the end of my last post. It was so different from the CPXs that I had participated in previously. Instead of focusing on one patient for 45 minutes and having a couple of days to write up a clinic note, I had to zip through six patients in 15-minute intervals and then write brief clinic notes on them, each of which I had only ten minutes to complete it in. It was a whirlwind of an exam, especially with the constraints of the time limits…but I think I did alright on it. I know that I could have done better for sure, but the GAG is that it was formative! Which means that it doesn’t have any impact on my grade at all!

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I sure am glad that we got the opportunity to experience this exam in a stress-free environment, because I know have an idea of what to expect when it comes time to take Step 2 Clinical Skills. We’re going to have to do this exam again at the end of the school year before taking Step 2, but with this reference point now in mind, I’ll feel more confident about my performance when it comes time to do so. However, I am very interested in hearing the feedback from my performance because Lord knows it was far from perfect 😅.

Before I finish this post, I want to share with you some very insightful advice I recently received from the course director of my clerkship. In my short meeting with him last week, I had explained how much I was liking Pediatrics so far and how I’ve begun to actually consider it as a career path alongside Ophthalmology. He smiled and then responded with saying that my main mission as a third-year student is to enjoy the ride while being aware of which specialties I mesh really well with…then as third-year comes to a close, I’ll have a lot more clarity than I have now and I’ll be better able to “find a specialty that feels like home”. This is all stuff that I’ve already known for some time, but for some reason his “home” comment really resonated with me. It was such a simple, yet profound message. It makes total sense that I should feel at home in whatever specialty I end up choosing to practice in. There are so many variables that go into picking a specialty, but if you don’t feel at home in it then you’re ultimately doing yourself a disservice that you may unfortunately regret. This is a message that I’ll hold on tight to and it’ll definitely play a huge factor into my decision when it comes time to choose my specialty.

Lol, what a great way to end this post. Next up in my Peds experience is the newborn nursery! Looks like this week is already shaping up to be another great one!

Y’all have a sensational week!

“The key to accepting responsibility for your life is to accept the fact that your choices, every one of them, are leading you inexorably to either success or failure, however you define those terms.” – Neal Boortz

– Black Man, M.D.

P.S. – I finally got my Ob/Gyn course grade back this weekend…let’s just say that I done came up A LOT from my Internal Medicine rotation grade! I pray that I’m able to have a repeat performance with this rotation! 😅

P.P.S. – Miami is 6-0 baby!!! Let’s keep the momentum going!!!

How Did I End Up Here?

Y’all.

I’m in the middle of a crisis right now.

I’m not entirely sure what I want to do with my future anymore.

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Never in a million years did I ever think that I would be reconsidering my “definite” decision of pursuing Ophthalmology as a career. I had been told numerous times that clinical rotations tended to steer people towards career paths that they never envisioned themselves in before, but I was always so sure that I had a steadfast hold on my goal of becoming an Ophthalmologist. Like, I used to have a quick answer every time someone asked me what kind of doctor I wanted to become. I definitely didn’t believe that I would be one of those who had the potential to be swayed into another specialty, especially because I had been interested in vision care ever since my early high-school years. Now don’t get me wrong, I’m still interested in vision care and the field of Ophthalmology as a whole. But maaannn, the field of Pediatrics has been really tugging on me!

Like I said a couple weeks ago, a lot of my friends had said to me time and time again how they could see me becoming a wonderful Pediatrician. It always seemed crazy to me whenever I heard this because although I knew that I could tolerate kids and deal with them well, I just did not see myself ever deciding to become a doctor for kids…especially since I spent the majority of my childhood helping raise my five younger siblings, whether I wanted to or not. This is why it’s so unreal to me that I’ve been having so much fun on this rotation so far! From the people I’ve been working with to the families that I’ve been serving, my experience in this rotation has been a very interesting one. And I haven’t even started my outpatient experience yet! I’ve also noticed how much I’ve been enjoying the primary care aspect of this specialty, something I had not previously considered since I was all gung-ho about Ophthalmology up until recently. Man let me tell you, third-year is something else. Makes me wonder if I’ll run into another specialty that I find myself liking a whole lot…

You’ll probably hear me talking about my joy in this rotation about ten more times in the near future, so let me stop and actually tell you how my week went. I was on a service where I helped care for kids with chronic conditions relating to their GI (esophagus, stomach, intestines, rectum), Cardiologic (heart) and Nephrologic (kidneys) systems, and I was able to learn a lot about their various conditions. Like, A LOT. Both the residents and the attendings on my team were very willing to teach me as much as I wanted to know about anything I asked them, and believe me, I wanted to know A LOT. They were also all just very nice and cool people to be around, which made my 11-hour shifts something to look forward to each night.  Wait a minute, looking forward to 11-hour shifts?? Did you read that right? Sounds crazy, doesn’t it? Lol well it is, which why this all seems unreal. The days really just flew by during the week and before I knew it, it was Friday afternoon. And with the end of that week came the end of my inpatient part of this rotation.

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While I was working in the hospital, I kept myself even busier (what a great idea) outside of the hospital by helping host a Mentor/Mentee mixer between the Twin City Medical Society Chapter of the National Medical Association & the Wake Forest Chapter of the SNMA, attending a discussion on keeping a humanistic perspective while working in clinical rotations, organizing a glaucoma screening within a health fair that was taking place in the community yesterday morning, and now volunteering in the Ronald McDonald Family Room in the Brenner’s Children Hospital at Wake Forest Baptist Health. I could talk more about each of these events, but I tend to write novels when I get carried away with my thoughts. Plus, I’m lowkey running out of the time I gave myself to write this post 😅. To make long stories short, I’m really glad that I’ve been able to find the time to pursue other endeavors while on my clinical rotations. It’s been a bit tough to do so, but far from impossible. Participating in extra-curriculars also keeps me motivated as well as disciplined, and it allows me to continue being a well-rounded individual, something that has been an integral part of my identity for as long as I can remember. I feel like my life would probably be easier if I weren’t as involved in a number of things outside of my curriculum (including running an ever-expanding website), but I also know that I wouldn’t be as happy as I am now.  With that said, I would trade easy for happiness anytime, anywhere.

Alright, I gotta go on ahead and gear up for the outpatient part of my rotation, which starts tomorrow morning! I also have a CPX (Clinical Practice Examination) I have to complete tomorrow afternoon, where I’ll be interviewing six simulated patients (15 minutes each) and writing notes on them (10 minutes each) in succession. Seems excessive, doesn’t it? It kind of is, but it’s all in preparation for the Step 2 Clinical Skills exam that I’ll need to take after my third year is over. Step 2 though? Didn’t I just finish up Step 1 like not too long ago?? Smh. The tests never end fam. They never do.

I hope that each of you has a spectacular week! Also, please pray for the world. And then make it a point each day to do something, no matter how small or big, to make it a better place. There’s so much trouble in the world right now and it’s almost impossible to keep up with all the craziness just in our country alone. Believe me, I know it’s hard…but try your best to not to let the negativity around you consume you!

“The most difficult thing is the decision to act, the rest is merely tenacity. The fears are paper tigers. You can do anything you decide to do. You can act to change and control your life; and the procedure, the process is its own reward.” – Amelia Earhart

– Black Man, M.D.