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.

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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.

Gaining Ground

Well, I’m still studying for Step 2 CK. Nothing much has changed regarding that aspect of my life. My question block scores have been pretty stable this past week, with many more highs than lows. I also took a diagnostic test on Thursday and according to my results, I’m at a much better level of preparation than I had anticipated! I wasn’t feeling too confident while I was answering those questions, but after I got my score back I felt like I could just go on ahead and take Step 2 the next day just to get it over with lol. I have a little less than two weeks to finish preparing for this exam, which is both good and annoying. It’s good because I can only get better from where I’m at, and I have the potential to have a high peak performance on test day. On the other hand, it’s annoying because I’m starting to lose patience with these study days and this endless cycle of answering questions and reviewing them is actively draining my desire to study. Plus, I don’t want to end up performing at my peak before test day. That would really, really, reeeally suck. But alas, the grind must never stop. I’ll continue to chug along with this study process and ensure that all this hard work brings about a fruitful result.

In other news, I took some time off last Wednesday to participate in patient advocacy at the state capital! The event, White Coat Wednesday, is an annual event hosted by the North Carolina Pediatric Society that is focused on meeting with state legislators in order to discuss pertinent issues relating to the health of children and families in NC. My whole morning was spent having important discussions with various legistators alongside Wake Forest faculty members, residents and fellow classmates who are also interested in a career in Pediatrics. It was a pretty neat experience, because it allowed me to witness firsthand what engaging in patient advocacy on a legislative level was like. It’s really not as intimidating as you would think it is. Before meeting with the legislator, you come up with a few talking points that you want to emphasize during your conversation. Ideally, they would be topics that you believe would be most likely for both you and the legislator to agree upon, because you want to ensure that the meeting will be a productive one. Once you have those set talking points, you literally walk up to your legislator’s office and attempt to talk with him/her for a few minutes. Of course this part is easier if you have already scheduled a meeting with them beforehand. You hit on your talking points during the conversation and hope to inspire the legislator to act upon at least one of your suggestions. Then the meeting is over and you both go your separate ways as you work to locate the next lawmaker that you want to influence.

It’s actually a pretty simple process once you get the hang of it. But then again, the lead Pediatrician we were with has been doing this type of work for a while now, so I’m sure that this is all second-nature to her. She really made the whole process look so easy! As a future Pediatrician, I know that I’ll certainly be drawn to advocate for my patients on many levels, especially the legislative level. With that said, I really am glad that I decided to participate in this event because not only did it make the whole process less intimidating than it initially seemed, but it also proved to me that I could really help make a difference in the lives of others on a larger scale just by talking to the very people who help create the laws we live by.

All done here! Now go on and have a sensational first week of June!

“Everyone has inside of her a piece of good news. The good news is that you don’t know how great you can be, how much you can love, what you can accomplish, and what your potential is.” – Anne Frank

– Black Man, M.D.

High Noon

Okay, crunch time is officially here.

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I have 11 days until my Surgery shelf exam, and I’m going to be losing an hour thanks to Daylight Savings Time next Sunday. Believe it or not, 11 days is not a lot of time to review all the material that I still need to get through in order to be comfortable enough to take that shelf exam. Although I’ve already completed a large portion of the questions that I need to get through, I still need to study the answers to them and further review the concepts that I don’t totally understand yet. In addition, I have to begin preparing for my cross-country trip to the SNMA’s Annual Medical Education Conference at the end of this month, where I’ll be playing a much larger role (thanks to my status as one of the National Future Leadership Project Fellows and as one of the members of the National Community Service Committee) than I did when I went for the first time last year. The conference will be taking place in San Francisco this year, which I’m very excited for because I have never been to Cali before!

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There are also emails that I need to send out and respond to (I’ve accepted the fact that this is going to be a never-ending problem), projects that I need to continue to coordinate, assignments that I need to complete and things I need to figure out as I continue to prepare for applying to residency programs and for my final year of medical school. There just always seems to be a cascade of things to do at any given moment and because of this, my mind has developed this habit of racing through tasks while at the same time calculating my next moves. Even as I type this post, I’m thinking about the many things that I need to get done before I go to sleep tonight while at the same time plotting out my plan of attack in preparing for my upcoming exam. It’s honestly remarkable how on most nights, I’m able to calm my mind down enough to go to sleep.

Speaking of, starting tonight, I’m going to have to go back to going to sleep real early because I have to be at the hospital by 6 AM tomorrow morning to begin the Anesthesiology portion of my Surgery rotation. I knew that these early mornings were coming back to rear their ugly heads, so I’ve been mentally preparing myself for it for weeks lol. But in any case, this service is going to be an interesting one and I’m certain that I’ll learn a lot of good information during these next two weeks as I rotate through this specialty. I’m apparently going to be in different places on different days in order to rotate through as many of the sub-specialty areas of Anesthesiology as I possibly can, so I gotta make sure that I have my schedule straight at all times. I’ve been at the wrong place at the wrong time on several occasions, and it’s certainly NOT a fun thing to have to go through. I’m also ready to start on this service because I have yet to meet an Anesthesiologist here at Wake who isn’t a chill person! The atmosphere that I’ve sensed from the physicians in this department so far gives me reason to look forward to working on this service for the next couple of weeks.

With the start of my last service on my Surgery rotation comes the end of my fascinating experience in the Ophthalmology department. During my last week on this service, I had the opportunity to work with Ophthalmologists who specialized in the cornea, the retina and the pediatric population. In addition, I was able to work with a resident who answered consults throughout the hospital, allowing me the opportunity to observe all kinds of patients who had some unique findings in their eyes that I had never seen before. I appreciated the things that I was able to see and do during this week, but something specific that I took note of was how the Pediatric Ophthalmologist interacted with his patients. He had the challenging task of examining and diagnosing children with ocular disorders, which meant that he had to ensure that these kids stayed patient enough to follow the specific directions that he gave them while he assessed them. It was incredible to watch how he used the tricks that he had up his sleeves to retrieve important information from his patients, and to realize just how knowledgeable he was about ophthalmology. I’m definitely going to have to borrow some of his clever tricks and use them with my own patients in the future!

All in all, even though the patient presentation that I was supposed to give during Grand Rounds last week got pushed to this week, I had a great and intellectually stimulating experience while on this service. There were times where I was tempted to reconsider pursuing this specialty again, but at this point I’m comfortable enough to say that I’m committed to a career in Pediatrics. Where this road will take me, I have absolutely no idea. But I do know that I’ve developed a very real passion about this specialty that I can’t shake off, and the opportunities that a career in Pediatrics presents truly excite me to no end. Who knew that it would have ever come to this? Apparently just about everyone but me 😅. They weren’t lying when they said that crazy things can happen during your clinical rotations!

Alright, gotta go now. Be sure to start your month off on a positive note! And remember to get yourself ready for the insanity that is March Madness…

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“If you have a positive attitude and constantly strive to give your best effort, eventually you will overcome your immediate problems and find you are ready for greater challenges.” – Pat Riley

– Black Man, M.D.

P.S. – The two presentations that I gave last week went well for the most part! Well, one of them went sort-of-well in my opinion, and I ended up doing a much better job with my other one!

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.

Christel Luhhh The Kids!

Multiple people have told me time and time again that they could definitely see me as a Pediatrician. Whenever I used to hear that, I would usually laugh it off and say something like, “Maybe, maybe not. Who knows?” with a shrug. But after this first week in inpatient Pediatrics, I can finally see why people have always told me that they could see a future Pediatrician in me.

I’M FREAKIN’ LOVING THIS ROTATION SO FAR!!

From day one of this rotation, I was a little too excited to start it and my excitement hasn’t died down since! Having such an AWESOME team to work with this past week only added to my excitement! There wasn’t a minute during the week where I wished I were somewhere else other than the hospital; my team was just that much fun to work with. And in regards to the patient population I was serving (newborns to late adolescents), I found myself very inspired and driven to help care for them. Part of the reason I was so driven to help them was because of my inability to stop thinking about the unfairness of the situations that many of these kids were in. They did not deserve to be as sick as they were, especially with such full lives ahead of them. Seeing sick children in general bothered me, but it was especially bothersome when the youngest of them had either serious chronic conditions and/or terminal conditions. Like, what did they do to deserve those gravely unfortunate conditions?? And as for the families of these children, they really deserve kudos for doing their best to keep the child’s quality of life as high as possible. I can’t even begin to imagine just how hard it must be to care for a chronically ill child.

In addition to thinking about how these kids deserved the best treatment possible in order to continue living out their lives, I found my mind repeatedly wandering off to what my life would possibly look like if I were to decide on becoming a Pediatrician and I must say, I can definitely see myself being perfectly happy in that career path. I don’t mind working with children at all, and I actually find myself playing with them as I’m caring for them. I also feel like I tend to get along with the family members of the patients, whether they be parents, siblings, cousins, uncles, aunts, etc. Plus, I believe that a career in Pediatrics would align very well with the various goals and plans I have for my future, especially the primary care aspects of it. But with all this being said, I’ve only been in this rotation for a week….so it’s probably a bit premature to say that I love this specialty, especially with five more weeks to go in it lol. I’m still interested in the field of Ophthalmology but in all honesty, Pediatrics looks like it’s starting to become a serious contender….

I’m going to be working inpatient nights this week, so I’ll get to have another unique perspective of this specialty. But before starting this night shift, I’m going to be attending a wedding for one of my fraternity brothers over in Phoenix, Arizona, where I’m currently at right now. It’s pretty trippy over here y’all. The sky is always blue, there’s no grass, there are a bunch of cacti in the city, it’s pretty hot, you can see mountains in the distance, and we’re in the middle of a freakin’ desert. I really feel like I’m on another planet right now…it’s hard to believe that I’m still in America. And oh yeah, I’m a whole three hours behind from the East Coast. That really tripped me up yesterday. But I’ve been having a fantastic time here with old and new friends alike, and am looking forward to this wedding ceremony that will be taking place in a few hours!

Y’all be sure to have a glorious week!

“Life is a matter of choices, and every choice you make makes you.” – John C. Maxwell

– Black Man, M.D.

 

City Boy Back In A Country World

As you can see from the title of this post, I was back in the good ol’ town of Lenoir, NC this past week. Unlike last time though, spring break isn’t starting…instead, I’m starting my Gastrointestinal block tomorrow. Le sigh. It’s okay though, this is the last block to get through before Thanksgiving break! And then after break there’s a week of Dermatology and two weeks of Renal before Winter break! ‘Tis the season of holidays 😄. Which also means it’s starting to get chilly…man I hate cold weather. But I also hate global warming. Just can’t win man, just can’t win. Honestly, I just need Summer ’16 to come back.

Before I get into my second, and final, Community Practice Experience that I participated in this past week, I just wanna touch on a few quick things. First, my Pulmonology test results. I passed comfortably. That’s good enough for me these days, although I felt like I studied hard enough to get an even higher score…but that’s neither here nor there. Y’all know I’ve been more concerned about learning the material for Step 1, which brings me to my next point. I’ve officially entered my testing location and date for that wicked exam. Unless I decide to change the date, I’m taking my USMLE Step 1 exam on Monday, April 10th, 2017. If it wasn’t real when I registered a couple of weeks ago, it sure is real now. I was actually going for April 12th, but all the spots in Greensboro were taken already. How they were already all booked, I will never know. But alas, I know I’ll be fine taking it a couple days prior, especially if I don’t have to drive an excess of 50+ miles on the morning of this fate-sealing exam to take it in another designated location other than Greensboro. Now I just gotta come up with an extensive study plan and stick to it.

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Last thing, I powered through and finished the book Overcoming The Odds, written by Dr. Antonio Webb, yesterday. I had been reading this book for a little over a month and I must say, it was definitely a story worth reading. Extremely inspiring too…this man went from a kid in one of the hoods of Shreveport, Louisiana to becoming a resident in the Orthopedic Surgery program at the University of Texas at San Antonio Health Science Center. The story of how he got from Shreveport to San Antonio is incredible. This man had to go through an enormous amount of trials and tribulations to get to where he is currently at, including serving time in Iraq as a medical soldier and applying to medical school THREE times before becoming accepted. His story is absolutely one worth looking into. Right after finishing that book, I bought Dr. Sampson Davis’ book, Living and Dying in Brick City. I’m looking forward to reading that one!

Okkkayyy, now about my week-long experience in Lenoir.

First of all, I must say that I had a very positive experience overall! Because I had been there before, I knew exactly what to expect in the clinic and in the town in general. I wasn’t hit with any surprises and I was a lot more comfortable talking with patients and discussing their conditions with my preceptor than I may have been back in February. I also wasn’t rear-ended, stereotyped by an officer, baffled by a kid wearing confederate clothing in the clinic, or buffeted by rainstorms this time around. As a matter of fact, everyday was a hot, sunny day out there! However, I did spot the confederate flag on three separate occasions during the week (yes I was counting) while driving through the Lenoir area. I also spotted hella Trump/Pence signs as well as a few Pat McCrory signs (the current NC governor who’s spiraling NC into a mess) during the week.

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I wasn’t surprised to see them though. My preceptor (who seems to be one of the few liberal folks in that town) and I had quite a few jokes to share when it came to this presidential election. I was a bit surprised to see a couple Jill Stein signs though. I also saw a grand total of ONE Hillary/Kaine sign, and that was when I was heading out of Lenoir Friday afternoon lol. Maaannn, y’all just go out and vote. Early voting has been rolling out across the country so make sure to get your voice heard! I’m going to cast my ballot this week!

As for my actual clinic experience, it was quite tiring and very enjoyable at the same time! Time always seemed to fly by there, especially when I was taking the time to interview patients. As you may or may not know, I was working in a pediatrics clinic, so I mainly saw babies, kids and teenagers at the practice. By the way, I heard the screaming babies again as I lay my head down to sleep every night. JESUS. Unlike last time though, there was a PA student working a five-week rotation with my preceptor as well, so we would talk and bounce ideas off one another whenever we got to a patient who needed a diagnosis. My preceptor allowed us to interview as many patients as we wanted and to do whatever necessary physical exams we saw fit before coming back to report the patient to him. So with that said, I got a ton of extra practice in taking histories and performing certain physical exams. I also now know why doctors traditionally have horrible handwriting; I was writing so damn fast while taking all those histories that reading my own handwriting became a puzzle-like game when it came time to report my findings to my preceptor. A few times, I was referred to as “the doctor” by the kid’s mother or father (or whoever the kid was with) and that always threw me off…I would be quick to correct them because I wasn’t about to be caught out there looking like another Dr. Love 😂.  Because there were two of us, the PA student and I took turns seeing the patients as they came in. Over the course of the week, I had about 40 separate patient encounters! A lot of them were well-check visits for babies as well as drug adjustments for kids with ADHD (I saw the same drugs over and over and over again…Vyvanse, Concerta, Ritalin, Focalin, Adderall, Clonidine, Quillivant etc.), but I also interacted with a number of other patients with problematic symptoms and conditions including fevers, exacerbated asthma, mysterious rashes, cerebral palsy, urinary tract infection, pilonidal abcess, constipation, and stomach pain, just to name a few. And because I’ve taken a few organ system courses such as Cardiology and Pulmonology, I knew exactly what to look for on those physical exam maneuvers. When we weren’t seeing patients, the three of us would have conversations about an endless array of topics in my preceptor’s office. Ultimately, I’m very happy to have had the doctor I was working with as my preceptor and I hope to continue a relationship with him even though I don’t have any more CPE’s ahead of me.

Time to get back to the grind! (Grind never ended though.)

Have an awesome week!

“The measure of who we are is what we do with what we have.” – Vince Lombardi 

– Black Man, M.D.

P.S. – My roommates and I hit up the same wing and BBQ spots we hit up last time we were in Lenoir. The food was just as finger-licking good. I also saw more diversity amongst the patients in the clinic this time around. That was refreshing!

City Boy in a Country World

Hey.

Guess what?

IT’S SPRING BREAK BYYOTCHHH!!!

And it couldn’t have come at a better time. Okay it actually maybe would have been a bit better if it came a week later, which means it would have then lined up with the spring break of most universities that I know of…but no complaints here. I’ll take what I can get. This week I’m only focused on relaxing, having an unforgettable time down here in Miami, and recharging for the final block of my first year, which starts next week. 😳 I’m honestly feeling a mix of both excitement and astonishment at the same time at the fact that after this next block, it will be summer…meaning that I will officially be a 2nd year medical student. Wow. They say time flies by in medical school….well they weren’t lying. Better yet, it damn near flashes by. I’ve learned so much and although it feels like anatomy was a lifetime ago, it also feels as if I graduated from college last week. I actually still feel like a college kid at times that just happened to make it to the next level by the grace of God. I’ve already accepted that it will take a good while for me to fully mature into more of an adult mentality, so I’m content with happily living out my days as a youngin’.

Now about my Community Practice Experience last week. Lenoir, Lenoir, Lenoir. I’m not even sure where to start. It was definitely an unforgettable experience, to say the least. The clinical exposure I received at the pediatrics clinic was amazing, and I’ll be happy to go back for my second and final week later in October. The nursing staff was fabulous, the doctors were very willing to teach students and the patients were suprisingly overwhelmingly willing to allow me to interview them as well as physically examine them. As for the actual town of Lenoir…..let’s just say that it makes Winston-Salem look like a metropolis. I swear I saw black cows roaming around the front lawn of a house at one point while driving to the clinic. No offense to anyone that loves the countryside but in my opinion, the town looked kind of depressing… and the fact that it rained all throughout my first two days there didn’t help much at all. The rain also showed me the epic driving skills of Lenoir residents. Someone hydroplaned and rear-ended into my rental car at one point, and on another occasion somebody in front of me was really begging to get T-boned by another car. Jeez. (It was a minor dent in my car and I got everything taken care of in regards to insurance. Thank God for Trip Protection. 😊) I also just want to add that one of the officers that helped to take care of the rear-end collision assumed that I was a ball player from Wake. Typical. I politely corrected him and told him that I was actually a medical student that was on a week-long clinical rotation in Lenoir, which really surprised and impressed him. I love the responses I get whenever I completely flip a stereotype on someone. In Lenoir, a highway literally cuts through the town and the roads are typically full of trucks. (I absolutely HATE driving anywhere near trucks.) The town also went nighty-night around 9 PM at the latest and from what I experienced first-hand, there was an amazingly low amount of diversity. As a matter of fact, my classmates/roommates that were placed in Lenoir with me and I walked into a brewery at one point to get some 50-cent wings and to taste some of the local beer there. My group consisted of two Asian guys, an Indian guy, and two black Africans, including me. We literally WERE the diverse element in the brewery that had about 50 people in it at the time. I’m not kidding. Everyone else was white. We got a few stares as we walked in. 😐 It was kind of strange to me because I’ve always been in diverse environments, so being in an environment like that made me slightly uncomfortable. I won’t lie though, those wings were definitely bomb as hell. Plus the waitress served us with some good ol’ southern hospitality, so I had no complaints about that dinner. Also my classmates and I ended up having an interesting convo about race and how people decide to classify themselves/how society pressures all of us to check boxes of race in order to categorize all of us accordingly. It definitely proved to be an interesting conversation. Alas, I can’t talk about the finger-lickin’ wings without talking about the barbeque restaurant we went to a couple days later. My dinner there consisted of pulled pork with barbeque and specially made hot sauce, baked apples, mac & cheese and a roll. It was simply AMAZING. Plus the staff was the definition of southern hospitality. We will definitely be hitting that spot again in October.

In regards to my actual experience in the pediatrics clinic, I’ve really surprised myself on how comfortable I’ve become in obtaining an accurate history. I still tend to miss small things here and there, but I’ve also noticed how often patients conveniently tend to leave out vital information in an interview even after I specifically ask them for it. 😒 By the end of the week, I was literally interviewing every patient that came to the clinic to see my 2nd preceptor. Talk about practice. Backing up to the first couple days of my clinical experience, I quickly saw both the value of the clinic to the community and the closeness of the community as a whole. So many patients came in on a regular basis to maintain their health and the vast majority of them had some kind of relationship with both my first and second preceptors. I thought that it was pretty cool to witness how much the people in the community depended on the expertise of the doctors in the clinic and how vulnerable they were willing to be in order to maintain their quality of life. However, I’m not a doctor, nor do I look like one. So when I started interviewing patients on my first day, I made sure to wipe off the look of surprise on their faces by reassuring them that I wasn’t posing as a doctor or anything and that I was simply there to practice my interviewing skills with them. After that whole spiel, they tended to be more relaxed with me in the room. I also quickly realized how different it was to interview the guardian of a patient that couldn’t talk, like a baby. I had to shift my questions around a bit because I couldn’t ask the patient directly about how he/she felt. That was definitely a new and vital experience for me. My 1st preceptor made sure to ingrain in me that whenever I interview a patient, I should not be merely checking off a checklist. I should be able to walk out of the room understanding who the patient is and how he/she is suffering from their reduced quality of life. He also allowed for me to perform simple physical exam maneuvers on his patients, like the HEENT exam (Head, Eyes, Ears, Neck & Throat) and the respiratory exam. Note to self: Babies HATE having their ears looked into. To add to my unique experience, I saw circumcisions performed for the first time in my life while I was there. That…was….unexpected. My preceptor didn’t even warn me man. He just took the baby into a room with his mother and by the time I realized what was about to happen, it was far too late to brace myself. It looked hella painful. Poor kid.

My 1st preceptor was a pretty cool guy from Canada who bought me lunch and answered my many questions about medicine and the difference between the Canadian and the American healthcare systems. But he had to leave midway through my experience so I got paired up with another preceptor for my last couple of days who had a more grandmotherly approach to interacting with patients. She was very nice and willing to work with me, but she also did not hesitate to work me. She had me interviewing all of her patients and reporting to her their history before we would both walk in and see the patient again. I probably took a medical history of close to 25 patients in those last two days alone. Being exposed to these children so much also meant being exposed to various illnesses. 😰 I was constantly praying that I wouldn’t catch something from any of these kids who came in with illnesses ranging from a common cold to strep throat. Best believe, I was using hand sanitizer religiously and drinking massive amounts of orange juice. I’d be damned if I caught strep as soon as spring break started. There was one occasion where I was interviewing a little black girl and her mother about a condition the girl had. The girl really seemed to like me and was shy, but was also smiling and chirping answers to my questions whenever she wanted to. She was pretty fun to interact with. After that interview, my 2nd preceptor told me that I was a valuable asset to the clinic because she constantly sees little black children come into the clinic who neither have a positive male role model to look up to that looks like them nor has even been exposed to one. I wasn’t really expecting that statement from her at that moment, but it really moved me. Looking back on it, there’s a good chance that this little girl had never seen a black man in a doctor-like role before, and that maybe because of this brief exposure she was able to perhaps subconsciously attribute that she too could grow up to be in a similar role of success. I’m probably stretching it a bit, but it’s real awesome to ponder on.

All in all, I realized how chill the pediatric clinic lifestyle was. It was very low-stress and fun to work in. But just because it was chill didn’t mean that it wasn’t busy. It sure was busy most of the time. And the days were remarkably long. I would be in the office from around 8 AM to around 5:30 PM. That was a struggle to adjust to at first, but I adjusted a bit better as the week went on. Also, I haven’t heard so many babies cry in such a short span of time ever since those communal Cameroonian meetings I used to go to as a kid with my family. Bruh, I heard children screaming in my head as I lay my head to sleep at night on two separate occasions. That’s not normal.

I definitely had a very interesting week in Lenoir. But I was happy to leave in order to start my spring break, and I wasted no time in coming down to Florida to spend it. So with that said, please have a remarkable week!!

The greatest mistake in life is being afraid to make one.

– Black Man, M.D.