well i made it through ob/gyn.

barely.

needless to say, i don't think that ob/gyn is the specialty for me.

as much as i love having all women as patients, and being an advocate for women's health issues, i realized that the actual career of ob/gyn might send me to an early grave.

(if med school itself doesn't off me first.)

so now i'm on surgery. anyone who knows about med school knows that ob and surgery are probably the hardest, most time-consuming rotations there are. so like a true masochist, i elected to have them back to back.

i never thought i'd see the day when i would utter these words, but i actually kinda like surgery.

unbelievable! the people are actually nice (for the most part) and want to help you learn.

but the hours are horrendous. there are very few days when i am at the hospital for less than 14 hours. and don't forget about call, where i spend the night at the hospital every fourth day. fun!

in my opinion, the majority of people in surgery are actually clinically insane. how could anyone in his/her right mind ever think that the life of a surgeon (especially a surgery resident) is normal? where is the little voice that says it's just not right to stand up in the OR for 9 hours without stopping to urinate or eat, leave the hospital at 9pm, then come back at 5am the next day?

i also find that i am losing interest in medicine in general. (maybe because of overkill-- i spend more hours per week in the hospital than i do at home.) almost every day i have to remind myself that i am about to be a fucking doctor. it's just starting to hit me that yes, i will actually practice medicine. that after 2007 i will never go to school again (so help me god) and be sitting around in anticipation of what will be, learning about what to do when the day comes that i'm actually a real professional person. i soon will actually BE. even now, a lot of the decisions i make throughout the day are as though i AM. to most of the patients, i am their doctor. it doesn't register that the short coat and confused face means i am only a student. i've cut out gall bladders. removed pieces of colon. stapled up incision sites, praying that the patient doesn't wake up before i'm done. {note to people who have ever had surgery in a teaching hospital - students have been inside of you, hacking and retracting, suctioning and suturing. you just don't know about it or were too doped up to realize.}

this doctor stuff is already very real to me, even though a part of myself still doesn't get it. i only have 4 more weeks of surgery so i am just trying to make it through. so far, here are some things i've learned:

1. no one is all good or all bad. the one resident who constantly bitches you out and gives you a hard time overall may be the same one who sticks up for you when the attending comes around.

2. almost anyone can be a doctor if they are patient. doctors would like to have you believe that it takes supersmarts to be in this field. i disagree. the only thing that has really kept me going is my patience (which by the way, is currently running thin). a career in medicine is less about memorization and genius and more about putting up with long hours and difficult people.

3. you will never be perfect. at the beginning of the year i used to be so afraid of not knowing the right answer that i would read all the time and stress myself out about the questions that would be thrown my way. but the thing is, whenever you know anything, they will keep probing you to find something you don't know, then focus on that one thing as a reminder of how imperfect you are. i'm learing to deal with just having an idea and not always being on point.

4. one of the worst things in america is to be poor, black and sick. or poor, latina and pregnant. the way they are treated and services they are denied are a blatant violation of human rights. our people are dying. right in front of our eyes.

so since this is one of my few days off, i'm going to stop right here. do me these favors, though, so i don't have to see any of you in the near future:

1. wear your seatbelt.
2. don't buy a gun. don't have friends who have guns. stay away from people you know own guns.
3. don't ride motorcyles. if you do ride motorcycles, wear a helmet. an actual department of whatever whatever certified helmet, not some goofy walmart head thing that looks cool.
4. if you find a lump anywhere in your body at any point in your life, go get it checked out. if the doctor brushes you off, go see another. even if you are dead broke you have a right to a second opinion.
5. if there is blood coming out of your anus at any point in your life, go get it checked out. if the doctor brushes you off, go see another. even if you are dead broke you have a right to a second opinion.
6. if any appendage or extremity turns black at any point in your life, go get it checked out. if the doctor brushes you off, go see another. even if you are dead broke you have a right to a second opinion.
7. if a doctor tells you you have "sugar" or "high blood" and gives you medicine for it, take that medicine. and then keep coming back for check ups. if you don't, you will die.
8. if you know you are pregnant, go see a doctor immediately. if your period is 5 weeks late you are pregnant until proven otherwise. go see a doctor immediately.

thank you.

my first abortion.


no, don't panic. it wasn't me that had one.

but a few days ago i witnessed my first abortion.

those that know me well knows that i am adamantly pro-choice. i'm not going to write a dissertation here about my views. and i'm not going to be too simple on a complex issue. but i will say that i believe NO ONE (and especially not a man) should be able to force a woman to do (or not do) something with her own body.

anyway.

i formed this opinion way before i'd seen an abortion first-hand. and i now believe that anyone who has such strong opinions should be a witness to this procedure, if given the opportunity. they should not just witness the procedure; but also speak with one of the 1,000,000 women who exercise this choice every year.

one opinion that i've seen among those who are anti-choice is the belief that pro-choicers think abortion is not sad. that we run around with our "liberated" minds, sleep with anyone we want, get pregnant, have an abortion, jump up from the table and go sleep with whomever else we want.

lather.
rinse.
repeat.

i will tell you that i have ALWAYS thought abortion was sad. even moreso after this week. i was in the OR for three consecutive abortions. they were equally tragic. i can't think of anything more lonely than laying out on a cold table in a blindingly sanitary operating room with your bottom half in the air, naked and exposed to the world. (or at least 4 strangers).

alone.

woman #1 seemed relaxed at first. she chatted it up with all of us; discussing everything from her career aspirations, to her son, to her minimum wage job at the grocery store. i found out pretty quickly that her loquaciousness was just a defense mechanism against her uneasiness and anxiety. as her body tensed, she began to speak less and less.

the second woman didn't talk the whole time. finally, when the (male) doctor performing the procedure asked "are you okay?" she replied "i'm praying for forgiveness."

the wave of silence returned and drowned the entire room.

the third woman cried during the entire procedure. somewhere in the middle of everything, she released a vanquished sigh and whispered "could someone please hold my hand?"

i felt so much pain for these women.
and not because i felt what they were doing was wrong (because i didn't, and still don't). instead i felt the sadness in each of their conditions. that no one was at the hospital with them to help them through their situation. that somewhere along the line, something went wrong, and this became what the felt was their only option.

i've always said that if i became an ob/gyn or a family physician, i'd definitely perform abortions. i still stand by this. not everywoman is as fortunate as me to have grown up in a loving, supportive environment. not everywoman has had the education about sex, contraception, and hell, her own body, that would greatly reduce the chances of her ever getting pregnant. not everywoman has a man that doesn't beat her to a bloody pulp or force her to have sex against her will each night. not everywoman has the luxury of knowing that she (let alone her child) will eat tomorrow.

what has changed more for me this week was a stronger conviction to keep abortion from having to happen. this sounds so corny, and is probably pretty naive, but if only i could take every young woman and surround her with love. teach her about her body and her own self-worth. prevent her from selecting the type of mate that would ever allow her to go to the hospital and have an abortion all by herself.

but i have to graduate first.

i wish i had more time to write, but the very essence of 3rd year medical school is the lack of time to do anything but 3rd year medical school.

hopefully i'll have more later though...

betchall thought i was gone.

(don't call it a comeback...)

so.

just for those who care, i passed step 1. and i actually had some cushioning between my score and the "pass."

hallelujah.

what does that mean?

rotations.
in the hospital.

i am in the midst of my first one: ob/gyn. we started yesterday, and i have ABSOLUTELY NO IDEA WHAT I'M DOING.

"i hope none of your grandmothers die during this rotation..."
that's a direct quote from the chief of the ob/gyn dept during yesterday's orientation.

guess why i have time to actually write in this blog?

my grandmother passed away this morning.

she was 90 (would have been 91 in september) and had just had her legs amputated due to gout. she was also plagued with various sequelae of old age, such as heart failure, kidney failure, lung failure, failure, failure, failure, failure...

so as hard as it is to know that i won't see her again in this lifetime, i know that her passing away when she did was definitely for the best. i got to visit with her, and she got to see me go off to medical school. i know she was (and still is) proud of me.

i'm sure had she known, she would have chosen to pass away a few weeks later or earlier, as not to interfere with my "schoolin'." that's just the type of woman she was. but life and death will always happen, regardless of your own personal circumstance. even when you're in the midst of one of the most gruelling periods of your life.

i got the news in the middle of the day from my dad.

somehow i had to bring myself to some kind of coherence in order to tell the department chief what had happened. with about 3 minutes of allotted crying time in her office, we were on to other things. i was actually surprised at how comforting she was; i sensed something was "off" when i first met her. she continues to rub me the wrong way. there's still something that tells me that my blubbering in her office and opting to go home early MAY be held against me.

now i have to negotiate a day (or two- GASP!!!) to travel to the funeral.

wish me luck.

but she did send me home. which is why i can write a little today and clear my head. i also can actually go to the store and get the books i was somehow supposed to magically acquire at some point in my "free time" for this rotation. [i've been at the hospital since 5:45am and was scheduled to be there until 6pm. the bookstore closes at 5:30. anyone know how i was supposed to work this one out? not to mention we haven't received financial aid checks yet...]

my parents raised me on an academic lifetime of perfect attendance. from first through 12 grade, i missed four days of school. two were due to strep throat in fourth grade. the other two were painfully negotiated with my parents in order to make college visits in the 12th grade. as much as i hated never being allowed to miss school, this attitude has carried on into my adult life. now don't get me wrong, i won't hesitate to miss or be late to a class. but i can't remember the last time i missed an entire day of school without having something major going on. and then the majority of our grades at the hospital are subjective (how the residents FEEL about you vs any standard measure of performance). i don't want to be remembered as the girl who was crying on the second day. they don't remember you as the medical student who lost her grandmother on the second day...

they remember you as the girl who was crying and had to go home early on the second day.

but hopefully i'll get the hang of everything. the unspoken motto of ob/gyn (or mabye all of 3rd year?) is "don't tell them anything, expect them to do everything..." i already got in trouble for not doing something today because i didn't know how. i have to get over my fear of looking bad or making a mistake, and instead just jump in. at the same time, manage to not harm (or kill!) any patients.

yikes.


most the people there are nicer than i expected. i also have a new-found respect for male ob/gyns. in the past, for many of them, i'd questioned their motives and been suspicious of their intentions. but most of the ones i've met here have been the most caring, patient and willing to teach. maybe the females are meaner (especially to the females) because they want us to work hard and get the most out of the rotation. maybe it's because of what happened to them. working 80+ hours a week can also wear down on your interpersonal skills. i am trying to remind myself that there are a lot of jerks in the hospital, but most of these jerks want you to learn.

i also have to manage my life in these:

trust me, although very comfortable, and ergonomically designed to support your feet and spine during periods of prolonged standing and/or walking, you don't want to walk a mile in my shoes. i can't remember the last time spent over $100 on a pair of shoes i DID like, let alone a pair of shoes that i abhor.

but i would walk five hundred miles and i would walk five hundred more...

in other news, operation south beach diet has been postponed until a later date. i am living a lifestyle that barely allows for any kind of regular, planned eating, let alone carb-free-for-two-weeks-type-planned eating. the types of snacks that can be stashed in a lab coat for stealthful munching are not south-beach friendly.

and, fyi, i now know first-hand that snacking on celery during lecture is a no-no. even if you try to bite when the lecturer is taking a pause or changing slides.

anyways

underneath all the fear, guilt, worrying and self-doubt, i am actually very excited about this year. i am actually starting to FEEL like a doctor. (well at least i look like one- i got the shoes and everything-didn't you READ!?!?) i can't wait to have my own patients and to be a part of their care.

even if it is without celery breath.