Missionary Doc in the Making

So I took Step 1 yesterday and that test was truly challenging. I’m not sure how I did, but I’m praying in faith that it matches my practice test scores. I got my CBSE in and it predicted between a 245 and 250, which is still quite unbelievable to me, but whatever. I won’t find out my scores until July 15, so I’ll be praying until then.

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So I’ve taken a couple of practice tests and the scores coming back are unbelievable to me, but I’m trusting that God actually makes these things reality. UsmleWorld offers 2 simulation tests (4 hours, 192 questions each) that are supposed to hopefully be harder than Step 1. I took the first one and they predicted that my score would be a 242. I was totally shocked by the number because it is vastly higher than I expected to get, especially since I felt like crap during the test because it was so hard. I thought that test was a fluke, so I took the free 150 questions that come straight from the NBME and I got 83%. If you plug that into an unofficial score calculator at http://www.medfriends.org/step1_estimator/, it estimated that my score would be a 245, which once again is vastly higher than I expected. I don’t know…if all this works out I will feel so stupid for fretting and lacking faith in what God can do.

Anyway, I take the test on Monday and right now it seems pretty stupid to study crazy hard since not much else will stick. I plan to go through the pictures and the high yield facts in the back of First Aid and kind of call it a day.

P.S.-interestingly enough, that site (medfriends.com) told me that if I used my MCAT score alone as a predictor of my Step 1 score, that my score would be a 226.

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I must admit that studying is pretty hard these days. I know I need to hit it hard, but my brain keeps feeling overloaded. I break for 10 minutes, and then can only study for 15 minutes before I need another break. Honestly I feel like I’m just about maxed out…I can’t wait until I take this test and have a little vacation.

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After any serious battle or tribulation, you must treat yourself. I have already preordered my treat, and it is set to arrive on June 19th:

Yeah baby!!!

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The picture says it all:

It feels so good to be done. Now I plan to really try to go over all the section in First Aid that I feel weak in. Only a couple more days left.

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I am so freaking sick of this Step 1 study crap already that I can’t even find educated words to describe it. Although I only have about 98 questions left out of the 2,035 Step 1 Prep questions from USMLE World, I am starting to feel more and more demoralized by the difficulty of these questions. I’m getting more right than wrong but at times I truly feel like I’ve learned nothing in my 2 years. I just feel like once again I’m gong to do just average on this test like I did on the SAT and the MCAT. For once I would like my hard work that I put into the first 2 years to actually manifest on a standardized exam. Okay, my rant is over.

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So today I took the Comprehensive Basic Science Examination (CBSE) that basically every medical school in the U.S. gives their students. The CBSE is supposed to test and evaluate how well you know all the basic science you should have learned in your first 2 years of medical school. So in essence, the CBSE is almost like a pre-Step 1 test, and many have said that you tend to score within 5 points of your CBSE score. The test actually wasn’t too bad except for the fact that every since question was expansive and wordy with unneeded lab values. The test was 4 grueling hours and 200 questions long; I finished with barely any time to spare and now I have to wait about a week to get my scores back. The funny part is that I take Step 1 on the 15th, so I may not even get my CBSE scores back in time to see whether I need to push back my Step 1 date. If I do receive t before I take Step 1, I may not even look at it, because if it is low, it may depress me and cause me to jinx myself on the real deal.

At times I feel at peace about Step 1, and other times I have freak out sessions. Like today, I completely destroyed the Microbiology Subject Exam, but my Pathology Subject Exam was average. They say Pathology makes up most of Step 1, so I started to freak out, thinking that I need to push back my Step 1 date and really get on top of Pathology. After 1/2 hours of freaking out I decided to actually start trusting in God again; trusting that He will do what He has always done for me and my wife. Its so much easier said than done but I think right now that it is the only thing that will keep me sane. Anyways, I will surely enjoy my Sabbath, and then as soon as sun sets tomorrow night, I plan to hit it again, non-stop until June 15th!

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So this past Tuesday marked the last test that I was required to take by my school…so I’M DONE!!! Last night I went to sleep without setting an alarm, which I havne’t don’t for the past month or so. It felt so good just to sleep; of course I still have Step 1 coming in about 11 days, but at least all the school required stuff is over. I honestly wouldn’t wish this year on anyway. 2nd year is so much more interesting than 1st year, but it takes so much more out of you. But I can honestly say that I am at peace with Step 1; I’m not sure whether I will do well or not, but I know that is is God’s hands. I’m just going to put in the work and see what results come back. Anyways, I’m tired now.

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I woke up this morning not happy. We still have classes here at LLU and I have about 27 days until Step 1. I have finals starting this week and I’m stressed, tired, and truly sick of all of this. I know I should be grateful and glad for the opportunity to be in medical school; I know I should see this experience as an opportunity but right now it is just a source of unhappiness. I know 3rd year will have its share of unhappiness, but nothing can be this terrible. The stress seems almost insurmountable at times. I don’t know……

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So at the time of my writing this post I have exactly 1 month 3 hours and 5 minutes until I take Step 1. During this time it is impossible to talk to any second yr. medical student that doesn’t have this test on their mind for a good part of the day. There is just an amazing amount of information that you are responsible for, and the NBME can pull a question from anywhere; and God forbid if your school has a subject that generally sucks in terms of quality of teaching because that makes it all the harder to get a grasp on the subject (and trust me, every medical school has one of those subjects). So you days are left with paraoxymal anxiety, optimism that everything will work out, despair over why you even decided to attend medical school, happiness that 3rd year is approaching, and sadness that Step 1 must occur before 3rd year can start.

Through all of this it is quite easy to forget where God has a hand in all of this. I can absolutely say, without a doubt that my wife and I are both in medical school together only through a miracle. We had some serious obstacles to both getting in and the Lord cleared those away. When I was a senior in college and I saw the seemingly insurmoutable challenges we had to getting into medical school I lost faith in His ability to work things out more than I’d like to admit. And when we finally saw everything fall into place we just knew that it was God, and our faith was strengthened. Now both me and my wife face a seemingly insurmountable obstacle called Step 1, and it is so hard to remember that the same God that got us through our previous challenges can get us through this one. It’s easier said than done, but I want to truly not fret about this test anymore. I’m going to do my best and know that my best will get me where God would have me to be.

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I’m typing this currently from my blackberry so forgive me if there are spelling errors.

When I started college the preident’s wife, Dr. Baker told all of the freshman to start strong because it is much easier to maintain a high GPA than to increase a low GPA. I took her advice seriously and did very well my freshman year which was very good because when senior year hit and I didn’t feel like doing my school work my high GPA buffered my senioritis. Well I think that advice definitly applies in medical school. By the time you come to the end of your 2nd year you have studied more than you studied for the 4 years of college so technically the senioritis comes back. However I really started strong my 1st year and 2nd year so thankfully my current contempt for studying pathophys may not hurt me too much. I am jsut truly tired of the grind right and preparing for step 1 and finals is just more stressful. So I’ve decided that I don’t care about my finals that don’t directly apply to step 1. And by not caring I mean that I don’t plan to study hard for it. Now if I was on the brink of failing a class then this strategy would be much more difficult. So yes my class rank may drop a bit or a lot but I’d be much more happy with a good step 1 score. So my advice to premeds who are about to start med school is START STRONG so you can rest later.

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So yesterday about 3 hours of my night was taking up in a mandatory CPR class. I’m actually glad that I took it because before this if someone collapsed in front of me I would have had no idea what to do. Now if someone collapses in front of me, I probably still won’t know what to do immediately, but eventually I’ll get around to it.

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Well it is is 1:30 a.m. and I just woke up. I went to be around 8 p.m. last night and my body decided it had had enough sleep. I don’t mind though because I have tests next week that I am not ready for. I made the mistake (or maybe not) of studying so much for Step 1 that I neglected to spend much time on my current coursework. Hopefully I can make up for it by studying all day. This is my last normal test week of medical school!!! After this is finals and then Step 1 and then 3rd year!

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I currently drive a 1992 325i. I got it in my 2nd year of college and I instantly fell in love with the car. Even as a sophomore I was pretty sure that I wanted to be some type of surgeon so I decided to get some personalized plates that would mirror my interests. My personalized plate basically spelled out the word SCALPEL. So since college I have been rocking that license plate but since I got into medical school I have started to become increasingly embarrassed by my plates. The plates seemed so cool in college but now that I’m actually in a medical environment it just comes off to be as showy and ostentatious, even though that was not my intention at all. Every time one of my classmates sees my tags they always chuckle…and not the kind of chuckle that says, “Hey that’s cool”, but the kind of chuckle that says, “What a D-bag, who do you think you are?”. No technically I don’t care what others think, but I can’t really describe how much discomfort I was starting to feel about my tags. I just want to be normal, and I don’t think now that I need to advertise that I want to be a surgeon, especially not on a material thing like a car. So I have decided to switch them out for normal plates…I guess its part of growing up.

Funny story though, I was driving down a road past the hospital with my scalpel plates and I pulled up at the light beside a Toyota that was being driven by a guy in scrubs. As I took off when the light turned green the guy saw my tags, and when we stopped at the next light the guys was now wearing his surgical cap!!! He started to rev his engine, I guess desiring a surgeon drag race. To be honest he was probably a scrub tech or something like this but this just encouraged me even more to just get my tags changed, lol.

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So yeah, I didn’t exactly know that the General Surgery Basic Science conference actually started at 6 a.m. and not 7 a.m., so I missed that. What did happen at 7 am. though was the Morbidity and Mortality (M&M) conference where surgeons from all the fields (vascular, CT, general, peds) present patients who they either killed or made worse by their care. When I walked in I could certainly see a stark difference in atmosphere between these guys and the ortho guys. These guys just looked sad and very tired; I’m not sure if I can jump to that conclusion but it was certainly palpable.

So I heard about some interesting cases but the thing that stuck out to me the most is that they seemed to still talk about a lot of internal medicine stuff like acid-base, fluid status, etc. But they also took them in and tried to fix what couldn’t be fixed with medicine. I really liked that about what I heard; it seemed like the General Surgeons could be a pretty good internist, and a great surgeon at the same time. So yeah, I think I’m interested in General Surgery again…I just need to do some research.

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So technically I’m a little behind the game in this Ortho stuff because I have no medical school research experience. People say that you can count the research you did in medical school for residency, but the smart ones know that for a competitive residency you need to get yourself on a project in medical school quick. So since I went on a mission trip last summer instead of doing research (which I don’t regret at all), I realized I need to make up for my lack of research. So every Tuesday, the LLU Dept. of Orthopedic Surgery has a Basic Science Lab where they either do hands on stuff like drilling screws into expensive styrofoam bones or where they present their current research projects. Today was the day that they were presenting their current research projects and throwing out ideas for future research projects.

So I decided to attend this conference. I was pretty nervous because 1) I honestly don’t think I’m smart enough to get into Ortho 2) All the ortho attendings and residents were going to be there and I didn’t know them all that well 3) Some of my classmates who have been attending these conferences since last year will finally see that I”m gunning for ortho too. So I walked in and people were kind of just chilling around talking and eating food that a Orthopedic Supply company had brought in. I greeted the residency director that I had shadowed last week and just stood a around a little trying to find my place. I saw another 2nd year medical student sitting down so I starting chatting with her for a little. After that I chatted with some 3rd year medical students but I was generally a little too nervous to walk up to a resident or attending that I didn’t know. Then I guess I got lucky…one of the older attendings that specializes in Sports Injuries decided to sit right between me and the other 2nd year. So I got to talk with him a little about iPhones, and how bad AT&T’s reception was, etc.

The research presentations started and I sat back to listen to what an Orthopedic resident had to learn during their 5 years and throughout their career. Many of the projects I listened to basically dealt with them drilling pins/screws into expensive synthetic bones, applying serious pressure by some machine that can measure the tension on the screws and the bone, and then seeing how the various angles that they screwed the pins in would affect the strength of their joint. I know that I am certainly oversimplifying what I saw, but that is the general gist I got. As listened to the presentations I couldn’t help but feel like I was back in my college General Physiology class. Orthopedic surgery deals with alot of physics like angles, tension, work load, etc. I didn’t mind physics in college, but I really hated it on the MCAT and some of that disdain started to creep up again when I was listening to the projects. So I heard all the projects, smoozed a little after that with some residents and attendings, and went home.

I was actually pretty happy that I went to this basic science meeting because it helped me to realize that Orthopedic Surgery is probably not the best fit for me. Yes the two surgeries that I saw last week were the coolest thing ever, but at this basic science conference I realized that the bones and joints actually don’t interest me very much at all. And I was trying to force myself, but I just couldn’t get excited about all the angles, and joint reconstructions, and tensions, etc. that made my classmates that are interested in ortho giddy. I had been so scared I wouldn’t be smart enough to get into ortho that I overlooked the fact that I could actually not like it very much at all. Also, I don’t feel like the field fits my personality much; my personality is such that I love to be really busy doing a variety of things at the same time. Orthopedic Surgeons really stick to their game and don’t seem to venture into the abdomen much; they really are masters of the skeleton which is good, but I like the other areas of the body too. Some say ER is good for me, but I definitely love the OR more than that, and it really seems to me that General Surgery gives me that variety, especially if I’m in a rural area or on the mission field. What I did is actually advised by a lot of medical students; if you are really interested in a certain specialty, you should make it a point to read a couple of journals and research articles in your field. If you find that subject matter dry and boring then that should send up a red flag, because as a resident you will have to be reading these journals to keep up with the rapidly changing field and this continues into your future practice also. So yeah, the ortho residents were great, and the attendings were super nice and supportive but I realized that I couldn’t get passionate about orthopedic surgery and bones and tendons, which is alright, because everyone can’t be passionate about the same specialty.

So when I got home I decided to look online at LLU General Surgery department to see when they were having their Basic Science Conference. Their conference starts at 7 a.m. tomorrow morning so I am going to sit in on that and see how it goes.

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So I think that I may have the Orthopedic surgery bug. I’m not sure where it came from but I just woke up one morning sayin, “Maybe I should do ortho.” Now this really actually started to cause me a lot of distress because I tend to have a one track mind, so when I decide to pursue something I really like to see it to fruition. This change to ortho made me nervous. I had to know if ortho was for me before I decided to change my desired specialty track. So I made an appointment to see the Orthopedic Surgery Residency Director here at LLU. The guy was really nice and down to earth. He answered a lot of my questions and generally what I came back with was:

*Orthopedic surgery is a very competitive field to get into (I knew that already)
* You need to get in the 230s on Step 1 to make the cut off for most residency programs and you need to be in the 240s on Step 1 to be really competitive
*You need to have research experience, preferably in orthopedic surgery
*You need to be an absolute superstar for the 4 weeks you have for your Orthopedic Surgery elective
*You need to be in the top of your class

And even after all the information above it is still possible that you may not match simply because there are many top people in medical school classes around the world gunning for Ortho. So yeah, I was a little taken back with how much more competitive Ortho was than General Surgery but I just couldn’t shake the desire to go into the field, so I asked the program director whether I could shadow him to see the types of procedures that he actually did. He was actually performing a hand surgery today, so I woke up early and went in to see him. I actually ended up seeing both a knee replacement and a medial nerve repair, both of which were extremely cool. Yes, the resident ortho doctors were quite tall like me and many of them look like they could bench press me, but not all of those residents fit the stereotype. Some were short and skinny, but one thing I must say is that all of them were super nice and all of them seemed super happy with what they were doing. So yeah, so far Ortho seems like the residency to beat on my list because these surgeries are really exciting and they seem to improve the quality of life of your patients 10 fold. The only thing I’m worried about a little is how applicable orthopedic surgery would be to rural missionary work. Certainly an orthopedist is needed on the mission field, but their field requires alot of cool power tools and I’m not sure how that would work out in a rural environment. I don’t know, we’ll see.

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I got my first choice, and my wife and I have the same schedule so everything is pretty nice right now. Now I just need to pass this stupid year to get to the rotations.

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So I hit a major milestone today. I finished reading First Aid for Step 1 2008 today. I will probably need to re-read it 2 more times before the actual test date, but for now I’m happy where I am. Now I plan to go through as many USMLE World question as i can, and annotate into First Aid whatever info isn’t in there. Its hard to do this when you haven’t actual read the whole book, so hopefully annotating should be easier. We’ll see how everything goes.

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I’m on spring break, and I’m about to get my wisdom teeth taken out. They are putting me under which now that I think of it, I’m kind of scared of.

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I almost forgot today was match day since we had tests. At LLU the students stick their face on the map where they matched. Check out the pics to see where folks went.

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Why did got give us kidneys? Medical school would be 1000x easier if we had no kidneys and if I didn’t have to learn about renal pathophysiology. I know its important, but it makes my brain work after studying since 6 a.m. this morning. Our renal pathophys test is tomorrow at 1 p.m., so keep us in your prayers. Apparently this is the test that usually most of the class fails.

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My sister just got a letter offering her acceptance to the University of Maryland School of Law!!! She was so sure that she had no chance of getting in there but she did! Love you sis and congrats!

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I truly realized the importance of good counsel this week. Because of the good counsel I received from various 3rd years, my wife and I have made several changes to how we plan on scheduling our 3rd year rotations and when to take Step 1.

My medical school has something called the National Auxillary, which is basically an organization that was formed many decades ago by the wives of the medical students and the wives of the doctors at Loma Linda. Of course, in this current age, there are just as many husbands of medical students, but the group is still going strong. Well, they have monthly get togethers for the married medical students at the houses of various professors and physicians, and at one of these meetings last week we got good counsel from a 3rd year and his wife. He told us that my wife and I should strongly consider taking the hard, grueling rotations at the same time (like medicine and surgery). They were telling us that during these rotations we may often “live” at the hospital, and if my wife is on an easy rotation like Psychiatry, and I am on a tough rotation like Surgery we really may barely see each other for up to 6 weeks at a time. Then it will repeat itself, because then soon she would be on Surgery and I would be on a easy rotation like Family Medicine. They told us that it was much better to do the easy and hard rotations at the same time so when we had an easy one like Psychiatry, we could enjoy that quasi-vacation time together rather than alone. My wife and I hadn’t really even considered this until they told us. We were simply looking at which rotation we really want to shine in, and then trying to put that rotation in a good spot so that we would be competent enough to get good evals from the residents and attendings. After that 3rd year’s good counsel, we decided to rank our rotations tracks the same way. My wife is still very interested in OB/GYN and I am still very interested in Surgery, so we still needed to place these rotations in a place where we would have enough other rotations under our belt to still do well, but not so late in the year that we would run out of steam. So the rotation order below is what we chose (click on the thumbnail to enlarge it):

Technically the tracks we ranked 3rd and 4th would be ideal but I’m a little concerned that I would be too tired by that time to give 120% for that rotations. And my wife is confident that the position of OB/GYN in the tracks ranked 1st and 2nd would be late enough for her to have enough knowledge under her belt. Honestly, doing your Medicine rotation first probably prepares you for all the other rotations so it should be a good thing. But in end, we are still just ranking our preference and we don’t know exactly whether we will get our first choice or not, but at lesat our ranks 1-4 would all benefit my wife and I. I think we will find out which track that we were assigned in a month or two. The only thing that I am concerned about with our first and second choice is that we have heard that EVERYONE who wants to do surgery does it right after Christmas break. This means that I will be competing with alot of other students, many of which may be gunners. I really don’t have the personality to return gunnerish tactics done to me, so I may get the short end of the stick. I’m still very competitive though, so I hope that I will be able to shine enough to get noticed.

On Wednesday, the 3rd years had a little meeting to give us their advice on how to handle all of our final exams and subject boards coming up and also how they prepared for Step 1. They gave us so much advice that it would be too much to write it out, but one thing that each one stressed was that they wished they had taken their test earlier. They advised that we take the test no later than 2 weeks after finals and that even 2 weeks was pushing it. Alot of them recounted how after they had taken Step 1, they realized that that extra week of study didn’t really make a difference in how they would have done on that test. With that in mind, I moved my test day up from Friday, June 19, 2009 to Monday, June 15 2009. This will almost give me 2 weeks of vacation time before 3rd year begins on June 29. So yeah, I’m really grateful for the good counsel I received this week.

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So the Dean of Academic Affairs came in to talk to us yesterday about getting ready for 3rd year. As part of that speech, they told us about an online section on the school’s website where we had to rank our choices for our 3rd year rotations. To be honest it felt very good to even be sitting in a meeting about 3rd year rotations. The fact that the meeting was even taking place meant that this hell of a 2nd year would soon be over. As exciting as chosing my 3rd year rotations is, it is quite hard also to get the right order down. In theory, you don’t want to do a rotation in the field that you think you want to go into until you have gained enough basic skills from other core rotations; since I still think that I want to go into General Surgery, it would make sense for me to get my core skills down first in Internal Medicine, Pediatrics, Family Medicine, OB-GYN, etc. So below are the 8 different tracks that I have to rank in order from 1 to 8, with one being my most desired track (click the picture to see the whole thing):

So there you have it. I’ve talked to a good amount of 3rd years that I trust and I am leaning towards a couple of tracks. I’ll blog about my choices soon.

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This morning my wife and I scheduled quite possibly the most important test we will ever take…STEP 1.The testing slot is allotted for 8 hours but I here that folks usually finish within 6 hours. Now that I have a date I think that I’m going put a countdown on my blog. Anyways, back to studyng.

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I tell you, I’m doing a terrible job this year of blogging. Trust me that its constantly on my mind, but this year is just alot busier, and there is nothing I can do. We just finished tests today, and although we only had 4 tests (Pathophysiology, Pathology, Microbiology, and Pharmacology) it felt just as bad as when we used to have 7 tests in one week. It didn’t help that I just got a new gadget either:

I tell you, I truly have a problem. When I get a new gadget, or I get on some new self made project (like teaching myself to program, or researching an airspray to clean computers, lol) I become all encompassed by it. I can honestly think of nothing else but accomplishing that task. I guess this quality is great if focused on the right object at the right time, but it always seems to pop up at the bad times like during test week. So yeah, I would study for 20 minutes, then spend about 40 minutes on the computer, downloading stuff to make my new Pocket Pc faster…better than it was before, lol. Thankfully, the Lord blessed me to be able to pick stuff up quick, so I didn’t feel too bad when I took my tests. But only the grades will tell.

Latino Beat Down

On a more sad note, something pretty terrible happened to some Black first year medical student friends of mine. 2 weeks ago, on a Saturday night they were coming out of a restaurant after celebrating a friend’s birthday. I guess it was about midnight when they were walking to their car in the parking lot; all of a sudden a whole grip of Latino gang members jumped them. Two of them got beat until they were unconscious, and the other got his face messed up pretty bad. After the gang members did their dirty work, they left. This incident really opened my eyes up to the truth and reality of Southern California. I guess I had always heard how there was some feud between the black gangs and the Latino gangs, but I thought that was only in LA. I didn’t think it would make its way up to the quiet, quaint, well-to-do, predominantly white area of Redlands, CA. My friend’s experience initially caused me to look at any Latino male suspiciously, sizing them up, and making sure I wasn’t going to be the next victim. But I stopped myself very quickly from that line of thinking; by doing that I was being no different than those White women that would clutch their purse a little more closely when they got on the elevator with me. Because of a few bad black people out there, that woman felt like she had the right to fear me, and I didn’t want to get into the same mindset because of a few bad Latinos. I tell you…this world is so complicated and so dangerous.

Being Content

The more and more that I progress through medical school, the more I realize how hard it is to be content. You are happy with the 85% that you got on a test, right up until you learn that your study buddy got a 96%. As a medical student it is so hard to just be happy with how you have done. And you know what, it is slightly understandable; most medical students have been used to being at the top of their class since Kindergarten. Getting an A on a test was the norm…but it still brought lots of satisfaction. Then you come to medical school, and you study harder than you have ever studied in your life, and you can’t pull any higher than a C or a B on most of your tests. But your study buddy somehow seems to be able to eek out an A on their test consistently, even though you guys are studying the same thing. It happens with ranking too; right now I’m ranked somewhere in the top 20% of my class, but you know what I say in my head when I look at my ranking? I say, “I can’t believe X% of my class is smarter than me,…I have to work harder.” Isn’t that ridiculous? Rather than being content with the fact that X% of people are doing worse than me, I’m looking at those ahead of me, grabbing for their coat tails. I believe that it is imperative to overcome your overall lack of contentment when you start medical school, because there will ALWAYS be someone better or smarter than you. I’ve been working really hard at this and it has honestly made me happier. When I get my test scores back and X% of the class did better than me, I shrug my shoulders and start surfing the net or going on Facebook. If you dwell on the subject you will drive yourself crazy and you will probably end up doing more poorly in school because you are adding undue pressure on yourself to beat the man at the top.

So yeah, to be honest there really isn’t much exciting stuff to talk about right now as you will soon find out when/if you decide to come to medical school. By the time you get to 2nd year, especially this point in 2nd year you are just tired of the montomy and routine of it all. Your day mainly consists of studying your butt off, and your nights consist of Step 1 prep. I could blog about that but I’m sure my readership would drop like 20%. So yeah, that is what is going on these days.

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Wells the folks at the USMLE now have $495 of my money, so Step 1 is paid for…now I just have to pass the thing. I must admit that this test tends to be on my mind a lot. You learn so much during your second year, and you have to try your best now to not let the newly learned information slip away as the year goes by, because it “Could be on Step 1″. It seems like my teachers make that previous statement a whole lot; the test really isn’t long enough to include everything that they say will be on there, so I don’t pay them much mind. I focus mainly on UsmleWorld and its 2000+ questions and First Aid. I feel that right now I am truly doing my best to prepare, and I really hope that it pays off in the end. I’m not trying to kill the thing, but a score in the 230s would make my day.

So enough with Step 1 talk. Right now in class we are learning about pulmonary pathophysiology, renal and pulmonary pathology, cardiovascular preventative medicine, and antibiotics. I’m the most excited about learning the antibiotics because its really starting to make me feell ike a doctor. Know what to give a patient if they have TB, or community acquired pneumonia, or T. gondii is pretty cool. In microbiology we have also been learning about parasites and I must say that the helminths (worms) are THE MOST DISGUSTING THINGS ON THIS EARTH. The concept of a worm larva boring into your skin as you are walking barefoot, traveling to your lung, causing you to cough, and then getting coughed up and swallowed so it can go to your small intestine and grow into a tangible worm is simply evil. My classmate who did a lot of missionary work in Peru was talking about how many of the rural people had worms, and it was so common there that people would cough some times and spit out a whole glob of worms. EEEWWWWWWWWWWW!!! I tell you, I love medicine but somethings still really gross me out. I think I would probably take draining an anal abscess over dealing with helminths.

I got a really pleasant surprise this past week that I wanted to share with you. I don’t know if you remember my experiences on my mission trip this past summer in Zambia, Africa but I helped deliver a baby and the mother named him after me. Here is a picture of him when he was first delivered:

Well, this past week, his father e-mailed me with some pictures of their son (Jaysson Mwale) and I was so cool to see how much he had grown. It is kind of wierd having a namesake that is so far away but it is kind of cool too. Here is an updated picture of him:

You know, there are just so many joys to doing missionary work, and having a child named after you is one of them. I have to admit that my fire for service and missionary work has sometimes dwindled due to the stress of medical school, but seeing these pictures rekindles it every time. I must also say that being at Loma Linda and going to our Missions Interest Group meetings has really helped to rekindle that fire too. At these meetings I get to listen to missionary doctors who have come home for a sort period of time and their stories are so amazing. From hearing their stories I’ve realized that a missionary hospital can’t really survive without support from your physician friends back home, whether that be monetary or medical supplies. I’ve also learned that you can make a much bigger impact if you assimilate your culture with theirs, because people will truly get to know Christ better in their cultural context than in mine. I honestly can’t wait to finally go over and serve, but I have to complete this medical school journey for now.

P.S.- I know some people may read the paragraph above and think that I am so selfless, but just like most medical students I constantly think about how good life would be to get into a top residency like neurosurgery or dermatology, make a ton of money, live in some exclusive million dollar neighborhood where we are the only black couple, lol, etc., etc. I certainly think about those things and to those who are smart enough and lucky enough do live those types of lives, I am at times envious. But every time I think like that I have to beat those thoughts down, because for me and to all those that Christ has called (which I believe is everyone, lol), the Bible calls us to a life of service to those who don’t have. Not just patching up poor Mexican and poor Blacks up in the ER, but getting into their lives on a more personal level where they can see the Jesus inside you. So yeah, don’t think that I’m all that selfless; I constantly have to remind myself of what Christ would prefer me to do, and head that way, or else I wold certainly head the wrong way.

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It was really hard to get back into my groove after 2 weeks of Christmas vacation. It didn’t help that I bought like 5 Blu-Ray movies and started watching them this week. I bought Transformers, The Incredible Hulk, Patriot Games, and The Sum of all Fears. I was content with my slow transition back into school until the Dean of Academic Affairs (who teaches us Pathophysiology) started talking to us about Step 1. He scared me enough that I started to get on the ball by Wednesday. Its so crazy to think that I’ll be taking that crazy test in about 6 months. There is so much more to learn and study and really so little time.

I had a really interesting experience this week. In the picture you see a $100,000 mannequin. He is one of the many mannequins that LLU has in their simulation lab. In my pharmacology lab this week, they broke us into small groups of four, took my group in a room and read us our case. In my case the patient/mannequin was a 58 year old man presenting with crushing mid-sternal chest pain that woke him out of his sleep. Now this $100,000 mannequin simulates a lot of the real life presentations of a patient; if you palpated his heart you would know it was fast, you could also hear lung sounds and see all of his vital signs on the monitor. He even reponds if we shock him with a defibrillator. So yeah our ptaient had a BP of 178/110, and a heart rate of like 210 bpm. The doctor there basically told us to save the patient using what we knew already in terms of drugs and interentions. It is really amazing how hard it is to think straight when the pressure is on like that. We had learned the drugs to give to someone with supraventricular tachycardia (what the patient had after we looked at his ECG) in class, but it was so hard to actually bring that stuff up in our minds and apply it to the situation. Eventually we managed to save the patient and stabilize his vitals but the lab made me realize how crazy the actual hospital experience could be. I could just imagine being a 3rd year medical student with a patient who presented like our pharm lab case, and being a little unsure of myself as to which drug to push and which procedure to do. I could imagine a nurse or resident pushing me out of the way and cussing me out as they saved the day. I know that all it takes is experience, but its scarey to think that in just 7 months, I won’t be dealing with expensive mannequins anymore but real people, with families and expectations. Well I’m glad I’m getting some practice in now.

Besides that, nothing else interesting happened this week. All of our classes right now are dealing with the respiratory system so I’m having to remember the respiratory physiology I learned last year. This Sabbath I’ll be singing on the praise team…I really like singing, and I hope that small joys like that don’t get pushed aside as I continue my  medical training.

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In all honesty, this test week truly sucked. They made us take a crazy amount of tests in 1 week, while last year they gave the 2nd years 2 weeks to take these tests. You know, I can truly see how folks can get jaded in medical school. Yes, doctors have the amazing opportunity to touch people on such deep levels. But the process of becoming one can almost sometimes zap that altruism out of you. This week I slept about 15 hours (truly), trying to make sure that I remembered the minutia that was required of me. Medical school at times can be so physically and psychologically demanding that you honestly forget why you started in the first place. To be honest, I asked myself this a couple of times this week…and you know what, I think its important to ask yourself periodically whether medicine is what you want to do. Yes I certainly have my gripes about the process that it takes to become a doctor, but each time that I asked myself why I started medical school, I remembered that many good things about the field. I remembered the little kids I got to help in the refugee camps in Zambia and the experiences I had last summer on my mission trip; I remembered these events and reminded myself that medical school truly is a means to an end.

By the time that I become a physician, I will probably only use about 20% of what I actually learned in medical school, but that isn’t the point. The point, is that if I DON’T get through medical school, I will use about 0% of what I have learned. This week more than ever I realized that medical school can truly be devoid of joy and fun, but there is always a light at the end of the tunnel. For me that light is 3rd year; I know it will have its own share of suckiness, but if you don’t have anything to look forward to you truly will go crazy.

Anyway, I’m getting ready to go home, so I’ll probably share more updates when our grades are posted.

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Well I’m on the grind right now and that is all I can really say about medical school. In 2 weeks Christmas break starts but before I can enjoy any of it I have to go through a test week which also includes 2 subject board exams (Neuroscience and Psychopathology). I technically have 1 more week to get ready for it and there just aren’t enough hours. But it doesn’t make sense to complain about that anymore; right now I just have to put my head down and come up for air when it is done.

LIke my Chiropractic Medicine experience a couple of weeks ago, my school also required me to go to an Accupuncture clinic. I was not impressed at all. Their theories for why things work (i.e.- increased kidney function makes your hair grow longer) has no physiological basis, and they are fine with it. I don’t doubt that when they stick a couple of pins in you along their Meridian lines that it makes you feel better. But their are countless examples in medicine were people are “made better” from the placebo effect. Our bodies are amazing machines and from what I was shown, accupuncture only affects the internal placebo system. But you know what, everyone wants a piece of the healthcare pie, and people are paying these “doctors” to toture them, so what can I say. I don’t think I will be sending my patients to them.

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