The Private Life of DrKt

So... I have decided that now is the time to make my blog private. Applications are in and have been downloaded, I have 1 secondary to fill out, and am currently just waiting to hear what else is going to happen.

I know I've been horrible about updating, but I've been super busy with my acting-internship (or as we call them, "sub-internships") and studying after work for my national board exam at the end of this month.

I promise that I will try and be better in the future... Sorry for my fails.

sometimes medicine sucks

we had a young patient that came in about 2 weeks ago... he was sitting up and talking to us, but in acute heart failure with critical aortic stenosis.

he became hypotensive... the aortic stenosis wasn't allowing enough blood out, which made his heart more ischemic, which made his hypotension worse, which made his heart failure worse... it spiraled down and down.

there was nothing we could do.

we exhausted all of our options.

we all go into this field in an effort to make a difference, to save people. what do you do with medicine fails you... when you can offer no options... when you're sitting there after the fact replaying every decision trying to find a way to have approached it differently?

how do you approach a family in tears as they watch their loved one, while watching the BP monitor as it spirals down towards death? how do you accept their thanks when you felt like you've done nothing and could do nothing?

In honor of step 2 studying...

school photos... really?!

On Friday I have to get a senior picture taken.

The picture will be taken at school... elementary school style.

It's required for the "Class Composite" that will be placed in the hallway of the school for years to come.

The session costs $29.

And for an extra $20, they'll add the photo of your choice (from the 4) to ERAS (isn't that nice).

Once you add tax and shipping... sitting down for 10 minutes is going to cost 1 dollar and 6 cents shy of $60.

Does anyone else feel like this is complete robbery?

just documenting...

sorry in advance for the ADD post...

• today was the last clinical day of third year! all that's left is the daunting medicine shelf exam and the end of the year osce... then VACAY!!!! for a whole week and a half!!!!
• july = surgery sub-I! and not only that... it's pediatric surgery!!! i didn't even request it... who can say, excited?!?!
• also, i got my away elective for october. :) but not for august. :( trying to finagle my way into an anesthesia month (1. cause it's good to know, 2. i need to be studying for step 2 during that month and september). we'll see how that goes.
• i got nominated for an organization that i really want... i won't hear back for awhile, but i'm really hoping (without getting my hopes up)
• my continuity clinic preceptor offered to write me a letter of recommendation for residency... this makes me very happy.
• the weekend attending (who apparently wrote the pathology curriculum for a med school at the age of 20) told my resident he was impressed with me... my other resident told me she thought i did excellent this month as i was leaving.... i don't know why, but it makes me happy (and feel like i'm fooling everyone).
• i was actively involved in my first code on saturday, doing chest compressions... after 4L of hematemesis, 30 minutes, multiple rounds of medications and levophed drip, we transferred him to the unit (fixed and dilated). the family choose terminal wean...
  
• my mom opened and closed an AMAZING rendition of "light in the piazza"... she was nominated for 11 awards (in one of the three different award given organizations for lansing)... and her show won 10!
• i'm no longer blonde... but kinda red... i've been blonde since forever. i'm still not sure how i feel about this, but i know i don't hate it.
  
• the last few days have been really good...
  

HAPPY DAY!!!

Despite the rainy cold Michigan weather... I am happy! God blessed me with great lottery slots for my 4 year scheduling! Our school does it in 2 phases (1st = required stuff: sub-I, ER, ambulatory; 2nd = electives)... and I was in the 6th out of 15 groups for phase 1 and 4th out of 15 groups for phase 2. The only thing still up in the air: getting my away electives and convincing the school to accept a surgical ICU month as a medicine elective (I'm gonna sell this really well).

With all that said... my registration is complete (more or less) and I can give you all my 4th year "promised land" (and my dream) schedule:

July: Surgical Sub-Internship
August: Transplant Surgery (pending host school approval)
September: Ambulatory Medicine (taking Step 2 CK)
October: Surgical ICU (pending host school approval)
November: ER Medicine
December: Off for Interviews/ Christmas
January: Off for Interviews/ Step 2 CS
February: Advance Surgical Skills
March: Radiology (at "ClubB")/ MATCH!
April: Off for.... well, traveling?
May: Off for... partying, finalizing stuff??
June: GRADUATION! Holla!

Can I just say again that I am very happy right now!

4 years later...

Remembering 4.26.06. Please be lifting up the families of those lost.

The Year is Coming to an End... Sort of

It's true... It's the end of the year for many people. My freshman from Thailand are posting about there only being 12 more days in their senior year; I helped out with the Ace the OSCE last week, which is that last test of 1st year; 2nd years are finishing up and starting to freak out about boards; and all my 4th year friends are on vacation courtesy of residency relocation loans; Today is the Detroit Medical Orchestra concert (I play the violin). Even some of my friends at other medical schools are starting to finish up their 3rd year experience.

Then there's me, and the rest of my class. We start our last 2 month block of 3rd year tomorrow. And while that does mean that the end of the year is near, I still have the behemoth that is Internal Medicine. This is both good and bad... it's good in more senses than not; I've already learned a handful of it through my other rotation; it's put me in good position for my second board exams (Step 2 CK). But it's bad in the sense that this is the rotation that counts (outside of surgery).... so NO slacking off for me. Instead of enjoying the wonderful end of the year and the wonderful spring weather, I will be stuck in my office studying after work, trying to remember everything I learned during the past 2 years. (The only bright side is Kansas on the 14th of May...)

Enough of the negativity though... today is a happy day. I'm going to church, I get to see my parents, and there's an amazing drizzle coming down from the sky. And I rearranged my rooms yesterday, giving me a sense of starting anew.

So here's to starting something new...

Free Lonely Planet Guides!

If you know me at all, you know that I LOVE to travel. Which makes me SO exciting about the following: Right now on iTunes, for a limited time, Lonely Planet is having a "Volcano Relief Sale." This means that most of the European cities' guides are FREE! Check it out now!

The ones that I could find are:
Amsterdam, Barcelona, Berlin,Budapest, Copenhagen, Istanbul, London, Moscow, Munich, Paris, Rome, Stockholm, and Vienna

HAPPY BIRTHDAY BEST FRIEND!

My best friend is probably one of the most amazing people I know. And she's ALWAYS been that way; I can say that because she's been my best friend since she was born 2 weeks after me... So, I think outside her mom and brother, and possibly her boyfriend, that I can say this on good authority.

HAPPY BIRTHDAY BEST FRIEND!!! I miss you and wish you were somewhere near me so we could celebrate together!

The Internet Just Made My Day

I have to tell you all that the internet just made me insanely happy. For the past 1 1/2 years I've refused to give into making ringtones on iTunes... and then I heard a rumor you can make them in Garageband... AND YOU CAN! I just made 3!!! Addicting? I'd say yes!

Just had to share my elation!

Happy Easter

Happy Easter to you all! I hope it was full of spring cheer, family time, and remembrance.

__________________________________________________

Today I had Alice in Wonderland in my Easter basket (yes, I still get and Easter basket). I can't tell you how happy this makes me. Alice in Wonderland is one of my favorites. I've loved the Disney movie since I was a little girl. I read Through the Looking Glass in high school and college. And was in line the first weekend the new movie came out. I don't really know what it is about this story that I love so much, but I do... I can't explain it but I'll try in part...

In true Sunday fashion, my mother and I went to Barnes and Noble today after church.. and there was a book on the philosophy of Alice in Wonderland. There was a line in the first part of the book that talked about how 2 women in a class described Alice as their favorite fairytale girl because she accomplishes everything through her own means, no prince or fairy godmother necessary. And during that her journey she becomes what everyone else needs her to be, only to discover who she is... and when she does she's accepted. I loved this description.

I don't know if that explains everything about why I love this story... but at least it's a start.


And now I need to get back to my movie. :)

the ladybug

as i was driving home today i noticed a ladybug on my window. as i continued down the highway it maintained it's determination to not be thrown off in the wind. at one point both of it's wings were forced out from his shell, threatening his stronghold. however, he not only held on but also got his wings back under him. a testament to his resilience.

i admire this little ladybug.

umm...

i don't know how i feel about this...
and by that i mean.. that all my friends are preggers. ;)

simplicity.

(via weheartit.com)

i think i've spent my whole life looking ahead at what's next... which means i'm usually prepared. but at times i turn around and wonder where my life went. sometimes i wish i could go back and be that little girl running around the house with her best friend.

instead, we grow... we move apart... we move forward with our lives.

4th year already??

Tomorrow is the beginning of the 4th year advisathon... After 3 years of being told what to learn and when to learn it, we are finally given the opportunity to choose our own schedule.

This can be good and bad. For my friends still trying to figure out what they want to do, this comes with the stress of the unknown. They don't know what electives to do, when to do what, and on top of all that they are still trying to figure out what to apply to for residency. For those of us who know what we want to do, comes the stress of trying to figure out what electives would be best to prepare us for the future (I know, definitely the better place to be).

4th year at my school only has 3 required rotations, and 5 electives. The 3 required rotations are emergency medicine, ambulatory (outpatient) medicine, and the sub-internship ("pretend your an intern... and try to impress the socks off your attendings in order to get a STRONG* letter of recommendation"). As for electives, up to 3 can be away electives (I'm going to try and do 2 away electives: transplant surgery and surgical intensive care**)... and I get a free elective for doing Co-Curricular during 1st and 2nd year...

Which means only 2 other electives to figure out.*** I'm debating between anesthesiology, cardiology, and radiology... all of which would be really good to have for the future.

Anyways, tomorrow marks the beginning of becoming that individual everyone else in med school envies: a fourth year student. A year considered to be the easiest of all 4 years, replete with plenty of time to relax, and outside of USMLEs, without studying for exams!****


* I swear I'm going to hit the next person to tell me not to ask for a letter of recommendation, but a STRONG letter of recommendation. I get it... strong... it needs to make me look good. Can we move on now?
** Which I'm going to try and make into a medicine month... cause I mean, really, it's the ICU... although they're surgical patients, it's all medical management... and if I can get it to count as a medicine month I get to do Advance Surgical Skills.... Which I otherwise wouldn't be able to do, due to limits on the amount of electives in one specialty (the school wants us to be more well-rounded, whatever... I volunteer, play in an orchestra, and was well-rounded in college)
*** Please note that an 8 month year means I'm done at the end of March/April (depending on months off)... which means TRAVEL!!!!!
***That's not to say 4th year is not without stress, a lot of stress: USMLE Step 2, Residency applications, Interviews, and Match to name a few.

3rd Thursday in March

Today is MATCH DAY... the day when all 4th year medical students find out where they'll be spending the next 3-7 years of their training.


So, for all my friends out there who matched today... CONGRATULATIONS! May you have ended up somewhere you loved! Best of luck as interns! (I can't wait to be where you all are!)


For more information about the match, I recommend:

Just for laughs!

Thanks Angela for sharing this... it has had me laughing for the past few days.

Lampoon Domination

The winning video from Lampoon 2010, courtesy of the class of 2011!

Major language and content alert... This video is a NR-17 version.

LAMPOON DAY!

In honor of Lampoon today, we have an information blog (all taken from http://med.wayne.edu/Aesculapians) :

About Aesculapians

Pronounced “es-kyu-LEY-pee-uhns” Aesculapians is an honorary service organization that is devoted to the city of Detroit and the WSU School of Medicine. Every March, new members are nominated and elected by their peers for their interest and participation in extracurricular activities. Our organization consists of approximately 50 members from all four classes.

In addition to participating in many community programs throughout the year, the Aesculapians are also involved with many medical school activities including First-Year Orientation, the Annual Alumni Telefund, and sponsorship of the ever popular Lampoons.

The serpent is the symbol of Asculapius (Aesculapius) because it represented rejuvenation (renewal) as demonstrated by the periodic shedding of its skin. Many believed that snakes lived forever and that they helped discover health-giving medicinal herbs. According to one legend, a snake brought such herbs to Asculapius (Aesculapius) and to show his gratitude, he took on the shape of a serpent, too. The wooden staff was also designated as his symbol, because it represented his wanderings from place to place as he dispensed cures.

About Lampoon

LAMPOON is an annual medical school event that raises money for a local Detroit area charity organized by Aesculapians. Medical students from all four classes and faculty write, act and produce their own skits to parody life at Wayne State and in medical school. Through past events we have raised money for charitable organizations such as the National Marrow Donor Program, the Capuchin Soup Kitchen, and Motor City Blight Busters. It is also a time in which we elect new Aesculapians members and honor outstanding teachers and faculty with the presentation of the annual Lamp and Staff Awards.



About our Charity: Summer in the City

The charity for LAMPOON 2010 is the non-profit organization Summer in the City. During the summer, college volunteers lead high school student volunteers in working on various projects throughout Detroit, such as working with elementary school students, planting gardens, painting murals, building parks, and demolishing blighted houses. These projects are a means for youth to be involved in their community in a fun and constructive manner. Since 2002, 2750 volunteers have contributed over 55000 hours of service. Summer in the City is funded by grants and corporate sponsorships but mainly through individual and family donations. It is greatly in need of funding for its 2010 season and we hope you will consider making a donation through our organization.

Lampoon and Pediatrics

In honor of it being LAMPOON this weekend (and being on peds)....

start both around 1:00 min...




"I'm Yvonne Friday bitches, and that's the more you know."

A Day of Trauma Call

I thought I would take the opportunity to share what a day in the life of trauma call is like for anyone interested... these are based on, but not actual, events that occurred. (On trauma call days we can't arrive before 8am or we go over the 30 hour shift... pre-call days we're at work between 5 and 6 am).

6:15am Alarm goes off
6:45am Actually get up (I'm really bad at getting up)
7:15am Leave for work
7:45am Arrive in surgery resident's lounge and start writing down: vitals, labs, radiology/pathology results, and medications for patients I'm responsible for seeing
8:00am Start seeing patients
9:00am Rounds with the Chief Resident (the senior most resident)
10:00am Get work done; wait for the page to round with the staff; possible case in OR
??:??am Rounds with staff
11:00am-5:00pm Get work done; cases; wait for trauma codes
Sometime after 5:00pm Trauma Code: MVC vs. Pedestrian, eta 5 minutes (this exact call happens about twice per night... Detroiters love playing frogger on the major roads).
8:00pm Dinner with the team
10:00pm Evening pre-rounds
11:00pm Evening rounds with Chief Resident
12:00pm Trauma code 1; GSW or stab wound; eta 2 minutes
2:00am Grab a nap if you're lucky
4:00am Pre-rounds
5:00am Rounds with Chief Resident
7:00am Rounds with Staff
8:00am Some random OR case
10:00am Finish work
12:00pm HOME!

Trauma codes of course come in at any time during the 30 hours, with a few actually ending up in the OR. For "getting work done" there are a lot of things involved: consults from other services; bedside I&D (cutting open sacral decubitus ulcers); ER consults; pulling lines; walking patients; checking up on labs, etc.

This week I got to see and do some cool things: 1) saw my first external hemorrhoids and cut to cut them open, 2) saw compartment syndrome and the emergent four compartment fasciotomy and positive crescent roll sign*, 3) had a combative patient who had to be held down by 7 people and admitted to having alcohol, cocaine and heroin on board... there's more, but I'll stop there.

And on that note... it's time to get back to my research...

*Crescent roll sign: the rapid expansion of the compressed muscle upon fasciotomy, much like the release of dough from the crescent roll can.

because it's worth watching.

"It's so cold in the D"

This month is my elective month, which means that the masochist in me came out and I signed up for an extra month of surgery... trauma surgery, at Detroit Receiving Hospital... which means all sorts of craziness.

When I first arrived everyone asked why the crap I was doing an extra month of surgery in my 3rd year, including one of my attending (who happens to be a god of trauma surgery.. more on that later). My answers... I wanted to make sure surgery was right for me; although I was almost positive I was set for surgery after my surgery rotation, I wanted to see if I could cut it at a "harder" hospital (So far it's only made me want to go into surgery more); I wanted to learn about medical management of surgical patients (which I knew I'd get on the Ls team); and I couldn't imagine having the opportunity to do surgery for a month and spend the month doing something else... Plus, there's always the goal of getting a potential letter from any elective you do in your specialty (not gonna lie there...).

More on my team... I'm working with the legends of DRH: Charles E Lucas and Anna M Ledgerwood, also known as "The Ls". Both of them have published tons of papers on trauma and the effects of trauma. They are both BRILLIANT. They expect excellence. They are amazing surgeons and compassionate physicians. Basically, they are who I want to be at some point in my career.

Not only are my attendings on the service great, but I have to say that my senior (top resident) has been a great example. He is calm through everything and expects a lot. He does a LOT of pimping (which in the lingo for asking questions), but it's forced me to study and actually learn. I think I've learned more in the past week and a half than in a comparable amount of time on any service. Not having a shelf exam hanging over my head helps...

Needless to say, the past few weeks have been an amazing experience... and only confirmed my passion for surgery. So here's to being a pseudo-sub-I* and taking q3** call on an elective. Bring it. :)



*a sub-I is a month long rotation during your 4th year, where you're expected to act as an intern and cover the ICU patients... we don't have a 4th year, so I'm covering the ICU patients
**q3 means spending every 3rd night in the hopsital.

Drunk Monkeys!

Help Out Detroit Kiddies!

As you know, I am a 3rd year medical student at the Wayne State University School of Medicine. I am also a member of the Aesculapians honor society, a group of students who have been recognized for our dedication to community service and the city of Detroit.
 
Every March, we sponsor and plan the annual “Lampoon”, a fun-filled evening of skits and videos that showcase the lighter side of medical school. Each year, we select a local charity to honor and focus our fundraising efforts. This year, we have selected Summer in the City, a program that strives to improve community service in Metro Detroit with the help of high school and college students. With the current economic climate, it is even more imperative that we help those in need and I hope you will consider donating. Summer in the City is locally focused and in great need of our help. Any amount you can contribute will go a long way and will be greatly appreciated. You can even donate online! Thank you so much for considering our cause.
 
To read more about Aesculapians, Lampoon 2010, our charity and to donate online, please visit our website at: http://www.med.wayne.edu/Aesculapians/lampoon2010.asp

I need to get away.

Mix Craziness

Earlier this week I got an email from a friend asking to put together a workout mix for a new workout routine she's starting. And because she's one of my favorite people ever I, of course, said yes. As I was finishing it up tonight I realized two things:
1.) I never shared my fall or my winter mixes this year.
2.) Boards got in the way and I never even made a summer mix. Fail. Hmm.

All that being said, I thought that I'd throw them out there for the world, for prosperity (and because I've done that over the past few years... tradition and all).

Side Note: It's amazing how much the music tends to reflect my emotional state/energy needs/etc. I've also noticed that I tend to have way more pop music in my winter mixes, and more easy listening during the summer. Is it because that's what's out there during that time of the year? Anyone notice anything like that in their lives? Anyways... here you are (and the italicized name is how they are named in my iTunes playlists, it represents my title most reflective of the season):

Winter Mix: Empire State of Mind - Winter 2K10 (still under construction... since winter's not over yet.)

Fall Mix: I Gotta Feeling - Fall 2K09


Staci's Mix: Work It! (clearly a mix of the above two mixes)

i fail at blogging this year

the title pretty much sums up this year... this year has been so busy i feel like i barely ever have time to stop, let alone study. this month has been a little bit better, but there's been too many other stressors in my life that i can't really write about at this point (sorry)... but i guess i can update you all:

1. holidays - AMAZING! i love spending time at home with my family; hanging out with my mom and dog in her room, getting crushed when my brother jumps onto the bed while we're watching TV, spending time with my dad... coffee shops... and most importantly having absolutely no expectations. it was a great break.

2. family med - hmm... interesting? i've had a good experience in family med so far, but it's really not my thing. i'm SOOOO glad that there are people who do this and love practicing this type of medicine, but i just can't see myself being one of those people. i need something more than med refills and 3 month follow-ups. but at the same time, i see the importance of it and how it will save people from seeing me in the future (when they need some sort of surgery.... at least that's where i'm hoping to be).

3. life - it's been... okay. the new year hasn't been treating me as well as i would have liked, but i'm thankful for all the amazing friends i have in my life that seem to pop up at the right times. and thankful for my mother, who always takes my calls and listens to my complaints, while trying to help me figure out what to do.

4. all those resolutions? - hmm, needing to revamp those. they might be "new month resolutions". one of my resolutions was to play more video games (hahaha... which means play wii fit at least 4 days a week). i'm still needing to work on some other things as well, but i'm not really comfortable airing dirty laundry right now. ;)

all in all, life is life. it keeps going. and at the end of the day i am thankful for everything... and excited to see what's going to happen next.

and not to be cliche, but:

KEEP CALM AND CARRY ON