Last week of 1st semester

Hey guys,

Sorry for the radio silence. Med school kicked into super-sonic high gear lately, and I've barely had time to breathe. We had a major problem with our community, they were going to close the health center where we go!! But by sheer luck, we managed to talk to the right person at the right time and prevent it from closing (major win!!!)

I also had my mom for a visit, which is great, but eats up a lot of my time and it's not what you want, 10 days before finals. 

This week we have a million things to turn in, I'm currently on a bus to the community where we're giving a workshop to the school about sexuality (community has high rate of teenage pregnancies) and next week we get our "continuous evaluation" grades which will in part determine whether we have to take giant monster cumulative exam in  July or not. 

To say I'm stressed out is an understatement. 

But such is the joy and the pain of med school. Work hard. Help people. Sleep when you can. And we already accomplished more than I ever thought we would, with the health center. 

All in all, my first semester of med school flew by. It's tough, but that was expected. I'm loving it. 

Cross your fingers for me, so things go well on finals!!! :) 

The thing about stress...

We've been seeing a lot of things about stress lately, and how much it affects your quality of life, mental health and physical health in general. In Uruguay, the leading cause of death for those above 40 years old is cardiovascular problems.

Well, high levels of stress cause high blood pressure, increased heart rate and even mess with your cholesterol levels. Stress also disrupts sleep, which is what the body needs to recuperate and keep us healthy and sane. And I guess there's no need to mention that stress also damages our mental health and influence our lifestyles in a negative manner (people who smoke and/or drink, usually smoke and/or drink more when they're stressed, don't have time to exercise or relax, etc.)

For the two weeks before my exam, I was very stressed. I wrote about this a couple of posts down, but I didn't give many clear examples. You guys, I was really stressed. I was yelling at people for no reason. I was not sleeping well, which made me tired and cranky on top of stressed. It was not good. And the worst part was that I knew I really didn't have to be that worried about the exam, because I had been studying and knew the material, but I could not reassure myself.

So this time, I am trying to do things differently. I have 3 1/2 weeks before my second midterm, and my goal is to not become a horrible stressed out person. I made myself a schedule and I'm keeping strictly to it. It includes time to relax, time to go for a walk/run, time to see friends. Obviously, it includes lots of time for studying. But I think that if I keep to my schedule and remember that my study techniques apparently work (so far, cross your fingers!), I can keep the stress at bay and make it through the exam and on to my month off in July (here's hoping!).

This schedule, of course, may not be the "stress cure" for everyone, but I think it might work for me. I just want to encourage each of you, whether you're a med student, doctor, nurse, or nothing at all related to medicine, but as all human beings, still vulnerable to the stress of life: Try different things and see what works for you. There are lots of different things that can help with stress management, and definitely improve your health and quality of life. Your present and future self will thank you. Chances are, your friends and family will too. 

The day after...

the midterm exam, that is. It was a beautiful day, sunny, not a cloud in the sky. Warm. The exam took me 2 1/2hrs (we had 3 1/2hrs total, so ample margin!) and started at 9, so I got home around noon. Changed into a bikini and a beach dress, grabbed a book and some sunscreen, and spend the afternoon on the beach, **reading a book** that had nothing to do with medicine! (Only my med-student friends will understand what this means. Oh, it was heaven!

Then I slept for about 10hrs.

And then, I got on a bus to go to Valizas, a place on the coast of Uruguay, which only has wild beaches and barely any houses or people. It was 36hrs of walking through nature, collecting delicious edible mushrooms, cooking, talking to friends, and generally just relaxing. I even turned off my cell phone for the 36hrs, in order to really disconnect from school. I knew they would be posting the answers to the exam soon, and I didn't want to see that.

Came home late at night and very tired, so I slept like a rock (for 5hrs!) and got up the next morning to start all over again. That's when I finally checked my answers and realized I had done very well on the exam. :)

Now, until the next exam, I have a little breathing space. It's only a month, but I'll take it! 

Mid-terms and stress

Just a quick post about my midterm exam: 

It's stressful. Very stressful. This is a 3-hr exam that covers ALL of the material of EVERY class we've had so far. 

The way my school is organized, we have 2 midterms and if we have an average of 80% on the exams, plus 80% on the "continuous evaluation" which includes all of homework, presentations and participation in class (and is completely subjective, which I hate!!), you get a month's vacation in July. 

If not, you have to prepare for a 3rd exam in the 3rd week of July, which covers all of the material for the entire semester. 

Folks, remember this is med-school. That well-known metaphore about drinking from a firehose is a great illustration. So the material for the entire semester, in one killer exam? I'd rather not, thanks. 

Hence why I'm currently stressed out and studying so I can get the best possible grade on this midterm. If I get less than 80%, I can forget about my chances of not going to Final Exam. It also doesn't help that my otherwise adorable kitty is going through puberty and decided to wake me up in the middle of the night, every night, meowing at the door of my bedroom. (She can't get spayed yet, she will as soon as they let me!) 

Wish me luck. I'm really stressed out, and I really shouldn't be. I know my stuff. I have been studying. But since it's the first exam, I'm not sure what to expect. 

Yey! Med school! Just 3 more years of this (before clinics)! 

P.S.: Can I please just poke somebody with a sharp object? I feel like if I don't get to handle a needle or IV line until December, that I might explode. 

1st year of med school and community work

Little background: I’m a 1st year medical student in Uruguay, a tiny country at the bottom of South America. My country has recently had a major change in its health care system, which, although was always free, it did not reach 100% of the population, and like the majority of healthcare systems in the world, it was not based in primary healthcare (PHC) or promoting health and preventing disease. (You can read more about PHC here: http://en.wikipedia.org/wiki/Primary_health_care)

When the healthcare system changed, the medical education also changed, to adapt to the new system. And let me tell you something—it is awesome! 

Throughout our clinical years, and since the very beginning, we are divided into groups of 28-30 students and given a poor, sometimes rural community to work with. It is our entire responsibility to go to the community, get to know the people there, the clinic doctor, the schools, understand the politics, the needs, and come up with a plan to improve it. 

First year of medical school is pretty boring. We are cramming our brains full of facts, when we really got here because we wanted to work with people. Help people. Well, with this program, going to the community once a week, gives us the opportunity to do just that. We learn how to see people as a whole, to discover all the things that influence their health, not just to see their disease. We start out by doing an epidemiological survey of the population – I confess that I had no idea what that meant. I’d heard the word “epidemiology” before, but if I’m honest, I had no real understanding of what it was. Now, not only do I know what it is, and why it is important, I am actually doing it myself.

They have a pizzeria!!

My community has a population of 2,852 people, only 2 paved roads, one tiny clinic open from 8am-6pm Monday through Friday, with one doctor and one nurse. You know what? They are **happy** to see us come. They want our help. They’re also happy to teach us. We get first-hand experience, and start helping people from day one. 

This is the CAIF- "Centro de Atención a la Infancia y a la Familia" -- help center for children and families.

They get excited students with lots of energy and the desire to change the world. We’ll do health education talks, sexual education talks, we’re planning an exercise program, we want to resurrect their football team (which died last year for lack of participation), we’ll go to the youth center and help the kids there, and to the primary schools and treat the kids for parasites (apparently an appalling percentage of the kids here suffer from intestinal parasites). We get to do stuff, impact a whole community and see the results of our work. And to me, that’s what this med school thing is all about.

Bikes and a sign for a junk yard

So here’s my advice to you, if you’re in medical school or pre-med and planning on going to med school: go to a rural community. Find a little town close to where you live, go to the clinic there and talk to the doctor. Ask him if you can help. Get involved and really put your heart into it. Not only can you make a real impact in that community, you’ll get a lot of experience, you’ll be a better doctor, a better human, and if all of that weren't enough, I’m pretty sure it’ll look great in your resume.

Learn before you do

I think the most frustrating part of med school for me is the fact that there's a lot of learning but not a lot of doing. Obviously, that makes sense. You can't throw the average 1st year medical student into the deep waters of a hospital and expect them to swim. Or not kill anyone. However, I'm not your average 1st year. And please, don't misunderstand me, I'm NOT saying I'm better than anyone. I just have more experience than most 1st years. I've worked in hospitals before (on a different capacity, but I've learned a lot). I have gone to Tchad.

I don't have a lot of the book-knowledge that you acquire in medical school (and which I'm acquiring now), but I have a lot of practical experience. I know how to put in an IV, the steps for an above-knee amputation, how to poke my index finger and find an inflamed prostate inside the belly of a 60-year-old man. Those are things your average 1st year does not know. They simply had no opportunity to learn it yet.

Most 1st years, and indeed, most doctors, haven't seen refugee camps in poor African countries. It's hard to wrap your mind around a population of 140,000 people suffering from everything under the sun (malaria, intestinal parasites, typhoid, high blood pressure, tuberculosis) and one doctor with barely any supplies, to try to help them.

I'm not making much sense in what I'm writing, sorry. What I want to say is that I miss Tchad. I miss doing things and seeing the improvement of people's lives. And I want to do so much more. There are more and more people forced to leave their homes, fleeing conflicts in several African countries, CAR, Burundi, Nigeria and becoming refugees. I feel useless and powerless.

But that just motivates me that much more, to be the best student and become the best doctor I can be, to bring the best help I can give. Learn before you do. I am learning now, but I cannot wait to go back and do.

A moment of truth...

So here we go... 

I think **one** of the reasons I didn't go to med school earlier, is because I was afraid I'd never get in. I'd never make it, so I might as well not try. 

When I was a freshman in college, I was the TA for my chemistry class, and I got a C in one of the lab write ups. The teacher, an old German dude, came to me when I was working in his office and said "you think you can get into med school with C's? You can't. You'll never make it." Folks, it was a lab write up. I did NOT get a C in that class, but the damage was already done. His words stuck with me to this day, 15 years later. 

I eventually changed my life and decided to pursue a career in something completely unrelated to medicine. It was not because of what that professor said, but I am *sure* I would not have given up so quickly, if I hadn't had his words echoing in my head and that horrible feeling that I just couldn't make the cut. 

So I graduated, got a job in Germany, (one of those real, grown up jobs) and started to settle into "grown up" life. Until I realized I wasn't happy. That my job did not make me happy. That I was not making the world a better place, and if I wasn't there, at my job, nobody would even notice. 

That realization came when I was 29 years old. Not an easy moment to face, even in the best circumstances... 

So I had a mini life-crises, questioned everything, and realized that the only consistent dream I had ever had, was to become a doctor. And thought it was insane. Crazy. No way could I do it now! 

Luckily, I have a couple of really good friends, who heard my rants, held me while I cried, and assured me that yes, I could do it. That if it was really what I wanted, not only *could* I do it, but I *should* do it! 

That brings us to today. Getting into med school is not easy, and it actually took me a little while from when I made the decision to this day. I am in my first year of medical school. Until today, I wasn't really sure I could make it. Today that has changed. I belong here. I am not only going to be a doctor, I'm going to be a great doctor. Dr. F (the chem teacher)'s words may have done a lot of damage, but they weere not true. I'm here. I made it. And I'm not nearly done! 

Watch out world! :) 

There's a song that fits perfectly with this post: "Let it be" by Superchick -- check it out!