Dreams

                   

It seems impossible. I can barely believe it, and I'm the one living it! I'm 10 days away from finishing my 2nd year of medical school. 

It seems like it was only yesterday, that I was living in Berlin, having a crisis about my future and talking with a good friend about the fact that the only thing I had really ever wanted to do was medicine, but the chance had passed me by. I was too old. I couldn't drop everything now and start over. 

Or could I? 

The phrase on the picture above is so obvious, but so hard to see sometimes. Medicine is a long term goal. It takes a lot of time and effort. You might have to give up other things, and you'll definitely have to make sacrifices in order to achieve it. But if it's what you really want, you owe it to yourself to go for it. Because if you don't, the time will pass anyway, and you might look back and realize that if you had started then, you'd have accomplished it now. 

So do it. Whatever your dream is, run to it. Be brave. The first step, the decision, is the hardest. After that, nothing can stop you. Nothing should stop you. 

Life in Chad

I was talking to a friend this week and realized it's hard for people to imagine what day to day life in Chad is actually like. So I went through my pictures and did a little research to get some data to share with you guys.

First off, some numbers about the healthcare situation in Chad, taken from the Human Development Index compiled by the UN (click to see better):

I put together the top 10 countries and the bottom 10 countries. For easier comparison, I highlighted the United States and Chad. (All info can be found at http://hdr.undp.org/en/content/human-development-index-hdi ) 

Some other interesting information gathered from the same index: 

Percentage of the population with some high school: 95% in the US  -- 5,5% in Chad

Percentage of the population with access to electricity: 100 % in the US -- 6,4% in Chad

Chad hasn't moved forward in time, and people still live as they did 2000 years ago. No, that's not a typo, I mean 2 thousand years ago. The men work the fields, the women gather wood to cook, fetch water from a well/river, take care of the children, cook, sell vegetables in the market. The meager 6,4% who have electricity, have their own gas fueled generator (like the hospital). There's absolutely no sanitation or waste disposal systems. What little trash they produce which is not biodegradable, they burn. 

Mode of transport of the RICH -- most people just walk

What the villages look like

A little closer

The houses are single rooms build from mud bricks and straw. The "kitchen" is in the center of the yard, where they build the fire to cook over. You might remember the story of Adamah (beware of the photos!) who had extensive 3rd degree burns over large portions of her body. This happens very frequently and I know of 4 people (2 adults, 2 children) who died due to burns from cooking fires. 

Carrying a ridiculous amount of wood on their heads

Cooking on burning wood

The school

If they want flour, they have to make it themselves, plant and reap the grains, let them dry, and then pound the heck out of them until it becomes flour. (The women do this, the man in the video was just showing off *because I was filming.*

The market in town

The pharmacy (yes, meds straight out in the sun with temperatures of up to 35-40 Celsius)

With the exception of the main highway which connects N'Djamena (the capital) with Moundou (the second largest city) there are no paved roads, and even the conditions of that highway would make you cry if you saw it. 

And lastly, a little view of the hospital where I worked the previous two times: 

The men's ward (there's an equivalent female ward)

The central yard where family and patients hang out

The OR

And below is the hospital I will be working at this time, which is different from the previous 2 times. It's a much bigger hospital with a little bit better infrastructure, even though it is *really* in the boonies instead of the city and it takes 7hrs on a bus plus 1hr in a moto-taxi through dirt roads to get there from the capital.

Chad - Round 3

The last time I went to Chad, in January this year (not even a year ago!) I thought it would be my last time. The day I left, I remember watching the city of Moundou going by the window of the bus, and feeling sad that I would probably never see it again. It was weird, because part of me felt like Chad was home. It had won a little piece of my heart.

Well, it turns out that *I am* going back!! Dr. Scott is no longer there, he moved to a different hospital in Sierra Leone. But the Bere Hospital has some great doctors, whom I met for a weekend, and they were happy to have me come and volunteer with them. So I bought tickets!

This is a bigger hospital at a very rural area. Some people travel for days to get there and receive medical care. The work they're doing there, against all odds and against all reason, is incredible. I can't wait to become a part of the team, to help anyway I can, and to learn as much as possible.

To make my trip possible, I have started a crowdfunding page. For those of you who want to and are able to help financially, every dollar counts and it will be greatly appreciated. Otherwise, every prayer,word of encouragement and positive thought is also very valued and much needed!

Watch the blog for more stories from med school and from the upcoming trip. Oh, yeah! And here's the link for my page, feel free to share it and help spread the word!!

https://www.gofundme.com/medical-volunteer-trip-to-africa-2v983vnw

That time when... med school kicked my butt

Second year of med school has been a blur so far. I arrived back from my trip to Africa on the day my classes started, literally dropped my bags at home and went straight to class. I do not advise doing that and will not be doing it again.

My brain was not ready to jump from Chad straight to classes. So while I tried to adapt to being back, I started running behind class materials and felt like I was playing catch up. The entire semester. My stress levels went to record highs, and I even had insomnia, something that, with rare exceptions, I had never had. I passed all of my classes, but my class ranking suffered a bit and I'll have to work extra hard to recover.

The result is that I finished the semester utterly exhausted. But since I'm an overachiever at heart, instead of taking advantage of winter break to recuperate before second semester, I went ahead and signed up for an elective. Because I'm insane. I did escape for a week to go to the beach, because I felt that I could simply not start 2nd semester without recharging my batteries at least a little bit. I'll talk about that on the next blog post, suffice to say, it worked! A week in paradise was just what the doctor ordered. :)

However, I realized that I need to cut myself some slack, and not be so hard on myself. This semester was pretty tough, but I passed. Beating myself up because of class rank is stupid, and I know I can do better next semester, when I won't start out stressed and already playing catch up. Plus, we start out with Neuro and I love neuro!! So it should be fun.

So the two lessons to take home are: 1- don't come back from a stressful trip to Africa (or elsewhere) the same day your classes start. Give yourself some time to arrive and adapt before classes start. 2- do your best and don't beat yourself up if the results are not exactly what you expected. After all, it was just 1 semester and I passed!!

Mentors

Even before I started med school, I knew that I would need a good support system. And I knew that was going to be a little complicated, because I was moving to a country where I knew nobody at all. I have good friends, but the closest to me geographically, are still in the next country. It's 4hrs away, so it turned out ok and I get to see them on a somewhat regular basis (money and time being short and all.)

I also knew I'd need mentors. I had never actually had a mentor, so I didn't know where/how to find one.

Then I went to Africa and worked with Dr. Scott. Before I went, I had no idea if we'd get along, I was even a little aprehensive. But we got along great, he taught me a lot, trusted me, and told me to come back any time. So I went back, and learned even more. I know he'll be there for me if I need help or encouragement, and I'm lucky to have him.

Last year, I had also contacted a Neurosurgeon from the US about an article he wrote, and to my greatest surprise, he wrote me back, gave me his phone number and told me if I ever had any questions, to feel free to contact him. I am planning on working with him in the near future, so we've emailed a few times, and even though we haven't met yet, I feel like he's also becoming a mentor, and I'm grateful for that.

To finish, I recently went to a neurosurgery congress and met another great neurosurgeon. It was a small congress, and I ended up talking one-on-one with him on numerous occasions, about medicine, but also about philosophy, injustice and traveling. He gave me some great advice and also invited me to do a rotation with him when the time comes (I'm still an MS2).

I can't believe how lucky I am, that without even trying to, I have found myself 3 mentors. Three great surgeons and great human beings, to look up to, ask advice from, and generally have "in my corner," should I ever need help or get discouraged.

To all of you pre-med, med students and residents out there, find a mentor. At least one. Someone you can trust and who can help keep you motivated, inspired and give you a little push once in a while. We all need it. :) 

Neurosurgery

I'm on cloud 9 right this moment. Sorry it's been a while since I wrote, but I got back from Chad on the day my classes started, had a friend come visit, then my mom, and between studying and trying to get my life organized, time got away from me.

But I just got home after being out of the house for 15hrs, and had such a fantastic day that I had to come and share. Let me explain: today was my 1st ever medical congress, and it happened to be a Neurosurgery Congress.

I am a lowly 2nd year medical student, and even though I've done and experienced a lot more than your average 2nd year, none of it was in my country and my university doesn't know anything about it. I get no brownie points for going to Africa and assisting in surgery, or doing internships in hospitals in Germany. Therefore, I am really, just a lowly 2nd year med student. Who happens to be fluent in French.

The guest of honor and main speaker for this congress, was a heavy weight French neurosurgeon. I had obviously googled him prior to the congress. This morning when I got there, imagine what isn't my surprise, when the 1st person I see, standing alone close to the door of the auditorium, is The Man Himself! So I smiled and said "Bonjour" to which he replied "Vous parlez Français?" To which I replied in French and we somehow immediately fell into conversation. It was just 30 seconds, but it was enough.

A little later, we had a coffee break. This is a small congress, so most people already knew each other and I was the only med student, lost in the crowd, nursing my cup of coffee. The Neurosurgeon guy comes, all by himself, talk to me. We end up talking for about 10 minutes, I tell him a little about myself, ask for advice, and walk away with his card and **an invitation** to come do a rotation with him, once I get into the clinical years! YES!!!!!!!! I am over the moon!!!!

As if all of that wasn't enough, I later met a team of Neurosurgeon/Neuroradiologist/Radiotherapist from Brazil (and I also speak Portuguese!) and one of them said casually that if I wanted to come do a rotation, I'd be more than welcome. I didn't let that pass and immediately got their contact info and even went so far as to suggest a possible date (winter break, I have 3 weeks off!).

You'd think the day's riches had been exhausted, but they weren't. The French Neurosurgeon *comes back* to talk to me, and we start talking about travel, philosophy, and of course, Neurosurgery. The guy is simply awesome. Not only is he a great surgeon, but his holistic philosophy of care and his emphasis in Quality of Life above Overall Survival is something I had always thought about.

Just to sum it all up:
- I befriended a world renowned Neurosurgeon and got an invitation to do a clinical rotation with him in France.
- I befriended an entire Neuro-onc team and also got an invitation to do a rotation with them in Brazil.
- I learned A TON about the latest treatment options and diagnostic imaging for brain tumors + made a list of things I don't know/didn't understand so I can read up and catch up.

Today was a really, really good day. The only thing I didn't do was make any local friends in Neurosurgery, which is kind of a downer because they're the ones who can let me into surgeries here and now. But hey, there's still tomorrow!! :)

Back home

Sorry guys, I got busy and sad and then in a whirlwind I was back in Berlin for 4 days, in Paris for 14hrs, then flying home. I arrived Monday at 11am, went home, ate, showered and *went to class*!!

I am exhausted. It's Thursday evening, I got back from class a little while ago and all I want to do is sleep. But I have to study. And my mom is still here. So I'm procrastinating and writing a blog post. Mom leaves tonight.

I only had 4 days of class, but I feel like I'm so ridiculously behind already. One of the profs definitely loves the Socratic method, and is pimping us hard. I also met the 1st gunner and wow, she's annoying.

I guess I better get my act together, or this semester is going to kick my butt!!!

I'll write more about Chad later, there are still many stories to tell. :)