Okay, so me and Kristyn are safely in Peru. We have been for about 36 hours now. We flew from Miami to Lima and then to Iquitos. We had a really great trip getting here, everything seemed to fall into place. We have two explanations for the perfection of our travels, 1) We prayed to Jesus and 2) Kristyn was wearing her lucky leprauchan socks. We didn´t have a flight to Iquitos, but after we landed at 4 am and got through customs we went to the airline counter and they had a ticket for 6 am - so we went back through security and flew straight to Iquitos. On the plane I sat by some men who worked in Iquitos. We struck up a convo (which is impressive since they don´t know a word of English). They told me that fish and reptiles taste like chicken when I told them I only ate chicken. I told them that I would try a fish and a reptile once only to see if that´s true (I haven´t yet tho but will report to you when I do , although I need verification from the Adventists whether reptiles are clean or not).
When we got off the plane, my new friend helped us get our bags and get a cab ride to the hospital. It was all perfect. They put us up in a hospital room, no joke, we have two patient beds and our side tables and even a nurse call button. We have our own bathroom but we can´t flush the TP. Oh and the shower is cold '- BUT we are not complaining because we have air conditioning which is amazing. When we got off the plane pure humidity hit me, worse than Florida. I am getting used to it and it´s not awful but the air conditioning is appreciated. It has been cloudy since we got here and at least once a day it rains cats and dogs, but I am still looking for the sun and hoping that I get a tan soon so I don´t stick out so much while walking to the Plaza.
We are working in the emergency room this week and sometimes it is busy while other times not so much. Yesterday we saw 1 moto accident with a Collin´s fracture, a lady in septic shock, and a stab wound. This morning was not as excitings, just a cut leg, lots of malignant hypertension, a UTI, and oh yeah 3 possible cases of Dengue fever. Kristyn and I need to read up on Dengue fever.
The food here is different. When we left, Abby told me that I should be ready to miss salad or basically anything green - it´s true. I haven´t seen any since we arrived. Today our lunch salads were made with this long, 1 cm wide tasteless flower petal looking thing. We had to be told by one of the guys sitting with us that we were supposed to eat the food as a salad!
There have been a lot of humbling moments especially since barely anybody speaks English and those that do don´t speak a lot. We are learning rapidly though (Kristyn hopefully agrees) and we think we will at least be able to communicate a lot better when we are done with our time here! The people here are SOOOO nice too -they are really understanding and helpful even though our Spanish sucks.
We really have been blessed so far, but continue to need prayers. Love you all!
Tuesday, March 30, 2010
Saturday, March 27, 2010
all my bags are packed
so, tomorrow i leave for peru, or if you want to be more exotic, THE AMAZON!!! :) it's a pretty exciting adventure that my roomie kristyn and i am embarking on. i have my big kelty backpack packed to the hilt and my carry on can't get much bigger or i won't be able to carry it on. i have called all my credit card companies so they don't shut off my credit card and made a million copies of mine and kristyn's passports. i think i've done everything that was required before leaving.
abby is packing too, she is going to europe with irene and kim on a big adventure! they will have a grand time as well. so our house is currently a blurr of travel sized toiletries, clothes, granola bars and electronic devices. it's a grand time.
kristyn and i leave from lax at 2 tomorrow - we fly to miami and then to lima. from lima we will fly to iquitos - but that will happen on monday. we will spend 4 weeks in iquitos at a hospital there. some surgeons that kristyn has worked with in the past will meet us in iquitos which will be cool. then we will travel after. that's the jist of the trip - the plan is to update this blog while i am gone - so keep reading and share in the adventure!
abby is packing too, she is going to europe with irene and kim on a big adventure! they will have a grand time as well. so our house is currently a blurr of travel sized toiletries, clothes, granola bars and electronic devices. it's a grand time.
kristyn and i leave from lax at 2 tomorrow - we fly to miami and then to lima. from lima we will fly to iquitos - but that will happen on monday. we will spend 4 weeks in iquitos at a hospital there. some surgeons that kristyn has worked with in the past will meet us in iquitos which will be cool. then we will travel after. that's the jist of the trip - the plan is to update this blog while i am gone - so keep reading and share in the adventure!
Friday, March 26, 2010
I only have one reader...
and her name is Irene. She's a real cute one - she's one of those friends that is perfectly herself - there is nobody like her. We became friends first year and we have had some of the best venting sessions together through the years. She's one of the only people who will yell at me for not delegating and call me on stuff when I am being a jerk. She also loves Jesus a lot which is surprising for a heathen (just kidding of course). Lastly, but not least, I totally trust her with my life as evidenced by me letting her hold the other end of the rope while I attempt to climb 40 foot walls. I'm gonna miss her a lot... She's my only reader and I know this because she's the only one that leaves comments - so I dedicate this blog to her.
I will however try to entice others to read this blog by posting about Peru....oooh la la!! I may change the look of the blog to make it more appealing - we'll see! :)
I will however try to entice others to read this blog by posting about Peru....oooh la la!! I may change the look of the blog to make it more appealing - we'll see! :)
Tuesday, March 23, 2010
I matched to Indianapolis!!
This is a delayed post - but I recently read a book on medical school and this morning realized that a chapter in that book described the last week of my life. The book is "Not an Entirely Benign Procedure" by Perri Klass. I don't think that this is plagiarism or illegal since I am telling you who wrote it - so much of it is so true though that I could have almost wrote it (if I had any skill in writing). The chapter is entitled Match Day.
Perhaps this March 19 didn't mean anything special to you. Maybe you had a child applying to college and were focused on April 15. Or maybe you had nothing momentous pending this spring. But for most of us in our fourth year of medical school, March 19 was Match Day, and nothing has been the same since.
Every June new doctors graduate from medical schools across America, and somehow they have to be sorted into the hospitals in which they will continue their training, as interns in surgery, internal medicine, pediatrics, whatever. Every medical student needs to a place (the MD alone does not qualify you to practice medicine), and every teaching hospital needs a full set of interns to take care of patients and generally to keep the place running. And so we have the Match, a national computerized sorting system. Earlier in the year we chose our specialties, applied to various programs, and traveled around the country for interviews, attempting to look like people dying for the opportunity to work more than a hundred hours a week. We came up with polite answers to direct questions ("Do you really want to come here?") and less direct questions ("What are you looking for in your medical education?"), we wore suits and toured one hospital after another, and we questioned interns in all the programs ("What time do you get to leave the day after you're on call?").
And then finally we submitted our rank lists, rating programs in the order in which we desired them, and all the programs submitted ranked lists of applicants and a computer did the work. So for a couple of months before March 19, whenever I met a friend from medical school, we talked about who had ranked what program first, who had received what kind of encouragements from where, and so on. It's forbidden for the hospitals to tell applicants where they stand, but in fact a great deal of vague unofficial notification goes on.
The day before Match Day I woke up from an anxiety dream; I'd been searching through empty rooms at school to find some very improtant event that was taking place without me, in a room I couldn't locate. I went to the class I was taking, told a few people about my dream, heard about their dreams. Taled to somebody who ranked programs in both medicine and surgery and so was waiting to find out not only where he would be but also what he would be. Talked to someone else who had ranked a certain program first but no longer wanted to go there, figured she wouldn't get in if a certain other student in our class did. Calculated our own and everyone else's odds.
Match Day. It is traditional for those who match to bring along their spouses and what the medical school chooses to call their semispouses (also know as "significant others"). People bring their children. Everyone's fate is being decided, so everyone comes to see.
The envelopes are made available at noon in Boston; in Chicago they're available at 11:00 AM to compensate for the time difference, and so on across the country: all students receive the news at the same moment. At noon, we lined up and got our envelopes, tore them open on the spot or took them out into the hall, hin in the bathroom or in deserted upstairs classrooms, opened them and found out where we'd be fore the next three to five years, where we'd train, where we'd live. Much hugging and congratulating, and a photographer who kept trying to take pictures of people with children (my own child was howling because he'd wanted to open my envelope and I'd been in too much of a hurry to wait while he worked it open).
And after Match Day, things feel different. The transition, which has been for the past four years almost impossible to imagine, has suddenly become real. We're all going to be doctors. When you have the name of the hospital, you can picture yourself working there. Not as a medical student, as a doctor.
At the beginning of medical school I had a tendency to scribble down every stray piece of clinical information that happened to emerge in a lecture. Most of what we heard was "basic science," and pretty far removed from the hospital, but if some lecturer chanced to bring up a disease, a treatment, a risk factor, I wanted to make sure I had it on paper. My brother once said to me, not joking, that if he went to medical school, he'd be afraid to fall asleep in a lecture, afraid to miss something vital, which would one day lead to his killing someone. Of course I've become a bit more blase over the past four years (I regularly and deliberately fall asleep in lectures and seminars in the hospital, fighting for my seat in the valued last row, where you can lean your head back against the wall, where the lecturer can't see you so clearly). I've come to understand that left to my own devices and my own knowledge, I would kill many people, no matter how hard I studied; a residency program is designed to keep me from overreaching my experience while at the same time nudging that experience gently along into realms of greater responsibilitiy.
But the point is that even as I became more comfortable sleeping in lectures, I still regarded it as my responsibility to learn something about any given medical topic, and so, I think, did most of my classmates. I'm going to be a doctor and that's a disease-of course I have to what it is. Well, no more. Ever since Match Day, I feel completely allied to my chosen field-pediatrics. With a smirk, I say to friends going into adult medicine, "Klebsiella pneumonia in the debilitated alcoholic-that's your territory, not mine."
"I'm not even going to that lecture," says a classmate. "Malaria is not what I'd call a surgical disease."
Although many of us have known for quite a while what we were going into, we seem now to have pledged exclusive allegiance in a new and forceful way. Recently I was in a discussion section where we were evaluating the case of a fifty-five-year-old woman with mysterious fevers and gastrointestinal symptoms. "Run her bowel," suggested a future radiologist, meaning in a seres of X rays. "Call in the surgeons," suggested someone who matched in surgery. I looked across the table at another future pediatrician, and we shrugged. "Ear infection, put her on Amoxicillin," I whispered, suggesting a common diagnosis for a two-year-old with fever.
I don't know all that much more than I knew a few months ago; certainly, I haven't made some quantum jump in knowledge that brings me closer to competence as a pediatrician. But I have begun to identify myself completely with the group I'll be joining in July. In part, I suppose this is jubilation-I'm really going to graduate, I really matched, I'm really going to be a doctor. In part, it's probably also fear; in the midst of my terror at having to get out there and be a doctor, it's reassuring to remind myself that there are certain things I don't have to do, certain things I don't have to know. I can worry about whether I'll be competent in pediatrics, and not worry about how much surgery I do or don't know. I can limit my worrying to the specific kinds of emergencies I may have to deal with in a couple of months, and allow myself to write off areas that would be very important in other fields of medicine-coronary artery disease, say, or lung cancer. Instead, I have to worry about whether I know enough about congenital heart disease or leukemia, the things that affect children-it's still overwhelming, I'll never know enough, but at least it's limited.
But it isn't just the feeling that I'm going to be a doctor that has affected me since Match Day; it's the awareness that we're all going to be doctors. That young man who once gave me such complete misinformation about how the nervous system worked (I believed it, so did he' nonetheless we both did brilliantly on the test) is going to be in a prestigious medical residency. The stable people and the unstable ones, the private people and the people whose every affair is a medical school event, the people who seem to know what they're doing and the people who always looked dazed or blank-they've all been sorted into residencies, they'll all be doctors.
I don't mean to suggest that they're unfit. It's just that I know who they are. I know how little (or how much) they know, because we've all had substantially the same education. I know how big some of our gaps can be. "I always meant to learn the kidney before I graduated from medical school, " one of my classmates told me, worriedly. "But the thing is, I really want to take May off to travel." I knew what he meant. I feel that way about the liver: a big black box. Ask me about the liver, I'll give you my grandmother's recipe (sorry, medical student joke). It's not that any of us wants to stay in medical school any longer. Quite aside from the cost, and the human urge to crawl a little way up the totem pole (though goodness knows interns are only a couple of millimeters about the mud), we've had enough of being in school. You can't learn to be a doctor in school; you need an apprenticeship. You need to have responsibility for patients. And in fact, we're all itching to get out there and be doctors. But it still feels amazing to realize that we are all going to be doctors, that if you get sick in July, we'll be seeing you.
Perhaps this March 19 didn't mean anything special to you. Maybe you had a child applying to college and were focused on April 15. Or maybe you had nothing momentous pending this spring. But for most of us in our fourth year of medical school, March 19 was Match Day, and nothing has been the same since.
Every June new doctors graduate from medical schools across America, and somehow they have to be sorted into the hospitals in which they will continue their training, as interns in surgery, internal medicine, pediatrics, whatever. Every medical student needs to a place (the MD alone does not qualify you to practice medicine), and every teaching hospital needs a full set of interns to take care of patients and generally to keep the place running. And so we have the Match, a national computerized sorting system. Earlier in the year we chose our specialties, applied to various programs, and traveled around the country for interviews, attempting to look like people dying for the opportunity to work more than a hundred hours a week. We came up with polite answers to direct questions ("Do you really want to come here?") and less direct questions ("What are you looking for in your medical education?"), we wore suits and toured one hospital after another, and we questioned interns in all the programs ("What time do you get to leave the day after you're on call?").
And then finally we submitted our rank lists, rating programs in the order in which we desired them, and all the programs submitted ranked lists of applicants and a computer did the work. So for a couple of months before March 19, whenever I met a friend from medical school, we talked about who had ranked what program first, who had received what kind of encouragements from where, and so on. It's forbidden for the hospitals to tell applicants where they stand, but in fact a great deal of vague unofficial notification goes on.
The day before Match Day I woke up from an anxiety dream; I'd been searching through empty rooms at school to find some very improtant event that was taking place without me, in a room I couldn't locate. I went to the class I was taking, told a few people about my dream, heard about their dreams. Taled to somebody who ranked programs in both medicine and surgery and so was waiting to find out not only where he would be but also what he would be. Talked to someone else who had ranked a certain program first but no longer wanted to go there, figured she wouldn't get in if a certain other student in our class did. Calculated our own and everyone else's odds.
Match Day. It is traditional for those who match to bring along their spouses and what the medical school chooses to call their semispouses (also know as "significant others"). People bring their children. Everyone's fate is being decided, so everyone comes to see.
The envelopes are made available at noon in Boston; in Chicago they're available at 11:00 AM to compensate for the time difference, and so on across the country: all students receive the news at the same moment. At noon, we lined up and got our envelopes, tore them open on the spot or took them out into the hall, hin in the bathroom or in deserted upstairs classrooms, opened them and found out where we'd be fore the next three to five years, where we'd train, where we'd live. Much hugging and congratulating, and a photographer who kept trying to take pictures of people with children (my own child was howling because he'd wanted to open my envelope and I'd been in too much of a hurry to wait while he worked it open).
And after Match Day, things feel different. The transition, which has been for the past four years almost impossible to imagine, has suddenly become real. We're all going to be doctors. When you have the name of the hospital, you can picture yourself working there. Not as a medical student, as a doctor.
At the beginning of medical school I had a tendency to scribble down every stray piece of clinical information that happened to emerge in a lecture. Most of what we heard was "basic science," and pretty far removed from the hospital, but if some lecturer chanced to bring up a disease, a treatment, a risk factor, I wanted to make sure I had it on paper. My brother once said to me, not joking, that if he went to medical school, he'd be afraid to fall asleep in a lecture, afraid to miss something vital, which would one day lead to his killing someone. Of course I've become a bit more blase over the past four years (I regularly and deliberately fall asleep in lectures and seminars in the hospital, fighting for my seat in the valued last row, where you can lean your head back against the wall, where the lecturer can't see you so clearly). I've come to understand that left to my own devices and my own knowledge, I would kill many people, no matter how hard I studied; a residency program is designed to keep me from overreaching my experience while at the same time nudging that experience gently along into realms of greater responsibilitiy.
But the point is that even as I became more comfortable sleeping in lectures, I still regarded it as my responsibility to learn something about any given medical topic, and so, I think, did most of my classmates. I'm going to be a doctor and that's a disease-of course I have to what it is. Well, no more. Ever since Match Day, I feel completely allied to my chosen field-pediatrics. With a smirk, I say to friends going into adult medicine, "Klebsiella pneumonia in the debilitated alcoholic-that's your territory, not mine."
"I'm not even going to that lecture," says a classmate. "Malaria is not what I'd call a surgical disease."
Although many of us have known for quite a while what we were going into, we seem now to have pledged exclusive allegiance in a new and forceful way. Recently I was in a discussion section where we were evaluating the case of a fifty-five-year-old woman with mysterious fevers and gastrointestinal symptoms. "Run her bowel," suggested a future radiologist, meaning in a seres of X rays. "Call in the surgeons," suggested someone who matched in surgery. I looked across the table at another future pediatrician, and we shrugged. "Ear infection, put her on Amoxicillin," I whispered, suggesting a common diagnosis for a two-year-old with fever.
I don't know all that much more than I knew a few months ago; certainly, I haven't made some quantum jump in knowledge that brings me closer to competence as a pediatrician. But I have begun to identify myself completely with the group I'll be joining in July. In part, I suppose this is jubilation-I'm really going to graduate, I really matched, I'm really going to be a doctor. In part, it's probably also fear; in the midst of my terror at having to get out there and be a doctor, it's reassuring to remind myself that there are certain things I don't have to do, certain things I don't have to know. I can worry about whether I'll be competent in pediatrics, and not worry about how much surgery I do or don't know. I can limit my worrying to the specific kinds of emergencies I may have to deal with in a couple of months, and allow myself to write off areas that would be very important in other fields of medicine-coronary artery disease, say, or lung cancer. Instead, I have to worry about whether I know enough about congenital heart disease or leukemia, the things that affect children-it's still overwhelming, I'll never know enough, but at least it's limited.
But it isn't just the feeling that I'm going to be a doctor that has affected me since Match Day; it's the awareness that we're all going to be doctors. That young man who once gave me such complete misinformation about how the nervous system worked (I believed it, so did he' nonetheless we both did brilliantly on the test) is going to be in a prestigious medical residency. The stable people and the unstable ones, the private people and the people whose every affair is a medical school event, the people who seem to know what they're doing and the people who always looked dazed or blank-they've all been sorted into residencies, they'll all be doctors.
I don't mean to suggest that they're unfit. It's just that I know who they are. I know how little (or how much) they know, because we've all had substantially the same education. I know how big some of our gaps can be. "I always meant to learn the kidney before I graduated from medical school, " one of my classmates told me, worriedly. "But the thing is, I really want to take May off to travel." I knew what he meant. I feel that way about the liver: a big black box. Ask me about the liver, I'll give you my grandmother's recipe (sorry, medical student joke). It's not that any of us wants to stay in medical school any longer. Quite aside from the cost, and the human urge to crawl a little way up the totem pole (though goodness knows interns are only a couple of millimeters about the mud), we've had enough of being in school. You can't learn to be a doctor in school; you need an apprenticeship. You need to have responsibility for patients. And in fact, we're all itching to get out there and be doctors. But it still feels amazing to realize that we are all going to be doctors, that if you get sick in July, we'll be seeing you.
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