On “Do what you love and it won’t feel like work”

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“Old Medicine Glass Bottles” by Tambako The Jaguar on Flickr

I tell you what, it feels like work. It has felt like work every single year in academia. It has felt like work every single exam season. The hard stuff has always felt like work, from the time I was 14, sitting down to do battle with my math homework and erasing so many times I wore holes through the paper, and literally wanted to cry with frustration. Or hit things. Getting to where I want to be, proving to myself that I can do this, that I can make it, has never ever felt easy or effortless. Rewarding? Yes. Fulfilling? Yes. Easy? Hell no. I wonder, at what point in medicine does it stop feeling like work? Is there a magic moment where I become so good that I just whistle through the days and weeks, never banging my head against anything? For some reason, I doubt it very much. This is life, not a Disney Movie (thanks Cal), and everything that I have in front of me right now is only here because I was willing to sit in a chair for hours on end, doing something hard. Doing something that, at that moment, felt very much like “work” and not a lot like “love.”

But on another level, how great is that? How great is it that I get to sit down in a chair for hours with the only task in front of me being to learn about the body and how it works. To learn how to be useful, how to help people, how to feed myself and my family one day with a career I worked for. How many people on this Earth get a job like that? It feels hard. It feels like a slog. But what it really is is the opportunity to do something fantastic, epic, incredible. It’s not as slick or sexy as “following your passion” or “doing what you love.” If my life were a movie, this part would be condensed into a snappy, time-lapsed montage because the audience would get up and leave otherwise. And that’s exactly what I cannot do. I cannot get up from this desk. I cannot leave. I have under a month to get all of this information under my belt, throw down during exams, and leap forward into travel, matrimony, moving and the Clerkship Years. Yes, it most certainly, definitely, positively feels like work.

Getting Rid of Facebook

"facebook" by Dimitris Kalogeropoylos on Flickr

“facebook” by Dimitris Kalogeropoylos on Flickr

Happy Easter everyone! I’m not religious, but my family is, and for this year’s lent (which I love to participate in) I decided to give up something that many teens and 20-somethings wouldn’t dream of letting go of…

Facebook.

Well actually, it was the holy trinity of Facebook, Netflix, and Reddit, but today I’m here to talk about saying goodbye to the blue banner.

Before lent, Facebook had become for me, like I think it has for so many people, the pause between my thoughts. I’d be doing something, and suddenly wonder if there was something new on my feed, or perhaps a juicy notification or private message. The human brain craves novelty… it’s nagging, almost painful, to know that something bright and exciting might be waiting for you a click away. So I’d check. It wouldn’t take long, a couple seconds or minutes max. A reply here, a “like” there. Then I’d refocus on the original task with the Facebook itch having been scratched.

It’s ingenious, when you think about it. Many of us use computers every day to work, and Facebook, social media in general, is positioned perfectly to tempt us away from whatever we’re doing and bombard our senses with the new, the colourful, and the salacious. Angry anti-vaccine posts and their counter arguments. Adorable baby photos. Little hellos from family and friends. Overly revealing profile pictures. Humble-brags. So funny/terrible/thought-provoking it’s hard not to look.

But it gave me a feeling that I didn’t like. A feeling like maybe at the centre of this there is rot. I missed the space between my thoughts, and being comfortable with that space. I generally rebel against the feeling of addiction, craving, or need (being a bit of a type A), and so I resented that a website could convince me to turn from studying for my dream job, even for an instant, just to check what is usually a giant, never-ending stream of people staging their lives the way home-sellers stage their houses. I wanted to kill that mental congestion, so I pulled the plug on Facebook.

What happened?

  1. My house got cleaner. The sudden mental silence made me go “Jeez, that counter hasn’t been wiped down in ages…” I had the mental room to recall all the little organisms that would be breeding there. Gross.
  2. Handsome and I started talking more. Not that that’s ever been a trouble, but as he’s one of my favourite people, it’s a great perk.
  3. I started to listening to Podcasts when I wanted entertainment, and as a result, actually learned things about psychology, minimalism, pseudoscience, and more (I highly recommend Freakonomics, Oh No Ross and Carrie and Simple Life Together for podcasts about each of those things, respectively).
  4. I went back to the gym (LOVE the app Zombies Run on the elliptical. It’s very entertaining and motivating, without being *too* scary.)
  5. Friends who couldn’t reach me with a click anymore texted me. They called me. They came over and played board games. I got invited to events by only those people who thought highly enough of me to go out of their way to call.
  6. Our fat cat got more playtime with us, and more (struggle) cuddles. Cat owners, best toys out there are Da Bird and Cat Dancer. Just saying.
  7. I visited my friends with babies, rather than creeping their photos.
  8. I got more mental room to breathe.

That last one is a doozy. Seriously. And I know because today, Easter, for the first time in 40 days, I logged back on to Facebook.

I did not like it. I felt, of all things, immediately guilty. A friend of mine had been thinking of visiting in March, and I missed her message, so the visit didn’t happen. Wah! But then I thought to myself… why doesn’t she have my number? We have mutual friends, could she have gotten ahold of me? Does this mean I will never see her again (probably not)? I had another friend write on my wall that she missed my posts… who knew there had been this sort of quasi pressure for me to put out good stuff? Then there were the soap-box-stander-onners with posts that were angry, incredulous, exasperated (I remembered that I had been one of them, and felt guilty again…). There were pictures of celebrities bawling dramatically with big block letter captions below. There were class debates and politics on the med group. There were posts telling me to repost if I loved my dog/mom/partner/children… they reminded me of prions, which are inanimate proteins that, because of how their constructed, change other proteins around them into proteins just like them (it’s what causes mad cow disease, and CJD).

It was like an adrenaline rush of meaningless emotions, and after over a month without it, returning to it felt like bingeing on cheetos and coke. I think I’ve come to cherish the focus that going without this colossal distraction has brought. Suddenly, the world right in front of me, the cat hair on the couch, the phone call home, the laundry, the muscles and nerves of the eye, all became more pressing concerns, and by addressing them, my environment improved. I think I improved. the only thing I found myself truly missing was the ability to visually connect to family and close friends who live overseas. Facebook was an easy way to do that, and that part I truly want to keep. But the strange social contract that says “we knew each other in real life, now we have to be Facebook friends or it’s rude”… I’ll pass. For now there are enough pressing needs and conversations to be had right here. No need to go looking for more, simply because they are new or for fear of offending acquaintances, former coworkers, and people I haven’t seen since high school.

So what now? I think going forward I will be on Facebook periodically, and use it for the problems in life that it actually solves. I think I see myself revamping Facebook in a huge way in the future, cutting down the friend list and unfollowing people ruthlessly. For now though, I think I’ll just stay away. Garbage in, garbage out.

The End of Second Year Medical School

 

https://flic.kr/p/sqvgr

Photo by cori kindred on Flickr (https://flic.kr/p/sqvgr)

The human mind is a strange thing. It allows us to re-experience the past, experience the present, and invent the future. It’s this 3D, interactive world in our heads that we control (most us, anyway). And with it, and this blog, I can see where I’ve been, and possibly where I’m going.

I remember being terrified to take a blood pressure my first day in clinic. I fumbled with the arm band, afraid to somehow hurt the patient by putting it on too tight, unsure if I had it up high enough on the little old lady’s arm, and then afraid (again) that I might hurt her by inflating it. It took me 2 or maybe 3 tries to get it right. Looking back, my tutor must have had to bite her tongue. She didn’t look impatient with me, she didn’t treat me like an idiot. She just waited, and helped where she could. The world “doctor” comes from the Latin word for “teacher”, and in middle English it means “learned person.” And so it seems that every doctor I’ve had the privilege of working with so far is first a teacher, remembering all the while that they themselves had to learn to get there.

Now I stress about taking a blood pressure about as much as I stress about what kind of toothpaste to buy. The strange sensation comes from the fact that as I was taking that first blood pressure, I thought to myself “one day this will be easy. One day I won’t think twice about this.” And here I am, in that place, thinking back to thinking that thought. Weird.

Now, nearing the end of my second year of medical education, here’s what I stress about:

  • Balancing all the things I feel I need to ask when taking a patient’s history (“and how is your sexual function today, Mr. Smith?” “Ms. Jones, could you characterize your bowel movements for me?”) with the limited time I realistically have for an interview.
  • Remembering all the symptoms I need to ask about on a “Review of Systems,” which is essentially a quick verbal screening questionnaire for every organ system. Here’s a link to a generic ROS checklist I found via google, to give you an idea.
  • Whether or not the Welch Allyn Pocket Junior diagnostic set (which I acquired for about $250) will work when I get into the hospitals this August, or if I’ll get laughed out of town for A. having bought a set in the first place (some people say you don’t need them, others say they’re a must have) or B. not getting the Welch Allyn Pan Optic Opthalmoscope… which apparently let’s you see the back of the eye a lot better, but costs a whopping $680 and is about as handy as having a beer fridge in your pocket (nice to have, but somewhat unwieldy).
  • The move… yes, we are moving AGAIN for my medical career. Admittedly, it is by choice. Handsome and I got together and settled on the fact that our main priority right now is getting me the best education possible so that we have the most options available to us when it really counts… i.e. down the road when we have a kidlet or two. So with that, I’m offloading books I haven’t had the chance to read, clothes that I haven’t worn in years, and all other excess baggage to prepare for our new home. Where is our new home? Well, I’m toying with the idea of revealing a little more about where in Canada I’m doing my medical training on this blog, but for now let’s say this: it’s a small city, mostly blue-collar from what I’ve been told, and reminds me quite a bit of home. When Handsome and I went apartment hunting there, it seemed like everyone had a smile on their face. People wiped the grease or saw dust or plain old dirt off onto their ripped blue jeans before shaking your hand, and then clapping you on the back like you were a long-lost relative. We went to check out the back unit of a duplex and as we walk into the back yard, several neighbours kept a wary eye on us… which I adored, because it means they keep an eye out for each other, and for trouble. It actually made me a little homesick, and made me miss my Dad (with his perpetually grease stained hands and great big toothy smile :D), and my neighbourhood back home. I digress…
  • Finals. That has not changed. This semester (my last semester of undergrad-like school, I realize), we have dermatology, neurology, reproduction and paediatrics to study for along side our other courses. Neurology is easily the biggest and the scariest boss to overcome, but it was also fascinating, which helps with the studying. This time of year is never easy. Handsome takes on the lion’s share of the household duties (cooking, cleaning, laundry) and I cloister myself in my study cubby (a converted walk-in closet… have I mentioned that here before?) for weeks on end. He is a gem, but since he works full time, he is also overworked. So, it becomes a fairly stressful month or so, after which there is much celebrating and I take over a good amount of the household chores.

So that’s the concern right now, at the end of second year. It will be neat to see how this all changes as I take on the actual hospital wards this August… real people who are really sick, with real symptoms. Wow. Makes blood pressure look like a breeze…

 

Love, marriage, and debt-free by 30?

So, Handsome and I are getting married!

Yep, that’s correct. You read it right. After 2.5 years of being together, 2 of those living together, Handsome has popped the question and I, being no fool, gave him a resounding YES! We hugged and kissed and celebrated with our families and friends and after much fanfare, a new awareness soon dawned on me. 

Not that I was going to become wife or his wife. Those are the best and least stressful parts. No, the realization was that now we had to plan a wedding. 

Hmmm… how to do this? See, I was never the girl who dreamed of her wedding day as a child. Nope. I dreamed of being married to someone awesome, having children, and later, of maybe becoming a doctor and having an incredible career. I didn’t dream of all the choices that go into have a wedding day. Silk, taffeta, lace, satin? Cake flavours, colours, tiers? Peonies, begonias, azaleas, daffodils? Big wedding? Small wedding? Elopement? Don’t get me wrong, I’m excited to get to create this day, but between dress shopping (ugh), finding an officiant, nabbing a venue, deciding on decor and colours, catering, photography, bridal parties choices, I’m feeling a little overwhelmed. Overwhelmed in a good way, I guess. So far it’s been fun creating lists and tackling them item by item. But for every item we tick off, there’s a sound-cue in the back of our minds, and it sounds like this:

Cha-ching!

Money. Moolah. Dollars and cents. We’re a young couple, and we haven’t been to many weddings nor have we hosted a couple of our own. How much do you spend on a wedding? How much can we spend? How do we negotiate this major rite of passage, financially? We both come from families where money was tight and budgeting was key, so here’s an really rough, incredibly informal crack at it. 

The situation is as such: I have 5 figures of student loan debt pre-med school. Not a high 5 figures, but not low either. Let’s put it in the neighbourhood of 20-30k. Call it 30k to be generous. Handsome has a 4 figure student loan debt (let’s say 5k, and yes, I’m fudging for privacy’s sake) and a line of credit that he has about 3k on it. That puts the pre-med combined debt load at 38k, give or take. So far, we’ve managed to move, furnish our house, buy a car and live off just about 40k of my med student line of credit. We have no credit card debt. So over all, we are looking at a combined debt of close to 80k. Assuming we spend another 40k each year from now until my residency, we will be 200k in debt by the time I have my MD. I doubt we’ll buy another car or refurnish our house in that time, but 4th year is supposed to be very expensive indeed so I’m fudging upwards, hopefully. 

Now let’s chuck a $30,000 wedding+honeymoon on top of that. 

So, 230k of debt in 3 years… but not really. Handsome will hopefully have been working starting this September, so let’s call it 3 years of him working for about 20/hr, 30hr/week. That’s a total of 90k by the time I’m a doc. It’s a crappy job market though. Let’s call it 80k over the three years. 15% is eaten by taxes. Now we’re down to about 70k that he’s earned for us in 3 years.

So, we’re actually in 160k of debt by the time I’ve got an MD. Residency will be about 45k a year, and 25% of that will go to taxes, so I’ll take home 33k a year for 2 years. If handsome’s income goes solely towards our cost of living, and my income solely pays down debt, then by the time I’m out of a two year residency, our debt will be down to 94k. 

Now let’s assume I become a GP, and gross about 150k per year. 28% of this will go to taxes, leaving me with a take home of 108k/year. Maybe our lifestyle has inflated, maybe there’s a baby, we’ll call it 100k take home per year. If Handsome and I continue to live a relatively modest lifestyle, and he continues to have reliable part time work, we will be out of debt, all of our debt, the first year that I am a practicing doctor. 

Holy crap, did I read that right? Our household will be debt free by the time I’m about 30. My promise to myself, entering University, was that whatever I went into would allow me to get out of debt completely 5 years after I finished school and was out in the workforce. This puts me way, WAY ahead of schedule. I know I’ve left out the interest rate on the med line of credit, but it is very low, and even if it added 2 years to our plan… Debt free in 3 years after graduating. Whoa. 

 

WITH A THIRTY THOUSAND DOLLAR WEDDING! 
Mom, we’re going dress shopping. Holy smokes. 

 

Year 1 is over!

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photo by Danny Montemayor on Flickr

Hello everyone!

So there you have it, in a blink, year 1 is over and summer is here. The exam process was a long, LONG 8 weeks of hard studying. Here was a typical day for me:

– Wake up at 5:45 am
– Make a beverage (tea or coffee)
– Head to my makeshift office (it’s a closet, really) to study for an hour
– Close the books, brush hair and teeth and put on clean(-ish) clothing.
– School until 4:00
– Come home, watch 1 episode of tv or read blogs (about 30 minutes)
– back into closet/office to study
– Handsome reminds me I need food. I remember that I forgot to eat all day.
– Scarf the wonderful dinner Handsome has lovingly made, then study again.
– Pass out.
– Rinse and a-repeat.

Glamorous, isn’t it? Note how without Handsome’s influence I would have subsisted on coffee and grit. He is amazing. He literally shouldered 90+% of the household workload while I was studying (I took care of the catbox most times and still paid the bills online). How do people do this without a partner? If you are out there doing it all by yourself (raising kids, busting your butt trying to make a career, whatever) I have infinite respect for you.

It is important to note that I was also a train wreck of emotion at various intervals throughout this process. The constant wondering if I can do this, comparing myself to classmates with PhD’s or else are wunderkind 20 year olds with publications in their name… Suffice it to say that there were many times I just laid down and cried from the stress. That’s even before we factor in the tests themselves.

When they say that learning in medical school is like trying to drink out of a firehose, guess what? They. Aren’t. Kidding. Holy moly, they aren’t kidding. If you were to stack all of the notes we were responsible for throughout in the year vertically, without their binders, the stack would be about 2 feet high. Two feet high in regular 8.5×11 inch sheets. There are so many details, so many different lecturers with different learning styles and expectations that it can be hard to know what depth, exactly, you are responsible for in terms of learning all of this info. So you fret (or cry, or both) because do you learn ALL the transporters in the kidney’s nephrons, or just the big ones? Do you learn ALL the formulae for the respiratory section? Do you memorize EVERY empiric treatment for exacerbated bronchitis? How do you know which to do? What is everyone else doing? How do THEY know what to do? For an over-analyzer like me, it was a recipe for anxiety, and a pretty far cry from the Zen student I wanted to be at the outset.

That said, I created a plan, and I stuck to it. I started earlier than a lot of my peers. I worked very, very hard. And….

I passed! I passed every single stinking exam and I’d tell you specifics, but I don’t know them. They don’t tell us. All we get to know is whether we passed or failed, and I passed. I almost can’t believe it. Just like that, exam season was done and summer came.

So now it’s rediscovering exercise and healthy eating. I gained a not-too-pretty 15 pounds over the school year (or was that just the exam period?) so I’m paying more attention to what goes in my mouth. I’m trying to balance my summer job doing some curriculum development with some shadowing starting next month and planning for some other exciting happens (more on that in another post). I’m in essence trying to refind a sense of balance and normalcy, and trying to take good care of Handsome, since he took such good care of me.

Eight weeks of monastic studying, over 600 (yes, 600) flashcards created, countless meals made and cleaned up for me, and now its summertime.🙂

Keep Working

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Photo by alirjd on Flickr

It’s a beautiful day and I’m gonna be stuck inside, making flashcard packets to cover weekly objectives, trying to cram every detail into manageable, portable study packets. 

It goes like this: read the objective, hunt down the answers in my notes, balk at how many pages of info it takes just to cover one (of 30 or so) objectives, begin to piece it out and write it on note cards. Repeat. Repeat again. Repeat until you have burned through two standard packages of flash cards. Die a little inside when you realize you’re not yet done the first week, and there are 5 weeks in this block, and 5 in the next, and 4 blocks total. Gaze longingly at the sun and remember how you used to work your butt off waiting tables and now you’re in medschool. 

Keep working.