Head and Neck

I got an email with the topic for my very first treatment planning exam.

Aside… A treatment planning exam is an oral exam where we get grilled on our management of patients from presentation to treatment and follow-up to help us practice for our licensing exams at the end of residency.  It can include basic questions right up to referencing why we do treatment in a certain schedule and where a target its. They start in third year, which is where I am now.  They are supposed to start off easier and get harder as time goes by.  At least in theory.

The site is “Head and Neck.”

Agh!

My issue with this?

Head and neck is probably one of the most difficult sites to treat and master.

I mean, we don’t do much head and neck related stuff in med school or even the first two years of residency and then, bam!  I’m treating cancers there.

At least, I have for the last two and a half weeks of this rotation.

I like head and neck.  I have said it is likely a site I’ll want to treat.  That doesn’t mean I feel anywhere near confident in it.

And it is my first exam.

When I opened the email, I just cracked up laughing.

Apparently most people get something like bone metastases from another primary.  Nope, not me.

Maybe it will be more simple than it sounds.

But, I don’t feel optimistic.

It is going to force me to read more.  But, I really was hoping for a relaxing weekend home.

That is how life works.  And how residency works.

Learning is good.  Looking stupid is part of learning.  I just need to embrace that.

Thank goodness Dr. Bond gave me some notes and tips.

I just hope my examiners remember I’m just in third year.

Ten Authors I’ve Only Read One Book From And Need To Read More

It is Top Ten Tuesday day! This week’s list is ten authors I’ve only read one book from and need to read more.5f1e1-toptentuesday

  1. Stephen King. I read 11/22/63 and loved it. Sometimes, the plots of the books Patrick reads by him sound great, but I get nervous when they are super suspenseful. Nonetheless I want to check out more.
  2. Gillian Flynn. I loved Gone Girl just like everyone else I seem to talk to. Even though mysteries and crime and suspense make me nervous, I still wat to check out other stuff she has written.
  3. Stephanie Perkins. I read Anna and the French Kiss and although it was nauseatingly annoying teenager, I did enjoy it. It made for a great easy read, so I only expect her other books to be similar.
  4. Rainbow Powell. Eleanor & Park was one of the best books I read this summer. She does a great job of getting in the heads of those characters and creating real situations.
  5. Markus Zusak. The Book Thief was an epic novel. It alone makes me want to read his other books, but I have also heard good things about them too.
  6. Pierce Brown. Red Rising was another one of those first books in a series that left me wishing and hoping for the next book to come out sooner.
  7. Iain Reid. The Truth About Luck was a journey. I kind of hope his other books are similar.
  8. Graeme Simsion. Apparently, The Rosie Project is going to have a sequel. I have mixed feeling about sequels, but I still liked the first book so much, I wanted to check it out.
  9. Timothy Keller. Everyone tells me his writing and preaching is awesome. I read The Meaning of Marriage and I must admit I loved how it was written and conveyed.
  10. Emma Donoghue. Room was great. I heard her other book (books?) is/are different, but that just makes me more intrigued in a way.

What authors have you read just one book from and want to read more?

How Did That Happen?: How Did My Job Eat My Life? And How Do I Make It Stop?

It has been almost a week since I last posted.  And what a week it has been…

For this week’s How Did That Happen?  I present How Did My Job Eat My Life?  And How Do I Make It Stop?stethoscopes1

Being in medicine is a time commitment.  I have heard people say it is a lifestyle or a sacrifice.  The guy from the bank who was trying to sell me a credit card called it those things and more.

Those were the last words I wanted to hear.

Usually I feel like my work-life balance is pretty good.  At least half decent.  But, the past few weeks before and after this conference, I am questioning that.  And this week, I had significantly more work than life.

So, how did my job eat my life?

Step one… Work with staff who seem like to take extra consults, at least at this time, and acquire sick inpatients.

Step two…  If something could go wrong with a patient, my computer, my schedule… It will.  And probably more than once.

Step three… The internet never has the information I am seeking readily available.  Clearly, I can’t find a good how to delineate a mediastinum on the internet.  Or good information on BRCA2 in men and cancer screening outcomes.   Lots of random stuff, but not what I want to see.

Step four…  Try to get things done in a reasonable order.  Suddenly everything less important will become a priority.  And get rescheduled.

Step five… Someone will send you an assignment for half day the night before.

Step six… The number of inpatients will increase nearly exponentially over the course of the week before you are on call.

Step seven…. Lose all sense of organization on your desk so that it is covered with papers that need to be filed, organized or shredded.  Get distressed by this whenever you sit at your desk then waste time trying to figure out if you have time to deal with it.

Step eight… Realize that your job has eaten your life and that you haven’t been home before 7 all week.  Then realize you are on call for the weekend.  And then worry about one of your inpatients such that you are up half the night even though you weren’t on call that night.

So yes, life eating has prevailed.

My plan to beat this is captured in this picture….

IMG_0429.JPGI’m on call… I can’t undo that.

But, I will win otherwise.

I will eat my delicious burrito and read a fun book tonight… Even if I take pages in between.

I will not work on research or study tomorrow or Sunday because it is already very apparent I’ll be at work a good chunk of the day rounding and admitting and all that stuff one has to do.

I will spend time with our friends visiting from home in between all of the work stuff.

I will say no to the second research project I already said I would work on because it isn’t something I am super excited about and I have other things that might come up.  I will not die because I said no to something.   I don’t have to say yes to everything.  And I was kindly reminded this week that not everything that is work or residency related is necessary because it may not meet my end career goals.

I figured out this week that if I go to the gym by 6:20, I can get a workout in and still be at work for 8.  That means I’m only dragging myself out of  bed an hour earlier than normal.  It still stinks.  But, even if I do it once or twice a week that will increase my gym time, which is great for my energy and health and all that stuff.  That also takes back some of my evening for studying or Patrick or other stuff.

I joined a band.  Small groups are starting up again soon.

I finally got a day planner and it is awesome.  Especially for planning ahead for presentations and classes (when they don’t get rescheduled a million times).

Work will stop eating my life.  At least for the most part.  I just need to be proactive about it.  And remember that some weeks work is hungrier than others.  I just need to make life fight back.

 

 

BAND!

I joined a band.

Not a cool, I’m a hipster singing with my banjo band.  Or a rock band.  Let’s face it… I love music, but I’m not that kind of awesome.

I joined a concert band.

Yup.  Bring back the band geek.

As I have said before on here, I am super in to music and play a few instruments.  In fact, I even went to band camp.

Unfortunately, med school ate my life.  As a result, I haven’t played in a formal band in about 6 years.  I also realized I haven’t played my saxophone (my first love) in at least 4.  Seriously.

I haven’t been happy with this trend.  I vowed I would pick it back up in med 4, but the travel got the best of me.  I said I would join something after my first year of residency, but given the fact that my program likes to basically force us to do not one, but two years of internship of sorts, that was near impossible.  My time is consumed by all kinds of things.  I might love music, but often I was too tired to go through the effort of getting stuff together to play.  Patrick was starting to get tired of me always saying I wanted to play but never playing.

But, now I am in the coveted R3 year.  That means I am on-service.  Which means I am insanely busy, but it also means my life is slightly more predictable.

So, I started looking into bands.  For living in a bigger city, this was no easy task.  Especially because the only band in town meets on a night I am often on call and isn’t looking for my instrument and wants people to be at almost every practice and concert (I agree this is a fair expectation, but anybody who knows anyone in residency knows that this is almost impossible).  So, then I looked in the surrounding areas.  I must say, some people really need to hit the internet era.  There were at least 2 groups with non existent or out of date web pages with no clear contact info.  Apparently word of mouth works for them.

I ended up finding out that a town about 25 minutes from my house has both a formal concert band made up of people from the city and surrounding areas.  They also have a “feeder” band called the 9am band.  This group is for anyone who has a year of band experience who wants to play music/become better musicians.  Anyone.  No specific instruments.  No big contracts.  No tryouts.

As someone who was studying high level band stuff, this is everything I never had.  And everything I want right now.

Confession… I cracked out my sax, Fuzzy, out for the first time last night.  Much to the horror of Jeter.  It is like riding a bike.  I’m a bit unsteady, but it all comes back so fast.  Music is like a language to me.

So, Fuzzy and I went to my first rehearsal this morning.

Yes, Saturday morning.  At 9 am.  And it is a half hour drive… Took me 40 minutes today because I got lost a million times.  The timing sucks, but Saturdays also means that I am only working that day one weekend a month and I still have the evenings to do homework or spend time with people and such.

The band was welcoming.  People were friendly.  It was a diverse group.  Mostly tweens and teens.  And probably their musical parents.  But also some older folks too.

The saxophone section consisted of a female tenor sax player and 6 altos including me.  I was the only girl.  There was a middle aged man.  3 boys that couldn’t be older than 14 and another boy just starting high school.  There were some wrong notes happening, but the good part is they are all playing and were happy to be there.

The music is mostly simple.  The songs range from really easy to some fun concert arrangements that would be on the easier side at the band I played with back home.  Apparently the concert band is really good and their easiest stuff is often closer to the hard stuff this one plays.  In a way, I want that.  In another way, I’m glad to start out slow.

I went in to this expecting it to take some time to get back in the groove.  I picked this as the group to try because it worked time wise and I had less guilt about commitment in a group with fewer concert commitments and less stringent requirements.

I loved it.  Sure, at times it felt like school again.  But it was so great to actually be playing in a group.

I had to laugh because I went in with no expectations except to play.  The kid next to me informed me he was a 1st sax.  This was funny to me because being 1st was such a big deal to me around that age.  It is an accomplishment.  It means you are often one of the better players of the section.  For me, it was a pride thing.  Today, I could care less.  Which is good because he informed me that I would probably end up being a 2nd because I’m new.  I’m just happy to play. Whatever.  But, I had to share music with him today, which did not thrill him.  And I confess, I did harbour some pride when we played a more complicated piece and I didn’t miss as many notes as he did (yes, I am a terrible person).

I think the Saturday mornings will be rough sometimes.  I think this is a very different group than some of the ones I have played with.  But, I think this is the right place for me.  Where I can shake the rust off and just simply enjoy the music again without the pressures that sometimes come with it in more “professional” groups.

I love enjoying the music again.  Sitting with my sax in the middle of a band feels like home (even in a room full of strangers).

Top Ten (Twelve) Characters Who Would Have Sat At My Table In High School

I’m a day late but this week’s Top Ten Tuesday with the Broke and Bookish was too awesome to pass up. The list is the top ten characters who would have sat at my table in high school.5f1e1-toptentuesday

My table in real high school was a bit of a mixed bag. There were other nerds like me, and then the odd people we acquired and the people we were friends with as a result of various activities (mainly band and musical and yearbook. Half the time I was busy with some lunch time activity like choir or band or various yearbook meetings. But, when I was at the table, it was an interesting time. We often filled more than one table (shockingly) and did “crazy things” like build condiment castles one day and then spend the next cramming for that IB bio test we were all going to fail.

So, I expect my bookish high school table to be similar…

  • Hazel, Gus and Isaac from The Fault in Our Stars by John Green. I’m serious. Hazel is basically teenage me in a lot of ways, so I’m sure we would have gotten along. And the guys are very much like some of my friends in high school complete with the randomness and interesting characteristics that make them unique.
  • Quentin, Ben and “Radar” from Paper Towns by John Green. Maybe I like his books because he basically writes about characters I get or would have known. Either way, these guys all meet my table criteria. Quirky and nerdy for the win!
  • Eleanor from Eleanor & Park by Rainbow Powell. Misfits and outsiders were welcome. In fact Eleanor reminded me a lot of a couple people we hung out with in junior high and high school. Plus, I would have enjoyed their awesome taste in music.
  • Clay from Thirteen Reasons Why by Jay Asher. Because the token nice, smart shy guy has to eat somewhere.
  • The 4 girls from The Sisterhood of the Travelling Pants by Ann Brashares. Yes, all 4 of them. Because they are basically my 3 closest friends and I anyway, so why not include them all at the table?

Well, that is 12 people, so I guess the table is too full.  I think it is just a bit cozy.

What characters would have been at your lunch table?

Nehemiah is not Nineveh

I was reading Nehemiah in my nightly Bible reading last week.

I kept getting excited when I opened up my app (because I am that kid who needs an app to follow any kind of Bible reading plan) because I kept thinking Nehemiah was Nineveh.  Which is not a book of the Bible, but a place… The place where Jonah had to go and didn’t want to go and got scooped up by a whale.

I love the book of Jonah.  I get Jonah.  I’m a big chicken sometimes.  And I freak out to the point where God just sticks me in a situation where I have to suck it up and face the music.  Not quite eaten by a giant fish music, but you get the picture.

I love the lessons of grace seen in Jonah’s misadventures.

But, Nehemiah isn’t Nineveh, which isn’t Jonah.  

But, every night for about 3 nights, I got crushed when I realized that all over again.

It also made me remember this song that we once were forced to sing one Sunday night because the pastor was preaching about Jonah and other Father thought it was a great idea.  I thought it was a funny idea.  Everyone else on the worship team was kind of irritated to sing a children’s song, but I never heard it before, so I didn’t make the connection.  I have been singing it to myself for days.  Problem is that apparently the internet cannot read my mind and find the song I am searching for based on the few words and tune I remember in my head.  I’ll get over that, though.

Plus, I found this gem (although it does get annoying and doesn’t have a lot of point to it)… 

 

Some Photo Favourites (from our island adventure)

Last week, we had a chance to go back to some of our favourite places in a city where we once lived.  

Thus brings me to a very photo-full post.

My highlight was going back to one of my favourite views in town.  I love getting to have a little “hike” in the middle (sort of) of town.  The history at that place is pretty neat too.  

We also went back to the most easterly point in Canada.  Because that is what one has to do when you are in that part of the world.  Even if it is so foggy you can barely see the water.  And you are one of 4 cars there because the only people there are either making out or have limited “tourist” time like us.

Oh yes, and we went to our favourite used bookstore where we spent just under an hour digging through the shelves for a couple new books.IMG_0387

Good trip.

The saddest airport

Today marks our last day visiting the city where I did med school and where we spent our first 3 years of marriage.  

It was a great trip.

I’m sad it is over.

I’m sure I will share more of the awesome stuff I learned and the places we visited.

But for now, I must share that the airport here is one of the most depressing airports I have ever been in.  It isn’t the ugliest, or the sketchiest, or the smallest or biggest or any of those.  I have been stuck here a few times but not as many as in other places.  But, to me it is always sad.  

Maybe it is because I arrived here too many times with nobody there to greet me (actually I did have friends pick me up sometimes, but often it seemed we were on our own).  Maybe it is because I was always dropping off people to leave .  Or sometimes I was leaving people.  

The airport is on two levels.  Arriving, you can see people awaiting those who they love.  It is great when you see your person from either end.  It stinks when you are on your own.

But worse is when you are leaving or having someone leave.  There is an escalator to the secure area.  So, it is like they leave slower.

I’m sad to leave today.  We had fun with great friends.  I nerded it out at a good conference.  But, now it is time to get back to real life.  And likely not see our lovely friends for at least a year or so.

This airport makes me sad.  Okay, it is probably the circumstance.  But, I blame the airport.

How Did That Happen: How I Got Through Med School Orientation

I realized today that it is about time for med school to be starting up again.  It blows my mind that about a 6 years ago, I hopped on a plane with 4 giant suitcases and my drugged mother (she was hopped up on cough syrup) to move to the town where I did med school.  Interestingly, I am leaving today for that same city to visit some friends and attend a conference.

I had been there twice before.  Once for my interview and once on a whirlwind room renting hunt.

To be honest, I was less scared of moving or even starting med school.  The thing that produced the most anxiety in me was orientation.

Yes, you got that right… Orientation.

I mean, yes, of course med school was terrifying and being told some of us WILL fail in orientation did not help.  Each first had its own level of terrifying… First lab, first exam, first standardized patient.  But orientation still wins in my books.

Thus for all of you shy, introverted (I say both because they are different) new to everything about a place people, here is my How Did That Happen? for the week.  How I Got Through Med School Orientation.stethoscopes1

I know some people love that kind of stuff.  Socials, dances, sporting events.  Not so much my scene.  I get that some people consider these sorts of events a highlight.  Or at least they don’t dread them. I dread them.  That’s just how I roll.

My med school took the whole orientation thing seriously.  I’m talking a full week of stuff.  And it was “mandatory.”

Seriously, mandatory “fun”?  Sounds like cadet camp all over again (seriously, they had these evenings where we were obligated to attend a “fun” activity like sports (ew) or the zoo (okay the first time, but it was a pretty lame zoo) or a movie (probably a bad one).  We called it mandatory fun night.  It was funny because it was by far not the most fun night of the week (dances or concert nights or parade nights won every time).

Events for this mandatory fun included whale watching (the best part by far).  An 80s mixer (ummm… I like the 80s, but when you stick them in a mixer, not so much).  Outdoor games complete with a slip n slide.  A pub crawl.  Various talks.  Photo scavenger hunt (epic, but not as fun when you don’t know where you are or who you’re with).  Dinner with some Med2s followed by a dance.

I was not pumped.  Except for the whale watching.

I knew one person I went to high school with.  Not well.

70% of people knew most everyone.  They all did undergrads together, they did their masters together, heck, they did all of their schooling together and they live down the road.

Just shoot me.

So, enough whining… I’m supposed to be talking about getting through it.

First of all, I tried to embrace the fact there were other people as lost as me.  I found them.  Found the first one lost in a hall as ridiculously early as I was.  I stuck with them.  She fell asleep on the bus on the way back from whale watching.  I fought the urge to run away.  As it turns out, we sat togther through most of our classes.   The randoms I stumbled upon ended up becomign some of my best friends through med  school.  So, find someone looking as lost and sad as you and say hi.

Realize that med school is like high school.  There are cool kids and cliques.  It did not take me long to conclude I was not cool, nor would I be part of the key cliques.  They were already formed before I even came in.  That’s okay.  I’ve never been one of the cool ones.

Show up for events.  Seriously.  They said it was mandatory, but not everyone came and this ticked some people off.  When you are as shy as I am this is nausea inducing, but it was also how I actually was forced to meet people.  Nothing says get to know people than getting thrown in a 2 door car with 4 other people you have never met to tear around the city taking pictures (especially when we ended up breaking into a more senior med student’s (who I also didn’t know)  house…).

Have fun.  I mean, if you have to be there and people worked hard to plan it, there probably is some fun in there.  Some of our stuff was really awesome.  Other stuff was awesome for people who weren’t me.   Just try to have fun.  Fake it until you make it.  I was pleasantly surprised.

Find out what is okay to skip and know that it is okay to take a breather.  Yes everyone will question your decision.  At least the people who noticed you exist.  But mental health for the win!

Participate.  If everyone is doing something to make themselves look stupid, you might as well do it too.  It might end up being fun, or at least make for a funny story.  My team in these messed up olympics they held won.  We got gift cards for coffee or booze.  It was thrilling.

There is free stuff at some of the events.  Free reflex hammers (which is like gold when you are just getting started and anything “medical” is the best thing ever), free bags, pens and best of all, free food!  Moving and doing a million more years of school is expensive.  Love the free stuff!

There really is useful information in there.  You won’t remember it all.  But they do tell you some important stuff.

If your school is anything like mine, the dean of something or other will get up and tell you scary stats about failures, people crying and people quitting.  This really does happen, but it will be okay.  It is an important reality check, but it does really sting.  Especially when odds are you were already nervous.

Tell yourself it will be fun and okay and all that good stuff.  It will be.  At least some of the time.

Remind yourself that despite the social anxiety and such, this really is one of the most relaxed times in med school.  Embrace that.  The real work is coming.

Remind yourself it is just a week (or less, if you’re lucky).

If you’re from away, it gives a chance to at least kind of figure out how to get to and from school, where some key stuff is and get settled before the real work starts (although the hours were so crazy, it was still tough to get any real unpacking done).

Things like orientations are just a bit awkward.  They end and eventually you know people well enough, you kind of wish you could have done that with the same people a year later.  Not all of that stuff, but some of it.

As much as I think I could have done without so much mandatory “fun,” I really do think orientations are important.  I still say they are overwhelming.  But once it was over with, I had other stuff to worry about, so no need to dwell.

What was your orientation like?  Do you love or hate them?  Do you have any tricks to get through orientations and mandatory “fun.”