My Study Buddy

I’m studying.  Again.

You see, I have another sporadically scheduled treatment planning exam this Tuesday.  I had one last Tuesday (which got cancelled… And has yet to be rescheduled… UGH).  It seems that I have a “get me to do something” sign taped to my face.  This week’s topic is Rectal Cancer.  Last week’s was Small Cell Lung Cancer.  We can’t get much further apart.

I spent my morning picking up a few things at the grocery store and cleaning (ah, I do love a clean house (just don’t look in the guest/to-be-baby room or our room)).  I have mac and cheese in the slow cooker and the oven preheating to make some veggie crisps (looked like a good idea on the internet).  Patrick is playing Wii with his little brother with Big Brothers Big Sisters (great organization, by the way).

I decided to hole up finally and get some studying done.

I can’t study on my own anymore.  I have these two study buddies.  One goes everywhere with me, thanks to a little thing I call the placenta.  The other is the feline that can only travel as far as the confines of the apartment (hypothetically).

Jeter has a strange obsession with sticking nearby.  Today, he passed out on my textbooks.  Including the one I wanted to read. 10325749_10153286555099316_5885870976480320603_n

Silly cat.

Plus, the placenta attached study buddy is having a small dance party in my uterus.

Clearly these folks are not the best study partners.  They did not get the memo.

So, I’m updating my phone and my laptop and writing a blog post.  With a textbook open in front of me.  If it is open, it at least half counts, right?

How a movie, physics and my day-to-day nerdy life combine

Patrick and I went on a date tonight to see the movie about Stephen Hawking, The Theory of Everything.  I have been wanting to see it since I saw the preview a couple months ago and finally we had some time (read: I have a treatment planning exam this week and am on call next weekend, so I wanted to be “normal” and also simultaneously procrastinate).

I was impressed.

Not only did I get to nerd out a little bit (although science and/or medicine weren’t the main focus of the movie), but it was at times funny, and heartwarming and sad, much like life is.  It was quite a journey.

Seriously though… I would watch it again.  Happily.

Then, we went home and spent an inordinate amount of time nerding out in a different way by looking into how true to life the movie really was, how the actor learned to portray gradual motor neuron decline so well and all that good stuff.  Apparently, it is pretty close to life, although there were, of course the odd composite characters and embellishments or sugar coating.  And the actor studied a ton with dancers and videos and such to get the movements (or absence thereof).

All in all, a good movie.

And now I want to read the book (written by his ex-wife, Jane).  In fact, I saw it while we were out and about today and I almost told Patrick I couldn’t see the movie before I read the book (since that is my general life rule), but I decided against that.  And I need to read his book too, because I like to be well-read and because I love science and physics (and I do firmly believe that much of it does point to God).

Also, it reminded me that physicists are some of my favourite kinds of people.  Seriously… I work with a ton of them… Not cosmologists or theoretical physicists, but medical physicists who are equally nerdy and insanely intelligent.

This in turn reminds me that before I read these books I should probably study my physics and radiobiology so that I pass them this year (although that is improbable because as a rule that doesn’t happen and we repeat them in 4th year).  And that in turn makes me continue to put that stuff off because it is way too early.  And as I said, I have a treatment planning exam this week that I need to study more for because it is on prostate and I haven’t worked with a doc who treats prostate in almost 2 months, so I am way rusty (and realistically never got the hang of it particularly well).  There is, of course some physics in there, so I guess it all relates back.  Kind of.

The Happy In My Halloween

Today was a happy in my Halloween.

I managed to arrange for transfer for one of my patients.  It is always good to get people back to home hospital, but it is especially good when it also makes my day start off well.

I presented Morbidity and Mortality rounds today and people actually kind of participated.

It is Friday half day, which means an afternoon of lectures, which is tough at the best of times, but especially on Fridays.  This week, I was supposed to have Radiobiology from 4-5, which is the most potent form of educational torture there is.  Unfortunately, our instructor went home sick with the flu.  Fortunately, that meant we didn’t have that lecture and although it has to be rescheduled, I was glad to not sit through it at 4 on Friday.

Also in Friday half day, the radiologist who taught us an awesome head and neck lecture brought us Halloween candy.  And not just any Halloween candy… The good stuff with peanuts in it that can kill people but tastes soooooo good.

I realized in said head and neck lecture that I am finally beginning to figure out head and neck and knew things in the lecture.  It was an exciting “ah ha” moment for me.  And thank goodness it is starting to come together because I have a treatment planning exam this week and it is yet again on head and neck (the universe or at least my staff seem to hate me on this front).

Patrick and his class went on a field trip today and had a good party afterwards (complete with cookies he made last night).  I was impressed at his craftiness and ability to get through Halloween with a classroom full of third graders.

We went to a Mexican restaurant tonight for supper where I got to feed my most recent craving… Spicy chilli.  I love a good burrito.

It is Jeter’s “birthday.”  The anniversary of when we inherited him two years ago.  He threw up on the carpet for us when we got home from work and is now happily carrying around his new “birthday” replacement feather on a stick.

We are settling in for a night of watching Charlie Brown and other relevant specials while waiting for the kids that never come to our apartment. It is to bed early tonight for band and a day full of studying, house cleaning and a potential games night!

Happy Halloween!

The last few weeks in a nutshell.

When it comes to regular blogging, I have been an epic fail lately. Sometimes life is just plain busy and my priorties have been such that sitting down to write has not been a priority.

So, for those of you who care… Some updates on my last couple weeks in a nutshell.

The treatment planning exam I wrote about went decently. It was challenging. I got through it and my score was not good, but was good for a first exam. Plus, that means I met the milestone of doing my first treatment planning exam.

The Child and I started going to Body Pump classes. Once a week. But every week. For those of you who are regular Pump attenders, this may not seem like much, but it is a huge stretch for us to commit to going every week and getting stronger (even if it would be better to go more than once a week, I’d rather set a realistic goal). As a result of attending these classes, we have turned into bigger gym rat-like people, not only discussing our run times at times, but now also plotting out how we could go up on our weights or do a certain move better.

I went wedding dress shopping in a real wedding dress store for the first time ever last week with my sister-in-law. True story. I am married, but I bought my dress online from Sears. I lived away, so I didn’t go dress shopping with any of the friends that I know who got married. It was an experience. I feel okay with never having to do it again.

I am very excited to go see Gone Girl later today. The book freaked the heck out of me (once I got past the first ¼).   I expect the movie could do the same.

Patrick and I went to a produce store yesterday that is known for its ridiculous deals. We have had friends from church recommending the place for ages, but had yet to go. We now understand the beauty that it truly is.

My program changed our academic half days to Friday afternoons. It is a form of torture to sit through 4 hours of lecture on a Friday afternoon. Especially when you have a busy review clinic all morning and no time to see your inpatients until after all the teaching. I discovered caffeine and cookies help, but don’t cure the Friday half-day blues.

I had a post-call day last week because I was stuck in hospital until 2am with a spinal cord compression who, after we treated, started having “new” chest pain (that in retrospect wasn’t new) and then was called several times overnight. I was so excited to have a post call day. And didn’t even feel that guilty for taking it because the night was that kind of ridiculous. Then I remembered, post call days suck when you were actually up most of the night because you need to sleep. Silly.

I love treating head and neck cancers. Even though they tend to get so sick from treatment. And even though some of the patients are tough drinkers/smokers who don’t want to do anything they should. I like a challenge. And I really want to help. And we can cure people with this type of cancer, which is always cool.

My computer at work was giving me the blue screen of death and shutting down intermittently. It got to the point that I couldn’t get any work done and had to use someone else’s computer. The helpdesk person had no real explaination as to why my computer blew up in my face like it did. He had to reload everything back on it from scratch (and I lost everything that was saved on the computer itself (not much)). In retrostpect, I like to rest my feet on the computer console thing under my desk and twice in the last few weeks I accidentally kicked it over. That might be related. Whoops.

I have been attempting to read The Maze Runner for two weeks. Much like my blogging, life has gotten in the way of my fun reading. Silly.

I have been obsessed with listening to Needtobreathe lately. Not sure why, but their mellow has been drawing me in. Like this song:

What is new with you? Anything exciting?

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.

June!

I found this gem on the walk to pick up some groceries on the way home from work.  I am totally impressed with whomever put a bird house in a park.  It is very June.

I found this gem on the walk to pick up some groceries on the way home from work. I am totally impressed with whomever put a bird house in a park. It is very June.

It is June!

I know, it was June yesterday. But, yesterday was church day (for which I was on set-up duty), in-laws visiting day and finish my freaking molecular genetics presentation day. It was not a blog posting day.

I feel like the end of April and all of May was that brand of chaos that comes from having too much stuff to do all piled on top of one another in sequence. After my presentation today (ps, the molecular genetics of brain tumours is super cool), June feels like a reprieve. Journal club is the only bigish work project this month. Sure, we are getting my support group project ready for publication (I got two emails about it in the time it took me to write this). Sure, I am starting a new project looking at radiation for lung cancers. But, there are no giant epic mountains of manuscripts, presentations and exams to worry about. That could change if I failed physics. Let’s not talk about that.

In other things June not to talk about, there are the June bugs.  I don’t like shelled insects.  Exoskeletons give me the heebie jeebies.

I quite like June. It is my birthday month, but I’m not too huge on birthdays, so that isn’t really a big deal. It is the month where the weather becomes nice enough to go outside and do stuff. It is the end of the school year for Patrick. And it is the end of the residency year for me.

It is tough to believe that I am one day away from starting my final rotation of PGY-2 (so long as I pass everything) and thus also finish what is our ridiculously long rotating internship of sorts. And then I will be on-service. Agh. I don’t even know what I will do with myself when that happens. Crazyness.

Tonight, we celebrate with the Child and D survival of the insanity that was May and 2 days of June. We will eat (and eat and eat) and play Munchkin (which is an awesome game… Check out the Tabletop video below (and know that Tabletop is also awesome)).

Then maybe we will enjoy the fact that our house is not full of extra people for a little bit. We will enjoy that I am not continuously operating on a new deadline (realistically, that never happens in residency, so I don’t know why I dream that big). I can get back to the gym, although maybe not running quite yet (heck, maybe that darn toe will stop hurting).  Maybe…

How Did That Happen?: How Did I Pass That Exam?

I have that sleepy and yet high energy feeling that comes from a post-exam hangover. Yes, ladies and gentlemen, I am done junior physics (minus the exam review) so long as I pass that exam.stethoscopes1

That brings me to this week’s “How Did That Happen?” post – how did I pass that exam?

Pick the answer you actually want to pick. My thing today (although passed exam is still kind of up in the air) was in one of the multiple choice questions I had to select an energy for an electron beam to cover a tumor but not kill the spinal cord. I misread the question initially and puzzled over it thinking photon beams (for everyone except the, like two people who understand this, photon and electron beams behave pretty differently). Then, when I was checking the exam over, I noticed my error and did the very simple math to pick an appropriate beam. I was debating two answers, then circled one as the person came to pick up the exams. I walked out and realized I had circled the wrong one. The definitely wrong one. Minus one point. The big question is did I pass that exam?

Don’t change answers. Someone told me this in undergrad and I struggled to believe it. Odds are, your first instinct was right and whatever you change it to is wrong, unless you are certain of your error. I had to do a mini analysis (because heaven forbid I believe things at face value, I say that makes me a true scientist), but it is true.

Get the right exam questions. When I wrote the MCAT, it was the first year it was offered on computers (that dates me) and there was some weird computer error where one of my verbal reasoning passages did not correspond to the questions at all. I just guessed all of my answers.

Efficiency or gas masks. I have a terrible taste (and smell) aversion to bananas. All through med school, the guy who was after me in alphabetical order liked to eat a banana part way through every exam. He ripped it out when he was about to check over his answers.   After having to sit through his banana stench once or twice, I developed a system. I would do the exam as fast as possible and bail before he ate the banana. It worked for almost every exam.

More efficiency.  There are time limits.  If you are like me and always finish exams early, stick with that because the one time you start to run behind, that will be the time that they will make you stop writing at the right time and act all unforgiving about it.  At least that is how my neuroanatomy exam went down.  Also, when you aren’t used to being there at the end, you do what I did today and pick the wrong answer because you get weirded out by the exam being over when you are just finishing checking it.

Choose your seats wisely. Because I am a creature of habit, I always sat by banana guy, even when I had options. I had a friend with OCD who had to sit in a seat based on some internal numbering system. I had another friend who couldn’t have anyone within eyeshot.  During part one of the LMCC, I sat between two friends, one of which had a bunch of candy we binge ate before the exam started.  Delightful.

Go in the room. During the LMCC, one of the doors to one of the rooms was sticky. I went to knock and go in the room and it wouldn’t open. I body slammed it and it still wouldn’t open. I started to panic. Then, I charged at the door and went bursting out the other side to almost land on the “patient.” Whoops.

Show up, preferably on time. I always want to punch the late person who makes things start late in the face. Or the person who fails to show up and makes things late. Don’t have me want to punch you.

Talk fast.  Many medicine exams are verbal and you need to cover a ton of information in not a lot of time.  In preparation for OSCEs, I had a few friends who I studied with by practicing old stations and suggested stations from textbooks. We timed ourselves and did every station at least twice as patient, examiner and student. As a result, we had memorized most possible stations and responses. I went into one room and hammered through a long exam, differential and a question in what was probably record time to have the examiner laugh at me because he hadn’t heard someone speak so quickly before. Its a gift.

Don’t whip the patient. Same OSCE. Just got done a psychiatry station which meant my stethoscope was in my pocket and not around my neck where the person could hypothetically strangle me (seriously, pro tip: you got points or lost points for this, can’t remember which). Next station was a cardiac exam. Whent to haul out stethoscope and it got caught in my pocket. Somehow then came sailing out to smuck the med 1 (because they make the best cheapest exam patients).

Tell them what they want to hear. Oral exams are probably one of the more daunting exams in med school. There is something bizarre about explaining your way through hypothetical cases. Someone once told me to include all details you think are relevant and do it in a systematic way as if there was a patient in your face. This becomes more challenging when you have the peds sick and can barely speak and then the fire alarm goes off.

Do what they say. If someone says wear a lab coat or bring a calculator, do it. I have heard of people who failed or lost significant marks for professionalism for not wearing a lab coat, not bringing a stethoscope or not having the stuff they need to actually do the exam.

Turn off your phone/pager. Seems simple. There is almost always one. Nothing sucks more than being that kid with the pager going off while everyone is writing the exam. And not thinking it is yours until someone pinpoints your bag. Then, having to creep forward to turn it off from the very back of the room while people stab you with their eyes.

Study the right material. Seems simple most of the time. I had an anatomy exam in the middle of our course in med 1 where the instructors failed to communicate and included a section we had barely covered and omitted another piece of anatomy we thought was on the exam. That makes for some mighty angry med students.

Put your name and student number on the exam. Why is this still an issue at this level of education? Looking back, I didn’t put my name on last year’s physics exam… Good thing there was only two of us.

If at all possible, read your examiner’s mind. The good old “guess what I’m thinking.” Agh. Sometimes, you can perceive the nods or redirects in an oral exam, but written or a stone faced examiner are more challenging. Psychic abilities are always helpful when trying to figure out what someone is actually wanting to know in that question or why the person administering your oral exam keeps cringing (is it just indigestion or is it my stupidity?).

What are some of your exam conundrums and how did you pass?

Physics Avoidance

I have been eaten by physics.

Okay, I really like physics, but I have this exam coming up on Thursday (unless someone decides to move it again).  And unlike last year, I have to pass it this time around.  Silly world expecting me to actually know stuff.

Needless to say, I goofed off all last week on vacation with my parents visiting and such (and before that it was manuscript writing), so this week is hammer time with the physics books, well, that and showing up to my Molecular Genetics classes and labs and watching playoff hockey (please don’t let tonight be the last game for the Habs, please!?!?).

And yet, I am here, writing a post.  It will be short and sweet and simply some randoms.

I finished The Rosie Project by Graeme Simsion on Sunday night (it was my final act of vacation… That and staying up late to watch the hockey game, but I do that during the playoffs without vacation, so it doesn’t count).  It was one of the better books I have read recently.  I can relate to the main character who has a Sheldon Cooper-like (and thus, in some ways, a Trisha-like) personality.  Very funny, very easy read.  You should check it out.

The Child and I, after about 2 years of playing Super Mario Brothers on the Wii have made it to level 3.  If you can’t guess based on the timeline, we die a lot.  And level 3 is filled with us screaming “PENGUINS” and then dying.  I think it makes the death more fun.

My “nephews” turn 12 next week.  They are the same age as the kids Patrick teaches.  That makes me feel so freaking old.  It also makes me remember I need to get them cards.

I have discovered during this Molecular Genetics rotation that DNA is beautiful.  Especially when being analyzed by FISH or SKY.

Spectral karyotyping. I love the pretty colours.

BCR/ABL is an abnormal fusion gene that is found in leukemias. Image from Wisconsin State Laboratory of Hygiene.

My herbs are sprouting!  I have no clue what is what.  Hopefully that will become more clear as they mature.

On another plant related note, Jeter killed our orchid.  Snapped it clean in half.  Jerk.

Jeter broke a mug at 3am.  Well, we assume it was him.  Or we have a poltergeist.  Or a clumsy thief who forgot to steal stuff.  Really, this is another reminder why we shouldn’t leave stuff on the counter.  It is also why I am grateful that I sleep like I am dead because Patrick had to wake up and deal with it.

Speaking of my destructive cat, the Child showed me these videos on YouTube called Simon’s Cat.  I find them delightful.

Patrick is going on a field trip this week with his class overnight.  He is excited.  I can think of few things I would want to do less than hang out at a camp with a ton of 11 and 12 year olds.  That is what makes us different.

Being a Leisurely Commuter

It was a good morning.

I was seeing some consults at another hospital and I was told to show up at 9:45.  That is basically halfway through the day.

I got up around the same time and went downtown for coffee and some physics studying.  I love doing work with caffeine, food and the bustle of people heading out for the day.  Especially with a good view and Eddie Vedder playing in the background.IMG_0036 IMG_0037

I then commuted using the ferry.  Yes, the ferry.  I never get to travel by ferry.  It is more awesome than the subway, in case you are wondering.  IMG_0040

I then took a more scenic walking trail to the hospital.  Although, I did get a bit lost, it was worth it.IMG_0043

I concluded I could do this.  Be a ferry commuter, specifically.  If every day was as sunny and leisurely as this morning.  But when the weather sucks (or I just want to sleep as late as reasonably possible), I am glad I am close to the hospitals I usually work at.

Really, I am a commuter.  I take the bus or walk every day now that Patrick has a real job that sends him an hour out of town every morning (meaning he leaves at 7 in the morning every day).  That kind of commuting just isn’t as novel to me.  The having a husband with a REAL teaching job (at least until the end of the year) is, though, so I like it nonetheless.

Even finding out my physics exam was rescheduled AGAIN couldn’t ruin my morning.  Okay, it did have me agitated most of the day, but it is a growing experience.

Imposter Syndrome

Image from lizmartinresearch.wordpress.com.

I used to think imposter syndrome was when someone actually pretended to be someone they weren’t.  Kind of a crazy person, like people who tell everyone they are someone they aren’t. That kind of bizarre.

When I started residency, I remember someone talking at our orientation about how many of us will experience some degree of imposter syndrome.

And no, we aren’t just all crazy people pretending to be doctors. We just think we are.

Imposter syndrome is defined as a psychological phenomenon in which people are unable to internalize their accomplishments.  This means that despite objective evidence of competence, the individual is convinced that they are really a fraud and don’t deserve the success or accomplishments they have.  They can dismiss it as luck, bad judgement and often expect to one day be found out.

I found this graph kind of helpful. Except that I don’t see myself being that high on the how good you are scale to meet Imposter Syndrome criteria, which is kind of diagnostic. Image from saalonmuyo.wordpress.com.

Props to a combination of Wikipedia, and Webster’s Dictionary for helping me out with that explaination.

Today’s writing prompt from the Daily Post asks the question, “Are you full of confidence or have you ever suffered from imposter syndrome?”

My answer is that I experience imposter syndrome all the way. I think my photo could be under the definition.

Okay, I do have some confidence in some things.  Like public speaking (weird, I know), having difficult conversations with people, cooking.

But, I tend towards imposter syndrome and it is a constant struggle.

At least, I think I do based on what people tell me and some objective evidence.

Gosh, I even have impostor syndrome about my impostor syndrome.

Image from informedjourney.com.

I got through med school.  I know I passed all of my licensing exams.  I passed them with scores well above the mean.  I get consistent positive feedback.  I work hard.

Nonetheless, I still get a voice in the back of my head that says that one day they will figure me out.  That I am just lucky that nothing terrible has happened when I am on call or in charge. That I must have charmed my way into doing well.

Like anyone, I love getting positive feedback.  It is nice.  But, anything that addresses things I think I am still not good enough at makes me uncomfortable.

I know it is normal and even healthy to have a reasonable level of self-doubt. It helps keep you sharp. It keeps you from becoming complacent. It protects me from going all crazy and trying to do surgery on my own like Christina Yang.

And even beyond medicine, I have a hard time processing the fact that I am an adult.  A married adult with an apartment and car and bills  and responsibilities.  It is not what I thought it would be, therefore, it can’t be real.

Image from cheezburger.com.

There is a lot of stuff out there about imposter syndrome.  Especially in professionally women.  Apparently, I’m not the only one.

That being said, I think we make much out of it.  More than we probably should.  Awareness is good, but blaming that for failures is a whole other issue.  And we put getting over it too much on ourselves too.

It isn’t of God.  The doubts, the fear, the worry.  None of it.

It is of man and my reliance on self instead of on God.

For me, it isn’t just a confidence in me issue.  It is a confidence in God and His provision issue.

At least, I’m not alone in any of my crazy.