Clerkship Freak out

So, today I had my first clerkship freak out. I'm not sure how I've held on this long without having one, but anyways, today was the first. There's a big meeting that is held in the fall of our clerkship year during which we decide where everyone is going for their rotations, and which specialties people will be doing during medicine specialties and surgical specialties. I AM GOING TO BE AT A CONFERENCE IN ANOTHER PROVINCE THE DAY THAT HAS BEEN ANNOUNCED FOR THE MEETING. I. AM. FREAKING. OUT.

This basically means that I'm going to have no say whatsoever about where I go and what I do and I've really been looking forward to this meeting because I have some very specific ideas about where I want to be. I know that I want to do my obstetrics and surgery in a smaller regional hospital. I hope to god to get clinics instead of wards for at least one of my medicine subspecialties. I want to do urology instead of ortho. And, guess what, none of this is probably going to happen. Yes, I can get a friend to try and advocate for me at the meeting, but when it comes down to it the person who isn't there usually gets the things that nobody wants.

Why the hell didn't they give us this date earlier. I've been signed up to present at this conference since the summer. I have a plane ticket and can't back out now. I had a crying breakdown and thankfully my roommate was able to talk me down off the window ledge, but I'm still very freaked out. This is the next 1.5 years of my life we're talking about - the remainder of my medical training. I want it to be the best that it can be. Does anyone want to go to this meeting as my representative?

Patient Follow Up

My days in family clinic are coming to an end soon. I only have two sessions left and then I'll have to move on to other things - that makes me really sad. I really like my preceptor and the patients I've seen and next week I'll be seeing my first patient for follow-up. It makes everything we learn in medical school feel both real and oversimplified at the same time. My preceptor and I have been talking a lot about evidence based medicine and intuition and how practice takes a bit of both. There just aren't evidence based guidelines for everything, and there are different motivations for doing things that aren't necessarily based on evidence. For example, patient reassurance. I took someone's temperature the other day to reassure her that she didn't have a fever. There really wasn't any indication for it, but it didn't cause any harm - I think that's ok. We sent a patient who was clearly a vasculopath for a stress test. There aren't any specific guidelines for his situation, but we thought it would be prudent from a preventative health perspective - so we did it and I think that's ok.

I used to think that I would love family medicine except for the boring office part. Now I'm realizing that the office part isn't really boring at all. It's one of the things I've come to like the most about family med.

Yesterday I had my first patient express regret that I wasn't going to be able to follow her as her family doctor. Now, if you're cynical, you could think that she was just trying to play me for drugs or buttering me up for a sick note, but I really think she was sincere and it made me feel really good. I like being able to have a good chat with people about their health and where they're at. I like being able to find a solution to a problem that makes everyone happy. I like family medicine.

private practice

Tonight we're watching the first episode of "private practice", the new spinoff of Grey's Anatomy. As of now, it has yet to disappoint - good drama, good characters, good bad medicine. Yes!

I'm feeling a little better today and a successful family medicine event and a great day in family clinic have definitely buoyed my spirits. I also saw a previous PBL preceptor today and it was SO nice to see her. I haven't seen her since Christmas last year and I forgot how much I like her. It's nice to be gathering mentors with time during medical school.

I'll write more later - I'm on a sugar high and a cold low. Sorry I haven't written too much lately.

*** Edit: Private Practice definitely went downhill after I wrote that post (the first 10 minutes). I'm not sure I'll be watching next week.

sick

i feel like crap.

Electives

Applying for medical clerkship electives is kind of like putting all your future plans + 100 dollars into a bottle and hoping that someone will pick it up out of the ocean and call you in 4 months to offer you a spot. The system seems so impersonal and confusing and full of forms that don't make sense or that you need to shoehorn your electives into. For example - a form says "hospital and faculty" and I'm applying for an elective that a) has no listed hospital in the electives catalog and the school won't reply to my emails about which hospital it's at and b) could be from two different faculties and which one isn't clear in the email and the school won't reply to my emails. The whole thing makes me feel like an idiot.

I had a nap this afternoon and now I fear I won't be able to sleep tonight because of a combination of a) not working out today b) maynards swedish berries and c) cherry vanilla coke.

Two babies!

One big, one small. My labour and delivery shift last night was awesome. I ended up staying until 1:30 am because I wanted to see a woman who had been there since I arrived go through all of the pushing and end up with a baby! The other deliveries I've seen have been of the last minute run into the room and the babies are pushed out variety so I wanted to see the process. It was very interesting and I don't think I've seen a happier mother. I'm not very tired now (I didn't want to wake up though) but I woke up with a bitch of a headache. I was going to go to the gym right after class again today but now I think I might go home and take a nap.

Tonight we're having the first event of the year for the family medicine interest group at my school. We're showing a family medicine movie and we're trying to recruit lots of first years. Hopefully we're still in the keen phase where they come out to everything because we got a LOT of food!!!! I could be eating subs for the rest of the week....

Anyway, I'm too tired to write anything else and I need some tea, so, adieu.

My bathroom mate was very happy about the cleanliness and was appropriately appreciative, for which I am grateful. There's nothing like doing something and having nobody notice to dissuade you from doing it again. I'm just killing some time at school looking up pediatric rashes before heading off to the gym. I have my labour and delivery shift tonight for our obs/gyne block and I'm pretty stoked about that. I hope there are some deliveries this time because I've had mixed luck the other times I've been there. I don't think there are too many residents/clerks on so that should give me a good idea what it will be like to be a clerk. Which, by the way, still terrifies me.

We finished endocrinology today (thank god) and are moving on to Obs/Gyne tomorrow. I'm stoked for that and think it should be relatively easy learning. I finally finished the report for my summer project that has been hanging over my head so hopefully my friend who's reading it won't think it's too bad and I can hand it in to my supervisor to be marked. I sent her an email the other week apologizing for being so tardy and telling her it would be in soon - I didn't get a reply... I hope that isn't a bad sign.

Ben and I had an active weekend filled with mountain biking at a new place (where I had a small breakdown over the fact that I couldn't ride anything but then recovered and we moved on and I'm chalking that down to PMS), running, snuggling and eating. The days went pretty fast because we were so busy with activities but we both felt pretty good about ourselves so that's always a nice way to come out of the weekend. We did less work than we were supposed to do though, more play!

Next weekend I need to do some fabric shopping and sewing. The dress I made last year for party season has been to all of the parties so I need to make a new one to wear to all of this year's parties. I'm going to make this. It's very similar to this one I made last year but the style works for me so I'm going to go with it. I think I'm going to make it out of broadcloth because it's cheap and then put in a nice accent fabric for the waist accent. Hopefully the sewing will go well!!!!

The bathroom in my new place was filthy when I moved in and nobody seemed to notice... I went on a cleaning frenzy this weekend and now it's spotless. I put in a new shower head because the old one sucked. I hope somebody notices.

Fitness Frenzy

This week I've kind of entered a fitness frenzy. I'm not sure why, this is kind of uncharacteristic of me. I guess it's because I'm semi-addicted to spinning class, although I've realized that it may not be the ultimate workout for me (I need a bit more abs in my life so I'm going to add them in after). This week I've done 2 spinning classes, a yoga/pilates class and a step class. Tomorrow I'm going to do another spin and Saturday Ben and I are going biking. All in all I think this is a good change for me, but I'm not sure I"ll be able to maintain it. I've also been trying to change my diet to be a bit healthier. No more treating myself for going to the gym with ice cream, no more waffles for breakfast, no more bread. My diet this week has been mostly salad with avocado, goat's cheese, cranberries and tomatoes for lunch, and some kind of whole wheat based italian dinner (which the exception of stirfry and trout tonight). I'm not on a diet per se, I just want to eat less junk and make more things from scratch. I froze some tomatoes last week that a classmate gave me from his garden and I'm excited to use them for making sauces. I really want to learn how to make marinara sauce from scratch and a good thick pasta sauce. I will always remember my first tomato sauce experience in Rome and I long to be able to reproduce that. Send me your recipes!

I hope everyone else is having a good few first days/weeks of school. Harry, you start soon, good luck!

Family Clinic

I had my first day in family clinic today. It was awesome, everybody was so nice and I really like my preceptor. He also is probably the most tanned person I've ever seen in my life... except maybe my cousin. I shadowed a resident who had a really complex and cool patient and then got to see a patient on my own. It was funny, I felt like I was in an OSCE station the whole time, but it was real. My patient was very reminiscent of a patient I've seen before. It makes you appreciate that the things they teach in the OSCE really ARE like real life! Anyway, I've got a million things to do tonight starting with writing the family medicine interest group newsletter. I need to find a good family medicine based short story - I've used a story of Dr. Charles from the examining room of Dr. Charles before but I can't seem to find his blog? If anyone has any suggestions, please let me know. Then I've got a bunch of PBL to do and I need to write the discussion section of my paper from the summer. I really want to get that monkey off my back. In good news, I've kept up my workout schedule and I really am starting to feel good about it. I've been spinning 3 days a week and doing something else 1 day (I'm doing yoga/pilates tomorrow). Hopefully I'll bring down my fat percentage a little bit by christmas... I want to be a hard body! Well, not really, but I want to feel good about myself and it's good to get a good crack at it before things get really busy. I also bought a really SEXY binder today at Staples. Mmmm, strawberry.

I got my hair cut today. I finally found a hairdresser in this town that I like, and, she's less expensive than the other one I went to and regretted later! I always think that I look like Haley Mills from the parent trap after I get my hair cut, even though I don't really.

This week has been a good easing back into school week. I haven't had any clinical stuff this week but I have two next week so this weekend I'll be boning up on my physical exam skills with Ben as patient. I'm starting to get back into my family medicine leadership role and today went to a very interesting meeting on the role of family medicine in undergraduate curriculum, how to teach it, and what it should look like. My medical school is a specialist-taught model - all subjects no matter how much they really relate to primary care are taught by specialists. If you didn't know better, you could walk out thinking that all chest pain and hypertension was dealt with by cardiologists, all headaches by neurologists and all acne by dermatologists. Very untrue. This year it seems that there's a team dedicated to making family medicine teaching work, which is very encouraging. As was pointed out in the meeting, it's hard to teach a subject that is case-based and patient/continuity of care centered in a system that was set up for diagnosis/disease based teaching. Family medicine topics are often seen as "fluff" lectures and are poorly attended, which isn't helped by the fact that they're often in the afternoon after a full morning of lectures. So, the key is to find something that draws people in and to make the lectures so good that people will come back and bring friends. How to do that is still up in the air!

I'm really looking forward to my first two family medicine clinics next week. I meet my preceptor on Tuesday and I hope he's as great as he sounds in all of the emails!

This weekend Ben and I are going up to the cottage just the two of us. I think we're going to do a bit of biking/hiking/paddling. It should be great!

Phone

So, my new place doesn't have a home phone and that probably makes sense because there are so many people living here. Today I went and got a new cell phone. It's nice and whatever - I don't get very excited about these things. Unfortunately, I can't sign on to the internet site that is required to use my new plan to set up the numbers of the people I want to call for free. So I'm stuck now not being able to USE my new phone. How much does that blow?

Unpacking

I feel like I've been unpacking for the past 3 days (more like 3 hours but I'm dramatic). I didn't know I had this much stuff. At least it helps me put off the whole going to bed alone thing... Although I'm going to have to conquer that demon sooner or later. New house with new people is strange. I don't know where anything is or how we share dishes or where the laundry is or how the wireless works (obviously I've figured that out) and it's pretty lonely. My room is very warm and Benless so I'm not sure i'll be able to sleep tonight. At least I know two of my roomies and I can see 1/2 of my floor... another 1/2 to go! i never knew I had so much crap. It's hard to throw things away that you know you don't need but have sentimental value. I have thousands of cards my grandmother has sent me because I know that someday she won't be here anymore and I'll want to go look back at all the nice letters she sent. But... they're in a box, collecting dust. And the 65 issues of the JOGC and CMAJ that I haven't read... will I ever?

EDIT:

Last night was hell. I forgot how loud frosh week is in the student ghetto. My room is on the front of the house right on one of the main streets where students live. I had to keep my window open due to the very very hot temperatures so I was tortured all night by frosh yelling things like "Amanda I can't find you, wave your arms in the air, turn left, you look so skinny, oh my god I haven't seen your new haircut, I've lost my shoe, why didn't we take a cab.........". When I finally fell asleep after 1:00 I was then woken up a bunch of times. I seriously wanted to kill someone.