Inside EVMS

Twenty four hours from now, I will be finished with the last exam of my first year of medical school.

That sentence deserved to be in its own paragraph. Quite honestly, I have no idea how I survived. I don’t think any of us really understood what we were in for when we showed up for orientation in August, but nine months and 36 exams later…I am almost done. I still have LGM stuff to finish over the summer, but tomorrow is the end as far as classes / exams are concerned. I am exhausted to the point of numbness, but I am sure after my first full night of post-exam sleep, the full realization will hit me.

There were periods in my life when the idea of attending medical school seemed beyond impossible. It was so far out of my reach. Now, by some miracle, I am sitting in my apartment surrounded by study materials, preparing to complete my first year. Even though it has thus far been a stressful, chaotic, all-consuming whirlwind, I am grateful.

With very little undergrad science background, med school was an uphill battle from day one. On top of that, countless things seemed to go wrong this year – health problems, financial difficulties, relationship issues, car accidents…the list goes on. I will admit, there were moments I struggled to balance everything. Without the combination of my amazing peers, my own innate tenacity, and a thousand small miracles, I don’t know if I would have made it.

Medical school has certainly chewed up and spit out its fair share of pre-physician hopefuls. Medical school can be a brutal task-master; it requires its participants sacrifice (or at least alter) their friendships, relationships, physical well-being, time, sanity, money. There is no part of my life that has escaped the impact of my decision to pursue a medical degree. But, I love medicine. I love people. I am passionate about improving people’s lives by impacting their state of health. I am in love with this calling.

Successfully completing my first year of medical school is one of the hardest things I have ever done, but I am confident that the end-result will be worth the difficulty. Not everyone gets the opportunity to pursue their passion and make a career out of it. It’s an exciting prospect. So, I have decided to sacrifice my 20’s to this spectacular sleep-stealing, debt-generating, life-consuming beast. I can’t imagine doing anything else with my life.

Weeks 36 – 37: Monsoon.

The expression “when it rains, it pours” comes to mind as I reflect on the last two weeks. Let me start at the beginning…

Every medical student has done it. We’ve all had to tell friends and family, “I can’t make it”, “I wish I could be there”, “If I didn’t have school…”. Well, I was sick of giving that response every time I was invited to a wedding, birthday, or baby shower held by people that live outside of this warped med school universe. So, when an old friend asked me to come to her wedding scheduled for May 5^th, I said yes (despite having an exam scheduled for the following Monday and finals shortly after). I rebelled against my schedule and my own common sense and it backfired … big time.

The wedding was in Lynchburg, which is four hours away from Norfolk. A week before leaving, I realized that my car’s state inspection sticker and registration had expired several months ago – another casualty of a brain on med school. When I took the car in for the inspection, I was informed that a very expensive repair had to be made in order for it to pass. Bad omen #1.

Once the car was taken care of, I started to pack things up for the trip. I even managed to record some physiology lectures on my ipod so I could passively study as I drove. Due to factors beyond my control, I barely slept the night before I left. Lesson of the day: listening to lectures + driving while sleep deprived = car in a ditch. Yes, ladies and gentleman, I was in my second car accident of the school year (and this one was actually my fault). Thankfully, Calvin (my car) escaped with little more than a muddy bumper. I, on the other hand, face-planted into the steering wheel and wound up with a bloody nose, bitten lip, and a concussion. Despite bad omen #2, I continued on to Lynchburg.

When I finally arrived at the hotel, I had very little time to get ready for the wedding. I was out of practice when it came to dressing up and putting on make-up (yet another casualty of med school), so it took me longer than I planned to get myself together. I successfully figured out how to conceal the scratches from the accident and managed to get to the church on time. The wedding was your standard small church wedding and went smoothly. Things were looking up.

For reasons I will never understand, the bride decided to have the reception 30 minutes away from the church. As I started to drive to the reception, it began to rain. This wasn’t your delightful, misty, pitter-patter kind of rain, though. This was an all out monstrous monsoon that only allowed drivers to see a few feet in front of their cars. To make matters worse, the route to the reception involved several winding country roads. Bad omen #3.

By the time I made it to the reception, my head was pounding and I could barely suppress the concussion-induced nausea anymore. Thankfully, I was able to wait until I left the reception later in the evening before I actually started throwing up. Needless to say, my plans to study in my hotel room were foiled.

For those who have  been keeping count, we’re up to three bad omens. Since it’s common knowledge that bad things happen in threes, you would think I was in the clear. You would be wrong. Between arriving back at the hotel at 8pm and leaving the hotel the next morning at 9am, the following occurred: my laptop stopped working, vomit ruined my dress, pain from the concussion escalated, my bank account experienced technical issues, I received tragic news about a close friend, and I was confronted with a poorly-timed break-up. Needless to say, that was my second straight night of no sleep.

When I checked out of the hotel that morning, I could not wait to get home. To prevent another encounter with a ditch on the drive home, I blasted the air conditioning and music as loud as I could to keep myself awake. Luckily, a terrible headache makes it difficult to actually fall asleep, so that helped as well. I survived the drive home without incident. I did manage to vomit all over the side of my car as soon as I parked, but at least it was better than throwing up inside of my car.

When I walked into my apartment, I was incredibly relieved and grateful to be home. I was in no condition to efficiently study for the physiology exam that was less than 12 hours away. Thankfully, my roommate gave me a crash course that covered the main points of the material I hadn’t yet reviewed. Because my head still hurt, I didn’t sleep much that night either. I am sure I looked like a zombie when I walked in half an hour late to take my exam on Monday, but I was glad to get it over with.

Now, it is time to focus on recovering from the concussion and preparing for the last three exams of M1. I am glad that I did so well academically throughout the semester because now I have  a cushion that allows me to bomb these three finals and still pass the classes. It is disappointing, though. I’m not really the type to obsess over grades, but I do feel disappointed when I don’t do as well as I know I could have done. I have put in so much effort this semester and done better than I ever thought I could, so it’s a little sad to fizzle out and end on such a low note. It bothers me when I see an outcome I know could have easily turned out much better. I wanted to finish strong.

I know there’s no way I can properly recover from a concussion, deal with my baseline amount of ever-present life chaos AND study as hard as I need to during the next ten days. Who knows, maybe after all of my recent misfortunes, I’m due for a miracle…or at least a break. Either way, I am sure of two things. 1. I know have experienced far worse and survived intact. 2. I know none of this will matter three years from now when I have MD after my name.

Last weekend was preview weekend – an event where the accepted and wait-listed students can come scope out the school a second time. They go on tours, listen to presentations, and attend social events. I volunteered to host an accepted student and went to the registration/reception event to meet up with her. It was surreal to see all of the incoming students in the same position I was a year ago. It made me realize how quickly this year has gone by. I remember opening my acceptance letter in mid-April of last year, but it really doesn’t feel that long ago.

The prospective students all had a ton of questions and it was fun to answer them and tell them horror stories about first year. Overall, it seems like a good group of students coming in. There were a surprisingly large number of young folks (i.e. coming straight from college), which is a little strange for EVMS. I can only think of a handful of people in my class that did not have at least a year of “real world” experience under their belt before coming to med school. I cannot imagine taking all of this on at the age of 21 or 22, but if there are people out there that can do it and keep their sanity, more power to them.

It was fun to see everyone “show off” our school. We all sounded like those grandparents that corner people in the elevator to brag about their amazing grandchild. Most of the prospectives I talked to were in the process of deciding between EVMS and another school. I am proud that EVMS lives up to it’s “community-oriented” reputation and made sure to communicate that to the prospectives I spoke with. They all also picked up on the genuine sense of community and collaboration we have here at EVMS.  If that is the sort of environment they are looking for, I think they have found the right place.

Summary of Events:

- attended an AMAZING lunch-time lecture called “pharmed out”; glad I attend a school that would allow for the speaker (apparently not all medical schools do)

- finally got to visit my new LGM (the doctor that I am assigned to shadow for ITP class) at a pediatric clinic; officially in love with treating infants

- took incredibly harsh biochemistry exam; officially not in love with biochemistry

Every year, EVMS students help with the Norfolk Emergency Shelter Team (NEST) for one week. NEST is a coalition of churches that provide temporary overnight shelter for homeless individuals on a  rotating schedule between November and April. For one week, EVMS students from all programs can volunteer for different positions (shelter manager, etc.) and different shifts. The shelter must be staffed from 7pm to 7am, so plenty of help was needed. Each night, a different program/year (i.e. MPH, MD15, etc) was responsible for cooking dinner. The overnight volunteers were responsible for making “goody bags” full of soap, combs, socks, etc. to hand out to the guests.

I signed up for two 9pm-1am shifts and had a great time talking to the guests and organizing the goody bags. I went to high school in New York City and college in Boston, so homelessness wasn’t a novelty to me, but it is always humbling to see other people in such difficult situations. The old phrase, “But for the grace of God, there go I” comes into mind. I think it is easy for onlookers to judge homeless people from a distance, but I it’s important to remember how incredibly easy it would be for any one of us to fall into the exact same circumstance. Everyone is one economic loss, one mental illness, one natural disaster, one familial fallout away from being at risk for homelessness. When people begin to see the homeless as peers instead of “others”, propensity towards judgment fades and the urge to help becomes overwhelming.

I’m thankful that I had the opportunity to take a step back from classes and remind myself of all of that for a moment. Things like that can be hard to learn and easy to forget. I definitely plan to volunteer again next year.

This week, I performed my very first male and female genital exams. EVMS is fortunate to have standardized patients trained in teaching genital exams. We refer to these people as “GTAs” (genital teaching assistants). GTAs meet with groups of 3 students at a time and walk us through every aspect of the exam. This includes the prostate exam for men and the pelvic exam for women. I suspect this is the administration’s way of subtly hazing first year students keeping first year students ahead of the clinical curve. Even though the training sessions were very long and slightly awkward, I’m glad we are allowed to gain some experience in this area before being unleashed on actual patients.

For something that seemed to arrive so slowly, Spring Break sure has gone by fast.  Spring break kicked off with Saint Patrick’s Day. Coming from a partially Irish family, I was obligated to cook corned beef, cabbage, and colcannon…and eat nearly all of it in one sitting. The next few days of Spring break consisted of studying neuroscience, cleaning the house, and catching up on bills.

By the time Wednesday came around, I needed an escape. My boyfriend and I decided to take a trip out to Charlottesville. We met up with another EVMS student and visited Monticello and (more importantly) Whole Foods. (Back story: I am allergic to everything that tastes good milk, gluten, and soy, so finding things I can actually eat is very exciting. Find things I can eat that I don’t have to cook from scratch is a miracle). Whole Foods is indeed a miraculous place. We came back from Charlottesville the next day with a cooler packed with groceries. It may have been the best vacation of all time.

Sadly, Spring Break is coming to an end. The days of leisurely studying at my own pace and getting eight hours of sleep each night will soon be a distant memory. Oh well, summer is only eight exams two months away.

The last two weeks have been exhausting. There have been four exams during the last two weeks and I am ready for retirement some rest.  This week, I feel like I’m living in a Salvador Dali painting. Time seems to be moving so slowly. Blame it on the fact that as of 11am Friday, I will be free from classes for an entire week. That’s right – Spring break is around the corner.

The word “break” is a little misleading. I will be spending my time catching up on housework, working on yearbook spreads, and studying for the upcoming neuroscience exam. Regardless of the amount of work I have lined up, I am looking forward to it. It will be nice to relax a bit and study with fewer “alligators attacking my boat”, as Dr. Aravich would say.

The only thing standing between me and Spring break is the renal physiology exam on Friday. My impending freedom and the gorgeous weather outside make slacking off a very tempting option. Focus has definitely been a struggle. Everyone (including the professor) says that the renal physiology exam has traditionally been one of the easier exams, but I’m not so sure. Word on the street is that the exam will have all new questions this year, rendering the practice exams that everyone relies on to pass less helpful. Hopefully, everything will turn out well.

I turned 25 on Sunday. I have no idea how this happened. College graduation seems like it was yesterday; the last three years have been a blur. When my birthday rolled around, I took a little time to reflect on where my first twenty five years have gotten me. When I was in fourth grade, I made a list of things I wanted to do before I turned 25. Here is an excerpt:

10-year old Tyrrell’s List of Things to Do Before Age 25:

• graduate from college and medical school
• get married
• have kids
•  travel all over the world

 25-year old Tyrrell’s List of Accomplishments:

• graduate from college : check
• graduate fro medical school : work in progress
• get married : not interested
• have kids: not anytime soon
• travel all over the world: work in progress (3 continents down, 4 to go)

I may be a little behind schedule according to my fourth-grade timetable, but I’m fairly content with where I am in life. I can’t imagine being intellectually or emotionally ready to tackle medical school any earlier than I have and DEFINITELY can’t imagine tackling marriage or having kids before age eighty-five twenty-five. Now that I’m older, I suppose it’s time to make a new list. That will have to wait until the summer, though, because now it’s time to get back to studying.

The annual Spring Retreat was held last weekend in Nags Head, NC. It was a nice change of scenery, but would have been more enjoyable if:

1. It had actually taken place during the Spring.

2. I didn’t have a biochemistry exam the following Monday.

3. I hadn’t dislocated my shoulder trying to put down my absurdly heavy school-recommended laptop.

Even though it was 40 degrees and I spent the entire time studying in the hotel room, I am glad I went. It felt good to have a change of scenery. If I have to be stuck inside studying, I’d rather be studying something that’s actually clinically relevant  doing it with an ocean view. There must be something lucky about the ocean, because I ended up doing well on the biochem exam. The next exam on deck is the ITP physical exam practical. The newly dislocated shoulder should make that exam rather interesting. Oh well, life goes on.