Out of breath

So I had a doctor's appointment to check up on that whole fainting spell thing.

It is so weird being the patient. It is not comfortable. Those one-size-fits-all gowns (with ties open in the back) are tent-like! The standardized questions (Do you smoke? Do you drink alcohol? More than a twelve-pack a day? Do you have working smoke detectors? Do you wear a seatbelt? A bike helmet?) are silly even to me - and I know it's just procedure. It's strange when the doctor leaves you in this tiny room for you to change, and you end up sitting on the exam table, anxiously looking around and wondering when the doctor is going to come back, as what feels like eons of time tick by.

Remember, you're just sitting there. In a giant poncho. Naked.

Anyways, I digress.

She was going through all the right motions. Listening to my lungs, palpating my abdomen, checking my heart - and then...

Doctor: Oh, wow! Did you know you have a pretty significant murmur?
Me: Uh. Really?

Remember, I'm still sitting there on the exam table, with the worst exam gown in the world - my back and butt exposed to the world. Talk about patient insecurities and bad design!

Doctor: Yeah, no one's ever mentioned it to you before?
Me: Nope.
Doctor: Here...listen!
Me: Oh.
Doctor: Do you hear that really large whoooooshing sound?
Me: Oh. Umm...oh yeah!

I lied.

Really, all I could hear was my heart going tachycardic on me. I mean, she was all smiley and excited about this murmur finding, what with the exuberant hand motions she made every time she heard "that really large whooooooooshing sound" but I just wanted to be told that it was nothing serious. That I wasn't dying of congestive heart failure. That I didn't have endocarditis. That no, it was not aortic regurgitation. I'm a med student! Med student syndrome is inherent in all of us!

Me: So, what exactly does that mean?
Doctor: Well, I'm not sure. I'm going to have you go get an echo.
Me: Oh, okay.
Doctor: What kind of insurance do you have?
Me: Student insurance?
Doctor: Oh no. It's not going to be covered.
Me: [joking] It's okay. What's peace of mind worth? $100? $300?
Doctor: Haha - yeah, except it's more along the lines of $1500.
Me: ...
Doctor: Yeah.
Me: Holy crap.

So after a little bit more discussion about how my health care in California has been, well, sub-par, we decided that it was probably a benign congenital murmur that has just never been diagnosed until now. Never mind that in PEX, we listen to each others' hearts all the time, and even my most studious classmates have never picked up any kind of whooshing emanating from my heart.

So I picked up my stuff, shook her hand, and headed on my merry way. After all, ignorance is bliss. And curiosity killed the cat.

Fast-forward two weeks to our Physical Diagnosis class on Heart Sounds and Murmurs. Taught by a self-proclaimed world-renown physician, I figured that it couldn't hurt to have him listen to my heart. Especially since it'd be free!

He listened for five seconds. Paused, looked at me, and then listened some more.

Then he stood back up, looked at me triumphantly, and smiled.

Oh thank god, I thought to myself. It must be benign!

"MITRAL VALVE PROLAPSE!" he proclaimed instead. Loud enough that if people were standing outside the door, I'm sure they would now also know my diagnosis.

Go get an echo, he commanded me.

Yes, yes sir. Except... And then I told him all about my health insurance woes.

Oh, that is a problem indeed. He stood there for another twenty seconds, stroking his beard. No joke.

And then he looked up, smiled triumphantly, and proclaimed:

"All right! You do this! Get pen and paper! Write this down! Go to [purposely omitted] Directory and look up the cardiology branch. You call! And someone named Wanda will answer. You tell her - this is important! - you tell her that you MUST talk to Janet personally. She will connect you. Then when Janet answers, tell her you need to speak to Dr. Tanner. She will give you a lot of hogwash about Dr. Tanner being too busy - but you tell her it's VERY important. Tell her you will wait, or if she could kindly patch you through to Dr. Tanner's personal voicemail... And she will connect you! And then you tell Dr. Tanner the situation and that I want her to give you a "discounted" echo. And if she refuses, remind her I know about that incident in September!!!"

I really hope my murmur is just misdiagnosed, and it's something benign. But just in case it isn't, I guess I'll be blackmailing a cardiologist later this afternoon. Cross your fingers and wish me luck.

1, 2, 3, 4, tell me that you love me more

For the most part, we all came to med school to learn how to care for patients. To help people. To make them feel better. More comfortable. Less pained. Even those who came for the fast cars and the easy money, snapped to reality really quickly and either left, or realized that they actually want to help people.

And we all came in, for the most part, bright-eyed and excited. Hungry to be getting out there to make an impact on the world. I mean, most students can tell you everything about their first patient. First and last name, age, date of birth, what they presented with in the ER, the complete differential, and possibly even how many dogs and cats they have. It's because we're hungry to help, hungry to finally be able to touch someone's life. And so that first patient is super special, because it's validating. This is, after all, why we came to medical school. For the patients.

But somewhere along the way, we got a little bogged down. Bogged down with studying and tests and just trying to get by. We got a little jaded, and a lot more pessimistic, and now people talk about getting out of med school because it'll be an end to the studying and the lectures and...well, it'll be an end to the pain and suffering.

Maybe I'm just generalizing. I should go back and correct the last couple of paragraphs so that they only apply to me. Because I'm sure there are people out there that don't feel this way. And I can only write what I've been feeling. And that's how I've felt. To suddenly have my entire life worth be defined by a single unit test, once every five weeks, is not validating. To have everything I do in life, lead up to just a single 3-hour test, is not why I came to med school.

I came to med school because I want to help people. No matter how cliched that line might sound, it's the truth. I genuinely want to help others. And the thing is, if I knew a better way to do it rather than through medicine, I would. If I could bake fantastic pastries, I'd hand them out on a street corner. If I could enunciate and express myself clearly so that I could teach arithmetic to a classroom for thirty rowdy intercity kids, I'd be making lesson plans right now. If I somehow could learn to roll my R's and figure out the points of tildes and accents, I'd be a translator. If if if. If only.

Today I had my first humanities seminar. It's a really small class with only six students, and it's entitled, "The Spirit of Healing." Not going to lie, I totally thought it was going to be about religion and death and how to deal with patients in those contexts. But it wasn't. It was about being a med student. It was reaffirming.

It was about how you need to be compassionate to be a good doctor. No matter how much med school might try to suck the soul right out of you, you can't let it. You're in it for the right reasons. Because you care. And, the class made me feel so much better about myself as a student. It made me feel better about myself as a person. Because while 'the care of the patient starts with the care of the patient,' to really be able to care, you need to care for yourself. You need to care for the care-givers. Only then can you actually truly start to care for your patients.

So in the end, the unit tests are not what matter. The PBL evaluations don't make a difference. The leadership roles and popularity contests mean nothing.

What matters is your relationship with your patient. And how you treat them as a person will make a huge difference in their medical treatment. It's about having heart. And at the end of the day, I know that I have a good one. I care. And that will ultimately make me a good doctor.

Forget the exam scores. I am not studying purely for that pesky little thing called boards. If I end up in North Dakota for residency, it will be okay. Because the things that count usually can't be counted. I will be useful, I will be compassionate, and I will be a competent doctor, no matter where I end up.

At the end of the day, I just have to remember - the things that count can't be counted.

Not myself

I think God created PMS to test boys.

I think God created PMS to make sure that the boys that hang out with us, the boys that we're willing to jump through hoops for, are worth all the conversation overanalyzing, the bouts of insecurity, and all that waiting by the phone. [If I ever find out who created that whole three day rule, I will personally chew their head off.] God wanted to make sure that those boys would be willing to wade through fire swamps , scale cliffs of insanity, and fight rodents of unusual size. Because once a month, I turn into a snarling, overly hormonal, overly emotional, three-headed monster.

But at least I know it, right? I apologize to those close to me, sometimes two or three days in advance, before I snap and eat their children for dinner.

I mean, girls are pretty great. Most of the time. If you're sick, we'll come through with a bowl of chicken noodle soup. Yes, we'll even stove top it for you. Nothing but the best Campbell's Soup for you. There will be no talk of microwaving. We'll fold laundry, help with dishes, and we're always here with compliments and words of encouragement. We'll even buy you an occasional cup of coffee to help you through your day. Anything to bring smiles to your face and cause moonbeams to rain down around you.

So I think God created PMS to even out the playing field.

'Cause if you find a guy that's going to understand that once a month, your hormones take over and you are not normal, and that same guy is willing to see you the next day? Maybe even take you out to dinner even though you might have yelled irrationally at him for things beyond his control the day before? Honey, hold on to him. Well, first apologize for your terrible behavior. And then make sure you let him know that you appreciate it. That you appreciate him. And that you know you're actually quite lucky. Because he's willing to climb mountains and ford streams for you, with you.

It's a little sucky, I know. To have to put up with a whole lot of crazy around the beginning of every month. But, if I'm gonna suffer through the worse cramps ever once a month, it only makes sense that boys should suffer a little too, right?

Just be glad that it's only temporary.

I personally think the cramps might be a little worse. Just a little.

And so are you.

In all of my twenty-three years, I've only been on one Valentine's Day date.

Well, I mean, not unless you count third grade when everyone was required to bring in those little valentines that you wrote to everyone in your class. Of course, I made sure to give the cutest card with the puppy to the people I actually liked, and I would tape the BEST chocolate (krackel, of course) from the Hershey's grab bag that my mom had bought, onto the valentine. And if I really liked you, I would outline the card with glitter glue. Oh yeah, if you were my friend, you got nothing but the best.

Third grade. Those were the days. I'd go home with my brown paper bag full of cards and chocolate and conversation hearts that tasted like chalk, and eat myself into a sugar oblivion. Oh, Valentine's Day, 1992. I had thirty-three valentines, and they thought I was a tweet-tart, or wanted to BEE mine. And if not them, at least Scooby-Doo would say, "I love youuuuuu."

Yet, somewhere along the way, some girls started expecting flowers from the boys, fancy dinners and nights out on the town. They wanted a fairy tale ending, and didn't care that you didn't have a fairy godmother to make it all happen for them, no matter how much you wished you could. They wanted a red carpet made out of rose petals, and a happily ever after, damnit.

I was one of those girls until James.

James was a pretty all-around talented guy. He played the piano impeccably well and he could sing and he composed songs. Really good songs. Songs that would make you fall in love with him. And he claimed to be a fantastic cook, and he would make these amazingly intricate sculpture-kinda things out of our organic chemistry molecule sets. Go ahead and laugh, but let's face it, at the end of the day, I'm still a huge nerd inside and out.

Anyhow, I had HUGE expectations for Valentine's Day. So, February 10th rolled around and I started hinting at the big V-day.

Michelle: Hmmmmmmmm, gee I wonder why everything is pink this week!
James: Duh, it's for Valentine's.
Michelle: Oh, hm. Speaking of which...are we doing anything?
James: Uh, no.
Michelle: WHAT? Seriously?
James: I need to do laundry that night.
Michelle: [laughing] Oh, stop.
James: No, I'm serious.

I was pretty convinced he was planning to surprise me. And so I busted out my chef's hat and baked him a brownie cake. Let me just say, it was amazing. Frosted and made with organic raspberries. It even had icing. True, maybe you couldn't read what the icing said, but you know, that was part of the fun!

Anyways, I digress. The night sucked. I showed up at his apartment in my prettiest red dress, with this cake of love, and he answered the door in his pajamas. Turns out we really were just studying. (And yes, he actually did do his laundry.)

Since then, I've had absolutely no expectations for Valentine's Day.

But one year, I had a Date. An actual pick-you-up-at-six-I-made-reservations-for-6:30 kind of date. When I opened the door, I couldn't see my date's face, because the bouquet was so gigantic. It was one of those dates where you saw everything through rose-colored glasses. Walked on air. And even though it was freezing and I was wearing open-toed strappy sandals, I didn't feel anything but happy.

The thing is, after the date came and went, I realized a couple of things. True, the food was fabulous, and the flowers were gorgeous, but what really made my night was the company. We had the best seat in the house, but I barely looked out the window. I couldn't wipe my smile off my face. I was tingly.

I was tingly because this someone went to all these extremes to show me that they cared. Even though he didn't need to.

I've said it before, and I'll say it again. A girl just wants to know that you care.

And the thing is, even if we had just stayed at home to watch TV, or make dinner together, or something less extravagant, I think I would have had just as great as a time. Because I would still have known that I meant something to someone.

And that is the best feeling in the world. Knowing you're special. That someone really does want you to be theirs.

Not going to lie, the glitz and the glamor of a five-star restaurant are pretty fantastic. But the real fantastic thing - the real thing that matters - is the company.

That night probably ruined all future Valentines' Days for me. But it was great. And I'm smiling right now, just remembering it.

Thanks for the memories.

Sugar is sweet...

Violets are blue...

Roses are red...

My heart will go on

I love the second - sometimes third - Sunday of every February because that's the day I run over to PostSecret and see what valentines other people - lucky and unlucky - in love have sent in to Frank. It's nice to see that secretly, some of us are all dorky high school nerds quoting romantic comedy cliches, standing before boys, asking them to love us.



I've got company in the hopeless romantics circle.

Black holes and revelations

It's impossible.

I look at my stacks of notes and books, kilobytes of information saved on my computer, and the drug charts and mechanisms I've taped to my mirror and fridge, and I just can't see how I'm going to do this. Everything goes in one ear, and out the other.

And I swear it's not for lack of trying.

It really is impossible. More impossible than happily ever afters, that one song from Man of La Mancha, and drawing perfectly straight lines without a ruler.

I want to tear my hair out. It's so frustrating that I seem to have lost all capacity to learn.

I guess I should take comfort in knowing that other people are feeling the exact same way. One of my friends wore a really cute hat to school today, and when I complimented her, she replied, "I hate hats. I'm only wearing one because I need physical barriers to keep the information from flying away..."

So true. Except, forget retaining the information, I'm having trouble getting the material into my head to begin with.

How on God's green earth, am I going to get all of this information into my head? By 8AM on Monday?

It's impossible.

Keep your fingers crossed for me that I beat the odds. 170:1.