[Photo Blog] - December/January

Better late than never, right?

Photo blog of my 2-week winter break - including Disneyland, Los Angeles, Van Stavern family Christmas, NYE with the besties and back to LA!

Gingerbread house making in LA

Christmas in Nor Cal

 Van Stavern family Christmas! 

My precious little niece! 

Kelsey and Nicole

Wine and cheese restaurant!

Mother-Daughter date to BeniHanas

NEW YEARS!

Back to LA

Lunch with the one and only Mel Stern!

Specialty Search: OB/GYN

My 3rd clerkship of the year: OB/GYN.

This is one that I could not WAIT for! Between my first and second year, I did an externship at St. John's Hospital in Grosse Pointe, MI (See here) where we rotated through various sub-specialties and I got my first glimpse of the beauty of OB/GYN, so I couldn't wait to start! On the flip side, Ob/gyn at our hospital doesn't have the best reputation -- its known for being quite catty and for having many residents/doctors who pick favorites. Part of our grading includes evaluations from residents/doctors and this clerkship was known for people getting low evaluations that excluded them from honors (which I know isn't the most important thing, but it was still worrisome). Lastly, I was nervous because of the horrible hours associated with this clerkship. More so than any other clerkship, the amount of night shifts/24 hour shifts during OB/GYN would pretty much take up all of my weekends available in the clerkship to study/stay sane.

On the first day of the clerkship, we were handed our schedules and walked through what would be expected of us. My schedule was as followed: 1 week of orientation/lectures, 2 weeks of Gyn Surgery, 2 weeks of Labor and Delivery, 2 weeks of out-patient clinic,  1 week of oral exam/written exam/random wrap-up things and (of course) the dreaded 24 hour weekend shifts sprinkled in between. Overall, I was very happy with this since it meant I was ending on out-patient clinic (which had super relaxed hours) and I would have plenty of time to study! Also, just talking about the clerkship made me excited - finally something that I was truly interested in!

GYN SURGERY - My two weeks on gyn surg were great! Having just come off of an 8-week surgery clerkship, I was kind of ready for a break from the OR, but it turns out gyn surg and gen surg are totally different! Yes, there are some long procedures (ex: hysterectomies) in gyn surg, but I just loved that a large proportion of the surgeries were 45 minutes long. Get in, get out - get the patient home! I also loved that Gyn Surg is specialized surgery from the start. Learning specialized surgical areas to select body parts is way more interesting to me than learning general surgery. At the end of the two weeks, I was not ready to leave Gyn Surg... I wanted more! That has to be a good sign, right?

LABOR AND DELIVERY - This was definitely a roller coaster of emotions! It was high stress and you really had to put a lot of effort in to know what was going on when. Unlike surgery, live births aren't scheduled...obviously. So, if you weren't waiting outside your patients rooms at the right time, no one would call you and you would miss the delivery. Also, I had several moments where I really thought I screwed up bad, which is such a horrible feeling. Ex: my very first cesarian section (ever) was right when I was coming on at sign-out of my first L&D shift. The resident told me to run and introduce myself to the patient so that I could go in on a Cesarian section secondary to severe pre-eclampsia. So, I did as I was told. I walked into the patient's room and proceeded to say "Hello! My name is Kailyne and I am a medical student. I would like to observe your c-section today." At that moment, the nurse gave me a death stare and stated "She hasn't been told she was having a c-section yet." Worst. Feeling. Ever. In the end, it turned out fine, but still I felt like a piece of bleep. On the other hand, the L&D can be the happiest place in the hospital. What is more beautiful than watching somebody come into this world? I think the highlight of my whole medical school career thus far is doing my first solo delivery, knowing that I just helped a baby successful gain life. So overall, I really really enjoyed these two weeks. Even though its extremely high stress, you adjust. Once I got my footing and felt comfortable in L&D, it was my absolute favorite place to be!

OUT-PATIENT CLINIC - This semester, I have had VERY little time in the outpatient setting. Going from IM to Surgery to OB/GYN, I had maybe 10 clinic days total up until now. So, I really didn't know if I would like this or not. Well, I loved it! I love that ob/gyn clinic is also semi procedural. I love that there is some continuity of care. I love that this element is also so predominant in the field, because of how diverse the field of OB/GYN is. I had a really great experience and got to perfect my ability to do a pap smear, while also being able to rotate through subspecialties. I also wasn't ready for this to end.

FINALS WEEK - After my 7 weeks of the clerkship, it was finally time to face the music and test out what I had learned. This week, we would have both our oral and written exam. Up until now, I had screwed up the written by a few points to not allow me to honor the rotations, so I was ready to finally get that H. Also, I knew if I was really serious about maybe going into OB/GYN, getting that mark would be important....and sure enough...I honored!!! Finally!

What a great rotation. I loved every (well, at least almost every) minute of it! But, like every field, there are definite pros and cons:
1) PROS: Women's health is an interesting and important field, continuity of care potential, procedural field, diversity of patients and diversity of settings to work in, and the incredible rewards of obstetrics. I was never EVER bored and went home every single day with a smile. I looked forward to going to work every day and was very sad when the clerkship ended.
2) CONS: The two most obvious are 1) the unpredictable hours and 2) malpractice insurance. The only other real con is that you really do just have to give the babies away immediately. I will never ever see a pediatric patient, which I don't know if I can handle.

So thats it! It was a great rotation and definitely a possibility for my specialty of choice! :)

Thanksgiving with My Mama!

For the last 3 years, I have had the Thanksgiving tradition of being with S, making us a fabulously extravagant dinner, him doing the dishes, and us calling it a night. Its nothing big, but it became a tradition that I think we both enjoyed. So, this year..when we realized that S would not get any time off for Thanksgiving now that he is a real doctor and I wouldn't have enough time off to go to California, we realized our Thanksgiving tradition had come to an end. I was upset for a while, especially since this was usually a time that we could break our long distance and be together for a while, but I accepted it and moved on to come up with new plans.

My mom suggested that she could come up for Thanksgiving. Since I ALSO hadn't seen my mom since June and even that was only for a few days, I loved the idea. What was even better was that my retired mom is a HUGE planner..so she quickly scheduled us a huge fun packed weekend.

My mom arrived on Tuesday. Unfortunately, the week before Thanksgiving, I was on nights. So, she arrived to my apartment at 4:15 PM and I had to be out of my apartment by 4:30 PM. While it was great that my night shift meant she could sleep in my bed during the night and then, when I came home, I would sleep in my bed during the day...this did mean I really didn't see her or speak to her at all until my night shifts were up on Thursday/Thanksgiving morning. Luckily, since I had nights that week, my clerkship directors gave me the whole weekend off. So, we thanksfully had a lot of time to hang out and explore all of the things she had planned.

THURSDAY: On Thanksgiving, my mom and I had the most awesome day! One of the things on both of our bucket lists was to go to a GB Packers game. If you know anything about my mom and I, its probably that we are big Packers fans. She has loved GB for years and I grew up in that environment so I was raised to love them, but neither of us had ever been to Wisconsin and had never been to a GB game. So, it couldn't be more perfect that GB Packers were playing the Lions in Detroit on Thanksgiving Day! ...Well, it could have been more perfect, because Aaron Rodgers was injured, out of the game, and we lost 40-10 ...BUT, it was amazing and a dream come true, none the less.

Our ridiculously close seats!!! 

Fellow Cheeseheads! 

FRIDAY: We decided to venture off to Canada...which is a whole 5 miles outside of Detroit. We decided to go to a casino in Winsor. We ate at the nicest buffet in the world...they had every cuisine you could think of and everything was made to order (like omelet bars at breakfast buffets) and over 100 different types of desserts! It.Was.Amazing!!! After recovering from food coma, we went and played craps for a few hours. We did decently well....my mom had one streak where she rolled probably 15 times and won us LOTS OF MONEY...Sadely, we ended up giving it back to the casino and walked out collectively $50 in the hole. Not bad for all day craps play, I think!

SATURDAY: I took my mom to one of my favorite Michigan spots: Frankenmuth! I love love love this little Bavarian town! It is basically a real life Christmas village. Its just pure magic.

After a fun day of cheese shops, fudge shops, and Christmas shops...we drove back to East Lansing and went to a movie. I had been dying to see the movie Frozen and I thought my mom was the perfect person to see it with...since she is really a kid at heart just like me! The movie was even more amazing than I thought it would be and I would recommend it to anyone! :)

SUNDAY: Sadly, the day had arrived that my mom had to leave and head back to California. She contemplated staying a little longer, but with my crazy busy schedule, I would never really see her. So, we said our goodbyes and she left for the airport.

It was such a great Thanksgiving! I loved having my mom here and being able to spend a holiday with her! Even though I love Michigan, this trip kind of made me realize how nice it would be to live closer to home...which is another point in favor of me heading back to the West Coast for residency. We will see how that goes!

Specialty Search: General Surgery

The months of September and October were definitely a challenge. With the start of my 2 month long surgery clerkship, I knew that I was in for a long period of little sleep, high expectations and little sympathy for my complaints. Although I knew it would be difficult, I had absolutely no idea how to prepare myself. Even though S is a surgeon and he gave me as many pointers as he could, there isn't much you can do to learn the etiquette of an OR without just sucking it up and living through the trial and error.

The first week of the clerkship was kind of a joke. It consisted of lectures, suture clinics and IV drawing workshops. The hours were super easy and I loved every minute of it!

Too bad the easiness didn't last...

The next two weeks, I was on Trauma surgery; one week on days and one week on nights. These weeks were pretty good. The mornings consisted of rounding, upon rounding, upon rounding. Around 1PM everyday, the other med student and I would sneak away from even more rounding to go hang out in the ER and wait for trauma activations to roll in. There were a lot of MVCs, some GSWs, and a few burns/explosions. Overall, it was pretty cool! My week of nights was really awesome; when you are on nights, your team is responsible for everything surgical that goes on in the hospital. So, we covered all the traumas, all the pre-op and post-op surgical patients and anyone coming in with emergency surgical problems that needed to be operated on over night. So, we stayed busy and had a decent amount of responsibility, which is good enough for a medical student. Overall, I enjoyed my time on trauma service, but was ready to really get into an operating room and get my sterilized and double-glove-protected hands dirty with surgeries.

For the next 5 weeks, I spent my time alternating between the general surgery service and the "specialty" services that included plastic surgery, pediatric surgery, orthopedic surgery, colorectal surgery and many more! The first few days were awesome...the surgeries were cool, the gave us a decent amount of responsibility, and the majority of people were welcoming to students, which was a happy surprise on this rotation.

The rest of the rotation can be summarized in the good v. bad.

THE GOOD:
Overall, the cases were very cool. I really really liked the OR. I liked having patients that would come in with problems that you could take into a room, cut it out, sew them back together and occassionally fix the problem. It was a big change from Internal Medicine, in which a lot of the cases I just felt like we were playing a waiting game, without actually helping the patients. So, in that sense, I really did enjoy surgery. I also liked that during surgery, medical students have a job. It might just be cutting sutures, or retracting, or occasionally closing the skin...but we were able to use our hands and be apart of the action.

THE BAD:
While I did enjoy a lot of the rotation, there were definitely a lot of negatives. First, and most obvious, were the horrible terrible ridiculous hours. On a good day, we could show up at 6 AM and would be released by 6PM. However, Wednesdays and Thursdays we would have morning didactics, so we would have to be there and start work at 5 AM. What made this even worse, is that every few days, we were on call until 9PM-ish. I was a lucky student that happened to have a lot of Wednesday night calls. So, I would wake up at 3:45 AM, start work at 5 AM, stay until 9PM, get home at 9:30ish, and would have between 9:30PM-3:45AM to get everything I needed to do taken care of, eat and sleep. Yeah. It sucked. I knew that I could survive that short term, but man oh man I could never be a surgery resident that lived that every day. The second thing I didn't really like was everyone's attitude. Even though the residents and attendings were (mostly) all nice, you could just tell they were angry. It has nothing to do with the individual people...its just the culture of surgery that makes you that way. I know that it doesn't have to be that way and that there are many surgeons that this is not true for...but compared to Internal Medicine, there sure seemed to have a larger proportion of angry surgeons than IM docs. Finally, I didn't love the lack of continuity of care. Yeah, sure...there was some. There were patients that came to the service A LOT...like, several times in the two months that we were there. Also, doctors will see clinic patients, operate on them, and see them again for follow-up...BUT, it just wasn't the same. The care, for a majority of patients, seemed fragmented...and I didn't love that.

So, overall....I did enjoy the rotation. I'm 99.9% sure General Surgery is NOT my chosen field...but it was still a good experience. I learned a decent amount..and hey, you have to go through a lot of specialities to cross things off before you can figure out what you're calling is! Right?

Thats all for now!

Lansing's Own Beerfest

In October 2008, I had the adventure of a lifetime and got to go to Oktoberfest in Munich, Germany! It was one of the craziest and funnest days of my life.  So, when my friends approached me about going to another Oktoberfest that was a little more local, how could I turn it down? So, this past October... thats right folks...I got to go to the one, the only, Lansing Beerfest! *crowds cheer*

Ok ok...this Oktoberfest was definitely much smaller than the one in Germany. It had less beer options and less German entertainment. However, it was close, it was cheep, and it had enough beer and german food to make my heart and stomach happy!

We arrived about the hour after the event started. One of my friends found this great deal on groupon...so instead of paying for 4 tickets, we only had to pay for 2! When we entered, we were given enough tickets for 1 drink and our drinking mug that we would take from beer station to beer station. All together, I think we stayed for about 4-5 hours. I had a lot of fun and it was such a great break from the struggles that were my life on my surgery rotation!

Michelle's dog Kuma wanted to come...he even had a costume!

Justin Timberlake Concert

Hello readers! Like I mentioned a while ago, I have been so crazy busy the last 6 months that I have SUCKED at blogging...so now that I am on Christmas break (woo!!), its finally time to catch up.

So, here we go...

Way back in October, my musical hero (Justin Timberlake) came to Detroit to do a concert with Jay-Z. I unfortunately had to work, so despite how much I wanted to go to the concert, I knew that it was a no go. Three days before the concert, I decided that I would request a switch in my schedule. Administration made it incredibly clear that we were not, under any circumstances allowed to change our call days, but for some reason, I thought I would just ask. At this point, we were 6 weeks into my 8 week Internal Medicine clerkship, so I knew the clerkship director pretty well. So, I decided to be honest...

Me: "Julie...If I needed to switch one of my call days this week, would I be able to"
Julie: "Under no circumstance are you allowed to switch your call schedule" .... *looks around and whispers *"Come ask me in my office in 10 minutes"

10 minutes later...I walk to her office....

Julie: "Ok. So, why do you need to switch your call day?"
Me: "I don't have a good excuse. There is a Justin Timberlake concert I want to go to in Detroit."
Julie: "Hrmmm...Ok I will switch it for you, just don't tell anyone"

So, by some miracle I got the day off, snagged last minute tickets and got to attend one of the best concerts of my life!

Pre-drinks at Hockey Town across from the stadium!

Excited that we have TICKETS!! 

My souvenir. 

*Sigh* I love JT. I will marry him one day, just you guys wait!

Specialty Search: Internal Medicine

My first rotation of 3rd year: Internal Medicine.

I had requested this clerkship to be in slot #1 for a few reasons. First, I figured I would hopefully not sounds like a total idiot, having just come off of Step 1 studying; this unfortunately didn't matter and I now realize that I was going to sound like an idiot no matter what, but at least I tried. Second, I figured having this first would set me up well for all of the rest of the clerkships. Finally, I didn't think that there was any chance that I would like Internal Medicine enough to make it my lifelong profession, so why not take it first?

What I loved:
1) Amazing diversity of cases - Every patient was so different; loved seeing the rare and and interesting diseases I didn't think actually existed in my patients!
2) In patient setting - The really really really sick patients (meaning interesting/complicated cases) are all in-patient. So, the fact that the clerkship was 6 weeks in patient, 2 weeks outpatient was a BIG plus for me!
3) Knowing everything about your patients - IM doctors are the main provider for their patients. So, these doctors know their patients medical history inside and out. Unlike the other fields I have been exposed to, which only really care about the organ they specialize in, IM peeps look at the patients as a whole and know every little detail...its pretty awesome actually.
4) Flexibility on what/where you practice - IM has about 123928109 different sub-specialties and about 230432840 different settings you can work in. From a general internist that works mostly out patient to a cardiologist who does mostly in patient procedures, IM truly has so many paths. So, for someone like me who is indecisive on what they want to do, this is very appealing.

What I didn't love:
1) No pediatrics/obstetrical patients - Lets be real. I LOVE babies. I love teenagers. I love pregnant women. I love sexual health. So, the biggest thing that turns me off on IM is that this is the field that has none of these patients. Any time there is a kid, they are sent to family med or peds. Anytime there is a pregnant lady, they are sent to family med or OB/GYN. So, literally my two favorite patient populations are not included in IM. Big bummer.
2) No procedures. None. I literally did not do a single procedure on my two months of IM. I know there are some sub-specialities like cardio and GI that are more procedure-based, but getting to that means a lot of non-procedural rounding days. Don't know if I can handle that.
3) Talking, instead of doing: So.Much.Rounding. Literally all day is rounding. Sometimes it felt like we were discussing problems really thoroughly and spending a lot of time conceptualizing what was wrong with the patient, but that work didn't really translate into much improvement in the patients care. Obviously thinking about medical problems is important and the basis of medicine, but all day? It was too much.

So, overall...Internal Medicine was a great experience. I actually really did enjoy it a lot. I am unsure that this is my future profession, but I havent completely ruled it out!