Things to do when an abundance of free time is on your hands

So I made a list a couple posts back of the things I wanted to do over this winter break. I'm excited to announce that I actually checked off a few things. The big one is that I finished watching the whole first season of Heroes. Holla at your girl! Now I understand the obsession that my roommate has with the show. I'm trying to finish season two so at least I'll be somewhat caught up in order to carry a decent conversation about super human powers:)

As for the Twilight saga...I'm almost done. Book three was tackled today...so melodramatic! Bella is quickly becoming a character I despise. Granted that her friends are vampires and werewolves and it's hard to hold her own among them...but still...she's getting on my nerves!

So far, my winter break has been so relaxing. My sister and I have been hanging out doing random things. I went out with my parents last night to listen to some music at a lounge...shout out to J.A.M.M. who plays nightly except Mondays at Bally's Hotel Lounge. I've also been taking pictures...lots and lots of pictures with my new Nikon D80. Finally got it! Yay!

At the very least, I accomplished a big goal: Med school is currently NOT on the brain.

Weddings

I'm convinced that weddings are the best things on earth:) I just got back from a wedding of a dear friend and I had the most fabulous time! It was like a family reunion of sort because some old friends were there and some of my parents' old friends were there...people who we grew up calling "aunty" and "uncle". Yeah, they were all there! haha. It was a good time. The most hilarious part of the night was when the bartender said we were his busiest patrons...as in me and my sister. How sad!

Laundry list for winter break...

Because I can't seem to stop thinking about Christmas and winter break, although I have two monstrous exams looming over me, I will write out ten things I would like to do or need to do this break.
1. Attend a wedding of an old friend- TOP OF THE LIST!
2. Hiking at least once with my sister
3. Snowboard with Susan for the first time....ahh!
4. Analyze my data from my summer project...this is a "NEED TO DO" but not a "want".
5. Watch Heroes seasons 1, 2, and...is it season 3 now? I will make my mom watch with me.
6. Finish books 2 and 3 of Twilight
7. A handful of spin classes...this may be pushing it.
8. NEVER SIGN ONTO GMAIL...NOT EVEN ONCE!
9. Play Rockband with Clari and the gang.
10. Visit Firefly's to drink some sangria and eat some tres leches...yum!

I didn't get the memo about Christmas season.

The madness begins...

Scenario

Today I finished my first of four final exams for this semester and as soon as I walked out of the exam room, I went straight into my study room to set up shop. Many hours later into studying about lymphomas for Monday's Path final, my roommate (who is one of my classmates) asks me one of those "would you rather" type of questions. This is a snippet of our conversation with another one of our classmates:

Roommate: "Would you rather give birth to a baby or go through second year all over again?"

Me: *stunned and speechless*

Other classmate: "Are you crazy? I don't want to tear."

Roommate: "No, seriously. I think I would rather deliver a child than go through this semester again."

Me: *Still stunned and speechless with crossed eyes from staring at my computer screen for way too long>*

Other classmate: "Well...I would rather deliver a child than go through the first TWO years of medical school. If someone were to take my place for the first couple years of med school and I would have to deliver a baby in return, I would sign up for that...I would deliver three children!"

Roommate: "That's just excessive. I just asked about one child. Heck no I wouldn't have more than one! Are you nuts?"

Me: "I think I agree with classmate on this one, roommate. I would deliver three children in the place of the first two years of med school. Just get it done and over with. No big deal."


Productive studying at its best.

Picture says it all...

TIME SENSITIVE: Master's Program Scholarship

So a friend sent me these applications, but I'm already in a program of study. The University of Ryukyus in Japan is looking to accept and offer a scholarship to one Samoan from Apia to complete a Master's Program in health sciences. The application is due soon as they're looking to start classes in March of the coming year. If you know anyone, please send them my email and I will be happy to send them the application for this wonderful opportunity!

Thanks,
Email: annabjana@gmail.com

3 olives shake it up...i like it dirty.

Today was a little interesting...which is surprising considering that all I have been doing for the last few weeks involved me being permanently plastered to a chair and table. So this was a treat...sort of.

Today, we were trained on the Genital-urinary exam and I performed my first prostate and rectal exam on a male. Now, I know what you're thinking. But, you have to understand that for the past year and a half of my medical school career, ALL of my patients have been women because I follow around an OB/GYN. Not that I'm complaining because I'm really interested in going into something related to women's health. But when something so different comes around, IT'S INTERESTING!

First, I have to say that our standardized patients were great today. They were extremely professional and very proficient in teaching this exam. I honestly cannot imagine getting multiple speculum exams multiple times in one day by a number of different people, but I guess they are very well compensated for their "troubles". But still...compensation would have to be SUBSTANTIAL for me to agree to get up on the stirrups voluntarily and more than once...and even if that were the case, I can honestly say that I would still say "NO!" So, I'm really grateful that there are people who are willing to sacrifice their bodies and a little of their dignity so little pre-docs like me can learn:)

Also, I have come to the conclusion that the woman's wellness exam is not only much more difficult- it's extremely messy! I mean...guys have it so much easier. A cough here and there, a "minimal" prod in the rear, and we can call it a day. Well, it's not that simple but...just the speculum exam alone requires some hard knock thinking. Have you ever held one of those speculums? It LOOKS dangerous and I'm sure if you tried walking through airport security with it, you will get tackled to the ground by a dude of substantial weight and size, at the minimum! And the instrument has to be manipulated with only one hand, while the other hand figures out all the swabbing and collecting of samples. Opportunities for technical difficulties are at every corner.

What's even worse is that I'm one of those people who's facial expressions give away everything that goes on in the brain. It's a real surprise that I come away from poker tables with some money still in my pocket. So while I fumble awkwardly with the speculum, my face sells me out on the fact that a) i have no idea what i am doing (BIG surprise here!) b) i'm agitated from no sleep and not eating all day and c) all i want to do is sit on the beach, which is what i always want to do. Oh...let me add that a festive but strong cosmo is very much needed, which would be d.

Thanksgiving fun!

I had so much fun this Thanksgiving because I managed to keep going home a big secret from my parents. They were pleasantly surprised when I met them and my sister at dinner the Wednesday before Turkey Day. I mean...how could I possibly not be home on my absolute favorite holiday? I did use the excuse that I needed to study when I broke the "bad news" to my parents that I wouldn't be going home for Thanksgiving this year...and of course, they bought it! Hahaha....the schemes.

My cousin Andrew, who is a marine stationed in Okinawa was visiting his brother and mom for the holiday so we had a special guest this year. And of course, there's never a complete Thanksgiving without some poker. Holla at your girl for winning a round of poker!

Being sick aint no fun!

Last night, I got home and felt rather queasy. I figured it was my stomach telling me it didn't like my rapid change of food from yummy delicious Thanksgiving food to the boring med student meal of sandwiches. So I get ready to study and learn about viruses and very quickly, the queasy feeling became this uncontrollable urge to puke. Of course at this point, I'm laid out on my bed with my laptop trying to concentrate on the material but it gets quite difficult considering the room is spinning a little. I then run to the bathroom and try not to look at the toilet because it will be all over at that point. I splash some water on my face and take a few deep breaths. The wave of nausea passes...and I figure that I'm safe to get back into the comfy confines of my bed.

The night then progresses into my laptop falling off my bed onto the floor (luckily, my room is carpeted and my bed isn't too far up from the floor) and me writhing in pain from this stomach situation. Oh God, I think. I canot afford to get sick right now! I have so much studying to do and my night is now over. Gosh, I hate being sick!

Whatever it is I got, it sucks! It's amazing how terrible you feel when you get sick. Your body doesn't feel right. The world doesn't feel right. And everything just gets out of your own control. It's now day 2 of this thing that I have been calling gastroenteritis/food poisoning/stomach flu (I refuse to go see a doctor bc I dont have time) and I still haven't eaten and really don't feel an urge to eat in fear that I will expel the contents in some way.

A thought just came to mind...does anyone have a good recipe for chicken soup?

Holy Moly...how did I get so behind?

This is a question I ask myself EVERYDAY in medical school and I ask this of myself when I just remembered about my blog. Haha. I just realized that it has been a while since I last posted. I really can't write up on what I like to call the "back scoop" because it would take way too long and it's already 2:30 am, which is way past my bed time. So, I will sum it up as best as I can. Here goes...

So, the last set of exams were cruel and unusual punishment...even the worst terrorist wouldn't deserve those exam questions. I turned 25 and celebrated with some fabulous people and wine, of course...but sadly, I didn't get an opportunity to blow out candles and make a wish for the next year of life...but that's okay, because I made a wish while sipping from a wine glass:) I decided to surprise my parents over Thanksgiving by flying home and playing tourist with them and my sister, Deidre, for a couple nights on the LV Strip. I consumed an exorbitant amount of food, played poker (and won), and spent time with family on Thanksgiving Day. I am currently obsessing over getting two things: a nose piercing and a Nikon D80 (I know...I'm still thinking about it). The nose piercing will have to wait until Christmas because I have way too many military obligations this semester. I am praying every possible second to pass my exams in 3 weeks so that I can enjoy a dear friends' wedding (shout-out to Christine who will no longer be a single gal in t-minus 3 weeks). And last but not least, I just bought the new Blackberry touch phone (Storm)...this thing is pretty sweet but SUPER ANNOYING TO LEARN! I must confess that this was the first handbook I read cover to cover. Such a loser! I thought I could figure it out on my own, but finally gave up when I locked myself out of MY OWN PHONE and had to go to the Verizon store and ask for help on this one issue. I know the Verizon guy thought I was some kind of nincompoop.

Until the next post, hasta pasta.

Medical Student interviews

I love talking to interviewees who visit my school in hopes to attain admission to GW's medical school. It really does serve as a humble reminder of where I started in this long process. It also brings about bad memories of obsessively checking emails for new updates from any of the schools I applied to and of heartaches from the many, many rejection letters as well. Trust me....there were many.

The application process is seriously a crap-shoot in my opinion. You start applying to medical school in the first week of June and have to be "verified" by the online application company. Verified means having every piece of relevant information about your life submitted into the database. This includes transcripts from all the schools that you attended, a personal statement about your interest in medicine, and descriptions about every relevant experience you may have had that you want all the medical schools to know about...just so they can look you up and hopefully find that your love for garage sale shopping is unique and interesting...so much so that they will offer you an interview at their school. Not! No, I'm just kidding. The process then continues up until about May of the following year when you pretty much know whether you received admission anywhere or whether to assess your options for the future i.e. reapply the next cycle, wait a couple years, or re-evaluate if this is really what you want to do.

But, do you see how aweful this can become? As an applicant, you have enough self-esteem to really think that you're good enough and smart enough to get into medical school, but then you receive your first out-right rejection from some school and it really burns you. What...they didn't even want to get to know me? They're just going to reject me without even getting to know?!? What kind of people are they? Don't they know that I have done this and that and this... and the list goes on and on. And the rejections keep flying in. I actually thought about getting a separate mailing address for all these rejection letters because it was so disheartening.

The thing is is that you could be spectacular, but just had bad luck in the process. Someone who may have looked at your file and who saw your love for garage sale shopping (in addition to your passion to help save people's lives) may absolutely hate hand-me-downs. Maybe they grew up being the youngest of 10 children who ALWAYS got the leftovers from the big sibs and despised it their whole lives that once they went on their own, they made it a life long vow to never buy something used EVER AGAIN! I mean...who knows?

So yeah. Talking to applicants really helps remind me of the bad days when I first started in this process, where I prayed every day for some school to look at my file and invite me to their school for an interview just to learn that I am worth the investment. Half the battle is translating your passion and determination on paper and the other half is really proving it. For this reason, I like to talk to applicants and offer some encouragement that medicine is really great once you get in. It is more than anything I expected in a good way and even though it was a tough road to get here, I would do it over again. The thing that makes me sad about this process is how many great individuals who get so disheartened by the rejections and the closed doors, that they re-evaluate and choose another field, even though they could have been excellent physicians. *Insert sad face here*

Remember where you are right now...

Because history has been made today. As Americans, we came together as a country to vote for the first African American President of the United States. I have never been so proud to be an American until today, and I am extremely moved to be part of the generation to put this man into office. Tonight is a day to remember and to talk about with our children and grandchildren. As I sit here and listen to the acceptance speech by the man who moved a nation to make change happen and to believe in a symbol of changing America, I am literally moved to tears by this huge milestone that we have achieved.

I saw President Barack Hussein Obama last night in his last rally as senator with almost 90,000 of my fellow Americans in Manassas, Virginia. Seeing him speak with my frozen fingers in my pockets, I beamed with pride that this man was most likely going to serve as our future President. I had to take a moment to really embrace what exactly was taking place.

Remember this time and place. Because it will go down in the history books. And yes, we do have work to do as a country, but I believe that America has voted for the right person to serve the needs of all Americans. He is truly a symbol of good change that we need. And as his followers chant, "Yes We Can", I join in cheer with tears in my eyes knowing that my vote absolutely counted in this historic night.

Fired Up and Ready to go.......

Yeah that's right!

I have to thank one of my classmates, Megan, for listing this video in her gchat status update. This is so powerful...pretty much everything you want to say on the issue, except so much better.

Should I get one?

I've been eyeing the Nikon D80 Digital SLR for quite some time and have been going back and forth on whether I should buy it. The pendulum swings back and forth from yes to no...sometimes multiple times a day. Yes, I am that indecisive! This is why I love buffets and buffets love me (at least my midsection). I don't really have to make a choice because all the options are available to me:) Should I get it or should I not? Should I wait? Oh gosh...another question just got inserted into the mix. How does a pendulum swing in three directions?

NY Times article on burned out med students

So true. We are worked to the bone. It will only get harder. It is a depressing time in our lives. And it may seem like we are masochists because most of us would probably do it all over again and not do anything else. More on this later. I need to spit out the bitter taste of exams first.

From class time to patient time

So last week Thursday, I slept through four alarms and found myself almost an hour later to my "Practice of Medicine" class...something we GW med students like to call the "touchy-feely side of medicine". So I snuck in late and as my small group wrapped up the discussion, my physician mentor called upon the late person (me) to do the first standardized patient interview. These are actors who get paid by the med school to act out as patients in a clinical setting. I did read the required readings, but completely missed the discussion on who my first patient was going to be. However, I found out really fast just what I was in store for. Needless to say, there was a vomit of mistakes as I fumbled through one of the most uncomfortable exercises I have had thus far in medical school.

My "patient" was a 17 year-old female who came into the clinic for her first woman's wellness exam because of complaints of vaginal itching and redness. Her mother accompanied her, explaining that her daughter had something "not sexually-related going on down there". Of course, me being me and because I missed the discussion, I outright asked the "Are you sexually active?" question right after the young patient described her symptoms of itchiness and redness on her vagina.

First, I must commend the actress who played the part of the controlling-but-yet-forgivable-because-her-duaghter-is-17 mother because she did her job well. By the time I was done interviewing (miserably) and was able to successfully kick out the mother from the examining room so that I can get the "real" answers from my fake patient, I was sweating profusely and completely exhausted. I was exhausted because I really didn't know what part I had to play here. If I was really a physician in this scenario, it would have been a lot easier to explain to the mother that her daughter is almost an adult and that regardless of whether she was sexually active or not, she is on the cusp of becoming an adult and needs to be treated as one now. But, I understand how hard this would be for any parent to do...letting their kids become independent individuals. It's a tough decision, which is why I stumbled shamefully all over myself in this interview.

Anyways...this whole scenario wasn't the point of this blog. Today, I took a full history for a new obstetrics patient for my physician mentor. The patient is a 19 year old who was accompanied by her mother and the father of the baby, who is also 19 years old. I knocked on the examination room door and walked into this crowded room and just prayed that this mother would not be like last week's mother. Oh my goodness...because if that was the case, I really don't think I would get through the million questions I had to ask from every new OB patient. Luckily, the mother was silent (she was texting in her iphone the whole time) throughout the whole questioning except for once when she piped up to the FOB (father of baby) that he needed to answer my genetics questions as well. She wasn't really paying attention to the fact that I was asking him the questions as well and he responded to my questions by shaking or nodding his head. Although this interview was nowhere near as uncomfortable as last week's fake scenario, it was still a little weird to be asking all these personal questions from my patient with two other people in the room.

So I successfully got through asking all the questions, including when she thought her last menstrual period was and calculated how far along she was in her pregnancy (about 10 weeks according to the wheel). I then left the room and presented my patient to my physician and we entered the room to do the physical exam, pelvic exam, and pap smear (which I did...yay!). Low and behold, home girl was off in her date by two months! We felt the size of her uterus and approximated her pregnancy to be closer to 18 weeks instead of 10 weeks. Now this news wasn't received very well by our patient. She seemed very sure that her last period was 10 weeks ago. The only one smiling was the "father of the baby"...who was happy by the news maybe because he has some information the rest of us did not have...

Now this drama... my class and readings did NOT cover.

NG Photos of the day

An image of health. Angiogram of the heart with blood vessels in fine detail. Also, my favorite organ!


Giant river cave- one of the largest in the world- located in Laos.

Photo by: Dave Bunnell


Colorfully painted men from the Huli clan in Papua New Guinea.

Photo by: Jodi Cobb


A nontoxic dye highlights water currents surrounding sea urchins (Astropyga sp.) off the coast of Vancouver Island, British Columbia. There are about 700 species of sea urchins in the world.

Photograph by Paul Nicklen


Silver argiope spider from Costa Rica that weaves a pattern called stabilimentum, which is believed to help deter birds from flying into these webs.

Photo by: Darlyne Murawski

I'm noticing a TREND here...

GOBAMA

Dave Barry-

It is a well-documented fact that guys will not ask for directions. This is a biological thing. This is why it takes several million sperm cells... to locate a female egg, despite the fact that the egg is, relative to them, the size of Wisconsin.

My first

speculum exam was done today! Woo-hoo! My CAP preceptor, who is an OB/GYN that I follow around once a week and who is just absolutely fantastic, let me do my first speculum exam and breast exam today. It was so awesome! I really didn't think it was going to be that simple, and neither did my CAP, but I found the cervix in one try. Granted my patient was bleeding A LOT, but that's okay. It just made it a little gooier (is that even a word?) and easier to slip in the speculum. The breast exam however, is another story. I mean. Us women do the breast exam on ourselves...well, we are SUPPOSED to do them on ourselves at least once a month right after your period. And sometimes, it feels a little lumpy. But I can distinguish what's normal lumpy in my breasts from what's abnormal lumpy (aka a new lump). But, that's difficult in a patient. To tell you the truth, i felt lumps today in doing that breast exam and I just waited for my CAP to do her follow-up exam and see if she would say if anything was abnormal. Everything was normal, in fact. This left me confused on how to distinguish normal versus abnormal.

They say in medicine that you must be trained to know what normal is so that when an abnormal finally comes along, it will hit you right between the eyes. I learned this through my CAP last year who made me do many pelvic bi-manual exams to train my "feel" for normal uteri (i think this is plural for uterus) so that when a gravid (pregnant) uterus or one with fibroids came along, I would know. And I did eventually learn how to distinguish between these conditions! Fibroids within a uterus is typically really hard, whereas a gravid uterus is somewhat soft feeling. But, this is the extent of my knowledge. So far, I'm learning so much from my CAP, whom I will call Dr. B. She is so brilliant, it's astounding. But she's great because she teaches so well and I'm excited about all the learning this year:)

AB out....

Catamenial Pneumothorax

Say what!? Yes, try say these words five times fast. So, this condition is insane! It was listed on one of my classmates status updates on gchat and man oh man...I am NEVER complaining about having my period again! Women who have catamenial pneumothorax get a collapsed lung usually 72 hours after they start having their monthly menstruation cycle. Seriously? I really have no grounds to complain about the sore back and the cramps...and maybe the fact that I'm bleeding out. Sorry about the visual...but this blog is about medicine and health.

But these women! The incidence of this condition isn't very high, but the fact that they can potentially get a collapsed lung every month is insane! Actually, the cause is endometrial tissue attaching to the pleural space of the lung which then causes the lung to collapse because of an accumulation of blood and endometrium. Endometriosis is a terrible disease wherein the endometrium (tissue within the woman's vaginal walls that is sloughed off every month )grows ectopically at other sites of the body. In this case, there is endometrial tissue in the lungs.

The treatment will probably be an emergency chest tube to drain the fluid accumulation and then probably surgery to take out the ectopic endometrial tissue.

This condition is out of this world crazy.

Wal-mart is the devil

...it really is!! You plan to go into Wal-mart to buy ONLY a handful of things, but your plans get shattered once you enter this monster of a store. I mean... I went into Wal-mart today to get 3 things...3!! It was toilet paper (I was literally on my last square of toilet paper...I was actually cursing myself for wasting 2 squares on the last roll I threw away), sandwich baggies, and detergent. But what happened? Obviously not the game plan. But business strategists are so smart when they strategize the floor plans of these super-marts. They calculate the routes of shoppers and strategically place items that catch the shoppers eyes in prime spots so that...for me in example...as I am reaching up on the shelf to retrieve my Purex concentrated detergent, my eyes also catch the clorox bottle next to it as well as the bounce fabric softener. Of course I need these other two items! I cannot possibly do laundry without clorox and bounce...even if I may have some leftover bounce at home. The thought of possibly running out of bounce is too much to handle at the moment, and I instinctively snatch a box and throw it into my cart.

What is worse is that, although I only have 3 items on my original list, it still requires me to find the toilet paper and the sandwich baggies. And you're forced to peruse ALL the aisles of wal-mart to find these items! Especially sandwich baggies! They're incredibly hard to find because they are NEVER where they're supposed to be. It's just like loofas. You can never find a loofa where the body washes are located. Usually, loofas are in some random aisle hanging suspiciously from a clip...and you're left to wonder "what the hell is a loofa doing here?"...when YOU DON'T NEED A LOOFA!

Anyways..back to my rant. So, I'm trying to find the sandwich baggies and I come across the school supplies aisle. And there is never a good enough reason to walk through this aisle without carefully checking out the prices of all the highlighters. They are way too expensive in most stores that you CANNOT ignore highlighters in a wal-mart...so I grab some and throw them into the cart on top of the bounce, purex, and clorox. Now...remember the strategists? Those punks. After the school supplies aisle, it all goes downhill. The snacks are next and this takes a considerable amount of your time because no one ever remembers if there's enough snacks to last the week/month. I mean...your stomach wins out every time. In they go into the cart with the toxic chemicals and highlighters.

Now, once you pass the snack aisles...it's really downhill because you are so far away from your original list at this point that you forget what you're looking for and as you're walking and scratching your head trying to remember what you even came to wal-mart for (toilet paper), you manage to maneuver your cart into the clothing section. And before you know it...you have finally made your way to the toilet paper section after miraculously finding the hidden aisle that stores the sandwich baggies and you could barely push your cart to the register. At this point, you are so tired, super hungry, and as the cashier is ringing you up...cursing wal-mart for stealing your money because you only planned to get three things when you walked in the door but you have managed to be swindled into buying a cart load of "necessities".

I love wal-mart.

Life goes on

I remember the first time I saw someone die. It's not one of those memories you want to hold, but it stays with you...at least it did with me. I remember that day in the pediatrics ER at the University Medical Center in Vegas like it happened yesterday. A 7 year-old boy was ambulanced in from a birthday party, where the child fell into the pool. His young, hysterical mother trailed the stretcher closely, but it was surrounded by frantic nurses and doctors pounding his tiny chest with desperate attempts to keep his heart pumping blood to his brain. The room was chaotic and messy. There were sheets on the tiled floors as well as unused tubes and syringe caps. Usually, the curtains would be drawn to keep an incident like this private and hidden from the other emergent onlookers. But that little rule was broken due to the frantic atmosphere.

And as fast as it began, it ended. The code was called. Time of death: 3:28 pm. As each of the doctors left the room, another ambulance announced their arrival with another emergency. And although this was a tragic event and something most doctors pray they don't see on their shift on any given day, it happens. Children will go to birthday parties and unfortunately, will jump into a pool without close attentive eyes on them. And their number will be called...even if they're only seven years old and have their whole life ahead to look forward to. And we who witness this robbery are left with a piece of our sanity taken and with only aweful memories stored safely away in files in our minds that we visit once in a while upon sad recollection.

To Advance Direct/ To not Advance Direct

My small group discussed the topic of medical ethics this morning. This class, in which most med students complain to be a "touchy feely prepare you to be a doctor" course meets every so often to discuss big topics revolving mostly around patient doctor relationships. The goal of these discussions is to highlight the obvious ways in how to deal with certain circumstances as we will encounter them throughout our med school and future careers.

Usually, our group only has a physician to facilitate the dialogue, but we were fortunate to have a psychiatrist present in the discussion as well to offer some insight, especially in psychiatric cases. Today's talk was a great addition to a small group case we had last week wherein we had a homosexual male AIDS patient present to the clinic, who had appointed his life partner as his proxy but the patient's parents disputed this arrangement and wanted to make the final decisions regarding their son's care. This situation would have been a hot mess if this patient did not designate his partner to be his proxy, which is a person whom the patient entrusts to carry out their last wishes as it pertains to their health care. This brings me to the topic of this blog: advance directives (AD).

This legal document is what physicians base the final wishes of an individual in regards to their health care when they no longer can make their own decisions. In the case of our patient mentioned earlier, he designated a proxy but he could have also outlined his wishes in a document just in case there was any question to what his final wishes were. The basis of an advance directive is to outline what types of treatment a person would want or not want in the event that they are not conscious or incapacitated to make such decisions. Do you want a feeding tube? Do you want cardiac resuscitation? Do you want to be on a respirator to keep you breathing? There are more questions like these and all clarify what exactly you would want. In addition, an AD asks what you would like to do in terms of donating organs.

Well, after today's discussion on such morbid topics, I started thinking just how important this document reall is. Death is something most people do not like to discuss, I imagine. But, it is a really important topic as it pertains to how people like your loved ones would handle your last days in this life and how to properly carry out your wishes once you have past on. It would be difficult to lay such a heavy burden on your spouse, children or siblings when they may feel complete guilt in "pulling the plug" when that might have been your wish all along. I guess I could make this blog my advance directive in saying that I would not want to be on long term artificial respiration especially when I am "brain dead" and obviously not conscious to breathe on my own but a machine is the only thing keeping me alive.

I guess my main concern on this and why I am writing a blog about it is that there are too many loopholes that can be created if your final wishes are ambiguous. The Terry Schiavo case comes to mind on this. Terry's parents fought her husband on pulling the plug. One of the main reasons why it was stuck in court for so long was that she did not have a plan set out just in case something were to happen. This is not unique to her, as I would bet most healthy young individuals do not plan just how they would like their end of life care to be handled.

The discussion just got me thinking...should I fill one out just in case? Or am I being overly concerned and a control freak?

Killing trees

Medical school is a tree killer...

...No, seriously. It totally is. I'm ashamed to say exactly how many trees I have killed last year during my first year of medical school, but I am pretty sure I can rival those tree hunters down in the Amazon basin. It is just astounding how much we have to print off for notes, extra notes, and even more notes to study! Thankfully, the med school gives us printed notes for most of our classes, but even with that, I find myself printing more and more. I am really glad that the first floor printing stations of our library took the liberty to automatically make all the print settings front and back to save on paper. At least my guilt is somewhat controlled because of this bold move. At first I was upset because now I wasn't getting the free blank space in the back of the printed notes to jot down my own notes...but I got over it quick realizing just how much paper I could go through.

So, I decided to take matters into my own hands and I ordered my first printer today. No more waiting in lines at the printer stations and spending $.07 a page. I will be printing from home and most likely in color! Moving up in the world...but sinking even deeper into my guilt as more trees are targeted under this plan. I must admit that I do a lot of work online but I prefer the old school method of pen and paper and highlighters. My roommate will attest to the fact that I will go through boxes and boxes of highlighters.

Paper and highlighters. Watch out.

"Hope" Is The Thing With Feathers

"Hope" is the thing with feathers-
That perches in the soul-
And sings the tune without the words-
And never stops-at all-

And sweetest-in the Gale-is heard
And sore must be the storm-
That could abash the little Bird
That kept so many warm-

I've heard it in the chillest land-
And one the strangest Sea-
Yet, never, in Extremity,
It asked a crumb -Of me.

by Emily Dickinson

Walking towards awakeness

I just noticed, as I was walking to school the other morning, that DC is a late riser. You would think with the atrocious number of lawyers and politicians in this city that morning traffic would be much heavier early in the morning as the hustle and bustle of a business day begins. Not really...

I was walking to school last Friday and since it was an exam day, I left for school around seven in the morning. I do not usually go to school this early as a typical day starts around 9 am. But as I was walking, I could not help but notice how empty the streets were without busy traffic and people. For a second, I thought that maybe there was a Daylight Savings time switch the night before and I just did not get the memo! Seriously...the streets were empty and it was a Friday morning...which in my opinion is busier than a Monday. There is nothing like getting to work on a Friday knowing that there is happy hour that evening and a weekend ahead with your name on it.

I could literally hear how quiet my neighborhood was on this walk to school that day! The silence was a little creepy and disconcerting, to tell you the truth. I mean, shouldn't people be up by this time trying to get to work by 8am? Are there people with jobs that start at 7? Well, I guess thos people would be late already and obviously wouldn't be on the street walking with me since it was past 7 at this point.

Well, it's not that I'm complaining about how quiet my walk was to school. Usually, my ipod volume has to be much louder than normal because trucks and cars passing by me on the street are annoyingly loud. But on Friday, it was a nice a calm walk to school without honking horns and the sound of trucks shifting gears. I could classify it as therapy considering I was able to calm myself down before I took my exam.

Bird watching

Today I decided to start studying in what we med students at GW like to call the "suicidal carrels". Basically, these study carrels are just big enough to fit a desk and a chair...and possibly a human being if they have totally expired all forms of air out of their body. But these carrels are where I put most of my productive study hours and I'm really not ashamed to say it loud and proud that I enjoy my time being sardined into this small space. At least the carrels I choose to study are right next to a window that overlooks our front courtyard right next to the GW hospital.

Now maybe it's not such a good idea to have this expansive window which provides more than enough visual stimulus to procrastinate studying...which totally defeats the purpose of being cooped up in one of these darn things in the first place. But anyways, before I go off-topic again, I have to admit in writing on one of my favorite hobbies...people watching! Yes, i love it! People are so interesting to watch. I can't say that I dislike long lay-overs at airports because I really enjoy just observing people, their facial expressions, and how they interact with each other. And for the obvious reason, it is so much more fun to watch from a place where no one can really see you. I especially get a kick out of watching people in our courtyard duck from all the flying pigeons.

The med school has a huge pigeon problem! Today I was outside talking on the phone with my mother and this flock (i'm not sure what to call a group of pigeons) of them flew RIGHT AT ME! I had to duck. THEY did NOT swerve at all which is disturbing. I would have lost an eye and maybe my pony tail if I didn't have such stealthy reflexes. And I'm sure there was someone out there who saw all this go down and was bent over with laughter. Coming from first hand experience, I can tell you that there was no humor involved with ducking from these torpedo-ish birds, but seeing others go through the same thing cracks me up. I know it's mean. I can't help it. I'm sorry.

I love perusing National Geographic's photographs of the day. Here are some beautiful pics from what I saw today!


Water spilling down a cliff at the Grand Canyon National Park in Arizona.


Perfect example of what Palin is trying to destroy...poor polar bears:(


Coral Reef off Australia.


Fire dancing. Originated by a Samoan man in 1946.

The Painted Line Swagger

The time ticks and blinks that it is over
So soon after what is said and done
I halt in my line, walking sober
In my slight apprehension, the mice on the mind's wheel has begun.

Now there's no stopping who says what
Where those words land, it is unknown
My somber mind relays but I already forgot
Just what I was going to say out of a mess so grown.

Life for that minute moment has stopped
All levels of life as you know has a focus on just you
Recover so energy and fuel retains stock
Or not and you are yet to be blamed for being a fool.

You are stranded and alone in this
Nowhere to turn or run and hide
Determined to not fail so you can spend the rest of your days in bliss
You step forward- one foot in front of the other- confidently to walk the straight line in stride.

Favorite words of the week

1. Suppurative
Tied 1. Exudate: Oh my goodness! This made my day when I first heard of suppurative exudate! Oh medicine...why do you have to be so fancy with the name calling:)
2. Treponema: So many syllables...so great!
3. Neisseria gonorrhoaea (genus and species of the bug that causes...you guessed it..gonorrhea!! But i enjoy the pronunciation of these words. It almost sounds like you're saying, "nice serious gonorrhea". It's just wrong to have that word combination.

When in doubt choose..

PNEUMONIA OR UTI! Both do not sound like too much fun, but after studying hours and hours on these bacteria for a micro test I have on Monday, I have come up with the conclusion that the answer would be one of these disease manifestations, if I was stumped on a question. Like for real...all these bacteria cause either pneumonia or a urinary tract infection or both! Dang...can you imagine having an aweful UTI while you're drowning from water in your lungs?? That would be a rough day.

Ascension to progression

She questions, is this really it?
By 23, two little girls were God's gifts.
Ambition aside. Young life waiting beside.
She steals moments by the window and sighs.
Leaves, they change
The lines on her sweet face reaarange
And her hair grows a different shade
She questions, is this really it?

Her girls are growing
The seeds in the backyard, she starts sowing
While her back breaks from bowing.
Working day in and day out to put her family first
And never once quenching her own thirst
She questions, is this really it?

Working and saving to move to that new World
For she wants better for her girls
And to her home, a big wave of farewell to grab life and thrive
A house to live. A table to eat. A car to drive.
She questions, is this really it?

Fast forward to today as she ponders what's next
Her daughters are grown. They've taught her how to text.
The country that welcomed her ten years ago
Has finally embraced her to call it her home.
That house is now lively and that car grew to be four
She feels loved and respected.
And yet she questions, is this really it?
Well no...she finally answers, "I am just starting".

A day to remember

Gosh. It's september 11 again...one of a only a handful of memorable days, in my life at least. I still remember exactly what I was doing when the planes crashed into the twin towers in NYC. At the time, I was a sophomore in college at the University of Montana. It was really early in the morning and I woke up to my phone ringing and me cursing because I didn't think I set my alarm on my phone. Obviously, I was planning to sleep in through my first class that morning! But, no. It was my mom calling to tell me to get up and turn on the television. Actually, the first words out of her mouth were "WE'RE BEING BOMBED!" I was like, "MOM...REALLY? It's too early to be melodramatic." But, no again. She wasn't overreacting because we were really being bombed. I quickly hung up the phone and ran downstairs to the only place I knew where there was a tv...my head RA's room. And for the rest of the day, I (along with ten or so random people) sat on her floor and watched the horror unfold, thinking "How could this happen?"

Looking back, I wasn't deeply affected about the situation until the next few days and weeks when the death toll kept climbing and the number of people still missing in the rubble was unfathomable. My heart ached for all those people who had missing family members or had loved ones who filled the morgues of the big apple. Of all cities, my favorite city in the USA got hit.

And now on the 7th anniversary of this terrible day, it is amazing to see how far the city of New York has come to rebuild herself from the spiritual catastrophe it and its people endured. Somtimes we take for granted the blessed life we live here in the US. Although we are mourning for all those lives we have lost since the attack of 9/11, here and abroad, we sometimes forget of the many countries who are in constant turmoil on their own soil. One of my professors joked the other day (after feeling after shocks from implosions done on a nearby construction site) that if she were in Iran, she would instinctively be taking shelter. For the majority of us, we laugh at the joke wholeheartedly because we really don't know what it is like to live a life of that kind of fear. The fear of war and constant violence wears on people and their souls. And even though it is selfish for me to say it out loud (or at least in writing), I am very happy to live here in the US, where at least I feel safe and where I don't have to take cover from bombings or hide from guerrila warfares. Yes, we have been bombed by terrorists, but it is nowhere near what some other countries experience.

And as I end this blog, I send up a prayer to God to bless all those people who have been affected by this tragedy...a tragedy that has affected us all as Americans.

cute cartoon

This is hilarious..particularly the top left..hahahaha!

Grinding

Nose to the grind. Nose to the grind.
Wiping your brow, sweat you will find.
Day in. Day out. Same rituals, same plan.
To be the best in the world while getting scrapes from the sand.

Nose to the grind. Nose to the grind.
Praying every second for a bullet to be kind.
Signed up at eighteen and lost without your voice.
Your third tour away from your sons and the gun is your only choice.

Nose to the grind. Nose to the grind.
Hustlin' in these streets getting paid from these crimes.
No love can be found without quarters and dimes
And you're sick to death of poverty, even if you soon do time.

Nose to the grind. Nose to the grind.
Pumping down on chests, all the while losing time.
The young are born. The old will die.
We are given life to put up a good fight.

Twilight

Oh my goodness. Yes, I should be studying instead of writing this blog. And yes, I should not be reading a book that has nothing to do with my studies because I really have no time right now to read anything but pharm, path, and micro. But I just have to mention that I'm totally obsessed with Twilight. I'm a new fan of Bella and Edward so I'm barely finishing up the first book of the series, Twilight, and just cannot wait to get my hands on the next book. But, I will try my best and refrain before I fail my exams that are just around the corner. I can hear those exams breathing down my back and frankly, I am really scared. As I write this, I must admit that one of my windows is currently opened to searching through Amazon for the next book in the series. What am I going to do with myself?

What is faith?

The title of the blog has a little to do with what I will be writing about. I just received a heart felt email from a friend who was checking up on me and my "path of faith". We had a great conversation the beginning of my first year of medical school (about a year ago) that had to do with religion and faith and my relationship with God. As you can already tell, it was a pretty deep conversation. But it was well needed. At the time, I was struggling with a few things not really concerning my faith in God but with my faith in people. We talked about my struggle to really accept the fact that non-believers in Christ will quote unquote go to a place we call hell. First off, I am Catholic and was raised in a Catholic household. So, yes, I do believe there is good and evil present in our world, and in my mind, evil resides in a place called hell. However, I really have a difficult time digesting the fact that some people feel that all non-believers will go to hell. Growing up and educated in a Baptist school, we were always told that if you didn't believe in God, you were going to hell. I always had a problem with this because I constantly meet people who are great individuals and who are kind hearted and good souls, but yet do not believe in Christ. My reasoning on this is that they may have different religious views. They may not believe in my God, but they may have a "God" themselves. Who am I to tell them that my God is better or different than theirs? Who knows? They may be different interpretations of the same thing!

Needless to say, our conversation ended without a resolution. However, the conversation helped churn the wheels in my head about maintaining my faith. Part of this is my responbility to keep asking questions about God and how I can strengthen my relationship with Him. I was invited to my first prayer meeting with other medical students and from there came many many prayer groups and meetings. Although I still struggle with the same problems and questions I had at this initial conversation, I feel I may be getting somewhere with my goal. Some Christians may feel that living a life free of sin is the ultimate goal in life. I see things differently, because I think we are only humans and may strive to be perfect like God but fall short many times. But God knows this! He didn't make us from his own image to be perfect beings. He gave us the gift of choice and although we may make bad choices at times, He is loving and He forgives always. If there was one thing that I have learned from my journey of faith in the past year, it would be that God is always there for me. Although I may have a slanted view about faith and religion, that may be different than the books, I know and understand the big picture. He loves me always and will always forgive. And this is what keeps me praying and thanking Him everyday.

Reflection on this time last year

Wow, I cannot believe how fast time flies! Exactly this time last year, I was in orientation for medical school. I am writing this blog because of the numerous emails I am receiving daily about orientation week at GW. The Class of 2012 is currently there enjoying the free breakfast every morning and fun activities all the while meeting new faces and seeing new places. How exciting! I am giddy just writing about this because it brings fresh to mind how excited I was at that point. I was finally in medical school and ready to be on way to save the world! haha..it really was that dramatic in my mind:) Of course I'm still uber excited, but it doesn't compare to the initial feeling of disbelief I had that first week of school. I was actually in medical school and I was at a school I really want to go to! I am definitely excited to head back to another grueling year...although I'm currently pouting that my last summer of freedom is now coming to a close.

I am proud to be an American..

Yesterday, I attended my mom's swearing in ceremony to become a United States citizen. My mom, dressed in her best and looking her very best sat in the front of the auditorium with an American flag on one hand and an expression of elation that this day finally came. Next July marks the ten year anniversary of when me, my little sister, and my parents moved to America from a little island in the South Pacific. I was starting my junior year in high school and my sister was starting high school. As I write this blog, memories of the many little adventures we had and enjoyed as a family at that time, come to mind as if it were yesterday.

My parents were business owners back in the islands. They set their own hours, which meant they worked all the time, but they enjoyed not answering to anyone about how they ran their daily lives. Together, we ran a sewing and boutique shop, a laundromat, a refrigeration company, and at one point a restaurant as well. Regular jobs are hard to come by back home. Most people choose to run their own bunsiness, which is exactly what my parents did.

However, higher education was not available on the island and knowing that me and my sister were on track to go to college, they sacrificed and decided that a move to America was pertinent. And so began our journey from the little island of Samoa to the flashy and entertaining city of Las Vegas in Nevada. I remember me and my sister, Deidre, perusing through the brochure of our new high school. The girls wore fancy clothes, everyone looked so different, and there were so many clubs and sports to be involved in. At the time, tennis was the only thing on my mind and I was elated to find out our school had their own tennis courts! Our high school, Silverado High, wasn't unique in this, though. In fact, almost every school in the city had tennis courts. We were stunned to find the volleyball and basketball courts to not be made of concrete like they were back in the islands, but of glossy wood! And we had an athletic trainer...what is going on here?? America is AMAZING! Little discoveries like these were milestones to simple island girls. The super wal-mart was its own adventure and we gulped in every ounce of the American way of life.

Of course, everything wasn't all peaches and roses. Thank God my dad was able to find a job in the bank, which was pretty good money so we can afford an apartment and then finally a car. My mom then found a job with the Wal-mart down the street as a cashier. Slowly but surely, we built our lives as newly-crafted Americans. Of course, the idea of being American wasn't novel to both me and my sister. We, at least, were born on U.S. soil, albeit a territory located thousands of miles south of the state of Hawaii. We hold American passports and never felt different when it came down to our status of citizenship. The same thing goes for my dad. Back in 1962, he and my grandfather moved to the state of Hawaii. My grandfather was a lawyer and was invited to work for the U.S. Consulate office to the Philippines in Hawaii. This was the beginning of my father's journey to becoming a U.S. citizen.

My mother's journey, however, started nine years ago in July when our family moved to America. For this reason, yesterday was probably one of the most memorable days of my life, and I suspect of my mother's life as well. I don't know much about the way of life in other countries, but I humbly assume that nowhere else is the quality of life better than here in America. I love traveling and seeing the many faces of the world and although I can imagine to live in this place or that (specifically Florence, Italy), there is no other country I would rather pledge allegiance to. Earlier this year, I swore an oath to help defend the rights and liberties of this country when called upon by the U.S. Army. It wasn't until yesterday that I was proud to have made that decision.

In the nine years our family has been in the United States, we have been blessed tremendously. My parents own their own home, where we have enjoyed celebrating many Christmases, birthdays, graduations, family reunions and Thanksgiving dinners. My sister and I have graduated from college and are finding our own way through the world. This year, I will vote in the second presidential election. My mom will be able to vote in her first. And although we may vote for different candidates, that will be okay because we live in a country where different opinions are welcome. And although our country's history may be tainted by racism, sexism, and many other "isms", I am proud and happy to be part of a generation that believes in progressive thinking and in creating a world that will be greener, healthier, and more open-minded than ever before. Making a statement such as this is bold, I know. But how can I help but be optimistic and this ambitious when I know that I live in a country that affords us all the freedom to make big dreams possible and allows us to use all possible resources to get ahead in life? As of yet, I don't know of any other place like the good 'ol US of A:)

Rock Bottom

Will you make it stop for one moment?
When my eyes close and you're still there,
With a voice speaking tongues blowing commanding air.
Willingly, this room gets smaller and I suffocate
Wishing upon my lungs to suppress its rate.
Wasting away painfully as all exits point to you
While you sit there, waiting, all along knowing the truth.
Withhold from me, this you do, of seconds that turn into days
Which makes me write this doctrine of deep sorrow and hate.
Waiting outside is harsh...BUT IT IS MINE and mine without these chains.
Wishful thinking...when I know Seclusion protects me even from the rain.
Withstanding the real world by closing doors and my eyes,
While you put me to bed and numb body and soul through the night.

Away From Boredom

Away From Boredom


What is your high and what is your low

A question weighted heavily, when thrown

To be a skeptic of the past of your day

And not knowing a thing about what went each way.



Bumping people...a system like crashing cars

Suppose if you hit hard enough and they can be pushed far...

..far far enough into the distance of the higher mind

To be connected with what is important and how little we have in time.



Sell your soul to that devil who is unknown

But who is evil enough to own the everyday drone

Walking purposeless into each task

Thinking not of your impact, for you are just a parasite in a flask.



You drink up the sun, the moon and life

And discard nothing usefull but cries

Your tears, even, go without notice

For nothing substantial can grow out of useless.



Pray your roles are reversed

You're in the other car, the one that gets hit hardest

So your life, its beauty and real essence impacts you

Revealing a generous gift...one that was always right in front of you.

My first time in the delivery room

It is near impossible to describe in words my first night in the delivery room. I believe it was a Thursday night at LBJ Tropical Medical Center in Pago Pago, American Samoa. I was spending a couple months as a student interning through the OB/GYN department and following around the Chief of obstetrics. My mentor, Dr. AC, is this amazing guy who has spent the last 15 years or so working in Pago, although he's originally from another island called Samoa. I know, it's weird that there are two islands with similar names, culture, and people but are yet run by different governments. Well, Dr. AC is amazing! It's just inspiring to work with people who are so passionate about medicine and taking care of their patients, despite the gruesome hours and lousy pay. But that's another blog story so back to the delivery room...

It's a thursday night and Dr. AC is on call but is catching a few zzz's since the midwife is also on duty. I get a phone call that a couple women have reached about 8 cm's and I rush to the hospital. At the moment of the phone call, I was drinking a diet coke and playing dominoes with my drunk cousins who were all trying to convince me to stay and party with them. But, being the nerd that I am, I wasn't about to give up this awesome opportunity to see a baby brought into the world. So off I went.

The mother is a girl about the same age as me and when I got to the hospital, she was already in the delivery room and pushing. I must admit that I didn't know what to expect when I got there. I always thought the delivery room was a serious place to be, and I guess it could be at times, especially when you have a difficult delivery. But that night, it was one of the funnest places I've been to in a hospital. The nurses were laughing and cracking jokes at each other. The midwife was telling me funny old delivery stories. I was feeling guilty having a jolly good time while the poor patient was writhing in pain from the contractions and pushing a baby that wasn't yet ready to see the world. But who am I to question? Afterall, I am just a student starting out in medicine.

After two hours of coaching the patient through her delivery, we finally see the head of her baby boy. A medio-lateral episiotomy was done to prevent eventual tearing and assist the delivery of the baby out of the vagina. Oh man..when I saw the midwife take that pair of scissors to cut the perineum, all I could do was look at the patient's face to gauge her reaction from the pain she will be experiencing. But...I did not see a reaction from her! I'm assuming that the pain of the contraction was so severe at that point that it masked the pain of the scissors tearing through the tissue. I really don't know how often this procedure is done in U.S. hospitals, but according to the midwife at LBJ, it is a pretty standard procedure that is done based on the decision of the delivering healthcare provider. Being the inquisitive student that I am, I asked the midwife on what grounds she based her decision making process to go ahead with an episiotomy and her answer was that "25 years of delivering babies just gave her an inkling to know which women will pull through without tearing and which women, she would have to make the tear for them." I really don't like this answer. It's like when I ask my dad exactly how much soysauce or vinegar to put into a dish where I'm making 3 pounds of chicken and his response is, "Years of making this dish and you just gauge what's enough soy sauce and vinegar..you throw in a splash of this and that..maybe a half a cup and just season to taste...that's all!" GRRRRRrrrrrr.

Well let's just say that the patient survived my screaming and I survived the pain of seeing scissors cut through tissue without local anesthetic. Yikes! But big day folks! I just saw a delivery. It wasn't what I imagined. I thought angels would start singing as soon as the baby was out and that there would be this unbearable silence as soon as the head poked out..almost like a silent anticipation. Well, I was right about the latter but the angels singing....well that was probably all in my head. But honestly, it was by far the coolest thing I have ever seen! To see a baby poke through a canal that you know in your mind to be a very narrow hole which then transforms to be this gaping hole leading to the inside of a woman's uterus...I mean...wow! The wonders of the human body...well a woman's body in this case!

So yeah, baby and mama were doing great the next day when I rotated through the post-partum maternity ward. It's funny how weird babies look as soon as they're delivered and then you see them afterwards when they are all cleaned up, bundled in a pink or blue blanket, and looking infectiously cute in their head warmers. As I tickled the little guy's foot, I couldn't help but think in my head.."Dude! I was there when you entered the world!" How cool is that?

in the army now...

I almost forgot to mention that I joined the U.S. Army. It's really not one of those moments that you forget to mention, either. It's just that it hasn't hit me yet that I have joined the military. I was fortunate enough to receive a scholarship in the Health Professional Scholarship Program (HPSP), wherein the Army pays me through my medical training, and in return I work as a physician for them when all is said and done. It really took me a while to think this through and in the end, this was the best option for me.

I just went through my first year of medical school accumulating a little over $65,000 in debt for GW's tuition (private school) and living in D.C. Although living in the nation's capital while going to med school makes me the coolest person beyond comprehension, it does not erase the fact that this city is ridiculously expensive! But I love it here and I love going to GW. Nevertheless, I spent most of the year stressing out about how much debt I would incur over the four years of medical school. Also, let's not talk about my debt to income ratio when I get done with school and starting working as a resident. Scary!!

So, long story short...the Army is the best option for right now. This decision will not really affect me until about seven years from now when I will most likely be done with residency and will start working as a physician. But how can I possibly know what my life will be like in 7 years? A year ago, I could not imagine finishing my first year of medical school! I will be a different person when I will be done with medical school and will definitely be a different person when I get done with residency. But...I'm hoping for the best and hopefully when the time comes, I will thoroughly enjoy being in the Army. Who knows? Maybe, I will like it so much that I'll make a career out of it! It is hard to make this type of decision when all variables are not being considered at the time, but at this point, I know I made the right choice to get me through medical school financially. It will be an interesting journey and I'm excited to start..


p.s.
My roommate joined as well! Sweet..maybe we'll end up at the same army hospital for residency! That would be a trip:)

Barefoot heaven

So my trip to the islands of Samoa is winding down. I'm actually trying to leave early...not because I'm sick of Paradise already but because I would like to spend some time with the family before second year starts. I just have to say that my summer is flying by so fast. I didn't realize that it's already the second week of July and I might be on a flight out of here by next week. Sad! It has been 7 years since I've been home sweet home. I realized just how much I missed Samoa when I went on a little vacation trip to an island called Upolu. Although I was born and raised on the island of Tutuila, I spent a lot of time growing up in Upolu, the island where my mom and grandfather is originally from. We just took a quick 5 day trip to visit with old friends and cousins, but I was in barefoot heaven while I was there. Although the island is progressing well into the future of tourism, many things remain the same: the sights in the back villages, certain smells, and the feeling of finally coming home. A strange feeling that I cannot quite describe overwhelmed me..as if I was waiting to exhale out a huge sigh of relief. I was home and I made a silent promise to myself to not stay away too long.

I might be leaving in the next couple weeks and it's just sad that my "last summer of freedom" is coming to a close. My trip to come down here was a good decision, though. I am learning a lot at the hospital following the Chief of OB/GYN and also learned some painful mistakes with my summer project. So although my summer involved some considerable damage to my liver and an abundant amount of time hanging out with my cousins and old friends, at least there has been some learning:)

The end of MSI

Wow. I can't believe it's finally here! Finals are finally over...well, first year of med school to be exact...and now I'm sitting on my favorite couch at home in Vegas while ribs and shrimp skewers are being cooked on the grill:) I love summers in Vegas. It's super hot but it's always a great time. Gosh, what a sigh of relief. Well, we have not received our final grades yet but at least finals are over and now it's just a waiting game for our grades. I hope it works out...

Until then, I will be hanging out at home, catching up with Bones and Greys Anatomy, watching new movies, and maybe do some shopping for my summer trip to the beautiful islands of Samoa. I can't wait to go back home this summer! I'll be really busy with the survey I'm going to administer but I'll be catching up with old friends and people I haven't seend in about 7 years. Crazy how fast time flies!

But back to medical school, this year has been amazing and crazy and fulfilling and more than what I imagined med school to be. I learned an astronomical amount this year! A year ago, I would not have believed it was possible to learn this much, but the brain is an amazing organ and proved me wrong. I'm really scared on what second year will bring to my plate because I hear horror stories on how much MORE information there will be and how harder it's going to be, but I'm looking forward to another crazy year....well, not just yet. I want a nice long 13 weeks all to myself without medical school on the brain. I want to just chill and hang out with family and friends having bbq's and going to the beach and reading books other than text books. What a fabulous summer it will be...

I miss Vegas and I miss Montana and I miss Samoa and I miss my parents and my sister. That's my update for now.

An ode to my mentor

The smell, so strong at first, it strikes me.
And cold air, its purpose known, shakes me.
My first sight of you terrifies me.
The death of you disturbs me.
Your intricate layers, folded away, intrigues me.
God's purposeful map laid out baffles me.
The temple of your soul instructs me.
With each deep cut in you, it stabs me.
Knowing a person once lived here scares me.
A reminder of your generous giving comforts me.
And now knowing your true story inspires me.

(Written after taking Anatomy my first semester.)

Drunk lullaby

Come tip a few with me
Transcend your world into mine.
With but a few gulps you could be on bended knee
And sway this way and that unable to stay in line.
Come drown a few sorrows with laughter.
We are all friends or will become better friends.
With maybe purer liquid we'll falter
Just keep in mind we must always deter our ends.
It is that task of freedom.
The lack of fear that runs through our veins.
We are inebriated some.
But it is a culture we refuse to give up reins.
Come live a night with me.
You shall forget your wills, your deeds, your lives.
And with your lost souls you can see
A slower projection on how my world thrives.

Words of steal

The words, they rumble.
My thoughts speak in written form.
Slanted but an odd beautiful form.
Softly hearing the scratches when ink meets its foe.
For it takes its breath away;
Each stroke steals and evacuates the very fiber of its life
And splatters it across white color.
Illuminating..enlightening..instructing.
A comforting thought for the instrument,
Comes in knowing the potential permanence it may provide.
In understanding what others will read
May inspire and may create heart.
A heart just enough to realize that what was stolen was a purpose.
A purposeful life worth losing
For the greater good of the masses.
To learn, to get inspired, and to acknowledge..
..the heart is in the reading.

A dark turn

Were you there with me driving through dark lanes?
Lined with ghosts of trees waving at me.
Silently you sat there in thoughts like blurred vision through rain,
You going in and out of consciousness and me wondering whats real.
No light up ahead.
None in my rear view.
My fingers grip so tightly,
My heart pounds, my head prays softly.
For safety from whats unknown.
Who's out there, who knows..
The beam of lights on my sides illuminate the periphery.
But the sound of enveloped silence overwhelms and swallows me all into its darkness.
If I scream, will anyone hear?
Lost voices probably have wondered the same.
What is salvation at life's last breath?
You would never have thought this on a busier road somewhere familiar...is my guess..

White picket fences

She sits there and stares at the flowers
Many colors combined to shine a reflection of higher powers.
What can she do? She cannot question this fate.
The color is there. Who would not believe this natural trait?

Where does the mind begin to inquire?
Is there no end to this madness?
A continuous labyrinth of opened endings that require first the mind, then the body, then a complete wholeness.

Those flowers, they eventually ease her mind.
The thoughts run slower giving up to something faster.
She cannot compete and outlast this continuous grind.
She is but one thought, a mind temporarily plastered.

She sits and with easy eyes
Sees the flowers' colors emerge from hiding.
Her mind is slow but does realize
She only needed time...this time the world and its rules abiding.

Words in a bottle

I'm thinking right now..Do words really matter? Do they really carry as much weight as we suppose they do? I know that actions speak louder than words and words can, at times, be strong enough to cause damage. But how strong can they be when you throw out good advice and people do not listen? What happens when you show love through words and nothing comes from it? I pose this question because I am quite disappointed with some news I just received. I am not a parent and won't be one for quite some time but I'm just baffled at how difficult it would be to rear a child. Just through my own experience growing up, I understand that most parents try and steer their children in the "right" direction. You know...the get-your-education-steer-away-from-drugs-and-jail pathway that is pretty generic. For girls you can probably throw in -not-become-pregnant as well. But how do you control your kids from going down the wrong path? How do you try to be there for them financially and lovingly when you're not there 24 hours a day to watch their every move just in case the minute you turn around, they decide to steal something and get handcuffed and taken to jail? How? I really do not know. Some say you gotta show them you love them and that you care for them. Well, what if you do and your kid still decides to one up you and make stupid decisions? You can try all you want to "talk to your kids about drugs". They still just might get hammered and get into the driver's seat and drive their car into a wall. You can always give sound advice with heavy words but the recipient must be able to receive those words. I guess you can't control any of this. People make their own decisions and as a parent, you also have to live with those decisions if there are grave consequences. I'm scared to death to have my own children because I'm afraid of the type of person I would become.

Admissions committee

Yay, I just got the email today that I got the position on the upcoming year's admission committee at GW! I'm so excited:)

The complexity of the heart

What makes the heart grow fonder?
Is it really time that makes it flutter?
Each beat strengthened more than the last
Its rhythm purposeful until it reaches fast.
Should we suppose this pattern is genius science?
A crippling reflex to feel compliance.
This tug and pull towards obligation
Because you become captured, body and soul, and stationed.
But what if one day the clock stopped ticking
The juice behind the wheel runs dry...the wheel goes creaking.
You feel like the blood of life is not flowing
For your heart has stopped, it no longer is glowing.
That love you once felt has changed to something else
An infection has seeped through and no intervention can help.
You reason why because that person, your partner, is still the same
But you don't recognize evolution, its hand difficult to tame.
For that person has changed as much as you,
Your steps away from each other, they weren't exactly a few.
Then desperately, you wonder, what is the cure to give this love its pulse
You will take any pill or syrup at whatever dose.
The many years gone by...this cannot be it
You’re in now and always
And your heart, you know is fit.
But your heart IS tired and old and weary
And the blueprint created this perfect fit in your lover’s hands…
…the problem is they know this clearly.

Life Unwanted

Hey there, yes you
I saw you from across the room.
With sunken eyes, deep and sorrowful
Did you not know this plan came with a tomb?
The room seems cold to you
It does for me too
The only sound separating your world from mine
Changes your life as it does mine.
Where did you come from? How did you get here?
Questions that don't matter, for they are here to allay your fears.
Meet the 12 week mark and sign the dotted line,
The only thing against you here is time.
Protesting: WE WANT LIFE, WE WANT LIFE!
Their cadence unwavering, it pierces you like a knife.
This is the right thing to do, you think over and over.
...A boy, he could be named Trevor..and for a girl, maybe Serah.
Those thoughts pushed aside for the millionth and one time,
For you've opened their door..you're sure they heard the chime.
It's too late to rethink, you have made your choice.
You spoke up for the one who had no voice.

Ingrid Michaelson on Friday

Yeah, so that was a quick rebound from depression in the last post. I just wanted to mention Ingrid's awesome concert this past Friday night. It was for the Music Inspires Health concert series that was hosted at Lisner Auditorium at GW. I was actually surprised that it didn't sell out because Ingrid is HUGE! But, I'm not complaining because we got great seats and the tickets were 15 buckaroos. The opening acts were April Smith and Ari Hest. Ummm...tell me why I came home and downloaded their music??!! I'm currently obsessed with Ari Hest because 1. He's hot, 2. He sounds like Elvis with his deep voice 3. Although he has a deep voice, he has a beautiful falsetto and 4. He's hot. So yeah it was an eventful night because I got to finally see Ingrid live and I must say she's amazing and so lovable! There was some malfunction with one of her guitarists so she proceeds to play the piano and has the crowd singing with her on her version of the Intro song of the Fresh Prince of Bel Air. Amazing:) Musicians have the best job in the world. They play music all day everyday. What could be better than that?

Home

I have 4 weeks and 6 days left before I'm home. I don't know why but I am really homesick! It may be the everyday drone of medical school that is getting me a little down. I wish I can get on a plane and fly home even for a day. But, that isn't practical. To me the money would be worth it, but it's way too expensive right now. Anyways, this is a waste of a post..

Clorox bottle

Today is Saturday and the image of a large clorox bottle has been burned in my mind since Thursday. I went out to Virginia to shadow my CAP physician while he worked at a women's clinic for the afternoon. I knew before hand what type of clinic this was, but I really did not realize just how this visit would affect me.

In summary, I saw nine abortions in the span of an hour and a half. Virginia law allows only first trimester (12 weeks) abortions. I believe the District of Columbia allows abortion up into the second trimester. The latest term I observed was 11 weeks and 2 days.

I will not go into too much detail here just because I do not feel like reliving that 2 hour span just yet. My CAP physician is an amazing individual, I must say. After the day was over, we had a recap session and he asked me if I had any questions. Of course I had a million questions at this point, but I filtered my questions to just those I won't be able to find on my own. This narrowed it down to one important question, which centered around how he felt after doing his first abortion on a woman and how he deals with it emotionally patient after patient. I asked this because almost every woman was crying during and after the procedure was done. Their tears may have initially been spawned by the brutal clamping of the cervix but may have been exacerbated by the finality of their decision with the last pressure sucking sound of the vacuum. Do you know that sound a vacuum makes when it is struggling to suck up an object from the carpet or floor and then when it finally gets it up through the tube and the object makes its way into the vacuum container, it makes that strong pressure releasing sound? Now imagine me intently observing my CAP right behind him and underneath the hot lamp waiting to see what was to come out of this woman and into the clear vacuum tube. It was as expected. Slowly at first, clear fluid came out and then bright red blood and then a dark red mass. The pressure within the tubes then increased to get the large dark red mass into the vacuum container. The sound I was describing earlier happens right before you see the dark red mass. I'm assuming this dense material was the target of the vacuum tube. Finally, a quick dip into the clorox bottle to disinfect the tubes from HIV and other viruses and the switch is turned off from the vacuum.

I just could not help but imagine myself in the place of any of these women and how this two minute procedure could change the course of their life. I understand that abortions are necessary to give women options. Like my CAP physician says, "Everyone makes mistakes but I'm not that person to make them live with that mistake for the rest of their lives. I give them options." I'm still contemplating on his words as I think about the events of that Thursday afternoon.

The problem here is not understanding the necessity of abortions in women's health. It's more my problem in dealing with them emotionally. I imagined myself in the place of these women, but I also imagined myself not being able to go through with it. I also imagined myself as my CAP physician and turning the machine off before I inserted the tube into the cervix of the patient.

But I'm trying to reason this out. I want to go into public health. I feel that my education teaches me to be objective and to see it from my patient's point of view regardless of how I may feel about the situation. This is a conflict...a conflict between what my brain tells me what is right and what my heart and soul says is right.

I see a young girl who may have just finished high school and may not have the resources to rear a child on her own and I see how this procedure can help her situation because who knows? She may be on her way to college or she may be one of the sole earners in her household and may not afford for another mouth to feed. Whatever the reason, there is one. But... all my little heart sees at this point is the little 11 week fetus with a head and hands and legs and feet all on a petri dish submerged in clorox.