The Wookie

Weekends, sometimes, are the hardest part of the week for me. It's not the classwork; that's certainly more difficult during the week. It's not the voluminous amounts of chores that need getting done amongst the studying. It's not even balancing of all of the above. It's the loneliness. During the week, I'm in contact with my classmates every day in class. I see them, get to talk to them, get to share stories and thoughts. During the week, I look forward to the solitude in the evenings. Then the weekend rolls around, and it's two days of having to live in my head with no one else to talk to. I know I've been without human contact when I start having full conversations with my cat. Yeah, so I know for a while last year I was posting most weeks about my little, little boys (Rex and Cody). In February, I adopted a ten year old Maine Coon.

Chewbacca is roughly 13-14 pounds, and absolutely beautiful. I try to not tell him that too often, don't want it going to his head. Unfortunately, I think he already knows how gorgeous he is. He's actually small for his breed. One of his brethren just broke the world record for longest cat (four feet from tip of nose to tip of tail). But Chewie has the most personality. When I come home from school, I can hear him coming all the way down the stairs from my room. The pitter patter of his feet and his tiny meows (I mean, he's a full grown cat that meows like a tiny kitten). He meows all the way down the steps and then gets into the living room and sees me. He flops on his side, rubs his face with his paws and meows at me. "Why hello Chewie!" which prompts his pulling himself around the living room on his side. That's right, he follows me around the living room by scooting along the floor on his side.

Chewie is also strange when it comes to food. See, the only type of meat he'll is fish, especially tuna. But he won't touch turkey or chicken or meat. Yet, he loves banana flavored ice cream, and really any sort of ice cream. He loves pumpkin (bread, cake, pie). He likes chocolate, and he loves the salt off of the goldfish crackers. I've never had such a strange cat. He plays fetch, comes to his name, plays soccer. I think he might actually be a dog that just happens to look like a cat.

At any rate, during the weekends, he is my primary social contact. I spend almost the entire weekend talking to him. I convince myself that it's completely normal to have full conversations with him. Sometimes he'll just walk away in the middle of a conversation, and I find myself getting sort of sad. It seems so silly, but I get even more lonely. He'll just wander upstairs to sleep on my bed, and I'll be left alone downstairs feeling abandoned. Yes, abandoned. I'm not the poor cat who was purchased as a kitten by a husband and wife and then shipped off to the humane society after living with the same family for 10 years. Yet, I'm the one that feels abandoned when he wanders off to take a nap.

I think I need to get out more...

Penny for your Thoughts?

I started having recurrent nightmares about being a doctor about a week into med school. It was always the same dream, and I would have it about once a week. It went something like this:

I walk into the exam room. The patient is sitting in the chair, and I introduce myself and sit down across from her. She then starts describing her ailment. She describes a runny nose for a couple of days, post-nasal drip, sore throat. It's a classic history of a URI viral infection, the common cold. But I start panicking. I'm listening to the history, and all I can think is "OMG! I don't know what this is. Can the patient tell I'm completely clueless, that I don't know what's going on with her?" It's absolutely terrifying. All I want is to be able to take care of my patients, and I can't even diagnose the common cold. I want to run out and leave and hide away and just cry. I mean, how can I be a good doctor if I can't even diagnose the common cold? How can I even consider being a doctor if I can't diagnose the common cold?

I would wake up from this dream in a cold sweat and usually crying. It made me feel like if I couldn't diagnose in my sleep, how could I be counted on to diagnose a real person. What kind of people would choose to be my patients if I was such a terrible doctor as to be incapable of caring for someone with the common cold.

Then, over the summer, I had time to sleep, to relax. I had time to not remember dreams. I didn't have my "I'll be a terrible doctor" dreams. It was relaxing. I spent the first 6 weeks of second year sleep deprived. If I had dreams, I never remembered them. Then GI block happened. It's so much more low key. I have time to sleep, lots of sleep. And I started dreaming again. The first dream I remember has already been chronicled, the one where I was called on to save the world. The second one was the newest installment of the "I will become a terrible doctor" dream. It was different, and went like this:

I've already been in the patients room. We've obviously been talking for quite some time, and I've figured out that she has depression. I know I need to prescribe her a an anti-depressant. And that's when I start panicking. I don't know what drug to give her or how to dose it. I'm sitting there in front of the patient, and she and her entire family are staring at me, waiting for the script. I can't write it. I can feel the tears pricking my eyes like hot needles, but I'm trying so incredibly hard to not just start bawling in front of the patient, so I excuse myself. I tell them to go ahead and check out, that I'll bring the prescription to the car. And then it takes all my will power to not just run out of the room. I walk to my desk, and the office manager is there, and I just start bawling. I tell her that I can't do this, I don't know what to do. I tell her I don't know how I got this job if I can't even write a prescription for one of my patients. How can I care for these people if I don't know how to prescribe them the right medications? The office manager looks at me and says, "You can do this. You know what to do, just take a deep breath." And I try that, and somehow I figure out how to write the script. I take it out to the patient, and when I come back inside the office, I see that there are 3 of 4 rooms filled. I feel like I'm doing alright...that is, until I look at the list of appointments for the day, and realize that I'm actually 10 patients behind. The panic begins again right before I wake up...

I don't know why I have these dreams or if they will go on for the rest of my life. I sort of hope they don't because they are absolutely terrifying... I mean, what if I do finish all this up and still don't know what I'm doing? What if I can't take care of my patients? I hope these dreams don't come true...

Maybe you should call your nearest Psych Ward to see if one of their patients escaped...

Yes, I did just post less than 5 minutes ago. I have too much pent up energy that needs to be let out. My creative energy has been working overtime in my sleep, and so I thought I would share the insanity of my dreams.

Last week I dreamt that it was my job to save the world from an evil force being created in a fortress in PA. According to google maps in my dreams (yes, I know for a fact that it was google maps because it is the ONLY map source I use in real life and apparently in dream life). So anyway, according to google maps, this fortress was a simple drive up 40 to 70 from my little townhouse in Winston-Salem, NC. In case anyone was confused, 40 is an east-west highway, and, if 70 exists, it would also be an east-west route. Yet, PA is definitely and always has been north of NC. Guess dreams aren't always true to life...but I digress. So, I get in my little Honda Civic and get on the road, occasionally checking the printed off google map to make sure I was still on trek. Granted, a large ominous fortress in the middle of PA should have been blatantly obvious AND the map directions had only 2 directions on them (1. get on 40, not sure if it was east or west though I distinctly remember getting on 40 west; 2. get on 70...it said north, but I know for real life purposes that can't be...) Anyway, so I get to this fortress and it looks a little like Minas Tirith from "The Two Towers" and apparently myself and the rest of the US population was trying to get in. I swear the line into Doom was longer than the lines to a Nascar race at Lowes Motorspeedway, and we weren't moving. The entire time I'm thinking, "Dang it, do these people not know what they are headed into. We're all gonna die (spoken like Roz from Monsters Inc.)" I finally get into the fortress and immediately go to work finding the mastermind behind the Doomsday army. Yeah yeah, I know, super creative. I find him take something that looks like a flashdrive from him and then have to figure out how to get out of the fortress with it. Must have been the boot drive for the robot army. I think 3 different cars and a high speed chase later, and I arrived back in NC, safe and sound having thwarted the plot of an evil mastermind in PA in a fortress...wish it was that easy and that cool in real life.

That was one dream. I'll get on posting the other ones over the next couple of days for my practically non-existent audience...or existent. One can only hope...

What's the MD all about?

When I was a sophomore in college I needed an outlet for my creative energy. This was meant to be my reprieve from the real world, my release. I wanted to write whatever I wanted whenever I wanted. As life has gotten busier, I have left my creativity to the wayside, pretending I would pick it back up when things quieted down. Yet, even in the quite moments, instead of writing, I slept, I watched TV, I ate. I let my creativity become necrotic, atrophied, cachexic. I said, "Oh, it'll all come back," or "I'm just not motivated enough". Yet, it was the writing, itself, that motivated me. I would ramble and ramble in my writings, and eventually would come up with something that resembled a thought, a belief, a story, perhaps. Maybe, (maybe, I thought...) someone else could be inspired by me and create their own beauty in words. But then I quickly realized that was impossible. Perhaps, somewhere on the other side of the world there is someone waiting for my next post, my thoughts, something to get them geared up and ready to create their next work. I kid myself, though. I am not that great. In dreams, perhaps, I write great stories, stories that people want to read, enjoy reading, read at book clubs or "hey, did you read this book...it's amazing" or "my children just love this book. They make me read it to them every night" or "she's such an amazing writer, and to think this happened while she was in med school". But what does a med student write about?

"23 year old female presents with delusional thinking and ideas of grandeur."

"23 year old female presents with vague abdominal pain, head aches, and is convinced she has every disease known"

"23 year old female presents with too many hopes and wishes that will never come true but everyone around her is afraid to tell her the truth"

What do doctors write about? We write about ourselves through other people. We can't face our own truths, so we throw them on our hypothetical patients. They become us. We are touched by those who remind us of ourselves. We brag about the patients that we can fix, but deep down know we are closer to the ones that are difficult cases. The ones we scratch our heads over and proclaim concern over not being able to figure out the problem. But if we do figure out the problem, can we fix it? Can we take the patient and make them whole again? Give them back their identity after it had been stolen away by an EMR number? If we give them back their identity, what becomes of ours? Does it expand or contract? Are we more ourselves or less ourselves?

Are doctors really just glorified, overpaid storytellers? Do we weave truth and guesses together and call it a history, a SOAP note? Do we explain real people? Sad to say that after a little over a year in med school, and I'm not completely sure. We collect histories, perform physicals, do tests and imaging studies, make up something of a differential diagnosis and then cross of unlikelies. In the end, we treat what's the most likely cause of an ailment. Then, we write it up, make it pretty, add pronouns, verbs, flesh it out and give it breath. In the end it looks like a person, but it's only a small piece. The piece we were allowed to explore during the person's time with us in the hospital, the part that was poked and prodded endlessly by doctors, residents, med students. And the person usually gets better and goes home, and the only remembrance we have is that note we wrote that now looks like illegible chicken scratch. Do they realize they touched us and molded us and help shape us into who we become? I am a med student. I know nothing, yet I learn more from the patients I talk to, and they make me who I will become, more so than I think either of us realize. And I thank them, all of them, all the current patients I talk to for my educational benefit, all the patients I will talk to as a 3rd and 4th year, for my educational benefit. I am a selfish being in a profession where all I want to do is give hope. Am I too naive for the career I've chosen?