Study groups and exams

Just a quick note… yesterday three of the girls came over to my place to review for physiology. We have exams coming up on Monday (they have a total of 8 exams… 2 this Friday, 6 on Monday). I’ll have three exams on Monday: Microbiology/Immunology, Biochemistry, and Physiology.

Anyhow, the girls came over and we opted to review the later half of the course thus far. We were able to get through two of toughest lectures: Cell signaling/homeostasis and cell electrophysiology (membrane potentials). I’m so glad! I feel much more confident in that particular area.

Tomorrow I am meeting with another girl to review the last two lectures of this chunck: membrane potentials II (action potential – a lot more complicated than you’d think!) and synaptic transmission. I’ll probably review that again on Friday afternoon with a different study group, but I don’t mind. Hopefully they let me “teach” it like last time – it helps me to learn.

I really need to put some time back into micro/immuno and biochem though. I cannot underestimate them the way I did last year o.o

Yeaaah, this tends to happen a lot ._.

A box of tissues with lotion in them

I found a few good friends at medical school last year but we’ve been separated because they are now M2’s and in different campuses. I was really worried this year about being able to find friends that I could fit in with. I know the exact moment today when I realized I had found them…

I mentioned that I wanted to go to Puerto Rico one day. She invited us all to head over for a week to stay with her (that’s her home) in the summer. I hesitated and said, “Hmm, it depends on how my family is.” Another girl asked me how my family and I were doing and dealing with the passing of my Abuelito. I told her that we were still struggling. I told her that I was especially sad right now because in two days, if he were still here, it would have been his 81st birthday. And then I told the group of girls that I was worried about talking any further because I knew I’d break into tears and that I was having much too good and happy of a morning to have it end in tears. The girl from Puerto Rico got up and, as she went to her room, said,

“I’ve got a box of tissues, the ones with lotion in them!”

And that’s how I knew 🙂

One life to love

You only get just one time around

You only get one shot at this

One chance, to find out

The one thing that you don’t wanna miss

One day when it’s all said and done

I hope you see that it was enough, this

One ride, one try, one life… To love…………

– 33 miles: One Life to Love

Little randoms

A few days ago I got my first piece of mail that was addressed to “Dr. [My First and Last Name].”  It was from a company that insures doctors. In any case… PBT Insurance Office… you are four years too early! I don’t graduate until May of 2014  🙂   Here is a picture of it because my sister insisted on being able to see it (I had already torn it up at that point though…)

Mail addressed to "Dr. Susy Grajeda"

Now, shameless plug for the cuteness of my cat, Liesl:

Chilling on the couch

Yes, how may I help you? 🙂

This is one of my favorite places to sleep. Check out the awesome cover that Susy's Mami Nena made her 🙂

Aren't I a cute cat?

“Press on and just fight the good fight”

An old friend wrote me yesterday and said this (excerpt from the email):

“Great to hear from you, but so sorry about your news.  I saw you added a new photo on Facebook of your Grandfather.  I am so sorry for your loss and hope that you and your family are starting to do a bit better.  During the 4K, I can remember the exact stretch of road where I think that the trip really turned for the better for you.  I was amazed at how strong and confident you became, and how disappointing it was when you were injured right before the Rockies.  But you still pushed through.  In the same way, I hope that through the pain and sorrow of your loss that you will be inspired and strengthened in your medical career beyond what you dreamed for yourself.”

For quick reference, “the 4K” was a cross-country cycling trip that a group of us from my college (and other colleges) made in the summer of 2006 to raise money for the Hope Lodge in Baltimore and for the American Cancer Society. It is now known as “4K for Cancer.”

In any case, the stretch of road that my friend is referring to was in the state of Missouri. We had entered the state the day before and I remember being intimidated by just how hilly the terrain was. The only thing I could focus on at the time was that the climb up was always so hard. I remember pulling over to the left side of my friend’s bike at the beginning of the ride and asking, “How do I learn to ride these hills?” My friend told me a very simple thing:

“You should be pedaling your hardest on the downhill, not the uphill. Use what you gain on your downhill to fly back uphill.”

It made so much sense. From that moment on I conquered those hills and the mountains that came.

That last bit that my friend told me, about being inspired and strengthened in my medical career beyond what I imagined for myself brought to mind a lecture that we had this past week in school. One of the courses that I am taking this year is called, “Introduction to Human Disease.” The introductory lecture featured many of the four campuses physician-professors giving us a talk about what they have learned throughout their career and what we should keep in mind.

Medicine is a collaborative field. Learn to work well with everyone and with grace.

Don’t be afraid to be wrong. Physicians are constantly checking each other and providing each other with new information or corrections.

Learn that the clinical faculty at your school really sees students as a member of their profession. Really!

First impressions are so important. When you approach your clinical faculty, think about how you present and ask your questions.

Be a child in medicine. Report what you see, hear, smell, and feel, even if it means that you are the only one that does. Some ailments can be discovered in that manner. [Story of Atrial Myxoma and Medical Student who did NOT hear a murmur despite other reports that murmur WAS present.]

As members of this profession, even if you are barely starting, you will no longer be able to ignore friends or family who approach you to ask you about their predicaments. Listen to their story. Learn from it. And then say, “Oh, gee, that’s really interesting. Why don’t you go see your doctor about it?” [Oh man, the laughter that erupted from our class when the doctor said this….]

Be curious about everyone’s story. This is how you learn in medicine.

Don’t speak in jargon to your patients. Remember your very first day of encountering these new words [he was referring to medical abbreviations/language] and how you felt [lost, confused, worried, intimidated]. Make sure you make your patient feel comfortable.

[Probably the most meaningful to me:] You’ve been given an opportunity that not many people in the world have. People will share with you matters that are so private to them that they do not even share with their own spouse or family. Respect this. And do whatever is in your power (ethically) to help them.

Hearing all these things really reminded me of what’s to come. In a sense, though, I’m already here.

But my other pediatrician ALWAYS gives us medicine!!!

So what would you do? Say that you are fifteen or twenty years into the future, that you are a pediatrician or family medicine doctor, and that a mother comes in with her young child who has a throat that hurts? What if, after examination, you find that the cause of the throat hurting is viral and that there is nothing you can give the child that will help him or her? A viral infection, after all, only really goes away on its own after a while.

But say that the parent insists on being prescribed an antibiotic. What do you do?

That was the topic of one of our lecture in IHD last week. So what do you do?

Listen to their point of view. Ask them what it is that they expect for or hope that the medicine will do. Tailor your response according to their belief. Do your best to understand why it is that they want the antibiotic.

Talk to the parent about why an antibiotic is not recommended. Discuss the facts with them about bacteria versus viruses.

If you are a parent yourself, speak from that point of view. “If my child had what your child has, this is what I would do…”

Utilize the support of your staff (nurses, for example).

Probably the most important… reassure your patient and their parents that you are on their side and that you want them to recover quickly. Let them know that if you believed that antibiotics would be effective, you would prescribe it to them, but since you do not and they could instead only be harmful, you will not prescribe them.

Now the real test… let’s see what happens when I encounter my first situation like this 🙂

Everything happens for a reason and all things work out as they should.

The title says it all for me. It is a belief that I hold very near and dear to my heart, but it was also one that I had/have had much difficulty in completely believing. Still, when I think about it now, after I’ve had a chance to catch my breath, I look back and see how uncanny it was that everything played out the way it did. And then I see for myself just how true that belief is.

Last year I struggled with the decision to decompress. Before that, I tried in vain to figure out why I hadn’t gotten into medical school during the first season that I applied in. And if you look further back yet, I agonized over why I couldn’t be one of those students who was able to get into medical school straight out of college.

Well here I sit now and finally (I think) realize why things played out the way they did and how they allowed me to be in the right place at the right time. It was actually my abuelito that got me thinking about all this.

A few days after he had finally been able to return home (on hospice care), we had a conversation. It was the middle of the night and he had woken me up because he needed help with something. So there I was, at the side of his bed (I remember specifically on his left side) and I was taking care of him. I hadn’t turned on the light because it was nice to just have the room in moonlight. He turned to me and said (in Spanish of course),

“You know – I thank God so much that you are able to be here with me and to help me through everything. What a coincidence that you are in a part of your life where you can be here without any commitments to anywhere else, or without any worry outside of home, don’t you think?”

Hmmm. So very true. He knew about every obstacle I encountered and would always tell me along the way that things happened for a reason. He was telling me now that he believed that one of the reasons that everything I listed above happened was because it eventually allowed for me to be with him.

Think about it. Say, for example, that I had NOT decompressed. A number of things could have happened.

• Option A: I pass all classes and am able to move onto year 2. But this would mean that I would have had to return to school much earlier (end of July/early August). If all had proceeded with my abuelito exactly as it had in reality, the events that would have occurred would have been his passing, his funeral, and a straight flight to school. No time to grieve with my loved ones. Ouch.
• Option B: I fail one or more classes. This would have meant that I would have had to remain at school for the summer and study for/retake cumulative exams. I would NOT have been able to return home, thus denying him one of his final wishes/requests. I would have been overwhelmingly sad, inconsolable, distracted and distraught while “fake” studying. I might or might not have been able to pass the exams. I would likely have had to repeat my first year in its entirety all while knowing that I would not have been able to be with my abuelito or my family. Double triple to the infinity ouch, right?

So how beautiful it is that everything occurred as it did? That I decompressed, passed everything, that I learned just enough to be able to do for him what I had to do but not more than I needed to know at the moment and so NOT freak out (some ignorance IS bliss), and, finally, that I was able to be home for him for as long as HE needed me to and to even have time to grieve with my family. I absolutely detest the fact that my abuelito is no longer “here,” but if God had a plan for him and decided it was time for him to leave us and return to him, then I am tremendously thankful that that events played out the way they did, in this manner. If things had to happen, I’m glad they happened like this. At least I know with all my heart that I did everything I possibly could for him.

First day of decompressed M1 year 2

I think I mentioned some time back that I am now the UHP Anatomy TA. I had a great deal of practice this summer being the TA for the Summer Prematriculation Program, so I am confident that I will be able to help whatever students come to office hours. Still, I remember being taken aback by the first lecture of the class (dealing with PNS/CNS and what fibers make up a nerve going to where, etc) so I decided to attend to make sure I have my information correct.

It’s amazing just how much sense everything makes now! Tell me. Why don’t I have the capacity to “just understand” new concepts the first time around? Aish…. Anyone ever feel that way?

I feel like I am going to be attending the class more often and a few other ones too (maybe embryology?). I want to make sure I don’t forget key material.

I wanted to sit in the first row but that was filled (haha, I guarantee it won’t stay that way past the 4th week of school though). Seems like I’ll just have to wait until the “I’ma-study-from-home” and “I-prefer-listening-to-podcasts” people are filtered out. I happened to meet a couple of cool people today (Ann(e), Susan, and Allison). Unfortunately for me they are all on the Rockford track 😦  Oh well. I really liked talking to them today so hopefully they’ll be willing to form a study group or something for oh…. say…. physiology?

Today was fun in the sense that biochemistry was a total kindergarten hour! The professor had us make 3D models of the DNA helix. This particular professor is a favorite of mine because she really seeks to encourage and build confidence in the student first. She reasons that success follows confidence, and that confidence and success should be mingled in with fun. I agree 🙂

Routine is pretty important during the school year. I’m trying to work one out right now. I think I’ll stay at school until 3pm (at least) everyday to make sure I get my studying done. Then I’ll go to the 5:30pm gym sessions and get back to work around 7:30pm. At about 9pm I’ll stop to make the next day’s food and take it from there. We’ll see!

I leave you with a few pictures of biochemistry class fun 🙂

Protected: Yes, I happen to be one of those girls that plans this event from childhood on =p

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Let’s make this a habit.

One thing that I remember most about my abuelito was that he loved to get up at the crack of dawn (sometimes before!) and begin moving around. His “exercise,” he’d always tell me. It was one of his favorite parts of the day. He’d tend to the front and back yards, sweep away fallen leaves, wash his car and then those of other family members. And then he’d proudly show off how his shirt was dripping in sweat. Ay, abuelo!

So today is a month that you’ve been gone. I still have trouble believing it. Sometimes I don’t want to admit it, but who am I fooling? I had a choice today to either cry and sulk or to live today as you would have done if you were still here. So I did the former (okay, and maybe a little bit of the latter).

I went to my crossfit gym and got back into the swing of things. I’d say that I was fairly winded and had to scale back quite a bit, but I held my own and did the best I could. I’m glad I got to show abuelito my pictures of me at the gym. He was so impressed and so proud 🙂

Susy at Momentum Gym - This was a "thurster" at 95# (max)

One of the other things that I remember he would love to do while he was still living with us was to visit the Farmer’s Market at Wilson Park (back home). I went with him a few times. We would eat caramelized popcorn together 🙂  There is a Farmer’s Market at Lincoln Square in Urbana that goes from 8am-12pm. I’d never made it before because I was just too lazy to get up from bed. Well – no more! Today I went right after my workout and it felt so good to walk and see everything. Coincidentally, going to farmer’s markets and “meets” is an interest that my brother, sister and dad (especially) share too! Mom … probably not so much, hmm? :-]

Hot and Spicy Chiles - These are for you, Abuelito!

So yes. I did what he would have liked to do. I exercised in the morning, and I walked in the farmer’s market.

Yeah. Let’s make this a habit, shall we?