Today is a new day!

Ok, so I have a new goal, to post weekly! I would like to get into the swing of this blog thing. It is summertime in lovely Milwaukee. Actually starting this week, I am spending my weekdays in Madison, and coming back for the weekends. This will be for several months. I am enjoying my current rotation. The schedule is light enough that I have been commuting almost daily, and I am really enjoying learning to read radiological images better. Xrays, CT scans, MRI's, and then there are the Ultrasounds, which are harder. But this is a great skill developing time. I think I've decided that I really like it when there is a specific goal, and skill to be developed. It is much easier to see that I am making progress, than other more nebulous goals like "understand diabetes management". I mean, there is a basic understanding, there is intermediate understanding, there is advanced understanding, there is researcher level understanding, there is patient level understanding, etc. It is rarely specified when we reach the 'good enough for this level of training' stage, and so I constantly feel inadequate. Here, the requirements are basic and laid out. They want us to be able to see pneumonia, collapsed lungs, dissecting aortas and have a basic grasp of other concepts. They don't expect us to be radiologists. It is very nice and respectful. Hooray for reasonableness and adult style education!

I went to the Family Medicine National Conference for Students and Residents, which basically had all the residency programs in the country to talk to. One of the programs I talked to had just restructured their residency to be based on adult education theories. This is unbelievably rare in this field. For incoming interns (first year of residency), they have them start for a few weeks, and then they take them out of the hospital for a few weeks to reflect and design their own learning course. This is truly innovative. I wish I wanted to move to Allentown, PA, because that program seems amazing.

One thing that can be terribly frustrating is not having much control over my schedule. The medical school can be so unreasonable. I was just denied a request to be absent on the Tuesday after Labor Day. I am going to be going to a wonderful wedding that Sunday, and I would have liked to stay an extra day to visit with family. I can't come a day early because one of my closest friends in med school is getting married in Milwaukee that Sat. I am going to appeal it, however it is unlikely to be approved at this point. If it wasn't a transition point, I would just work it out with my team (even though this is not what we are supposed to do, it is often the only way to make this type of thing happen). One day of training will not make a difference, and I offered to make it up with either my team or an extra day of call. They are so inflexible, and this is infuriating sometimes. It feels quite disrespectful. Anyway, this is just an example of the challenges in the system.

I just wrote a long email to a dear friend, and a portion of it seemed relevant, so I am going to share it here. Recently I posted on facebook that I missed my old life. Thanks to all of you who responded that my old life misses me too.

"I do really miss my old life. Right now it is just about one day at a time, one foot in front of the other. Less than one more year to go. I am having many doubts about going in this direction in my life. I am not changing course right now, but having some misgivings. I am hoping it will all work out in the end, and I'm sure it will because I will make it, but does happiness lie at the end of this road? I'm not exactly sure. I do know that this system blows big time. I hate the hospital/managed care environment, but I probably knew that before I started. The medical-industrial complex, as someone recently reminded me of this terminology, is messed up. It hurts patients and staff. It is a societal problem though. This goes back to realizing that our society is messed up. I think that we can do our part and leave a positive impact. I also think that I miss my bubble world which runs by slightly different rules that make more sense to me. There are tons of studies on how medical students become the most cynical at the end of third year. I thought, "this won't be me, I am a positive person", but here I am. I think it all hit me about a month ago. The people I've helped care for, the breakdowns in the system, the nasty comments about patients, students, nurses, doctors, everyone. It can be really painful. I think I romanticize that being in CA would be different, but I think it would likely be similar. I am constantly treading water just to stay in the same place, much less get swept away by the current or swim upstream. There are good people here, and the integrative medicine departments are good, and family medicine has lots of great people in it. I feel very sure about the field I am going into. I think it will help when I am in residency to be surrounded by these colleagues more of the time. These are people who value people, who know that being healthy is more than physical ailments. The ends do not justify the means, the process is equally important. I just really hope that I can Match into a program where I am valued for my background and training, and for my unique perspective, as well as a program that supports its residents amazingly well. So that is on my mind these days as well as the process is beginning."

Oh yes, the Match process is looming in every 4th year medical student's mind right now. This is this crazy process where you apply to residency programs, then go on interviews. At the end of this in February, all applicants submit a list in rank order of every program they would be willing to go to, and every program submits a rank list of every applicant they would be willing to accept. Some computer runs some crazy process to Match it all up, and then on the third thursday in March, everyone across the country finds out the results at the same time. So March 17 is gonna be a crazy day. However the process of applying is beginning now, so it can be hard. Writing a personal statement is so difficult because it is supposed to be great, convey who you are, and be witty too. These are the attributes of great writing, and while I may have been a better writer before, I have certainly not been writing much lately.

So I called this post "today is a new day" because it is true! Everyday is a new day to reinvent yourself, to re-experience life! I have been re-membering myself, and part of that is re-embracing my pre-med school self, and focusing on bringing more mindfulness to my daily activities. Being present in the here and now is all we truly have.

Lastly, this week is Jerry Week, the week encompassing Jerry Garcia's birthday (Aug 1) and passing day (Aug 9). I have been listening to some amazing music, interviews, and analysis of his musical talent and development. It is wonderful and a blessing to have his legacy continue.

So, Happy Jerry Week to all, and love life and each other as best as you can!