March 2, 2018 § 5 Comments
Today marks nine years since I moved to Norway. Every year on this day, I take the time to reflect on everything that has happened. On who I was then. On the challenges experienced. On the memories created. And finally, on who I have become. This time nine years ago, a man seated next to me on the plane asked me where I was going and how long I would be there. “Norway. And, I have no idea.”, I’d replied. I remember getting lost in Heathrow during my connection. I remember feeling the most alone I’d ever felt in my life. As the plane passed through the clouds blanketing Oslo, it hit me. There was snow – everywhere – and I hadn’t seen snow in almost a decade. From that point, from that shattering realization that home was no longer a familiar concept, everything changed. I am no longer that clueless, hopeful girl with a one-way ticket.
It’s been quite a while since I wrote. It’s not for lack of caring – or lack of reflection or content – but rather lack of time. The weeks following USMLE Step 1 were extremely tough for me, as can be gathered from my previous post. I was exhausted and felt completely defeated. I set my focus on my trip to the states and any motivation I was able to muster up was funneled into preparing for my final exam in internal medicine (one of the biggest exams of our final year).
On December 13th, on my way home from the gym, I got THE email I’d been waiting for since the moment I’d selected “submit”. At that point, I had absolutely no idea how I was going to react. So, I continued home, where I started cleaning and organizing the apartment. After half an hour or so, Amir called me. It turned out he’d been waiting in my apartment building for the past twenty minutes. The results are released on the Wednesday three weeks after your exam at around 15:00. I’d initially wanted to be alone when I opened the results, but I invited him in and tried distracting myself with cleaning and meaningless conversation. He finally convinced me to stop avoiding it. If you ask him, he’ll tell you that the moment the result loaded on the screen, the look on my face told him I’d failed.
“Oh my god…. I passed.” Pure shock ran through my body.
Allowing him to be there while I got the result was the best decision I could have made. I had been so sure I’d failed, that I genuinely didn’t know how to respond. Having your best friend there in such a moment, celebrating you with such pure excitement, is priceless. It dragged me out of my state of shock and allowed me to start feeling the relief and happiness that one should feel after such an accomplishment.
After that moment, a certain confidence began to set in. Pushing myself through those months of studying, the countless hours spent going through questions and memorizing pathways and tables, had altered my brain. It took all the unfiled knowledge I had packed away in my mind after five years of medical school and put it all into place. It taught me how to think like a doctor. The first time I realized this was on a night shift in internal medicine. As we were running up the stairs to see a patient who had just been admitted to the endocrinology department, my doctor said, “Patient presenting with severe dyspnea and hyperkalemia. How do you treat hyperkalemia? Think about it and tell me when we get there.” Initially, I felt panic. I told myself I didn’t know and began to worry that I would look stupid. But then, I stopped myself. I pushed away the immediate block I’d put up, took a deep breath, and began to think it through. By the time we got there, I was ready.
T: Good. Another?
B: Mmmm, diuretic?
T: Which one?
B: Loop. Furosemide?
T: Good. And a third? (She gave me the hint that it was an ion)
T: Yes. Good.
Had I learned this in pharmacology? Yes. Had I been tested on it in my endocrinology exam? Yes. Was it knowledge easily accessed as a result of studying for school exams? No. Was it knowledge easily accessed as a result of studying for Step 1? Absolutely. Preparing for that exam has made all the difference. It took my mindset from that of a medical student to that of a clinician.
We left for Minneapolis the day after our final exam in internal medicine. What followed was three blissful weeks with my amazing family. I allowed myself a break from everything. After the year I’d had, I wanted to check out and live completely in the moment. I was going to need a rested body and healthy state of mind to tackle what lay ahead.
Sitting at the airport in Amsterdam on our way back to Budapest, Amir asked me how I felt about coming back. At that moment, it felt like I was heading into hell. While studying for Step 1, I’d pushed off everything I possibly could. Coming back meant having to finally deal with everything. My thesis (which I hadn’t started), applying for internships and summer jobs, starting the study process for Step 2 – all on top of my rotations, exams, and teaching.
It’s been a little over a month and a half and now I’m standing at the top of the mountain, looking down at everything I’ve accomplished and all the possible futures that lie ahead. My thesis is finished and my defense is scheduled for next Friday. I’ve submitted applications to the U.K. and Norway. I’ve registered for Step 2. The things that at one time felt so impossible are now just ticked boxes on a checklist.
So, what do I have ahead? Interviews. Step 2. Rotations and rotation exams. Boards.
After that? We’ll just have to wait and see.
November 20, 2017 § 8 Comments
It’s midnight on Sunday and I actually had to force myself to stop studying and go to bed. At this point, I honestly feel like I could just go on forever, until my body is nothing but a pile of dust. I think this last little spurt of motivation and energy is because I can finally see the finish line. I need to be careful though, because this finish line is not actually a finish line…it’s another marathon. It’s THE marathon. And if I go sprinting towards it, there won’t be anything left of me when it actually counts.
Today I finished my second round of UWORLD. Together with the NBMES and UWORLD simulation exam I’ve done, that brings me to around 6,000 questions reviewed for this exam. I did all of my questions in blocks of 40 (timed and random) and it took me anywhere from two to eight hours (if not more) to review a block (to read through the explanations and cover corresponding theory).
Tomorrow, I’ll start my day with my last simulation exam before the real thing on Friday. I’m a little nervous because getting a bad result will really destroy my confidence. As I get closer and closer to this exam, I feel myself losing control of my ability to rationalize and to quell my fears and anxiety. I’ve put so much time, energy and money into this exam and I’m scared that I’ll blow it. That I’ll sit there and know nothing. I know that’s not the case, but again, rational thought and control are segmented now (just like the lesions of temporal arteritis). Yes, social skills are still on point.
Otherwise, I’m going through my endless notes and flashcards, rehearsing my mnemonics and trying not to let my mind wander into any dark places. I can’t believe this week is finally here…
October 30, 2017 § 2 Comments
I’ve told myself almost 100 times now that I can treat myself to writing a blog post when I reach my goals (for that day). Clearly, that hasn’t happened yet! So here I am, sneaking time away from studying even though I’m nowhere close to finishing today’s task list.
Studying for this exam is unlike anything I’ve ever experienced. I’m literally being tested on everything that I’ve learned, every single subject simultaneously, and there is absolutely no end to it all. I could probably study for this exam for years and years. Luckily, that isn’t what is required to pass this exam.
I am 25 days out from my exam and I am officially freaking out (while still being mildly functional). For at least the past month, I’ve lost my ability to communicate like a normal person. I can tell when I am having conversations with my friends that I’m just not making sense anymore. How do I know? Because even I don’t know what I am saying! I’ve also lost my ability to come up with metaphors that DON’T have something to do with medicine (e.g. “Haha, he’s just like a retinoic acid receptor!” or “You’re just like Class IB antiarrhythmics, both of you have a predilection for damaged tissue”). I wish I was kidding about that. This sort of mania is something that I think only people who have studied for this exam before can understand. My friend Stephanie is the best example: she NEVER gets stressed or anxious for exams (or honestly about anything) and yet, even she had panic attacks while studying for this exam.
Luckily, teaching has been really helpful and I’ve enjoyed the break away from the books to spend time with my students. We are covering neuroanatomy this semester and preparing for the lessons has made me ace almost all my neuro questions. They’ve been amazing and are always so engaged. I share some of my Step 1 questions (the ones relevant to their material) in our facebook group and I love seeing how they process and discuss the possible answers. I’ve been so, so impressed with their knowledge and efforts!
So, what exactly is my life like right now? I wake up at 5:00 (sometimes 6:00 if I’ve had a rough night sleeping, which happens more often than not), throw random grains and nuts in the rice cooker (if I don’t have some leftover), do cardio while doing questions/watching Pathoma or Sketchy videos, shower, settle in for rounds of questions (UWORLD: I do a full block (40 questions), random (all subject and disciplines) and on timed mode every time. This is the best way to simulate the exam experience. The exam is as much about knowledge as it is about endurance.). Doing the rounds and their subsequent review can take the whole day (and it usually does). I study as late as I can and then I do flashcards in bed until I fall asleep. If I’m lucky, I’m asleep by 22:00. Obviously, there are various dips in energy and focus throughout the day. I haven’t been able to nap longer than 15 minutes for the past two months and now I’m even down to only 5-10 minutes before my brain starts going through uncontrollable UWORLD withdrawal. Now that I’m starting to get even more anxious, I’m going to start studying out of the apartment more. I need to dissociate my exam from my home if I am going to stay sane these next few weeks.
Everything in my life right now is 100%, absolutely full-force USMLE. I’ve tried to minimize all other obligations so that I can (a) have more time to study and (b) prevent spreading myself too thin and doing horribly in all areas of my life. I’ve pushed A LOT until after my exam. This includes my thesis and my gynecology final, as well as a huge chunk of my internal rotation (which I am doing now). My friends Marianne and Dushyant have offered to take some of my anatomy classes, which is extremely helpful. It is really important to me that my students have a good teacher and I’m so lucky to have strong, competent friends who are willing to step in when I can’t be that for them. Marianne is doing most of her rotations in Norway, but she is here for two months to do her pediatrics rotation and she’s been at my place studying almost every day.
Ok, the books are calling, so I’m going to leave you with some pictures that I’ve taken the past two months. Clearly, my life is little more than studying, cooking (I’ve been making literally all my meals in a rice cooker – those things are amazing!!), and going out for groceries or to walk Baloo. Luckily, I live in a really beautiful part of Budapest, so leaving my apartment is always a treat.
Music has been my saving grace through all of this. I listen to music from when I get up until I go to bed – and the selection is all over the place!
- Acre: random collection of my favorite more upbeat songs these past months (lots of Nigerian artists, my new obsession!)
- Blue Dream: random collection of my favorite more calm songs
- Block: This + Rainymood when I am doing my blocks!
- For the lonely hours or im closing my eyes: When I am reviewing my blocks or when it starts getting late (lately I’ve been adding Rainymood as well)
- Caffeine 300mg or 150mg: usually in the mornings and early afternoons
- They don’t know or Carrrrdddio: for my morning cardio!
September 2, 2017 § 8 Comments
I’m struggling to find the words to describe where I am at this point in my life. These past two and a half months have changed me. They’ve forced me to face parts of myself that I either never wanted to face or didn’t know even existed. I’ve had to evolve and grow all while embarking on some of the greatest challenges I have yet to encounter.
I’m in my final year of medical school and the idea that I will be a doctor this time next year is… paralyzing. It’s exciting, yes, but paralyzing at the same time. I’ve spent more than half of my life trying to get to this point and now that it’s finally here, I feel like I don’t know what to do with myself. Knowing that I am about to achieve THE goal leaves me feeling almost empty. Checking that box will mark the end of almost 20 years of doing everything I possibly could to make this happen. It makes me wonder, will anything ever even come close to that?
Since I last wrote, I’ve been re-familiarizing myself with… myself. All while studying for one of the biggest exams I’ll ever take. There have probably been more bad days than good days, but the bad days are becoming fewer and fewer as time passes.
We started sixth-year rotations in the middle of July. My first rotation is surgery, which lasts for about 8-9 weeks. I only have one week left now and will take my final exam on September 12th. I’ve really been struggling with how to balance everything on my plate. I’m planning on taking Step 1 at the end of November and that exam requires EVERYTHING from me. But I can’t give it everything. I have my final exams in surgery and obstetrics and gynecology (not to mention the rotations themselves). I have my thesis. I have teaching. I have applications for next year. It’s…suffocating.
So where am I now? What am I doing? What am I going to do? These are all questions I’ve asked myself almost daily since the beginning of June. If I’m going to be completely honest, this has not been an easy summer for me. Everything I thought I knew about myself, my life and my future changed. My foundation fell out from under me right when I needed it the most. I needed to be the best version of myself and I didn’t know how anymore. So, I slowly started picking up the pieces, forced myself to accept whatever I was able to produce – regardless of how small – and pushed forward.
I turned 30 almost two weeks ago. I really wish I could describe the feeling I had that day. I know that birthday means different things to different people, depending on where they are in their respective lives. For me, it meant everything. It meant saying goodbye to myself. It felt like starting over. Like stripping myself of everything I knew. Complete and absolute vulnerability and, oddly enough, strength. What made the experience even more “life-altering” was the fact that I celebrated it in the historic city of Acre, Israel with my best friend and his family.
In the days leading up to my birthday, I was in a constant state of reflection. With the way my life has developed, the multiple life paths I’ve entertained, the struggles I’ve endured to get here…it’s not uncommon for me to take a moment and think about where I am versus where I would have been. Whether sitting on the banks of the Danube with a bottle of wine, wandering through the crumbling barracks of Auschwitz, looking out over the fjords from Tåkeheimen, reading the names on the stone plaque beside a Sarajevo rose, or feeling the jasmine scented footprints of Muhammad at the Al-Aqsa mosque in Jerusalem, I always have the same thought: I wasn’t supposed to be here. In that moment, I think about all the points where the course of my life changed, all the decisions and challenges that brought me there and how rich and special my life is as a result. On the eve of my birthday, I stood alone on Amir’s parent’s balcony and watched the sun dip into the sea. As I sipped a glass of wine, I said goodbye to myself as I knew me in my 20’s and reflected on who I will become in my 30’s.
That trip changed everything. I had a moment in the car on the way to Jerusalem where everything clicked. Suddenly, I could see my future. I saw exactly where I want to be and what I need to do to get there. Every time my future has crossed my mind in the past two years, it’s been followed by absolute nothingness. It’s been a source of anxiety and fear and prevented me from enjoying the present. So when everything clicked, the feeling was indescribable.
Once I’ve worked out some details and made some progress with my plans, I will share them here – I promise.
Otherwise, things aren’t very exciting here. I pretty much only sleep and do practice questions. I’ve been sick since last week and my cough has been pretty extreme. Since I’ve been holed in my apartment studying, I didn’t even notice that I’d lost my voice until I went to the pharmacy to pick up an expectorant. When I opened my mouth to utter the first words I’d spoken aloud in three days, nothing came out. There were a few strange squeaks, followed by a long, intense cough. The pharmacist began to laugh. I laughed and coughed. Exciting stuff.
It’s off to bed for this one! To be continued 😉