How sad and bad and mad it was – but then, how it was sweet!

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: So?

B: Insulin.

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)

B: Calcium?

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.

Every moment is the paradox of now or never

December 2, 2017 § 6 Comments

It’s been one week since my exam and it has not been an easy one for me. I started writing a post on Wednesday but had to stop because it was just too soon for me to write about everything. I’m extremely, extremely hard on myself. I always have been. Over the years, I’ve learned to direct my focus to the constructive self-critique and ignore everything else. Well, at least I try to. It’s a constant battle. I’ve learned to appreciate this quality. I think its one of the reasons that I push myself so hard, that I am constantly striving to be a better version of myself. But every great strength can also be a great weakness and this week has been a heavy one for that.

I’m going to post what I wrote here. I don’t mind sharing my low moments with people. There are only a select few that I turn to when I am actually deep in the thick of it, but afterward, it’s a learning experience. We all encounter periods like this at one point or another and pretending that we don’t doesn’t make us stronger. I’ve always believed that acknowledging and embracing my weaknesses takes away their power. If I own them no one person or one situation can use them against me. Then I am free to work on them at my own pace.

At this point in time, this is as much as I am going to share about the exam. I still have another two weeks until I get my results and I have plenty of other things to focus on now. Now is not the time to relive the experience, to criticize myself or even to reflect on these past few months. In two and a half weeks, I will have the result, I will have finished with my final exam in internal medicine, and I will be on the way to the US to spend three weeks with my mom and brother. I’ll be traveling with Amir and Baloo and am looking so, so forward to spending so much stress-free, quality time with some of the people I love most in the world.

Unpublished post: 124 hours

I’d been told what to expect when I finished the exam. I’d been primed for the feelings of inadequacy, the sheer disbelief, the relief of it being over and the anguish at the thought of having to wait three weeks for the result. I’d been warned of the flashbacks that would hit me in the days that followed and that the wait would be heavy and torturous. If you’re expecting this to continue into a more melancholic post, you’re correct. If you were expecting it to take a positive spin, this won’t be the post you thought it would be. Unless you count pushing through hell as being positive.

I’ve been in a bit of a daze since Friday. I’m finding it hard to put my feelings into words. Coherent is the last word I would use to describe my thoughts these days. I just feel very, very…sad. Maybe a bit shell-shocked. Empty. Low. Defeated.

The exam was…I can’t even think of a word to describe it. I thought I was ready to write about it. I thought sitting here now would be cathartic…

That exam coupled with my intense self-critique broke me. I was stripped of all my armor and skill and thrown repeatedly back into battle with every block. Dragging myself through those 9 hours was one of the hardest things I’ve ever had to do. It was so different than what I expected or what I’d prepared for that it honestly felt like they’d given me the wrong exam. It felt like I’d studied Spanish and was getting tested on French. After the first block, I locked away my pride and told myself it would get better, that I just had to stay positive and keep pushing through. But then the second block was the same. And then the third. And the fourth. It wasn’t until the 7th and final block that I finally got questions that I felt confident on. Questions where I knew what they were asking. Questions where the answers made sense. Questions that finally made me feel like I could show what I knew. But by then, there was honestly hardly any of me left.

Everyone keeps saying that they think I did well, that it’s a good sign that I felt it was so difficult. Right now, I don’t agree with any of them. I feel so, so strongly that it didn’t go well. There are weeks and weeks worth of learned material that I didn’t get tested on. It wasn’t like any of the question banks or practice exams I did. The questions were such that there wasn’t even any point of quickly browsing through my quick-review notes or looking in First Aid during my breaks. Those couldn’t help me. I did the best I could. I really mean it when I say that I dragged myself through it. I took several short breaks rather than one long one and used those to inhale water and a rice cake, rub my temples, take a deep breath and jump back in.

I do want to end this post on a more positive spin, so I am going to share something else I wrote: a letter to myself. In the days before the exam, I found my thoughts getting more and more negative and a special sort of panic begin to set in. One night, after two hours of not being able to sleep, I asked myself what I would say to someone I cared about if were him or her going through this and not me. Then, I wrote those things down. It felt silly at the time, but it worked wonders. I read it to myself several times a day after that.

Letter to myself

This is not something you get lucky on. This is a fully comprehensive exam with 280 questions that span almost every subject you’ve learned in your entire medical education. This is not a “pick two topics and hope you get the ones you studied” exam. This is unlike anything you’ve done before. So you need to have a different mentality about it. You have been preparing for this for months now. You’ve done thousands of questions – and done them well! You’ve learned so much from when you first started and your brain has adapted so amazingly well. Of course there are going to be things you wish you could improve upon, things you wish you could do differently. But that is not an indication that you HAVE done something wrong. In fact, it’s just a testament to your growth, to your ability to evolve. You can look back on any situation in life and see how things could have been done differently, at what you could have done better, at how things could have been more streamlined. And you can do that because it’s in the past. Now, you know what happened. It’s easy to criticize after the fact, to see exactly what went wrong, but only because you already know the outcome. What you can’t do is let that criticism stop you from progressing. There is literally nothing that comes out of allowing it to debilitate you. So why would you let that happen? Why would you let yourself be weakened now?

Now is not the time for critical reflection. You’re not done yet. Stop trying to rush things. Look ahead. Look at the time you have left and what you can and WANT to do with that time. Literally anything you decide to do is good. You could get tested on anything, so it doesn’t matter what you do. I promise you, when you are done with the exam, you will have time to analyze how you prepared. Even better would be to wait until you get your result. Why? Because you can’t trust yourself when it comes to evaluating your knowledge. And B, there is no possible way you can manipulate this exam in your favor. This exam is way, way bigger than you. It’s sole purpose is to evaluate and quantify the knowledge of medical students. So trust it. Let it do what it is supposed to do. Do what you can now. Take care of your mind and your body, remember that this exam is as much about endurance as it is knowledge. Your mind will not work in a hostile environment, so remember that you need to create a safe space for it. No fight or flight response. When you’re there in the exam, that is literally the only place in the world you are supposed to be. Nothing else exists. It’s just you and the question you’re working on.

All the anxiety you are feeling now is the result of you thinking that you have control, that you can somehow determine what is going to happen in the future. You are taking responsibility for something that has not happened yet and for something that you are not even supposed to be taking responsibility for. Who do you think you are that you think you control the future? Let it go. This is not what the battle is. The battle is preparing yourself to the best of your abilities at that point in time, challenging yourself, and then evaluating the outcome. You have done exactly what you should have done when you needed to do it.

If there is a lesson to be learned, let it present itself in due time. Let the lessons of this world appear when they are supposed to appear and stop trying to predict and control them. There is no shame in saying you were wrong, in admitting you could have done something differently, in apologizing. We are dynamic, forever evolving and adapting creatures. You are not perfect now, nor will you ever be. You will never be done learning. You will never be “done” or “complete”. There is always going to be a better version of you down the road. So stop looking back. Stop looking at where you are now and obsessing over if it is the right place or the wrong place or if you made a mistake somewhere that you need to fix. Leave all that noise and move forward. Embrace the self-development, embrace the humility and the strength that comes from enduring these challenges. You live for this. You know you do. So let yourself breath it in!! Right now, you are the most perfect version of yourself that you could be in this moment. And tomorrow, there will be a new, stronger version that is perfect for then. Leave things to grow and develop at their own time – yourself included. You are not in control and you never will be.

Tomorrow is a Wednesday. Wednesday is the third day of the work week (depending on what country you live in). Some people call it “hump day” because it’s seen as the hump of the week. There will be another Wednesday next week, another one after that, and another one after that. Tomorrow will have different meanings for everyone in the world. Some people may remember it forever while others will never think of it again. For you, it happens to be the second to last day before your exam. You’re going to do some practice questions, go to the gym, take a hot shower and maybe take a short power nap, pack for your trip and review some notes. Then it’s going to be over. You’ll never live that day again and it will never hold more meaning to you than it did while you lived it. It’s as simple as that. Find peace in relinquishing your perceived control of the uncontrollable.

#soon

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…


Indication of my mental state – this just had my laughing HYSTERICALLY for a good 2 minutes straight:

10 days to go

November 14, 2017 § 4 Comments

The time has finally arrived where I can answer “next week” when asked when my exam is. Do I have time to be writing this? Not really. But I don’t have time for anything. Not sleeping. Not eating. Not washing my hair. Accepting that was crucial. This is not an exam for which you can be “done” studying. It is not an exam for which you can perfectly prepare. It is not an exam that will allow you to feel confident with every question. So, I’m simply doing the best I can. And that is going to have to be enough.

I’ve had dips of panic in the past few weeks when examining the discrepancy between the days I have left and the things I want to get done. There are so many different recipes, techniques, methods of attack for this exam that it’s possible to lose your mind trying to figure out what you should do, how you should handle your last days. I’m lucky enough to have people in my life who have been through this and who knew exactly what to say when I needed to hear it.

Preparing for this exam has been unlike any challenge I’ve experienced before. I look forward to being able to fully reflect on this experience and to finally entertain and indulge those fleeting moments of reflection I experience throughout the day. There are so many thoughts I want to express now, but if I’m being honest with myself, now is not the time for reflection.

At present, I’m a perfect blend of anxiety and calm. The anxiety is self-explanatory. The calm comes from taking a moment to step back and appreciate how lucky (yes, lucky) I am to be where I am now. Seeing how I’ve progressed since I first started, to experience how quickly my brain works to diagnose a case, to witness how I recall and store information has been such an amazing and humbling experience. Sometimes I will actually laugh when a question comes up because I can so vividly recall the first time I dealt with that same topic in a different question, how much guilt and shame I felt then for not knowing the answer. I’m so proud of my knowledge now. I feel confident in areas I felt so weak in before. My knowledge is so much more accessible and my differentials so succinct. I have to appreciate where all of that came from, from all those moments of weakness, of feeling worthless and stupid, from all of those incorrect questions… I’m stressed, but I’m also really happy and genuinely enjoying myself. I’m giving it everything I can, I’m learning from my mistakes, I’m evolving and most importantly, I’m growing, personally and knowledge-wise.

My brain has noticed that this is not USMLE-related, so I have to go back to UWORLD, but I’ll leave you with this picture and amazingly accurate description of what these questions are like (discovered by my reddit pirate younger brother):

Original Post

Hey guys, I just took the beast a week ago. I’ve been using this forum as a resource for a while now, and I just wanted contribute those who have yet to take it.

I also posted it on SDN. This is for those want to have a “feel” for gauging the test.

One thing very difficult to grasp and that I’ve wanted to know prior to my exam was: What is the STYLE of questions compared to the practice tests. Here is personal interpretation from my exam:

Type 1. Straightforward knowledge-based question. Seen in typical NBMEs, and a good deal of questions on the Step.

What’s the state capital of California?

a) Kathmandu

b) New York City

c) Sacramento

d) San Francisco <– The only other “PLAUSIBLE” answer

e) Beijing

For these questions, if you read that paragraph on FA or heard Sittar’s beautiful voice on Pathoma, you’ll get it. Pretty straightforward.

Type 2. The verbose stem but straightforward type. Good deal of questions UWorld, some on the real Step 1.

State capitals are really nice. Some are big, some are small. The patient comes from some the state capital, and he really likes them. He also likes dogs and cats, but not skunks. Why not skunks? Because they smell. Here’s a map of Nevada:

By the way, what’s the capital of California?

Same answer choices.

For these questions, it’s simply a matter of skipping to the end (if you’re confident) or skimming it (if you’re a fast reader) and ignoring irrelevant BS. The trouble is not getting bogged down. I distinctly remember a handful of questions on my test that had the key facts in the middle of the literary novel.

Type 3a The straightforward question with HARD answer choices. Some Uworld, a large minority Step questions.

What’s the state capital of California? “OOO I KNOW THIS”

a) a large commune sitting at the base of the Himayalas. <– “OH **** can’t be Himalayas”

b) New York City <– easy elimination

c) a population center which has a subpar NBA team windward of the Sierra Nevadas. “WTF…this..maybe?”

d) a metropolitan area closely associated with the MUNI transportation system. <– you gotta know MUNI is SF and NOT Sacramento

e) a city in a province <–Classic vague answer choice.

As you can see, the QUESTION itself isn’t hard. But the answers PARAPHRASED with additional facts that you must know to answer that question. You might know that the Sacramento Kings are a bad NBA team which would help. You may have never heard the word “windward”, but you can sort of guess what that means. This is when good ELIMINATION and INTUITION come in.

Type 3b. Straightforward ANSWERS but vague QUESTIONS. A large minority of Step.

There’s areas that may determine the legislative future of its surrounding area. That large region around the Pacific that’s part of the US, what’s that legislative-area?

a) California. “What? no?”

b) Oahu. “Well, it is around the Pacific…but legislative?”

c) Sacramento

d) the White House. “It IS politically-related…but it’s not an AREA?”

e) Dolphins <–easy elimination

I would say 3a/3b are why people come out of tests so unsure. Notice how it’s awkwardly phrased with non-specific words. It’s not terribly long, or terribly anal in its wording, yet it’s hard. I suspect there’s only so many ways you can test one fact, so they gotta soup it like this.

Type 4. “WTF?!” Only seen in real Step 1.

Who’s that one construction worker who worked on that capital building of the capital of California? <–super specific

or…

Where do you get sandwiches around the capitol building? <– easy if you KNOW the answer but WHY WOULD YOU?

I would argue there’s NO DELIBERATE WAY to study for these questions, other than having incidentally heard it OR having closely listened to professors during your first two years. It helps to have good long term memory too.

On MY TEST (YMMV), I would say the approximate break down would be:

40% Type 1 questions.

15% Type 2 questions.

40% Type 3a/3b questions.

5% Type 4 WTF.

These are obviously arbitrary classifications (just as in a lot of medicine). There’s overlap and some questions can be a combination. But I hope you get the idea.

So in summary, MOST Step questions (Type 1/2/3a/b) can be answered with UFAP studying, but a good amount require ADDITIONAL processing of the question or the answers. And obviously some questions are next to impossible (type 4) but I wouldn’t worry about those.

Hope this will help someone with a similar mind to me 🙂

Still here? Let’s take a look at some snapshots from Biancasfantasticsuperamazingexcitinglife.

25 days out

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!

 

Berlin

September 7, 2017 § 4 Comments

The date is set! There’s no turning back now.

Registering for Step 1 is a pretty long process (really a lot of waiting). First, you have to register with ECFMG. Once that is assessed, you are sent an ID number and eligible to apply for a three-month exam window (I chose September to November). Then you need to submit a form to your university, who then has to send it to the US for further processing. That’s where the waiting comes in; I completed my application in mid-June and didn’t receive my scheduling permit until the end of August!

(Studying for USMLE: You know you’re in deep when you get really, really, genuinely excited about seeing “cerebral amyloid angiopathy”!)Screen Shot 2017-09-07 at 19.30.03

I already knew that I would be taking my exam at the end of November, but I didn’t know the exact date or location. Amir took his Step 2 exam in Berlin and really loved the city and the testing center, so I decided to follow suit. I’ve been putting off setting the date because….well, there is really isn’t a good reason. Once you set the date, things suddenly become very, very real, and I was probably trying to put that off for a little longer.

I’m extremely nervous for the exam. I want to do well and I have so much going on in my life right now that I’m worried I won’t have enough time to prepare myself. But there is nothing I can do about that. I can only push forward, maximize my time and hope that my best is good enough.

My final exam in surgery is on Tuesday, so I’ve switched over to exam cramming for now. I am so, so thankful that studying for exams doesn’t mean covering an entirely different subject! The surgery exam consists of three topics (out of a possible 168) and we are examined orally by one general surgeon and one trauma surgeon.

That’s all for now! Be nice to me, Berlin…

0_109861425
Berlin

 

Starting over

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.

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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 😉

 

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