“You should be a surgeon”.

May 1, 2015 § 4 Comments

It’s an absolutely beautiful day in Budapest. May is here and that means one thing: exam period is coming! Registration on Tuesday went really well. I used my little tricks and had registered for all of my exams within 40 seconds or so. When it was over, panic began to settle in. All of a sudden finals are real! For the first time I’m taking a big exam on the first date. Last year I took the physiology final on the first Wednesday, but it doesn’t feel the same since we had to study physiology so consistently during the semester (we had two quizzes every week, one on lecture material from the previous week and one on the lab material for that day). My exam dates are as follows:

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With the pathology final so early, I have to go super exam-mode from now. I’ve known for a while that patho would be my first exam (it was just a matter of getting a spot during registration), so I’ve been studying patho for the past few weeks already. My plan is to get all my topics together and then spend the last week just reviewing and memorizing. I am already feeling so nervous about it….I really hope the anxiety doesn’t get too great.

Yesterday we had our second laparoscopy practice in surgery. There are two competitions in our Basic Surgical Techniques class: (1) suturing and (2) laparoscopy. During the laparoscopy practices, we were timed while completing various tasks and the person with the best time was selected to go to the competition. For the first practice, we were tasked with using one hand to organize different colored rolls of paper into bowls and then to place the cap on a needle. For the second practice, we had to move colored rings from pegs on one side of a board to the other, passing them between the tools on the way, and then back again. At the exam, this needs to be done in under 2:30. During the first practice, I had pretty decent times: 0:31 for placing the paper rolls in bowls and 0:05 for placing the cap on the needle. The peg board with the rings was by far the most difficult task. We trained for about 40 minutes and were then timed by either the teacher or visiting teaching assistant (TA).

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I was feeling pretty nervous, even though I am already exempt from the exam after the suturing competition. Even though I was shaking a little bit, I started singing a song in my head to keep me calm and then just systematically went through the motions. All those hours spent playing Skyrim and Assassin’s Creed in the past must’ve paid off because I managed it in 1:09. I didn’t really realize what this meant until people around the room started reacting in disbelief. I later learned that the record last year was 1:23 and that someone had beaten it the day before with a time of 1:21.

After some exclamations were made, my teacher said something that probably meant nothing to her, but everything to me, “You should really be surgeon.”. Lately I’ve been pondering the concept of talent quite a bit. There is this notion that there are certain careers or lifestyles that people are meant for and sometimes I worry that, because I am such a hard worker, that I will never know what I am truly, inherently good at. I’ve been worried that maybe I don’t have a talent for medicine/medical school and that later down the line I’ll learn that the only reason things went this way was because I kept pushing for it. In the end, I guess it doesn’t really matter. I have such a passion for medicine, I love studying it and I look forward to a career in it. At the same time, I feel sad thinking that there is something I have a true talent for that I will never discover because I am always pushing in other directions.

I’ve put so much pressure on myself in this surgery class this semester because I know that I want to be a surgeon but have been worried that I don’t have a talent for it. Whenever people have asked me what kind of doctor I want to be, I’ve always told them a surgeon and then added that I have to “see if I’m good at it first.”. My little successes in this class have made me start to believe that it is possible that my passion and talent might one day be the same. My teacher saying this seemingly simple sentence to me meant so, so much to hear. Hopefully it’s the beginning of a long and exciting journey.

I won’t be partaking the laparoscopy competition (due to my previous exemption), but it feels good knowing that I could have. In the grand scheme of things, this is nothing big, but it has fueled a little fire burning inside of me and for that I am grateful.

Now it’s time to go exam period mode for the weekend. I’ve started out the day with an intense workout and filling breakfast and am ready to dig into patho. I have quite a few emails from blog readers to reply to that I will be responding to during my breaks (just in case any of you are reading this – I haven’t forgotten!). I’m looking forward to spending the next 72 hours in my little study area 🙂 Since today is Labor Day in Hungary, my studying will be accompanied by the sounds of the air show taking place down by the river. At least I won’t be alone!

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The past is never where you think you left it

March 12, 2015 § 4 Comments

I’ve mentioned before that I prefer to write blog posts when I find myself in a reflective mood, one in which the words simply flow through my fingers without any obstacle of forethought or manipulation. I find that the time between these moments is growing ever so slightly despite my best efforts to stop and appreciate where I am and how far I’ve come. This idea brought me to consider that maybe it’s not just that reflection begets writing, but also that writing begets reflection.

This post is going to be quite the reflective one. The reason? It is March, my “month of change” if you will. I received a notification from WordPress (the company that hosts this blog) wishing me Happy Anniversary with them. It’s officially been three years since I started this blog and six since I moved to Norway in hopes of somehow, someday, becoming a doctor.

In honor of the time that has passed between the person I was when I left Los Angeles and the person I am now, a 3rd year medical student in Budapest, I want to share some excerpts from Marches passed.

March 200921 year-old Bianca living on the island of Tjøme off the coast of Southern Norway with Aunt Vibeke. Next to no money and almost no plan. Just a hope that things would find a way of working themselves out.

Day 1

When the plane sank through the clouds during our descent, my heart began racing madly. For the last three months I have put my full focus on getting to this point and now that I am here I almost feel purposeless. At one point, it even crossed my mind that I should just turn around and go home. I am so out of my element here; I know I have the necessary skills to survive and support myself back in the U.S., but I feel like none of those skills are of use to me here. Literally everything is different and it really confirms the feeling I have of this move as a blank slate. However, underneath all the immediate worry and anxiety lies that deep excitement and yearn for a challenge. I know this is going to be difficult and I set out with my future in mind. All the necessary quotes fuel my confidence: “What doesn’t kill you makes you stronger. Reach for the moon, if you miss, you’ll land among the stars. We’re not here for a long time, we’re here for a good time.” Life really is too short to wonder what things could be like, or to look back at the chances you had to change the course of your existence and didn’t.

Day 7

I miss having friends and meaningless conversations with random people I meet throughout the day. I miss knowing where I am and how to get where I want to go. I miss my family and knowing what they are doing. But in the end, this is where I am supposed to be. I just heard word from my old roommate that the house I was living in in LA is being foreclosed and now they all have to find a new place to live by the end of the month. As soon as I heard the news I was consumed by thoughts of how I would have had to manage everything if I was still there. When you move on to a new chapter in your life and see the chapter you left sort of collapsing behind you, you can’t help but feel a deep sense of relief and purpose – and confirmation. I’m still scared, still lonely, and still have a sense of restlessness, but this is the right path for me. There is a quote that I love, from a kid’s movie nonetheless, about the importance of living your life. I’ve read this quote over and over again at times when I needed to believe that these huge changes would be the best ones I ever make.

“When King Lear dies in Act 5, you know what Shakespeare has written? He’s written ‘He dies”. That’s all, nothing more. No fanfare, no metaphor, no brilliant final words. The culmination of the most influential work of dramatic literature is: He dies. It took Shakespeare, a genius, to come up with ‘he dies.”? And yet, every time I read those two words I find myself overwhelmed with dysphoria. And I know its only natural to be sad, and not because of the words ‘he dies’ but because of the life we saw prior to the words. I’ve lived all 5 of my acts, and I’m not asking you to be happy that I must go, I am only asking you that you turn the page, continue reading, and let the next story begin. And if anyone ever asks what became of me, you relate my life, in all its wonder, and end it with a simple and modest ‘he died’.”

I want my life to have this same sense of wonder and glory. This is how I know that I am taking the right step. If we don’t push ourselves, we will never truly know the greatness we are capable of.

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Day 11

I’ve been asked a lot about my choice to move here. I usually respond with something along the lines of school and the general experience, whatever jumps into my head at that moment. I have a small notebook where I write down everything that makes me laugh, quotes that inspire me and thoughts that I have. I find that, depending on the point in my life, I am drawn to different quotes in this book. As I read through it on the bus ride home today, I came across one with quite an alluring point. It follows in the category of the “why not?” response when inquired about my move.

“For believe me! The secret to harvesting the greatest abundance and the greatest enjoyment from existence is this: Live dangerously! Build you cities on the slopes of Vesuvius! Send your ships into uncharted seas! Be robbers and conquerers… you knowing ones! The time will soon be past when you could be content to live hidden in the forest like timid deer.”

-Friedrich Nietzche

We inherently suffer the fear of the unknown, the fear of change. Why not conquer this fear and throw ourselves out there? The worst thing that could happen is that the stories of our lives would be worth telling.

March 2012 – Med school finally became tangible. At a meeting with a school counselor in Oslo, I learned that there was an entrance exam in two weeks time and that I was eligible to apply.

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After I was finished he said, “I am going to change my mind about you. At first, I thought I would recommend that you come back in June and try again. But now, I see that you know much more than I first thought. Like your brother, I can tell that the intelligence is there. But you must review. You must review a lot. You cannot begin medical school without knowing these things. There will be no time to review the basics once you start.” He then proceeded to make some changes on my form and marked the top with an asterisk. “I will fight for you”, he told me, “But it will be hard to prove because your scores are not so good. But I will tell them that you know more and that you will review. I cannot guarantee anything. But I will tell them.”

Only four days later, on Thursday the 8th of March, we all got our acceptance letters to University of Pecs Medical School.

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Christian’s 22nd Birthday

I spent all day today reading Complications and making my brother a cake for his birthday tomorrow. He is turning 22 and in lieu of recent events, I feel it is only fitting to have a medical themed cake – so I made an animal cell! I had a lot of fun doing it, though I didn’t plan for it to take all day. Hope he likes it when we wake him up tomorrow.

First round of acceptance letters

Skjalg and I just received our letters from Szeged. This was originally our first choice, but after finding out that it is not on California’s list of accredited universities, we decided against it. Skjalg got in and I got accepted to their “preparatory course”. It shouldn’t matter much since we have already decided against  the school, but it still made me a little nervous. Skjalg asked me, “What are we going to do if I get into Semmelweis this round and you don’t?”

March 2013 – Second semester of first year

On conquering exam anxiety

So after listening to this a couple times, I came to a conclusion, which I immediately shared with Skjalg:

“The test is simply an evaluation of how I have been studying so far. If I pass, that’s great. I can keep on doing what I am doing and possibly make some further improvements. If I fail, yes, it will suck. However, I will be forced then to review the material more thoroughly, to learn it better and really understand it. In all honestly, I benefit either way. One way is just a little more challenging.”

It’s amazing how much mental power you have over your perception of a situation. Accepting that failure was an option and thinking of the good that could come out of it, rather than focusing on the bad, put me in control. Eleanor Roosevelt’s quote “No one can make you feel inferior without your consent.” applies, not only to other people, but to yourself as well.

Mindfulness: 1 ; Defeatism: 0.

An entire post about reflection

Ponderings of a 22 year-old me 

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March 2014 – Second semester of second year. Posts are less about reflection, more about midterms and studying. Although, there is one that chronicles a morning I spent enjoying the city.

Appreciating the city

Budapest is Beautiful

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Upcoming anatomy midterm

We’ve been covering anatomy superficially these past weeks and after Thursday’s physiology tests, we were ready to go hardcore anatomy. Between Friday afternoon and early Monday morning, we studied for a total of 37 hours. For this exam, Skjalg, Jannie and I decided to go through the material together. It made for a fun weekend, albeit slightly stressful. We presented topics on the giant white board, made up funny ways to remember things and peppered each other with spontaneous quizzes. In my post-midterm bliss (aka pure exhaustion) it’s hard for me to recall the horrible anxiety that slowly took root over the weekend. For that, I’m thankful.

March 2015 – the present

You’ll have to tag along to find out…

Quote by Katherine Anne Porter

Time is the longest distance between two places

February 28, 2015 § 6 Comments

Time has, yet again, completely eluded me. We have just finished week 4 of our sixth – our sixth! – semester. It feels like we’ve just started. At least until I look back and focus on some of the things we’ve done and learned. In those moments, I realize how far we’ve come.

Third year has been by far the busiest (something that is clearly reflected in my activity on here). I’ve planned my schedule in such a way that there is something I should be doing during almost every hour of the day. The breaks between my classes are sometimes barely enough time to run to the restroom and once I’m done at school I have to get as much studying done as possible.

We have very few midterms this semester, so pretty much everything is riding on our levels of self-motivation. Lucky for me, that’s one area where I’m not lacking. Though this self-motivation is chiefly anxiety driven, I’m just happy that I am getting somewhere.

I’ve still be struggling a bit with exactly how I should study for all my classes. In their respective classes, all the subjects seem so important. Prioritizing one of the other has been pretty difficult for me. So, I had to just decide to put most of my efforts into pathology. It was my worst subject this past exam period, and I think it deserves more attention this round. Plus, our final exam in it is going to be a monster. It will consist of several practical parts and then one theoretical part, consisting of 3 hand selected topics from a total of 191 topics (check the list here)! For the practical part we will have:

1 specimen identification with description (there are around 70 or so pathology specimens (body parts) in sealed jars)

All 3 pathpots

1 histopathology identification with description (i.e. told that this is the small intestine, identify that it exhibits features of Crohn’s disease and discuss the theory behind it)

Crohn's Disease

1 autopsy case: we will be presented with the internal organs of a patient, given time to examine all the pathological changes, and then determine the cause of death (primary disease) and any secondary complications.

1 case report: we will be asked to discuss one of the autopsy cases we reviewed during the semester (we have a total of 14, of which 10 will need to be remembered for the exam).

At the moment, my study technique is to prepare the topics as I would want to present them on my exam. For patho, I’ve switched to taking my notes in a notebook. I’ve found that the freedom of the note-taking app on the iPad is great for some classes, but more “damaging” to others (efficiency and efficacy-wise) . For example, for the pathology topics I did in my iPad, I unconsciously spent way too much time making the perfect layout and having all the points in a perfect order. Now, I read though the book, then through my lecture notes and notes written by a past student. After that, I visualize a sort of “topic- map” for myself and only then do I draw it out into my notebook. When I add in things, it can get a little messy, but I can tell that I am actually learning a lot more than when I took notes in my iPad.

Before: on iPad

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After: notebook

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But then for microbiology, it is really great to have the iPad notes. We have to learn so many different organisms and one of the ways to do this is image association. Last semester we covered bacteria and I used SketchyMicro. They just announced that they will be releasing videos for viruses and fungi on March 14th this year and I couldn’t be more excited! Before they announced the release though, I figured I had to take things into my own hands and make my own drawings. I did several for protozoa and Notability was the perfect tool!

Example of SketchyMicro’s images

Staph Aureus

Bianca style! 😉

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Outside of these, we still have pathophysiology, genetics, surgery, internal medicine, medical psychology and…I honestly can’t remember the last one. Oh! Medical imaging.

Last week, we were supposed to have our first surgery practice, but we missed it. There was a lot of confusion around it because we were supposed to take it during the second week but there was a conference, so they moved it to the third week. We thought that the retake would be on Thursday, the normal day of our practice, but when we got there we found out that it had actually been the day before! We were both really bummed, so we decided that to make up for it, we would do a “surgery date night” that Friday.

Skjalg picked up surgical tools at school and we settled in for the night with some partially peeled oranges. We didn’t have any proper training, but it was still fun to pretend.

My first ever sutures!

My first ever sutures! Now I know that they are a) cut too close to the knot, b) knots shouldn’t be over the wound site, should be off to the side c) too close to the wound edge, d) not properly spaced 😛

This past Thursday was our “second” surgery practical and was going to be our day of learning sutures! Since Skjalg and I had practiced at home, it wasn’t too foreign. Although, there were a lot of “rules” that we hadn’t followed properly and suturing an orange is a lot different than suturing the weird tissue sponge thing we had in class. We spent the first half of the class learning two knot types: Viennese and surgical. We need to know how to do them with both hands and let’s just say that I was completely unaware of just how lacking my left hand is when it comes to dexterity. Practice, practice, practice!

For the second half of class, we practiced suturing. After about half an hour, our teacher told us that we had 10 more minutes of practice and then we would have a little competition. I suddenly got nervous and started shaking (great) and when she came over to check my work, I proceeded to do every single thing wrong (i.e. breaking the needle in the “tissue”, holding the forceps wrong, pulling the thread all the way through the tissue, making a knot in the thread before I was done, etc.)! Luckily, it was still practice time…

When the 10 minutes were up, she told us to clear our sutures and prepare for the competition: 3 stitches in 10 minutes. Since I want to be a surgeon and this is the closest thing I’ve ever been to that, I was putting a lot more pressure on myself than logically necessary. Still, I managed the three sutures and then did a forth just in case. The sutures have to be 1 cm from the wound edge, 1-1.5 cm apart from each other (and parallel to each other), and the thread should be cut 1 cm from the knot. After 6 years, I’m still in this weird limbo state between inches and cm, so I was a little worried I’d over(or under)estimated.

After the time was up, we all got up and walked around to examine each other’s sutures. We each then chose two people to vote for. Once the teacher had tallied the votes and announced the winners, I was shocked to hear my name called for first place. There are two more little class competitions and then the winner gets to go to a competition for the whole year. At this competition there will be one person from each group. The top 3 will get a grade of 5 for the class and the rest will get 4’s – so it is a pretty good deal!

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Ok, back to patho for me!

Post title: Quote by Tennessee Williams, The Glass Menagerie

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