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.

7th semester: check!

January 26, 2016 § 1 Comment

We’re just a little over halfway between my last exam and the start of a new semester. In the past week I’ve slept as much as possible (in my best efforts to force away the post-exam period hangover), gone on a weekend trip to Amsterdam with an amazing group of friends and done a Making of a Murderer marathon.

The last couple days before my last exam – pulmonology – were really, really tough. I’ve been going so hard for so long that I was just absolutely, completely depleted. Having to live the same day over and over and over again for weeks is a special kind of torture. Get up, sit down, study, freak out, study, coffee, study, sleep, get up, sit down, study, etc. On the Saturday night before my exam, slow streams of tears began falling from my eyes. I wasn’t scared or stressed or panicking. It was simply because I was so, so tired. The idea of having to push myself further when I felt the way I did was an impossible task in my mind. Luckily, I’ve been through this before and know some tricks to keep pushing forward. On Sunday afternoon, Skjalg sat down with me to do an amazing thing: let me explain each and every single one of the topics to him. We sat for a total of 10-11 hours and actually managed to go through all 55 topics. I don’t think I could have done it otherwise. Sometimes, being alone while you are studying is the worst thing you can do. It lets the crazy take over and slow you down!

I slept about 5 hours before that exam which, if you’ve been following me this exam period, you know is more than twice what I normally get before exams. My friend Andrea and I took an Uber up to the exam. There was a strike against Uber that started that day, so it was a bit of a stressful start to the day. Cabs were parked in the major intersections of the center and the Uber driver couldn’t get to me. Andrea had to fight him to wait for me rather than leaving me behind. Such a dramatic situation!

I’m still not used to being examined in the actual hospital. It’s such a strange feeling to pace back and forth in your suit and heels, muttering your notes under your breath Rain Man style, while sick patients and their families wait nearby. I usually try to stay as out of the way as possible. One thing about Hungarian patients in that they are generally very sweet. I remember after my internal medicine exam last semester, a patient stopped me to ask me how my exam had went. She had such a huge smile on her face and seemed so generally invested in how it had gone (she had seen me reviewing for the 2-3 hours while I was waiting). When I told her it went well, she was so happy and squeezed my hand.

My heart dropped when I read the list with the our names and our assigned examiners. I’d been assigned to the exact examiner I had absolutely hoped not to get. She is…special, to say the least. I don’t know how, but it went really well – which I was so, so happy for! On the way out, I noted that I felt nothing. No relief, no sudden burst of emotion or happiness. In my mind it was just one more down and however many more to go.

I wasn’t able to sleep when I got home, so I watched movies instead. That night, we met up with some friends at this amazing new tapas bar called Vicky Barcelona. After some amazing food and company – and several glasses of sangria – I was finally ready for my post-exam crash. I’m usually a total zombie for a few days after my last exam. I have a tearing headache, my eyes feel swollen and I have no energy to do anything. This weather doesn’t help either!

On Thursday morning, we flew out of Budapest on the 6:00 flight to Amsterdam. The trip was absolutely fantastic! Skjalg and I stayed in a charming boutique hotel along one of the canals while the rest of the group rented a 3-story apartment in the city center. I’ve never been to Amsterdam before and I have to say that I think it is my favorite out of all the cities I’ve ever been to – even in the winter! It feels like a beautiful, giant village, like you’re walking around in one of those miniature Christmas towns (which I love).

We got back early Sunday morning and decided to close out the trip with lunch at Vicky Barcelona. After that it was home to watch a movie and relax. I had no plans on napping (didn’t want to ruin my sleep) but half way through the movie, I feel asleep and didn’t wake up for another three hours!

Yesterday, Stephanie and Amir came over and we did a 12-hour Making of a Murderer marathon. It was cold and grey out, as it has been, so it was a perfect day to stay inside. I made banana bread and corn bread and we munched on some delicious Dutch cheese we brought back from Amsterdam. Life after exams is not bad at all!

I’m still not 100% recovered, so I’m going to call it a night for the blogging. I will make a post about our trip to Amsterdam and another one about my exams (for those of you who are interested in how those were). Now, I’m off to work on some of your emails!

The back of the medal

December 8, 2015 § 9 Comments

Yesterday, I received an email from a new doctor in England whose brother is a 2nd year student here at Semmelweis. She was curious about exams here, about the demand placed on us, and said that it seemed more difficult than her studies in England. 

I received it at a funny moment. I was in the middle of crying over my notes and being so thankful that they were in plastic sheet covers. What a coincidence that I should come across this photo this morning:

I don’t consider myself to be a very emotional person (generally). The only time you’ll see me cry is while listening to certain songs or watching movies; usually ones that touch on mortality (like About Time). I AM a perfectionist. Though I’d like to think I’m a recovering perfectionist, if there is such a thing. I’m also, as my mom once wrote in one of my birthday cards, “intolerant of inadequacy and incompetency”. She wrote that after a story about how I freaked out on a plane one time because my younger brother Christian was coloring outside of the lines in his coloring book. On top of this, I demand a lot from myself. I set impossible goals and when I don’t make them, I get really upset with myself. Studying medicine seems like the perfect fit, right? The perfectionist and the infinite subject.

I know it seems that I’ve gone off on a bit of a tangent (or five), ones detailing quite personal things about me, but I promise they all feed into a point. 

Exam period is hard. That’s nothing new. I’ve written about it many times before. However, I usually write when I feel a spurt of inspiration, sort of as a means to motivate myself through the hell of the moment. I may convey that I’m stressed, that I’m nervous, that I don’t know if I can do it. 

When I read that email, I felt so connected to her brother. It’s so easy to isolate yourself in moments of weakeness, to feel like you are the only one feeling what you are feeling. I usually add on to it by thinking that everyone else is doing fine and that is just me that can’t handle my emotions.

I started to wonder if that comes across in the posts that I write during exam periods; these specific chunks of the year where I am a full-blown emotional wrek. It’s not that I want to portray weakness or that anyone really needs to witness this wholly irrational version of myself, but more that connection; that moment where suddenly you feel normal and truly believe, even if only for a second, that everything is going to be ok. Sometimes Skjalg will joke around with me and say, “Buda-B doesn’t get scared” or “Buda-B doesn’t back down”. If I’m seen as super strong or if people are under the impression that I always have control, I’m flattered, but that’s just not the truth. 

Let’s take a look at the ugly truth. This morning I was supposed to have my semi-final in pharmacology. I’ve been studying well (or so I thought) through the semester. I finished my notes for the topics last week. I started reviewing the topics we’d covered at the beginning of the semester. I started building my wall of insanity:  

   
But pharmacology is memorization. And for some reason, I hit a total block. I started obsessing over some topics, not trusting my notes, searching through 20 different sources saying slightly different versions of the same thing. As time passed, I started to panic. I was spending 3 hours memorizing 1 topic. I calculated that if I somehow brought that down to 20 minutes per topic, that would still mean 16 straight hours of memorization. 

Yesterday, I got 2 topics done in 9 hours. I felt hot and cold, exhausted and overstimulated, motivated and depressed, and I could feel my entire circulatory system throbbing in my body. Tears left me dead by 22:00, so I decided to call it a night and wake-up at 3:00 to continue; to salvage what little chance I had left. What happened? I started studying, but got only half a topic down in the first hour and a half. I felt nauseous but decided to force down some food. Then I distracted myself with some YouTube videos while I ate. Then I started thinking about all the topics I couldn’t answer. All of them. At the same time. Into the shower I went, hoping that the steam would someone distract me from my hyperventilation. It didn’t help. I can’t do this, I thought to myself, I really, really can’t do this. 

There were still 40 minutes before Skjalg’s alarm was supposed to go off. No way I was waking him up before then. So I got into bed and stared at the dark ceiling while observing the stress race through my body. 

When his alarm went off at 7:00, I leaned in and said, “Hey, I don’t think I’m going to go today.” He responded with a simple “ok” and lay with his eyes closed for a few more moments. “Why not?” he asked. I began to explain that I really, truly wasn’t ready, that I didn’t want to go and get lucky on my topics, that I wanted to learn it properly so that I know it long term and not just for now. “I think that sounds like a good idea,” he said, eyes still closed. With that, I started sobbing. I felt such a sense of relief that he supported my decision. I was so scared that it was a hasty decision being made out of fear, that it wasn’t rational in any sense, that I was just succumbing to weakness. 

That’s just it: we are complete messes in exam period. Some of us lay on the floor and stare at the ceiling for hours without almost so much as blinking. Some of us sneak out to the corner store and literally jump at the site of another human being. Some of us cry about anything and everything. Some of us are complete roller coasters. And some of us are like a storm, calm in the beginning, but with a dark strength that grows larger and larger until the storm hits. That’s me. 

I hope you’re still following me at this point. It’s been a long, long day. I made a really tough decision that feels like a really strong decision made in a really weak moment…one that my brain is still trying to define as weak. My thoughts are scattered, my eyes are throbbing and I should be sleeping so I can get up early to review for tomorrow’s surgery exam. 

So why did I write this? Because I wanted to show that there is a side that doesn’t get published. That no one likes to talk about. That many would say shouldn’t be talked about. That the weak moments are there and sometimes they are the only thing we know. And yet, we keep pushing forward. Exam after exam. Semester after semester. And we can feel so alone while we do it. We can be so quick to think that everyone else has it so easy while we have it so hard. I don’t want people who read my blog to think that I always have everything figured out. That I don’t go through tough moments. I do and I know them very, very well. But there is such a beauty in that weakness. Not during, of course, but after. Smooth seas do not make skillful sailors. 

As I lay in bed this morning, in a pool of my tears on Skjalg’s chest, I gave him one of the most heartfelt “thank yous” I’ve ever given. “It’s ok baby, it’s the back of the medal”. I’ve never heard that expression before and hearing it then in that moment that fit is so perfectly, I couldn’t help but smile. It’s so easy to feel isolated, especially with social media being what it is today. You compare yourself and your life to everyone’s highlight reels. You only see what others want you to see. So, I wanted to share with you a glimpse of the “back of the medal”. A side Skjalg knows all too well. A side that we are probably all too familiar with in some way or another. 

  

This is fine

December 7, 2015 § Leave a comment

This is my 300th post and while I had been hoping to write something profound and reflective, I am as far from that mindset as possible. Instead, I will leave you with two photos. A picture is worth a thousand words, right?

Screen Shot 2015-12-07 at 12.50.33 IMG_1720

Pathology: CHECK!?

May 20, 2015 § 6 Comments

Yes, you read that right: I AM DONE WITH PATHOLOGY! I had made such peace with the idea that I was going to fail and it didn’t happen!

The exam is split up into 3 parts, two practical and one theoretical:

Part 1: Autopsy

When I entered the locker room, I was told, “We’re all getting Dr. X”. Dr. X is probably my favorite lecturer, but I had been dreading getting him at the exam because I’d heard that he really likes to drill the students. He told us in lecture once that at the final exam, we should be able to do things like group all the tumors by their color. He is extremely systematic, a feature I love in a teacher and fear in an examiner. Having a systematic method while studying is great, but being forced to be systematic on the spot, in the context of a final exam, can be difficult.

I was so resigned to having to retake the exam, that I didn’t feel nervous at all. “I’m going to go in there, give it my best and really learn from the experience,” I told myself, “then I’ll know how to prepare better the next time around.”. We were called into the autopsy room in groups of 5. Awaiting us was a similar sight: the autopsy examination table displaying the different organs. I was actually able to find photo of the room online. The picture is quite small, but at least you get an idea. Usually, there are two or three mobile metal tables with the cadavers on them in the middle.

We were each assigned an organ and I ended up getting the one I wanted the least: the urogenital complex. It includes the kidneys, the prostate and the rectum of the patient. We were allowed about 5 to 10 minutes to look over the organs and note any changes. I got a little nervous at one point but quickly calmed down and told myself to focus on the pathology and not the outcome. Dr. X called my name and asked if I was ready. Now or never!

I described the morphological changes and answered any follow-up questions he asked. The organ complex showed pyelonephritis, nephrosclerosis and cystic lesions on the kidney, benign prostatic hyperplasia (I had to explain how I knew it was hyperplasia and not carcinoma), with compensatory hypertrophy of the urinary bladder (trabeculated) and adenocarcinoma of the rectum. There were some things I fumbled on, like the term hydropyonephros, but other than that it went very smoothly and I ended up with a 4/5.

Part 2: Histology slides and Specimen

For this part, we moved on to the histology lab. The room was full with students and examiners, so I had to wait for a few minutes outside. We were only 11 English students being examined that day and maybe 30 Hungarian.

I was escorted to a computer and the technician helped me log in and open my slides. My heart dropped a little because I hadn’t reviewed the slides I ended up getting. Rather than letting that get me down, I reminded myself yet again to focus on the pathology and not the outcome. In our last histology practice, our adjunct professor told us, “We know how hard the histology is, trust me. Sometimes, we don’t even know the diagnosis when we first see it. It takes a lot of time and a lot of practice. What we want to see is that you know how to use proper histological terms to describe the changes and that you can use your pathology knowledge to properly diagnose the tissue sample”. We have covered 121 slides in these two semesters and get 2 at random at the exam. The only information we are given is which tissue the the slide came from.

I ended up with one from the colon (coincidentally adenocarcinoma, just like I’d had in the autopsy room) and one from the lymph node. When I felt I was ready, I raised my hand for one of the examiners. Once she had seated herself beside me, I began describing the tissues, first describing how the normal tissue should look, then describing the morphological changes and finally linking those changes to my diagnosis. I made sure to sort of guide her through my thought process while showing her the slide at the different magnification levels. (These are screenshots of the slides, with notes written by the fantastic Charlotte.)

For my specimen (we get 1 out of a possible 60 or so), I got this beauty: the hydatidiform mole. It’s a tumor of the cells of the placenta. When I saw it, I actually got quite excited because it meant that a new study trick of mine had worked. For the past several weeks, I have kept a google image search of whatever disease I am covering theoretically open on my screen. That way any time I look up, I have a visual association with the disease. I remember this one well because it is so creepy looking. It looks like a bunch of grapes! If you want to see another tumor with “bunch of grapes” appearance, check out the female genital tumor: sarcoma botyroides (be warned!).

10433860_10153269651618390_5004690945385099437_n

Everything went very smoothly, save for some little fumbles, and I ended up with a 4/5 for the section.

Part 3: Theory

This is the part you have to worry about. You can fail the other sections and still pass the exam, but the theory is the big one. We ended up having to wait quite a while before we were called in to our exams. I don’t think I was called until around 12:30 (and the exam started at 8:00). During that time, I tried reviewing some topics and keeping calm. I just wanted it all to be over!

I was assigned to the same examiner I’d had for the semi-final. Her topics (each of the professors have their “topics” that they are especially adept in) are hematology and oncogenes. For the semi-final, I’d struggled with my topic on oncogenes and it ended up being the reason I’d gotten a 3. That was an experience I was hoping not to repeat at this exam.

When I pulled my cards, the smile quickly dropped from my face: (A) Autosomal Dominant Diseases, (B) Oncogenes and their role in carcinogenesis, (C) Inflammation of the Trachea and Larynx. (A) and (B) were both topics that I was not looking forward to having to answer – and (B) was a serious deja vu!

For topic (A), I talked about Huntington disease and Marfan syndrome in detail and then mentioned osteogenesis imperfecta and adult-type polycystic kidney disease. She wanted me to describe the genetic alterations, pathological consequences, clinical manifestations and treatment for each and then wanted me to mention familial hypercholesterolemia and its complications.

Topic (B) was where it went downhill. This was one of those topics that I kept telling myself I needed to commit to memory, but really only superficially covered. I’ve watched videos on it, taken notes and even have a chart hanging up in my study area. Still, my brain was coming up with very little of what I should know. I tried to recall everything I could, but she was quite picky on the topic. Had I memorized this table, it would have been perfect, because this is exactly what she wanted:

Screen Shot 2015-05-20 at 12.12.12

From Pathoma (board review for pathology)

Screen Shot 2015-05-20 at 12.11.50

Biancafied!

 

Towards the end of this topic, she seemed pretty disappointed and said, “Ok, let’s talk about lung cancer”. My teacher is the “lung” expert among the professors, so I had no problem listing out the classification of cancers of the lung. But then she asked me about the oncogene related to adenocarcinoma of the lung. When I couldn’t answer, she got a bit upset and told me that she is sure my teacher has mentioned it before and that I should know it. This is what she was referring to:

20150520_130856

She shook her head, waved her hands in the air and told me that the 3rd topic would determine my grade. No pressure! Topic C was easy, but that was it’s problem…it was too easy! It’s one of those topics that feels so unimportant that you kind of jump over it. Luckily, I’d looked at it the day before. Unfortunately, it wasn’t a juicy enough topic to showcase my knowledge. Here is the topic I got plus another one just to show how much of a difference there is between them!

20150520_132456

 

My topic above, versus another respiratory topic below. Which would you prioritize? 😉

I ended up with a 3, again. I’m a 50/50 mix of excited to be done and disappointed in myself. But I’m not going to dwell on it. I worked hard, I’ve learned a lot and I have a lot to learn. These topics will be repeated over and over again during the next three years, so I will have plenty of time to get them down.

A lot of growing and self-reflection accompanied this exam and I am stronger for it. I have some improvements to make but appreciate that I have the opportunity to do so on my own time.

Skjalg’s pathophysiology exam went well, so we celebrated with some wine down by the river.

Here are some snapshots from this past week:

My study cave :D

My study cave 😀

Joshua (the teddy bear that my mom got at my baby shower - yes, he's that old!) helped me review topics. Needed someone to explain everything to ;)

Joshua (the teddy bear that my mom got at my baby shower – yes, he’s that old!) helped me review topics. Needed someone to explain everything to 😉

20150517_17160220150517_171610

Spent the last day before the exam studying outside at Starbucks

Spent the last day before the exam studying outside at Starbucks. Nice to get out every now and then!

Our celebratory wine and snacks by the river 😀

Bye, bye patho!!!

Hello, pathophysiology!

20150520_114408

 


The Gray Twilight

May 15, 2015 § 3 Comments

Three days out and I’m feeling both extremely calm and extremely anxious at the same time. I’m really making an effort this round to not let the stress and panic get the best of me. Last semester’s exam period was horrible and I don’t want to go through that again.

For the past hour, I’ve been holding myself back from sinking into a more negative, hopeless mindset. My eyes feel tight and dry and that makes it hard to sit here and continue reading. Sleep will come, but if I don’t feel happy with what I have accomplished before bed, negative thoughts will seep into my dreams. I can’t have that now. So, I’m trying to process it rationally.

What am I afraid of? I’m afraid of being asked something I don’t know, of standing there with my heart pounding in my chest while the examiner stares at me, waiting for my answer while I frantically search my brain for some semblance of an answer. I’m afraid of realizing that I don’t know the answer and getting caught in this endless battle of not knowing whether to admit it or just waiting until they acknowledge that I don’t without my telling them. I’m afraid of missing a major point, as a result of having spent too much time on unnecessary details. I’m afraid of saying something completely wrong. I’m afraid of feeling embarrassed, humiliated or ashamed. I’m afraid of failing this exam. I’m afraid of failing the retake and having to push all my other exams back and then failing those.

Normally, this is where I stay. I stay here, with my heart in my stomach and these thoughts swirling around in my head. I try to fight my way out with reassuring thoughts, telling myself that everything will be ok and everything will work out in the end. But those reassuring thoughts are no match for the others.

I’m changing my tactics now. Hearing that everything is going to be ok, that it all works out in the end, etc. doesn’t work for me. It’s too… aspecific. It has no foundation other than hope and I can’t work with hope during exam period. No more fighting the negative thoughts. Instead, I’m going deeper. I’m going as far down as I can go, until I reach the heart, until I reach a place where I can face them head on.

What am I afraid of? I’m afraid of failing. What does failing mean? It means that I did something wrong. And what does that tell me? It tells me that I need to change something. It is feedback and that is all it is. If I spend too much time fusing over unnecessary details and miss an important concept, then I need to learn to set the details aside and look at the bigger picture. The exam is the only place where I will get feedback on my preparation. If it is wrong, I should not feel ashamed. I can feel sad, for a moment, but then I should change and come back. I should improve and try again.

I can’t manipulate the future, I can’t figure out the perfect plan for these next three days, a plan that would ensure that I pass. I need to do what I can, what I know how to do. I need to focus on the tips our teachers have given us. I need to take it one step at a time. There is no shame in failure. Failure teaches. And that is what I am here for. The panic I feel before exams gains strength only because I think I can control the outcome. It is because I think I can do something in those few days before to make it go in my favor. What I don’t realize is that it doesn’t matter. It goes in my favor either way. If I pass, it means I prepared correctly. If I don’t, it means I have some improvements to make, improvements that will make me stronger for the next challenge. I either pass through with the armor I’ve built or build it stronger for the next round. It doesn’t need to be – and really shouldn’t be – more complicated than that. Fear and anxiety are petty emotions. Nothing comes of indulging them.

I know this from before and I’m sure I’ve written about it many times. But it is easy to forget. It is no less true for me now in third year than it was when I was in first year. I am dedicating myself to a career that is characterized by a lifetime of learning. I need to learn to be comfortable in that position. To admit when I am wrong and to learn from it. To not be afraid of vulnerability. To not feel shame when I don’t know something, but rather to feel excited at the prospect of having something new to learn. This exam is not to be feared, it is to be anticipated with great excitement. This is the foundation of medicine and I want to earn its respect. I have no doubt that I will make it through in the end because I will give it everything that I have to give. But through this all, I need to remind myself that I am a student of medicine and must learn much more than the medicine itself.

A quote I repeat to myself:  I did then what I knew how to do, now that I know better, I do better.

The competition this past Monday went better than I’d thought. I wasn’t one of the top three, but I did come in at 5th place. I spent a good few days with my mind consumed of “If only I’d…” thoughts. I finally had to throw those aside and be happy with the confirmation that I know more than I think I do. I’ll share more details about the competition itself once this exam is over. Now, it’s back to the books!

The young think that failure is the Siberian end of the line, banishment from all the living, and tend to do what I then did – which was to hide.
— James A. Baldwin

 

It’s not necessary to fear the prospect of failure but to be determined not to fail.
~ Jimmy Carter

 

You must accept that you might fail; then, if you do your best and still don’t win, at least you can be satisfied that you’ve tried. If you don’t accept failure as a possibility, you don’t set high goals, you don’t branch out, you don’t try – you don’t take the risk.
— Rosalynn Carter

 

There are no magic answers, no miraculous methods to overcome the problems we face, just the familiar ones: honest search for understanding, education, organization, action … and the kind of commitment that will persist despite the temptations of disillusionment, despite many failures and only limited successes, inspired by the hope of a brighter future.”
— Noam Chomsky

 

But there is suffering in life, and there are defeats. No one can avoid them. But it’s better to lose some of the battles in the struggles for your dreams than to be defeated without ever knowing what you’re fighting for.
— Paulo Coelho

 

Failure is instructive. The person who really thinks learns quite as much from his failures as from his successes.
— John Dewey

 

No one can defeat us unless we first defeat ourselves.
— Dwight D. Eisenhower

 

Life is to be lived, not controlled, and humanity is won by continuing to play in face of certain defeat.
– Ralph Ellison

 

No matter how hard the loss, defeat might serve as well as victory to shake the soul and let the glory out.
~ Al Gore

 

The greatest mistake a man can make is to be afraid of making one.
– Elbert Hubbard

 

Only those who dare to fail greatly can ever achieve greatly.
— Robert F. Kennedy

 

Far better it is to dare mighty things, to win glorious triumphs, even though checkered by failure, than to take rank with those poor spirits who neither enjoy nor suffer too much, because they live in the gray twilight that knows not victory nor defeat.
— Theodore Roosevelt

Pathology, oh, pathology…

May 11, 2015 § 4 Comments

One week out from my first final and I can feel it in my entire body. For the past three days, I’ve done nothing but sit in my little study spot and push myself through topics. After so much work, I find myself already completely exhausted. And tonight, is the pathology competition.

I should be doing everything I am to cram for it, and trust me I will, but only with the time I have today. Last week, I had a goal of finishing 90 topics (we have 191 total), which I then had to adjust down to around 60, and I even fell short of that goal. Yesterday, I had to make a decision: give it everything I have for the competition, with what time I had left, or aim at finishing my topics. With the stakes for the competition being so high, I decided to go for the latter.

The competition will consist of 8 cases with 10-15 questions each. One teacher told their group that there will be 6 more normal cases and 2 really strange ones. Only the top three will get a prize: the first gets exempt from the entire exam and the second and third get exempt from either the theoretical or the practical portion. There is also a rumor going around that anyone that makes it into the top 10 will have a “nicer exam” based on their performance.

I really, really wanted to go for the competition, but I didn’t want to put everything I had into it and then fall short, leaving me with only 6 days to prepare for my final exam. In the beginning of the semester, the head of the department mentioned a book of cases available only in Hungarian that they soon would be translating into English. A couple of weeks ago, I heard that the cases for the competition would be taken from this book. I bought it (in Hungarian) and sat down with a plan to go through 20 a day for 20 or so days. The first two: took me 5 hours! I remember that night well because Skjalg and I got into a big discussion about my beliefs about what is possible or not. Even though I knew it was impossible to go through 290 cases in Hungarian in just under 3 weeks, I couldn’t stop myself from feeling like I’d failed.

We ended up finding someone who was willing to translate the cases, but that plan fell through. So, the cases have just been waiting there, taunting me.

Screen Shot 2015-05-11 at 07.45.24 Screen Shot 2015-05-11 at 07.45.33

I’m feeling so scattered at the moment, so I really don’t know if this post is making any sense. The reason I started writing (rather than sitting down to start cramming) is because I felt the need to mentally prepare myself for today. I am so used to giving 100% of myself to my tasks that I have a really hard time when I can’t. The hardest of all is when I’ve made an active plan not to. My natural instinct is to feel like I’ve failed, so I need to work against that and look at the good. I made the decision to prioritize topics over the competition. Studying for it today will be a benefit to me – no matter the outcome – because I will have to apply my knowledge in a different way than I have been doing. It will allow me evaluate the practical use of my knowledge and give me an idea of where my focuses need to lie in these next days before the exam.

It’s hard to put so much work into an exam and not be assured that it is going to go well. For the past few weeks, I’ve done nothing but study patho. The idea that that still may not be enough makes my stomach turn. Still, this is a mountain and the only way I’ll climb it is my taking it one step at a time.

This is what my weekend (or life) looked like this past weekend. I really enjoyed the clouds – as you can tell!

20150509_18514520150509_202756

20150511_070205

So strange that this much time, work and energy can still feel so inadequate…

Whenever new students ask me for tips, the first thing I say is, “Evolve, constantly.” This is actually something that I have struggled with myself quite a bit. I never really know when enough is enough and rather than thinking “they seriously can’t expect us to know all this”, I think “why can’t I get all of this in my head?”. My friend Amir said something really good that I’ve been repeating to myself, “I’m a medical student, not a parrot”. I like that way of thinking and believe it to be true, I just need to figure out how to gain confidence from it.

The reason I brought up the “evolve” idea is that my notes for this exam are a perfect example. I’ve gone from doing 1 topic a day to having to cram in maybe 10 or more. I’ve had to sacrifice doing the topics the way I would if I had all the time in the world for progress. In the end, I’ll never have all the time in the world, so might as well learn that lesson now.

In the beginning, I typed up lecture notes and topics in my iPad.

2015-05-11 07.11.03

20150511_070717

Then I started writing them all out by hand, making sure to make plenty of charts or diagrams to make the information more fluid (at least for me):

2015-05-11 07.10.22

Then I thought I should go back to doing it on my iPad – but this time print out the notes. This ended up being too time consuming and honestly, I can’t afford to pay for that many color copies!

20150511_070507 20150511_070535

Finally, I found something that worked. There are two sets of “notes” made my previous students. One is by a girl who recorded the lectures and has created topics based on those, while filling in from the book. She’s squeezed most of them onto 2-4 pages, so sometimes I have a hard time following the structure. The second is by a guy who made summaries based directly on the book, with some input from lecture. What I do now is read the topic in Robbins, while following the summary and adding in my own notes, then check the organization of the topic in BRS and then create my own little summary page of the topic. Finally, I look at the first set of notes to see if I’ve missed anything. While I’m preparing the notes for a topic, I’ve also started a habit of googling the disease and leaving up the image search on my screen, so that I look at it while I’ve coming the topic.

For this one, I was still writing out too much info

For this one, I was still writing out too much info

20150511_070249

My summary page…

20150511_070307

…and an example of the typed summary with my notes added

20150511_07033720150511_0704292015-05-11 07.09.47

Ok, getting too anxious now! Off to cram, go to lecture, go to class, cram, then finally challenge my knowledge. It’ll be great no matter what happens 😉

 

Where Am I?

You are currently browsing entries tagged with Exam at Buda-B.

%d bloggers like this: