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.

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 😉

 

The Transition

March 23, 2017 § 3 Comments

During a break on Tuesday, I mentioned to an Erasmus student from Germany how brilliant Budapest is when Spring really hits. I told her, “There will be one day where the temperature jumps and the parks fill with people – that is the day where everything starts.”. Wednesday was exactly that day. After class, I came home, opened up the doors to our small balcony and laid out a yoga mat. For two hours, I soaked up the first real taste of spring while listening to a samba mix. It’s amazing how much a difference the sun makes!

I took the rest of that afternoon to work on my study schedule (the one I was supposed to do Monday). I’m always searching for ways to improve my studying and I stumbled across a USMLE blog presenting a technique that I am going to try. It’s really common when studying to designate “days” for a subject. Whether it’s a certain day of the week, a certain number of days a month or a chunk of days for cramming before the exam, using “days” as the base study-time unit is extremely common. This new technique involves breaking up each day into sessions and studying different topics during those sessions. What I liked most about it is that it gives several opportunities to “restart” during the day rather than waiting until the next day to start fresh. If the 1st session doesn’t start on time or isn’t successful, the rest of the day can continue without that guilt and negativity trickling in to the rest of the day’s tasks. I’m definitely one of those people who gets thrown off if things don’t work out like I planned, so something like this is perfect for me.

I’m going to put a little more emphasis on preparing for my finals (which will take place during the middle to end of May). I want to get those out of the way as soon as possible so that I have more *pure* USMLE time. We have 8/9 exams, 4 of which are oral. During oral exams, we usually have to draw a certain number of topics from an assigned topic list and present each of these topics to the examiner. Thus, the best way to prepare for oral exams is to write out a plan for each topic that includes major points/info you should mention. For forensics, obstetrics and gynecology, pediatrics and internal medicine, I’ve divided up the topics over 6 weeks. If all goes to plan, I will be done preparing a week before exam period, which means that I won’t need as much time between exams during exam period.

My tentative plan for next week

Today was my first attempt at this plan and it went really well – in spite of not actually going to plan! I slept an hour longer and took a 2-hour walk with Baloo, but still managed to get a chunk of topics done within different subjects. It felt really good to be able to look at my schedule for the start of the next session rather than waiting until the next day. No more entire-day sabotaging for me! It was also really nice to mix the subjects (5 years of medical school and I still haven’t figured out how to successfully study multiple subjects at once). I was tempted to repeat gyno for a session because I was really enjoying it, but now I’m happy I moved on because I really look forward my next session with it (and it feels good to have made progress in other subjects).


I’ve been a bit more reflective this week than usual. Fifth year is not what I thought it would be. It feels so much more final than I ever could have imagined. We still have one year left, but most people go back to their home countries to do their final rotations there. As such, most people are treating this as the last semester. I notice so many different ways of coping with this transition, of cutting ties with Budapest, of closing out this chapter. We’re going to be doctors soon. An overwhelming fact that weighs heavier with each passing day. And with such an immense transition ahead, it’s hard to focus on the present. Every effort is placed on cushioning the inevitable blow that follows graduation.

In autopsy on Wednesday (our current block is forensics), we had two young men, only 21 and 22 years old, who had been killed in a car accident. One of them had just gotten a new haircut. The day before that, we had a 18-year old male that had died from complications associated with his almost decade-long history of drug use. The fact that I am almost 10 years older than them was not lost on me. It’s so important to savor the present, to soak it all in. The sights, the smells, the sounds. To just marinate in the moment. Life is too short to rush through a transition, even one as big as this.

Here I am, maximizing this moment 😉

 

Block system, research and teaching – oh my!

October 11, 2016 § 2 Comments

It’s been a while since I last wrote and I have to say I’ve missed it a lot! The rest of August was packed with work – we even worked on the day that we left for the flight back to Budapest. It will all be worth it when we get our pay checks, but it was quite tiring then!

We started school the day after we got back. This should be a calm semester – we have the block system now, so we only have one subject for 1 or 2 weeks at a time – but I don’t think I’ll ever experience “calm”. The reason my semester isn’t calm has to do with something I never could have imagined happening: I’m teaching anatomy!

Along with my friends Dushyant and Amir, we are the three 5th years students who each have our own group in anatomy. It’s a huge honor and I feel so lucky to have been offered this opportunity. It’s also A LOT of work! I teach 3 classes a week (one histology and two in the dissection room) and outside of that I spend maybe 10-20 hours a week preparing/reviewing for the class. This semester we are focusing on the locomotor system (all the muscles, movements, nerves, vessels etc. of the upper limb, lower limb and thorax).

I absolutely love apps/technology/organizing and teaching this class is giving me the chance to let my technology freak flag fly high! In order to share useful sources, links, notes etc. with my students, I’ve created a page on a website called Trello. It’s more of a project managing site for companies, but I feel that it also works really well for teaching.

I re-organized it last night (one of the keys to success is constantly evolving your tactics, right?), so now it shows each board by topic. Previously, I had organised by week, so that they could follow along during the weeks of the semester. With midterms approaching, I think it is more efficient to have everything in one place.

This is how the main page of the Trello account looks:

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When you go into specific boards, you can see that different topics or weeks are divided into separate lists. Each list is composed of various cards.

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When you click on a card, it will open up to a smaller window and show you the details included in that card. For each histology slide, I include links to videos or websites covering the theory, details from the new histology guide written by the department, details from the old histology guide (which I feel has more detail and information) and then at the end, a picture of my own notes for that slide.

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In addition to Trello, I use the website Memorang for creating flashcards. I’ve used this app before for previous courses and absolutely love it. I do prefer traditional, hard copy flashcards, but the benefit of this site is the algorithms (if you get a card wrong, it intermittently repeats it until you hate it) and the statistics (it gives you percentage progress with each card and with the deck). My students have access to the cards and I can see the top students on the leaderboard for the different sets.

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On the online version of the site, there are different testing methods – which can be really great when you are tired/bored with studying and need a little kick.

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I use the multiple choice option the most, but the traditional flashcard version is great when you need to first learn the material.

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Another program/app that I’m using – or will start using today – is called Socrative. I really like how online quizzing systems can be integrated into the classroom/lectures. I’ve heard that one of the pathophysiology teacher has started doing it in his lectures and one of our internal medicine teachers did it during one of her presentations. It’s such a great way of keeping students engaged and interested. I’m not sure how I will integrate it into my practical classes, so for now I am using the site to arrange online quizzes that the students  can do at home. My friend Amir and I have created almost 100 questions that we will launch in two rounds. My group will have their first quiz today and their second on Tuesday evening.

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I will open the quiz for 1.5 hours and can track their progress throughout that time. At the end, I can download reports that are either (a) question specific or (b) student specific, which the students can then print out and use to study from late.

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In addition to teaching, I’m doing research with two departments: Department of Surgical Research and Techniques and Department of Public Health. If all goes well – which I’m sure it will, after a lot of hard work – I will present my work in both departments at the TDK conference (Student Research Conference) in February. I had a really great experience with my 2nd semester public health professor and he has offered to be my thesis advisor. There are a couple of potential projects I can consider for my thesis (which must be completed by the end of 6th year, but which should be started – at least – by 5th year). I won’t tell about any of them yet – don’t want to jinx myself! With so many different departments, possible topics and potential thesis themes and advisors, I feel lucky to have a place to start.

I’d hoped to make this post longer and a bit more informative, but at this point I just need to press “publish”! I’ve sat down to write a new post countless times in the past two months and always get interrupted by something :P.

Tomorrow I will be examining 1st year medical students for their first midterm (covering the entire upper limb) all day. There are exams at 8:00, 10:00 and 14:00 and I’ve agreed to be there for all of them. It still amazes me how different things are now and how crazy it would be to go back and tell my 1st year self where I am today!

To get an idea of what the students need to know for their exam, check out the checklist I made for my group. That’s a lot of new vocab to learn!

Ok, off to Memorang flashcard land I go! Meanwhile, my students are finishing up their second quiz. I love being able to follow along live. The quiz Amir and I made is really, really tough (designed to make them think and use their knowledge), so I’m not too worried about the incorrect questions.

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Life can only be understood backwards; but it must be lived forwards

January 31, 2016 § 10 Comments

Out of the seven exam periods we’ve survived there are three that I will always remember. Not because they were amazing, but because they challenged me to my very core and forced me to push forward when I had absolutely no hope or belief that I could. These exam periods were all, coincidentally or not, winter exam periods. I’m sure the weather and short days had a lot to do with it. Nothing stresses me out more than the end of the day in exam period. And in winter, the end of the day comes quite early.

All I can remember about the third semester exam period is anatomy. I set aside 14 days for that exam. Why? Because I knew I had neglected it during the semester (with the introduction of physiology into our curriculum, it was hard to focus on anything else). I expected that I had a lot to learn during that time, but I had no idea just how much it was. Nor did I expect how complex it all was, at least when compared to what we had previously learned in anatomy. Neuroanatomy is almost entirely theoretical, at least everything outside of the macroscopic structures of the brain and spinal cord. Learning things from scratch, understanding them and preparing yourself to present them at an oral exam is a lot to manage in a short amount of time. I was really positive when I started out studying for that exam. I had plenty of time, was excited to only have one subject to study and excited to learn something I knew I’d avoided all semester.

As the number of days dwindled, the panic started to set in. We have a guest room in our apartment that I absolutely never use. It’s mainly used as Skjalg’s office/den. The first, only, and last time I used it is while preparing for this exam. I lived there for the 7 days. I slept in the bed, used only the adjacent bathroom and emerged only to grab food and water and wave at Skjalg. In the 3 days before the exam, I developed a sort of insomnia where I could only sleep for ten minutes at a time before waking from a nightmare. The nightmare was always an exam scenario. An evil examiner, humiliating questions, forgetting how to speak, getting topics I didn’t know well enough, etc. When exam day finally came I felt hopeless and exhausted. I was 100% sure I was going to fail. What happened? Nothing. I got a kind, though demanding, examiner. I got topics I didn’t think I knew but that came forward once I calmed down and gave it some thought. I got a histology slide that I could identify right away. I had a good exam. Some mistakes, but absolutely nothing like I had imagined.

Fifth semester exam period was the next big blow. We no longer had just one or two huge classes. Instead, everything felt huge. Pathology was the monster, then pathophysiology (which included EKG analysis, which I felt so unsure of at the time), microbiology, immunology and our Hungarian final. I’m probably forgetting something, but you get the idea. This was my first time having to deal with so many large classes in what felt like such a short time. I didn’t feel confident in anything at the start of the exam period and was worried that I wouldn’t have time to properly learn anything. I spent those four to five weeks criticizing my study methods from that semester, fantasizing about ways I could improve and praying that I would make it through. So what happened? Again, nothing. I wish pathology had gone better, but otherwise all my examiners were kind, did their best to make me comfortable and to really evaluate my knowledge. I even got the “crazy, mean one” for micro. She was a little tough on me for my mistakes, but otherwise fine; she even complemented me on some points.

Then there was this exam period. I’ve matured enough that I didn’t suffer to the same degree as the ones mentioned previously. I’ve learned ways to quell the panic, or at least limit it to five minutes rather than 2 days. I’m actively working on mastering my emotional self, something I think is important to do now in medical school. This is probably the first time we are under this kind of stress and learning how to handle this version of ourselves, learning how to cope and how to act appropriately and efficiently, will be vital as doctors.

The problem with this exam period was the number of exams and the fact that I put the exams before everything else. I put them before my health, my relationships, everything. I allowed myself to be completely consumed and that is not something that can be done for such a long period of time. Reflecting on this exam period, I realize – and I mean truly realize – the importance of balance. There is no point of a victory if your mind and body are destroyed in the process, if you are not there to enjoy it in the end.

I’ve learned that I’m not good at taking breaks. To be honest, this is something I’ve always known about myself. The difference is that now I am going to do something about it. The way I’ve planned to deal with this is to do all of my “exam period cramming” during the semester. For each new exam, I start by printing out the topic list, dividing the number of topics evenly over the days I’ve set aside for the exam and then going through the topics one by one. I write my own notes, using a combination of sources, and try to finish them so that I have one day for memorization. Then, for the day before the exam, I try to memorize everything perfectly. This is where things go a little crazy. On this day I feel responsible for all of the knowledge at once. I feel as though I know nothing and that I wasted my time and should have done things differently. So, my plan now is to complete all of the note preparation for all of the subjects before exam period, maybe even a couple of weeks before, and utilize the power of spaced repetition. For exam period, my plan is to power through everything in a short amount of time. With all of the work done during the semester, I will only need to review and memorize.

This may seem like an obvious plan, something that I should have been doing all along. It is always my plan at the start of the semester to prepare notes from the topic list, but it always gets dragged out. During the semester, I feel like I become so short-sighted. I get distracted by midterms, weekly projects, research, visitors. I spend time reviewing or writing notes from lectures and not setting them up as topics. Another thing I tend to do – something I really dislike – is that I spend way too much time on one topic. For example, 1 topic during the semester may take me 10-12 hours to prepare. In exam period? I can power out 17 topics in a day. When I have the time, I spend it. So I need to be more strict with myself and exercise efficiency. In our oral exams (and most of our exams are oral), we draw a certain number of topics and have to present those topics. It makes sense then that this would be the format for note-taking during the semester! Easier said than done, I know, but I’m promising myself that this time, that’s not the case.

The best part is that my schedule this semester is AMAZING. It’s quite similar to 4th semester in that the class load is very low. I took 36 credits last semester and this semester I only have 25! I am looking so, so forward to having time to study during the week, to stress-free time at the gym, and maybe some early nights off where I can read in bed.

This is my schedule (not including research, not sure yet when that will be):

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And this is how I’ve planned out my time during the week:

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I want to be more strict with my schedule (i.e. only allowing myself to study during certain times so that my time is used more effectively) and want to spend more time studying outside of the apartment. With this schedule, I’m out at school/gym/studying for 12 hours of the day and then I’m home to relax, read, spend time with Skjalg before bed. It might make this feel like more of a job/something we do rather than being everything we are. It definitely isn’t like this for everyone. I know a lot of people that have done an excellent job balancing life and school. But for the crazies like me, this is something that needs to be worked on. I’m just happy to have the self-awareness and drive to acknowledge and change these things. Better to do it now than later.

It’s probably pretty clear that a lot of reflecting has been done this exam period and in the weeks following. It’s been the perfect amount of time between exams and the new semester, at least for this round. I’ve had enough time to relax, binge watch TV shows, organize notes, answer emails, spend time with friends, etc., but not enough time to get lazy. Over the past couple days, I’ve prepared for this first week of school. Purchases school supplies, organized my folders, downloaded lectures and notes. All of the busy work that takes time once the semester actually starts.

One of my big post-exam projects (that I’ve never completed until now): go through all the notes/papers from the last 4 years:

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All this is going to be recycled! Must be at least 4,000 pages in there:

I’m really excited for this semester. I’m excited to challenge myself to improve as a student and push my comfort zone. I’m excited to get more involved in surgery.
We’re getting closer and closer to becoming doctors now. I almost can’t believe it sometimes. It feels like just yesterday that we started…

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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.

Entrance exam 1

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

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