Tuesday, May 29, 2007

va sub-i and the fun of fourth year

so, if you're one of my loyal readers (and a former/current med student), you probably remember me being a *little* freaked out about starting back on the wards on a VA medicine sub-i. you may even wonder if i have survived this sub-i month, considering i fell off the face of the earth, am no longer allowed to obsessively IM people (the VA blocks a lot of sites!), and haven't updated. of course, the month is going great (like everyone said it would); i survived my first day back on call (also my first day of 4th year), and have become a pro at CPRS (the VA computer system) in no time. i'm confident about my ability to take care of patients, generally admit 2 patients every call night (we take q4 with the interns), and follow-up on their issues with a daily note and orders until they're discharged. i still think it's going to be crazy to take care of 9 patients all at once as an intern, but so far am doing fine with three. i've remembered a lot more than i thought i would, and actually am looking forward to have everything come together and hardcore study for step 2 to get it over with.

i have to say, it is GREAT to be a fourth year. the interns and attending treat me as part of the team, i don't have to round on the entire census, and im more in the loop regarding what's going on with my patients since i take more responsibility for their care (ie getting studies done, etc). i also feel like im contributing to the team because the interns have to take one or two less patients on call (although it may be more work for the senior). she's been awesome though (AND she's going into ID) so it's been good times.

i'm always really lucky when it comes to teams (knock on wood) and this one was no different. our interns switched last week, but my first two were great, really supportive, and gave me some tips on the interview trail and their impressions of different programs. we celebrated the end of their va month with a trip to dominick's post call. the cashier at dominick's was kinda funny when he was taking our order and said he hoped we weren't going back to the hospital to save lives after downing our order in dirty scrubs. no worries - after i drank both beer and sangria and didn't eat lunch, i promptly fell asleep when i got back home (waking up with a hangover four hours later). fun times post-call.

speaking of post-call, my schedule has also worked out surprisingly well for making graduation parties, bbq's, and other fun gatherings my friends have planned before many of them leave ann arbor for good. so far, i've attended Emily's graduation party at Al-Ameer, Lori's graduation party at Andiamo's, Susie's Memorial Day BBQ, and more - all post-call! the highlight of susie's bbq/bonfire (held saturday night) was definitely getting to meet little Noah, who is almost walking at seven months and just a really happy baby. i've decided that maybe i do like kids a little more than i thought, and i'm looking forward to the day chris and i have our own, although that shouldn't be for a couple of years (the fortune teller in Bangkok said we *could* have an accident this year, but we're doing all we can to make sure that DOESNT happen).

back to the va. the new interns on our team are super nice, and i know one of them from AMSA days, so it's been nice to catch up. we had a super slow call day over Memorial Day Weekend (i got my first - and only - admission of the night at 10:30 pm) and i got a chance to bond with my team, tell the story of how chris and i met, listen to the story of how other people met their partners, and get advice on 4th year/residencies/etc. ive been really happy with all my medicine experiences at michigan and am strongly considering staying for residency, but will definitely try to interview broadly and see what's out there. my parents (esp my mom) are of course thrilled about this and i'd definitely be happy about staying close to home, esp for when we are thinking about having kids. as always, chris is super supportive about my career and although i think he would be happy going back to cali, he would also be really happy not having to move and pay a million dollars in rent every month. we'll see how he likes his first year at his new job and what he's thinking about re: grad school, but it would definitely be awesome if he did his MBA at michigan. it IS great to be a michigan wolverine - we're excited about getting partner football tix for this season after not having them since M1 year. bring on the tailgates :)

Tuesday, May 15, 2007

pentwater!

note: i never finished this entry but i decided just to post it now anyway because it's long overdue. next entry: update on va sub-i, which is more than halfway over (only 3 calls left to go!)

after a blissful, relaxing weekend in pentwater at the eaman house, i returned to ann arbor for a few days and hit up the Class of 2007's graduation before starting my internal medicine sub-i at the VA yesterday. im post-call as i write this, so y'all are going to have to bear with me, but i wanted to get some stuff down before i got wayyy behind in my blogging life.

pentwater was really good and the first time (in four years!) that suhani, liz, and i really just ran away from all our responsibilities and devoted 24-7 to hanging out with each other. all of us were super lazy, but we filled our days browsing the few open shops downtown, eating, napping, eating more, watching scrubs and america's funniest home videos, and going to the beach. the most strenuous activity i engaged in during our 2.5 day stay in pentwater was climbing 'Mt Baldy', or a seriously tall sand dune behind the Eaman house overlooking the beach (and Lake Michigan), which was more than enough exercise for me :)

on the way home from pentwater, we stopped in grand rapids to meet suhani's mom for lunch at noodles & company (suhani's mom kindly took all of us out!), admired phone pics of suhani's mom on a pimped-out harley davidson, and went on mad shopping sprees for graduation accessories at a local mall. it decided to pour intermittently all the way home but liz was a great driver and we all made it home safely.

Tuesday, May 08, 2007

home sweet home

if any of you have been obsessively checking my blog to read about my safe return to the us, i apologize for being a slacker about updating. however, anyone who knows me really well also knows that i never plan on any downtime when coming back to the us and usually just throw myself into whatever commitments i have (ie med school orientation). this time was a little more relaxed, as i had 1.5 days in between getting back to ann arbor and getting on a plane to washington dulles airport for amsa exec, but im back on EST and back in action.

saying goodbyes in bangkok was not as difficult as it has been previously because both myself and all other parties involved (nan, krit, maddie, amalee, etc.) knew that i would be coming back sometime within the next year. that being said, there were no tears involved, although i did feel (as i was going through immigration) that a part of my life was coming to an end. in a previous conversation with sural, a friend who is going abroad to lima, peru, this upcoming year (yay fogarty!), she asked me about the impact this year abroad has had on my life. both sural and i had spent a year abroad in between college and med school and now were also taking a break between M3 and M4 year to go abroad again. my reflections on the difference between the two were that as a recent college grad, i felt the whole world was open to me and i didn't have any great expectations about the work i would accomplish or the difference i would make on the world (although i did care about the impact my actions had on other people). i was more concerned about finding a direction for myself, learning about what it was like to live (and work) abroad, get in touch with my thai roots and build relationships with family, and just experience and try to get my head around what things like 'HIV/AIDS', 'commercial sex work', and 'IV drug use' really meant in people's lives and lived experiences. my fulbright year was defining for me because it gave me a direction and a purpose, and helped me define what my priorities would be in my medical school career. it also helped me put things in perspective while i was struggling through my preclinical years at michigan, not feeling really smart enough and not doing really as well as i would have liked, and gave me a place to come back to, not just emotionally and mentally, but also physically as well.

the past year was not as life-shattering or ground-breaking for me in terms of figuring out what i wanted to do with my life but it was valuable in a lot of other ways. whereas previously i had felt that the whole world was open to me (and sometimes i still do), i have recognized that being a physician gives me unique power (and means of) contributing to a larger fight for social justice. although im not saying that being a physician restricts me in any way, i think it does circumscribe the areas in which i can effectively (and knowledgably) make a difference. it took me a long time to realize this, and i struggled with the question while at the WHO in Geneva a lot, but i think it's nice to realize that you can't do everything for everyone (or even for yourself) and that's totally fine. this year helped me to define how i want to contribute as a physician (or public health practitioner), what i want my career to look like, and helped me identify what areas i needed to address to help me achieve my goals (anyone want to teach me stats?). personally, a year off (and abroad!) also gave chris and i the opportunity to explore what it would be like to live abroad together, and grow as a married couple. i now have a more defined direction regarding what i want to get out of training (and what i want to do with my training when im actually finished), and chris and i have a stronger relationship and foundation as husband and wife (i don't feel so weird saying husband anymore!) :).

in any case, i was thrilled to be done with the ridiculously long plane ride back to the US. both flights were packed and i had no layover in tokyo (i seriously ran off the plane, went through security, and then boarded the tokyo-detroit flight). i also had the pleasure of sitting in a section where the air hostess was unbelievably rude (esp to people who didn't speak english as a first language, where she became increasingly loud and rude when people didnt understand her questions such as 'chicken or beef') and wouldn't clear the trays of this chinese couple sitting next to me for over an hour. service on american airlines is really ridiculously bad (maybe ive been spoiled by living in thailand for the past year, but UGH!!). ok, enough about the plane ride. it took me a long time to get my baggage and clear customs in detroit (thank god they didn't send me to inspect my bags) and chris came to pick me up. i ate a bellacino's grinder for lunch on the way back home to Grosse Ile, which took an inordinately long time since it was the first day that the free bridge closed for repairs. still being incredibly jetlagged, i took a nap at home, played with dogs, and ate dinner with my parents (but i wasn't hungry, so i didn't really eat). this came back to bite me later on in the night, when i dragged chris to denny's for buffalo chicken strips because i was starving. all in all, a standard day back at home in michigan.

the next day, chris and i went to northside grill for breakfast (yummy!!); i ran into some med school classmates, and we went shopping for our celebratory BBQ at costco and meijer. we also stopped briefly at briarwood and i bought some lancome foundation for an awesome free gift (i think i may try to wear some makeup like p'noi taught me at red earth in bangkok) and then we went home to get ready for the bbq. as usual, it was a never-ending potluck, and i had fun catching up with many friends that i hadnt seen for a year or so. i did feel kinda time-warpy in a a way though as many people are moving on (graduation, residency, etc) and i felt like i had missed a lot of the big milestones of the year (like match day!). it's all good though, and i feel like i'll have a harder time adjusting when many of my friends, like liz and suhani, move away for real in the coming weeks. highlights of the bbq were eating lots of american food, chris being proud of himself for grilling some kickass organic beef hamburgers and hot dogs, watching grey's anatomy and scrubs, and feeling at home again (and enjoying the space!!).

post-bbq, i had to pack and get ready to go off to amsa exec in reston, va. this year, i am the global health action committee (or GHAC) chair, and serve on the AMSA Action Committee Exec Committee with seven other action committee chairs, the Action Committee Trustee, and the Director of Student Programming (all med students). i arrived friday afternoon, hung out with some SOS (student office staff), met with Pete from The New Physician about my piece i submitted to 'Letters from Afield', and then went to dinner at Chris's cousins' house in Maryland. it still never ceases to amaze me at how good chris is with kids (he played with karen, lucas, and matthew, ages 6-9, for hours) and i know he'll be an awesome dad!

saturday and sunday were jam-packed (as usual) with agendas, meetings, discussions, and the like. what's really exciting is that many of us have taken a break from amsa and have returned as chairs, and that there's also new leadership (and action committees) in the house. i was particularly excited to see catherine jones, the community and public health action chair from tulane, who i interviewed for this piece in Global Pulse about doing work post-Katrina, but really felt thrilled to meet new friends and colleagues and catch up wtih old ones. i got some terrific hugs (and welcomes) from people which i've missed while being away (hugs, especially between the sexes, are not so common in Thailand). i also discussed the use of public space (and trying to get used to strip malls ad nauseaum) with cjones, sadly ate dinner at an overpriced thai/chinese restaurant, and happily went to bed early with many other 'lame' ac exec members who like to stay in. thanks to everyone who made it a memorable weekend - i do feel energized and excited about amsa again, and am happy that i started my time back in the US in a place where i feel like i'm part of a family and a movement that helps me contribute (and achieve) things i believe in.

i am currently writing this from liz's dad's house in pentwater, michigan, where i'm spending a few days with liz and suhani before graduation (this friday!) and the beginning of my sub-i at the VA (may 14th!). i love weekends (or pseudo-weekends, like this one) in western michigan, and will write more about our fun adventures and relaxation here once i get pictures from liz and suhani. yay being back!!