Thursday, March 13, 2014
It’s funny how God finds ways to prove a point. I’ve been struggling with the thought of being a “Real Doctor” next year when, despite hours of practice, I can’t seem to rise above the 33rd percentile on my question bank…
I had been debating whether or not to attend my cousin’s wedding this weekend, but I really wanted to observe and get suggestions for our own wedding. So down Brian and I drove to Dunedin on Friday morning, quizzing each other on immunology and listening to podcast series. I’ve been so swamped in medical land that it’s a strain to talk about much of anything else.
We walked down the long aisle, arm linked with arm, behind Grandma and my parents, and sat in the front row near my gaggle of 20 or so cousins. Brian leaned over to me and whispered, “I feel like having our wedding somewhere like this would be hypocritical considering I haven’t been to church in years…” I wanted to retort, “Well I have so whose fault is that?” But I just shrugged it off.
Lindsay looked gorgeous, and she cried all the way down the aisle. I tried so hard not to cry, but of course, I shed the largest river of anyone in the place. Brian put his arm around me but seemed altogether confused by it. This heavily Catholic-centric wedding, complete with ups-and-downs, songs, holding hands up to the newlyweds to bless them, and Communion was a bit much for him. I thought it was very meaningful: after all, what else holds the marriage together as strongly as faith? But I had to agree that I guess it was a bit long. He liked the relevant verses, but I agree that having Communion isn’t necessary.
So we filed out of the church, and I excused myself to the restroom to wipe my face since I was still crying. I deplore this weakness but I just can’t help it. I’m hoping that someday when I’m as aged as Grandma I will have used up the tears and stop being such a faucet!
We proceeded past the stretch van-limo to the reception across the street. The cocktail hors’douvres were delicious (I had to convince Brian 3 different ways to try any of it though), but there was no seating and I failed to realize what a strain this would be for Grandma. I couldn’t get a drink at the “Open Bar” because I didn’t have my ID so I was pretty ticked off, but Dad grabbed one for me. Furthermore, I hadn’t RSVP’d ahead of time so Brian and I didn’t have a seat at the tables.
Miracle 1: Aunt Pam and Uncle Bob had received a letter in the mail stating: “We are so sorry that you couldn’t make it to our wedding.” Which they took as: We love you, but don’t show up. As Mom and Dad are really the only cousins that can tolerate Aunt Pam, they were assigned to our table on the name cards. So Brian took Uncle Bob’s place for the night, and I took Aunt Pam’s. That couldn’t have been a coincidence, considering the night’s proceedings…
The reception hall was gorgeous. It was a gym, but they had covered the walls in elegant gold fabric, and streamers from each corner of the room converged on four pillars at the center, each topped with gorgeous hydrangeas. The tables were white-clothed and elegant with towering crystal-like centerpieces, also hopped with hydrangeas. The couples danced their first dances, and tear-shedding toasts were shared. Brian thought these, too, were far too long and started looking at his phone. Mom wasn’t impressed so I nudged him and mouthed: “Stop!”
A few minutes later, the toasts were complete, and I looked over at Grandma, who had pinched the bridge of her nose. I thought she was having an emotional moment, perhaps thinking about Grandma, but it still seemed odd. I heard Mom say, “She’s not feeling well,” And to me: “I think I’d better take her home.”
In an instant, I knew something was wrong, and I said to Brian,
“She’s going to pass out.” Suddenly, her arm started shaking, and my first and second thoughts were: stroke and seizure. “Get her on the floor.”
Everything happened so quickly and adrenaline must have been oozing through my blood because I immediately switched onto autopilot. We eased her to the ground, and I listened for breaths and felt for a heartbeat, and I felt nothing. I told someone to my right (not sure who) to get her legs up onto a chair, and I said:
“Give her 2 breaths, I’ll do compressions.”
Funny, in retrospect: she’s my Grandma, I should probably have been giving the breaths, but hey: now that Brian’s given grandma mouth-to-mouth, he’s REALLY part of the family!
I completed 15 compressions when a nurse in a bright purple shirt came over and said, “Excuse me, I’m a nurse!” And promptly pushed Brian out of the way, but he stayed closeby. I said I was her Granddaughter and a medical student. I tried to give her 2 more breaths, but terrifyingly, her jaw was clenched tight shut, as if she were about to seize. The nurse told me to give to breaths through her nose. I was still pinching her nose from trying to breathe through her mouth and the nurse gently told me that that might not work (lol). So I unpinched, and breathed twice through her nose, which worked surprisingly well as her chest rose and fell with each of my breaths. I kept breathing for her as someone said, “Her pulse is back”.
Somewhere behind me, Mom was sobbing hysterically and as if I wasn’t already, Mom said through tears: “Amy, do something!”
I asked anyone if there was an AED, and people shook their heads and I muttered, “How is that possible, it’s a gymnasium…” because I was worried that although we had her pulse strong now, who was to say it wouldn’t go away later from the ischemia?
Someone had gotten a BP cuff I suppose (who carries a BP cuff in their pocket?) and her pressure was up to 150/80, which is really high for grandma and a huge relief. I asked for a watch and someone else shoved one into my hand.
Like magic, she opened her eyes, and I was the first person she looked at. Her eyes were so intently focused, and her expression so symmetrical that I knew that, thank God and her army of angels: she hadn’t had any brain damage.
“Grandma?” I asked, holding her head in my hands. And she nodded, slowly.
The nurse leaned over and said: “You saved your Grandma’s life, you know.” And of course, the floods let loose again and I was watching the watch tick as I read her pulse through my tears.
EMS came out of nowhere (Dad had called 9-1-1 immediately) 9 minutes later, and I left her side to let them through. I told the scribe what I knew of her history, and Dad drove back home to get her medication list. Mom was being comforted by her horde of cousins.
When EMS left, I turned around to a deluge of people who I hadn’t even known were there. A trail of relatives, including the entire bridal party, had left the table to stand and watch.
“You were so brave.”
“You are a rock star.”
“You did such an amazing job.”
“I have 3 girls, and all they can do is hair!”
“Thank you SO much.”
Out in the cocktail area, Mom went to the restroom to blot her face and I followed. As I walked in, I heard Jessie say, “If it wasn’t for—“ I walked in, “Amy-JOY!”
“Was that scary?”
“Yeah”, and said something dramatic like: “I’ve only seen one patient die, and I know that I’m going to see a lot more. But not today. Not her.” I’m sure that sounded like overkill, but it was honest.
She really could have died, and if Aunt Pam and Uncle Bob had been there instead of us, and if I hadn’t come, and if I hadn’t immediately recognized what was going on and taken charge of CPR, she may not have made it…
So, God had planned a very unpredictable way of boosting my self-confidence. Who could have known that the first time I’d EVER do CPR on a living soul and potentially save a life would be on my own GRANDMOTHER?
And with my fiancée! We first met in First Responders, and before we really ever knew each other we were paired for the final exam. This was one of the scenarios so to a degree, we’d had some practice…life really does come full-circle.
Back in the ER, Grandma was having some serious chest pain, apparently, from my own compressions. She remembered nothing of that evening and kept throwing up (probably also from the compressions). Her left eye wouldn’t open, which really bothered me because it had been that way for a while. My immediate thought from the first time I saw it was Horner’s Syndrome, and the neurologist is going to look into it. He pimped me and asked, “So with the ptosis, what am I looking for on a chest x-ray?”
“A pancoast.” Chills…yay!!! Oh, and it wasn’t a pancoast. Otherwise I would not be saying “yay”.
And one of the bonus rewards? That night, Brian lay with me in bed and said: “You’re so smart and beautiful and nice…it’s so cool.” He said as he wrapped his arms around me and squeezed me tight. “You are too. That’s why we’re the best couple ever! And we saved Grandma!!”
I couldn’t sleep that night and spent an hour or two looking up medical stuff to try and diagnose her. And there’s lots to it…
…But today she’s back at home, and the worst she has is a sore chest. She has Geranamo, her stuffed giraffe I gave her a couple Christmasses back, to hug in my absence.
And I’m back in Tallahassee, studying constantly, on my Spring Break, but loving it even more than before. I still can’t believe it. And I’m feeling so much more confident that this is what I’m meant to do, and I’m going to cherish it until I can do my best for every patient that I get the pleasure of meeting.
Percy died. Trisha had left him in the tank for a few days, unsure of how to dispose of the poor little beta fish. He’d been tilted at a 45 degree angle for a while now, and despite my research (which told me to try and feed him the shell of a frozen pea to fix his constipation), he didn’t get better so we were all expecting the worst. Together, we said a eulogy and carried the little guy down to the dumpster and said our good-byes.
Saritha came over and the three of us had an in-depth discussion about my grandma’s medical history and what could be the etiology of the problem.
Oh, and I ran my first 10k ever on my own through campus two days ago!! Woo! Still training for the big one in 2 weeks.
So life is back to normal. And I’m back to missing Brian. And my family. And my friends. But I have friends here and a family of sorts, and so much to be thankful for. This weekend was stark proof that it all pays off…
Thank you, God, for helping me find a job that’s not a job, that I adore and is useful in this world. Lord, please give me the miracle of knowing what to do in the right situations to care for people, and the right words of comfort when what I try to do fails. Help me to never give up, and keep pressing on.
Wednesday, February 19, 2014
The stress is starting to encroach.
I took this morning "off" (and by off, I mean I went to class from 8-10, went home and fell asleep because I was exhausted, and semi-read slides to prepare for today's genital exams), and did a quick yoga routine. I told myself that I "needed" the break since I had studied from 9-9 on Monday and Tuesday. And I did need the sleep.
But I went down to the CLC today and had a very difficult time performing the female and male exams. Of course, I haven't had any experience with this so I didn't have a clue about what I was doing. It's kind of like prepping for the cadaver lab: you can pour over all the books and images you want, you can draw them yourself five times, and it NEVER looks ANYTHING like what it does on a human being.
But, once again, for the third time in the CLC, I had Dr. G helping me. I suppose it's a good thing, in retrospect. He's the one that taught the lectures, and he is the best. He is brilliant. And as such, he intimidates me.
Now to look at the situation differently: I learned from the best. Of course, I'm going to feel like a peon next to him. But I might as well learn from HIM and learn to do it excellently, even if I'm stumbling all along the way.
I was very chagrinned though. He tried his best to explain how to do the breast exam and to examine the cervix before walking into the room. And he is a good teacher, but he left very little opportunity for me to practice on the models before going in or to ask questions. So I stumbled throughout the entire exam.
The girl, who looked like a supermodel, was very clear and very helpful about saying what "felt right" and if I was in "the right spot". When I swept my hand in and down on her abdomen while pressing up on the cervix, she knew simultaneously when I knew too that I'd felt the tender, bumpy surface of the ovary. But we had to shift the speculum around in a clock-face for what felt like 10 minutes (of course, it wasn't...we wouldn't have subjected her to that after everything else she must have experienced by now with us students…) to find the pink little cervical opening! On the models you simply press down, stick the speculum in, and open, and voila: it's waiting for you like treasure at the end of the vault. On real people? Not so.
I have to admit though, finding it was one of "Those moments" when you get this tingle like: "I FOUND IT!! THAT'S SO COOL!", and you think, "Ooooh, that's where you put it, God? Pretty clever…", and so was feeling the ovary sweep past my fingertips.
I know I was more anxious and sweaty through the whole thing than she was. And Dr. G was just looking at me like: "Come on, I taught you this...can't you figure this out yourself?" Groan…
I guess it's better to stumble now though rather than later. Even though I feel like I'll be tumbling through it for a few years to come...I guess I should get used to that little feeling of shaky insecurity though, and find comfort in the fact that, eventually, I will "get it" all. It will just take time.
But this is the THIRD time I've had him! What are the chances?! Again?!! And he's the one who interviewed Brian for the transfer, so of course I want to impress him! But then again, they should know that my performance will have very little impact on how he will do, here.
I think I'm just feeling a little over-emotional today in general. My first (and second, and third) woman exams were very traumatic so I don't associated this with happy memories.
As far as the stress goes: I asked Nate if he wanted to work out at 7:10 am tomorrow and he said, "I don't have time. I don't work out anymore, I'm just making those sacrifices now between all the work for class and Step."
So should I be working HARDER? Is that even possible? I'm working from 9-9, but now I feel guilty for taking a morning off.
But I know me. At this point, I need it for my sanity...my health...my sleep! Today, the wrinkles on his forehead looked particularly prominent. All this work is for our patients. It's worth it. But I need to stay sane to make it through this journey.
That being said, I feel thoroughly energized and ready to make use of the rest of today. Time to catch up on the morning's lectures, organize my First Aid notebook, and prep for tomorrow!
I love this stuff. I really do. And as long as I remember that, and remember to enjoy every new fact that could help someone, the journey feels a little less scary.
Wednesday, March 06, 2013
No joke: I just finished my 4-week plan successfully TODAY, and one hot dress at gala, a few pounds, and an awesome exercise routine later: I win 500 spark goodie points!! This is such ideal time for a reward!!
Praise God! I am so motivated, so happy, and I feel oh-so-good. And I went running 30 minutes with Brian! And I've been working out with friends lately! These are all ah-hah moments that make me realize how much of a joy being active is in my life. Yay :)
Saturday, March 02, 2013
Big achievement: Reaching my lowest weight in over 2 years...and just before my medical school gala!
Biggest happy moment: Being able to run with my boy for 33 mins yesterday. We're at the same jogging pace now--yaaay! I never knew having a running partner could be so fun and motivating :)
Monday, February 18, 2013
Today I travelled to The Shelter, where several students in my year perform blood pressure and general health screenings for the residents. They sit packed on long benches at tables before two small TV screens at the front of the room. Sometimes students from the FSU College of Music play in quartets for the residents, but usually there’s a game on for all, even those huddled far in the back, who sip their community coffee and squint to see the screens.
Some people chat with one another, brothers of a common daily struggle to survive that is a part of life. Some sit with tormented eyes, staring at something that only that person can see. This disturbed me the first time I attempted to ask one if they’d like a health check, but I felt safe enough to ask away. Sometimes these people answer, but more often than not a friend (or something) will pipe up for the person and decline. Citizens of the streets are more in-tune to mental illness than I am as a first year medical student, I think. They know when an illness signals danger, or is merely a prisoner of a wandering mind.
Today we arrived to find a camera crew stationed in front of the colorful, painted Shelter. I noticed more activity stirring outside on this cold February day than usual. The residents normally stay inside, but at the bus stop next door a large black man with an angry glare stared at us as we approached the other students and the Doctor overseeing us this evening. The man was surrounded by several other streetlings, including an elderly woman whom several scraggly others helped hoist her and her walker onto the bus as I watched.
“So here’s the situation,” the Doctor started, and somehow I knew the news wasn’t good. “There have been rumors of abuse, particularly of women and children, staying at this shelter. A woman at a nearby mission that helps these people decided to go undercover in a wig and see what it’s like to stay here for a night.
Well, apparently she was subjected to a lot of abuse by the employees. Several times men came up and propositioned her saying, ‘You shouldn’t stay here, why don’t you come home and stay the night with me?’
Well the woman felt very threatened that night, and finally she called the cops. She wrote about all of this in a blog that was posted in the Tallahassee Democrat that was published a few days ago. Several of the Doctors at the school, particularly our women’s physicians, have spoken about this and think that it’s best that we stay out of the political hayday, for now.
We have also discussed in the past how much of an influence we really have for these people. I mean, we come in, take a few blood pressure screenings, and then send them off to other clinics to get checked up.’
I’d followed him up until this point, but at this statement I was taken aback. I kept listening.
‘Really all these people care about when they show up is a clean meal, a shower, and a bed. So we’re going to meet and reevaluate what we can do from here.’
I’d listened to all of this with a feeling of utter grief and sympathy, to the point that my chest felt really constricted inside. As we walked away, I looked at all the people that had accumulated by the bus stop.
Where do you go when your only reliable shelter in town has been closed? How desperate must you be to subject yourself and your young children to abuse every night, for the sake of a scrap of food and lukewarm tea, when it’s the only thing to keep you warm inside?
So now you get shoved out with the rest before sundown, with some of the dankest miscreants and nighttime scum of the streets.
I feel personally betrayed by humanity. On the flipside, how low must you get to abuse someone who is already as low as it gets, who is just trying to breathe a little for the night, getting a few hours of sleep before the brutal cycle begins all over again?
This is where the scrapings of humanity get lost down the dingy drains of town. And as we drove away, I watched several people bundled in layers of mismatched jackets and scarves scatter away together, and it was like watching the very beginning of humanity: hunter-gatherers, looking for the next source of food and brief respite in a world of carnivores.
Even more startling, I watched was a man in a wheelchair across the street tensed up, almost falling out of his chair, and for a moment I couldn’t believe my eyes. Four people were gathered around him, trying to hold him in. I’d never seen a seizure. I’d only watched videos of a grand mal attack in neuroscience last semester. And low and behold, as the light turned green and I panicked, wishing that I was driving, knowing that even if I did ask the driver to pull over that there was little any of us could do, every muscle in his body became taught, and starting with a rhythmic whirling of his arms, he slowly started to seize. He must have been 40-50 years old, wheelchair-bound. And his friends/family/whoever did all that they could to support him.
They are better than I. For we drove on back to school, and I have done nothing.
I disagree with the physicians who claim that we have little impact. Perhaps this is a little selfish, but I would want to continue because of the impact they’ve had on ME. I met Chance, a UF fan who always bantered with me about the FSU-UF rivalry and has accepted me because he knows I’m dating a gator. He always remembered me every week. I met a man who had written and carried along with him in his small pouch over a hundred different hymns that he had composed himself. I met an ex-pastor for whom life had taken a dramatic downturn, and said he prayed for a reason for all of this. I met a man who could and did recite a 20+ line intense poem of sheer passion to me from straight memory.
All I did was bring my little colorful band-aid covered BP cuff and get practice. They gave me a glimpse of all they’ve got.
But I’d like to think that just talking, and understanding, those who fall through the gaps has an impact somehow on both of us.
I’m on this crazy doctor journey because a part of me wants to save the world. A part of me just can’t do anything else but try to help. And because a part of me is just saddened, and has a great deal of hope that I can be there to rectify wrongs that just shouldn’t take place.
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