Trust me, I'm a Medical Student: Reflections on Life at Stanford Med

Workin' 5 to 9

2012-02-09T19:51:00.000-08:00

Today, as I was driving to the hospital a little after 5 in the morning, I saw a man running in the dark along the side of the road.

My first thought was: "what the hell kind of crazy person would be running at this hour?"

My second thought was: I am that crazy person!

And not only that. It hit me that I have been that crazy person my whole life. Instead of chasing boys and sneaking into bars with my bad fake Kansas ID, I spent my teenage years going to bed early and waking up at 4:15 for swim practice, just to dive in a cold pool in the dead of winter. That's right. Crazy. Maybe I should consider psychiatry.

Medicine knows no business hours, at least when you're a medical student or a resident. I began my inpatient pediatrics month earlier this week, which requires me to wake up around 4:30 in the morning, and some nights, stay at the hospital until 10pm just to wake up at 4:30 again the next day. And I am NOT the kind of person who does well on little sleep.

I have to admit it: one of the most difficult parts about being a 3rd year medical student is the schedule. Since I've been in school my whole life (and will be until I'm 82), I've never worked before. Now I'm wondering if Dolly Parton's song "9 to 5", about how hard is is to work a regular 8 hour day, is a joke. I'm working 5 to 9, honey! For free! No, sorry, that's a lie. I'm paying $80K a year to work this much! Yet again, crazy.

STOP MOCKING ME, DOLLY!

Get More: 9 to 5, Dolly Parton, Dolly Parton Videos

Sometimes I wonder how all these residents survive overnight call and 3+ years of 80+ hours a week. Sometimes I wonder how I will survive residency.

Of course, work hour restrictions have made residency much more humane that it used to be. My dad, like all dads, tells me how hard it was "in his day". Except in his day, it really was f-ing hard.

He did his internship in Medicine at Cornell in NYC back in the day. His schedule was as follows: 6 am be at work. Work all day. Work all night. Work all day the next day until 7pm. Sleep (finally). 6 am be at work. Work all day. Sleep. The next day, he would be on call again (call every other day). Nowadays, call is usually every 4 days or so. I should stop my bitching (and so should Dolly Parton).

My hubby always asks me how I get myself out of bed in the morning. It's not that I'm not tired. The only answer I have for him is that I actually really like what I do. Most of the time, I don't mind the long hours, because most of 3rd year has been fun and thrilling and emotional all at the same time.

But now it's 7:43 p.m., and I seriously think I might go to bed. This is not me being sarcastic.

Medical school: when you have the bedtime of a 4 year old.

Deep thoughts from Dr. Laly on: the Surgery rotation

2012-01-23T19:33:00.000-08:00

For the first time, I'm going to feature a guest blogger! The guest of honor is incredible smart, talented, and wise Dr. Laly, who (don't tell anybody), isn't technically a doctor yet, but a 3rd year medical student at Vanderbilt School of Medicine. She also happens to have some of the best Facebook status quotes of all time about medicine and medical school, which I will share with you here.

Get ready to become enlightened with the first installment of...

Deep thoughts from Dr. Laly.... The Surgery Rotation

"Dilemma of the day: do you tell your attending, who also happens to be the chief of the department, that he's been doing breast exams with his zipper down for the past 2 hours?"

"Overheard while walking by the OR's "this is not greys anatomy! We do not have sex in the OR!!!" Well, glad that's settled."

"First words out of my 75-year-old patient's mouth as she came out of surgery: 'well hello love! Have you ever had a margarona?'

'No ma'am, what's that?'

'That's a margarita with a Corona dropped in it'

'Um, well that sounds interesting...'

'Yeah, let's have one later. You're young, have 2.'

Have I mentioned how much I love working with patients?

"I have seen my bosses remove cancer from pancreases, meticulously sew together carotids, and other miracles of modern medicine, and all they could come up to help me get over the flu was, "uuh drink lots of fluids and don't cough on me". Frickin useless."

"Surgery attending today, referring to my Indian attending :"where's the anesthesiologist? Is he taking another break? He's probably at lunch. Probably eating some chickpea thing." Surgeons are not especially politically correct."

"There's something very wrong with being up at 4 am on a Saturday and being totally sober."

"I walk into my pre-liver transplant patient's room today and I see his wife rifling through a whole bunch of info about transplants and go: "well sir, aren't you lucky to have such an organized, helpful wife?" "Oh I know...she is the love of my life. And the huge pain in my ass." Now that's a successful marriage, folks."

"I don't know what's sadder: that the very nice surgery nurse tried to set me up with her cousin within about 10 minutes of meeting me, or that the main reason I said no is that "I probably don't have time for that while I'm on surgery"....I need to fix this social life situation."

"That looks a little retarded"- my clerkship director while I tried to learn surgical knot tying. Future in surgery, here I come.

"Last week on surgery. Pretty bittersweet. Thankfully, God continues to have a sense of humor when it comes to my life and my two first cases this week are butt reconstructions."

Stay tuned for more Deep Thoughts from Dr. Laly!

So, what kind of doctor do you want to be?

2012-01-20T19:00:00.000-08:00

The stereotypical dinner party:

Them: Hi, I'm blahblahblah

Me: Hi, I'm Katherine. Nice to meet you.

Awkward pause......................

Them: So, what do you do?

Me: I'm a medical student.

Them: Cool. Do you know what kind of doctor you want to be?

Me: gulp Well, uh, no, um maybe ok um...

Them: (I believe they're now thinking I've either got a severe thhhh-peech impediment or Asbergers)

Let's pause here. I must get asked several times a week what kind of doctor I want to be. I don't mind the question. It's just that like most medical students, I really didn't have a good idea because I've only been in the clinics seeing patients for a few months. The first two years of medical school are all in the classroom. And trust me...bullous pemphigoid is nowhere near as gross in a textbook as in real life (see below).

(Incidentally, coming into medical school, dermatology is the only field I had ruled out for reasons like the above picture. I think I need some Zofran...)

In other words, the first two years in the classroom do not prepare us at all for making the decision of what kind of doctors we'll be. Which leaves 3rd year medical students anxious and balding from pulling all our hair out.

Though medical school is 4 years or more, we really only have less than a year to decide what we want to do with our lives. The time to decide for me is now, the third year, the year between the classroom years and applying to residencies, when one does their clinical rotations. Choosing a specialty is harder than one might imagine. Medicine is one of the broadest fields out there. In medicine, you can be a bench scientist, a pure clinician, a generalist, a geriatric neuroendocrinological surgeon, a writer, a consultant, Dr. Oz, Dr. Kevorkian ....the possibilities are virtually endless.

With the exception of the future neurosurgeons and psychiatrists, most medical students will spend their first 3 years of medical school agonizing over what they want to be when they grow up. It no longer is simple enough to just say "doctor". or medical students, "what kind of doctor do you want to be" is the million dollar question. If you're thinking plastics. Or if you're thinking pediatrics, it's more like the $100,000 question.

I've spent the past 2 weeks on outpatient general pediatrics, and I think (uh, sorta, kinda, possibly, maybe) that I've answered the $100,000 question. I absolutely love pediatrics! I'm a little anxious that this may all change, but I'm gonna cross my fingers and hope I've finally figured out what I want to be when I grow up.

Best google search terms leading to my blog, round 3

2012-01-10T19:47:00.000-08:00

10. "Jim Harbaugh"
9. "Jenny McCarthy nude"...I wonder how many thousands of Google results one has to sort through to find my post on Jenny McCarthy and autism?
8. "ferrari mansion" ...I must digress a lot, because none of these have much to do with medicine
7. "hard time studying for dat". You know what? I have a hard time studying for dat too.
6. "how do ppl get worms". A short answer for whoever is searching for this: one way ppl get worms is by eating undercooked meat. Or eating worms. So ppl should cook their meat and not eat worms.
5. "cow print clogs" The fashion statement of the new millenium
4. "fungi jokes," "immunology jokes", "surgery jokes", "EKG jokes" ... it makes me happy that there are more dorky people out there like me who love these kind of jokes
3. "i'm a med student who faints" Yes, I am too. A few words for you: compression stockings, big breakfast, hydration, keep food in your bag, pickles (seriously....the salt helps keep your BP up)
2. "give me some shine to improve my life. I'm a medical student." Hang in there! Medical school can be hard at times, but soon you'll be a doctor and you can drink all the moonshine you want.
1. "broke out with herpes today. was a contiguous 48 hours ago?" Contiguous? Perhaps. Contagious? Likely. Please get yourself to a doctor and reach out to your sexual contacts and let them know. Don't want to tell them in person? Send them an e-card!
http://www.inspot.org/TellThem/tabid/58/language/en-US/Default.aspx

"give me some shine to improve my life. I'm a medical student." Hang in there! Medical school can be hard at times, but soon you'll be a doctor!

Medicine vs. Pediatrics, Initial impressions

2012-01-10T19:22:00.000-08:00

Ok, y'all. I've just finished my second day of outpatient pediatrics. Already I'm impressed by some differences between it and inpatient medicine, the last rotation I did.

For example....

Inpatient medicine:
"But she's so young!" said an attending, referring to a 65-year-old female with metastatic ovarian cancer
versus
Outpatient pediatrics:
"He's an old one" - said a resident referring to a 15-year-old boy

Inpatient medicine, chief complaints: myocardial infarction, stroke, GI bleed, pneumonia, death
versus
Outpatient pediatrics, chief complaints: common cold, ADHD medication refill, acne, well-child check-up

Inpatient medicine, past medical history: coronary artery disease status post CABG x 3 vessel, cerebral vascular event x 2, type II diabetes, prostate cancer, hypertension, migraines, COPD, asthma, rheumatoid arthritis, depression, anxiety, seasonal affective disorder, seasonal allergies, erectile dysfunction
versus
Outpatient pediatrics, past medical history: none

Inpatient medicine: White coats. Must be nicely pressed.
versus
Outpatient pediatrics: No white coats. They're scary and germy. But plastic monkeys that clip onto stethoscope are cool.

Inpatient medicine: Katherine's purple stethoscope is the only non-black stethoscope on the service
versus
Outpatient pediatrics: Katherine purple stethoscope fits right in. If only I had a plastic monkey to clip on it...

Inpatient medicine, worst habit: smoking
versus
Outpatient pediatrics, worst habit: soda

Inpatient medicine:
"You're getting off early tonight." Definition of early = 8:00 p.m.
versus
Outpatient pediatrics:
"Sorry you're getting out late tonight!" Definition of late = 5:15 p.m.

Inpatient medicine, ways to make patients feel better: pain meds, upgrading to regular diet, pain meds, discharge, pain meds
versus
Outpatient pediatrics, ways to make patients feel better: Stickers!!!!!!!!!

Inpatient medicine, greatest hero: Sir William Osler
versus
Outpatient pediatrics, greatest hero: Whoever brings the stickers!!!!

Inpatient medicine, how to induce a tantrum: colonoscopy prep
versus
Outpatient pediatrics, how to induce a tantrum: choose to enter the room at the wrong time. Look into ears.

Inpatient medicine, color of the walls: slightly off-white, so that you're not sure if the walls are supposed to be that color or if they're just dirty
versus
Outpatient pediatrics, color of the walls: the colors of the rainbow!!

Inpatient medicine:

versus

Outpatient pediatrics:

Tips on how to survive your Medicine Rotation

2012-01-03T18:48:00.000-08:00

First off, happy 2012 blog readers! I hope you all had an aaaah-mazing holiday season (and hopefully some time off too)

I've been kind of in veg mode since finishing my medicine rotation a few weeks ago. BUT now it's a new year, I've had 3 weeks off from school, and I'm ready to start thinking about medicine again! I've compiled some tips on how you can make it through your medicine rotation.

1. Be on time
Ok, duh, Katherine.

2. Go to bed early
You want to play Angry Birds. I know you do. Damn you, Angry Birds, for being so satisfying. You are like crack cocaine to a sleep-deprived med student's battered mind. But if you're a normal person like me and not some sort of super hero who needs only 4 hours of sleep a night, body will hate you tomorrow if you stay up til 1 am playing Angry Birds. I found that at least at the sites where I did my clerkship, it was possible to get almost enough sleep (nothing a cup of coffee wouldn't fix). And sometimes, you should choose sleep over studying.

3. Read about your patients.
I don't think I've ever had an attending NOT tell me to do this. It can be really really hard to read anything after a long day. To be perfectly honest, I have such a hard time studying after a 15 hour day. I mean, how can you say no to a new Glee episode?...and then New Girl comes on... It's damn near impossible to resist. But when you're at the hospital and you have some spare time, use it to look at Up To Date to read about the diseases your patients have. Come up with questions, and then find the answer yourself. Your residents and attendings will appreciate your curiosity. You'll find that by reading about real people, you will retain more of the information. And when the shelf comes around, there will be several questions when you're like, thank you, Mr. Schnicklebottom, for teaching me about the management of a lower GI bleed...

4. When at the hospital, never do nothing. When you are off, sometimes you should do nothing.
This has seemed to work for me. As a medical student, on some days you will have times when you will have some free time. This does not mean you should start checking Facebook. Use the time to read up on your patient's diseases, run down discuss scans with the radiologist, check in on your patients, help your resident make phone calls, etc. Don't catch yourself doing nothing. If you work all day when you're at the hospital, you'll find that you can allow yourself some "doing nothing" time at home when you're off.

5. Be a team player
The medicine rotation is all about working with your team. You will spend a lot of time with these people over the next several weeks, mostly with the interns. You will all be tired, stressed, and at times, running around the hospital with no end of work in sight. The last thing you want to do as a medical student is be dead weight and slow the team down (note: this does NOT mean to NOT ask questions...my residents were really enthusiastic about answering my questions...just don't ask questions that you can easily look up yourself). Find the little things that will help make your intern's life a little easier. Bonus: the sooner your intern is done, the sooner you're done.

6. Spend time with your patients. Find out the info that nobody else does (i.e. Social history!)
It's a little sad, but as a medical student, we have the MOST time to spend with patients. Slowly, with more years of training, the number of minutes you have to talk to patients diminishes (apparently along with idealism, which also diminishes pretty linearly from the beginning of medical school). So take advantage of this! Once you get to know your patient, you can ask them the nitty gritty stuff that nobody else does. Social history is huge. You may find out some pretty important stuff that your patient drinks a liter of vodka a day or has smoked since the age of 5. This is the kind of information that will really help out your team in the medical management.

7. Ask for feedback early
If you don't want to be surprised with some less-than-glowing feedback at the end of the rotation, be sure to ask your residents and attending how you can improve early on. Take it with a grain of salt, and use it constructively to improve. I know all you med students out there are perfectionists, but you're only just starting. If you were already perfect, what would all this training be for?

Damage control:
Uh oh, you're sick. Now what?
This happened to me, and will, at some point, happen to you when you're on your clinical rotations. When I got home from my first day on my medicine rotation, I noticed I had a sore throat. 2 days later, I had a fever to 101 and chills. I hardly knew my team, and had not yet proved myself to them. I anguished over whether or not to tell them I was sick. I finally decided to tell them, and the team unanimously said, "Go home!"

Generally speaking, here are some rough guidelines on what to do when you're sick:
- If you have a fever, or "can't control your secretions" (according to one attending): call your resident early and tell them. Most likely, they will tell you to stay home. Don't argue with your resident. This is not the time to prove that you're a work-a-holic. Nobody wants your disease, and it can be dangerous to your patients anyway.
- If you have a simple cold with no fever, you probably should go in. WASH your hands all the time. Wear a mask when seeing patients and explain you have a cold and don't want to get them sick. They will likely appreciate the effort.

2. Your alarm doesn't go off.
Yep, also happened to me. My husband woke me up at 7:00 a.m. (the time I was supposed to be getting sign out from the night team) and said, "hey, aren't you supposed to be at work?"
Then came on the tachycardia, and I managed to get dressed in record time (with one brown and one black sock...)

In this situation, here's what to do. Call your resident ASAP and tell them you overslept. Get ready fast (girls, if you wear it, skip the mascara). Apologize when you get in. I felt so badly about it at first, but fortunately my team was very kind about it. Trust me on this, it has or will happen to everyone, and will not cause you to flunk out. Then, go get yourself a better alarm clock, or set two clocks.

Overall, I enjoyed my medicine rotation. It was definitely challenging, but I learned tons and it was definitely doable. I like the thought process of medicine and seeing patients. If you've made it to the third year of medical school, chances are good that you'll like your medicine rotation too. Good luck, don't stress too much, and try to have fun while you're at it!

Quote of the day

2011-11-17T19:37:00.000-08:00

Actual conversation between two of the interns a few weeks ago:

Intern 1: Hey, did you hear about your patient Ms. M?

Intern 2: Um, no.

Intern 1: She passed.

Intern 2: She what?

Intern 1: She PASSED.

Intern 2: Oh my God, that's terrible! How did it happen? She wasn't even that sick...I'm freakin' out right now.

Intern 1: Oh, oops, I didn't mean...I meant...she passed her swallow evaluation

Intern 2: I hate you.

More reasons why I love Stanford

2011-11-16T18:17:00.000-08:00

Reason 1248 (I may have lost count) why I love Stanford:

I'm currently week 5 of 8 of the big kahuna rotation in medical school, The Medicine Clerkship. More on the medicine clerkship coming. Our clerkship director also happens to be best-selling author, Abraham Verghese (his book Cutting for Stone is number 17 on the New York Times best-seller list for fiction). Pretty cool doing bedside rounds with a famous author-doctor and just a few of my classmates!

Reason 1249 why I love Stanford:

Our star quarterback, Andrew Luck, who is probably going to win the Heisman and/or be the number 1 NFL draft pick in the country this year, also happens to be a total nerd majoring in architectural design with a 3.5 GPA (which, by the way, is by no means an easy major). He also chose to stay at Stanford this year, delaying a multimillion dollar NFL contract, so he could graduate and get his Stanford diploma. I don't even care anymore that Oregon ruined our winning streak of 17 games, by far the longest in the nation and ruined our chances of playing in the BCS national championship game. Oh wait, yes I do.

Anywho, yay for doctors who write books (which I hope to do someday) and star athletes who care about academics! All these reasons why I love Stanford help make it less outrageous that I am paying exorbitant amounts of dinero to work 80 hours a week. By the end of med school, I will have spent so much money that I could have bought a Ferrari. Literally. (Of course, I would have then been $200000+ in the hole and jobless, but we'll ignore that tiny little fact)

This one would have been nice:

The Atherton mansion in the background is not included, unfortunately. Unless your sugar daddy lives there. My sugar daddy (i.e. my husband, who is not really a sugar daddy) and I live next to Atherton, kind of like how the slaves used to live next to the mansions on the old southern plantations. He drives a Honda Accord. It's sort of the same thing as a Ferrari, just like Franzia is sort of the same thing as nice red wine. But I digress...

For now, I'll leave you with a limerick on metabolic acidosis I wrote during rounds last week. One of the social workers asked what metabolic acidosis was (a not-too-easy-to-answer question), so the resident on my team jokingly challenged us to describe metabolic acidosis in verse. Of course, me being me (i.e. weird), I did:

There once was a man from Nantucket
And ethylene glycol he drunk it.
His bicarb went low
C-O-2 off he blows
So he wouldn't kick the bucket.

Everybody's Gotta Get Away Sometime

2011-10-14T11:49:00.000-07:00

"Baby's just a little bit tired of the city,
Billboards and bullshit got her down,
Seem like you need a little hill country,
A Little back roads driving, little bit of the old top down,

Yeah, everybody gotta get away sometime,
Forget about yourself for a while,
Seems to me that all you need is a ragtop car to ride with me,
Ok, alright, just might get a little high tonight,
Ok, alright, carry on"

Ahoy long lost blog readers! I have missed you. Yes, I know I haven't posted in several months, but that doesn't mean I didn't miss you!

An extra gold star for somebody who knows who sang the lyrics above who 1) isn't from the south and 2) didn't Google it. This song is one of my favorites, though not mainstream. Because sometimes, you just gotta get away and forget about yourself. And your blog. And the fact that you're going to be a doctor in 1.67 years and still feel like you know nothing, and your grade in your neurology clerkship and that your paper still isn't published and you haven't written in your book in 6 months. Eek. Sometimes, reality hurts a little. Especially when you've been hiding from it for awhile.

That's why I fully believe that everybody, yes, even those who choose to a career in helping others, need to get away. Which is precisely what I've been doing for the past month.

I was caught off-guard when I wasn't scheduled a clerkship for this month. My first instinct was to email the clerkship scheduler and protest and demand to find an open spot in anything, proctology or podiatry, whatever. But then, I thought about that. "What the hell, Katherine? Take a damn vacation!" I realized, perhaps the most brilliant thought I have had all year. Fortunately, Stanford gives us some extra time in our clerkship years to take off, so I did what no med student finds natural: I scheduled to have nothing scheduled on my schedule. For a full month. The thought left me a little uneasy. But, what will I do? What will I work on? What will I accomplish? Medical students are inherently overachievers. Break-time is when you're supposed to accomplish everything you've been meaning to do for years now.

So what does one medical student do with a FULL MONTH OFF? Do I go save babies in Africa? Do I do cancer research? NOPE! I go to Hawaii! (C'mon, you really think we med students are THAT selfless?)

After all, don't we med students deserve a little break? After winter vacation last year, I haven't had more than a few days worth of non-med school. And this included finishing up the preclinical years, taking boards, and starting clerkships (including that walk-in-the-park surgery rotation).

So my husband and I booked our tickets to Kauai and didn't look back. My favorite professor arranged for us to stay at the beautiful beach home of his close friends. So for 12 days, we toodled. We toodled to every corner of that little island. The weather was perfect. We ate yummy food. We hiked the famed Na Pali Coast. We got high (and before you freak out, I mean we took a helicopter ride over the island). We kayaked, boogie-boarded, and zip-lined all over that beautiful island. During all this toodling, I forgot that I was a medical student. I was just one happy toodler.

12 hours after getting back to the cold, rainy Bay Area (which makes me a believer in seasonal affective disorder), I boarded a plane to Atlanta, my home, where my entire family aside from my hubby lives. I hadn't been home in nearly a year, the longest I've ever gone without seeing my sister, my house, and my sweet, adorable, albeit neurotic dog with undiagnosed canine OCD, Tex.

My sister arranged a surprise party for me, inviting many of my oldest, bestest friends in the whole world, who have all fallen in love with athletes (seriously... we had an Olympic swimmer, an NCAA Division I basketball player, and an NFL player all in my parent's den). Though I missed my husband (who is neither Olympian nor pro-sportsman, but a geneticist and hubby extraordinaire) like a crazy woman, I realized that few things in life are better than hanging with your oldest friends. One of my friends told me that night that she wants me to deliver her first baby, which would be awesome provided that I 1) know how to deliver a baby by then, and 2) I don't drop it (I hear they're slippery little buggers). My other friend said, "No offense, Katherine, but you are NOT going to deliver my baby!" No offense taken. I went shopping on a Thursday during the day and wondered who all these other people were and what they did to let them shop on a random Thursday. I saw a Shakespeare play. I played trivia (and discovered I know nothing trivial if it doesn't have to do with medicine).

And now, I'm in Montreal with my husband who is attending a genetics conference. I am not here as a conference attendee, nor med student. But as a wife to a geneticist who blogs and enjoys toodling around. I went to the Montreal science museum yesterday morning, where I was the only one there who was not on a 6th grade field trip. It was kind of awesome, because I could push all the buttons and play all the games and not have to yield to a kid whose eyes tell me they want nothing more than to push that button and watch the tornado go, or whatever. For once, I got to push the buttons and spin the wheels and bang the drums (see, I told you... not THAT selfless). It was kinda awesome.

Right now, I'm sitting here in the middle of the Montreal convention center, with thousands of very intelligent-looking people strolling around, people much smarter than me. Tonight, my hubby and I will go dine at a fine French restaurant and stroll the cobblestone streets, pretending we are in Europe. Or real French people with only the ambition to drink wine and enjoy art (Apparently, we pass for French people. Everybody here speaks to us in French, which neither of us speak). We will pretend that reality will not return come Monday, 3 days from now, at 8 a.m. sharp with my HIPAA forms and PPD results in hand, when I will report for Day 1 of my Medicine rotation. Until then, just let me toodle.

Things I will miss and not miss about my surgery rotation

2011-08-19T19:01:00.000-07:00

After 8 weeks of waking up before dawn even thought of coming, I have completed my surgery rotation. Sure, it's only the first rotation I've finished, but my classmates and I who went through it together feel as though we've just finished a triathlon (in fact, the rotation did have three legs...1 month general surgery, 2 weeks each of 2 different subspecialties).

I have to say, surgery was actual way more fun and interesting than I thought it might be. I wasn't planning on becoming a surgeon, but at times I found myself saying, hmm, maybe I should be a surgeon. And then I thought about it again and realized that though it's super-cool and interesting, I don't know if I want to sign up for the surgical lifestyle.

So what will I miss about the surgery rotation?
1. My resident...I was assigned to the most awesomest resident while at Kaiser. He taught me soooo much, not just about surgery, but about doctoring and life. He knew so much, I felt like I did when I was a little kid and my mom knew everything.
2. Suturing. I never thought I'd like it so much, since I've never sewed anything in my life. But it's actually pretty fun!
3. Pulling chest tubes. Also kind of fun, although it can get messy.
4. Getting to wear scrubs and sneakers everyday to work.
5. Learning a crazy amount in a short period of time. I think I got smarter.
6. The people I worked with. It's a little sad that right as you begin to bond with the team, you have to leave. Medical students are like nomads. Or homeless people. Or orphans. I'll miss my patients too, since I will probably never see them again or learn what happened to them.

What I won't miss so much:
1. Goes without saying, but the loooong hours. I will enjoy having at least part of my non-med-school life back. I think my husband will be glad to see me occasionally too.
2. Having t minus 2 minutes to eat all meals. And any sort of bar. I've scarfed down so many so quickly that I am looking forward to the opporunity to eat real food.
3. Standing up for God-knows-how-many-hours at a time. I may be young and in reasonably good shape, but that sh** ain't easy on the body. Even with those "miracle shoe" Danskos. There is nothing miraculous about a pair of clogs.
4. Never seeing the sun. It's a little sad to watch a beautiful California summer go by from the windows inside the hospital. Ok, very sad. I miss my free summers profoundly, as this is the first time I haven't had an official summer vacation.
5. Testing my bladder capacity. My sphincter muscles have gone through boot camp and are currently in very good shape.
6. Not having time or energy for things like exercise, husband, friends, hair cut, shipping a package, getting an oil change, doctor's appointments, etc.... It's amazing how many things have to be done during regular business hours. And how much builds up on your plate when you haven't been free during regular business hours in 2 months. Surgeons don't believe in regular business hours. A 40 hour work week is a half week to a surgeon.

Overall, I'm so glad I'm done, but it really was a pretty great 2 months. Being in the hospital is much much much much better than being in the classroom. So if you're about to embark on a surgery rotation, don't worry. You will survive!

Quote of the day

2011-08-18T19:14:00.000-07:00

"Is this the Magical Mystery Tour?" - a patient's first words after emerging from anesthesia

The Magical Mystery tour is coming to take you a way, coming to take you away!

Mmm...butt pus

2011-08-12T06:27:00.000-07:00

7 out of 8 weeks of surgery rotation are done. As I've gone further in the rotation, I've gotten to do more, like different kinds of suturing, pulling chest tubes, and mastering the staple gun (stay out of my way...that thing is fun). But going along with that is the opportunity to drain people's butt pus.

I just spent last night draining a couple of patient's perirectal abcesses. Pediatrics is starting to sound more and more appealing.

Also, I have a surgery pet peeve. I was a part of a very interesting case yesterday, of a 60 year old woman who was found to have something called intussusception, when the intestine tubes into another part of the intestine, on CT scan. This usually occurs in kids, but in adults it's usually due to cancer. However, our patient had just had a normal colonoscopy and no mass was seen on the CT scan. In the OR, it was discovered that she had a mass in the small intestine, which was not seen on either the colonoscopy or the CT. Small bowel cancer is very rare. At the end of the case, the other docs were saying, "wow, you're so lucky to see that case as a medical student....that was such a great case!" They were obviously pumped about finding the tumor.

The strange thing is, the tumor they found was huge, and there was a nearby lymph node that was equally huge and hard, meaning that the cancer had likely spread. Meaning this women has a poor prognosis. I just have a hard time hearing it's a "great case" when the results mean this lady is going to die.

I guess I prefer butt pus...kind of like popping a huge zit...grostesquely satisfying

A personal portrait

2011-08-08T18:14:00.000-07:00

Proctology clinic really was all it's cracked up to be. Lots of assholes. Lots and lots of assholes.

The highlight was when a patient handed me a very expensive camera, and asked me to take pictures. Of her anus. She told me she was desperate to have a close-up of her hemorrhoids. After each attempt, she would look at the picture I had taken, and say, "no, a little to the left" or "no, a little more in focus" or, my personal favorite, "this time, a little closer". Ok, m'aam, but I think I'm close enough. There will be no pixels on this picture.

Not to brag or anything, but I think my personal photographic perspective of her hemorrhoids was a piece of art worthy of the finest museums. Perhaps the finest hemorroidal portrait ever taken.

Being a medical student....much more than being a student of medicine!

Proctology Clinic...It's the shit

2011-08-07T17:56:00.000-07:00

Tomorrow, I will have the once-in-a-lifetime opportunity to work in a proctology clinic. I know you're jealous. Not gonna lie, I'm a little nervous. I've heard that proctology clinic is just a bunch of assholes. Plenty of bums too. And all the patients say it's a pain in the butt. It's OK though. If they're giving me crap, maybe I'll just give them the finger.

You couldn't make this stuff up

2011-07-20T18:34:00.000-07:00

I'm on my 4th week of my Surgery rotation, and so far have done 2 weeks of vascular and approximately 1.88528 weeks of Urology. Yes, I'm still alive. Yes, I literally curse my alarm at 4 in the morning when it goes off. Yes, I have seen more genitals in the past 11 days than the most professional women of the night.

I'm starting to get a sense that each specialty has its own culture. The stereotypes are true. Vascular surgeons are perfectionists with very long attention spans and amazing fine motor control. They tend to be serious, as their surgeries are serious. Urologists, on the other hand, are anything but serious. They are the jokesters. Penis jokes never cease to be funny, and Urologists constantly make fun of their profession. Of course, being a penis doctor means you've gotta do some pretty interesting things. Like inject an needle with an enema-sized syringe into a man's painful testicle. Or hook your patient up to all sorts of wires and catheters and fill up their bladder until they can't hold it, then you make them pee in front of you. Or Botox somebody's bladder. Just in case it was getting crow's feet. And for this painful bladder disease called interstitial cystitis, you know what one of the most effective known treatments is? Distending the bladder with tons of water, and then flushing it out with bleach. Yes, bleach. Doesn't that sound soothing? Somehow, it works though.

Today, a man came in complaining of not having good enough erections. The doctor asked him if he had tried Viagra. The patient said that Viagra won't do.

"Why not?" the Urologist asked.

"Because I don't just want ONE erection. I want an erection that lasts all day long." The patient was not joking.

"Why do you want an erection that lasts all day?" the doctor said.

"Actually, I don't want just one erection. I want lots of them throughout the day. Because it's good for my health."

Also, few words sound like my name, Katherine. But seriously, every time somebody says, "catheter", I immediately turn around and say, "Yes?"

Oh, and I got to see a repair of a buried penis. It's just what it sounds like. And that's really just about all you want to know about that.

All that said, it's been pretty fun. Waaay more fun than stupid board studying. I've also realized that I basically know nothing about medicine. Not sure what I learned the past two years, but it really doesn't have much to do with real live patients.

Surgery. 1 week down, and I'm still here!

2011-07-04T10:28:00.000-07:00

Howdy folks,

Happy 4th of July! I have been graciously given the day off to celebrate the 4th after 1 week of being on the Vascular surgery service at Stanford.

I didn't know much about vascular surgery before I started, except that it dealt with surgery on vasculature. Now I can tell you all about abdominal aortic aneurysms and carotid stenosis and intermittent claudication. I think my rate of learning in the clinics is much higher than in the classroom. And it's easier to remember stuff when you actually have first-hand experience dealing with a patient with the actual disease. I don't think I'm going to miss those preclinical years much!

There were a few things I was worried about before starting surgery, but so far so good:

-Being grossed out: It's actually pretty cool stuff, and I haven't been grossed out once. However, I don't have a problem seeing blood. If you do, then you probably want to stay far away from vascular surgery (and surgery in general). To me, blood is waaay less gross than some of those nasty derm lesions... And I think I've discovered my least likely specialty: gynecologic dermatologist.

-Not getting sleep: I'm one of those people who just needs a lot of sleep. If I let myself, I can consistently sleep 10+ hours a night. Not kidding. So how am I going to deal with getting up at 4:30 a.m.? This may not always be an option, but I have been going to bed really really early. As in earlier than I did when I was 5. And because surgery involves constantly running around and never sitting, it's almost impossible to fall asleep during the day.

-Fainting: My blood pressure tends to run on the low side. So low that I actually got prescribed a very high sodium diet by a Stanford cardiologist. There have been several occasion in the past when I've randomly fainted (but I prefer the word "swooned"). It happened on one of my med school interviews. THAT was fun. So I've been worried that by being on my clogged feet for too long, I would bite it. Well, folks, I made it through week one without having a vasovagal syncope (fancy term for fainting).

Mean attendings: The truth is, every attending I've met this week has been really nice, in a no-BS sort of way. There is no sugar-coating, but sometimes that's nice because you know when they say, "good job," they really mean it.

Amazing medical moment of the week:

I was talking to a 92-year-old post-op patient, and she told me that her mother is still living...at 111! Apparently she wanted to fly across the country to "take care of her kid" after her daughter's surgery. When people ask the 111-year-old mother how she's lived so long, she says, "Trust in the Lord, and wear nice clothes." And apparently she has recently given up eating pork, but she still eats tons of bacon...her favorite food!

Summer vacation

2011-06-25T21:22:00.000-07:00

For the first time ever, I no longer have an official summer vacation. I guess this means I'm officially a grown-up. Damn!

Instead of the typical 3 months of summer, between the 2nd and 3rd year of medical school, we got a week off. From 3 months to 1 week. Ouch. So, since summer is by far my favorite time of the year, I've tried to cram all 3 months into 1 week.

There are some things that every summer must have. Here are the ones I squeezed in to my abbreviated one:

Strawberry shortcake! I just baked my own gluten-free version using the new GF Bisquik! Woohoo! So yummy and healthy. Right?
Sundresses! I wore mine today, and the check-out lady at the grocery store told me I smelled like summer. I didn't want to tell her that the smell was probably sweat and sunscreen, since I had just come from a very sunny...
Barbeque! Although it took me six years of living in California to realize that "barbeque" in this state means "grilling out". For instance, in California, a barbeque means grilling veggie burgers and Tofurkey. In the South, "barbeque" means pulled pork, cole slaw, Brunswick stew, and sweet tea. I have to say I'm partial to the southern version, but I suppose the California version will do for now (kind of like a California roll...a sad attempt at pulling off a new version of sushi...the real thing is SO much better! But if it's all you've got, you make do somehow)
Sweet tea! Also something that doesn't exist in California. You say, "I'll have a sweet tea" here and the waiter looks at you like you're insane and will bring you a hot tea with 12 sugar cubes on the side. Trust me, I've tried it. So that's why I made my own.
Watermelon! Nuff said.
Beach! Last week, my classmates and I took a field trip down to Santa Cruz for a beach day. It was seriously the best day of medical school so far.
Pool! Check. Laid out by my friend's apartment's pool the other day. It was approximately the size of a large tub, but that's a big enough pool for me these days.
Summer lovin! This one is taken care of, thanks to my awesome hubby! Who is off at a party while I go to bed at 8:30 on a Saturday night to prep for my surgery rotation that starts on Monday morning, 6 am sharp. I figured the least I can do is let him go to party without me because he's going to be hearing my alarm go off at 3:45 a.m. every day for the next 2 months.
The top down! On summer days like these, I'm so grateful for my Mustang, Sally. Yes, she has a name. And a gender. Girl, I better slow my Mustang down.
Sunscreen! Ok, I actually have a genuine hatred of sunscreen, though it is a necessary evil because I am about as tan as Marilyn Manson. But I do it anyway. Thank you med school for scaring the crap out of me of all the diseases I'm going to get, yet again. After all, it made me smell like summer.
Sandals! I got a cute pair just for this week. Unless you think they'll let me wear them into the OR?
Summery music! "Summertime" -Kenny Chesney, "Six-Pack Summer" -Phil Vassar, "Something like that," -Tim McGraw. Ok, I'll admit it. I love country music. And I may be her oldest fan, but I like Taylor Swift too! There, I said it. And when I was a kid, I liked Hanson. And Ricky Martin. Gawd, I am such a dork.
Urology! Ever since I was a wee one (pun intended), I've dreamed of growing up and getting to do urology every summer. And this summer, I finally get my chance! Kidneys and penises and prostates, oh my!

Unfortunately, not everything could be squeezed into one week of summer:

The 4th of July at my Atlanta neighborhood's pool. Since I was born, I've only missed one 4th of July at Leafmore pool. It's a little too bad, especially because I'm the 3-time defending champion in the mom category for the greased watermelon contest (it's actually 18 and up women, but somehow, every year I am always the only one without children). It's one of my most cherished accomplishments. There's also a water balloon toss, a splash contest, and mother-daughter relays (although my mom retired a few years back after she raised her heart rate above 120 for the first time ever and thought she was dying). And lastly, there is a barbeque. The real, southern kind of barbeque. As in no veggie burgers. Instead, I will probably be doing rectal exams and checking wound sites. I suppose that could be fun in its own sick way.
Fireworks...Instead of fireworks this year on the fourth of July, I will be doing vascular surgery. Ok, I won't be doing vascular surgery (I hope). But I maybe I will get to hold something during a vascular surgery? The ever important role of the medical student!
A huge birthday celebration. This year, probably all I'll want for my birthday is a bed to sleep in! That's OK. Somebody recently pointed out that after you turn 25 (when you can rent a car on your own), the next exciting thing to happen on your birthday is when you qualify for Medicare.
Most importantly...I'll be missing my family. This is the first summer ever ever that I haven't gotten to spend time with my amazing fam. Maybe I can convince them to relocate to Cali?

It's past my 8:30 Saturday night bedtime, so I'm gonna sign out now to you and to summer. Peace, y'all*!

*Y'all= a conjunction that southerners use that makes so much more sense than "you" referring to more than one person, or "you guys" when there are girls too, or the worst, "you's guys". This word will get you many funny looks and comments if you say it anywhere outside the south or midwestern United States.

RIP the Rich Cronin, the cute blonde guy from LFO, who died last year from acute myelogenous leukemia

My new stethoscope

2011-06-16T21:41:00.000-07:00

Today, I ordered a fancy new stethoscope, the Littmann Cardiology III, which is supposedly one of the best (that is at least somewhat affordable).

I could have gotten a black one, if I wanted to be traditional and fit in. Or gray. Or perhaps navy blue. But no, I thought the plum was more my speed!

I am fully expecting to get snarky comments from my attending physicians regarding my purple stethoscope, but I'll know they're just jealous that their stethoscope doesn't match their scrubs as well as mine!

Quote of the Day

2011-06-16T20:49:00.000-07:00

"I'd rather stick my fingers in a pencil sharpener while sitting on a porcupine and getting sprayed by a skunk" - my sister, Allison Bell, when I told her what time I have to be at the hospital for my surgery rotation

Just for the hell of it

2011-06-14T22:52:00.000-07:00

Today, for no good reason at all, I decided I would ditch campus for a couple hours and go get a (hot pink) pedicure and my favorite food, sushi.

And then, when my husband got home, for no good reason at all, we hopped in my convertible, put the top down, and drove the scenic route towards Half Moon Bay to watch the sunset.

Why do I forget sometimes that I live so close to this?

I think my urge for spontaneity is partially due to the fact that in approximately, 10 days, 7 hours, and 43 minutes, I will be starting my 2-month surgery clerkship. While I expect that it will probably be one of the most exhilerating times of my life, I also know that I will probably not be able to do much "just for the hell of it". It's not like I'll be able to say to my attending, "peace out," and go for a joy ride. Or a pedicure.

Hell, I probably won't even be able to shave my legs for 2 months. While bathing is essential, even on surgery, I have a feeling that shaving my legs while on surgery will only become essential when I know other people will be looking at my legs, or when I start to feel too much like a dirty hippy. Or French. (Not meant to offend...I totally love French people and hippies...I've been to Burningman where I wore furry leggings with the best of them...they just tend to be a little more furry than your average California girl)

You know what, I'm gonna go shave my legs RIGHT NOW. You know why? Just for the hell of it!

And tomorrow, Santa Cruz beach day with classmates:-)

To all those of you in USMLE Step 1 purgatory

2011-06-13T21:48:00.000-07:00

Those of you studying for the USMLE step 1, you're not alone. Occasionally I check out the search terms leading to my blog, and today alone, somebody out there has googled the following (and ended up finding my blog):

"Balance life with kids while studying for usmle step 1"

To whoever this was: you are my hero!

"Going crazy USMLE"
Yes, we all hit that point. Once you start to feel that way, please do yourself a favor and take a break. A long one. Do something fun that normal people do. Sometimes, all you need is to feel like a person again!

"I hate studying for boards"
We all hit this point too. The test becomes the bain of your existence. But it WILL be over. Promise. And you will feel goooood afterwards!

"Fungi joke"

Ok, I'm not sure if the last person is studying for the USMLE. But for some reason, a lot of people like jokes having to do with fungi or immunology. It makes me feel a lot less alone in my nerdiness.

Also, a note about Student Doctor Network:

I know you want to know how well your Q-bank score correlates with the real test, and how many biochem questions you'll get, and how to take your bathroom breaks. I did too, and you can find some good info on that site.

BUT if you are feeling stressed about your score, stay far away from SDN. I'm serious. I swear, I don't know how it happens, but everybody who posts on that site swears they got a 265+ (or 99th percentile) on the boards. I mean, really. You med students know statistics. What is the probability that out of 1000 people posting their scores, 990 of them score in the 99th percentile? It will make you crazy and make you feel stupid. But you are not stupid. When you get your 260, then you can spam the site with your score all you want and make all the poor suckers still studying for boards feel inadequate and force them to bask in your greatness. Won't that be fun?

Surgery Shoes

2011-06-10T16:01:00.000-07:00

This post is dedicated to Sarah B. for opening my mind to the latest clog fashions (during lecture, of course)

It's official...I've decided that I'm going to cave and get a pair of those hot clogs so I don't get premature bunions while on my surgery rotation. (Note to my fashionista sister, Allison: please don't disown me as your sister for buying a pair of these. I promise you, 6-inch stilettos won't work too well in the operating room)

I discovered some aaamazing styles that will match every personality type. With so many viable clog options out there, how is a gal to decide?

The Disco Ball Dancing Queen:

The Flower Girl:

The Vegan (these shoes are, in fact, vegan themselves):

The Anti-Vegan:

The Cougar:

The Gold-digger cougar:

The Beach bum:

The Bowler:

The Hippy:

The Girly-girl:

The one who saves babies in Africa:

The Party Girl:

The Drama Queen:

Publicity!

2011-06-09T18:23:00.000-07:00

My blog has been featured in the Spring 2011 edition of the Stanford Bench & Bedside, the alumni magazine for Stanford medical center. Woot woot!

They also let me write a column for them on the balancing act of being a med student and the fine line between being a passionate student and overcommitting.

Not gonna lie...it's a little intimidating to know that some uber-successful Stanford MDs and PhDs may be reading my article and this blog. I'm not really the type to seek the spotlight. But I have to admit...it's also kind of cool at the same time!

If you found this blog from reading Bench & Bedside, welcome, and hope you enjoy!

My Ever-changing Definition of Early

2011-06-08T21:39:00.000-07:00

Today, I woke up at 4 a.m. for the first time since high school, when I had to wake up at that time to make it to 5 a.m. morning swim practice.

"Why?" many of you non-medical folk might be asking. "What could you possibly be doing at such an ungodly hour?"

Well, today I had my pre-clerkship day. My first clerkship, which starts in less than 3 weeks, is surgery. And medical students need to be at the hospital before the attending physician, before the chief resident, and yes, even before the interns. So today I got a brief glimpse of what I, the medical student, the loweliest peon, will get to experience in a few short weeks. And today, I shadowed a 4th year medical student who showed me the ropes (which basically means that in the surgical heirarchy, I am the bubblegum on the bottom of the lowliest peon's shoe). But that said, even the king himself, (horn blows here) The Attending Physician (capitalized much in the way that God or Jesus is) made me feel welcome.

I felt like I was on an epic adventure. I probably hiked 6 miles around the hospital, which made me feel better about probably not being able to exercise much on my surgery rotation, but also brought me to the sad conclusion that I will probably have to cave in a buy a pair of those ugly clunkster doctor clogs.

Wait, didn't I see this at Fashion Week?

I also realized that my definition of early has changed dramatically over the years. In high school, "early" was 4:00 am, then in college, "early" was that 10:00 a.m. class. Seriously. You should hear how much Stanford kids complain about 10:00 a.m. class. And you better never go near a Stanford student who has a (gasp) 9 a.m. class.

In the first two years of medical school, early was waking up at 7:30 for 9:00 a.m. class, which ceased to be the hour of the devil like it was in undergrad.

While studying for boards, I began waking up at 6:00 a.m., the time I would need to get up on boards day.

And now, I'm about to start my surgery clerkship. And I will be waking up early. As in 4:00 a.m. early, like I did this morning. Hopefully my definition of "early" won't be getting earlier anytime soon!

Don't expect to hear from my much between the end of June to end of August. I will be on my surgery rotation (I know understand what this means).

Thoughts I am currently pondering:

How the heck am I going to survive the 2 months of my surgery rotation?

What does it say about me that I chose the sport and the career with some of the worst hours?

Can somebody please explain the difficult concept of why comfortable shoes and cute shoes are mutually exclusive?

10 Steps to Survive Studying for the USMLE Step 1 (and stay sane while you're at it)

2011-06-02T10:09:00.000-07:00

If you're a medical student who is anything like me, you probably started medical school dreading that five-letter B-word more than anything else. Boards.

And how could you not? You know that sometime during your second year of medical school, you will have to spend a good hunk of your youth studying for a damn test. A damn hard test. While all of your fellow twenty-somethings are off clubbing in Vegas (or so it feels), you are sitting in a room of fluorescent lighting and towers of books and flashcards.

Somehow, though, I managed to make it through the period of boards studying without going crazy. And I have to admit it now...I actually really dislike studying. Ok, I hate studying. There, I said it. Although I know I have to study to become a doctor, I signed up for this medical school thing so I could take care of patients, not so I could sit on my ass and study from dawn to dusk.

I came up with some tips that I think helped me survive this somewhat painful period of my life. And to be honest, it was not nearly as painful as I had anticipated!

1. Clear your plate
Yes, I know you want to get your research published, train for an Ironman, find yourself a boy/girlfriend, and write a book in the next month. But in order to study effectively and efficiently, you should put all these other tasks off until after the boards. If applicable, make it clear to your research adviser or parents of the kids you babysit that you will be out of commission until you're done with the boards. You want as few distractions as possible. Of course, entirely eliminating distractions is not going to happen. You will still have to pay bills and go grocery shopping. You should also remember to talk to your mom on occasion (trust me on this).

2. Keep it simple
There are a million and one resources on there that claim they are a "must-have" for scoring well on the Boards. While I haven't gotten my scores back yet, I can honestly say that 97% of my test was covered in either First Aid or USMLE World/Kaplan Q-bank (I ended up using both, but if you're choosing one, go for USMLE World). I tried using flashcards, but that just didn't work for me. At first, I felt guilty for not using all the resources I had purchased, but the truth is, you don't need them all. The only time I looked at other resources was if I didn't quite understand what was covered in First Aid/Q-bank. So in summary, if all you did was study from First Aid and a Q-bank, and take 3-6 NBME practice tests to see where your score is, you have the opportunity to score welll!

3. Focus on your weaknesses
Inevitably, your medical school will not cover some of the topics very well. For us, that was microbiology and pharmacology. Start with the subjects you aren't very familiar with, and make sure you leave enough time at the end of your study schedule to review them another 1-2 times. For some reason, it's easier to study what you know best...perhaps because it makes you feel smarter...but DON'T GIVE IN!

4. Healthy --> Happy --> Effective studying
You've probably heard this a million times, but it's true. You need to take care of your health during this time of high stress. This means sleeping as much as your body requires (for me, this means a full 9 hours...I think I'm in the wrong profession). This also means taking breaks and setting limits. I set a limit of 8 hours of studying a day. To make sure that my 8 hours were actually spent studying and not on Facebook, I started a stopwatch whenever I had my head in a book, and stopped it whenever I "just had to" check my email. Once I reached 8 hours of studying (that was about all my brain could handle anyway), that was it for the day. I also took at least 1 full day off a week. Some weeks, I split that full day off into two half days off. I think this was absolutely essential to rejuvenating me. I don't think I could have persisted in my studying without that day off. During your breaks, get some exercise in. But not TOO much exercise. I used to be the queen of too much exercise (as are all competitive swimmers). So take it from me that a little exercise makes you feel energized. Too much exercise leaves you run-down and exhausted. Don't forget to shower, brush your teeth, and wash your clothes, or at the very least, your underwear. Please, for the sake of anybody who will come into contact with you. I promise that spending 10 minutes a day on personal hygeine will not affect your board score.

5. Rest your brain
When you're an athlete, you have to give your body time to recover between workouts. Well, boards studying is kind of the same thing. I found that at the end of a full day of studying, all I was able to do was sleep or watch TV (I assume because it requires almost zero brain activity). So go ahead...watch Glee. You know you want to.

6. Remove yourself from stressed out people
Some people seem to thrive on stress, but I am not one of them. I prefer to go about things my own way at my own pace. I've found that being around others who are also studying can be stressful, as they are sure to know something you don't, which can make you wonder if you're doing the wrong thing. If you like to study with other people, find calm people who won't make you more stressed out than you actually are.

7. Spend time with people who are not medical students
This is important. Studying for boards is a weird time. You can almost forget that the rest of the world is going on. Fortunately for me, I have a husband who is not a medical student who was able to help take my mind off the test. When I got stressed, he was able to put it in perspective for me. So go hang out with your non-med student friends for a bit. It will make you feel more normal.

8. Do things that non-med students do
Going along with number 7, I think what refreshed my the most was to get away from my desk and go do totally normal things. For instance, go to the mall or the grocery store. It will take your mind off the boards for a little bit, which trust me, is very necessary at times.

9. Forgive yourself if you fall off track...and then hop back on
There will inevitably be a time when you just cannot look at one more word in First Aid. You may end up requiring to take an unintended half or full day break. This happened to me, so I said, "screw you, First Aid," and I watched the documentary on Babies (because babies make me happy). I promise...you will be OK...you are only human, after all. And those missing those few hours will not affect your score in the end, as long as you get back on schedule the next day.

10. Remember that this test is not worth sacrificing your physical or mental health
If you find yourself getting sick, burned out, or depressed, please seek help. Your well-being is far more important than this test. After all, you are training to be the doctor, not the patient.