Am I too old?

This semester has been hard. Cardiology, Respirology and GI, the basis of internal medicine. Did I mention that I work like crazy? Well, for people out there who never saw a med student studying, let me tell you, we work hard. How hard? I study every day until midnight, 7 days a week. I am not the most efficient in the morning (I’ve never been a morning person), so I am rarely very useful before 9:30, but it depends what I have to do. If I have a lecture to listen too, I can do that at 8:30. My sister-in-law was saying that she was working 20 days straight without a day off, and that it was crazy... and then I realized that I am doing that for 4 months straight... and usually more than 8 hours a day. So by the end of the semester (meaning, right now!), I am exhausted.

Anyway, all of this to say that I study hard. Harder than my classmates?  I don’t think so. Maybe harder than some, but then others might do more than me. (Yes, I know... how can it be, there is only 24 hours in a day... I have to confess that I rarely do anything between 4:00 and 8:00PM, because this is family time).

I had some comments last year about my age, but not so much. Maybe, I am more sensitive this year because it is one of a big change... The big four-oh is just around the corner. Or maybe it is because it comes sometimes from people I care about. For example, an uncle I appreciate very much told my mom, who was saying that I was studying so much, that it was more difficult to me because of my age (to which my mom also agree). And a colleague of my husband told me just last week that it was surprising that med school would accept someone my age...

So, am I too old? Do I learn less quickly because of my age? I believe there are more to this than just the speed of learning. There is the part where you just have to remember, to put more and more data in your brain. Maybe for that part, I am not as quick as I was when I was twenty. I can live with that. Even though I don’t believe it is really significant. Studies have shown that our learning capabilities might start to decline during our forties, but not before. And I never stop to learn, I’ve always been in school, so my brain didn’t forget about how to learn.

But, there are also other part of learning and studying... First, there is the foundation on which you build your new knowledge. And I know the foundation of my knowledge is very strong. I need to revisit information I’ve learned a long long time ago, but it’s not like learning it for the first time. And there is new stuff that I learn for the first time. Even though it’s new, I usually have some knowledge on the edge that helps me to make connection and better understand the concept. I also have life experience, and I know a lot of sick people. It’s unfortunate to say but this helps solidify information because you can link it to something (or someone) you already know.

I have worked for 15 years on a normal schedule (9 to 5), travelling for work, studying in between flights, organizing my life around all this. I have learned a few things about organization. I believe I can handle my life and studying pretty well. I am not overwhelmed by having to dedicate 60 hours a week to this. I am not saying that it is easy, but I am used to it, done it before and know I am able to do it again.

Finally, there's the motivation to do it. And no one can beat me to this. I love what I do. Yes, sometimes I am tired and would prefer to take the weekend and go visit some friends. But it doesn’t happen too often. Most of the time, I don’t feel the weight of doing it. I am lucky enough to have a wonderful husband who support me so well; and a nice cottage where I can go to isolate myself and study.  I am not sure I would have had all this motivation but also dedication earlier in my life...

So, again, am I too old? I believe your age is in your heart and your head... And I think that I am a much better med student now than I would have been earlier. I also bring a different perspective to my fellow med students.

In the end, I believe each med school should have a mature student J!

Summer projects

Summer is over.  This semester got off to a flying start. And my brain, which has been on a break all summer, took a few weeks to get back on wheels. But I feel much better now.


Are you wandering what I did this summer? Here a small list:

• I went hiking with Princess to different places in my neighbourhood
  
  
  
  
  
  
  
  
  
  

• I have been seen on the street wearing this (yep, sometimes you don't remember what Princess put on your head)
  

• But mostly, I did some home improvements:
• Here is what the house looked like a year ago when we bought it, and a year after (it was nicer this summer with all the flowers)

• We have done some organization in the garage (which we built last Fall). You know, putting some shelves and stuff like that. Nothing very inspiring for a woman :-)
• Painting, painting and painting, outside and inside (is there an end to it, I wander?)
• ok, this one, you might think I am crazy, but I assure you, I am not :-) We finished Under the front balcony... let me explain: you see, I have big windows in the basement that look just under this balcony and it looked terrible. One the these windows happened to be in my study, so I looked to it a lot, about 60 hours a week of it. I wanted it to look neat. And painting it white brings more light to the room. 

• We worked to improve my study. About 8 months ago, while I was freezing in the room I call my study, we found that old fireplace behind the wall (even with some logs!)

This summer, we destroyed the fireplace (believe me, it was not easy!), found a few surprises, but in the end, I am satisfied with the results.

• There was also the backyard and the new patio, because the old one was falling in pieces...

So, my summer was kind of busy. And I was SOOO happy to get back to school. After a year, I still think I have taken the right decision... it's a good sign, don't you think?

Vacation

Going on 6th week of vacation today... My colleagues are doing research or international internship, or working to pile up money for next year, or traveling around the world. I, on the other hand, have decided to take the summer off to have some quantity time with Princess. We had great time so far. We went to New York with my sister's family and I saw "the phantom of the opera" on Broadway with my sister. It was on my "to-do list before I die". It was fantastic! I love the story and the music since high school, so I knew every line of it. Then we went to a long weekend to see our dear friends in Montreal. That was great and wasn't long enough for my taste.

People who knows me well would know that this is not really enough for me. So, I have a few projects going on around the house. I might have my home office re-done by the time I go back to school in August. I say "might" because, well, you know when you have a 1960-something house, you start to demolish what was there and find more than you thought you would... Last Saturday, it was raining in my office(more accurate description would be water infiltration, but it doesn't feel as dramatic). So I am in contact with some specialists to see what can be done to stop the water entering the house (which is what expected, isn't it?). It feels good doing some "project management".

And still, with all this going on, I am bored. The first three weeks were perfect. That was the time I needed to re-fuel my batteries. Then, fourth week was ok. But since last week, I don't know what to do with myself after 8 o'clock at night, which is usually my most productive time. I take a turn around the house, looking for something to do. I have already looked into the books I need to buy for next semester to choose which one I am buying and from where. You know what? I believe the main issue is that I am not intellectually stimulated. I need people to talk to, to have a real discussion (which you cannot really do with a 7 years old). The only adults I see are my husband and my parents. And I don't have much to say because I don't do much in my day...(I hear you... what a complainer, right?)

I had a great discussion Princess today about monk, people praying all day long. We are not religious people and she is very curious about religions. One of her friend goes to the church every Sunday (which is uncommon here), and she asks a lot of question about it. Today, while we went hiking, we saw the wall of an old monastery and I explained that there lived people who prayed most of the day. She was intrigued by their way of life. After some consideration, we determined that this would not be a career choice for her, as she talks all the time (and when I say all the time, I mean, really ALL the time!). That's finally one that we can cross from her very very long list, that includes ballerina, engineer, hairdresser and garage mechanic as a few examples.

And you, what are you doing this summer?

I did it!

Wandering if I would be able to get through it in one piece? Apparently, I did... I am amazed how resilient we all are. I am a quarter of an MD, but I feel less competent than before I started. It feels weird to think that I have 8 weeks of vacation ahead... "Surreal, but nice" (from Notting Hill).

I had my OSCE yesterday morning. That was the end of my first year as a medical student. Then, I went shopping for Princess's birthday (which was yesterday). As I was waiting in line to pay, it felt bizarre not to be in a hurry to get to study. I had time to run my errands... I felt everything was attuned to my good mood. Listening to the radio, they played a song from my High School years and it reminded me very good memories. 

One of my colleague is a cancer survivor. She has learned the hard way the meaning and value of life. She talks about the importance of the little "moments of happiness" that are there in our lives and we don't always recognize. It is so much easier since yesterday to see these moments. 

Starting tomorrow, I am going to plan for our trip to New York next week with my sister's family. Another "moment of happiness". 

My plan this summer? Live fully every minute of it, to be ready to start next year on better foundations (i.e. relaxed and rested).

Here we go again...

My next round of exams start this Friday. Only a few days until then, and I am certainly not ready as I was last time (in April). There is a combination of factors for it, but the most important one is procrastination... which is probably related to being very tired of studying. At some point, your brain just stop working (or it may be just mine, but judging by the general vibe in school right now, I feel I am not the only one!)

Tonight, I finished my last tutorial of my first year med student! What an accomplshment!

And then, I'll be a second year student. Life goes so fast! 

In less than two weeks,  I'll be on vacation... I am still trying to understand what it means. I don't remember last time I had "vacation". In the last two years, I took vacation to move here (and this was really not even long enough to get the house organized), and we built the cottage the previous year. I always had big projects for "vacation". This year, I have some 10 weeks, and no project yet... Just quality time with Princess. My husband believes I am going to turn nuts, which might probably happen... To be followed...

Sigh of relief

My marks for winter semester went out last week. These were my first "real" medicine marks, since last semester was all about basic sciences. And the first mark I got in the Fall was not as good as I expected. I felt very anxious because I absolutely had no idea what to expect this time...

And, at last, I know how I did in my exams. And I am positively surprised. Actually, the one I feared the most, I had the best mark. Since I started this program, I have been pretty bad in guessing my marks.  Well, it doesn't change anything, anyway... I'll just enjoy this short moment of hapiness. And then, go back to revision, for exams in less than a month. Go Go Go!

Don't worry, I am still very much grounded to the Earth and I don't think I am so much more brilliant than the rest of my family and friends... I was unable to change channel on the television for Princess this weekend... this problem shows that:

1- Even though I can succeed in studying medicine, I could be under average in other area of life.

2- I don't watch enough tv...

Ethics

A few years ago, my brother lost a child to a terrible genetic disease. In this case, there was nothing to do; when the diagnostic was established, there was nothing we could do. Not a single experimental treatment. Well, when this Precious Little Sunshine was conceived, she was handed a bad set of genes and that's it.

A week ago, my sister sent me an article that was published in the newspaper about a family's battle for their little one. The child has the same disease our Little Sunshine had. In the last few years, research had progressed. There is currently an experimental treatment available in Canada for the condition. Unfortunately, this child was born 17 days too early to fit the criteria, so was ineligible. I am taking shortcuts here, but let's just say, the parents didn't take no for an answer, got the magic formula, asked some lab, that is making drugs for animal (and not human), to synthesize the medication and travelled to Mexico to have it injected in their child. And now, they have to go to Mexico every 45 days or so to give it to the child, since no physician here or in United States would agree to do it.

I felt this article was more an editorial about big bad pharma and the health care system not trying to save this baby's life. Maybe it was not the journalist intention, but it is how I felt it. And I felt criticized. I worked for almost a decade in clinical trials. I believe I have some ideas on how things work and why they work that way.

I do not have to agree or disagree on how the parents handled the situation. I do not judge if they did right or wrong. They did the best in this situation for their family.  Would I be in the same situation, I have no idea what I would do. All I have to say is that I am impressed with their creativity and resilience.  

Even though sometimes, from the outside of this closed little world that is clinical trials, we can have the impression that the decisions are made only to save money and bring the drug to the market as soon as possible, it is not exactly how the decisions are made. First, even though we are treating patients one by one, the decisions are taken at another level. The investigator (physician who treats patients) follows a protocol designed to demonstrate if the drug works. Each criteria is there for a reason and we have to trust the judgement of the statistician and specialist physician involved in the design of the protocol. 

There is a pretty solid safety net around research as well. Regulatory bodies (Health Canada or FDA) and the institution ethic committee review the protocol and decide if it is ethical and if the benefit that can be expect outweight the risks taken. These people approve a protocol, and therefore it is not to be taken lightly or not followed.

I feel sad that people always complain about pharma, one way or another. When you are in a situation, you see one tree but not the whole forest. A trial is done with the forest in mind. Decisions cannot be made on the basis of only one individual. If the investigator do not comply with the protocol, the results won't be admissible. 

Unfortunately for this child, he was ineligible for this trial. But, when I think of all the other babies that can be treated if this medication works and get to the market sooner because the investigators were compliant with the protocol and there was no delay, I understand the reason. 

I am not giving my blessing to everything the pharma world does, far from it. I try to keep a critical mind. I do not have all the specifics about this case, so it is very difficult to comment or make a judgement... but there is a possibility for compassionate use of a drug for this kind of situation. From the outside, it looks like it was a perfect case for this kind of program. Why the child couldn't receive the drug this way, I have no clues.  And I hope from the bottom of my heart that a viable long term solution will be find very soon for the child to receive the drug that seems to help him.

When someone asked my brother what he thought of the situation, his answer was:  "I do not necessarily agree with the way they did it, but when you are there, you could do anything. However, it shows that the research is progressing and this is a good news." I am so proud of you! I love you, Brother! 

"Summer" semester

I survived my exams... Well, I believe I did. The results are not out yet, so I hope I did ok. I was surprised how relaxed I was when I got there. I even felt almost ready (you can never be ready, but at some point, you know that studying more wouldn't get you a significant advantage, so you go to bed).

And then, I had a fantastic, amazing, incredible 4 days without any studying to do. I didn't open any med school book. I enjoyed a 4-days weekend with some friends who came to visit. We had missed them so much, it was very good to see them. We all enjoyed the visit, and I was surprised how the kids were so happy to see each other as well. I thought that at 6 and 9, after 4 months of not seeing each other, you don't mind that much, but they showed me that it's not the case, and we had a lot of fun.

And I was back in my books for what we call "summer semester". Did I say summer? Well, that's what it's called... Not what we have! I have some doubts really that there is going to be a summer this year... I was gone from this region for too long I think, and I didn't remember... Or my memory lost the information (kind of a psychodynamical defense mechanism). It is freaking cold here! (and yes, I know that you think it is very cold this year in the Big City, but you won't win this one.) Today, May 6th, it snowed! Yes, I assure you, actual snow. Very depressing! I have an above-ground pool and it is still frozen on top. Again, very depressing! When do you think we will be able to use it, if it is still frozen on May 6th? Ok, for people who know me, they know that the answer is probably never, because I don't put a toe in a pool if it's not over at least 82 degrees Farenheit.  (it's weird that we use Celcius for almost everything, but when it is for pool temperature, Celcius don't seems right). 

Anyway, I am back to school for another month and a half. My last exam of that semester is the day Princess finishes school as well, and it is also her birthday. So you can imagine the party we are going to have. I am currently going through tough material (locomotor: all the musculo-skeletal system) in a very short period of time. The hardest part, however, is that I seem to have misplaced my motivation. It's nowhere to be seen right now... Everything feels heavier. I have spoken to my colleagues and it appears to be a very common disease among us. Feel better to know that it's not just me... People had told me that I would have some very tough time. I suppose this is it, even though I don't see is that difficult. Not comfortable, but still doable. Our current problem is a patient who has rhumatoid arthritis, which I find very interesting. Therefore, working on this one seems easier. I might be on my way to get back my motivation. (I wish as well the sun could be there with my motivation and might finally come back!)

Anxiety

Tonight, I might finally see a light at the end of the tunnel... I am not sure yet if it is a train, but I am confident it is not (so please don't break my confidence!)

My exams are 3 weeks from now. I don't remember if I ever told you how it works in my program. Our classes are done in phases, each phase about a system. We do one phase at a time. And then... we do the three exams of the semester in the same week, plus a day for the clinical abilities that are named ECOS. The first medical phase is a little different, being about pediatrics and geriatrics, but the two others phases I have this semester is neurology and psychiatry. I did with the first phase in January, then neurology until the second week of March and we are currently working through psychiatry. So you can imagine that the stuff we saw in January is pretty far in my head. 

Did I ever said that study medicine is difficult? Well, it is not difficult per se. My husband is an engineer and I think his stuff is much more complex. I was never very good with calculus, so when I see what he can do, I am always impressed... That is difficult. Medicine? The concepts are not hard to understand. The issue is more with the amount of concepts to learn in a limited time... There is a phenomenally large amount of information we have to remember, process and be able to use to analyze clinical signs and get to a diagnosis. 

So, to be ready for the exams, I started reviewing my first phase during Spring Break. I didn't do as much as I hoped, so I was starting to get anxious... I don't feel ready at all, and I still have to go through the second phase, which is much more complex... Since last weekend, I was getting more and more anxious (actually, we studied anxiety disorder during that weekend as well, so I better understand the feeling).

But tonight, I see a change in the wind. I finally got to neurology, and it is quicker and easier than I thought... well, maybe (and I say maybe), I can survive this. Maybe, I am smart enough to remember all that stuff. 

I still have a lot to study before being ready for my exams... but I am a strong, determinate woman, I CAN DO THIS!

Sleep tight

After 7 months and many sleepless nights looking at it, my bedroom is finally painted and done! Since we moved in in August, I haven't found the time to paint it. It was really depressing, because there was many holes in the walls that had been filled. My walls were looking like polka dots...

So, last weekend, while babysitting my brother's 4 and 8 years old, I decided it was about time I did something about this and painted it. It is nothing exceptional and it won't make the next issue of any decoration magazine, but for me, it made a huge difference. Maybe you think I am a little "precious", but I feel it is much more relaxing to sleep in a room where there is no spots on the walls. 

And as my husband said, that was the last room that had not been painted yet... upstairs, except for the bathroom, but that is another story. There is still a few rooms that needs painting in the basement, including my study. I am confident we'll get to that, someday.

(My next project: the upstairs bathroom... I am already working on my plans, my husband don't know it yet, so don't tell him :-) It will be so fantastic to finally have a shower there!)

Spring break or reading week?

This week is what they call "spring break"... Why is it called like that? Have you ever been to Quebec in March? It is surely not spring!  I didn't had the heart to send the kids play outside yesterday, cause Siri told me it was -26 degrees Celcius. I figured they would be frozen within 15 minutes, so not worth the time of putting on their snow gear and then remove the whole thing. And I would risk hypothermia for both, and since I am babysitting my niece (her parents are in Vegas), I am not sure my brother would appreciate a call to come back because his daughter is in the hospital with a few toes missing!

So, what are you doing during spring break? Vacations in the sun? Apparently, we are suppose to take time for us, and go outside... Well, it's not how I did it, not for the whole week. Last Friday, as we were planning the week with my husband, I calculate that to do all I wanted to do, I would need approximately 80 hours. So, clearly, this was not going to be a walk in the park for the whole week! Have you ever been told that medical student have time for a life outside of studying? Well, it is true, but you have to take everything into account. My "outside" is my family. 

For this week, trying to cut stuff out, there is some that I have no choice, like doing my tutorial that is due for Monday morning. That alone is about 20 hours. Since I have 3 exams the same week in mid-April, I wanted to start reviewing, so I have a first review done. In this program, we have only 1 exam that counts for 100%. In April, we will have the 3 written exams, and a practical exam, on the same system as the Mini-Multiple Interview. That gives you 12 minutes to prove that you have mastered what you needed to learn during the phase. I am not that confident that I will perform there...

What am I doing during this spring break? Studying. Studying. And, let me think, yes! studying... I still want to try to keep a balance life, so we decided I would study during the week, and keep the weekends textbook free. Last weekend, we had some shopping done on Saturday (I don't remember when I went to the shopping mall before, probably for Christmas gifts) and then we went skiing the whole family on Sunday. That was fun! Princess was very happy to have me with them (she is going with my husband every other weekend). We haven't planned next weekend yet, probably some painting, maybe even our bedroom (that still have a lot of white patches from wall repair we've done but not painted yet!) I feel that having a real relaxing bedroom would help with sleep. What do you think?

Who I am

I was never the cool chick, even in high school. Therefore, you can understand that when I first went to university, my friends were not the cool chicks either (sorry if you thought you were!). Among them was someone I considered a very important person at that time... She was 42 when we graduated. Same age I will be when I graduate from this. 

Where is this discussion coming from? Well, my birthday was last week, and it made me think about her. We lost contact a few years after graduating. Her kids were quite older at that time than mine today. (Well, actually, her kids were 2 to 3 years younger than me, when I think about it). 

For me, she was my friend and part of my life. The fact that she was twice my age didn't mean anything different for me. But today, I have a different perspective, right? I can understand that it could have mean something different for her.  I would love to find her and have a discussion about all this. Because today, I have a different perspective on the person I was back then. The difficulties I face is not on the day to day... but it is in the day to day perspective... The cultural difference is huge! Think about it... I was in university the year they were born. To paraphrase Icona Pop, I am from the seventhy's but they're 90's kids... I live through the first Star Wars movies, Indiana Jones and E.T. (just to name a few, but there is much more than that, you can figure) We have major cultural differences. Sometimes I have to remind myself that they weren't born yet when this or that happened (you can imagine the fall of the Berlin Wall, Challenger space shuttle explosion or USSR)... It change your perspective on things when you were there versus stuff that happened before you were born. They don't know life without internet... Internet didn't exist in the way it does today when I was in university... It changed the society... They didn't experienced the world before that. 

You know what? I might not be 20 anymore, but I am very comfortable with who I have become and with my life as of today. I am very lucky to be where I am, with the people around me who love me enough to follow me in this crazy project of mine.  I don't have regrets about being back in school at this time. I wouldn't want to be back in my twenties. Sure, it is not easy everyday... but my experiences made me who I am, and I think I had a fantastic life before medicine. It will help me to have perspective as physician. Well, I certainly hope so anyway...