I'VE NEVER KEPT A DIARY BEFORE SO WE'LL SEE HOW THIS GOES. I'VE DECIDED TO GO BACK TO SCHOOL AND FINISH MY PRE-REQS FOR MEDICAL SCHOOL. IT ASTOUNDS ME LOOKING BACK HOW I MANAGED TO GET A BACHELORS OF SCIENCE WITH NO CHEMISTRY, NO PHYSICS AND NO BIOLOGY. I NEVER THOUGHT I'D GO TO MED SCHOOL BECAUSE I GET GROSSED OUT PRETTY EASILY BUT SINCE I'VE HAD CROHN'S MY THRESHOLD OF GROSS-OUT HAS MARKEDLY INCREASED. THE THRESHOLD FOR PHYSICAL PAIN, HAS INCREASED IN DIRECT PROPORTION TO MY DECREASED NEED FOR PERFECTION. THIS HASN'T HAPPENED WITHOUT A LOT OF THOUGHT AND THE VERY DOCTORS IN MY LIFE WHO'VE TRIED TO TALK ME OUT OF IT ARE RESPONSIBLE FOR PIQUING INTEREST AND DESIRES IN ME I DIDN'T KNOW EXSISTED. MY DH HAS HAD RESERVATIONS ABOUT ME GOING BACK TO SCHOOL. I PROMISED I WOULDN'T GO BACK FULL-TIME (DON'T NEED TO) AND SCHOOL IS FUN FOR ME. I'VE LAID IN BED NEARLY TWO YEARS WAITING FOR LIFE TO HAPPEN AROUND ME AND THERE IS ONLY SO MUCH REALITY TV YOU CAN WATCH AND FAYE KELLERMAN BOOKS YOU CAN READ BEFORE YOUR MIND STARTS TO THIRST FOR SOMETHING MORE.
IT STARTED ONE NIGHT WHEN I TOOK AN ONLINE IQ TEST. I KNOW IT SOUNDS DORKY BUT I DO ONE EVERY OTHER YEAR AROUND MY BIRTHDAY TO MAKE SURE I'M NOT SLIPPING. IT WAS THE SAME AS IT WAS AT 16, 18, 20, 22, 24, AND 26 SO AT 28 I WAS STILL HOLDING STRONG. THEN OUT OF CURIOUSITY I GOOGLED "AVERAGE IQ OF MD" AND FOUND OUT I WAS 25 POINTS HIGHER THAN THE AVERAGE MD. HMMMMM-WONDER WHAT THAT TEST WAS TO GET INTO MED SCHOOL? FOUND A PRACTICE MCAT AND SCORED A THIRTY SOMETHING. I WON'T REVEAL IT BECAUSE I WAS HORRIBLY EMBARRASED BY THE PHYSICAL SCIENCES RESULT. I COULD DO THIS IF I WANTED AND THE NEXT QUESTION WAS DID I WANT TO?
THIS HAS BEEN A STRUGGLE FOR ME BECAUSE I HAVE BEEN FRUSTRATED AND BORED PROFESSIONALLY. I WORK IN A RADIOLOGY PRACTICE DOING CASE MANAGEMENT OR PRECERTIFICATION FOR PATIENTS' TESTS. THIS BOREDOM HAS MANIFESTED ITSELF WHEN I HAVE OFTEN BEEN SOMEWHAT IMPATIENT WITH VARIOUS MEDICAL DIRECTORS AT CERTAIN HMO'S THAT SHALL REMAIN NAMELESS. I KNEW THAT I WANTED TO DO SOMETHING MORE AND MEDICINE WAS THE FIELD. NURSING SCHOOL? MAYBE NOT BECAUSE I HAD THE FEELING THAT WITHIN YEARS I'D STILL HAVE THE URGE AND DESIRE TO BE ONE WRITING AND GIVING THE ORDERS. MY WORK ALSO FRUSTRATED ME BECAUSE I WOULD TALK TO A PT GET THEIR CASE PRECERTIFIED AND SCHEDULED AND THEN WOULD THINK OF THEM DAYS LATER AND WANT TO KNOW WHAT THEIR RESULTS WERE, WHAT TREATMENT DID THEY DECIDE TO DO, HOW WERE THEY FEELING ETC. BUT IT WAS BEYOND THE SCOPE OF MY RESPONSIBILITY AND INAPPROPRIATE TO CALL AND FOLLOW-UP. I REALIZED THAT AS THEIR DOCTOR I WOULD HAVE THE PRIVILEGE OF BEING INVOLVED IN ALL THAT.
MY DH UNDERSTOOD ALL THIS WHEN I EXPLAINED IT TO HIM AND HE EVEN OFFERED TO TAKE PHYSICS WITH ME THIS SUMMER. HE CANNOT SHAKE THE IMAGES OF THE COUNTLESS TRIPS TO THE ER FOR REHYDRATION (I WAS ON A FIRST NAME BASIS WITH THE NURSES AND ONE PARTICULARLY SWEET RESIDENT THIS LAST SUMMER), THE ELEVATED BUN AND CR RESULTS, THE TEARS OF BEING MOVED TO ICU WHEN I WENT SEPTIC, THE FAILED OSTOMY REVISION WHICH RESULTED IN AN INFECTION THAT ATE AWAY A GOOD PORTION OF THE SKIN ON MY ABD., ALL THE NIGHTS SITTING UP WITH A 32CUP TUPPERWARE THATSA-BOWEL VOMITING AS I ADJUSTED TO MY METHOTREXATE. HE WAS SCARED AND IF I STAYED IN BED FOR THE REST OF MY LIFE AND NEVER GOT SICK AGAIN HE WOULD BE HAPPY, BUT EVEN HE SAW THE DEPRESSION START TO CREEP IN. THE METHOTREXATE KICKED IN AND WORKED WONDERS AND I STARTED TO GET RESTLESS, HE SAID HE WOULD RATHER SEE ME CHALLENGED THAN HELD BACK. HE GAVE ME HIS BLESSING BUT WHEN I PULL MY MED JOURNALS OUT FROM UNDER THE BED TO START READING OR REVIEW MY OLD CALCULUS BOOKS FROM COLLEGE I SEE THE WORRY BEGIN TO CREEP ACROSS HIS FACE.
Well this has been a good week for my Crohn's disease and DH and I sat down to talk about how best to pay for the remaining pre-reqs that I have. I want to pay cash to get in the habit of keeping loans minimal and I think we can do it.
I admit I am struggling with the decision making process of going to medical school. My faith is a central part of my life and I know it must be taken into account when making this decision. I want to make sure that my motivations are clear and healthy before I make the final decision to apply. I know from watching others around me that when people start looking in the mirror instead of to their Heavenly Creator Father/God for their happiness and contentment that their life becomes unecessarily complicated and messy. I don't want that for my life and I want to know that my will is purely God's will. I want to make sure that I'm not going to medical school to serve some pathological need to understand and control disease processes that at this present age sometimes cannot be controlled and sometimes not even managed. Living with Crohn's for 10 years has taught me that we don't always fix what's broken and that while devastating; disease, pain, and death are very real parts of the imperfect world we live in. I don't want to become one of those doctors who takes every failure in treatment as a personal insult. I think that is one reason Palliative Care interests me so much with the spiritual nuturing involved as intimately as the physical. I think there would be freedom to embrace patients in Palliative care because when you help a person prepare for death and your goal is to aid in their comfort in the time of their life surrounding death then the professional self-protective walls that can be built when curative or management efforts are unsuccesful are a non-issue. You can embrace the patient and their choice not to pursue further medical intervention and nurture them wholly. I am very aware that the basic tenets of Palliative Care go against EVERYTHING I would be taught in medical school.
I read the message boards and wonder how realistic it is to maintain a healthy marriage and family life during residency. Maintaining these relationships during MedSchool doesn't worry me because My family studies and reads alot together anyway and academics have always come pretty easily. I've been blessed with a steel-trap memory. I have taken a spiritual gifts inventory and by a wide margain my strongest gift is that of discernment, then administrative, then teaching all in that order. I wish that in making the biggest decision in my own and my family's life that discernment of the right choice was so much clearer and easily sought. There still remains the sticky issue that the advice my GI doctor (Dr. A) gave me is to RUN as far and as fast as I can away from medical school. For the life of me his advice puzzles me because despite the usual and customary hassles of medicine he appears to truly enjoy his work and if he doesn't then he fakes it really well for those 20-30 mintues I see him every few months. I adore him and his advice means alot to me and the fact that we share the same illness lends him credibility in my heart that others don't have privilege to. I see him in another 2.5 mos. and I am thinking of asking him if I could "shadow" him for a few days. The impression I get of practicing physicians is largely shaped by the 13 radiologists I work with and from what I see the stresses that are described on this board don't exsist in any great measure for them. They work 8-5 with 1-2 Saturdays from 9-12 once a month with no call. It "appears" rather cushy even though I know there are things I'm sheltered from in my position. My doctors I work for are pretty happy people for the most part-that's encouraging. I know they work very hard and have a great volume of work but that is encountered with any job. I wonder if shadowing Dr. A during office visits, procedure clinic and hospital rounds might open my eyes realistically to what happens in a "typical" practice and the stresses that are unique to it. I perceive medicine to be a JOB, not some esoteric calling; albeit a job with the greatest responsibility but a J-O-B none-the-less. Most of the burn-out I see in physicians appears to come from a disillusionment that the disease, and compliant patients would bow at their feet and behave predictably. The belief that patients will do whatever it takes to get well and be eternally grateful when many of them resent the fact they even have to come see you to face illness with the inconvienence and expense in dealing with said illness can be unrealistic. Those expecations just seems like a sure-fire formula for disappointment and anger.
Well I enroll tomorrow in Chemistry for the Health Sciences and Anatomy and Physiology or General Biology depending on what is still open and available. Classes will start January 19th and we have been able to budget so that I can pay cash. The freedom of not filing for financial aid is terrific. I hate the FAFSA it either makes me feel really poor (which I'm not) or very marginal which is worse than poor. It's like the government says "Yeah you could sure use help, but we think eating ramen noodles for a semester will build character.". I'd rather just take my chances on my own and circumvent Uncle Sam completely.
This week has continued to be great for my Crohn's Disease. My energy and libido has returned with a vegence and less of my hair continues to fall out from the methotrexate which is a good thing. I don't look sick and I don't feel sick and I think I could get used to that.
I've been doing a lot of reading this last week. I've read "When Doctors Get Sick" by Harvey Mandel and "One Hundred Days" by David Biro. Both of them were terrific books for very different reasons.
Mandel's book made me laugh several times at the doctors relaying their tales of gross hospital lunacy that comes with 2am medicine rounds, 4am lab draws and 6am vitals checks. I loved when they came away from their experience with an awareness that everything they order comes with a price to the patient. It also tore me up when they spoke of the anguish of uncertainty in a diagnosis and the hostility that develops towards those who want to help you most (family and nurses) with those exceptionally long hospital stays that can drag on for weeks and months like my last major stay. I cried several times throughout the book. On a less emotional level it was like reading a patient chart only with alot of the curiousity about the emotional or spiritual state of a patient satisfied. The clinical breadth if not the depth is fascinating and useful.
Biro's book really piqued my interest in immunology and what that could mean for my future. Why did my thymus allow rogue T-Cells out and about to screw up my body? What is the future of T-Cell depleted bone marrow transplants and their potential implication for the future of auto-immune disorders? What do stem cells hold for the future of auto-immune research? He is a fantastic writer and I picked up so much clinical information and a crash course on immunology to boot. He also talked about the hostility that can develop during an illness and the sacred dance between doctor and patient when outcomes are unknown and life and death treatments have to be decided with research pulling you two opposite directions.
I think any medical professional being sick is a scary prospect because you have such intimate knowledge of everything that can go wrong and have very set ideas about how things should be done. I related totally to the one doctor who became rabidly protective of his central line after he'd gone septic and the how the nurses treated him differently (not in a warm friendly way either) after he insisted on aseptic technique every time they touched it. I know central lines while a great relief to me in so many ways caused great anxiety when my past experiences were riddled with thromboses and infections. The terrible thing is that part of me knows that I might relate to patients on a more intimate level because of my own experience but the fact remains that just because I could relate to them I won't always be able to relieve their anxiety. I also know that such a depth of empathy can be draining on a person when your heart gets tore up and your sack of "tricks" (read treatment options) is running low.
For now while my husband and I pray about a medical school decision and I work my way through volumes of well intended fiction and non-fiction before classes start I am working on reconciling myself with the woman of Proverbs 31 thanks to the advice of another member here (thanks Victoria). I know the stresses of having a family and higher medical education are often antithetical and the more I comb through commentary on this passage the more I come to fully realize what an AWESOME responsibility that God has given me charge of with my family and others around me. It weighs on my heart what tenderness I bring to the home as a female and that presence wouldn't be as fully or completely there. I better realize how little I know about myself :confused: and have to do the hard work of reidentifying myself in the image of God instead of the world's image of wife, mother, employee, student and most of all patient.
On a lighter note-I finished the article I was writing about the ten-year anniversary of my Crohn's diagnosis and a synopsis of what is RIGHT in modern American Medicine. I will hand it off to my editor friend this weekend and have plans to start an outline of an honest-to-goodness book. :wave:
Well this week has been pretty interesting. My Crohn's is doing fabulously. No nausea, output is under control, no sore joints, and no fever of any kind-I'm rockin' along-PRAISE THE GOOD LORD!! I'm starting to feel like I did P.C. (pre Crohn's) and am dreaming of a new year with no hospital or ER visits for the first time in 10 years. I have the Bob The Builder song in my head as I write this "Can we do it? YES WE CAN!!" :boggled: We'll see soon enough! Well of course that Chem class conflicted with my Biology class so I had to drop that Bio class and get special permission to join another Bio class on opposite nights as Chem :banghead: !!!!! It all worked out-DH is happy I'm keeping on track and being a "prudently good steward of our financial resources". I'm nervous regardless of all those nice things he said to me. Next time I write I'll have the first night of class under my belt.
Well I'm feeling such a myraid of things right now this very moment. A good friend called who've I have been talking to about her son off and on for several months. Her son is a little younger than me and has had some serious post-op complications. He has become physically dependent on pain medication for legitimate reasons and is frustrated because he feels his life has come to revolve around his medicine. I remember when I was at my worst physically and I lived for my pain meds every four hours. It made the pain "tolerable" the pain never completely resolved until MONTHS later and it would make me loopy enough to where I didn't care and sometimes I could even mercifully sleep. My heart breaks for him and he's clinically depressed to boot. I remember the depression being so severe I often hoped I'd never wake up. I didn't want to leave the safety of the hospital and deal with 6 months of mail, unpaid bills, student loans coming due, short-term disability paperwork, and bill collector calls. It seemed so cruel to cocoon me in the hospital for 3 months then send me back out to the wolves to be eaten alive. I wasn't strong enough emotionally to deal with it. I'm really sad that nobody looked after his spirit and mental health and angry looking back that nobody-not doctors, not nurses, not case-workers ever asked how I was feeling or "dealing". Why when you're chronically ill the very innermost core of who you are as a patient becomes invisible to those who are trying to fix your body? Good grief I'm about to cry :ouch: this hurts! Writing in this blog is terribly therapuetic I probably should've been writing about these issues a lot sooner. I wish I could go see him and give him a hug.
How does this pertain to my med-school decision? Well I'm wondering if I could be objective enough to treat patients the way they need to be treated, and still not be so objective that I lose sight of the patient in front of me and who they are as people. Now I don't think every patient would affect me like this because obviously some are more critically ill than others but the tough cases would be the hardest to remain objective about. Not just knowing but having experienced the complications of surgery, TPN, and central lines would that make me prolong decisions about these treatments for my own patients? I need to seriously figure this out before I even apply for the April 2006 MCAT.
Well DH and I bought me a digital watch today for class that starts next Wednesday and I got my notebook and I feel a little more ready and the closer I get to Wed. the more butterflies I'm feeling.
I had a couple people PM me about how I picked out my handle and what does it mean. Fearlessphoenix has been my handle for several years. A phoenix as most people know (or anybody who's read Harry Potter or seen one of the movies) is a mythical bird that has the mystical ability to carry great burdens beyond what would be expected. When the phoenix reaches the end of it's life-cycle and dies it bursts into flames and becomes a pile of ashes only to rise up in a resurrection and be reborn. With my Crohn's and a distant history of anorexia I've carried burdens that I didn't know I was capable of carrying and that loved ones around me didn't know I was capable of carrying. I've not only carried it but I've even experienced several rebirths in my self-confidence and my spiritual life for having carried these burdens. I've got a deal going on with God-I've reached an agreement with him that I don't need to be cured of Crohn's as long as he uses it and me to further his kingdom. It gives a senseless disease some scope of sanity. I feel privileged that I've been trusted with this disease-reading through the book of Job in the Old Testament I've come to realize that the most faithful are trusted with the toughest tests of simple faith. Do I get angry? Sometimes. Would I like answers to "Why me?", not anymore just an answer to "What now? What do you want me to do now?". The "fearless" part of the handle is because I've become pretty fearless when it comes to life. I'm not so afraid of rejection, I'm more apt to seek intimacy and risk vulnerability (I've been rarely disappointed and that has probably influenced some of my attitude) in my relationships. I know that I'm going to be 30 years old whether I'm in medical school or not - so my age is no longer an excuse for me and the better I begin to feel my fatigue and fear of ambition interrupted are no longer an excuse. For many years of life I didn't undertake any great projects because they were frequently interrupted with hospital stays and relapses, how much I've missed!!
I'm joyful most days and those days that I'm not I don't beat myself up I just spoil myself with a few extra girl-scout cookies, a trip to Barne's and Noble or an adult beverage and extra prayer. I don't need to be perfect, just faithful.