30 December 2008

New Year

I don't do New Year's resolutions, mostly because I don't usually find the end of the year to be a good time for reflective contemplation. Between the holidays and all the birthdays, the end of the year is more of a time for doing all the stuff that needs to be done. This year, we're traveling (fingers crossed) so maybe a few unoccupied hours at the airports will lead to some decisions.

I'm still struggling with the decision on where to go to school, the two programs I'm stuck between are quite opposite. Rural vs urban, two years of straight science vs starting patient care right away, $57k vs $41k/year, 340 vs 140 students, and yet I'm drawn to each of the programs for the unique features they offer. I believe I could get a good education at either program and that I will make myself into a good physician regardless, but this is still an important decision to me. I want to be at the right place, the place where I'm learning and growing, not fighting the system or the aspects that are holding me back.

25 December 2008

Not exactly what I had in mind

Hope everyone is having a merry Xmas! K and I ended up being home instead of in Seattle and Grand Coulee, but we're still trying to make it to Vegas for part of the trip. After being delayed multiple hours and being told we were going to miss our connecting flight, have to stay the night in Chicago and that there were ZERO available seats the next day, we decided to stay home. Between weather in the midwest and weather in Seattle, it just wasn't happening. So today wasn't too much like a holiday here, no decorations, no presents, just K and I hanging out. He's working tomorrow and I'm working Saturday since we're here, but at least we're safe and sleeping in our bed instead of airport chairs. Take care and appreciate the ones you love.

22 December 2008

Cha-ching!

I used to want you to want me, now I'm not so sure. I have been admitted to three medical programs, 1 MD and 2 DO. The MD program required a $50 deposit (non-refundable) within 21 days, which I happily paid. The 2 DO programs require a $500 deposit (non-refundable) within 30 days and a $1500 deposit within 60 days. Big money to hold a spot while I make up my mind - thus, not money I am going to spend until I make up my mind. Therefore, I must make up my mind within 26 days and counting...

Factors weighing heavily on my mind:
  1. The MD program is at least $15,000 a year more than any of the others because I am an out-of-state student, with little hope of changing that.
  2. I want to provide the best possible medical care for my patients, using all appropriate therapies.
  3. I do not want to spend extra studying energy on practices I am not going to use.
  4. I want to kick ass on all further required standardized tests so I can have more choices and better success in finding a residency and in my practice.
  5. I am nervous about buying a house in a severely economically depressed area which I feel is unlikely to maintain it's value over 4 years of school.
  6. K wants to move west.
So, lots of soul-searching for the next month. If you see me staring off into the middle distance, try not to startle me.

15 December 2008

Dark

Still no power at the homestead. The wood stove is heating us nicely, with downstairs reaching 70 degrees a couple of times and upstairs now in the mid-sixties. The weather gave us a break today with outside temps reaching mid-fifties. Watson was not convinced about the wood stove at first, but he's now made friends with being toasty warm on half his body and rolling over as needed. He still sleeps upstairs, but then he's always preferred it a bit cooler for sleeping, we've trained him well.

I've never been quite so happy to see power trucks cruising the neighborhood, we've even got international representation with HydroQuebec here to help us see the light. Power came back to the library last night, hence the ability to post, and it was actually all the way to the edge of the neighborhood that we spend a lot of time walking the dog through, but not all the way to our house. I don't know why it grates on me that people who do have power have all their Xmas lights on - it isn't any more wasteful now than it was before the storm, just seems rude when the folks across the street are still shivering by candlelight.

Makes me laugh at myself that the time I post the most is when I have the least convenient means to do so, but I guess sitting in the dark squinting to read with no aural distractions has given me time to think and to write.

13 December 2008

Home again

I finally made it home Friday afternoon, to return to the house being cold and dark. Power was out everywhere, couldn't even pick up Watson because the kennel was closed. K and I finally got motivated enough to hook the wood stove up to the chimney so we could have some heat. We're lucky enough to reach 60 degrees down stairs by the stove and 54 upstairs. Better than lots of folks who are without power and worried about bursting their pipes because the indoor temperature is getting down to the low thirties. I'm supposed to hear decisions from the last two interviews some time at the end of next week, so fingers crossed!

11 December 2008

Stuck

Sadly, I am not home tonight sleeping in my own bed like I was supposed to be. Upon arriving in Chicago, I was informed that ALL flights home were cancelled and here's the number of a place to help you find a hotel (on my own dime of course). It could be worse, I could be sleeping in the airport. Right now, don't know whether I'm going to make it home tomorrow - fingers crossed that the ice really turns to rain somewhere before noon, my plane is supposed to land at 12:45.

10 December 2008

Apply, Apply, Apply again

I’ve moved away from writing here too much about my application process for medical school, even taking it off the sidebar so I don’t have to see it regularly. Not to imply that it doesn’t continue to saturate every day of my life, but at least it isn’t quite so visible to everyone else. This year is the third year I’ve applied to medical schools and I decided at the outset that it would be the last. Applying is an expensive, time-consuming and emotionally exhausting process, followed by the expensive and stressful process of interviewing, the outright painful waiting for a decision, and for me, ultimately the disappointment of wait-list placement (or death row, as I think of it) with no last minute stay of execution for my dreams of practicing as a physician.

I changed a small number of strategic things this year and have had increased success. The primary change was to include osteopathic medical schools in my applications. These programs do not result in an M.D. degree, but a D.O. degree. At the end, you still are referred to as “Doctor”, you have the same prescribing rights, the same ability to perform procedures, the same state and national licensing, the same liability. It took some serious investigation to convince myself this was a reasonable pathway because I had some reservations about the image of D.O.s falling into the “holistic”, “homeopathic”, “naturopathic” and to be honest, all around crunchy-granola end of the medical spectrum. But ultimately, it was an image and not a requirement of training nor practice of osteopathic physicians.

And finally, some success. I have four interviews in Nov/Dec and have already received an offer of admission to one program with others suggesting decisions will be forthcoming prior to the holiday break. Hallelujah, Amen!

01 December 2008

This is only a test

I was recently guilt-tripped into participating in a haz-mat mass casualty training drill with a multitude of agencies spanning state borders. If you've been paying attention, you'll remember that I only work out of the North station, not the South station that would actually be involved in this incident, so I'm pretty much fish-out-of-water to begin with, then we're going to add the complexity of having no idea what is going on, trying to work on communication channels we never use and being told I may be asked to take patients to two hospitals further south which I've never been to and don't know how to get to. The longer I stood at the briefing, the more convinced I was that this was a terrible idea and likely to result in a lost ambulance circling the city. But what the heck, grin and bear it, right? Nothing like 5 members of the "management team", known as white-shirts for their uniforms, participating in an activity to make sure it goes all kinds of crazy.

After hanging around a fire station for more than an hour while some of our "patients" were made up to look horrible, buses took them away and we commenced "normal daily activities". In this case, we all stood around outside the fire station waiting to hop into the ambulances and head out - just like every day, right ambulance folks? Off we go in a convoy lead by several trucks of white shirts (including 2 in a wheelchair van - clearly a first response vehicle!), no lights and sirens, trucking down the highway to the mall. We check in and resume standing around doing nothing. Move the ambulance 400 feet closer to the mall, resume doing nothing.

Then, a "patient" I recognize from earlier is walked over to the ambulance area with quite some commotion. She's soaking wet (from the decontamination shower), shivering and more than a little freaked out. The half of a story we hear is that when she was being extricated from the scene, she was backboarded, then dropped. A white shirt is busy yapping at her after sitting her on the bumper of my truck, discussing how this is "a little too real now" and basically not accomplishing anything. I finally get around him far enough to get the poor girl a blanket, then suggest that it would make more sense to put her inside the ambulance where it is light and warm. Then we find out that she has chest pain and a congenital heart condition making chest pain a real symptom and not a panic attack.

I'm sure you can guess what happens next, a giant clusterfuck. My paramedic and I are talking with the patient, then his ex-girlfriend who just happens to be in a BLS truck from another company at the same drill hops in to help. What?!? Whatever. I finally have to get out of the ambulance and try and protect the damn doors because every 3 seconds some other white shirt or random person is opening the doors. Very difficult to provide good patient care, including a 12-lead EKG, and keep it warm in the ambulance with all this going on. Next comes the fun of explaining to each white shirt, individually, why it is not appropriate to send this patient with the BLS crew and why it is stupid to wait for a transfer truck that hasn't even been dispatched yet to get here before we leave. Finally, everyone's close to agreement, so honestly, I just went.

After a thankfully uneventful transfer, we arrive at a hospital which is expecting "patients" from this drill, not an actual patient from the drill and there is several moments of confusion trying to get everyone to understand that although we brought her from the drill and she has the stage makeup on, this one is for real. We finish up and head back to the mall, relieve the transfer truck and resume doing nothing. Eventually, we get a "patient" just before they decide to stop dousing volunteers with cold water in 40 degree weather and cancel the rest of the drill.

I have to say that the only part of the drill that in any way resembled what I believe would happen at a real incident was the hysteria and confusion over our real patient. The ambulances, wheel chair vans, city buses, and haz-mat trailers all arriving immediately with appropriate staff is pretty much a joke.