Just keep going

Somehow it's been almost a month since I last posted. I'm not sure how that happened, because I usually write it in my planner every two weeks. At any rate, here I am, writing again as the school years is finally winding down. The title of this entry is something I find myself thinking a lot, about a lot of things. Not the least of which recently has been school. With only a week and a half of real school left (our last two weeks are clinical weeks that are not only usually fun but also significantly less dense), I'm running on fumes. Thankfully, ID (infectious diseases and microbiology) is fantastic and it's far easier to pay attention and focus than during a sequence I liked less (let's just say that if I was doing renal right now I might not make it)... But apart from class, I'm also training for the Breast Cancer 3 Day.

The 3 Day is just what you'd think from the name. I'll be walking 60 miles over 3 days (20 miles/day for those of you who dislike mental math) in August, right before the start of M2 year. For those of you not from Michigan, this may not sound quite as difficult as those of you who have experienced the 90 degree 99% humidity weather common in August. But I promise that it will be challenging, but also rewarding.

So far, my training walks have totaled over 100 miles. Training for a long walk or not, time for fitness in medical school can be difficult, but definitely not impossible. Many of my classmates use exercise as a study break. I find that I focus better on the treadmill than almost anywhere else. In fact, on a recent 10 mile walk one Saturday morning I reviewed a full 3 weeks of ID notes. By mile 9, and most of the way through my studying, I kept saying to myself "just keep going." My commitment to the 3 day has motivated me to make time for exercise even when school is crazy, and I definitely feel better for it.

In addition to the physical benefits, however, my commitment to the 3 day has made me think about my own patient experiences and my future care-giver experiences. As the bearer and compulsive checker of a fibroadenoma (a benign fibrous lump of breast tissue identified only a week after I learned what the word meant in our first pathology sequence), I know what waiting for a diagnosis is like. It's a time filled with worry, what-ifs, and pre-emptive decision making. It's hard, and even harder to describe. At the same time, I can only imagine that the pain of waiting for a diagnosis and wondering what was going is nothing compared with the pain of breast cancer treatment both emotionally and physically. It's the kind of pain that you probably can't treat with medicines...

So I'm walking. I'm walking and fundraising to raise awareness about this issue, and to push myself. And hopefully, someone reading this will decide to pick up a breast self-exam card, hang it in their shower, and keep themselves healthy. Or maybe someone will pick up 10 and pass them out to female friends, family, co-workers, neighbors, and maybe even strangers on the street. I can only walk and hope.

To read more about my walk, and to hear from my mom, who's on my team, check out: http://www.our3dayteam.blogspot.com/

The medical Babel-fish

Many people in my class have experienced the odd sensation of hearing about the diagnosis of a friend or family member with a condition we had just covered in class, or learning about something in class that echoed a recent diagnosis. It’s a surreal experience, and one that places me, at the very least, in a strange situation with a bizarre sensation of disorientation. To illustrate, consider the following two situations, both of which occurred fairly recently:

Firstly, my grandmother had several pulmonary emboli. She didn’t die instantly, which is clearly a step in the right direction, but her outcome is not the focus of my post. Throughout her ankle surgery (and immobilization… and subsequent re-hospitalization after the emboli) I was only connected to her and her care through my dad on the phone. I was neither the patient, nor even an immediate family member present in the hospital, nor her physician, nor even a medical student on the team that was caring for her. With my limited experience, and the reference of last fall’s pathology sessions and my path book, I could only explain what was going on to my dad, and offer enough insight to agree timidly with the course of treatment prescribed by the attending physician. Placed in this awkward position of medical interpreter, I alternately gloried in my ability to help my father through what was a very difficult situation, and wishing that there was more than I could do.

Fast forward to several weeks ago, and we’re presented with the second experience of the medical twilight zone. My stepmother was diagnosed with an infection, and put on antibiotics, following beautifully the course of my infectious disease course. After the antibiotics didn’t work, it was determined that the infection had spread upward to the kidney, and she was given a different course of antibiotics. This too followed the ID sequence perfectly. As we learned more about more serious infections, her antibiotics continued not to work. Here I may recount my first triumph as a medical student. It went something like this: “Dad, if she still has a fever you need to call the doctor. Something’s wrong. I have no idea what it is, but just call the doctor again.” They called the doctor who sent them to the emergency room where she was diagnosed with an abscess from an infected diverticulum. She was hospitalized and I was once again thrown into the strange place between doctor and patient. Better prepared this time because of my recent ID sequence, I was again able to translate for her doctors to my dad.

I’m not sure that I like this position, though it feels wonderful to be able to make something scary and unclear a little easier to understand. I can only imagine that this will get both easier and more difficult as my medical career continues. On the one hand, I will know more about what is going on, and be in a better place to narrate (and annotate) my family’s journey through the healthcare system. On the other hand, I will know more about what is going on, and be equally powerless to care directly for my ill family members. Since this medical land of ambiguity and my role as Babel-fish will probably never really go away, I’d better start getting used to it. Just don’t squeeze me too hard when you hold me up to your ear.