Movin' On Up!

Since I've been in Atlanta, I've been looking here and there for somewhere else to live. I kept waiting for the ideal situation that maybe a girlfriend from school would come here and do rotations and we could get a 2bedroom. If you haven't ever looked into it...living in Atlanta is NOT cheap!

Since January I've been living in an extended stay hotel. It's perfectly fine for me. I figure if I can live in Dominica for 16 months, I can live in the States in practically anything. For the last 6 months, I've called it home. It has been incredibly convenient, both for moving, and for my commute to work.

At the beginning of August, I saw an ad for a 1 bedroom studio garage apartment. It looked awesome! However, I tried to stay calm about it because probably 80% of the apartments I would find online that looked great, would be either in terrible condition or in a terrible part of town once I drove to check it out. I sent an email to the person posting the ad, just figuring..."eh, we'll see what happens"...

After a few emails back and forth with the lady renting the space, we set up a time for me to come visit. I took Caroline (sister-in-law) with me to view the space. The neighborhood is great, still close to work, grocery, shopping. The best part is that it's just a man and wife that own the (very nice) home with detached garage. They have been wonderful to work with. After viewing, and loving the space..............We planned for me to move in September 1st!

I was all for moving in ASAP, but there was a girl living there at the time. Therefore, I would have to wait for her to move out. This kind of put a damper on things because my rent would be due again at the hotel on the 21st, so I would have to pay more money here....dilemma? Maybe, but God always has a way of working things out for the best!

I got an email today that I could move in on the 21st for an additional $200. I kindly emailed her back and said that I would love to but I was trying not to spend extra money. However, if she would just change my lease to start on the 21st, then I would be there with boxes in hand! She agreed (again, super nice to work with)!!! So with that...just have to get through my first week of Internal Medicine and pray that I don't have to work this weekend, so that I can pack up, move, and then unpack again!! :)

I'll post pictures once I have everything set up!

Goodbye Peds...Hello NICU

So I've been finished with my pediatric rotation for a month and have been meaning to write a post about all of the cool things I got to see. The doctor I was working with has been in the business since the 1970's or so. During that time, she became the resident pediatrician for a local news channel, and as such gained a lot of fame and appreciation with the public. Therefore, she has a lot of 'special case' patients.

The pediatric rotation lasts for 6 weeks. During my time, I tried to keep a running note of things that I deemed to be interesting cases. So here it goes:

--Umbilical hernia

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001982/

--Klipple-Trenaury-Weber Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001205/

--Pilionidal dimple

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0003737/figure/A003253.B9746/?report=objectonly

--Coxsackie A virus (Hand-Foot-Mouth disease)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001961/

--Scrotal fungus

--Torticolis

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001757/

--Juvenile Huntington's disease

--Functional bedwetting

--Achondroplasia

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002544/

--Patau Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002625/

--Turner's Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001417/

--Ringworm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002411/

--Poland Syndrome

http://www.polands-syndrome.com/

I know not everyone has a passion for medicine and illnesses, but I can't help but think that one must appreciate being able to see all of these abnormalities in the same location over 6 weeks!!!

Now that pediatrics is over, I'm doing a 4-week elective in the Neonatal Intensive Care Unit (NICU). Things are going quite well (I'm currently half way through). There are two doctor's I work with, both of which are amazing people and physicians. It's definitely fun to go to work everyday knowing that I'm going to see tiny babies, but nothing like I thought. Doctor's don't do what I call the "fun" part of the NICU work. I say the "fun" is holding & feeding the babies...but that's all up to the nurses. So every exam consists of: wash hands, open incubator (if in one), listen to heart, lungs, abdomen, feel stomach, feel head, look at vitals, walk away, wash hands and go to your computer. The majority of the day is spent at a computer, putting in orders, changing orders you previously put in, or discontinuing orders you no longer need. Therefore, while I love it..I don't know that it is for me. I love talking to people and having more patient contact, so I don't think this is my nitch.

So far we have lost 2 babies during my time. Only one was our patient. However, he was born at 23 weeks - normal term being 40. Therefore, he was born with so many factors against him - he was not neuroligically in tact, couldn't breathe well, his liver was large but non-functioning, couldn't eat so was being fed by tube...it was just a mess. On top of that, he had a large hole in his heart. All babies have this hole in their heart when they are still inside their mom. It serves the purpose for blood to bypass the lungs. There is no need to make that trip when inside mom's belly because they aren't using their lungs. Therefore, this is a normal finding. However, once babies are born and they come out screaming, it signals the lungs to work and that hole (called a patent (meaning hole) ductus arteriosus) to close. This generally does not occur in premature babies (any baby born before 37 weeks). This baby had this problem, but his was so large, it was causing him to be in heart failure. All in all, yes, it was sad to lose a baby and extra sad for the parents. However, that baby is no longer in pain, and the parents now are not faced with the decision to send him to surgery (which could kill him) or to pull the plug and let him go. Amazing how God takes care of you, keeping them from making that decision, while always looking out for each of us.

2 more weeks of NICU, then starts Internal Medicine!

Why Pediatrics is Pricesless

I get tid bits of info sent to me as a medical student...this one really made me thing today....I went to school because my entire life I've thought God engineered me to be a pediatrician. I have an immense passion for children and helping them to feel better. Also, I love to teach (basically anything), so being able to educate families and help them stay out of the doctor's office always appealed to me. However, I'm currently in my 4th week of a 6 week pediatrics rotation...and I've been doubting it this is the plan God had for me or not. However, after reading this article and thinking about what I really want in life, this may well be it...but we'll just have to wait and see where He takes me :)

Why Pediatrics Is Priceless (by: Peter Y. Jung, MD)

An extra blue scrub top is tucked away in the lower right cabinet of the nurse's station. Every so often, after being sprayed with bodily fluid, I have to make a midday swap of my work clothes. However, it's a small price to pay to be a part of children's lives; one day the baby who spits up on your shoulder will be the same kid who runs down the hall screaming your name and clings to your leg with the dexterity of a koala. What makes pediatrics so rewarding is the long-term relationships that you build with children and their families who every day make you feel like a small hero.

Practicing general pediatrics often feels like searching for a needle in a haystack. Hidden in a sea of upper respiratory infections, reflux, eczema, and diaper rashes is a cystic fibrosis diagnosis, for example, that the astute clinician must not overlook. There are enough challenging cases to keep you on your toes to make everyday clinic interesting, but they don't overwhelm you. As a result, you'll have plenty of time each day to build new relationships and foster old ones. These relationships create the backbone of a successful pediatrician's practice.

By knowing the histories of an individual family -- for instance, remembering the grandfather who has Crohn disease or the younger sibling who has a milk protein allergy -- a pediatrician has unique insight into each medical conundrum that presents itself, no matter how big or small. The trust and relationships that you develop allow you to take a personal and tailored approach to an ill-appearing child. That can save countless hours in an emergency department or avoid an unnecessary x-ray or blood test. Knowing that a mom is meticulous and reliable gives you an extra day of watchful waiting for a fever that an emergency department doctor might otherwise work up. This saves time, money, and anxiety.

A successful pediatrician should also be an excellent educator. The better job you do teaching your families -- that fever is a symptom and not a disease, that every cough does not need medication, and that in most cases diarrhea will go away with time -- the better doctor you will be. Using an evidence-based approach to simple problems will help prevent more complex ones; by avoiding the overuse of antibiotics for routine viral infections, you can curb the rise of antibiotic-resistant bacteria and the subsequent complications that they create.

Most pediatricians do not hold master of public health degrees, but we each play a vital role in preventive medicine to protect the individual and society as a whole. Immunizations are probably the single greatest advance of modern medicine. Diseases such as small pox, polio, measles, mumps, and rubella have been extinguished to the point that most modern pediatricians have seen few if any cases of these maladies. The world has benefited from the immense power of immunizations, and pediatricians stand at the front line in protecting children and the public at large.

Pediatrics is not everyone's cup of tea. You should have a high tolerance for shrieking, crying, and the errant stream of bodily fluid that will disrupt the occasional workday. Perhaps the most difficult aspect of caring for a child is working with the array of parental personalities. Both the pediatrician and the parent may have the best interest of the child at heart, but misinformation from old wives' tales, the Internet, and Aunt Bertha can confound clear communication and good intentions. This is where the art of medicine shines its brightest: Strategic word choice and good listening can go a long way to assuaging anxiety and making sure that children receive the best care possible.

Sometimes in the routine day-to-day of things, it is easy to forget that every visit counts; that each teaching moment may save an unnecessary test; and that each shot prevents a possible death. However. when you feel the familiar clutch of a child on your leg, you remember why you chose this job, and you gladly take your blue scrub home to be washed so that you're ready once again for whatever comes your way.

Ouch!

Don't you just love those mornings...so unsuspecting, when you get up and get ready for church...drive there all excited to have some awesome worship and hear what God has for you that day...only to realize, as it smacks you in the face, that it's exactly what you needed and exactly what you'd been struggling with all week...month...or even longer???

The guy preaching in church today said he heard a quote from Time Magazine this week that said "the defining factor of our culture today is stress and anxiety"....yep...not generosity, charity, overcoming odds, helping our neighbors, progressing as a nation, or anything else positive like that...just STRESS and ANXIETY!

As much as I hate to admit it...I'm a worry-crazed woman at times. It's amazing how fear and anxiety can completely consume you if you allow it. It's like when you're home alone and you hear a noise...it doesn't take long for you to convince yourself that there is someone else in the house and they're coming to get you...before you know it you're upstairs hiding in your room with the door shut! The power of the mind is amazing....but the power of God is far more phenomenal!!!

Most people struggle with this...all sorts of things we worry about on a daily basis: money, our future, our relationships or lack thereof, our schedules, our jobs, our families, our health....the list could go on and on...The beauty though is that there's nothing to worry about at all!!! The Bible has a lot to say about this life. The one topic it talks about the most is money (i believe)...but I would be willing to bet (since I'm not certain), that worry and anxiety are pretty high on the list of things that God talks to us about....here are some examples....

“Do not be afraid, Abram. I am your shield, your very great reward. ” -Genesis 15:1

"Do not be afraid, for I am with you; I will bless you and will increase the number of your descendants for the sake of my servant Abraham.” - Genesis 26:24

"Do not be afraid of them; the LORD your God himself will fight for you.” -Deuteronomy 3:22

"Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the LORD your God will be with you wherever you go.” -Joshua 1:9

The list could go on an on...in fact...I looked it up on www.biblegateway.com (love this website) and found that there are 106 times the phrase "do not be afraid" is in the Bible...and that's just one way of saying it!

I know it's tough...and I'm talking to myself the most, but letting go of the everyday stresses and worries that we as humans so desperately hold onto is critical for our faith. I feel like this is a "soap box" issue for me so I could probably go on and on about it for a while...but I'll end with just a few things I wrote down from church today that really hit home with me:

--Fear only attacks the things you care about...if you didn't care, it wouldn't matter.

--There is a huge difference in "Believing in God" and "BELIEVING GOD"

Believe God for what he says, take him at his Word (Bible)...he will never leave you, never forsake you...he's got your back...ALWAYS...even when times are hard

--Fear never tries to change your belief in God...it only tries to change the believability of God.

--Fear wants you to believe in Gods ways and what he calls you to do...but never act on it.

--Fear doesn't want you to change your belief in God, it just wants to make it meaningless -- fear doesn't care if you're a Christian...it just doesn't want you to act like it.

The pastor gave a great example...when we freak out about things we're dealing with...we never jump to...Oh, well this sucks, I'm an atheist now...but oh how easy is it to completely forget that God is right there with us...and that he will carry us through whatever we are struggling with...

Want a good story in the Bible about fear...and overcoming it...check out 1 Samuel 17 (http://www.biblegateway.com/passage/?search=1%20samuel%2017&version=NIV )

Family Medicine

So as usual, it's been a while since I've written anything. I am currently in my Family Medicine rotation, which lasts 6 weeks. Family is your typical primary care physician. They see patients in all walks of life, from newborns to the elderly. I've already completed 3 weeks and have 3 to go. It's not as exciting as ob/gyn was, but there is always something more to learn...so I'm taking each day as a new adventure and trying to learn as much as I can along the way. I see a lot of patients with chronic problems, such as high blood pressure, cholesterol, and diabetes. We also see a lot of mentally handicapped patients. Here are a few of the interesting patients I remember from the last three weeks:
--10 year old that had swallowed a game coin from Chuck E Cheese - he was quite proud of himself might I add
--Anterior shoulder dislocation due to raking leaves (see Mom...I always knew yard work was no good) :)
--a lot of Cerebral Palsy patients, who I'm learning are some of the strongest, both physically and in their will, and also some of the sweetest patients
--a poor man came in with an O2 sat of 84 when he got to us, shaking, freezing. We put him on O2 immediately, but his body wouldn't hold it, so we call for an ambulance. He was in the hospital for a little while, but unfortunately did not make it. He was elderly and had been battling pneumonia at home for days before coming to our office
--a lot of patients getting B12 injections for weight loss
--a 2 day old newborn there for her newborn exam...she was so tiny, even wrapped in her infant snuggie

Also cool, my doc is starting an allergy program in his office. As part of the training for the nurses, I got a free allergy test. Turns out I'm allergic to more than just pet dander like I thought. The pet panel lit up immediately, with positive readings in dog, cat, horse, and apparently guinea pig...who knew! I'm also allergic to bahia, kentucky blue, and fescue grasses, pecan and hickory trees, house dust, and one of the two types of dust mites. Always better to be educated about yourself I say, so at least I know now :)

Three more weeks...then I'm off for 2 weeks of vacation. Bring it on!

Adios OB/GYN!!!

My last week of ob/gyn was this week. All of the excitement started Tuesday with my last day of call. It wasn't too extensive though, but at least I got one last c-section under my belt before getting out of there!

Then today was the last day. I had to give a presentation, which I did on Endometriosis. I was naturally a little nervous (I get mildly nervous with any public speaking event). However, the presentation went really well. It was just in front of one other student, my friend Linda, and two of the clinic doctors, one of which was the one I worked with for the last six weeks. Luckily I wasn't grilled on too many questions, and those that were asked, I knew the answers for! :)

I would be lying if I didn't admit that I'm going to miss ob/gyn. I wasn't sure how much I would enjoy it...but the moment I saw a baby being born, I was hooked. It was an overly obvious reminder of just how amazing God is and how he works miracles in our lives on a daily basis. I was also spoiled with a wonderful attending physician. He certainly set a high standard for the ones I will have to follow.

Up next: Family Medicine for 6 weeks. I must say, I'm not nearly as excited about family med as I ended up being for ob/gyn, but I'm up for the challenge of the next chapter of this journey! So bring it on people...flu, diabetes, and high blood pressure...bring it on!

i LOVE my love

Call Day #4 was yesterday, Valentine's day (It was an incredibly slow day...nothing to write about). Therefore, Chris came down this weekend so we could celebrate V-day together. It was phenomenal! He took me to "Bone's", a steakhouse in Buckhead (www.bonesrestaurant.com). I admit I was a little uneasy at first. I don't tend to go to such fancy places often because I'm happy with a steak from Outback! :) However, it was Chris' treat for me and he "just wanted me to feel like a princess"...well he easily surpassed that! The food was exquisite! I got a filet and Chris had a tbone. The service was amazing as well...the waiter greeting us with, "Good evening Mr. Pitts, and madam", showing us a wine list, to which each waiter carried an iPad with ! Despite being full after dinner, we shared a piece of pecan pie a la mode. I'm quite certain it was the best pecan pie I've ever eaten. If you've ever seen me eat pecan pie, I'm quite annoying about it. I LOVE the filling and crust, but despise the large pecans on the top. However, with this one, they finely chop the pecans, and soak them in something so wonderfully flavorful that I would eat them alone. Then, the pie was rather hot and topped with ice cold vanilla bean ice cream!

After dinner, we drove down to this awesome little venue called "The Variety Playhouse". Chris had gotten tickets for us to see Kathleen Madigan, a comedian. Neither of us knew much about her, but I remembered seeing her on one of the first seasons of 'Last Comic Standing', so she must be decent! We were pleasantly surprised. She was indeed, quite comical!

It was a WONDERFUL valentines day...I'm so grateful that I've found my valentine, and I get to keep him for the rest of our lives!

Baby Mania!

Call Day 3....my goodness! We start call at 7ish by meeting with the doc that was on call the previous day. That doc will brief my doc and I on the patients that are currently still on the floor, and then we'll "round", which is going to see each of these patients. We started at 8...at 8:20, we were prepping an OR for a c section. This lady had been on Pitocin (a drug that induces labor) for over 24 hours and wasn't making any progress..."failed induction" is indication for c section. She was given the option to wait a little while longer, but she had been in the hospital 4 days already, and wasn't allowed to eat or drink, so naturally...she opted for the c section (I would've too...I bet she was starving!) All went well during the surgery. If you've read the previous post, I did all of the same things during this procedure...helping with the entire procedure, but my favorite...manually pushing the baby out of the mother, and then helping to suture and staple to end the event. This was baby boy #1 :)

There was another lady that was similar to this, being on the pitocin for 24+ hours with no progress. However, her situation was complicated more than usual. She had something called preeclampsia, in which she had elevated blood pressure and protein in her urine. She was on medicine for it during her labor, however, the primary treatment for preeclampsia is delivery. On top of this complication, she was only 28 weeks. Babies are considered "viable" at 24 weeks, so that wasn't the concern, however, it was very apparent that the baby would have to spend quality time in the NICU after birth.....so c section it was. However, there was another section for a different doc going on, so we waited (being Sunday, there weren't as many nurses to run multiple rooms).

While waiting, we thought we could round and see some patients. We had 17 total, so I started at the top of the list, while my doc started at the bottom. I had seen two patients when my phone rang. It was my doc telling me to rush downstairs. There was a girl that came into triage ready to drop her baby in the floor....literally. I guess she just decided not to come to the hospital until the VERY LAST MINUTE. Being this close to delivering, she can't have pain meds (epidural) because it will go straight to the baby...which she wasn't too happy to hear. I rushed to get my gown and gloves on while she was screaming that she needed to push. I stood by my doc as the mom began her pushing. It definitely didn't take long...and there was the head. To my surprise, my doc said..."alright...get in here!!"...WHAT THE HECK! :) I thought to myself..."um....are you saying you're going to let me deliver this baby!?!?!?!" And yes...that's exactly what he meant! He coached me every step of the way, and kept his hands over mine, which were on the baby. I had the baby's head, then he taught me how to pull down, then back up to release the shoulders...and that's it, OUT COMES BABY! I can't explain how amazing it was! My first vaginal delivery...just something I wish everyone could experience...to God be the glory for such an amazing experience!!! Baby boy #2 was here for today

Ok...so after that excitement, I went back upstairs to see more patients. I saw one patient and headed back to the nurses station to write her progress note, and just as I put my pen to the paper to start the note...the phone rang again. It was my doc telling me that another similar lady just came into triage. He wanted me to go see her, do a history and physical, and then stay with her! She was already 6cm and it was her 3rd delivery, so we knew it wouldn't take long. So, I put up the chart I'm working on and race back downstairs. My patient wasn't hard to find my patient, just had to follow the high pitched screaming into triage, and there she was. Just like the first girl, this lady was too far into labor and was progressing incredibly too quickly to get any pain meds. It wasn't long before we had her in a L&D room and her fiance and their two little girls came back to be with her. She had a 5 year old and a 2 year old that were incredibly adorable! We turned cartoons on for them to watch, but all the wanted was to see their new baby brother :) Again, I got to deliver this baby and the placenta, with the supervision and guidance of my attending of course. I'm not sure the excitement of that could possibly ever get old :) So this was baby boy #3 for the day.

Ok, so after ALL that...we went back to the lady with preeclampsia and got ready for her c section. Everything went well through the surgery, all the cut, suction, push, suture, staple normal activity. The amazing thing was how little the baby was. Being only 28 weeks, she was a tiny little thing, but was truly beautiful. They took her straight to the NICU, so I'm not sure how much she weighed, but you could tell she was quite small...I would guess in the 5 pound range, give or take.

Well, that was the extent of my daily excitement this past Sunday, which was actually GREAT! There was a little game on tv this past Sunday...the SuperBowl as you may know..and luckily all the babies were out and I was able to chill out and watch the entire game.

The only other call I had was around 12:45 we had a woman come in with her 8th pregnancy (to deliver her 6th child), also in full labor. However, she was not progressing as quickly as the other ladies did. But, I went to see her, did my usual history and physical for her, then called my doc to tell him the deal. Nothing was worrisome at the time being, so they were going to admit her, and I went back to my room to go to sleep. Around 3:30, my doc called just to update me on her progress. She had made it to 7cm, so he was letting me know, in case she shot up to 10 and was ready to go! I drifted back off to sleep and woke up at 6:15. She decided to wait it out, so we passed her off to the next doctor that was coming on at 7am.

Well, that was it...on call day number 3 complete! I LOVE being around all these babies...I can't believe my life!

I Can't Believe This Is My Life

So Friday was my first day of being on call for this rotation. Typically "on call" makes you think of people living their normal lives until their beeper or cell phone goes off. In OBGYN, you don't have that kind of time, so you stay at the hospital....for 24 hours...
I got to the hospital around 6:20 to make sure I was in the right place to meet my Doc at 7am. We reviewed the patients that were there from the night before with the doctor from the night before, and then we were off to see them. The patient list wasn't too bad, but there were some crazy cases...I'll tell you about my two favorites!
1) There was a very kind lady who was there to have her first child. She had come in the night before and was induced, but wasn't having much luck progressing. She ended up with some other complications, which led to her having a cessarian section. My doc told me to scrub in for the procedure...which meant that I would be pretty close to the action, but that was all I thought. Little did I know, I was about to be all in the action! I had never seen a C-section before, or a baby be born for that matter, so I was incredibly excited!!! Before I knew it, we were starting...with my doc on one side of her abdomen, me on the other, with one nurse beside me. Doc cut her abdomen, one layer at a time to avoid damage. I manned the suction. At one point, both the doc and I put two fingers in the abdomen on each side...and pulled! Seems kind of brutal, but we had to get a baby out of there! Next, doc pointed out the uterus and asked me if I could see what he was pointed at..."Is that the baby's hair!" I said...and I was right! I couldn't believe it! We were seconds away from bringing this baby into the world! I couple snips later, and the uterus was open. Doc asked me to put my hand on the mom's stomach, and then kindly reminded me that because of her spinal anesthesia, she couldn't push the baby out. So doc looks me dead in the eye and says..."ok, you're going to push this baby out....and you have to like, for real push!" Before I knew it, he was holding the baby's neck while I pushed her out! 3 big pushes later...our patient was a first time mommy to a beautiful baby girl!! The umbilical cord was clamped and I cut it. Not too long later, the placenta was delivered, and then it was time to suture this lady back together. The suturing took as long if not longer than the delivery. Then, doc put her outer skin layer back together as I placed staples across her abdomen....and that was it! I had helped deliver my first baby!
2) Baby number two for the evening came rather quickly. We knew that the mom was getting close, but being her first child, it would generally be a slow progression. I was in my call room on the 4th floor when my phone rang. It was doc...saying "Hey! Get down to L&D now!" which is on the second floor. There weren't steps near there, so I had to wait for the elevator. I got to the room right as doc was gowning and getting set to start. You could tell mom was ready to go. She was already saying had to push...she just had to get it out of her! :) Being my first vaginal delivery and not as much involvement as the c-section, I stood behind doc and watched this one. Mom and dad were super excited! The grin on dad's faced when he realized his baby was almost here was priceless. Labor is supposed to take a while when it is your first pregnacy...but this lady set a new standard for first time deliveries! Within 10 minutes, their baby girl was there, screaming, and ready for some loving! I must admit, I got a little teary-eyed with this one. Just seeing the look of first time parents, and seeing them cry got to me.

I think I was emotional after seeing the parents cry and hold their new baby girl for lots of reasons. Partly, I've just become a big softy, so them crying was enough. Partly, the idea of what the mom must have felt...carrying this baby for 9 months and in a matter of minutes, there she was, in her arms...it was just beautiful. Mostly though, I was amazed at the things God is allowing me to see and do in my life. I most definitely don't deserve any of the great and wonderful things He lets me be a part of, but I'm so thankful that he does!

Well, those were the high points of the on call night for me. I've seen a lot thus far, and that's just the first week!!!

Oh Baby!

So after a very long, but appreciated break, I'm back in the swing of things with school. I have finished all the classes and passed all the necessary exams....they're letting me bust into the hospital! I have 90 weeks of rotations ahead of me, but I like to look at it more in small chunks. My first "chunk" is OBGYN. I started Monday and so far everything is going wonderfully! i have been privileged to see quite a few in office procedures (pap smears, annual exams, STD screens, etc) but the real fun for me came today. The doctor I'm following has it set up as so: He shows me, then it's up to me. While I am not legally allowed to do everything I would like to do, I jump at the chance to do what I can. Today was the highlight of that chance for me so far. Until today, we had only seen gynecology patients (girl parts...ya know), but today we had a few OB patients. For the first one, he showed me how to use the doppler machine to detect the fetal heart beat. Therefore, since he showed me, the next one was up to me. The patient was super nice about everything! I assured her that if when I put the doppler on, if we didn't hear anything at first, it was no indication that her baby didn't have a heartbeat, but that instead it was my first time trying to locate one so it might take me a while. To my surprise, it only took me about 15 seconds. I was like a kid in a candy store. This huge...and I mean HUGE grin hit my face. There was life inside of her and I could hear it!!! I'm blown away by the way God created us...I think that is the biggest thing I am learning from all of this.

Tomorrow will be my real test: 24 hour shift at the hospital. I freak out at the idea of being late, so I will be there by 6:30, but My doctor is the on-call doctor for tomorrow at the hospital, which means I'm on call also! :) However, this is not the, we carry a pager and live our normal life until it goes off kind of on call. I will be at the hospital from 6:30 tomorrow morning until at least 7am Saturday morning. While I know that's going to be a long time...I'm pretty excited about it. He's the person in charge of the entire OBGYN unit...which means that most likely I will get to see my first child be born tomorrow!! Now you want to talk about miracles....can't wait to see one of God's most miraculous adventures known to man! More to come...... :)

Welcome to Life as a Doctor

So I spent last night from 8pm to 7am this morning in a local emergency room doing a rotation. It was by far the most exciting and educational evenings of my medical career so far...here's a summary of the patients I got to see:

1) 54 yo F presented with chest pain and HA
PMH (past medical history) of Hypercholesterol, HTN (high blood pressure), Asthma, CHF (congestive heart failure also incredibly stressed and worried about everything in Haiti...which we later found out was b/c she's from there and still has family there
ordered a CT chest w/ contrast...
--> cardiomegaly, CHF
admitted
she was my first pt....great pt...actually using her for my write up
interestingly....around 6 this morning we're called upstairs b/c she's losing it....we get up there and it was like she had ODed on opiods or something
they still hadn't figured it out when we left...but she was perfectly alert and oriented a few hours prior....maybe the husband gave her some of her regular meds before he went home and it messed her b/c she was already receiving lasix IV, tylenol, and nitropaste

2) 19yo female - can't swallow and throat hurts...DXed with strep throat monday...tongue had some erosion that almost looked like a Candida infxn but once you depressed the tonge, the tonsils were so swollen they were nearly occluding the entire throat....hence the dysphagia
3) 73yo M with rectal and penile bleeded...go pulled away from him though to go to a code blue for a
90 yo F found in asystole (flatline)...gave epinephrine and atropine, 3 rounds with chest compressions and bag ventilation throughout...
which is where stuff got awesome...CPR person got tired...Dr asked if we knew how, I said yes, he said "get your gloves on, let's go" so i gave compressions, then D gave some, and the woman after a while came out of asystole and got a rhythm back....so i'm feeling nothing in this womans femoral artery for the longest time and then finally she gets a bounding pulse with the last dose of atropine....absolutely insane!
4) 66 yo F attacked near her home, didn't let go of her purse so the criminal stabbed her with something in the arm...had to get an xray and sutures
5) 29 yo creole woman that didn't speak english...substernal pain, pain uder right breast, and pain in the pelvic region, especially after sex...ended up being nothing that they could figure out though
6) 67 yo M with severe backpain, PMH: HTN, pending prostate biopsy, nothing showed up on CT of abdomen, pelvis, or chest
7) 71yoF PMH: HTN, DM, Arthritis came in with SOB, chest tightness...had a CXR but didn't come back before we left
8) 36 yo F PMH: schizoaffective, reported listening to the spirits and voices and walking around for 3 days but she was at a bus stop and had fallen and hit her head...CT cervical spine w/o contrast, CT head or spine w/o contrast, CXR...ended up with C2 fracture (she broke her second vertebrae in 3 pieces...this is the same vertebrae that Christopher Reeves was affected by)...the freakin dens was broken in 3 pieces...it was crazy...so we needed her to lay still to preserve the spinal cord...but she had been on neuroleptics long enough that she had developed tardative dyskinesia (makes the patient twitch, almost like Tourettes) so it was hard for her to sit still...
9) 38 yo M PMH: schizophrenia, HTN, depression - having suicidal thoughts, missed his meds yesterday, girlfriend died 7 months ago...not sure what they did with him...he was still there when we left
10) 19 day old baby boy (adorable) running a fever...so protocol if they're under 30 days is to do a full septic work up, which includes a spinal tap...but it was amazing how much better it was for an infant...they don't have to use as big of a needle and the baby doesn't really feel as much of the pain

So that was what I got to do last night...first time seeing all this mumbo jumbo I have to learn really put into practice...and I LOVED EVERY SECOND OF IT!!!!

Medical School Prom

So as amazing as it is that it has come so quickly...I'm nearly 30 days away from finishing my time on the island. As a gift to the 4th semester class, the school pays for a huge banquet for everyone to attend, which was this past Saturday. The dinner was great, there were performances by members of the class, and dancing. The favorite part for me was it was held at Fort Shirley, a historic landmark here in Dominica (the first mass emancipation of the British Empire took place there). I was on the planning committee, which proved to be a lot of work, but to see everyone having a good time and random people thanking me for everything...it was well worth it.

I'm actually in lecture so I'm not going to draw this one out...but it was certainly an amazing evening full of friendship, laughs, and great pictures! It was nice to actually be able to enjoy the island without having to study for an evening :)

Godly Parents

So this week at NewSpring, my home church, we started a new series called "Don't Get Married Until..." for singles and engaged couples on preparation for marriage. Sunday was "Don't get married until you hear from God". There were so many great moments during the sermon, but one that really stuck out to me was when Perry (the pastor at NewSpring) addressed the parents. Here's a link to what I'm talking about... http://www.youtube.com/watch?v=L8q2o-y_hF0 I highly suggest checking it out if you have time.

Anyway, being a parent is something I have always looked forward to (one day a long time from now...haha). And there are many times I come across people and think "weren't you raised with more manners than that?" or something to that effect. Perry touched on this during the sermon. He gave the example of mom's that try to be "the cool mom" to their young daughters and dad's that don't teach their sons to respect their mother and other women. Without a second passing, I thought to myself...SO GLAD I HAD THE GODLY PARENTS HE'S DESCRIBING! Naturally there have been millions of times I'm sure that my parents have annoyed me, as I do them or we disagree, but regardless of all that, I cherish them so much and am so thankful they were the ones God chose to raise me.

My mom is a rock. I've seen her deal with a lot in her life and watched her handle every circumstance. I think she gets that from her mom, who raised 4 amazing children as well as my cousin as a single mother after the death of my grandfather. We aren't promised that times will always be easy, but you do the best you can with what you have, something my grandmother taught me when I was little. My mom has dealt with a lot in life, just like anyone else, but through it all, she stands. When my dad was diagnosed with two completely separate cancers and her mother was told she had a brain tumor...my mom, although I'm sure terrified like the rest of us, was there for the rest of us, always making sure my brother and I were alright. At the same time, growing up she was a mother to Jeremy and I...and that was priority number one. It's because of that mentality, and not trying to be the "cool mom" that has brought us to where we are not. At the age of 23, my mom is one of my best friends and someone I actually enjoy hanging out with, shopping with, having coffee and talking with...something I'm so grateful for!

As for my dad...I definitely grew up a "daddy's girl". My mom always tells us we are "two peas in a pod" and she's right on point. My dad and I have always "been on the same page" with a lot of things. My love of sports started with my dad. I remember growing up and going to Clemson football and basketball games as a family...especially football. Always stopping at KFC or something in Easley on our way to Clemson to grab lunch and parking near this giant tree on the campus. Unloading our picnic table and having lunch as a family and then Jeremy and I climbing in that giant tree...then throwing football around with dad for a while before heading over to the stadium to cheer on our tigers! From there it was baseball and basketball...with dad as my coach. He always knew exactly what to say to encourage me, motivate me, or piss me off just enough to make me a better athlete. :) Even when I got to high school and college and dad went from being my coach to on of my biggest fans, he still knew the right things to say...always helping me analyze the game. My mom memorable time was when dad told our family he had been diagnosed with cancer...to this day I'm not sure how he did that. It was as if it wasn't a big deal...I don't know how scared he was on the inside...tons I'm sure...but he never, not even for a second, wavered in his faith. He knew that God could take that cancer away at anytime and would if that's what was His plan. He prayed over our family and the doctors he was working with and that was all it took. His faith inspires me and taught me the type of dependence on Christ I wanted my future husband to have. One of the points Perry made in his sermon was about dad's "dating their daughters" and being the man that tells them they are beautiful so that when some guy comes along and tells them...they already know :) . This is something else I have cherished over the years. Both of my parents always compliment me..but something I remember from when I was little was dad bringing mom flowers and bringing me one as well. Flowers from daddy never gets old.

I feel like this blog was so scattered with random thoughts, but that's just what they were...random thoughts of gratefulness I had while watching the sermon...I'm so thankful for the Godly parents that I've been blessed with and I wouldn't trade them for anything! Also, if you want to see the entire sermon, you can watch it online at www.newspring.cc

A day in the life of Dr. G

So despite being constantly around medical knowledge and situations, I still enjoy watching medical based television shows like House and Life in the ER. Another show I enjoy watching when I have time is "Dr. G - Medical Examiner". If you've never seen the show, Dr. G is basically the best at autopsy examinations. I got the chance to step into her shoes this past week.

Twice during 4th semester at my school, students are required to go to the hospital for rounds. My second trip was last week. The schedule is the same for everyone, in the morning you follow a physician and do whatever they do, sometimes participating, sometimes just watching. There were three girls plus myself that went to the Pathology department. The physician we followed was from Cuba and did not speak English very well. So...thank you to all the teachers who taught me Spanish in high school and college because it got me through the day :) We went through a short presentation in her office and then it was off to work. We left her office and went outside to what looked like a shed or something that should be on a farm. While looking a little shady on the outside, the inside was a fully functional lab. The man was a 76 year old Dominica with a cause of death of CVA - Cerebral Vascular Accident. Just before we began, the mans wife and two other relatives came in to identify the body. That was definitely tough. To see the mans widow walk in, see him, start crying, and with tears streaming down her face told us that was her husband. After that, the relatives signed some papers and then left...and it was time to start the examination.

So this is the part that will gross you out if you're squeemish...so there's your WARNING!

So the autopsy began with cutting the deceased from his throat down to the bottom of the abdomen. The autopsy technicians cut through the fat and abdominal muscle wall to expose the abdomen. A saw was used to remove the center of the ribcage and expose the chest cavity. And this was the part that amazed me...so as you may or may not know, there are large arteries that come off the heart and then the large intestine connects to the rectum. These are the major areas that hold everything in place. These two areas were dissected through, a couple other things happened, and then in a few minutes, all internal organs from the chest and abdominal cavity were removed in one big mass and layed on the examination table. This is where the pathologist takes over. She has to inspect each organ for other signs that could have lead to his death. Everything is cut open, weighed, and sometimes samples are taken to be looked at under a microscope. However, since the cause of death that was suspected was the CVA, it made sense to look at the brain first. So we did...we had to first remove what's called the calvarium..basically the top of the skull so the brain could be removed. Once the brain was on the table the pathologist started working her way through it. It didn't take long to find the cause of death. There is a group of arteries that runs through the brain, so if you know where to look, your job is much easier. There is a one called the basilar artery. It had an "atherosclerotic plaque" in it. That's the same issue we all hear talked about with high cholesterol and eating too many cheeseburgers. The plaque closed off this artery and prevented the blood, which carries the oxygen from getting to the brain. So basically this man died because he couldn't get oxygen to his brain.

Once the pathologies was finished looking through all the organs, they were put back inside the man and he was sutured up, which was impressive in itself because the incisions that were made were barely seen.

And that was it...I had seen my first autopsy and confirmed the diagnosed cause of death....something that is so gross to many people, and was one of the highlighted days in my life on this island.

During the afternoon at the hospital I interviewed a post surgical ward patient and performed a full physical exam for him. However, it pales in comparison to the excitement of the morning...and my class has started, so that's all for now :) I can't believe I only have 43 more days here!!!

The little things in life....

There are a lot of rituals that occur after exams at my school...one of my favorites is cooking with my friend Michelle. It tends to be a post-exam ritual because that's the only time we have to do it. My favorite thing to make is egg salad because 1. it's amazing, and 2. I can make a lot of it and have sandwiches throughout the week. I didn't have any eggs, so I went to the grocery store to grab a dozen. Pending where you go here, they may or may not be refrigerated. At the place I went to on this day, they were. As I reached for the eggs, it was almost as if I were dreaming...I could swear that I saw pasteurized milk...but I thought...there's no way...I've lived here a year without "normal milk". If I've never told the story of milk here on the island, here's the short of it...the milk here comes in a box with a flip top, sits on the shelf...therefore NOT refrigerated...tastes absolutely NOTHING like what, as an American, I am used to...so basically I bought it just for cereal, to feed local cats and to occasionally put in my coffee. Anyway...I looked again, and sure enough, the store had pasteurized milk!!! I asked them how long they had it, to ensure that I hadn't missed it over the last year, but they said they had just started getting it. It is shipped in from Barbados (I believe). I payed 11EC (Eastern Caribbean dollars) for 1 liter (which is roughly $4 US), but it was COMPLETELY worth it. To top it off, I had just received a package in the mail from my parents the day before and they had sent me some oreos....needless to say, I had a night of oreos and ice cold milk!!!!! It's amazing the little things that can excite you once you've lived outside of your "normal"...makes me realize how much I take for granted living in the USA...even something as small as a glass of milk. :)

Best Day at Ross Thus Far!

So I admit...I'm officially the worst blogger ever...I just end up not finding the time that I would like to write about all of my experiences here. However, I couldn't pass up the chance to write about this past Thursday.

In fourth semester, students spend two full days at the hospital...and Thursday was my first day. I got up early, ate breakfast and popped my Dramamine for the hour roller coaster of a car ride to Princess Margaret Hospital in Rosseau, the capital of Dominica. I was a little anxious. I felt confident in all I had learned to prepare myself for the day, but being the first time...I had tiny butterflies :) We arrived at the hospital around 9 that morning and were given our assignments for the morning. There were different specialties that were sent to observe, including family medicine, OB-GYN, pathology, geriatrics, ENT (ear, nose, throat), anesthesiology, primary surgery, and post surgical rounds. I sat there anxiously awaiting my assignment...my first preference would be surgery...no luck...then anesthesiology...no luck there either...pathology?...nope...I began to worry about how much I would enjoy the day but tried to remind myself just to be grateful that I was going to follow around a physician that morning instead of sitting in class. I leaned over to my friend Diana and joked that we probably got stuck with OB-GYN (no offense to anyone that has that profession...just not really what I want to do all day). I ended up with ENT...but poor Diana got OB-GYN (she said she learned a good bit by the end of the morning shift...but she never wanted to see a vagina again). I wasn't pumped about the ENT assignment, but awaited instructions anyway. Then, a guy in my group that had been assigned primary surgery asked to switch to something they had an open spot in, so immediately I asked for his place in surgery and I GOT IT!!! I was SO excited!

We headed over to the OR, which was an experience in itself (note to all reading...hospitals at home can be annoying and frustrating...but we should all be grateful for he luxuries we have by where we live). I went to the ladies dressing room and changed from my "professional" attire and into what I think are some of the most comfortable clothes ever invented...SCRUBS. We were given hair nets, face masks, and booties...a quick overview of the patients we would see that day, and that was it...time to start!

The first surgery we saw was absolutely my favorite and it would be a shame not to explain it fully. The man having the operation had a bad fall previously and broken his femur (longest bone in your body...from the hip to the knee). At the time of the break, he had surgery to reset the bone and inserted a large steel rod to allow the femur to heal. Luckily for this man, his leg had healed very well, however, that meant that he needed another surgery to remove the rod. The surgeon made a 4 inch or so incision in the right hip, and then proceeded to jab back and forth with surgical scissors until the end of the rod was exposed. Once it was exposed, he used fancy pliers to pull on the rod to loosen it a bit. Once he finished with the pliers (with the rod visible from within the mans hip), the surgeon began putting his tools together. The long rod that was placed in the mans leg had a small hole in the end of it. The surgeon put a T-shaped handle onto a long steel bar with a hook on the end. He jabbed this into the leg a few times until he was able to get the hook of his tool into the hole in the rod in the mans leg. From there, it was a tug of war between the surgeon and this man's leg. Eventually, with probably 3 giant pulls, the rod quickly slid out of the mans leg....I know this seems kinda harsh for people that are squirmy...but i ABSOLUTELY LOVED IT!!!...I've often wondered if I would like Orthopedic Surgery...so it was definitely awesome for me to witness one. It's amazing to me how brutal the surgeon was...made me think about how much pain people are in when they wake up...wondering how much of that is from the surgery and how much is from the surgeons method...?

I also saw a prostatectomy, removal of a foot nodule, removal of an epigastric hernia, and catherization of a man that had not urinated since Sunday (keep in mind that I went to the hospital on Thursday). Those surgeries were also exciting, but nothing like the femur rod removal...and that was just my morning.

After lunch we were sent to interview a patient and do a full physical exam. I was sent to the womens ward and met Octavia, a lovely 33 year old mother of 4. She was born with only one kidney and about 5 years ago, her kidney started to fail. She was a wonderful patient. We laughed and she told me all about life in Dominica...and amazingly, then asked me where I was from. When I told her South Carolina she said, "Greeenville, right?" which absolutely blew me away. She said she has a good friend that is going to Bob Jones University right now...small world huh? :)

Well, I better get in bed because it's one in the morning here and I need rest...but I couldn't resist getting this up while I had a few minutes....hopefully more awesome stories will come again soon.

P.S. Aunt Linda: I hope my descriptions don't churn your stomach, but I wanted you especially to know how my hospital day went. Also, I still had that pack of PB crackers you gave me...I took them with me and ended up giving them to Diana when she was feeling sick...so on behalf of her, Thank you for those!!! :) love ya!!!

Mini's...a new measurement of time

Being in med school and living in what is considered to be a third-world country, where the slow pace of island life is clearly high on the priority list, I often find myself losing track of time. The only way I ever know the date is by checking while I sit on the computer doing school work. However, I can't complain (though I often try, and do...I shouldn't).

Today was what I often refer to as "Mini Monday". The school that I attend happens to test all subjects on the same exam. There is one test every month. Ironically, they call these exams Mini's, despite the material that they cover. It's amazing the way these exams can, if you let them, control your every thought and action.

I was very stressed of this last exam (and probably will be until the scores are issued). This was Mini #2...and #1 did not go nearly as well as I had hoped. Therefore, I was doing all I could to prepare for this one. However, that led to more and more stress, which I don't always do a good job of dealing with (it's definitely something I need to work on). I would spend all day studying, and then go home feeling like I didn't know the material. Anyway, I often keep stress to myself. I don't want to appear stressed in front of other people because I feel that they have enough stress of their own...and I would rather be cheerful and try to alleviate their stress. However, for the people closest to me, that I care about the most, that's not always the best. For example, my stress caused me to be short-tempred with my fiance over absolutely nothing. He is AMAZING when it comes to my stressing out and many times has told me that he would rather me take it out on him than bottle it up...but that's not fair to him, not at all. I was also short with my parents, when they were just trying to encourage me to keep pushing and to get the rest they knew I needed...these are the people I love most in the world and yet I often treat them the worst.

Anyway, today before the exam, I got up early to study, but I made sure to leave time to read my Bible before I went. I've been reading through Matthew and today was the story of Jesus walking on the water. When the disciples saw him, they were scared and so Peter said, "if that's you Lord, tell me to come out there with you" (this is my translation of course). So Jesus does, Peter goes, but then the storm got worse and Peter took his eyes of of Jesus. At that point he started to sink into the water and had to cry out for help. I AM PETER!!! When I read the part where Jesus was asking Peter why he had so little faith, I felt like God was sitting there asking me that. Why do I let these exams stress me out to the level that they do. I know that I can't do this on my own..I've never done anything on my own. God designed me to be a doctor at a young age, got me into and through an amazing college, got me into medical school, and he's going to get me out! Why have I had so little faith in that...? I've seen him work so many miracles, just in my family alone...what's a mini exam to Him??? I guess sometimes it takes weird things, like Mini exams to remind you of how amazing God is. Despite the scores that come back from my exam, God did a MAJOR work in my life today! He guided me through that exam, but more importantly , He taught me a lot about my own perspective....and with all that said, this may be the only night I have to relax, so I'm off to do just that!

Life is Good

So I haven't written anything in quite a while due to the heavy load of schoolwork. My first exam for this semester was this past Monday. The email of our responses and the actual answer key were sent out today, so you can calculate your raw score. That's where my day turned sour. However, that's not the purpose of my blog today (or hopefully any day). When I got the scores in my email, I had also received an email from the post office telling me that a package had arrived for me. I know that getting actual mail has lost it's appeal in the States and isn't really something to be excited about anymore. However, when you're on a tiny island and all your loved ones are at home, getting something from them is more exciting than Christmas! My parents mailed me two packages about 3 and 1/2 weeks ago...and today was the day I finally got to enjoy them. They sent all sorts of things, like sticky notes with my initial on them, body spray, and my absolute favorite thing to get down here...FOOD!!! It's hard to find a lot of the normal conveniences of home when you're in Dominica, so in a way (and yes, as cheesy as it sounds) it was like getting a piece of home today in the mail. :) However, my favorite thing out of the two boxes was a green handbag they send. it's a canvas tote from the brand "Life is good". I love their stuff just for the sense of optimism it brings. Not only was the bag green, one of my new favorite colors lately, but it had a daisy (which are my favorite flower) on the front and read "Life is good..." above the daisy. The bag couldn't hvae been more perfect for me and I've already made use of it.

I guess the point is kind of like..."when life hands you lemons, make lemonade", but so much more. I'll be the first to admit that I was absolutely angry and sad all at the same time about my test scores this afternoon. I sat alone in the building I study in with my hoodie over my head frantically writing notecards and getting to work on my new material...determined to rock the next exam. I was short with anyone that even attempted to talk to me. However, I won't blame anyone else for my own mistakes and I take full blame...and although I was rather upset this afternoon, I finally realized that although the frantic studying was good and I was rather productive, the attitude in which I was doing it was completely wrong. All in all, the tote bag I got in the mail today was so much more than a bag to me. It was an instant reminder that I've been blessed...absolutely BLESSED with an AMAZING life. I get to live on a tropical island while pursuing my childhood dream. I have two wonderful parents that are my biggest supporters and never fail to show it, even through something like a care package from home. I have a brother that I absolutely adore and my life would not be the same without. And for the last three years of my life, I've had the most wonderful man standing beside me, facing every giant I do and telling me how much he believes in me. The gifts God has given me, which I completely do NOT deserve are uncountable...I can't wait to see what he has next in his line up! :)

Life's Little Reminders

Last night was one of the hardest nights I've had since being on the island. I had my usual Friday: class most of the day, volleyball in the afternoon, dinner with friends, studying until bedtime. I generally study in a building near my apartment. I got home around 7:30, hopped in the shower and then was off to dinner. I went straight to the study building after dinner and stayed there until 11:55. This is the routine I've had since August of last year...with no problem. Last night was the change. I walked into my room and turned on the light to find that someone had broken into my apartment.

One wall of my apartment is made of wooden slats that open to allow for air flow. This is typical architecture for the Caribbean I assume. There is a large screen (like any normal window screen) outside the slats to keep mosquito's out when the windows are open. I walked into a giant section of the slats missing. Apparently whoever wanted to get into my room had cut a large rectangle of the screen away and then broken the metal clasps on the slats. They were quite neat crooks because they took the time to stack all of the wooden slats nicely in a chair that was on my patio. I was very lucky that I was not involved, such as being home at the time, as well as nothing was taken from my apartment. Luckily I had most of my valuables with me and the ones that were in the room were not in plain view. I was mortified and basically completely freaked out at the fact that someone had come into my room, or even that it was possible.

I spent the day today moving apartments to a room without the slats (simply because it makes me feel more safe). While I was moving, I kept thinking to myself...I can't believe this happened. However my thoughts were quickly turned away from the unfortunate event to the good fortune that God had blessed me with. Yes, someone broke into my apartment and caused some damage to the window unit. However, and I think most importantly, I was and am completely unharmed and safe. Materialistically, I didn't lose anything in the event. Unfortuanately a guy that lives two doors down from me was also robbed and lost his computer and iPod, please keep him in your prayers as he is trying to deal with all of this, on top of the loss of all his school work that would've been on his computer.

I was listening to some music that Chris, my fiance had recorded and emailed to me tonight while I was trying to get things straight in my new apartment. At the end of one of the songs, he goes into a song that most people know, but rarely take to heart...it really hit home with me as I was thinking about all that has happened since last night...

"Jesus loves me, this I know...for the Bible tells me so....little ones to Him belong...they are weak, but He is strong...Yes, Jesus loves me....Yes, Jesus loves me...for the Bible tells me so..."

Not only does the Bible tell me of God's love for me, but Jesus Himself shows it to me in the most miraculous ways. Obviously my first thought wasn't..."oh goody, what's God trying to teach me through this experience"...that would just be un-human. However, now that I've had time to think about it and God has really been speaking to me, I can only thank Him for the grace and protection he sent my way last night. I pray that God takes care of the people that were affected by last nights events, for the men/women that broke into my (and other people's) apartment last night. I pray that God finds some way to get through to them and completely rock their world the way He has mine!!!

The Key to Medical School

So yesterday was the first day of my third semester (start of second year) of medical school. The first two semesters were challenging but fun. They covered classes like anatomy, physiology, histology, and biochemistry...all subjects I have covered in undergrad. However semester 3 marks new territory, or "a whole new can of worms" as my dear friend Suma often says. We are now studying pathology (basically the study of when normal things in your body become abnormal), MMI (microbiology, molecular biology, and immunology), pharmacology (the study of drugs), and behavioral science (basically physciatry and how to interact with your patients). I'll be honest, pharmacology absolutely freaks me out. However, I just have to force myself to stay on top of it all, which I plan to do. Anyway, enough about that...

I often have people ask me for my advice or opinion on things that I have already gone through here. Apart from the usual academic answers, I find that there is one major key to medical school (for me at least...)...which is a solid group of friends. There is a group of 5 or 6 girls that I surround myself with as much as possible. It's amazing the impact they can have on the situations we all face here. Each of them brings something different to the table....

My best friend here on the island, Michelle, just got in today. We've only known each other since the end of first semester, a mere 7 months ago or so, but we became fast friends. I know that I can go to her for whatever I need help with and she'll always be there for me, but my favorite thing is our ability to laugh at some of the most ridiculous things.

Suma is a tricky one. We have been in the same PBL (problem-based learning) group for both semester 1 and 2. She was actually the only person I associated with from my groups on a regular basis. At first, I thought she was JUST a sweet girl with a very deep heart. No matter what I came to her with, she always found the positive in the situation and encouraged me. I've now come to learn of her comical side with her quick wit (especially with Diana). Suma if you read this, please don't get mad about the picture...we kknow you have no problem with your mandible, but I need more pictures!

Mary (unfortunately not in the picture) brings some northern spice. She shares a great passion for sports, particularly football with her, but still. I always enjoy her stories from home...but mostly I like to remember the time she saved me from Angelman....TWICE! :)

Diana (mentioned in Suma's blurb)....oh "double d"...there aren't really words to explain this girl from northwest Arkansas. She's absolutely hysterical and someone I find a true joy to be around. She shares my love for sarcasm and we often tend to spark each other in that direction. While I love Mary's stories, I love to WATCH Diana tell her stories with her infamous hand gestures as she explains.

Steph is my favorite Canadian girl ever. She has such a sweet spirit and always wants to help people. I admire her determination to any task she puts her mind to. She has competed in ironman competition, which I find absolutely astounding and something she should be incredibly proud of. One day I might be able to keep up with her when we run :)

So I'm sure that most people that read this haven't and probably never will be able to meet these 5 incredible women. However, I can tell you, that if just some of their attributes rub off on me during the course of our friendship, I will most certainly be a better person for it! I love each and every one of them dearly!...but for now I'm gonna run...time for dinner..with the girls!!!