Probably no one will notice

So I graduated this last weekend.

I KNOW

Matt and me at prom - I mean, graduation.  It was awkward,
okay?  There were so many people STARING at us.  So we left a little room
for Jesus just in case anyone forgot we've been married for years.
For real, though, we were really happy in this picture.

I have wanted to be a doctor my entire life that I can remember.  There was possibly a preschool interlude where I wanted to be an astronaut or perhaps an elf, but ever since then it's been medicine all the way (well, and during middle school I really wanted to go to Hogwarts, but even then I figured I'd be a healer but WITH A WAND, you GUYS, it would be so cool.  Anyway).  It made graduating on Friday a really big deal for me.  And I had so much family there.  I think we were that annoying, enormous group that clogs up the hallways and where everyone overflows with pride all over the place.  It was wonderful.  I have received so much love and support from family and friends during school, and to have so many of them there, some from very far away indeed, to witness the ceremonial transition from student to professional was overwhelming for me.  The silly octagonal hat, the choking hood-scarf thing - I loved all of it.

So.  This was the first graduation ceremony that really mattered to me - and I tripped.  Twice.

It's my fault for being completely clumsy, and also for wearing tights with a pair of heels that I'd never done that with before.  I wasn't counting on the lack of friction between my foot and the shoe.  So walking into the auditorium, when all eyes were on us, I felt the shoe slip halfway off my foot midstep.  Everyone behind me tells me I did a good job of recovering, but I'm pretty sure I actually groaned and stumbled down the aisle much like a zombie with one foot and a moist, slippery stump where the other should be.  I made it to my seat without actually hitting the ground but it was a near thing.  It meant I spent all of the speeches in a cold sweat, picturing myself completely wiping out as I reached the front of the stage and possibly taking out one of my attendings as she prepared to hood me.  The crowd would make that dismayed, rumbling, "Whoooaaa nooo" that it always makes when someone does something irredeemably embarrassing.  I could see it, over and over.  Lord, please, no.  Please no.  My feet hurt a lot.  Please get me across that stage with a bit of decorum.  I'm going to pass out.

I am thrilled to report that I made it across the stage, receiving my professional hood and diploma without incident.  Instead, my shoe tripped me again as soon as I got behind the curtain.  I took them off completely at this point.  And so, as I got my official graduation picture, all hooded and proud, I was also barefoot.  (The picture is from the waist up, we're good).

I also walked back into the auditorium barefoot, shoes neatly hidden in the folds of my fancy robe.  And the things stayed off until it was time to walk out.  And so this is the first lesson I learned as a brand-new lady doctor: embarrassing things are going to happen all the time.  JUST FAKE IT.  NO ONE WILL NOTICE, PROBABLY.

PROBABLY.

February #1: Ophthpththtpthtpphphththpth- Eyes

So this rotation introduced me to something special and wonderful.  No, not that the inner part of your eyelid and the clear top layer of your eyeball are actually all one continuous layer (although!  how cool is that?! And isn't that also kind of weird?  Because the inside of your eyelid is pink, but that outer part of your eyeball is clear.  And also it's weird that that layer, your conjunctiva, is not made of the same stuff as the clear part that you look through, your cornea.  Crazy.  Anyway).  No, gentle reader, this is the rotation where I learned why spring of fourth year is so vaunted.  It's because you do nothing.

Let me be clear that when I chose my rotations for the spring semester, I was not trying to choose easy rotations.  I wanted to use this time to try to learn about things I'd had very little exposure to.  I chose ophthalmology, radiology, HIV clinic, and anesthesiology.  Sounds legit, right?  Ha!  Wrong!  Because as I found out, once people know you're a fourth year student rather than a third year, they find any number of reasons to send you home early or have you not come in in the first place.  Real examples:

"It might snow today."

"You've been working hard."

"You've already seen this stuff a couple times and you seem to get it."

"Your head hurts; why would I make you work with a headache?"

"You have an appointment scheduled for late morning, so just take the whole morning off."

"If you came in you'd only be working for like two hours anyway."

"I'd like to stay home but I can't, so you do it."

"You're a fourth year."

I felt so weird arguing with people to let me stay and work.  After the first few times, it became easier to just go with it.  And I have discovered something wonderful: having a full life.  I read books.  I watch extra sermons.  I lead study groups for second year students.  I am helping my husband lead our Bible study group.  I exercise, cook, do laundry, talk to my husband, AND I sleep...  is this what all you people with lives get to do all the time?  Surely not; it's too awesome.  If it were possible for people to always live like this the secret would be out, right?  I also love working at medicine, but working all the time doesn't hold a candle to having a balanced, varied life that is full of different sorts of challenges and chances to enjoy people.  I had no idea.  I don't think I have ever had this before.

Despite everything I just said, I did go to work sometimes while I was on my ophthalmology rotation.  It was a whole new totally overwhelming world, actually, which made a two week rotation feel like those impossible multi-site tours people are always inflicting on themselves when they go to other countries.  You take a bunch of pictures of towns you don't catch the names to, you try unsuccessfully to learn a phrase in the local language, you try some weird foods that you're not sure you like, and then you go home.  It's experience with no context to ground it; fun, but with limited return on your investment.

Doctors don't generally learn much about eyes.  They're there.  You see through them.  Don't get stuff in them.  Sometimes they get dry.  You want the jelly part to stay inside.  Go see an eye doctor.  The end.  We learn a fair amount about what leads up to the eyes, i.e. how the brain manages vision and how damage to the brain/ nerves specifically affects sight in different ways, but that's not the same as understanding the eyes themselves.  Eyes are highly complex and fascinating.  They're also quite important in that eyes are the only place in the body where we can directly see blood vessels and nerves without doing surgery or something, because we can shine a light into the eye and see straight through to the back.  That means all diseases that affect blood vessels or nerves systemically (think diabetes, high blood pressure, high cholesterol, some infections, etc.) will show up visibly in the eye somehow.  This is in addition to all of the specific eye conditions that someone can have.  There is a ton of very specific tech and wordage surrounding this, and in two weeks all I got were some basic eye exam skills and a glimpse at a huge body of knowledge that I know nothing about.  I watched a lot of cataract surgeries.  I did not have to watch anyone get their eye surgically removed, and I will always be grateful for that, because ew.

Also I looked at peoples' irises under high magnification a lot.  I was meant to be contemplating the deep mysteries of the pathologic retina at the time, but irises are cooler to look at if you're not an ophthalmologist.  Did you know irises have kind of a black background, and the colour is actually a bunch of fibers radiating out from the pupil?  They stretch out almost flat when your pupils are small, and they curl up when your pupils are dilated.  And a lot of people have little spots of other colours in their irises that aren't visible normally.

Somewhere in there I made P. F. Chang's chicken lettuce wraps from scratch and got all my dry cleaning done and had some work done on my car.

You can tell this was an enormously productive rotation.

Quick thoughts from the interview trail

This city is getting nicer and nicer, he said.  Take the area we're in right now.  It used to be a bunch of projects.  But they tore all that down about 10 years ago, and now there are all these nice bars and restaurants here.

I nodded, but all I could think was, Where did all those displaced people go? I didn't ask.  He wouldn't have known.  But it's interesting how once you decide to start seeing the poor in our country, your eyes are opened to a whole horrible world that most like to pretend doesn't exist.  That man probably didn't even realise he was talking about people's homes.  It was just a Bad Area that has now been magically transformed into a Good Area.  How wonderful.  How bloodless.

Changing subjects slightly.

Interviews are hard because all the talk is about how great the program is for you, how it will give you everything you want, how cushy it is, etc.  I'm not denying that comfy things are comfy, but it hits right at the heart of the self-centered mindset of the rich that we are meant to be so on guard against.  And I wonder how best to fight that mentality while continuing to aspire to the next step of my career.  And I wrestle with how deeply I can enter into this world of having everything I want while still counting it all as scubula. 

"More than that, I also consider everything to be a loss in view of the surpassing value of knowing Christ Jesus my Lord. Because of Him I have suffered the loss of all things and consider them filth, so that I may gain Christ."

Failure. Pleasing others.

So I started this audition month by looking at a joint x-ray.  After about 30 seconds of confused contemplation, I finally gathered my courage and asked the resident, "Hey, where's the patella on that x-ray?"  As soon as the words left my mouth, my eyes made sense of the radial head.  Crap.  That's an elbow! Before she could start to say anything, I was shaking my head and saying, "Ooh.  I mean.  Never mind because that's not a knee that's an elbow and elbows don't have kneecaps.  Let's forget I said anything.  In fact, I was merely remarking on what a normal looking elbow that xray is showing."  She laughed at me. 

Apparently I began as I meant to go on.  I've missed IVs, messed up Foley catheters, placed endotracheal tubes in the esophagus, placed orogastric tubes in the lungs, had to rip out a few sutures, fumbled immobilisations... I'm such a klutz and it is beyond frustrating!  I am not super neurotic, but I'm certainly type A enough that I HATE doing stuff that I'm bad at - and at this stage of my training I'm bad at everything.  Still.  I've been trying my best to keep a good attitude about my failures, work hard, and ask thoughtful questions.  I may not be good at anything, but I swear I'm teachable! 

I have been struggling very much lately with wanting to please other humans.  This, I think, is the quintessential struggle of any Christian who is currently aspiring to some new position.  This morning I was reading the letter written by Jesus' brother, James; these passages in particular became my prayer today:

"For jealousy and selfishness are not God’s kind of wisdom. Such things are earthly, unspiritual, and demonic. For wherever there is jealousy and selfish ambition, there you will find disorder and evil of every kind. But the wisdom from above is first of all pure. It is also peace loving, gentle at all times, and willing to yield to others. It is full of mercy and good deeds. It shows no favoritism and is always sincere. And those who are peacemakers will plant seeds of peace and reap a harvest of righteousness.<sup>"

"</sup>Don’t you realize that friendship with the world makes you an enemy of God? I say it again: If you want to be a friend of the world, you make yourself an enemy of God...  But he gives us even more grace to stand against such evil desires."

^{That last sentence is perhaps the most important.  Through the Holy Spirit, I am empowered to fix my eyes on my King, and to allow Him to set my goals and priorities.  I am glad to let Him.}

Carving your own way is not always fun

So here I am, at 5:30 on a Sunday morning, awake.  I have learned that one of the harder things about working in the ER is the shifting from days to nights and back again, generally with only 24 or 48 hours to do so.  I find myself frequently staying up for 24- 36 hours because I have things to do, or simply because my body has no idea what it needs.  I stare at the ceiling and rehearse interview questions a lot.

As a fourth year student, I'm in the phase of trying to get into residency, my required postgraduate training.  Generally, that takes this form:

- take Step/ Level 2 board exam during the summer
- apply to residency programs during the fall through a standardised system, the Electronic Residency Application Service, aka ERAS
- during autumn, spend time at various residency program locations for 2-4weeks at a time, trying to impress and hopefully scoring...
- interviews, which are how a program shows interest in an applicant after their ERAS application has been submitted
- during December/ January, students and residency programs create ranked lists of the programs/ students they would like, respectively.  So I might make a list that said my #1 choice was Program A, #2 is Program B, and so on.  At the same time, those programs are making lists that might say their #1 student pick is Jane, #2 is Zoe, #3 is Steven, etc.  All of these lists are fed into a computer that works through a matching algorithm, pairing students with residency programs according to their preferences.
- Match Day, the day when all successful matches are revealed, occurs in February for D.O.s and March for M.D.s.  Everyone hopes they received a match to a program, but as some fields are more competitive than others, there are invariably not enough spots in each area for all the people who want to do that work.  Hence the Scramble.
- the Scramble is something no one wants to do.  The day after Match Day, a list of unfilled residency spots is published, and it's a barely restrained free-for-all.  Think of tossing a pile of gold pieces into a crowd and saying, "Go!"  Yeah.

I just finished my third audition rotation: one family medicine, two emergency medicine.  I have one more ER audition and then I'm finished with this part and can get back to working/ learning without also feeling like I should be jockeying for a job.

The thing about this season is that it is insecurity-inducing and it impels you to contort yourself to please people.  You see how high-stakes this is, right?  Because you want to get a job, but you know you aren't that great as you are, so you start to compromise yourself in order to look more attractive to whichever program you are with at the time.  Which of course, is a futile goal, and one not pleasing to Christ.  My job isn't to please other humans.  My job is to do my best to please Him, every day.  Walking through this time has taught me a few very important things:


- not everyone at every site will like me, and there may be nothing I can do about it
- I most certainly will not like everyone I will have to work with
- pursuing Christ will make me enemies - the more openly I do it, the more enemies I make
- being a patient advocate will make me enemies - the more openly I do it, the more enemies I make
- a few doctors still think of women as not good physician material
- some programs will expect you to abandon your dignity and become a supplicant rather than an applicant who seeks to become an equal.  These programs will provide ample opportunities for you to play their stupid game
- we who seek to glorify the Lord are truly a remnant, a small band of rebels trying not to get shot down as we slip through and around the rigid expectations of others
- calling missions "international aid" or "providing care to those who are less fortunate" is a good way to keep from getting doors slammed in my face for now
- many people will want to compare notes with you endlessly - where you've been, how many programs you applied to, what your boards scores are, how many interviews you have.  It's easy to get obsessed with statistics and probabilities
- these people will not be inspired by you telling them you trust God to place you where you're meant to be.  They will look at you with pity.  They think stress is how you know you're doing it right


I can't even tell you what a weird process this has been.  The whole point of it is to prove how awesome you are and to get what you think you want for yourself, even if getting what you want means doing a bunch of stuff you hate and lying to people.  The pressure to conform is high and constant, and I've dealt with a lot of anxiety as I grapple with this system that I must survive in but still want to reject.  It is very hard to see an opportunity to impress or agree with someone who you know has power over you, and to count the cost and deem it too high, and to consciously allow the opportunity to pass.  There's no earthly reward for that kind of behaviour. 

I work to avoid straying from pleasing God to pleasing men because God has impressed something deeply on my soul.  It is not about getting into residency.  It is not about emergency medicine or family medicine.  It isn't even about being a doctor.  My purpose is to serve the King - to trust that He will let me know what my tasks are for that day, and to work at them diligently.  The tasks themselves are pretty much incidental.

Now how is that supposed to translate in an interview, hm?

Again With The Future

Okay so this year has been pretty hard.  I submit evidence for your perusal:

• my husband was deployed to fight in Afghanistan
• I got pretty classic adjustment disorder after he left and almost quit school
• Step 1 board certification exam - enough said
• my husband got some injuries overseas, but not bad enough to send him home - I had to hear about these at work via Phone Calls that started with, "Hey, we need to talk now" instead of, "Do you have a second?"
• holidays by myself for the first time ever

I haven't said much (anything?) about my husband's deployment on here for several reasons.  The first is that deployment is difficult to talk about in a way that will reach others.  Unless you have experience with being in limited contact with your loved one for months at a time while he is (as far as you know) in mortal danger, you can't really know.  I didn't know.  The second is for what the military calls OPSEC - operational security.  You never know who's reading, and so the less information that is floating about, the better.  The third is quite simply that medicine is easy to talk about.  A year of solitary nights (broken by bouts of workaholism when the silence gets too overwhelming) is not.  He has been gone from my days this last year, yet he is inescapably present - an excruciating paradox.  I hate this limbo.  Anyway.  This year is finished and I don't mind.

Next year promises to teach me about uncertainty, which makes me itch.  I've never dealt much with uncertainty.  My whole life, I knew I wanted to be a doctor.  It was a vague plan that, as I got older, developed all the necessary steps. But I've completed all of those now.  Cue nausea.  I HAVE RUN OUT OF PLAN OH NOZ. 

Just like there's the quintessential first year conversation ("I'm so stressed I will never pass this test I hate my life") and a standard second year conversation ("I'm so stressed what are you doing for boards I hate my life"), there is one conversation that all third years have, constantly, until it's settled.  It revolves around what field to go into.  And for the first time I don't mind participating in the talk because we're finally talking about something constructive.  Sort of.

My dilemma is this: I want to do missions, possibly long-term.  But what field prepares me best for that?  The easiest answer is probably family practice - primary care, teaches you to deal with all types, good for developing relationships with people.  But.  The second tier of my problem is that modern suburban family practice makes me want to go back to retail while I frequently leave the ER singing.  So do I just do what I want?  Is that a good enough reason?  Here's why that last question is even worth asking: sometimes the Lord gives us honest desires as clues to what to do next; sometimes those desires are actually temptations (not from Him) and He asks us to walk away from them.  We have to wait for His guidance to be able to reliably tell the difference.

Six months ago this was not really a problem because I didn't need to make decisions yet, but my time cushion is running out because soon I need to start arranging my fourth year.  Fourth year for osteopathic students is mostly for audition rotations - you travel to the residency programs you really want to get into and rack up some face time.  Hopefully you impress the program with how smart and personable you are and help assure yourself of a spot there the next year.  Not to belabor my point, but I cannot start setting up audition rotations if I don't even know what field to look into. 

This is by no means a unique problem - I can list five classmates off the top of my head trying to make the same decisions - but I do think I have an edge.  Just because I don't know the plan doesn't mean my God doesn't have one.  And I know He will let me know, and I know it will be in enough time for me to make the right decisions.  I just get impatient sometimes.

Okay fine, I get impatient every day.  AT LEAST I'M HONEST.

Please Don't Mind The Echo, or, How I Got Into Medical School

So let's just get it out of the way that my second medical school acceptance call, for the school I now attend, was totally normal.  I was sitting on the couch playing video games with my husband when my phone rang.  I answered, the friendly admissions lady on the other end told me I'd been accepted, I thanked her profusely, and we hung up.  It was quite nice.

This is not about that phone call.  This is about my first med school acceptance call, and it involves one of the most private of places.  Let's start at the beginning.

The application process for medical school has several steps and takes about 6 months.  After taking the MCAT (which is its own 6-month ordeal) a student has to make it through primary and secondary applications, as well as a formal interview.  Using this body of information, the school makes a decision on who gets admitted to the incoming class.  The acceptance rate is below 15% at most medical schools.

I didn't have very good grades for the first 2 years of college, courtesy of balancing real life crap and school.  This meant when I talked to my premed counselor during my junior year, he sighed deeply and informed me that I wasn't a competitive applicant.  I let that pronouncement eat at me over the next year, even after doing well on the MCAT.  I tell you all of this so you will understand just how on edge I was during this process.  By the time I'd made it to the interview stage, I was practically vibrating with nerves.

Cut to November of my senior year.  I'd just had my first! ever! interview and was in that terrifying period just after: waiting for a response.  This particular afternoon I was hard at work in my college's histology lab, memorising slides with my fellow premeds, several of whom were also anxiously awaiting answers.  And like good premed seniors, we had our cell phones with us.  Always.  ALWAYS.  I would set my phone on the edge of the tub when I showered; otherwise it stayed in my pocket or my hand, where I would glance at it constantly.  It had been a week of this, and this day was no different. 

Until I had to pee.  Perhaps you see where this is headed.

I tossed my phone to one of my friends with strict instructions to answer for me if an unknown number called and tell them I would call back.  And I was still sitting on the toilet contemplating life when the main bathroom door slammed open and I heard my friend's half hysterical voice ring out.

"Zoe!  Someone called for you!  Where are you?  I'm bringing you the phone!"

"What?  Don't answer!  I can't talk to them right n-"

"No, no, it's too late, I already picked up, she wants to talk to you-"

"But - wait - "

It was indeed too late.  A hand shoved my phone unceremoniously under the stall door and shook it excitedly.  In a panic, I Kegel'd harder than any woman ever has in history, accepted my bloody phone, and squeaked, "He- hello?"

"Is this Zoe?"

"Yes, yes it is."  No.  Oh my goodness, no.  This cannot be happening.  Squeeze, Zoe.  Squeeze!

"Hi, this is Admissions Lady from The Medical School."

"Uh, ha, hi.  What can I do for you?"  Must talk less.  What if she hears the echo?  Oh, please, Lord, please don't let her notice an echo.  Please.

"I wanted to thank you for coming out to see our school, and I also wanted to let you know that we have decided to accept you into our school's incoming class."

Pause.

"Hello?  Zoe?"

I honestly don't remember what I said after that or how I got off the phone, because all I could focus on was that if I gave full rein to my relief and gratitude... well.  I really didn't need that poor lady on the phone to hear just how relieved I was.  I do know that I laughed uncontrollably for about five minutes afterwards.  As did both my mother and mother-in-law when I told them what happened.

There are some good lessons to be learned from this.
1. We often speak of God's perfect timing.  I would like to emphasize that He also has perfect comedic timing.
2.  Sometimes we will be blessed by having humility baked into a set of circumstances.  I can never talk about how I got into medical school without that story, and it is a beautiful demonstration of how little I actually control.

The last eight days, or: Med School When You're Really, Really Depressed For Some Reason

So you could say I've been dealing with a major depressive episode.  I'm not sure why, to be honest.  My best guess is that my learned hatred of medical school coupled with a bunch of other personal things combined at just the right time to throw me off course almost completely.  To show you what I mean, let's use me as an informal psych case study!  Here is what the last week has been like, with a new but ultimately textbook twist at the end:

Monday I cried between every class and a little bit in class.  Then I took a test.

Tuesday I fought with everyone.  And then apologised.  And cried myself to sleep, then slept oddly.

Wednesday I think I avoided everyone because of the snow.  I thought about cleaning or making food but just sat on the couch instead, possibly doing nothing at all.

Thursday I woke up determined to have a good day.  I got my hair braided and chatted.  Then I sat in bed and cried.  A lot.

Friday I made it through a whole day of class - barely - then sat hopelessly on the classroom floor for half an hour because I couldn't pack up my things to go home.  Then I went home and crawled into bed and cried.

Saturday Matt was home.  We went shopping, and then I was so tired I slept most of the day.  And, after surfacing for dinner, a full night.

Sunday I woke up, cried, and went to church.  Then I was so tired I slept most of the day.  Matt went back to training.  I scraped myself out of bed and went to study with a friend.  Then went home and cried.

Today I woke up and it was like someone shook me awake, handed me my life, and said, "I don't know where the hell you've been for the last six weeks, but you have a test today.  And one tomorrow.  And makeup work to do.  And next week you have three tests, as well as a mock patient to see and a patient interview to do.  Get up."  And so I have spent the day in a spasm of anxiety-driven energy.  I'm grateful because it let me do things, but this is also just a different kind of wrong, albeit one I have more experience with. 

Depression is insidious and poisonous.  Anxiety is like trying to tame a beast - it has energy, it fights you.  Which means you can fight it. Fighting depression, it has seemed these last weeks, is like fighting quicksand.  The phrase doesn't even make sense to me.  You push, it gives, you get sucked in deeper.  I don't know how to deal with that. 

But at least after today I understand why they say anxiety and depression are two sides of the same coin.  At least this will make me a better doctor...?

So I guess this blog will be useful again very soon

Yesterday Matt and I were at Target and I saw the school supplies section.  For the first time EVER my instantaneous reaction, instead of a thrill of joy at the thought of school inching closer, was a sinking sense of dread.  Oh no, school is creeping back up again.  I really have to go back to that.  I am so thankful that I don't have to be a first-year ever again, but I still have to go through the meat grinder a second time, just on a different setting.  Like, really.  I have to do that again.  Except without Matt there for half of it.  People are already asking me about whether or not I'm going to get the jump on Pathology, and school is still almost a month away.  But that's not the worst thing.  The worst thing is that I know they're right, and I should start studying for Path before the semester begins because in 2nd year your return is directly related to your investment, and so I probably will.  Which means buying the textbook before I go visit my family and taking it with me so I have a good two weeks to get myself familiarised with the basics.

Now.  I will probably love the material - I'll finally be learning the real doctor stuff - and so studying will probably go well.  But I'm not even worried about that.  I know I can study; that's not my problem.  The problem is that I don't really want to do this again now that I know what I'm heading into.  Like every other naive premed, med school was The Big Shiny, the most attractive thing we'd ever pursued.  It pulled us through all kinds of juvenile sacrifices and even through the semi-wringer that is medical school admissions.  And when I got that phone call I gave heartfelt thanks, because at last I had arrived.  So I conveniently forgot that med school is a process, not a destination.  And the process sucks.  It beats as much out of you as it can: irresponsibility, yes, but also enthusiasm, compassion, empathy, human connection, drive, physical health, integrity, self-preservation, honesty, sanity...  I refuse to let that stuff go, but I still feel the pull, and I know I can't retain my full capacity for everything while school is going.

I warned myself when I started this.  'Welcome to your new life,' I told myself when I began first year.  'This is the new normal.'  And I repeated that a lot, in anger, in despair, with resolve and at times also with deep bitterness.  But summer has been such an amazing reprieve that I forgot that I don't get to be this complete a person all the time.  I've gotten to read books, sleep as much as I want, lose weight, shadow at two excellent medical missions, reconnect with my husband, move to a new apartment, play lots of video games, see all my friends... I have truly shed all of the awfulness of the last year; half the time it seems like a vivid nightmare because it has nothing to do with how awesome summer has been and will continue to be.  But the trade-off is that I feel emotionally unprepared for the coming semester.  I watched the class above me burst into their second year, certain that it would be fantastic - and then abruptly get crushed by the workload and the stress.  To be sure, they handled it better than we firsties did our trials because they'd already been through it, but the demands on them were also correspondingly greater.  Last year watching what they went through terrified me, and I think I'm afraid that I didn't learn enough, didn't toughen up enough, didn't ________ enough to be ready for this coming year.

Which ultimately brings me back to the other thing I repeated to myself constantly last year: it's a damn good thing none of this is in my hands.

Hx - School, School, School.

To begin, I suggest you look up 'giraffe in quicksand' on Youtube.  It serves as a good summary of the first year of school.

I'm losing all sense of time, which for someone with as regimented a schedule as I have, is stressful and frustrating.  As one of my classmates said, "The days are long but the weeks are short," which is sort of right and basically means that I can't remember something that happened this morning, but feel like it's only been two days since three weeks ago.  But an eternity since summer, which was... actually, I think that was three weeks ago.  or four.  three.  four.  mmmph.  [shakes head to clear it]

I am slowly losing my home life and have lost what little social life I had.  This is stage 1 of the medical student transition.  Stage 2 is when I find myself growing a new life that is simultaneously home life and social life, and is one with medical school and the people in it.  I AM FIGHTING THIS.  Most medical students lose all ties to the outside world and then, attention-starved, turn to each other (and then - stage 3 - eventually on each other.  I never said this was healthy, just codependent).  I think the downward slide is inevitable but I'm still resisting.  For instance, I am frequently home for dinner, and so far I have ALWAYS been home before 10pm.  I have to see Matt or I'll go postal and kill everyone.  Staying in limbo like this is sort of painful, though, and it's sort of costing me friends all the time, which sometimes doesn't matter to me and sometimes makes me sad.  Whatever, I never made friends easily.  I'm just not used to having to try and unsure if I feel like making the effort.

OMM is still the coolest thing I've ever seen or heard of, though.  I can't wait to start really learning.  Yesterday was the supremely awkward Day of Major Anatomical Landmarks, where we palpated everything from the clavicles to the ankle bones to the sacrum and pubic bones.  Yes, on each other.  Yes, regardless of gender.  Yes, even more awkward things loom in our collective future.  Next semester in OMM is all pelvic and sacral work.  Awkward, but also still the coolest thing ever.