Recommended Reading

Friday, August 2, 2019

I was going to do a post about going for what you want and how you need to really lean in, but that doing it the right way can seem - and will be - selfish.

But I kind of don't have the energy at the moment to delve into that, so it will have to wait for a future post.

However I wanted to update that I start my ER internship on Monday! I'm kind of cheating because it will be at the orthopedic hospital thats close to my house and they only take in wounds and orthopedic injuries, so my experience will be limited to those things but its close to my house and at least I'll get SOME experience. Unfortunately, I've learned a lot of people just get their internship forms signed without doing ANY work, so I don't feel bad. What I do feel bad about is that I totally forgot to order the suture practice kit last week to practice suturing on...I hope that if a wound comes in that the Dr I'll be working with will show me what to do, because I can't remember anything from the suturing course I took earlier this year and I'd love the chance to do some real live suturing.

Then in late August I'll be starting a family medicine internship. I met with the Dr I'll be working with today and he told me told me to look up the most frequently prescribed hypertension medications, because apparently thats the number one medicine he prescribes in his practice. But he seemed like a really decent guy who loves his job, so I look forward to working with him.

Otherwise I'm really enjoying this summer. Its not nearly as nice as last summer was, weather-wise, but I'm still enjoying it nonetheless. I've been able to get a lot of exercise in and it feels really good. I would love to figure out how to maintain this level of activity once school starts again.


Wednesday, July 17, 2019

A third of the way

Wow, I just realized today that I never did an end of year post! This is probably because as soon as exams ended, my in-laws came to visit us from NZ and then we all did a road trip to Croatia. We just got back on Sunday and are settling in to the summer for real.

I'm happy to say that I passed all my exams again and I'm very happy with my grades. I did much better than just pass but I'm mostly just happy I can enjoy the summer with my family without worrying about having to do any retakes.

Next up will be my family medicine summer internship (still in the process of organizing this).

In the meantime I'm going to chill, exercise and read some Scandinavian crime novels. And celebrate that I'm a third of the way through!

Saturday, June 22, 2019

Exam fatigue

I have 4 days left until I'm DONE with exams and I can't wait. I'm having some real exam fatigue at the moment.

I'm half way done with final exams (two of four done) and have two more to go. Luckily we get our final results really quickly so I know I passed both genetics and biochemistry AND I was pleasantly surprised to get a bump in my final grade in biochemistry because some students who showed an extra effort (attendance at lectures, participation at seminars, actively leading in labs and/or high marks on mid-term exams) got about a 10% increase in their final mark which was pretty awesome for me. Especially since for me biochemistry was the hardest course this year and the exam I feared the most. Plus I was happy that we were given a reward for our hard work and consistency, which is something I find lacking in the program overall. Everything comes down to the final exam and I really think its not the best strategy to test our knowledge. So at least I'm happy with this one course making an exception.

I have physiology and immunology next and they are unfortunately back-to-back. I'm feeling ok about immunology because I really like the subject and really liked my teachers but I have no idea about physiology. Mostly because the course was a bit fat mess with some less-than stellar teachers, cancelled classes, inconsistencies in the test questions and how they were presented in class and in general I feel like the exam will be a crap shoot. Plus we've heard from upper year students that they just recycle old questions so studying for that class is mostly just going over old exam questions and thats boring. I feel like I'm studying to the test and not studying to learn.

In any case I'm just over studying. I've been preparing for finals for six weeks now, with four of those weeks still wrapping up some classes. I'm tired and feel guilty about being away from the kids, plus I MISS them so much. I went home last Tuesday after the biochem exam and took the afternoon and evening off before heading back into town on Wednesday morning and setting up camp in the conference room of my dad's office.

But I have to remind myself that in 4 days I'll be DONE 2nd year and will officially be 1/3 of the way through medical school!

Thursday, June 6, 2019

Relate

A little while ago as part of our first aid course we were taken around the hospital and the ER to show us the protocol of what happens with ER patients. Part of that tour was showing us where patients are later admitted to ICU.

We saw a few patients, but two stuck out and made me realize how differently I think I look at things compared to some (most) of my younger classmates, because I can relate.

The first was a very young child that has been hospitalized for the past several months due to complications from the flu. And by flu I mean the proper influenza virus, not a GI bug. The little one may or may not live, and the doctor told us at this point in time the prognosis was 50/50. It really hit me and reinforced (again) how important it is to vaccinate, even against the flu and especially how important it is to vaccinate children, because they are the worst affected. But I don't blame the parents here for not vaccinating because I find in Poland the barriers to the flu shot are big and annoying. You have to be very determined (and be able to afford it) to vaccinate for the flu.

The second though, for me was worse. It was another child, though older, with leukemia who was in the ICU due to a different medical complication. However, it wasn't the illness or the suffering of the child that got me - it was the sight of the mother sitting on the chair, next to the bed, holding the child's hand in hers, her head bowed against their chest. For a moment, I felt I was that mother and it was my child in that bed and in just that moment, my heart broke. I could feel that despair and pain of seeing your child who is already suffering and been dealt such a shitty card so early in life, with another issue. The helplessness and emotional exhaustion just radiated from her, yet I feel like I was the only who felt it.

I don't know if this will make me a better or worse doctor. I hope the former. But maybe I will be able to help some of these patients by being able to relate.

And a major realization I felt afterwards is just how important it will be for me to have regular access to mental health support once I start to practice or even once we start clinical classes in earnest. Because as hard as it is to have these feelings, I don't want to become immune to them. I don't want to be able to "just deal".

Friday, May 24, 2019

Easier

Recently I realized how much easier being at mother at med school has gotten. And its mostly because all my kids are getting older. They all sleep well through the night now - with the odd wake up by my three year old demanding a drink. Plus I think they are now just so used to it, its like they've forgotten what it was like when I was around all the time and its been so good for my mental health.

Yesterday I was able to attend a non-mandatory evening event organized by some students in my year - on a whim - for the first time ever because I know my kids will be fine.

I can't remember if I ever discussed this here, but I definitely had some mental health struggles last year over the guilt I felt about pursuing med school with three kids. The adjustment was a little rough, particularly for my oldest son (which surprised me) and combined with some other stresses had me feeling really low for a while.

Luckily I had the presence of mind to realize something was wrong and I sought counselling and it was the best decision ever. My therapist helped me work through my feeling and I felt such a burden be lifted from me.

Which brings me to another thought. I still read so much about the relentless medical culture of pushing doctors and nurses and other health care professionals to the brink. I recently read "This Is Going to Hurt" by Adam Kay about his time as an OB in the NHS and one of the things that really stood out is the lack of mental health support for them.

Maybe its because I've read so much about this and maybe because I have already experience some mental health issues myself, I feel like I'm going to be going into it with open eyes and hopefully will not keep my thoughts and feelings bottled up. I want to actively fight the stigma and hopefully will be able to be there for colleagues to lean on as well.

I'd love to write more on the topic but I gotta study so I'm going to end this here.


Tuesday, May 21, 2019

How to prevent abortion

I debated bringing the topic of abortion up on this blog again. Last time I did, I was viciously attacked by an anonymous person (side note: if you truly stand for something, own it and use your real name - don't hide behind an anonymous profile) simply because I stated I was pro-choice and attended a rally in Warsaw to prevent further restricting the already incredibly strict abortion laws in Poland. But I digress, this isn't the point of this post.

With the recent news about several US states imposing strict abortion laws (banning abortion in all cases, even rape and incest) and setting the stage to overthrow Roe Vs Wade, there has been a lot of talk about abortion in general in social media where everyone is sharing their opinion. So I thought I'd share mine too.

This is a difficult topic. I'm not going to be flippant about it and say that a fetus is "just a bunch of cells" or whatever. I respect and accept that people believe that a life begins at conception. It is not a crazy belief. When I had a miscarriage at 7 weeks, it was devastating to me. It wasn't a bunch of cells, not to me.

BUT I also can't be flippant about pregnancy and postpartum and being a parent. Pregnancy is inherently dangerous and kills women every single day, even in countries like the US. But aside from death, pregnancy takes a huge toll on a woman's body. From permanent disfigurement, loss of future fertility, depression, to prolapsed uteruses and incontinence, the list of risks a pregnant woman faces is long and depressing. I had complication free pregnancies and I still ended up with bad incontinence. I still had my body distorted. I still had postpartum depression. I stalled in my career, even when I went back. Being a parent is hard, exhausting and expensive. And I had all the support and love in the world. So it was all worth it to ME. However, I can't imagine going through something like that for an unwanted pregnancy. Or worse an unwanted pregnancy that was forced on me by rape.

So instead of yelling at each other and hurling insults, especially those to claim to be pro-life, what can we actually do to prevent the abortions in the first place? But first let's look at why banning abortion won't actually lead to less abortions or less death at all.

What happens when you ban abortions?

1. More people die overall - just like when Romania banned abortions, this led to an increase in both maternal and infant mortality.

2. Interestingly, the number of abortions increases. In fact, in a 2016 analysis published by Lancet finds that the average abortion rate in countries where the procedure is prohibited is 37 per 1,000 women compared to 34 per 1,000 in countries where it is legal. A real world example is Canada - where there are no restrictions on abortion - which has lower rates of abortion than the US or many countries where they are restricted or illegal.

3. The number of unsafe abortions increases - as does the number of maternal death and serious health consequences for the women as this study shows.

4. Women find ways around it - rich women will just go somewhere where they can access it and poor women resort to back-alley abortion clinics or take drugs that will end their pregnancies. For example, in El Salvador, where abortion is illegal, 1 in 3 pregnancies still ends in abortion.

5. Maternal death increases - when you criminalize abortions and make doctors criminally liable, they are less likely in intervene in obstetric emergencies. For example, in Argentina many doctors will allow ectopic pregnancies to continue until the fallopian tube explodes because they fear that the fertilized egg will considered "living" prior to that - making it fatal for the mother as well. Some doctors won't treat women with chemotherapy because of the high risk to the fetus. And lastly, there is a huge up-tick of maternal suicide, especially in teens who are distraught by their situation. In fact, suicide is the 3rd leading cause of maternal death in several countries where abortion is illegal.

6. You open the door to investigate any pregnant woman who has a pregnancy loss. Imagine you are a pregnant woman who starts to bleed in your pregnancy - this is common but as any woman who has gone through this can attest to, incredibly scary. I've been there and I know. Now imagine you go to the hospital for help and instead are not only not helped but are reported to the police because suddenly you are suspected of attempting to end your pregnancy. Because doctors can't tell the difference between a natural miscarriage or abortion by misoprostol, an ulcer drug that is about 85% effective in inducing an abortion on its own. Which can be scary if you have a young or over eager doctor who wants to impress the administration and will report a miscarriage as an abortion. Or have doctors refuse to even admit you because they are scared of being involved and being arrested for conspiracy to commit murder.

7. The underprivileged suffer the most. No doubt that live-births will result from the abortion ban. But this will just perpetuate the cycle of child abandonment, neglect and abuse that are rampant in many parts of the world. Women and children will continue to be stuck in a cycle of poverty and violence. Is this really how we want to bring children into this world?

So. What can we actually do to prevent abortions? I'm especially looking at the people who are firmly anti-abortion and most vocal about it. Because if this topic really means that much to you, I really hope you are doing more than calling those who support a woman's right to choose "murders" on social media. Because let me tell you, shaming women will not reduce the number of abortions. So ask yourself what you truly want. Is it to prevent abortions from happening or is it just to feel morally superior in a hypothetical situation?

What you can do to prevent abortion

1. Actively support policies, organizations and political parties that are geared to women's health. A good place to start would be to support universal health care (I'm looking at you, USA). This may mean *gasp* ditching the political party you've always supported in favour of a party that wants to provide those things. Studies show that countries like Canada that universal health care have lower rates of abortion than the USA.

2. Actively support sexual education and free contraception, especially the birth control pill, which is credited with a huge drop in teenage pregnancy.

3. Actively support improved financial support and parental leave for parents. Don't just focus on mothers either. Give incentives to fathers to take time out of their careers to care for children. Plus if you look at the stats of countries that have strong parental leave, they also have much lower rates of abortion than countries that don't.

3. Help unburden the overburdened foster care system - register to be foster parents. Because these kids are the products of unwanted pregnancies.

4. Actively support policies that make adoption easier - for LGBTQ community, single dads and basically anyone who isn't in a "traditional" family situation adopt. Also, consider adopting yourself.

5. Adopt a single mother - commit to helping a single mother with all the costs involved in delivering and raising a child for 18 years. Giving a bit of money in a church collection every once in a while doesn't count (nor does it do much). Put your money where you mouth is and take on all the costs.

6. Can't "afford" to give your money? Then give your time and volunteer with families that have children with special needs. Step into the shoes of a mother with a child with a severe illness and give her a break. Make it regular and frequent. Show women out there that they will get help and won't left abandoned with a sick baby. There are many organizations that facilitate this.

7. Prove you are really pro-LIFE and not just pro-birth. Because those are two different things. Being pro-life means you believe in improving the lives of everyone already alive as well. So consider how things like education and the state of the environment are affecting life. Here in Poland, our ultra "pro-life" government continues to push the use of coal as our main energy and has led to Poland having the most polluted cities in Europe. A recent report came out to show that almost 50,000 people die prematurely in Poland every YEAR due to air pollution. And that number doesn't include the number of miscarriages due to birth defects in fetuses due to the pollution and toxic effects of inhaling coal dust.

8. Educate yourself on what abortion really is. I think there is a lot of misconception about abortion. Abortion means terminating a pregnancy - this doesn't always involve terminating the fetus. If the fetus would be able to survive outside of the mother, in the vast majority of cases the doctors will deliver the fetus alive and depending on the circumstances, fight to keep it alive or allow a natural death.

Please, before you preach about abortion and murder and how you think these abortion bans are wonderful, consider your agenda. Is your agenda to prevent abortions or is it to feel morally better than those who believe that a woman should have the basic right to control her own body? So, unless you are prepared to do the above list of things that ACTUALLY work to prevent abortion then please stop with the insults and shaming of women. You are not helping your cause and you are actively contributing to more death and misery. Please think about this.




Monday, May 13, 2019

I couldn't think of a title for this post, so I decided to just skip making one. I actually should be studying right now but I just wanted to update on here instead.

I have a biochemistry exam tomorrow that is pretty important. Its almost like a midterm, except the term is over, but I have to pass this exam in order to be allowed to write the final, which is in June.

I'm not that well prepared because I had an optional course that I had to do over the weekend, which greatly cut into my study time and my husband was away over during this time, so when my course was over I had to rush home to take over from my nanny, who kindly agreed to come over. Then today I had class from 8-6PM. I grabbed a ready-to-eat salad at the grocery store on the way home (well, not "home" so much as the apartment in the city my parents have that is currently vacant) and then plan on getting on with it.

Before I realized that I had the course this weekend I had thought I would have all this time to go over some of the material in more depth, but alas its not meant to be. I'll do my best do, and will get cracking as soon as I hit "publish".

Overall though I can't believe I'm just over a month away from finishing my second year. I'll be 1/3 of the way through! I feel like this year just whizzed by. I'm really looking forward to starting third year because FINALLY we'll be starting clinical classes and I can't wait for that.