Putting a pet down and end-of-life care decisions

Two things about this post before I go on:
1) It may be a bit heavy for the holidays, and
2) I promise that the two things in the title are related.

I have 15-year-old Siberian Husky that's had its fair share of health problems: diabetes, cataract surgery, liver cancer, debilitating arthritis...you get the point. She's old. My mom refuses to put her down. Like, we have made appointments with the vet and at the last minute she'll change her mind and not allow us to take the dog.

My dog in old, but better, years.

But the thing is, the dog needs to go and I say this in the most compassionate and sorrowful way I can convey over the internet. She can't stand for more than a minute. She has trouble standing up at all and makes it about 4 steps on average before falling over (not sitting down...I literally mean falling over, often onto her side). We have to hold her up so she can pee and often she soils herself before we can get her outside. In short, it's her time to go. And I wholeheartedly believe that we'd be doing the right thing by putting her down. Mom thinks the opposite and refuses to budge.

How does this relate to medicine and more importantly, human medicine? Well, it seems to me that the feelings toward extending someone's or something's life are reversed here as compared to how these decisions are regularly made.

I have been in healthcare for a while and I've seen relatives insist on keeping their elderly parent alive at all costs even when the patient's quality of life is non-existent. Usually these relatives are detached from direct care of the patient either due to distance or lack of relationship, and simply cannot bear the thought of losing the patient because they "want more time."

Usually this request to keep the patient alive is due to their guilt about not spending enough time with their loved ones in the years leading up to the illness, and thus they feel like they need to extend the parent's life as long as possible to squeeze in the time they've missed.

On the other hand, the caretakers and/or the family members who see the patient on a regular basis watch the suffering and decline of their loved one and thus are better able to come to terms with the end of their parent's life. In fact, in some cases death is seen as a relief and a thing that some people wish upon their loved one simply to end their suffering.

All of this is a gross oversimplification of an abundance of end-of-life issues and this scenario is not always the case, obviously. But if a trend can be attached to this stage of one's life, then this would be it.

However, it seems that the roles are reversed in my family. My mom, who does nearly all of the care-taking, insists on keeping my dog alive until she dies on her own (not happening any time soon, from what I can tell) even if that means she lives a miserable existence until then. On the other hand, my brother and I, who both live several states away and rarely see the dog these days, are completely okay with putting her down.

This does not mean we want to get rid of her by any means. I wish she could live forever, but unfortunately at this point in her life she has absolutely no quality of life, seems to suffer through her days, and gets no joy out of anything that happens around her. In the several weeks I've spent with her between October and today, I haven't seen her wag her tail once or show any interest in the delicious meaty dishes we cook up every day. She used to run/meander to the kitchen from the front yard as recently as June, so this is totally out of character and a good indication of the loss of her personality.

I know that putting a pet down does not compare to saying goodbye to a mother or a father, or any human member of one's family. But this dog situation and the family dynamics surrounding it have got me thinking about the human aspect of these issues.

I am a huge proponent of ceasing medical interventions at the request of the patient at a certain point in their care and letting them die with dignity and on their own terms when it becomes clear that they are terminally ill (which translates to putting a pet down in the animal world). This does not mean I advocate euthanasia but I definitely think hospice has a great role to play in patient care and it needs to be considered as an option more often than it is currently.

This situation has also started a discussion within my family about what we want others to do for us when we reach that point in our lives. That, and writing about it all helps take away some of the anger and helplessness I feel about watching my dog suffer unnecessarily.

Lastly, there are more complicated issues surrounding my mom's resistance to putting my dog down than what I have included here. I don't agree with them, but they exist. Regardless, I don't want this to become a discussion (between my three readers and me) about my mom's decisions or what we should do in this situation. We've discussed it ad nauseum and I really don't want to hear about it anymore.

Other than that, discuss away and happy holidays!

Dirty camping dog, at age 13.

Emergencies on airplanes

I've slowly been writing about my experiences over the summer and the following occurred on one of my flights. This post was originally written in response to a thread about helping in medical emergencies as a doctor and if such interventions make a difference in patient outcomes:

About half an hour into the flight they asked for a doctor, nurse, or anyone with medical experience. A little while later the plane took a hard left to divert for "an unexpected landing" as they called it.

(This was a foreign airline so most announcements were in a language I didn't understand with English translations lasting a fraction of the original announcement. So I only have a bare-bones understanding of what really occurred.)

Either no one was available to help or no one volunteered because the flight attendants were the only ones providing medical care to the passenger. I was asleep and awoke to the sudden turn and "unexpected landing" announcement, which scared the crap out of me because I thought we were going down, until I saw the oxygen tank attached to an unconscious dude being carried down the aisle.

All in all, I don't think a doctor or medical professional would've changed the outcome for the passenger since the guy was hooked up to an AED ("No shock advised" numerous times) and CPR was being performed with an hour still left to our emergency landing (we were over water). At that point, the flight attendants were doing all that could be done with the limited resources found aboard an airplane and more training on their end wouldn't have made a difference.

I'm applying to med school now thus I'm not a doctor but I've been in EMS for 6 years so I'm familiar with emergencies in weird places. I like to think I would've volunteered had I been awake and no one else had been available. But I don't know.

What's worse is that the guy didn't suddenly die. He had some sort of medical emergency that eventually led to cardiac arrest so maybe even my basic assessment could've helped him in some way. And had this happened on land, with the 30 minute lag between the first signs of medical trouble and cardiac arrest, he maybe would've made it.

But since we were airborne, there's really not much anyone could've done in that situation with such few supplies and such a long transit/landing time to higher level care.

In short, a plane over water is most definitely the worst place to have any kind of medical emergency.

Stressing out

I promised myself I wouldn't be one of those neurotic pre-meds during the application cycle but I've turned into an unrecognizable ball of stress. I'm riling myself up to the point of getting sick days before my next interview, and I absolutely NEVER get sick normally. I didn't even fall ill in the days leading up to the MCAT. And I stayed healthy while waiting to get my MCAT scores when I was pretty sure I had scored sub-30, which would have been the death of my chances to get into medical school this cycle.

Not hearing back from my dream school when I know a good chunk of others have already gotten in is the source of most of this stress. I know they will continue reviewing my file until March but if they didn't love me this time, what's going to change between now and then? I have nothing more to give.

It also doesn't help that at this point I thoroughly believe I bombed the interview. Every time I go over the answers I gave, the worse they seem to be. Or at least only the low points stick out in my mind right now. Maybe I should've smiled more throughout the day (I remember being exhausted), or channeled my enthusiasm towards "Why medicine?" instead of only perking up at the mention of broomball (and the prospect of an ethics question...I did get visibly excited when that came up). Or perhaps I should not have challenged my interviewer with an emphatic, "I know." But I really did know, and it seemed like the appropriate response at the time.

I like to worry and work myself up about things. Take this and this and this and this as examples, and I can provide many more. I used to be really good about letting things go but I feel like my admission into this school is still somewhat within my control. And that's why I just can't ignore the silence and simply wait for some form of communication from them. I feel like I need to DO something.

In addition to all that, not only do I REALLY want to get into this school, but it's also the only one at which I have a decent chance of getting into. I've only received two interview offers total this application season (thus far, of course, but it doesn't look like any more are coming along) and the other school is very hard to get into as an out-of-state applicant. So if I can't get into my local school, who else is going to take me? The thought of going through this again is absolutely sickening.

Honestly, I don't know what the point of this post is, besides maybe to vent. But writing this all out has helped me realize that I really need to chill out and enjoy this year off, because it'll be a while until I have this much free time again.

And in that respect, I really have taken preventative measures to minimize thinking about this process. I've blocked the friends who are also applying this cycle from my Facebook feed, I've cut myself off from SDN (again), and I've told my family not to mention medical school applications to me even just to inquire about how it's going. I'll update them if/when something changes.

The final step is finding a new hobby that will take an inordinate amount of time and has nothing to do with medicine whatsoever. Underwater basket-weaving, perhaps?

No news and interviews

Birthday week has come and gone and still no news. I'm sure you figured that out from my silence because I would've announced an admission to the world. I guess that post will have to wait for another day.

That's not to say I have an admissions post written by any means. I am not that ahead of myself. Right now I'm brainstorming a letter of intent to my dream school in case it comes to that.

Speaking of the dream school, I'm pretty sure the admissions committee met sometime last week because my status on their website changed during that time instead of directly after my interview like it normally does. I'm still not too concerned because few people get in during the first post-interview committee meeting or even the second, with most people hearing back in late February/early March. I really don't care when I hear back from them, although the sooner the better. I just hope I get in at some point this cycle.

Anywhos, for now I need to focus on my upcoming interview and get prepped for it like I was for the last one. I will let you know in vague detail how that one went when I get back from it.

Birthday week news?

I have this weird feeling (or is it a hope?) that I will get tremendously awesome news on my birthday this week. It's happened before with a job offer so I'm not completely going crazy, I swear.

The admissions committee for the school I interviewed with last month supposedly meets sometime in the next couple of days and not only do they email acceptances but the dean of admissions also calls each accepted student.

So my secret hope is that he realizes it's my birthday this week and waits to call me with great news on that particular day.

One can dream, right?

Interview recap

My first interview was a couple of weeks ago and it was absolutely exhausting. I think most of that exhaustion stemmed from having to get up at 5:30 am to get to the interview site on time, but being "on" for whole hours on end drained me.

The day consisted of an introduction in the morning by the charismatic dean of admissions followed by two 30-minute interviews. With my group assignment, I had half an hour before my interviews began to hang out and talk with everyone else in my group and we were a pretty jovial bunch. We stayed away from the "How many interview invitations have you gotten?" questions and instead talked about where we were from and what we were doing in life.

Since this school is very non-traditional student friendly, the stories of my fellow interviewees were interesting and engaging so time flew. Next thing I knew I was headed to my first interview.

My first interrogator was a surgeon (Dr. S) who was in private practice and was not affiliated with the medical school at all. Her style of questioning was more conversational and she seemed to honestly want to understand my thought-process and decision-making regarding choosing medicine as a career, especially after giving up on it in undergrad. She asked questions very specific to my application and only threw in one ethical question that was super easy and had an obvious correct answer.

The interview was also being "observed" by a second year medical student (Mr. M), and I put that word in quotations because he did ask me a few questions instead of just seeing how to conduct an interview.

At the end of my interview, I struggled to find questions to ask Dr. S because she had nothing to do with the school. Eventually I figured out that she had done her residency here and so I asked what had brought her out here. That's all I had for her and then I turned my attention to Mr. M who was very helpful in explaining his opinions regarding the unique curriculum. I hope not having anything for Dr. S isn't going to hurt me too badly but I really couldn't come up with anything.

Overall, I think I did well enough. I definitely didn't knock it out of the park because I could've answered some questions better, either stated things more concisely or made my point clearer. But I also didn't do poorly so really I have no idea how to grade myself. I found Mr. M much easier to read with regards to how I was doing than Dr. S but since I don't think his opinion carries any weight I'm in limbo about this one.

My second interview was with a different M2 (Ms. T) and it had the standard, "What are you strengths and weaknesses?" questions. Essentially the whole thing was like that. There was one mention of something on my application but the rest of the questions were incredibly general, especially "Tell me about your clinical experiences." What about them? Can you be a bit more specific? Haven't you read my application?

In the end, I was able to emphasize the one point I wish I'd done better on in the first interview so hopefully that'll help. I think my answers were sufficient but definitely not ones Ms. T would mention as memorable.

And by that I mean, I don't think either interviewer will say that they really enjoyed talking with me. That doesn't mean the conversation wasn't enjoyable because it was, especially with the first one, but I don't think it stuck out to them as awesome. There were a couple times in the first interview when I felt Dr. S wanted to call me out on my bullsh-t but thought better of it (for example, she thought I had no idea what I was talking about, which I did but whatever). Or that could just be my insecurities rearing their ugly heads.

Anywhos, I handed each interviewer an update letter to take to the admissions committee that discussed my recent research accomplishments (poster presentation at a major conference in my field and submission of a paper for publication) and wished them a good day.

The rest of the day included a lunch with current medical students, more presentations, a tour of the campus, and a Q&A with even more medical students. No one really had any questions for them because we were completely drained, and also because the presentations and other opportunities to speak with students had answered all of our questions.

Honestly, after my interviews I just wanted to go home. This is my local medical school and I've heard their spiel many times before. It's my absolute top choice and if I get in then I am definitely going here. No doubts. So the rest of the day seemed almost like a waste of time to me mostly because I was tired and wanted to go home, but I had to put on my happy face and look excited.

Overall, I have no idea what my chances are at this school right now. The dean of admissions said that those invited for interviews have a 2 to 1 chance of getting in, so I like my odds. Also, if you assume they offer 2 spots for every 1 in-state person that matriculates, then my chances go up to > 75%. I like those odds.

The school is pretty quick about sending out acceptances post-interview if they really like you so I guess I'll know soon enough. But plenty of people don't get in until mid-March, meaning this application process could just drag on forever.

If I don't hear back by early January, I will send a letter of intent that further elaborates on my strengths, my commitment to medicine, as well as my huge desire to go there. So there are options.

I plan on fighting for this school with all my might.

Another interview invitation

As I was powering off my phone on the airplane to fly to Mexico last week, I noticed an email from an admissions office inviting me to interview*. In the text of the email it said I had seven days from the date of the invitation to schedule said interview, which wouldn't exactly work since I'd still be out of the country.

I called the admissions office as the plane doors were closing hoping to be able to do it quickly right then, but the lady who schedules the interview was at lunch. They asked if I could call back in an hour. Umm, what part of "The plane doors are closing and can't you hear the flight attendant in the background", do you not understand?

Anywhos, I wasn't able to book the interview before we took off and they said they don't book them over email (I tried), which led to me using Skype over our very shaky internet connection. Lots of, "Can you please repeat that?" and "I'm sorry, I didn't quite hear you" comments later, I was booked for an interview in a couple of weeks.

I won't be able to attend the first date they offered (early next week) because I'll be at a conference presenting a poster, so instead I'm scheduled for one that is 10 calendar days and 5 interview dates later. Not ideal, but that's just the way it worked out.

I also emailed other schools in the pseudo-area telling them I'll be there during that time and that if they were to offer me an interview I'd appreciate it if it could be while I'm around. So far I haven't heard anything, but then again it's technically only been two business days since they got that email. I'll give them another one and if I don't hear back by tomorrow I'll book the flights for just this interview.

Lastly, I will post an interview recap of my dream school interview from last week in the coming days. In short, I don't think I killed it but I didn't do badly either, so I don't know how that'll affect my chances of acceptance. We'll find out soon enough since the admissions committee meets at the end of this week and/or beginning of next week.

In the end, everything worked out wonderfully with scheduling my first interview as well as being able to enjoy my vacation. All in all, I got to have my cake and eat it too. Now if I could get an acceptance on my birthday next week, that'd just be the icing on that most delicious cake.

---
*This is at the school that just recently marked me as "Complete" after sitting on my application for three months, and then invited me for an interview not even a week after that. Black Magic, I tell you. Or different schools have different versions of what it means to be complete. Whichever.

Black Magic

That's how I believe medical school admissions operate.

Today I got an email stating that I was finally complete at a school whose secondary I submitted in mid-August. My letters of recommendation were ready before I even submitted that so I have no idea why it took them this long to mark me "Complete".

It's not like this is Jefferson or Boston University that each get 10,000 applications a year. WTF.

Reality check

My mock interview with the Pre-Health Office went very well on Tuesday. I don't know why, but when I talk with medical people my answers get twice as long. With Career Services, I was able to communicate my path to applying to medical school in 4 minutes, while in both Pre-Health interviews it was on the order of 10 minutes. No bueno. I need to stop rambling!

Other than that, the practice interview wasn't nearly as dreadful as I had anticipated. I know what to work on and how to improve my answers and disposition so rocking the real interview is entirely doable. And the adviser assured me that it's completely normal to be rejected from the schools that I've been rejected from.

So far, I've been rejected from mostly reach schools, ones I have very little chance of getting into based on my overall GPA or my out-of-state status. So it makes sense and I shouldn't stress out too much about it.

If all else fails, she gave me pointers on what I should do to improve my application for next year in case I have to reapply. I can't really improve my GPA or MCAT any more than I already have so the next step would be getting more recent clinical experience in the form of a clinical research position.

I'm hoping I get into the school I'm interviewing with next weekend (it's my state school and I have the best chance to get in there) so I don't have to worry about balancing my current job with a clinical research position an hour away from where I live. Also, I REALLY don't want to have to rewrite all my essays for another application cycle.

Practice interviews and more news

My first medical school interview is in a week and a half and to prepare I've been taking advantage of the practice interviews offered on the campus at which I did my post-baccalaureate studies.

Last week I did a mock interview at Career Services, which was helpful in answering general questions such as the loaded "Tell me about yourself" or "Describe a time when you have failed." It was nice to hear how to structure my answers and also to see how I come off to someone who doesn't know me. It's crazy how much the interviewer could deduce about me just from a general description I gave of myself.

Tomorrow I have another mock interview, this time with the pre-health office and I'm looking forward to it but I'm also a little terrified. I've never seen this adviser before so I don't know if she'll be like the one who crushes my dreams or the nice one who's always excited to see how I'm doing. I've heard she's pretty hard during interviews, which is honestly what I need to prepare for the real thing.

On the other hand, I'm looking forward to practicing medical school specific questions such as ones dealing with ethics and the healthcare overhaul. I don't like answering those sorts of scenarios because I'm pretty middle of the road and I don't feel like it gives the interviewer a good opportunity to get to know me. But there's a good chance these will come up so I'd like some feedback on my answers.

All in all, I'm not too stressed out about this interview thing. I feel like I know myself and my reasons for pursuing this path well enough to speak about them with confidence. And as long as I can communicate those things effectively, I think I will be just fine. At least that's what I keep telling myself every time I think how important this interview is for my future. Because when I focus on that, I start to freak out a little.

On the responses from medical schools front, I got two more rejections (one pre-secondary and one post-secondary) on the same day that I passed the initial screening at another school bringing me one step closer to getting an interview invitation there. I honestly don't know how many people are in this "small pool" and how rigorous the screening for it was, but a significant amount of people have been rejected before reaching this pool so it must be something.

I'm not reading too much into these things because there is no way of knowing how each school does their admissions. And I can't control getting an interview invitation at this point. It's completely out of my hands now.

In short, I need to focus on rocking this interview and enjoying the freedom of having too much time on my hands.

This does not bode well for a career in medicine

I recently began refereeing rugby because I know my days as a player are limited and I need another way to stay involved in the sport.

Yesterday, I helped with an all-day tournament during which I refereed 14 games of 14 minutes each (7s, for those who know rugby). I left home before sunrise and got back well after sunset. By the last game of the tournament, my back hurt, my legs were sore, and I was in a generally foul mood.

It was simply exhausting, and a day later I'm still feeling the effects. I dragged myself out of bed this morning at 10 am just so I could fall asleep tonight. I spent the rest of the day in the hammock reading and now I'm waiting for it to get late enough so that it's acceptable to go to bed.

I don't remember tiring so easily last year when I had so much on my plate. I got a lot more accomplished with a lot less sleep and rest. So I'm hoping this is just the vacation version of me being mad that it had to do something, and now needing some time to recuperate.

Because if spending an entire day on my feet wipes me out for the entire next day, I am so screwed in medicine.

First interview invitation

I just got an email inviting me to interview at my DREAM school!!! There are so many good things about this (one of which is that all of my letters of recommendation are positive...what a relief!). But there is also one bad thing about it: the date they assigned me is the Saturday before Thanksgiving.

I don't think I have any vacation plans for the week of Thanksgiving, which is different from other years when we've gone on vacation to Mexico with the family since we don't celebrate Turkey Day. Regardless, I would like to keep the option of going somewhere fairly open and not being able to leave until Sunday would put a damper on those plans. On the other hand, it'll be nice to have the distraction of a vacation right after interviewing at my dream school.

Like I've stated numerous times before, I cannot make decisions for myself, which is why this is a real dilemma for me.

Other than that, happy days!

It's the little things in life

I was in a funk yesterday because I got another medical school rejection and now I'm a little paranoid that one of my letters of recommendation will indeed bury my application. On the other hand, the latest rejection was from a school that required family connections to the region, which I didn't realize until after I submitted my secondary so it's not exactly surprising after-all. But it still stings.

Regardless, I was in a funk and on the way back from my volunteering gig at the hospital I stopped by Target to see if they had heat blankets in stock yet. We were due for a dusting of snow this weekend and our house doesn't have insulation, so it's often unbearably cold. And I really wasn't looking forward to shivering all evening.

Shamelessly stolen photo from a friend's Facebook from this morning.
It had all melted by the time I woke up (at noon).

Well, I couldn't find any heat blankets, but when I asked one of the Target ladies if they had them she said they're back in storage waiting to be put on display. She then offered to look to see if one was easily accessible to pull out for me and came back with one in a color that I actually approved of. My frown suddenly turned into a huge smile. I wish she knew just how much she had made my day.

So I went home, plopped on the couch with my tea and new heat blanket, and spent the evening doing logic puzzles. Suddenly, all was well with the world.

As cliche as it may sound, good customer service can really brighten somebody's day. I didn't believe it until something as simple as finding a heat blanket turned the entire day around for me.

First rejection

It came in the form of a slim white envelope and was from a school that had yet to send me a secondary. Without even opening the letter I knew I was being rejected.

But it was my reaction to their decision that surprised me: I was completely at peace with this result. It was a top 10 school and while my MCAT was in line with their median, my GPA was woefully low (as it is for 95% of the schools I'm applying to...stupid undergrad!). All in all, my chances were really slim anyways and I wasn't really set on going there, so I guess I wasn't too invested in the result. That, and not even being offered a secondary didn't bode well for me and kind of set me up to expect rejection.

On the other hand, when I dreamt about being rejected from my in-state/DREAM school before even being offered an interview, I kinda sorta panicked when I finally woke up. I really hope I at least get a shot at interviewing, because I'm amazing at interviews.

All in all, I'm slowly starting to freak out a bit about this application process. Quotes like these from SDN don't help:

It sent a pretty strong message to the students to apply early (and also let them know what "early" meant -- basically be "complete" by the end of August and you're good as there is no difference in chances b/w June, July and August, but if you wait 'til September, your chances are basically cut down by like 1/3 and then another 1/3 by October with just a couple percent chance if you're complete in November and no chance after that).

That's because I wasn't "complete" at most schools until early to mid September and I need all the help I can get. I know I should've slacked a little bit less but I'm terrible when there aren't any hard deadlines and that's the best I could do.

So yes, I know it's early in the application season and I know people who apply when I've applied still get into medical school, but I'm not a regular applicant and it scares me that my procrastination will result in me having to reapply. And if I do have to reapply, the only thing I can really do to significantly improve my application is submit it earlier. That's not a convincing application argument.

Ay ay ay!

That God-awful MCAT

Note: This is the first in a series of posts rehashing the beginning of my summer.

My MCAT was finally scheduled for May 19th at 8 AM and since it was about an hour away from my house, I stayed at a friend's place closer to the test site.

I'm a night owl and rarely fall asleep before 2 AM so although I'd been trying to get myself to wake up early in the mornings leading up to the MCAT, I just couldn't do it and thus got only about 3 hours of sleep before the test. I'm used to doing important things on little sleep so I wasn't too worried about it, but I think it may have influenced how my day was going to go.

Long story short, I thought I bombed it. As I walked out of the exam room I began praying for a 30, which is a far cry from the 33-36 I was expecting based on my practice scores. I had mistimed the Physical Sciences section so I was rushed towards the end and Biological Sciences just kicked my butt and bruised my ego.

Here's an excerpt about the BS section from an unpublished post I wrote the next day titled "Picking up the pieces":

Biological Sciences - Oh boy. This section reduced me to a pile of tears. Well, not during the exam, but immediately after. There were a couple of ridiculously hard sections that I just couldn't comprehend. I read them over and over again and I wasn't getting anything out of them. I don't think more time would've helped either. The worst part was that all the questions relied entirely on info from the passage and so I couldn't even reason my way through it with my background knowledge. More than a few discretes had me scratching my head and essentially guessing randomly, and that hasn't happened on any of my practice tests. It's very disconcerting.

A note about my feelings, also from that unpublished post:

I walked out of that exam honestly in tears. I am not much of a crier so this had clearly been a kick to the balls. I felt like all the hard work I had put into studying for this had been for naught and I had just killed any chance I have of getting into medical school this cycle. But at the same time, I don't think any more studying would've helped much. I may've gotten a couple more discretes correct in the Biological Sciences (BS) but I still would've been killed by two of those passages.

And my thoughts about voiding the results, again from that post:

If I hadn't been leaving the country on Tuesday [three days after the MCAT], I would've totally voided the exam and tried again in a month. Although, I don't think I had another month of studying left in me. I was pretty done by the end of it, so maybe that wouldn't have made a difference either.

On the bright side of things, two out of the four people taking the exam had massive computer failures in that their screens froze for over an hour. Maybe it's because I had people praying for me on two continents, but luckily that didn't happen to me. I don't know how I would've handled that, but I'm sure it wouldn't have been pretty.

Anywhos, I gave myself one day to mope and feel sorry about the whole situation, and mope I did. I held back tears at the baby shower I went to after the test and couldn't speak about the exam without welling up. It was BAD.

I had organized a paintballing excursion for the next day, which was great planning since it totally got my mind off everything. And then I started packing for my Asian adventure that I was leaving for three days after my MCAT. Again, good way to take my mind off things.

Paintball: The perfect post-MCAT stress relief.

The issues, emotions, and events that occurred during my international medical relief mission with the U.S. Navy were enough to keep me even more distracted while waiting for my score to come in (that's a post for another day). So all in all I really only suffered from this experience for about 24 hours.

But I am so glad I never have to go through that again because it's a complete mind-*&^#. Well, that is, until Step 1 rolls around in 3 years.

And now onto the score I received on the day I set foot in the United States again, which I checked at the tail end of a 48 hour journey home that included lost passport scares (plural), a death on an airplane, and a subsequent rescheduled flight. All in all, not ideal circumstances to deal with the feelings of getting my MCAT score back. But again, that's a post for another day.

Without further ado, ta da!

Click to enlarge.

Apparently I do really well when I'm not firing on all cylinders.

P.S. In my original unpublished (for a reason) mopy post, I did a breakdown of each section of the MCAT. Here is what I had to say about the writing part. Pop culture for the win!

Writing Section (?) - I don't even know what this section is officially called, so that shows you how much I prepared for it before the real thing. It was pretty straight-forward and kind of fun, actually. I channeled a bit of Jon Stewart in that I used a Nazi example for one of my responses. I was laughing on the inside the whole time.

Quasi done-zo

I've finished up my secondary applications* (finally!) except for a few that I'm only doing to appease my mother, most of which I have absolutely no chance of being admitted to. Turning them in this late doesn't help in that respect but I told her I'd apply so I have to get them done eventually. And I don't particularly want to attend these schools in the first place so that's another reason not to get too worked up about most definitely being rejected without even an interview.**

Anywhos, remember my confidence about getting admitted this year? That's all about gone at this point because of the tardiness at being "complete" at all my schools.***

I'm actually starting to freak out a bit about possibly not getting in because so many people already have interview invites and/or have attended interviews and all I have is one measly email saying I've been moved to a "pool of applicants who potentially will be invited to interview with us."

That's not very hope-inducing but it does mean that the letter of recommendation I was worried about turned out to be pretty spectacular. It was either going to sink my application or make it (no in betweens) and I'm glad that it was the latter.

I don't know how I would've answered "How have you improved your application since the last time you submitted?" if I had to reapply. Umm...not piss off my letter-writer within a week of asking him to write it? I don't think that explanation would fly.

Also, pardon all the stars here but I'm using this post as a not-very-well-organized explanation of the medical school application process to people not familiar with it.

Lastly, here's the most recent Facebook meme I found hilarious:

If T. Rex had just one wish, he'd wish he could cuddle.

(Full disclosure: It's not the most recent, but the cleanest. I have one up my sleeve that's not exactly politically correct. I'll save it for when I'm feeling particularly feisty.)

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*For the non-medical school folk, after submitting the primary application that consists of a personal statement and description of extracurricular activities to the medical school application black hole, each school you have applied to can choose to send you a secondary/supplemental application that requires paying another fee but also often requires writing essays about greatest challenges, moral and ethical dilemmas, or your prized possessions. This has been the greatest hang-up for me because I absolutely hate formal writing that needs to put me in the best possible light.

**If schools really like you, they invite you for an interview. You can't get in without one. The earlier you get your application in, the better your chances of being asked to interview. And the earlier your interview, the more likely you'll be admitted (at most schools, at least).

***Being "complete" means having your MCAT scores and secondary/supplemental application submitted, paying the application fee for that specific school, and having all your letters of recommendation ready.

Existential crisis

One of my secondary applications asks, "If you couldn’t be a health professional, what occupation would you choose?" Simple enough, right? Wrong!

It derailed my entire afternoon.

I got to thinking about all the other careers I thought would be fun and cool and how medicine sucks the life out of you with its years of training and stress. And although I could do a lot with an MD even if I didn't end up working in a hospital or similar capacity, I couldn't figure out if the whole MD thing was worth it.

Then I stepped away from the romanticized view of my life, thought about it logically, and looked for themes within all these jobs.

Here's the deal. I love working with people. I love science. I love working within a group. And I love doing something that improves someone else's life. The problem with these criteria is that they can be applied to jobs that have nothing to do with medicine. And that's where the existential crisis comes into play.

But when I really think about it and stop considering escapist thoughts, medicine fits quite well with everything. No matter what job I decide to pursue, I will be busting my butt for the next 10+ years if I want the level of success I hope for. So I may as well be doing something I've been dreaming about since high school, the only thing that truly fulfills me, and stop being a wuss about making a commitment. Because ultimately that is what is causing all this fear.

And here's another question from this application that I just can't figure out an answer to: "What is your most prized possession?"

I can write a killer essay about moral dilemmas, being humbled, or overcoming a challenge, but for the life of me I just cannot think of a prized possession. Honestly, if my house was burning down, there is nothing I would run inside to rescue. Can I just say that I'm a minimalist?

And on a completely unrelated note, late late Monday night I was sitting on the couch watching "The Big Bang Theory" when I heard what sounded like a rabid dog attacking something that squeeled very loudly just outside my window. A normal person would go outside to chase it away. I ran upstairs and climbed into my roommate's bed. Yup, I'm fearless.

It turns out a mountain lion had eaten a neighborhood cat and was killed two blocks away by the animal control people because it had no fear of humans. So maybe it's a good thing I have an irrational fear of wildlife.

Fire under my butt

I've been sitting on my secondary applications much longer than I care to admit and I have finally found the urgency to get them done. I didn't realize just how long I'd been putting them off until I realized that it's almost September. Yikes!

So I've given myself a deadline of Thursday to get them all submitted. That puts me well beyond the arbitrary two weeks that people suggest but before the "late" crowd, so I've been told. Regardless, there is no way I can get them done any faster at this point (I'm already struggling with writing this much) so there's really no need to stress any more than I already am.

Regret seems to be my modus operandi and the way I choose to live my life, so I guess I shouldn't be too surprised that that feeling is becoming a major theme in this application cycle. Mostly it's regret at taking so long to fill things out that actually don't take that much time. But a lot of the regret stems from my college years o' fun, which I don't regret at the same time, so I kind of feel like I break even.

Anywhos, on a brighter and more analytical note, I did submit my secondary a couple of weeks ago to the one school I REALLY want to get into. So that one was relatively on time. The main reason why I haven't been quick about the rest of these is because I honestly don't care where I end up, short of the #1 school. So if I don't get into some school because I submitted my secondary 10 days later* than I had originally planned, I won't be too torn up about it since it didn't really have that soft spot in my heart.

Maybe I need to stop being so cocky about this whole application process. I don't know for sure that I'll be getting in anywhere so I should be maximizing my chances at each of the schools to which I'm applying. But for some reason I'm lacking in the motivation department. A rejection or two from a "safety" school would probably help with that, but I don't really want to wish that upon myself just to make me more efficient.

---
*Another coping mechanism I'm using is that my committee letter wasn't ready until August 17th, so even if I had submitted secondaries prior to that, my application wouldn't have been considered until then. So I'm really only about 10 days behind at this point, which in the grand scheme of things isn't that bad.

If you can't tell, I can make myself feel better about these types of things by convincing myself it had to be that way. It's a pretty effective coping mechanism.

What I'm currently thinking about

With my primary application being verified any day now resulting in a flood of secondaries I have yet to even begin, I should be focusing on getting into a writing mode to churn these babies out. I should be worried about the length of time it'll take my pre-med committee to send in my committee letter to the medical schools so I can finally be considered for interviews. And I should be bummed that I am no longer "early" in the application process, and thus my chances of acceptance are a bit lower than I would like them to be.

Instead, I'm stressing over where the creator and writer of my new favorite TV show "White Collar" are taking the series and whether it'll be around for a few more seasons because it is just plain AWESOME. I can't wait for August 14th not because I will be that much closer to having a complete application at the medical schools to which I'm applying, but because that's when the next episode of "White Collar" will air.

Priorities, right?

P.S. "White Collar" is an amazing TV show about a con man who now works for the FBI agent who caught him. It basically picks up where the movie "Catch Me If You Can" (with Leonardo DiCaprio and Tom Hanks) left off and runs with it. The con man and FBI agent have amazing chemistry, there are plenty of hilarious one-liners, and it's just very smartly written. The main character is ridiculously pretty (Matt Bomer from "Magic Mike" plays the con man) and the story lines are engaging. In short, it's a winning show and you should definitely start watching it.

Just start with the pilot and you'll be hooked.

Back to work and nothing to do

Today was the first day of work after a 2-month vacation. You read that correctly. With the exception of the week it took me to finish my medical school application, I haven't done anything productive in 2 whole months. It was glorious.

So now it's back to the grind, except it's not really a grind at all. I didn't put in my "I want to work more hours" notice early enough so I have another month of 10 hours/week employment until it really picks up in September. (I had gone down to those hours this spring semester because I just couldn't hack my schedule of classes + MCAT + medical school applicating + volunteering + shadowing + work.)

Without half of those obligations, I have absolutely no idea what to do with myself. Even if I go back up to 40 hours at work, I'm still not going to know what to do. There are just way too many hours in the day right now.

Any suggestions for what to do with my time? Take up underwater basket-weaving, maybe?

P.S. Because I actually have to be productive now, I will need to procrastinate as well hence this blog post. As a result, you can expect some catch-up posts to fill in the bullet point summary of my goings on.

World Cup words of inspiration

When I get overwhelmed about the mountain I have to climb to get accepted to medical school (my undergrad grades are shite), I find articles like this inspiring. This is the Italian soccer coach talking about playing Germany, addressing the fact that everyone has pegged Germany to win.

When the Coach was reminded that Germany are younger, unbeaten in 15, score more goals, had two further days to rest and are the tournament favourites, he joked with the journalist asking the question.

“So we should just go home now, then? No, it just means that playing this game will be even more intriguing than it already would be."

“At this moment we are very relaxed and want to put into practice everything we’ve done so far. I think difficulties make challenges more fascinating.”

"Prandelli revealed he had taken a nap before the England game, showing how calm he was going into that quarter-final."

“I must confess I had a bit of a half-hour today, though I’m a little ashamed to admit it. When I close my eyes and dream, I dream fantastic things. I hope to dream of a magical and marvellous night."

The last month in a nutshell

I bet you're wondering about what's been going on in my life the last month or so. Well, a lot.

Here's a bullet-point list of my goings on since then.

• May 19 Morning - Took my MCAT.
• May 19 Afternoon - Hit up a baby shower and moped.
• May 19 Evening - Moped some more while getting my butt kicked at nerdy board games.
• May 20 - Tried to pick up the pieces after a disastrous MCAT experience.
• May 21 - Met with my boss to get a letter of recommendation, got a haircut, and got a professional-looking portrait done for applications.
• May 22 Ass-Crack of Dawn - Began a series of flights to Guam.
• May 23 Evening - Boarded the USNS Mercy at U.S. Navy base in Guam.
• May 24 - June 18 - Hung out aboard the USNS Mercy.
• June 3 - 9 - Camped out in an Indonesian village of <1000 inhabitants providing basic medical care as part of a humanitarian mission with the U.S. Navy.
• June 19 Morning - Boarded first of many planes to get home from a tiny town in the Philippines.
• June 19 Evening - Took an unexpected visit to a small island due to a very serious medical emergency aboard our flight.
• June 19 Morning - Found out my MCAT score at the Honolulu airport. Massive sense of relief followed.
• June 19 Evening - Finally arrived home after visits to way too many airports for my liking.
• June 19 - Present - I've done absolutely nothing during this time.

The problem with that last point is that I need to get my medical school application submitted ASAP, but I'm having trouble finding the motivation to do it by some imaginary deadline. I'm a major procrastinator and have found that rolling deadlines are my Achilles' heel. Well, one of my Achilles' heels, at least.

I will go into much more detail about the happenings of the last month in the coming weeks, but for now I wanted to provide a quick summary as another way of putting off working on my personal statement.

Last preparations before the MCAT

This stupid MCAT is happening on Saturday (in two days) and I have mixed feelings about my preparedness. I had tried studying yesterday and did a practice Verbal Reasoning test after a leisurely morning. But I gave up on all of it after I got 80% of the questions wrong. I'm not joking. It was bad.

I got a bit depressed after that, thinking that I'd passed my peak and that I'd be screwed for the real thing. Maybe I should've taken it last weekend like I had originally planned. Maybe I shouldn't have left most of the studying for the week before the exam, and spread it out instead. So many maybes.

In true college fashion, I grabbed a beer to ease the pain of failure and decided to get some real work done. You know, the kind I get paid to do. It's overrated, I tell you!

Anywhos, one beer turned into two and my work turned into the 2-hour season finale of "Criminal Minds", followed by Tuesday night's 2-hour "NCIS: LA" season finale. Some sushi rice and many beers later, it was time to go to bed because after-all, I had an important test to take soon.

I woke up at 7 am this morning (on my own, might I add) bright-eyed and bushy-tailed, ready to take on the world. I sat down for that last practice test, praying that the verbal would go better than yesterday and hoping that I hadn't forgotten too much basic science after cramming minutiae into my brain for finals last week.

And this was my score:

To say I was surprised by this result is a gross understatement. It's the highest score I've received on any of the practice tests and a welcome surprise. Hopefully the real thing goes just as well.

Moral of the story: To get a good score, take 7 beers to the face the night before an 8 AM MCAT.

Glass half full?

Five years after I graduated from my first undergrad, I've completed my second undergrad in the form of post-baccalaureate classes for pre-med requirements. For the last two semesters, I've second-guessed my choice to take classes beyond those required by medical schools. And in the fall, I really questioned the decision to blow a grand on an EMT class that I didn't think I would ever need or use again.

But now that it's all over, I'm really happy with the way I went about fulfilling my requirements. Good things have come out of all this. Or maybe I've turned into an optimist in my old age choosing to find the positive in everything.

Regardless, I'm feeling very content with my life and my decisions. The extra classes have helped with my MCAT studying and are supposedly useful for at least some parts of medical school. And I definitely wouldn't be going on my awesome international Navy adventure without the EMT course.

So all in all, this wasn't in vain.

And since I need to brag to someone about this and neither Facebook nor SDN are appropriate places, here is what I have to show for my blood, sweat, and tears:

Choosing medical schools

It's that time when I need to decide to which schools I'm applying. With over 100 to choose from, this decision is kind of a big deal. And since my overall stats are not competitive at 75% of the medical schools in the U.S. due to having way too much fun in undergrad, I can't just pull out the MSAR (an awesome resource with admissions statistics for all the medical schools) and see where I stand. It's a bit more complicated than that. And I'm really bad at making decisions for myself.

So I went to see the pre-med advisor for some guidance. Out of the three available in the office, I met with the one (Ms. D) who is great at crushing my dreams. That may be a bit harsh, but I always feel a little more hopeless after meeting with her. This is compared to the "I'm awesome!" feeling I get from the other advisor (Ms. E), who just happened to be one of my committee letter interviewers. Boy, I lucked out with that one!

Anywhos, Ms. D gave me a list of schools at which I might be a good fit, and also gave me a lot to think about. I've been pretty dead-set on the local med school and if you had asked me yesterday how I would feel if I didn't get in there, I'd probably tell you I'd cry. And I'm not a crying type of person. At all.

Everything about the local medical school (LMS) is right up my alley. It's got great weather, the student body is very laid back, there is an atmosphere of making others look good instead of gruesome competition, and it loves non-traditional students. That, and I have a good life here that I'm just not ready to leave. The chances of someone in my position being accepted are ~20%. It was (and still is) my *DREAM* school and I was pretty certain that I'd get in there. And then I met with my advisor.

With Ms. D's not-so-enthusiastic opinion on my chances of getting in, I began to reconsider my options and also stopped thinking of LMS as my be all end all. The way she went about suggesting medical schools for me made me start looking at schools in a different light, one in which I could present a case of what I could offer them instead of what they could do for me.

I don't know why it took a pre-med meeting to see things that way, because I've been in the real world long enough to realize that that's how things work in life, and have tailored my applications and approaches at meetings to reflect such a position. In fact, it's probably the major reason I got the Navy gig I'm leaving for in 10 days. I know to emphasize the right things to get what I want, and so far I've been rather successful at that.

But after reading numerous threads on SDN (now I see where I went wrong), I've become more self-centered to the point of thinking that I am God's gift to medical school. Well, maybe not quite that good but good enough that my concern with fit is the only one that matters. Trying to find a school that matched my experience became a search for a city in which I could be happy living, instead of focusing on where my experience went along with the type of student the admissions committee was looking for.

I don't believe too much in "fit" in the traditional sense. For me, a good fit would be a school located somewhere with enough sunshine to prevent me from staying in bed most of the year and also with a cooperative and generally not-so-intense student body. My only pseudo-requirement for curriculum is that there is a block system, but even that is negotiable. It would be nice to have some patient contact early in the non-clinical years, but even if it's not an official part of the curriculum, I'll be able to find it on my own.

So really, I'm not that picky. Research, primary care focus, PBL v. lecture preferences really don't concern me. I can adapt to all that and get whatever I desire out of med school. Now you see where the SDN cockiness and ignorance has reared its ugly head.

But Ms. D made me realize that I have had it all wrong. A good fit for a med school is not limited to where I could see myself living for 4 years, but more importantly, a place where my past experiences and activities go along with the mission of the school and the type of doctors it is hoping to shape.

Yes, I can be research-focused at a primary care oriented school, or get enough clinical experience at a huge research institution. But, that's not how the admissions committees see things. And that's not how I should see things, either. I can adapt, but I shouldn't have to.

There is enough variety in the nation's medical schools to find one that is in line with my past experiences and interests and also is in a city that has sun, water, and laid back people. Those things are not mutually exclusive. I just need to do a little more digging to find them.

P.S. Two posts in one week? Clearly I don't want to do what I should be doing. But don't get used to it. :)

Resentment

These last few weeks have been rough, school- and stress-wise. I have a lot to do and my future is riding on how I perform on these finals and the MCAT. As such, I've been physically and mentally holed up in my room or in the office trying to be productive so I can be awesome, while everyone around me seemingly doesn't have a care in the world.

Take Cinco de Mayo, for example. I had a biochemistry final at 7:30pm that night, so I was trying to cram in the last details of random mechanisms and regulatory pathways before the exam.

What were my neighbors doing?

This:

That is indeed a living room in the yard, complete with a showing of "Robin Hood: Men in Tights" on one TV and a Super Nintendo console with Super Mario on the other.

I, too, am in this photo taking a study break, but I just couldn't bring myself to enjoy the "holiday" as it should be celebrated. It's hard to have that kind of fun with an exam looming over my head in a couple of hours.

(Side note: What is it with finals/exams on major rugby holidays? An evening final on Cinco de Mayo and another evening exam on St. Patrick's Day? Blasphemy!)

I know that the path towards medicine isn't the easiest one to take and there will be plenty more times when I just can't live as carefree a life as the people around me. This was a major reason for dropping the pre-med thing in undergrad and pursuing a different career. But in going back to school for pre-med prerequisites, I realized I'd much rather work hard in medicine than work a little less hard at a job that doesn't ignite the same passion in me as medicine does. That was (and is) my choice and I think it's definitely the right one for me.

This also isn't to say that medicine is the only profession where one has to sacrifice some things for a successful career. My friends bust their butts during the week to make this sort of relaxing Saturday a possibility, and they are often out of town on weekends for work. So it's not all unicorns and rainbows for them either.

But, that doesn't mean I can't feel a little resentment and jealousy once in a while.

But what's on the exam?

As much as I dislike my exams this semester, I pretty much know what to expect every time. This wasn't the case for a particular class I took in undergrad many moons ago.

Here is the conversation in class the day before a midterm:

Prof G: "The midterm will have 4 or 5, questions. S, how many questions did we decide on?"

Prof S: "Four."

G: "Right, there will be 4 questions. What did we decide, S? Can they bring the book?"

S: "Yeah, they can bring the book, but it won't do them any good."

G: "So you can bring your book. You won't need your calculator. You won't need a table of units. You'll have to rely on reasoning."

Student: "How should we study for this? Should we study the notes or the book?"

G: "I'd say, both."

Different student: "What will the questions be like? Will they be kind of like the problem sets or from the book?"

G: "Both."

Me: "Quantitative or more conceptual?"

G: "Both."

Student: "Can we get a previous year's exam."

G: "Well, we've never given a midterm before in this class, so that's not really possible. Sorry."

Student: "But can you give us an example of a midterm question?"

G: "I suppose. Hmm. Well, you have this reservoir of a certain height. You need to build a dam. How would you build a dam to get what you need? S, any other examples?"

S: "Nope."

G: "Tara?"

TA Tara: "Nope."

G: "Alright, then. See you all on Thursday."

Burned out

I am 100% checked out of school right now. I just don't have it in me to study anymore. I have a biochemistry final tomorrow and I literally need to talk myself into opening my notes, otherwise it's just not going to get done.

And it's not that feeling of "I know it all and am bored with having to go over it again." I wish that was the case.

Instead, I'm overwhelmed by the volume of material covered on this exam and I have no desire to even attempt to learn it. That, and I don't believe my grade on the final will make any significant difference in my final letter grade. As long as I know the stuff well enough and don't completely bomb the final, I will keep the grade I currently have. So there goes that motivation.

I don't know what it is about this class that makes me feel so done. The whole biochem series has been incredibly frustrating for me, mostly because my grades haven't really reflected the degree to which I understand and know the material. I'm not blaming anyone but myself for this mess that is my grade, which makes the feeling even worse. I just have to keep telling myself that 2 Bs are not going to sink my medical school application. (Here is my justification for being so neurotic these days, because I didn't used to be this way.)

I am so done that at this point I'd much rather be studying for the MCAT or filling out my AMCAS. I am that much over school.

(Yes, this post is whiny. That's what happens when I get grumpy.)

It hasn't sunk in yet

In 25 days, I will be somewhere above the Pacific on a flight headed to Southeast Asia to volunteer aboard a Navy hospital ship and serve as part of an international medical relief mission. Even though my plane tickets are bought, my immunizations are scheduled, and I have a packing list in my head, it still hasn't sunk in that this is happening so soon, or even at all.

I have yet to accept the fact that I will be spending six weeks working...

1. as a medical team member,
2. on a boat, and
3. in a foreign country.

I am not exaggerating when I say that this is a dream come true.

And because it has been my dream for so long, I just can't believe that it's happening so soon in my medical "career". It just seems way too good to be true.

Two years ago I re-began the journey towards being a doctor by signing up for a few pre-med prerequisites. At the time, applying to medical school seemed so far away and I couldn't wait to be done with all of it. I just wanted to be in medical school then and not wait the years it would take me to finish up everything.

Instead of the expected long, hard slog, these last two years have flown by and I'm much closer to my goal of being a doctor. Even with all the work I've already put in, I still have a lot to do before I leave.

But when I get on that plane on May 22nd, my MCAT will have been taken, my medical school application will be finished, and I will have decided on which schools to apply to. That is a very scary thought.

Postponing the MCAT (again)

Ever since I saw that all the seats for the May 19th MCAT were filled, I've been obsessively checking the rescheduling website to see if anything has opened up. Eventually I resigned myself to taking the MCAT on the 12th and stopped checking the site. On a whim, I opened up the AAMC website today and lo and behold, May 19th was open!

So after much thought (and I really mean a lot of phone calls and discussions), I gave another $70 to AAMC to move my test date by one week.

You'd think this would be an easy decision to get another seven days of studying, but 1) I suck at making decisions for myself, and 2) I leave the country at 6:19 am on May 22nd for two months. So a May 19th MCAT puts me in a bit of time crunch with regards to getting all my things in order before the trip.

With this move, I have now had 7 confirmed and pseudo-confirmed (in my head) test dates, but really only 1 actual change (my wallet thanks me!). Luckily for my sanity, this is the last possible date I can take the MCAT without putting in a super late application for medical school.

So no more changing for me! D-Day is officially 5/19/12.

But, if I change my mind again and really want to go back to the May 12th test date, I'm sure I won't have a problem getting my spot back, as not many people are going to be pushing up their MCAT exams. The chances of that happening are slim to none.

My first practice MCAT

Even though I'm about a week behind on studying for the MCAT according to my schedule and technically still need to review a whole bunch of chapters, I decided to begin taking the practice tests now because my real test is only 5 weeks away. That doesn't seem like very long considering all the things I have to learn and do between now and May 12th. It's very overwhelming, actually.

As it stands, I've finished all the content review and just have to re-read chapters and review my answers. So it's not a bad time to get a general idea of my weak points so I can focus on those instead of feeling the need to memorize everything.

And...drum roll please...I scored a 33, with the breakdown being 11, 11, 11. While it's not a score that I'm happy with (I'm shooting for 36+), the 11 in Verbal Reasoning is incredibly reassuring.

When I first started doing Verbal passages, I was consistently scoring 7 and I was absolutely terrified because that is not something you can just cram for like you can for the other two sections. Lately, though, my scores have risen to 9 and then 11 on the last two sets of practice passages I've taken, so this "official" MCAT score lends credence to my thinking that I'm getting better.

Also, my timing is amazing on these tests to the point that I have 10 minutes left on each section to go over any answers that I'm unsure about. And the Biological Sciences section is a lot easier than my practice passages, while physics is not nearly as emphasized in Physical Sciences as I thought it would be. And that's very good because I haven't taken physics in eight years.

All in all, I think that if I had had a bit more confidence and read a bit more carefully, I could have scored at least 12 on both Biological and Physical Sciences because I missed at least a few questions in each section due to careless mistakes.

But since I have 7 more tests to take and whole bunch of passages still to do, I think I can improve in both of those areas.

Shadowing in the OR

This week I shadowed an orthopedic surgeon in the operating room and watched him do two cases. At first, I was a bit grossed out by seeing the surgical fellow pull on stuff inside the dude's knee, mostly because I was imagining how much it would hurt to have my tendons stretched like that. But then I remembered the patient had a nerve block, was under general anesthesia, and was prescribed some serious pain killers for recovery, and the feeling of empathetic pain went away.

For the first procedure, I had some decent questions to ask the surgeon because I have a bit of background with that injury and knew generally what to ask. So it wasn't so awkward. But the second procedure consisted of me standing quietly in the corner not saying a word, until the surgeon mentioned he had lived in Italy and I inquired where because I, too, had lived in Italy recently. Other than that, I kept my mouth shut, which is not the way to go apparently.

My interactions didn't get any better after that, and instead I managed to communicate the fact that my undergrad GPA was crap and that I don't like evening classes, which resulted in the surgeon chuckling a bit under his breath. Oops. Way to make a good impression. Not! I should just learn to keep my mouth shut.

One of the biggest issues I had with shadowing was not knowing when it was ok to ask questions. The surgeon also had a fellow doing most of the work so he was teaching a fair amount of the time, and I didn't want to interrupt that. He was also doing a lot of shop talk with the biomedical sales reps so that didn't seem like a good time to interject with a question. But there was also a lot of silence, so I can't use all that as an excuse.

My other problems included not being prepared for the second procedure, and being too afraid to ask "stupid" questions. The thing is, as a pre-med, I'm not expected to know anything so unless I'm asking things like "What the heck is a shoulder?", my questions most likely aren't perceived as idiotic.

I'm generally a very curious person, so why do I have such difficulty being around doctors? Why am I so quiet and insecure about medicine? These are the questions to answer.

And since this was supposed to be a learning opportunity, here are some lessons learned:

1. Being prepared is always a good thing.
   I should have looked up the second procedure before I observed one because then maybe I could've asked some decently intelligent questions.
2. I don't have to come off as awesome all the time.
   I need to stop being afraid to ask seemingly stupid questions. Usually, they're not stupid and I have a right not to know the answer.
3. Better to keep your mouth shut and be thought a fool than to open it and remove all doubt.
   I need to learn to paint myself in the best possible light and stay away from the self-deprecating talk. I shouldn't lay out my flaws for everyone to see.
4. Doctors usually like teaching.
   This especially applies to those at teaching hospitals and those who take on fellows, so I should not be too intimidated to ask questions. They are most likely more than happy to answer them. At least that has been my experience with all the doctors I've encountered. They've been pretty awesome.

I may ask to shadow this same surgeon again over the summer to see a joint replacement. The two procedures I had yesterday were mostly arthroscopic so replacements would be a nice change. And it would give me a shot at redemption.

Mostly, I want a re-do because if I get into the local medical school, I will most likely be asking to do research with this surgeon. So I need to make a better impression of preparedness than I did this time.

Oh, I almost forgot to add...I posted a thread about this to SDN and this was one of the replies:

Physicians will know that a college student won't know much medicine/surgery, so don't be afraid to ask basic questions. It would be strange to NOT ask questions at your stage.

I guess I was the strange kid in the corner then. Oops.

The good part was that I was fairly animated outside of the operating room, except by that point, I had verbal diarrhea. Here I go with the self-deprecation again. It's a vicious cycle, I tell ya!

Preparing for the committee letter interview

The pre-health advising office at the university at which I'm doing my post-baccalaureate courses (what a mouthful!) writes an all-encompassing "report" on us called a committee letter that is sent along with our letters of recommendation to all the medical schools to which we apply. It's kind of an overall assessment of our candidacy for medical school and includes their take on whether we have the qualities of a good doctor.

As part of the process of getting a committee letter written, we had to complete an appraisal packet that was composed of questions such as the following:

• What characteristics do you have that will make you good at your chosen profession?
• From what situation, experience or interaction have you learned the most about yourself?
• Describe an example of a time when you showed intellectual curiosity, problem-solving and/or self-directed learning in any area.

These allow our committee to get to know us better and write a more effective and complete letter.

Anywhos, my interview is in two days and I'm starting to prepare my responses to common questions I know they'll ask, such as "Why do you want to be a doctor?" and ethical dilemmas, as well as greatest strengths and weaknesses questions.

Most of these answers are pretty straightforward but I'm having a really difficult time thinking up a 5-minute speech on why I want to be a doctor. Mostly, this problem stems from the fact that I have answered this question in my personal essay and in two questions on the self-appraisal packet, so I can't think of anything original to add to that. Obviously I want to bring in some new information so it's not just a regurgitation of the things the interviewers have in front of them, but I went all out on that packet and don't have much more to give, at least not convincingly.

I think the solution is to stick with what I've written previously and just organize my response well. Hopefully I'll think of a few examples that are different enough from my earlier answers that the interviewers get some new ammo for that committee letter. In short, it's time to wrack my brain!

MCAT issues

Sometimes this blog is written just for me to figure out plans of doing things a certain way in order to simplify my life. This is one of those posts, so feel free to ignore it.

I'm having some major problems retaining all the information needed for the MCAT. Reactants and conditions are not staying in my head for organic chemistry, and concepts I found easy in my general chemistry class are just not sticking. So I've formulated a new plan to make me remember all this stuff.

Here it is:

• Compile one-page "cheat sheets" for each chapter of each subject that include vital conceptual information as well as equations and tricks for solving MCAT problems quickly.
• Create examples of how to solve recurring types of problems unique to each chapter, with worked out solutions.
• Write up all the organic chemistry equations that are necessary for the MCAT.
• Review one chapter a day of all subjects. Rinse and repeat.

Since I do best when I have to do things over and over again, I hope that going over these home-made worksheets daily will help me retain this large volume of information, and will provide a great way to organize everything in my head. And 1 - 2 pages for each subject turns into ~8 pages total a day. That shouldn't be too hard.

Now if studying for the verbal section was this simple, I'd be set!

Something has to change

Lately I've been feeling like I constantly have my nose in a book and that my life is class, study, sleep, and repeat. Work should be in there as well, but I just haven't been able to fit it in. And even with such a bare-bones schedule, I've been sleeping very little so clearly this isn't working for me.

I thought about this last night and realized that I actually do have enough hours in the day to accomplish everything and still have a reasonable life. I just have to be more efficient and not waste so much time.

So I've proposed a new schedule for myself where I am super productive from 9 to 6 and then can be as lazy as I want. I think I need that separation of life and school/work to be sane, otherwise I'm going to go crazy with stress, as has been the case these past few weeks. With dedicated relaxation time that won't be interrupted by school and/or work, I won't feel the need to squeeze in a show here or there, which is my downfall with regards to productivity.

And of course, like every other plan I commit to, this will have to start after this series of exams is done. So until next Wednesday, I continue to have no life.

!!!

Received tonight at 11:44 pm*:

Looks like Option 1 from my previous post is actually going to happen. Happy days!

*Pardon the stars and redactions. One of the forms we have to sign deals with not releasing the location of the ship until we have left the area. And another one says we need to run everything we plan to write about the trip by the coordinator. The details omitted from the copied email aren't pertinent to this blog post and thus have been removed.

Summer abroad

Originally I had planned to apply to only one summer program abroad and leave it at that. If I didn't get in, then I'd enjoy the peace and freedom of this summer here in town. But, a friend of mine has forwarded another opportunity on to me about a group leader position in a huge number of countries that would last about 5 weeks. It'd be a great reason for me to go back to Europe and visit my family, because it doesn't look like the sailing trip is going to happen the way I had hoped.

So here are the two programs I'm applying or have applied to:

1. A humanitarian mission aboard the USNS Mercy, run by the UCSD Pre-Dental Society
   This organization partners with the U.S. Navy to provide medical staff and volunteer assistants for missions abroad aboard a hospital ship. This summer they will be traveling to Southeast Asia, visiting Indonesia, Philippines, Vietnam, and Cambodia for about 4 months total (2 weeks at each site plus a few days of transit between countries). I've applied for the whole summer but if I am chosen for only two sites then I requested Vietnam and Cambodia because it would give me more time and lee-way for MCAT studying (in case I have to push it back...again), AMCAS submission, and writing secondaries. I've been told by someone who does these kinds of missions regularly that I should go for the duration of whole thing if I have the opportunity because it's a once in a lifetime experience, but I would also like to have some time to be at home during the summer. It's fun over here. As of a week ago, they had received my application and now it's a waiting game. If I don't hear back within the next 2 - 3 weeks then I'll email them for an update but for now, I sit and wait and fret. I REALLY want to do this. It's right up my alley!
2. The Experiment in International Living, as a group leader for high school students
   This group plans homestays for high school students in countries around the world, and is in need of group leaders to be the contacts for these students when they're abroad. It would be the perfect opportunity to go back to Europe (or maybe even Australia) and live with a family and experience the international life I've been missing since I moved back to the States. I wish my Italian was better because then I could go to Florence, too!

Those are the plans, at least the international ones, for the summer. If I do end up staying here in town, I may volunteer at a summer camp for cancer kids, which is something I've been wanting to do since undergrad but just haven't had the time to do. Or, I may take an Italian summer course so I can take the more advanced language classes during fall and spring. Or I may just go camping a lot. Man, I'm already dreaming of the freedom I'll have once my MCAT and AMCAS are done!

No pressure

This weekend a few friends from the summer camp I used to work at and I rented a condo in the mountains to have a few days away from the hustle and bustle of life. It was awesome! We lounged in the condo (I still can't ski because of my knee), did puzzles, played Settlers, and laughed our butts off.

I had an absolute blast, but as soon as I got back home I began thinking of all the MCAT studying I should have done this weekend and then I got sad. If I don't get into the local medical school, all these friends will no longer be a part of my life and that's depressing. And this thinking just exacerbates the problem I have with leaving my brother.

In short, I have so many reasons to stay here and that stresses me out because now, I have to get into this medical school! And to do that, I need to do really well on the MCAT. No pressure.

Going back to my old ways

I skipped class today because I couldn't find parking. Seriously. And instead of being productive during that extra hour, I watched last night's episode of "Parenthood", read all my usual websites and blogs, and am now updating the blogs that I write for myself. And that's three hours gone that I could've been studying for the MCAT, doing biochem homework, or working. Oops.

Plans for the "Gap Year"

Because I'm a planner, I'm already thinking of ways to spend the year between the time I submit my medical school application in early June and the day I (hopefully) matriculate in August of the following year. And right now I'm torn.

Part of me wants to do something clinical or medical just because. But another part of me wants to say "Screw it!" and mess around during that time. I'm already planning a month-long trip abroad for next February or March, but I'm also thinking of extending that and making it more of a 6-month trip. All of this is obviously dependent on the success of my application cycle, but for once I'm leaning towards the optimistic side of things and thinking I'll get in somewhere and won't have to spend the year building up my application for another cycle.

For example, if I don't get into my local medical school, I am less likely to move abroad for the 6 months that I'm dreaming of. Even though I haven't hung out with my brother much lately (and by that I mean, at all), I still would like to maximize the time I see him if I have to move. And that means hanging around here until I go away to school elsewhere.

I love where I live and life is becoming pretty awesome lately, so this wouldn't be too bad of an option, but I still would like to get away if I'm going to be bogged down with school come late summer. I need a vacation like crazy and this would be the perfect time.

But, if I were to have an acceptance to the school here, I could go away for a long time and not feel guilty about missing out on bonding time with family. Most likely, though, I will have to make this decision in a year's time when more of these things are clear. And that means having plenty of back-up options and multiple planned vacations so once I know what's going on, I can get on with whichever idea sounds the best.

A collection of BROOMBALL! photos

There's so much medical school talk on this blog that I feel the need to add in some photos of my other passion: BROOMBALL!!! It's what gets me through the winter and it keeps me feeling young.

With the regular season wrapping up, it's time to post an assortment of photos from my teams. Yes, you read that right, it's plural.

Onesies.

Camouflage theme, complete with face paint.

A close-up of our awesome face-painting skillz.

Tooth fairies.

Face-off at center ice. That's our (male) captain on the left.

There is plenty more where this came from, so I'll keep adding when I need the study break. Stay young, people!