Spin. Davie, FL. 29 Sept. 2009.

Who are you?

Are we being serious?  You know me.

Who are you?

You know me.  I am Randy.

But who are you?

Somewhere in existence there is a room that is pure white; people are taken there in their deepest moments.  Within this room, everything is as it solely is in that moment of time.  Clothes are temporary – each individual is taken as they were born, stark and pure of any hair, wrinkles, christened melanin deposition.  They simply exist.  You must not only question who you are, but question what you stand for, and how that plays into your essence.  Who am I?

Two years of education has come to a final culmination as I study in preparation for my COMLEX.  This examination is, without a doubt, the pinnacle of my education to this point.  The MCAT tested my competence; the COMLEX tests my ability to integrate, synthesize, and manipulate my understanding of what I have gathered, not through just my medical education, but throughout my life.  The test questions your understanding of basic science, clinical science, pathology, pharmacology, and behavioral science.  But the examination is not the true test.

The truth is that every person that will pass the COMLEX (or any major examination), already has.  The examination is a piece of data; the true test is whether one can stand against the pressure.  I was in the clinic for a manipulation treatment a few weeks ago when one of my professors reminded me that the test is really just to see how we will be able to handle ourselves in a clinical situation; it is not made to kill our brains.  All the same, it is hard to keep that in perspective at times.  The process of studying the broad depth of information is quite humbling – and calming.  To be able to make connections and integrations, to truly understand.

Tonight, while studying biochemistry of all things, I had an awakening.  I stood in the white room, hairless, stark, and pure.

Who are you?  I am the same person I was when I entered this program 2 years ago.  But who are you?  I want to help people, and to embody selflessness.  Why will you not let go?  Let go of what?  Why will you not let go?  I’m scared.

I have been struggling recently with selfishness.  I am humbled by the philosophies of those that came ahead of me: Romero, who selflessly slept on his cot behind the pulpit so that he could connect more with the impoverished; Merton, who separated himself from society so that he could find God in the silence and mystery of the universe; Xavier, who, too, meditated upon the Holy in silence and contemplation; Day, who threw aside the concept of privacy and ownership to humble herself before her fellow man.  I want to be broken.  I want to truly understand what it means to be selfless before humanity, and to offer the strength that has been given to me through my provision.

I want to be able to throw aside my own needs and desires so that the world can become a better place.  How can I get there?

First Aid. 8 June, 2011. HPD Library, Davie, FL.

Dirt flew against frightened young faces as a mortar exploded overhead.  I heard a voice yell to my left, “KNEEL DOWN!!! IT’S COMING IN FAST!”

I buried my face in the dirt of the trench that lay ahead of me, kissing the ground only to realize that the action was more for the comfort of feeling alive than it was for anything else.  Another explosion filled the night as the smell of phosphorous and potassium nitrates filled the air.  You’re alright.  Breathe.  You can make it.  A grenade landed to the right, and I dove out of the trench as pieces of shrapnel, dirt, and flesh left their embrace upon me in the dark.

We’re in this together.  252 of us entered this damned program a little less than 2 years ago, and the majority of us will continue.  It’s funny how one exam can bring people together so much; questions that are written by old physicians in a minute can be enough to bring medical students to tears as they approach their examinations.

The sad reality is that the problem has nothing to do with resources.  The market for USMLE and COMLEX review resources rivals the world of cookbooks.  For every book on how to make the perfect meal in 30 minutes, there are at least 2 reviewing clinical vignettes.  There are books for reviewing pharm, there are notecards for reviewing the books for reviewing pharm; to top it off, there are videos to pair with those, and then probably even pirated audio lectures that from review sessions with the elites of the field.  Now the question is, how do you get all of that into your head?

Here’s my recipe:

1. Attend lectures and learn the basics so reviewing will be easier – check.  Path was too boring, and as the test drew closer I started skipping class to watch it online so I could squeeze in more Kaplan.
2. Listen to Goljan’s pathology tapes throughout the year as systems pass – check
3. Read First Aid throughout every system - check
4. Watch Kaplan Pathology videos before each examination – check
5. Subscribe to Doctors in Training and complete weekly questions, review, and then complete the program with videos a month or so before the exam - partial… the group sessions were too cumbersome, and I felt like I was not getting enough out of the questions by blowing through them.  I did 2/3 of the questions before starting the program.
6. Listen to Kaplan Microbiology at the gym second semester – I made it through about half, but plan to take a couple days to finish it off, and I’m still working on it at the gym
   
7. Watch Kaplan Pharm - half done.  Stopped for DIT
   
8. Watch Kaplan Physiology for areas I am weak in – check
9. Watch Kaplan Anatomy’s section on neuroanatomy – half done.  Stopped for DIT
10. Do 40-50 questions on question banks per day for the month up to the exam – working on it.

Of course, road blocks come along.  I have had to restructure my study schedule a couple times, and have had to make adjustments.  I moved my test from July 20th to July 11th today to alleviate the strain placed by the conflicting schedules of the OMT fellowship and my Board.  The question remains: will this study structure work?

Simply put, it has to.

Kind of Blue. Davie, FL. 23 May 2011.

Any student that has had to sit on hold with Nova can attest with unrelenting certainty that they have the largest public library in South Florida (and a host of other things they like to boast about, like a pretty rad mural by Guy Harvey in the 4,000 square foot Donald Taft University Cent… I digress).  The hold system has wasted many of our braincells with these useless tidbits; I really think they should start looping the mechanism of actions for different antibiotics or something else that’s too mundane to learn on our own.  Or Chapman’s reflex points… something like that.

So back to the library.  It’s a public library, but you have to use an ID to scan into it.  Sit on that for a second:

a public library that you have to use a student ID to scan into.

If it’s a public library, how the hell is the public supposed to scan into it?  I finally broke down and asked the security guard who mans the gate at the front of the library just how this worked with the mission of it being a public library (and, yes, this a public library with a mandatory card scanner for entry that is watched over by a full-time security guard).  He stated it was so they could track the number of visitors.  That made me stall for another second, but I decided it probably was not worth asking why they needed to know how many people entered the library each day…. I guess it’s probably for some grant or something.

Of the patrons that enter this library each day, about 75% are students, and the rest is a healthy mix of happy families and sex-offenders.  As a medical student, I have probably logged a few hundred hours in that bad boy, and I now take this opportunity to share a few of my favorite stories.  First, the patriot.  There is a guy that migrates between the Health Professions Division (HPD) and Alvin Sherman, sporting an orange backpack and an American flag baseball hat.  He reminds me of the kind of guy Ruff McGruff warns children to not say hi to: greasy black hair, dirty clothes, black rimmed glasses.  If this weren’t enough to scare you off from commending his dress code, he watches porn on the public computers.  My favorite story involves me walking by after spending far too many hours studying for an anatomy exam only to see areolas and ladybits stretching across the screen as he minimized five windows nervously.  Regardless of how many times I attempt, he still won’t make eye-contact to this day.

Story two.  I decide to check my email on a computer since I forgot my laptop (note: if the last story makes you wonder, yes, I do wash my hands after using these computers).  I’m sitting next to another homeless person, this time a guy in his 50′s with a trimmed beard, a 70s classic rock tee, and a gray ponytail.  If homeless people have a cleanliness scale, he’s definitely on the higher end.  Now, keep in mind Nova has an undergraduate school attached; this was during finals time.  A young, attractive female has a phone that starts to ring- she slowly steps up to take the call.  As she rises and turns, he clamors to his feet, lets his tongue hang out and starts whispering “hubba hubba hubba aaaaaahooooooooooo”.  He then looks at everyone else at the computers to rally support for his wolf call.

Act three is my personal favorite, but comes on loan from a friend of mine.  She decided to sit down to study on the fourth floor of the library one day.  A guy next to her has his socks off his feet to air out a really putrid rash.  He has bottles of herbal supplements spread around him burdening the air with a foul aroma, and a pile of books next to him.  He smells of body odor, and has a crazy look in his eye as he reads with his glasses on the tip of his nose (in case you can’t tell, I’ve passed the guy maaaaaaaany times in the library).  She sits next to him because there’s really no other place left – this was, again, during finals period.  He starts reading quietly aloud to himself, whispering the words; she puts her headphones on to drown out the noise.  Soon he starts getting really into the book, then voices “Bang.  Bang.  Bang”  and makes hand gestures of a gun.  Needless to say, I haven’t tried studying next to him.

So where I’m really going with this post is I need to start reviewing psychiatry for the Boards…. But seriously, this post is for all the creepers that bless Nova with their presence.  Creepy homeless lady who abruptly joined me at my study table only to stare at me while I studied, this one’s for you.  If you think medical students are odd, try the people we encounter as we study non-stop; or perhaps this serves better as an explanation of why you find so many of us at coffee shops instead of libraries?

Perception. 29 April 2011. Sarasota, FL.

Three thousand, two hundred fifty-three miles from here lies a cave.  And inside this cave?  Every single Nalgene I have ever lost, as well as two favorite coffee mugs this past week.  I have a bit of a problem, and it involves losing travel mugs and bottles (perhaps a more concise name- fluid vehicles?  Aqueous transporters?  Liquid containers?).

I lose things when my life gets chaotic.  The closer I got to my thesis in undergrad, the more costly the Nalgene debt.  In the first semester of medical school alone I lost two aluminum bottles, and left a third at home in Colorado.  With second year, things got more expensive.  I lost an iPod touch, and another aluminum bottle before switching to the water fountain for a while.  I caved about 5 months ago and finally bought a new BPA-free Nalgene after pathology showed me that I was going to die of something anyways – I’ll be damned if it’s thirst that takes me to the grave.

I was living proudly until this morning.  After 5 months, I still have that new(ish) Nalgene!  But, after running between offices, computer labs, classrooms, and copy labs, I realized that I didn’t have my coffee cup.  It was a Dunkin’s mug, and I had been to about 10 different places within a 35 minute interval, so I figured it really wasn’t worth the opportunity cost to try to track it down right away.  With my vast experience in abandoning aqueous transporters (okay fine!  I’ll stop!), I have found that people generally want your water bottle or coffee cup just about as much as you want them to have it; I planned on grabbing a different one when I got home to switch textbooks and dealing with the lost cause later.  Imagine my disappointment when I arrived at my apartment only to find that my second favorite coffee cup was gone as well.  The Boards are coming, and I will be losing more vessels.

So, this is my homage to lost water bottles.  To the monster that lives in the cave hoarding my containers, or to the evil bastard elves who steal them every time I turn my head, I offer this haiku:

Lost water bottle,

Still the flow of my cold tears,

Drink-to-go, no more.

Please, sir(s)/ma’am(s), leave me to my drinks.  Let me enjoy my coffee wherever I please.  But seriously, if you ever need an idea of what to get me, a travel mug or a water bottle is a great place to start.

Sarasota Bay. 31 April 2011. Sarasota, FL

TF, 45 y/o male roofer, presents with C/C SOB and PN on inhalation.  PN is isolated, localized to the 4th L intercostal space; patient characterizes PN as “stabbing”, and consistently painful.  Patient recalls chest congestion 2 weeks ago w/ productive sputum (non-tinged) and fever, but felt recovered 5d previous.  Presents today w/o chills, fever, exudate; patient appears alert, oriented, and otherwise healthy….

Short.  Concise.  The writings of Hemingway rarely danced about with extra details.  My favorite short-stories, those of Nick, seem to describe the world with as few extra details as possible.  Picasso portrayed images and thoughts with representative shapes; I prefer my world to be stripped of excess and adornment so that I can see what I’m really dealing with.  However, these days I’m blessed with the unexpected and unfamiliar stream of possibilities within my future.

If I could write my life as a SOAP note, it would look something like this:

S:  RD, 24 y/o male medical student, presents with C/C of blurriness of vision.  Patient states actual vision is maintained, but characterizes the lack of vision as a blurring of details, a “lack of sharpness and definition.”  Blurriness began 2 years ago, and is intermittent.  He states loss of vision is currently 2/10; at worst, it seems 4/10 (w/ 10=worst).  Patient denies weight change, LOC; feels “confused” at times, but is unable to elaborate.

O: Vitals WNR, No significant findings.

A: 1. Delirium, 2. Borderline

P: F/U 3y
Medical school is nearly half-complete (it will be once my Board is done – July 20th), but it seems like I know less about what I want to do than what I don’t want to do.  I begin the OP&P fellowship at NSU-COM in July as well; it carries with it the opportunity of another year to see where I want to go, and just how I want to practice medicine.  I’m not unmotivated, but I’m definitely not on the edge of my seat.  Looking at the photo above makes me realize how much uncertainty can stand in front of you, and how even things that seem clear can be shrouded in the darkness as well.  Lately this has made me a bit anxious, but I think that it is time to view this moment as an opportunity to drift along with the pace of life and let the natural ebb and flow carry me where they may.  If this were a somatic dysfunction or a strain, perhaps following the tension will allow the difficulty to unwind, and I’ll be able to see where I need to go and what decisions I need to make with my life.

A break from the norm tonight… studying for Boards is making me nutty, so here’s a tease of the start of a story I’m working on…

=====

The air was painted with a fragrant mask of departed bubble-gum and Scotch whiskey.  A leftward glance showed a bum sprawled out across the back of the tram; to the right, a disregarded McDonald’s sack.  A shallow breath filled the dead-space of his lungs with air he deemed not quite worth perfusion; his exhale added another collection of gas to the night’s chaotic ambiance.  Double-checking the cabin wall for the train’s identification number, he reached into his back pocket and instinctively tapped a cigarette from the package and lit it in one collective motion as it touched his lips.  The smoke detector is still broken, he thought, briefly shadowing the air before him with a wisp of cool, white smoke.

A lady in the corner was coughing.  Tuberculosis.  A man scratched his neck to the left.  West Nile.   Infected – every last one of them.  Sick.  He thought how the train streamed through the city like the raft of Charon glided across the sea of souls in the river Styx.  Breathe the death in.  Let the smoke dance with across the gaps of your alveoli like the sun paints the shadows between blades of grass.  She got to him, and he knew it.

"wakinglife". Davie, FL. 13 April 2011.

One of the personal rules I have about my blog is that I only update it with photographs that I have personally taken – at least that’s a rule I taut to those who ask me to update my blog (there are actually people that do so?  Yes.  And more than one?).  Anyways, a friend emailed me the photograph above and told me I could now update my blog, insisting to “just say that a good friend took it.  [And] that [it's] as badass as anything [I] would’ve taken.”  So, three cheers to the friend and to a new entry.

So it’s time to throw on the 80′s montage cinematographic scene and a soundtrack of your choice.  I suggest the theme from Growing Pains Season 6; you know the one – complete with the a cappella harmonies… Click and enjoy http://www.youtube.com/watch?v=QXgS2YnykDg.  Today is the last day of class.  Ever.

‘Twenty years ago I would have been finishing pre-school at the Little White School House.  Let’s be honest – playing with Tube-Traxx doesn’t really constitute formal education; I’ll omit this year from the blog title’s count, but I need to make mention of it.  So Year 0 started with mom dropping me off, me acting strong, mom acting strong, and both of us breaking into tears seconds after we walked apart.  She thought I wanted to be there, I thought she wanted me to be there, but, really, we both wanted to be at home drinking Diet Coke, eating Red Baron Pizzas, building couch forts, and watching Smurfs.  To the staff at TLWSH (we are in the age of abbrev’s people!!!), thank you for the Honey Graham Crackers and the sweet memories.  You guys really could have invested in another Tube-Traxx though, because everyone was always fighting over it and that one bastard kid wouldn’t let go.

Year 1.   The first of many years of brilliance played out with my moment of beaming glory: I starred as the Elephant Child in an Oscar-winning performance in front of my class.  My performance was, of course, outstanding; people cried as my elephant trunk was extended from its nubbin form as my supporting cast pulled at the knit hat.  We stood for mass applause, and Emily, the blonde haired girl, licked her hand and panted down my cow-lick down to insure that this moment would carry us proudly through the rest of our lives.

Year 2.  If I’m going to become a fully-fledged, respectable physician, I have to reveal my dark moments at some point.  Mrs. Rundle (WHAT?!?! I FOUND A PICTURE ON GOOGLE?!?!?  See Mrs. Cathy Rundle on the left), I was a bad first grader.  I stole Dylan Heister’s Shnookums and Meat’s Funny Cartoon Show pog.  I also cheated when you needed us to spell the word oblong because you had it written on the black board for everyone to see, but I was the only one who noticed.  Remember how you wanted to skip me a grade?  I really hope that spelling word did not affect your decision.  Oh, and the rubber cement (which I ate thinking non-toxic would mean I would become impermeable to fire), did not seem to have much of a lasting effect.  Or did it?

Year 3.  Begin Christian school.

Year 6.  Mr. Waggoner, I threw rocks at the cars during playground and lied to you.    I still regret what I may have done to the windshields, but I needed to express myself some how.  Mrs. Mitchell, thank you for teaching me how to express myself with art, because art does not break windshields (sometimes).  Year in summary: “I’m not gay.  Seriously.”  Sometime around here I found out that I wanted to be a doctor, or an animator, or a fireman.

Year 7-9.  Wow.  Black clothes, anger, more anger…. Scary.  “I’m not gay.  Seriously.”

Year 10.  First girlfriend – remember when I said I wasn’t gay?  I’M NOT GAY.  I just like art because it lets me not break windshields (sometimes).

Year 11-12.  Cars.  Tires.  School.  Anger.  Art.  Sometime around here I killed my knees, realized that animators really don’t make much and that it’s tough to become big, and decided I should really consider this doctor thing.

Undergrad: years 13-17.  Thank you, Saint Ignatius Loyola, for forming the Society of Jesus.  Jesuit education provided me a realistic outlook on the world around me while providing me with the tools to challenge everything I thought that I was observing.  Iggy, you changed my outlook on things; I may have learned more about plants, philosophy, English, and war than I needed to become a successful physician, but I don’t regret a moment.  3 Cheers to the Beer Monday Crew, to all the times with my Res Life friends, and to my family at the Romero House; you guys all made me who I am.

Medicine: years 18-present (19).  Let’s be real.  I still don’t know Biochemistry.  I still don’t know Embryology or Immunology well enough for the COMLEX.  But I can pop your back 3 different ways, get rid of your headaches, realign your elbow, and make you see colors by playing with your skull.  How many MD’s can do that without medications?  With all seriousness, to my colleagues, we are entering what AT Still called the proudest profession, and I really, truly do believe the time of the Osteopathic physician is now.  Regardless of how harrowed the media paints the state of health care to be, with our hands and our philosophies we can shape the future of medicine and change a system that is inefficient and sometimes irresponsible into something entirely new.  The final of my 3 cheers goes to you, my classmates, as we ditch our last day of class ever.

Miss Piggy got stitched.

I’ve decided to check in for my yearly update.  What’s changed?  A couple dozen tests later, I stand with the same mentality, but perhaps a darker appreciation of what exactly it means.  I am at home in Colorado, and getting ready for my first American Academy of Osteopathy (AAO) Convocation.  AAO is basically the manipulation portion of osteopathic medical societies.  I am also picking slowly away at the never ending pile of Board work, preparing for my next year as an Osteopathic Fellow, and sticking my head into the clouds occasionally to venture guesses as to what life might have in store for me.  All this to say, sometimes it just doesn’t even matter.

Japan was hit by a horrendous earthquake just a couple days ago.  Sure, it may be all anybody has heard about within the news for the past 48 hours.  Yes, we may be reminded about it every time we walk past a newspaper bin, or glance at the news feed within our inboxes; yes, we are probably becoming numb to the situation as we stand several thousand miles away from the incident upon firm and steady ground.  I have even seen some comments on news forums where people are mocking the situation, or making racist comments speculating as to why there is no looting.  While I think most would probably argue those comments are not in the best of taste, I am left questioning whether it is wrong to become numb.

Our bodies have this inherent mechanism where when anything goes wrong, it does its damnedest to save our pathetic selves.  If you lose enough blood, your heart will beat faster to compensate for the decreased level of pressure to maintain proper cardiac output.  If you have a central balance disorder, the vestibular portions of your brain will slowly compensate to allow the highest level of balance given your disorder.  If you cut your arm off… well, you’re screwed.  But the point is that numbness is the norm.  It is the mechanism nature has given us to become adjusted to the conflict of our surroundings.

My class at school just started our final block in the classroom setting as medical students.  Our courses are Women’s Health, Pediatrics, Geriatrics, Behavioral Science, and the rest of Neuro/Psych.  At one point I have strongly considered being an obstetrician, a pediatrician, or a psychiatrist.  Right now I am completely and utterly numb – the only thing carrying me through class is knowing that the Board is right around the corner – it is easier to keep learning the information now than it is to try to learn it fresh for the real exam.  So being numb is good?

The funny thing about big events is that you eventually even become numb to the numbness.  Stuff is repeated so much that eventually you forget it ever happened, and you move on with life.  This is not knock-knock joke funny, but instead watch the guy kick the iron soccer ball kind of funny.  It is one of the saddest parts of being human, in my opinion.  The only way that we break out of our numbness is when the next big event comes along.  The breaks in between are what give us the opportunity to regain our excitement or compassion for the next big event.

I suppose this is why we have Spring Break – so we can feel the pain when the Board comes along instead of being numb to it.

Rose (rendered BW with applied green filter). 7 June 2010. Victoria, British Columbia, Canada.

True to the tone of the blog, this post once again comes long overdue.  As summer vacation comes and goes, I find myself an OMS-II.  Colorado was wonderful; my family is truly too far away unless I am there.  The mountains stand as a representation of my elated spirits upon arriving home.  I miss the beer already.

One of the first articles that I ever came across when educating myself about osteopathic medicine during undergrad was by Stephen Barrett, M.D. (of QuackWatch.org), and entitled “The Dubious Aspects of Osteopathy.”  At this point, I was not really taking osteopathic medicine very seriously, just looking at it as a potential option rather than what I truly wanted to do with my life; the article provided some piercing attacks against cranial osteopathic therapy and ultimately suggested that patients looking for an osteopathic primary care physician try to find one that,

“(a) has undergone residency training at a medical hospital; (b) does not assert that osteopaths have a unique philosophy or that manipulation offers general health benefits; (c) either does not use manipulation or uses it primarily to treat back pain; and (d) does not practice cranial therapy.”

I am honestly grateful that I found this article when I did.  It intrigued me to develop my own sense of osteopathic medicine.  I now can say proudly that I do believe that we have a different philosophy, and that manipulation offers benefits to the patient that are unobtainable by other means.  I plan to use manipulation at any opportunity, as it serves as a means to avoid using medication to treat ailments.  Lymphatic treatments have even been shown to decrease the blockage of lymphatic flow; this provides potential to reduce infection periods by increasing the immune system’s area of effect.  Finally, starting today, I am also able to say that I am a believer in the foundations of cranial osteopathy.

Cranial osteopathy gets a bad rep, largely because it can be a pain to prove.  While there has recently been a heightened effort to provide a stronger research foundation, it still receives criticism across the medical community.  Some physicians report such successes as treatment of allergies, treatment of ADHD, and therapeutic management in autism.  It is far too early for me to make a claim on any of these aspects, but I will approach one of the key arguments against Cranial.

The father of Cranial osteopathy, William Sutherland, established a few basic principles; one was that the skull is composed of motile bones.  This is something I have questioned since undergrad; an instructor therein even told me flatly, “Skull don’t move.”  I thought it was a little silly, until I saw Dr. Hasbrouck treat a patient for a headache.  He had me place my hands on the patients legs; by simply feeling the patient’s head, he could tell that my left hand was heavier than my right.  He then told me that the index finger of my right hand was a little heavier, and I was blown away.  He taught me to focus so that I could feel the motion of tissues and fluids below the patient’s skin surface; he then told me what I was feeling as I was feeling it, including the direction of the rhythmic shifts of fluid and fibers.  I was, again, astonished, but I still did not know what to expect of cranial.

Today I felt an inwardly rotated temporal bone, and the resulting altered cranial rhythm for the first time.  Knowing that my palpatory skills have developed to the point of being able to sense such motions makes me feel so accomplished.  I was able to tell the physician I was shadowing when the bones were moving, how the rhythm was changing while he was treating (mind you he was treating from the patient’s legs by exaggerating the motions I had felt with Dr. Hasbrouck), and when it had corrected.  I know this is the first of a long road towards developing my abilities with Cranial therapy, but I am so excited to start down this road.

A.T. Still, the founder of Osteopathic medicine, once stated “Let your light so shine that the world will know you are an osteopathic physician pure and simple, and that no prouder title can follow a human name.”  I am not an osteopathic physician yet, but I am more happy than ever to have the opportunity to learn what I am learning.

A future unfocused. El Yunque, Puerto Rico. 30 March 2010.

El Yunque was a tease.  I consider myself a naturalist; the smell of a forest always elevates me to an inexplicable place.  When I die, I want my ashes to be spread in Muir Woods amidst the smell of redwoods, soil, water, life, and death.

Over the past 5 months, my classmates and I have taken at least 21 examinations – or so I am told.  While I’ll claim the number in this post, I don’t want to steal the thunder of being the person who types up a list of exams, prints it, hangs it on their wall, then marks it off week-by-week.  I’m not that person.  I am the person who doesn’t print my class schedule because it makes life more exciting to never know what class you’re going to.

Today is my first day as an M2.  This year has brought about a lot of changes, but I feel that the transformations have been brought about so gradually that I can’t comprehend what they consist of or how they might manifest.  If we are the sum of our actions and experiences, then each moment has the potential to shape us into a different version of who we are; medical school would then be a stone in the path I’m walking as I become the person that I am meant to be.

I’m excited to read a lot more this summer.  I’m excited to step away from purely academic reading and reach into new areas.  I want to read some philosophy, and I want to learn cranialsacral therapy.  I am also excited to learn more about my future, and about what options lie before me.  I would like to continue shadowing Dr. Staller, and I especially would like to find out more about Physical Medicine and Rehabilitation.  I’m ready to hold my aspirations against the light and see what the world actually has to offer for them – I’m ready to find out what I should do when I grow up.  Look out world – it’s summer!