Internal Medicine

I think my Internal Medicine rotation will go down as one of those not-so-rare moments in Pharm school when I get knocked on my ass without warning. And then kicked mercilessly. It was one of two 2-month long rotations which I have in the fall semester, the other being Ambulatory Care which I will start tomorrow. IM is supposed to be the most difficult of all the pharmacy clerk ships, and for my sake I really hope that's true.

I've never slept less, worked so consistently, put up with more criticism, or been so miserable for such a long stretch of time. My vocabulary expanded to include humiliating phrases like "I don't know," which I repeated often and with an ever sinking heart. My good humor, one of my most prized personal traits, got lost quickly in the 4 am mornings and the 9-11 hour shifts. I never "caught up" on my homework. I just stopped it for long enough to go to sleep. The grand majority of August I felt stupid and wasted, as if none of my hard work over the past three years had done any good at all. By Friday night I was too exhausted to do anything but sleep, and the majority of the weekends were spent recovering from sleep deprivation and doing homework. I talked to Mike about half as much each day as I normally do (which isn't even that much to begin with), and had to struggle around assignments and projects to spend time with him on my days off. Thank goodness he's so amazing and doesn't have a selfish bone in his body. You know, like me.

Luckily though, there is a bright side to all this (the above is probably enough complaining for one blog post).

Today was my last day, it being the last calendar day of September. After taking my final exam on Monday and doing last-minute wrap-up crap, my preceptor evaluated me and we said goodbye. She told me things I really needed to hear, though, before I went. She said my confidence was improved 100% since my first day. She said she often forgot that this was my first rotation (which I took as a huge compliment), and that she was impressed with the amount of hours I put into my work both at the hospital and at home on assignments. She complimented me on meeting every goal which I set for myself at midpoint. She told me the frequency and quality of my patient interventions increased significantly over the course of the rotation. And finally, she told me that I got an A !!!!

All of this felt really great to hear, but what I really wanted to know (the one thing I always wonder, every day I've been in this program) was if I was where I should be at this point. (Am I shaping up to be the pharmacist I want to be?) Or am I behind the curve? And she this is what she said.

"You are above and beyond where I would expect students to be at this point."

And you know what? It was worth every early, early morning (and every tear) to hear that.

This Brief Interlude

School has been keeping me busy. Really busy. Writing two 10+ page SOAP notes a week, getting ready for final case, studying for the final exam, and trying to work on Clinical Seminar (kind of like a thesis) all at the same time has sort of pushed a good night's sleep from my schedule. By the time Friday gets here, I'm too tired to go out and do anything! It's a good thing Mike is a teacher and just as tired as me by the end of the week. ;)

On the bright side, I feel like I've progressed significantly in the two months I've been at Hurley. My first three years of P school were sort of like baby steps, shuffling along slowly. I was learning it, but not knowing it. Now, since starting Internal Medicine, I can do so many things I couldn't before. I can look at a patient's drug list and pick out major drug interactions. I can recognize lots of usual dosages. I can pick out which medications need to be dose-adjusted based on poor renal function. I can look at their lab values and pick out abnormalities without needing a cheat sheet to tell me what the normal ranges are. I can calculate their Creatinine Clearance, ideal body weight, and adjusted body weight off the top of my head. None of these things I could do seven weeks ago. Those seven weeks have not been baby steps--they've been leaps towards knowing. I've got a long, long way to go, but I'm getting closer to a pharmacist just a little at a time.

A week from this coming Wednesday is my final day in Internal Medicine, and October 1st I'll begin Ambulatory Care at a family care clinic north of Bay City. That will take me through to Thanksgiving weekend, and will also put me halfway through my final year. My first Thanksgiving weekend without homework in college ever. OMG. I'm so excited for that.

Today is September 19th, which marks nine months until the wedding! Not that I'm counting or anything. ;) This weekend we're meeting with my cousin who will be our photographer, and my grandma and aunts who are throwing me a spectacular bridal shower! I'm so excited to take a break from pharmacy-related things and focus on the wedding, which has become something akin to a sweet finish line. Mike also whipped up some Save-the-Date templates which we hope to finalize this weekend! It feels good to be making progress. :)

For now though, it's back to the homework.

Our Box of Memories

Me: Man, this box is so full you almost can't close it.
Mike: Yeah, it has a lot of memories in it. Five years worth! *pause* Well, four I guess. The last year didn't have much love in it.
Me: *pillow smack*

September 11th, 2001

We're not better because we're a democracy. We're not better because we make all the right choices. We're not better because we're powerful, wealthy, or claim to have God on our side.

Our people are free, selfless, and together, even in the darkest hour.
This is what makes us great.

Money Well Spent

Me: are you covering the cranial nerve again?

Shruti: yeah. All the cranial nerves--there are 12.

OOH OOH OOH TO TOUCH AND FEEL VIRGIN GIRLS VAGINA AND HYMEN

Me: Omg, why?

Shruti: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vagus, Glossopharyngeal, Vestibulocochlear, spinal Accessory, Hypoglossal. That's our wonderful creative pneumonic. O.o THIS IS WHAT I DO IN MED SCHOOL

Me: That is so, so dirty. Can i blog it???

Updater

Five weeks in, and three and a half more to go in my Internal Medicine rotation at Hurley. It's really been challenging and I'm counting down the days until it's finished. I've been pretty consumed with assignments, without even enough time to update my blog, as you've probably noticed. >_< But the conclusion of this rotation will bring me 1/4 of the way through 4th year, and that at least feels awesome!

Aside from pharmacy school, a lot of other stuff has happened lately! My brother moved back to GVSU to begin his second year of college, and the house sure is empty without him in it. Having him gone really makes me feel like another school year has begun, only this time with me living at my parents' house, which has never happened before. I just got my desktop set up this past weekend though, which should make homeworking much more comfortable! :D

Mike recently moved for the first time to Ionia, where he'll begin his second year (third overall) teaching there. I love his apartment--I know he will be very happy there. If I'm able to find a job nearby once I graduate, it would even be a great place to live until we're able to purchase a house. :) Tomorrow is his first day back with students.

This past weekend his good buddies from high school Alex and Laurie got married, so we got to get dressed up and go to a wedding! It was very beautiful and of course when they said their vows I wanted to cry. I always get that way. At the reception we got to hang out with a whole table full of Mike's friends, including two of our own groomsmen, Tim and Dan! I ate a lot of cake, enjoyed some surprise fireworks, and danced the night away. :)

My pharmacy (class of 2010) had its banquet two weekends ago in Grand Rapids. It wasn't really that good to be honest--only about half the students came, the DJ got a flat tire, no one was dancing, etc--but I still had a blast just because I got to see all my favorite pharmacy peeps. As much as I hated class, the one thing I miss about it is getting to see my classmates everyday. Rotations seem so isolated and lonely sometimes. I stayed for dinner and cake, and then a few of my friends invited Mike and I to go out with them to the nearby dueling piano bar, which we did and it turned out to be much more lively than the banquet. ;)

I got to see my friend Beth from P-school for about three weekends in a row, which was awesome, because now she's graduated and a real pharmacist. I can't even believe that. But she's taken a clinical pharmacy job down in Pennsylvania, so I pretty much won't get to see her again for a while. :( I'm so happy for her though, and I had a blast hanging out with her so much before she had to move. I can't wait to have her back in Michigan for my wedding. :)

I just want it to be fall now. So bad. I'm so excited to carve pumpkins. :D

Wistfulness

Today while rounding with my physician team, we were joined by a 3rd year MSU med student. We started chatting about how much it sucks to be a student, how tired we are, and how awesome it will be to finally have a passable level of knowledge at the forefront of our brains. She asked me when I finish with school, and when I told her less than a year, she got a wistful look in her eyes.

I know that look well, and just where it comes from. That small, deep part of your heart that is constantly trembling with hope--uncrushable. This time around, I was happy to be on the receiving end of it.