Recent Thoughts

Apparently blogging is my most recent study procrastination strategy 😉

So many things to think about in the past week.

1. I passed my human organ systems exam. Despite feeling excessively prepared I came through with an 81% overall. Primarily missing histology questions. I didn’t study histology at all and got 93% on the non-histology portion. Note to self: study more histology.

2. I am totally freaking out about my immunology exam. Seriously don’t know what I’m even supposed to know for it. It’s all random letters (C1q binds the activated IgG, then activates C4b which activates C2a then the C4bC2a complex activates C5b which leads to formation of the C5bC6C7C8C9 MAC and C5a runs off to stimulate TNF-a etc etc)

3. The Biggest Loser. All I have to say is wow. It’s a strange experience though. She is approximately my height and weighs exactly what I do right now. I look at her and can sort of see what people are freaking out about, but I look at myself and swear to god that I definitely look 10-15 lbs heavier than I am. So I’m in this strange place where I actually almost understand why people are worried about me because I do think Rachel doesn’t look all that good. But then my brain goes in to overdrive to tell me that I definitely don’t look like that and could still lose more weight without looking any different.

4. And speaking of weight….I’m on a short rope right now (surprise surprise!). This seems to happen every time I’m in therapy and lose weight and yet every single time I don’t understand why people make such a big deal of it. My therapist told me I had 2 weeks to stop losing weight (I’m pretty sure he would have preferred one, but he doesn’t believe that’s a completely fair measurement). He said that he had seen a significant change in just the short time I had been back to see him. Now I am totally paranoid that everyone is looking at me and thinking I’ve lost too much weight and the worst part is I don’t even know what I look like to them! And then there’s the whole I have to stop losing weight thing too. We discussed the 3 main factors: eating, purging, and running. I had a minor outburst at his suggestion that reducing exercise might be good for me (ok, he said it was a major outburst). And I’ve been trying to stop purging for well over a year and haven’t succeeded, so surprisingly food appears to be the variable most easily modified here. And it’s not easy at all. I also spent a good half hour trying to convince W that my exercise was not a problem at all and that I was not obsessed with it. Apparently arguing about running when he didn’t even say I had to stop running does not give the impression that I am not obsessed with exercise. He didn’t really say much about what happens at 2 weeks if I can’t maintain my weight, he just said we would have to discuss other options. I then told him as long as I was passing tests I wasn’t leaving school. We both have concerns about my ability to do this on my own.

5. My car died today. I was just starting on a ~35 min drive to a clinic to shadow a doctor for one of my classes and 5 minutes in my car stopped responding to the gas pedal (while I was on the interstate). I was just going on an entrance ramp to another interstate and stopped to see if I could get it to work again. But alas, it only got worse. Fortunately, if my car had to die it chose a very good moment and place to do so. I was still very close to home and on the entrance ramp there were 2 tow trucks winching a car out of the ditch (from the snow/icy roads we had this morning). As I fiddled with my car, called my physician mentor, emailed school, and called my parents they finished up and came over to check on me. I then paid a ton of money to have my car towed to a repair shop. The shop was about done for the day so I don’t know what is wrong with my car. I’m hoping it’s nothing serious. My trust cav has come through a lot with me and I’m not ready to giver her up yet.

6. School has been hectic recently. But it should start to get better. As I looked through the next month my schedule is much more free than it has been the past 4 weeks. That is good because this month has been just as bad as first semester. I have been in class essentially 8:30-4:30 every single day. From here on out I primarily get done at 2:30 and even have some days where I’m done at 12:30. Can’t wait.

7. Cold. I hate it. It will be the death of me. In related thoughts, I realized today that every winter for 4 (I think?) winters my weight has been low. This led me to wonder how different winter would be without starvation induced coldness on top of my already somewhat low cold tolerance.

8. There’s probably more, but I have about another 20 minutes of immunology studying and a neuroscience lab video to watch yet tonight.

Read Full Post »

Study Slump

I’m in a Thursday night motivation slump and am struggling to continue to study for my exam tomorrow. First exam of the semester: Human Organ Systems–covering epithelium, skin, muscle tissue, nervous tissue, connective tissue, and pretty much whatever doesn’t fit in to the “real” organ systems. I think part of my lack of motivation is that I’m still not fully back in to the school routine. I haven’t had an exam yet and the reality of exams every Friday has yet to hit me. The other part is probably related to my brain struggling through the eating disorder fog.

But the stuff we are learning is definitely more interesting.

Ok. Honestly, I can’t even think straight enough to write a coherent blog post right now so the rest will just be random thoughts.

Neuro is cool. At least the playing with brains part. I was enjoyed neuro lab today and was like “ooooh! that’s awesome!” and one of my lab partners responded “it’s neuro, it’s not awesome.” And he was somewhat serious. I thought that was strange because I’m holding a real human brain! how on earth is that not cool?! He then suggested that perhaps I should be a neurologist. I will almost certainly not be a neurologist, but I will continue to think brains are cool.

Wound healing is awesome. Ok, so I did once time in junior high document the phases of a random largish cut I had, so this shouldn’t be all that surprising that I like wound healing. Sadly, with my low weight I struggle to get extremely excited about things, so although normally I would be over the moon about learning how wounds actually heal I’m more like “meh, that’s interesting. I’ve always wondered how that worked.”

Immunology….uhhh I’m somewhat lost there right now. I should probably get unlost before the exam in it next Friday. It’s not that I don’t understand it…ok so I don’t understand some of it. It’s primarily that I don’t have a clue what I should or shouldn’t even be trying to learn.

I was looking forward to learning the neurological exam and then I went to learn it and had a quiz on the musculoskeletal exam right before that and the standardized patient gave me 50% for stupid nit-picky reasons and it ruined my mood for the neurological exam. It did however, make it somewhat more satisfying to gag her and prick her with a pin as part of the neuro exam (don’t worry, I didn’t do it too hard).

I really hope I don’t fail my exam tomorrow. If I did fail tomorrow though, it would make me consider taking time off for more intensive treatment slightly more than I currently am. I think I would probably have longer-lasting success if I could get back up on my own. But most nights I feel so stuck and in such a deep deep hole that I’m not sure it is possible to get out on my own.

Read Full Post »

I want…

I returned to therapy.

It all somewhat started the week before Thanksgiving. I was having an exceptionally rough week in school and my anxiety and depression were utterly out of control. I broke down crying every night, I couldn’t focus in class, etc etc. So I went in to the medical student counseling center and talked to someone. And of course my past history came up and although I wasn’t intending on telling anyone at school about it, I mentioned to the counselor that in previous times of stress I had turned to restriction and purging. And one thing led to another and my current purging came out. Clearly she was worried because she wanted to see me relatively soon after that, but fortunately she also recognized my reluctance to returning to any sort of treatment and didn’t push too hard for me to see a psychiatrist or therapist. Eventually I came around and scheduled an appointment with a psychiatrist. And from that eventually scheduled one with a therapist.

It is a different therapist than I was previously seeing although I know him because he is the primary therapist for the partial and inpatient eating disorder programs. The psychiatrist is completely new (though we had briefly met when I worked at the hospital) and of course the medical school counselor is new. I haven’t had to get to know a new provider for 3 1/2 years. I have trouble opening up to new people, especially when combined with the fact that I was really hesitant about returning to treatment in the first place. It’s a little strange that a year ago weekly therapy and routine psych visits were part of my routine and life felt off-kilter without them and now it is completely the opposite. I feel uncomfortable checking in at the clinic and sitting and talking to someone. I suppose with time though this will change.

Anyway, the reason I started this post is that I saw my therapist this morning and his question to me was, “What do you want?” And I didn’t really know at the time. (other than to stop purging because that really sucks) But now I do know.

I want to eat. I want to eat good, healthy food and not feel guilty about it. I want to wake up in the morning have a nutritious breakfast and not spend all morning obsessing about how to compensate for those calories at lunch or through exercise. I want to embrace my love of cooking and experimenting with food and not fear it because cooking leads to eating. I want to feel strong when I run because I have not starved or dehydrated myself. I want to spend my free time pursuing the things I love, not hunting for ways to cut calories out of food and add calories in to physical activity. I want to do amazing things with my brain and my body. I want to be free.

Read Full Post »

How?

The semester has flown by. I last blogged 2 months ago. How has time gone so quickly?

Blogging crosses my mind sometimes but every time I sit down to write my mind goes blank. I’m never quite sure what to write. Every week is essentially the same. Go to class, study, take an exam, repeat. The last few weeks have felt a little different, primarily because I’m doing “lasts.” Last cell bio exam, last patient interview (for the semester), last dissection. It feels good. I have officially passed 4 classes in medical school. The hardest 2 are left (anatomy and biochem) but I don’t need fantastic scores on the final to pass either class (34 and 37% respectively). I think the most difficult thing will be motivating myself to study for the next 7 days.

Most days I continue to ask the same question. How have I done it? How have I gone from someone who failed (almost) every exam in the summer prep course to someone who has very little chance of actually failing any class? I still don’t feel like I’m smart enough to be here.

On the personal side, things have been difficult. I’m struggling a lot with purging, consumed with the thought that I am excessively fat, and just been in a lower mood overall. I’ve been going to the med student counseling center briefly every week and this week am meeting with a psychiatrist though I’m not sure I want to start medications now. Mostly I’m afraid of getting back into the never-ending cycle of mental health appointments though I am also afraid of continuing to purge and jeopardizing my relationship. Perhaps things will get better over break without the massive stress of finals.

Read Full Post »

Speed

The weeks go so quickly. I wake up, grumbling, on Monday morning. Before I know it I’m going to bed Wednesday night and waking up to Friday with an exam in my face. This is already week 7 (I think?) of a 16 week semester. And despite the fact that I wake up every Friday morning, completely convinced that I will bomb my exam that day, I have yet to fail one. And even though I remind myself of this fact every Friday as well as the fact that I will not be kicked out of med school for failing one exam, I am still utterly convinced that this Friday I will fail and they will kick me out of med school. But I do think I’m getting better at studying. Or at least getting used to studying again.

It’s stressful, but I’m managing. Better than I’ve managed a lot of stressful times in my life. Or at least I think so. I’m maintaining an ok weight and ignoring the fact that I purge 4-5 times/week.

Denial.

My biggest defense.

I think I was in denial about anatomy lab, too, for the past 6 weeks. I didn’t think it bothered me all that much. But after writing a piece about it for my writing class I realized that it does bother me.

A lot.

It doesn’t matter that we cover up the face and keep the body under layers of towels. We are still cutting in to a human. It’s not natural and at the end of a dissection it resembles nothing like the body you started with. And I feel for the donor. Whenever I’m in lab I feel this pull to hold her hand or rest my hand on her thigh as I would do with a child as they got stitches. Seeing her hands makes me so sad. Every week I am thankful I do not have to dissect her hands. Instead I have to dissect her face. I’m not sure which is worse. But the worst part of lab is that I don’t feel like I can tell anyone about how much I dislike it. It’s not that I’m squeamish. I don’t even know exactly what the emotion is. It just bothers me. I avoid it as much as possible and I feel extremely guilty every time other people go in to study and I don’t.

And I’ve had a lot of friends struggling with their own issues. I love that they trust me. I feel so deeply for them though, that it’s hard because I just want to take away their pain and I can’t. Although I think it would be much much harder if they didn’t tell me. (So you friends reading….don’t use this as an excuse to not tell me things)

So to sum up this blog post: I’m doing ok. But in many ways I’m really not. But I’m still telling everyone that I am.

(and after some more editing I’ll post my most recent writing piece)

Read Full Post »

Lying in the bed I made

I feel like recently I have been upset and frustrated with things and I have no one to blame but myself.

My summer class is not going as well as I would like. I’m pretty sure the primary reason for this is that I spend 20 hours working every Saturday/Sunday. And who thought they could work through this?

Me

I have not had a day off since the 4th of July and it’s totally stressing me out. And the last time before that was like 2 weeks before that. But again, who decided to work and take a full-time class this summer?

That’s right, me.

I have been having GI issues again. Recently I’ve been having more gas and bloating (sorry if this is TMI). I couldn’t quite pinpoint what seemed to be causing it so last week I avoided dairy products. Lo and behold, gas and bloating, gone. So one day I had a couple slices of cheese and 30 minutes later, gas was back. I’m stuck. Last summer when I was inpatient, they tested me for lactose intolerance and it was negative. So I started eating milk, cheese, ice cream and all that other stuff again, and I didn’t have issues until recently. But I’m afraid that if I stop eating dairy again people will think I’m restricting or making it up. A bed I made twice: messing up my body with a stupid eating disorder and losing trust about food/eating from those around me.

On the bright side though: Only 4 more days of class. Followed by a whirlwind of celebrating my grandparent’s 60th(!) wedding anniversary (I cannot even fathom being married that long), shadowing my rural mentor for a week, a brief stint home, the state fair, a trip to Syracuse, NY, and then real school. Ahhhhh!!!!

I always tell myself that things will calm down and go back to normal and then I’ll be okay. Then I remember that as a physician a hectic/abnormal schedule are the normal. Then I wonder why someone like me (who doesn’t like change and craves a solid schedule) is going into medicine where I probably won’t have a stable schedule for another 8-10 years.

Read Full Post »

What if…

What if I just can’t do it?

These days that seems to be more and more of a possibility these days. I’ve now had 3 exams in my summer program and have yet to pass one. Passing is 70%; I have received 60%, 60% and 57% respectively.

Now I know that this program is quite a bit different than the school year for several reasons. First, every exam covers 3 different subjects. Second, I only have a week to learn and understand all the intricate details. Third, we are just getting bits and pieces from different times of the semester without the conect lectures between them. Fourth, Many of the professors are compressing 2 or more lectures in to a single 1-hour lecture.

And on the non-school differences. My little brother is living with me so I want to spend time with him and there’s more cleaning and whatnot to do, I’m still working 20 hours every weekend in addition to spending ~30 hours in class each week, and it’s summer when I just don’t have the inclination to study as much.

I know several of the people in this program last year said they failed multiple exams in the summer but did just fine in the fall. That makes me feel slightly better, but I’m terrified I’ll be the exception. I’m afraid school will come and I won’t want to study more or my study tactics will prove to be ineffective. Although I don’t have a lot of evidence for that because every week I have one subject that I do awesome on. Week 1 I killed anatomy, Week 2 I aced biochem, and this week CellBio was totally my thing.

I’m trying to make myself feel better, but it’s not helping much. I almost cried after my exam and I had to leave the building and just go outside and walk around campus for a while.

I don’t know what to do with myself.

Read Full Post »

Autophagy

“Eukaryotic cells have evolved a way to resist eating for long periods of time by digesting their own components. When starving conditions are prolonged, cells digest part of their own cytoplasmic components to recycle metabolites needed to synthesize essential molecules…” Nature

Ever since this came up in lecture I imagine my lysosomes munching away on non-essential proteins. They probably aren’t right now, my eating has been ok, but I still imagine it happening.

 

But lecture…and school. I started my summer, pre-matriculation program last week. Wowzers. There is a lot of information. A lot of details. And it all goes quite quickly. I’m good at the big picture. It makes sense, I completely understand how things move, etc. However, I am not at all good at the little details. And that’s what’s tested.

First test was not good. Fortunately this summer is not graded and is my chance to make these mistakes.

I’ll be honest, I’ve never had to study. I made it through both my bachelor’s and master’s without putting forth any real academic effort.

But that has to change.

Next Friday is another exam and another chance to try some different study tactics.

 

Read Full Post »

Searching for Answers

Sometimes the stats for my blog make me sad. No, not because I have so few visitors, I expect that. I am saddened by the ways people are brought to my blog.

What do you think is the most common search phrase that brings people to my blog?

“Why am I such a screw up?”

That never fails to surprise me. And make me sad that there are people out there hunting for the answers to this on the internet.

But it’s only the top in terms of precise search terms. The top category is a combination of eating disorder plus some term related to medical/grad school (MCAT, medical school, medical school interview, grad school). I’ve googled these before. It’s nearly impossible to find any answers. Eating disorders in medical school (and to a lesser extent, grad school) are not talked about. They are not written about. They are hardly mentioned at all. Which also makes me sad. It also makes me think that I should write more about that and how having an eating disorder does fit (or not) into medical school. My struggles, the decisions, my successes. Making this less personal (I know 99% of the people reading this probably know me) and more helpful for others like me who feel alone in this struggle.

Read Full Post »

My Crazy Dream

I’ve always had this crazy dream, but I don’t tell people because it just seems strange considering where I am right now.

For a long time I have dreamed of starting an eating disorder treatment center in my home state.

Perhaps it’s not all that strange. There are a lot of people with eating disorders that talk of wanting to be therapists or nurses and work with eating disorder patients. So, in addition to being not strange it might even be a bit cliche.

I have a dream of starting a center that doesn’t just treat patients but also is a research hub. The research on truly effective treatment of eating disorders is lacking and I would like to add to that body. I am also interested in how to manage severe eating disorders in a community/outpatient setting.

And our state could certainly use more eating disorder services. Currently the only intensive treatment is located at the academic medical center I am at which has only 8 inpatient beds (located on a general psych unit) and 10 partial spots. The waitlist gets extremely long at times. And finding outpatient therapists with eating disorder experience outside the university is difficult.

A medical school admission gets me one step closer to achieving this dream. Right now my biggest obstacle is myself and getting out of this *** disorder.

Read Full Post »