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Archive for July, 2010

Last week I went back to the county fair in my hometown. While growing up the county fair was the highlight of my summer…sort of.

I truly loved livestock, photography, dog obedience, and everything else I showed. I excelled at nearly everything. I played the part of a “good” 4-Her.  I never felt like I really belonged there.

But I tried so hard. I arrived at the fair early to feed the livestock and clean out pens. I put myself in jeans and boots to fit the picture. I hung out in the barns until long after sunset. And I thought that this was the real me. That if I just tried hard enough I would feel like I belonged and not just look like I belonged.

Going back this summer–in my shorts, and nice shirt and shoes–I realized that I was banging on my edges to make myself a certain shape. A square. But no matter how hard I tried I could never break through the basic skeleton of me. A triangle. I could change the color, I could change the size, but I could only change the angles so much. I could only have 3…never the 4 that would allow me into the coveted square hole.

But I’m okay with that.

Two years ago (or even last year) that realization would have been heart-wrenching. Knowing that I would never be a perfect copy of my father or older brother. But I’m happy with where I am now and I wouldn’t change it in order to go back to the point where I was trying to fit into a particular mold. I see now how miserable I was while I was attempting it. Perhaps if things had gone differently in my life, if my parents had given me more freedom with farming things, I wouldn’t be a triangle. If if if…but it’s the way things happened. I am who I am today and I can’t change the past.

As I left a couple of hours later and returned to my city condo to work in an air-conditioned hospital I realized I’m not only okay with that…I quite happy about it.

On a side note, this week I ran across this: http://www.facebook.com/video/video.php?v=450292110309

Which includes this song….which I love…and goes along with today’s post.

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Know what it’s like to walk through an unfamiliar house at night?

You walk in the door, groping the wall and hoping the switch appears under your fingers. Perhaps it does, maybe it doesn’t and you have to take a few tentative steps in and try a little further along the wall, or a different wall entirely. Breathing lightly, stepping lightly, and straining for any glimpse of what lies in front of you. With a constant fear that your toe will crack into the couch or an errant shoe will break your balance.

The light comes on and one area is bathed in the warm comforting glow. You move confidently for a while until the room ends and you enter the hallway.

For a short time you can just slow down and see a bit using the excess light from the previous room.

Soon nothing but darkness is ahead of you and your hand again slides across the wall praying that there is a light switch. Straining to see, hoping that there is nothing unexpected in your path, and completely afraid that there will be.

Ahhh…a breath of relief. Saved again. You can continue to the end of the hallway and turn into the final room.

Standing in the door frame an eerie square of diffuse light lies across the carpet. And you realize that yet again, the light switch has to be found.

Maneuver around the edge of a dresser, slamming your hip into the corner. Swearing under your breath and searching, searching, searching for that damn switch.

Finally. Breathe in peace. You have reached your destination.

What does this have to do with anything? This week I saw the physician for the first time who will be coordinating my medical needs (in regards to the eating disorder) here in I—. She asked how often I got on the scale. (A lot….) Then she asked me why? What did the scale give me? There must be some reason I continue to do it again and again and again. When I get up, before I get in the shower, before I go to work, after I run, before I eat, etc.

I thought about it and realized that the scale is my light switch. I step on and it lets me see where I’m at. I can walk a little further without intense anxiety. But eventually the light runs out and I’m straining to see, starting to panic, stubbing my toes. So I step on the scale. And the light comes back on. But I never reach the intended room. There is always a different hallway, a new passageway, another room to find. And I find myself looking for the light switch again and again and wondering if the experience will ever stop.

I’m not sure what it helps me see though. Does it show me a life map? Not really. A personal health map? No. It just seems to be the only thing right now that alleviates the anxiety, if only temporarily.

The elusive light switch when what I really need is a flashlight.

Or the confidence to take on the dark.

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I have turned a corner, so to speak. I realized Thursday that I am happy with where I am in life right now. I have mostly adjusted to the changes and feel more comfortable with what I’m doing and where I’m headed.

I’m not sure what changed. Possibly become more confident in my job and feeling like I know what’s expected of me and knowing that I can meet those expectations. It’s great to come into work and fall into the regular routine of report and finding out how the patients are doing and how the previous shifts have gone. I love leaving work and feeling confident that I completed all my requirements and handed off all my patients. A lot of this comes from being done with orientation. While I was on orientation I was required to follow an aid and couldn’t have any of my own patients. I felt restricted by having to follow their lead, their preferred order of doing things, asking permission for simple tasks and whatnot. It’s quite freeing to head onto the floor and make my own decisions about how I want to do things that day.

I’m feeling more comfortable at home. Zef and I have gotten into a pretty regular routine with running/walking. I’ve sorted out the bus routes and deciding whether to [bike, bus, drive] to work and how to deal with each option. I feel more confident about grad school.

I hope things continue on this path.

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My new therapist really knows how to hit a point home. We were talking about my motivation to recover. I’m not sure where it is most of the time; I do hate a lot of things about how I feel now but at the same time I am completely and utterly terrified of gaining weight. She pointed out a chair across the room and designated at the ED-free life zone.

“Are you willing to get out of the chair you’re in now and take a step toward that chair?”

Silence

“It can be something small. In fact it doesn’t have to even be a step at all; it could be scooting yourself forward to prepare to stand up.”

I might be able to do that.

“The catch is, you can’t go back to that chair when something happens or when you feel uncomfortable. Well, actually you can, but that doesn’t help. You need to keep moving forward. Let uncomfortability be your guide.”

Dunno about that one. It’s pretty easy to fall back on ED.

“In five years you could still be sitting in that ED chair. It would be no problem at all. But is that chair getting you what you want? How about medical school in that chair? I assume that medical school will be a challenge enough as it is and adding the challenge of an eating disorder could sabotage it all. Do you want to have to take a semester, or a year, off for treatment and fall behind your class? How about having to tell your staff doctor that you need to take a medical leave of absence from your favorite rotation because your weight is dangerously low?”

Damn you. I know medical school is impossible in this state. Taking time off? Why would I ever do that? But hearing it said aloud scares me to death.

I ferociously guard my history of an ED at work because I’m afraid that people will want to limit my options if they knew about it. If the behavioral health people knew I was struggling with an eating disorder would they worry about me working on the psych unit and getting pulled to work on the unit with the eating disorder program? I am very good at separating work and personal life; despite my extensive history with this hospital (my mother’s extensive hospitalizations there, my brother’s severe accident and subsequent time in the ICU, my own time in ED treatment) when I get to work my mind thinks only about work and what the patients need. My own issues never cross my mind. But people don’t know that. Talking to someone who knew about my treatment I was advised that I should tell my supervisor about my history so she could “be aware of the effect of the patients’ issues on my own recovery.” Ridiculous. I know myself better than she. I know what makes me worse and it is definitely not work.

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One of my “to-dos” for my new medical school application is to receive feedback from the schools that rejected me and find out what they saw to be weaknesses in my application. I have emailed some, I plan to call others. My new job is actually at a hospital affiliated with one of the medical schools I applied to (one of my top choices, too) and so I was conveniently able to meet in person with their admissions director. It was an interesting meeting.

She had pulled up my application and made notes on it. I’ll run down it…

Grades: Excellent GPA. Last fall I had a couple difficult classes that I didn’t do so well in because I was pretty sick with the eating disorder and couldn’t focus long enough to read an entire textbook page. In the comments I wrote “extended illness” because I didn’t feel that they really needed to know more than that. She said I didn’t need to take any post-bacc work to raise my GPA. I told her I was starting the MPH program and she thought it was great.

MCAT: Fine. Within their average accepted ranges. She said I could choose to retake it, but it wasn’t really necessary. (I had already registered to retake it, so I continued with it)

Experience: Wonderful. She appreciated that I had worked in so many medical situations (hospital, nursing home, psych and medical units). I had shadowed doctors and really seen what they did and determined that it was what I really wanted. I volunteered in both healthcare and other areas that I had interests in.

Interview: Outstanding. She said they thought I did wonderful on the “structured” portion and I really “blew them away” on the unstructured portion. Apparently, most people who graduate early struggle with the unstructured portion.

Then the written application is reviewed by a committee and given a numerical score. She estimated that I had probably missed the waitlist by 5-6 names. Great.

What I got out of the conversation was that my application was more than sufficient. However, I still didn’t get in. Frustrating, no?

It relieved me from the fear that I hadn’t done enough this year to improve my application because apparently my application is quite good. But at the same time I find myself thinking if this application was good enough this year and I didn’t get in, why the hell would I expect to get in with essentially the same application next year? I suppose I should trust myself…and the admissions professional…

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Update on Life

It occurred to me that although a lot of my recent posts have been on the changes in my life, I haven’t written about what I am actually doing here.

I of course graduated in May with a bachelor’s degree in music and all the required pre-med classes. After the rejection from my final medical school in March I moved quickly to decide what I wanted to do. I chose to move to I— where they have an outstanding academic hospital to work (as well as one of my top choice med schools). In April I discovered that the university also had a public health program and that the deadline for applying wasn’t until May 1. So I applied. And was accepted! I was also offered a full-time job as a psychiatric nursing assistant in the hospital.

I took the job an am now working on the medicine-psychiatry unit. It isn’t quite what I had wanted. In A— I had worked at the hospital on the adult psych unit and in a residential treatment program. I was hoping for something more like that–mostly psych. What I got was essentially a medical floor where the patients have psychiatric issues. I don’t get to do anything with psych; instead, I give showers, help feed people, change people, etc. It’s busy work and goes by quickly but I’m still hoping to switch to one of the other 4 general psych units.

And I accepted the offer for the Master of Public Health program. This really excites me. Public health is something that I am really interested in, but prior to being rejected to med school I never would have considered getting the degree because I was so focused on going somewhere (anywhere) as fast as possible. My subtrack is Community and Behavioral Health, a wide category that includes health promotion, health education, community resources, mental health, and of course interventions to deal with those issues and more. One great part is that this really won’t set me back any more. The school here has a combined MD/MPH program and if I am accepted into the medical school I can enter that program and count some of my MD credits toward my MPH degree. Most MD/MPH students take a full year between M2 and M3 to work solely on the MPH requirements. However, since I am spending this year working on those requirements it should save me the year in the middle. Outstanding! Part of the degree requirements include a practicum in public health. After talking with my advisor she mentioned that my work in the hospital can count toward practicum hours if it is related to my practicum, so now I am talking to various nurses and other staff to see what I can do in the hospital and how to transfer to that. Making money while finishing school requirements sounds like a good deal to me!

And I am still reapplying to medical. I have the beginnings of another post drafted about my meeting with the admissions director here….be excited for that coming up.

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Just Trust Me

Trust. Sometimes it seems like a magic, cure-all. Right now in my life it most certainly does. Trust my treatment team. Trust my meal plan. Trust the honest feedback my friends give. Trust myself.

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