COMLEX + 1 Week

Remarkably, today marks one week since I sat for my Step 1 boards. It has taken nearly a week for the anxiety surrounding the boards to slowly ebb away. For many months I've been studying myself almost into a stupor. Now, abruptly, I have nothing to study. The day I got home from the boards I sat down at my little desk out of habit, ready to open my USMLE First Aid book. I stared at it dumbly, suddenly realizing I was done. I actually felt lost for a few moments. What do I do now? I thought to myself.

Since coming to this realization, I have had the extreme pleasure in spending more time with my family, doing some local teaching, and reading about those medical subjects which were a little weaker for me (can anyone say PHARMACOLOGY??). I am looking forward to 3rd year with profound excitement: finally, we get to help patients on the wards! For me, this is a "return to the wards" as I have 18 years of military medical experience in clinics, the field, and hospitals. It feels like I'm coming home.

Meanwhile, I have at least two more weeks of waiting before board scores are released. No use being anxious now - what's done is done and it is quite literally in God's Hands.

I'm grateful for getting this far and very much looking forward to the next two years and to residency beyond.

Be blessed, dear reader. I'll keep you posted.

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Tomorrow....

Tomorrow, May 24th, from 0830 hrs to (about) 1730 hrs, I will be taking the medical boards Step 1 exam: the COMLEX. This exam is eight hours long and consists of 400 questions covering everything we have learned during the first two years of medical school. Quite literally, from day one, my medical education has worked to prepare me for this event.

As you might imagine, the stress is incredibly high. Thoughts assault me: What if I fail? What if I'm not cut out to be a physician? What if I've messed up and wasted my life and spent literally hundreds of thousands of dollars for nothing? What if I fail my family? Am I crazy for trying this at my age? And on and on and on....

In the midst of all of this stress two irrefutable facts remain: 1.) God, Who is very real and very close, has been so faithful to help my family and I through these challenging times. Quite literally I would not be here if not for Him; and 2.) My wife and children and many other kind folks have been and remain a source of extraordinary encouragement and support. I am thankful for both of these facts and I feel very honored simply to have the opportunity to sit for this test.

I don't know what will happen tomorrow. I do not know if I will pass this exam. I do know I am going to throw myself at it and, for eight hours, give it everything I have.

Thank you for reading. I'll keep you posted.

That Four-Legged Evil

Never before, in my wildest dreams or most terrible nightmares, had I suspected that one day I would so loathe an object as seemingly innocuous as a chair. 

But loathe it I do. 

All I do these days is sit: I sit in my chair behind my desk and study for the boards; I sit on the couch and study for the boards; I sit at the kitchen table and study for the boards; and, if I'm feeling truly daring, I sit outside and study for the boards.

Yes, it is that time in my young medical education - STEP 1 COMLEX boards are 20 days away as of this writing. This eight hour, 400 question exam will test how much I have learned in the past two years and, if I pass, usher me into official status as a 3rd year medical student. 

Thus, like my colleagues, I spend nearly all of my waking moments studying. My tuchus is tired of sitting. The chair has become an evil taskmaster telling me to open another book, read another power-point presentation, watch another educational video.

Sometimes I look out the window and yearn to go jogging or even take a brisk walk. "No time!" cries that cursed chair and back I go to plant my derriere in that unforgiving seat.

Speaking of which, I've already taken too much time sharing this with you. Only 20 more days! I should be studying!

Hello chair.....

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Le Premier Jour du reste de ta vie....

Will you let me wax philosophic for a moment?

I turned 45 years old yesterday.

45...

I'm on the downhill slide toward 50, nearly a half a century on this little spinning globe.

I know that age is merely a number, a count of the times I've shared the earth's racing around the sun. Every day, though, I am reminded of my lost youth and the reality of being entrenched in the rigors of "middle age". At school I am surrounded by the "next generation", a hodgepodge of young people who are bright and tight and brimming with vigor. At the end of a lecture they bound out of their chairs laughing and talking while I slowly rise, knees and hips screaming in protest against the punishment of sitting for so long. My youthful colleagues go over a lesson a couple of times and move on. I read, study, reread, re-study, and pray that my aging memory will somehow retain what I need. My colleagues are looking at a good 40+ years of practice as doctors after graduation. I will be 50 by the time I finish residency.

Don't misunderstand me: I'm not jealous. I had my time as a youth and tried my best to negotiate my 20's without making too many mistakes. By God's grace, I came through okay. I would be lying, though, if I didn't say that I wish I had started this journey becoming a physician a couple of decades ago.

What is the point? Namely thus - I've learned that one is never too old to live one's dream. I've also learned, though, that living one's dream later in life brings its own set of challenges. I need to work harder than most of my colleagues merely to keep up with them. I don't have the physical stamina I once had. Is it worth it? You bet! Does it come at a cost? Absolutely. "Better late than never" is a wonderful adage but needs an addendum: "and be sure to move your joints!"

Thanks for letting me rant. I love this journey. The sacrifices are worth it - without question.

Back to the books.

Why I Wear It

In 1989 I joined the Army - the desperate attempt of an 18 year old young man to get out into the world and see more than his small hometown. During basic training in a broiling Missouri summer one of the first things done to me, besides shaving my hair and riddling my thin body with countless shots, was the granting of a new set of clothes: slightly ill-fitting clothes that I would wear for many, many years to come. They were not fancy, simple patterns of green and brown, a pair of black boots (I would spend countless hours shining to a gleaming luster) and a stiff round, billed cap which, later, proudly bore my ever rising rank.

Basic training was hard for me: grueling months of challenge and change. Through it all, though, my uniform was a source of pride, a physical reminder of what I would eventually become: a soldier. Every night I washed and pressed and hung my precious uniforms, realizing that here was a physical reminder of my transformation. Before basic training I was a civilian. At graduation (which finally came in September) I marched past the podium in precise time wearing a perfectly groomed uniform. The clothes on my back were now merely a reflection of the change that had happened within. I was different - my role in society had changed - I was now in the service of my country and pledged to defend her people even, if needed, with my very life.

Fast forward a few decades and here I am again: not quite as thin and now sporting silver hair along with my original black. This new calling is no less an honor and involves no less a life-altering transformation. The challenges are vast but the final goal remains the same: service to people with my very life. Every morning, when I don that slightly ill-fitting white coat, I am reminded that, by God's grace, I am in training to become a physician. It is an outward and vibrant symbol of a very real change happening within. Instead of weapons of war I am now learning methods for mending. This transformation is reflected in that thin white coat.

My particular medical school does not require that students wear their white coats to class. That's fine. I do anyway. It is my new uniform and a reminder, both to self and society, of my new obligations and my new identity.

This is why I wear it.

Dinosaurs Rock!

How is it possible that the 2nd year is already half-way over? Time truly does fly when you're having fun - or, when you're being being mercilessly tormented by hyper-intelligent professors with Herculean amounts of information over which you are consistently tested.  It is even more extraordinary when one considers that 75% of the didactic information needed for us to be general physicians has been already taught. This idea stuns me as I feel, right now, most incapable of being a doctor. No doubt the 3rd and 4th years of school are intended to mold us into that most enviable professional role. 

Until then, I am thoroughly enjoying my three weeks of Christmas vacation. Though I should be studying (and have, to some extent), I have spent most of this time with my family. What a joy it is to reacquaint myself with my children and wife! We have gone to see movies, spent time at home cooking, and stayed up late watching cheesy films from the '70s. This break has reminded me of one of the main reasons why I'm doing this med-school thing in the first place: to make a better future for my family. 

School starts again in about a week. I promise to be in touch with you before then. Meanwhile, for me, it's not back to the books yet - I've got a dinosaur to chase with my ten year old son. 

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I'm Still Alive....

I've been so naughty. It's been 18 weeks and I have neglected to update my blog. The reason is two-fold: 1.) Second year is nearly all-consuming and has thus taken almost all of my attention, and 2.) When I have had a few moments of repose I've simply been lazy. I have no excuse. There's honesty for you....

To be frank, second year (the first semester of which is over in a mere two weeks. How did that happen so fast?) has been incredible. Finally, after the stress and strain of first year, things are coming together. I'm actually, just a wee bit, beginning to feel like a doctor. This semester we have studied pathologies - what can go wrong with the body - and a modicum of related treatments. There have been plenty of "aha!" moments as things we learned in first year suddenly fall into place (So THAT'S why we had to memorize that seemingly insignificant random fact!). With each ensuing class the picture becomes more clear and I'm being reminded, nearly daily, of why I went into this in the first place.

Medicine is cool!

With this newfound zeal comes, of course, increasing pressures. We had an exam this past week that covered 46 (yes, forty-six) lectures. The exam itself took three hours to complete. In the words of one of our professors, "it's a bugger". Thank God, I came through okay.

The next two weeks we will have three exams: our final block exam consisting of Repro-Derm-Heme, our last Osteopathic Principles and Practices (OPP) written exam, and our final OPP hands-on exam where we are given a simulated patient and we must diagnose and treat said patient using osteopathic medicine principles. It's going to be a busy two weeks but it is followed by three weeks of Christmas break. Whoo-hoo!

Oh, did I neglect to mention that COMLEX Step 1 is coming up? This eight hour test, to be taken in May or June of next year, is a summary of EVERYTHING we have learned in the first two years of medical school. This COMLEX must be passed before I can continue on to third year. So much for resting during the holiday break - I will be studying for COMLEX. (For those of you who may have a perverse interest in this torture test called COMLEX, click here.)

Meanwhile, it's good to be in touch again!  I hope, dear reader, that you are doing well. As for me, it's back to the books.

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