Match!

Hello friends, family, and my one international follower in the Philippines. World wide fame really suits me. 

I have my MD (!!!!!) and write it everywhere I’m given the opportunity to. My personal favorite is when I buy airfare and then, sometimes, they say “welcome aboard Dr. Lamont”. I promptly die and give them the $5 I promised if they said it. I kiiiid I’m too cheap (read broke) for that nonsense. But it has happened once, thank you very much. Still waiting for someone to have a medical emergency in the air. Nothing too serious that they’re in danger but something where I can be like hi yes you called for a doctor and there’s a solid 70% chance that I know what to do. 

It’s been an eventful few months, the pinnacle of med school, match season!  Basically, I sent out a whole bunch of applications, then some decided to interview me, then I spent all of my time bouncing from airports and the dry cleaners. My interviews are over and I’m excited for my prospects. And emotionally exhausted. I can’t smile and talk about myself anymore, not gonna happen. I know you’re all dying to know what goes on behind those closed doors so here you go. 

An interview typically starts with a pre-interview dinner or mixer with program staff and/or residents. You get free food and to ask whatever questions you want, it’s pretty good. The next day you and your other group of suit clad interviewees meet in usually a conference room with pastries and have a series of interviews and tours followed by lunch and freedom. My personal favorite is the tour because one, you get a feel for the culture and two, everyone stares at the group of 10 people walking through the halls in obviously uncomfortable black suits. I like to think they think we’re some kind of important people. In reality, they probably think we’re high school kids on a field trip learning about healthcare.

 It’s really great to see all sorts of programs and meet with their faculty but it is exhausting.  I then usually try to change out of my suit ASAP which almost always means in my rental on the way to the airport. You’re welcome fellow drivers.  

Now that “the trail” is over, I’ve got to rank the programs I went to in order of where I most want to go to least. Then programs list the applicants from most tolerable to least and a computer does some black magic leading to (hopefully!) a match but more importantly, a JOB. It’s far too complicated to explain via blog but if you’re curious how the match works, there’s a bunch of good YouTube videos explaining it out there. 

My rank is done and submitted and now we wait. On 3/11 I’ll find out if I matched somewhere and then on 3/15 I’ll find out where I matched. It’s very exciting and not at all terrifying. I definitely don’t need an economy sized pepto. 

In the meantime, I have a brand new nephew! I can’t wait to go meet him. I’m currently on my way to a “don’t think about match” vacation with my friend who has been through college and med school with me to celebrate our graduation. And I’m still doing research at UM. It’s a really exciting time, even with the looming dread. Hopefully, the next time you hear from me I’ll be employed! 

The ER, NY, THE END

Hello internet.  Somehow, I’ve got four weeks left of medical school. Four weeks baby, four weeks**! (As the great Monica Geller once said). I can’t believe it. Honestly, I cannot believe that these past four years are coming to an end. It simultaneously feels like it took somewhere between 30-40 years and went by in the blink of an eye. It still amazes me that I can answer questions my family throws at me and more than that, being confident in my answers. I’m not saying I don’t do something stupid or forget to ask a patient with abdominal pain if they’re throwing up equally as often but it’s nice that the confidence is catching up to the “ummmmmmmm”s and blank stares. 

I’m currently writing to you from poolside at my Uncle David and aunt Maria’s lovely house in the Hamptons after a two week ER... immersion here in NY. It’s been an experience. From accidentally booking a basement with no AC in August to intubating a patient after they swallowed all of their teeth, there wasn’t a single dull moment. 

One of my most notable patients was a mid 30s gentleman who “slipped while holding a knife” and somehow gauged a giant laceration from ear to ear. You know, as one does. The police were skeptical about his story but, what are you gonna do? Arrest the girlfriend with blood on her hands? While that might have been the logical course of action, the police decided it wasn’t worth it and voila I stitched up a man’s neck for two hours. (Ok I helped the surgical resident but I got to do SOME). 

I think that story really encapsulates life in the ER, it’s never what you expect and SOMEONE needs stitches. (If you can’t find anyone, check yourself for wounds). 

One facet of this rotation that was difficult to swallow was treating patients with colds, toothaches, sore throats, etc because they have no other access to a doctor. It’s really frustrating the third time you seem a “toothache” pop up on the computer but I think it’s an important commentary on our health care system and we need to remember that they’re there because they have no other choice not because they want to be a nuisance. Insert healthcare reform line here. 

NOW! Back to the gore. My favorite patient was because of her family - to be fair she had a broken femur so probably not at her MOST charismatic. The patient was young, way too young for a femur fracture, so we ordered some pathology studies and wham - cancer. It was really hard to see such a young patient and know what they were about to go through. However, unlike a lot of patients she had the whole family around her for support. That really made me realize how important it is to me to match somewhere with family. No one else is going to bring you a slurpie and hold your hand to help you get through that kind of news. 

Back to the cheerful! We’re about three weeks later from when I started this post (my bad) and

I’m back in Miami and officially applied to residency. It’s TERRIFYING. I check my email so often I might as well leave it open and FORGET about going somewhere I can’t check or don’t have service. Nuh-uh. Because, you see, as residencies send out interview requests they send them to let’s say 50 students but only offer 10 spots. So it’s stressful. And it’s why I’m writing this on my phone while I sit in front of me email. (Yeah, even on a Saturday!). It’s so exciting though. I can’t wait to see where I’ll be in the next year. 

*hey HIPAA, listen up, I changed my patients ages and genders (but not ALL the genders because then we’d all know they were just opposite and C’mon) so they’re all fake please don’t arrest me. 

**its ONE week now. ONE!!!

The Caribbean Hustle

As many of you, particularly those who read the little sidebar on here, know I'm a Caribbean medical student. I know, I know, but you're so smart and hard working! (We all are). But you got good grades in college! (Most of us did). Ordinarily, I avoid the topic. I'm proud of where I am in my education but I like to avoid being stigmatized when possible. A typical conversation on the first day of a rotation goes like this:

Other medical person: "What school are you from?"
Me: "AUC"
OMP: "What's that?"
Me: "American University"
OMP: "Oh, where is that?"
Me: "In St Maarten"
OMP: "Where is that?" growing confused and inpatient
Me: "The Caribbean."
OMP: "OH!... ok."

While I could spend hours talking about why it's stupid to stigmatize a whole group of people because their path looks different than yours (ahem, how politically relevant), that is not what this post is about. What it is about is the Caribbean hustle. You see, American students have the benefit of an established institution with a name that means something. They have people all around them doing research, they have their own residency programs, and they have a path sort of already set up for them to take. We don't. We have to be proactive and make our own way. We gotta hustle. (Thanks Lisa Rinna).

All of this is to lead up to a small little story. In April I was rotating with the cardiac consult team and realized "Oh hey, I love cardio" but knew that as 1. a woman 2. A Caribbean student I would be a minority in the field and I needed to set myself up to succeed. Fortunately, the fellow* on the team was also a Caribbean student, and from a less well-recognized school than mine (ya, we ALL do it, you guys at Harvard don't have snobbery market cornered). He was a really helpful person to meet. He told me about research going on at the university and who was in charge of these projects and who was the nicest amongst them, etc etc. So I went home and looked them up. I saw that they took students from UM and that there was a whole little rotation they could do that wasn't open to Caribbean students so I decided "hey, what could it hurt to just e-mail the head of the lab?".

Call it naivety, call it balls,  call it 2 glasses of pinot grigio but I did it. And within 20 minutes, this world-renowned scientist e-mailed me back to set up a meeting. When I tell you I almost peed my pants, I am not. lying. (Don't worry, I didn't!). I seriously believed nothing would come of it because that has been the case so many times. I cannot tell you how many e-mails I've received with a single line saying "we don't take students from your school". The opportunities in the medical world just don't exist for Caribbean students in the same way they do for American students. While we are qualified, driven, and incredibly hard-working; a lot of people can't get over the name of our school. Because of that, we have to make our own opportunities. So that's what I did. And now, I will be a member of the UM Interdisciplinary Stem Cell Institute. The lab that has shown we can reverse damage from myocardial infarcts, the lab that has almost figured out the cause for eclampsia, a crazy insane lab that I get to be part of. I'm actually squealing.

The reason people "end up" at a Caribbean school is not uniform. But I think we should be proud to be Caribbean students. Everyone told us no and instead of taking it we turned around and made it happen for ourselves. We have to forge our way in a system that begrudgingly tolerates us and we have to be better than everyone around us. Each one of us has to stand out as amazing because if one of us falls, we all fall as a name.

Hello fourth year!

Third year is over! And with it, graded rotations and exams! (well, let's just pretend licensing exams aren't real for now). The light at the end of the tunnel is glowing and I'm feeling optimistic. I also am feeling a bit guilty for abandoning my blog for so long. A lot has happened since we last spoke, internet! I got a dog, he's great. I delivered a baby or two, that was great. I stuck a bunch of children with needles, not so great. I found my anti-calling in psychiatry, extra not great. But the most great; I was published! Not so many details to come on that but it's all very exciting.

OB/GYN was... not for me. Delivering babies is FANTASTIC. It's amazing, it filled me with awe and instantly made me believe in a higher power. However, it's also only a small part of being an OB/GYN. Arguably, it's the most fun part, but small nonetheless. I spent most of my time listening to fetal heartbeats, reading fetal heart rates, answering questions from moms, giving pap smears, and waiting. There is a whole lot of waiting around in OB/GYN. Babies are tricky like that, they don't read time well so they're not great at adhering to a schedule. Thus, I'm a big fan of planned c-sections. Interestingly, the rate of c-sections is going up because babies are getting larger and women's pelvises are getting smaller. Ironically, this trend was caused by women electing for c-sections and now they end up having to have them, just as natural births have returned to popularity. Regardless, no OB/GYN for me.

Pediatrics was very different. I would say it was my most surprising rotation. I went into it thinking I would hate it and left thinking "I could totally do this. I won't... but I could". I think a large part of that was my attending physician. She was an older Spanish woman who said exactly what she thought and took no nonsense. My personal favorite trait of hers was telling parents to pay attention to their child and not their phones. She also gave me a lot of autonomy (and was very quick to tell me exactly when I had screwed something up). That independence allowed me to learn a lot about how to be a doctor. Kids are great to practice your interview skills on because they don't know what to tell you or what's important; you've got to pull it out of them. So you have to think of every question you need to ask and make sure you cover all of your bases. Otherwise, I was definitely going to get a look from the attending. She was hands down one of my favorite attendings of my entire third year. I honestly miss her and her clinic.

And that leaves.. psych. Ah, psychiatry. There is no place quite like the psych ward and no people quite as honest as psych patients. I learned quickly that psychosis isn't always obvious. I also learned that you have to really trust your gut. One fun part of psych is listening to a patient talk, realizing you're having a hard time following them, thinking "why is this so hard! am I not listening well?" and realizing they're actually psychotic so OF COURSE I can't follow. I never really learned to get out of that, I went through that sequence with almost every patient. Psychosis isn't always obvious and it can be very subtle. It was very hard for me to deal with. Psychiatry ended up being one of the hardest rotations for me. It was beyond emotionally taxing. I saw children as young as 7 with suicidal thoughts, I saw adults who had been failed by their family, I saw patients who kept coming back because there was nowhere else for them to go. I saw a lot. I think I would have to be a much stronger person to be a psychiatrist, or at least much more guarded. It's hard to see the same people coming in and out of the psych ward, from the street, to the ward again. They've got nowhere to go and our resources are finite. A lot of patients have comorbid problems - addiction, diabetes, you name it. They can't manage them on their own and there aren't enough places for them to go to get the help they need. So they end up locked up in the psych ward. It's an ugly cycle. On a lighter note... I also did a brief rotation in the psych unit of the Miami corrections department. Now that was interesting. It's remarkable how normal people can seem until they leave and nurse Vaga whispers "he murdered his mother in law and flushed her body down the toilet in pieces". Classic Vaga.

Now for the ever popular - "what's next?!" segment of our broadcast! Well boys and girls, next are electives! Starting with family medicine. I'm pretty excited. Also a tad nervous to start studying for the next round of licensing exams. We all know what a joy I am to be around when those roll in. After that, I will be applying for residency in September of this year. Right now, I am most interested in internal medicine but who knows! And before you know it, I'll be an MD. (As in, in September). So get ready for me to be really obnoxious about it on social media!

I know. You've all been wondering desperately this whole time about the dog. "Forget med school! WHEN WILL WE HEAR ABOUT THE DOG?" Well, dear internet, now! His stats: he's a 7 year old puggle at a slim 27 pounds with a sassy attitude and desperate need to cuddle. He has IBS just like his momma except he can enjoy chicken (Rude). His name is Roscoe from obvious sources and hes really my favorite. Although, last night he was attacked by a Rottweiler (TWIST!) so he's currently on the mend in the cone of shame. (He's alright, minor surgery and a couple weeks recovery until he's good as new). Not to worry, he has a lion cone on the way so he can retain his ferocity.


We both can't wait until the stitches and cone are gone. Until then, sad eyes from Roscoe.

Fake it until you make it and other adventures as a fake doctor

Hello boys and girls! Well. It's been a few months. One hell of a few months, to be exact. I moved to Miami! It's insane. More on that another time. I just finished my internal medicine rotation, as in, took the exam today (Don't worry, I only cried ONCE afterwards). For those of you keeping score, thats 3 months of surgery and 3 months of internal medicine under my belt. So, basically, I'm a doctor now, right? Wrong! I had a very mixed experience in IM and some of that included time in the ER where I had quite a bit of autonomy - to diagnose, treat, and sew people's faces! I loved it. I actually understood the patient poaching on Grey's Anatomy. (Read, one patient comes in with head laceration - four medical students want to sew that head - must guard that head). I'm not kidding, I went with my patient to their CT scan and sat outside and then marched right back with them. I was GOING to sew that head. (Don't worry, I did!)

Anyways, ER side note aside, it's been intense. Learning how to work with different attending physicians every week, with very different teaching styles, learning that patients' really hate being woken up at 5 a.m by the med student, learning it's best not to wake patients up by leaning over their bed and whispering "Good Morning Mr. Smith". Apparently, that's "unsettling". Just kidding! I didn't do that! It was Mrs. Smith! Hahaha, hohoho... so funny. ANYWAY! Let's get to the topic of this post - Medicine is 100% fake it until you make it.

Let me explain - if you're wearing a white coat and speak with authority, people will believe you know what you're doing. Something else no one mentions, patients don't know the proper physical exam technique or question sequence sooo when you mess up, if you just pretend you didn't, no one knows! (Man, I use A LOT of commas). This worked very well when I was trying to find my patient's kidneys a feeeww inches too low and just readjusted. Yup, totally had to check your bladder, sir. He had no idea. I know, I'm sly. In all seriousness, this really helps you develop your clinical reasoning and skills. A big part of medicine is controlling the room when you're taking an interview or doing a physical exam and a big part of controlling the room is having self-confidence and being authoritative. There's no room for nerves or self doubt when you're interacting with a patient, what patient is going to tell you their life story, including all the private little details doctors need to know, if you're sitting there playing with your hair and mumbling. You gotta fake it until that fake confidence becomes real, I'm convinced it's the key to being a successful medical student.

All of that being said, I think the most important thing I've gained from this rotation was confidence. I feel comfortable working through a differential diagnosis, asking questions and doing a physical exam to narrow down what's going on. I even think things like "Hm, I wonder what the creatinine came back as this morning... that would make this diagnosis more likely". I KNOW! Before you think I'm incredibly smooth and talented, you should know that I also still do things like:
-ask the wrong patient, who is not on dialysis, when they go to dialysis
-get hopelessly lost because why does one hospital need 19 buildings and 213823984 elevator bays?
-Try to find coupons to support my starbucks habit
-get my toes run over by gurneys
-have absolutely no idea what I'm doing and just ask a patient a WHOLE bunch of random questions hoping one willl give me an idea but often I just walk away knowing their great great uncle died in a train accident
So, don't worry, I'm still humble and awkward and embarrassing. It's been a blast, I've got pediatrics up next and, unfortunately, it's during flu season. Everyone please hold for the sniffles featuring yours truly.

Being a Single Woman (in medicine)

Disclaimer: I can only speak of my experiences and those people have shared with me. 

"You need someone to share your life with". Is a common remark people say to me. It comes in many different wordings, from many different mouths, and with many different intentions. Is it true? Maybe. Does it overlook everything else I've accomplished in my life? Yes. Maybe that's what I'm thinking too. Maybe that life isn't for me or won't fulfill me the way medicine has. I have no idea. But it's for me to decide without other people's judgement.

I've never minced words about how demanding medical school is. It is my husband, my child, and everything else in between. It takes up my money, my sleep, and my time. It leaves me with nothing left to give. But it has given me so much. I'm proud of how hard I've worked and what I have accomplished. I'm proud of being able to claim something as my own, knowing that I'm the one who put in the blood, sweat, and tears to make it work. I regret some of the sacrifices I've had to make but I wouldn't change it for anything. 

That being said. Is that not enough? Do I have to have a bouncing baby and doting husband to be seen as an accomplished adult? I don't think so. I didn't think other people thought so. But they do. What bothers me the most is this isn't something my male peers encounter. Men are never asked if they'll pick a more relaxed residency to be home with the kids. Men aren't expected to know how they'll balance it all and if they even want to. It isn't expected of them as a condition of their success. No one comments on how older dads can still be great dads when they hear they're in medical school, not planning on kids for awhile. No one asks them if they'll give up their practice to have children. Everyone assumes they'll marry someone who is not a doctor who will take care of those things for them. 

It's almost as if society will allow women to become physicians but only under the condition that they remain in their typical gender roles. Yes, you can be a doctor but you also better be at all the kids' soccer games and support your husband. Male physicians are not expected to balance it all. It's assumed someone else will handle the home front. But women? We're expected to not only want to take on both but bad mothers, wives, citizens if we don't. 

I'm 26. I'm single and have no kids. But I feel this pressure often. I notice the lack of women physicians in a room (which is a whooole other topic). I cringe when my friends comment on how happy they'll be to stay home with the baby, how lucky they are to have babies young. I quietly smile when someone asks me why I'm still single as if succeeding in medical school is not enough unless there's a man cheering me on. I don't know where my life will take me. I don't know if I'll have children or get married and frankly, I don't care. Right now I care about medicine and I care about doing my very best. It breaks my heart that people don't care about my passion or drive, preferring to hear about who I'm dating. But that's what it's like. People don't see female physicians as doctors first. They seem them as women and mothers first and doctors second.

Surgery is Terrifying

The world of the operating room is clouded in mystery to the general population; leaving a lot of room for imagination, dramatisation, and fear. Surgery is scary for patients. To them they see people being wheeled into the OR on Grey's only to have three massive bleeds, four heart attacks, and a stroke. So of COURSE it's scary. In reality, that doesn't happen (often, I mean, it probably has once over the course of surgical history). Surgeons are precise, careful, and surrounded by a team of people who make sure that doesn't happen. The sheer volume of machines monitoring every little thing within your body is astounding. So why are patients so scared?

I think part of the answer lies in vulnerability. You're naked, you're sick, and you're about to be cut open by people wearing funny masks and hats. It is an incredibly vulnerable position. Particularly in our society where people often do not understand what is going on within their bodies. That failing lies both within the education system and the healthcare system. Patient education is a crucial part of the doctor-patient interaction but it often goes untouched. Patients who understand their health and who feel like they are part of the decision-making process are more likely to be compliant with their medical plan. It also takes some of the mystery out of surgery, and thus, some of the fear.

I feel like I can speak from both the healthcare side and the patient side. I have both been a patient in surgery and a student in surgery. I remember how scary it was to be wheeled away from my parents and brought back to a freezing operating room full of equipment I didn't recognise or understand. I remember laying on the hospital bed as they told me to move to the operating table thinking I could get up and run (I was 14, what can I say). I remember the anesthesiologist holding a mask over my face and counting me down to sleep. I don't remember ever seeing my surgeon in the room. That one familiar face could have helped quell my fear but I distinctly remember being surrounded by strangers and I was terrified.

After working with different surgeons I have noticed different styles and the ones I personally resonate with the most are hands on. The surgeons who come into the room while the patient is still awake and says hello, asks how they're doing, helps calm any fears-- those are the ones who have the best patient relationships. I know, every surgeon goes and talks to the patient in pre-op but pre-op isn't scary. The OR is scary. I also understand how busy surgery gets, believe me. I know there isn't always time but I think that it is important to make time because, after all, we're all there for the patient's benefit.

One of my biggest take aways from this rotation is it's more important to take the extra minute to hold a patient's hand than it is to be fast (I mean, unless they're bleeding out.. but I'm a student, I can still hold their hand, not about to pretend I'm any use in that situation). Alright. Everyone brace yourselves for a cliche moment - I've started to feel like this is really my calling. Not surgery, ha, NOT surgery. But patient care. It fulfils a part of me I didn't even know existed. I love checking up on patients and talking with them, seeing how they're doing. I actually look forward to early morning rounds. I love giving advice and being able to help. Despite the hellacious journey, medicine is definitely the right fit for me and I am so excited to see where it takes me.