One test!

I took my first multiple choice test in five years last week. It is astounding that this is really how we evaluate future doctors. I mean, it is sort of amusing, except that it is stressful. I think I did OK . . . I've done a stellar job of studying every weekend and most evenings through the rotation. As long as they don't make me take it again, I'll be pleased. I wasn't even all that stressed about the testing part, though I got to watch a couple of other med students totally freak out two days before the test. I don't miss that.

I was going to take the entire day before the test to work. I had clinic until 5 and then I was going to study at the coffee shop until 11. All day I was in a poor mood because I wasn't going to see the kids at all (I left at 7:30). Then I realized it was my own stupid choice and if I was going to be that upset about it, I should just go home for an hour. So I did. Good call.

I also get 1 gold star for only having to eat out 4 times in 8 weeks.

This next rotation may not go so well. It is internal medicine in the hospital and there will be very early mornings and some long nights. It isn't even all that bad (relative to residency) with only 5 nights of short call (there until 11PM) this month. But those are days without babies. I am really not asking too much of the system that I should be able to see my kids every day.

The highlights of my primary care rotation include realizing that the meeting rooms in one building were the old dormitory rooms for the nuns. A sink in every one. More spacious than I would have presumed. The building is a funny mix of beautiful custom woodwork and tile that reminds me of elementary school. Also that the nursing home I went to had Wii bowling. And having enough exposure to pharm reps that they officially became scary. Some are very pushy and really want to talk about why the doctor isn't prescribing their drug more. Some just top by to stock the cabinet and remind you that they did so and then chat about sports. Those ones scare me more because it really reinforces how subliminal all of it is . . . they wouldn't be paid otherwise. And it also scared me to see the doctors prescibing based on what was in the cabinets - if one drug was out, they moved to the next one over. Not really the way I hope to do it . . .

I was hoping that the primary care rotation would expose me to a lot of things and I'd get my medical chops back before hitting the more intensly medical rotations (as a medical student, I can get pretty far in primary care with just being comfortable talking to and examining people). And I did see a lot of things. The problem was that I wasn't at all focused in what I needed to learn. I'd come home with a list of 15 things I wanted to look up and then only have time to do 2 of them. This got better as the rotation went on - I relearned the structure of the information and can now plug the information back in. Starting tomorrow.

7 weeks, 1 virus

And I don't even know where it came from since Turing and I came down with it on the same day . . . the zoo? Certainly not the clinic. I wasn't entirely sure if I should go to clinic or not. On the one hand, it would be totally lame to pass it on to some already sick people. On the other, I have three half days I can take off this rotation and I already had to take off 2 because one of the doctors had some out of town commitments. I wasn't feverish or coughing, so I went. And washed my hands a lot. poor cuticles.

When using that alcohol gel all day, it is important to remember to wash your hands with soap and water before leaving the office. I do a really good job of not sticking my fingers in my eyes or mouth when I'm in the clinic. But I apparently rub my eyes when I drive and that residual gel really dries them out and I'd have to pull over to the side of the road. It only took me 6 times to figure it out.

In a week, I have my first multiple choice test in 5 years. I'm having a hard time taking it seriously. Multiple choice?! Wouldn't it be awesome if patients came with multiple choice? Like a real-life choose your own adventure.

I meet with some other MD/PhD types to study up for this rotation. We are all fairly unphased by the entire experience. It's "yup, I'm behind and I've forgotten a lot, I'm studying, I'll catch up." But not stressful. Confidence! One of them rooms with a bunch of regular MD student types and says they simultaneously manage to watch 3 hours of TV a day, complain about how stressed they are, and how they're too busy to, say, get a boy/girlfriend.

I'm just too busy to lose weight. Or, I lose 7 pounds over a couple weeks, then promptly gain in back in a week. When I stop nursing, I won't have an excuse anymore. I've started running farther. Blah.

In other news, the boys seem to both be more adjusted to me being gone so much and seem to be getting along for a moment. Turing can climb onto the porch and has his train tracks set up there where Huxley can't get them. And they're generally doing a good job of otherwise not annoying each other. Huxley is climbing, climbing, climbing. And climbing. I got an official "mama" this morning. Sweet. Turing's language and imagination continue to grow in leaps and bounds and in ways that I can't describe. He's also more into drawing again. But not the potty.

Babies, babies

I have Fridays off at the moment and have been using them to spend time with the babies and read my email. Which is out of control (the email, not the babies). I feel like I just figured out how to organize my graduate school info and it is very unclear how to organize medical school information in any good way. Hrmph.

Today, I took the babies to Trader Joe's and then the zoo. Turing and Huxley ate an entire pint of blueberries in one sitting when we got there. Turing then ate a banana and 5 packets of dried fruit strips when we got home. And one bite of egg. And some ice cream. That's going to be quite the poop tomorrow.

The babies have had some trouble adjusting to all the changes - the new nanny is great and I'm around more than I'll be in another 4 weeks, but it is hard. Trouble has been home for the last three weeks and that seems to help. For the first two weeks, Huxley wanted to nurse the minute I walked in the door, but that seems to have calmed down. Turing is still throwing tantrums in the evenings after he goes to preschool. He apparently does really well at school, but he obviously hasn't adjusted entirely to the idea.

And we've officially decided it is time to potty train. Turing is not the kind of guy who is going to do it on his own - he is so cautious he stopped sliding down slides for a few months despite having gone down slides for about a year. So we're applying gentle pressure. I hope.

And the babies seem to get along pretty well. The main problem is that the most interesting toy is always the one the other one has. And Turing will get frustrated and try to get Huxley away by smashing his fingers or using his body to squeeze between Huxley and the thing he's using to stand up. But this is shockingly rare, all things considered. It's mostly a sign that I need to stop holding Huxley's hands so he can practice walking and tickle Turing for a little bit.

And my baby stamina is much higher than it used to be. It is probably a combination of older kids, calmer hormones, good weather, and practice. Wouldn't it be nice if the hardest part really is over?

Things to do

Medical school has not been too bad, yet. Really. Despite the silence. The weekdays are All Craziness All The Time, but the weekends have some more wiggle room to them. It's just that three weekends ago I went to a wedding and then two weekends ago we went to the waterparks at the Dells on a whim (and short notice of some free tickets through a friend).

The wedding was lovely. It was the first time I had been away from Huxley for any real stretch. I slept through an entire night then promptly offset those gains by drinking too much at the wedding reception the next night. I read two junky novels on the airplanes. It was like living someone else's life.

The waterparks were fun as well. I just went with the little guys, so no pictures. I was a little worried it would be near impossible to handle two little kids in the water without one of them drowning, but we actually had a pretty good time. They splashed around in the shallow end for hours and then slept pretty good at night. Turing isn't terrified of water anymore (still doesn't like his head wet) and Huxley wouldn't even consider being afraid of something. They were both the cleanest they've been in months after soaking in the water for the afternoon. Don't worry, we ground some dirt onto their knees first thing the next day.

I've been doing a pretty good job of being presentable. I've almost figure out how to pin my hair up so my bun isn't a giant mess of loose ends. I also think the extra two inches of hair have helped a lot. I've rotated my shoes every day and they are all very comfortable, but I am just not used to having to stand all day. Standing is actually fine, but I'm not used to standing still in one place. There just aren't enough seats in those exam rooms for all of us. And figiting to keep my feet active doesn't seem appropriate either. My back hurt a lot the first week, but is now better. But my hands are going numb . . . I don't know if it is just the adjustments in my posture or that I'm wearing my stethoscope around my neck.

I've also done a stellar job of packing my lunch - only missed one day in 4 weeks. I don't expect to keep this up on the other rotations, but I'm pretty proud of myself for this one. Of course, as I read up on various things, I also realized that I'm technically overweight and 10 months post-partum is a bit long to still be blaming it on baby-weight. It isn't clear to me where I'm going to cram more exercise in my schedule. Packing lunch might help, though, as I am not standing in my house and snacking all day.

I've had all sorts of fun experiences so far. Pharm reps are all cute and perky and their sheer numbers are overwhelming. Driving to work is very weird - I can't believe I really used to commute an hour each way - but the NPR time is rather nice. It is kind of fun to be the medical student and spend some time with the staff . . .note to self: you want to be like the doctor all the nurses ask questions to and not the ones they all avoid and make snide comments about behind their backs.

It is nice to be older while doing this and not the nervous New Medical Student Who Is Looking For The One Right Answer. I get that these are all just people, someone has my back, every doctor has their own style and adaptability isn't that hard, and it is OK to be learning. I am entirely unintimidated by taking histories and practicing (non-invasive) physical exams on my own which seems to phase a lot of other students. Now I just need to be more aggressive about taking the stab as assessments and plans though I am amazingly clueless. I remember no medications. My practial ability to generate differential diagnoses is comically bad.

Practice, practice.