But not inexplicable. I have been busy. COMPLETING MY FIRST YEAR! Finally. Jeez.

After more than a few tense moments, I can say with confidence that I will begin second year in August. I’m really excited. And in a couple of weeks, I’m starting my preceptorship with a family physician; I’m looking forward to that as well.

Since I took my last exam I’ve spent a lot of time hanging out with the fam. Zoe is sweeter than ever. This weekend she had her very first recital.

Adorable, yes? Our little ballerina. Forgive the early cutoff – I had to cheer loudly for my tiny dancer.

Does it get any better than this?

All of her grandparents (and everyone else in spirit!) cheered her on, showered her with post-performance flowers, and generally made a large fuss, which she loved. I must admit I wasn’t sure how the whole thing would go, given that we missed the dress rehearsal. But she was so excited to be on stage, and we were so proud of her – she just shined up there. I believe a star was born.

Other excitement has included time to straighten things around here. I still have plenty to do, of course. It’s a project. Speaking of straight… I also became free of my braces! I only had them for ten months, and they came off last Thursday. No real pictures yet, much to my sister’s dismay, though I did send her one… But I’m sure they’re coming. So far I’ve had to tell most people that they’re off, which makes me think I should have been less self-conscious all along – though I really like having straight teeth.

I also started Jillian Michaels’s 30 Day Shred. Krystal and I are on day 6, officially. I started a couple of days before to see how it was, then I took a day off to do Zumba. It’s kicking our asses; I feel stronger and better. Now to get my diet polished…

That hardly covers two months. So I’ll sum up the time before the last ten days or so: I was studying. Now to live it up during my last summer ever!

But not today. No. Today they were 1. out of non-dairy creamer, and – what’s worse – 2. completely unapologetic about it. In addition, 3. their potato tacos, which most days are worthy of high praise, were not hot. And by hot I mean temperature, which is all the more important now that I’m more aware of what bugs may lurk in less-than-hot food. Thus they have been sacked. This was just the thing I needed to get myself out of bed earlier to make my own breakfast. Maybe now I’ll get to the bus on time.

First, a little background.

Overall Block I exams went alright but, as usual, less well than I had hoped. The quickness and the breadth of material, especially for immunology, got the better of me, and while I held it together fairly well (i.e., I only called my sister in tears once and threatened to quit via no more than four texts), by Friday I was sure that after turning in my micro test I would walk over one building and check myself in, either at Hermann for exhaustion/septic strep (I lost my voice during the week) or at the Harris County psych ward. Not to be dramatic or anything.

Friday night I ended up doing my post exams routine of cleaning and attempting to prepare ourselves for a nice weekend at home without staring at a couch full of laundry or a pile of dishes or lying around on dog-hair-carpet. Because that’s how we roll most days. (I’ve learned to let it go, superficially, until I have time to deal with it, but deep down it’s still on my hamster wheel of concerns.)

I was excited to retrieve Zoe, who was in excellent spirits after school. The evening was pleasant and uneventful, and we went to bed late, in my hopes of sleeping late.

Saturday, 7 AM: Zoe is awake, for good, and she wants to “watch a few shows”. I oblige and return to sleep; when she gets cranky, Joel sweeps her away so I can rest. I am grateful. A few minutes of light sleep later, I tire of hearing her protests and requests for me, and I stomp out grumpily, and we begin our day of nothing. Glorious nothing. We played play-doh, watched shows, napped, and generally enjoyed each other’s company. At 6 PM we ventured out on some errands: Goodwill donating, recycling, and groceries. Across from the recycling center was a Chick-Fil-A, and Zoe excitedly requested dinner there. It was delicious, and she loved playing on the playground with a rambunctious young chap called Ian, or Phillip, or Bill. NOT Kevin, NOT Steven, which he thought Zoe was saying, which she wasn’t. Target was a blast, and we saved 10% with coupons = bonus.

Sometime around 3 AM we were awakened by a Zoe in mild distress. I’m not sure how we knew, because she wasn’t making much noise. Joel figured out that she was lying on her back and pointing to her mouth, which was piled high with vomit. The poor baby. We cleaned her up, stripped the bed, decided she needed a full bath, did that, and got her all ready for bed again. Laundry was begun, and into clean sheets we went. Less than half an hour later, we repeated the whole thing, with the variation that the vomit landed almost entirely on my person, and the two of us took a shower. Putting our last set of sheets on the bed, we decided to put a few extra blankets below Zoe and to keep a pan by the bed.

She learned quickly, warning us when she would vomit in time to place the pan, keeping us updated with, “Here it comes… I have more… I’m almost done…” I was aching for her and so proud of her at the same time. And so it went throughout the night and next day. The laundry never ceased. Despite her illness, she remained in good spirits while awake, though mostly she slept. Family required status reports, particularly my squeamish-only-when-it-comes-to-vomit sister, whose fascination/repulsion necessitates description of the quantity and quality. This provided much comic relief to me, as did Zoe’s comments. After a Dora popsicle: “Hey! Pink throw up!” Apropos of nothing: “Mom? Throwing up is not fun.”

Sunday night went a little better, with evidence that whatever-it-was was moving down the GI tract. I’ll spare you the details except to say that the laundry.continued.all.night. The last incident for which I was present occurred at 5:30 AM before my alarm went off at 6 AM. Joel kept her at home on Monday, which I am so grateful he can do. I trudged off to school, embittered that my post-exam “relaxation” and “preparation for block 2″ weekend was neither of those things, and I began yet another block completely exhausted. A bright spot in the day: Joel texted me with a Zoe quote that I will hover for you in order to protect her privacy somewhat. Hilarious.

Amidst the chaos, there were many moments like that, actually. She’s amazing. And we’ve learned some things, mostly that we should get a plastic sheet.

Now it’s Wednesday, and perhaps for the best, I have forgotten most of the things that inspired my irritation and grumbling and today’s post’s title. I do recall that I broke yet another backpack. And that I missed my morning bus by 30 seconds, thus missing my first class which turned out to be quite important, setting me behind before I even started. Dispersed throughout the day were various and sundry instigators, coming full circle with missing my evening bus, only after running for it like a total moron with my two bags of 70+ pounds of crap, arriving at the bus door only to remain unseen by the driver and amuse the other waiting bus patrons with my misfortune. And THEN I studied while waiting for the next one, putting away my materials when I expected it to arrive, only to wait an additional half hour because for some reason, it never came.

I know these things seem small. But in aggregate… wasting my time and feeling behind already and suffering a severe sleep and mental stamina deficit… It was a little much.

Plus I’m really over my commute.

Long story short, I’m quite difficult to live with. And I’m sorry about the preposition there. I know I have several balls in the air, none of which I’m prepared to let drop, though they have been pruned in the past year. I have to work on grace, and on the schedule and routine. One might say I am hell bent on implementing some consistency, ideally for the whole family, and at least for myself. I did order a new backpack, so instead of hauling around my pigpen in multiple bags like a hobo, I can run for the bus in a streamlined fashion.

Perhaps the most pervasive thing about having failed… repeatedly… is that even the smallest success feels uncomfortable. Even with a little confidence back, there’s this incredulous feeling when I get something right, and then I double check it, thinking, “Surely there must be some mistake.” Or when I say something aloud that makes sense, my brain says, “Are you sure? That sounds like something a smart person would say – you probably better backpedal or something.” Messed up, right?!

And it doesn’t just apply to school. When Zoe seems well-adjusted or does something reflecting her obvious brilliance, or if I’ve completed a workout, gotten to bed on time, checked things off my to-do list, or made an especially great cookie… It’s like “Once in a Lifetime” by Talking Heads. “How did I get here?… This is not my beautiful [life].”

I have to keep reminding myself that we are what we do. I’m a mom to a beautiful child. I’m in medical school, and I will be a doctor. In August I decided these things, that it was a matter of when, not if. It is just taking a little longer than I would have expected to condition myself. I need to be comfortable with that and act the part – no, BE the part. And really it isn’t up to anyone else. I’ve sat around wishing I were this way or that way, and really except for a few physical impossibilities, I can be whatever, however, whoever I want.* Once I’ve done something consistently, I am that way. Make good grades – you make good grades. Be a good mom – you’re a good mom.

On that note, I’m headed for a run. I run.

*I recognize that there are many, many things in place that allow me this freedom.

“I think it would be a mistake… as one might charitably describe us as… ‘barely keeping it afloat’. I agree with your sentiment, and it would be great if something like that were feasible.”

During the unrelated argument we later had, we wondered if maybe the child would prefer his or her current situation to any tumultuous craziness here. Amidst a heated debate over whether or not unintentionally forgetting to start the washer full of peed-upon sheets (thanks, Zoe) was a cardinal sin, there was some mention of the unavailability of pain medication stronger than ibuprofen for life-saving limb amputations. For some this sobering fact might have put things in perspective long enough to acknowledge the ridiculous pettiness of the original offense. (Though, for completeness, it did neither in that moment nor for at least an hour.) In the end we decided that he or she would be sleeping happily like Zoe was, and thus unaware of said argument, so that was moot. Now the waking crazy… Time will tell. Zoe will let us and/or her therapist(s) know how that turns out.

Anyway, while the idea came from a real place and a deep ache for the people experiencing horrendous tragedy, obviously there are more effective ways for us to help the world in our own way. As happens with any acute awareness of a particular catastrophe, the cascade begins and I’m reminded of all the things that need fixing. Add that to my two months and counting stint of listening to NPR instead of Top 40 while I get ready in the morning (meaning I now get 15 minutes of news instead of whatever gets filtered to me from Joel), plus my two main lunch time lecture series: one on health care reform and another on serving the homeless population, and there’s a bangin’ pity/outrage/inspiration party. Everyone’s invited. Sigh.

Meanwhile I’m doing what I hope is a step toward my part of it: studying. The first block of exams begins Tuesday – but then you knew that, because I’m writing again . I love my classes, particularly neuroscience and neuroanatomy lab. Micro has potential. Last semester’s knowledge is coming in handy (even that bitch biochem, though don’t tell her I said that). I’ve grown fonder of the classmates I already liked, met a few more who didn’t repulse me, and had my initial opinions confirmed on a few. So it’s somewhere between a wash and an ever-so-slight incline on the class personality front. I managed not to spazz during my last few standardized patient encounters. A little confidence goes a long way, and I get that from practice and preparation. (P, p, p. Too much Dr. Seuss. Which I would like to read to a Haitian orphan before bed. NOW who can’t complete a thought?!)

Until then, I’m really enjoying this break. Happy holidays!

The third block of tests went pretty well. I did better on everything but anatomy, which I felt I had to sacrifice in favor of biochem, to stay out of the danger zone. I’m proud to say that I had the wiggle room to do that. Ideally I’d honor everything and not play the game like that, but we do what we have to do. If I get a chance to talk with 2008 Blake, I’ll tell her to go ahead and do the alternate pathway the school offers and save herself a lot of misery.

I’ve been and will continue to be candid in my opinion of my fellow MS1s, and at this point in the year, I can say to my class (as if they would even care) that on the whole, I do not love you. But I have grown accustomed to your face. It may be that my first love’s shoes are just too large to fill. So I’m not ruling out that with time we may develop a friendship, and I’ll take responsibility for my role, what with the antisocialness. I actually had someone to whom I had introduced myself the first week and chatted with on multiple occasions, when I ran into him and asked how he was, say, “I’m sorry – are you in our class?” Wow.

I want to do a better job of balancing in the coming months. Mostly I feel like I have so much on my plate that I can’t be the friend I want to be to anyone new, and I am so uncomfortable not being able to give my part. Once I’m keeping the family, school, and sanity plates spinning, we’ll see what happens.

Last year I made lots of friends and very poor grades. This year I kept my head down to survive, making the grades but very few friends. Those friends – notably my tank mates and last year’s repeaters – have been essential, by the way, and I know it. While I may sound like a high school drama queen, ranking my “peers” in niceness and other criteria, it’s important to me to be a part of my class and feel like we have a common goal. Because this road is too long and difficult to go it alone. I think most people want to have camaraderie in their careers, and in the team-oriented field of medicine it seems especially important. I chose to pursue this path after a life-changing experience and deep, deep introspection. I want to help people, and I’d like to think that’s a pretty standard answer among people entering medicine. I find it hard to believe that anyone would choose it solely because of an ability to make good test scores or a desire for prestige and income (because believe me – those last two are not compelling – or even realistic, anymore – reasons). So I’m making it part of my education to figure out some of what makes the people around me tick. It has been less evident with this group than with last year’s, but absence of evidence is not evidence of absence, right? I’ll find their souls.

All I have left now are two finals: devo and anatomy, and Friday I am a free woman for a few weeks. Amanda is spending the holidays with us here in Houston, and I can hardly contain myself! This break should be a good chance to catch up on the things I’ve been missing since August. Writing, organizing, music-making, and working on my fitness are a few. I want to start something: most nights, in addition to reading to Zoe, I want us to write just a little blurb about the day or what’s going on. We were doing that for her the first year, and then we got busy and abandoned it in favor of easier, less mentally taxing things, like taking pictures. Now my camera’s broken. But we can still write, and now she can participate. Anyway that’s a goal.

Alright. Back to the studies, for just a few more days!

To procrastinate I just wanted to update here. Zoe has been ill lately, and after three antibiotic shots from the doctor this week (in lieu of liquid medicine, which she absolutely refuses to take, clamps down her mouth, and if some should enter, it is immediately vomited; we are all better off with the shots). She seemed to be better until last night, when she spiked a fever and generally had a very fitful sleep. This morning between the hours of 7AM and 11AM, at which time she is STILL sleeping, she has stated the following, after which she returns to sleep:

“I want to go to the zoo.”
“Let’s Skype with Gigi.”
“Chuggachugga CHOO CHOO!”
“No, no, no, no, no. Hmm-mm. No.”
“Whatcha doin? I love you.”

Her sleepy head companion and Dad has shown himself in the past minute. This is a good three hours, at least, past her usual wake-up time. I hope this is recovery sleep and not sick sleep… She even let me listen to her heart and lungs, count her beats and breaths per minute (172 :/ and 40), and percuss her chest without waking. I’d like to say for the record that I have either a hunch or a delusion of med student hypochondria regarding her condition. Either way we’re going to push fluids and rest today.

During the practical we have rest stops, one or two between each question, so there’s a lot of time to stand there and look around, but not look around like at other people’s answer sheets, or the questions in front of or behind you, or even at your classmates too much, because you’re bound to make a super dorky face that could potentially look suspicious and earn yourself a janky eye from a proctor.

The point is that I let my mind wander during those rest stops, since in the past I’ve used that time to second-guess myself and change right answers to wrong ones. A few things struck me as amusing during the practical, which itself is pretty odd: 50 questions, about 40 of which are “wet specimens,” human remains with engaged young people getting up close and personal from every angle to identify some tiny feature on a bisected head. So there’s that.

Then at a couple of the rest stops are buckets with mini candy bars. And naturally we have become accustomed enough to the fixative smell to consume said candy while, say, carefully considering a brain and which artery that might be with the pin in it. Chocolate and gray matter… mmmm.

I also had to chuckle at one of the tanks… The body had crossed ankles, like she was just lying back, chill.

Tomorrow is developmental anatomy, aka devo. I managed to neglect that class pretty well this block, so I have some work to do tonight and tomorrow morning. My only break tonight will be SYTYCD, because a brain needs rest sometimes. Wednesday is solely a study day, Thursday is biochem (which I’m enjoying a lot more this block), and Friday is histo (still by far and away my least favorite).

And then Halloween. We haven’t decided what our plans are yet, but I’m sure Zoe will look cute, and I may dress up as something. The little munchkin and her Dad are getting some Garland love right now, which is really working out for everyone involved. I am grateful. And I just ache for her when she’s away. They plan to return tomorrow evening, and I will be happy.

A word on the social front: I was probably a little less than kind in my last post concerning my new classmates. I will say that just this week a few individuals have improved my opinion of our class quite a bit.

To the study cave once more! Also, if you haven’t already, check out last.fm. It’s keeping me sane.

Update: This just in! Keys up. PASSED!

And it paid off.

I passed all my exams and even HONORED developmental anatomy. HONORED IT. There’s honor, high pass, pass, and marginal performance. I’ve never done anything more than pass before. In med school anyway. I had high expectations of myself, most of which I met. I plan to do better in my other classes next block (which is only a short month away), but I’m considerably more confident of my abilities than I was when I started. Forgive me if it sounds like I’m bragging, but this is what I have wanted for a very, very long time.

The first week was rough; I won’t lie. I had prepared myself that it would be difficult seeing all my former classmates in their second year capacity while I was again upstairs, meeting my new classmates, going through the same motions, with all the awkwardness plus some. But it was worse than I expected. I felt stigmatized by the incoming kids, even though there are many from last year in a similar situation as mine. Each class has its own personality, and I truly love my initial class. I was still, after having seven whole months to deal with the reality, grieving. And I was embarrassed. So embarrassed. For many reasons that are not known or obvious to my former and current classmates, I did not perform. I just couldn’t hang. I felt that the new kids looked at me with a janky eye. Last year’s classmates, legitimately concerned and very sweetly supportive, seemed to pity me. I feared for the next person who cocked their head and said, “How ARE you?” in a tone that could be considered condescending, even though I’m sure it wasn’t meant that way. Every time I saw an old friend, I was reminded I wouldn’t be in their classes, and every time I met someone new in my class, it seemed they were familiar in some way, but, best case – slightly less cool than people I already knew, and worst case – out and out rude. This was my perspective.

Failing last year was traumatic. Dealing with that was like reliving the cancer. Honestly I was more upset about that than the cancer. Maybe that’s ridiculous, but it’s how I felt. I was so angry. With cancer, it’s something that happened TO ME. This I felt I did to myself. There were circumstances out of my control, what with the storm and all, but everything else was up to me. And I let myself and those around me down. I felt like I lost another year of my life.

And for about three days I was miserable. Excited to be in school and grateful for the opportunity to try again, but just miserable. It was weird.

Then I had an attitude adjustment. Instigated by Dr. Oakes’s talk during our AMWA meeting, I felt like I had been… not slapped, but restrained. You know how when your toddler is freaking out and tired and fighting sleep and generally a danger to herself and others, and you just have to hug her really tightly and speak softly but firmly and wait until she gets it? That’s what happened. I’ve heard that message a few hundred times since I had to take a leave of absence. I’ve heard it from those who love me and from myself. Repeatedly. I’ve taken it to heart. But it never lasted longer than my own self absorption.

This time I just wanted to feel something different. She was talking to a whole lecture hall full of people, but every word applied directly to me. So something sucky happened. Now deal with it. The past is the past; you can’t change it now. Let go. Give it away. Quit wasting your time being miserable. You’re still here.

Something clicked and I stopped passively hearing it or telling it to myself. I thought it. I became it. I’M STILL HERE.

And so I worked. I learned more those first ten days than all of last fall’s semester. I have never known academic focus like that. (Oddly, the actual grades were better before I had this focus. That was before med school.) I learned what works for me – what I’ve always known – that I learn the very best, initially, alone. But I do need other people to keep me on my toes. I have a fantastic main study partner and several others willing to help when I have questions, all of whom I thank tremendously.

Of course I’ll never be able to thank my family enough for their support. Joel’s parents saved us this week – with Zoe sick for almost three weeks now, Joel and I on the brink, they drove down and truly saved the day. Had I not seen the physical car, I’d think they flew here with their capes. Though perhaps they hoisted it on their pinkies and flew anyway – I’ll never know.

There were ups and downs this block, and I’m sure before I’m done with this semester or this year or residency or my career, I’ll have more of those moments were I wonder why I’m doing it. But I’m going to be the best doctor that only I can be. I may come to like my colleagues better and laugh about my initial impressions of them. I probably will. Maybe I won’t. I really don’t care. What other people do think or might think about me isn’t much of a concern. I’m putting my energies into what works for me and my family, what gets us though these hurdles whole and happy.

Tomorrow a new block starts, and I’m doing it all again. Hopefully I won’t fall off the face of the Earth this time. Maybe I’ll tweet less and put it into here. For now, I’ll share what I found via my friend’s blog. Our Deepest Fear by Marianne Williamson. I need to read it every day.