Immunology test for 40% of my grade – done. I can’t say that went especially well, but I knew some things.

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.

In response to my suggestion that we foster a Haitian orphan, Joel gingerly and diplomatically offered the following:

“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?!)

I followed the advice of my sister to this post by another Amanda from Texas living in NYC whose blog I enjoy reading. It’s a template for taking an inventory of the past year. I liked it and thought I’d give it a try. What else does a toddler parent do on NYE?

In 2009, I gained a little more confidence in what I’m doing as a student, a mother, and a person in general, a new apartment, and a whole lotta knowledge that I didn’t learn last year.

I lost about 8 pounds (net, gross was about 16), three pets (Amanda’s Kiddn from our childhood, Sophie and Sarge to different homes), some volume on that nagging voice inside my head that was saying I can’t do it.

I stopped eating mammals.

I started back to med school again.

I was hugely satisfied by my first block study habits and healthy withdrawal from timesuck activities.

And frustrated by balancing my responsibilities.

I am so embarrassed that I had to take a leave of absence and do the whole first semester again. (But I believe I may have mentioned that.)

Once again, I tried to cut back on sweets (with some success…).

Once again, I let myself get distracted.

The biggest physical difference between me last December and this December is I have braces and much straighter teeth.

The biggest psychological difference between me last December and this December is I’m less concerned with what others think and more accepting of who I am.

I loved cuddling on the Cozy Sac with Zoe.

Why did I spend even two minutes feeling not good enough? (Borrowed from Noisiest Passenger.)

I should have spent more time exercising, playing music, volunteering, writing, and sleeping (anything but worrying basically).

I regret spending about eight months of my life wallowing instead of making the best of things.

I will never regret quality time spent with Zoe.

I was self-absorbed way too much.

I didn’t sleep nearly enough.

Parenting a two-year-old nearly drove me crazy.

The most relaxing place I went was the pool when I went by myself.

Why did I waste so much time?

The best thing I did for someone else was listen.

The best thing I did for myself was taking steps to improve my mental health and going back to school.

The best thing someone did for me was figuratively smack some sense into me.

The one thing I’d like to do again, but do it better, is parent Zoe. (That’s one of many.)

Happy New Year.

(Fill-in-the-blank template from Mary Schmich at The Chicago Tribune)

Not really though, because I worked for this: I passed everything! New classes begin on January 4, 2010, and I plan to work twice as hard.

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

Again I come here during exams. I don’t know if I’m particularly thoughtful during these natural intervals to take stock in performance, evaluate goals, and look toward the future, or perhaps it’s just a good study break/procrastination. Probably. Either way, here I am, in my last week of my second stab at the first semester of medical school. Wow that sounds a lot less exciting than I feel it is…

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!

Thank you, Julie, for the pretty edit!

I’m studying again. Block 3 this time. And as usual with these stressful times, illness threatens us.

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.

I thought I would post a little something to say I am alive and well. Today we took the gross anatomy written and practical exams. Not bad, not bad. The keys aren’t up yet, but I’m feeling pretty good about it. Dr. Cleary alluded to some “character builders” among the questions, but I think it was fair. Anatomy is a high maintenance relationship, but I kind of love it. At least compared to the others, I think it’s the most applicable, and the anatomy department is by far the most organized and efficiently-run.

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!

I promised myself going back to school that I would cut down on the tweeting, facebooking, and general internet piddling. Weekly Flickr and blog posts were acceptable, but no more. As it happened, I barely uploaded to Flickr and (obviously) posted nothing here. I was significantly less attached to the computer and my phone and more engaged in my work.

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.

Last weekend I went to see Amanda on her new turf. We had such a great time. Being with my sister always feels like a cozy, comfy pair of fat pants, and I love her.

It occurred to me then and occurs to me now as I upload to Flickr the few pictures from my trip that our agenda had much to do with food. I am a gastrotourist. What do people do if not go from eatery to eatery? This is not to say that we ate a lot. We ate a rather conservative amount, and surprisingly, the only things we bought at any of the cupcake shops were not cupcakes – Amanda got Zoe a Magnolia “I (cupcake) NY” shirt, and at Crumbs we got coffee. Otherwise we just smelled. Anyway perhaps because of my fugness with the braces, or so I didn’t look like SUCH a tourist, I didn’t take many pictures, and the majority of the ones I did take are of food. Tickle me fat.

Now we did get one of each of the Levain cookie flavors and shared them over two days. For all the hubbub in the baking blogger community over these cookies, I must say my expectations were a little high. They were super yummy cookies, and definitely inspirational in terms of cloning efforts, but now that I’ve had one part of four, I think I can put the fascination to rest.

We walked several miles per day, seeing the sites. I loved the subway, as I always have been fascinated with mass transit. As for the cabs, I never did fear for my life, and I found at least one of the cabbies to be extremely pleasant. Amanda’s roommate’s boyfriend’s birthday was Saturday, so Friday night we made him a cake. I say we, but really it was Amanda; my contribution was to color frosting and fondant, eat cake scraps, and get in the way. But I’m glad she tolerated me, because I love to be in the kitchen with her.

We also got to catch up with Duke over some delicious fancy pizza before we headed to Chelsea Market and shopped. Everyone should have a Duke hug at least once a year. Saturday the aforementioned birthday boy was celebrating at Central Park with a softball game, so we spent some time there. I loved the park. The grass felt like heaven’s carpet on our tired feet, and I enjoyed meeting Amanda’s friends.

We met another of Amanda’s friends from work later for dinner. We stumbled upon a Middle Eastern restaurant with delicious gyros. The original plan was to end up at Pommes Frites, but we were so full that we got them to go and continued walking. I had seen these Belgian fries featured on the Food Network years ago and decided I must have them some day. After fatting around at home for a little bit, we decided to catch the night’s last showing of 500 Days of Summer. I recommend it – very cute and clever.

Saturday night/Sunday morning saw a very heavy storm, which was great for sleeping. When we got up, we found a street fair and falafel, walked through Times Square, and then on to Levain Bakery. More walking and shopping, dinner at a very lovely and tasty Thai place, followed by Julie and Julia, which was great. I am now as in love with Julia Child as my Dad has professed as long as I’ve known him. She was the only woman for whom my Mom gave him a pass. After the movie we scooted in the door of Tasti D-lite with a minute to spare before they closed.

Monday after Amanda left for work, I piddled around, just walking wherever I decided to go, ducking into shops and delighting in the fact that the streets are laid out such that even a geographically challenged bumpkin such as myself can navigate them without too much hassle. I wish I had 1. seen my cousin and his girls, 2. seen my friend who just moved there, 3. seen the World Trade Center memorial, and 4. walked to the edge of the island to see the ocean. But I ran out of time before I headed to Amanda’s work to meet for lunch. Always leave something to see on the next trip, right? We ate where she eats most days, Digby’s, whose iced hazelnut coffee is commendable.

After that Amanda got me into the MoMA before heading back to work. I shuffled about, sort of half-heartedly looking at drawings and artifacts and generally being a little blah, probably because I was leaving. I shaped up when I realized HEY, YOU’RE STILL HERE, and decided to see what I love – painting and sculpture, which were upstairs. I’m so glad I did. Without sounding too cheesy, I was moved. Even with a lot of people around, it felt calm in there, and I was able to focus on things and be excited without feeling ADD about it.

After a little more shopping, I went up to Amanda’s office with cute pictures on her desk, and then we walked home to get ready to leave. She walked me to the subway – goodbyes are hard – and I did my first truly embarrassing, idiotic thing of the trip. I wedged myself and my luggage in the turnstile and missed the window for turning it to get through. Ah, well. AirTrain, JFK, and JetBlue – check, thumbs up, for the most part.

Of course along the way were sister chats and the delicious worst of TV (Toddlers and Tiaras, for one). New York is a pretty amazing place with a lot to see and do. I continue to be impressed at Amanda’s gumption, her move to Manhattan, and how she acclimated so quickly and so well. I can’t wait to visit again, and thank you to my parents for the funds and encouragement.

So I’m really glad I got to go on that trip before school starts. Which is Monday. I think the anxiety about that peaked yesterday, and now I’m just focused on being prepared. Instead of “Don’t eff it up” on a hamster wheel in my head, I’m trying to tell myself, “You can do this!” Cognitive behavioral therapy for the win. I hope.