ShortCoat

A (Happy) New Year
By Alexandra Sowa MSII



I generally view myself as a rather cheerful, optimistic, glass-is-half-full type of gal. But not today, my friend, not today. Today, I feel like I’m never going to do well on my test this week, never make it out of the library and into third year, never learn how to successfully balance this “life” with any sort of real life, never be creative again, never…this list could go on, but I’ll spare you the rather dreadful monotony of it all.

So why have I, the perpetually Positive Penelope, turned into such a Debbie Downer, a Sulky Sally, a Whining Wilma? (Forgive the egregious alliteration, but I’m trying to cross “never be creative again” off my list of complaints. Baby steps.)

Perhaps I’ll blame it on January.

Perhaps I’ll blame it on the fact that I’m running out of space on my rather large bookcase and I just had to pack up F. Scott Fitzgerald in favor of F. Henry Netter.

Perhaps I’ll blame it on the fact that many of my friends are still reveling in their Christmas’ bonuses and I’m almost twenty-five, broke, and about to be kicked off of my parents’ health insurance.

Try as I might, I can’t place the blame on the calendar, my overflowing bookcase, or insufficient monetary funds. I’m almost too embarrassed to admit it, but the finger can only be pointed at one thing, and one thing alone: USMLE Step 1. At this point in my medical education, USMLE Leap 1 feels more like it.

Everything seemed to be going so well. My life first semester was filled with learning pathophysiology and the basics of physical diagnosis (I know how to take a blood pressure! I can hear a carotid bruit and tell you what it means!). Not terribly difficult stuff, but exciting nonetheless.

Everything seemed to be going so well, that is, until 11:59 p.m. on December 31, 2007. At the stroke of midnight, a rather alarming thing happened: I turned from a charming, happy future physician into a pathetically downtrodden second year medical student. Just call me Cinderella, M.D.

I first realized my dramatic mental metamorphosis upon receiving a thoughtful text from a medical school classmate in the first few minutes of 2008. “Happy New Year,” he wrote, “This year is going to be a big one!”

Although these were the words in the text, this is not what I read. Instead, I processed the following message: “Happy New Year – this is going to be the longest, biggest, most important year of your life. Not only are the next six months going to lead up to the do-or-die Board exam, but you will then be thrown to the wolves on the wards. Have fun!”

Ugh, a happy new year, indeed.

I know how inane it is to think like this, but much like my former five-year-old self who was afraid of monsters under the bed, I simply can’t help it. I know that the only rational response to the Boards is to study as I have all along, just as I knew that monsters were just about as real as my imaginary friend, Eddie.

Now that I’ve made my overblown fears public, I guess there is nothing left to do but attempt to relax, enjoy the rest of my second year, and of course, study. As such, Eddie and I are off to the library.

ShortCoat is a column that discusses the humor, heartache,and humanity of becoming a doctor. Alexandra Sowa is a second year medical student at NYU School of Medicine.

ShortCoat

Life of a Second Year

In a fruitless effort to tidy up my life and work space, I recently came across a writing assignment from the end of the first year of medical school in which each class member was asked to write a short reflection on medical school. I wrote:

In reflecting upon my first year of medical school, only one word immediately comes to mind: stress.”

Of course, I went on a bit more eloquently to say how the stress was worth it because learning to be a doctor was my goal, and yada, yada, yada.

If I were to repeat the little writing exercise this year and come up with one word to describe second year, I would choose…well, I would pick…actually, I have nothing.

Content? Well, yes, I am content, but I definitely want more. It is not as if I went around as a little girl saying, “Gee, I want to be a second year medical student when I grow up.”

Overwhelming? Occasionally. Intellectually stimulating? Of course, but at times, studying is just plain boring – no matter how interesting the material.

No adjective seems to fit quite right. One thing for sure, I am definitely not stressed– at least, not in the way I was stressed as a first year student.

Last year, having just moved to the big, bad city of New York, armed with fresh memories of my post-collegiate existence, I was severely alarmed by the amount of time I spent in the library. When I was not studying, I found myself thinking about how much I should be studying. I was in the middle of the most fabulous city in the world, and yet, the highlight of my first year fall semester was mastering the brachial plexus. Maybe I exaggerate--but not by much.

This year, I find myself studying even more than I did last year, and honestly, a part of me actually likes it. While one might attribute this to some sort of study-related psychosis, I think it comes down to one basic fact: I am finally becoming semi-literate in the foreign language we call medicine.

Instead of needing to look up every fifth word in papers and textbook assignments, I now only look up every twentieth word and fluidly incorporate jargon like “cachexia” and “cyanosis” into routine conversation. As an attendee of the recent American College of Surgeon’s annual clinical congress in New Orleans, I sat in on various lectures ranging from robotics and surgery in the 20th century to lower leg reconstruction--and I actually understood what was being presented! (Well, maybe not all of it, but a good 90% of it.) It was as if, through this new language, I had gained membership into a secret society in which everyone is required to wear suits, nametags and carry around dorky conference bags. Of course, with over 70,000 members, the American College of Surgeons isn’t really secret. Regardless, I was pretty satisfied with myself.

So is that the word that describes second year? Satisfying? Well, perhaps for a nanosecond. I was satisfied, that is, until I stepped on the plane to return home to New York City and realized that if there were a medical emergency and someone shouted for a doctor, my ability to offer medical aid would be nothing short of inadequate.

It was at that moment that I realized no amount of word mastery will qualify me to be a physician. In the language of medicine, actions truly do speak louder than words.

And until I begin to master those actions, I will not be satisfied fully. I can’t think about it too hard, though. If I do, I’ll be back to square-one, and back to stressed. Perhaps for the moment, I will just have to be satisfied with being inadequate.

Yes, that’s it. Life as a second year medical student is satisfyingly inadequate.

ShortCoat is a column that discusses the humor, heartache,and humanity of becoming a doctor. Alexandra Sowa is a second year medical student at NYU School of Medicine.

ShortCoat

How Not to Frost a Cake...

Imagine this: I am out to dinner with a few friends. We eat, we laugh, we order dessert. We decide upon chocolate cake and eagerly await its arrival.

Much to my surprise, the bearer of the dessert is not our previous waiter, but the plastic surgery fellow with whom I work. He looks frantic.

“You have to save this cake.”

“It looks fine to me,” I shrug, extending my fork in the direction of what looks like a perfectly healthy slice of cake.

“It is melting fast and you need to sew it up. Stat.”

He whips a suture kit out of his back pocket and tells me to sew the melting frosting back onto the cake.

“But be careful,” he adds, “You must not get any of the frosting into the cake, only on the cake.” This seems terribly counter-intuitive to me. Frosting in the cake sounds yummy!

He does not buy into my reasoning. “Look, Sowa,” he says sternly, “This is the closest thing to a real human being you can get.” And as if he were speaking in boldface characters, he adds:

“If you want to be a plastic surgeon, you sew this frosting back onto this cake.”

I decide upon a running stitch, but try as I might, I can’t get the gooey icing to properly adhere to its spongy interior, and there is chocolate gushing everywhere.

“It isn’t fair,” I plead. “I’m a terrible cook!”

(While I do make a mean chocolate chip cookie, I am not the most accomplished chef. In fact, I have been known to burn instant pudding. How one burns instant pudding, I do not know. Yet, I did.)

“Sorry, Sowa,” my plastic surgery fellow says, as he attempts to pry the plate out my trembling hands. “We can’t save them all.”

I hate to break it to you, but the aforementioned scenario was a dream. Well, everything except for the burned instant pudding. Unfortunately, that really did happen.

I share this story with you for two reasons: one, it is entertaining and two, it is disturbing.

If respite from my somewhat strange career path can’t be found in sleep, where can it be found? Truth be told, however, I am actually less concerned about medical school trying to ruin my peaceful slumber and far more worried of its attempt to sabotage my love of chocolate cake.



ShortCoat is a column that discusses the humor, heartache,and humanity of becoming a doctor. Alexandra Sowa is a second year medical student at NYU School of Medicine.

ShortCoat

Some Sound Advice...

As a rising second year at NYU, I have been deemed a seasoned-pro at medical school by the admission’s office and have been entrusted to serve as a “big sib” to three incoming first years. I’m not exactly sure what being a “big sib” entails, but I imagine it involves giving some sort of advice. I am a seasoned-pro, after all. If asked about anatomy lab I’m going to tell them:

“The tissues go into the bucket on the shelf.”

The first day of medical school, one of my esteemed professors gave an introductory lecture to the much hyped, much fretted about gross anatomy lab. I only took one thing away from that lecture: “The tissues go into the bucket on the shelf.”

I remember this bit, because I was struck by the considerate nature of this gesture. “They know how gross this is going to be,” I thought, “And they are providing us with tissues to clean our hands.” The following day, I showed up, and at the end of the hour, when I had finally gathered enough courage, I lamely picked at my body.

“Dr,” I asked, holding out a piece of fat as far away from my body as possible, “Where does this go?” “Looks like someone slept through my lecture yesterday,” she teased. “The tissues go into the bucket on the shelf.”

Beat. (It took a few seconds for my brain to decipher my immense confusion).

Not thinking about how stupid my forthcoming revelation was going to sound, I replied. “I thought you meant Kleenex tissues.”

I have never felt so blond in my whole life.

To the incoming first years… let my blond hair shield you from potential embarrassment and remember: “The tissues go into the bucket on the shelf.” And by tissues, I really mean everything gross you can ever imagine coming from your cadaver that isn’t legal to throw into the trash.


This is the best advice I can offer about anatomy lab. Oh, and double glove, invest in some scented hand cream, and remember to shower before you re-enter the outside world, because the smell of formaldehyde is not normal, no matter how much you will begin to think it is.

ShortCoat is a column that discusses the humor, heartache,and humanity of becoming a doctor. Alexandra Sowa is a second year medical student at NYU School of Medicine.

ShortCoat

Call Me (Im)Patient

Let me introduce myself: My name is Alexandra Sowa, I am twenty-four years old, and although I have only one year of medical school beneath my short white coat, I am absolutely ready to be a doctor. Forget second year - bring on the wards, the patients, and the title of “Medical Doctor!”

Before you assume that I am some cocky, over-zealous second-year, please give me a chance to explain.

When I was a little girl, waiting in line at the grocery store with my mother, an older woman cooed at me: “My, you are a pretty thing. How old are you?” Without missing a beat, I replied: “I am a sixteen-year old, trapped in this five-year-old body.”

I genuinely thought that the years I spent under five feet was some sort of cruel mix-up (I am now 5’6", just in case you were wondering). Don’t get me wrong - I had a wonderfully happy, fairly normal childhood. (I say fairly normal, because my mother was a bit of a hippy and didn’t believe in feeding me processed sugar. I didn’t know what a cookie was until kindergarten). I just wanted to move forward and do the next exciting thing. While some might argue that childhood is exciting, ask yourself this:

Would you rather learn how to drive a car or play in a dirty sandbox?

Although I was young, I was not stupid. Driving a car = fun. Playing in a dirty sandbox = not fun.

This has always been a problem of mine. When I was in 8th grade, I decided I was bored with middle school. So, I did as any logical thirteen-year-old would do: I opted to home-school for a semester and enrolled in classes at the University of Delaware. Without ever having set foot in high school, I decided I was already over it. I wanted to high-tail it to college.

Although some might label me with a “too big for your britches” syndrome, I don’t ever think that I’m too good for my current situation. Rather, I’m just so excited for the next stage that I can’t stand the wait.

This summer, I have been exposed to some amazing stuff at NYU Medical School, ranging from beautifully complicated reconstructive procedures in the operating Room at Tisch Hospital to profoundly moving physician-patient interactions in the clinics at Bellevue hospital.

And let me tell you: I am in love. You know the feeling – the weak in the knees, butterflies in the stomach, can’t stop smiling – type of love. Sadly (especially for my grandmother), I am not falling in love with a man, but with the profession of medicine.

This may seem counterintuitive, considering I have already committed years of my life to pre-med classes, MCAT studying, medical school interviewing, and last, but definitely not least, an entire year of medical school.

However, while immersed in the culture of medicine this summer, away from the books, the cadavers, and the stress, I discovered that I actually want to be a doctor – not a make-believe, far-off in the distance doctor, but the real deal.

I recently read Treatment Kind and Fair: Letters to a Young Doctor, by Dr. Perri Klass, a pediatrician at NYU, and came across a passage that made me realize why my revelation was so delayed.

“Medical training is transformative, I promise you that when you come out of training, you will in some sense divide the world into doctors and non-doctors, and you will identify as a doctor.”

Although the five-year-old in me secretly wants to simply fast-forward a few years, I finally understand that medical school is not just about knowledge, but about transformation. In the past year, I have transformed from a girl who wanted to be a doctor to a girl who is actually becoming one.

ShortCoat is a column that discusses the humor, heartache,and humanity of becoming a doctor. Alexandra Sowa is a second year medical student at NYU School of Medicine.

ShortCoat: musings of a medical student...

Change: From the Inside Out

"So what year are you guys?" says the preceptor. The medical students look around at each other with confused half smiles, "End of third year? Beginning of fourth year?" The preceptor replies, "Well if the class of 2007 graduated in May that makes YOU the fourth years." This felt good. Really good.

However, during a two week “selective” at the end of our third year, I began to wonder if I made the right choice to be a doctor. Of the eight electives offered, I chose Global Public Health, something every med student claims to be interested in from the moment they start typing their med school essay.

The doctor running the seminar challenged us to rethink our role as physicians immediately posed an interesting statement. "In these international relief efforts or disaster-stricken areas,” he said, “the doctor is probably one of the least useful people in comparison to the water engineer or sanitation coordinator. The doctor really acts more as a pair of hands." Fantastic, I thought. I’m going into debt to be a “pair of hands.”

We examined several problems in the seminar--global warming, urbanization, access to clean water, etc. The numbers are overwhelming: 20% of world lacks access to clean water, 40% lacks access to basic sanitation; 3.1 million people die every year from diarrhea-related illnesses, mostly children. 1.6 million of these deaths could be prevented with proper water management. The statistics weighed heavily on me and made me and my two hands feel fairly insignificant.

At this point in the course, I wondered if I chose the right profession. Should I have become a politician or an economist in order to really effect change? Perhaps I should’ve become a banker, ran a hedge fund and rubbed noses with the uber-wealthy. At least then I could have gotten them to write checks to supply a small country for the next ten years. It’s hard enough to get people to listen when you’re just a doctor, let alone a ‘short coat’.

Later we watched a documentary on a Médecins Sans Frontières doctor working at a refugee camp outside of Darfur. Romantic, hip, or cheesy as it may seem, watching this made me and several of my classmates excited again. Thinking about these enormous problems, seeing the staggering statistics, and watching our own government fail us can be overwhelming. But we can and do make a difference every day. In this context, I think I will be happy with just being a “pair of hands” dealing with the ‘smaller’ problems. I’ll be living in the big picture as only a brush stroke, but hopefully changing it ever so slightly from the inside out.

Written by Tom Kim, a 4th year medical student at NYU School of Medicine

ShortCoat is a column written by medical students describing their tumultuous journey through medical school. This column is open to all medical students who would like to contribute their stories. Please send your story to nyemergencymedicine@gmail.com