Med school's a bear market, and lucid dreaming masks

So in a recent post I mentioned nightmares.  I was pleasantly surprised while writing that entry that I hadn't had any within the last week or so, and I thought that since my 3rd year was finally wrapping up that maybe I was on the down-slope of the stress and anxiety.

SO WRONG!  After writing that post, that same night, I had another nightmare.  I know this is a totally weird topic to do a blog on, but just having finished my psych rotation, and learning about Freudian and Jungian dream interpretation, I felt the need to share how applicable that is AND how much med school is affecting my subconscious.

If you want to know more about the nitty-gritty of psychological dream interpretation, this site is a good place to start.  It's honestly pretty fascinating.  Anyway, the point is that they both theorized that dreams are/can be manifestations of your subconscious problems, frustrations, etc.

You'll have to research on your own to learn more (highly recommend it!), but back to my nightmare.  Like I mentioned, mine usually involve me in life-threatening situations (makes me wonder if I have nightmare disorder because adults aren't supposed to have nightmares much at all).

So this time I was camping with a bunch of med students (so unlikely on every level: I hate camping/outdoorsy things and I don't really hang out with my fellow med students at all outside of class), and all of a sudden there's a huge, ravenous bear tearing through our campsite trying to kill and/or eat us.  At first we were all working together to find places to hide or escape, but after a while of having to keep moving and hiding, we all get to the point of "ratting out" other students to save ourselves.  It turns into a Hunger Games/Lord of the Flies hybrid but without the gore and without the killing each other part.

I know at one point the bear was kind of also a really evil person and I got caught and somehow escaped (can't remember those details) but I remember running like h*** when I did.  It was also nighttime and it was hard to see where you were going but I remember considering the bear having the advantage because it could still smell.

Anyway, this is a pretty obvious example of my (sub)conscious revealing my true feelings of med school: (in the MOST BASIC SENSE) that they're out to get us and that they are (kind of?) pitting students against each other to "survive" (ie get a good residency).  I think it's been extra tough lately because I've been told that I don't have the best application for residency and may not ever achieve my lifelong dream of becoming a cardiologist.

I know it's not really like that, and that my school is way better than a lot of others (they really do want to help), and the students, on the med student spectrum, are on the compassionate, normal-people side if that's even possible.  Regardless I'm obviously stressed about this whole residency thing!!

Regardless, I'm leaving for a tropical vacation tomorrow for an entire week and hopefully that'll alleviate some of my worries.

On a brighter note, I've been contemplating getting one of these amazing lucid dreaming sleep masks.  That's not exactly the one I was looking at - there's a new one being advertised for about $100 and it's made some of the bigger news outlets.  I'd never spend that much on a sleep mask (I'd have to try that one out before spending that much!), but it's such an amazing idea.  I read about it as a kid and have only been able to lucid dream once or twice (you know, where you're almost awake and can control what you're doing).  The mask somehow detects REM sleep and flashes lights so you eventually are supposed to be able to recognize the flashing lights and know that you're dreaming.  There are a lot of techniques out there to train yourself to be able to recognize that you're dreaming and this happens to be a sort of "cheat."  Anyway, it's pretty neat.  If I could do that I'd fly or sit on a beach or something instead of being chased by a bear.

Lessons from an addiction clinic

One of the really great lessons I learned from my experience in the addiction clinic is that of forgiveness.  I know that one of the 12 steps in Alcoholics Anonymous (wow, I've been to way too many of these groups, as a med student of course!) is about forgiveness.  When the group started discussing it this time, I thought, psh, this isn't something I can apply at all.  I had been able to use a lot of the behavioral techniques in other areas of my life- controlling anxiety, restructuring my assumptions so I have fewer irrational "girl moments," etc.  But forgiveness??  I didn't have anyone to forgive or ask for forgiveness.

Boy was I wrong.  Looking back, I've had a pretty amazing life.  It's been a struggle- I've worked for most things I've gotten (a least the big stuff, and the recent stuff, like med school).  But one thing that I'd pushed from my mind was my last relationship.  I'm so thankful for a wonderful relationship right now, but I realized during this group that I still hadn't really forgiven my ex.  The relationship turned my life upside-down at the beginning of medical school, right when I needed stability the most, and although I've "gotten over it," I don't think I ever had closure.

These days I'm so busy, so I choose to ignore or suppress memories and events that are unsettling.  I am aware that this is an immature defense mechanism, but honestly I guess I think "I'll deal with it when I have more time."  Which by the way, in the life of a med student, is never.  So I think I'm getting out easy.  But then it just builds up, a million of these "I'll just forget it" moments, and I'm full of anxiety again.

The idea of forgiveness isn't easy.  And even more, how do you freaking accomplish this?  You don't usually just wake up one day and think, my conscious and subconscious has forgiven this person!  So I guess part of my problem was not knowing how to start.

The counselor, one of my new heroes, made it really simple.  AA is Christian-based, but it doesn't have to be religious (you pray to your HP, or "higher power" for all of these things).  Anyway, for it to work, he told us, you have to get down on your knees and pray.  (I'm not super-duper religious, for those of you who don't know me.  This was kind of awkward.)  You ask for all the things you want for yourself- happiness, closure, a good relationship, success, money, whatever.  Then you finish at the end by saying that you wish all of those things for whoever you are forgiving.

The thing is, you don't have to really mean it. That's why you say that at the end- that it's for that other person.  You can better reflect on what you want (or what any other reasonable person would want) and then stick that on the end.  And again, you don't really have to mean it.  But it you do it over and over again- 14 days to be exact- the counselor said that you would forgive the person.

I still thought this was crazy.  But I had realized that I needed to forgive my ex.  So I tried it.  I asked for all the things I wanted, then threw in a few that I already had (good relationship specifically, since that was my big issue with him), and asked for it to be given to him.

I didn't feel any different.  And I have to confess I only did it one day.  But the craziest part was that night, I had a dream where we met face to face and I was able to verbalize my forgiveness and I had an overwhelming sense of peace about that part of my life for the first time.  The reason this kind of dream is so weird is that for the past couple of months I've only had nightmares where I'm about to die.  (That's a whole different blog unto itself...obviously my stress has manifested itself in my sleep.)

Anyway, I probably should have finished out the two weeks but I figured at least my subconscious had at least partially forgiven him.  (This is a great example of how my life is full of "I'll do it later" thoughts.)  So the point is, if you have someone you are still angry with, or even someone who doesn't like you for some reason and you can't figure out why (the counselor suggested that scenario), and you're willing to try this, it might help.

Oddities, tics and analogies

I apologize to my two or three dedicated followers for the long hiatus; this last rotation of this year is like a sprint to the finish. (unfortunately, like my real-life sprinting ability I feel like I'm expending a lot of energy and still moving at a slow trot.) 

My other excuse is that I got engaged last weekend to the guy who literally keeps me going. I am so fortunate to have a life built around a strong foundation of a relationship. Plus he's very tolerant, forgiving, and patient.

Being in a relationship with him while going through the stress of med school has brought to light some new (yes, new, although my fiancé strongly disagrees) quirks:

-Abuse of analogies: apparently I severely overuse (no- slaughter) this grammar tool (I deleted one from this post already). I am very skilled at "turning a stupidly simple concept into even more stupidly simple pieces of a concept."

-Inability Too lazy to screw on caps.  Rather than screwing a lid or cap back on, I place it on and give it a half of a twist. This results in a lot of spilled cranberry juice. I can't convince anyone else that (except for soda) the lid is more of a courtesy, and that if you live with me and just assume that no lid is tightly secured, nothing will get spilled.

-I have a list-making addiction. I attribute it to a poor memory. If it's on a list it'll probably get done; if it's not on a list it probably won't get done.  Hence, honeydo lists are made by me (list-maker addict) for my fiancé (forgetful anti-list maker). But seriously, it alleviates my anxiety (blaming it on poor memory). Plus The Checklist Manifesto says lists are good.

-I have weird sleep issues: apparently I can sleep through my dog licking non-stop for 8 hours, or a loud train horn, but the light from the alarm clock or my fiance using his phone light to find something in the middle of the night will completely ruin my sleep cycle (and therefore my whole next day).  I'm too broke to get a new alarm clock, so I put a scarf over it at night.  I went the cheap route on the sleep mask and it lets in a lot of light so I haven't really been sleeping well these days...

-A few specific aversions to water: the oldest one is having wet hair on my back after a shower.  This is incredibly repulsive for some reason...it used to just be because I hated the feeling of a small area of soaked shirt around my neck, and now I just can't stand it at all.  My fiance also thinks it's weird that I won't put my face into water (washing my face, in the shower, or anywhere), although I don't mind swimming.  My explanation is that my eyes don't close all the way and the water burns when my contacts are in.  He still thinks it's crazy.  (I've lost enough contacts while swimming to know that it's not fun...and now that I have to pay for them I squeeze my eyes even tighter!  This is only applicable right now because I'm leaving for HAWAII in two days!!)

Shocking medical mistakes and how to avoid them!

CNN's headline article right now, "10 shocking medical mistakes,"made me REALLY angry for like, 5 seconds.  Until I read it, and realized it could have been summarized in two words:

AVOID SURGERY.

Ok, there are lots of great examples of necessary surgeries- heart attacks, exploding bowels, gunshot wounds, etc.  But I also see a lot of patients having multiple surgeries for absolutely ridiculous reasons.

Plastic surgery, you say?  Nope, I'm going to lump that into the "I-wouldn't-do-it-but-at-least-you-have-a-reason" category, even if the reason is vanity.  Seriously, a lot of people have surgery because of absolutely ludicrous reasons.  (By the way, I spelled "ludacris" hoping spellcheck would help, but apparently it's so different from the real spelling it doesn't recognize the incorrect spelling at all.  In fact, I had to use thesaurus.com and look up ridiculous synonyms.)

Some of my favorite:
1. Loneliness: you get a LOT of attention in the hospital.
2. Boredom: apparently patients get ipads and satellite TV..
3. It's free: why turn down free surgery??
4. I like being in the hospital.

Here's the article, notice the overriding themes:

(CNN) -- When you're a patient, you trust you're in good hands, but even the best doctor or nurse can make a mistake on you or someone you love.

Here's a list of 10 shocking medical mistakes and ways to not become a victim:

1. Mistake: Treating the wrong patient
• Cause: Hospital staff fails to verify a patient's identity.
• Consequences: Patients with similar names are confused.
• Prevention: Before every procedure in the hospital, make sure the staff checks your entire name, date of birth and barcode on your wrist band.
• Example case: Kerry Higuera

2. Mistake: Surgical souvenirs
• Cause: Surgical staff miscounts (or fails to count) equipment used inside a patient during an operation.
• Consequences: Tools get left inside the body.
• Prevention: If you have unexpected pain, fever or swelling after surgery, ask if you might have a surgical instrument inside you.
• Example case: Nelson Bailey

3. Mistake: Lost patients
• Cause: Patients with dementia are sometimes prone to wandering.
• Consequences: Patients may become trapped while wandering and die from hypothermia or dehydration.
• Prevention: If your loved one sometimes wanders, consider a GPS tracking bracelet.
• Example case: Mary Cole

(This is probably more common on surgical services, because surgeons prefer being in the operating room to chasing dementia patients.)

4. Mistake: Fake doctors
• Cause: Con artists pretend to be doctors.
• Consequences: Medical treatments backfire. Instead of getting better, patients get sicker.
• Prevention: Confirm online that your physician is licensed.
• Example case: Sarafina Gerling

(I would prefer a fake family doctor over a fake surgeon...think potential damages.)


5. Mistake: The ER waiting game

• Cause: Emergency rooms get backed up when overcrowded hospitals don't have enough beds.
• Consequences: Patients get sicker while waiting for care.
• Prevention: Doctors listen to other doctors, so on your way to the hospital call your physician and ask them to call the emergency room.
• Example case: Malyia Jeffers

(This is probably because people with colds go to the ER. And seriously...they advise calling your doctor before going to the ER???  Maybe I'll start calling McDonalds and placing my drive-through order so it's ready when I pull up to the window.)

6. Mistake: Air bubbles in blood
• Cause: The hole in a patient's chest isn't sealed airtight after a chest tube is removed.
• Consequences: Air bubbles get sucked into the wound and cut off blood supply to the patient's lungs, heart, kidneys and brain. Left uncorrected the patient dies.
• Prevention: If you have a chest tube in you, ask how you should be positioned when the line comes out.
• Example case: Blake Fought

(Again, surgery.)

7. Mistake: Operating on the wrong body part
• Cause: A patient's chart is incorrect, or a surgeon misreads it, or surgical draping obscures marks that denote the correct side of the operation.
• Consequences: The surgeon cuts into the wrong side of a patient's body.
• Prevention: Just before surgery, make sure you reaffirm with the nurse and the surgeon the correct body part and side of your operation.
•Example case: Jesse Matlock
(My expert advice: give your surgeon a literacy test prior to surgery.  Or at least make sure (s)he can tell right from left.)

8. Mistake: Infection infestation
• Cause: Doctors and nurses don't wash their hands.
• Consequences: Patients can die from infections spread by hospital workers.
• Prevention: It may be uncomfortable to ask, but make sure doctors and nurses wash their hands before they touch you, even if they're wearing gloves.
• Example case: Josh Nahum

9. Mistake: Lookalike tubes
• Cause: A chest tube and a feeding tube can look a lot alike.
• Consequences: Medicine meant for the stomach goes into the chest.
• Prevention: When you have tubes in you, ask the staff to trace every tube back to the point of origin so the right medicine goes to the right place.
• Example case: Alicia Coleman

(Again, surgery.) 

10. Mistake: Waking up during surgery
• Cause: An under-dose of anesthesia.
• Consequences:  The brain stays awake while the muscles stay frozen. Most patients aren't in any pain but some feel every poke, prod and cut.

• Prevention: When you schedule surgery, ask your surgeon if you need to be put asleep or if a local anesthetic might work just as well.
• Example case: Erin Cook

(Wouldn't advocate for local anesthesia during major surgery.  But again, surgery.)