THE REAPING (...AKA MATCH DAY)

Match Day. It's a 50-year-old tradition that defines the transition between being just another person and a doctor. (Yes, hint of sarcasm, because it's downright crazy that one day you're nothing and the next day you're an M.D.)  I'd been planning on doing a short piece about the nuts and bolts of the Match (and a few personal opinions and grievances) and had an epiphany in the shower. (TMI, sorry!)

Forgive me for the frequent references to the Hunger Games when trying to describe medical school- it has just been such a great analogy.  If you haven't read it, shame on you. You won't get most of these references. And seeing the first movie doesn't count; it didn't do the book justice.

HOW THE RESIDENCY MATCH IS BASICALLY THE HUNGER GAMES' REAPING

• The reaping (Match) is an annual event that takes place in each district (medical school)

A TASTE OF YOUR OWN MEDICINE

We all go through it at some point, thinking we have Guillain-Barre or diabetes or the plague. We even know those thoughts are irrational...but then something actually happens.

About two months ago, while wrapping up interviews, I noticed a prickly, tingling sensation in all 10 toes. At first I brushed it off- maybe my hose or heels were too tight, and I had been sitting for extended periods of time on airplanes. But it never went away-it was constant and in both feet.

My first thoughts, of course in panic, were diabetic neuropathy, a spinal cord lesion. Statistically, I knew that diabetes is extremely common, but I didn't have ANY other symptoms. And not only is my BMI a nice 21, I had recently started eating more healthily, nearly eliminating simple carbs and fats completely. I considered stopping by student health to have my blood sugar checked.

Stupidly, I googled it. I knew very well I'd run across crazy, rare diseases and freak out. Multiple sclerosis kept coming back up, and that almost seemed more likely than diabetes at one point. A resident I know was diagnosed recently and I couldn't get that out of my head.

After two weeks of parasthesia that quickly spread throughout both feet, I finally called my mom, a pharmacist. She quickly recommended getting some B vitamins in, because apparently oral contraceptives are associated with that (I had no idea, and have taken them awhile without problems). I had actually considered a vitamin deficiency early on and took them for a week or so without improvement so I stopped.

After about a month of vitamins, it finally went away. I guess between my "healthy diet" and OCP, I became a statistic. And I learned a really important lesson.

You can't objectively assess yourself. Going to the doctor sucks, but sometimes it's better than the alternative of getting much worse. I am even cautious about discussing medical issues with close family, because the closeness still impedes objectivity.

Also, healthcare professionals should take their own advice and not google their own symptoms.

GRANDE SKINNY WHIPPED UPSIDE DOWN MACCHIATO PLEASE

I think I had a coffee revelation today. I've never really loved coffee. Growing up, my idea of coffee was a 1:1:1 mixture of coffee, creamer and sugar, which I would prepare myself as a 5-year-old at the Fresh Market. (Just a tiny cup, of course, in my mom's defense.)

I prefer the caffe mocha- almost the perfect ratios.

As you get older, it isn't really socially acceptable to be seen putting that much cream and sugar into your coffee. Acceptable colors are black, and "really close to" black.

At first I tried to hide the color in a lidded coffee cup, but the sweet syrupy smell gave me away every time. So I started thinking, how do I get the caffeine, without the coffee? (Even better, without the calories?)

I first came across caffeine supplements like NoDoz during my paramedic days, when I had to stay up for 36 hours at a time. So, for the past few years, I've been taking a quarter of a caffeine pill (that's less than one cup of coffee, but enough to prevent withdrawal headaches because I can't seem to completely wean off of it.)

IT'S A NICE DAY FOR A WHITE [COAT] WEDDING

My personality has changed a lot during medical school.

(Or so I hear.)

In my opinion, I just have a lot less patience in general. Grocery store lines, traffic– I just can't handle it as well anymore. My mom says I'm just more concise and to the point (much like the doctors she works with), and I agree. Why use 20 words when two will suffice?

Even conversations have become more like patient presentations. You better have a point, and get there quick.

So when it comes to planning a wedding, the same rules apply. If someone asks what kind of glassware to use at the reception, I want a limited number of discrete options.  Even better, a well-formatted comparison table in Excel with bullet points. Which one is more expensive? Does the other one contain lead? Are plastic cups couture yet?

Don't get me wrong. Like every other engaged female, I want a perfectly-executed (down to the second) beautiful wedding that people talk about for 10 years.

The wedding industry is a well-oiled machine. They've got things down to a science. Why isn't there any initiative to streamline the process?

My humble hypothesis is that it has something to do with bridal hype- TV shows like Bridezillas (guilty pleasure), huge bridal shows, magazines and now websites and Twitter accounts. Being a bride has become a 1-2 year marathon (Miss America?) rather than a one-day sprint. If the process was streamlined, brides AND planners would be out of business. (I now wonder if the articles, dresses and "new" DIY projects are just cataloged and recycled every 5 years.)

I kind of get it. It's fun to flip through a wedding magazine and rip out pages of ideas. But in the end, society had still allocated only one "official" day for us brides to temporarily sabotage everyone else's lives, and no one else- not even the groom- will remember much more than the food (and if the dress was hideous or not) ten short days later.

THE ONION/FLU MYTH

There are lots of old wives' tales out there: carrying a pregnancy high means it's a boy, drinking water upside down cures hiccups, etc.

One rather odd one I didn't expect to hear quite so much about this year is how an onion will "draw out the illness" and turn black. I am a firm believer in the placebo effect, as well as the importance of optimism on patient health and outcome. Still!

Snopes has a page explaining the origin of the myth; apparently, the superstition has been around for over 100 years.  Not only is there no scientific evidence, there are no studies because it's SUCH a ridiculous claim! (It would go into the same category as testing unicorn horns for a cancer cure.)   Snopes quotes a Wall Street Journal article:

"Biologists say it's highly implausible that onions could attract a flu virus as a bug zapper traps flies. Viruses require a living host to replicate and can't propel themselves out of a body and across a room."

MYTHBUSTERS: RESIDENCY INTERVIEWS

MYTH: Interviewing for medical school, you have to sell yourself to them.  Interviewing for residency programs, they're selling themselves to you.

Generally, the big picture is fairly accurate. There are a LOT more candidates for med school than residency, and the further up the ladder, the stronger the application's correlation with good performance and success. Imagine looking at MCAT scores, college grades, and extracurriculars to decide if someone will be a good doctor one day.  "Lab assistant" could mean anything from washing pyrex beakers (me) or being first author on a publication (not me). Residency applications, on the other hand, are a slightly better representation of one's ability, focusing on medical board scores, clinical rotation grades and recommendation letters from other physicians. 

First, you have to understand the idea of cutoffs....

CHANGE OF PACE

Awhile back, my mom mentioned to me that changing my blog title to “No ifs, ands or buts” demonstrated how much I’d changed over the past few years. I was finally able to appreciate the humor in those trivial but frustrating situations that used to nearly drive me over the edge.

As I rapidly approach another big milestone in life (graduating from medical school!), I feel like it’s time for another change of pace (a pacemaker pun).  Also, I have one more week of vacation and I’m going crazy from boredom. My bizarre penchant for blank slates has now leached into other parts of my life- every few months I’ll buy a new calendar/planner just to start fresh, with one ink color. (I did that last week but only got about halfway through transcribing before I got bored, so now I’ll probably redo the blog.)

So, back to this coming year being full of exciting changes.

REFLECTION ON MORTALITY

People often comment about how close we are to death, as healthcare professionals. When I first started into medicine, I assumed that that constant exposure would make death easier to deal with- whether myself or those close to me. I thought it would be like exposure therapy in psychology, overcoming fear by incremental, gradual introduction.

Instead, it has done the opposite. My experience in medicine has made me feel infinitely more removed from death; paradoxically, because it is so routine. The problem is that I've been conditioned to assume that it's never me or my family. Death is always in the controlled environment of a hospital, and it's usually not unexpected or sudden.  I guess my mind has developed this corollary that if my family isn't in a hospital, then they are immune to death (but when I hear someone close to me has been taken to the hospital, I am immediately overcome with anxiety).

I'm always surprised to hear from others that a death was unexpected (of course there are exceptions, like a car accident)....