Archive for the ‘The Graduate School’ Category

Tomorrow, April 20th, is my last official day of graduate school. Technically I haven’t been in the clinic for the past 2 weeks, but I’ve been working extensively on a research project to continue to fulfill my time and even though I’ll still be working on the project beyond tomorrow, it doesn’t change the fact that tomorrow, I’m finished. Tomorrow, I have completed all my units, all the hours of clinical time.

Tomorrow I will officially have fulfilled all my requirements for my doctorate.

And in less than a month, I’ll either walk across the stage or be mailed a diploma that indicates that after 3 years of extremely hard work, I’ve finished. And with a graduating GPA of 3.74, which exceeded any GPA I ever imagined. I’ll have new initials to put after my name (on important documents), I’ll have a fancy title. I will be as educated as I am ever going to be.

I want to say something profound, because this truly feels profound, but words are failing me right now.

I’m not sure if I ever really thought this day would come. I have had April 20th, 2012 starred on a calendar for almost 3 years. It was my end goal and then everything just…got derailed. There were headaches, MRIs, lumbar punctures, blood patches, more MRIs more lumbar punctures. There were weeks of school missed, days of nothing but constant crying and disbelief that things would get better. Things felt completely hopeless time and time again. I really thought that my dream was done.

And here I am, at 10pm on April 19th. I’ve done it. I made up missed exams, I caught up on missed lectures and studied more than I ever thought was humanly possible. I found a balance that allowed me to take care of myself and still master the material. I somehow didn’t give up, even when it was all I really wanted to do.

Tomorrow, I am finished.

April 20th was always the light at the end of the tunnel. And we’re finally there. And I have to say, it is glorious.

I don’t have time or energy tonight to give this the pomp and circumstance that it deserves, but tomorrow is my very last day in clinic as a student. Ever.

I technically have 2 more weeks of working on a research project after this week, but even still, after 3 year of hard work, all that lies between me and being finished is 6 patients and a few signatures on papers. That’s it. I’m finally finished. I’m finally at the end of this graduate school experience. I can’t believe it.

Just one more day.

Sigh. Today has not been my favorite. But the story of what happened today starts back in January.

In early January I got a bill from one of my student loan companies saying I owed money for one of my loans because I was out of school from between December 15th to January 3rd (in which time, I was apparently supposed to get a job to pay for these loans. But whatever.) A day later, I got a letter from the same company saying that my student deferment had kicked in, which I took to mean that I didn’t have to pay that original payment.

A month later, I got a late notice on the original bill. Confused, I logged onto the student loan website and looked. It said that my account was overdue, but next to the amount owed, it said: “Due Date: June 1, 2012.” So, I didn’t pay it. Because why would I pay a bill that’s not due until June? I left the page and thought little of it.

A few weeks later I got another late notice. I got back online and found the same screen with the same due date. This time I attempted to call the student loan people, but because their working hours are the same as mine (well, they’re actually done an hour earlier than me, lazy bastards), I could only call during lunch. And either there is a high volume of calls at that time or they were on lunch too, because I never got through to anyone.

So I double checked online, verified the June due date and closed the page.

This happened again the following month, exactly the same thing. Late notice, June due date, no one answering my call at lunch, me giving up. I thought I was being a relatively responsible adult. I was apparently wrong.

Last night I received a notice from the student loan company that they were reporting me to credit agencies for being significantly late with my payment. Once again, I logged on and was MYSTIFIED to see the same June due date, but thankfully today when I called at lunch, someone picked up after only 10 minutes on hold. Not so thankfully, the woman I spoke to was a totally incompassionate witch, but that is sort of beside the point.

I explained to her my predicament and she came within a half a breath of calling me an idiot as she told me that the due date online is for my next payment. Which is SO obvious since they do not, in any place, say that it’s not the current due date. Have a look for yourself. This is my account as of today. Please, by the way, feel free to steal my information and pay off this loan for me.

Yes, it absolutely says my account is past due, a point that the Customer Service Witch pointed out repeatedly because apparently I do not sound literate. But it also says, RIGHT NEXT TO THE TOTAL DUE, that the due date is June 1, 2012. I consider myself to be a relatively intelligent individual, so please tell me I am not the only one who would read this and think the payment (which was totally manageable and not something I couldn’t have afforded), was due in June.

The Customer Service Witch informed me that credit agencies had already been sent information and that even if I tried to file an addendum or whatever information you can file to dispute this, that since it ultimately goes back to them and they don’t give a flying fuck about their customers or their stupid website believe their website is crystal clear, that they’d decline the dispute and no good would come of it.

Oh look at this creek I’m up. And oh look at my profound lack of paddles.

I am trying so hard to remain calm, but I imagine that as a result of this situation and the LOVELY conversation I had with their customer service representative, that my blood pressure is about equal with my credit score. Like I said, today has not been my favorite.

So the clinical situation. Sigh. I re-emailed the director of clinical education and when he continued to no reply for several days, I emailed my faculty mentor, who loves me dearly and has moved mountains in the past. Within 5 minutes he emailed me back and said that we would fix this situation.

I was totally elated.

So he and I spoke and then he called the director of clin ed, who apparently didn’t have email access which is why he never replied to the most recent email. But he said he would take a look at my emails and get back to me. So I waited. At 9:15 last night I got an email from him saying that because of previous incidents with students, there would be no compromising. I could end my clinical whenever I needed to for my health, but I’d have to take an incomplete and make up the remaining weeks in the summer.

I was totally crushed.

I spoke again with my mentor and he insisted that this wasn’t the end of the negotiations, but I thought that was probably just his way of being comforting. I went to bed feeling totally defeated. I know my body and my limits pretty well and 5 more weeks of this clinical simply will not work. No matter how much I want it to.

When I woke up I had another email from the director of clinical education. He read my most recent email again and thought that it was possible we could work something out. He told me to call him on the drive to the conference I was going to today and that we would discuss it.

So I did.

He said that with further thought, it seems completely insane that I would need to make up 2 weeks of clinical time when we’re talking about 50 total weeks throughout my program. It’s not like 2 weeks are going to drastically alter my education, it’s such a small amount of time in the grand scheme of things that this is kind of ridiculous. Nevermind that making up those 2 weeks would not be a good use of time, I wouldn’t hardly have time to get to know my clinical instructor or the clinic (and if I went back to this clinic, both of my current clinical instructors would be gone), before the end of the 10 days. We agreed that making up 2 weeks would be a waste of everyone’s time.

Also, he initially said that because I have been in a traditional clinical setting, he couldn’t just switch me to a research hybrid (half clinical, half research), but upon further consideration, he realized that I’ve been working on a research project this whole time, one that conveniently needs to wrap up just at the end of my affiliation, so actually he could kind of switch me.

So the very tentative current plan is that I will end my clinical 2 weeks early (at 36 weeks of pregnancy, 3 weeks from today) and spend the remaining 2 weeks at home with my time dedicated to sleeping and writing the abstract for the research project I’ve been working on. It’s not said or done, there still needs to be approval from several sources, but it seems like it is a decent possibility.

I am now very cautiously hopeful. I should know the official plan by early next week and in the meantime, I just need to stop thinking about it and try to enjoy my weekend.

Today, like each Wednesday, was a NICU day for my clinical. I can’t really explain why, but I was dreading the day. Wednesdays are just, well, they’re really long days. Half of the day is spent assessing myself to see if I’m about to pass out, and the other half is spent observing extremely sick or small infants. It’s a stressful day.

But the other reason I was dreading it, is because I didn’t want to face a reality I’ve been trying to ignore. And that reality is one I’m trying to avoid facing every other weekday too.

You see, I am just not loving this clinical.

There’s nothing wrong with the facility, the people are fantastic, the patients and families are great. I just am finding out more and more each week that this setting isn’t for me. For 3 years I’ve told everyone that when I graduate, I’m going into pediatrics. And now I’m realizing that I’m not sure if that’s at all what I want or what will happen.

And it’s just a weird thing to face each day. And I get to face it 5 times a week for the next 10.5 weeks. I just don’t love it. I don’t love the diagnoses I face, the treatments I’m creating/managing, etc.

I loved my last affiliation. It was an outpatient setting, primarily with adults, but I was fortunate enough to see many pediatric patients while there, which, incidentally, I loved. Minus a small sexual harassment issue (I was on the receiving end, not giving, just for clarification) I would happily go work there (and they pretty much offered me a job) after graduation (and baby and boards), but I feel this odd sense of…guilt.

I feel like I’ve led everyone astray somehow. Like by saying now that I don’t think I want to do pediatrics, I’m changing what everyone thinks about me. Like by saying I’d maybe rather work in an adult or adolescent setting, I’m disappointing the people who have educated me, who have supported me.

I know that isn’t necessarily the reality, but it’s the way I’ve been feeling. And so I don’t want to get up in the morning and go to clinical because it’s just a reminder of this feeling. It’s just a reminder that I’m not quite as sure of my path as I thought I was. That despite being a meager 14 weeks from graduation, I’m not sure at all what I’m going to do after that. Minus the baby part, obviously.

And just like the past few nights, I really wish tonight wouldn’t end. That tomorrow’s alarm clock won’t go off and that I can just stay in bed, at home, and bury my head in the sand.

I’m just not ready to face the uncertainty ahead.

I awoke bright and early his morning to get ready for my clinical. I realized that after 3 weeks off, I’ve kind of forgotten how mornings work. I was laying in bed thinking, okay, well, I’m awake, but what do I do now? After a few minutes I got up, brushed my teeth and then tried to remember what came next. Though it took a while, I got out the door by 6:45 and on the road.

I arrived on time and found out that I was one of 5 students starting today, including one of my classmates. We all did security stuff, got parking permits and then spent 2 hours reading through very thick binders of information about the hospital. Once all the forms were signed, I found my clinical instructor (CI) and we chatted for a few minutes.

She warned me that the first patient we were going to see was a very unstable baby with some other issues I’m not going to divulge. She offered me the option of going to lunch instead, but I decided to stick it out and eat lunch after. Though I grabbed a granola bar because I didn’t want to pass out.

And yes, the patient was…intense. I spent a lot of time reminding myself to breathe, bend my knees and relax. And I did fine. I ate lunch and then we went and saw a few more patients.

I got to hold and assess a couple of (stable) babies, I learned a ton about various aspects of NICU care and was really enjoying myself. My CI offered to let me leave at 4, but I told her I was fine to stay until my arranged time of 4:30 and so we went to see one last patient. This patient wasn’t in the NICU, he was a full-term infant in the normal hospital rooms with his mother. Basically, he was the lowest stress, most stable patient of the day. And all I had to do was listen to my CI explain something minor to the patient.

After about 10 minutes I started to get really warm. I have to wear a white coat and unlike everyone else, my only white coat is long sleeved and goes down to my knees. A few more minutes passed and I was getting more warm. The gloves were not helping. The room was stuffy. I was not handling things well. I wasn’t stressed, but suddenly I knew that I needed to get out of the room.

So I washed my hands quickly while my CI finished up and I stepped out in the hallway. By the time I got outside my vision was tunneling and my hearing was almost gone. I took my coat off and fanned myself but it was clear where this was going. After the longest few moments of my life, my CI came out into the hallway and I told her that I was going to pass out.

She got me a chair and some juice and after about 3 minutes, I was fine. I mean, I had a horrific headache and I was so tired I wanted to go to bed for the day, but I was no longer light headed, I could hear and see fine and I wasn’t hot anymore. The passing out danger had passed. I was fine. I was just HUMILIATED.

My CI told me that this has happened to all the pregnant women who’ve been in the NICU, which should make me feel better, but all it really makes me feel like is that I have 16 more weeks of freaking out about passing out every day. It’s so frustrating because I LOVED this day until those last 5 minutes. It was so neat. And now I’m home, exhausted to my core (it’s so ironic to me that losing consciousness is so energy draining) and even more worried about going back tomorrow.

Realistically I know the steps I need to take. I bought a short sleeved white coat, I will carry fruit snacks with me to keep my blood sugar up, and I will sit. But I also feel like I went from being totally in control to as out of control as I could possibly be. I guess it was good to learn this lesson early without actually passing out, but I would give anything for a do-over right now.

And to go back to the peace of mind I felt at 4:25 this afternoon instead of the crushing exhaustion and embarrassment I feel now. It’s gotta be uphill from here, right?

Tomorrow morning is the first day of my final clinical. I believe this is my very last first in graduate school and it’s one that I am a bit apprehensive about. I wrote about it over at Babble, but this clinical is a little different because instead of being in a clinic or treating in a rehab center, I’m working in a hospital. In a NICU.

Technically I’m only in the NICU on Tuesdays, Wednesdays and Thursdays, while Mondays and Fridays I’m working in an outpatient pediatric clinic, but the bulk of the time, especially with holidays, will be in the NICU. I am legitimately nervous about this.

One part of my nervousness just comes from the delicacy of the patients. I have done some very limited work in a PICU, but I’ve never worked with anyone as medically fragile as these babies will be. And it’s kind of alarming to realize that any mistakes could be not just unpleasant but life threatening. Now, most likely I won’t really get to do a lot of hands on stuff, at least not without extremely close supervision, but that doesn’t make it any less frightening.

The other part is obviously the total mental mindfuck that is being pregnant in a NICU. So far I’m feeling relatively okay about it, but only time will really tell with this one.

And more than anything else, I’m sad to be finished with vacation. I really, really love vacation and this was the last one I’ll ever really get. I mean, the last child free, relatively care free vacation of my life. Or at least for like 20 years. That is a long time from now, in case you’re not big on math.

I had planned a quiet day today to get all the last minute things ready for tomorrow, which meant that absolutely nothing went according to plan and today was the exactly opposite of relaxing. Maybe in the end that’s a good thing since it means I haven’t had time to worry too much or to get too bogged down thinking about anything. I’ve had to focus on other stuff like my nieces, my cat being a tremendous asshole and putting together a crib. But now I’ve got 2 hours before bed and I’m starting to feel unsettled.

There is a small part of me that is excited, it’s a new experience and it may be something that I want to do for the rest of my life. The prospect of that is exciting and scary. And even if it’s not something I want to do forever, in 16 weeks it’s over, and I’ll be ready to graduate.

It’s 16 weeks, 79 days. I firmly believe that I can do anything for 79 days. So we may as well get this show on the road.

I hadn’t really planned on blogging tonight since it’s already really late. But I just checked my grades and I just wanted to share quickly.

In my last semester of graduate school, the one that is supposed to be the toughest, I got straight As. I can’t emphasize enough how rigorous this semester was. It was supposed to be basically he culmination of all 3 years and the final exams I took were basically 3 years of information in two hours. It was intense. And I got straight As. It feels nothing short of amazing.

I still have one clinical affiliation between me and graduation in May, but my graduating GPA will officially be a 3.74. It’s not too shabby considering how close I came to quitting 2 years ago over fears of failing.

Suck on that headaches.

On Thursday I reached a milestone that was a long time coming. I took my very last final exam. I walked out of my classroom for good. I am officially finished with academia. I still have another 4 months worth of clinical time before I graduate in May, but the quizzes and midterms and finals are over. Forever.

I am kind of gobsmacked by this realization.

I texted my friend and she replied that she remembered 2+ years ago when I called her, on the way home from school, to tell her that I had decided to quit. I remember it too. It was after I had missed several weeks with a spinal fluid leak. I had missed a major midterm and so much class. And they wanted to do another lumbar puncture that would knock me out of school for at least a few more days.

That night I called my program director to tell her the same thing. I was ready to quit. I just didn’t think there was any way I could do it.

But I did.

As I was driving home from school on Thursday, a song came on my iPod and I heard the words in an entirely new way.

“And high up above or down below
When you’re too in love to let it go
But if you never try you’ll never know
Just what you’re worth

Lights will guide you home
And ignite your bones
And I will try to fix you”

School, this career was something that I have wanted to do for as long as I can remember. I hated the idea of quitting because it was something that I wanted so badly, something I loved from the first moment I started. I was convinced that I couldn’t do it and so I wanted to quit before I could fail.

But because of the people in my life, my husband, my family, my friends and many of you, I didn’t. I found out what I was capable of.

You are the lights.

You have led me.

You have ignited me.

You have fixed me.

And now I am home. I am finished.

And all I can say now is thank you. I couldn’t have done it without you.

I reached another school milestone today. I took my last midterm. The last one ever.

At this point there is literally only one test standing between me and graduation and it’s not until December, so I can safely procrastinate for several months. There’s a presentation sandwiched in there too, but those are always manageable.

The exams today went fine, they were all pretty much exactly what I anticipated. But something kind of cool came out of them. I realized just how far I’ve come in this process.

My first year of school was all about details. It was about numbers, it was about the very nitty gritty details instead of the big picture. And today I realized that I have gone from memorizing details and regurgitating them on tests to actually understanding processes. Today’s tests were very much still about knowing the details, but it wasn’t about plastering them on paper. It was about understanding what they meant. It was about knowing what those details added up to.

My oral test today was a patient case where the diagnosis was incredibly uncertain. In my first year of school that would’ve killed me. Because the first year was a year of black and white. You had condition x or condition y because those were the options. And I’ve since learned that sometimes it’s neither x nor y, sometimes it’s both x and y and sometimes it’s half of one and a quarter of the other. I had to defend my potential diagnoses and I was able to do it, intelligently, without stress and without killing myself studying for days.

The practical exam was similar. I no longer stand in front of instructors with trembling hands. I didn’t have every single answer on the tip of my tongue today, but I had the tools to figure the answers out and I think that ultimately, that’s better, it’s more practical and more realistic for long term practice. And when I didn’t know the answer today, I remembered that sometimes that’s reality. Sometimes even the most expert clinicians have to look things up.

Admittedly there were a few skills I could’ve done better on, especially toward the end of the test, but I was able to problem solve, perform complex skills without help and answer most of the questions about them. And I got feedback so that I can continue to improve.

It’s such an odd feeling, the lack of stress in exams. I was appropriately scared of the unknown, but not panicked. I knew that I had learned the material, I knew that I could manage the questions if I just took my time and thought it through.

And now it is done.

Now there is only one test left. There’s only one more day where I’ll stand up in front of instructors and perform techniques. Where I’ll justify my assessment or treatment. Where I’ll get feedback, get some praise and some suggestions. I might sound nostalgic for the days of testing, but it’s really more just amazement at how the time has passed.

Of how far I’ve come in my learning, in my confidence of myself.

And of how little time I have left to go.