Archive for the ‘The Graduate School’ Category

Today I reached the halfway point for my clinical rotation. TODAY I REACHED THE HALFWAY POINT. I know, you don’t like the shouting, but I just felt like that needed to be yelled, because it’s kind of a big deal to me.

In honor of today being such a big landmark for me, my body decided to pull out all the stops. My left hand which is normally week and clumsy, was all kinds of screwed up. I couldn’t feel my 4th and 5th fingers on my left hand at all, and I could barely coordinate the movements of it. My head has been a special brand of miserable, and on like 5 different occasions I was totally convinced I was sitting through an earthquake. I wasn’t.

Thankfully no one seemed to notice.

Each day, I fight pain, I fight anxiety, I fight whatever that day is going to hold both from my body and from my patient list, and I do the best that I can. I don’t remember everything I’ve learned or everything I’ve been told to do. I don’t remember some of the things I should and sometimes I’m not as great at what I’m doing as I’d like to be.

But I am doing the best that I can, and so far, it’s enough. It’s more than enough. I’m not just surviving, honestly, I’m succeeding. I’m getting compliments, I’m getting some praise. I’m getting told by my clinical instructor that I’m managing more than she did when she was at my level in her education. I’m getting told by my patients that I’m making a difference.

I am imperfect and I’m accepting that. I fumble a lot, I struggle, I still mumble and second guess myself about a thousand times a day, but I am succeeding.

I can scarcely tell you how close I came to quitting school last year. My husband talked me down off a ledge I was more than ready to jump head first off of. I had drafted the letter to my program director, I had told some friends. I didn’t think there was any way I’d pass my classes that semester, I didn’t think I’d ever be able to actually go on a clinical. I didn’t think this was possible. I cried for hours at the thought of watching this dream dissolve, a dream I had already worked hard for.

It’s possible. I am succeeding. I am still working so incredibly hard for it.

I know you’re all probably tired of hearing it. I know this isn’t exciting to a lot of you, but it’s something I’m just incredibly proud of, something I want and need to celebrate. I haven’t had all that many things to celebrate in the last 12 months, or many things that I felt like celebrating.

I’m celebrating this. I’m celebrating surviving. I’m celebrating managing. I’m celebrating success.

I’m halfway.

I saw a new patient today at my clinical. Her referral listed a simple diagnosis, but it was apparent from the moment she walked in that she’d be anything but simple.

She was near to my age, lived near me and well, the more I read on her chart, the more I found that we had in common. This girl who was so much like me on paper, was also obviously in a lot of pain. She later told me that on a scale of 0 to 10, her pain was a 30. And you know what? I believed her. There are many people who say their pain is a 12 out of 10, and it’s not that I don’t believe them, but I often wonder if I could tolerate their pain. You know? I wonder if their 10 is the same as my 10.

Not this girl.

I looked this girl in the eye and I saw bits of myself. I saw sadness and defeat. I saw hope that was dwindling, but still present. But I also saw pain that if I’m lucky, I will never understand. I saw hardship that she doesn’t deserve, that I’m not sure she can handle, that I’m not sure anyone can handle.

I wanted to take her hand and tell her all about the chronic pain resources I know, about all the wonderful people on the internet, but I couldn’t. I couldn’t for a number of reasons, but mostly because I was so completely beside myself that I couldn’t hardly utter any words besides the ones I have rehearsed in my head hundreds of times for patient interviews.

I looked this girl in the eye, I heard about her pain and I wanted to cry. I wanted to cry for her. Because I saw the fear in her eyes, and I just sat there, feeling impotent. Feeling helpless. I can’t help this girl. It’s entirely possible that no one can, but I’m going to have to be one of the first to break that reality to her.

The more I’ve thought about this girl, the more I’ve considered what happened today, what she told me, what I heard and saw, the more I understand some of the reactions I get from people, from doctors, from my own family. I saw someone suffer today. I had someone tell me that she’d do anything to make her pain stop, I had someone say to me sentences that I’ve said to others, that I’ve written here in my most desperate hours.

I understand things now.

I understand why people walk away from those in pain. It’s terrifying to watch someone shrink from pain. And it’s soul crushing to not be able to do anything for it.

I understand why doctors fire patients, why some respond to chronic pain patients the way they do. It’s horrible to see something you don’t know much about, that you can’t fix. That no book or lecture can ever help you understand the realities of.

I understand why family and friends cry for those who are suffering. It’s because sometimes it’s all you can do.

I am not saying that I understand this girl’s pain, because if I put my pain on the same scale as hers, even tonight when it’s relentless and gnawing, I don’t think that it would hold a candle to hers. But I understand a lot of what she’s feeling right now, and some of what she’s gone through and will soon face.

And for the first time, I understand how it feels to watch someone suffer. I understand how helpless you feel when you stare pain in the eye and have no answer, no help.

I understand now.

I almost wish that I didn’t.

I do have more to say about Utah, but I’m interrupting that to talk a little about what a big freaking day today was. Because it was.

Back in March, I wasn’t allowed to do a clinical rotation because of lifting restrictions from the blood patch nightmare in January. I had to watch as all my classmates went off and did hands on learning, while I was again, couch bound. I had to hear about the highs and lows of my classmate’s clinicals for weeks afterwards, and explain why I had no stories. I had to feel different, defective, again.

I tried to stay positive. I failed.

When you throw missing the first hands-on experience on top of a never-ending headache, missing a crapload of school and a ridiculous amount of stress, positive is not an state of mind that is easily found.

But this morning I got up, showered, did my hair, put on ironed clothes and went to my first day of a 7 week clinical. It wasn’t a perfect day, by any means. I didn’t know the answer to every question I was asked. I hurt over every inch of my body from standing up for 11 hours, my headache is massive. I am exhausted.

But

I didn’t have to quit.

I didn’t have to ask for a break.

I didn’t have to miss out, again.

I know that making it through one full day of work doesn’t seem important or significant. I know it’s probably silly to celebrate a feat that most of you accomplish every single day. I know that.

And yet I’m celebrating.

I’m still in significant pain, but I’m living with and in spite of it. I’m managing. I’m succeeding.

One day down, 33 to go.

After the world’s crappiest night of sleep, with a hideous headache, I took my last final exam of the semester today. Stick a fork in me because I am done with this semester.

I have no idea how to wrap up this semester. I don’t have any eloquent words or flowery monologues today. If I’m being perfectly honest, I don’t know how I managed.

In January I had a myelogram that created what my neurosurgeon called a “massive” spinal fluid leak. Even putting a pillow under my head while lying down created such pain I literally thought that I was better off dead. I have never felt anything like that. And somehow, less than a week later, with many MANY milliliters of my own blood in my back, in a pretty significant amount of pain, I was back at school.

I can only describe this semester as the work of sheer determination. This semester I had one lumbar puncture and 3 blood patches. This semester I had a headache every single moment of every single day. This semester I struggled with pain, I struggled with the re-emergence of an eating disorder. I struggled with thoughts that my life wasn’t worth it any more.

I have never struggled like I have this semester. This year if we’re being really honest.

But tonight, this year isn’t what I’m thinking about.

Because two years from today, I will graduate.

Two years from today, I will hold in my hand a doctoral degree from an outstanding program, I will have a hood placed over my head indicating that I finished, that I made it.

My transcript will never show straight As. I won’t cross the stage with extra cords around my neck, or with awards in my hand. I will not be in the top of my class, nor will I make the news. I won’t be one of the graduates they ask to come back and teach. I won’t be one that mentors or tutors other students.

And that’s okay.

I used to dream of those things, but life has a way of changing dreams. Of changing perspectives. Would I love for those things to be in my future? Of course. But what I am doing right now is worth more than any award, or cord, or honor. I’m doing the best that I can. And that’s all that I care about. That’s all that matters.

Because what I will be in two years is a graduate.

I will be successful. If only because of a desire to prove everyone wrong, I will succeed. If only because I set my mind to this, because I decided that this is what I wanted, I will succeed.

Two years from today I will gain a few initials after my name. I will enter a profession I have only dreamed of. I will begin the future I’ve planned and erased in my mind so many times.

Two years from today, I will cross a stage to the rest of my life.

Two years from today.

I think I can honestly say that the last seven days have been among the longest in my life. Tomorrow is my 8th and last final exam for the week (and the semester). I am exhausted in every way that I could even begin to describe.

This week, for the second and third time ever, I’ve actually used the extra time I have through the student disability accommodations I got this year. And what that does to my psyche, I can hardly begin to explain. This week I have felt mentally sluggish, emotionally fragile and perpetually frustrated.

I didn’t struggle in high school. I put in a lot of effort, but any class I studied for, I got an A in. In college, the same was mostly true, though many of those As were replaced with an A- or B+. But now, for literally the first time, I’m facing the possibility of not succeeding. And ironically, it’s come at a time when I am working harder than I have ever worked before.

And yes, this program is tough. But this program is not impossible. I have nearly 100 classmates, and all but a very, very small percentage of them are passing, many with high grades.

But it’s not about my classmates. It’s about me.

It’s about the fact that I spent 20 minutes yesterday crying because I could not, for the life of me, figure out my mock patient’s right from their left. Simple things that everyone else can do, I cannot. Simple things I used to do, I cannot. It takes so much more effort to remember things, except for the totally unimportant details, which always seem to stick immediately and indefinitely in my brain.

I am tired.

I’m tired of working this hard to do what everyone else does. I honestly don’t care how my grades compare to my classmates. I only care about how my grades compare to what I’m capable of. Or what I used to be capable of. 5 years ago, I would calculate the exam grade necessary for an A, or A-. This week I’m calculating for a C. The lowest passing grade in my program.

I just feel like I’m trapped in a life, in a brain that isn’t mine. I feel held back in areas I used to be successful in. I feel confused by simple concepts. I feel like each day gets more difficult instead of less, each day the pain gets a little worse, a little less tolerable.

And yes, the easy solution would be to withdraw from school. To wait, to see if we can fix my headaches and try again later. And I know that many of you shake your head when I refuse to do that. But I can’t.

I cannot lose anything else to this pain. I will not lose a year of my life, a year of my career, a year of the life I planned, to pain. I wish I could explain it in a way that made sense, and in a way that didn’t confuse and irritate some of you, but I can’t. The best way I can describe it, is that it’s like I’m fighting for every piece of normal I can find in my life right now.

And until I lose that fight, until normal isn’t a possibility at all, I have to keep going. I owe myself that.

First thing Saturday morning I got an email from one of my instructors. The exam I’d taken on Thursday was graded and my score was available online. I clicked over, anxious to see how I’d done. I knew my grade wasn’t going to be as good as exams in the past, but I was hopeful that I’d at least pulled the class average of 90%.

And so, when I saw the 85% in the gradebook, I was crushed.

Logically, I know that an 85% is fine. It’s passing by a wide margin and I’m glad for that, really I am. But I can do better, I have done better.

Today is the second consecutive day of class I’ve had to leave out early because of pain. I did everything I could both Friday and today to make it through to the end, but I couldn’t. The headaches are escalating, and my ability to cope isn’t keeping up with the changes in pain. I’m a mess. A weepy, tired, sad mess. And I am so frustrated, so in pain, so tired of all of this.

It’s not fair. There, I said it. I know it’s a kindergarten response, but today, I feel like a kindergartener. I have no control over anything in my universe. I can’t even go to school all day.

And the more this happens the more I find myself constantly thinking about how things would be if it weren’t for this headache.

I got an 85% on that test, not because I didn’t know the material (I did), but because of little mistakes, little mistakes that I never would’ve made 8 and a half months ago. And because of that, I am overcome with questions. With hypothetical wonders.

I wonder what my grades would be like if I didn’t have this headache, this life sucking vortex, this sleep stealing pain. I wonder if I would be more confident, and less stressed. I wonder if I would stand out as a competent student instead of as the girl that needs accommodations.

I wonder what my marriage would be like if I wasn’t in pain. I wonder if I would be a better wife, if I would do more of the things I always envisioned myself doing. I wonder if I would cook dinner with more regularity, if I wouldn’t cancel plans as often. I wonder if we’d fight less, if we’d be happier.

I wonder what shape I’d be in if I wasn’t in pain. I wonder if I would be exercising, if I’d be fit like my classmates. If I’d have a trace of muscle, even with the 2 month lifting restriction. I wonder how much energy I’d have, what I’d do with it. I wonder if I would spend as much time lying on the couch.

But mostly, I wonder who I’d be.

Because what I am today is so far from anything I ever imagined, that I’m practically a stranger to myself.

Many days I can cope with this change, with being this stranger. I can maintain some level of hope trust that things will get better, that frankly things HAVE to get better. But today, like many of my most painful days, it is a struggle. I don’t know how to keep moving forward when things aren’t improving. I don’t know how to push through when there’s no end in sight. No matter how hard I try, I just don’t know to keep my chin up when things are only, are always, moving down.

I find myself facing the worst wonders of all. I wonder if I’ll get used to this life. I wonder if at some point, I’ll stop caring that my life, my future, has been completely changed.

I wonder if this is who I am, for “good.”

On Tuesdays and Thursdays my morning class begins painfully early. The class starts at 7:30 sharp and we almost always start with a quiz. This means that if you’re 10 minutes late, you miss the quiz, and there are no makeups, period. Living 30 miles of solid traffic away from school means I’ve already missed 2 quizzes this year for being late and let’s not forget the 3 from being stuck at home with an enormous spinal fluid leak. As if you could forget.

Anyways, so I’ve been getting to school earlier lately to try to avoid the quiz missage, and so far, so good. I’ve found that if I leave the house at 5:55, I get to school by 6:45. If I leave at 6:10, I get there at 7:20. The time-space continuum is severely disrupted on the 10 freeway.

On Tuesday, I arrived at 6:45, got to my classroom by 6:50. In fact, I got there before the professor. He let me in a few minutes later and shortly thereafter another student arrived and sat down at a desk in the front of the room with the professor. They began talking about the other student’s midterm and I realized that this was a pre-scheduled meeting and that perhaps I should step out to give him privacy. I didn’t really have to, but I know I wouldn’t want other people listening in on my midterm discussions, especially if I hadn’t done well. I grabbed my notes and sat down in the hallway.

A few minutes later another of my classmates came to the classroom and asked if the door was locked. I told him that it was open, but that (the student) and our professor were having a meeting about the midterm. He understood and stayed in the hallway with me. We studied silently for about 5 minutes before 3 other students walked up. 2 of them, let’s call them Tweedledee and Tweedledum are good friends, and they are the “gunners.” They are the students who are happy to trample anyone else down if it helps them succeed. I sit behind Tweedledee in a few of my classes and I’ll be honest, I don’t care for her. She can be quite nice, she can also be a tremendous asshole.

Tweedledee walked up and let out a HUGE sigh, and blurted out, “You’ve got to be kidding me. It’s locked?” Without missing a beat, Tweedledum echoed her previous statement about this being ridiculous and I calmly stated that it wasn’t locked, but that our classmate was having the meeting, and yadda yadda yadda, and DUDE, it’s only 7 oh freaking 5. You have 25 minutes before the quiz, chill the hell out.

And before I could finish my sentence, Tweedledee looks at me and says, “Who the hell cares about his test? I’m going in. He can deal, it’s not my problem.”

And with that, Tweedledee and Tweedledum burst into the room, mid-meeting, and I was left in the hallway with 2 other classmates, all 3 of us stood there totally speechless. I mean, it’s one thing if this was happening 5 minutes before class, but we had 25 minutes and there’s an empty unlocked room next door that they could go into.

I could not believe the audacity of my classmates. I cannot believe that they care so much more about themselves than about giving one of their peers some respect, some common courtesy. It’s funny, because I’m in the same program, at the same school, and I would love nothing more than for all my classmates to succeed. All but one of our classes is graded on a standard non-curve scale, so there’s no reason to want others to not do really well too.

I just feel like there are already enough things standing in the way to success, it’s wrong in so many ways, on so many levels, to become another barrier. And no matter how competitive things get, I refuse to halt someone else’s success.

Even if that means not baking laxative brownies for Tweedledee and Tweedledum the day before finals start.

I’d be lying if I said it wasn’t a little tempting.

This weekend has long been scheduled as a weekend of preparation. I am packing a suitcase and make travel plans.

Back in December I found out that my request had been accepted and I would be completing my first 2 week clinical experience at a facility in New Orleans that I was familiar with. I was ecstatic. I chose it because I knew that I could learn there and not feel the awkwardness that I would at other facilities, I knew it would be a great first clinical experience. I marked it on my calendar. I made plans.

I let myself get excited.

And then January happened.

The instant that the nurse handed me the post-op instructions from the neurosurgeon, I knew there would be a problem. I knew that March 1st through 12th fell well within the 2 months of not lifting more than 5 pounds. I also knew that in the profession I’m going into, few things that I’ll do will require lifting less than 5 pounds.

I tried to stay positive. I focused on the good. I was getting better, the spinal headache was gone, I was going to be able to return to school. All good things. On my second day back I sat down with my faculty advisor and got the first inkling that my optimism was useless. He scheduled a meeting for me with the program director that afternoon.

As I sat down in her office, I was prepared to fight. I wanted this. I had worked hard for this spot at this clinic, hell, I’d worked hard just to finish the 1st semester. These 2 weeks in New Orleans were among the few things that kept me going last semester when I wanted to quit. I didn’t want to let down the people at that clinic, the people who were working to find a way to let me come learn from them. I wasn’t going to go down without a fight.

But as the conversation began, it became clear that I was going down, fight or not. The program director told me what I already knew. There was no way to complete the clinical without lifting more than 5 pounds. And observing instead of doing hands on work wouldn’t allow me to meet the objectives of the rotation.

As I used every ounce of strength I had to keep the tears from pouring down my cheeks, I asked her what I was supposed to do. Deep down I was terrified that she was going to tell me that it was finally time to drop to half-time status and add an extra year to my 3 year degree. It is something she’d suggested in November and something I had absolutely refused to do.

Thankfully they already had a plan for me, they’d just add one more week to my 6 week clinical this summer and one more to my spring clinical next year. She assured me that this was the best time this could happen.

I nodded and said okay. I didn’t argue. I didn’t fight.

I left her office and walked to the library for class, feeling my warm salty tears pour down my face as the cool wind whipped around me. I was overcome with emotion, with pain. Frustration of more plans being ruined burned in my head. Jealousy of my classmates, for the normalcy they take for granted seared through my heart. Anger over the lack of control over my body coursed through my veins. But mostly sadness and regret washed over me, rendering all the other emotions quiet and small.

I was all at once a small, quiet person, drowning in tears, in pain.

I kept walking and crying. I kept thinking how I wished I could go back in time and somehow undo this. Somehow change something to stop this chain of events from getting me to where I was that day, where I am today.

Because I am packing. But I’m not going to New Orleans. I couldn’t stop this from happening.

I’m going home to spend a week with my family, and then I have two more weeks of vacation. I realize that 3 weeks of vacation sounds glorious, and on some level that I have yet to reach and appreciate, it is. But I would gladly give up 10 of those days to be in New Orleans, doing what I’m supposed to be doing. The realization that I just spent hours and weeks catching up with my classmates so that I could be 2 weeks behind again is painful to accept. I feel like I’m fighting a perpetual uphill battle and most days I can’t decide if I want to rest or just quit and fall all the way down the hill.

But so for 3 weeks, I’ll be doing the former. I’ll be resting. I’ll be visiting family, I’ll be baking and relaxing. I’ll be having a few small pity parties here and there and writing a few papers that are due in late March. I’ll be wishing that things were different but knowing that there’s nothing that can be done about it.

I’ll be trying to find a way to acknowledge that though these 3 weeks of vacation are not at all what I want, perhaps they’re what I need.

After 5 days filled to the brim with stress, papers, powerpoints, word documents and mostly hours and hours of exams, the week my classmates have nicknamed “hell week” is officially over. I completed 6 exams in those 5 days, and only had to push one back to the end of the semester because it was a practical exam that would require lifting more than 5 pounds.

In case you wondered, EVERYTHING weighs more than 5 pounds.

Last night was probably the most stressfull of nights because to really finish off hell week with a bang, the two biggest exams were today, one at 8:30 and one at 2.

The afternoon exam was one that all the second and third year students had warned us we would fail and when it came down to prioritizing to study Thursday, that second exam? Well, it fell low on the list. Just every so slightly below getting sleep. And the almost 4 hours I got were pretty glorious.

The morning exam didn’t go perfectly, but it went MUCH better than any of us anticipated.

The afternoon one? Um. No.

The only way I can describe that exam and frankly this day and week is as a giant shit show. I sat down to take the exam, knowing full well that I was unprepared, but not yet aware of the magnitude of the situation. Ignorance, it was bliss.

The exam was supposed to take 2 hours, though I get time and a half for my slow processing brain, so I wasn’t sure how long it would take. After flipping through the test once, I realized that it wouldn’t take much time at all. In case you didn’t know, it doesn’t take long to play eeny-meeny-miney-mo on multiple choice questions that may as well be written in a completely different language. At some point I should probably learn what pleiotrophism is, since it was a choice for almost every question.

I finished in 45 minutes, not just feeling like I hadn’t done well, but rather knowing that I have failed it. I know that I have cried wolf enough times that none of you really believe me when I saw that I failed, but I can assure you that without a curve, I did not pass that test. I did know even a single answer.

It was my fault, I could’ve studied more. But I reached a point and I made a choice. 6 exams in 5 days is hard, especially with classes in between tests and a 6 month old especially ugly headache. Now I have to wait and see if all my classmates did as poorly as they said and what the curve looks like.

But the reason I’m blogging about it at at all is because even though I failed a test, I’m not dwelling on it. I’m not letting it get me down.

Tonight, despite an astoundingly awful headache, I am celebrating 2 things:
1. I have 3 weeks to rest, see my family and did I mention rest?
2. I’m caught up. I have learned all the information I missed from the first half of this semester, a feat that I truly wasn’t sure was possible. I missed more than 1/3 of the first half of the semester and aside from this one test, I believe I passed.

It may not seem like much, the act of catching up and making Cs on exams, but it feels like I ran a marathon. I am exhausted, I am worn down, but I managed to do what people thought I couldn’t. And this feeling is worth more than any grade I could’ve possibly earned on a test.

I have regrets unrelated to the tests, which I’m sure will find their way into writing soon, but for now, I’m just feeling proud. And really, really tired.

I may or may not have mentioned that I have 6 midterms and a presentation this week alone. It’s not pretty. It’s really really really not pretty.

I’ve gotten roughly 10 hours of sleep in the past two nights and while the first test went pretty well, the second one was a total mindfuck. Everyone seemed equally upset by it, so that’s a good sign. But you just never want to walk out of an exam feeling like you were defeated by a packet of paper. And dude, I totally was today.

When it comes to tests, I am crazy superstitious. I have routines that must be kept, otherwise in the totally irrational part of my brain I just know that I’m going to fail. I’m sure that few, if any, of these things make a difference, but I’ve never claimed to not be totally batshit crazy.

The routine begins the night before. I always sleep in a shirt from my school. It can be any color or style, but it HAS to be a school shirt. No school shirt, no sleeping.

When I get dressed the morning of the exam the outfit is entirely crafted out of superstition.

First, the underwear. Yea, that’s right, I have exam underwear. I just happen to have 5 pairs of them (in different colors), so I don’t even have to do laundry during exam week. I am nothing if not a planner. I also may or may not believe that one color of the 5 is slightly less effective than the others. I tend to wear those on the days when I feel the most confident. You know, when I don’t need to pull my luck from my underwear.

Then, the shirt for the exam has to be yet another school shirt. And if I’m layering and putting on a sweatshirt, it also has to be a school one. The pants have to be sweats. There can be no jeans when you’re sitting and freaking the hell out for at least 2 hours. Just no. And unless it’s raining, the black reef flip flops. Always.

When I leave for school, I have a playlist to listen to on my drive. It has to be played as loudly as possible and I have to sing. I think it works by distracting me from the gigantic mental breakdown that’s usually rapidly approaching. And the last song on the playlist has to be the same one. This varies over time and since my current obsession is Glee, my last song is always “Keep Holding On” on the highest volume I can manage. If I can’t listen to that before the exam, I feel unprepared and unfocused.

And finally, the writing implement is and always has been the passing pencil. It’s a really worn out blue mechanical pencil with a separate clicky blue eraser that I’ve used on every test for as long as I can remember. I have proven the efficacy of the passing pencil by not using it on a number of quizzes upon which I have set low grade records (23% for. the. win.). And if the passing pencil ever runs out of lead in the middle of an exam, the world might literally stop turning.

Rationally, I doubt any of these things help, but irrationally, which, let’s be honest, is how I operate, I need things to be just so. No, I’m not a control freak, why do you ask?

But surely these aren’t the craziest superstitions, right? Feel free to suggest any that might be useful in the remaining 3 days of mind draining exam filled psychosis. I’ll try anything. Even studying.