The White Coat

I'm a very symbolic person.  I like to pepper my life with little hints of symbolism, sort of like Gus's affinity for living his life in metaphors in The Fault in Our Stars by John Green.  For instance, my cousin's favorite color was purple, and when she died, the fact that she loved purple was very glorified (as you do when people die).  Everything that was involved with her was purple, and purple became a very comforting color for me.  When I bought my suit for my interviews I got a purple top to wear with it, and any day I was feeling like I would need a little something extra that day I wore purple.  Also, every medical school interview I went on I had my Hunger Games Mokingjay pin on hidden under the ruffled part of my shirt.  The Mokingjay pin was a symbol of defiance and strength in the series, and that was something I wanted embedded to my person as I went on these interviews.

As you can probably guess, what I wore to the White Coat ceremony was riddled with symbols, and everything I was wearing was worn for a reason.  I may not be a writer, but I like doing things for reasons, even if no one really knows about it.  I wore the nicest dress in my closest, you could say as a symbol of wealth, but it was mostly because I just like looking nice and getting dressed up.  Also it was dark blue, one of the University of Pittsburgh's colors.  I find that I have a lot of Pitt and Pittsburgh pride now that I'm not in it (so it always goes).  I wore my best, and hottest, pair of heels.  For two reasons, another one of those I really like to dress to the nine's when I can, but more because I bought those shoes at a second hand store in Portland when I came up for my interview at UNECOM.  I had on earrings that my younger sister bought me and I wore my late grandma's fur coat, as another way to have my family close to me even when they are far away (or dead).

White Coat was awesome--and I mean that in the real definition of awesome way, not the "oh that shit was awesome" type of awesome.  I couldn't help but get emotional as I was sitting there listening to all the speakers and watching my classmates get coated and think of all of the people who helped me get there.  I am indebted to my best friend and former roommate, Meg, who was my rock during the whole application process.  We were both applying at the same time so we were able to be each other's cheerleaders when we needed it.  She was there for me on those days when I felt like all my trouble and hard work would be for naught, like the day I came home fuming mad because my professor told me I should find something else to do with my life because I'm not going to be a doctor with my stutter, and as soon as I started telling her the story I dissolved into tears and waves of "Am I doing all this for nothing?" feelings came crashing over me, but it was Meg who told me that was ONE person's opinion and clearly that woman doesn't have any idea who she's talking about because I'm going to be a great doctor.

I am indebted to my stuttering friends in Pittsburgh who showed me how to live a life with a stutter.  It is thanks to Seth and Sara (and the many others) that I even started to think that you could be happy and have a stutter.  Anytime I was with either Seth or Sara or a group of stutterers out in the real world (as opposed to our NSA meetings) I always felt so empowered, sitting in a coffee shop with a bunch of "normal" speakers around us as we chatted away while stuttering.  It always made me wish I lived in a world where stuttering was the normal, or on an island populated by only people who stutter.

Mostly I am indebted to my parents.  To my dad, who always works so hard to support me and my dreams financially, and who is so proud to say he has a daughter in medical school (and I know he loves bragging about it).  I inherited his drive and work ethic and it's thanks to all of that I was sitting in that chair at white coat thinking all of these thoughts.  To my mom, who maybe doesn't always understand everything that I do or I like, but is proud as hell of me and always there for me when I need her (and especially when I need her to move me somewhere).

As I was sitting in white coat I was just very happy--feel in it in your stomach happy.  It's one of the many "I did it!" moments that I'm going to have in this life- like the first acceptance letter I got (unsurprisingly, UNECOM), and walking out of my clinical practical having spoken at least 95% fluent during the full 45 minutes, and I'm excited to keep having them.  I'm excited to live in this medical life and be around medical people.  Also during white coat, I kept thinking about the time Meg, Russell, Sean and I were out one night in Pittsburgh getting dinner and drinks and we got Sean talking about his work and he was telling us about Ulcerative Colitis and Meg, Russell, and I (med school applicant, med student, and med school applicant) were ALL sitting on the EDGE of our seats while Sean (surgery resident) talked about ulcerative colitis..ULCERATIVE COLITIS! Of all the things we could be interested in we were FASCINATED with UC! Not a pretty disease! It was hilarious because we were all so into it and asking so many questions because we love and thirst that knowledge.  That might be one of my favorite memories from this past year.  I just loved that I found people who were as into medicine and the science behind it as I am, not because they have to know the information for a test, but because they are honest to god interested in how the body works.  Of course, now they are all hundreds of miles away from me-which is the one drawback to this profession-the constant leaving that happens--but that, my dear friends is another blog for another day.

These are always SO SAPPY.  I promise I am also a very fun person, I just apparently can't write anything unless it drips with feeling.  Here's a picture of me at white coat to unsappify this-- (maybe my favorite picture ever of me)

The Culture of Osteopathy

--Disclaimer: I started writing this on Sunday (Sept 22) night, but then got tired and wanted to go to bed and wasn't feeling inspired enough to finish it until today.  I'm too lazy to go back and fix all the dates of stuff, so pretend it's Sunday.--

I mentioned in my last post how I was elected as one of my class's student representatives, well I then also decided to be on the SGA(Student Government Association)  E-board as the Public Relations Officer.  To be honest, I had no idea what E-board even stood for or meant (Executive Board), but I knew that I wanted to be as involved with school as I can and the main responsibility that came along with the title was to take care of the website, and since my tag line is- "I'm good at the internet." I thought, why not?

Because I'm a member of the SGA E-board, I had the opportunity to have dinner with the President of the American Osteopathic Association (AOA), his wife, Dean Kelley (our Dean of Constitutive Services), and all the student leaders of the SGA and SOMA (Student Osteopathic Medical Association) tonight and it was a really amazing dinner.  Besides the fact that the food was delicious and the restaurant we went to was beautiful (I devoured my entire meal of scallops, green beans, and mashed potatoes), hearing Dr. Vinn talk about osteopathy and the culture of osteopathic medicine really made me think.

I think it's very fair to say that a decent number of us students of osteopathic medicine got into osteopathy not really knowing exactly what it is.  Sure, we knew it was an approach to medicine that was more about the whole body and finding health instead of focusing on disease, but what does that really mean?  I still struggle with trying to explain exactly what me becoming a DO instead of an MD really means to my friends and family, but hearing Dr. Vinn's answer to what being an osteopathic physician means to him just reaffirmed once again that this is exactly what I want to be doing.

He stressed that being an osteopathic physician is being apart of a family. It's about connecting.  It's about connecting to our patients and our colleagues and caring about one another.  It's about helping each other out.  It's about seeing people and patients as complex beings and being cognizant of more than just what is wrong with them.  It's about touch.  It's about physical touch, it's about emotional touch.  It's about so much more than getting a history, running some labs, and diagnosing the patient and sending them on their way to keep wandering around in the darkness while they look for health as they circle around disease.  It's about the connection.

After almost two months of being here I already see how the osteopathic touch is really an incredible asset in medicine.  The first time we learned the real OMM (OMM stands for Osteopathic Manipulative Medicine - which is where we use our hands to introduce health into the patients body by working their musculoskeletal system ...I'm still working on my definitions for things to make it easy to really understand what we do)..but the first time we learned the real good OMM techniques we all left class feeling AMAZING.  Actually, half of our class have OMM on Wednesday and the other half have it on Thursday -- I have it on Thursday, and Wednesday night I ran into some friends at the local coffee shop who were raving about the OMM class and how great they all felt after having spent three hours practicing on each other in class. They were right.  We were learning a lot of techniques that worked out problems in the neck and back area and I left class, changed out of my sportswear, and texted my partner I was working with that day how I felt like I could actually breathe better.  Which is a HUGE deal for me.  I do not have great lung capacity,  ask my cardiologist, ask my speech therapist--they will tell you.  Also, this may or may not be related but anatomically I have two left lungs. Add in the fact that my spine is fused together and you can see how I clearly don't have a lot of movement in my back area, and I really felt the difference when I left class.

But it's not just that.  It's the fact that osteopathic medicine is all about that physical connection with the patient.  There is a really big problem of depression and mental illnesses in our society and it's because we don't touch and connect with each other.  We're all so scared of showing affection, but we are literally killing ourselves because we're depriving ourselves of that human connection.  Dr. Vinn said tonight that DOs are huggers, and they are! I noticed that it's in his nature to touch people when he's talking to them, a gentle hand on the shoulder to show them he's listening.  I think more behavior like that could really help people out.

I just really loved what he said about the osteopathic culture being a family.  I already feel like my class and the school act like a family.  We have weekly Sunday dinners and on Saturday we got a group together to go apple picking and it sort of made me laugh because while there were about 15 of us who went, we wanted to all stick together as a group and not split up into a bunch of little groups. The second years help us out like older siblings and really make school a lot easier with their block reviews and old notes and general advice.  I can walk through the school and first years, seconds years, and even faculty will say hi to me and use my name.  This isn't the kill or be killed environment you're used to from your undergrad--we're all here to help each other out, we're already living the life of an osteopathic physician and I don't think we know it.  I can go up to anyone and ask them for help on a certain subject, I can go into the lunch room by myself but within ten minutes find myself at a table full of medical students, and I can go into a social situation only knowing a few people and come out a few friends richer.  That is what I love about this school, it's a true community, and that is what Dr. Vinn was saying is one of the hallmarks of osteopathic medicine, and luckily for me I found a school that already has that so engrained in it's culture.

In the Mind of a Stutterer Before Speaking

I want to try to keep this blog as a way to keep all of my friends and family back home in the loop with all of the interesting things that happen to me while I'm out in Maine for med school.  I wish I could individually tell everyone all the great stories, but I'm realizing that is way too time consuming so I'm doing the semi-impersonal thing and just writing my feelings for the world to read.

A part of me actually finds it easier to tell personal anecdotes to large groups of people instead of more intimate groups (the only exception here might be a one on one conversations).  About two weeks ago, during our last class on a Friday, we had a lecturer who wanted us to think of something that we don't like that we can't control and to think of what we do to resolve that.  Immediately, my stutter came to mind as a perfect example.  He first wanted us to talk about it in our small groups (our main classroom is set up as a bunch of round tables with 6 chairs at each for members of our small groups so we can do more interactive learning), and then he was going to ask some people to share their thoughts to the class.

My thought process went as follows:

"Man, my stutter is a perfect example of that. I should really share it.  I don't really want to share it with my small group...I want to share it with the whole class.  Wait. That involves speaking into the mic.  I'm pretty sure I've only met about 40% of the class so far... that is a large majority that has no idea that I stutter.  What are they going to do when I start speaking and 0.1 seconds later I hit a block?  What is the professor going to do? I've never met him before, will he realize what is happening? Will he be one of those people that recognizes stuttering or will he be confused? I shouldn't care.  I know I shouldn't care."

I'm mostly silent the whole time my small group is talking this over, and then he starts to ask for volunteers to share.  I'm listening to a few of the examples and getting continually more agitated because of how much I want to speak and how badly I also do NOT want to speak at the same time.

More thoughts rattling through my head:

"I have to do this.  The next time he asks for a volunteer I'm going to raise my hand.  Okay, the NEXT time he asks for a volunteer I'm going to raise my hand.  I can't let this opportunity pass me by.  It is literally the perfect way to actually tell my whole class I stutter in one shot.  I'm not going to do it.  I don't need to.  No, I do need to.  The ONLY reason I'm not doing it is because I'm scared.  I'll be really mad at myself if I miss this opportunity.  No, I'm not doing this."

Then, as someone is talking I realize my heart is racing:

"Woah, what is happening, I'm not even definitely speaking in front of the class and my heart is freaking out.  Damn, not only is it racing, but it's also pounding furiously in my chest.  Okay, this is not great for a person with congenital heart disease.  Shit, I have to calm down.  Okay, take deep breathes.  Deep breathes.  Everything is fine.  I am fine.  Is this working?  Um.. maybe.  It doesn't matter I can't have my heart working this hard.  Fuck, calm down!  When did this even start?  This is annoying.  More deep breaths.  Maybe deeper deep breathes will help.  I think that might be helping a smidge. Okay I have to do this.  My heart is only going to calm down if we move past hearing from volunteers or if I just do it.  I WILL be mad at myself if I don't do this.  Damnit, I have to do this.  I'm going to start out as "Well I stutter."  "Well I stutter"  "Well I stutter"  I don't know what I'll say after that.  Do I even need to say anything else, that seems pretty self explanatory to me.  That is a cop out, don't think like that, tell the story.  Um... something about speaking up in front of people is really hard and I've gotten over it by making myself do it and meeting other stutterers.  Or whatever.  "Well I stutter." I'm going to get stuck on that "W" and then it's going to be terrible.  "Well I stutter."  Okay..next time he asks for a volunteer.  Damnit..okay if he asks for one last volunteer. Okay.. Okay.. here we go.  Putting my hand up.  Cannot turn back now.  Does he see me..my hand is straight up."

My mind finally silences as he points to me.  I ask for the mic from the people at my table, pointedly not looking into anyones eyes, wondering if they are all dumbfounded that I rose my hand to speak.  I put my hand on the button to turn the mic on and begin speaking.

"Well, I st-st-st-st-stutter."  Man my voice is shaky, I sound like I'm near tears.   I don't exactly know what I said after my opening phrase, that was all I had planned and one of the main things that stuck in my memory.  But I realized a lot of what I said were thoughts that I think to myself all the time (you can now see that I think about stuttering and perseverate on phrases way too much for my own good).  I talked a little about how just the act of speaking on that mic is actually terrifying for me but I have to make myself do stuff like this everyday because not speaking hurts worse.  When I said this is terrifying the class erupted (may be an exaggeration) into applause and that made my heart want to swell and burst, in the good way--with feelings.  I really wish I knew more of what I said, I touched on the fact that I have learned things through my stutter and the one way that I cope with it is making myself do frightening things.  By the end, I was elated.  I thought, Wow, I sort of love this.  And the last couple words I said into the mic were with PERFECT technique and I was just so proud of myself, because after the fear was gone I could actually use my speaking tools that are so damn elusive normally and speak in my favorite voice of all time.

That was a defining moment for me.  I will never forget it.  I was suppressing a smile for a good 15 minutes after that.  It was crazy how easy it actually ended up being, how much I loved doing it, but more importantly how amazingly my class responded.  I had mentioned to my speech therapist within the first week of me meeting everyone how really well everyone has been receiving my stutter, more so than I'm used to by a long shot. But then, speaking and stuttering in front of 180 people and them applauding me and getting messages from people afterwards saying how awesome that was, I never in a million years imagined that.  I was on a major life high that whole day.  So much so I decided to run for one of our class reps ! (spoiler alert: I am now one of our class reps)

It's not even just the students.  Every Monday in Anatomy lab we have oral quizzes where one of the faculty members comes around to our little anatomy groups and asks us questions they give out the previous Friday.  I was initially really scared of this, but after the first one and I stuttered my way through it but still explained things decently well, and I started to allow myself to care less about my stutter and just let it be.  Then this Monday, my favorite anatomy professor was quizzing us again (really awesome retired surgeon) and I noticed he didn't really give me a real question and was asking me sort of one word answers, and then right before he left us he asked me to find him after class.  And I did one of my bad habits and tried to spell out a word I was stuck on so I was thinking, damn, I shouldn't have done that I know better than to do that.  But I tried to just put it out of my mind because he's a really nice guy, who knows what he's going to say.

After class he finds me, and I go to walk away with him and he says "Lets just stand over here.  I notice when you get stuck on a stutter you sometimes try to alphabetically get yourself out of it, have you ever tried writing down what you're trying to say?" This is it? Man, this guy is awesome.  We then spent a good 10 minutes talking about neural pathways and Pittsburgh and confidence and he told me the hardest part of medicine for me will be patient interviews and when I'm in residency and everyone decides to act like jerks and ask impossible questions on the spot.  Then he said, "If I could punch anyone in the face who gives you grief about your stutter I would, because your patients are going to see who you are and they are going to LOVE you." I even asked him if he would want me to go over the questions after class so he knows that I know them and he said, "I know that you know them.  I can see it in your eyes.  They dilate when you know the answer.  I know you know the answers."  That, right there, is another reason why my stutter is the coolest thing about me, because one of my best friends from Pittsburgh confirmed that she knew exactly what he was talking about.  My stutter might suck a lot, but if it leads to people noticing little things about me like how my eyes change when I know exactly what I want to say but my mouth won't let it come out, then I think it's actually pretty awesome.

I just cannot believe my good fortune--to go from being told by multiple people I'll never get into medical school with my stutter, I'll never be a doctor if I don't fix my stutter, to a retired surgeon on faculty at a medical school giving me the most incredible boost of confidence after only a handful of (admittedly, awesome) interactions.

 Maine is beautiful, the weather has been awesome.  So much enjoyable outside studying, studying on the beach, the stars!!!  Sure, I have a handful of mosquito bites on my person at all times, but from everything that has happened so far I feel really fortunate to be here, and really glad that life brought me here because I think it's going to be really great for me.  Especially if I keep making myself face my fears.