The Iowa Decision

Hi friends! So I allowed a select few to see my updated school status on Facebook...and chances are that you're reading this because the two lists overlap.

This fall, I am going to attend the University of Iowa Roy J. and Lucille A. Carver College of Medicine. I think most people shorten it to simply UI, Iowa (it's the only medical school in the whole state of Iowa), or Carver College (which also happens to be a Bible college in Georgia). Not sure what I'm going with yet.

The decision was made soon after I departed to vacation in Hawaii. So you can imagine me standing on beautiful tropical beach sand, absentmindedly glancing at sea turtles sunning while on the phone with my dad. It went something like,

Me: Hi Dad! Iowa gave me the Dean's Scholarship today. I think I might take it...
Dad: That is excellent news, Connie. I am very proud of you.
Me: Thanks, Dad. Uhm...I have to go now, we're going snorkeling! Call you later.  

It was a pretty fantastic day. Although not a full ride, the scholarship definitely lightens the heavy burden of impending student loans. And if you were wondering, yes, my father does tend to speak quite formally--he once sent me a text message that started with, "Dear Connie," to invite me to lunch. Those are stories for other times.


Anyways. Then sunk in the realization. That I was going to move to Iowa. And live there. For four years. At least.


Here's what I knew about Iowa when I made the decision: 

1. There are lots of cornfields.
2. It snows in the winter and gets blazing hot in the summer. It also is subject to raging floods and tornadoes.
3. It has a very prestigious ophthalmology program, according to all of the ophthalmologists that I worked for. 
4. The medical school is ranked 28th in the US, right behind the Mayo Clinic.  
5. There are lots of cornfields.

 So...yeah.


When people used to ask me about where I wanted to go to medical school, my only wish was to stay in California. Iowa was never on the list of schools that I could envision myself attending. Although I have strong ties to Iowa through my parents (it was their first US home state), I attended the interview mostly for the novelty. Funny how every time I try to pull something like that, God seems to change my mind completely about my intentions and stir up my comfort zones. Like, really stir them up. With tornadoes and snowstorms. Equally funny is that when I want to settle for one thing, He gives me something better. Like, a scholarship for four years? Are you kidding me! It seems like just yesterday when I felt like medical school was the farthest thing from my grasp. 


Now that I am coming to terms with attending Iowa, at least logistically--I have a roommate, put down a deposit on a terrific apartment for August 1 (Bay Area folks, you won't believe what I'm paying!), am starting to pack things up for a cross-country road trip in my little Corolla--I am trying to find peace in my heart with what my life will become.


The Facebook group and school demographics released online suggest I am going to be one of perhaps four Chinese-American students in the entering class of 140, and one of 40 non-Iowa residents. Having never moved more than 25 miles away from my birthplace of San Francisco, I find these statistics to be mind-boggling. I cannot imagine a school more polar opposite to UC Berkeley. It is both terrifying and intriguing at the same time! Who are my friends going to be? Where will I buy my Asian vegetables? How will I present myself differently to my peers, if at all? I suppose now would be a great time to re-explore all of those cultural-racial-identity issues that IV touched on years ago.


For now, I'd love advice on moving and adapting to another state, or just to chat in general. I have about one month or so of unemployment to enjoy, and would love to hang out as much as I can before I leave!

Accepting an Acceptance

Today, I wondered why God would give someone like me, so indecisive and so fretful, so many options. I tend to like to explore all options before committing to any one. D says this is why I'll be a good surgeon or internist--because I can gather facts and plan accordingly.

But man. I drive myself crazy all. the. time.

I received my fourth acceptance to med school today. For the last two days, I've been scrambling to get my immunizations up to date on short notice before I leave for a trip to Southern California (flight is at 7pm tonight!) and then, Hawaii (!!). Anyone who has ever had a TB test knows that it's a multiple-day process. Which means that I won't be able to meet Cincinnati's deadline. My offer of admission may be suspended or rescinded by the school. As you can imagine, it was incredibly distressing and unsettling to hear those words from the administrative nurse's mouth. I wanted to plead and beg, but refrained. 

After I ranted to a friend about how unreasonable this process has been, how I didn't receive any notice, how horrible this timing has been right before my vacation, I also told her that if I got into Iowa, I would go there. Just to avoid all of this drama!

Exactly one minute later, at 12:36pm, I received an email that I had gotten into the University of Iowa Roy and Lucille Carver College of Medicine.


So...now what? Stay tuned for more first-world premed problems.

How to quit your job graciously

• Give your two weeks' notice, and then refrain from (audibly) counting down the days...even if someone else does it for you.
• Do all the work that is required of you as if you will be held accountable in the weeks to come. Don't go de-alphabetizing the charts now...there's enough of that by accident.
• When patients give you a hard time, just know in your heart and thank the Lord that their follow-up isn't until August.
• Invite everyone to the after-work happy hour that your coworker is planning for you...but actually don't because you don't want it to be a big deal. It's awkward.
• Make everything in the office nice and neat for the following day...just the way you like it, even though you won't be there. 
• Gifts, gifts, gifts! I knew that I wanted to give my coworkers and bosses with tokens of my gratitude. But what to give...? This has been a week-long planning and brainstorming process in which I have spent more than I can afford at six stores (Beverly's, The Container Store, Godiva, L'Occitane en Provence, Papyrus, and Safeway). 

I don't take the best photos and I'm pretty sure you weren't here for my iPhone photography anyway. So just focus on the story, okay?

Couldn't decide on a color scheme, and ironically
ended up with my high school colors for ribbon.

These boxes were 70 cents each. And will
most likely be thrown away immediately.
(I wonder why I bother sometimes.)

The assembled 3x3x3 cube cookie container.

Made a second trip to Beverly's to hunt for doilies.
Seriously...doilies. Even Siri didn't know where
I could get doilies in a 10-mile radius.

Cute right? I wanted--no, NEEDED--to prevent
unsightly butter stains from greasing through
the boxes.

Snickerdoodle, Chocolate Chip, repeat.
Each box snugly fits four freshly baked cookies.

The madness continues with cardstock for
personalized name tags...

After a touch of hot glue gun...TA-DAA!
Repeat 15 times, one for each employee
or employer in my office.

My favorite hand cream for the female doctors! This stuff is
pure luxury. And isn't that an awesome box?

Three identical gifts, because I didn't want to
plays favorites.

Complete with cute thank you cards from Papyrus.
I would not be able to afford these if not for 40% off.

Surprise! They flip this way.

Finally, Godiva for the male doctors. No one can complain
about Godiva, right? I had the sales lady
switch out the ribbon for maximum effect.

Excited to give away these gifts tomorrow! And for Hawaii next week! A new chapter is ending and starting simultaneously...and it's all very scary and exciting and real.

Boundaries Part 1: Patients

Recently, a coworker told me about a patient's husband who made her uncomfortable. He didn't do anything inappropriate, per se. He had merely pulled her aside and told her how much he appreciated her patience and kindness in his wife's care. The tipping point was when he started crying into her shoulder.

Now, many of you are probably thinking, "What's wrong with that?" Isn't one of the great rewards of medicine being able to help people to the point of expressed gratitude? That's probably why many people decide to go into medicine, after all.  

Like my coworker who is wary of these uncomfortable situations, I find that I tend to avoid patients who especially seem to like me.
 
There is one patient, who, due to perhaps our shared ethnicity (and his shared age with my dad...), loves to tap me on the shoulder whenever he sees me for no reason other than to announce that he is here. Instead of writing his name on the sign-in sheet like a normal patient, he taps me on the shoulder or gives a playful nudge. He always asks for me when he calls, even if someone else can take care of the issue. He asks me if I'm wearing a new blouse, or new glasses. And I absolutely dread screening him.

Last week, another patient found out that I am Christian. During my screening, he had shared with me that he's undergone 10 eye surgeries, each one less promising than the last. He told me that he turns to the Lord for comfort and reassurance, and is finding peace in his prognosis of potentially going blind. It was then that I revealed that I too, find great comfort in my faith. We shared in a very poignant moment of appreciation for life. But....ever since then, he has brought literature to the office to give me, invited me to his church so that I can learn to speak in tongues, and wants me to visit him at his home.  Now, I absolutely dread screening him as well.

What do all of these cases have in common? For one, all of the offenders are men. I cannot think of a single woman patient who has complimented me who I would want to avoid. Secondly, all of the patients are nice, but have overstepped professional boundaries. There might also be a physical aspect--the touching, observing, etc. that violates our personal space.


My coworker says we are creeped out because we are young and female. And she's right.

Oh, the agony

Remember how tormented I was about interviewing at Cincinnati, how indecisive I was about going or not? Well...now I am ten times more agonized by my summer vacation plans. I haven't booked a return ticket yet from my marathon trip (San Francisco to Orange County to San Diego to Los Angeles to Hawaii to Los Angeles) which is happening in about four weeks.


Why? Because I am not at peace with my applicant status.


Simply put, I am still waiting for a med school to take me (or not! just tell me! now!)...and this med school happens to start very, very early. Everything hinges on this school--when I will quit work, when I will move away, whether I will need to fly back to California for two weddings, and most pressingly, whether I should hurry back from my vacation or if I can extend it.


I really just don't know. And the part of me that wishes to control these things...well, she's keeping me up at night.

May 15, 2013.

As I wrote my withdrawal letters to medical schools that have accepted me, I was humbled to tears. I wish the committees could know how grateful I am for their willingness to give me a chance. 200 out of 10,500....340 out of 4,944...I am but a measly number in this huge pool of premed hopefuls. And yet, they saw something in me. How is it that God has blessed me so abundantly?

May 15 is bittersweet because with this choice, I may have just set into motion the rest of my life!

Med School Apps By the Numbers

Disclaimer: This probably will bore the pants off of you unless you 1) applied to med school yourself--in which case you don't care, or 2) are applying this upcoming cycle and need guidance. People have asked me privately for all sorts of advice (which I will still happily give) so I thought I'd lay out a concise summary of my experience, at least logistically.

I can be like a person possessed when it comes to meeting self-imposed deadlines. So...do what you will with this information. Good luck!
 

CONNIE'S TIMELINE:

05/01/2012: AMCAS primary available online 
06/08/2012: date of AMCAS primary submission
06/18/2012: date AMCAS received my last transcript (green light for verification)
07/02/2012: date of first secondary application in my inbox (note: unscreened) 
07/12/2012: date AMCAS completed verification*
07/27/2012: date AMCAS received letters of recommendation
08/10/2012: date of last secondary submitted
09/11/2012: date of first interview  
10/16/2012: date of first acceptance
02/22/2013: date of last interview
03/06/2013: date of last acceptance  
03/2012: month of wait lists
05/15/2013: magical date in which all applicants must give up all but one acceptance. So don't ask me where I'm going before this date.

*Note that there was a 1-month lag from the time I had all my primary app components in order and the actual verification by the Powers That Be. In that 1 month, all I did was work at The Office and watch Netflix. I didn't even think about the application. D submitted his application a few days after I did, and his application wasn't verified until a few weeks later. Translation: days you wait = weeks they make you wait. 


Okay, more numbers.


$7,500 spent on applications and interviews this cycle
7 letters of recommendation in my committee letter packet
2 months' notice for my professors to write a letter  
33 secondaries completed
38 days spent writing secondaries
9 interview invitations (5 public, 4 private)
2 interviews declined
1 Multiple Mini Interview
11am-4pm (PST): shortest interview day
8am-4pm (EST): longest interview day
3 accepted schools  
2 wait listed schools
2 schools still in limbo as of today
0 UCs interested in me (harhar)
#11, 12, 13: application submission order of my three accepted schools (coincidence..?)

2,874 miles separate farthest accepted school from home
2,064 miles separate closest accepted school from home


If there's anything else you'd like to know or that I forgot (the application process sure is getting hazy), email or message me. Good luck!

"Good" patients versus "Bad" patients

In my four years combined of volunteering in a hospital setting and working at a private practice, I've mentally compiled a list of attributes that determine what constitutes a "good" patient versus a "bad" patient. "Good" patients make a practitioner's job easy, whereas "bad" patients can tax an office staff's time and resources. Obviously patients run the gamut, and these aren't based on any single person....some attributes are even oversimplifications. In these months leading up to starting medical school, I've been ruminating on what I'm getting into for supposedly, the rest of my life.

“Good” patients Are at least somewhat educated Follow directions Speak the same language as you Can afford brand-name medications Have good insurance plans or are able to pay out of pocket Don’t mind waiting up to an hour for an appointment Respect the doctor and staff Are appreciative  Are understanding of human errors Ask good questions Volunteer information that may be indirectly pertinent to care Make appointments and keep them Have positive attitudes and are grateful for care Trust the doctor’s advice and are willing to consider treatment options Bring the office staff treats

“Bad” patients Have low levels of education Have poor compliance Speak a different language from you Cannot afford medications, or purchase questionable meds from unverified international or online retailers Have insurance plans that don’t cover services completely or limit visits Threaten to leave if not seen immediately upon arrival   Are litigious Don’t ask questions even if something is obviously wrong Withhold information or are bad historians Forget appointments and then demand to be squeezed in on busy days Have a “this is a waste of time” attitude Ignores the doctor’s advice and gets defensive about health Bring their poorly behaved children

Any Way the Wind Blows

March is not only a long month with no holidays, but also signifies the beginning of the end of the medical school application cycle. Typically, schools stop interviewing in March. So when I got news that my last California school--also my dream school--was a no-go, I was disappointed, but not surprised. It was the last school on my spreadsheet that I cared about. I went to work in a glum mood yesterday, but Russian Lady Technician told me, "Vat should we do, zis is life."


My mom had a similar reaction to me, but with much more theatrics. She was anguished that I most likely will not attend a med school in California. She wondered if things would be different if I had gone away to Johns Hopkins for undergrad; perhaps then I would've gotten into a UC for medicine. Or maybe if I had taken that full scholarship to another "easier" UC, my GPA wouldn't have been "Berkeley low," and then I could have had a better shot. My dad scoffed and said that she watches too many Korean dramas and thus lives in an alternate fantasy land.


As I was listening to her musings and what-ifs, anger and bitterness started to bubble up inside of me. I asked her why it wasn't enough that I worked hard in college, made straight As in several semesters, and still lived a well-rounded life. Why wasn't it enough that I have been invited to interview at nine schools? Why wasn't it enough that I have three acceptances so far? When will it ever be enough for her?


My mom replied that she wasn't criticizing me, but only wanted me near to her. I told her that I appreciate that, but I've lived in the Bay Area my entire life of twenty-four years. Medicine is something that I've always wanted to pursue despite my parents. They've tried to dissuade me because it's hard work and a long road, and they want to see me live an easy life. But for once, this is something that I am doing for me. I might not end up in California in the Fall, but maybe the change will be good. 

 
I told my bestie yesterday that I am scared of picking the wrong med school. I never thought that I would actually have options, and now that I do, it is terrifying.

Med School Interview #7 | Almost didn't go

When I got invited to interview in Cincinnati last week, I scoffed and said no immediately. What the heck is in Cincinnati? The Red Sox, right? Right?


Then I thought about it some more, and then I said yes. My colead S from Highland is interviewing on the same day, UC is a pretty good (public!) school, and the interview is in MMI format instead of the traditional one-on-one (oooh exciting)! Then I thought some more, and then I said no again. A plane ticket is $565! I have to miss two days of work! I have to fill out a tertiary application?! Heck no no no.


And after a series of events ($260 plane ticket!) and more thinking, I took the plunge. So here I am. These have been some of the most indecisive days of my life.


It's strange to think that just last night I was having a nice romantic dinner with the boyfriend in the city. As usual, I ordered mussels and Danny filled up on bread with balsamic vinegar and olive oil. Always an enjoyable experience at Cafe de la Presse!

 

Two planes later, I'm in Ohio for the third time on my interviews trail. Why can't California show me this kind of love?    

Six days of different weather.
Is that HAIL on the forecast for tomorrow..?

The hotel that I'm staying at is on the medical campus. In fact, it's where relatives of patients can stay while their family members are undergoing procedures, or in my case, where students stay during their interviews. In all honesty, this place is creepy. Down the hallway from my room is a Sleep Disorder Center, and when I was trying to find a vending machine for water, I stumbled upon a dirty utility room just like the ones we have at Highland. I guess this place is first and foremost a hospital and not a hotel.

After interview season wraps up and final decisions are made in May or June, I'll write a post about interview content, impressions, etc.--stay tuned!

Whine

My day started off with a BART equipment malfunction that caused me to scramble off the BART at 7:09am two stops before my own. I was the only one opening up The Office this morning. I literally ran one mile down Market Street in Downtown San Francisco in my work shoes, jumping over puddles and tripping over homeless people. So much for getting coffee before work.


I'm covering for two other coworkers this week, which means more work and less time to do it. I've also been sort of sick this week, but am pressured to keep coming in because no one else can make it.


At 7:22am (and only 5 minutes late, I might add!), breathless and sweaty, I opened the doors, turned off the alarm system, put on my white coat, and started seeing patients in an empty building by myself. But of course, the patients can't know that.


At 7:40am, the doctor arrived and saw the office in a state of disarray. She asked why I was the only one on duty--screening patients, doing eye scans, answering phones, making appointments. That is a question I ask myself all the time.


At 10:00am, I stapled my finger under my nail (how does that even happen?).


At 1:08pm, I ate lunch after working nonstop for nearly 6 hours. On lunch, I'm called several times to do other things. I regret not stepping out for McDonald's.


At 2:25pm, I got three paper cuts across my knuckles.


At 3:40pm, I was getting ready to leave when a call came in. My coworker asked me to take it even though I was on my way out. It turned out to be a patient calling with complications and unusual bleeding from a surgery. I scrambled to follow up and take symptoms.


At 3:45pm, I called the operating doctor to relay the symptoms. At 3:45 also, I was yelled at because the doctor didn't want to be disturbed.


At 3:48pm, the doctor called and apologized.


At 4:00pm, I went home. I still regret not getting McDonald's.


So...who wants to work at The Office with me? We're currently hiring.

Med School Interview #6: Good Ol' California

I'm blogging from sunny Southern California! Only it's not sunny at all. In fact, the weather may be rainier than in the Bay Area right now. Oh well. 

Danny and I interviewed at Loma Linda University School of Medicine a couple of days ago. It was a good experience. I enjoyed the school's Christian mission and approach to medicine. Also, it was my first interview that started at a later hour--11am!--and there was no compounding time difference to make me extra sleepy (8am EST was terrible to wake up for every time). Hurray California! 

Just a quick story: on my way to my faculty interview at the medical center, I stopped and asked a girl for directions. A suited man speeding past stopped and said, "Interview? Let me take you!" I thought he might be on the admissions committee or something, but turns out he was just a really helpful doctor. We wandered around lost for several floors, and on the way he introduced me to his residents and told me stories. Eventually we made it--a little flustered and out of breath, but I was grateful nonetheless. If I hadn't been in such a time crunch to make a good impression with my faculty interviewer, I would've liked to chat with him more.

Morning rain

Glad I wore pants and not a skirt

Desert oasis / Good Samaritan sculpture

It also felt great to meander around campus at a leisurely pace after the interview instead of taking a cab to the airport right away. Danny and I took advantage of the Southern California traffic on the way back to debrief our interviews. I'm glad we had the opportunity to experience this together.

Quite simply, I've been avoiding going back to The Hospital.

Around the time that interviews started this Fall, making the trip across the Bay became less and less frequent for me. Ironically (even hypocritically), my personal statement for medical school is about riding the shuttle to The Hospital.


Over the last three years, as my colleagues stopped volunteering for personal, work, or professional reasons, I always maintained that I would faithfully serve until I moved away for medical school. I sacrificed much to be at The Hospital as an undergrad at Berkeley. And even when I regularly showed up an hour late to Large Group, having not eaten dinner, exhausted and soaked from walking in the rain, I knew God's calling for me was to serve in this way. It has changed my life forever. And I loved it. I've probably logged over 1,000 hours volunteering, but I helped to implement the electronic tracking system some time during my second year, so I guess we'll never know. 


This past summer, the weariness started to set in. I simply saw one too many broken bodies and broken lives in the Emergency Department (I recall one particular car accident on one particular day caused me to burst into tears). And that was that. I reluctantly put away my scrubs and said goodbye to serving the community I loved, so entrenched in drugs, poverty, violence, and abuse....until I joined the Pain Clinic at The Hospital. I figured that it would be a good way to cling to my conviction of serving the same people, only in a less traumatic and less heart-wrenching way.


At the Pain Clinic, I told myself it was the boredom. I wasn't needed there. Being needed is the number one reason why I do anything in life, and without it, I feel purposeless. At the Pain Clinic, it didn't matter if I showed up or not, there was nothing for me to contribute. The doctor didn't remember my name even after six months. He would always--not very inconspicuously--sneak a peek at my name badge during the morning meetings, and if my badge was obscured, I would just be Hello there.


In some ways, being at the Pain Clinic was more heart-wrenching than being in the Emergency Department. The ED was a beacon of hope and brimming with life-saving bustle. The Pain Clinic was an experimental dose of maybe-this-will-help, and the patients must live with persistent suffering from chronic pain. I found ambulatory care boring and uninvolved. When my interviews for medical school started in the fall, I was happy to fade away without anyone noticing.


I haven't been to The Hospital in months, due in part to a flu shot technicality. But the day has come. Tomorrow, I am going in to inform Boss Man that I am not coming back, for good. It feels strange to me that I will be boarding the shuttle tomorrow (does it still run?) just like I did all of those years, but am actually quite nervous. How strange it is for me to return to a routine once familiar, and now so dreaded. I am mourning the loss of a big part of my life, much like when I graduated college and left IV. But new beginnings occur when we least expect them, right?


I'm bringing Boss Man some lemon bundt cake.

Med School Interview #5: The Homeland (part 1)

Once upon a time, two students immigrated separately from Taiwan to a little town in the middle of the United States for graduate school. They met and got married and had a little boy after obtaining their degrees. They enjoyed viewing drive-through movies and having ice cream at the Dairy Queen.


Those grad students were my parents, and that little town was Waterloo, Iowa.

And here I am, interviewing! This is my first time setting foot on my parents' first real US hometown. Last night, I stayed at a hotel the first night near the school that served freshly baked cookies and coffee 24/7 in the lobby.


For the rest of the weekend, I am staying with my mom's host family: Grandpa Clifford (who my older brother is named after), Grandma Marcie, and Auntie Vickie (where my middle name is from). Auntie Vickie actually stood in the delivery room with my mom when she gave birth to my brother, since my dad was already in San Francisco by then--they're the family that always mailed us birthday, Christmas, and graduation cards without fail. Even though I've only met them once when I was probably 9 years old, I am a now guest at their spacious home!

This is the downstairs floor, which I have to myself.

They are just about the nicest people in the world. Meet the family!

L to R: Auntie Vickie, me (surprise!), Grandma Marcie,
Grandpa Clifford, Cousin Brooke and husband Drew,
and Julie (Drew's mom)

Can't forget this cutie, Trinket. She snuggled and licked my hand the entire 2 hour car ride from Iowa City to Cedar Falls. My host family declared that Trinket loves me as much as they do. 



We had a "soup supper" at Julie's house. It was delicious. Afterwards, we went to a "dessert theater" which is hosted by a local church group. The title of the play was "Toys in the Attic," and featured dessert. I chose the caramel macchiato cheesecake. Mmm.

L to R: Byron (Auntie Vickie's husband), Auntie Vickie, Cousin Brooke,
me, Grandma Marcie, and Grandpa Clifford). 

And man, it was SO HARD packing for this trip. Let's face it, people in California dress a certain way (San Francisco, I'm looking at you). Other than my interview suit, pounds of See's Candies, scarves, and other gifts for my host family, I had to actually pack clothes that are presentable to Midwesterners AND warm enough. I even bought a pair of riding boots right before I flew out to trot around comfortably on the Trent Farm.

Stay tuned for farm explorations tomorrow! 

Med School Interview #4: Into the Storm

To be honest, I wasn't thrilled about this last interview. Not because the school isn't great academically (it is) or that it's expensive (it's public!) but because I am simply tired of traveling. Flying toward the east coast also distressed me because of the hurricane. To top it off, I had a record number of flight connections in these 24 hours because let's face it, I don't work enough hours to upgrade to direct flights. I'm missing work as we speak.

So here I am, sitting at ironically storm-free LAX waiting for my last leg, a delayed flight home. I haven't had dinner in 2 days and am looking at photos of the Giants and Halloween festivities and munching on a sad apple. My only solace is that my boss said it's okay if I don't come into work tomorrow. Oh, and that I guess my interview went as well as it could have.

I'm going to read now...I started a 600-page book 12 hours ago and am almost done.


UPDATE: It is now 2:20am. I just got home to rainy San Francisco after traveling for 14.5 hours. I'm going to stay in bed with a cup of tea tomorrow. I mean today.

Med School Interview #3: Californians really are nicer

Every time I've ever met someone not from California, I'm asked a bunch of the same questions or told a bunch of the same statements as if they were fact. In Virginia several years ago, I was known as the girl who said "dude" far too many times. In Saint Louis, someone asked me if I surfed, and if that was why I was so tan. 

Yesterday in Philadelphia, my fellow non-Californian interviewers agreed amongst themselves that Californians are "laid back," "mellow," "nicer," and "like to mosey."

Uhm....what? Hahahaha. Okay.

(On a side note, I just wanted to add in there that non-Californians have it easy when applying to medical school. It's no secret that on average, Californians apply to more schools. I rolled my eyes when a girl said she applied to "Wayyy too many schools--13!" to which I said, "Uhm. Try 33." How's that for "likes to mosey," EH?)

I found that I missed the Bay Area terribly when I got to Philadelphia. Just look at this. 

The SEPTA is like a web...of lies. It was quite frankly a nightmare to navigate.

Maybe it's because Philadelphia is one of the great historical cities, but the subway system is so old school. A conductor walks down the aisles and hole punches paper sheets while whipping out giant wads of cash to make change. The floor is littered with tiny punched-out tickets. A conductor walks down each aisle to call out each stop as the metal doors jangle open and riders leap across the gap. I missed BART in all of its shiny linearity and automated machinery. People in Philly don't make eye contact, nor do they smile or stop walking when you say, "Excuse me, how do I transfer from the airport line to the broad line?"

This photo was taken by a homeless man who promised
he wouldn't run off with my camera. Beside us are protestors.

I stayed with my friend C who used to go to my home church in SF once upon a time, and it was great. We ate at a pizzaria somewhere after walking dozens of blocks around the city. I toted my suitcase on the uneven pavement and sometimes sewage-y streets. Good thing I packed only essentials. I was on high alert after night fell, and my spiking adrenaline levels caused me to be really gross and sticky in that skyscraper-dense area. 


Since the school that I interviewed at was in a rough neighborhood, there was tight security into the building. I had my driver's license scanned and my photo taken on a fancy computer:

Dang my picture came out so well. I was worried my smile was too wide.

Pretty illuminated microbial pathogens. Mmm.
Ambient lighting for sure.

Anyways. I missed the Bay Area a lot after this one. I'm grateful that my friend C took me in after my student host plans fell through. During the interview day, the four other Berkelians (ranging from c/o 2001-2012) and I high-fived and GO BEARS'd and then I felt more at home.

In an anticlimactic turn of events

I was accepted to medical school on Tuesday, October 16. When I turned off my iPhone alarm in the morning after landing from Cleveland, I checked my email in one fell swoop...I love being able to do that. And there it was in the subject line--"Saint Louis Acceptance." I turned over and went back to sleep. I didn't even read the rest of the email. I later texted my two brothers and waited for my parents to come home from work to tell them in person. My dad hugged me and said something about being the second "Dr. Chen" in the family but the first MD, and my mom said, "Oh, good," as she unloaded groceries. 


It hasn't hit me yet. I guess. Probably. Maybe. Eh.


Mostly because I am still in the thick of interviewing. If I only knew right now that SLU is the only place that accepted me, then I would make peace and start to plan for attending next fall. But I am still waiting on 23 (!) schools to get back to me...and that is a lot of hope spread over a lot of schools...and a lot of time. The secondary application cycle hasn't even closed yet.


Three years ago, an adviser told me that no medical school would ever consider me. I cried that night at Large Group, sitting on the floor in the aisle of Evans, as the worship team played. A friend on the prayer team interceded for me, and I'm pretty sure my noisy, messy sobs embarrassed him and everyone within earshot. He asked me, "Do you believe that adviser, or do you believe that God can redeem?" I sure as heck didn't want to believe the adviser, but I wasn't sure I believed God could redeem my mediocre grades and now, shattered self-esteem and broken dreams.


But He has. And oh, He has.


These last years have been a slow buildup to showing me His mercy and kindness and goodness. These last years have been a tumultuous battle against my own fears and insecurities, of number crunching and what ifs...and this is just a small instance of how He conquers. Yes, getting into medical school is just a small instance! It doesn't end here, I'm certain of it. And this is why it has been anticlimactic--because this isn't a peak that overshadows other achievements. It's merely another step in this journey that will cause me to need Him more and more.   

Med School Interview #2

What's the difference between my first interview and the second?

1. iPhone
2. the boyfriend
3. rainy weather
4. Northface Jacket

On Saturday, D and I traveled to Cleveland, Ohio together for the first time before dawn cracked on the West Coast. We entertained ourselves with napping for four hours on the plane, singing songs, and mimicking each other. We also watched 30 minutes of Up before our connecting flight from Chicago to Cleveland landed....in which I cried at the vignette of Mr. Fredrickson and his wife.

We were also blessed to have

5. Mike
6. Esther

Mike hosted D, and Esther hosted me oh so graciously. D and I had nice weekend frolicking at various Cleveland attractions. It was so great! I loved Case Western and the surrounding area. The actual interview day was interesting and action-filled. We were at the school from 8am-4pm! D and I were exhausted from waking up at 4am-5am PST this whole weekend. Too bad we don't have any pictures in our power suits.

It's all in God's hands now!

OREX: the conclusion

Remember how excited I was one year ago about OREX at The Hospital? Well, I missed my last surgery observation day a couple of weeks ago, and I'm missing the final meeting on Saturday due to a pesky medical school interview. Oh well! 


OREX has been really amazing. But honestly, on many days, I didn't feel like waking up at 5am to bus to The Hospital in darkness--my safety feels threatened as it is in the daylight. I didn't feel like standing stiffly for 3, 4, 5, 6 hours in refrigerator-like operating rooms and smelling my own breath under my surgical mask. I didn't feel like hiding invisibly in the corner for fear of disrupting that magical surgical flow....or touching anything sterile that will potentially have serious consequences. But man. What a great opportunity. I will admit that even before I started volunteering at The Hospital, I had my sights set on being one of those 15 people who get to stand bedside in that operating room floor. I tried my best to not squander that privilege, or let my hunger, impatience, or desire to sleep in dilute my experience. 


I read through a lot of my old OREX forum submissions in preparation for said interview, and wanted to share a couple with you. I've changed the names, but everything else I left in gory detail. Read on if you're into that kind of stuff! :)


FESS-- “Functional Endoscopic Sinus Surgery”

Dr. McDonald was performing a FESS procedure on a middle-aged male patient with polyps in his sinus cavity and a deviated septum. The procedure is done with a probe camera, and so it was very clear and easy to see on screen, just as Dr. McDonald had promised. He started with inserting the camera into the nose, past the nose hair forest, and it revealed many grayish blobs in the nasal cavity. These are polyps, or abnormal growths in the mucous membrane. They were simple to remove: a long device was simply inserted and clamped around the base of the polyp to pull it out of the nose. The motion was really as simple as clamping and yanking. Some bleeding ensued, but the blood was staunched later with packing of gauze after all polyps were removed. I’m normally not squeamish, but when Dr. McDonald dangled an especially large 2-inch blob of mucous-dripping tissue near my face, I had to turn away for just a minute. A microdebrider called "the hummer" was used to cut away excess tissue around the sinuses to further open the airway. I marveled at how clear the sinuses looked after removing about a dozen polyps from the man’s sinus cavities, and how in the world he managed to breathe before the procedure.

Laparoscopic superovarian cystectomy and partial hysterectomy

The patient was a 44-year old woman who had a right ovarian cyst that measured 7cm in diameter, heavy menstrual bleeding, and uterine fibroids. Dr. Do explained that the woman would need to have her uterus, cervix, and fallopian tubes removed, but ovaries intact. She said that they didn’t want to induce early menopause in the woman and have to resort to estrogen therapy sooner than necessary. With patient in stirrups on the table, an incision was made in the belly button and widened by wedging metal prongs. The special camera was then inserted and just as images of adipose tissue and underlying tissues were showing up on the screen, everything was shut down abruptly. I asked Dr. Do what was going on, and she said that the nature of the cyst made laparoscopic surgery too risky, and an open cystectomy had to be performed. It turns out that the cyst was an endometrioma, or “chocolate cyst.” This occurs when the endometrial lining that is normally in the uterine wall and sloughs off during menses forms an outpocketing elsewhere, and thus the blood pools within in a membrane without being drained. The result is a dark brown-colored fluid-filled cyst.

A longincision was made in above the pubic line, and a circular metal retractor was used to hold open a space of about six inches in diameter. The plan was to drain and excise the cyst without touching the ovaries. Eventually 300 mL of brownish fluid was drained and its jellylike membrane was removed. Occasionally, Dr. Do would ask the anesthesiologist if the urine was clear or not--this was because the area of interest is very close to the bladder and ureters, and if it were disrupted, blood would appear in the urine. Luckily, there were no complications at this point. Two hours later, the uterus had been carefully sutured around and removed as well. It came out in three pieces--the apple-sized fundus (body), the smaller neck, and the cervix, a coin-sized, whitish donut of a specimen. The left fallopian tube was also removed, as were many little cysts that looked like clear yellow vitamin E tablets. Dr. Do later had me put on gloves to palpate the pieces in formaldehyde solution before they got sent to pathology lab, and it was neat. 

Dental Extraction 

I followed Jackson to the dental extraction performed by Dr. Garvin and Dr.Wu. Dr. Garvin explained that on Tuesdays, they perform surgeries for people with special needs. Having worked with special needs students in college, I was touched by this fact. The patient needed to have teeth 1, 16, 29, 28, 27, 26, and 22--all of the rest of his teeth!--extracted because they were decayed. Due to his history of seizures and treatment history, this more challenging case was done in Surgery and not in the Dental Clinic in the Old Building. The procedure itself was reminiscent of going to the dentist office, with gum scraping and forceful pliers rotation. Since the mouth is a small space to work in, Dr. Garvin would tell me to come closer, and even moved out of the way to show me the exposed jawbone! They needed to smooth the jaw bone down, remove excess gum tissue, and suture up the gaping holes. Special needs patients don’t do well with dentures, Dr. Wu told me. Thus, the patient will probably have to chew with his gums from now on. 

Wound Debridement 

I followed my curiosity and went to OR 5, which the white board had listed simply as a “wound debridement,” which in my experience, wasn’t a particularly interesting procedure. But I peeked in, and was immediately intrigued by the sight of a young Asian girl was sedated on her side with her left leg up to her hip entirely eaten away by necrosis. The fat and muscle on her buttock was putrefied and left the area concave. There appeared to be no healthy skin left on her leg; only exposed muscle with blotches of black skin and pus. My immediate thought was, “How in the world does this happen?” 

It turns out that this 18 year-old girl was hit by a bus two weeks ago, and was rushed as a Level 1 Trauma to The Hospital ED. She has been in and out of consciousness in the ICU for the last two weeks, and doesn’t know the state of her leg, which became infected from a hip fracture. The doctors said that they’ve never seen anyone survive an injury of this magnitude.

 The worst part is, the doctors had wanted to amputate for some time now, but the family had refused it. The only consent the surgeons received was to clean the wound and debride it. Perhaps the family still hoped that the leg could be saved. “If not amputated soon, the girl will die of uncontrollable sepsis. The only reason her body is holding on is because she’s young,” a nurse told me. It was all very sad to see the nine doctors and nurses crowd the table, sullenly stripping away some of the necrotic fat and tissues while murmuring about the tragedy at hand. After some whirring of the microdebrider, the procedure ended anticlimactically with bandaging up the bloody slab of a leg. Since the infection had spread up her hip and lower back, her entire pubic area was agape as well and her lower abdomen had to be packed with several packages of acrylic gauze. Joan had said that because most of the buttocks was gone, the anus may become a freestanding protrusion of the intestine--if the girl survives. 

It shocked me that a pelvic fracture is one of the most life-threatening fractures a person can sustain, because the pelvic region is so highly vascularized. It also shocked me that bacteria can eat away at an entire leg in a matter of days. I’ve read Atul Gawande’s book, Complications, in which a case of necrotizing fasciitis was destroying tissue before the surgeon’s eyes. (I highly recommend reading the book if you haven’t already, and also Better.) The images stay with you. But perhaps one of you OREX-ers in the next coming days will be able to witness the follow-up amputation surgery and share some good news.
 

..........

These were just a few of many things that I saw over a period of one year. I'm incredibly grateful that God has opened my eyes to this type of work, and for the restorative nature of surgery.