One of the things that some folks struggle with while in medical school, or grad school, or any kind of school, really, is putting off starting a family. I know that I want kids, but I also know that while I could have them in medical school and/or residency, I wouldn't be able to be the kind of parent I want to be if I do that. Thus we wait. It's hard, though. I love children and both enjoy and hate watching my friends have children. I am so pleased for them; so far, they have all proven to be good parents. I get great joy out of seeing their children, playing with them. I know logically that we will be able to be better parents in a few years, but that hasn't stopped some of my peers from having children and being good parents. A gal entering third year is expecting and is thrilled. An acquaintance of mine is going into fourth year and his wife is pregnant. Not perfect, perhaps, but not the end of the world either.

Partially, I am afraid that when it is time for me to try to have a baby that I won't be able to. I didn't really make plans for my life, but part of me always thought I'd have kids by the time I was 30. At this point, that might not be entirely likely. When the time comes, though, will I be able to have a baby, or will I struggle to conceive? Will we be eligible for adoption? My parents were nearly too old when they adopted me; apparently Oregon had strict adoption laws in the eighties. Now they simply can't afford road signs. Oregon is a weird state. What if I am "too old" to have a baby?

Maybe I'm just frustrated because while I am doing this school thing, my friends are doing other things and leaving me behind. At the same time, I really enjoy my schooling. Gah.

The most ridiculous thing ever

I've done a lot of nutty things this summer. There was the time that I walked into the Charleston Naval Shipyard and asked if it was Massachusetts General Hospital. That was funny, wasn't it? Then there's the whole hanging out with people while they die thing. This is less funny, but it's not something that most people do during the summer time. I also convinced my husband (not to mention myself) to scale a rock face at Acadia National Park. This particular hike is called "The Beehive" and although it's purportedly only 0.8 miles long, it's pretty ridiculous.



Today, though, I think I may have outdone myself.

Every Thursday for the past month or so, I've been attending the didactic sessions that the palliative care fellows go to, sort of to get an idea of what it's like to be a palliative medicine fellow. They're fun and I understand about 5-10% of everything that is said. All in all, they're an excellent use of a Thursday morning. Today is the last one that I'll be able to attend, and I'm stuck in Wakefield. This is because I've lost my keys somewhere in this house, and I CAN'T FIND THEM. It's beyond the point of even looking at this point, because I've already missed my bus by about a half an hour, and even if I could find them, I couldn't get all the way from Wakefield to Dana Farber by eight o'clock. It's just not feasible. Even if I could, I can't leave the house because, well, this isn't MAINE or Lummi Island, where you can leave your house unlocked and your keys in your car with the windows rolled down and not worry about anything. Wakefield is a nice area, to be sure, but it's not that nice. And I'm not leaving my friend's house completely unlocked.

Oh well. One of the things they were gonna talk about today is delirium, and there were like four MSTAR presentations on that on Tuesday.

The pictures were taken by one of my classmates as he hiked the Beehive at Acadia.

I brushed the cats and got enough fur off of them to build another cat.

I am also officially overweight. I didn't go to the doctor, but pretty much every good source that I can find on the internet says that I'm at least ten pounds overweight. This is a huge deal for me, because although ten pounds isn't that much, it's the notion that I'm overweight at all that gets to me. I try to exercise and am fairly successful; I generally exercise between three and five days a week, for about an hour at a time. I feel like I eat ok, but that is clearly not the case. I think the main issue is that while I eat healthy overall, I eat too much of those healthy foods. I think it's the portion size that is the problem. I mean, I don't live on donuts, cupcakes, or macaroni and cheese. Sometimes that sounds awesome though.

I think I'm going to start up the No-S Diet again. It's a good diet and isn't really a diet.

Harry Potter today! But for now, back to work.

AFAR MSTAR - the end is near

I (probably) have my presentation mostly done. I'm going to start practicing it either tomorrow evening or Wednesday. It's not exactly the worst presentation in the world; I basically have to talk in an organized fashion for ten minutes, and then allow five minutes for questions from the peanut gallery. I have a few good case studies that I can share, as well as a framework for end of life communication that I can present.

The other slightly more stressful aspect of this is that I'm attempting to write a review of the literature that is appropriate for publishing. The problem that I'm running into isn't the literature search; if there's an article out there about family meetings in the ICU or in end-of-life care or in pediatric palliative care or in palliative care or whatever, I've read it (that is if it was written after about 1990). I've even been fairly successful in keeping track of my search criteria, search terms, and how I culled down the articles. I'm at this point now where I have my big stack of paper print outs and I don't know what to write about. I think I actually have enough for two reviews, one which would present the current view points and frameworks for family meetings in end of life care and one that would deals with prognostication in family meetings. A lot of the articles could even be used to make a third review about family satisfaction with end of life care and family meetings. I just don't know how to write this. They haven't taught us this in our didactic sessions because most people are doing more data analysis stuff. Basically, my thoughts are scattered.

Computers, not casinos. I like it.

Crunch time

So I have two weeks before I have to give some sort of presentation on the work I've been doing this summer. It's interesting, because I know I've done a lot, learned a lot, but I'm not sure how to best share that with people. I've learned quite a lot about the current opinions concerning family meetings in palliative care; I could probably summarize for you the best accepted format for said meeting. I've begun to develop what I think is a good way for someone, not me (hopefully), to start researching how family meetings in the ICU affect the family's understanding of prognosis. There are papers out there about how best to talk about prognosis with the family. Sure, there's like five, and they all say the same thing, which is "it depends on the family." Clear as mud, right? For the short term, I'm attempting to do a literature review, which I've never done, in such a way as to make it acceptable for publishing, which I've never done either. I also have some nice data for case studies of family meetings; there have been quite a few this summer, but understandably, not many of these families are keen to be the subject of research of a medical student, even if she does have IRB approval (yes) and even if she is nice (yes). Basically, I bit off way more than I can chew.

I have two weeks to figure out what to present; the paper can come later, although it'd be nice to have it done before school starts (not likely).

On the entertaining side, though, hearing half a million people sing "Sweet Caroline" along with Neil Diamond is really scary.

What can brown do for you?

I just had a phone date with a friend from college. We email, chat on instant messenger, and text each other fairly regularly. He's one of the very interesting people I know from undergrad, not in the least because he started out as a computer science type guy. He then evolved into a scientist of sorts, then became an EMT, started going to Burning Man, and applied to medical school. When I first met him, I didn't imagine that he would be a doctor, but now I think it suits him quite well. We're med school buddies now. We go to different medical schools together. Quite a departure from taking a photography class and eating moochi together during undergrad.

Hmm...now I want moochi. And sleep.