Valentines Edition: Things we LOVED about our premedical and medical journey!

 It’s Valentine's Day! Whether you love it, hate it, or simply refuse to acknowledge it as an actual holiday, we are here to bring you a blog we hope everyone can enjoy! Our medical journey has been both a long and arduous one. From countless sleepless nights of studying, to stressing out about exam scores, to disappointments we thought we would never overcome, and ultimately, to those victories, both big and small. I honestly thought I would never reach graduation day, but alas, May 2021 is right around the corner. Amidst the chaos and years of sacrifice, there were many things that we took away from our experiences, that I wouldn’t change for the world.This blog is dedicated to love: Love for our medical journey. Love for the people we met along the way. Love for what we learned about ourselves throughout the process. Love for medicine. Love for the immense privilege that was bestowed upon us to live, learn, breathe and ultimately, to practice medicine.  MelissaThis is a long, far from comprehensive, list of things I have loved from premed to present.Grad SchoolA couple of years before medical school, I completed a Master of Biomedical Sciences program to raise my science GPA before reapplying to medical school. I have always struggled with academic self-esteem, but about halfway through this program was the first time I really felt like I could be a doctor. I also learned how much I liked immunology!WorkAfter my master’s program, I had a really hard time finding a job in the medical field. I took a job as a barista at Starbucks for about 8 months. I like coffee, but at the time I felt like such a failure because I wasn’t using my education. Now when I look back, I really enjoyed the levity of making coffee. I will always respect how well-managed the store was. The free coffee was also great but getting migraines for the first time in my life was not!Eventually I got a job working in a Flow Cytometry and Hematology Lab. I made blood and bone marrow aspirate smears and did cell differentials (counting different cell types) and looked for clonal populations (ie cancer cells) representing blood and bone marrow cancers. Three things stand out about this. 1. The Hematopathologists that I worked with were amazingly invested in educating and sharing interesting cases with me and my coworkers. 2. Did I mention that I really like immunology? 3. The cast of characters I worked with in the lab, was at times, worthy of its own blog series.OregonGrowing up in Colorado, I never imagined that I could see anywhere else as home. Oregon quickly became home. I don’t know where I will be in the upcoming years, but I am so grateful to have spent the past four years in beautiful Oregon. I’m particularly fond of southern Oregon. My internal medicine rotation brought me to Ashland during the fall. In addition to being surrounded with beautiful landscapes, I was also able to enjoy some pretty good local food and coffee. My boyfriend, Daniel, came down to visit and we took a day trip up to Crater Lake. For a different rotation I stayed in Medford and was able to do a weekend trip to the Redwoods. Daniel and I did a lovely 16 mile hike to the ocean, which is the longest hike I’ve done since leaving Colorado.Friend and Family SupportI can’t tell you the number of times throughout my education that my dad would tell me, with tears in his eyes, how proud he was of me, or how many times my mom would listen to me cry and run to the store in the middle of the night so I could have ink to print my PowerPoint slides out.I have a few friends who have been supporting me since high school or even before. Never once did they get upset when I told them I couldn’t go out for the second month in a row because I was studying for college exams, MCAT x3, board exams, etc. They were never upset if it took me days or weeks to respond to their calls or texts. When I did have time, they were willing to adjust their schedules so we could spend time together. Then med school started, and I met some wonderful new friends who have inspired me, made me laugh, motivated me, and commiserate with me.Ashley was one of the first people I met when I started medical school. I felt compelled to talk to her when I saw her at the welcome BBQ the first week; it was particularly out of character for me because I am fairly introverted and so is she. In the years that have followed, she has become such a treasure to me. We share a lot of similar experiences in our upbringing/adult lives that I wasn’t sure I would see in my medical school peers and I am so grateful for that. Anyone that has met her can also attest to the fact that she is one of the most quietly kind humans out there; anyone that really knows her is inspired by her ability to regularly overcome obstacles that would stop others in their tracks long before medical school. My DanielDaniel is my SO of 6ish years (it’s okay, he doesn’t remember when we started dating either). There is so much I could say about him, but I’ll try to be brief. I got to know Daniel at an interesting time in my life. I finished my masters and was studying for the MCAT. During that time, my stepmom passed away and my dad started to get really sick. Daniel has been there for the toughest years in my life; ever since I met him, he has always challenged me to be a more understanding, gentler person. His acceptance and respect for people from all walks of life was such a necessary balance in my life, especially back then. It is his gentleness that inspires me to never forget that everyone is worthy of dignity and respect, and partly inspired my desire to work with underserved populations.On a less serious note, he also spent many days during my first year of medical school sitting on the floor of my apartment with me, while I cried. And for a while, I cried a lot… Let’s be honest, I’m still a pretty emotional person. He always makes sure I have an ample supply of emotional support ice cream, emotional support pizza, and emotional support neck rubs; Even now, he is currently tolerating early 2000s emo music while I write this. Daniel also brought his wonderful and incredibly supportive family into my life.“Studying” OMMDuring our first two years at school, we learn osteopathic manipulative medicine which is kind of like a hybrid between physical therapy, massage, and chiropractic techniques, with the underlying assertion that the body is a complete unit capable of healing itself. Like with any other lab, we had OMM practicals where we would have to demonstrate our competency in different techniques on our classmates. What I loved most about these was that my friends and I would start “prepping” for them way far in advance. Functionally, what that meant is that I hung out with my friends in the OMM lab and gabbed about all sorts of things, and occasionally learned a thing or two. As the practicals approached, we spent less time gabbing and more time practicing.Family MedicineThis was my first clinical rotation. I was terrified, but I lucked out with such a great group of physicians. My preceptor (the main doctor in charge of you on rotations) told EVERY. SINGLE. PATIENT. so excitedly that it was my first rotation ever. It was a silly thing, but it made me feel like I was welcome to learn and make mistakes. Those patients were gracious enough to let me do some of my first procedures there, including knee injections and pap smears.Addiction Medicine RotationDisclaimer: this one is personal and kind of heavy. I’ll start by saying, so many of the patients I worked with were dealt a very difficult hand early on: growing up with substance abuse at home, parents being absent or actively encouraging their children to use substances, suffering every type of abuse imaginable, and so on. Like many of the patients I worked with on this rotation, addiction permeates through generations of my family. I lost my dad right before I started interviewing for medical schools. He was a lifelong drinker, but mostly he was my dad: the goofy, creative, music-loving outdoorsman. I could go on and on about how amazing my dad was, but that’s a subject for another time.Dad started to get sick around 2013 as my stepmom was battling cancer. The next couple years were filled with oscillations between home and the hospital. He would try to stop drinking on his own as he had in the past, but now he was dependent on it so he would get really sick when he stopped. In 2016, he passed away somewhat unexpectedly, and unfortunately, he died the night before he was scheduled to go to inpatient rehab. My addiction medicine rotation was so challenging on a personal level because I saw the hope that my dad never had the opportunity to see. And while I do not necessarily think that one trip to rehab was going to save my dad, if he was going to have a shot it was going to be with that kind of help. Addiction is a claiming disease. Addiction is not a matter of fortitude or will. To reclaim oneself from its grip, intense physical and psychological support are paramount. Those things are what treatment facilities have to offer and what our hospital systems seldom offer. Oftentimes that support comes from staff who intimately know what addiction looks like because many of them are in recovery themselves. And while many people look at rehab as the step after rock-bottom, I cannot see it as anything but hope.Pandemic PupIn mid-March 2020, after COVID-19 started to rear its ugly spike protein in the United States, I was pulled off clinical rotations. Daniel and I had been looking for a dog a few months prior but didn’t have much luck until April; that’s when Ella came into our lives.Ella came to us out of the back of a white van in the Hillsboro PetsMart parking lot. She was driven in courtesy of Animal Rescue Kingdom, a nonprofit that rescues stray pups, and pups from high kill shelters in Texas, and adopts them out up here in the PNW. She was a tiny 7lb, 20-week-old mutt pup that we picked out on the internet in about 5 minutes after finding out we were approved to adopt. She got carried out of the van to us with a tail that wagged so vigorously we were concerned she might take flight. Her tail, though bushier now, still vigorously wags with every new human she meets. She enjoys sitting on her humans, emotional eating, non-emotional eating, middle-ground emotional eating, and being chased by other dogs, especially corgis, at the dog park. Coming home to her goofy antics, especially after emotionally draining days on rotations, has been an absolute joy. Ashley Now, I will discuss some of the loves I discovered throughout my medical journey, as they have attributed to the person I am today. LoveIt is Valentine’s Day, so I guess I should throw something about romantic love on here! I met my fiancé in 2011, when I was least expecting it. I had just moved to Portland (on a whim honestly); I felt stunted somehow in Las Vegas, and felt strongly compelled to start fresh somewhere new. I continued my pre-medical journey by attending university in Portland, volunteering and working to make ends meet. It just so happened that my partner and I were hired exactly one day apart at a hotel in downtown Portland, and never would have met if I did not agree (hesitantly) to meet coworkers for drinks downtown after work one evening (he worked graveyard shift). The only reason we met was because the hotel locks their parking garage after a certain time, so I had to wait awhile for someone to unlock it. He kept me company that night, and after 5 months of friendship (and his persistence), I agreed to our first date! In 5 months, we will have been together 10 years, with plans to marry in the Spring of 2022. In those 10 years, we have truly lived so much life together, from living in 5 different cities, spending long days in the school library tackling MCAT concepts, battling the difficulties of long distance love for 3 years, traveling cross country together twice, and most of importantly, growing up together. He has shown me what true love, kindness, support and sacrifice looks like. He has sacrificed so much for me to be standing here today. I am forever grateful to him and I hope to make him proud. I am also in love with the family that came along with him :) Along with finding romantic love with my relocation, I also fell in love with Oregon. Living in the desert my entire life, I had never fathomed that the picturesque beauty of the Pacific NW existed! Upon moving to the beautiful Pacific NW, I discovered my passions for hiking, chasing waterfalls, the Oregon coast and nature photography.  Volunteering: Giving back, underserved communities, Spanish :( My medical journey began almost a decade ago….Goodness I feel so old!During my decade trek filled with successes, failures, and self-discovery, one of the things I discovered about myself was my love for volunteering, particularly serving underserved and marginalized communities. At my undergraduate institution, there was a medical student run clinic whose sole purpose was to provide free healthcare services to the uninsured community. They would recruit pre-medical students to volunteer for months at a time to help facilitate the clinic to provide essential, free medical care. I recall a fellow pre-medical student telling me I shouldn’t bother applying, because it was so competitive…..I am beyond thankful I didn’t listen to her, as this experience proved to be one of the most fundamental and formative experiences of my pre-medical journey. I even discussed this experience in my residency interviews. This experience truly shaped who I am and the type of physician I want to be. Most of my family is underserved and lacks easy accessibility to healthcare resources, so this experience really struck close to home. As positive as this experience was for me, it also reminded me about how much I wish I spoke Spanish!! But…this blog is about things we love about our journey, not regrets 😉LeadershipTo preface,I am one of the most shy, introverted people you will ever meet. I hate being the center of attention more than anything in the world! So, when I moved to a new city to finish the last few years of undergrad, I very quickly (and oddly) integrated myself into the pre-medical community by becoming secretary of a large pre-medical organization. It wasn’t a position that required speaking much, so it was easy, right?! But, just the following year, I had networked enough that someone wanted to run as co-president with me….and we won. As you can imagine, many thoughts rushed through my mind: Can I do this? Can I put my insecurities and fears behind enough to run an entire club? The answer: Heck yea!That entire year, I thrust myself into a world where I not only conquered my fears of public speaking, but started to develop confidence in myself to realize that I was driven and dedicated enough to lead a group of leaders to facilitate a successful club where we would create an environment that fostered growth and success. We hosted multiple, successful events and this remains one of my most coveted experiences that helped me grow both professionally and personally. My favorite event consisted of cooking Thanksgiving dinner for 3 underserved families in the community, something that this club still does to this day!If it weren’t for my tenacity, drive and fearlessness, I would never have discovered my love for leadership and collaboration. I continued my love for leadership in medical school, where I partook in multiple leadership opportunities, including helping to teach 1st year medical students the art of clinical skills in medicine and leading the OBGYN interest club. Women’s HealthPrior to starting medical school, I served as a scribe/assistant to an OBGYN physician in Portland. I hold this experience very close to my heart, not only for the opportunity to learn more about clinical medicine in women’s health, but also for learning more about myself. It’s astounding how very little I actually knew about women’s health! The crucial importance of regular preventative screening, the art of obstetric care, red flag symptoms women should always look out for, pelvic floor physical therapy…this list can go on! Apart from the medicinal aspect, came the humanity: holding someone’s hand through their first miscarriage and reassuring someone that they were not at fault; informing a heartbroken, 18 year old girl that the person she let her guard down with after a break up had given her genital herpes that she will endure for the rest of her life; to telling someone that they have cervical cancer and will need to be referred to oncology. Although I will not be pursuing women’s health as a specialty, I will always be very partial to this field, as any field that empowers women, promotes education and provides comfort during some of the most trying times a woman can endure, will always be important to me. Medical School:Didactic Years (1 & 2): Friendships, Laughter, MORE laughter, & Research. Honestly, these first two years of medical school were so grueling and absolutely traumatic, I often find myself trying to actively block most of it out. While I am not pretending this period of time never happened, I reflect back on my favorite aspects of those didactic years, and I would have to say it, hands down, it was the friendships I formed. While my colleagues are truly amazing human beings, I became particularly fond of 3 beautiful, bright, and phenomenal women. From countless coffee runs, to hour long gab sessions that should have been study sessions, to OMM practice turning into flat out comedic sessions, to always finding something to laugh about in the front row during lecture…..I would have not survived those formative (and traumatic) years without you by my side (particularly second year). You know who you are…..thank you for being my lifeboat. Also worth mentioning were all of the lifeboats I met along my journey, ranging from Nevada, Pennsylvania, Oregon, to New York. It is, without a doubt, my friendships with all of you that helped me survive some of the most trying times of my life, and have shown me what true friendship and sisterhood means. You made it possible for me to be standing here today. Another experience that I am very fond of is my contribution to medicine in the form of research. Like Melissa, I absolutely love immunology. So, when the opportunity presented itself to work in a neuroimmunology laboratory whose purpose was developing a neurotherapeutic drug for neuroinflammatory disease (ie Multiple Sclerosis), I was more than ecstatic to jump on the opportunity. I was not only excited for the privilege to be part of something bigger than myself, but also for the challenge of thrusting myself into a foreign environment to see how I would acclimate. Although only 3 months, I quickly learned the ins/outs of the lab, learned the art of processing mice specimens and performing flow cytometry, and most meaningfully, felt deeply welcomed into the Vandenbark Lab family. I would not trade my experience for anything in the world….with one exception: I would take back the 3 months I had to be actively involved in the euthansia of lab mice for experimental purposes.  Clinical Years (3 & 4): FREEDOM, Psychiatry, and the Art of Psychotherapy After being cooped up in a building for two long years, we were finally free to rotate in various specialties, as we frantically attempted to figure out what we were going to do for the rest of our lives! As I was attempting to balance rotations, boards, and my sanity, it was during my third year rotating in inpatient psychiatry, that I had found my love for the art of psychiatry, and realized exactly what I wanted to do for the rest of my life. I had always had a passion for mental health, stemming from personal experiences throughout my lifetime, but it was during my clerkships that my love was solidified, and I made the decision to pursue. Another thing I loved about 4th year was our freedom to travel to various programs throughout the country! As COVID-19 put a limitation on our ability to travel as much, I had the phenomenal experience of rotating in New York and Montana. This allowed me the ability to explore places I may never have gotten to see otherwise and to learn from some of the best in their fields. No matter where I end up, I will have taken something with me from each experience, and for that, I am forever thankful.One of the most rewarding aspects about my experiences on the wards, are the relationships I have had the privilege to develop with my patients and their families. The first psychiatric patient I ever cared for as a medical student, I spent one hour on the phone with his brother, explaining his condition of schizophrenia and how we were going to be taking care of him.Although I thoroughly enjoyed all of my rotations and took something important away from each experience, it was my Addiction Medicine rotation that really stood out to me! It was unique in the sense that medical students not only got to consult patients into the addiction medicine service, but we were responsible for following our patients closely and conducting psychotherapy visits (visits designed to allow a person to talk through and process their thoughts and feelings). One story I love to tell is, I had a 16 year old male, who presented to our service with withdrawal from marijuana. He was stable now, but my preceptor wanted me to follow him a few more weeks. At first, as you can imagine, this teenager wanted nothing to do with therapy, but after time, he eventually opened up about how he was (subconsciously) masking his anxiety/depression with cannabis, and now things were slowly creeping to the surface. It was this experience that made me decide to integrate psychotherapy into my future as a physician.Now, with match season only a month away, I toggle between being absolutely frightened that the culmination of my hard work will result in my not matching (meaning none of the programs I interviewed with accepted me into their program), with being beyond excited that all my years of hard work will finally pay off, and I will end up exactly where I am meant to be. Either way, I choose to LOVE the process and element of surprise, because either way, I will be okay. We dedicate this blog to everyone in our lives who made it possible for us to be standing here today. Thank you. Co-authors: Melissa Mahoney, OMS IV & Ashley Maestas, OMS IV