So, I am writing, first, to give you an update on this mind-humping task of studying for my medical board exam aka USMLE Step 1, and second, to ask my annual favor of assisting me in filling-my suitcase to serve another year of my 6.5 year prison sentence, I mean medical school education.
For these past eight-weeks, I have faced one of the most difficult challenges of my life, more of an obstacle to becoming a physician. The national medical examining board unbelievably accepts around 65% of correct answers as passing. I have never hoped and prayed to get a 65% ever in all of my of schooling, but as I go into robot-mode sitting through the 8-hour exam consisting of 322 questions, all against the clock, yes…I will be hoping to get 65% of these mind-humping questions correct. I imagine myself coming out of the exam with some form of post traumatic stress disorder, lying on the sidewalk in the fetal position, sobbing out of relief, or maybe just unresponsive. Mom, just be prepared to retrieve an inebriated child after the exam. The pressure is on, grateful to have the voices of my Cuban professors telling me what the right answer is in the back of my mind. Educated guessing, as I call it seems to be in my favor. Repetition is key in conforming my brain to the national board of medical examiner’s standards of quality. Oh believe me, putting in 12-hour study days, training my mind and body for this marathon of an exam has not been easy. Thank you to all who have been praying for me, snapping me out of my break-down moments, and cheering me on through this process--especially, my mom who has tolerated a not-so-normal Sarah these past 8 weeks. I feel like somehow everything is coming together as I head into the final stretch. Yesterday, I sat through a 4-hour practice exam at the testing center, and passed. By this time next week, I hope to have closed this chapter, celebrating with my dearest friends and family whom I have neglected for these past 8 weeks.
I plan to travel back to Cuba on October 7, and I am hoping that you can help me with some suitcase love. I am including a link to my wish list from amazon.com. http://amzn.com/w/1FRMSH7O5SV3I This summer, I am requesting a few books, but as you can see I have quite a list of toiletries and I am in need a new school uniform. My others are 3.5 years old. Gross, as you can imagine 3.5 years of hospital cooties, amongst my own that accumulate in the hot, humid climate of the Cuban streets. Honestly, if I did not need these items I would not be requesting them. And please, if you do purchase something, request a gift receipt. I was so upset to learn last year that I was not receiving purchaser information with the orders so I was unable to properly thank the gifters. I sincerely apologize if any of you did not receive a proper thank you from me for your donations. I am always super grateful and will make sure that you receive a special thank you note. As my favorite gun-totin' judge in Northern Nevada puts it, "shed a little karma."
Sunday, September 2, 2012
Saturday, July 21, 2012
Monday, July 2, 2012
And I know it is to time to come “home” when…
…the mangoes grow to be the size of my head, when I can no longer tolerate the feeling of a sweat mustache and chest condensation from the intolerable heat and humidity. Yes, mangoes and sweat mustache, I must come back to Ahmurica in order to prepare for my STEP 1 exam, yeah…you know that exam that I have been studying for the past nine months for, amongst having to study for internal medicine and working at the hospital, doing long on-call nights in neurology. The exam that was forever looming in my conscience, the conscience that would push me to stay in and study on many Friday and Saturday evenings, when all I desired to do was go out and play in the streets of Habana. Oh yes…that is the one…that 8 hour/$800 exam that I only want to take once. So yes, I arrive back to the U.S. to mount up for 10-12 hour study days, as I prepare to take my first board exam at the end of August. This is 4th quarter, baby. I am mentally, physically, and emotionally exhausted, but I keep on carrying on. Thank goodness for thoughts of fueling myself with Peet’s coffee, having unlimited access to wi-fi, and of course having my dearest family and friends within a phone call or brief visit away, cheering me on to push me through the end of the game.
I am closing the chapter of the longest/shortest year of medical school ever. I say longest, because I thought it would never end, but the shortest because somehow it went by incredibly fast, but I think I was just more or less distracted by everything that I learned, learned about medicine and myself, the amount of character I have built in extremely challenging circumstances, continuing on when a part of me wanted to say “f*&k it.” Mostly, I learned from my patients in the geriatrics ward. They taught me life lessons, just by listening to them, to their histories. I learned more of what love is, how to overcome struggle with integrity and grace, to learn the importance of listening and knowing the histories of my patients as a compassionate human being. I was in midst of true revolutionaries, “combatientes.” Every patient has his/her history, and if physicians and other healthcare professionals take the time to truly listen to their patients we can all know part of what makes them who they are—how their life circumstances, or histories, form the human being who sits in front of us, trusting us, welcoming us to bring some type of healing to their life. Señora Juana, my incredibly sweet, strong, resilient, 74-year old patient, whom I discover has been married (and still feels in love) to her husband for 52 years. Señora Juana has known her husband for 60 years, however tells me that she did not see him for 6 years because “well you know…he was in the Sierras, but you know I was waiting for him when he and all the others came back into Habana.” I asked her, “The Sierras? As in the Sierra Maestras? Like with Fidel, Che, and Camilo?” She simply replies to me, “Yes…” I was like what the heck?! Her husband was in the mountains of Cuba, guerilla fighting during the revolution, and she was there in the famous scene where Fidel, Che, and the other young Cubans marched triumphantly into La Habana, waiting there for the love her life after 6 years of him being away fighting. After examining her one morning, I said see you later to her and her daughter (who brought me a morning snack every day), we hugged each other and she lightly caressed my head in the temporal region, and told me what a good doctor that I am/will be. That was the last time I saw her. She passed away that evening. I cried that following morning. Then, there is another bad-ass revolutionary, whom I found out just by talking with him that he was also a “combatiente” en las Sierras. His son brought photos to show me. This guy, was 19 years old, guerilla beard, military fatigues, holding a rifle, amongst the other young revolutionaries, in the Sierras--young men and women, fighting for their people. The next photo he shows me is of him coming out of the top of the tank triumphantly, with Fidel at the Bay of Pigs. All I could do was express to him, in awe and gratitude, what a grand part of world history he was a part of and sincerely thank him for all of his sacrifices, because without him and the other young revolutionaries I would not be studying medicine in Cuba.
And then there is Señor Eloy, whom managed La Bodequita del Medio for decades (made famous for their mojitos by Ernest Hemingway), who was good friends with Hemingway and shared with me, amongst other stories, what a drunk and a jack-ass Hemingway was. He showed me exactly how he would stand over the bar, wobbling just like an old drunk man. Hahahaha. Señor Eloy, I will forever cherish the mint leaf masher you gave me before you checked out of the hospital. I will think of you always, especially when I am an old lady showing off my mojito making skills to anyone willing to take my mojitos-on. Thank you for teaching me to never take love for granted, that I must live every day and love as if it could be my last, to not worry about tomorrow, but to live in the moment that I am in. And…I will see you when I return to Cuba in October, to start my 4th year of medical school, to take you up on that offer of dinner at your family’s home, so that I may continue the celebration with you and your family.
Saturday, March 3, 2012
Keeping Calm and Carrying On
As I watched the taxi-driver shift the gears on the steering wheel of his ’52 Chevy during my direct-route to the beach after my final exam, I began reminiscing over the events from these past two months. Was chasing mosquitoes and doing check-ups on a turtle really that horrible? Everything was put into perspective for me as I looked out at the bright-blue waters of the Cuban coast on my left, taking deep breaths and decompressing from the last 2-months of adventures and 2-weeks of final exams. I realized that mosquito hunting was a huge exercise of pure preventative medicine on the part of the Cuban government. My semester of working in the hospital came to a complete halt to combat the spread of Dengue fever. The Cuban government declared that the health of their people was a priority, and sent us baby-docs into the street to learn what public health really is. U.S. folks who are interested in public health get a masters degree in public health or pay thousands of dollars for elective public health courses, and here I was learning about preventing disease as an integrated part of the medical school curriculum in Cuba…for free. I know I was whining and moaning about the suspension of the semester, because after all I am here to learn medicine. But, when it comes down to it, I really was learning a pertinent part of what medicine is—preventing disease. I was working with the same neighborhood who was actively participating in their own health for 6 weeks. My daily rounds in the neighborhood allowed me to form relationships that I would not have formed if I was in the hospital. House calls still exist! My first week of mosquito-hunting, I met a 17-year old kid (the turtle owner from my blog titled “I hunt for mosquito”), so young and so full of life. The following week, he was traveling back to another state to visit his grandma and decided to go for a walk at the bus-stop. There was an accident and he died. His death not only affected his mom and older-brother, but an entire apartment building that I would describe more as a big house with individual rooms because of the family dynamic between the neighbors. Two years ago, this family suffered through the loss of the dad who died suddenly of a heart attack. I found myself not only taking care of the turtle owner’s mom’s physical manifestations of stress and grief over her son’s death, but also simply stopping by to check on her and the rest of the family. I listened to stories and after a few weeks our visits began to consist of more laughter and less tears. Then, there is my incredibly beautiful (inside and out) new friend, who lives in the same building as the turtle family. I found out over an incredibly abundant lunch-spread at her apartment, that her ex-husband left her to go to the U.S. and had promised to send for her. He re-married in the US. and left her with his 90-year old mother, whom she is caring for and even shares a bed with. She not only cares for her mother –in-law with an inconceivable positive-spirit and amount of love, but also checks in on Margarita (the turtle owner’s mom) and the elderly, eccentric English speaking Richard who has had his foot amputated due to complications from diabetes. What mosquito hunting really taught me is that Cubans are incredibly good at taking care of each other.
These past 2-months challenged my patience, especially as the rumors spread that we might have to repeat the year. I was pissed-off to the “N”th degree, especially as I thought about me being at a critical age in breeding-years. Part of being in medical school, I learn all the risks of being a woman of my age (and still aging) and being a “childless monster” as I am considered in Cuba because I am a 32-year old, childless, un-married woman. There is an increased risk of having a child with Down syndrome and other congenital defects, as well as an increased risk of getting cancer. I am not saying that I am ready to be with child at this very moment, but the administration better not dare mess with my precious breeding years by threatening suspension of an entire year of school ever again.
So, at the 3-year anniversary of my being in Cuba, I am saying “see you later” to the Groundhog –Dengue-Day season and gearing-up for internal medicine and pacing myself for the next 16-weeks of STEP 1 study (countdown to my first board exam). Life is back in perspective for me. Cure: a 20-minute ocean-view trip in a ’52 Chevy with bikini already on under my lab coat and scrub pants because that is how I sat through my theoretical exam, to a beautiful beach right outside of Havana to celebrate the completion of final exams and a farewell to my first (and not last) Dengue Fever season with a few bad-ass, as we now call ourselves, reggaeton doctors.
Saturday, January 14, 2012
I hunt for mosquito
With the semester suspended until further notice and my official Dengue kit (two thermometers and an official ministry of health pen) in hand, I joined the volun-told mass of thousands of medical students from all over Havana in the hunt for mosquitoes this week. I am unsure of what a normal first day of mosquito-hunting should consist of, but by offerings of fresh pineapple juice and conversation from an old-cat-lady, a Cuban made mocha from a super suave bachelor who just had to get that standard Facebook self-snapped photo of him and two U.S. doctoras, I think I have a better idea. What is abnormal about having some good laughs as I face 8 hour days/7days per week of walking door-to-door taking temperatures, looking for stagnant water in buckets and plant-holders, and oh yeah…of course reminding Cubans to make sure to change those glasses of water on the altar to Saint Lazaro? Oh yes, I cannot forget about coming across a little turtle’s home of dirty stagnant water without wanting to disturb his cozy environment, but reminding the owner to change his water regularly…and top it with a net. Poor little turtle, you are not to blame for the Dengue Fever epidemic. Prolonged warm weather, extensive rain, gaping stagnant water filled pot-holes on the streets, faulty fumigation, and bad decision making are to blame. Bright side: I will receive an official diploma accrediting my Dengue hunt, for official course work, and you know I am definitely going to frame it and place it up on a wall where it will await, until 2015, the arrival of my official medical doctorate diploma.
Monday, January 2, 2012
Groundhog Dengue Day
I never imagined going back to 1959, working as a “doctora” in a geriatrics ward in Habana, Cuba would become everyday-Dengue-Fever day, where my clinical training would be supplemented by the inhalation of asbestos and mold fibers in a basement, looking at an x-ray from 1966 or examing a CT scan on a computer similar to the one I played Oregon Trail on in the 3rd grade. I have begun to question my decision to study in Cuba more than ever these past couple of months, throwing my hands in the air and screaming, “Where the f*&k am I?” Although I am supposed to be in the midst of one of the most important clinical years of my medical education, some dumb ass bureaucratic decision has me becoming a specialist of Dengue Fever and/or a glorified secretary. Glorified secretary scares me more than Dengue Fever Specialist, because the thoughts of continuing on in my life as a county secretary sent me running to Cuba in the first place. I don’t think “Specialist of Dengue Fever” will count when I begin to apply to residency programs in the U.S., because Dengue Fever is basically non-existent in the U.S. A long, warm summer/fall/winter with abundant rains has left a class of 97 third year medical students starving for any patient that does not have Dengue. We are thirsty for illness. Give us some sick patients! I know, we should never be hoping for sick patients, but how else are we supposed to learn. The first clinical year is supposed to lay the foundation of our career, where we learn signs and symptoms and become bad ass docs, the kind that can just look at a patient, ask a few questions and come up with a diagnosis. Yeah…you know…wannabe “Dr. Houses.”
I am grateful for the mental, emotional, and physical rehabilitation I have received during my holiday vacation, to feel two weeks of comfort and normalcy. Do I stay, or should I go? I shall return, to see what is in store for me. Oh man…I am a glutton for punishment. But, oh wait, maybe it is not punishment buying ice cream for $0.15, drinking mojitos for $0.50, or having the satisfaction that even my new buddy/adopted street pup named Junior will not eat hairy pork fat (see...I am not alone).
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