Holidays at Home

Snow Day Snuggles

Well, I can now officially say that I'm done and I passed my first semester of medical school. To express that I'm ecstatic, relieved, and exhausted would not even come close to putting how I feel into words. Officially, I arrived home Wednesday night, but left Dominica on Tuesday afternoon. Considering all the possible cancellations, delays, and hiccups that could have happened over the course of those 24 hours worth of traveling, I was very fortunate to have only run into a small hiccup on the last leg of my trip from Dallas to Minneapolis where the maintenance crew was unable to locate a spare medical oxygen tank for our MD-80 aircraft within the vicinity of DFW. Luckily, an hour and half later, they found a generous flight crew elsewhere within the airport who was willing to share theirs, and we were on our way to the snowy winter wonderland that is Minnesota. At first I was a little apprehensive about coming home and how I would feel. Would it feel like home? Would I feel like an outsider in my old stomping grounds? Would I hate the cold and snow? Would Elphie be as excited to see me as I am to see her? Well, needless to say, I had nothing to be apprehensive about. As soon as we broke through the thin, wispy layer of clouds that separate the incredibly humbling and beautiful collection of fluffy, cotton candy-like clouds at 33,000 feet and the equally beautiful and humbling world upon which we all live to see the ginormous and perfectly lit up tree along Cedar Ave in Eagan, I was home. The overwhelming feeling of comfort and joy that washed through me as we coasted over the Mall of America (there's a new LL Bean store?!), and landed on my second favorite runway at MSP is another that I could never put into words. The smile that appeared on my face was immovable. Add to that the grin on my Mom's face when she picked me up at baggage claim, and the endless tail wagging and endearingly adorable squeaks from Elphie when I got home, and you have one happy, content camper. Don't get me wrong, Dominica is a beautiful place to live, and I am excited to be able to go back in a few weeks, but there is absolutely nothing like home. 

Over the course of my 25- hour travel journey, I had just a little time to begin a series of books "for fun!" Granted, this series, called The Emily Tales, chronicles the series of chemotherapy and radiation treatments of a 2 year old girl who is diagnosed with a rare form of kidney cancer called Wilms' Tumor, but reading about and studying medicine are two completely different things. I have read medically related books in the past, but for the first time I actually KNEW what they were talking about, and it was one of the most empowering moments I can recollect in recent history. Not only did I understand the general sense of what this family was going through, but could follow the specific drugs, their mechanisms of action, as well as the reason behind the various blood tests that were being run. I've honestly lost track of the number of "flags" and bookmarks that I placed throughout the book regarding places to go back and delve deeper into what is going on medically, and I can't wait to get into those details. Throughout the semester I knew I hadn't picked up every single piece of information that had been thrown at me, but being able to read the passages presented in this little girl's unfortunate twist of fate and understand them, was incredibly exciting and motivating. It makes me realize that the "someday" that I think about in terms of being a doctor has already started. No I'm not a licensed, practicing, full fledged physician, but I'm more of one now than I was four months ago, and, again, am brought to a point of being speechless about how incredibly grateful I am for the opportunity and ability to utilize the incredible power of the human mind and the human condition.

Now that I’m back in the United States for a bit, I’m finding more so than ever before a genuine appreciation for the abilities and opportunities that we have. Just last night I was at Target and could not believe how many new types of Tostitos chips there are, or the fact that I can get peanut butter again for less than 10 dollars?! I know this sounds quite silly, and I don’t mean to make it sound like Dominica is unable to provide the basic necessities of life, but I have also adjusted to a different lifestyle and am thankful for the opportunity to do so. That being said, I am incredibly grateful to be able to be home for Christmas. I know of several students who are not going to be home with their families and friends for the holidays for various reasons, and I couldn’t imagine not being able to snuggle with my favorite pup on Christmas Eve with a movie playing the background, and a warm fire in the fireplace.

On a very different note; however, after being home for a few days, I can’t help but feel as though I am simply passing through in this visit to Minnesota. Not for the lack of welcome from family and friends, or the initial joy and relief I felt upon passing through those clouds, but at this moment in time, this isn’t my life. I remember feeling this way when I came home for the first time as an undergraduate student. Being completely ecstatic about being back in my house in my own bed with my family, friends, and pets surrounding me at my favorite time of the year, but simultaneously feeling like it no longer fit. At that time, I couldn’t pinpoint what the exact feeling was, but I remember thinking I’d love to return to Minneapolis and stay at my apartment if I had had one at the time. I had established a separate life- one that was mine and only mine. As much as the years since I graduated from the “U” have helped shape the person I’ve become, I never felt like any of it was 100% mine. In preparing to come home at the beginning of this week, I wondered if I would experience a similar sense of transiency upon arriving in Minneapolis, and I honestly didn’t until 2-3 days into my visit. Once the initial excitement of seeing snow, watching the local news, sleeping in a bed that doesn’t have springs sticking out of the mattress, and sipping wine with my favorite humans, it began to sink in that everybody here still has their routines- their own lives- just as I have in Dominica.

While waiting to pick an incoming traveler up from the airport, I sat in my favorite parking lot and watched hundreds of people come and go on planes that had served as my tickets home barely two days prior. I was brought back to one of my first posts here in August regarding the various changes that occur when one moves abroad, and was beginning to see many of the truths of that list. Now, as I mentioned, absolutely nothing beats being home for the holidays- especially the care and concern that can only come from a mom’s experience as I fight off an unwelcome sinus infection that finally caught up with me following lack of sleep and increased stress of the semester, but I can also honestly say that I will be ready to return in a few weeks to finish what I’ve started in Dominica.

If I don’t return before January, Merry Christmas and Happy New Year!

With Love,

Ashleigh

Gratitude

I know, I know, it's been far too long again. Let me tell you; however, that the last few weeks have been a little crazy, and the next week and half.....I don't even know if I know what to expect. That being said, I wanted to take another, what I hope will be brief, period of insomnia to sit down and communicate a little.

As you can probably tell from the post title, I want to touch on a few things that I've learned in terms of gratitude. As all of you in the United States know, last week was Thanksgiving. Most of you celebrated with friends, family, and other loved ones; and I am extremely fortunate to say that I did the same. A group of about 15 of us put together a potluck dinner and met in a communal area on campus. Since most of the students here at Ross are from the United States, a couple restaurants had offers for a full Thanksgiving meal complete with turkey, mashed potatoes, green beans, etc., but I'm really glad that we decided to have our own version of Thanksgiving. I, personally, made cooked carrots, while others brought ham, chicken, yams, dressing, green beans, cheesecake, and pumpkin pie. We all had studying to do (what's new?), but it was wonderful to be able to sit down and enjoy food that we all had put some effort into preparing (even if it was finding the time to meet up with somebody else who had made it ahead of time). We don't always see each other outside of class, but the group of people who were able to make it for that dinner are very rapidly becoming my family. Without them, I would be at my apartment everyday counting down the days until I return to Minneapolis. Don't get me wrong, the fact that I will be home, sleeping in my own bed in less than two weeks is not far from my mind, but I do not go to bed each day here with a heavy heart wishing I could go home sooner. That, in and of itself, is enough to be grateful for. A couple months ago, I was asked by a friend of mine to post everyday for 5 days, 3 things that I was grateful for. So, in the context of this current train of thought, here are a few things that I am incredibly grateful for:

1. The colleagues and fellow students whom I have met, and am privileged to be working alongside. Many of us have very different backgrounds, and have had varying life experiences, but they all inspire me each and everyday to keep going; especially those who study in the same place as I do. Sure, we all have small eccentricities, but going "home" to spend evenings that turn into nights with these people is something I can honestly say I look forward to.

2. Technology. Even though I was unable to physically be with my family on Thanksgiving, I was able to put together a few brief video messages to send to them. I, of course, had to include the fact that it was still warm enough here to wear a tank top, while the subzero temperatures read loud and clear on thermometers in Minnesota, but I enjoyed being able to connect with each of them in some way.

3. Dominica. Despite its quirks and frustrating moments, the way this island has embraced my colleagues and me is amazing. No, it is not always the most comfortable (ie: rain all day everyday for 2 weeks straight, or dealing with mosquito bites constantly), but it has taught me about what it takes to really be human, and to be truly alive. As I mentioned a couple posts ago, the way that relationships work here is completely different than most in the United States. I believe I made reference to the young lady who works at the coffee shop on campus, and the way she greets me pleasantly by name every time I enter to order my large coffee (usually multiple times a day). I have come to find that sense of personal investment and honest effort in many of the relationships I have formed with the people of Dominica. For example, there is a taxi driver who has driven my friends and I to a restaurant on the island a few times, and also operates one of the nighttime shuttles from campus. Seeing that I am often on campus until wee hours of the morning, he usually will drive me home. Although it is usually no more than 5-10 minutes, he has taken the time to get to know me and really care. As I walked to class on Tuesday this week, he passed me on the road and offered to give me a ride the rest of the way. I told him I didn't have any cash for the ride, and he didn't care. Later that same day, I went to buy grapefruits from a young lady who sells fruits, pasta salads, and an amazingly crisp and refreshing avocado- cucumber salad. She knows me by name, and I see her nearly everyday. Together the grapefruits cost 1 EC (the equivalent of about 40 cents in the US), and I only had a 20 EC bill. I felt awful for not having anything smaller, but in response, she just said, "pay me tomorrow; I know you'll be back. I see you everyday." Now, these are only two of the most recent experiences I've had, but these types of encounters occur daily. I will miss this sense of trust and accountability when I return to the United States.

4. Kids. Not in the sense that I would like to have my own right now, but in the way that they bring out the side of me that appreciates the little things and sees the beauty in just being. As an assistant clinic coordinator for the Pediatrics club, I helped plan and execute a community clinic two weekends ago at an elementary school about 10 minutes away from campus. Mind you, I know I was completely stressed leading up to that day, and had volunteered at a similar clinic the weekend before, but this was different. After all the stress and preparation leading up to that weekend, what really mattered was that these kids had an opportunity to have their basic health examined. That they didn't have to worry about not being exactly who they were- just kids. Some of them were shy and didn't have a whole lot to say, while others wouldn't stop talking. We had blank paper and coloring pencils/ crayons for them to draw with while they waited to traverse through the various stations, and the overall zest and enthusiasm for being able to color was indescribably inspiring. As medical students we get so bogged down with the details and stresses of life that sometimes we forget to just live. We forget the importance of letting loose and making funny faces just because we feel like it; of finding a stick in the grass and conjuring up a dramatic story about its significance. Don't get me wrong, that's why we're here- to be focused and get a medical education- so the details DO matter and we do have to know them, but not, in my opinion, at the expense of forgetting how incredibly beautiful and awe-inspiring something like a rainbow or a sunset/ sunrise is, or how important it is to take time to just laugh and be shamelessly yourself.

As always, I could go on for days about so many different things, but being that I do have the first of my last set of exams on Monday, I'm going to cut this one off. I will leave you with a reflection that I jotted down on my phone as I arrived home a few nights ago after studying, as well as a few pictures I have taken over the last couple weeks.

With love,
Ashleigh



"Studying tonight, I looked out my window and noticed the moon setting. I walked up onto the top of my apartment to try to take a picture, but knew it could never do the setting justice. The feeling of being completely enveloped by the night sky and its trillions of stars; of looking out at the moon as the clouds roll in to try to obscure its light, failing miserably as the reflection off the Caribbean will never hold back the moon's radiance; of the peace that comes with living in Dominica where city buses and skyscrapers are only a distant thought. Today the 4th semester students received their final grades for the semester. They will be heading back to the US in two weeks. Unlike the rest of us; however, this time it will be for good. As I've been talking to them about returning home, I've observed many mixed emotions. Of course they are ready to go home and to be off the island, but many of them are going to miss it, and appreciate what it has taught them. As you probably know by now, I am quite sentimental, so I can only imagine how I will feel come next December when those shoes will be mine. For now, I'm going to continue appreciating where I'm at, and the fact that it has embraced me with open arms. My countdown to Minneapolis has reached the less than two week mark, and you better believe I'm excited to be with family and friends, but you also better believe that I'm going to miss aspects of my new home and my new family while I'm gone. As always, I continue to learn that taking the time to appreciate, and I might even go so far as to say, marvel at, those little, everyday things, like the moon's reflection on the ocean just outside my doorstep, is the only way to really, truly, and humbly live in the present and understand that everything is transient- nothing is ever permanent."

Double Rainbow outside the Library

Kids coloring at the clinic while they waited

My neighbor's dog snoozing on the patio.

Thanksgiving Day

Pancakes.

Pancakes. What kind of image does that word inspire? What other words come to mind to describe them? I imagine for most people such things as salivation, anticipation, excitement, and if you’re an adult, a sense of childhood. For us, here, at Ross; however, that word has forever been tainted by a speech delivered during orientation. In fact, it made such an impact that using a graphic of pancakes was an option we voted on for our class shirts. Context: imagine each day is a pancake. Each day you receive at least four hours of more information. Each day you are expected to understand and master that day’s material before moving onto tomorrow. If you fall behind, the next day you now have not only that day’s pancake, but also the pancake from the day before. Now, you get two days behind and you have three pancakes. You get the idea, I’m sure. Let’s just say I have about five pancakes sitting on my plate right now, and feel a bit overwhelmed. Do we have an exam coming up? Nope, not for four weeks, so I’ve got time, right? Well, technically, yes, but within those four weeks lies both the majority of my grade for the semester, as well as the busiest days we've had thus far. Additionally, every upper semester student I have spoken with has one piece of advice for the fourth mini exam of the semester: “Don’t get behind.” Let’s just say I’m keeping the faith, but at times, barely hanging on. Then again, what would medical school be without that feeling of constantly being on the brink of losing your mind, at least to a certain extent? It’s a feeling I’ve quickly grown accustomed to, and now embrace, especially knowing I'm not completely alone.

This topic of pancakes; however, leads me to a conversation I had with a friend of mine earlier this week. She and I have established a weekly “lunch date” during which we meet, if even for 15 minutes, to get out of our respective study spaces and have a human conversation. One thing that came up in our discussion this week was what to tell our friends and family regarding what the day to day activities consist of. I mean, here I am in Dominica, 3000 miles away from the place I’ve called home for 25 years, so my life must be pretty exotic- I must be going on great adventures to see the island and meeting local community members, right? Actually, not at all. Outside of my walk to and from campus each day, and the regular stop at the shacks for food and local juice, I don't have a whole lot of time to get out. Now, in my mind, writing about this and telling you all that I sit in a classroom all day staring at a computer screen is completely boring. Where’s the excitement and imagination in that? She; however, had a different take on it. That IS exciting. The whole reason I started this blog was to keep you up to date with the goings on in my life, so laying out my day to day is something that I should include, right? I think so. Thus far, you’ve gotten a pretty good insight into how I’ve been feeling and what various experiences have taught me, but I haven’t said much about what I actually DO. So, with my cup of Yogi tea and Billy Joel Spotify playlist, here I am.

First of all, days of the week? They don’t exist. There are now either “days that we have class” or “days that we don’t.” I can’t count on one hand the number of times I have been completely unaware of which day of the week it is, and have answered people’s questions with the incorrect day. Luckily, most of us are in the same boat, and we all find it incredibly funny. Humerus, if you will. Secondly, weekends simply serve as days to catch up on everything we didn’t get through during the week, review material from the previous week, and begin to answer some of the many practice questions in attempts to drill the content further into our brains for recall throughout our future careers. For me thus far in the semester, Saturdays have been defined by my getting up in the morning, packing my backpack for the day, grabbing a quick breakfast on the way to campus, staking out a table in the LLL, pulling up GopherSports.com on my computer, and simultaneously tracking whatever Gopher Football game is going on and checking items off my to- do list. Granted, it’s not ideal, but it’s my new normal. My beers and La Loma chicken burrito have since been replaced by water, coffee and an abundance of citrus fruits, and the immediate company of fellow Gopher fans has been replaced by text message conversations, twitter exchanges, and sometimes brief FaceTime meetings with the best Gopher fans I could ever ask for- former college roommates and family. 

Typically during the week, lectures are delivered from 8am to Noon, and the remainder of the day is made up of preparing “study products,” reviewing whatever material we received, and going into the anatomy lab for dissection or simply to study. Studying is my job. “How do you stay sane?” you may ask. Well, that depends. Depends on what exactly is driving me insane, how far behind I am in subject matter, and what I feel is needed to decompress. In many cases, due to time constraints and other responsibilities, a fifteen- minute break to take a walk down to the ocean or watch the sunset does the trick. On Thursday and Friday afternoons, there is often an intramural football game played just outside of my “home” at which you will most likely find myself and a close friend. We chit- chat about things not related to school, and at the applicable games, support our “firstie” colleagues as they face their opponents. Other times, a social life is necessitated, and a few of us head to one of the four bars near campus, grab a couple beers, and just decompress. And, on those days that it all seems completely insane and I begin to believe it may be impossible, taking a personal day to stay home, paint my fingernails, watch a movie or read a book, momentarily forgetting the main responsibilities awaiting is exactly what I need to recharge and begin to put one foot in front of the other again.

Of course, me being myself, simply being a student without being involved in organizations and campus life is nearly impossible. Therefore, at the beginning of the semester, I decided to become a member of the Pediatrics Student Association and the Ross Emergency Medicine Association (REMA), two of the specialties I am most interested in entering once I graduate from medical school. Despite my apprehensions of being “too busy,” I applied to an open executive position within the Pediatrics Association to serve as an Assistant Clinic Coordinator. This basically means I help sort out all of the details for one of two clinics run throughout the semester at an elementary school in the community. My clinic is in a week, and yesterday morning I got a taste of what to expect next Saturday. Myself and about twenty- five other Ross students traveled 45 minutes south of campus to the capital city of Roseau to an elementary school where roughly 500 students arrived with their parents. They were mandated by their principle to go through a fundamental health screening and receive a basic lesson in public health with topics such as the importance of brushing one's teeth and staying active. We, as medical students, were responsible for collecting such information as their height, weight, visual acuity, blood pressure, pulse, hearing, and an overall general survey of their health. It was amazing. I spent three hours taking blood pressure with what we began to fondly refer to as our “arm hugger,” and taking pulses of kids anywhere from one year old to sixteen years old. It was better than any “practice session” I could have done on campus, and I can’t wait to do it again. There are honestly so many things about this clinic that I would love to talk about, and yet neither know exactly where to start, nor have the time right now to lay it all out. Maybe after my clinic next Saturday. Aside from that, though, despite it being school related, this clinic was my break. I returned to campus and hit the ground running to try to tackle the endless mound of pancakes awaiting my return with a newfound sense of enthusiasm and level of energy.

Now, despite me feeling like I have an incredibly long list of topics in addition to the clinic that I want to talk about, and again, not knowing exactly where to start, I must leave you with a “to be continued…”

In the meantime, I have some pictures to share of the school where we held our clinic, as well as an example of signs made by students at the prep school on campus (children of students attending Ross) that were placed throughout campus and have been incredibly inspiring for me over the last week.

As always, with love.

One of several signs made by the students at the prep school

Classroom where we held our BP/ Pulse/ Cardio/ Respiratory station
for the clinic.

3/4 of your BP and Pulse team! 

Music and Medicine

It’s been longer than I would like it to have been since I was last able to sit down and just write, but as is expected, school has come first over the last few weeks. Now; however, I’m allowing myself a few free moments to touch base with reality, remind myself why I decided to start this blog, and move 3000 miles away from home to start this crazy adventure. So, welcome back. :)

Over the weekend, I was studying for our most recent anatomy practical exam, and started thinking about how music influences our lives. As I looked over the anatomy of the abdomen, Spotify began playing “Everything I Want” by Matthew Puckett. Don’t worry, I don’t expect you to know anything about this song or its existence. If you were to sit down and just listen to the song, the lyrics are clearly directed from the singer to another person regarding their presence and the fact that having him or her in their life is worth fighting for. At one point, the lyrics state, “You’re everything that I want I’ll never give up, been through this before, and it can get rough, you can push me away, I can deal with the pain, I need you to know, you’re everything that I want… Friday nights, Sunday mornings, simple days, funny stories.” Clearly, this is about a relationship. The relationship I’m speaking about; however, is with medicine. You see, for me, anytime I hear this song, I am immediately taken to the summer between my sophomore and junior years of college living in Minneapolis with three of my best friends. That summer, abc released a show called “Boston Med,” for which “Everything I Want” was the theme song. Throughout the summer, 8 episodes aired every Thursday, and by God I didn’t miss an episode. Just ask my roommates. That entire summer, I would sit down on my couch and for an hour was transported into the future to see where I wanted to be. To know that Friday nights and Sunday mornings would likely be spent at the hospital or on call. That there would be painful times, and that I would probably want to quit at least once, but in spite of that, a passion for all of it still existed in my soul. It drove me every day to keep going, to work through the frustrations, the awkward phases of growing into an adult, the friendships and relationships that would come and go, and continue moving forward. At that time, not only did I want to spend my life practicing medicine, I also desperately wanted to move to Boston. To this day, I hear that song, and imagine several very specific late nights studying Organic Chemistry, Anatomy, and Physiology in the Bio-medical Library in the basement of the Philips-Wangensteen building at the University of Minnesota. As I listened to the song on my walk home, the air was perfectly crisp and Fall-like, the lights on the Wells Fargo building downtown Minneapolis still hadn’t been extinguished for the night, and it was just my music and me. It still keeps me going.

This whole recollection occurred over the course of about three minutes, and after a conversation soon thereafter with a very dear friend of mine over Skype, started me thinking about the greater significance of music in our lives. How many times are you walking down the street (or driving in your car at home), a song plays on the radio, and suddenly it’s like you’re in a completely different place. Whether that place is literal or figurative, music has that transformative power. It can take you over 4000 miles away, or it can take you mere centimeters simply into your own thoughts and motivations. I can’t imagine what my life would be like without music. Whether I just need to unwind a bit and listen to a little One Direction, or I need to focus on studying and listen to jazz, it never ceases to accomplish exactly what it needs to. It can turn an overall great experience into an outstanding, unforgettable memory. It unites people from all different backgrounds in a common space with a common agenda. Although, I understand that my perspective may be a bit skewed because I come from a family in which emphasis was always placed on music, not in the sense of being the best performer, but on appreciating it for what it is- art and a universal language that everybody can understand, but I also think on some level, everybody can relate to the power of music. In one of our lectures a couple weeks ago, we discussed the importance of recognizing and appropriately handling patients who may come into our offices suffering from depression and suicidal tendencies. While we won’t all be in a position where we are responsible for explicitly handling their mental health, one of the coping strategies brought up was listening to music. Now, I don’t know all the science (yet) behind the way your brain reacts the way it does when you listen to music, but the fact is that it does. Whether you cognizantly appreciate it or not, it is nearly impossible to deny that music of any kind has that trans-formative power.

I know my writings have a tendency to shift more toward the philosophical than the concrete goings on of my life, but I have to say, much of my experience in Dominica so far has been philosophical and extremely insightful in terms of who I am and what kind of physician I want to be. Although I already knew most of the things I am learning I value (as one of my best friends pointed out to me a few days ago), moving in and out of situations and experiences over the last 11 weeks in Dominica have brought me face to face with them. They’ve shown me that I can try to minimize these ideas and values, making them seem less important, but at the end of day, it won’t take them away. Those values and priorities are still just as important as they were before. That although I will always look for the best in the people, and will continue to work toward treating everybody with respect, I never have to compromise what I hold valuable.

On one last note, I will leave you with something I wrote in a notebook about a month ago while I was in sequestration following my first anatomy practical exam. Mind you, we had also had our second written exam the day before, so I had spent an abnormally large amount of time to this point studying, and wanted to get a few ideas out on paper with regard to what I was going to write about here. “… as much as I was ready to pull my hair out and reached a point that my brain physically hurt, [studying] continued to show me how incredibly amazing the human body is. I was looking for a blank piece of paper in an old undergraduate Biochemistry notebook and realized that most of the notes I had taken were exactly the same as ones I’ve reviewed since last Wednesday. I felt like I had jumped into a time machine as I glanced at them and knew exactly where I had been when I took them. It makes me wonder what I’ll think or how I’ll feel in a few years when I look back on this blog and remember where I was and what life has taught me to this point. At one page in the notebook I digressed (as I often seem to do), and took what I estimate to be about one minute to comment on the amazing being and structure that is the human body. ‘Does something ever happen to you that makes you think it’s amazing to be alive? I’m sitting here studying Biochem, and I felt my heartbeat. It’s something so routine and mundane and yet so amazing. The processes that have to go 100% correctly in order for your heart to beat are incredible, and yet so easy to take for granted.’” As I read this, it makes me think of a verse in one of my favorite songs these days, "and the gift of my heartbeat sounds like a symphony," and how even without trying, music always finds a way into my life. 

And now, despite having said I would be done after that last "note," I have thought of one more thing. This past week, while hunkered down in a study space three of us have lovingly begun to refer to as “our home,” there was an ultrasound clinic for both the OB-GYN and Cardiology Clubs on campus to learn how to perform various types of ultrasound procedures. One of the volunteers for the demonstration happened to be pregnant, so we were able to observe as the physician explained how to perform an ultrasound. Let me just say, between all three of us at the table, we were absolutely speechless. I mean I’ve seen pictures of ultrasounds, and have even watched videos of them, but to be in the same room with a person who is only 12 weeks along in her pregnancy, and watch as a being just slightly larger than the size of a circus peanut moves around safely inside the walls of her abdomen is incredibly humbling. Each and everyday, we are all given incredible amounts of information, and more often than not feel extremely overwhelmed by what is being given to us, but when you have moments like this, the scope and significance of it all is brought completely back into perspective. So, today, do me a favor, and take some time to appreciate the juxtaposed simplicity and complexity of your heartbeat. It’s worth it, I promise.

Until next time, and for all my friends and family currently in Minnesota, I leave you with this and a lot of love.  

Diagnosing (Ashleigh) in Dominica

The last few weeks I've finished each of my posts worried that I wouldn't have anything "new" to write about for the next weekly installment of my blog. I mean how many times can I write about "embracing the environment I'm in," taking advantage of everything this opportunity has to offer, how my classes are going, what my friends are like, and the things I miss about home? Granted, all of those things are extremely important aspects of why I wanted to start this blog, but they can only be discussed so many times before they become repetitive. Up until this week, I'd reach my weekly "day to write," and somehow something just came to mind for me to write about. Whether it was a thought or revelation that I had, or a unique experience that had occurred, I had something. Yesterday arrived; however, and I honestly had nothing. Not that nothing had happened, but the majority of my time since last Thursday had been spent on campus in a space called the Large Learning Lab (LLL) with a few other classmates reviewing lectures, discussing questions we had come across, and really just focusing on our studies to ensure we continue to progress through the semester as well as we would like. I took a few breaks to watch a couple episodes of Grey's Anatomy and NY Med, exercise, and walk along the ocean, but for the most part it was a fairly uneventful span of days. Definitely nothing to write home about. I knew I wouldn't necessarily stick to a strict "every Monday" writing rule, but I was afraid that my not writing yesterday would turn into not writing for another week, which would turn into two weeks, three weeks, etc. I'm sure you catch my drift. Well, I think somebody, somewhere sensed this onset of fear, and decided to give me something to write about. Whether you want to look at it as fortunate or unfortunate is completely up to you, but I'm choosing to view it as both (as well as a bit ironic).

Last night I was in my "usual spot" in the LLL with one of my friends going over the Anatomy of the Anterior Abdomen lecture we had been given earlier in the day. We had just gotten back from a brief trip next door to the Pic 'n Go coffee shop, where they now know me by name, and greet me with "Hello, my dear," every time I enter, for our last jolt of java before they closed. As I moved my chair out to sit down and get back to work, I noticed that my right foot and ankle were significantly larger than my left due to what appeared to be inflammation. Now, at this point, let me just say, being "doctors in training," studying lecture material for the rest of the night was not going to happen. We had entered full-blown investigation mode.

Between the two of us, we began palpating different aspects of my foot to determine what the problem was. Ruling out possible infection due to a lack of heat radiating from either my foot or ankle, we moved on to investigating possible sprains, fractures, and other soft tissue or skeletal related problems. She went through the standard patient interview protocol that we learned a few weeks ago, and I recalled that throughout the 6-7 weeks we've been in class, my foot has been a little sore on both the bottom and top surfaces, but nothing that had caused significant discomfort or excess fluid build-up. I assumed it was a result of poor footwear, a weak plantar aponeuorosis (a fibrous tissue overlaying the bottom of my foot), and weak arches. I've always had minor problems with sore feet when I don't wear the right shoes. I didn't think anything else of it this time. As I continued to think back throughout the last 8 weeks of being "on island;" however, I remembered that the weekend before classes started I stepped in a muddy patch along the road leading to my apartment and fell. Since my foot was literally stuck in the mud, I ended up twisting slightly as I fell. Now we were on to something! She and I both continued searching for possible causes of "localized pain and tenderness along the dorsal (top) surface of my foot and oriented more laterally." Consulting WebMD as a "symptom checker," we ruled out several things, and finally reached something that aligned pretty well with my presentation. Lisfranc Fracture Dislocation. (The Lisfranc joint is another name for the junction between your tarsal and metatarsal bones, or the border between your midfoot and forefoot.) We were sure of it! Well, actually, knowing that we don't really know anything, we accepted the high probability that we were completely wrong. That being said, I continued to research it, and prepared myself to be in a non-weight bearing cast for 6 weeks followed by a supportive boot for an additional 6 weeks. I went to bed last night with my foot elevated and an ice pack wrapped around my foot/ ankle.

As soon as I could this morning, I went to the clinic on campus (although I still just wanted to "wait until I got home" to see my regular physician), and consulted the Dominican physician on staff. Based on my presentation and history, he wasn't exactly sure what it might be, and wanted to get further confirmation from x-ray. He placed a phone call to the Portsmouth Hospital to see if their x-ray machine was "up and running" today, filled out an order for the x-ray, I hopped into one of the Campus Security trucks, and arrived at the hospital about 10 minutes later. Knowing I would not be walking into the kind of hospital I am used to, I wasn't exactly sure what to expect. Honestly, I would equate it to a large clinic in the United States. One floor, each respective department pretty much running itself, and 30-40 patients sitting on benches just waiting. Signs encouraging early detection of HIV and diabetes lined the wall, and posters urging children and families to begin healthy teeth-brushing habits early were impossible to miss. We found the Radiology department (luckily I had the security guard with me) and knocked on the office door for the technician. He took the imaging order from my doctor and led me into the radiology room. 2 different views of my foot were taken. Ten minutes later both films were developed, I was assured "it's okay," and was on my way back to campus to follow up with the physician. He deemed it a soft-tissue injury, gave me medication for the fluid build-up and pain (basically a stronger version of Tylenol), encouraged me to wear sandals or "non-limiting" shoes so as not to place additional pressure on my foot with the fluid accumulation, and sent me on my way. Extremely different than the United States in terms of the details of my medical encounter; however, at the end of the day, incredibly similar.

Am I happy my foot isn't broken? Absolutely. On the other hand, I still really have no idea what's wrong, and the not knowing is driving me crazy. Guess I'll have to wait it out for eight more weeks, and follow-up with my MD at home. Who knows, maybe I'll never find out what the actual problem is/ was.

At the end of the day, our diagnosis was wrong, but it was a "real-life" opportunity for us to apply what we're learning in class, and we loved it.

Moral of the story: NEVER doubt that there will be something to write about.

Now, for your viewing pleasure, the bones of my right foot.   

Believe

“I am an idealist. I am an optimist. I am hopeful. I believe the best in people and situations.” These nineteen words were the first snippets of a document that I started early last week in an attempt to clear my ever- wandering mind as I prepared for exams early this week.

As of Tuesday afternoon I am about one third of the way through this first semester in medical school, and I must say, so far things are going quite well. I’ve made friends, I’m progressing and learning how best to approach the most important, academic, part of it, and have found ways to embrace the environment I’m in. Since arriving in Dominica, I think the span between my last post and this one is the longest yet; however, it feels like the shortest. Each time I’ve sat down to this point, it seems I’ve had a purpose- a specific topic or train of thought to carry out. In some ways, it even seems like they all run together and follow a common theme. Maybe that’s a good thing- maybe not; I’ll leave that for you to decide. What I do know is that for the last week and half, I’ve had a Microsoft Word document open on my desktop simply for collecting quotes and sayings I’ve come across, events that have happened, thoughts that have crossed my mind, ideas for what to call this next blog, and even (shamelessly) the results for an online “Which Disney Princess Are You?” quiz I completed while taking a much needed study break over the weekend. The result being Jasmine: “stubborn, energetic, and compassionate. You want to see the world and be allowed to make your own choices,” just in case you’re curious.

As I mentioned last week, writing is a great stress reliever for me. Unfortunately, I’m not one to sit down and write little bits at a time- it’s either all or nothing- hence why I’m taking this current period of insomnia to write. Therefore, I started the aforementioned Word document as a way to at least get some of the things swirling around in my brain out. What I did not necessarily expect; however, was the insight it provided with regard to where my brain tends to go when my studying mind begins to wander. Although it was a completely trivial and meaningless thing to do while I felt like my brain was going to physically burst, the results of said character “quiz” were actually quite accurate. Anybody who knows me in any way would probably also agree. Despite my best efforts to conform at times and “go with the flow,” I’ve always been one to “do it selfie.” Case in point, when I was barely in second grade, I packed my hardcover Webster’s Children’s Dictionary (roughly 500 pages, mind you) in my backpack for a family vacation because I wanted to be a “big kid” with my own backpack and my own books. Needless to say, despite my best efforts, I finally had to give it up and let my Dad carry it for me. If you asked me now, I’d give anything just to have that Esmeralda backpack filled with just a notebook. :) Don’t get me wrong, I’m not necessarily one to break the mold (or the rules, for that matter) just for the hell of it, but I also have never been one who settles for something because “everybody else is doing it,” or it’s the thing I’m supposed to be doing because “that’s where I’m at in life.”

Secondly, one of my favorite questions to ask people is, "If you were to win the lottery tomorrow, what would you do?" (Feel free to answer if you'd like). In asking this question, I feel like a lot can be learned in a relatively short amount of time about a person and the values he or she holds in highest regard. I honestly don't care how you would spend your money- whatever decisions you make are completely yours, and that's all I want to know. Who are you? What makes you answer this question the way that you do? What experiences have you had that helped shape your outlook and perspectives about life? I'm simply curious about people, and love to ask meaningful questions. For me, there are several things I would do, but traveling and “seeing the world” would be top on the list. Thanks in great part to my family, and the opportunities they provided my younger brother and me when we were growing up, a love and respect for traveling has been fostered in me for as long as I can remember. Granted, I know I’m not the only person who was fortunate enough to travel around the world as both a child and a young adult, but I also know that I never treated it as a right or something that I deserved. Honestly, some of the best memories I have of traveling as a kid involve NOT making it on a flight. Every single time we traveled, it was an adventure. Whether I sat by myself or talked my Dad’s ear off for the entire Trans- Atlantic flight, I appreciated every single minute of it. I believe it is from these experiences, and the attitude that all four of us had toward every single chance we were given to learn about a new place, that my desire to explore and see different cultures, meet new people, and embrace other societies stems. Do I have great stories about all the places we visited? I could probably talk your ear off. On the contrary, do I have stories that might make somebody else never want to travel again? Honestly, probably more than not. That being said, I STILL would probably chose to fly on a pass over buying a guaranteed ticket.

Along that same vein, one of my favorite places to go when I need time and space to myself in Minneapolis is a parking lot in front of the airport. Without a clue as to where the planes are going or who is on them, the entirety of the experience from the smell of aviation fuel to the powerful, yet humbling, roar of the engines, is soothing. At one point, I thought I wanted to be an airline pilot. Up until I was twelve, the airport was my second home, and to this day, there are very few places that I feel more comfortable in than airports. I know it may sound strange, but it doesn’t matter where in the world I am, being in an airport feels like home. What I began to realize; however, is that becoming a pilot might take away that feeling. Instead of the simultaneous thrill and comfort I felt while being surrounded by airplanes and endless possibilities of where to go and what to see, it struck me that those choices of what to do and who to see would already be made for me. I was afraid it would become a chore, and realized that the freedom that comes with closing my eyes and sensing, feeling those precious, fleeting moments of contact with the ground between when the nose gear and the main gear, respectively, leave the runway, is something too intrinsic for me to place in somebody else's control.

Who knows what the culmination of my various interests will be down the road, but for right now, I’m choosing to return to those nineteen words that I wrote last week, and believe that they will hold true no matter where the future takes me.

The Power of Words

If I’m being perfectly honest, I am writing this right now for several reasons, one of which is to distract myself from the amount of stress I currently feel. Our next exam is a week from today followed by an Anatomy Lab Practical on Tuesday, and despite knowing that I walked myself into this situation fully understanding that my limits would be stretched in every single way possible, this knowledge doesn’t take away from the pressure and weight I feel at this moment. If there is one thing this blog has shown me over the last several months, it is that writing always makes me feel better. Ergo, here I sit with a fresh cup of coffee and a cup of Chicken Wild Rice Soup.

In thinking back upon the first 25 years of my life, it had never really crossed my mind to question or evaluate how I best coped with stress. Somehow, on a level that I didn’t even understand, I just knew how and I did it. While looking through files on my computer over the last few weeks, it struck me how many times I had taken 15, 20, 30 minutes when I was stressed to just sit down and write. Write about the weather. Write about my classes. Write about relationships, buildings, experiences, anything. I just wrote. More often than not, whatever it was that I would end up penning (or typing) had absolutely nothing to do with where I started. It would generally start on one topic, and end in a completely unrelated realm of my life. As I was taking a study break earlier this afternoon, I stumbled upon the blog of one of the most eloquent, mature, beautiful (inside and out), and truly genuine young women I have ever met; my brother’s girlfriend, Jackie. Six and half years ago they started dating, and I never imagined that she’d still be around. Wait, don’t take that the wrong way. By that I mean, he was seventeen and she was sixteen, and I don’t know about you, but thinking back to when I was sixteen? I could barely decide on what shirt I wanted to wear to school, let alone think about starting to date somebody who would be around for what would turn out to be: two more years of high school, eight combined years of college, a parents’ divorce, several study abroad and internship experiences, and, most recently, emergence into the “real world.” To me, they are both amazing, and despite our ups and downs, she is the sister I never had.

As I was reading through some of her posts, it struck me how completely raw they were. Not in the sense that I felt like I was reading something I shouldn’t be, but in the simple fact that they relate completely to the human experience. To things that so many people are afraid to talk about or simply experience because of social, cultural, familial, educational (whatever else you may call it) norms and expectations. How did we get here? How did we reach a point where talking about our highest highs and conversely our lowest lows is not only undervalued, but discouraged? Shouldn’t we be open to facing those human experiences together? Words, whether their usage (or lack thereof) is well thought out beforehand or not, have an immense power that I believe has become underutilized and in some cases abused. In one of her posts, she says, “If I had one wish, it would be that people embraced with aliveness and with reverence the power and sacredness of words and wordlessness.” In reflecting on this, not only in how I experience my personal friendships and relationships, but also how it impacts me professionally, I am brought to a lecture we had a couple weeks ago about the importance of the patient interview and how we go about obtaining a patient’s history. So much of the measure of success in this experience is the way in which we, as physicians, use our words, and subsequently how we interpret and accept the words (or wordlessness) of our patients. As we were told in this lecture, 85% of the information we need to make a diagnosis when a patient enters our office is obtained during the patient history. Why wouldn’t we use this tool to the utmost extent to ensure we are giving our patients the best care and experience they could possibly have?

On that note, I now digress to where my mind was upon beginning this post. In looking back over the last few weeks, my posts have mostly been written on Mondays, so today being Monday, I began thinking this morning about what I wanted to write. In what became a failed attempt at straying away from an introspective, philosophical post, I began thinking about rain. As I was falling asleep last night, raindrops the size of skittles (yes, I just referenced Skittles, and perhaps their ad slogan “Taste the Rainbow” came to mind as I wrote it) began slowly tapping my window. Now, I don’t know about you, but the sound of rain on my window is one of the most relaxing, peaceful sounds that I can think of. Maybe it has more to do with growing up in Minnesota and getting cozy in a full armchair on a rainy (or snowy) day with a book and a wonderful cup of tea, but the crisp and refreshing smell of rain on what is normally a hot and sticky island was extremely welcome. When I woke up this morning, the rain was still falling. At that point; however, instead of thinking about how peaceful it was, I began thinking about having to walk to school in it. Remembering how three weeks ago I had left my apartment equipped with my umbrella “just in case” only to arrive 10 minutes later on campus with the bottom half of my pants dripping with water, and the notes in my backpack running ink, I was not excited to even think about experiencing that again. I was determined it wasn’t going to happen. Not this time.  Not today. I loaded my backpack, wrapped it in the waterproof cover that I bought, grabbed my rain jacket and umbrella, and set out for class. As I walked out onto my balcony expecting to be hit with a wave of humidity, I was instead faced with a refreshing breeze, and again, that peaceful, soothing sound of rain. Not wanting to lose this moment, I pulled out my phone and took a couple pictures. Granted, the Caribbean is not visible when it rains, but I realized how incredibly beautiful this place can be, even when it’s raining. 

Last Friday I received an email from the postal department alerting me that I had a package to pick up between 10am and 1pm today while the customs office was open. Along with at least 10 other people, I wandered over to the office this morning to pick up my first big piece of mail since arriving on the island. I knew it was coming, but it still didn’t take away from the excitement I had to be receiving something from home. When I approached the window to obtain my "package slip," I was surprised to find out that I had also received two additional pieces of mail! One from an old friend in Minneapolis, and another from my Grandparents. As it had when I walked outside my apartment to venture onto campus earlier this morning, it struck me how the littlest things can often make the biggest difference.

With that, I now must return to studying, and will leave you with a couple pictures of my first “care package,” as well as some of the “decorating” I did this past weekend in my apartment to keep the inspiration and motivation flowing.  

Note: Mug did not arrive with coffee (although I wish it had)

Until next time and with love,

Ashleigh  

The Dream, The Process, and The Outcome

Have you ever woken up one morning and just felt different, or made an executive decision that today was going to be different? That feeling accompanied me this morning…once I made the decision to allow it in. What I have come to find on this island, is that fighting against any of the experiences you have is extremely detrimental. Yes, we’re going to be homesick. Yes, we are going to wish for things that we have at home but can’t get here. Yes, we are going to miss our family, our friends, our significant others, and our pets who remain in a location and an environment that we’re comfortable in, but we cannot let the fact that we miss those things keep us from living our lives to the largest extent possible while we’re here. I know I’ve expressed that already, but it hasn’t really sunk in until now. Over the last couple weeks, I’ve come to terms with where I’m at, and made an executive decision this morning to work toward embracing an attitude that “everything works out in the end.” Anything that I felt tied to at home in the US will either be there when I’m done here in Dominica, or it will no longer be needed for me to continue moving forward with my life. As is said in one of my favorite movies (if you’ve never seen it, watch it!), The Best Exotic Marigold Hotel, “Everything will be alright in the end...if it’s not alright, it’s not yet the end.” I do not consider myself to be a very religious person; however, I do believe that there is something bigger. Something that gives life meaning, and serves as a reminder that we are not completely in control of what happens in our lives. As a “scientist,” it is sometimes difficult to accept the idea of a higher power, but there are so many things that no matter how well we plan, decisions and choices have to be made based on what life offers. Do I think we’re completely at the mercy of life? No, I do not. I do; however, think that there are experiences we each need to have, and that these experiences get worked into the decisions we make for our lives. In order to fully appreciate and learn from these experiences, we need to learn how to detach our decisions and happiness from specific outcomes. For example, when I was applying to medical school a year ago, the thought that I would be in medical school in Dominica was the furthest thing from my mind. I submitted my applications early, in July, to various schools throughout the United States in an attempt to give myself the best chance possible of getting into one of the programs as medical school admissions are completed on a rolling basis. Slowly, I began receiving the much dreaded “I’m sorry, but we cannot offer you a spot in the Class of 2018” letters. After receiving the first rejection, I began to feel discouraged about the future of my career. I wasn’t “good enough.” So much of my life had been spent dreaming, planning, and preparing for the day I became a physician. To think that this dream may not come true was devastating. That night, I received an email from the admissions department at Ross University inviting me to apply for the Fall 2014 semester. All the sudden my perspective completely changed. Any ideas that I had about not staying in the United States for medical school, and what that might mean for my future took a complete turn. I began researching Ross, and having formerly worked with a current student, reached out to him for opinions and perspective. No stone was left unturned in my research, and I finally decided that submitting my application could only help increase my chances of pursuing my long-lived goal. It was December 2, 2013. At this point, I knew the likelihood of getting accepted for the following year was low, but when I submitted that application, something about it just felt right. Most of the other people I knew applying for school were already accepted or at least interviewing, and here I was just starting another application. Needless to say, I was invited to interview on January 6, 2014, and received my acceptance less than four weeks later. Elation, gratefulness, disbelief, and shock do not even begin to sum up how I felt. Since that moment, I have continued to feel those emotions, but I have also felt fear. Fear of the unknown. Fear of failure. Fear of losing or missing out on things because I wouldn't be living in the United States. That being said, I have received quite a bit of motivation and pep over the last few days, and wholeheartedly believe that had I not received those unfortunate letters from the other schools I had applied to, I wouldn’t be here, nor would I be having the unique experience I am having.

I decided long ago that I was going to be a physician. Thinking about my future and where I will be, I can’t see myself in a particular place, but I cannot envision myself being anything other than Ashleigh Burt, MD. A few months ago in this blog, I said, “In the long run, what's two years?,” with regard to the time I would be in Dominica. I was right. In thinking about the grand scheme of life (assuming and hoping that my life is not even close to being complete), what is two years? I now know; however, that when placed in a situation or environment that removes you from anything and everything you’ve ever sought for comfort or stability, time has a completely different meaning. In thinking about the last five weeks, it seems like it was a decade ago that I arrived in Dominica and began my new life, but at the same time, it feels like just yesterday. When considering how much material I have learned over the course of three weeks, I feel like I should already be preparing for finals, and yet, it’s only been three weeks. The idea of having twelve more weeks of material to learn in order to continue into my second semester of medical school is extremely daunting, and it’s easy to get caught up in feelings of defeat or being overwhelmed. Within those overwhelming moments, though, are opportunities to do things like sit down for hours and dissect the nerves, arteries, veins, muscles, tendons, and bones of the human body. The euphoria and contentedness that I get when I’m doing THAT trumps anything else. This is what I’m meant to be doing, and I’m slowly learning why Dominica is the place I am meant to be learning how.

Finding Oneself

As of about 5 hours ago, the first exam of my medical career is complete. How did it go, you may ask? To be perfectly honest, I think it went quite well. At this point I'm not sure if that sentiment has more to do with the elation I feel simply having completed my first medical exam, or if it actually correlates to the accuracy with which I responded to their questions. Based on past experience, I think a combination of both. Either way, I'm done, and that feels amazing. Having essentially sequestered myself in classrooms, the library, group study spaces, my apartment, and the apartments of my colleagues over the last few days, a sense of freedom, even if for a few short hours, is extremely welcome.

Over the last few days whilst pouring information into my brain hoping it sticks, I've had a couple thoughts upon which I have wanted to reflect. Of course, in attempts to keep my priorities straight, I did not take the time to document them; however, now I am thrilled to have the chance to delve into them. The first observation I've made is related to the position and field of work I was in prior to matriculating at Ross. Working in a Genotoxicology lab testing medical devices, I knew there would be crossover between what I had been doing in the lab and my future career in medicine. I did not; however, expect the crossover to occur so quickly nor to have any profound impact on me. Last week while completing the required task of defining the brachial plexus in my first "patient," I overheard one of my colleagues say something about a pacemaker. Having tested several types of pacemakers during my time in the lab, I approached this group simply to look at the device. Obviously I knew that my work had a broader impact than just simply what I was doing on a day to day basis, but to actually see the potential outcome from the small part I had to play in the overall process was surreal, and even a bit overwhelming. Granted, I know I didn't do anything with THAT pacemaker, but I did have a part of play in how it got from the manufacturer to the patient. Secondly, as I had my nose buried in notes and lectures over the last few days, I came across a table of drugs used to treat various types of conditions affecting how a cell's internal structure in maintained and how its components are transported within the cell. In and of itself, this chart is interesting but nothing different than other tables of drugs I've seen in the past. This particular chart; however, listed a component required as a positive control for one of the main tests we ran in my former lab. Again, I knew there were clinical applications to everything we did, but to now see it in a completely different context was mind blowing. As much as I know it was time for me to move on and begin the next phase in my life, being able to see how important my work was in the overall scheme of medicine makes me extremely grateful for the opportunity I had to work in that lab. For some who may read this, I know how much I might have vented about various events or circumstances that came up over the last three years related to my job, and maybe even how excited I was to move on, but at the end of the day, having the experience I had taught me a lot of things. Without those experiences, I wouldn't be here today, nor would I have any idea how incredibly fascinating or biologically/ medically relevant chemicals like cyclophosphamide, methotrexate, and colcemid actually are.

The second thought I've wanted to reflect upon is related to "finding oneself." Throughout the course of our orientation and even the white coat ceremony last Friday, multiple people emphasized the importance of figuring out who we are while we're here in medical school. Clearly, we all understood the importance of making sure the reasons we are here align with our personal values, goals, and "identities," but I did not fully understand the significance of this until about halfway through last week. You see, starting about a week ago, I started to experience my first pings of homesickness. The first inklings of wanting to be with the people I love and not needing to coordinate our schedules in order to do so. Was it because of something that happened here in Dominica? Absolutely not. I still love where I live (although, I might do well with just a little less rain), and have really found some amazing friends who always seem to be on the same page as I am in nearly every situation we encounter. Honestly, I think the fact that I DO still love it here is exactly what made me homesick. I want the opportunity to share the experience I'm having with my friends, with my family, even with my dog. Talking via Skype, Viber, FaceTime, etc. is fantastic for keeping in touch with people, and I am incredibly grateful for those resources, but there is absolutely nothing that can compare to being in the same place with somebody and directly being able to share the ups, downs, and in-betweens as you go. For the first time this last week, my life had reached an equilibrium where it was "normal." The honeymoon phase of being on the island had really worn off, my schedule at school had become a routine, and I wanted to be in that normalcy with the people who know me most. One of the greatest gifts I received prior to leaving for school was a set of pre-written out greeting cards for various moments while I'm in Dominica. Last Sunday when those first feelings of homesickness started to hit, I pulled out the first card for "When you feel homesick." Appropriate, right? :) Although it didn't completely dispell my feelings, it made a world of difference. As some of you know, my favorite Disney character is Piglet from Winnie the Pooh, and contained within this card was a quote from Winnie the Pooh. "'I wonder what Piglet is doing,' thought Pooh, 'I wish I were there to be doing it too.'" Being away from home, it's easy to get caught up in what's going on in your own world, and know on some level that the people you left behind still think about you and care, but reading this card reminded me that most of these people deeply care and genuinely want to be here with me too. It really reassured me that, despite knowing I am capable of becoming the best physician I want to be, I also have people who will be there when the going gets tough and I just need a shoulder to rest on for a moment. In thinking about "finding myself" over the last four weeks (yes, it has already been four weeks!) this past week has shown me how much I value the people in my life. Honestly, do I miss Minneapolis? Of course. There are things about the city of Minneapolis, and the state of Minnesota, in general (Fall, changing seasons, sledding, theater and culture, state parks, etc.), that I can only find there, but the real thing that I miss are the people that I am able to enjoy those things with.

That being said, to anybody who has had any role in my life up to this point, know that I appreciate you, and that I miss you.  

Until next time,
Ashleigh 

The White Coat

This afternoon ceremoniously marked my entrance into the medical profession. The white coat was placed by current RUSM physician faculty members onto each student's shoulders. The actual "Donning of the Coats" only required a small portion of the ceremony's total duration; however, as much as I would have liked this portion to be completed in a more individual fashion for each student, I think it served as a symbol of the type of profession we are entering; One that cannot function without an entire team of people working together to defeat tough enemies. Instead of putting each one of us on a pedestal to receive our coats, we did it together- as a team. Throughout the course of the ceremony, various keynote speakers talked about what it means to be a doctor. Each one of these speeches was fantastic, but the one that really stood out to me was related to the connection between our white coats and who we are as physicians.

Now, I want you to take a couple minutes to think about what a physician's white coat symbolizes. 

What kind of images does it evoke? What kind of emotions? Memories? Ideas? Expectations?

This question was posed a few hours ago by a RUSM faculty member to myself and my fellow MDs in training. She followed the question up with single words that describe what our white coats will become over the course of the next four years. In some cases, the words used to describe our white coats related to how the public and our patients will perceive us. Such things as: "knowledgeable," "role-model," "moral," "trustworthy," "intimidating" (ie. in Pediatrics, some children are afraid of the white coat and what it means for what they will have to go through), etc. In other cases, it literally related to the different purposes our coats will serve while we wear them. "Handkerchief;" patients sometimes need that shoulder to cry on, and we will have to be that for them. "Pillow;" there WILL be times that we will fall asleep with our white coat crumpled and used as a makeshift pillow. "An indication that we need to do laundry;" the sleeves are dirty and the lapel is wrinkled (so much for the classic "whenever I run out of underwear" rule :) ). "An extra layer;" clinical rotations in the Upper Midwest in the middle of January, anyone? At the end of the day, though, in spite of all these words and mental pictures, our white coat symbolizes our entrance into an elite and respected group of professionals. When we wear this coat, we are no longer just people walking down the street. There is an expectation, a standard universally understood, that we, as physicians, will be all of those things listed above.....and more. I, personally, heed this responsibility with immense gratitude and appreciation, and know that I will never have to do it alone. Am I going to be perfect? Absolutely not (who is?), but the challenge to constantly be better, to seek improvement every single day with every single patient case I have, is one that I could not be more thrilled to tackle. I read a quote after the ceremony that goes as follows:

"We can't help everyone, but everyone can help someone." - Ronald Reagan  

Upon reading this, I immediately applied it to the medical profession. We all are here because we want to help people, but so often we forget that there are going to be times when we won't be able to help someone as much as we want. That reality will not be an easy one to digest- especially the first few times- however, knowing that I have colleagues who will still support me, or who might be able to help someone in a way that I am unable, is incredible.

Although I know teamwork will be a critical piece in the future success of my career as a physician, I have learned over the last 5 days that the teamwork starts as soon as you start medical school. Never in my life have I experienced the sensation of consistently running as fast as I can on a treadmill and still not being able to keep up. The lecture contents are dense and the time that the student has to master the material is significantly less than any educational program I have been a part of. That being said, I wouldn't have it any other way. Am I tired and want a nap? Yes'siree. Are there times when I just want to sit down and watch a movie? Absolutely. What keeps me from doing those things; however, is knowing what awaits at the end of the seemingly endless tunnel of coursework. Experiences and interactions that I have with faculty and upper semester students only works to solidify what I already know- that being a doctor is what I am supposed to do. Additionally, at the end of the day, I actually love what I am learning. Being able to personally dissect the human body is incredible. After my first lab on Tuesday, I was on cloud 9. Learning about muscles, bones, ligaments, blood vessels, nerves, etc in lecture and from a textbook is one thing, but to actually SEE it, is completely different. By the time I return home to friends and family in December, I'm not sure how my brain will be able to process the idea of having free-time, but I won't worry about that just yet. 

In the words of Jimmy Dugan from A League of Their Own, "It's supposed to be hard. If it wasn't hard, everyone would do it. The hard.....is what makes it great."  

Until next time, 

Ashleigh