Diagnosing in Dominica: Life in Color.

Again, I know it’s been forever, but as I near the end of what will be the only mid-semester break I’ll have while in Dominica, listening to One Republic’s “Life in Color,” I decided it might be an opportune time for an update. As I said, myself and my fellow 3^rd semester colleagues are coming to the end of our “spring break.” “Spring Break in med school?,” you may ask. Yes, and a much needed one at that. Now, did I get a break in previous semesters? No. That being said; however, 1^st and 2^nd semester workload and content have nothing on year 2 of med school. Despite the increased workload, I LOVE IT. Not in the same sense that I enjoyed 1^st and 2^nd, but in the sense that I actually want to sit down and study. Not only is it material that I have pretty much never seen, but it’s finally the application of all the foundation and basic sciences that we reviewed in the first year. The semester so far has been “Fundamentals 2,” which is the second go around for a lot of the topics we covered for the first part of 1^st semester last Fall. This time; however, we didn’t learn about what is “normal,” but instead, all of the things that can go wrong. Neoplasias, risk factors for cancer, bacterial and viral infections, and the list goes on. Now, when writing this list out it’s quite depressing. These are all the things that we never want to deal with, right? I mean, nobody wants to get sick. Nobody wakes up in the morning wishing for a stuffy nose and a cough. The fact; however, is that it does happen, so in those cases, I want to be able to fix it. And, finally being able to apply what I know is so incredibly rewarding and exciting. It doesn’t make it easy, but it makes it completely worth it. For the rest of the semester, we’ll hone in on specific organ systems and processes, starting tomorrow with the circulatory system and the cells it contains (ie. White and red blood cells). I’m quite intimidated by this block based on feedback I’ve received from students who have been here, done that, but I think I’m up for the challenge.

Secondly, for the first time, we have the opportunity to work with actual patients within the community and be real doctors. I had my first community clinic a week ago, and I can’t even begin to describe how wonderful it was. I was paired with another student from Ross, and we had one patient- a gentleman from the community who had come for a check-up. In the past, we would have been required to conduct the interview and the physical exam with a member of the faculty watching our every move. This time; however, we completed the entire process on our own. Yes, there was a faculty member present within the clinic to make sure we didn’t miss anything major, but the overall process was completely our own. Additionally, we have weekly standardized patient sessions on campus that require each of us to conduct a patient interview and focused physical exam twice throughout the semester. Despite each of these cases being “standardized,” meaning that a volunteer from the community acts from a script as a patient with a specific concern, they still give us a chance to really practice the skills we’ve learned. In the past, we have had these types of cases, but they were conducted in pairs and didn’t include the physical exam part. I won’t go so far as to say it’s been surprising, but in many ways, encouraging, to see how much of what we’ve been taught in clinical skills over the last 2 semesters has actually stuck. Obviously we were learning them all for a reason, but at the time it seemed so disjointed. You don’t think you’ll actually remember when to apply each part, and when to do a complete respiratory exam vs. the abbreviated version. All of the sudden, though, you’re just doing it and you’re not even sure where it’s coming from. If I had to describe it, I think I’d say it is very much intentional and second nature, while also being quite surreal. When I was placed in the role of “Dr.” for our standardized patient this week, I’ll admit I was quite nervous, but despite the slight quiver of trepidation that accompanied my words for the first few moments, I loved every minute of it.

Now, shifting gears completely, in all of our free time, 5 of my fellow students and I are getting SCUBA certified. We’ve had 2 confined water dives so far, and have 2 more total dives remaining. As I mentioned the last time I checked in with you all, I had done a “Discover Scuba” course while my dad was in town and fell in love. To this point in our training, we haven’t seen anything other than the sandy bottom of an area that’s about 10 feet deep; however, even that is incredible. I don’t know how many of you have been scuba diving, but when it finally hits you that you’re under water, just sitting, as fish swim by and the currents come and go with each wave, it’s amazing. Granted, I know I’m not the first person who has ever been scuba diving, but realizing that, with enough air in my tank and at the right depth, I can literally stay underwater and simply observe a whole different world for hours is amazingly humbling. When I went diving with my dad, he made a reference to icebergs, and I found it to be so accurate. On the surface (and even snorkeling), you get a sample of what life under water is like. The fish and the coral, the sand moving each time a wave comes into the shore, but once you get 45 feet below the surface? The world as you’ve always known it to be becomes tiny. You’re eyes are opened to a completely new existence and life, and you realize how small we are. You watch schools of 50 fish swim by, and it suddenly strikes you that the world doesn’t revolve around us. That, like I’ve mentioned with reference to the stars at night, there are so many other things in the world that rely on the existence of the earth. I’m not sure if we’ll be able to finish our certification this semester due to time constraints, but I do know that I will be certified when I leave the island, and I can’t wait to explore.

As strange as it may sound, I’ve found today that writing has been more difficult than it usually is. Normally, I don’t know where to begin because I have so much that I want to say. I’m not sure why, but I haven’t been able to really find a common theme or string to run with. Perhaps because I’ve had a week off not to really think about school, and actually relieve stress. Or, maybe because I haven’t done much other than school for the last 5 weeks to this point, and feel there is not much to tell you about. Who knows? What I do know; however, is that my eyes have been opened even further to where I’m headed, and I like the way it looks. My time in Dominica is more than half over, and as much as there are things I am going to miss, I also am becoming more and more ready to move back to the United States. Perhaps because I didn’t go home for our last break, and didn’t feel like I really was able to re-charge, but it feels very much like this semester is dragging. I know, come tomorrow with class starting again, things will pick up and I won’t even know what to do with a spare moment, subsequently looking at the calendar and realizing it’s time to go home and I will be ready to start my last semester in Dominica, but right now, it seems like an eternity. At the same time, I think about the fact that I’ve been in Dominica for almost a year, and it blows me away. Where has the time gone? I’ve had several conversations recently with both friends from back in the US and friends here about the concept of time. The realization that I base my perception of time passing on the seasons. Now, I realize that I fit right into the cliché of being from MN. All we talk about is the weather, right? Well, I now accept and fully embrace that, although I don’t want to JUST talk about the weather, it is something that defines how I go about experiencing my day to day existence. Did I miss the traffic and hassle that comes from driving in MN in the winter? Absolutely not. How about the below zero temperature that often accompanies that snow? Nah, not really. I did; however, miss the transition that occurs signaling the passage of a new month. The simple fact that seeing the leaves change color from a lush green to a crisp yellow or a fiery red means it’s time to put the shorts away and take out jeans and sweatshirts. Time to sit outside at night with the refreshingly crisp breeze and a blanket next to a bon fire. Similarly, how the sudden aroma of lilacs signals the end of those cold, winter months and the beginning of more bearable temperatures and much longer days. Here in Dominica, the length of the days remains the same, give or take 10-15 minutes. Yes, there is hurricane season bringing rain and more humidity, but it’s consistent. Temperatures fluctuate 10 degrees at the most. Rain comes whether it’s the “rainy season” or not. Palm trees maintain their long, green leaves year-round. Don’t get me wrong, it’s beautiful. Being able to look at the Caribbean Sea everyday is something that I will never take for granted. But, it’s also placed me in a time capsule of sorts, leading me to believe that it’s still only the beginning of 2015 when I was home where the snow signaled winter and the start of a new beginning. Knowing that the month of June is more than half over, yet feeling like the new year just began is a strange sentiment to express. Just like it’s imperative that a pilot maintain visualization of the horizon as a reference, I need the temporal, seasonal changes to orient with time passing. If I were to stay here in Dominica, I know that losing those seasonal changes would become the norm. That time would pick back up, and I would no longer feel as though I am stuck in a capsule. For now; however, I am left to try to take the day to day and accept that it is, in fact, June, and that time doesn’t actually stop. That life is continuing around the world despite me feeling as if it’s on pause and all I need to do is push “play” again to get back to normalcy. This IS normal, and it is, in fact, unique and beautiful. In many ways, it’s life in color- even if the color is a little different than what I have always considered to be “normal.”

With that, I will leave you with a few pictures from a brief stint in Barbados last weekend, and of course, lots of love.