Midnight Musings

Where to begin?! I honestly don’t know. That being said, please forgive me if this gets a bit lengthy.

I guess, to start, I’ve officially been back in Dominica for 8 days, and can confidently say I feel completely at home. Although I felt at home here before I left for break, I didn’t realize HOW MUCH this has actually become my home until I left and came back. Not only in the sense that I am used to its quirks and individual characteristics, but in the sense that I walk into my apartment and feel completely comfortable. The fact that I know walking down the street exactly what to expect. I know that I can go out on my front walkway and see the Caribbean. That the people in my study home know who I am, and I them. So many things that I’ve never really thought about, and yet, now being back and seeing the new first semester students adjust to life on the island realize are incredibly significant. I cannot tell you how comforting and refreshing that feels. As I made my way back from the below zero lands of Minnesota, it was a completely different sentiment than my departure in August. Not only did I know what I was going back to, I was looking forward to being back. Upon my arrival, I was fortunate enough to have my landlord’s brother pick me up from the airport and take me back to my apartment (with all my luggage this time!!!). It was that moment, as he and I made our way through the twists and turns of the roadway from the airport to Picard, where I reside, that I was overcome with a sense of respect, familiarity, and fondness for the landscapes we passed through. I know I’ve experienced similar feelings throughout my various experiences in Minneapolis, but for the first time, nobody else (except for the thousands of students who attended Ross before me) that I knew from Minneapolis had driven that road. Nobody from home knows how it feels to honk around corners to alert oncoming traffic that you’re coming. The first time I encountered that route in August, it was all so new and so incredibly fresh, but this time it was warm and comforting. For the 45- minute drive, he and I chatted about break, the holidays, and the upcoming semester. Unbeknownst to me, we were going to pick up his sister, drop him off at home, and pick up her kids on the way to my apartment. Despite the 15 minutes added to my trip back home, it was an indescribable experience for me. I know it may sound strange, but it made me feel even more at home. I no longer felt like a tourist who takes a taxi or bus directly to the safest place, I was a part of the community. I was a part of the daily routine of somebody in Dominica. Like I said, it was indescribable. I felt completely welcome, and a part of the Dominican community.

As a recap of my break in the US- it was wonderful, refreshing, completely lovely, and just what I needed. I had many opportunities to catch up with and reminisce with friends and family, and I got just enough taste of the MN winter to last me until next winter. Christmas with family was incredibly comforting and familiar, and showed me even more how much I value people and my relationships with them. That being said, over break, I had a wonderful weekend in Iowa visiting one of my best friends. The first wonderful part of this jaunt was my ability to drive a car again. It reminded me how much I genuinely love being in a car all by myself for hours- just driving. It really doesn’t matter to where, but the simple act of driving- appreciating the landscape wherever you are, listing to whatever music you want, and going wherever you want to go. Pure freedom. The second wonderful part was the conversation I had throughout the weekend with her. Since we met the first night of spat camp in 2007, completely new and innocent to the UMMB experience, we have always been able to just sit and talk. During one particular conversation over the weekend, we discussed the aforementioned topic- people, relationships, and family. She posed the question: “Can you be a family person even if you don’t live in the same city or state as the rest of your family?” We both agreed that yes, you can. I’m not saying that somebody who believes you cannot is wrong, but I also know from my personal experience, that I value my friends and family more now that I live in a completely different part of the world than I ever have before. I talk to each of them just as much as I did while I lived in the same city, if not more, and I value their opinions and perspectives immensely. On the other hand, I also know that I know myself and trust myself more than I have in a long time. That, I believe, makes me even more of a family person than I was when we lived mere miles apart because I know how important they have been to my entire adventure here. Would I feel the same way if it were not for the incredible technological resources available to me in order to keep in touch with them all? Probably not. In fact, I know not. Just this past weekend, my younger brother proposed to his incredibly lovely girlfriend of seven years, and because of technology, I was able to be a part of it. Let me tell you, it was a perfect way to start the first week of second semester, and I cannot wait for them to officially start their lives together.

FaceTiming for my brother's proposal to this wonderful young lady
aka: my future sister-in-law

Now, onto the topic of why I’m here- school! We have finished the first week of second semester, and boy what a breath of fresh air. I’m definitely not going to sit here and say it’s easy, but relative to first semester, it’s a completely different pace and experience (so far). First, we no longer have anatomy lab, so the afternoons of Tuesday, Thursday, and Friday are much more available. Second, our classes are now and forever structured in blocks based on organ system. Instead of having 4-5 classes each day in subjects that are related but not cohesive, each of our lectures fits into the one (or several) before. Studying makes much more sense, and I feel myself getting much more excited about learning. Our first exam is composed of the first 3 weeks of material; which encompass the cardiovascular and respiratory systems. Throughout the rest of the semester we will study the renal, gastrointestinal, reproductive, endocrine, and neurological systems. Although we will not get into the specifics of diseases and abnormalities (pathologies) within each until next semester, things are actually starting to fit together and it’s amazing. The number of times over the last week that I’ve contacted friends and family in the US regarding specific questions I have about conditions because I now understand parts of what is going on can’t be counted on one hand. I love it.

Despite school being absolutely enthralling, my feeling completely at home with my friends, and the way my life is unfolding, I have to admit this past week has also been a bit of a roller coaster in terms of events. Unfortunately, it seems that the cold/ flu currently circulating throughout the US caught onto myself and many of my colleagues, causing several of us to be a bit ill. I was, unfortunately, sick over my break (even succumbing to pink eye, which I don’t think I’ve dealt with since elementary school), but received a 10- day prescription for amoxicillin and left the country on my merry way. Well, let’s just say I had forgotten how weakly my body responds to amoxicillin, and within 2 days of returning, the cough and congestion that plagued me while home had returned. I did not end up going into the clinic on campus due to a slight discrepant feeling I have between it and a clinic in the US, but I had received a precautionary antibiotic prescription before I moved in August, and have since started that. I now feel like a million bucks, but it was not exactly how I wanted to start the first week back. Ah, well, such is life. It could have definitely been much worse, and I know of several people who are still dealing with similar symptoms, and in some cases, even worse. I’m considering myself extremely lucky, and hope we can all get back on the right foot soon for a successful semester.

Now, not to be a Debbie Downer, but if I don’t document events both good and bad here, I will be doing this blog a disservice, so unfortunately, in addition to feeling under the weather, I had my first experience with not having running water in my apartment. Most local Dominicans will tell you that the “rainy season” is over, but I’ve come to realize that every month out of the year could really be counted as the rainy season. For 3 or so of the days in the last week, it rained for the most of the day, and it rained hard. I honestly don’t completely understand the way the water system works in each of the apartment buildings on the island, but I do know that for about a day and a half my apartment did not have any. Yes, I had received warnings from upper semester students that it happens, but there’s nothing you can really do until you’ve experienced it yourself. Was not being able to take a shower for a day the most pleasant thing? No. But, was it the worst thing that could have happened? Nope. It did; however, make me realize how much I still take for granted, and how much living here, although it is still a developing country, is really not that much different than being home. Yes, the details are different and there are little things that I miss, but I still have my own space, a roof over my head, wireless internet in my apartment, and a landlord who is extremely attentive and caring. She was out to our building at 11pm at one point during the week due to an unexplained power outage just in our building. How many other landlords in the US would do that? Honestly- none of the ones I had. Needless to say, I’m constantly learning to appreciate the little things.

In fact, those little things are the things that I missed most while home in MN. For example, I was walking tonight with a few friends and somebody mentioned star- gazing on the roof of an apartment building. All I could think was, “yes!” Toward the end of last semester, I made it a habit to go up onto my roof each night, no matter what time I got home, for at least 5 minutes to take in how humbling it is to simply stand under the black, enveloping sky lit by millions of little specks. Granted, the stars can be seen in Minneapolis, and I appreciate them there, but my ability to notice the difference in their ages based on how much they “twinkle,” is something I’ve become accustomed to here in Dominica. As I mentioned toward the end of last semester, it really keeps things in perspective and keeps me completely in the moment. Living in the past or future would completely prevent me from noticing those little things.

At this point, I don’t have any pictures from my time back on the island, but I will definitely work on improving that in the future. Secondly, in addition to the close group of friends I have made, I have had the privilege of encountering several other people on campus who appreciate reading this blog, and I honestly cannot thank them enough for their kind words, their willingness to keep going alongside me, and completely voluntarily telling other people about my blog. In fact, I was unbelievably humbled last weekend when I went out with a few friends and ran into a fellow classmate, Kenji, who was with his girlfriend. One of the first things he said after introducing the two of us, was how much he enjoyed this blog. Although we kept going with our conversation, I really do want each of you who read this to know how much I appreciate your support. I would honestly probably keep writing it even if I knew nobody read it, but the fact that you all do, means more to me than you’ll ever know. So, with that, I will leave you with an “until next time, and with lots of love.”

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.