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.   

Free drinks upon arrival.

Chocolate cake with chocolate ice cream and chocolate sauce. Need I say more?

Breakfast on the balcony.

EBV out on the town.

Paso a Paso

Can I start by saying I’m sorry for being quite remiss these last few months about keeping my blog up to date; however, I had reached a point where I really needed to re-evaluate my priorities and take a few things off my plate. Unfortunately this was one aspect that reached the chopping block. I am so happy to say, after two weeks of break, I’m ready to get back into writing and a new semester. And, yes, I did say it, a NEW semester! I successfully passed second semester, and am now officially a second year medical student. Honestly, the time has flown and part of me can’t believe it’s actually true, but it means I’m one step closer to moving back to the United States for good. There are many people who have not only been there throughout the past two semesters, but have offered ears to vent to, shoulders to cry on, wine to celebrate with, and experiences to relate to. Without these people, there is absolutely no way I would be where I am today, and for that I am indescribably thankful.

Now, on to the fun part- playing catch up! As most of you know, I usually have a hard time knowing exactly where to start when formulating my thought process. That’s over the course of a week or two- to try to determine where to start with life over the course of two months?! Oh, boy we’ll see how this goes. I’ll start at the end and maybe work my way backward. In reference to one my favorite parts of the University of Minnesota Marching Band pregame show- ARE YOU READY?!

As I mentioned earlier, I’ve been on a two- week break between semesters, and it’s been wonderful. Since it takes me about 2 days to get back to Minneapolis from Dominica, I decided to forego the trip home this time and instead, welcome a few visitors here with me. For the first week, my mom and her boyfriend, John, came to visit, and the second week my dad and his girlfriend, Victoria, came. Not only was it absolutely wonderful to see all of them, but having them here also gave me a reason to get outside of my comfort zone and the small area I spend most of my time in during the semester to see the small, yet simultaneously expansive island I currently call home. Between both of their trips, we ventured to waterfalls, the botanical garden in the capital city of Roseau, under the sea for some scuba diving, and to the second largest boiling lake in the world. Mind you, that last activity was what I thought might be the end of my life. I had heard from former students and faculty members that the hike to Boiling Lake was long, arduous, and challenging; however, it was, honestly, one of the most physically and mentally taxing things I have ever done. As I was hiking through various segments of the trail, one part of which is called “The Valley of Desolation,” different things popped into my head in attempts to keep myself motivated and encouraged. Anything from movie quotes to song lyrics to reminiscing about an experience I had downhill skiing as an 8 year old in Sun Valley, ID. I'll try to keep it short, but to put it into context, I digress briefly to share that story. As an 8 year old, I knew how to ski and had gone several times in Minnesota; however, this was first experience on a mountain that would take more than just one run to get to the bottom. I was terrified, but knew there was only one way out of the situation- down. Thanks to my mom for being there telling me all I had to do was go “fluffy to fluffy,” ie: just ski across the hill from one mound of snow to the other such that my speed never got away from me, I made it down the hill. That metaphor came back, and I knew all I needed to do was go segment to segment, step by step, and eventually I’d get there. At the end of it, I have to say it’s quite the feeling of accomplishment. Needless to say the things I did with my parents here were things I probably wouldn’t have had time to do otherwise, and I’m really glad they came.  

Botanical Garden in Roseau
Tree knocked down in 1979 by Hurricane David

 

Lobster Dinner at Sunset Bay

Post Scuba Dive Pina Coladas

Snorkeling

Survived to Boiling Lake after a few honest tears

Boiling Lake

At the end of my mom’s time on Dominica, I left the island with them for a 3 day mini-vacation in Puerto Rico. If you’ve never been to Puerto Rico- GO! It was just enough for me to get away for a few days to a place of four lane highways, CVS, Starbucks coffee, a chlorinated swimming pool, and speaking Spanish. One of the things we did while there was the Bacardí distillery tour- not just good rum, also much history! Although my drink of choice has changed since moving away from the land of Diet Coke, a Cuba Libre is still one of the most refreshing drinks there is in my book. At the end of our tour we participated in rum tasting, which was incredibly enlightening for me. I’ve never been one to enjoy spiced or dark rum; however, as our tour guide explained the undertones and flavors within each of the four rums we tasted, I gained a newfound appreciation for darker rums, and also other liquors. After the distillery tour, we took a ferry to Old San Juan where we ate a delicious lunch of plantain nachos, Mofongo, and chicken empanadas followed by an educational, albeit sweaty, tour of the El Morro Fort. By the end of this day- I was wiped and knew that everything I had wanted for the break was waiting for me the next day- 16 hours sitting by the pool with my book. Let me tell you, it was glorious. I had started the book Wild about halfway through the semester and had yet to finish, so having the opportunity to sit down and read without any other obligations was indescribable.

Bacardi Tour

Rum Tasting

El Morro

Drinks our last night at The Vanderbilt Hotel

In an attempt to keep this a little more succinct, I think I’m going to try to put the rest of the semester into a highlight reel of sorts.

1. I followed through playing powder puff football with a fantastic group of ladies, and am proud to say we as Category X pulled off the win to beat the 3^rd and 4^th semester team. Since we are medical students, most of the sports teams we have on campus derive their names from something related to medicine. In our case, Category X refers to drugs that are completely contraindicated in pregnant women, and also in women who have the possibility of getting pregnant. Since it is unsafe for women to take any Category X rated drug, we thought it an appropriate name for our team with the tagline, “Under no circumstances can women take us.” It proved to be true. :) 

 

2. I fell in love with our neuroscience block. Not necessarily to the point that I am thinking about changing my specialty to something related to neuro, but enough to make me understand, appreciate, and respect the human body even more. Granted, each of our blocks this past semester, based in some aspect of human physiology, brought more and more to light in terms of how much our bodies do without us even having to think about it, but without the neurological system, NONE of that would happen. That’s humbling. Not only further bringing forward a sense of respect and humility, but also the honest interest it piqued in me. The various ways in which your brain is organized to control movements, senses, memories, and so much more. Knowing that all of your five senses except smell have to make a pit stop in a specific part of your brain before reaching their final destination. Or, that your spinal cord is organized in such a way that the majority of the information traveling TO your brain is contained in one half, while the information traveling AWAY from your brain is contained in the other half with a few other things interspersed between. Absolutely incredible, if you ask me. In fact, if you do ask, I probably won’t stop talking about it. Talk to anybody I’ve interacted with in the last couple weeks who are not in medical school, and they can probably attest to the fact that in nearly every conversation something pops into my head that ties everything back to medicine. What can I say- even when it’s hard, I still go back to what I love.

3. A wonderful young lady whom I have met and gotten to be friends with since moving to Dominica and her fiancée got married last weekend, and although I was unable to attend the wedding due to having visitors, I was honored to be a part of her beautiful bachelorette party about halfway through the semester. We started the day at one of the local restaurants owned by the sweetest British couple for breakfast and mimosas, and continued the day about an hour south of campus at a hot spring spa. Not only was it a spa with multiple hot/warm/cool natural pools, but as we walked around to explore the area, we ran into a guide from the resort who pointed out that there were also hundreds of different plants, herbs, and foliage, along with a peacock and many stick-bugs. Concluded by an amazingly delicious home-cooked lobster dinner, homemade apple pie, and a bonfire on the beach, it was by far the best bachelorette party I’ve been to with a group of some of the strongest, most supportive, and fun-loving people I’ve ever met.  

Cacao Plant

4. I planned and coordinated my second pediatrics clinic for about 100 primary school students about 45 minutes south of campus, and can honestly say it doesn’t get old. Yes, there were days that I was frustrated with some of the people I need to coordinate with, or was nervous that things weren’t going to come together in time, but in the end, all that mattered was that we were there and willing to provide as much support to these kids as we possible. Although clinics are great ways for each of us to practice clinical skills in a clinical environment, the best parts of the clinic for me are the kids who come. Some of them are shy and won’t leave their parents’, while others don’t stop talking. They’re each so different and unique that it honestly never ceases to put a smile on my face. Now, after this past semester, I am passing my coordinator torch to another member of the Pediatrics Student Association as I take on a different role within the organization, but will have no problem signing up for the clinic, simply to go.

As many of my colleagues, myself included, have now reached the halfway point of our time on the island, it’s definitely starting to become bittersweet. On the one hand, being on The Rock (or Jurassic Park, as many others fondly call Dominica) has afforded me opportunities both personally and professionally that I would not have had in a different environment or at a different school (did I mention I’m getting scuba certified this semester?!). On the other hand, because it is a small island and you often run into the same people and the same situations, it can become stifling if you let it. That being said, there are less than 8 months during which I will call my apartment, this city, and the island of Dominica my home. I know it is going to fly, and just as things have unfolded thus far in this experience, I will continue to take life one step at a time, or paso a paso.

Until next time, I leave you with all the love in the world, and a few more miscellaneous pictures. 

Welcoming Spring with the Indian holiday of Holi

The only regulatory street sign posted within several miles of campus

 

Loving Life.

Well, as nearly everybody in the world knows, today is Valentine’s Day, or as some of my fellow singles may say, Single’s Awareness Day. Although that may be true, I am in fact spending today technically single, I couldn’t be happier. You see, the truth is, despite having been single for the majority of my adult life, I’ve come to really appreciate and embrace it. Even more than that, I love my friends and what they bring to my life. Just last night I had the wonderful privilege of going out to dinner at a restaurant about 45 minutes south of campus with a group of fellow students whom I don’t usually spend a lot of time with. Despite not knowing them very well, I had a fantastic time. Based on the way our evening began- I wouldn’t have expected anything else. This not being the first time I’ve been to this particular restaurant, I was caught off guard when our transport was not a large taxi van as I had taken in the past, but two yellow taxi- cabs. Yes, they do actually have yellow cabs here in Dominica. As a result, our group of 11 needed to split into two cars. Now, I don’t know what the condition of the other vehicle was, but the steering column in our cab revealed a few exposed wires, and there was a tablet on the dashboard which the driver fiddled with consistently throughout our drive. Add to that a Styrofoam cup filled with vodka (completely legal here in Dominica) given to us by a member of our group in the other taxi, and how could this evening NOT start on a good foot?! Throughout the course of our drive through the ups, downs, and twisting roads of Dominica we enjoyed conversation and the salty wind rushing through the windows as the cup was passed around- each of us trying to avoid drinking it. As we arrived at the restaurant so aptly named “Sunset Bay,” the sun was just beginning to set through the clouds. Although I may say it all the time, and I’m sure everybody back home is sick of hearing about it from me, I don’t think there will ever come a time that the view of the setting sun over the water will become mundane or “just another thing that happens.” Each day is different- from the way the colors reflect on the water to the way the clouds absorb and display those exquisite tones. To put it simply, I love it, and take pictures at every chance I get. In addition to it being a beautiful place to watch the sunset, Sunset Bay’s other “claim to fame” is its lobster dinner. Between 8 of us, we split 5 lobster dinners and 3 buckets of garlic mussels. Although I had dined there previously, this was my first experience with their lobster, and let me tell you, there is only one phrase that may even come close to describing it- to die for. At one point, the person I was sitting next to and I looked at each other with garlic butter covering our fingers and agreed that we felt like we were literally inhaling our food because it was so incredibly delicious. In addition to the lobster, the mussels are exquisite. We’ll just say that at the end of the meal, Ashleigh was a very happy camper. I was so grateful and excited to have had the opportunity to spend such a wonderful evening getting to know people who I see everyday, but may not have had a chance to talk in the same way without this dinner.

Now, the dinner, the sunset, and the company were great, but that was just the beginning. You see, over the last several weeks, one of my friends has been trying to put together a game night at his apartment. Between exams and others’ schedules, it just hadn’t worked out until, finally, everybody agreed on last night. He and his roommates had everything planned out based on the number of people coming, and we all had to sign up on a team to make sure all of the games worked out. Everything was supposed to start at 9, and I figured I’d have no problem being back from dinner at that point. Well, I was wrong. Our taxi arrived back on campus at 9:30, and I felt awful. Not only was I going to be late, but I was letting my game partner down by not being there. Luckily, the start time had been pushed back by an hour, but even had that not occurred, the response from my teammate, Ericka, who is honestly much more like a sister to me than I could have imagined, was completely understanding of it. Yes, I think she was a little worried I wasn’t going to make it in time, but she knew it was out of my control and she just rolled with it. So, we got to the party, had a great time with other wonderful friends, won some rounds, lost others, and went home laughing about those little things that in the end add up to a lot. Needless to say, despite all of the cliché and cheesiness that it brings, I’m extremely lucky and feel incredibly blessed to have met so many wonderful friends since moving here, and one in particular whom I know will be around for the long haul.

The last thing that I will touch on before returning to the current love of my life, school, is actually school. As I mentioned in my last post, the first few weeks of the this semester were a little rough for whatever reason in terms of getting back into the swing of things. I felt like I was in a funk that I just couldn’t shake and I couldn’t figure out why. Now, I’m not here to delve further into that or even explain why it happened, but to do quite the opposite. To express how doing things like practicing physical exam (PE) skills brings me back to the roots of why I’m here. Yesterday we didn’t have classes, but we, as 2^nd semester students, had our abdominal exam PE skills lab in the afternoon. Now, we’ve had experience with these several times up to this point for various things- blood pressure, pulses, cardiovascular and respiratory exams, and an intro abdominal exam last semester, so we all knew what to expect. We had watched the introductory video online and read (or at least skimmed) the handout posted before arriving. Knowing we would have a standardized community patient, we arrived at school with our white coats and professional dress in tow. After stepping into my group’s exam room (imagine your standard Dr.’s office exam room), we waited for our patient to arrive so we could get started. Walking in just on time, our patient walked in, and it was none other than Mr. Charles! Okay, okay, for anybody reading who is not from Ross, that means absolutely nothing, but let me try to explain it to you. For each of these labs, as I mentioned, we have a video that we have to watch that essentially goes through the entire exam as we are supposed to practice and perform it during our sessions. In nearly all of these videos, Mr. Charles is the patient, which pretty much makes him a local celebrity. I had heard from friends who had had previous sessions with him that as a result of him doing these sessions multiple times, he knew the protocol of each exam almost better than the students, but for me to have the chance to work with him? I couldn’t believe it. Everything that I had heard from others about him was absolutely true. His hands were already raised in preparation of them being checked for jaundice caused by possible liver failure, and he knew exactly where to place them in order to perform a test checking for ascites, or extra fluid, in the abdomen. He was funny, which put everybody at ease, and was completely comfortable with us all poking and prodding him for practice. In fact, maybe a little too comfortable. Halfway through my exam, he fell asleep!! I was trying to check for possible lower abdominal pain caused by appendicitis, and asked him to lift his leg against resistance. The response? Nothing. No movement, no verbal response, just silence. Despite my best efforts (and the efforts of everybody else in the room), we all just started laughing- Mr. Charles included. Needless to say, although it wasn’t an incredibly tense environment to begin with, his falling asleep definitely removed any remaining tension or nerves. It was refreshing, and it reminded me again not only how much I really do enjoy what I’m working toward, but that every encounter I have with a patient has the possibility of becoming something I don’t even expect- whether good or bad.

As always, the writing could continue for days and days, and although we have a long weekend due to Carnivale on the island, I just don’t have that much time and I need to get ready for what will arguably be one of the greatest Valentine's Day dinners with the best teammate, study buddy, and most of all friend a girl could ask for. That being said, I hope you all have a wonderful Valentine’s Day wherever you are, whomever you’re with, and whatever you’re doing. Until next time, and with lots of love.

 Team #Flawless: best teammate ever

Sunset at Sunset Bay

Challenges.

Hello again! Despite me “having more time” this semester, I’ve ironically found it more difficult to find time to sit down and update you all on the goings on. So, here I am on a Friday afternoon to sit down and do just that.

To start, I have successfully completed my first mini exam for second semester, and it finally feels like I’m back in school. It’s a hard sentiment to express, but the first three weeks were a little hard to get into. Not because the material was boring, or even because I wasn’t trying to study, things just didn’t feel like they were falling into place. Luckily, I was able to get a grasp on things last weekend before the exam, and everything worked out. After our exam on Tuesday, everybody from my class gathered, as usual, outside the testing center as the security guards attempted to clear us in order to allow the second group of students to begin their exam. Let me explain that for a minute- our class is too big for all of us to fit inside the testing center, so they have to split us into two groups based on last name alphabetically. Therefore, whoever is part of the first group of testing needs to clear the area surrounding the testing center as soon as possible so as not to delay the second group. With that minor detail cleared up, I’ll get back to where I was. We were all gathered trying to determine what the plan of action would be for the rest of the day. Initially, I was going to be productive. I arrived at the testing center at 7:45 before my exam, not with my backpack (what’s the point of bringing notes to review mere minutes before the test?), but instead with my insulated grocery bag. You see the grocery store is right down the street from the testing center, and the testing center is more than halfway between my apartment and the grocery store, so it just made sense to continue heading that direction for just a bit longer and take care of my errands. Well, this exam was probably the most challenging exam I’ve personally taken on the island. Not because I didn’t understand the material, but in the way the answer choices were presented. I rarely finish an exam without at least 20 minutes left to go back through and review my answer choices. In this case, I barely finished. My brain was fried. So, as you may guess, I didn’t make it to the grocery store. A few friends decided to go out for brunch, and the state of my brain much preferred that option to “being productive.” I have yet to make it to the store. :)

Following brunch, people started heading to the beach- where we all tend to congregate in the aftermath of exams. I followed suit for a few hours, and then returned to campus for a group training session with six colleagues who serve as leaders of the New Student Ambassador program. At the time, I didn’t know exactly what to expect from this training, and if I’m being completely honest, was a little sad to be going back inside on the first afternoon in a while that I literally didn’t have anything to do related to school. What started as a leadership training session; however, became an hour and half of team building and bonding that I wouldn’t have traded for anything. Don’t get me wrong, I absolutely love the beach, and pinch myself frequently in disbelief that this is where I live, but the discussions we had were invaluable. Based on the book, The Leadership Challenge, we went through each of five practices that make an effective, successful leader: 

1. Model the Way
2. Inspire a Shared Vision
3. Challenge the Process
4. Enable Others to Act
5. Encourage the Heart
            

Each practice had a different “activity” associated with it, but my favorites was "Model the Way." We each had to sit down and make a list of our top ten values. Now, I understand, that this may sound cliché and “cheesy,” but it made me realize a few things. 1. Choosing only 10 values is hard. 2. Although they are each separate, each value somehow stems from another. In other words, they are all interconnected. 3. When you work with people who have similar goals, your values tend to overlap. Once we had finished, we each briefly discussed some of the ones on our list, and subsequently had to choose ONE value that we hold in higher esteem or of utmost importance. This was hard. It further demonstrated; however, how interrelated each of our values is. Now, this will not be the first time that I mention this, but my number one value was relationships. From the diverse relationships I currently have in my life, and those I’ve had with people in the past, I am able to observe and really appreciate my other values. Some of which include integrity, education, creativity, honesty, and understanding. I had never really thought of each being so connected, but it was really enlightening to realize. This activity also brought me back to a conversation I had with a colleague back in August. She has become one of the best people I’ve met since moving to Dominica. At the time, she and I were out to dinner with a larger group of people, and at one point in our conversation she asked me what I value more than anything. Bear in mind, I'm from Minnesota where people tend not to skim more than the surface when it comes to talking about life, how things (actually) are going in life, and opening up about who they really are, so having only met her a couple days prior, I was a little caught off guard by how her question probed directly into who I am as a person and why. Not in an offensive or off-putting way, but in a way that was refreshingly genuine and completely real. She and I have a weekly lunch date that we’ve maintained since the middle of last semester, and within those breaks, whether for 15 or 45 minutes, we cover the gamut of topics. I always walk away feeling better than when I sat down. It’s honestly incredible. In the midst of the stress and consuming nature of medical school, it feels really wonderful to just be human and remember what that means. After all, that’s why most of us want to go into medicine, right- to be human and help heal the human condition, whatever that may entail? I suppose that sentiment will vary from person to person, but it's an interesting thought to think. 

As I was walking to class this morning, I was struck by how much things have changed since I’ve been back. Granted, the last time I was here, I commented on how comfortable I feel here in Dominica, and how excited I was to be back. Although I still feel both of those things, I experienced a much stronger sense of homesickness this semester than I ever did last semester. Actually, "homesickness" can't even come close to describing how I've felt. I missed my friends and family, but knew I'd be seeing them again soon. I missed my dog, but again, I'll be able to see her soon. Minneapolis pulled at my heartstrings, but I wasn't dying to go back. So, what was it? Still to this day, I can't pinpoint what it was that I felt. I knew I would adapt and settle in again, but it was really one of the most unnerving feelings. After all, hadn’t I lived here for four months? Gone through the adjustment? Like I mentioned a couple weeks ago, shouldn’t I be able to walk back in knowing exactly what to expect? Theoretically, yes. For whatever reason; however, I couldn't figure out how. I spent much time pondering this and why it was different now than last semester. The conclusion I came to was that this (“this” being Dominica and school) is no longer new. I know exactly what to expect. Where to go for the best food at the shacks. What to do when I need to stay on campus to study, but the Large Learning Lab is closed. How to go about getting approval to run a clinic for Peds. Basically, I know enough to get by and live successfully day to day. These days; however, that’s not enough. So, I’ve been thinking about what more I can do to be successful and content here. What opportunities can I take advantage of this semester that I didn’t have time to do last semester? How can I adjust my life in a way that I get out of each day (almost) exactly what I want? Instead of needing to simply survive as I did in first semester, I need to establish a way of life. That was it. Something had finally clicked as I realized that as much as I don’t like change, it allows me to never have to establish parameters. For the last 5 years, I’ve known what I wanted to do (become a doctor), but I’ve never been in a position to have to settle down. To establish a life. My mailing address has changed at least once a year since I graduated high school. I had three different jobs over the course of nearly three years within the same company. I’ve started, but not finished, a master’s degree. Now that I’m finally getting to do what I want to do and starting to "settle down," it’s scary. Don’t get me wrong, I’m absolutely thrilled, but for the first time, I don’t have to think about when I’m going to start doing that thing I’ve always wanted to do. I’m actually doing it, and as much as I’ve wanted for the last few years to be settled, the idea that I’m getting there is terrifying. Now, quick perspective, I do still live in the Caribbean, and there are still a lot of things about my life that are up in the air. For example, things that often run through my head are: “Where will I spend the last two years of school while I complete rotations? Where will my residency placement be? Will my family continue to mostly reside in Minnesota, or will better opportunities present themselves elsewhere that encourage them to move?” That being said, the one thing that has been uncertain for so long is finally not uncertain, and I’m finally coming to terms with that. Does it mean that I don’t want to be here? In no way, shape, nor form. Still to this day, I can’t imagine doing anything else. It does further show me; however, that continuing to face life with an open mind and one that is focused on continuous growth and learning is essential. The fact that my life isn’t constantly changing for the first time in a while is a change…..so, maybe I’m actually more resistant to change than I realized. :)

Alright, alright, enough with the serious, philosophical talk. What I have not mentioned is that I am playing powder-puff football this semester with a few other first and second semester young ladies. We’ve had two practices so far, and it’s been a blast! Technically it’s a flag, no-tackle game, but our practices have gotten a bit intense at times, and I know that the games will only be more. It’s been a really good way for me to get outside of studying for a bit, though, and meet some people from my class that I otherwise wouldn’t have a chance to get to know. Needless to say, I know I’m biased, but I think our team is going to do quite well. I’ll keep you posted.

Unfortunately I believe I should move my head back to where it needs to be- the books- but I will leave you with a few photos of the island since I’ve been back, and as always, lots of love.

The Beach: ideal location for snorkeling and studying Cardiovascular Pharmacology

A young kid on my way to campus.

Rain clouds rolling in over the mountains toward campus

Sunset on the ocean

A local stray who followed me home from school.

Dominican sunsets will never get old.

Faint, but very present rainbow on a Friday walk to class

 

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.”