The imminent future

The end is in sight.
Some days,
it feels like FOREVER before graduation.
Other days,
it feels like I'll blink and this will all be over.
Even still,
we are on the down hill slope of this 4 year mountain we were crazy enough to start climbing.
And that feels exciting.

Jason is already half way through his required rotations.
12 weeks of internal medicine.
Done.
6 weeks of pediatrics.
Done.
6 weeks of family medicine.
Done.

9 more weeks of surgery,
then 6 weeks of OB/GYN,
and 6 weeks of Psychiatry.

And then Jason takes boards.
Again.
Step 2 this time.
Remember Step 1??
{I have PTSD from those days}

But anyway,
after boards it's on to 4th year.
4th year means:
Electives
Away rotations
Applications
Interviews
Submitting a rank list
Match Day
Graduation

Woah.
4th year is going to be a ride.
But let's back up a sec...

See away rotations above?
Those are electives he gets to do at other programs around the country.
The strategy is that you do an elective in the specialty you are wanting to pursue after medical school.
You choose locations where you would hopefully want to train,
and do your elective rotations there.
That way,
when you apply there,
they know and remember you,
and are more likely to offer you an interview.
Away rotations are four weeks long.
J is hoping to do 3.
June, July, August.

That may seem far away,
but applications for these rotations are due by the end of the year.
We are down to the wire.
We need to decide on a specialty,
make plans,
and lists,
and start seriously talking about our future.

For a year and half Jason has thought he wanted to do urology.
He shadowed a few urologists during his first couple years of school and totally loved it.
We {okay, I} had researched everything there was to know about urology residencies.
Which programs were the best,
how to best increase your odds at securing a residency spot,
etc, etc, etc.

But then Jason did his official urology rotation.
I've heard it said that when people are trying to choose their specialty,
they know which one to pick because during that rotation,
they came home HAPPY.
Tired yes.
They always are.
But tired and happy.
Excited.
Fulfilled.
Enthusiastic.
I fully expected this from Jason during his two weeks of urology.
He did too.
And well,
he just wasn't.

Urology wasn't fulfilling him,
and he didn't know why.
He wasn't excited,
or fulfilled,
or giddy,
the way he thought he should be.

He started doubting everything.
He wasn't enthused about the future,
or medicine.
He wasn't sure God was listening.
He needed guidance and reassurance,
and he wasn't getting it.
Cynicism crept in.
If modern day miracles are true,
where's mine? he wondered.
He retreated to dark places in his mind.
I saw him withdraw.

I prayed so hard.
"God, you know his mind.
You know the way his logical, unemotional, rational decision-making brain works.
You're the only one that can help him.
Help him make sense of everything in the way HE understands the world.
Let him know you're there.
Reassure him.
Comfort him.
Guide him to his miracle."

The choice of specialty is heavy.
Not only are you sacrificing 5-7 years of your life for grueling surgical training,
it's also the rest of your life.
He didn't have long to make a final decision.
Applications due by the end of the year remember?
Time was not on our side.
His head, heart, and gut,
were all telling him different things.
And the weight of it all,
was sucking the life from him.
He ended his urology rotation with little clarity,
and so much uncertainty.

And then he started plastic surgery.
At the end of his first day he called me to tell me he was on his way home.
"I have something to tell you." he said.
"But I want to do it in person." 

I washed dishes and loaded them into the dishwasher,

as he sat down on the bar stool looking stoic.

"Something happened today."

My stomach lurched.

"Okaaaaay." I hesitated.

He told me about the patients of the day.

Burns,

cancer,

trauma,

reconstruction,

cosmetic,

congenital.

All different.

Different problems.

Different body systems.

Different genders.

Different ages.

Different surgical solutions.
Intricate, delicate, complex surgical techniques.

All beautiful outcomes.

Four patients.

That's all it took.

After four patients the thought entered his mind,

"Could I do plastics for the rest of my life?"

And then it happened.

{Insert his miracle here}

The sprit filled his entire body. 

Joy.

Excitement.

Enthusiasm.

Fulfillment. 

H A P P I N E S S.

God heard.

He listened.

And lovingly answered his struggling child.

J recounted how that same strong confirmation came back to him throughout the day

whenever he would stop and think about doing doing plastic surgery as a career.

Every. Single. Time.

Affirmed over and over.

This was it.

Still loading dishes,

tears streamed down my face.

Not only because he had made a decision,

but mostly because he felt Heavenly Father,

and knew that he was capable of getting direction and inspiration from God through the Holy Ghost.

It had been a long time since his belief in that was reassured.

Long enough for Satan to creep into his thoughts,

chiseling away tiny slivers of faith in Jason's pillars of spiritual truths.

The weight lifted was visible.

His excitement contagious.

With my still-wet hands {and cheeks}, 

we hugged for a long time in the kitchen.

Our course was set.

New goals in sight.

And after a few really hard weeks, 

I finally felt like medicine wasn't going to ruin everything.

Or steal away the Jason I knew and loved.

With this new development,

and with renewed faith,

we make new plans for the future.

We don't know where plastic surgery will take us.

We won't know until March 2020.

{Match Day}

It is a six year surgical residency.

And it will, no doubt, be challenging.

But this I know,

God is in charge.

He knows me.

He knows Jason.

He knows the 3 amazing little spirits he entrusted to us.

He knows the paths that will strengthen us,

refine us,

humble us,

the ones that will test our faith,

and the ones that will restore it.

And {hopefully} we come out the other side of medical training better,

resembling more of who He wants us to be.

Half way?!

In my last post,

Jason was four weeks from taking Step 1.

It was a long road to that exam,

but we survived and Jason did great!!
The anxiety leading up to the exam,

and then to finding out his score was intense!

After his exam,

he had to wait 3 weeks to get his score back.

We knew the email would come at 8 a.m.,

and I knew I wanted to be with him when he checked his score,

or at least be able to see his face via Face Time.

But on the day that his score was supposed to come in,

he had to be in a simulation class at 8 a.m.

They are in small groups,

practicing procedures on the simulation dummies,

and it would have been noticeable if he was either late,

or video chatting.

He had a half day that day,

and selflessly said he would wait until he got home to look at his score with me.

-1 p.m. it is!

But...

I couldn't wait.

At 7:59 I logged into his portal and looked at his score.

And then I cried.

I was so relieved, happy, excited, grateful, humble.

I knew I wanted to surprise him in some way,

so I bought some balloons,

butcher paper,

and some paint,

and me and the girls made him a giant banner with his score on it.

I recorded his reaction.

It was pretty great.

I felt a little bad for asking him to wait to look at his score,

and then I felt a little bad that I looked without him,

but it was totally worth it.

And he even said,

it was way better than finding out at school via his phone.

Wouldn't you agree?

 

Now that it's over {finally!},

and he's also done with his last block of his 2nd year,

(which was a dream by the way-

there were no tests during this block,

which meant no studying,

which meant lots of family time,

which meant happy mom),

we are officially half way done!!

Today is his first day of third year.

Third year marks the start of clinical rotations.

He will do 6 'core' rotations this year,

the same 6 that every other third year medical student in the country will also do.

Internal Medicine (12 weeks)

Pediatrics (6 weeks)

Family Medicine (6 weeks)

Surgery (12 weeks)

OB/GYN (6 weeks)

Psychiatric (6 weeks)

He will be at different hospitals and locations for each rotation,

and even multiple ones during the longer ones.

For internal medicine for example,

he starts at Maricopa Medical Center in inpatient,

then he will be in Show Low for a month,

and then finishes at St. Joes in outpatient.

For his surgery clerkship, 

he was able to choose some electives,

to gain some exposure to other fields of surgery,

and to break up the long rotation. 

He will be doing urology, plastic surgery, and trauma,

in addition to the required general surgery.

The electives are 2-4 weeks long each.

Rotations are a way for students to get an introduction into different areas of medicine,

so that by 4th year, they can hopefully narrow down what kind of doctor they want to be.

In 4th year, 

he will have to do an emergency medicine and neurology rotation,

but then the rest of his time will be spent taking elective rotations,

and apply and interviewing for residencies.

I have heard mixed things about MS3.

Some say it was the hardest year,

some say it wasn't so bad.

This is where the hours get long,

and the students are exhausted.

But this is also where they are putting to practice everything they've learned 

the last two years.

The patients are real,

they have actual problems,

and they will play a role in their care-

which is completely more fulfilling than cramming knowledge into their brains at 12 a.m.

Some 'real world' application to all those long nights of studying.

He will be gone for 4 weeks while he's in Show Low.

Which will be during summer.

Which will be when my kids are out of school.

Which means...

SOS.

But we will survive.

I remember his long weeks on call with DeWitt Equipment-

especially during the summer.

And it was all okay.

It was always okay.

And if one rotation feels hard and long,

the next one usually isn't as intense-

so hopefully,

with some luck,

I'll make it through summer with some dignity,

and maybe even a few shreds of sanity remaining.

In case you want to know...

Jason is taking a big test in one month.

Scratch that.

A huge test.

The USMLE Step 1.

Or just Step 1.

Or just Step.

{It's also called boards}

It's been on his mind since he started school basically,

and studying for it began at the beginning of second year.

USMLE stands for United States Medical Licensing Exam.

It's a three step exam for medical licensure in the U.S.

Step 1 is taken between second and third year of medical school.

It's a one day, 8 hour test.

Seven 60-minute blocks.

And the score determines a lot.

Like, a whole lot.

In fourth year,

Jason will start applying for residency programs,

and it is known that the score is what the residency program directors say is their most important criterion in selecting graduating medical students for their program.

(Because it is the only standardized measure of all applicants)

And sure,

there are other factors that hold weight on the application.

Letters of recommendation.

Grades on rotations. 

Research.

But for the most part,

there is an "average" step 1 score for most specialties,

and if you score below that average,

you may have to do some other things to beef up your application.

If you're TOO far below the average for that specific specialty,

well... you're sorta out of luck.

It's time to find interest in another field of medicine.

Several months ago,

we hosted an internal medicine resident

interviewing in Arizona for gastroenterology fellowships.

He said he went into medical school KNOWING he wanted to pursue orthopedic surgery.

But because he didn't score high enough on Step 1,

he had to choose something else.

It took him a long time to come to terms with giving up his dream of orthopedics,

and of being a surgeon in general. 

And that he still has moments where he wishes he could spend his days in the O.R.

It's kind of crappy that so much weight is put on this ONE test,

especially if you're initially drawn to a specialty that tends to be more competitive.

However,

the good thing about taking the test now,

is that Jason will know his score before he starts rotations.

If there are specialties that would maybe be a stretch to match into,

he will know that beforehand,

and be able to keep his mind open when being exposed to other fields of medicine. 

Okay, back to Step.

The more competitive the specialty, the higher the averages:

Orthopedic surgery (245)

Urology (243)

Plastic surgery (245)

Dermatology (247) 

Neurosurgery (244)

And I'm sure there are others I am missing.

{A passing score for Step 1 is a 194 by the way,

and the national average is 228.}

Most of the competitive fields are surgical.

Most, but not all.

(i.e. dermatology)

And Jason,

like the gunner he is,

wants to pursue surgery.

And at the moment,

 is semi-considering urology.

He is open to other surgical fields,

and even non-surgical fields if he finds what he loves outside of the O.R.,

but he says he is making urology his goal because it is competitive,

and he would need a stellar step score.

So he's setting the bar high for himself.

Jason takes Step 1 on March 6th.

A little less than 4 weeks from now.

He studies 9-10 hours a day away from home,

comes homes and spends a little time with the family,

and once the kids are in bed,

it's more flashcards and videos and review.

We are in full study mode over here.

A even I'm starting to feel the stress of it all.

It's very hard to be in a place of no control.

I honestly would be okay with whatever field of medicine he chooses,

surgery included,

if that's what made him really happy.
My hope is that his score will give him the ability

to choose what he loves- no matter how competitive.

25 days and counting!

(a normal sight around here)

2nd year down

Woah.

2nd year is over.

That is nuts.

And while it seems like he started medical school FOREVER ago,

I also feel like we got here so incredibly fast.

Second year has been exponentially better than first.

And I am grateful for that.

I thought I went into medical school with very low expectations,

but for second year,

I lowered them all the way down.

And then got rid of them all together.

They didn't serve me last year.

After coming out the other side that was first year,

I realized that I had been suffering from postpartum depression.

-No wonder I felt like hell-

Noticing that the changes within me were not JUST because my husband had started 

a demanding career path,

was like a light switched on.

It all made sense.

The thoughts and emotions I had been having made sense.

I could finally put a word to what I was experiencing.

And I found peace in that.

As time trudged on,

those thoughts and emotions became less severe and less frequent.

And I felt more like me.

Little by little,

normalcy came back.

Happiness came back.

Energy came back.

And now that second year is over,

and I reflect on the last 7 months,

I know there is still so much growing to do.

And lucky for me,

the road we are traveling will provide many opportunities to do so.

I also know that I have been blessed.

So many tender mercies from my Heavenly Father,

that keep me moving forward in faith.

Last week,

Jason and I went to the temple planning to do a regular session.

But when we checked in,

a small sign on the counter read,

"Temple patrons needed for sealings."

I pointed to the sign and asked Jason if he'd like to do that instead.

After thinking about it for a surprisingly long time,

he said "Sure let's do sealings."

And during that hour,

in that small sealing room on the third floor of the temple,

sitting next to Jason,

I had a profound spiritual moment.

There have only been a few times in my adult life,

where the Spirit is so strong,

that my entire physical body feels heavy.

Like I am completely grounded into the floor.

It starts at the top of my head and travels to my feet,

and then for a few moments,

I feel unmovable.

It is far different from other times that I feel the presence of the Holy Ghost.

It is hard to explain,

but those moments are unique and special,

and I feel so incredibly close to my Father in Heaven.

I am completely certain that He is aware of me in right then.

And in that moment,

in that small sealing room on the third floor of the temple,

sitting next to Jason,

the Spirit spoke something so very special to my heart.

And I was so very happy.

And so very thankful that Heavenly Father knows me so well,

and clear by the impressions I felt that night,

has a complete and beautiful plan for me.

The adventures are just beginning.