Get busy livin' or get busy dyin'

One of the my favorite movie quotes from Shawshank Redemption is the title of this post. And it's such a personal reminder that unfortunately, I spent much of the last 10 or so years of my life getting to a goal, instead of enjoying the journey on the way. Yeah I know, it sounds sooooo cliche', but very true in my case. And through a TON of soul searching I learned to really L-I-V-E my life instead of just letting life pass me by.

Along those same lines, here's a picture of me and one of my sista' mentors, Dr. E who recently went on to greener pastures after working with me at the Cancer Center where I'm currently employed:

Before getting together with Dr. E and a couple other female Scientists and Clinical Lab profesisonals, I'd seen 2 clients, attended an open house at another university that's throwing a LOT of money my kid's way, and cooked a few of my favorite southern treats to serve the ladies at our gathering. In other words, those bags under my eyes were VERY well earned LOL, but I was DE-TERMINED not to let that keep me from enjoying the evening. And enjoy it I did along with picking up another client for my business!

Of course all this running around caught up with me this morning and I didn't get out of bed until after 9 this morning which is MUCH later than my 5AM regular wake up time. But I know I needed the rest because in addition to the homework I have to do for my Bioinformatics course today, I have 2 clients to see today as well.

But it's all good, because I'm "livin' my life like it's golden" and "golden" it is!!!

Who's "got you"?

Reflecting on the mean ass, triflin' message left by an anonymous poster the other day reminded me of how absolutely critical it is for super nontrads (premeds over age 40) to have their support systems SUPER in tact.

Then I got to thinking about the numerous people who were in my life say 3 years ago, that no longer are. Or as in the case of my mother, folks who I just don't discuss details of my career plans with (which makes me really miss my Dad, because there was nothing in the world he didn't think I could do). Luckily for me, my support system is more in tact now that it has EVER been but I've had to adjust to a few things, because while it used to be easy for me to find mentors, the older I got, the harder finding supportive mentors became. And as much as I'd like to think my age isn't playing a HUGE factor in that, the fact is that I think it is primarily due to my MD/PhD goal.

Movin' on, my business is now really booming as in I'm almost making the same salary from my "real job", but working only 1/4 of the time. Yeah! :)

I also learned that I won't be able to start my fellowship until May or August of this year. And that's kinda sad but I think it means that there's more God wants me to learn where I'm at right now. So I've come to terms with that and I'm enjoying my current gig more than ever now that I understand why I'm here. Learn the lesson, then move on.

Class wise things are fabulous, I've got a 100% average in the second part of my Bioinformatics methods course and I've scheduled my ER and second IM clinic rotations for my Health Informatics course. My R programming course starts in a week and I have NO idea how I'm going to be able to do it all, so I may just drop that class depending on if I get a definitive start date on my fellowship.

Now I'd like to end this post with my favourite song by the group The Roots featuring my other girl, Eryka Badu. Because I know without equivocation that there are many people, both in my personal and professional life, "who've got me"!!!

MICU rotation, part 1

I'm pretty sure I'm going to need 2 posts to talk about what I observed in the MICU, it just REALLY blew me away. I didn't have much to say during this rotation, no thoughts on care, because obviously almost EVERYTHING was COMPLETELY over my head! Except, one case of COPD of unknown etiology until I asked about the occupation of the patient. And that happened to be in the chemical industry, so it was no surprise that an illegal immigrant working in a chemical plant, likely without the proper respirator equipment would have full blown COPD with heart failure at the age of 53.

Anyhoo, almost every patient on the floor was on a ventilator. Including a patient whose family I met at the nearby cafe which was on the same floor and around the corner from the MICU. And in the strangest form of irony, this was also the patient that coded while I was in the MICU. I accidentally met the family of the patient when I thought I was lost and was asking people I saw in the area if I were in the right place. The sister of the patient told me that the doctor I was looking for was her sister's doctor and that the doctor was a very nice lady (which she was and REALLY sharp too). I told her that I hoped her sister would have a speedy recovery and she slowly shock her head no then her head dropped down for a second. When she looked up, she had tears in her eyes and she replied that no, her sister probably wasn't going to be OK. And to that I said that I would pray for her sister and family anyway and I reminded her that God has the final say. At that point, it was time for me to report to the MICU.

The first patient I saw was the man with the advanced COPD, followed by a terminal case of squamous cell carcinoma of the throat, a case of cirrhosis of the liver, a brittle diabetic, and finally the sister of the woman I saw at the cafe, a case of AML which had not responded to treatment (As I understand it, AML is the worst Leukemia to have). The AML patient was my age 47, and had been diagnosed 4 months ago. Unfortunately, she wasn't responding well to treatment and had been in the hospital for the past 5 or so days. She was one of the last patients I saw and when I looked in her room, the sister I had seen at the cafe looked at me as if to say hello and I responded by smiling slightly and nodding my head.

Our group was just about done rounding when I heard all kinds of alarms going off and all the doctors in our group headed straight for the room of the patient with AML. Her head was tilted so that it was pointing down which I assumed meant she was having a blood pressure problem but I don't know for sure because I had to leave before rounds ended (I'm going to check with the doctor to see how this patient is doing, our being the same age struck a nerve with me). What I do remember is that she had had problems the night before due to an improperly placed Dobhoff tube causing a pneumothorax. A pneumothorax that was missed by the Resident and caught by the Attending who was none too pleased (Gosh, being a Resident must REALLY be hard). And I could tell the Resident who missed it really cared about the patient, unlike the 5'2", balding Jewish Resident who I overheard calling rounding "a bunch of crap". (He had on a Yamaka which is how I knew he was Jewish, and with Jewish ancestors, I'm comfortable calling his arse out!). I digress, I was happy that the patient's sister had already left when the emergency began but I'm pretty sure she was called back in. When I left, she was stable but her prognosis didn't seem very promising.

The other patient I remember well was a brittle diabetic, a Black woman who not surprisingly, was "very well nourished" and around my age too. In fact, EVERY minority I saw on the floor was overweight, reminding me that minorities really gotta' work on NOT "digging graves with forks". In her case, her diabetes wasn't well managed though I didn't really know why besides the fact that she looked non compliant based on her weight and poorly managed disease though I know the 2 aren't always associated. However overnight, her feedings had been withdrawn for reasons I can't recall. But what I do recall was that she was given 2 units of insulin in a fasting state so needless to say, things weren't looking good for her during rounds the following day. I also recall that this patient was assigned to the balding Jewish guy, and my immediate first thought was that his flippant attitude about rounding seemed to be carrying over into his bedside manner. So my question then became how in the hell did HE get into medical school?

Honestly, these are the kind of situations that have always worried me about going into patient care, what do you do when the person you're rounding with or are in school with seems to not care about what they do? It would be so hard for me to be silent knowing that my silence could cost someone their life, literally. But then I've already lost 2 jobs for not being willing to stand idly by as life threatening decisions are made, such as passing off bad data for a clinical trial. I just pray and I pray REAL hard that God doesn't allow anything like this to happen around me. Because I know if I were the patient, I'd certainly want someone speaking up to save my life.

Hey pretty ladies, I think I'll sit between ya'll!

 * Image from Google Images

This scene from the Pretty Woman is my absolute in the movie!!

Anyhoo today, I had a LONG day at work and wasn't feeling well, so this was just the pick me up I needed.!! The older man that greeted me and another young lady with "Hey Pretty Ladies......", was with his son who looked to be about my age. And they were at the cancer center getting treatment for his son's leukemia. The man told me that he, his wife, and son had moved to Texas last week and would be here a year, after not being satisfied with the treatments options at Hopkins. His exact words, he didn't feel like the folks there were doing enough.

He was from Annapolis, MD which is not far from where I had lived just last year. We talked about the good places to eat, how much new construction is causing the city of loose it's charm, and how nice the people here in Texas are.

About this time, his ride to the parking garage had arrived and then I felt a lump in my throat. Oh boy, I said to myself, here we go again. It took everything I had to keep the tears from flowing down my cheeks and regular experiences like these are a HUGE part of why working at a cancer center is so hard for me. Add that to the "code" I observed in the MICU earlier today, and I was a tearful basket case (I'll talk more about my MICU experience on a later post). But these are experiences I know God is allowing me to have for a reason, because in the end, I think they will make me phenomenal Physician one day.

From Comment to post, March 2014

*3/26/14 - I decided to edit this post because I'm aware more than ever that with all the evil and negativity in the world, I need to put positive stuff out there in the universe that's going to be associated with me.

** 3/27/14- I also decided to edit my song choice too because as aporpos as the Cee Lo Green song is, I think this song by my girl Jill Scott says the same thing with a LOT more class and conviction:

Patient 2, Internal Medicine rotation

The second patient I saw on IM rounds was a 45 year old Black man who was HIV positive. I can't exactly recall what led to his ER visit, but I remember quite well that his T-cell count was near 0 upon admission. I also remember that the others on the team wouldn't go into his room and while I gathered that he was a difficult patient, it seems VERY strange to me a group of current/future doctors would be "afraid" to go into the room of an HIV positive patient. At least that's how I read it, as fear. I mean if Mr. Jackson was throwing poop at folks when they walked in the room, I could understand "the fear" to some extent. But to me, their fear was just ignorant. You see I was a volunteer AIDS counselor for many years and used to do blood draws for HIV test at a rural public health clinic. So, I figured that since I wasn't planning on having sex with Mr. Jackson, I didn't have anything to worry about.

So I put on the disposable gown and went to visit Mr. Jackson with Dr. B.

The room was very dimly lit and the only other person in the room was Mr. Jackson's daughter. And she was beyond pleasant and thankful to Dr. B for essentially saving her Dad's life. Turns out, Mr. Jackson had a BIG problem with taking pills and I surmised that after almost 20 years of being HIV positive, he had grown weary of taking lots of pills everyday. So Dr. B had ordered a Hospice consult for Mr. Jackson not out of need per se, but to "encourage" Mr. Jackson to take his medication. And immediately after the hospice folks left, Mr. Jackson started taking his HIV meds. The day of our visit, his T-cell count was almost back to normal and Dr. B was checking in on how he was doing.

What I learned that day was that despite CLEAR evidence for how HIV is likely transmitted, people are STILL ignorant about it. And to see medical folks behave out of fear was mind boggling. I mean, all one student did was touch the door handle of Mr. Jackson's room and he disinfected his hands immediately after he let it go. And no, I didn't see him do the same with ANY other patient we saw that day.

Again, ALL I could think about was how what I saw that day rounding emphasizes the need for both more compassionate and minority Doctors. I also thought that my personal argument for why no one under age 25 should be admitted to med school was substantiated as well.

Yes!!!

Yesterday, I unofficially became a Predoctoral Fellow in Health/Biomedical Informatics at a major university. And my career in cancer isn't over either, I'll be studying cancer drugs which brings into serious play, my background in pharmacology and chemistry. Talk about a mixed bag project!!! Right now, my new PI is working on the "semantics" of the gig since it was advertised as a Post Doc position and that may take a little time. Needless to say, I'm pretty excited about combining most of what I've learned academically into the foundation of my dissertation!!

So the goal is to over the next 2 years, complete the remaining courses I need for the PhD, pass my cums and orals (that's PhD slang for cumulative and oral exams, let's keep it clean folks), then matriculate in medical school. How do I plan to finish PhD research while in med school? By busting my tail during the summer before med school and the one following first year. And because I've already taken most of the first year med school curriculum and have tutored in many of the subjects since then, I think I'll be able to put at least 20hrs/week toward my research project. Obviously, none of this  is set in stone, but this is the plan today. And it's a plan I've waited a VERY long time to see come to fruition!!