My final days of freedom.

My days of what practicing doctors call "freedom" are quickly coming to an end. One week in counting until I depart from Arizona to this mystery island in the Caribbean. It has been a busy end to 2013, so busy that it didn't even feel as if I had taken a whole month off from work: from U of A Homecoming to Thanksgiving to my birthday, to the best holiday baking party ever, gatherings with friends and family, Christmas in Tucson, New Years in San Francisco, and quick trips to Los Angeles in between…whewww. BUT it was all worth it! January 2014 is here - I am ready! In fact, my New Year's resolution was just to get through my first year of medical school. :)

In between all of that, I have managed to ship out 150 pounds worth of household items in a barrel and am getting closer to zipping up all of my suitcases..just a few last minute things that I will throw in before I take off. I am pretty sure my parents will be glad when I get those road blocks out of their hallway. Haha. And it looks like I am all set and registered for classes.  The class schedule looks like I will have 17 credit hours:

1. Histology and Cell Biology Lecture and Lab
2. Human Gross Anatomy and Development Lecture and Lab
3. Medical Biochemistry

Let the fun begin! Already getting requests for family discounts on consultations and such when I finish medical school. Love it! Next Stop: Grenada. Until then….

Can I Get A Little Help From The Higher-Ups, Please?

As a product of my Sicilian mother whom is also a Roman Catholic, I grew up going to a Catholic church, confiding in Mother Mary and the Patron Saints. Securing their support is not a dependency that I have on believing that I am excused from all Evil, but rather an attitude of "Hey, the more the merrier" and "Any help I can get from the higher ups is definitely a good thing." From time to time, my Mom and I visit her hometown where we usually hit up one of the local Catholic stores with my Aunts and cousins and see which Saint the time is calling for. Well, today the times call for St. Luke, Patron Saint of Physicians.

St. Luke was actually considered one of the first Christian Physicians and known for his extensive writing in the New Testament of the Bible as well as for writing the Acts of the Apostles. The title of Patron Saint is usually given to someone who is holy and virtuous and considered to be a defender of a specific group of people. As he is referred to as the "Beloved Physician" in Colossians 4:14, he teaches of the compassion of Jesus to the poor and suffering.  The following prayer is often said to St. Luke:

Most charming and saintly Physician, you were animated by the heavenly Spirit of Love. In faithfully detailing the humanity of Jesus, you also showed his divinity and his genuine compassion for all human beings. Inspire our physicians with your professionalism and with the divine compassion for their patients. Enable them to cure the ills of both body and spirit that afflict so many in our day. Amen.

Praying for all heavenly forces on my side. :)

The Nerves Are Kicking In

After being accepted to SGU, the time leading up to the actual start date is all dedicated to the art of administrative savvy. There are the obvious things of having to send in health forms, housing forms, flight itineraries, declaring insurance, and getting your loans all squared away. But that doesn't account for all the little things and all the pieces of knowledge that every other student holds. Am I covering all my bases, thinking of all the things I need to take care of before I go down to Grenada? Did I send in all the right paperwork? Am I doing what I need to set myself up to be as competitive as every other student? 

My heart is racing. I am short of breath. My stomach is cramping up in knots. I think I am making my first self diagnosis. I have Anxiety. And WebMD says so too! :)

WebMD - Anxiety Disorders

Of course I probably don't have any diagnosable anxiety, but I am feeling the nerves kick in and am sure that most other students are feeling these same pressures. My dad told me once in fact that medical school does take about 5 years off your life. After I mentioned that to one of my colleagues who was inquiring about his curiosities of my pursuit to medical school, he quickly said, "You know what though, that is 5 years you are giving to others!" I would like to think of it from that perspective, the dedication of my life to someone else's. But damn that anxiety - I think it will kill me before I even get to that point.

Some things that I have learned from the other really smart people that I didn't originally consider. Taking note….

• Setting up the ability to check my SGU email from my smart phone or turning on the forwarding feature to read all email from my Gmail account
• Becoming a member of the American Medical Student Association 
• Looking into SGU Selectives
• Accessing electronic-based versions of supplemental medical books
• Booking my flight home on the right day! (yes, I booked my flight home for after the makeup test week before being advised that you don't need to stay through that extra week)

The Good, The Bad, The Ugly

I am going to start a collection of quotes here on physicians - some grasp the grace and altruism of the profession, while others humorously mock the role that they play. If you find any good ones - the good, the bad, or the ugly - send them over to me. This is always good for a little motivation or a good laugh! 

The Good
•  "In nothing do men more nearly approach the gods than in giving health to men." - Cicero

•  "One of the essential qualities of the clinician is interest in humanity, for the secret of care of the patient is in caring for the patient." - Frances Weld Peabody

•  "To be a doctor, then, means much more than to dispense pills or to patch up or repair torn flesh and shattered minds. To be a doctor is to be an intermediary between man and God." - Felix Marti - Ibanez

The Bad

•   "Never go to a doctor whose office plants have died." - Erma Bombeck

•   "You may not be able to read a doctor's handwriting and prescription, but you'll notice his bills are neatly typewritten." - Earl Wilson

•   "I was going to have cosmetic surgery until I noticed the doctor's office was full of portraits of Picasso." - Rita Rudner

•   "A hospital bed is a parked taxi with the meter running." - Groucho Marx

The Ugly

•   "My doctor gave me six months to live, but when I couldn't pay the bill he gave me six months more." - Walter Matthau

•   "When I told my doctor I couldn't afford my operation, he offered to touch up my X-Rays." - Henny Youngman

•   "Finish last in your league and they call you an idiot. Finish last in medical school and they call you 'Doctor.'" - Abe Lemons

•   "Doctors are just the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you too." - Anton Chekhov

Opening Day

This might not be the opening day you were thinking of, but today, October 1st 2013, marks the opening day of open enrollment for the Health Insurance Marketplace (e.g. Healthcare exchanges). These provisions fall under the Patient Protection and Affordable Care Act, also known as Obamacare, and are recognized as the largest extension of government in United States history.

As I understand it, and with the help of a pretty good article titled Obamacare 101, it explains in laments terms that the basic pillars of Obamacare are grounded in

(1) shared risk, 

In other words, by increasing the number of people that have health insurance, there are more people to share in both the costs and the benefits.

(2) individual mandates, and

Every individual is required to purchase health insurance or will pay a penalty.  All individuals will have access to health insurance, either through their employer or through the exchanges. And those that cannot afford insurance will be eligible for federal subsidy. 

(3) employer mandates. 

Companies with more than 50 full-time employees will be required to provide health care insurance plans that meet some standard, basic coverage.

Last night we saw the government turn its lights out to the rest of the country: an official government shutdown.  There hasn't been a government shutdown since 1995. What's on the table though? - - from the desire to defund Obamacare by House Republicans, the delay of Obamacare for one year, removal of taxes on medical devices, and many other criticisms of the program. It is a big program and has some inherent flaws, but we will only see the value of it if we can get to some agreement in the next couple days...we shall see what the future will hold from both the perspective of the American public and from the physician. We ARE making history today. 

The Packing List for Grenada

As the time grows near and after reading tons of blogs & online student-doctor forums, I have started to assemble my own packing list for the first 4 months on the island (and of which may be helpful to other students in the same boat since there is not one single source that I have found yet). With some of the things on this list, you would think that I was going backcountry camping or something. Even though I am going to what is considered a developing country, that is not the reason my list is this way. My understanding is that because nearly all goods are imported into the country from the U.S., I will actually pay a highly inflated price for something as simple as school paper. Here is what I am working with. If any of my fellow classmates have items to add, let me know!

Packing List ✓ Computer/Technology International Travel Outlet Converters Adaptors/Transformers, 300W and 2000W Wireless Router Extension Cord Surge Protector/power Strip Batteries – all sizes Cell Phone/Sim Card – Lime (buy on island) External Hard Drive Camera Printer iPod Noise Cancelling Headphones Ethernet Cords Clothing Hiking Boots Raincoat Summer - style clothes Swimsuit (X3) Bug Repelling Clothes Two sets of nice clothing (White Coat Ceremony, etc.) Pants Sweatshirts Watch Warm Pajamas Sneakers Flip-Flops Sunglasses Toiletries Sunscreen Hand Sanitizer Bug Spray Women's Products Make-Up Hair Dryer Brush Hot-iron tools Face wash Medicine Cold Meds Advil Midol Vitamins Digestive Aids Sunburn Aids Benadryl Claritin Food items Coffee Splenda Coffee Creamer Books & School Supplies Flash drive Post-It Notes Back Pack Dry Erase Markers Highlighters Notecards & Notecard Rings Paper Binders Calculator Pens/#2Pencils Colored Pencils Paper Printer Paper and Ink Cartridges Sharpies Anatomy Kit with Extra blades Stethoscope and Blood Pressure Cuff Latex Gloves Scrubs (x3) Envelopes/Greeting Cards/Stationary USMLE Step Prep Books ✓ BRS Gross Anatomy, 7th Edition ✓ BRS Histology, 6th Edition ✓ BRS Biochemistry, 6th Edition ✓ Survival Tools Flashlights, Large and Small Battery operated Alarm Headlamp Swiss Army knife Scissors Matches/Lighter Umbrella First Aid Kit Water Proof Bag Duct Tape House Supplies Single set of eat and drink ware Pots Fry Pan Bedding, Pillow, Blanket Coffee Pot Towel Hangers Water Filtration/BRITA Water bottle Lunch Bag Large, Insulated grocery bag Tupperware Laundry Bag Laundry Detergent Dryer Sheets Shower Liner Travel Coffee Cup Plastic Bags - Sandwich/Freezer Bottle Opener Can opener Important Documents Drivers License Passport Birth Certificate Acceptance Letter Immigration Letter To Do Before I Depart Contact Bank to put notice on account, debit ($5 ATM fee for withdrawals and 3% exchange rate adjustment fee) and credit card (foreign transaction fee of 3%) ✓ Contact USAA for car insurance ✓ Unlock iphone 4 ✓ Call AT&T to suspend iphone 5 Cancel/Temporarily Suspend Gym Membership Email Friends/Family for white coat ceremony webcast: http://etalk.sgu.edu/white-coat-ceremony/ ✓ Get info on shipping methods (e.g. Amerijet, http://www.amerijet.com/StationsMap.aspx) ✓ Get info on opening Grenadian bank account, http://www.rbtt.com/ec/personal/everydaybanking/chequing/cid-232218.html Receipts for laptops/tablets ✓ Set-Up Direct Deposit with SGU @ https://apps.sgu.edu/members.nsf/direct-deposit  ✓ Provide list of passwords to Family ✓