“She Lived to Love”

The challenge my mother laid down: “Fight breast cancer for every woman who comes after you, who will suffer as you suffered. God willing, no woman will feel as though she has to face this disease alone.”

About a week ago, there was an article posted on “The MMQB with Peter King” (an NFL blog) written by a football player for the Carolina Panthers. This player, DeAngelo Williams, wrote about his mother’s experience living with breast cancer, which was passed down genetically via a mutated BRCA1 gene from his grandfather to his mother and all four of his aunts. After ten years battling the disease, she passed away late last month.

I’m not normally one to cry in response to reading or watching things on the internet, but this one hit me. Probably because my mother was diagnosed with breast cancer this past January (thankfully not BRCA-linked or estrogen receptive. Both really good things for her prognosis) and has been healing from her own double mastectomy the past few months. She is in remission now, so hopefully that’s the last we see of her cancer. I guess this story hit me so hard because it’s a reminder: a reminder of just how blessed my mother is to have caught her cancer early, and a reminder of the rampant havoc this disease can wreak on a body.

My mom’s case was particularly fortunate. She went for her routine annual mammogram, and the radiologist thought she saw a minor irregularity, a small cluster of calcification from dead cells, that was probably nothing to worry about. She chose to get a breast MRI, just to be on the safe side, and the image lit up like a Christmas tree, cancer cells swirling in constellation-like patterns throughout the tissue. Her diagnosis was ductal carcinoma in situ (DCIS), which makes up about 25% of all breast cancer diagnoses. It had not yet formed a tumor, so it was not picked up on the mammogram nearly to the extent that it was present in her body. It was highly aggressive and fast-growing, and if she had not found it so early on in its development, she would almost certainly be looking at a different prognosis now.

I wish DeAngelo Williams’ mother, and anyone else’s mother who has been diagnosed with breast cancer, could have had the same outcome that mine was blessed to have. Y’all, if you have a mom, tell her to go get a mammogram!

The full article can be found here: http://mmqb.si.com/2014/05/29/nfl-carolina-panthers-deangelo-williams-sandra-kay-hill-breast-cancer-awareness/

Science Joke Saturday – “Stomach Always Loses”

That One Time in the Pathology Lab

Advance Warning: if you don’t like descriptions or mental images of internal human anatomy, you probably shouldn’t read this.

Otherwise, continue onward!

I used to volunteer in my university’s hospital system at the Surgical Pathology Department. I only spent one semester there, because I was starved for human interaction (Fun Fact: this was the same semester in which I fully decided 100% that I wanted to become a doctor rather than a pharmacist. Too little human interaction back there for my tastes, sorry guys), but I learned SO MUCH about human anatomy in that time. My duties consisted mostly of organizing patient slides, maintaining patient records, and sorting through incoming biopsy requests from other neighboring hospitals, but I was also allowed to shadow in the pathology laboratory during my time there. Let me tell y’all, that experience was eye-opening. The first day I was allowed in there is seared into my brain so clearly.

I walked back to the lab, still not completely sure of where I was headed, until the attending pathologist barked out at me: “Hey, you. Volunteer. Grab an apron.” Just like that. No introductions, no stupid ice-breakers, no small-talk, no transition time. I got there, and I was immediately immersed. Not even five minutes later, I found myself shadowing a pathologist’s assistant (I sorely wish I remembered her name, because she was awesome, but she and I were never on the same shift again after that first visit; we’ll call her Sarah) who was talking me through the procedure of dissecting the results of a double mastectomy for cytology samples. I held a human breast in my hands. I felt the difference in density between the normal breast tissue and the tumor, and I was elated when I was able to successfully tell Sarah where the tumor started and ended. My elation was mixed with a sickeningly dead feeling in my stomach when I thought about the fact that this was not a model like the ones in my undergrad anatomy lab; only a matter of hours prior, it had been a live and functioning organ, and it had been attached to a real woman somewhere in that hospital, and she was fighting breast cancer while also having to become accustomed to the angry, sutured wounds in the place of her breasts. It was simultaneously the strangest, most somber, and most incredible moment of my medical experience to date.

Internal anatomy of human breast

Sarah moved right on, though, and the next thing I knew, we were dissecting a uterus/bladder/assortment of abdominal lymph nodes from an older woman who had presented with metastatic uterine cancer. I had no previous frame of reference with which to compare the size of these organs, but it was fascinating to see her pea-sized lymph nodes and feel their slightly grainy texture upon being sliced. Her uterus was tiny, and the fimbriae were all completely intact, their tiny fringe-like projections still reaching out towards nothing.

After that came a placenta from a recently delivered set of twins. I’m sorry, I’m sure experiencing the Miracle of Life is great and all, but I can muster no amount of reverence for the placenta like I did for the breast tissue or the hysterectomy samples. Placentas are gross.

Reaction upon observing the placental dissection.

Moving on, my final experience of the day was a foot-long segment of colon that had been decimated by Crohn’s disease. I got to identify the sigmoid colon, but much of the sample’s gross anatomy had been stretched and distorted by the disease. I got to palpate the internal wall of the colon, and it was so strange to touch and experience the fuzzy texture that the uneven topography of the microscopic colon crypts produced. My roommate for three out of my four years of college has been living with Crohn’s for a couple of years now, and I couldn’t help thinking about how she might end up as a result of this disease; would her colon end up looking like this person’s, diseased and tired and stretched out on a pathologist’s dissection table? Maybe I overthought it, but maybe I didn’t. That day was a massive growing experience, and every time I think about it is a reminder of why I want to do what I want to do.

Christmas

Hello, friends! I hope y’all have been having a wonderful and restful break from classes and stress and everything else like that. Maybe you’ve even had a chance to relax and do nothing, in which case, I say relish that as long as possible. Here’s my update on what I’ve been doing with this break thus far:

1. Material for next semester: I’m taking a class called Metabolic Chemistry & Cellular Regulatory Networks. I am SO EXCITED. I only have one required class left before I complete my chemistry major, so this class is just a superfluous one that interested me, and decided to take the risk of it being hard on my final GPA. I think it’s worth it. Anyway, I’ve taken notes and studied two chapters of my book, and I plan to do a few more in the next week so that I have at least some of the material under my belt by the first day of class.
2. Reading: I’m about halfway through The Immortal Life of Henrietta Lacks. I would highly recommend it for anyone interested in getting into the healthcare field, because it hashes out (and in no delicate terms) the issues experienced in the history of doctor-patient confidentiality, the ability of patients to question treatment recommendations, and ethics of obtaining patient permission. Society has made leaps and bounds since Henrietta’s life came to an end, especially given that she was a black woman dealing with cancer just before the start of America’s Civil Rights Movement. Anyway, it just provides a great perspective on treatment developments and the tissue culture industry and patient relations and it’s GREAT.
3. Apply to DO schools: I sent in an application to Campbell University School of Osteopathic Medicine. It’s the newest med school in my home state, with its entering class of 2013 being the charter class, and it’s got really excellent, brand new facilities. While it is not directly attached to a hospital, it has made huge progress in setting up clinical affiliations with several major hospital systems throughout the state, providing students there with the potential for exciting opportunities in the clinical years. This is the first osteopathic med school to which I’ve applied, so it went through AACOMAS, an entirely separate application system (same idea as AMCAS, but slightly different setup). For whatever reason, osteopathic school application deadlines tend to be much later in the season than allopathic schools (Campbell’s primary app deadline isn’t until March 1), so I am hopeful that I could still hear something from them in the next month or so.
4. Reuniting with old friends: my five dearest friends are people whom I do not go to school with. I met most of them in high school and we’ve all remained in touch over the past four years, despite the six of us being distributed between four colleges, two states, and extremely diverse career and life goals. As such, I’ve taken great advantage of all of us being back at home for this short while, and it’s been wonderful. Many a lunch, dinner, coffee, and beer have been shared over the past couple of weeks.
5. SLEEP: I have slept a lot over break. A whole lot. I’ve convinced myself that it’s because I’m still on a sleep deficit from the past two months, but regardless, it has been so rejuvenating. As premeds, we often feel that we can’t, or shouldn’t, take time to just be still. We have been so conditioned to believe that being still = lazy, and that leads to an exhausting spiral of thinking we could always be doing MORE. Don’t get me wrong, I am all about self-motivation and success and reaching the highest of my potential, but I think the ability to pause and be at ease, even for a minute or two, is grossly underrated.

My school starts back on January 8th, so we’ve still got another week and change to go! Might as well make it count. Happy early New Years, y’all!

ECU Interview

Y’all, I’m not sure if an interview/med school tour combo is supposed to be a religious experience, but it happened for me yesterday. I realized Brody was a great med school, but I did not remotely anticipate just how much I would love it there. The facilities are incredible (they have a new Heart Institute, which, if you’re a CV geek like me, should give you palpitations just to look at), they have ridiculously great technological advantages (the guy who pioneered open heart surgery with the da Vinci robot works there. Casual.), the medical school has phenomenal learning tools (personal favorite – the sim lab that the emergency medicine department wanted to add), and the people are SO UNREASONABLY NICE TO EVERYONE. (I feel like I’m a paid advertisement for this hospital system right now, but I’m truly not exaggerating). It’s amazing. I felt so welcomed by all of the students who interacted with our interview group. They were incredibly supportive, down to asking who our interviewers for the morning were and commenting when they heard a doctor/professor’s name whom they particularly liked.

This is an image of the entire hospital system + med school + health sciences schools (nursing, dentistry, etc.) in Greenville.

Speaking of which: the interview. This was my first interview, so I had absolutely no idea what to expect. I had spent the day prior coming up with outlines to answers of common questions I assumed they would ask, and it was definitely a good idea that I had done some prep, and my dad (who regularly interviews people at his work) did a mock interview for me. I think quickly on my feet, so I think I was able to effectively convey those outlines in words, and the mock interview definitely helped, but if I could go back and change anything about my interview prep, I would definitely have spent more time talking out the answers to myself in a mirror. I’m sure it would have allowed me to fit a greater density of ideas into the time I spent talking, which would be immensely helpful, given that the interviews were only half an hour long each.

The structure of the day: four of us came in for morning interviews, and four more prospective students came in for afternoon interviews. Our days overlapped for the tour of the school and lunch in the hospital cafeteria. We each had two interviews, which were 30 minutes long each, with a 30 minute break in between. This break helped us to re-group, assess how the first interview went, think about any answers we would change for the second interview, and left enough time to find the office of the next doctor with whom we were to interview.

I really liked this structure, more so than a single longer interview. I am convinced that the more people who look at your file, the less likely you are to be eliminated on the basis that one interviewer didn’t like you as much as another one might’ve, had you been assigned differently. I liked that ECU did it this way.

Moreover, neither of the interviewers had been allowed to look at my file beforehand, so they knew next to nothing about me. They received a sheet when I walked in that had my name, undergrad institution, majors/minor, and overall GPA. That. Was. It. I loved it, because, as the Dean put it, “Often, if an interviewer is allowed to read through a candidate’s file prior to interviewing that candidate, chances are he or she has already made up her mind about that person before they even walk through the door.” However, they have to read our files at some point, because we put so much time and effort and valuable information into that primary and secondary that cannot be ignored. For that, they chose two completely different committee members to review only our written files, without any input from interviewers, bringing the total number of people personally reviewing us (and eventually presenting us to the rest of the admissions committee for consideration) to four. Four is a pretty good number of people. Some schools leave this task to one or two people. I think this helps immensely to give a better overall picture of each applicant, with less of a likelihood of being removed from consideration because maybe one interviewer or file reviewer wasn’t as crazy about one of us as the rest of the reviewers were.

My next interview, which is at my lovely alma mater (UNC), isn’t until February, so I think this was an incredible opportunity for me in learning to navigate the interview trail. Regardless, if Brody were to accept me after the experience I had interviewing and visiting yesterday, I would end up on Cloud Nine and probably never come down. Here’s to hoping!

Pre-Interview Encouragement

“…Medical schools generally only extend interviews to students who appear to have the right stuff to succeed. Translation: if you get offered an interview, there is a chair in that school’s first-year medical school class with your name on it. Based on your performance in the interview, you will either claim it or give it away.”

– Quinn Capers IV, MD, FACC, FSCAI
Associate Dean for Admissions,
The Ohio State University College of Medicine

MCAT Words of Wisdom: Part 2

Hello again, friends! I promised a more in-depth description of the MCAT study regimen that worked for me, so here it comes. Keep in mind that this is just what worked for me, and it may not be the perfect strategy for everyone. Do what suits your learning style. Pick and choose points to use in your studying, ignore others. BE SMART WITH YOUR TIME. Simple as that.

1. EMULATE THE PREP COURSE STRATEGY AS CLOSELY AS POSSIBLE FOR AS LITTLE MONEY AS POSSIBLE.
   This was pretty much just a planning thing, but I kept it in mind throughout the entirety of my test preparation. Focusing on the prep course’s main emphases (review content, then expose yourself to as many practice questions and exams as possible) helped me to get my study progress back on track whenever I got too distracted by any one subject. Not a huge deal, just a suggestion to help keep yourself organized.
2. TAKE A FULL-LENGTH PRACTICE MCAT.
   My first order of business was to go in cold-turkey, without having done any review or preparation whatsoever, and take a full-length MCAT practice test. The way I chose to look at it was, “If I went to take this test for real tomorrow and didn’t study for it at all, what score could I make?” That served as my baseline score for the entirety of the preparation process, and the feedback report that came with the test was super informative in regards to which subjects I was solid on or REALLY needed to review. I would strongly recommend this step for anyone planning to take the MCAT, because it gives you a bit of a reality check in getting inside the mindset of the test and figuring out quantitatively what you need to work on to achieve your desired score.
   Kaplan offers a free online practice MCAT on their website, which I used, and I would recommend it for this step.
   
3. TAKE DIAGNOSTIC SUBJECT TESTS.
   Once I had my feedback report, I chose to focus my efforts on the subjects in which I needed to make the most improvement (physics and orgo, anyone?), and for that, I used subject diagnostic tests. Basically, they’re free online, there’s a separate one for each subject, and they have a ton of questions divided up into subcategories of relevant topics that could possibly appear on the MCAT. These also come with feedback reports and help you gauge your study plan even more accurately. Diagnostic tests are your friends. DO NOT psych yourself out if you do poorly on any of these! Their purpose is simply to show you where you should focus your studying in order to improve your scores efficiently. They are time and money savers.
   For these, I used Princeton Review’s website. They have five diagnostic exams, each consisting of about 200 questions, for biology, general chemistry, organic chemistry, physics, and verbal reasoning. They tell you your percentage score overall, as well as percentages in each subcategory for each subject. Incredibly helpful.
4. REVIEW CONTENT FOR ALL SCIENCE SECTIONS.
   This is a relatively broad statement, and can mean a lot of things. I chose a few different ways to do this. First, I invested in a comprehensive science review that would help me brush up on relevant topics commonly encountered on the MCAT. For me, this was a BenchPrep online course (I included a link to their home page in the title of this section), which has mini-lessons and accompanying quizzes for tons of different topics within each subject. BenchPrep does charge by the month for access to their review courses, so being the cheap person that I am, I crammed as much BenchPrep use as I could into one month and then cancelled my membership. I regret nothing.
   Second, I spent many days camped out in Barnes & Noble, because McGraw-Hill makes a series of question bank books (one each for biology, organic, gen chem, and physics) that are perfect for testing your subject knowledge. Be aware that the questions are not formatted like actual MCAT questions, so these are not what you want to use to practice your test-taking skills. Purely for knowledge review.
   Finally, continuing in the vein of camping out in Barnes & Noble, I used practice passage books for each of the three test sections to get a better idea of the format of the exam and the level of difficulty I could expect to see on the test. Kaplan makes a lot of these. Amazon search them. They were a really nice segue from knowledge review into practicing for the actual test format, and as a result, practice tests didn’t have quite the shock value that they would have otherwise.
   

   True Life: this was my bathroom mirror this summer. THE CLOCK DON’T STOP.

5. USE FLASHCARDS.
   I cannot express enough how valuable these things were. These are the tool for when you don’t have the time or access to your full arsenal of review books, question banks, or practice tests. Even if you only look at them for 5 minutes at a time, those little bits of “free” time accumulate to a lot more than you would realize, and you will have gotten that much more preparation than your fellow test-takers.
   Waiting for that fancy-no-whip-latte-concoction-thing you ordered? Flashcards. Stuck in standstill traffic on the highway? Flashcards. TV commercial break? Flashcards. Waiting for your friend to get ready so y’all can go out on Friday night? Flashcards. Live and breathe the flashcards. You will thank yourself on test day.
   I used Barron’s set of flashcards (linked to their listing on Amazon in the title). They’re about $15, incredibly sturdy and detailed, and overall awesome study tools for the times when you can’t sit down and dedicate a lot of time.
6. TAKE SEVERAL FULL-LENGTH TESTS.
   You could re-read all of the science textbooks and review books you’ve ever managed to get your hands on five times through (don’t do that. It’s stupid and wastes your valuable time), but that is a surefire way to land yourself a major case of information overload coupled with an overwhelming sense of inadequacy and discouragement. Please don’t be that person! Chances are that, if you’ve gotten to the point in life where this blog post is immediately relevant to you, you’re doing pretty damn well. No need to spend all that extra time (…which, let’s be honest, you probably don’t have) stressing that you can’t do it when we all know you can.
   Instead: calm yourself, grab a pot of coffee, find all the practice tests you can, and take them. Some are free, some aren’t. There isn’t a wrong way to do it, so budget it however you want. The AAMC has several available MCATs that were administered in previous years; one is free, and the rest are $30ish per test. Kaplan sells books with two or three practice tests and answers/explanations included. My recommendation for those: if you’re buying them, get slightly older editions. SO MUCH CHEAPER for the same quality of review. Otherwise, it might be time to break out the tent in Barnes & Noble again.

In the end, it boils down to taking as many practice tests as you possibly can. The best way to prepare for handling such a strategy-heavy test is to be familiar with its characteristics. The last thing you want is to be surprised by anything about the test at game time.

Know the length of each section. Know how long it takes you to read passages. Know how to pick out pertinent info from these passages. Know how long it usually takes you to pick out that pertinent info. Know how long you want to have leftover at the end of each section to review any questions you may have marked. Budget your time and don’t let the test fluster you. If you do that, you can’t lose. HAPPY STUDYING, FRIENDS!

MCAT Words of Wisdom: Part 1

I know I’m still in the process of applying to medical school, and as yet have not been accepted anywhere, so it’s probably slightly premature for me to be handing out “words of wisdom” to other pre-meds. However, if there is one thing on my application in which I have complete, unwavering confidence, it is the strength of my MCAT score. This post does not exist to brag about said score. If there’s anything I hope to accomplish with this blog, it’s to help even one other kindred soul succeed in trying to become a doctor. And the MCAT is definitely a major stepping stone in that. So, having been through it, I’ll write some things about it.

If you’re reading this and know absolutely nothing about the MCAT, this is what you need to know. It’s required for applying to medical school. It has three sections: (1) Biological Sciences, AKA biology and organic chemistry; (2) Physical Sciences, AKA physics and general chemistry; (3) Verbal Reasoning, AKA exactly what it sounds like. It masquerades as a scientific knowledge test, but it’s not. Don’t get me wrong, you need to have a strong foundation of scientific knowledge in all of those sections I just listed, but the key to the MCAT is not what you know, but how you can manipulate the information you do know in as little time as possible. It’s an endurance test, a strategizing test, and pretty much the bane of existence for pre-meds everywhere…not to be too dramatic.

Chances are you know a person whose desk looks like this. Please don’t be that person. Review books are phenomenal, but you really truly don’t need ALL of them. Promise. Pick a few and stick to them.

I took the MCAT in July of this past summer (2013), which may or may not have been the best time to take it, in context. I took a summer school course to get ahead on finishing one of my majors while also working 50 hours a week across two jobs, commuting, and preparing for this monster of an exam, so it’s safe to say the tensions were running high and the sleep levels low. I would not recommend this setup. However, I tend to produce my best work under high pressure, so the circumstances inspired me to put any energy I had left into exam prep. If that’s you, too, then go for it, but if you require a calm, relatively uninterrupted environment in order to succeed, be sure you have a significant chunk of time (like, we’re talking weeks to months here) in which you can focus all of your attention on preparation.

Truer words have never been spoken.

Unlike many of my fellow pre-meds, I did not enroll in a prep course. I chose to be a self-studier instead. I wish I could give a deep, insightful reason for that choice, but it honestly boils down to the fact that I didn’t feel like paying $2,000+ on prep that I could organize for myself for significantly less money. Simple as that.

The main idea behind prep courses is twofold: first, they briefly review relevant topics in biology, chemistry, and physics; and second, they throw AS MANY PRACTICE QUESTIONS AND PRACTICE TESTS AS THEY POSSIBLY CAN at you in as little time as possible. If you’re enough of a self-starter to put in a comparable level of time dedication on your own, then you can plan your own study curriculum and still have that $2,000+ to spend on other things. Like application fees…or an interview suit…or applications fees…or food for the semester…or application fees…

Enter my study regimen: I’ll highlight these in greater detail in Part 2, but for now, a general overview will suffice. (1) Emulate the prep course strategy as well as possible for as little money as possible. (2) Take a full-length practice MCAT. (3) Take diagnostic subject tests. (4) Review content for all science sections. (4) Find practice questions and do them all. (5) Use flashcards. (6) Take several full-length tests. And that’s it, in a nutshell!

Introductions

As you probably can already tell by the title, I created this blog to help myself sort through the complexities of applying to medical school. The process is long, arduous, EXPENSIVE (can I get an amen?!), and stressful, and expressing myself in words has always been an effective strategy for me to sort out the million and one thoughts swirling around in my head on these kinds of things. Besides for my own benefit, it is my hope that my experiences documented here will be able to help anyone who happens to stumble upon this blog and is also going through the med school application process.

The only prescription I need.

I suppose I should introduce myself: I am a 22-year-old senior in college. I’m double-majoring in biology and chemistry, as well as minoring in music (vocal performance). I decided in middle school that I wanted to be a doctor, even though I didn’t have a clue at the time as to what that actually meant for my future, but since then, my desire to practice medicine has only grown. People are my passion. I want my legacy to have been one of improving quality of life for anyone I came in contact with, and wellness is one of the most fundamental human needs I can think of. I believe that God created each person on this earth with a specific set of talents that benefit others, and my talents in critical thinking, working well under pressure, and empathizing are well suited for a career in medicine.

OKAY SO. Basic run-down of where I am in this process: I took the MCAT in July of this past summer and was extremely happy with my scores. I submitted my primary application to AMCAS at the end of September, after excessive battling with the registrar’s office to send my transcript and writing/editing/trashing/re-writing of the sadistic monster that was the Personal Statement. My application is still in line to be verified, so this means I have yet to receive the majority of the secondary applications I plan to submit. I have, however, received and submitted two secondaries so far: University of Cincinnati and Rutgers.

This stage in the process involves an insane degree of patience, patience, and MORE PATIENCE. And unfortunately, patience is one virtue that I severely lack. Impatience combined with a vivid imagination and a tendency to think about the “what-ifs” are making this a particularly unbearable season for me.

“What if I don’t get in? What if I’m really not good enough? What am I going to do?” This is my current mindset. Dark and twisty, I know. My plan is to update this blog any time something significant happens in this application process, either good or bad, so be on the lookout.

On the bright side: I asked for an interview suit for my birthday. And it looks damn good, y’all. Here’s to hoping I get to wear it sometime in the next few months!