Dr. MacDonell-Yilmaz

That will be the name on my medical license someday, because Tay and I got engaged!

As I mentioned previously, we spent a lovely Christmas at my family's condominium at Sugarbush, VT, with some presents in the morning and an afternoon of skiing, then a great dinner at one of our favorite restaurants. The following day, for the first run, Tay suggested we ski Sleeper, a very pretty trail with several offshoots that meander through the woods. Suspecting nothing, I followed him down one of these small side trails, and when he stopped on the side, I skied right past him. "Becky, wait! Stop!" he called after me. "Come back here!"

"You want me to hike back up there??" I asked, and when he nodded, I decided that he must have a good reason. There wasn't a great distance between us, and when I arrived, he stepped out of his skis, saying nonchalantly, "Let's take a break." And in that moment, I knew. He stepped in close to me, lifted my goggles from my face up onto my helmet, and as he began talking, I burst into tears. He wiped my face, then got down on one knee in the snow on the side of the trail and asked me to marry him.

After hugs and more tears and a resounding Yes!, I asked him if my parents knew about this. Of course, it turns out that they had all been in cahoots for a few weeks, and the day before, my mom had actually helped Tay scope out the perfect spot for the proposal. As we continued down the trail, there were Mom and Dad, standing off to the side smiling and waiting for us to arrive and share the good news.


My engagement ring is extra special to me because it is a unique setting (the jewelry company was nice enough to make a new mold, altering an existing setting to fit our preferences) and the center stone is a diamond that my late grandmother willed to me. I am still getting used to feeling it on my hand and to looking down and seeing it each day, and I love every minute of the excitement! Here are some pictures:

Although we are in no rush to set a date, I will admit to buying a wedding magazine yesterday and reading just about all of it in one sitting. As many of you know, I am a planner, and I relish the process of investigating different options and taking care of all the details. In any case, I feel incredibly lucky to have found Tay and to be able to share this happiness with my wonderful family and friends. Happy New Year and all the best to everyone in 2009!

1/8 MD!

As of last Friday, I have completed 1/8 of medical school! After lots of preparation and a fair bit of worrying, my finals went well. In fact, yesterday I got kind of an early Christmas present in that my biochemistry grade was posted and I was very happy! I'm still waiting on my final anatomy score, but I know approximately what it will be, and I'm totally satisfied.

It's really amazing how much can change in a few short months. I know this from past experience, and had tried to remind myself earlier in the semester, whenever I got worried and agitated, that eventually I would get used to this whole med school thing and it would seem like old hat. I realized I had reached that point about 2 weeks ago. I had the day off from class, but needed to go to my ICM (Intro to Clinical Medicine) site, where I work with an internal medicine doctor about once or twice a month, learning to do basic patient interviews and exams. I stopped by school to pick up my white coat and stethoscope from my locker, and as I hurried through the halls, I realized that the only thing on my mind at the moment was driving carefully through the rain to get to the site on time - a perfectly normal thing to think about. This was in stark contrast to earlier days when, in addition to normal worries, I had to think about finding my way around the halls of the Health Sciences Center where I go to school. (On the first day of class, after I finally figured out how to get from my car to the right entrance of the building, I had to follow other classmates because I didn't know which way to wind through the seemingly-labyrinthine halls to get to class!) School alone provides enough to worry about, so imagine how much was on my mind when I was still adapting to my new setting! It was like a full-bodied sigh of "Aaaaahh, I'm ok now," to realize that, without knowing when exactly, I had passed through that initial phase. Now my full concentration can be given to school rather than being spread thin between school, navigation, meeting new people, etc.

After finals, I slept past noon for the first two days. I'm starting to feel like a normal person again, re-entering the rest of life and taking care of things like laundry and buying stamps. I'm also starting to work out how I will spend next summer - my last free summer! I'm hoping to do some clinical oncology research (surprise, surprise), but I'm not sure where that will happen yet. I have already applied to one program, and will investigate several others as well.

And now the holidays are in full swing. Tay and I spent Sunday evening with his mom and her boyfriend, Monday evening with his father, stepmother, and little brother who just turned 7, and last night with my parents. We actually had my family's "official" Christmas last night, including a scrumptious meal and many thoughtful gifts, because we are heading up to Vermont today for four days of skiing. (We did save some presents to bring up there; I'm still a little kid and insisted we have something to open on the real Christmas Day.)

With that, I will end and continue cleaning the apartment and packing. I wish everyone happy and healthy holidays!!

Cadaver Dreams

Last night, with only six sessions of dissection to go, I had my first dream about anatomy. In it, Harvey was whole again - organs back in place, skin intact, face no longer marred. I was gathering clothing in order to dress him before he was sent away. I remember feeling very sad that it was time for him to go. At the end, I patted him on the chest and said, "Thank you, Harvey. I will be a better doctor because of you."

Just a quick post to celebrate the election outcome and share some pictures from Halloween. Hoping that Sarah Palin would henceforth disappear from the US political arena and such a costume would never again be relevant, I decided to dress up as her for Halloween, complete with folksy accent and incessant winking. (My pin says "I love Real America.") I admit I was probably channeling Tina Fey as much as the real Palin, but it made for a very entertaining evening and "also too" earned a ton of laughs. Maverick!

Change of Perspective

In the movie "21," which chronicles the adventures of a bunch of MIT students counting blackjack cards in Vegas, the instigating professor presents a probability problem to his class. It goes something like this:

Professor: I have 3 doors. A car is behind one of them. Pick one.
Student: I pick Door 1.
Professor: OK, what if I tell you that the car is not behind Door 3? Do you want to keep Door 1 or switch your answer to Door 2?
Student: I'll switch to Door 2.
Professor (clearly impressed): Why?
Student: When I first picked, I had a 33% chance of being right. Once you took away one option, the odds changed....

My understanding of the math gets fuzzy right around there, but I've been thinking about that scene lately and how getting a piece of new information can change how you think or feel about something. Two recent situations have illustrated this.

A week and a half ago, I took my Biochemistry and Anatomy midterms. I was somewhat terrified going in, convinced that no amount of studying would make me feel fully prepared, and aware that, given my proclivity for sleeping, eating, and exercising on a fairly regular basis, I didn't have time for unending cram sessions anyway. I entered the tests feeling that I had prepared to the best of my ability and reminding myself that all I really needed to do was pass.

Last week as I walked to my mailbox to get my graded anatomy exam, I repeated my mantra: "All I need is a 65; I'll be happy with that" over and over. I took one look at my grade (safely above a 65) and thought, "Crap! I want to do better than that!" Once I had that assurance that I was passing, my goals changed. In the end, I scored above average on both tests. That knowledge has made me enjoy my subsequent studying even more; some of the fear of failure has been replaced by fascination with the information I'm studying, which I think is a healthy switch.

The second instance of a change in perspective occurred last Friday in Anatomy lecture. As we study the branches of the facial nerve, we learn about Bell's Palsy, in which a nerve injury leads to symptoms such as a drooping of one corner of the eye and mouth. We also saw pictures of people who have just one nerve injured, and saw that an injury to the marginal mandibular nerve results in the bottom lip being paralyzed on one side, making it look like the other side droops. This injury can occur when a person has surgery on their submandibular glands for cancer, and indeed, the person in the picture has sort of an indentation right under his jaw.

Suddenly my mind flashed to my 9th grade Earth Science teacher, Mr. Pearlmutter, with his asymmetrically drooping lip and what looked like a strange indentation in his upper neck. This man who we ignorant teenagers had made fun of had most likely suffered a nerve injury during a surgery (possibly for cancer)! I felt really terrible and want to apologize to him, wherever is he is now. I'm so sorry Mr. Pearlmutter!

Loving the Jewish Holidays

I haven't set foot in anatomy lab for 3 whole days, which is a new record. I also slept until almost 9:30 this morning (gasp!). These luxuries are thanks to the fact that Stony Brook shuts down in observance of Rosh Hashanah. This extra time has let me [start to] catch up in my studies and begin preparing for midterms, which are only 2 weeks away.

Here's a quick (maybe) synopsis of the goings-on since my last post:

We had a fantastic guest lecture last week delivered by a gynecologic oncologist - in other words, someone who does exactly what I hope to someday! It was so much fun to hear her describe the surgeries that she does, and when she started using terminology that I've been learning, it was sort of a lightbulb-going-on-over-my-head moment, as in, "Hey wait! I know that! I'm learning some of the EXACT things that I will need someday when I practice medicine for real!"

I've been ruminating quite a bit lately about how different medical school is compared to college in that everything I'm learning is directly related to, and vital for, what I will be doing later. Even after I declared my French major, I didn't look at what I learned in my classes in terms of its application to my future studies - there were no thoughts of, "Hmm, I'll definitely use this verb tense or cite this piece of literature in my senior thesis!" Here, however, it's a different story. There's a lot of pressure that comes the knowledge that this actual information may be important for my career, but it's also a great source of motivation when there seems to be no end in sight to the amount of information to cover.

Back to the guest lecturer, though. I had actually met this doctor years ago when I was doing an internship at Stony Brook with one of her colleagues (who no longer practices here, unfortunately), so I introduced myself to her afterwards and told her of my interest in gyn onc. In inquired as to how I might get involved in the department's research, and she told me whom to contact. Yay!

Some classmates and I spent almost 8 hours in lab on Saturday "pinning" several bodies. One aspect of our exmas will involve identifying different organs/nerves/blood vessels that are marked in the bodies using pins, so we decided it would be good review to pin everything we have studied so far - about 175 structures - and then test ourselves. It was very helpful and fun, especially with our break for pizza. Long hours in lab never fail to make me hungry.

Finally, I had a personal training session at my new gym on Sunday, and the girl worked me so hard I've been hobbling around for a few days with extremely tight muscles. At least I have some new moves to do at the gym once I recover!

Looks like I've been verbose once again. There's just one more thought that I want to share, as well as to document it so I will remember it in the future. I was talking to the medical school's learning specialist (who offered some really great tips as to how I can study even more efficiently), and she told me that, although everyone will tell you something different regarding how much grades, board scores, and where you do your residency matter, it's important never to forget that it's a privilege to even have the opportunity to study medicine.

Missing the Big Green

I just read that Dartmouth's convocation was today, officially beginning the new school year. I know that the point of going there was to learn things that would prepare me to go out into the big, wide world, but sometimes I really miss being safely nestled up there in the mountains and trees.

White Coat, Breakdowns, and Amusing Anatomy Anecdotes

On Sunday, September 7, I went through one of the rites of passage of medical students: the white coat ceremony. My parents and Tay came to watch me go up on stage and have one of the deans put my white coat on me, welcoming me into the medical profession. Here are some pictures from the ceremony:




(On a side note, several other parents who were sitting in the audience turned to my mother and said, "I can tell which one is your daughter!" Yes, we now sport even more-similar haircuts. I'll take it as a compliment!)

The ceremony was an exciting occasion even though I can't actually do anything medical yet; my coat is a short one, which indicates that I'm a student. I wear it whenever I have any clinical interactions. So far, this entails practicing interviewing standardized patients (trained actors) in our Clinical Skills Center. The patients are given a certain complaint and medical history which we need to elicit while sitting in an actual exam room, being observed remotely by a fellow student who then provides feedback. It's a nice break from lectures and a great reminder of why I'm doing this!

By "this," I mean, of course, ridiculous amounts of work. I don't mean to complain; I got myself into this mess! It's just that the amount of information thrown at me each week has become somewhat overwhelming and I am currently upset with myself for (already!) having falling behind. That's exactly what I promised myself I wouldn't do! Perhaps I was too confident coming in, thinking that I was a mature, seasoned student who has figured out over the years what study techniques and time management techniques work for me. However, due to my earnest studying for the first anatomy quiz (which went very well!), I let the more current work for anatomy and biochemistry lapse. As a result, the second quiz did not go as well.

My "big sib" (a second-year student who was assigned to me as sort of a mentor) has assured me that she didn't really feel settled until at least mid-October of her first year. She also maintains that everyone will have at least one breakdown/freak-out within the first month. Well, I'm right on schedule! I woke up this morning with a cold, took the aforementioned not-so-good quiz (we take them electronically), and promptly burst into tears, convinced there was no way I could catch up and handle all of this work.

Mom and Dad, if you are reading this before having talked to me, don't worry; Tay took great care of me and I'm feeling much better now. I spent the afternoon studying in bed and then did an overhaul of all of my course materials, finally getting fully organized. I've realized that I need to focus my studies a bit differently, now that I can see what types of things my professor focuses on in exam questions.

On a happier note, I ran a 10K race yesterday with some of my new friends, and have joined a weekly "mindful meditation" group led by a psychologist at the medical center. It's supposed to help you relax and clear your mind so that you feel calmer and aren't as affected by worries and negative thoughts. I'm trying hard to maintain a few aspects of my life outside of my studies that will keep me happy and healthy.

Finally, I'll end with a recent amusing scene from the anatomy lab. (It's not for the faint of heart.) Our cadavers lie in bags on top of a steel table, in which there is a hole that drains into a funnel into a big bucket underneath. We have been warned never to move these buckets, as they collect all the "juice." Well, our bag was getting rather full of fluid, and we were strategizing how best to empty it without having it pour onto the floor. A friend from a nearby table said, "Just cut a hole in the bag right over the table's hole so the juice can flow through right into the bucket. Here - I'll do it." He did. And because, unbeknownst to us, the funnel leading into our bucket was clogged, the fluid poured all over our lab bench under the table (holding our tools, dissction books, etc) and all over the floor around us. All I could do was laugh and be thankful that this hadn't happened on the first day!

Anatomy Time

The verdict is in: anatomy lab is fun and amazing! I have completed three lab sessions (including a double dose on Friday), and I am looking forward to spending four afternoons per week there.

Let me back up a bit.... On the first day, I was apprehensive, to be sure. We had a lecture first, which oriented us to some of the nomenclature used when describing body structures and where they lie relative to one another. When we were dismissed to go to lab, there was a mass exodus from the lecture hall and then a lot of confused milling about; no one knew quite where the lab was! (In our defense, the layout of our health sciences center is a bit confusing.)

After changing into my brand new scrubs, retired running shoes, and one of my dad's old lab coats - I'm told that the more layers you wear, the less your skin will smell - I took a deep breath, entered the lab, and searched for my table. Stony Brook assigns 4 students to each cadaver, and I am lucky enough to have 3 intelligent, thoughtful, and kind lab partners. We are also lucky in terms of our cadaver. The man from whose generous donation we benefit was very large and well-muscled. During our first lab, when we identified the muscles of the back, our table was quite popular because we had a great example of what they should look like. (Although we sometimes have more work to do as we remove the skin and cut through certain structures, you can imagine that our cadaver shows much better examples of these than some of the very small elderly females that some of my classmates have.)

It didn't take long to adjust to the smell, to using a scalpel, or to digging around with my hands to define the edges of muscles and locate certain structures. On Friday we used a hammer and chisel to remove the outer portion of the spinal vertebrae in the lower back in order to see the spinal cord, which we also cut open. Then will turned the cadaver over (with a great deal of help from bigger male teaching assistants - 2 of my lab partners are girls who are smaller than me) to begin examining the muscles of the chest.

At this point we saw our man's face for the first time. Surprisingly, this didn't bother me. I just keep wondering who he was and what made him decide to give us this incredible gift. Some tables have covered their cadavers' faces as they work on the front portion. While it is generally good to cover any parts you are not working on with a wet sheet to preserve them for longer, we chose to leave our face uncovered. In a strange way, I feel as if, as we explore this man's body, we are getting to know him. We have discovered (and cut around) two tattoos so far, and have noted a distinct absence of wrinkles.

Later in the semester, pathologists will come in to tell us how each person died, although we are beginning to get clues. For example, our cadaver has some sort of a red dent in his forhead between the eyes, so we are speculating right now that he may have died relatively young from some sort of trauma. The one at the next table, an older woman, has two breast implants (which certainly surprised the students at that table as they were dissecting the chest!), perhaps as a result of a double mastectomy from breast cancer.

Next week we will remove the ribcage and begin dissecting the heart and lungs. There is an incredible amount of information associated with this class, but it is fascinating. The professors are very good about providing clinical correlations to what we learn - why, for example, lumbar punctures (spinal taps) and epidurals are done in the lumbar spine. (The reason is that the spinal cord itself does not extend that far down the back, so you don't risk puncturing it with the needle.) I am approaching this class as I would learn a new language, trying to learn trends and rules in the naming of structures. Many are logical (as in the case of the serratus muscles, whose edges look serrated where they attach to the ribs), though some just need to be memorized.

And now back to the books... enjoy the long weekend everyone!

Getting Oriented

Med school is officially under way! After a fantastic vacation in Mexico (see pictures here: http://picasaweb.google.com/BeckyEllen28/PuertoVallartaMexico), a trip to Vermont to relax and visit family, and a week or so of moving in and getting settled, I am ready to go.

Last week was orientation, with many presentations about the curriculum, the websites for the school and courses, student health services, how to succeed in medical school, etc. It seems that there aren't any huge secrets as to how to survive and succeed; everyone keeps emphasizing the need to manage your time and balance your life, which is what I certainly hope to do. Of course, our anatomy professor also told us that he once counted the number of body parts/structures that we need to learn, and they numbered over 2000. We also need to know where things are located in relation to one another. He readily admits that it really is impossible to learn all of this in one semester. Fantastic! To that end, I have already started studying on my own.

My other two courses are biochemistry and Foundations of Medicine, which combines a number of topics such as taking a history and physical, medical ethics, and professionalism. Tomorrow we will spend the entire day doing Basic Life Support (CPR-type stuff), and then the real fun begins on Wednesday with our first anatomy lab [cadaver dissection]. I am nervous and excited about that one!

There have also been a number of social activities during the past week, and, despite my only-child shyness, I have attended nearly all of them, trying to meet as many of my classmates as possible. I have actually become quite good at approaching total strangers to introduce myself and initiate conversation. The class seems to be full of very friendly, interesting people, and I've been able to remain calm and remind myself that making friends takes time.

As for the rest of my life - those elements that I will try hard to balance with my studying:
Tay is very happy in his new job with a large ophthalmology practice, which is very close to our apartment. (At the moment, he's actually in Ireland, visiting/working with a physician he met when he lived in Boston.)

I'm making a huge effort to continue working out, because I know it helps keep me sane. I've been shopping around for gyms, trying a running route on campus, and even attempting yoga. (I think anything that is calming and relaxing will be good to have in my bag of tricks for later.)

And finally, I've been seeing my parents about twice a week, which is so much fun! I ditched a house party on Saturday night to spend time with them, and it was so wonderful to not feel as though we had to make the most of every single second of a too-short visit. When Tay and I first moved in together, we wondered: how did we ever survive being so far apart and seeing each other so infrequently? Now I have the same feeling about being close to home; it feels so natural to see my mom and dad on a regular basis, to just stop by to pick something up or say hi. Even Bijou is getting used to seeing me so often; when I arrived on Saturday she came to the door, got excited for a few seconds, and then went back in the house as if to say, "Oh, you again? No big deal."

So here I go.... I hope to provide updates and funny stories every now and then. (They won't all be this long, I promise!)

In closing, here's an interesting fact I learned today: The tuberculosis virus can survive in the air for 8 days. (People ahead of me in med school: apologies if this is completely untrue. It's what they taught us in infectious disease training today.)