MedeMedeMed.

I'm going back to work tomorrow, after more than ten days of staying home for... viral... reasons, and I'm feeling off, like a mix of anxiety and bittersweetness and terror and laziness. Obviously, instead of dealing with that like a normal person, I decide to just word vomit on a blog where potentially more than twenty-one thousand people could be reading my most personal spontaneous thoughts. How's that for a Sunday night?

It's weird, isn't it. I matched into my dream program, this is what I've worked for basically all my life. I spent the first two weeks not being totally comfortable in this new skin though; not knowing how to stand, how to speak, what hat to wear. I was slowly shedding my past skin to become a new version of my resident self, while navigating a completely new environment, new people, new systems, new everything. And than I had to abruptly take myself away from that, and spend ten days at home, with absolutely nothing to do. I wanted to be productive, trust me. There were so many things I could've done; I could've studied, painted, written a new song, decluttered my digital space, unpacked that box of decor that's still sitting in my closet... but instead I went for the road with least resistance, the one needing the least energy, and I binged watched movies and TV shows (and read two books!). And part of me is mad at myself for that. But the other part just doesn't care.

It's a bizarre feeling, to feel so unmotivated in this new chapter of my life. I had felt some sort of senioritis hit me back in June, as I was finishing the last chapter, but I feel like it has never left? I still feel unmotivated, lethargic, like I don't belong anywhere. I'm not sure I feel quite at home in this new apartment yet, despite having spent 100% of my time between these four walls in the past few days. I feel lonely, but I also don't want to be social. I feel sad, and it's starting to become comfortable. It's an uneasy mess of emotions, and I don't know why it's happening.

That's a lie. Rationally, I know what it is. It's a lot of adjustment disorder peeking through. It's a lot of new things in very little time. It's also majorly imposter syndrome, hitting me right in the face with all the new responsibilities I've gained on July 1st. And just as I was adapting, I was thrown out into isolation, and I went into complete inertia. And the less you do, the less you want to do. Ain't that how it works? Rationally, I also know that motivation doesn't drive action; action drives motivation. I know that comes tomorrow, once I'll be forced to go to work, to see people, to get back into the role I was learning, the cogwheel will start spinning, and the engine will start again. Rationally I know all that. But right now, right before I get there, I feel like wallowing in this mess, and at the same time hope that I'll get out of here asap.

Until tomorrow, I'm gonna let myself be a potato and potate. But tomorrow is a new day, I know it. It has to be.

Hope your Sunday scaries are not this scary.

(and if you've read this far... whyyy but also i'm sorry)

It's my last day at my program's main hospital, my last shift at the ICU here, the last time I see some people who have marked my three years here. Two days ago, I cried at our end of the year party. Tomorrow I'm starting my last week working/living in this city.

I'm 100% nostalgic and sad and feeling all sorts of mixed feelings. I feel like I have moved here barely a year ago. Some of my best friends now were still strangers not so long ago. I don't know where time went; I don't know how life has decided that my chapter here was meant to be only three years, but here I am.

One day, this will be a fond memory, an incredible few pages of the book of my life. For now, I'll just let myself be sentimental living through this bittersweet ending.

Last night, things got really bad for a patient. We were out of options for him. He had really high doses of strong medications to keep his blood pressure up, antibiotics on board, was put on the ventilator earlier in the day, and his labs and vital signs showed us that all of it wasn't enough. Multiorgan failure is what we call it — organs shut down one by one, often starts with kidneys, and then quickly the liver, lungs and heart start to fail.

I got paged at 9pm. Things were getting worse. There was nothing more we could do. I had to call his family and tell them that this was it. He wasn't going to survive the night.

Over the phone, I listened to their sobs, but kept a straight face. As I waited for them to arrive, I joked around with the nurses, got hungry and craved social tea biscuits... and then I thought, am I heartless? Or is this just how we cope?

So I don't think about how I devastated them with a single conversation, how I destroyed their night and changed the course of their life.

So I don't think about how these people will lose their father, husband, brother, friend.

So I don't think about how quickly it'll deteriorate once we stop treatments, and how he'll pass not even two hours after that page.

So I don't think about how I would feel in their shoes, if that was my family.

So I don't think about how this morning, I was still talking with this man, giving him ice chips, holding his hand, and telling him we're taking care of him.

So I don't think about the message I left on his voicemail addressed to his wife that she'll have to listen to once she's home, a cruel reminder of this awful night.

So I don't think about how powerless we are, despite all the advancements in medicine.

So I don't think about how this is only one of the patients I lost today, and one of the many I'll lose in my career that's barely started.

I don't think I'm heartless. I got into medicine because I'm not. So these have to be coping mechanisms, right? But it still doesn't make it easier. In any case, it probably makes nights like these harder.

I know I'll remember the patient and his family, the difficult phone calls I made, and the drive home the next morning with tears streaming down my face thinking back on this. No one in medicine will teach you how to cope, not in school and not ever. But you learn. You learn, you remember, and you move on.

It’s been a while... during which I travelled, I graduated, I packed, moved, unpacked, and I got ready for orientation (which happens to be tomorrow). It’s been an eventful break, and far from enough, but I’m so excited to start this new chapter!

February has been absolutely life changing, both personally and career-wise. I’ve stepped out of my comfort zone and did something that scared me but that I knew I had to do one day. I checked things off my long-term list of things I wanted to do. And all of the effort I’ve put in in the past months and years have led to the news I received last week that will literally mold the next few years of my life. 

Since September, I’ve been documenting my Journey to CaRMS, where you’ve followed me through my thought processes, my insecurities, my anxiety toward building the perfect application, the overwhelming amount of letters to write, and the excitement from interviews, which all eventually led to this fateful day of February 26, 2019, where I finally got my match. And for those who missed the news, I was matched in internal medicine!! The news came as a bit of a shock, I wasn’t as satisfied as I thought I’d be, but I am now beyond excited to put this chapter behind me and start anew this upcoming July. I’m excited for this new adventure, and to be able to grow up and mature even more. 

I still can’t quite believe that I’m almost done with med school, and that I’ll be a resident soon (and as I’m typing this, it feels completely unreal) and that I will get paid (hallefreakinlujah). I’m ready to face new challenges, to have new great experiences, and you bet I will continue sharing my journey with you! 

Thanks for sticking around, for the endless support you’ve given me for years, and I can’t wait for what’s to come! :) 

From starting a new year to doing an amazing rotation in another city to doing six interviews on my interview tour, you could say this past month has been quite a whirlwind. 

I started the month – and the year – with a little panic attack (hopefully it’s not an omen for the rest of the year), but things could only go better from there. I got many rejection emails from residency programs but it didn’t matter, if anything it made my choice easier. I packed up and travelled to another city, where my brother lives, where I would stay for a week and a half for a short rotation in general internal medicine. I learned so much, and had such a pleasant time with incredible residents and an absolute gem of an attending. That rotation ended too soon for my liking, but did confirm my decision to go into internal medicine. 

As soon as I came back home, it was time for me to start my interview tour. I met many residents, staff and even program directors who asked me questions about myself, my past experiences and my interest for their specific program. Some interviews went better than others, but overall I’m not too worried about them (hopefully I shouldn’t have to). I finished my last interview a few days ago, and am now left with the very daunting task of making my rank list. Although some choices are easy to make, others leave me completely confused. Should I prioritize program over city or city over program? What kind of lifestyle do I want for myself? Am I ready to move for 3 years, maybe more? Which program did I really connect with? Which one has the best features? What do I want for myself???

Hopefully, I’ll end up following my heart but have my head back me up. These are very important decisions to make, but I also know I’ll find happiness in whichever program I end up in. I’m thoroughly excited for what’s to come, and next month will be equally crazy, if not crazier. By this time next month, I’LL KNOW WHERE I’LL HAVE MATCHED, AND YOU SHOULD STAY TUNED FOR THAT!! 

December has been a small break from CaRMS, but not an absolute break nonetheless.

A pharmacology exam has taken a major part of the first half of the month, where I studied as much as I could during night shifts or for hours after long days at work. I’m hopeful that the intense studying has paid off and that I’ve passed the exam, but I guess I’ll never know for sure until I get the confirmation. 

The whole month has been also spent in obstetrics/gynecology, which has revealed itself to be a pleasant surprise. I’ve delivered over a dozen babies, have witnessed a major urgent surgery on an unforgettable night shift, I’ve been there to deliver good news as well as some rare bad news, and I’ve learned so much about woman/reproduction health. For a few moments there, I almost regretted not having applied in obgyn as well, but I know I will be able to mold my future practice to include a bit of it, whether I match into internal or family medicine. 

To top it off, I was lucky to get 10 days of vacation for the holidays, which I spent doing absolutely nothing productive and gradually stressing over the upcoming interviews taking place in January. They are going to be crucial to my application and the match process and I honestly can’t wait to get them over with, but until then, I’ve got a lot of preparation to do in order to show myself in my best light!

November felt like such a blur, but such a satisfying one. 

From rushing and praying to get all documents on time to spending hours staring at a dozen personal letters, while having irregular schedules and working shifts and trying to study for a big exam, you can imagine how relieving it is to finally have submitted everything and being done with night shifts (although I unexpectedly really enjoyed those night shifts in obstetrics...) Now that that’s all done, I can finally start stressing out about my upcoming pharmacology exam...!

It’s actually crazy to think that this time next year, I’ll be working as a resident and actually get paid (!!!) for doing something I really enjoy. All the hard work will be worth it, and I absolutely cannot wait for it. 

I feel like I went through the five stages of grief in the span of the last month. 

I was in complete denial that the deadline for CaRMS was approaching. I would focus my energy on studying for my upcoming pharmacology exam or for the current rotation, and completely ignore the whispered voice in my head. 

I got angry at my preceptors for not providing their letters a month before the deadline, but I was honestly probably more angry at myself for not being able to chill and be patient, and being way too anxious instead. 

I bargained with myself that I would keep on studying for pharmacology and my rotations, but I would also spend at least a few minutes a day working on my letters and my applications. I also might have almost slipped in some retail therapy to make up for the stress... 

The days went by, I still got no answers from my preceptors about the letters, I had accumulated too much stress with my weird work schedule, with the upcoming exams, with how much I have to study while dealing with CaRMS season... I was feeling all too overwhelmed and seriously on the verge of another breakdown. I wasn’t depressed, but my mood was definitely not at its best, and it certainly didn’t help that the weather stayed cold and gloomy, and as much as I like fall, I like pretty fall, not poopy fall. 

A week ago, I started accepting everything, and things started falling into place. I pushed myself to get out of this funk, and I got moving. I worked quite a bit on my personal letters, I even have a few basically done. Documents have been uploaded, translation requests have been sent. The two preceptors I was waiting on answered and deposited their letters as well (!!!!). I felt like I could finally breathe a bit better, and I finally felt that things were going to turn out okay. 

There’s still an immense amount of things running through my mind, I’m still probably disproportionally anxious, but I’m learning to take things one step at a time, take them as they come, and I’m reminding myself to breathe. Things will work out, and even if they don’t, we’ll figure out the next step after. 

September has somehow felt really long. From an endocrinology elective in a community hospital that I loved so much I would’ve had twice as much without hesitation, to starting my geriatrics rotation back in the big hospital with a dozen other students, and the start of CaRMS season weaving its way through the entire month... I guess it’s just been quite eventful.

For those who didn’t know, CaRMS stands for the Canadian Resident Matching Service, and is basically the equivalent to the Americans’ ERAS. It’s what we have to go through to be matched in a residency program. We first gather all necessary documents, including letters of recommandation, academic records, resumes and personal statements, and apply in our preferred programs. Interviews then take place in January/February, and we’ll get to visit different faculties and meet their members – ie. potentially our next attendings and colleagues. Finally, Match Day happens on February 26, 2019, at noon exactly, when we get news of where we’ve matched for the 2, 3 or 5 years to come.

If it sounds overwhelming, it’s because it definitely is. Only last year, it felt like such a distant thing to go through, but now that’s it’s finally here, it’s hard to know how I should be feeling. I’m not the best when it comes to managing anxiety, but I’ve been doing better recently. I’ve learned to split things into smaller manageable tasks, and so far so good. I’ve asked some attendings for letters (still waiting on them), got some documents ready, updated my resume and started writing my personal statements. There’s still lots to do, but it’s true what people say: the only way to eat an elephant is one bite at a time!

One big progress has been made though, and it’s one I had been struggling for quite some time. The dreaded what do I want to do for the rest of my life question was hanging above my head, and there was a constant tug-of-war between internal medicine and family medicine. People would tell me I’d just know one day, and I didn’t quite understand what that meant at the time, but now I actually do. After that endocrinology elective, I had some kind of illumination – internal medicine was what I truly wanted to do. There are also less alluring things in family medicine that tipped the balance in the former’s favour, but there’s so many positive things in internal medicine that I can’t wait to explore.

It’s honestly been a lot easier knowing what I want and what I don’t want for the next decades of my life. As cheesy as it sounds, it does feel like the fog has been lifted. It has become easier to tread in clearer territories. On the other hand, there’s still constant doubt creeping in. Will I be good enough – There’s so much to learn – Am I interesting enough – Will they see me past the lack of research – Am I doing this just for ego issues – What if I don’t get in – What if I get in a program that’s six hours away from home – What if I end up in family med – What if –

But deep down I know. The doubts will always be there, but I’m still confidently marching forward. I’m capable, I’m motivated, I’m a hard worker. The obstacles I’ll meet might make me tumble, but I’ll get up from them, and I’ll keep marching. One step at a time, I will eventually reach that end goal.