Tuesday, April 28, 2015

Buses, Babies, and Broken things

Since my last post a lot has happened, but this time I'm going to talk about my experiences in reverse chronological order starting with today, and going backwards. here goes.


Late Sunday night Sarah was arriving on a bus from Detroit. She had taken the megabus, and it was set to arrive in Chicago at 1 am. But as with all public transport it was set to arrive late. Now, a side note about megabus. This company puts large graphics on their buses, but they failed to acknowledge the mechanical parts of the bus's layout first, resulting in this.

This my friends is an unhappy accident. I give you the Hitler bus. 

Unfortunate mishaps aside, Sarah arrived at 2am and we drove home quietly along Lake Shore drive. I had to be up at 7am the next morning so I went to bed promptly. My current rotation is OBGYN or everything related to women, birth, babies and reproductive studies.  I had a very long day at the Clinic today. We had so many patients back to back to back that I managed not to eat for 10 hours. (This may not seem like much but for me was a special kind of torture.)  Nonetheless, a long day without eating on only a few hours of sleep  made me have an early night (9pm bed time , which is also the earliest I've gone to bed since I was a child)

So I close my eyes and fall asleep. 

My phone rings at 2 am with my Doctor  on the line. (The one I follow at the hospital) "We have a delivery and we'll see you at the hospital ASAP!" 

Up I went. I got dressed in record time. I packed up my backpack with my lunch, my computer and something to drink and out the door I went. The average time it take me to get to the hospital in the morning when leaving at 8 am is 40 mins. When you leave for work at 2am though, 19mins. I was the only car on the road for most on my ride. So I cruising down Lake Shore drive and make a few turns here and there. Before I knew it I was 5 minutes out. I was going along and came to a cross street under a bridge with limited visibility. The light was red. So  stopped quickly. (And I didnt learn from my mom all these years when she would put out her arm to prevent my head from slamming the dashboard when stopping quickly)  My backpack that was on the passenger's side seat took flight and after doing a graceful back-flip, landed on the floor with a nice crunch. And here is the result: 


My poor laptop took the hit, but luckily I'm using it to type this very blog... for now.

So I continue to the hospital,  park, and fly up the elevator to Labor and Delivery. I got my scrubs on and walked into the room and within a minute I was there to catch the baby with my doctor. The Doc let me essentially deliver the baby. I delivered the placenta no problem and mom and baby are doing great.  I describe this delivery passively because like I said earlier, I'm working backwards in my storytelling. This was my second delivery :-)

I've been in my OBGYN rotation  for 3 full weeks now. I've learned and experienced so much in so very little time. In this rotation I've gotten to watch and perform Ultrasound. I've been able to tell a new mother she is pregnant for the first time, I've been able to identify fetal organs and heart beats. I've been able to identify the gender of the fetus and see the smiles of happy couples and now I've been able to hand over the newborn child for the mother to hold for the first time. Its a very rewarding rotation.  

The time in the clinic is very similar each day. We see very common infections, and other STD's. We also doing prenatal care (care for mom /fetus for 38weeks prior to delivery). The routine of seeing patients and writing logs on patients has become second nature (although I still need more practice).

The first delivery  I helped perform came on my 1st ever overnight shift at the hospital. It was a surreal feeling staying overnight knowing that anything,( or nothing) could happen. I spent my time working with a resident that night. After getting acquainted with the floor and layout, I spent a few hours studying in the lounge. That's when we got a call. The mom had come in with contractions 5 mins apart. The resident and I saw the pt and went back to the lounge to start writing a pt log and received a call a minute later. Her water broke. So we rushed back to L&D and got gloved and gowned . and before we knew it.


The baby came out in a matter of seconds. The resident taught me everything I now know about delivering a baby. he showed me the proper way to  get the head out, Checking to see if the cord is around the neck. (It's better if it isn't!) And using suction to get the gunk out of the baby's airway. How to clamp and cut the cord, Taking a sample of cord, and delivering the placenta. He even showed me how to examine the baby and after all the commotion has slowed down. I had a smile on my face the entire time.   





Going back further to the end of my pysch rotation. First off, I got an A in my Pysch rotation and nailed my Shelf exam! YES.  So that made me pretty happy. 


Moving on.  So life in the city has been a lot of fun. For my birthday Sarah gave me some super stylish cufflinks of the caduceus :


The cats have been a special kind of "good." The new guy we adopted we named Spock. and before too long we started calling him "Suck." he is trully wonderful being, but he is the equivelent of a child in the terrible 2's.  He cries and poops and constantly needs loving... but only from the hours of 2am-6 am. (We like the last part most of all).  The kitties get along  like dropping Pure sodium into a bucket of water. (if you dont know what that looks like you're in for a real treat)



(put the link  above into your web browser or click it and watch)

We actually went as far as to give Spock a middle name of Ulysses, just to make his initials :

SUK.

So is name is basically suck. :-)  


Here they are in daily life.










And she also got me a portable disc golf basket! So the weekend I got this we went to the beach and I practiced my throwing (putting) and had a great time. 







That's it for now!

The world in vivid color.

In the week leading up to orientation I became very active online with Ross students just to make sure everything was in order going into the start of my rotations (also called clinicals). Just a reminder, the next two years of my medical experience is called my rotations or clinicals, not residency. (residency comes later in the timeline)  Anywho, in the days leading up I noticed that several people in my class were informed to report to the hospital on Thursday (5 days prior to when I thought my rotation started). When I noticed this it was Wednesday.  So I began what any sane person does:           Freak. Out.



 Luckily some friends of mine sorted out that the important email I missed stating the time to arrive Thursday had been sent to my Junk mail folder (ugh). So I know now to be more careful.


Was I ready to start? Mentally I still had five days, but in reality I had hours. So I prepared what I could and went to bed knowing the big day had arrived.






Orientation was held in a room that would have been better used as a greenhouse. It was smoldering.  This day was -10 F outside and the room temperature was somewhere in the vicinity of making humans melt. Nonetheless orientation was helpful in filling me in on the basics of what to expect. A student that had just completed the "track" program at my hospital gave us the quick and dirty ways to study for the "Shelf" exams and for the Boards. ( A track is when I complete all of my core rotations [Psych, OBGYN, Peds, Surgery, Family Medicine, Internal medicine etc.] all at the same hospital, as opposed to traveling all over the USA doing one here and there.) (A shelf exam is the exam I take after each rotation mentioned above) (The boards are one of the 3 major exams that if I pass, makes me a Doctor)

After all of that, I re-condensed myself from the melted, liquid, form of  me and went home knowing that the real deal started on Monday.,



The first week of Psych proved to be very enlightening. I saw things in real life that I had been studying for a few years, only to see real cases right before my eyes. Mania, depression, schizophrenia and paranoia, I saw vast variety of mental illness. My job each day has been to interview the patients on the psych ward each morning. Interviewing I have always felt was a weaker skill of mine, until now. Oftentimes interviewing a mentally ill patient can prove difficult, but for whatever reason, they liked to talk with me.  I took a particular liking the manic patients. To paint a picture, I like to think of Robin Williams. When he was living, he was one of the best comedians to ever walk the earth. He was able to rattle off voices, speak rapidly and change thoughts and subjects in his head without batting an eye and all with a comical tone and manner unmatched by anyone. It's like his brain was on triple speed and his tongue was even faster. Think of his role as the genie in the movie Aladdin.  These patients were happy,  excited, energetic, and just plain fascinating.


The doctors have lectured us on various topics, and challenged us to learn both the pharmacological name and the trade name of the common drugs used in psychiatry. With regular use though has become second nature.


Today my group of med students went to visit a higher functioning set of patients in the IOP (Intense Outpatient Program). Let me tell you,  it was intense. These people travel to the hospital from a local nursing facility and take part in 3, 1 hour programs during a day and they do this 3-5 times a week. I was lucky enough to be able to learn a great deal from these people about their problems and ways to cope with them. One client in particular singled me out. This person I would describe as having Narcissistic personality disorder.  (A state of mind where you have a great sense of self-worth, better than those around you, and demand the respect of others).  This person and I talked for a few hours about his life and history. In our conversation he presented an interesting metaphor to describe his problems. With a past of working in electronics for many years, he described people as being in one of two categories: the color TV or the black and white TV. Let me elaborate. He explained that in the old days that the B&W TV's were equipped with a gizmo that could only understand a B&W TV signal. With the invention of the Color TV, additional equipment within the TV was needed to interpret the color signal.  Now think of this color TV signal as what our human experience is on earth could be. He described people as either being a "color" TV or the "B&W" TV, you are either equipped to see the world as it was meant to be seen (in color), or you lacked the equipment and your experience on earth was dulled (B&W). He described himself as having this special equipment to extract details from the world that others neglect or aren't equipped to see. I'm quite certain that he had this gift too, for he was very intelligent. His problems however stemmed from this thinking that he was enlightened far beyond his peers and that they could not understand him because he was so vastly intelligent. He spent his time trying to develop inventions to help the world. He is so preoccupied with his intelligence that he believes cancer researchers have taken his ideas on how to battle cancer using radiation (he has zero medical background whatsoever). I have no doubt he would succeed given the right resources, however. I found this individual fascinating, and I hope I described my experience well enough for you to feel it too.



I hope to continue having a positive experience throughout my rotations and I hope to share them with you.

Thanks for reading!






Wednesday, February 4, 2015

I'M BACK! Where I am now. And more.

It's hard to believe its been so long, but here is a recount of my journeys in the last (almost) year.


Since my last post (I had to read it again just to make sure I knew where I left off), A LOT has happened.  Let me begin with a flashback to whatever I can remember (everything is really fuzzy!)

One of my fondest memories on the island was playing intramural street hockey. It kept me sane and was one of my few ways of escaping the overwhelming burden of studying. I looked forward to it every week. As the season pressed on, we were very successful having only lost maybe 1 game all semester. As the playoffs approached we were determined to take down our opponents 2 final times. ( once in the semis and the other in the championship game.) To make a vague memory short, we won both games with ease and took down the competition: winning the Rossie Cup.

After the success of winning the the "cup" we only had a few weeks left in the semester before the final exams took place. And from what I remember they were difficult.



After the long hours barred up in the Annex, over-caffeinated and studying I learned that I had passed my finals. I took a deep breath and continued studying for the comprehensive science exam: better known on the island as the COMP.  The COMP is Ross's way of determining if a student is ready to take his first board exam (better known and STEP 1, more on this later). If a student passes COMP, Ross gives you the golden ticket to allow you schedule your STEP 1 test date. As you might have guessed I prepared the best I could for COMP, for they could ask you any question they wanted, from any discipline or subject from any topic ever covered (or not covered) in medical school in the first 2 years. Having taken this test almost a year ago, the only thing I remember about the exam is a staggering number of questions about a very specific disease that I happened to know a lot about.  If the test was 500 questions over 4 hours at least 15 of them were about gout. And for a test that's trying to test a broad range of categories, gout is NOT what you want to test me on...  but I'll take it.


It turned out that I knew enough about gout to push my score high enough to earn my "golden ticket." And yes, I celebrated.  I didn't put a lot of emphasis on this exam in writing  because I didn't find it particularly difficult.  On the contrary though, many of classmates did find it difficult, and failed the first time around.  I earned my golden ticket for the most difficult test I'd soon have to take (STEP 1), but  I also earned my ticket home. My ticket off the island was the only thing standing between myself and the sweet soil of Detroit Metro Airport.


 I sat in the plane on the runway one last time. I sat thinking to myself, I'll never have to pay $7 for a gallon of milk, buy my electricity from the grocery store, or deal with cockroaches in my silverware drawer ever again. (true story, not sure if I mentioned it in the blog earlier, so I'll have to check!). I couldn't help but think of the story I heard from the semester earlier from a friend of mine about her last plane ride off the the island. So here's her story.

She was sitting in the same position as myself, boarding her last plane from the island, and saying goodbye to the island for the last time. The engines roared and the plane slowly crept into its position on the runway. The captain hit the throttle and the engines roared as loud as they could and the plane began down the runway. Seconds later the plane dips its nose, the runway screeches , as every passenger catches their heads against the seat in front of them . The plane slammed on its brakes! Could you even imagine? You are seconds from being in the air and on your way home only to hear the cry of the rubber against the humid 120 degree asphalt against your eardrums. She got Rossed for the last time.  An aside to explain the word "Rossed"

(Being Rossed is a collective term created by Ross students for anything bad or unfortunate that ever happens on the island.) Some ways of using Rossed includes, but is not limited to:  "That exam was brutal, they never even covered that topic in lecture! I got Rossed." or " They raised tuition again!? We all got Rossed!" or "the toilets are bubbling up like cauldrons from the men's (and women's) bathrooms again! I'm wearing my white coat and I have to swim in knee deep feces-water out of the loo! ROSSED AGAIN!"

Her plane turned out to have a problem with its landing gear.  She had to wait an additional 12 hours for a new plane to take them home. After getting Rossed plenty over her 2 years, she got home safely.

Now back to me. My plane luckily had no troubles taking off, no landing gear issues and plenty of fuel. But of all things to go wrong, my plane was late and it had nothing to do with Ross, the island, or anything that mattered. It was just plain late. (Couldn't help but make the pun there.)

Once I got home I did what every sane being does after being away from family and friends for so long: I visited every last person that I could every day for a week.  After that week I made my trip to Saginaw. Wait, hold the phone. Didn't I say that I wasnt going to Saginaw in the last post from a year ago? I did. But I made myself a liar. I got some advice from a former student who was teaching on the island in the time he had off before he started his residency. This was the last and final chance for anybody to go to Saginaw for the 5th semester. It was close to home, and I still had enough time  to devote to studying for STEP 1 after that semester, so I took his advice.
 5th semester was very different than what I had expected. It was mostly lectures with a little bit of hands on experience mixed in. During this I got to see some awesome wounds, perform the "female" exam and stare at a retina (deepest part of your eye) for a short time and several others.  I learned some basic skills such as stitching and tying surgical knots, and placing a catheter and an IV line.  I passed this semester without a hitch and came home to hunker down for the longest study session I've known to date: 2 months.

Studying for STEP 1 took as much discipline as I could muster. Every day studying, reading, memorizing and answering questions on every topic. I woke up tired and went to bed praying that the lectures would sink into whatever crevice my brain had left. I kept myself sane by taking the periodic run to clear my mind. I was in mental pain. Studying medicine and necessary bodily functions were the only things that mattered.
When test day came around, I was as prepared as I was ever going to be. I took the 8 hour test. Being mentally challenged for 8 hours was an unreal experience. Staying composed was crucial. Searching my brain for any connection I could make to answer the questions correctly. I was caffeinated and anxious but I walked out of the test alive, but numb.  I didn't feel anything. I called my fiancee and my mother and heard their excited voices asking me, " how'd it go?! Do you feel good now that you are done?" and I couldn't respond with any feeling at all. The only thought was the dread of waiting the weeks until my score was posted. And I waited. I checked my email 20 times a day, every day for a few weeks, waiting for a score report.  Then it happened. The email came.  I talked with Sarah and we both decided that if it came, wait for her to get home so not matter what, she'd be there to hug me, for better or for worse.  All I have to say is, that went straight out the window when I got that email. I opened it, clicked the link, and took a deep calming breath. My heart was thumping from deep within my chest  as if I was opening Pandora's box to reveal the secrets that lie within.  The link loaded and the first line of text in big bold letters said "CONGRATULATIONS!" and I knew that I had done it. I had passed my first Board exam!  I passed with a score that I was very happy with. The studying had paid off. The hard work had paid off. I DID IT! 


After that day I did a lot of waiting. Waiting for Ross to get back to me regarding administrative crap. After getting multiple sets of labs drawn for the same thing (because they weren't correct and blah blah blah) I was finally able to apply for my clinical rotation site. I applied and received my first choice: Chicago. I chose Chicago for several reasons, but my main one was so that my fiancee could easily make the move from working in advertising in Detroit, to the vast world of advertising in Chicago. This choice however forced us to wait until late February to begin. We waited a total of 4 or so months to begin here.

We made the move to Chicago last week and are finally getting settled into our new apartment. Sarah is working from home and I'm also at home studying and preparing for my first rotation in Psychiatry.  I am very excited for this rotation for many reasons, but most of all because its my first real one. 

I plan to continue my blog during my clinical years just as I had done on the island.  Thanks to all my readers for checking in after my year-long hiatus.



Clinical rotations: To be continued



Thursday, February 27, 2014

Hospital visit, School Updates, and just some fun stuff





I hopped off the bus from Roseau with my hands full.  I tried to steady my hands with two pizzas, a white coat, a 1 liter water bottle and a backpack. As I began to ascend the hill to my apartment, I contemplated my days’ visit to the hospital and put another check in the mental column knowing that I chose the right profession. Here's a recap of my day.

I awoke this morning at 7am, rubbed the sleep from my eyes, and attempted to get dressed in the dark. Today was hospital day. I had to look like a doctor, for real live patients for the second and final time this semester. I arrived at the library with my classmates before taking the shuttle to Roseau. The ride took a little over an hour up the winding hills and valleys to the Dominican capital. We arrived at Princess Margaret Hospital and placed our things in our designated room, and tackled (to some) the most important task of the day, figuring out the orders for Pizza Hut. I can say with honesty that some people dreaded hospital day. At one point, I was one of them. This is the day that we can test our skills and look like a stud, or try and fail and look like a dud. I’m pretty determined to avoid looking like a dud. Many of my friends attended the hospital the weeks prior to my visit, and as always, they shared their experiences. The common consensus was that if you get the geriatric rotation (old folks) for the day, prepare for the doctor from hell. My friends warned me of the doctor’s demeanor and be prepared to know your stuff, or expect a tongue lashing.  My goal as you’d expect was to avoid that rotation if I could, but we don’t get the choice. As the stars aligned and they read off the names for geriatrics, my name was right at the top. I couldn’t help but think like Charlie Brown.

I swallowed my pride and prepared for what was certain to be a crappy day. Because the rotation for geriatrics isn’t at the hospital, we had to take a short bus ride to what they call the “infirmary.” When I heard what they called it, I thought I was going to the dungeons beneath Westeros. To say the least, I was in for a few surprises.

This is the Infirmary.






When we arrived, I instantly tossed out my preconceptions, but still prepared for the hellish doctor that would be overseeing my visit. We were greeted by two doctors, both pleasant and kind. And my six classmates divided into two groups and each saw our first patient.

Our patient was an elderly Dominican man, who greeted us with the widest smile one can have with only a few teeth. He was a very pleasant person, and he couldn’t wait to figure out what was wrong with him. He was like a child with huge secret that he couldn’t wait to blurt out. ( His secret was his condition.) Typically, we would interview the patient and gather history before doing a physical exam, but this case we had to use our Sherlock skills and deduce the problem by observing. To avoid getting in trouble with HIPAA and all that patient confidentiality business, I’ll avoid the boring stuff and simply say, that after doing all the necessary tests, my group figured out the problem in a matter of minutes (at least I did.) It was a “by the books,” “textbook,” “play by play” perfect example of an old stroke. (If a patient has a stroke in the right side brain, it affects the left side, and vice versa.) Medical jargon aside, it was fun seeing everything I would expect to see for a patient with that condition, and it felt good to know it. When we spoke to the patient about his “secret” he was happy to know that we got it right, then he strutted his way over to go and chat up the pretty ladies down the hall. He was a joy to work with, and interestingly, so was the doctor. (were my friends wrong about the mean doc?) After this patient we rejoined our groups and received a tour of the infirmary.  And I have to stop here and make a huge statement.

 Shame on us. 

What? What do you mean shame on us? Who am I even talking about? You, your friends, your family and the entire United States and myself. 
What was that all about? Are you offended for not knowing why? Let me explain.
I’m learning about medicine in a country that is ridden with poverty. A country where clean water is rare even from the tap.  A country that doesn’t have the capabilities of medicine that we take for granted in the USA. Where patients have to fly to a nearby island to get complicated surgeries or even simple ones.  With all this being said, they still treat their elderly with more respect and dignity than they ever do in the states, all with a tiny budget.

To paint a picture in your mind, the infirmary is a perfect square, three of the sides are wards for patients, and the last is the “administrative” part, the kitchen, and the “chapel.” The doctor explained that each patient is taken outside to enjoy the fresh air every day. This rarely happens back home, even in the nice weather. Each person enjoys a complete bath from a nurse and has their hair braided (mostly the women) every single day. In the US, nursing home patients are lucky to get a bath once every 3 days. Their beds and quarters were spotless, despite the building being old (likely built in 1940’s.) The physician said that the floors were so clean, that she would eat off of them (though I wouldn’t suggest doing that anywhere.) Their meals were prepared from scratch, made with local spices and veggies and spelled AMAZING. The patients in this building never got bed sores. not a single person. In the states, patients are often stuck in bed for days or even weeks, collecting bed sores like they are going out of style.  As I walked around the patio where the patients sat, many of them smiled and waved and said “Good morning doctors!” Hearing those words, brightened my already chipper day, and made me feel guilty all at the same time. (The feeling of guilt was from the realization of how different the Dominican and the US cultures differ in their values toward their elderly.)  We continued our rounds, pointing out visible clinical signs of old strokes and cerebral palsy. For lunch my group traveled to one of the few fast food restaurants on the island called KFC. (maybe you’ve heard of it?) After lunch we returned to the infirmary to conduct our patient interview and clinical exam on a new patient.

Our new patient was an elderly woman with no current complaints, but a laundry list of medical problems. As the patient entered the exam room in her wheelchair, I was able to use a few skills I learned as a nursing assistant to help her into the bed (you never know when old skills will surface again). This patient tested our group’s ability to remain professional while guiding the patient back to the interview after each 5 minute story of her life. (We only had 30 minutes to do the interview, and she told a version of the same story 3 times, hence cutting our time quite a bit) Nonetheless, we managed obtaining enough information to continue on to the physical exam. This is where my team got to shine. I was in charge of doing the cardiac exam, and my classmates did the general survey and abdominal exam. As a team we were able to determine a previously undiagnosed condition that the staff had not yet known about. (avoiding details to keep patients identity safe.) We thanked the patient for her time, and afterward we had to do the hardest part of our day. Dictate our findings of the patient to a doctor as if we were a doctor talking to the attending physician. (This is much harder than it sounds, because we have to abandon normal speech, flip a switch and speak a language called doctor.) In doctor language, we describe every aspect of every finding based on anatomical placement, hyper this, hypo that, jaundice, erythema, conjunctiva, pallor, bilateral, unilateral and the list goes on. (for my medical friends, I know this is simple stuff, but to some, it’s tough.)  Your sentences sound like “On examination, there was a erythematous papule of 2 cm diameter on the left lower extremity” or “On examination there is hyperpigmentation of the epidermis of the right hand’s proximal interphalangeal joint on the 2nd digit of the right hand.” A few of these sentences come out of your mouth and a patient nearby stares blankly as if you are speaking dolphin. In plain terms, the person has a freckle on their finger. After many verbal corrections from our doctor (who turned out to actually be an angel) on how to present a case, I now feel more comfortable with doing this task in the future.

We returned to the hospital to collect our belongings and returned home with a feeling of fulfillment and satisfaction.


About a week ago I was tested on my ability to conduct an interview and educate a patient about a topic that is usually tough for patients to talk about. (Such as alcoholism, child or spousal abuse).  The reason I am writing about this particular exam is because I walked out of the exam on top of the world, thinking that I had aced it.  I failed, and it was one of the better things that could have happened to me on the island. I’ll explain.  When I received my results, by default I entered into something called the “Stages of Grief.”

Stage 1: Denial
My first thoughts were that they made a mistake. I felt amazing during that exam! I knocked it out of the park! (They didn’t make a mistake)

Stage 2: Anger
I was furious. I was upset with my grader, myself and the world.
Stage 3: Bargaining
They must have gotten my exam mixed up with someone else! Maybe THEY made a mistake. I talked my exam through with my friends to confirm my suspicions and boost my ego.
Stage 4: Depression
It ruined my whole day. I was so upset that I couldn’t even study.
Stage 5: Acceptance
I got down off my ego driven high horse and considered the possibility that I made a mistake. Maybe I missed something important. Maybe I made a critical error. ( I did)

After meeting with a professor, it turns out that I did well in 4 out of 5 sections, and failed the last one by a single point. But if I hadn’t failed, I NEVER would have learned from the many tiny mistakes that I did make. If I passed, I would have pat myself on the back and moved on and been a mediocre doctor with a lot to learn. Instead, I was lucky enough to fail and was able to fix many of the problems that I was unaware I had. To me, that was something I am thankful for. The professor was confident I would have no trouble passing the second time around and I am retaking the exam in a few weeks. (Don’t worry, I’m still getting along fine.) I am a firm believer that the best way to learn is to make a mistake, and did I ever learn something here.


Just some small highlights and scattered thoughts:

For the first time in my med school career, I received my first B+ on an written exam. It may not seem like much, but that was my equivalent to climbing a mountain slightly smaller than Everest. (Heck, I can’t climb the whole mountain unless I get an A right?)  It was a proud moment worth mentioning, but I’ll move on.

From the very moment I chose to come to Ross, I wanted to complete my fifth semester in Saginaw, Michigan. It’s close to home, my family is there and my life is there. I got accepted to go to Saginaw for my fifth semester, and I have to turn it down. With my current timeline of events, completing my 4th semester at the end of April only gives me 1 month to study for the test that determines every part of my future as a doctor. It isn’t to be taken lightly.  So after talking long and hard with Sarah, I’ve decided to postpone my 5th semester for a few months so that I can prepare for this exam.  This means that I will continue my 5th semester in Miami Florida in September of this year before moving on to my clinical rotations early in January 2015.

I feel that some people go through life wearing a set of horse blinders that shields them from enjoying the little things. Every day that I walk the sidewalk to or from class, I always turn to look at the flower bushes growing along the way. If a person doesn’t stop and look hard enough, you’d miss one of the things the island is known for: it’s nature. Aside from the colorful flowers and fruitful trees, I’ll often see a plethora of hummingbirds zipping and diving around the bushes. I even stop in my tracks to watch them as people walk into me like I’m an idiot for having my brake lights out. Sorry.  Even on a recent run of mine through open trails deeper into the mainland (away from the water) I saw some of the famed parrots that the Dominicans proudly display on their flag.  It was one of my more memorable moments on the island.


  



 I did not take any of the above photos









Here are some pictures of stuff that's happened this semester:

To celebrate my friend Emma's birthday, we went horseback riding!

 Brad's horse face
 Kim and Abhi
 Emma



 The tree above Brad's head had thousands of hummingbirds









 Sunset from my roof
 view from the roof

 My building, look close and see the moon!
 Annex Rainbow
 Ok, be honest. The figures look like you're getting a PAP smear...

                                   Dedicated Americans and Canadians watching the Olympics



Thanks for reading!