"By the Road to the Contagious Hospital..."

I'm sad to say that this will be my last post on this blog.  Orientation finishes today, and tomorrow is my first day on the floors in the hospital in my new role as physician.

I even have an ID badge that tells people who I am!  It's very official-looking, isn't it?  Looking at it, someone might even mistake me for someone who actually knows something.

is this real life?

All joking aside though, I am so ready to start.  Being a medical student was amazing, but I can't wait to finally be able to introduce myself to patients and say "Hi, I'm your doctor."  It still feels fake - even after four years of studying and practicing, I don't feel like I know enough about anything to treat anyone.  This year is going to be an incredibly steep learning curve (I feel like even that is a HUGE understatement).

Any new beginning is scary - in medicine or in anything!  I've gone through so many new beginnings throughout medical school (every new rotation, hospital, attending) that I should be used to these first-day jitters by now.  But I do feel like I'm as prepared as I probably can be (or actually, should I have re-read Step Up to Medicine? Or all of Harrison's? Oh no! What if everyone else did that?), and I'm sure I will be well-supported by my co-interns, my senior residents, the attendings, the nurses, and the program administration.  All that's really left to do is just jump in!



Hopefully I'll continue writing in some capacity, and I hope you buy my book when I write it one day (just kidding? kind of?).  Thank you for sharing my journey with me, and always feel free to email me with anything at mdwalksintobar@gmail.com.

Tanzania and The End of an Era

I apologize for my lack of recent posting, but as you should already know (Vacation Post 1), I have trouble writing when it's not a form of procrastination for something else.  So let me bring you up to speed:


After match day, I had a couple other electives at UH, and then I went to Tanzania for just over three weeks.  One blog post cannot even begin to do that trip justice, but I'll do my best.  I went with the program Work the World in Arusha, and I cannot recommend them enough.  It was not cheap, but it was incredibly well-run, safe, fun, and gave me an incredible experience at Mt. Meru Regional Hospital.

I spent two weeks in the general medicine department, and I learned an amazing amount in my time there.  The Tanzanian doctors were great to work with, and I got a lot of hands-on experience.  I learned how to make do with very limited supplies (probably the most valuable thing I learned), I learned about typhoid and malaria and HIV and TB, and I learned so much about the amazing Tanzanian and Massai patients.

the female ward (pics taken and posted with permission)

families waiting for visiting hours outside the ward

mzungu Dominic learning on rounds

But enough about medicine - in those two weeks, I also got to visit St. Jude's, an amazing school for gifted but poor Tanzanian children; help out at two orphanages (Neema House and Paradiso); take a traditional Tanzanian cooking class; drink Konyagi; and go on a three-day safari to the Serengeti and to the Ngorongoro Crater with a fellow medical student on my program.  We had a fantastic time, and saw all of the Big Five + some extras (like my personal favorite, the zebras).

the beautiful Serengeti

Sarah and I in our jeep!

zebras are cool.

And after the program, I climbed Kilimanjaro.  It was very rainy, very very difficult, and I definitely got altitude sickness (which involved some vomit, and a lot of me trying to convince myself in the middle of the night that I had pulmonary edema... I didn't).

I (slowly) made it to the top with the help of my amazing guide Nicholaus and the rest of the crew.  I cried on the first night because I was alone in a tent and I was wet and muddy and there was a giant spider and I don't like ANY of those things and I was like, "WHAT am I doing here?!" but after that first night, don't worry, I got more and more miserable the higher and wetter I got.  But I was really good at faking smiles for pictures whenever the rain briefly stopped...

only day 2 - not too miserable yet

but views like this made it worth it (I guess)

Uhuru peak.  Phew. 5,895 m (19,341 feet) high!

I suppose it was worth it because now I can say I climbed Kilimanjaro!  And that's pretty cool.  But I'm oh so glad it's over.  :)

Kilimanjaro beer > Kilimanjaro mountain

Once I returned to the US, there was that minor thing called medical school graduation, and officially this blog is a misnomer because I am no longer a medical student, but Dr. Elena Welt, MD.  After graduation, I packed up my apartment, had to say good-bye to my awesome roomie of FOUR years, and now I live in DC!

My amazing parents without whom I couldn't have done any of the things I've done.

A new, exciting phase of my life is beginning.  Eek!!

Residency Matching Algorithm (Also, I Matched!)

I am so so excited to report that I matched to my #1 program on my list, Georgetown (Go Hoyas)!!!!!!  I loved everything about the program, and I’m excited to try out DC!

For those who haven’t been lucky enough to hear my many explanations on how the match works, here’s an article my brother sent me that pretty succinctly explains how the process works: algorithm.

But what I found MORE interesting about that article is that the two people who developed this algorithm (Dr. Shapley who invented it and Dr. Roth who later modified it to fit the NRMP’s needs) won the 2012 Nobel Prize in Economics for their work!!

Dr. Shapley (with Dr. Gale) created an algorithm in the 1960’s to solve the “stable marriage” problem – which, in a very simplified way, is this: if there is a list of men and women, how do you match them up (note: this does not take into account same-sex marriages) so that there are no “unstable matches” in which all involved would have been happier in a different match? 

They solved this using "deferred acceptance," meaning that there would be multiple rounds of matches in which individuals would select a second option/mate (and then a third, etc.) if their most preferred option rejected them.

However, this was obviously stupid as that is not how marriage or people work.  So while the mathematics world was thrilled (maybe?), everyone else just went about living their lives as usual.

…I swear I’m going somewhere with this.

While it may not be how romance works, it turns out that it can be how residency works!  In fact, when the NRMP (National Resident Match Program) was established by med students in the 1950s (because getting into a residency was PuRe cHaOs before that), it turns out that’s exactly what they were using without even realizing it. 

In the 1980’s, Dr. Roth showed that the NRMP actually was using the Gale-Shapley algorithm, and he then went on to revamp the process in 1995 to favor the match based on applicants’ lists rather than programs’ list (after much controversy and student protest basically forced their hand).

So.  The moral of the story here is that if you are creating something with absolutely no real-world application, just hold on another 40-50 years, and maybe someone else will come up with a use for it and YOU TOO could win a Nobel Prize.

No, the real moral of the story is I’m going to be an internal medicine resident at Georgetown next year! Yay!

more sources not already linked: Nobel Prize, NRMP, Nobel explanation (this one really explains the general algorithm quite well)

The Light at the End of the Tunnel

Boy, have I missed being here!  So many things I could have said about the polar vortex - wait, what's that you say?  There's another one coming this week?  Oh, phew.  I would hate it for it to be warm and nice and having nothing to complain about...


So at 9:00 tomorrow night, our rank lists are due, and the programs' lists are also due.  So now it is (literally) just a waiting game to find out where the universe will place us for the next few years.  Although for the big computer who makes our matches (I imagine the Sorting Hat + the ENIAC), this is really his one time of year to shine.

Finally the majority of our fourth year responsibilities are over.  We did our away rotations, we took Step 2 (both parts of it), we did our Acting Internship, we sent in our applications, we bought a suit, we traveled all over the place for interviews, we outgrew our suit, we sent 6,000 thank you notes (ONLY 6,000 you say? You must have forgotten some people!!), and we finally certified our rank list.

The hard part of medical school is over.  We can finally see the light at the end of this four-year tunnel.  We worked so hard to get to this point, and the light is finally here!  But wait... There's something off about that light.... Something sinister seems to be lurking behind it...

(in case embedding chooses not to work, click here)

Ohhhh right!  After we graduate, we have to be interns!!  This false sense of vacation and freedom we have is really just to lull us into a reverie until the angler fish (residency) EATS US and we fall right back to the bottom of the food chain to enter what will be one of the most challenging (and rewarding? yes? please..?) years of our lives.

Click here for the best thing you'll ever watch about the angler fish, I promise.  Feminism fo' life!

Welcome!

Hello there, and welcome to my blog if you've never checked it out before!  Feel free to look around, and click back through all my old posts to see my full journey from a scared first year to a slightly-less-scared fourth year medical student.  On the off-chance that you don't have hours to waste reading about me (although that just seems impossible), below are links to my favorite posts from each school year so you can get a small sample.

I'm going to be taking a brief hiatus on new posts, so this will have to satisfy for now.  And of course feel free to continue following my updates on twitter (@elenawelt) and continue to check back here for my return!


Where it All Began:
Welcome to My Blog

First Year:
Funkmaster Flex and the Future of Medical Education
Muggle Medicine or Magic?
Studying and My Bed

Second Year:
 Med Student Stereotypes
Jewish Housewives' Disease
Pop Quiz

Third and Fourth Year:
Adventures in Nomenclature: APGAR
The Best Way to Study
What I Learned in the Peds ED
Elena's Parking Space Theorum

Nostalgia

It took me awhile to see it, but I truly love being in University Hospital in Newark.  After spending so much time here over the past four years, I've realized it's started to feel like home.  I only recognize how comfortable I am here when I rotate at other hospitals.  There's a learning curve at every new hospital - the computer system, where everything is, the people.  Sometimes I spend a month at other hospitals and am in awe at how luxurious it feels - you mean you just order a lab and it automatically gets done?  Free lunch every day (ok, that only happened for me once)?  Carpeting in the hallways?  But I've just never been able to feel as comfortable at another hospital as I do at UH, no matter how amazing other hospital experiences have been (and I have had really fantastic experiences all over the place).

It's like vacation.  I love going away and staying in a hotel - who doesn't?  I mean, how great can it get - someone cleans up after you every single day, you could (probably?) drown in the fluffiness of the comforter, breakfast is included and set out for you each morning.  But no matter how luxurious my vacation may feel, I'm always ready to come home at the end.  There's just something so much more comfortable about sleeping in your own bed, perusing your own refrigerator (even if you know it's empty since you haven't gone food shopping), using your own bathroom products.


At UH, I love being able to wave hello to everyone in the hallways because I know the attendings and the security guards and the nurses and the other students.  I like being able to volunteer to run things down to the lab because I actually know where the lab is.  I like knowing that no matter what time of day I'm in the cafeteria, I'll be able to find someone to sit with.

(cheesy, but oh so true)

Maybe I'm just getting nostalgic because I can finally count the months left of medical school on my fingers.  Or maybe it's a little sad that I can describe a hospital as home.  And I know if I spend as much time in another hospital system, I'll get equally attached.  But whether I end up here for residency, or a program close by, or a program far away, I'll always think of University Hospital as my first "home" of my medical career.

Pearls of Wisdom from the ICU

Doing drugs is bad.  Doing drugs in 90 degree heat is really really bad.