Week 6: Short but sweet (like all those cookies and yummy treats you've been eating)

First, let me wish you all a Happy Christmas (as the Queen of England would say) and/or Happy Holidays! I hope you are spending some quality time with loved ones and if you can't be home with your family (as I wasn't home in Wisconsin this year) I hope you used today's technology of Skype or Facetime to stay in touch.

I wish you all.....a Heppe Christmas

I showed up for work on Monday and Tuesday. Other interns decided not to but I didn't want to risk my vacation days being used for days I could easily be working. I think my colleagues were quiet happy that I showed up.

Monday morning, still during rounds, the chief attending told me I'd be assisting in his operations that day. This was after we had almost seen all of the patients and about everyone of them had labs ordered. The ward doctors had hoped I'd be around to draw all the blood for them, when the announcement came that I'd be in the OR, even before the morning meeting started, the realization dawned on them....and their facial reaction was a little bit priceless.

We had two operation to perform. The first was a smaller one that was finished relatively quickly. The patient had a hydrocele. A sack filled with fluid in the scrotum essentially. This patient had decided to walk around with it for years and thought three days before Christmas would be a fabulous time to have it operated.......

Great Idea sir......

After the fairly quick first operation came the second, somewhat lengthier one. The patient had had his bladder removed at the beginning of the year and was back to have a incisional hernia repaired. The chief attending and I were joined by the general surgeon that I helped operate Pat. X with. Since hernias aren't part of the field of urology but the patient's incision was due to an urological problem, the departments worked together. Additionally, the surgeons are friends and don't find much time outside of work to see each other so they use operations needing both specialties as opportunities.  The chief attending and I were also interested in how hernias are being treated currently. Basically, a big sheet of material was inserted and sewn onto the abdominal inner wall.

After the operations, I returned to the ward for lunch and finishing up whatever needed to be done.

Monday night, I attended a basketball game with some of my girlfriends.

Tuesday, I was called back into the OR. This time however after rounds, morning meeting and blood drawing. This was the first time operating with this particular attending. We removed a testicle due to testicular cancer. The patient had noticed a swelling only two weeks earlier.

Public Health Announcement: Men, check your balls. Seriously, know what your testicles feel like and notice when something changes. It can go faster than you think. I have many guy friends, your guyss hands are in your pants 95% of the time anyways. Optimize that time ;)

I was allowed to leave after the operation was done in order to catch the train to Hamburg, where I spent the holidays with extended family.

My adorable little godchild

Hamburg Rathaus

In this time, I found a TV show to watch while babysitting my godchild. Cosmos: A Space Time Odyssey. I fell in LOVE! I've always been fascinated with astronomy and even took a class back at UW-Madison. This show is beyond fantastic! The information, the graphics, the facts and the way it is hosted by Neil Degrasse Tyson is just great. I read up a bit and found that it is a sequel to a 13 show series done by Carl Sagan. After I'm done with this series, I'll look at the older ones and see how far we've come. The show has resparked my inner super nerd. I would love to return to college after med school and take more classes in Astronomy, Biology and so much more. The world we live in, the present time, and we ourselves are so insignificant in comparison to the time of the universe. At the same time, this show portraits the stories of people who were so vital to our time and how the smallest of coincidences lead to where we are today. If you want your mind blown.....watch this show!

I'm in LOVE. I'm also a HUGE nerd.

Its back to work tomorrow and Tuesday. We have off Wednesday and Thursday, which I will hopefully spend in the lab and library. New Years Eve will be a quiet one (as of now) with a good friend.

I wish you all a great new year of life, filled with happiness, success and most importantly health! I hope that our civilization calms down with all the havoc going on in the world and focuses on the good and comes together instead of driving itself apart. Happy New Year!

V

Week 5: Vasovasostomies, tumor removals and Mozart!

I have a hard time keeping days straight during the week. Multiple times a week, I don't know what day it is. I usually know what number of day it is because I document the date so often....but the day of the week? Always lost. Monday night, while sitting at my desk at home, I suddenly yelled outraged that I had forgotten to attend the intern lecture that afternoon which takes place every Tuesday!.....I was about to grab my phone and text the other intern that we had forgotten the lecture when I realized that it was only Monday. If it wasn't for Throw Back Thursday on my Instagram feed, I wouldn't know it was Thursday. I'm not the only one with this problem and so we colleagues often confuse each other even more.

I had a visitor on the ward on Monday. The patient (from here on out referred to as Pat. X) with the tumor from last week, came to say hello and introduce me to his wife. He informed me that we was being operated the next day. It was important for him to come tell me personally because he wasn't sure if the other department was staying in touch with me. I told him I would talk to the surgeon and see if I could assist.

This I did and was granted permission by my ward doctor and the surgeon to assist in the surgery. The whole thing took about 4 hours and went really well. We were able to removed the tumor in basically one big piece.....weighing in at 3kg (6.6lbs). It was a rather impressive mass. It still amazes me that the patient had no other symptoms but the varicocele.
 
Thursday, during the morning meeting, the senior consultant summoned me into the OR. I had no idea what operation I'd be helping with. My back has been hurting the past week and I already thought I might have to help with a fairly long operation that day. Luckily for me, I was assisting the senior consultant with a vasovasostomy! The operation reverses the result of a vasectomy, in the hopes of re-fertilizing the patient if he decides, for instance, to have kids again. The operation is done in part through microsurgery which requires sitting! Score! It was a 5 hour operation but it was all spent sitting. I helped cut, hold, coagulate, find, position and in the end sew throughout the operation.

Dear men, please think about what it is you are doing when you get a vasectomy because the work that goes into reversing it is a lot of fiddly work for the surgeon. The surgeon told me I better find a guy that hasn't had a vasectomy. Will do sir.

Lemon juice + honey + hot water = deliciousness and cold fighting power!

I felt bad leaving my ward doctors by themselves while I was in the OR. Who would be around to make sure the guys ate breakfast and make them lemon and honey tea because they started to get a cold. I've definitely taken on a motherly role with some of the guys. They haven't been doctors long and get caught up in all the stress and forget to look after themselves. I do it because I care, not because its expected (just thought I'd point that out for anyone starting their internship soon and thinking they will have to do all sorts of non-medically things and become personal slaves).

Some days get so busy, I just grab lunch for everyone and we eat on the ward.

I stopped by the ICU on Thursday to visit Pat. X. He was awake and happy to see me. He himself was amazed at how well he is doing. This guys spirit is so great. More patients need to have his attitude. He intends to stay in touch with me, even after he is out of the hospital.

Thursday night, I met up with 4 of the guys for some spiced hot wine at the Christmas market and afterwards a drink in the Irish pub. Live music was being played and we all sang along with the chorus of one of the songs at the end of our night (about the same time that all the students were starting theirs). The next day one of the guys sounded 10 years older due to his rough voice (he obviously does not sing along loudly to music in his apartment...)

Hennessey & Ginger Ale

Friday was a rather slow day. The other intern and I spent some time doing ultrasounds on each other. We figured it would be super easy to find and evaluate our kidneys since we are young and slim. We thought wrong. We actually had a really tough time. One of the doctors even came and helped us. Luckily he informed us that it usually is hard finding the kidneys in young, slim women. Thankfully it's a lot easier with our patients!

Hello Kidney

Best Moment: The continuous positive progression of Pat. X and his treatment.

Worst Moment: Nothing bad happened. I wasn't in the best of moods at times. Mainly I think because Christmas is getting closer and usually I'd be on my way home to Wisconsin around this time. Sadly not this year.

Off Topic: My uncle and I surprised my grandma this weekend with her Christmas Present. A trip to Hamburg for dinner at Opera Ristorante followed by Mozart's The Magic Flute in the Hamburg Opera. It was a great night and a lovely show! I can recommend it greatly for anyone interested in opera.

 

Music: I downloaded the new J. Cole album "2014 Forest Hills Drive" and love it! In general, I like all of J. Cole's music. This album has a different vibe than his last one but great nonetheless! For any R&B/Rap/HipHop fans out there ;)

This coming week is a short work week for me. I'm only in the hospital Monday and Tuesday before heading to Hamburg to spend Christmas with my extended family.

I wish you all a very happy 4th Advent!

Stay healthy!

Week 4: Blood wurst, Basketball player, and bewildering patients.

This past week was a wee bit stressful.

Besides the normal work that needed to be done, we had to teach students almost everyday. This entailed about a group of 30 people showing up on the ward. I had to get them all situated and was running around like a chicken with its head cut off some of the time. I also had my catheter class everyday expect Wednesday. That meant staying at the hospital until 6 pm on those days. To top it all off, there were multiple instances were patients/relatives got on my last nerve.

It seemed like I lived in the hospital the whole week so I am having a tough time even trying to remember what happened on which day.

On some days it seemed like anything walking was getting a needle poked into their body by me. The patients even joked I was making blood wurst and that was surely why I was drawing so much blood. My ultrasound game was up too. I started to recognize the patients by their kidney ultra sounds.

If you have veins...I am drawing your blood. Beware.

I had another patient on the ward who didn't mind at all when I was there to do an ultrasound.....really didn't mind, if you get my drift. He asked about my life and what part of school I was in and complemented my personality. All very kind but it got a tad bit awkward when his wife came into the room to come visit him and he said comments which seemed to incriminate us of something we weren't even doing. "Oh see, my wife always catches us talking Miss Hasselhof!" (as wife walks in)......well yea, of course I was talking to you,.....you asked me a question about your further treatment....wasn't about to spell it out for you in interpretive dance.

Yes sir, you may leave tomorrow unless some foreseen distress arises!

Tuesday, I went and donated blood (or at least attempted) and dragged a colleague along. My hemoglobin level was too low. My colleague didn't hesitate to blame my vegetarianism as the culprit. The nurse basically egged him on though when she suggested I eat more meat....not knowing I don't. My colleague could hardly contain himself. Yea, yea.......

A little success story. The other intern was having a bit of trouble drawing blood from a few patients on her ward. I offered to help but also failed with one patient. The other patient was one of a 60 kg/m2 BMI. After two failed attempts, I was not about to give up. I had to make this work.....and I did! Little superficial vein on the side of the arm was the winner.

Wednesday night, we gathered on the Christmas market again before heading to good ole Thanners (the bar filled with med students every Wednesday). It was another fun outing.

Thursday, the Göttinger Eltern kardiologischer Kinder Organisation (GEKKO) (Göttinger Parents of cardiology children) had their annual Christmas event. I was able to get Jamal Boykin, from the local pro basketball team, to come and say hi to the kids and sign some autographs.

Thank you Jamal Boykin for coming over to say hi!

Friday was stressful. The day started bad when we were in need of beds for patients and our ward had 4 rooms occupied by patients paying for a single room (usually it is two per room). Now, everyone might have their own personal view on this topic and so do I. I hope I don't offend anyone with my view but it is how I feel. I work in a hospital. Not a luxury hotel. Yes, this is Germany and we have one of the best systems in the world and everyone is used to high standards.....but again.....I do not work in a hotel. Our main priority is to take care of patients. I also realize a hospital needs to work economically but then things need to be restructured if there is so much emphasis on patients getting their own room for a few extra bucks rather than caring for the patients who need our help. If we are not in need of beds and a patient wants to pay more for a single room.....be my guest at Hasselhof Hospital Hotel. If we need beds because we already tried finding beds to put our urological patients  in on other wards (with less specifically trained staff ) before putting them in "your" room then hotel very quickly turns into hospital so that everyone can be taken care of.  The people responsible for arranging beds for patients were going half insane because we didn't have enough beds. (People against my view might argue that it is the hospitals problem and not theirs if there aren't enough beds.....well then I hope you experience wanting to come to the hospital because you are sick and not getting a bed because other people with your selfish mindset won't give up "their" room).
So back to the ward. We needed beds and none of the patients were willing to share "their" room....not even after being asked a third time and told how we had tried to arrange something else but it simply wasn't possible.......how in the world were they not feeling the slightest bit guilty?! And to use the excuse that it's your last night and you would like to be undisturbed....the nerve! Exactly, it is your LAST night....so you can sleep at home tomorrow if the patient we decide to put next to you is a horrifically loud snoring, foul smelling beast of a human being......(all of which we are doing to intentionally pick on you, by the way)

Then, relatives accused us of not doing our job in contacting them after a patient's operation although we had tried several times with the number they left us. The relatives walked in the room all ready to complain about how unbelievable it is that we wouldn't call them. Even after explaining that we had tried to call several times and that in the end, perhaps it was the technology that failed.....nope, they persisted that we had failed and that technology couldn't be the culprit. You are right Ma'am...we are evil, so we decided not to call.

All that had me feeling an inner rage. Then the topic of drawing blood started again and the patient I had successfully drawn blood from now needed a new lab work up. I volunteered to draw the blood thinking it would take me away from the stress for a few minutes. Oh naive, sweet naive little Viktoria.  The patient complained left and right about drawing his blood. He went on about how all other doctors didn't have problems drawing his blood (I refrained from enlightening him that I was the only one that had been able to draw blood from him while in the hospital). He continued with telling me drawing from the back of the hand was so painful while I merely inspected his hand as a possible location. I replied that I was fully aware of this fact and that was precisely why I was spending so much time looking for a suitable vein else where but that his veins weren't exactly jumping out at me and that he was more than welcome to show me where these "great blood drawing" veins of his were located. (I remind you of the 60 BMI) He only took a glance at his arms and then refrained from making suggestions. There were multiple more comments that I had to suppress a reply to. In the end, I had all the blood I needed from one try.

My ward resident was in the OR for the second half of the day and I was alone on my ward. At about 2PM I realized that 30 students would be arriving in 15 minutes for class on the ward and my doctor was still AWOL. I took matters into my own hands and organised three patients to participate in the teaching and gathered all the necessary material. I coordinated the same procedure for the other ward as well. In a bit of a frenzy and more headless chicken runs, I had all 30 students distributed amongst the patients with the necessary documents and appointed doctors and rooms for the discussion that followed the patient interviews. I inhaled the lunch the other intern had kindly brought back for me. My ward resident strolled onto the ward about half an hour into it all and was glad to see that I had it all under control. While the students discussed with the doctors, I took a yogurt and hid in the admissions room for 5 minutes of peace.

Friday night, the department had their holiday dinner and I met up afterwards for some wine and some good laughs. A good way to end the week.

Best Moment: A few:
1. My patient from last week with the tumor called to give me an update because he wasn't sure the other department was communicating with me. I'm going to try to be at the operation.
2. I now have a pager! The doctors say I'll regret having one but I'm excited.

Next level!

3. Another colleague brought me chocolate! Yes!

Keep the chocolate coming please!

Worst Moment: Well the Friday work day kind of sums that one up.

Here's to a better week starting tomorrow!

Stay healthy!

V

Week 3: Catheters and Prostate checks!

This past week definitely had some highlights.

The work on the wards was rather limited after the ultrasounds were done and the blood was drawn. Two of my three peripheral lines I laid worked on first try (it might sound ridiculous to report something like that but its a little victory for me every time it does work.)

Urology bouquet

The urology rotation started this week for students. I applied and got the job for the teachers assistant position. My main job is to conduct the catheter class. This entails me standing in front of 15 students or so and showing them how to place a transurethral catheter with the help of three male and one female plastic model....consisting of the waist down to the upper thigh. There is always a low key giggle that goes through the room when I bring out the models. The three classes I had this week were all really good and everyone took the task seriously.

One of my colleagues was in Belgium for a daVinci training session and brought back Belgian chocolate for me! Yum! (Have I mentioned I really like my colleagues?!)

Breakfast with the nurses :)

Wednesday, all the interns, residents and even an attending met up at one of the guy's house for dinner. He cooked sweet potato curry and I made an American cheese cake. It was all very delicious and a really fun night.

Since work on the ward was usually completed relatively quickly, I looked for good things to do. I helped with admissions throughout the week. I was allowed to interview the patients and physically examine them and the doctor would have to do the informed consent discussion. (I did one discussion since the patient had had the procedure two times already and the doctor was still right next to me in case I forgot something). After having worked in the urology department last year for a month and this year three weeks already, I finally checked prostates! That isn't supposed to sound like I enjoy doing them but it is a part of urology and I really just wanted to get started with them.....the more prostates you check, the better you are at defining your findings.

I also spent time in the outpatient clinic. I was allowed to interview the patients, examine them and then report my findings back to the doctor.

A little urine analysis here and there

One patient came with a heavy feeling in the right scrotum. The patient's history was rather insignificant to his current complaints. I did an ultrasound of the scrotum and found a varicocele (which is an enlargement of the veins within the scrotum). One of the residents came into the room and confirmed my findings. He then had the attending come have a look to decide if an operation would make sense. 

The attending also did an ultrasound but then started to do an ultrasound of the patients stomach and started to palpate around the abdomen. At some point the light bulb went on in my head! A varicocele is typically on the left side due to the nature of the veins. On the left, the vein flows into the kidney vein in a 90 degree angle. Since an angle is not very smooth for fluid to come around, the blood can pool back into the scrotum and cause a varicocele. The vein on the right, however, flows smoothly into the vena cava. Consequently, if a varicocele presents on the right side, there is most likely something inside the abdomen compressing the testicular veins. This thought process was the reason why the attending spent so much time examining the patients abdomen. 

We found a hard resistance and an undefinable structure with the ultrasound. The patient was admitted to our ward for a CT-scan. The results were back the next day and this patient has a HUGE tumor. The current suspicion is a liposarcoma (fat tumor). The following day, the patient had biopsies taken and we are waiting on those results. The patient was transferred to the general surgery department but I continued to go visit him there because he is such a nice person and I really am interested in how this case goes. He told me he is so thankful towards me since I was the first person to examine him and kick start this whole process. We agreed to stay in touch during his treatment. 

It really is insane. I did not go into that examination room that day thinking this would be the result. The patient thought he was just going for a quick doctors visit and ended up with all that. I met some of the family and they were of course also shocked, not having expected anything wrong with their very healthy appearing relative. The prognosis is good. Of course it will be a battle and obstacle to go through for the patient but he has a great support system. I've dealt with a lot of patients with tumors but I've never been there for the moment of diagnosis.

December = coffee in a boot

Best moment: I won tickets to the Semi-Live Congress Urology 29th-31st of January over Facebook. They were giving away 10 tickets (350€ each) for the congress in Heidelberg. I've always wanted to go to Heidelberg and its my birthday so this should be a fun trip.

Worst moment: I don't really think I had one this week. A funny moment was when I was told to get an ultrasound machine while in the outpatient clinic and I asked three people if I could take the one from the back right room and they all said yes. As soon as I was out of the room, all the doctors (including the chief and attendings that had just walked in) stopped dead in their tracks and looked at me. I probably looked like a dear in headlights. The chief said he never had to fill out a death certificate for an intern before. I just smiled and asked if had gotten to that point now. Apparently that ultrasound machine is the chiefs and not allowed to leave the room......well I did ask 3 people and no one seemed to oppose....so I don't even feel bad. 

My Saturday morning working on my doctor thesis

Hope you are all enjoying the holiday season! Stay healthy!

V

Week 2: Near proposals and mini break downs

Week two: check mark!

Week 2

It's almost frightening how quickly this getting up and spending all day in the hospital has become routine. It's at the point again that I don't even look at my watch unless I have to document a time or my stomach is growling so loudly that it might be time for lunch. I honestly enjoy being around my colleagues and it beats sitting at home and studying (almost exclusively what I do when I'm not in the hospital).

People often ask why I, as a woman, would want to work in urology. Most men say that they'd prefer a male urologist (which is totally legit because I also go to a female gynecologist). None the less, I think patients in the hospital care less and probably care more when selecting a urology practice to visit. The men I talk to usually say they would feel uncomfortable having a good looking female urologist treating them (that wasn't me complimenting myself, I'm just saying what they tell me).

Well let me tell you, being a woman in urology definitely provides situations my male colleagues probably don't experience with the same frequency. I had a patient this past week who seemed to be quite fond of me. He even said that if he was still my age and not married that he'd take me on a date that night......(what does one say to that when in the position of the doctor?).  He also was always happy to have me do kidney ultrasounds on him......"See Ms. Hasselhof, we are already getting to know each other a little bit better." My colleagues even offered to do the exams on him for me....but I'm a big girl and might as well navigate my way through these kinds of situations while I'm still only the little intern.

Another patient and his family were so lovely that I took care of most of the communication with them and ended up exchanging information which might be useful in the future for travel.

The residents and interns go out for a drink almost every week. For some reason it didn't happen last week but this week it did. The Christmas market opened up in town on Wednesday and we hit it up after work. Since the only female resident was on call, it was me and the boys. Accordingly, I kept up with them in regards to hot spiced wine on the market and beers at the Irish pub (nothing a liter of water before bed can't handle). They all didn't consume as much as I imagine they would've if they didn't have to work the next morning. I respect their sense of responsibility. (Besides, we were all getting up at 6 a.m. or earlier the next morning and we were all home by 11 p.m.)

View from above: Part of the Christmas Market

Time for best and worst!

Best Moment: A few things here and there. I successfully placed 3 of 4 peripheral lines on first try this week! I did an ultrasound on a duplex kidney (two kidneys on one side). I lead an admissions conversation and examination. I was promoted to ward doctor for Thursday afternoon since the resident who was ward doctor for the week had to leave for a training program (he had finished everything that needed to be done before he left and the patients were all taken care of so really, I didn't have to do anything.....but something could've happened).

Worst Moment: That was today and I'm not even in the hospital! I've been fairly stressed lately (what else is new). With work all day and studying all night and that being a repetitive cycle, I was getting absolutely nothing else done. My scores on answering questions for the USMLE were far from satisfactory.
The way the USMLE is set up is so different from the German Medical exam. In theory, they should be asking the same information but the format of the American one is way more complex, or at least its seems so because I'm not used to it yet. I wanted to schedule my appointment for the exam in 3 weeks on the 21st of Decemeber. To my shock, neither Berlin, Frankfurt nor Munich had any available appointments within my eligibility period (ending Dec. 31st). Amsterdam had two next week, Paris a week after that and London had one of the 24th and 31st of December. Great.
Traveling would be expensive, stressful and inconvenient. I also don't feel prepared what so ever after these last few days of working through questions. I technically thought I still had 3 weeks and with a lot of blood, sweat and tears I may have made it work a bit better. This test score is just so immensely important that I felt the pressure crushing down on me again. And I wasn't even able to make an appointment.
Long story short, I extended my eligibility period for another 3 months.
Although I was looking forward to this exam studying being done by Christmas, I don't feel confident enough (and its just not possible) taking the exam at the end of December.
After paying the changing fee I called my parents and had a mini break down over FaceTime. I'd be lying if I told you this was the first one of these sorts over the past years and I wouldn't be shocked if a few more med students out there have been through the same.
I know a lot of other people are under a lot of pressure in life too but I can only speak for myself and my situation. And I tell you that going into medicine puts a LOT of pressure on you to be good, know so much, study into the wee hours, lack sleep, deal with the immense responsibility, work, work, work....It's valid to ask why anyone would voluntarily take all the pressure upon themselves. In my case its passion. Everyone has their own motivation. But it can be really, really tough sometimes. After the conversation with my parents I was feeling better and am newly motivated to get this exam done right.

It was this foggy all day long O_O

This upcoming week, I plan to have my own patient from admission to discharge. I'll suggest treatment options and procedures and see just how right my thoughts are. I think this will be a very good learning experience because up until now, everyone else was calling the shots and I just stood by and observed.

Stay tuned next week to see just how successful I was.

Week 1

Week one: completed! (below in a pic-a-day)

It was a good week.

Getting up at 6 a.m. isn't terrible if I go to bed at 10 p.m. I'm sure I will become more lenient with the time once this life style becomes routine.

Having worked in the urology department for a month about 1 year ago, I knew most of the colleagues sitting at the morning meeting. Those that I knew still knew me.

As I said before, our main job is to work on the ward and be involved in the daily work there. And so it was that I spent the whole week on the penthouse ward (we're all the way on the top....which can get fairly annoying with the elevators) except Friday, but I'll get to that.

On the first day, the intern that has been there for the past two months gave the other new intern and I a little tour of the place and told us what our tasks would be. At first, it sounded a lot like the tasks I had two years ago and was afraid I'd sit around with nothing to do during the day and wouldn't learn anything new. (I was almost constantly busy throughout the week. Certainly also due to the fact that I don't like sitting around and will help wherever I can).

Main daily tasks:
-take notes on rounds and keep track of available beds
-draw blood
-do the kidney and bladder ultrasounds
-place peripheral venous catheters
-help compose medical reports
-order labs/imaging/consultations
-writing up prescriptions

Besides those tasks, I help where I can, make sure the doctors are happy and have chocolate on hand for sugar lows.

Being a native English speaker has also come in handy this past week. We had two patients that didn't speak German, which led to me having most of the conversations with them.

I've decided to share my best as well as my worst moment of every week. Everything in between is more or less normal hospital activities and not really worth reporting on.

Best Moment: Friday I was called down to the OR to help in an operation. I worked with two of the attendings. The operation was a kidney removal. The interesting part was that it wasn't a normal kidney. It was a horse shoe kidney. Only about 1 in 500 people have it. Instead of two kidneys, they have a fused "U" shaped kidney. So being able to operate on that isn't common and even less common is removing a tumor from it. I held hooks for most of the time but the cool moment (and the moment the attendings said I would still tell my grandchildren about) was putting my finger between the aorta and the isthmus (connecting part of the two sides)! I don't know if they were being serious that I might never have that opportunity again but hey, I'll take it. I even was allowed to sew together the skin at the end! (a good reward for back breaking hook holding hours on end)

Worst Moment: Whenever I've been out of the hospital setting for a while, I always have to get used to drawing blood and placing lines again. I used to be really good at drawing blood, even on patients that seemed tricky. Placing lines even went smoothly at some point. Practice makes (nearly) perfect. Not having drawn blood or placed lines in a long while, I new I'd have to overcome the feeling of avoiding it. I didn't have a single line to place this week so I know that is still a task I have to overcome and start again most likely this coming week. The blood draws were going really well until Thursday. From the stature of the man, you'd think it wouldn't be a problem. I tried on the left side. No luck. I tried drawing blood from the line already placed on the left side. No luck. I tried drawing blood from the right arm line. No luck. I tried drawing blood from the right arm. No luck. I would've tried until I was successful but I take the patients feelings into consideration and usually get someone ranked higher than me to try the third time. I wanted to ask the doctor I was working with that week but the attending overheard our conversation and said he'd do it. I was already embarrassed to ask my doctor because drawing blood shouldn't be that difficult and it is our task to complete (but again, I put my pride aside in favor for the patient). I was even more embarrassed that the attending now planned on drawing the blood for me. He ended up trying around 7 times and through the lines before he finally got just enough blood from his last try to fill 2 of the 3 tubes we wanted. As sucky as the situation was for the patient (who put on a strong face throughout), I was glad that it wasn't that my blood drawing skills had gone away but rather the patient was just a really hard case.

My worst moment also nicely displays my next point, this department is a great place to work. I have been in other departments were I would not have felt as safe asking for help without getting a bitter response. Everyone, from the doctors (regardless of rank) to the nurses and the OR team, everyone is nice, willing to help and doesn't look down on you but rather approaches you on eye level. I wish all my future departments to be like this. Even if someone has a grumpy moment, it quickly passes and work goes on.

I'm excited to see what this next week brings. I'm setting a little goal for myself to try something new every week if the opportunity presents itself.

Have a great rest of your Sunday and stay healthy!

V

German Exam: check, Vacation: check (sad face here), Research: on it, Play doctor: starting next week!

Greetings everyone!

Let me get you up to speed.

I passed my German medical board exams! The rest of the course started becoming really tedious and I was glad when it was over. The three day written exam was a roller coaster of emotions. I don't get afraid before exams, I usually stroll quite casually into a written exam. My mentality, "Either I know it or I don't." Its not like the paper can bite me and I've put in the work studying. (I do get more nervous before oral exams. Its more anticipation than fear though.)

The first day went really well and I thought that if it continued like that (which I knew it wouldn't), my dream score would totally be achievable!

The second day was a big slap in the face! They picked the most exotic cases! I don't think we've ever discussed parotid gland cancer and I get asked 15 questions about it! Or sure, go ahead and take the most absurd and not common heart malformation a newborn can have and ask me 15 questions about that. Thanks IMPP, thanks. (IMPP is the institution that creates the exams)

The third day was better than the second but not as good as the first by far. There was a site online where after each day we could enter our results (we were allowed to take the question pamphlets with us) and by the end of the day, a panel of professors had answered the questions with a near percent percentage of being correct. After Day 1 and Day 2, I was directly on the boarder between the score I thought was likely and my dream score. This put me in the position of having to get into the range of my dream score on Day 3 for it all to work out.

I missed my dream score by 5 out of 320 points.....this isn't the official score and some questions still might be removed but I doubt enough to get me in that dream score category. In the end, I can live with the score I got and no one will ever really be interested in that score anyways considering my plans to go to America.

A few days after that exam, I flew to the States for my 3 week vacation. It was fantastic. I had so much fun and met so many wonderful people! I'm still trying to recover from my high of happiness and relaxedness (by recover I mean being content with how my life is again now).

I have mixed feelings about the time coming up. Deep down I know this is exactly what I want to do and I will enjoy the ride. On the other hand, all my friends that have kept me company in G-Town have either moved away or are in the process of finding a job elsewhere (for that person in particular I hope she finds a really awesome job that she loves, but I don't want her leaving me either). I have to return to a scheduled life. This of course is all a matter of getting used to again and within 2 weeks or so it'll be completely normal. I'm taking the American board exam in December, a few days before Christmas. Studying for that will occupy my nights after work and my weekends up until then. There is some real heavy pressure on me for this one. I just want to do so incredibly well but its sometimes hard to find the energy after having gone through all the stress with the German one. But I am determined and will make it happen. This week I am in the lab working on research for my doctor thesis. In a few weeks I will probably post about how much I love being an intern and these feelings right now will be irrelevant.

I plan on keeping up on this blog on a weekly basis. Most likely, I will try to write a post every Saturday. It'll recap my week at work, what I've learned, how things went but also include some life style things (what interns wear, neat gadgets for interns, what music keeps me going, new recipes and such, whatever is happening at the time I guess.)

I hope you guys enjoy, look out for updates and go ahead and send me any questions or comments you may have. I'd love to have you all join me on this trip through my internship year!

Internship year starts November 17th! One week until I get to play doctor!

Big hug! Stay healthy!

V

Medical-Board-Exam-Double-Whammy-Preparation-Study-Marathon-Time

Why hello world! Coming to you live from my desk......super exciting, right?!

Well, this is were you will find me for the most part until October....oh yes, its medical-board-exam-double-whammy-preparation-study-marathon-time (German and American). Can I get a Whoot-Whoot?!.......no?!.....understandable.

As promised, a quick look at my life since Africa:

What I've noticed since coming back from Africa:
-hot water...running water...from a faucet. I smile almost every time.
-I've become more conscious about my water use
-I really miss fried plantains
-I'm not constantly sweating
-my social program has dwindled comparatively
-my hair isn't a constant frizz ball

On a more serious note:
-the situations I experienced in the hospital really make me appreciate our level of care in Germany
-the first person died to whom I contributed a minor part of their treatment
-I saved a life which I am pretty sure would not have been fought for as much as I did in that moment
-the cultural differences have sunken in more, especially after retelling my experiences multiple times (when you live it, you may not notice the differences as strongly as being back in your normal environment and trying people about it)
-I definitely want to go back and help/learn/experience more
-I am thankful to each and every person there that made my experience what it was
-With the current Ebola crisis happening in parts of Africa, I can't imagine what it must be like for the health care providers and patients there and send them all the strength I telepathically am able to.

Since coming back, I completed my last semester of regular medical school. We had a little celebration after the last exam.

I flew to Miami for a bit over a week. I spent all day studying the packets for the MediLearn preparation course......and spent all night living it up in the various clubs with all my great friends there. Big shout out to my fabulous host!

I flew from Miami to New York City to meet up with my agent/second mother/party buddy. I helped her manage the talent we had competing in the IMTA competitions there. It was me jumping back into the other world I so gladly walk through when I'm not in my medical world. Got the rest of the packets read through as well.

I've been back here in G-town the 2.5 weeks. The prep course started the day I got back. Basically we have 4.5 hour lectures every morning, take a small day-topic-related exam, study the packet, and then answer about another 100 questions. That all takes the most part of the rest of the day.

It was a bit of a struggle the first few days. Getting used to the routine and the fact that it just must be done and I can't go travel and play took a while getting used to.....still not really used to it. I try to live in the moment and not think about the fact that this is my routine, day in and day out, until October. Every 6 days or so we a get a day off.

I don't ever really know what day of the week it is (let alone the day of the month....psssh, nope). The only important day to know is Sunday. I always have class on Saturday and Sunday so that's not really a help. Its important to know though since all stores are closed on Sunday in Germany.

The past week, my aunt and uncle have given me a car to drive. I've been driving out to their place to study and relax a bit everyday since. It definitely helps with the monotone hospital to apartment mode. Probably the most positive of the aspect that I am "stuck" in G-town is that I get to see them so much.

None the less, I am planning on what to do with my few weeks of vacation after the exam almost everyday.

Hope everyone out there is healthy and happy. With all the chaos going on in the world (I decided to watch the news once and was devastated by all the hate and killing I saw) and people passing from illness (physical and mental)....its more important than ever to try to be happy, healthy and love one another and help others in need.

That said, till next time

Baci

V  

Sure is hot out here....my last day....sniff,cry/jump for joy

Well here we are…last day in Ghana. But first, let’s look at the last few days...

Wednesday: I ended up going to the pool with Erica, Katie and Beth. The pool was at Unique palace, which is around the corner from my hostel. The place was nothing special but it was a big thing of water that we could submerge ourselves in! We hung out, chatted and played cards until the sun started going down. We then all went home to get ready for salsa night. I usually tried dressing pretty low key when we went out because I don’t need the extra attention but this night I just though, “oh well, I’m going to get attention either way!”. So I threw on my African skirt and a crop top showing a little midriff. I grabbed a taxi to Afrikiko and met up with the gang. During the night, more and more familiar faces joined us. The dancing spirit was not too high in the group though. That didn’t stop me from hitting up the dance floor and being twirled around a bit. I just get so sweaty so quickly from the combination of the heat and the dancing. A large portion of the group went home and I was left with Aaron chatting until Tolu came around midnight. Aaron went home and Tolu and I closed the bar around 3 just chatting. He gave me a ride home afterwards and I was in bed by 3:30. My roommate was leaving at 4 but I was so out I didn’t even notice her leave!

     

 

 

Thursday: I went to the hospital in the morning to get my paperwork done. I’m lucky I didn’t push it to Friday since I realized on my way that Friday was a holiday. I went to administration to get the stamp. They went through their records and said they didn’t have me in them! I told them I signed in at the OBGYN office. After some calls and waiting around for 2 hours….I finally had my stamp. I headed to the OB wards to meet up with Erica and see if a doctor there would give me a signature. I found one of the doctors I had worked with on the labor ward. As we walked on to the labor ward, a dead body was being carried past us. I got a weird chill. The thought that had that woman not been in these circumstances, she might still be breathing is a weird feeling. Erica and I headed back to her hostel to get the others and leave for Osu. We were all really hungry and headed to NutriLab Smoothies. They have really delicious smoothies (something like 40 flavors to choose from) and yummy salads. An actual salad! It was so good. We did a bit of fabric shopping afterwards. Well, they did. My suitcase is full. We got some frozen yogurt for dinner. Aaron met up with us and took us home. We then got ready and grabbed a cab to +233. It’s a live music venue and bar and grill. Katie, Erica and I went. The taxis we were flagging down were giving us outrageous Obruni prices like 20 Cedis. We eventually found a cab driver that would take us for 8 Cedis but didn’t know where the place was. Thank god for Google maps. Along the way he took a detour to go around the round about which I am pretty sure judging from the Google map, did nothing for us to save time. He was getting really annoying saying the ride would cost more and we said no. Once we got to the place, he asked where our husbands were (we said they were on their way) and he asked if he should join us for protection… thanks, but no thanks… we’re good. The music being played was Highlife, so African. The band was really good and there were some great voices. We ordered drinks and a pizza. I have been drinking Alvaro nonstop. It’s a malt drink with fruit flavor. Aaron joined up with us again and after chilling there a bit, he took us home.

Friday: Since it was a holiday, most of us didn’t go to the hospital. I walked over to the Osda house to the others because I wanted to take them to the Kaneshie market. Katie, Greg, Erica and I grabbed a taxi to the market. Outside was bustling as always with all the vendors selling their copious amounts of fish and other produce. I even took a picture of the others with one of the butchers there…there was a cut up goat spread across the table. The hoofs and face were the worst things to look at. Sadly the actual market inside the building was closed due to the holiday. We grabbed a taxi to the Mövenpick hotel. This place was heaven on earth! The lobby was done so nicely and was so cold! We went to the pool area and were met by the pool guy. The entrance on a normal day costs 40 Cedis and includes two towels to use and a drink. Since it was a holiday it cost 60 Cedis (about $24). We all hesitated at the 60. We had thought it might even be 100 but 60 wasn’t little either. The place looked SO good though; big pool, comfy lounge chairs, sun, waiters, palm trees. The pool guy noticed our hesitation and said he could let us in for 50 each. SOLD! We felt so luxurious. The towels even got me excited…yes…it’s that bad. We spent the next few hours lounging, swimming, eating and drinking and loving life. I may have gotten a bit burned. It was really hot and lets not forget I am just a bit above the equator and we were in the noon sun. I had to go jump in the pool about every 10 minutes to cool off and would be dry after being out of the pool for 2 minutes. We had such a good time and it was totally worth the money. 

Around 4:30pm, we headed back to the Osda House to get ready for the night. I exchanged pictures with Katie and put on my African strapless dress. We all got into a cab and left for Osu. We originally wanted to go eat fish (and I would eat couscous and fried plantains) but it started drizzling outside and we did not want to risk sitting in the pouring rain outside. Our backup plan was the Indian restaurant we had gone two about 2 weeks ago. The food was delicious once again. We shared a bunch of dishes, which offered a lot of variety for us. After the restaurant, we headed to the Paloma hotel for Karaoke. We got there around 8:30 but it wasn’t starting until 10. Some friends of ours started to show up so we spent the time chatting and seeing who would actually sing. I was all up for it because I love karaoke. Doe said he would sing with me. After a few performances, Doe and I went and rocked “I will survive” together. It was a good crowd that would actually sing along. I later sang “Umbrella” as well. While I was walking off the stage, I got pulled back up again to sing a song with one for the local guys. It was a great time. After karaoke, they went into a really long streak of Ghanaian and Nigerian music. Granted it is very lovely, I can only dance to so much of it. At some point, I gave the DJ three more songs and if by the third it wasn’t American, I was going to go to bed. Lucky for me, the third song started an about 20 minute period of all the songs I knew and loved. After that little period, a group of us left. I easily could have gone to bed but the others wanted to go check out a different club. I wasn’t about to be the party pooper. We got to the club and could already hear from the outside that it was only playing Ghanaian music. Luckily Tolu’s friend didn’t feel like going in either. No one was really motivated or just indifferent as to what to do next. We eventually agreed we would all just go home to bed. 

I hate having to say good-bye. I kept my good-byes short and sweet. I met some really friendly, kind, funny, energetic people here that I will miss. Thanks to today’s technology I can keep in touch!

Today I am finishing up packing, showering and cleaning and will head to the airport around 4. My flight isn’t until 8:35pm but I still have to check in and try to get exit row seats again!

It has been a really great experience in Ghana. I’ll reflect a bit and then post one more post about the experience when I am in Germany. That way I also have Internet and can post lots of pictures! See you on the other side!

Sure is hot out here....I'VE BEEN ROBBED!

 

Well.....what an adventure yesterday was!

I hadn’t slept very well again. I still can’t tell if its due to the lack of fan, the lack of breeze with the mosquito net, the not so comfy mattress, the pillows that feel like they were filled with sand or just a combination of it all. Either way, I was up at 6:30am and happy it was bright out so I could get up. I threw on my bikini and went for a morning seashell hunt on the ocean side.

Having learned that if I give the guys on the beach the slightest bit of attention that I can’t get them away from me, I put in my headphones and walked with my gaze on the ground…I was looking for seashells… so it just looked like I was really into it. I found some fantastic shells again. I think my suitcase will consist of wood, fabric and shells.

 

After collecting so many shells I couldn’t fit any more into the bag I brought along, I went to have breakfast… same old two omelets and bread. They ran out of coffee so I had tea. It’s so interesting. A lot of the time, just because it says something on the menu does not mean they actually have it. That doesn’t only happen in secluded places like this resort but also in the middle of Accra.

I spent the rest of the morning sketching and tanning. I actually think I finally got my feet (which were mostly covered by sneakers or sandals) caught up with the rest of my body color. I didn’t have any observers today but the manager did stop by. He was taking a group of Obrunis from the other resort out on a boat trip to see the rum factory.

I decided I’d rather lie in the hammock. Around lunchtime, I went and sat on the deck where food was served. Usually the two girls working there would then come ask me if I wanted lunch. They did do that this time however some fruit sellers stopped by and they asked if I wanted to buy something. I told them I would have to run to my bungalow quick to get some cash. I went and took 20 cedis out of my wallet (as you will see later in this post, I’m glad I took so much more than the 1 Cedi I needed to pay for the bananas and peanuts.) A bit later, the little kids that had been selling me mangos the last two days stopped by again. It breaks my heart that they have to go around carrying these big trays of fruit on their heads so I give them more than they ask for and usually a few Cedis each that I tell them is just for them to use as they please. I bought another mango and since they didn’t have change for my 5, I took a few wafers as well and told them the change was for them. After another little chill session in the hammock, I decided to go back to my room and get ready for a bit of tanning.

 

I unlocked my bungalow and entered and sat on the bed. I was confused as to why my shirt and pants were on the floor, and then I noticed my contact lenses case and toothpaste had “fallen” off of the table as well. Only then did I realize that the pillow on my bed was out of place and then my glance drew up to the window. Shock. The net had been cut and two windowpanes broken. I immediately shot my attention to my wallet. It was luckily still lying on my bed but all my cash, all 300 Cedis, were gone!! I was shocked! Luckily, they left the wallet with my credit cards and ID still in there and I had my electronics all with my in my big purse. I ran to the girls to tell them what had happened. They looked equally shocked and came back to my bungalow with me. I could tell they didn’t know what to say to me. I told them it was a situation that we couldn’t change now but that we needed to get in touch with the manager because I would be leaving for Accra that same night. No point in hanging around with no money and a bed I can’t sleep in since I was planning on leaving in the morning anyways. They went to look around the premises and came back with a wallet. They said they found it near the tent of the people camping near my bungalow. If there had been Cedis in there, they were gone but the thief left about 100 US Dollars behind. This very much surprised me since that is a lot of money. Whoever the thief was must have really only been on the look out for Cedis which makes me believe it was a local who didn’t know what to do with credit cards and either didn’t know the worth of US Dollars or didn’t know where to exchange them.

 

I packed up all my things and went to wait for the manager at the main building. I had informed all my friends back in Accra what had happened. They were all very supportive and some sprung into action to help me. Felix organized a money transfer. He had been at the neighboring resort the week before and had the manager’s number. He made a deal with him that if the manager loaned my 40 Cedis, Felix would send 50 Cedis with the next group of tourists coming to his place. Pablo helped my plan my journey back home. My phone was at about 3% so I really needed the manager to turn on the generator as soon as he got back. It took a while but eventually he did return. The girls had already called him and told him of the incident. He felt really bad about the whole thing. I told him it wasn’t his fault and when he started accusing the girls (I assume, it was in their native language) I sprung to their defense. I had been outside closer even to the bungalow than they had been so we all should have seen it equally. There was just a regular passing of people between the river-ocean junction and our place. Besides, the thief easily could have come around on the ocean side, not being seen due to the huge sand mountain separating the ocean side from the river side, snuck around behind the bungalow and tent and then crawled away again the way he came.

I had him throw on the generator so I could charge my phone. I wanted to get to about 50% before leaving for Accra. David, the manager from Maranatha, the resort next door, came over and gave me the 40 Cedis. All in all I had 55 Cedis to my name. My phone only made it to 30% before the generator started giving up. Just my luck. We got ready to depart for Ada Foah. Well, I got ready and was sitting in the boat but then the two Germans from the tent came back. I asked the guy if they had left any Cedis in the tent and he said they had all their Cedis with them. Good. So no loss. So I thought. The manager went to the tent with them. I was getting annoyed at this point. I wanted to leave. I wanted to be on my way to Accra before it got dark. Let’s go!

 

David and the manager went to the tent and did god knows what for about half an hour if not longer. I was getting so extremely frustrated. David gave me a little update from afar saying her diary and flashlight were missing. SO! Its not like we can change it now and I WANT TO LEAVE! I was feeling very German at this point with my impatience but lets look at the facts: whatever is gone is gone, its starting to get dark, they can look and make a comprehensive list of all things missing while I am being taken to Ada Foah and I can get on my way. The standing around discussing whatever and delaying my departure was doing nobody any good and just worsening my blood pressure. I was close to punching the boat. Eventually the two guys strolled back to the boat and mumbled something about asking other guys to take me to Ada Foah but then luckily got into the boat and we started. The second we started heading towards Ada Foah my mood was back to normal as well as my blood pressure. I just really despise wasting time.

 

The boat ride back gave me a really weird feeling. I felt like I was in some history channel documentary about indigenous tribes. The ride to Ada Foah started off with the resort I stayed at and the Maranatha resort next to it. The scene quickly transitioned into a lake from view of houses built from palm leaves and any other natural building material around. The sun was setting and it was getting dark and I saw no electrical light anywhere. People were strolling along the water. Boys were playing in the water. Mothers were hanging up laundry. It gave me a feeling as though time had stood still in this part. The scene moved on to what looked like more of the meeting center of the villages with the big colorful fishing boats. The laundry hung from the ropes and boys were playing in the water. So many boys around, I wonder were all the girls are. The next part along the river becomes a huge contrast. One second you see colorful wooden boats and housed made of palm tree leaves and the next you think you have been transported to the waterfront in Miami with huge houses, lights, gazebos and landscaping. It is the weirdest thing but those houses really make you want to be friends with who ever own them. The scene then goes back to a more basic one before turning into somewhat of a harbor with a few huge metal ships. This is where we stopped to get off. I thanked the manager for his help and David walked me into town. Again, I felt like all I saw was boys. I asked David about it and he said I was very observant. “We have so many boys and not a lot of girls so the boys have no girls to play with.” I thought maybe the girls were forced to do house chores while the boys played soccer.

 

My journey back to Accra was a lovely chain of helpful people. The manager had taken me on his boat to Ada Foah, David walked me into town and made sure I got a Taxi to Ada Junction. The taxi driver was going to help me flag down a trotro that drove by but I ended up getting that done myself before he could park his car. The last lady to get off the trotro in Accra told the trotro driver and his money collector to take me to Kaneshie market and make sure I got a taxi to Korle Bu. At Kaneshie, the money collector got out, hailed a cab for me and told the driver where I needed to go. The taxi drove me to Pablo’s house. Its nice to know how helpful the people can be here.

 

The journey took about 3 hours. I was the only white person on the whole trip. It was also dark so most people, myself included, tried to nap. I couldn’t use my phone because I was conserving the battery incase I needed it and my iPad was basically drained as well. This led to me having an about 3 hour-long inner monologue. It was rather entertaining and I wish I could have recorded it. The topics of my conversation included basically anything. I analyzed my current situation, my current relationships, relationships I have recently lost, the work coming my way as soon as I land in Germany, what presents I want to get people for their birthdays, future business endeavors, recipes I want to start making for breakfast and so on.

At Pablo’s, I made myself some spaghetti with ketchup (my comfort food) and watched while the others got professional salsa lessons from Pablo’s salsa teacher. I was too hungry to join in and the steps they were working on were natural to me. Pablo gave me a ride home a bit later and I was looking forward to sleeping in my own bed. Even if it meant knowing I would probably be awake by 5:30am due to noise.

 

And so it was, this morning my roommate was up and at it at 5:30. I didn’t really pay attention to what exactly she was doing but it was a combination of showering, organizing and talking on the phone. She left by 8 and since I wasn’t falling asleep anymore, I packed. My suitcase will probably be overweight and I already removed all the fabric to be put in my carry on. We will see what happens Saturday. Erica and I plan to hit up the Unique Palace pool today. I would have gone into town and did some shopping but after having 300 Cedis stolen and realizing my suitcase is filled to the brim, I opted out of that. Erica did the night shift in OBGYN so she is taking a nap and then we are off to chill together. I’m excited for the few days I have here in Accra with my great friends and have plans for every night but a part of my is also excited to be going home. But I will miss it here once I’m gone.