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Thursday, May 4, 2017

Boards, wards and...umbilical cord?

This is going to be one long rambling post. I know I've been mia (sorry KC). After finishing first year I just didn't have anything to write about. All I wanted was time to myself and with my family. Then second year came and went. I was able to stop pumping at lunch and ate lunch like a normal person (read: in the library, eating over my laptop, looking at slides). During winter break this year, we went on our usual family vacation to visit my in-laws and I spent two weeks loving life. I felt rejuvenated and was ready to attack the second half of 2nd year plus everyone's favorite, Step 1. Yes, I can do this, I am awesome and wonderful and multitasker extraordinaire. Want to see my color-coded Excel spreadsheet with my study schedule?

A few days into January, I felt funny. Funny, not like haha funny but rather oh shit I might be pregnant funny. I only had an expired cheapo Amazon pregnancy test. I don't think the second line could have appeared any sooner. It's just faulty, it's expired anyway (note: clearly scientific brain was not working at this moment.) My poor husband ran to CVS at 10pm at night and got me two real pregnancy tests and the first one I took turned positive just as quickly as the expired one. And then, I cried. We both didn't know what to say the rest of the night. We have two kids, we're living in student housing in a 3 bedroom apartment. I'm a medical student, staring down Step 1 and going onto the wards. He works full time and is doing a part time MBA. How would this even work? And for the next few days we honestly didn't know if we were going to go through with it and I found myself dumbfounded that I would be in this position, thinking about termination. Me, pro-choice advocate, having to decide for myself what my choice would be. I'll save you the drama and the back and forth, but long story short, we decided not to go down that route and we warmed up to the idea of having 3 (and by warming up, I mean we've accepted it and we're now excited but have no idea how we are going to deal with it come September). But can I just say how amazingly privileged am I to have been able to make a choice for myself, about my body? And equally important, privileged enough to have the resources to actually support another child. End political rant.

My first trimester was a blur of keeping up with school and keeping down my food. I had a meeting with my Dean and asked about what would happen to my third year "if one was to get pregnant." Luckily I was able to get a relatively decent rotation schedule and I start medicine during my late second trimester and finish with family and ambulatory before I go on leave. I just have to take my family shelf 2 days before my due date; I've already told my ob not to touch me during the month of September. I finished my last block of second year, which signified the end of my preclinical years. Somewhere along in there I had an NT ultrasound and my lovely doctor indulged me in a potty shot that revealed a penis, which after two girls, was amazing and surprising. I started studying for Step just as my second trimester began and the fog of nausea and fatigue magically lifted as if it was meant to be (but really, thank you placenta).

Alas, after weeks of studying, not seeing my family ever and having to rely heavily on the support of my husband, my mom and my nanny, I sat for the exam with baby belly, braxton hicks and stretchy pants with no pockets (so they don't make you turn them out during security checks!). I definitely felt a few kicks during the exam, cramped up a few times, but surprisingly 7 hours of testing with a fetus sitting on my bladder went by pretty quickly. And now, I have a few days off before 2 weeks of bullshit pre-wards orientation that are mandatory and then we're off to the wards.

I received an email today from the school letting me know I can't go to one of my doctor's appointments during said bullshit pre-wards orientation, that it's against policy. Because, you know, from 7:30am-5:30pm they're going to keep us prisoners with no breaks, no time for lunch or for me to slip out and see my doctor across the street. That I can do my glucose screen and prenatal check at another time (read: while I'm on call. On internal medicine. At the county hospital. An hour away from campus.) because that makes so much more sense. What bothers me most is this. I don't expect any sort of special treatment. Never in my 2 years at this school have I lamented about being a parent in medicine. I've never asked about more time for studying, I've never been absent. I haven't even taken a sick day. I've passed every single one of my exams and I've always made adjustments on my end to make things work on their terms. My school has ironically created a program called Parents in Medicine. Whoever goes to these events I'm not sure. I don't really know what the program actually is because if you're truly a parent in medicine, you don't have time to go to these things. While I appreciate that they're thinking of us, they're really not thinking of us the right way. We don't need to have events to talk to other parents in medicine and commiserate together about the system. Sure, having a fun family day is nice, but I can do that on my own. What we need is academic support and administrative support. I need to be able to go to a damn doctor's appointment, not have a 2 hour get-together in a park that I can't even attend because I'm studying. I need someone to answer my email that I sent out months before the start of said orientation about scheduling a doctor's appointment. End pregnant-lady hormone-driven rant.

Drama aside, I am excited to get on the wards and finally be closer to "practicing" medicine, but I'm also slightly terrified. I'm afraid of looking dumb, looking too pregnant, looking dumb and pregnant. Being away from my family and missing important events. Oooh and giving birth on the wards or during my shelf exam because I insist on finishing. Ironically the first rotation I'm on when I'm back from maternity leave is ob-gyn, so essentially I'll deliver baby boy huffing, puffing and screaming and then join the team a few weeks later - hey guys, remember me and my vagina? I'm already done with my birth plan. It reads like this: "No medical students please." Sorry guys, but let's be honest, it will be hard to pretend I don't know you.

Hopefully I'll have some time to write about being pregnant on rotation. I'm sure I will have some lovely stories to share.

15 comments:

  1. Congratulations, what a year it has been! You're quite the kick-ass med student! This post brought back memories. I went through second year of med school pregnant and that whole year is just one big blur to me. That was my only pregnancy, I can't imagine doing it with 2 kids. And taking Step 1 pregnant, again, baller! I couldn't do it. Color coded Excel spreadsheets, haha, yes I have mine too. I might even have to make a separate post about my relation with Microsoft Excel.

    Sorry to hear your school is being inflexible about their orientation scheduling. Have you spoken with your Dean about this? Sometimes if you ask the admin people they are more sticklers for following a set schedule because they have less control but the Dean maybe more understanding and may have more power to help you. I was very open with my Dean, I spoke to her about all my concerns pretty early on, and asked her questions as they arose. She was extremely supportive, had great advice, and looking back, I can't imagine having done all this without her support. It may have helped that my Dean was a woman who had children during training. With my particular situation, I wasn't able to attend the pre-wards orientation at all, they just handed me a folder full of paper and told me to look over it before starting rotations. Even if your school refuses to let you attend your appointment during orientation, it will super-inconvenient to do it driving from the County Hospital, but small potatoes in the big picture, don't sweat it too much.

    Your third year may be logistically different from most of your classmates. Though don't worry, starting out, most everyone looks dumb, pregnancy or not! Good luck with the exciting adventures ahead!

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    Replies
    1. Hah! I definitely don't qualify as being a kick-ass med student, but thank you so much for your support! My Dean has been really supportive as he's known since the first day I started med school that I'm juggling two little ones at home. He even mentioned once that he didn't know how I managed to get any studying done because he had a hard time studying for his recert with his kids around and had to park them in front of the TV. Definitely felt acknowledged there.
      While he has been a good advocate for me and made me feel like it was totally normal to have an altered third year schedule, I'm really disappointment with how the little day to day things are handled. I'm very grateful that I have this overarching support that from a higher-level, makes it seem like everything will work out fine. It really seems like theoretical support. But I'm living the day to day and navigating the small stuff kind of blind. I know I'll manage, but my pregnant-self just wants to rage. Thanks again for listening and for the kind words!!!

      Delete
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  2. I resemble this post! Well done, and yes- we as parents need admin support, not get togethers in the park.

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  3. Keep inserting your views to admin - I think you need to be heard. That's how changes are made! Being preggo during rotations is definitely a new challenge I can't wait to hear your stories on that. I was pregnant during residency twice and it made me feel a lot differently about some of the organs I was grossing. I would trade a fetus for a tough Whipple procedure so I didn't have to go there in my head.

    Love getting caught up with you this post made me LOL. When you are on the wards pregnant - I agree with above EVERYONE is dumb, try to shift the pregnant, no matter how swollen and awful you feel, to being more of a badass than your peers. I attained chief resident and excelled in my fellowship - all the while pumping, dry heaving in the stairwell from morning sickness, lumbering down the long sky bridge from UAMS to the VA to do needles, occasionally having to stop at the lone bench to sit and breathe through lower back pain during late pregnancy. How does that not make us amazing? And I didn't even have a third. You are a rock star, don't let any sideways glances or denials to let you go to the doctor at a reasonable time make you think differently.

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    1. I love hearing other people's experiences because they really confirm we are all so damn amazing!!! I can't believe you handled being pregnant twice during path residency. I had to leave during one of our labs during my 1st trimester because they brought in specimens and I just couldn't take the smell. My ob was surprised that I was most anxious about this pregnancy given I've done it twice, but I reminded her that I've just spent 6 weeks studying all the possible things that can go wrong with the fetus. I'm so thankful I'm not on peds or ob while pregnant. I don't think I could take that.
      I plan on following up with the admin. I think it's a little ridiculous considering how they keep preaching self-care to us. If it were an appointment for myself, I wouldn't care so much, but it's for my baby and that infuriates me. I'm trying to avoid being a step question stem that starts "A medical student with poor prenatal care walks into the ED..."
      Thank you again for your support!

      Delete
  4. you 100% must go to my med school. socal? your experience is sadly par for the course. i also took step 1 8 months pregnant, braxton hicks and all...(due end of august) i had planned to initially start a few rotations, give birth, then start again, but come july i was allowed 4 hours of walking time per day so rotations were out of the question. instead of taking 6 months and starting 3rd year in january i took a whole year off- and it was a complete vlessing in disguise. I had a chance to go to baby music class with my older one, have a nice long maternity leave, participate in all the volunteering i didnt have time for the first 2 years and start a cool research project. i also felt rejuvenated and excited when i went back to clinical medicine after my year "off." also something to consider is having to make up that time during 4th year. 4th year at most schools is super chill and an awesome chance to take time off to be with family, travel, or move if you need to for residency. so consider a leave as a viable option. now im a ms4 matched into em at an awesome program- my leave was considered a plus on the interview trail and i had no negative reactions. good luck with everything and feel good!!

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    Replies
    1. Congrats on matching in em! Yes my plan for leave will only really work out if this pregnancy is totally normal and uncomplicated. The possibility of needing to take a full year is very real and although I'm trying to avoid it as best I can, I think I'd be okay with it too. I think having a full year would be wonderful and I'd do all those things you mentioned research, volunteering, I'd also probably do a lot of nothing which sounds just as wonderful. My housing situation will get a bit complicated though. As will financial aid. It seems like the admin headache never ends. Thanks for sharing your experience! Good luck with intern year and beyond!

      Delete
  5. This comment has been removed by the author.

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  6. We've missed you, CaliMed! Loved the updates. Yes to more admin support. Can you challenge the doctor's appointment decision? Bump it up to student affairs dean(s)? Seems like an important request that should be granted as it relates to your pregnancy wellness.

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    Replies
    1. Thanks KC! I know, right? It seems like if they care to preach wellness with organized yoga and puppy therapy, I should be able to go see the doctor. (I'm actually not kidding, we have those programs; I have yet to take advantage.) Honestly I'm a little afraid of coming across as too much or too demanding, even though I know they're in the wrong. I can't help but think every little squabble will somehow end up in my Dean's letter.
      I will try to write more, I promise! Thank you for your support as always!

      Delete
    2. I get your concerns, but it is probably a big enough deal to push back on. One option might be to contact the person who sets up the yoga and puppy therapy and ask for advice on approaching this issue. Asking for help sympathetically can be a great trick for pushing without looking pushy.

      Congrats, and best wishes for everything to work out as best as it can for schedule!

      Delete
    3. I'm also going to wonder realistically how that would come across in a Dean's Letter- "well, little miss princess here wanted A FEW MINUTES OFF during PREWARD time to ENSURE the HEALTH of her CHILD, can you BELIEVE what a PRIMA DONNA?!" I mean, I can't think of a way where it would come across in a way that didn't reflect really badly on them, particularly as I imagine that even if they were vague in their wording, they would HAVE to know that interviewers would ask you to truthfully elaborate, and then they'd get your side of the story as above, and god forbid the interviewer is a mom......

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  7. Congratulations! Wow!!! I agree on pushing back on the appointment issue. I wish I had gone to more appointments while I was a pregnant MS3. Regarding looking dumb and pregnant- I think the culture of medicine is changing. I never once received weird looks, even when I brought a mini fold-up camping chair on rounds from about 20 weeks on due to bad lower back pain. I just presented while sitting down when I needed to sit, and multiple residents/attendings applauded me for taking care of myself. Do what you need to do for yourself and your family. As long as you are putting in some effort to read, show interest and take care of your patients, you will be great and people will respect you. You can do this!

    ReplyDelete
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