"The good physician treats the disease; the great physician treats the patient who has the disease"

The title of this entry comes from a quote by Sir Willian Osler. I hope that I can always keep that wisdom in mind as a physician-in-training and as a future physician. It gives my whole experience purpose, even when med school gets tough. And boy is it tough. Last week we had our first block exams. I'm glad that they're over, but I didn't do as well as I was hoping to. I did really well on my histology exam, ok on Anatomy, but not so well in Molecular and Cellular Biology. Although it was quite disappointing because I know how hard I worked, I've learned a lot from my block 1 exams. Here's what I learned:

1. It's hard to get down on yourself when you live on a beautiful Caribbean island! It's pretty easy to let your frustrations go with a relaxing trip to the beach while watching the sun set over the ocean sitting on soft, white sand.

2. Fortunately Block 1 exams are not worth a large percentage of the overall grade. I now have the chance to adjust my studying and do much better on the rest of my exams, now knowing what to expect. Although I was disappointed, I was also inspired to do better. It made me think of this clip from Remember the Titans

I have to change the way I listen in lectures. I have to change the way I study. I have to change the way I review. 

3. I learned about the importance of details. There were a lot of details that I didn't study that ended up being on the exams. It was a lot more specific than I was anticipating. At first I was a little annoyed because it's hard to know all the nit-picky little details, especially with the amount of information we're presented with. But then I thought to my future patients. What if I ignored a small detail in their treatment? What if I ignored a small detail in their health history? What if I ignored a small detail about their symptoms? It could have a profound effect on their future health. Details ARE important, and I'm glad I realize that now so that it can translate to the care of my future patients. 

4. I'm glad I have my family here with me on the island. When people find out that I'm married and have a baby they tell me, I generally hear from them, "Oh that must be so hard!" In some ways that is true. Sometimes I have to stop studying to take care of my daughter. Sometimes it's hard to focus with her crying in the background. Sometimes I don't sleep very well because she wakes up a few times every night. (side note: the other day we moved her into her own bedroom to sleep at night and my wife said, "I feel like I'm sending her off to college!" Haha she's growing up so fast!) But what they don't realize is that I have a TON of moral support! I have a wonderful wife who is always encouraging me and telling me, "You can do it! You are so smart!" Not to mention she takes care of the baby, keeps the house clean, and makes me dinner! It's nice to know that I can focus on my studies and that I don't have to worry about taking time out of my day to cook and clean. She is so WONDERFUL to do those things for me! Also my daughter gives me a great big smile every time I come home from school. It not only makes me happy, but it keeps me focused knowing that I'm not just doing med school for me, but for my family. 

5. I am learning to trust more in my Savior Jesus Christ through hard times. Looking back on the quote I used for the title "The good physician treats the disease; the great physician treats the patient who has the disease." Christ is our Great Physician. He knows us personally and know exactly what we are all going through.

I am excited for Block 2 and am confident that I will do much better!

Week 1 and White Coat

Week 1 is in the books! And week 1 was spent in the books haha! It's only been 3 days, but it feels like I've learned a whole semester's worth of stuff. It has been described to us like drinking from a firehose! Kinda like this:

We just get blasted with so much information at once, and we have to inhale it all somehow. There is no time for play, just study, study, study. I just have to maintain a good attitude. I have to keep finding ways of how to apply the information that I learn in a clinical setting, and look for how the things I learn can help my future patients. It's hard sometimes, especially when learning about cells or amino acids. But it's all connected.

So my general schedule is like this:

7am wake up

8am Molecular and Cell Biology

9:30am Anatomy Lecture

10:30am Histology

11:30am-12:30pm go home, eat lunch, change into my scrubs

1:00pm Anatomy Lab (cadaver dissection)

3:00pm STUDY

7:00pm eat dinner

8:00pm review material for the following day

10:00pm go to bed

Every 2 weeks or so we will also have a class called Intro to Clinical Medicine where we begin to learn in a hands-on way how to be physicians from taking a medical history to performing physical examinations. So this is my weekday schedule (monday-friday), and on Saturday I plan to spend at least half of the day reviewing the previous week's material, and spending the rest of the day running errands, spending time with my wife and daughter, and enjoying the beautiful island of St. Maarten. On Sunday we go to church from 9am-12pm, and I hope to keep the rest of the day mostly free from studying and treat it like the Day of Rest that God intended it to be. 

This has worked for me so far, and I hope I can keep it up. Medical school requires a lot of hard work, and I really respect all physicians who have gone before me because they did this once too. It's hard, but it's doable. 

On Friday we had our white coat ceremony. It was a formal introduction to the field of medicine. Unfortunately it was 3 hours long and messed up my Friday study schedule haha. It reminded me of a graduation ceremony. There were speakers, and then each of us medical students were called up one by one and given our white coats. 

For many, this was a great celebration. Yes, celebrations are deserved for actually making it to medical school, which is not an easy task. But to me, I felt like this is just the beginning of a long road. Many had parties planned following the ceremony, but I was not interested in the least bit. The white coat ceremony really opened my eyes as to how much hard work and effort this would take. I came here to study medicine not to party, so I went home and studied. I have set some high goals for myself this semester and I want to work hard to achieve them. 

But don't think that I won't have any fun while being here! First off, every night when I go home I have a wife and daughter happy to see me! Playing with my baby girl is a lot of fun. I wouldn't be able to make it through med school without them! I also find time to watch BYU Football! And I know I will find time to explore the paradise of St. Maarten. 

Pre-Med School Adventures (Photos)

Expectation vs. Reality

A move to a foreign country always takes getting used to. Luckily for both Megan and I we have both been out of the country before. She has been on international internships to Africa (2 weeks), Romania (4 months), and Peru (3 times for a total of 4 months), and I served a 2 year mission for the Church of Jesus Christ of Latter-day Saints (Mormons) in Argentina. However, this time around it's much different since we have a 4 month old daughter. It's a little tougher to transition. It's harder when, instead of worrying just about yourself, you have to worry about your wife and baby and make sure they are always safe. But, God inspired us to come here so I have confidence that He will protect them while I am in medical school. 

Before deciding to come to the island of St. Maarten, I did plenty of research in order to make sure that it would be a good place for my family and I. I read lots of blogs, Facebook posts, information from the school, etc. and nothing scared me away. What it did, though, was create a lot of expectations. So here is a list of a few of my expectations along with the realities that I discovered once I actually arrived here.....

1. Expectation: "3rd world" living conditions. Reality: There is a good amount of "3rd world" living with poorly constructed houses, unclean water, poor sewage system, no air conditioning, etc. but there is also a high quality of living standard as well. It's not a great idea to drink unfiltered water anywhere on the island, but there are some very nice resorts, houses, etc. The average person on the island enjoys a high standard of living, but it is well below the average standard of living in the United States. Many have air conditioning units, cars, internet, cable TV like what you would expect in the States. Here, reality was about what I expected. I find average island life very comparable to what I experienced in Argentina for 2 years as a missionary. 
2. Expectation: I thought I would have to part with my "American Items" such as raspberry jam, burritos, tools, etc. Reality: I should've left a bunch of stuff home...they have almost everything here! Sure it's a little bit more expensive than back home, but you can find it if you know where to look! They have grocery stores like Cost-u-less that is exactly like Costco (they even sell Costco and Sam's Club brand items) and LeGrand Marche which is like a typical grocery store back home. Or Ace and Kooyman are just like Home Depot. They even have a Bebe 'n Kids which has everything you would find at Babies 'R Us. Again, everything is a little bit more expensive, but it's not too bad.  
3. Expectation: Really slow internet. Reality: It's not too bad. It's harder to stream videos on YouTube, Netflix, or WatchESPN, but for everything else it's really not that bad. The hardest part is getting internet into the back room because all of the walls are made of concrete haha.
4. Expectation: Tons of mosquitoes. Reality: the real pest (at least in our apartment) is sugar ants. They come from nowhere! No matter how well we clean the kitchen, put up baby powder around the edges (supposedly it works haha), we still squish about 20 every day. We even live on the lagoon side which is supposed to have tons of mosquitoes. However, we found that by cleaning up the dead leaves and standing water around our apartment we have drastically decreased the amount of mosquitoes. We also try to keep our apartment enclosed as much as possible and use AC instead of open windows. It's too hot to keep the windows open anyways, but if we did we would have to make sure we had good screens on them to keep the mosquitoes out, especially at night. So far we're glad we haven't bought mosquito nets for the bed or baby crib. 
5. Expectation: We would spend tons of time on the beach! Reality: It's hard to go outside with a baby. It's really too hot, too sunny, and too humid to be out for very long with a baby. If we do go to the beach we have to stay in the shade and spray her with a water bottle when we are out, and she's terrified of the waves when we try to put her in the water. She's only 3 1/2 months so hopefully we can go to the beach more when she gets a little older. Also, I'm a medical student. I don't have time to go to the beach! I could just walk 5 min and study on the beach, but that might get a little distracting haha.
6. Expectation: We would go out to eat a lot since St. Maarten is known for it's wide variety of restaurants. Reality: We are a family of 3 and we can't afford to eat out all the time, especially when we're living off student loans haha. Also, like I just said, it's hard to get out with a 3 1/2 month old baby. 
7. Expectation: Lots of power outages. Reality: we have only been through a couple that lasted about 10 min. Maybe we'll see more. However, the other day our power went out for 4 hours! Since we were new and expecting power outages on the island we didn't think much of it, until 1 hour passed, then 2 hours, then we started noticing all of our neighbors lights turning on. We wondered if St. Maarten just had isolated power outages, or if we had reached a certain limit for the day and they shut us off haha. None of the breakers had flipped, so we called our landlord who got us in touch with the power company. They said someone was on their way. Another hour went by so we called them again. They reassured us that someone was on their way and would be there in 5 min...another hour passed! You can drive around the whole island in a couple of hours! Finally they showed up and come to find out we had blown the main fuse for our apartment, which should've never happened in the first place. The fuse we were working on was too small (according to the power guy) so he put in a bigger one which should've been there all along. But we did have a tender mercy, or a small blessing from the Lord, in that the fan on the AC worked! We had just enough power to work one thing in our apartment and we could work the fan on the AC! It wasn't cold, but it was better than standing hot air!
8. Expectation: Island Time. Reality: apparently 5 min means 2 hours! I was kinda expecting that though, especially after being in Argentina.
9. Expectation: Beautiful weather. Reality: It is beautiful! It's a little hotter and more humid than I expected, but I can't complain! It's in the 80's day and night (although it feels very nice at night). I wasn't expecting the random downpours that occur about every other day (at least at this time of the year). I hope that we never get a hurricane while we are here. One thing's for sure: I'm grateful for AC
10. Expectation: Pictures. Reality: Don't judge a book by it's cover. We saw beautiful pictures of our apartment, the school, cars, but they ended up being quite different than what we saw in the picture. Starting with the apartment, it looked like a dream house in the pictures. It had a beautiful view of the lagoon, spacious living room, master bedroom, washer/dryer. The lagoon view is still beautiful, but the pictures don't show the cramped bathroom, the awkward kitchen counter, etc. But, although it's not perfect, we still really like it! It took a couple of days to get used to, but I think after a couple years it will be hard to leave this place. Second, the pictures of the school make it look like a state-of-the-art clean and pristine medical school. The reality is had I seen the school before I accepted, I might not have come here. The infrastructure is a little worn down, the school is quite small, and it reminds me of a slightly run-down Jr. High. I hope the appearance of the school is meaningless compared to the instruction that I will receive here, and after talking to other students that seems to be the case. Compared to other Caribbean medical schools, this one is top notch. It is also very comparable to other state-side schools, and boasts a 100% USMLE Step 1 pass rate. It just lacks a little bit in outward appearance. Perhaps there is a lesson there, like the Lord says to Samuel, "for man looketh on the outward appearance, but the Lord looketh on the heart" (1 Samuel 16:7). Third, definitely don't judge a car by it's picture. I test drove 2 cars that looked brand new in their pictures, but when I actually saw them they were battered in, paint falling off, and making strange noises. The car I finally bought isn't perfect, but it's head and shoulders above the others that I looked at and it's in the same price range. 
11. Expectation: speaking of cars, buying a car seemed quite simple. Reality: It's a lot more complicated than it seemed. I think the majority of students selling cars have no idea what they're talking about. Everyone said that the insurance, registration, and inspection comes with the car. Not true. I learned all of this the hard way. Luckily I bought the car from a guy who mostly knew what he was talking about. He gave me a bill of sale and told me to get my own insurance. However, he (and many others that I asked) told me that the registration and inspection also come with the car. What none of them realized was that you need to get it all in your name. In order to get it all in my name I had to get my own insurance, then get a special government stamp on the bill of sale to make it official. So I had to drive all the way to town and get the stamp (not to mention I was given poor "island style" directions. There's no such thing as left and right, instead it's "this way" or "that way"). Once I got the stamp I had to drive to the inspection office, get the inspection in my name, then drive back to where I got the stamp and get the registration in my name. Complicated. Seeing as cops here don't do much it probably doesn't matter too much if you get everything in your name or not, but there's always that small chance that they'll randomly pull you over or you get in a wreck. Better safe than sorry.
12. Expectation: on the car theme...terrible drivers. Reality: It's different, but compared to driving in Argentina, New York, or even California it's very mellow. Like I said, it's different. For example, since all of the roads are only 1 lane each way, when there is a lot of traffic (and sometimes when there isn't a lot of traffic), if someone is attempting a left turn it is courteous to stop and let them turn. It is also courteous to let people merge from off the road in front of you, even if you have to slow down almost to a complete stop to let them in. Although this is the courtesy, it doesn't always happen and sometimes you have to "push" your way in and force people to give you the "courtesy." If you are a timid driver, you might have to wait for an hour before anyone lets you in, but with a little "push" people will show you the courtesy. The bottom line: drive like a local. Also since the police don't do much as far as traffic violations go, the best enforcer of speed limits is the trusty speed bump. They're everywhere! Just when you think you have a clear patch of highway, BUMP! They don't really paint them either so you always have to watch out for them. And don't ever drive between 4:00 and 6:00 (+/- 1 hour) going towards Phillipsburg. Since it's only a 1 lane road, traffic is awful. It's backed up for miles. 
13. Expectation: A small LDS Branch. Reality: A small LDS Branch! It's great to know that you can go anywhere in the world and still find the Church. Although it's a small island with a small group of Saints, it is the same Gospel, the same ordinances, and the same organization. I know I have immediate friends and family anywhere I go. In fact, the Church is how we found our apartment! We got in contact with AUC's Spouses Organization who gave us a "sponsor" to help answer our questions before coming to the island. We mentioned to the Organization that we were members of the LDS Church, and they gave us sponsors who were AUC students and members of the Church as well! Our sponsors got us in touch with another couple who were AUC students and members of the Church who would be moving out of their apartment at the same time we were moving in. We saw this as a tender mercy and knew that the Lord was looking out for us.

Although medical school is quite intimidating at the moment, I know that I have support from my family back home, the Church here on the island, my wife and daughter, and most of all from my Savior Jesus Christ. I look forward to the challenge, and look forward to the opportunity to dedicate my life to the service of others.