jenniferhawke.com

i have a weird twitch in my right thigh and $21 in my bank account.

things could be worse.

from the New York Times:

Over the next two weeks in hospitals and medical centers across the country, new medical school graduates will begin their internship. Among their many worries — moving to a new city, meeting new colleagues, adjusting to medical training — is a more profound, existential concern:

Do I have to lose my self in order to become the doctor I want to be?

According to a study from the Johns Hopkins University School of Medicine in Baltimore, … researchers interviewed residents, or doctors in training, from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects of their lives. While the young doctors interviewed defined well-being as a balance between all those parts, many felt that their medical training was so central to their ultimate sense of fulfillment that they were willing to live with whatever personal sacrifice was required, even if it meant a temporary loss of a sense of self.

“It’s partly a coping mechanism,” Dr. Ratanawongsa said. “We tell ourselves that we can do everything but not at the same time, so we are going to put off the thing that defines us as a person — time with children, running a marathon, painting, playing music — in order to get trained because being a doctor is also rewarding.”

That delayed gratification works well initially because residents believe it is only temporary. “A lot of what matters to residents at this time is the sense that they are learning to care for patients well and growing as doctors. They feel that what they are doing is going to be worth it.”

But when the imbalance persists for longer than initially expected, professional growth is not enough to sustain most young doctors. “The ones who are happier,” Dr. Ratanawongsa observed, “are the ones who have held on to one or two things and have said, ‘I’m not just another resident. I play the guitar, I run races, or I go home to family.’ They don’t do these things to the same extent as they did before residency, but they do them enough to maintain a sense of self.”

Residents who don’t find this balance are at risk of burnout, clinical depression or, more commonly, subtle forms of stress. “These residents may feel that even if they can give excellent care most of the time, there are times when they snap at a patient or don’t order a test fast enough because they are so burnt out.”

Although her study focused on doctors in training, Dr. Ratanawongsa sees the same challenges among doctors who have finished and are currently practicing. “There is always this expectation that at some point things will turn around. The interns say, ‘When I finish internship and become a second-year resident, things will get better.’ The residents say, ‘When I finish training, I will finally have balance again.’ And doctors in practice may believe that they will find more balance once they have retired.”

The danger is that physicians may end up leaving the work force or will become less effective caregivers. Dr. Ratanawongsa suggests that doctors learn how to create a better sense of balance in their lives from the moment they begin training. “We are taught to put our patients before ourselves; it’s in our charter of professionalism. I agree with that, but I also think there has to be some sense that I matter, too, at some point. If something important is going on with our loved ones or with ourselves, we need to be able to advocate for ourselves. And we need time to reflect on who we are and where we are going.”

“My belief,” Dr. Ratanawongsa said, “is that doctors will have a greater capacity to know their patient as a person if they know themselves. That kind of knowledge requires a sense of balance and an understanding of why they chose to become a doctor. It comes down to their capacity to be an empathic, caring and compassionate provider; and it comes not from their medical knowledge but from their soul.”

“This is something we should never sacrifice, even temporarily.”

just posting this article as a reminder not to lose the list of super cool stuff that makes me me.

in the last 24 months, everything has sort of watered down into “i’m a med student”… but i know that’s not entirely true because the About page i wrote 2 years ago has more than 4 words on it.

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photo: my sister Janice at my mom’s softball game last week. it was a gorgeous night to sit outside in lawnchairs, eating sunflower seeds, drinking cream soda and laughing.

the time has come.

you knew it would happen sooner or later. the light and lame recent postings had to be a bit of a tip-off… how can i prepare for a huge exam without at least a little bit of self-imposed internet exile??

i have 20 days of studying left between now and Step 1. i also have 3 NBME online practice exams, 2 USMLEWorld self-assessments, and almost 1400 unused Kaplan QBank questions that could be nicely divided up into 4 full-length practice exams. toss in a stack of flashcards as tall as my pink Starbucks mug with handwritten I Can’t Believe I Still Don’t Know This Random Fact, and you have my recipe for a perfect Step 1 Smoothie.

i originally planned to spend these last couple of weeks cramming each subject again. but i’ve decided to skip that idea in favor of getting my question stamina up. i know what i don’t know. so instead of re-re-re-reviewing(-until-i-barf) the stuff i do know, i’m going to LEARN the elusive stuff once and for all and make sure i don’t get too tired or frustrated come gameday.

here is an updated version of the next month or so.

but first! today is wedding errand day! i’m off to look for a dress for the reception and a bunch of navy stuff (placemats for the rehearsal dinner, napkins, candles, etc).

enjoy June. it’s flying by a little too fast for my liking, but i really, really can’t wait for July.

PS: if we haven’t received your wedding RSVP yet, now would be an awesome time to send it on in. thanks!

or is there a difference?

so, i just found out yesterday that i am probably going to have to get my butt to Oklahoma City to start clinical rotations the first Monday in August.

exciting stuff! yay! awesome!

unfortunately, the first Monday morning in August starts a mere 36 hours after our wedding.

hm.

so now i have a super important exam to prepare for, a wedding to plan, immunization forms to fill, titer results to document, police background checks to file, passport photos to take, student loan paperwork to submit, apartment-hunting to conduct, and all of my personal belongings (and Maddy!) to pack up. in about 7 weeks.

my head could explode at any moment.

but i’m trying to remember to stop and smell the flowers along the way. and i’m not spending a minute taking any of my wonderful blessings for granted. it’s so amazing the way Life plans Stuff to work out in spite of our best laid plans or intentions. if this is the way it’s meant to be, then i’m excited to roll with the punches.

still. head exploding is a real risk in the next couple of months.

other than 3 weeks off in April to pack up and leave Nevis, get engaged, visit Brandon’s family and come home to Canada — i have been studying for this stupid exam since January. i figured 6 weeks of studying without balancing MUA classes at the same time would be more than enough and the original plan was to take the USMLE Step 1 in mid-June. that way i’d have weeks and weeks to organize the wedding and get my score back in time to start August rotations.

which means i should be preparing right now to enter my last week of cramming…

but when i logged on to the Prometric Testing Center website and tried to book an exam in Saskatoon, the first available date was July 8th. so i have another month.

my left shoulder hurts. i can’t turn my head more than about 45 degrees. in total. i’m sick of question banks. i’m sick of First Aid typos. i’m succumbing to the blahs and the blues and the i-don’t-care-if-i-end-up-a-GP-in-the-middle-of-nowheres.

don’t get me wrong. i still need another month because i’m not scoring as high on USMLEWorld and Kaplan QBank as i’d like. but part of me just wants it Over With Already.

and i know that attitude can only hurt my score in the long-run. so i’m patiently plugging along, pretending that i am not too burned out to cram even more teeny tiny facts into my head and am happy with this grand master plan of waiting until July. i’ve purchased Shakespeare on the Saskatchewan tickets for my dad and step-mom on the eve of the 8th and a full-body spa appointment here at the renowned Temple Gardens on the 9th.

in the meantime, i’ll twiddle my flashcards until my umpteenth wind kicks in.

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photo: watching Kaplan videos in the library. taken with my amazing new present from Brandon that has superpowers and an American area code!

[edit: Bruce Fairman (author of "Moose Jaw, Then and Now" and "Moose Jaw, The Early Years") was kind enough to contact me with a few updates for this page.]

no real time to write and nothing real to write about. all of my days are the same. they come and go in a familiar marching pattern only punctuated by differences in what i have for lunch or how cold my toes are in the morning.

i’m tired. and i’m deathly bored of studying.

but you don’t want to hear me whine.

instead, here is a little bit of writing from other folks. some of you are traveling an awfully long distance to attend a wedding in this neck ‘o the woods. the rest of you might be interested in the fierce pride this little community has for its’ colourful history.

from The Canadian Encyclopedia:

Moose Jaw, Sask, City, pop 32 132 (2006c), 32 131 (2001c), inc 1903. Moose Jaw is located 160 km north of the US border. The city lies in a sheltered valley at the confluence of the Moose Jaw River and Thunder Creek. Moose Jaw is governed by a mayor and 6 councillors elected at-large.

South of Moose Jaw is 15 Wing Moose Jaw (formerly CFB Moose Jaw). It is the home of 2 Canadian Forces Flying Training School and the principle site of the NATO Pilot Training Centre. The Wing, first established as a training facility in 1941, is now the city’s largest employer. 15 Wing is also home to the internationally renowned SNOWBIRDS aerobatics team.

in the beginning, from MooseJaw.ca:

Moose Jaw was originally settled as a traditional Indian fur traders camp at “the turn” (known as Kingsway Park today). A narrow crossing of the river, plenty of water and game for food, made this an ideal place for settlement. It was a winter encampment for both Cree and Assiniboine nations, and there are burial grounds in the vicinity. The natural protection of the Coteau Range provided the valley with many warm breezes. The name Moose Jaw comes from a Cree name for the place, moscâstani-sîpiy, meaning “a warm place by the river”. The first two syllables, moscâ-, sound remarkably like “moose jaw”.

from Bruce Fairman:

In the middle of December 1881 Jim Ross and his party; his brother Fred Ross, Hector Sutherland, Dan McDonald, and Tommy Healy set out on their journey from Winnipeg to Moose Jaw Creek. Hector Sutherland was the son of Senator John Sutherland, the first Senator appointed from Manitoba. Tommy Healy, originally from Parry Sound, Ontario, was the designated cook. Using a bake kettle in the ashes of an open fire, he was able to prepare splendid Cree bannock bread – similar to the Scottish scone. Made with flour, water, sugar, baking powder and salt, bannock was remarkably tasty.

Using the new section of the CPR route completed during the summer of 1881 the five men travelled by train west through Portage La Prairie and Brandon to Flat Creek (Oak Lake) – the end of the line at that time. Leaving Flat Creek, they followed the Assiniboine river the short distance north to where it joined with the Qu’Appelle river. Travelling with horses and homemade “jumpers” – improvised sleighs made of poplar poles with wide, smooth runners which slipped easily over the ice, they made the frozen rivers serve as their highways.

Following the Qu’Appelle River west to its confluence with Moose Jaw Creek, they quickly covered the last twelve miles, arriving on January 2, 1882, at the site of what would become the city of Moose Jaw. Initially the men stayed in one large tent set up in a coulee which meandered along the north edge of the present Crescent Park. The men soon discovered there was no big game close by, although some jack rabbits and cottontail rabbits could be found in the bush, as well as quantities of prairie chicken. The menu therefore often consisted of salt pork or pemmican with beans or hot cakes with syrup and beans. Lots of beans. A meal often was only beans; boiled, baked or warmed up in a pan. There would be no potatoes or vegetables until they could be grown.

Using the 4th base line as their point of reference, Ross’s group got their bearings and chose their quarter sections to homestead. (Base lines were survey lines running east to west, parallel to the 49th parallel, located 24 miles apart. Caribou Road, now Caribou Street, was known as the 4th Base Line.)

from Virtual Saskatchewan:

The Tunnels of Moose Jaw is a high quality, interactive attraction that uses actor/guides and state-of-the-art animatronics to recreate the tunnel-and-basement underworld Chicago mobster Al Capone is believed to have frequented in the 1920s. That’s when Moose Jaw was a hub for booze delivered by rail to the United States during Prohibition. A second Tunnels tour focuses on the plight of Moose Jaw’s Chinese community around the turn of the century and a third, in the planning stages, will mine a rich vein of bootlegger stories.
More than two dozen murals adorn downtown Moose Jaw.

One of the earliest bootleggers was Annie Hoberg, owner of the Railway Restaurant in the 1890s. At that time, hard liquor was banned in Moose Jaw, which was then part of the North West Territories. Banned, but not unavailable, according to a story told during the colorful Moose Jaw Trolley Company tour of the city.

Annie served meals 24 hours a day to accommodate passengers of the Canadian Pacific Railway. Many of those passengers, male and female, enjoyed a drink at meal time and Annie didn’t let them down.

During her regular train trips to Winnipeg, she used her fashionably long skirts and petticoats to conceal specially fitted rubber bags filled with hooch she smuggled back to Moose Jaw. So emboldened was she by her success in this enterprise that she even dressed up kegs of whiskey to look like sleeping babies and disguised crates of booze to resemble commodities like flour or beans. Until one of those crates slipped off the station platform.
Halina Johnson works on a new mural near The Station Centre Liquor Store, formerly the train station.

After paying her fine in a Regina courtroom, Annie retired to Manitoba with a wealthy rancher.

Though it now bears little resemblance to the way it looked in its glory years, River Street is the setting for many of Moose Jaw’s most entertaining stories about gamblers, bootleggers, “tom-catters”, painted ladies, crooked cops and gangsters — the old Empress Hotel, which burned down in 1987, is said to be the place Capone stayed when he visited Moose Jaw.

Nobody can prove Capone was ever actually in Moose Jaw. His name has not turned up in old hotel registries and no one has come forward with photos of the crime boss posing with Chief Johnson, for instance, in front of the old fire station. But Grajczyk says there exist six first-hand accounts of people who claim to have met the Chicago hoodlum when he was in Moose Jaw, including one from a barber who claimed he used to cut Capone’s hair.
Beautiful Crescent Park is the heart of downtown Moose Jaw.

Chicago had a rail connection to Moose Jaw in the Soo Line, which ran from Saskatchewan to Chicago via Minneapolis. There’s no question the Soo was a prime conduit for Canadian booze entering the States during Prohibition, and there’s every reason to believe organized crime was involved in its procurement and transport.

Fitting, then, is the fact Moose Jaw’s old train station, built in 1922 and refurbished more than 70 years later, is now the most beautiful place in Canada to buy liquor. And it’s all legal.

there are other not-so-proud* moment’s in Moose Jaw’s history, but this little city has heart. a lot of people from Saskatchewan talk about how they can’t wait to get out. get to the west coast or the big city out east. i escaped to Alberta and Vancouver for almost a dozen years and was proud to leave the windy plains behind. like i had achieved something the suckers stuck here could only dream of.

and now i’m back. this time around i am old enough or wise enough to realize how great Saskatchewan really is and what a wonderful home province i have to be proud of.

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photo: our farm pond a couple of weeks ago before all the green showed up.

*like, being Saskatchewan’s KKK centre.

“The only place where success comes before work is a dictionary.”
~ Vidal Sassoon

after another wedding errand day that seemed to fly by too fast, it’s Tuesday again. time to hunker down in the library all day and try to crank out a couple hundred more practice questions tonight.

my initial review schedule is almost done. then i have two weeks of Topher’s Underrated Cramming with a final few days to finish off practice questions and simulated online tests. since Google Calendar seems to be wonky for me lately, i’ve included a screenshot of my monthly schedule here: May, June & July.

you’ll probably notice a little gap on the May long weekend. Tina’s birthday was totally worth it.

i hope the sun is shining wherever you are today. after dipping down close to freezing last night, it looks like a gorgeous Saskatchewan June day.

enjoy it!

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photo: Janice’s gorgeous Norton. if anyone knows the meaning of a good-healthy-satisfying day of work, it’s my little sister. have i mentioned she loves me so much she’s willing to wear a pink dress for me??