Ten item summer clinic capsule wardrobe - Family Medicine, Radiology

Clothes, hand washed, drying

This is more of a capsule wardrobe by circumstance, not deliberate curation. A bit about the status of my personal style and wardrobe now: I was building my professional wardrobe slowly over the past two years, and have settled on an equilibrium that I am happy with. I also moved to an apartment with much more limited storage, and am content being confined by space and eye-stress from clutter, if that makes sense. We also don't have a laundry in the building, so I am hand washing for the most part, and dragging my stuff to the laundromat less frequently.

I had my Family Medicine rotation - primary care, outpatient, plus a train commute - for six weeks, and it's over. The weather is slowly changing, but still swelteringly hot into the 90sF some days. I'm on Radiology nowadays and though nobody is really going to pay attention to what I'm wearing in a dark radiology reading room, we are in the hospital and I do feel obligated to dress better than I did in FM (+ no commute).

Here are my pieces:

Tops

1. Dark red sleeveless blouse - $20 - bought this for my medical school interviews and wore it to each one, looked very smart and professional under the suit that I babied it a lot. Now it's shown its nature as a cheaply made, fast fashion item and as nice as the color looks against my skin, I will definitely be spending more on my residency interview blouse
2. Purple flutter sleeve blouse - $15 - bought in 2010 for my high school job. It's very airy and breezy in hot weather, but that hardly matters if I have to wear a white coat. Unfortunately, it's showing its age and the fabric looks pretty worn (100% polyester), but I like the cut and the way it looks on me. I would not choose this color for myself again, though
3. Navy linen sleeveless shirt - $20 - this is a Uniqlo shirt that I wear usually for casual occasions, but it works in a pinch for the hottest of summer days. Very wrinkled, as expected of linen. I don't really want to buy more Uniqlo, but I am considering getting one of their rayon blouses
4. Black silk t-shirt - $25 - secondhand Eileen Fisher from Poshmark. Really good-looking shirt and fabric. With some of the above blouses nearing the end of their useful lifetime, I am definitely looking at buying secondhand, higher quality silk blouses for clinic purposes
5. Dark red mock neck shirt - $6 - from Uniqlo. This cheap little shirt is just barely appropriate for a casual primary care clinic, but I would not dare to wear this in the main hospital campus, even in the cover of darkness (again, Radiology). However, I did rely on it quite a few times in FM when it wasn't disgustingly hot
6. Blue and white psychadelic dress - $14 - this one again. It's 100% polyester too, but the movement makes it comfortable for the summer. I don't wear it too often

Bottoms

1. Black polyester A-line skirt - ??? - bought in 2010. Hardworking little skirt. I love it a lot, very versatile. I took in the waist and shortened (!!!) it to make it more professional, less witchy. It moves very well, and despite the 100% polyester, the cut is very breezy and comfortable in the hot, hot summer. I wear this about three times a week and hand wash on the weekends
2. Navy trousers - $9 - from H&M in 2011, a bit too casual for the hospital, but when there were FM attendings literally wearing leggings in clinic, I didn't care. I feel like this is okay for Radiology, but I have more professional trousers waiting for cooler weather

Shoes

1. Black flats - ??? - Lucky Brand flats dug up from my closet in high school. Don't remember ever buying them, and I never was a flats wearer until this year. I didn't want to tear up my pumps wearing them every day, and they were too formal for FM clinic anyways. These little flats are clear staples in my wardrobe now.
2. Sperry boat shoes - $95 - I don't remember exactly how much I got these for, but they are my default casual shoe and work when I'm wearing the trousers. Not sure I can pull these off once cooler weather hits, with darker trousers. Wouldn't dare wear them on Surgery, though

Looking back at this, ten items is a bit...Spartan. But I do promise you I'm handwashing very diligently. I'm not always comfortable with the "minimalism" game, but I feel pretty good about this. I am still actively pre-buying, that is, browsing Poshmark and keeping track of items I would want to buy. The plan is to replace the purple blouse with one of a similar cut, and buy another one. Professional shoes, too, for the cooler weather. 

The next post may be a roundup of outfits, and the one after that will be wardrobe planning for the autumn and winter. These are the kind of posts suitable for microblogging about minimalism in 2018.

Finally a breather - and something about Spanish

Somewhere in Boston, there is a garden

So, getting used to being a third year has kept me away from writing, but here I am in a more relaxed rotation, ready to write.

The first thing: I got my Step 1 score back. Some combination of disbelief, relief, joy, fear, and anticipation. I will be going full steam ahead towards orthopedic surgery. My score is below average for ortho, but still within striking range. So now what lies ahead is doing my best on my rotations, keeping up with research, maintaining my relationships with my mentors, and looking far ahead at Step 2 and away/audition rotations.

I finished my first rotation, Obstetrics & Gynecology, a few weeks ago, and am just as many weeks deep into Family Medicine. I think I will eventually write more thorough, thoughtful update and reflection posts on each specialty, but that those will come eventually, much like my posts about my trip to Germany in summer 2016, and my Grand Canyon hike. Someday.

The changes in my life, other than the shift from pre-clinical to clinical education and the new three digit number that identifies me are my (1) new apartment and my (2) improvement in medical Spanish.

For the first one: I moved in with two of my classmates into their apartment, where there is a larger, more home-like common space, a smaller kitchen and bathroom, and a smaller bedroom for me. In strict terms of real estate, it's a downgrade, but I realized that my old digs were not great for my wellbeing. I got along fine with my old roommate, but I also tended much towards being asocial and a shut-in unless there was a place for me to specifically go or people I wanted to specifically see. My new apartment is a lot more like my college one, where I interact with my roommates more, and we get along.

That said, a big thing that I realized about myself is that I really miss my college friends. Like terribly so. Maybe it's that we're all scattered out at different rotations, but I don't feel as connected as I used to with my med school friends. We don't actually have that much in common, whereas I felt I was very close with my college friends (and in love with one, who is not my ex-boyfriend). So lately I've found myself really keeping in touch with old friends, and old-old friends (my best friends, the ones I've had elementary-middle-high school + two years of college, and I'm lucky to have two of them).

Hollyhocks will always make me happy

And I guess the last thing I'll say is that my improvements in Spanish have probably been what I've been most proud of in terms of soft clinical skills achieved. My Family Medicine clerkship is at a community health center where probably 90% of the patients are either from El Salvador, Guatemala, or Colombia. 5% more are probably from the Dominican Republic. The others are old white Italian-Americans. So I've had the very special challenge and privilege of learning primary care en español, which means going in to see patients on my own, collecting a history and doing a physical exam, reconciling medications (with some patients illiterate in English and Spanish), distracting the little people accompanying parents to their visits, seeing patients as young as three days old to as old as ninety years old. In the past three weeks, I've perhaps spoken English to ten patients. I feel a lot more confident and competent as a clerk and as an hispanohablante. I am making progress.

I've been getting good feedback as a third year student, but I get really proud when the attending physicians (all of whom speak Spanish themselves, running the gamut of gringa to fluent) ask me where and how I learned Spanish. Even better feedback is when the patients grill me about where I'm from and are surprised to learn I was born and raised in the United States with parents from China, and not Peru or Puerto Rico or Mexico where the Chinese diaspora has also touched. That's the best trophy I have in the road towards professional Spanish fluency.

So I think I feel a lot of things, and I think I need to write a longer post about this. But I now speak medical Spanish much better than I speak medical Mandarin, which makes me feel very guilty on one hand, proud on the other. The next step will be to actively seek out learning or patient care opportunities where I will use those languages.

This year will be one of many changes. I already has been. I'm growing a lot. I loved OB/Gyn, and though I don't love primary care, I look forward to every clinic day. And I'm ready to get back in the operating room. A lot has changed, but really, a lot has not.

Spring into summer update

View of the green, green Colorado River from the South Kaibab trail

None of these pictures are in order. I think my dad took most of these. But since I'm probably going to take an eternity writing up a post about the Grand Canyon hike itself, here are some pictures.

Hello from third year of medical school. I'm starting on OB/Gyn and like it so far. Still waiting nervously for my Step 1 score and having catastrophic thoughts of not scoring high enough for my dream specialty. Felt all kinds of sadness and guilt and inadequacy when my research attending and some of the ortho residents I worked with last year said hello to me on the day I thought I would get my score back (they're delayed and I have to wait longer). Felt something similar when the resident who mentored me since first year called me volunteering advice for my surgical rotation (and then gave me some advice as a new parent whose wife delivered her baby on the floor I'm working on right now). Keeping an open mind is surprisingly not hard, since OB/Gyn is really cool, but it's also not hard to remember how happy and excited and home I felt in orthopedics.

I'm learning some things about myself. I'm getting better at talking to patients. I like our patient population (safety net hospital, non-white, non-rich, many immigrants, many complications). I have more role models now: two gynecological oncologists whose patients trust and adore them. Gyn-onc doc #1 speaks fluent English and Spanish, and proficient Haitian Creole and Cape Verdean/Portuguese Creole. Gyn-onc doc #2 speaks fluent English, Spanish, and Mandarin. About 1/3 of the patients that go through our hospital don't speak English (most common languages Spanish, Haitian Creole, Cape Verdean, Vietnamese...I would have lost my fucking mind if I had heard Doc #1 speaking Vietnamese). I don't think I'll go into OB/Gyn, but I do think I'll eventually work somewhere where I'll need to speak Spanish on the regular. Eventually I'll find my way.

My Spanish is getting good. I thought it was good until I heard Doc #2 speaking with perfect, perfect grammar. Subjunctive tense, correct yo forms of irregular verbs in all tenses, correct conjugation of mandates and everything. The feedback that I treasured most from last week was when a patient I interviewed asked me where I was born and raised, and if my parents were from Latin America. Like everything in third year, I'll get better at the things I want to improve on if I actively seek out opportunities to try. So on I go.

I'm moving into my new apartment at the end of the month, and I'm doing it slowly over the next few weeks. Always kind of been into ~~~minimalism~~~, but I've accumulated some junk during my first two years in Boston and am downsizing. Namely, I'm giving away some of my plants, since I propagated too many of them.

Lastly, I was really affected by Anthony Bourdain's suicide. I loved his shows, and his overall attitude and approach to life. He, too, spent some of his formative years in Massachusetts, and I'll spare the details so you read Kitchen Confidential. Part of this was because it came after the death of one of my friends and mentors from the free clinic I was part of in college. The O was the coolest almost-octogenarian I've met. He helped me find my feet when I was struggling with new leadership and more responsibilities in the running of the clinic. He gave me lots of solicited and unsolicited advice. I owe a lot to him, more than he knew. Wouldn't be in med school if it weren't for him, wouldn't have even wanted to become a doctor if it weren't for him. He said he'd thought he'd die in his 20s, then in his 40s, then went quietly a few days after a stroke pushing 80, surrounded by friends. I wish I could have seen him again.

Spring semester forecasting

Gloomy woods in Tilden Park

Now this is the final hurrah at UC Berkeley. The objective of this semester is this: I must become a well-rounded adult. I must prepare myself to be an educated, self-sufficient, autonomous, capable, thinking member of society, and future physician. MY GPA DOES NOT MATTER AT THIS POINT but holy Hell do I want to graduate cum laude or magna cum laude. I can take the classes that I think will most fortify my knowledge, but also be fun and interesting. I do not plan on attending any more medical school interviews, and have turned down/withdrew from a few schools. I will throw all of my free time into (1) making the most out of the last semester with my close friends, (2) finishing my research projects and publishing, and (3) making the most and best positive change at the Berkeley Free Clinic. I'll probably find a hill to figuratively die on.

Without further ado:

"A placeholder title for a class for semi-privacy reasons" (4 units, letter graded): this is an upper division class cross-listed between bioengineering, including about an even split of undergrads and grad students, having to do with the design and performance of medical implants, with particular focus on mechanics and materials science. With that description, a clever snoop can probably find exactly which class this is. The reason for the vague title is that this class is taught by my PI, in whose lab I have worked since the summer after freshman year. Needless to say, I am thrilled to be in this class, which is taught by a mentor and professor whom I have always admired, about a subject that I have always been interested in. I entered college and my bioengineering major dreaming about medical implants, I have worked in a research lab studying implant failure, and will continue pursuing this interest into medical school, and hopefully the rest of my career. Furthermore, my favorite classes at UC Berkeley have been those upper division bioengineering courses that have this huge mix of students: bioengineering, mechanical engineering, materials science and engineering...group projects + the scholastic melting pot have made the most rewarding learning experiences I have ever been privileged to have. My classmates are incredibly diverse and I have much to learn from them.

Intermediate Spanish (5 units, letter graded): finally. One of my ultimate goals of college was to improve my Spanish from the level I took the AP Spanish test at in 2011. It turns out that my skills have atrophied: I am not as proficient in speaking nor understanding, and my grammar is more haphazard. There's no remedying it except for taking a class and working hard to learn it, practicing every day, and willing myself to learn a language and learn it well. I will have Spanish-speaking patients in the future, and I hope that by improving in this area, I can better serve them.

The Structure and Interpretation of Computer Programs (4 units, P/NP): the introductory computer science course, taught in Python. After hanging out with my majority EECS and CS friends for the past 3.5 years, I will finally see what the fuss is about. I don't anticipate programming much in my future, but CS 61A is one of those quintessentially UC Berkeley courses, with a staggering >1000 enrollment a notoriously difficult professor (the infamous Prof. Hilfinger), and an almost mythic status as a general interest course of the 21st Century. I'm the only senior in my discussion/lab section, and one of the very few non-freshmen. An old dog can learn new tricks!

Wealth and Poverty (4 units, P/NP): this is another mythic UC Berkeley class, taught by former United States Secretary of Labor, and prolific Facebook soapboxer Prof. Robert Reich. I'm hesitantly excited for this class because I want to become more knowledgeable about the intersection of politics, economics, and society in this country...but Robert Reich's reputation precedes himself, as a loud, outspoken Left-wing radical, a decrier of GOP shenanigans, etc. These are not bad things, but I'm on the quest to build a political opinion of my own, which includes the decision of who to vote for in the Democratic primaries. First lecture down and he's emphasized that his political ideology is unimportant for the course, and that we should develop our own based on critical thought and research. So far, so good. An interesting feature of this course is that Prof. Reich hosts a small(er) group discussion after lecture; in the first "salon" of the semester, I asked my question and he answered, all in the presence of the film crew that had been recording all lecture.

Also: my total textbook cost of the semester thus far is a whopping $0, which is down from last semester's $15.

Burnout

This summer, it seems I've had a cataclysmic weekend at every turn. I'll face a few days of relative calm, and then BAM disaster. Usually, it has to do with the clinic.

Here's something to think about: this past Friday + weekend, I have spent 18 hours at the clinic. No rounding up: 18 hours over three days. I went to two parties over those three days, which were seriously fun, but 18 hours is ridiculous. As a note, though I am a coordinator (read: an administrator on good days, an autocrat on bad days), I am still a volunteer. If I'd been paid at my high school part-time wage, I'd be pushing $200, which is about two secondary applications for medical schools.

All that was furthered by personnel issues and the fact that I have taken on a behemoth project to implement (read: force) my section to use our electronic medical records system correctly. I'm not entirely sure how this happened, but sometime in the winter, our section (either I decreed it or somebody pushed it onto us) became the one to pioneer EMR. Of course, all this is good fodder secondaries because it shows leadership and struggle and this and that, but good God is it a headache.

I am told that this is usually the responsibility of an IT team. Though I am sure their timeline is much shorter, I carry the burden for an agonizing amount of time. But what about delegation? Don't make me laugh. Delegating in a volunteer organization with a collective structure is tough shit. People are lazier here. People don't need to care because they don't have accountability. Furthermore, the oversight and accountability administrator is me. More responsibilities, more headaches.

Why the hell do I do this to myself? God complex? Masochism? Not sure.

As this lovely picture shows, this weekend was a mess of clinic obligations, personal deadlines for secondaries, and social engagements. I didn't really sleep much, and towards the end of Saturday, it was already pretty clear that I was in foul weather again.

The Han Solo to my Luke Skywalker when I was a wee trainee (and he was a coordinator) always warned me about burnout. My parents and boyfriend do it all the time, but when it comes from my peers at the clinic who were in my same training cohort and have watched me grow into this responsibility say so, I feel it. All weekend, I was griping about not being able to finish my Duke secondary on time, not being happy with anything I wrote; I was really complaining about being overextended.

I think I burn out quite often, and just after I submitted my Duke app today (!!!), I felt rejuvenated. Fair enough, but I still have a marathon ahead. I want to really change the clinic, and what sort of change is truly good enough if someone didn't have to get tired over it?