Graduation day!

It’s here. Finally! I’ve worked my tail off for 5 years. I’ve cried, laughed, screamed, and prayed. The roller coaster that is my life has finally taken another turn. The future is unknown but provides huge possibility. Once I pass my boards I will be a licensed pharmacist. Today though, I become a doctor. Doctor now belongs in front of my name. Doctor. The term that provides people a sense of relief or worry. A term that people run to or run from. Pharmacists are one of the most respected, most trusted, careers there is. As a pharmacist, a doctor of pharmacy, I will be privy to people’s most intimate life moments. I will be trusted with the details of life as it really is. I will learn of people’s pasts and of people’s fears. I understand this and I will not let their trust be thrown to the wind. I have learned to love each human being, with all of their problems, all of their past. My past has provided me that love. Without my struggles, I would have never learned that perfection is not real. I understand the difficulties in life, I’ve lived many of them. I know without a doubt that those who trust me will find no judgement.

thank you for reading,

me

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ICU Thoughts on Life

There’s definitely a theme to my thoughts these days. I’m on my last rotation (Finally!). My patients are sick, real sick. They are recovering from heart attacks, or at least trying to. Or have heart failure, made worse by COPD (a lung disorder common in smokers). Some of my patients are septic. My journal club this month is on sepsis. It doesn’t look good. Almost 50% of people who have sepsis die before they leave the hospital. Their bodies are riddled with infection and are having a very difficult time recovering. Their hearts are working too hard, their lungs are tired, and they can barely rest enough to let their bodies heal. It’s awful.

Another one of my patients is going home today to meet his maker. His family finally gave up and allowed his life support to be removed. He’s not going to wake up here. At least with him, he has had a long life. I hope it was filled with the joy of family, friends and adventure. I hope his family can remember good times and great events spent with him. I hope his maker is pleased. He’s one of the lucky ones. If he were to wake up here he’d have a life of pain. A life filled with medicines, breathing machines, cardiac machines, dialysis, and a number of other things to help him prolong it. But waking up isn’t something he is going to do, his brain has already quit. I pray his transition is smooth both for him, and his family.

Life is short. No matter the age you die at, it will be too soon. I hope to change that. I hope to live with no regrets, embracing all that life has to offer. I hope to be an example to my family that life is worth living well, that life is meant to be lived fully. It is meant to have its ups and downs. It is meant to be full of adventure, and quiet moments. No matter how short life may be for me, I pray that each day is one that I lived on purpose. I plan to be present to each moment, to be present to my children when they speak to me, to be present to my peers, to listen with my whole body and not just my ears. Being present will mean that I have wasted no time on the frivolous.

My goals, though in the future, are but reminders to myself now. They are reminders that though today may be hard, there is another day to look forward to. They are reminders that there is no reason to quit, to give up, or to stop living. Goals are a driving force to keep me motivated. They provide the energy of living into an amazing future. When I have a goal set I stay focused better. My brain obliges me, allowing me to work toward that future.

My patients? They are reminders that wasted time is never returned. There is not one who will gain even a second back. Time marches forward with or without us. Those moments when I didn’t pay attention to my child are never returned. The time spent on things that don’t matter is wasted. When you take the time to be still, to quiet your mind and pay attention, then time slows down. Time has its own philosophy. Life is short, don’t waste it.

thanks for reading,

me

Almost there

It’s the middle of March. March?! I have only one more rotation until Graduation Day! Wow. These past several years have been a roller coaster ride, the least of which was school. Six or so years ago I heard a question, “what will your life be like in five years?” The answer was obvious, extremely obvious. The answer was ‘exactly as it is now but we’ll all be older and probably broker.’

The rule is that if you don’t change then nothing will change. If you think that ‘someday’ you’re going to be OK, or that ‘someday’ you’ll go on that dream vacation… you’re probably wrong. Plans without timelines just don’t happen. Years fly by in a trance and one day you wake up and wonder what on earth happened.

Do you wake up and realize you’ve just spent every day of the last ten years watching two, or more, hours of TV? Did you spend each of those days sleeping in? Or on Facebook? I haven’t done the math but let’s see… two hours a day for 365 days for 10 years….that’s 7300 hours or 304 days spent in front of the TV. That’s almost a year of life that could have been lived. I’m not trying to say not to watch TV, I’m saying is that every thing we do is a trade. Time waits for no one and nothing and it is the same for everyone. How we choose to use it is the only thing we can do.

What could you accomplish in just 2 hours a day? Read some new books? Go for more walks? Spend more time with your family? Learn a new language, start a new career? Two hours seem insignificant until you add it up. I’ve learned these past few years that it’s the small things that make all of the difference. It’s not just that it’s the small things, it’s that it is ONLY the small things that make the difference. Life is lived in the seconds, minutes and hours that then build our days, weeks, months and years.

Five years ago, all I could imagine is that there was something better. I could see others were happy and able to pay their bills. I could see they weren’t any different from me, just people. We’re all just people. As time has progressed, I’ve discovered that there are so many people stuck where I was, stuck in ‘this is my life, guess I should get used to it’ mentality. They’ve decided at 25 or 30, 50 or 70 years of age that their life is essentially over and not going to get any better. They’ve settled.

I say don’t settle. Don’t give up. Go ahead and remember to live your life now, not tomorrow, not next month or next year. Now. Life is short, embrace it. It’s supposed to be a roller coaster ride. Enjoy the ride!

thank you for reading,

me

Job hunting?

It’s almost time, the count down has begun. Graduation is imminent… After I graduate it’s the board exam and the law exam. Then… drum roll… then I have to adult and make my own money, pay off my loans, and who knows. I’m excited. I’ve waited for 5 years. I’m ready to go out on my own and I can’t wait! I’ve begun applying to jobs near where I want to live. I’ve managed to accumulate a small list of references. I’ve updated my CV and I’m ready.

Ready? What on earth will life look like in 6 months? In 3 months? I HAVE NO IDEA!!!! How can I be ready??? Up until now I at least had a constant. I knew I’d be in school. Now? I can’t think past May. It’s up to me to create the future I want. If I don’t create it myself it will be created for me and it won’t be what I need or want. So the real question I need to answer is what do I actually want? And how do I make it happen? This is my life and no one else’s.

I asked the question the other day, who am I? But the real question is, who do I want to be? I want to be free to come and go as I please. I want to be free to tell someone there’s a cheaper medicine, or a better medicine, or a better way and not be told not to. I want to be able to help people get off of their medicines. I want to help people get healthy and maintain their health. I want people to know that they count and that their health matters. I want each and every person I help to know that I know them and that they are not a number in a system. How do I do that?

I’m already doing that in little bits here and there. As I finish up my rotations I meet each person as an individual with unique characteristics and I stop myself from putting them into a little box or category. I don’t label them ‘diabetic’ or ‘hypertensive’. I label them person, with flesh and blood: someone’s brother, sister, mother or father; someone’s daughter or son. Real live human beings who need a hand up, a caring heart and loving spirit. These are the things that I am becoming.

So job hunting? I’m turning it into job creating instead. I’m beginning to create myself a ‘job’ that will be a joy to do. Something where I will be my own boss and where if I want to spend hours with a patient I can. I’m creating a way for people to learn how to be healthy again, how to reduce their medicines that they need, and how to prevent from needing new ones. I’m creating a way for them to be able to speak from their hearts and to be heard. I’m becoming the person who can listen, who knows that life is about the little things; the person who knows it’s not actually about me anymore. That is who I am becoming.

Thank you for joining me on my journey. Thank you for reading,

me

Ramblings from the Psych Ward

I’m finishing up my second week working on a psych ward. Before I began I had spoken with my therapist and asked him if he had any recommendations. He asked me only to do one thing, “look at them as if they are real people with real issues. Remember that how they act makes sense, at least to them..” I’ve tried to do just that and in the process I’ve learned a few things about myself.

I’ve learned that it’s a very thin line between ‘normal’ and ‘crazy’. I’ve met people who still have dreams but life has thrown a bunch of garbage at them.

I’ve met a young man who, for no fault of his own, cannot stop moving his mouth. He has tardive dyskenesia along with some catelepsy. It’s not fair that he can’t use one of the drugs we’d like him to have because he’d have no way to pay for it out of the hospital.

There’s a lady who rather than embracing her upcoming retirement has decided that life just isn’t worth living, or at least bothering with. She barely eats, barely sleeps, and just lies in bed all day, despite being on several medicines that should be helping her by now. We keep hoping she’ll try ECT but so far she refuses. She doesn’t believe she is depressed, just that she’s a realist.

Another lady, who is so similar to myself that it scares me, is manic. She doesn’t remember the difficulty the police had bringing her in, nor the way she behaved in the ED. She doesn’t understand why she’s still being held ‘hostage’. When asked about it she has changed the story so much that it makes me wonder why she’s still there. The reality, though, is quite a bit different when you talk to those who met her that first day. Still, some of her story is true. She really has lived several places, really has suffered tragedy, really has had life turn upside down on her. I look at her and I see just how close I came to being there as a patient with her. Instead, though, I discovered ways to handle my stress, ways to grow my way out, and continue to grow. I have to remind myself that she is not me and does not have the skills I’ve learned, despite our similar circumstances.

The truth is all of these people could be you, or me, or someone we walk by. They are no different than we are, not special, not broken. They have just become overwhelmed and need someone to help guide them out of their own caves. Today, I nearly broke down in tears listening to a man who had to move back in with his mother because of an unexplained seizure that then turned his life upside down. He’s my age. I think how my parents would be if I lost my ability to take care of myself, and I think of how I would be if my own children found themselves in a similar place. I feel for them all.

And then, there is a man, who if he could only control his anger could provide such beauty to the world. He’s an artist who has covered his walls with drawings he’s done while waiting. He is also a gifted musician and can provide so much more to this world. Smart, well-kept, handsome, young, and strong… all the qualities a man his age would love to have. He’s there trying to explain to us that his problem is that he can’t sleep, that is the reason, he says, that he sees so many strange things. Visions when he closes his eyes, radio waves in the air, dots on our bodies… He believes there are aliens and he is worried there will be war because of them. He may be right, he might not; it’s not my place to say. There’s a lot of perfectly ‘normal’ people walking around who believe in aliens so that isn’t something worth arguing about.

So what do I say to myself? What do I think? I think it’d be best if when we talk to those who are in the ward that despite how crazy they sound, despite how far-fetched their stories may be, that we should give them the benefit of the doubt. So, yes, I choose to believe my patient when she says she swallowed a bunch of flexeril as well as oxycodone, mobic, and citalopram with vodka. I believe her when she says she doesn’t know why she started feeling suicidal, that it doesn’t make sense to her. I believe her when she says she really wants to live, despite being alive only because someone else found her. I believe her. And? If my patient says he believes in telepathy, why not? Who are we to say what another has experienced? We aren’t them. If they say they lived in Europe, or DC, or wherever, then who are we to say they didn’t?

These are good people, not liars, nor embellishers. They are telling us exactly what they think to be true. They are only being honest with no filters…. if everyone was as honest as these, we’d all be in the psych ward…

thank you for reading,

me

Geriatrics Rotation… A much better fit

I have to say, being in Pharmacy school is hard. Doing the studying, the exams, the science, the math… all of that is part of it. But the hardest part? All of the exams, math, and science are useless during rotations. When you see a new drug that came out you think it’s great! You’re like, it’s about time, let’s get some people well. And then, then you realize that your guy wouldn’t have qualified for the trial. He’s too old, too fat, too young, too sick… they only use mostly healthy individuals for trials… people who only have the one disease they are trying to fix, or no disease because they’re trying to prevent it.  This is true for all of the trials and has an effect on all patients differently.

Geriatrics… I’ve been working with a population of men (because they’re veterans) who are between the ages of 74 and 95. 95?! Wow. Do you expect to be able to live to 95? What a ride that will be! But, back to my patients. When they aren’t in their youthful ages anymore, when they are just trying to stay alive another day but still loving their lives… then the rules of the medicines doesn’t really apply. There are almost no trials in elderly people. No one has any idea how the medicines will act in their bodies. AND! every single one of them act differently. In one man, if he takes a statin he won’t be able to walk. In another, it has no effect on him. Another can’t take anything like aspirin or ibuprofen, but can take Tylenol. Another only needs 15 micrograms per week of warfarin and the one next to him uses 30 micrograms per week…

For these, and really for all of us, age is just a number and has no bearing on the amount of medicine a person needs. The most important factor on whether you live to 95 or 102 is how old you feel, not how old you are. Over the last few months I’ve met people who are older than me but technically a lesser age. And I’ve met those who are 95 and look, act and feel, like they’re just in their 50s and 60s.

I ask them what they do? What they did to get to where they are? One man told me, age 95, that I had to go to war. He said it doesn’t work unless I go to WWII and then Korea, and learn to jump out of airplanes for 30 years. I could have listened to him for hours. I had to ask him if his birthday was right, I just couldn’t believe he was 95.

So, yeah, I love geriatrics. Here I deal with people who have lived full lives, who have had their chance already to make mistakes and to make dreams come true, or not. I love listening to them and getting to know them. They are a treasure trove of information and advice. This community is growing exponentially and needs people who specialize in their medicines. The wrong drug could destroy an otherwise healthy individual, but the right one can help. I look forward to being done with school… only three more months!

thanks for reading,

me

Living MY Life

I woke up early this morning having remembered another dream. I try to write them down before I forget them. I find it interesting how my subconscious works and whenever I get to see a picture of it after a dream I grasp at it in order to learn more about myself. It seems I’ve been on this long trail of discovering who I am since I am no longer being held back by my past… The weirdest thing of all is that when I put my past behind me is that my future became a giant possibility. I literally could become anything or anyone I want to become and it’s weird. I like the word weird… not quite scary, not quite fun… different, weird.

The part of my dream that I was able to capture was like being in a 3D movie as if I was flying a plane off of a cliff and then dipping down and finally leveling off safely ahead. My first impression when I woke up was that I was scared of my future. But I don’t worry about being scared anymore. Fear is healthy, it helps me plan and tests me. Fear is something I follow now so that I can understand me. I’ve discovered that as I follow my fears that I am able to grow and that life on the other side can be amazing.

Last night was the first night I spoke to another person about my intentions of moving, the first time I verbally said that I am going to relocate after I graduate. Up until now I’d say I was thinking about it, not that I actually am going to do it. Words have power. When I said I am moving it became real for me and so fear set in. It’s like jumping off of a cliff and then learning to fly and finally soar.

I’m excited, I’m scared. I’m beginning to create my life as I would have it look and it’s an amazing feeling. Now that I’ve said “I am moving,” I will take action, real action. Whenever I make a final decision followed by action, my results are guaranteed. I sometimes take forever to come to a decision, but once made, things move quickly. And I’m certain things will move quickly now… I graduate in May, pharmacy boards after, and job… I’m less than 6 months from when I plan on moving. Wow! scary… exciting.

Do something scary today, let yourself grow.

thanks for reading,

me