When it rains, it pours

The whole world has been glued on the Russian’s invasion of Ukraine in the last few days. Including myself. With every new video or picture that is released of the ongoing events, I feel very fortunate and grateful for the hand that I’ve been dealt. There’s an intense mixture of emotions as you watch brave men and women of Ukraine take up arms and rally around their country, yet, saddened by the amount of death and suffering they are also going through. One day, you’re living your life and the next day your home is being invaded. 

I’m not sure when it started, but I feel disheartened that I’m not able to contribute more. Or rather, I’m not sure how best to help. Personally, there’s been quite a lot on my plate ever since I embarked on my LinkedIn creator journey in January and I’ve pretty much been working every day since then. Every now and then, I force myself to sit back and reflect so I can collect my thoughts and more strategically think about my next steps. That’s when I realized, when it rains, it pours. 

Likely not unique to my life, but it seems as though things like to happen at the most inconvenient times. The obvious thing being the invasion and I’m just left wondering what are my innate intentions and why am I not more inclined to figure out how I can contribute. With my cousin’s wedding recently, the thought actually extends to my disappointing lack of effort on maintaining the important relationships in my life. I know I’ve been distant with many of my family and friends and I’m afraid that gap continues to increase with each passing year. Yet, I somehow feel as though I have something to prove to this world and keep hustling more. To be fair, there definitely are some major events that are occurring currently - and one in particular that will certainly change the trajectory of my professional career in the coming weeks. However, that’s a story for another time. 

Nevertheless, with each passing day, I question where my intentions are. I get a bit worried at times when I sense that relationships are slipping away, my lack of effort in humanitarian efforts, or my toxic work habits. Perhaps that’s just who I am though. Only time will tell. 

ay man, i just saw ur recent video, keep focusing on ur future, ur ex is messing around already so i wouldn't dread over her

I had no idea tumblr had messages.....so just now seeing this. I imagine this was in relation to my ex in 2017/2018. Thanks for the motivation! Breakups are always a bit difficult

have yu evr been in love

no idea when this was sent, but I imagine it was quite some time ago. But yes, I’ve certainly have. Once. 

a shell of my former self

I’m not sure if its because of all the uncertainty recently, the move to DC, the lack of meaningful relationships, or my fading ambition with work, but the last few months has been some of the most difficult months I’ve had in a long time. From an objective standpoint, my thought is that there is a mismatch between the amount of work I am responsible for and my apathy towards it. About 1.5 years ago, I had these similar feelings of apathy and yet, this time it’s a bit different. It’s a different flavor. I think the last bout was informed by the lack of challenges and this time it’s quite the opposite: a bit too much. Kind of? On one hand, I have some major responsibilities on my plate, on the other, I feel utterly useless and don’t feel like I’m contributing much. I’m trying to stay positive and keep pushing through as I’m hoping much of the stress I’m going through now will dissipate once I graduate in May 2020. However, until then, I find myself fighting cyclic depression on a daily basis. 

Now that I think about it, I wonder how much of it is caused by imposter syndrome. I feel as though I keep getting ‘recognition’ for things that I accomplished in the past, yet my present self can hardly compare to that extremely ambitious guy just a few years ago. I think the best way to describe it is that I feel as though I’m a shell of my former self. I don’t feel qualified to do the things I do anymore and it’s rather disappointing. Perhaps it’s a feeling of regression. You think you’d improve as time goes on, but it would appear as though that may not be the case. To be honest, I’m not really sure what I’m supposed to do or how to mitigate it. Even positivity appears to be a bit lack luster the last few weeks. As I begin (so I say) to make more time for family and friends, maybe I’ll find meaning in life again. On that note, maybe it’s as simple as the happiness equation in which it equals reality minus expectations. In reality, my career reality vastly exceeded my expectations. However, my personal reality with relationships, specifically a significant other, has certainly underperformed my expectations. Reflecting on this now, I think the last few weeks may have been gradually getting worse because I can’t really say that my career reality exceeds my expectations anymore. While I have nothing but gratitude for the position I’m in, I just feel incompetent and useless in contributing any value towards my organization. Days like these make you question what’s the point? Maybe it’s time to move on? Or maybe it’s just me? My guess is that it’s the latter.

Nevertheless, I’m really hoping that my move into my first permanent apartment this Friday will change things and then things around for me. I could really use some certainty in my life right now. And while may 2020 is right around the corner, my responsibilities seem to be continually increasing rather than decreasing.

Overcommitted

“Family, friends, and relationships are the key to happiness in life ” - that’s what I preach nowadays. However, a simple audit of my track record and you may think that I’m a hypocrite. While I’ve certainly scaled back exponentially in my work hours, mind you, to actually normal hours, I’ve completely miscalculated the amount of time I can spend outside of work. I have to admit, I’m at a complete loss as to how I continually find myself in these vicious cycles of feeling overwhelmed, and most certainly, overcommitted. Unfortunately, it won’t be getting easier anytime soon as I’ll be juggling work, school, and internship until May 2020. While that in itself is already a lot, I’m also simultaneously volunteering with many different organizations, and for whatever reason, keep signing up to do more. Don’t get me wrong though, I am so fortunate and blessed to have these types of ‘issues’ and I am grateful for each and every day I have the opportunity to reflect and contribute to these activities. 

As I’m finalizing my poster presentation for the AMIA Symposium in 2 weeks (taking a short break right now), I’ve come to realize that I need to make a more concerted effort in scheduling time with family and friends. Granted, this post is more of an afterthought from my trip to NYC last week. I went out there to do an external presentation to LIU College of Pharmacy, and more importantly, to spend time with my family. Specifically my two cousins. While it was a much needed retreat, especially during the weekend, from my usual obligations, I’ll be honest and say that I was a bit stressed over the looming workload that I’ll be coming back to (i.e. right now). Hence, this post to help ease some of that. Nevertheless, I’m excited to say that I’ve scheduled in reoccurring time blocks every week to reconnect with family and friends. As Michelle Obama said at the 2017 ASHP Midyear, not having time for family and friends is not a great excuse because you should be scheduling them in FIRST. So instead of “no time for family friends” it should be quite the opposite: “I can’t take on that project as I already have a planned family event”. There is, and always will be, time for things that are important. Be sure to cherish and make the effort for it. One closing thought on my mind is whether I should completely drop all my obligations beginning May 2020. Perhaps, an elaboration for a future post. I’ve chased the career ladder for a bit of time now, 32 years to be exact. I’m overdue in investing my time elsewhere.  

Self-Doubt

Lately, it seems as though I’ve been posting in my personal blog more often. As I reflect on my previous posts, they seem to occur when certain emotional thresholds are met. Today, that emotional threshold is self-doubt. I can’t recall when I last felt like this, but it’s not the best feeling. It was also quickly followed by a surge of depression. I found myself mindlessly scrolling through social media and starring off into space as I continuously recounted how the day went today: terrible. Strangely enough, I don’t think anyone else would have thought the same. However, I’m not sure how else to describe it either because I feel as though I’m making little to no impact in the work I currently do. I’m not sure if it’s because I’m doing a poor job of delegating work, mismanaging my projects, not escalating issues, or - likely - all of the above. To be fair, to say that I’m overcommitted right now is probably an understatement. There probably is some ‘paralysis by analysis’ going on as I’m trying to figure out how to balance all the various things in my life. 

Nevertheless, writing is therapeutic for me and something that I sorely needed today. Social media does a great job of hiding the lows, but I think it’s important we talk about them too because it humanizes us. Despite struggling for a solid 30 minutes on how to verbalize my emotions right now and probably making zero sense, I do feel a lot better. As I so frequently tell others that find themselves in a place of self-doubt, as long as we improve and grow from the person we were yesterday, that’s all that matters. 

Dichotomy

What began as a mere practicum/internship requirement for my MPH program, quickly escalated into something much more. I ventured out to Washington DC on June 22 – with pre-purchased flight tickets back to Rochester MN on Aug 13. I was going to intern at the office of the national coordinator for health information technology and help improve the interoperability of prescription data through rulemaking – notably the 21st century cures act. Within 2 weeks of being there, something clicked inside of me and I quickly realized that the ONC aligns exceptionally well with my lifetime goals. Moreover, at a time when I was contemplating my move to LA near the end of august, which mind you – I had planned for almost a year now, was now constantly at the back of my mind. Saying that I fell in love with the city is probably an overstatement, but it wouldn’t be entirely off. I absolutely loved the metro – and surprisingly – the commute. In Rochester, I lived about a mile from work and the grocery store was pretty much in my backyard. But something about walking to the metro, taking it for 10 minutes, and walking to work passing all these federal buildings (I worked 10 minutes from the capitol), was really fun and exciting. Maybe it was because I’m accustomed to driving and I’ve always wanted to experience commuting to work on the metro. I also really enjoyed the change. After 2 weeks of being in DC, I got into my routines. More out of necessity than anything because I was trying to balance a lot of things at once, I became accustomed to quickly shifting between internship, work, and school, incorporated gym 2-3/week, and went into a new 6-day meal-prep diet that was healthy, efficient, and tasty. So, why am I writing this post today? Because now I’m faced with a difficult decision – more specifically, a dichotomy of choices.

Moving to DC vs. LA

While LA aligned well with my lifetime goals of training the next generation of informaticists, the experience at ONC made me realize that I can have an immediate and direct impact on improving interoperability of information, reducing clinician burnout, and improving usability of technology. Moreover, there actually is, surprisingly, no pharmacy representation at the ONC and I think there needs to be. It’s obvious to those of us in pharmacy that advocacy and representation is abysmal within our profession and in comparison to other healthcare professionals, it’s rather embarrassing. I think that needs to change and I think my internship at the ONC has opened up an opportunity to do just that.  Further, I’d like to help create a pharmacy pipeline into the ONC so that our profession has some representation and we can help inform public policy. In light of all that, I don’t know if the move to DC would be permanent and LA could still happen in the future. What’s also nice about DC is that it sets me up to be closer to family and opens the door to make it easier to move back to Florida if I wanted to.  

Federal Government vs. Social Media

Similar to the social media path with LA, the experience at the ONC exposed me to the inner workings of the federal government. While the impact of social media is high, the impact of being in DC working directly with the federal government and ALSO doing social media, I think, is even more powerful and impactful than capitalizing on YouTube alone.

Career vs. Family

The thing about DC and federal government is that it presents another fork in the road: career vs. family. I frequently talk about how I’m trying to refocus on family, but staying in DC isn’t necessarily the best idea as I’m actually adding to my workload (i.e. internship). At this point, I think my thought is that I’ll go full steam ahead until May 2020 as I’m already hustling through work, school, and YouTube – might as well go 110% into another opportunity until I graduate in May 2020 when all of it will end. I imagine I’ll do a complete 180 to focus on my family, friends, and relationships after that. In the interim, I’ll still make sure I prioritize my calendar towards any family functions so I don’t miss those special moments in life.

ONC vs. CDC

For those of you who have followed me in my journey, you would know that going to the CDC has been a long-term goal of mine for quite some time. It probably started in 2012 when I became interested in infectious diseases through my antimicrobial stewardship rotation. Though, as I progressed through my MPH program, I’ve grown to expand my interest to beyond infectious diseases and look into the broader picture of population health. While I certainly don’t have a definitive answer right now, it does present another choice that may occur later down the road – am I more interested in harmonizing our nation’s health information technology infrastructure? Or am I, perhaps, more intrigued by the broader public health initiatives, especially infectious diseases, at the CDC. With that said, federal agencies do collaborate quite frequently and there is certainly a lot of collaboration between the CDC and ONC. One example is the CDC’s antimicrobial usage and resistance module and the ONC’s incorporation of it as a certification criteria in their certified electronic health record technology program.  

All In

All in all, at a time when I would have thought there would be more certainty in my life, I seem to have attracted and accumulated quite the opposite. But you know what? I’m okay with that. As my friend Ryan Haumschild said back in the day, “it’s when you are uncomfortable that you grow the most”. So as of 2 days ago, I made the decision to move to DC instead of LA. This is my why and I’m going all in.

Altruistic

“Altruistic” was the adjective used to describe what I was doing in DC by a new friend I made yesterday. While it certainly made me slightly hesitant for a moment and question whether I will actually make any difference, I’m also invigorated by the challenge. As I wrap up my first full week of my internship and shift to part-time, I’m excited for the opportunity to help influence the 21st Century Cures Act to further reduce clinician burden, increase interoperability, and promote usability of health information technology. As I begun to immerse myself this past week in the proposed CMS and ONC rules for electronic prescribing, I was somewhat surprised the department had no pharmacy representation. Apparently, they have been looking to recruit a pharmacist (their last two moved to different positions over a year ago) and my application came at the right time; truly characterizing “right time, right place”. Today, as I sit in my office trying to brace myself for the continuation of my part-time internship, full time work, and part-time school that will begin next week on 7/1, I reflect on the opportunities I have been afforded and hope I can make even the smallest dent in making the lives of our clinicians, and consequently, our patients, better. Lastly, I will be removing myself from all forms of social media for the next 2 months as I tackle this challenge. If you need you reach me, just call or text :). 

Ideas are never fully formed

In the last few months, I’ve done a fair amount of reflecting. I think it was some sort of ‘quarter-life crisis’ type deal after completing what is arguably the most significant milestone in my career this past May. Thing is, I should have been OOZING with excitement after its completion (I definitely was right before the milestone occurred), but I wasn’t. In fact, I found myself asking myself questions (Yes, it’s weird I know), like “What should I do next”, “Why do I feel apathetic”, “What is my purpose in life”, and “Am I even heading in the right direction”? Unfortunately, I didn’t have any answers and decided that I’ll run away to figure them out, literally: I booked a ton of trips hoping that somewhere, somehow, I’ll find the answers. Well, I’ve just completed my last trip this past week and still haven’t found what I was looking for. Though, I did come back with a lot of inspiration, memories, and new friendships. 

That’s not all I came back to though...I was also greeted with a whirlwind of work, emails, first day of Fall semester for school and....a lot of ‘coaching’. To elaborate on the latter, I’ve had the amazing opportunity to devote one-on-one time with three different pharmacy students & recent grads and interacted with many more via email & social media in the last few days. I also had a fitting end to this week with a google hangout call with some pharmacy students & recent grads hosted by my colleague and friend, Beju, about an assortment of topics related to pharmacy informatics. (Link below if interested). It made me again, reflect on the questions I posed to myself just a few months prior and specifically made me think about my purpose in life and how I can go about accomplishing my lifetime goals. One of the things I always ask my students is, “where do you see yourself in 10-20 years?” and “what is your ultimate goal in life?”. They probably think I’m crazy (which I’m not denying), but I think it’s important to set these goals so we can base our present decisions on them. 

You see, as much as I believe in having a ‘lifetime goal’, I also believe that ideas are never fully formed. In fact, they may even change and that’s okay. As long as we have a goal in mind and we’re working towards it, that’s all that matters. Furthermore, most would probably disagree with me, but I also think lifetime goals should be lofty, somewhat vague/overarching, and if it’s “impossible” - even better! There’s a quote from Steve Jobs that I really resonate with that goes, “The people who are crazy enough to think that they can change the world, are the ones who do”. For me, my lifetime goal is to improve health around the world and decrease healthcare costs. I don’t know how I’m going to accomplish that goal or even how to measure it, but I do know that every decision that I make will be influenced by it. This leads me to the impetus for my post today which came from a quote I read this morning by Mother Teresa, “I alone cannot change the world, but I can cast a stone cross waters to create many ripples”. This was a nice affirmation for myself as I’ve slowly defined the pragmatic manifestation of my goal: leveraging social media, specifically YouTube, to educate and spread awareness of the pharmacy informatics field. I personally think that the pathway to my lifetime goal will revolve around ‘scalable solutions’ and although pharmacy informatics is somewhat narrow in the grand scheme of things, I think there is so much untapped potential in pharmacy informatics (and it’s also my area of expertise currently) that it’s worth investing my time and effort into. Ideally, I hope to expand into other industries moving forward, but hey, that’s why ideas are never fully formed and why I strangely ask myself these questions and reflect. 

Link to Google Hangout Call: https://www.linkedin.com/feed/update/urn:li:activity:6444559295697690624

Reflecting on the Stoneman Douglas High School Shooting

The frequency in which I write in my personal blog, is about as frequent as I go the gym - hardly ever. However, the recent shooting that took place at Stoneman Douglas High school, really took a number on me and drove me deep into reflection. It’s odd because I’ve never felt this way before despite the insane amount of mass shootings that have occurred here in the United States. Was it because it occurred in Florida, the state I was born in? Because it was 15 minutes away from where I went to high school? Because a lot of my family and friends actually knew the kids that were either shot or killed? Because Peter Wang died holding the door for his classmates - died 2 days before Chinese New year; a day that is supposed to be filled with celebration and joy that will now forever be tainted for his family and remind them of this tragedy every year? 

I really don’t know. However, what I do know is that I am guilty of that vicious cycle that goes something like this: mass shooting -> thoughts and prayers -> debates on social media -> everyone forgets -> government does nothing -> rinse & repeat. I don’t want to be a part of the cycle anymore...even if it is unintentional.  

“If you want something you never had, you must be willing to do something you’ve never done”. Therein lies my dilemma and why inaction is no longer an option. The question for me though: what is the solution? The buzz words all over the media is riddled with “gun control”, “mental illness”, “politicians”, “NRA”, “automatic rifles”, “arming our teachers”, etc. So why hasn’t anything happened? Seriously, if ANY solution was so obvious - WHY hasn’t anything happened? Why does the United States lead the world in mass shootings? I truly have no idea and don’t plan on guessing. Instead, I’ll take the time to learn the history, the facts, and the policies that underpin these interventions and make a more informed decision about how and what I can do to contribute. To those 17 that died, Alyssa Alhadeff, Scott Beigel, Martin Duque Anguiano, Nicholas Dworet, Aaron Feis, Jaime Guttenberg, Christopher Hixon, Luke Hoyer, Cara Loughran, Gina Montalto, Joaquin Oliver, Alaina Petty, Meadow Pollack, Helena Ramsay, Alexander Schachter, Carmen Schentrup, Peter Wang, may you all rest in peace.  

The Facade of Success

It’s very comforting to know that I have a medium in which to express my thoughts whenever I can. I’ve actually had a lot of thoughts that have been on my mind for the last few weeks and been wanting to turn a couple of them into videos for my youtube channel. However, I’ve been plagued by a lack of action. Makes me think of the ‘5 second rule’ I learned about last week from Mel Robbins; I’ll probably pick up her book at some point. I also recently, in the last month, learned about ‘grit’ from Jordan, my former co-resident, and it’s been extremely refreshing to learn about it and reflect on how it has applied to me in various stages of my life. I’ve also been trying to get back in shape and super excited to say that I’ve made some monumental strides in my personal fitness. I’ve gotten into a routine of doing 30 push-ups every morning (it’s now a habit) followed by, at minimum, a 2.5-3 mile run every Saturday and Sunday. I’ve only been doing it for about 2 months and I’ve already seen some great results.

In any case, in light of all the things I’ve recently gleaned, things that range from motivational and inspirational videos to various books I’ve been reading (Steve Jobs, Elon Musk, and Jeff Bezos), a common theme has emerged in my mind that I’ve been wanting to put into a video: the facade of success. This post really isn’t meant to be a replacement for that video that I’ll eventually record and release, but rather something for myself to reflect on in the future and as a place to document some of my ideas when I finally do create the video. The main premise is that social media does a fantastic job of perpetuating this ‘facade of success’ and it undermines the underlying hard work that individuals put in to achieve said success. More importantly, it shelters failure. On a side note, every time I think of failure some cliche quote comes into my mind. Anyways, I think failure is discussed so infrequently that people think success just magically happens and that successful people don’t fail; I really resonate with that. Especially when I watched a video with Angela Duckworth in which she said, "People who succeed, fail all the time. In fact, I think they fail more than anyone else”. One of the first thoughts that came to mind was when I was in pharmacy school. Sure, I did pretty well grade-wise, but no one saw the long hours I put in or the failures that led up to the grades. Like when I had to drop various courses in college because I failed so many tests, or when I failed in getting accepted in pharmacy school the first time I applied, or when I failed to match for a PGY-1; I could keep going. What I really want to do and have actually been wanting to do for years, is to talk about those failures. I have faced so many failures in life, many embarrassing ones too (which is why I don’t talk about them), but I don’t think people realize that. I also think failure humanizes us because it’s relatable. I’m certainly not an expert in psychology, but I think the promotion of success via social media without the context of failure is creating an environment and culture that is harmful to creativity and risk-taking because everyone is so afraid to fail. 

As I write this, I’m thinking about turning my original video idea into a video series about the personal failures that I’ve experienced in hopes that we can create a community in which everyone can more openly share their failures and be okay with it. 

#writingatmidnight #failure #success 

Hindsight is 20/20

There’s been so much on my mind in the last few months and I wish I had more time to write about it. Two videos have really resonated with me over the last few months and I wanted to share it in hopes that it may influence someone else. 

The first of which is a Ted talk by Emilie Wapnick titled, “Why some of us don’t have one true calling”. It was posted to youtube on October 2015. In the video, Emilie’s discusses how society discourages individuals from having multiple passions or interests in life and how these kinds of societal expectations can have negative impacts on these individuals. She gave these individuals a name, “Multipotentialites”. In short, these are the individuals that don’t necessarily know what their true calling is in life because they are interested in everything and anything. These “Multipotentialites” also have three main “super powers”: 1) Idea synthesis, 2) Rapid learning, and 3) Adaptability. This video really hit home for me because I felt as though I’ve always been pressured to choose a path; a path that society deemed as successful at that current time. In my era, that path was pharmacy. You see, I grew up loving computers and technology ever since I was a kid. I ended up throwing those passions aside in undergrad to pursue a career in a completely different field. Don’t get me wrong though, I love the experiences I’ve gained from pharmacy and the relationships I’ve built with patients. However, I still love engineering and the ability to innovate. 

The second video is one that I actually watched today by Eddy Zhong. He starts off by saying how kids are actually becoming less intelligent every day they go to school. Not something surprising in my opinion. I personally feel as though education is becoming too rigid and standardized myself. However, the video captured my attention because of what he said at the end, “No one has ever changed the world by doing what the world has told them to do”. The main ideas of his video were about how ideas and innovation were suppressed from young kids. Moreover, kids in high school were not very supportive of these “wannabe Mark Zuckerbergs”. Eddy himself started a tech company at the age of 16. This video resonated with me because I wonder about the where I would be right now if I took some of the opportunities or chances just even a few years ago. One that comes to mind, was my decision to pursue a PGY-1 vs. applying to a 2 year internship/fellowship at the CDC in public health informatics. It’s something that I wonder about every day. 

In the end, I’m quite happy where I am right now with the decisions I’ve made. Especially since I am essentially in the intersection between a successful career (pharmacy) and my passion to innovate (engineering/informatics). It literally took 10 years for me to realize this, but like Steve Jobs said in his 2005 Commencement Speech at Stanford, “You can’t connect the dots looking forward; so you can only connect them looking backwards. So you have to TRUST that the dots will somehow connect in your future”. 

#journeytotheCDC #infectiousdiseaseinformatics #pharmacy #engineering

What am I doing with my life?

The last time I wrote something in my blog was when near the end of my PGY-1 residency; right before the Florida Residency Conference (FRC) in April of 2014? It’s insane to think that since then I’ve finished my PGY-2 at Utah and I’m now 8 months into my first real job. So many things have happened since then like traveling internationally to Europe for the first time as an adult, moving to Minnesota where I didn’t really know anyone, and securing my first real job at Mayo. The latter of which I wanted to elaborate on. 

I remember when I first interviewed for the Mayo position. To be honest, I wasn’t extremely excited prior to the interview because the move to Rochester, MN wasn’t ideal and the position wasn’t clearly defined. However, that all changed towards the end of the interview when the interviewers extracted my interest for infectious disease and public health. Apparently there was a need for someone to lead infection control and antimicrobial stewardship at Mayo and they haven’t found anyone interested as of yet. If it wasn’t obvious enough, that person is now me. 

Fast forward to 8 months later and 3 months into the “configuration” phase of Mayo’s Epic Implementation (pun intended) and there isn’t a day that goes by where I wonder, “What am I doing with my life?”. Not in a bad sort of way, but really trying to figure what my purpose is and if every decision I make right now is getting me closer to my dreams of working at the CDC. Kind of like that cliche way of saying, “If you aren’t moving forward, you are moving backwards”. 

The big questions that come to mind revolve more about what will I do after Mayo vs. what I am doing currently at Mayo. I love what I’m doing at Mayo. The opportunity to shape the convergence of an Enterprise Antimicrobial Stewardship Program from both a practice and an Epic perspective is amazing. However, what is next? Do I move to another state? Should I start my pursuit of an MPH now? Maybe I can just be a bum. 

I think these questions really started after my Europe trip in August 2015. I think my travel experience really opened up my eyes to what else is out in the world and how sheltered I’ve been in the last 28 years of my life. I’m now fascinated with European culture, art, and economics and how different they are compared to the states. I find myself reading more books about finance and politics. And today, I’m randomly writing about I don’t know what - maybe I’m just feeling enlightened...in a weird sort of way. 

Florida Residency Conference (FRC) Tomorrow!

Oh how much I have missed writing. I remember reading an article the other day about how a professor related a 'jar' to 'life' in his classroom and how I need to remember to make time for the things important to me in my own life. Link below if interested.  Anyways, tomorrow is day 1 of the 2 of the Florida Residency Conference in which all the pharmacy residents in the state of Florida present their major research projects. I'm sure everyone has mixed emotions from "It's just another presentation" to "I'm ready and excited!" to "End of year residency celebration!". For me, I have been looking forward to presenting at FRC before my residency even started (nerd?)...likely. However, as of late, I've been thinking about how close I am to finishing my PGY-1. I am still in disbelief that there is less than 2 months (6 weeks and 2 days to be exact) left before I make the biggest move in my life to Utah for my PGY-2. If you didn't know already, I'm bit of a futuristic person (source: Strength Finders book) and always wonder what I will be doing after I finish this or finish that. Now I'm wondering where will life take me after I complete my PGY-2....

As much predicting as I have done in the past, I think the next steps in my life will be guided by what is truly important to me in life. 

Promised link from above: http://theburiedlife.tumblr.com/post/33811181290/a-professor-stood-before-his-philosophy-class-and

My Journey: PharmD to MD

A Crazy Idea

I distinctly remember having a conversation with a few pharmacy friends in 2009 about the idea of going to medical school after pharmacy school. As crazy as it sounds, it was. We jokingly stated that we would obtain a medical degree, but practice as a pharmacist. I know, you are probably scratching your head right now and saying, "Why?". Fast forward to March 2012, when my clinical rotations began, the idea of medical school began to surface once again...but it was only a small idea. However, as I progressed through my rotations, I simply fell in love with medicine. Then one day I had an epiphany and remember thinking to myself, "Can I really do this everyday..... for the rest of my life?". The answer was no.  

The Research

I started to do some research: jumped onto student doctor to search for others in a similar situation, talked to med students, residents, doctors, looked into the requirements of med school, etc. One of the best perspectives was from Dr. Wayne Nicholson, M.D., Pharm.D. from Mayo Clinic in Minnesota. He completed his PharmD education first before pursuing his MD. He spent an hour detailing his experiences and his recommendation to me: "It isn't worth it, unless there is something in medicine that can't do as a pharmacist". I also started to shadow doctors during my rotations to gain a better perspective of whether or not this was something I really want to pursue; it was, but I needed a plan.

The Plan

Study for my MCAT during my month off in August, take the test in September, complete a pharmacy residency 2013-2014, then apply for medical school in 2014. It was already late July when this occurred and I had about 5 days left until I go back to Gainesville to prepare for my MCAT. I remember I was so pumped that I began studying for my MCAT during my current rotation in critical care. I would wake up everyday around 5am, drive to the hospital to work up patients, worked on my rotation stuff until around 4:30pm, eat 4:30-5pm, then go to the bookstore and study the MCAT Princeton review from 5pm-11:30pm everyday. I was drained...I was tired....but was excited for the path ahead of me. 

Since I only had a month to study for the test, I drew out a very strict timeline to complete all the Examkracker sections (shown in the picture).

I studied everyday as much as I could, but it was disappointing since I scored a measly 15-19 on all the quizzes/mini-test in Examkrackers. Finally, I finished all the sections and took my first AAMC practice test (scored a 19) as my August rotation began in Tampa. It was exactly one week before the MCAT. Even though I was pretty disappointed with my practice test, I drove to Jacksonville the next week to sit for the real deal: The MCAT.  MCAT Experience

I remained confident in my skills despite my low score on the practice MCAT and applied all those physics and chemistry formulas I memorized during that grueling month I had off. Even though I didn't think I scored that well, I felt good because in the end, I tried my best. One month later, as I finished a long day on my ER rotation, I received an email that my MCAT scores were posted. Anxious and excited, I proceeded to text a few friends to delay the inevitable. When I finally checked it, I was pretty excited to see that I scored a 25. No, I didn't get the score I wanted, but I was extremely proud of myself for being motivated enough to relearn Chem 1&2, Orgo 1&2, Physics 1&2, and Bio1&2 and score higher than my practice quizzes/exams. I only took one AAMC practice exam btw and never had a chance to review any of the material due to my time constraints. Needless to say, I was confident I could easily score above a 30 if I tried again. 

Now What? I received both my MCAT score and doubts about medical school in late October simultaneously. Doubts because I have a low tolerance of invasive procedures/blood. I tried to desensitize myself for a few months (multiple surgeries, procedures, videos, etc) leading up to this point and couldn't bring myself to overcome it. I wanted to become a doctor because I wanted to help patients. In my mind, if I have trouble with blood, I won't be the best doctor or provide the best care for my patients. Therefore, in accordance to "First do no harm", I decided I would no longer pursue medical school.  The End Result

Although I am disappointed with how things turned out, I am still ecstatic about providing good patient care as a pharmacist. If anything, this experience has strengthened my desire to provide the best patient care I possibly can. I am looking forward to beginning my residency training in a month and pondering where my next step in life will take me.  

The Next Step in Life

Today was the match for medical students across the country. One week from today, March 22nd, 2013, will be the match for pharmacy students across the country. As each day passes, I am constantly thinking, "Will I match?", and "If I do, where will I match?", or maybe "What if I don't match?". My future career will be determined by a computer algorithm that I have no control over.

The statistics from last years match results revealed roughly a 60% matching success (2268/3706). The unmatched 40% (1438 participants) scrambled for the remaining 145 positions. 

This whole residency process has been very humbling, and I have always thought of life in steps...this being another hurdle to overcome...an enormous hurdle with lots of chocolate and ice cream on the other side. 

-Middle school to high school (essentially every gets in)

-High school to UF college (~7200 accepted students)

-College to UF Pharmacy school (~300 accepted students)

-UF Pharmacy school to Residency (~4 spots in most hospitals)

 Regardless of the outcome, March 22nd, 2013 will be a pivotal day that determines the next step in my life. 

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Liver Transplant Experience

So today was an interesting day. Went on liver transplant rounds this morning and apparently it was going to busy. 3 Patients were admitted within the last hour for OLTs, aka othrotopic liver transplant procedures for today. So I spoke to a few ppl and got on board for the 12pm procedure. Very interesting might I say because we rounded on all these patients.

So the patient that I saw was a very unique case and I may end up doing my final case presentation on the patient since it was so interesting. Patient had a perfectly fine liver, but due to a rare disease, will need a liver transplant for a cure. Long story short, the procedure is a domino liver transplant in which his liver will be removed and donated to another patient that is on the waiting list. He will subsequently be transplanted by with a liver from a deceased individual. So I'm not too good with blood, needles, wounds, etc, one of the reasons why I never did medical school. This was my first surgery and I was surprised I didn't get sick or faint. The procedure itself was very interesting, the surgeon is known for being fast and it was a 3hr skin-to-skin procedure. I learned a lot about proper operating room etiquette, and the very distinct smell of burning flesh when they cauterize during the initial incision. The anesthesiologist was also very helpful teaching me and the PGY1 resident all the things that they monitor for during the procedure, the types of incision being made, and the actual procedure compared with the traditional procedure they used to use back 15 years ago.

After the liver was harvested from the patient, it was immediately set in the back where another team was getting it ready and prepped for the next patient. The OR room had roughly 15 individuals with 20ish or so total that entered and left the room. Overall, very interesting experience.