Did I Get a Gold Star?

What is success?

I’ve asked myself this question a lot in the last few months as I’ve battled with thoughts of comparison and self-doubt. My performance has been under the microscope as we hastily wrap up our third year of medical school where our grades are mostly determined through individual evaluations by our clinical preceptors. For them it’s a task on their to-do list, but for me these comments have impacts on my future opportunities. That feels like a lot of responsibility for a couple of sentences typed into a box on the internet.

As their words appeared on my screen some of them made me stop to think, “Is this enough to…?” To get the ranking, the membership to some society, the job at that residency program, to get the gold star. I wasn’t sure.

A conversation with a mentor has helped me start to shift my perspective. She validated my feelings, but then went one step further to suggest that perhaps my definition of success could come within. She challenged me to answer the question – what is success?

This past year success has looked like my patients telling me they would want me as their doctor in the future. It’s looked like someone telling me they trust me. Success has been making space for important people in my life outside of medicine. It’s been performance on exams, but it’s also knowing that this information I’ve learned will help me change a life. Success was overcoming my fears, trusting myself and leaning into the difficult and tireless moments. It’s reflection, tears and humanity.

The combination of letters in my evaluations might tell the story that I can take a good history and present it in a clear and concise manner. They might say that I’ve learned the neuro exam and have been a good advocate for my learning. But those are only a piece of the story and they’re missing all of the details.

I had the day before Thanksgiving off, but I had just finished a week on in-patient medicine and one of my patients was still in the hospital. I decided I would go visit her because she seemed so lonely, and I didn’t want her to feel alone around the holiday. We sat and talked about how she was feeling, then she told me about her family and what they normally do for Thanksgiving. As I was getting ready to leave, her eyes filled with tears and she looked at me and said, “Can I ask you to do me a favor?” “Yes, anything” I replied. She said, “Tell your Mom and Dad that they should be proud”.

That’s the gold star. Those are the details worth mentioning.

Not My Patagonia

I slowed my pace as I walked from the Emergency Department CT scanner back to my computer in Care Unit 1. My shoes briefly disturbed the down that had settled on the floor. Gravity pulled it back to the ground. 

As I passed the recess bay, my eyes turned to where more feathers rested amidst the gloves discarded in haste and drops of blood left behind on the sanitized stage. He was in the hands of the trauma surgeons now with act two listed as a pelvic artery embolization, followed by an appearance in the operating theater. For a moment, the emergency department had returned to calm as the actors dispersed at the end of a rehearsed performance.

He came to us for help after he was struck by a car. The charge nurse told the room as we prepared for his arrival by ambulance, “pedestrian versus motor vehicle”. My preceptor would later draw an image on a sticky note for me; pictured was a car and stick figure as they made contact. One of our learning points for the day would be the classic pattern of injuries seen in these types of situations.

Who was he, our main character? John Doe, a man who happened to be wearing a blue Patagonia jacket when he became the victim of an unfortunate accident. The EMS team wheeled him in and the room sprang to action; a dance unfolded before my eyes. We methodically assessed his airway, breathing and circulation. “Do we have a blood pressure yet?” 80/40. “Let’s get some fluids running.” He shouted in pain when we pressed on his pelvis. We wrapped him in a pelvic binder. Abdominal ultrasound didn’t show any free fluid, but that didn’t mean it wasn’t there. We rushed to the scanner in search of more information. There was a blush down in his pelvis on CT, a sure sign of ongoing bleeding and an explanation for his soft pressures.

It was almost a comical scene as I recalled the feathers marking his path through the hospital, the lead trauma surgeon failing to remove them from his pant leg while we waited for the scans, the suppressed laughter from the staff watching these repeated attempts, the EMT apologizing for creating this mess.

But, what was this mess? Would John have made a different decision on his choice of outerwear had he known that he would later be center stage?

In the wake of John’s appearance in the ED, we lamented the inconvenience of the feathers and commented on how we would continue to find them in various corners of the department for weeks to come. My preceptor and I discussed the sticky note. I wondered how he was doing in the next act. In the midst of this tragedy, I wondered if John would be upset upon finding his down jacket ruined and scattered across the hospital halls? Would he find some humor from the way he entered from stage right? Or would it not matter that his coat was destroyed in the effort to save his life?

It wasn’t my Patagonia, but it’s caused me to pause all the same.

Since that morning in the ED, I’ve had the chance to visit and learn more about who John is. When I told him about the jacket, a knowing smile erupted on his face and his eyes pointed to the cupboard in his hospital room – “It’s in there”.

Suction, please

I arrived at the hospital as the sun was rising, the sleep slowly wearing off and the coffee ran through my veins. I planned to sit down at a computer in the office to start reviewing my patients charts before going to see them, but the morning had other plans for me. My doc walked in moments after me saying, “There’s a patient in the ED trying to die on us”. My sleepy brain registered the labs he’s relayed to me – pH of 6.9, base deficit of -10, possible dead gut.

If you didn’t know, now you know, a pH of 6.9 is bad. It’s a measure of how acidic your blood is and normal is ~7.4. When the blood becomes acidic it’s a sign that lactic acid is building up, a sign that there are tissues that are not getting any oxygen.

She needed to go to the OR, stat. He showed me the scans and we took the stairs to the emergency department. There our patient was writhing in pain, conscious, but barely able to answer our questions. I’ve never seen anyone as sick as her and she was sick. My doc was saying she might die, but would she? I wondered how I would handle another patient death so early in my third year. Would it be like the patient before?

There was no time to ponder these questions as we wheeled her to the operating room, scrubbed our hands clean and approached the sterile field. This was going to be quick my doc told me. We were going to open her belly, see what was going on and get out as soon as possible.

That’s what we did. The first cuts through the abdominal wall revealed dead gut, revealed a stench, revealed a new life for this woman. Black tissue popped free the moment we broke through the fat into her abdomen. It was her colon and small intestine that were causing the problem. We removed them both, leaving healthy small intestine behind.

Her abdomen left open and she was transferred to the ICU in order to receive fluids and blood products. She was alive.

We took her back to the OR the next day for another operation. She was still alive.

She would go back to the OR again another day. She is still alive.


The opportunity to save this woman’s life does not escape me. We didn’t really do that much, but what we did do will change the course of her story. It allows her story to continue. It allows her grandchildren to know her more fully, for her family to spend more days with her. Life, it’s a beautiful thing.

Surgery was on my list of possible specialties going into my third year. It’s been at the back of my mind since I was an undergraduate performing surgery on rats, and I suppose since I was a child. My grandma recently reminded me of when I was younger and determined to be an orthopedic surgeon.

I learned this week that my left hand is uncoordinated. I learned that dead intestine smells horrible. I learned that six laparoscopic cholecystectomies can all be different, but every patient will be grateful for the removal of their gallbladder. I learned the three keys to success in surgery –

1. Eat when you can

2. Sleep when you can

3. Don’t touch the pancreas.

I learned that being in the OR is exhilarating and I learned that surgery is definitely staying on my list.

Welcome to Phase 2

Last Monday morning, Carley drove up to my house and handed me a pink T-shirt. The back read, “Camp CU SOM” and featured an image of a fire amongst the trees. We were headed for Estes Park, Colorado where we would help welcome 184 new students to the first phase of their medical education.

Contrast orientation from this year to last year and you get a different impression. Nervous, anxious, doubting and self-conscious are all words that you could use to describe me 365 days ago. This year, I was excited, relaxed and carefree. It was refreshing to catch up with classmates after 9 weeks, knowing that we had made it this far; we are MS2’s [medical student, year 2].

As time passes and we reach these arbitrary milestones, it’s comforting to know that we’ve successfully made it over some of the hurdles. I’m not saying that we’ve done it all cleanly. There have been a few times when I’ve crashed hard into the ground, stood up and brushed it off. There will be a few scars by the time medical school is over. Maybe a few extra lines in the furrow of my brow from the late nights in the library and early mornings in lecture, but you know,  we made it past anatomy.

At orientation, I looked around at all of the new faces, knowing that people were nervous, anxious, doubting and self-conscious. I felt for them, but I also felt relieved that I wasn’t in their shoes anymore.

Today, on my first day of the second year, I spilled coffee on myself in the car. Then I walked into the full lecture hall and was immediately overwhelmed by all of the people. I felt alone and short of breath. What happened to the confidence from only one week ago?

Today, on my first day of the second year, I spilled coffee on myself not once, but three times. Is that a sign for the year to come?

Phase 2 is a doozy of a year. We start off with the Nervous System, before moving on to Digestive, Endocrine, Metabolism. Finishing with Life Cycle, Infectious Disease and a 7-week dedicated study period.

This morning I was humbly reminded of the hurdles still out there on the course. Turns out, being a year further in medical school doesn’t mean I’m any less nervous, anxious, or self-conscious.


I’ve decided to write myself a mantra to meditate on this year. A simple reminder of where I have come from and where I want to be in 9 months.

This year will be marked by fearlessness and perseverance. This year will continue to be about showing up and leaning into the challenge of being present. This year we will dare to dream a little bigger and set our sights a little higher.

I challenge you to take a look at your life – Where have you been? Where are you going? Who will you be in 9 months?

A Week in the Life

The last few months have been BUSY, but we just finished up and I am officially a second-year medical student! I’ve recently had several people ask me what it’s like in med school – how do we spend our time and whatnot.

Sometimes it’s hard for me to imagine [remember] what life was like before school started. I know I had most weekends off, that even though I worked a lot, I still had time for writing and reading and cooking meals for myself. I know that these last few months, I studied most weekends, had no time for writing, struggled to finish one book and I hardly ever cooked for myself. When we started our block on the heart, lungs, and kidneys I got into a rhythm. I set the speed to high and settled into cruise control.

To give some perspective on what medical school is like I decided to keep track of everything I did for the last three weeks of class. Are you ready for it?

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One week – Purple is lecture, green is clinic time, blue is problem-based learning, pink is my personal calendar

My day usually starts with my alarm going off at 5:30 am, but I have a healthy relationship with the snooze button so I don’t typically get out of bed until closer to 6:15-6:30. I am a huge fan of slow mornings and my favorite ones are when I have time to make scrambled eggs with coffee.

I’m a lecture go-er and that runs from 8-noon, [Monday-Friday]. We have 10-minute breaks between lectures and often we use this time to grab a cup of coffee, go for a walk, or stand in the sunshine right outside the auditorium door. Not everyone in my class attends and as one of our professors calls it, these students are part of “Panopto Nation”. There’s nothing wrong with choosing to watch the lecture online, people are still engaging with and learning the material, it’s just a different way of approaching school.

Some days we have small groups instead of lecture. These are required sessions that we get questions and clinical cases for beforehand. The expectation is that we read through and come prepared for class. It’s more of a hands-on method that allows you an opportunity to see and struggle with the material in a clinical scenario.

Once a week, I go see my preceptor. She is a family medicine doc and she graciously teaches me the skills I’ll need to succeed as a real doctor. We are learning to interview, to perform a physical exam, to presenting, documenting and come up with an assessment and plan. While I’m there I usually go into the room first and talk with the patient. Then I present my findings to my preceptor and we go back into the room together. It’s awkward, I often feel unqualified and I definitely don’t know the answers. But, I’m learning and as the year has progressed it feels more natural for me to be asking the questions. I even knew some answers one day as we conveniently learned about acute mountain sickness a few hours earlier!

A bulk of the rest of my “free” time is spent studying – reading for lecture, flipping through flashcards, answering practice questions, making graphs, tables and drawing pictures in an effort to understand and learn the human body and diseases that we experience. *Spoiler alert – there’s A LOT*

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The “pretty page” for congenital heart disorders. I definitely am NOT an artist, but drawing helps give a visual of complex topics and ideas

However, I also try to find time for other things that make me happy like –

  • Exercise: I go to my Crossfit gym and I recently trained for a half-marathon so I was attempting to run several days a week.
  • Friends and Family: The good news is that I study with friends and then I usually eat dinner with my family. The friends that don’t live in Denver I talk on the phone with or we use this app called Marco Polo. You can record and send videos and the person can play them back whenever they want and as many times as they want. It has certainly made long-distance friendships easier!
  • Fun: In this particular week, we hopped on our bikes on Sunday and rode to some new Denver breweries, I went to a birthday party, met some friends at a restaurant and toured my sister’s new home.

My day typically ends around 10:30-11 PM and I’m out before I get finished with one page in my book.


Med school is a strange combination of exhaustion and fun. Our limits are tested, but I don’t even presume to imagine that it won’t be more challenging [and time-consuming] when we get to residency. It’s possible to do things outside of school, but I’ve definitely had to make some tough choices. For instance, when I had an exam coming up that I wasn’t prepared for and I ended up canceling on skiing to study.

Finding the harmony between when to say “yes”, and when to say “no” is never easy, but it’s a battle worth fighting in order to preserve the bits of yourself that aren’t a doctor or student.