As I sip my coffee and soak up the sun shining through the windows I can’t help but admire the knitting group in the corner.  I’m not sure why I find them so fascinating, I have no interest in knitting, have no clue about half of the things they are talking about, and have never met any of them.  Yet I find myself diverting from studying to observe them or some may say ease drop on them.  It isn’t hard since they aren’t whispering and when excitement about a topic or story is present you can hear the crescendo of their voices and laughter.  I can’t hold back my smile, as I look over all I can see is the small white caps of their hair peaking above the high back chairs…they are so cute!

Then I begin to wonder if there will be a time when I too will be able to meet up with my white haired girlfriends and spend the morning chatting.  Quite honestly thinking about the future scares me because I have not idea about where I will be.  I can’t even guess what state I will be living in two years from now.  In the end I have faith that everything will fall into place and have to remember to “not worry about tomorrow; for tomorrow will care for itself.  Each day has enough trouble in its own.”

Recently I did find out some exciting news, my placement for the rural track rotations.  I will be completing my Family Medicine, Pediatrics, and OB/GYN rotations in Joplin, MO.  However, this means that I will be living in Joplin from January 2011 until the end of May.  Joplin was not my top choice of places to go especially since it is 4 hours from both Columbia and Wash MO.  Yet I am looking as another experience where I am venturing out of my comfort zone.  Some of the best experiences in my life have been during the times where I stepped out on my own, going to a new place, meeting new people, and ultimately learning more about who I am.  

Last week I saw a patient who I will call Pat.  I will remember Pat because he/she was the first HIV positive person I have seen as a patient.  Don’t get me wrong I have met many HIV positive people, probably more than I will ever realize, so what makes this special.  I was acting in the role of student doctor and simply taking the history of this patient was fascinating to me.  


Pat was first found to be positive 18 years ago when patients expected only to live a few years.  Now 18 years later Pat hardly believes they are still alive.  I find it remarkable how far medicine has come in such a short time.  For some the discovery of effective HIV medication wasn’t soon enough but for many it has given them the chance to see their children grow up and to see their children’s children.  Pat never expected to see his/her own children reach adolescence and now Pat is watching his/her grandson approach adolescence. 


There was and still is a stigma attached to HIV.  It is perhaps not as negative as it once was but it is there.  I think the natural reaction is to be scared or precautious around someone who is infected.  I found my first reaction to the patient surprising.  The patient was being seen for an illness unrelated to HIV, HIV was simply another chronic illness such as diabetes the previous patient had.  When taking the history Pat simply mentioned he/she was positive and unconsciously I had a moment where I was apprehensive about seeing this patient.  


The feeling was a mix of feeling fearful and cautious around this patient.  However, it only took a split second before my rational brain took over.  You can’t contract HIV from talking to the patient, being in the room with them, or even doing a physical exam.  There needs to be direct contact with body fluids in order for transmission to occur.  It then dawned on me how I was probably a bigger threat to her since she was immunocompromised.  This means that a simple infection a normal person’s immune system can fight off an immunocompromised person can’t.  This patient’s CD4 count was about 250 and was on a corticosteroid further increasing the risk of infection.  Pat should have been apprehensive about me touching him/her.


Pat showed me how wrong first impressions can be and how fear can really obstruct your thoughts if you let it.  This patient also excites me for what the future of medicine may brings and I look forward to being a part of it.  

Looking at the last time I blogged you would think I gave up blogging as my New Year’s resolution.  However, that is not the case.  What I have been doing is focusing most of my time on school.  Currently I am in Block 8 of medical school, which is the last of the classroom, basic science learning period. 

My next step will begin in June when I enter my third year and start clinical rotations.   But before the rotations begin I must take the first part of my medical licensure exam known as the USMLE Step 1.  That is what every second year medical school student focuses on.  The score earned on this exam is used by the residency programs to determine if they want you for their program meaning that for some, it will be the deciding factor on what specialty they choose.

Perhaps that is what scares everyone so much.  What I am getting at is there is enormous pressure to do well on the Step 1 exam while still trying to balance your current schoolwork, your sanity, and your relationships.   So I guess school is the excuse I am using why I haven’t blogged in 3 months.

My new goal, as of this past weekend, is to get back into blogging.  The quality might not be very high and the grammar is most likely not going to be the best (keep in mind I am not a journalist) but I am going to make an effort.  Each Monday I will post a new blog and possibly more frequently as things come up.