Another month older, another month wiser

I had about five paragraphs talking about how I planned to cut my hair and how hair is such a big deal for black women and why is it even such a big deal in the first place but it fizzled out when I cut my hair and realized how big a deal it wasn’t. So now my hair is four inches shorter and I am out of a blog post.

In lieu of some introspective self-reflection, I decided to share a snapshot into my life for the last month. So in no particular order. . .

1. In early October I learnt that a family celebration does not, in fact, have to break the bank, and birthdays can actually be commemorated with low-key gatherings and cake. Definitely cake. My purse and heart are grateful.

2. In mid-October Montego Bay hosted its very first Pride march which was also my very first Pride march. I helped carry the rainbow flag and it maxed out my feeble upper body strength. And though the actual marching was pretty short (can’t complain, the sun was brutal) the feeling was pretty incredible.

Pride was definitely an experience – a lot more head top and dash out than I would have expected, along with uncensored dancehall songs on the people dem good good Sunday morning. But overall I had a sense of bittersweet, well, pride. I was proud of the LGBT movement in Montego Bay for coming out and enjoying themselves, even as a good number of them opted to cover their faces. I’m already looking forward to Pride 2019.

3. In late October I recognized a full year of settling into my leadership role at work. It was a good chance to reflect on how much I’ve grown, how many leadership books I added to my shelves (a lot) and how many I’d read (very little) and where I plan to go next in my journey to becoming a girl boss.

4. I’m participating in my high school’s mentorship program for the second year in a row, and I’m excited to see what new adventures and experiences are in store us for in the upcoming school year. Last year was a blast of learning and growth for both me and my mentee, and I expect this year to be no different.

What have y’all been up to?

Sundays are for Gratitude (and Homework)

Today I’m sharing a post that was written quite some months ago, because it feels especially relevant. Just this week one of the wonderful women I mention in this post reached out to me through a belated Christmas card and suddenly all the memories and nostalgia came flooding back. Real life mail can be so emotional sometimes. Anyway, while I am busy doing homework on this sunny Sunday, do enjoy this short reflection on gratefulness and belonging. 

~*~

I am thinking about gratitude.

How grateful I am for the women on LiveJournal who raised me, nurtured my budding social awareness, adopted this internet orphan, were my tribe in a time when I desperately needed to belong somewhere.

When I talk about my strange fixation with white women it probably started here. With these amazing wives and mothers (white and black) on LJ who lived and breathed feminism in an era before that word was so conflicted. They showed me that women could do anything. These women who coded and built their own websites, designed amazing graphics, wrote powerful stories, raised strong families. They showed me a version of life that I never would have known if I was left up to the devices of day to day Jamaica.

So I am eternally grateful for these women and the indelible marks they have carved on my path to adulthood. They didn’t have to accept this ‘little black girl from country’ as one of their own but they did, and I felt empowered to be among them. Not because they were elite (they were not) or foreign (mostly) or feminists (all), but because they admired and respected me the same way I did them. And that was a powerful lesson.

Clouds and their Silver Linings

The recent deluge haranguing Montego Bay has put a damper on so many things. Parties are in danger of being rained out, employees have yet another excuse for being late, and most frustratingly I can’t get the sunshine time my laundry needs to dry.

While I’m stuck in this limbo land of weather, I am realizing with greater certainty how important it is to be patient, with the world and myself. All good things take time; seeds and stories and life plans must germinate before they can flourish. Though Montego Bay is utterly miserable in a downpour, the rain brings much needed refreshment to a parched and grimy landscape.

In an effort to remind myself about this need to be patient I started a ‘Future journal’. In it I have been writing down all the things I think I need to have a good life. It seems materialistic, but by writing down these worldly wants I find that I can filter out most of my day-to-day whims (which are never necessities but still somehow make me feel like I’m missing something vital) and focus on the true essentials.

In the middle of this cold front I also managed to get sick again, which has reminded me to pace myself and listen more keenly to what my body is saying. Right now it’s saying that I need a health dose of Vitamin C and more blankets. But I hope the lessons in patience and listening will stick around even after my sneezing fits are over.

 

Evolutions II

I’ve always been big on letting go and moving forward. Which is the life coach way of saying that I like cutting my losses and starting over. It started with MS Paint and Word; if I didn’t like the way a drawing looked or a story sounded and I was in too deep for a couple of undo’s to do the trick then I would click the close button – don’t save, thank you – and open a new file. I approach my career and relationships with the same objectivity (or is it callousness?).

Whatever you want to call it, I have the remarkable ability to walk away with very little tears shed, once I’ve made up my mind to do it. Of course the build-up to the actual decision is fraught with feelings of guilt, several tears and usually at least two sleepless nights. But once its decided I usually feel relieved, refreshed and ready to move forward. Which all sounds very normal and emotionally healthy and therefore very unlike me. Call it my saving grace.

As I get older (sometimes I panic about how close I am to thirty, and I’m not as close as you might think), I spend more time thinking about the way my life has unfolded. I like to think that all this reflection helps me plan the next stage of my life, but really it’s mostly a lot of self-congratulation. Oh, I’m so proud of the way I handled that break-up. Oh, I’m so glad I made this career decision despite everyone telling me otherwise. But I also came to recognize this useful habit of letting go of the things that are harmful to me and moving on to different mistakes or healthier choices. Cue self-congratulation.

Recognizing that habit helps me to realize that as I grow and change some things about me will remain constant, like my ability to accept growth and change without too much struggle. And my ability to close the door on things that no longer have a place in my life, but also my ability to recognize things that will always be a part of my life no matter how long I neglect them. The nature of my involvement with hobbies like writing and dance will change – my time constraints will change – but even if I don’t publish stories, even if I don’t perform on stage there will always be a part of me that is a writer and a dancer no matter what.

Being able to believe in these less public aspects of myself despite our culture of “pics-or-it-didn’t-happen” translates into believing in myself on a whole. It gives me the confidence I’ll need to handle the rest of my twenties (and eventually my thirties) with not necessarily grace, but at least something close to resembling aplomb.

What is a CRH Internship like?

So here we are, one year out of medical school. Internship is behind us and we’re venturing out into the world of fully registered medical practice. And the question one everyone’s (no-one’s) mind is, what is internship at CRH like?

Internship anywhere in Jamaica and the Caribbean is rough. The high patient load and typically low resources keep our clinical practice particularly inventive, and adhering to evidence based medicine is a lot like playing whack-a-mole (just when you think you’ve hit the nail on the head, it’s disappeared and you have to try again).

I chose CRH for my internship for a number of reasons. Montego Bay is my hometown. Because it’s a Type A hospital we see more complicated cases and therefore get more clinical experience. Compared to the other two Type A hospitals, the patient load is a balance between overwhelming and nonexistent and the staff are (for the most part) approachable.

Surgery, Internal Medicine, Pediatric Medicine and Obstetrics & Gynaecology share the same basic traits no matter where in the world you practice. What I have found different is the slant of intern duties. In my opinion, a CRH internship gives you primarily clerical experience. Any additional medical experience is dependent on the interest and enthusiasm of the individual intern.

Broadly speaking, the intern’s job is to see or SOAP inpatients every morning, round with the consultant, carry out requested procedures and tests, and follow up the results of these tests and act on them. Variations of this theme can have the intern seeing or clerking new patients in the Emergency Department, making interdepartmental referrals, organizing procedures off the compound, administering medication etc etc.

At the end of the day the intern’s is tasked with making sure the patient gets whatever they need to get better and get out of the hospital.

A lot of your time is going to be spent writing request forms, writing referral forms, writing notes in the docket and writing orders for medication. Your practical procedures will primarily involve phlebotomy and placing intravenous accesses. There will be times when you don’t feel like a contributing member of the team and there will be times when you’re the one leading ward rounds. There will be plenty of opportunities for learning, and in the same breath you will feel stifled by your supervisor when they only want you to be a scribe and a gopher. Brush these moments off and look for teaching moments. They’re not always obvious, but you can learn something from everyone.

Surgery

On the Surgery rotation, interns spend six weeks in General Surgery and six weeks in a surgical specialty such as Urology, Orthopaedics or Paediatric Surgery (Neurosurgery didn’t take any interns at the time). There’s a lot of hands on experience to be had here, participating in major and minor operations like laparotomies, appendectomies and the ever-frequent digital amputation. It’s impossible to leave this rotation without knowing how to suture and the basics of pre-op and post-op care, especially since the intern is the one leading the ward rounds, the one with primary management of inpatients.

Paediatrics

Paediatric Medicine divides your time in two six week blocks of the paediatric ward and the special care nursery. Here you learn attention to detail, the importance of acting on the results of investigations and how to handle stress. While on paediatrics you pick up skills in lumbar puncture and intravenous access placement, medication administration and infection control. Interns on Paediatrics are responsible for  administering all IV medication, which is something unique to CRH. If this doesn’t sound daunting, it should. The ward capacity is 20 patients (each. For the ward and the SCN), who require medication up to four times per day.

Medicine

Internal Medicine is a straight three month block with no sub-specialization (small chance of getting some Nephrology exposure). Patient load is high, resources are low and most of your patients are frequent visitors to the ED. It can get frustrating, especially if you like ‘saving people’ because the majority of patients are repeatedly sick because they are non-compliant. There are a lot of social and economic reasons behind this non-compliance but tertiary facilities are the ones feeling the brunt of that primary care failure. This is where you hone the twin skills of BLS/ACLS and breaking bad news. The practice of Internal Medicine is roughly the same across the board, with variations in level of academic exposure and access to resources (CRH falls low on both spectra).

Obs/Gynae

Finally, Obstetrics and Gynaecology is the Other surgical rotation, where instead of gunshot wounds and pus filled abdomens you get happy bouncing babies and failed abortions. The scope of your exposure ranges from suturing multigravid vaginal lacerations to contacting the Centre for Investigation of Sexual Offences and Child Abuse (CISOCA) for your 13 year old patient with pelvic inflammatory disease. OB/GYNs balance surgery and medicine remarkably well, with a smattering of paediatrics (neonatal jaundice has to be diagnosed by the OB/GYN intern before referring to Paeds) and the general atmosphere of the department is one of bonhomie. Interns on O&G  don’t have very active roles in patient management (most of the decisions are made by the consultant, with the intern carrying out the orders) and the consultants round daily so you’re never really on your own (pros and cons, here).

Conclusion

CRH definitely has its ups  – interns have the option for on-compound housing, for instance – and its downs – necessary machines get broken, a lot. And at the end of the day the decision about where to do internship is multi-factorial. I wish I could offer a comparison among internship sites in Jamaica or even the wider Caribbean but alas. I’m not so lucky enough to have enough friends in high and low places.

I will say this: no matter where in the island or Caribbean you do internship, almost everyone will be prepping for USMLEs or some other foreign licensing exam. Internship may feel like the worst year of your life (and in some ways, it is) but it’s just a stepping stone to postgraduate qualifications and the start of your actual medical career.

Why Grown Ups are Really Growin’ Ups

If there are two things I’ve learnt from crossing the threshold into adulthood, they are:

1. That no one is ever quite sure what they’re doing with this life thing and
2. That no one is ever quite sure whether or not they’re doing it right.

Certainly some people are closer to their median of happiness than others – it’s an imperfect world – but for the most part we’re all plodding along in the vicinity of fair-to-middling.

And there’s nothing wrong with that! The only problem is our unrealistic expectations of being an adult. I remember thinking as a much younger Robyn that when I grew up, I’d have it all figured out (and I’d be a wildly successful journalist). Now I’m ‘grown up’ and I am no closer to figuring ANYTHING out than I was at that age. My priorities have changed, sure, and I’m a lot less prone to teenage angst but I haven’t yet achieved the kind of self-assured calm I always assumed came with the territory of grown-upness. Which made me wonder what ‘grown up’ even means.

And this is what I think:

Growing up means exercising our power to change the world, one gut-wrenching mistake and one amazing success at a time. It includes exercising the ability to adapt to the consequences of our actions and inaction.

That sounds kinda mature, I guess. It sounds hard. And it sounds like something you keep doing for a really long time. I suppose I can get rid of the idea that we cross some kind of kiddy finish line one day and get our Grown Up Medal. This isn’t like graduating to training diapers. There is a process at work here and we’re all at different stages.

So there is always room for growth.

image is mine