Live from New York, last Saturday Night, I lost my passport at a dance club. My only form of photo ID. My best souvenir of a year living and traveling in Asia. It vanished somewhere between the entrance and the women’s restroom. The music was decent, and the dancing was good. The security guards, bartenders, and coat check lady were all sympathetic, but no one had seen a US passport. I left the club with no proof of my name, age, or nationality.

Under normal circumstances, life without photo identification isn’t so hard. What’s in a name? Who cares about my nationality — I’m a citizen of the world, and aren’t we all? Plus, isn’t age nothing but a number? (Not when you’re buying wine at the store on Franklin. Oh well.) But, I have an exam this month. It requires proof that I am who I say I am. So. I panicked and went to the DMV armed with my birth certificate (which the doctor never signed), a utility bill, and a social security card. I didn’t need any of them. Just my signature. Who knew the DMV has digital records of my last drivers license. They even believed it was me with my new haircut. I left with a temporary license to drive, which I won’t use to drive, and then I headed to school. Student health flagged me for not having a tetanus booster, or for that matter a PPD… I guess, in theory, I could have picked up TB in Vietnam. But, let’s be honest, who doesn’t have TB nowadays. Am I right?

Two hours later I had a sore shoulder from a TDAP shot, and an email in my inbox. Someone found my passport! He googled me! He contacted the Luce Scholars program and asked them to give me his information! By the afternoon, I was in a gym in Manhattan with a bottle of champaign for the personal trainer who frequents the same dance clubs I do. A HUGE thank you to Anwar, both for giving me my passport, and restoring my faith in the kindness of strangers.

Monday continued on an upward trajectory — I met up with a friend from Vietnam for drinks and indian food. shoutout to Joanie! You are the bomb, and I am praying that you, Andy, and the girls find a way to teleport to New York.

The rest of the week was an interview marathon: 1) A hospital on the upper east side, full of celebrity sitings. Could this pop-culture-idiot end up doing pap smears for  rockstars? 2) A hospital on Long Island, full of surgical opportunities. Could  I be proficient on a surgical robot, and also a thick Long Island accent? 3) A hospital in North Philly. Could I go back to the motherland of brotherly love? Also, shout out to Morgan for housing me. Cher and Di live on! And, an additional shoutout to Angie for carpooling with me all over the east coast.

Now,it’s sunday again. I’m overdue in writing thank you cards. And, now that my photo ID is safe and sound, I have to keep studying my multiple choice patients.

Oh, it’s December, by the way. A Christmas tree has been erected in the apartment lobby. I bought a Menorah. It’s cold. Here’s a song, lovely reader, to celebrate:

 

 

Advertisements

Thanks a lot

November 25, 2012

We last left off in a small mountain town. After my interview I found the movie theater that serves gourmet pizza and beer, and movies are $3 a pop. I had my picture taken with the Christmas Llama in the thanksgiving day parade, wandered around a main street (art gallery, microbrewery, cute cafe, repeat), and cried my eyes out by the end of The Sessions. Must See, if you haven’t yet. By the time I left Asheville, I was convinced that the Blue Ridge Mountains could sing if they wanted to, and I also desperately wanted a puppy.

Interviews are ramping up. I had a second one last Tuesday in New York. Three next week. Three the week after that. a few more in the following weeks. In the spirit of the season I’ve decided to count my blessings regarding this process:

1) Even though my suit makes me look like a boy at his bar mitzvah, a little lip gloss is enough to genderbend me back to a grown woman

2) I have friends who will house me the night before my out of town interviews (Shoutouts to Liza, Alice, Morgan, and Laura)

3) Laura, can I crash at your place the night of the 20th? xox

4) I have enough stamps for thank you cards for all my interviews. And enough thank you cards for at least half of them.

5) Megabus. I love you.

6) I can divert any difficult interview question by saying something in Vietnamese

7) Hospitals love to feed residency applicants delicious food.

8) Barack Obama is the president.

On that note, Reader, a belated happy Thanksgiving. I’m obviously grateful for you – where ever you are in the world, whether or not you commemorate the relationship between native americans and pilgrims like my family does – with a long dinner full of turkey and mild tension, and PBS on the TV in the background. So, Thanks for reading 🙂

And, finally… live from New York, it’s Saturday Night!

 

A few long weeks, briefly.

November 15, 2012

The history class I followed was put on the back burner. Vietnamese class is on hold too.  I even stopped blogging for about a month… But, in spite of dropping most-if-not-all of my extracurricular activities, life was busy.

I was preoccupied with medicine – personally, psychically, professionally. Scheduling interviews, studying for the boards, and navigating life in the hospital. Some of my patients got sicker. Specialists floated into and out of their rooms as if through a revolving door. When one problem resolved, another appeared, and we had to draw more blood. I met my patients’ families. A few patients simply had neighbors visit, and one patient had no visitors at all.  My patients started to get better. They went home, or went to a sub-acute rehab facility, and I don’t think I will ever see them again.

Just as my sub-internship wrapped up, hurricane Sandy hit New York. The residents told me to stay home. I got restless during the day, tried to volunteer at an evacuation shelter, but ended up at my friend’s house and fell asleep watching Blade Runner. Reader, please don’t tell me what happens in the middle.

The skies cleared. Airplanes took off for NYC again. JFK reopened, and I got there three hours ahead of my visitor’s flight. For the next two weeks I went from novice doctor to novice tour guide. We went to Storm King. We learned the history of Times Square, watched improve comedy at UCB, climbed a wall in Brooklyn. We ate an apple pie that was mostly butter over the course of a week. We watched Obama get 4 more years (woot!). We walked a lot, and rode trains.

He went snow boarding while I went hiking around abandoned ski slopes. He met my grandmother, my parents, and my Aunt Mimi, and survived them all. He got a haircut.

Then we watched Skyfall (Anyone want to see it with me again?) skated in Bryant Park as soon as it opened. I found out I don’t have any of the BRCA genes in my DNA (HOORAY), so we celebrated at a Filipino restaurant. Yesterday I went back to the hospital, and he went back to JFK.

Today I went to JFK. Then to Charlotte, NC, and finally to Asheville for my first residency interview. It’s tomorrow. Reader, please say a prayer to the suit goddess for me that nothing unbuttons. Asheville is adorable (as some of you know).  The hospital is enveloped by the Blue Ridge Mountain Range, and there’s a decent bagel place across the street. Could this be home?

More to follow…

bootleg blogging

October 25, 2012

Hey all, 

since some of you have complained you are having trouble signing in to read the medscape blog I posted on Facebook. Here it is – bootlegged. 

*** This is directly from the blog I write for “The Differential”, which is part of Medscape Connect. 

Genetic Disease: Would You Want to Know?

Rosalyn Plotzker, Medical Student, 10:32AM Oct 13, 2012

 

 

I wore a patient gown for the first time in a year. It was cotton. I wrapped it around myself twice to compensate for its size, along with the deficit of clothing underneath.

The women’s health practitioner sat across from me in the exam room. I wanted to be in her place – both next year as an intern, and at that exact moment. I am more comfortable as the clinician. But, at that exact moment, I was the patient. I rambled the details of a year’s worth of health: the vitamins I took; the UTI last spring plus the URI last winter. She jotted notes on my chart. Today I felt fine. I even felt a little courageous. My residency applications were in. I liked my sub-internship team. All the tiny victories of daily life were aligned.

Next we reviewed my family history. (It’s infused with medicine – my father, uncle, and grandfather are all physicians. But instead, obviously, we discussed my family’s legacy of disease). On one side, my grandmother is 96 years old. On the opposite side, my grandmother is unknown to me. I inherited her name in exchange for losing her to breast cancer when she was in her 40s. Given a third family legacy – Ashkenazi Judaism – I wondered if I would also inherit her fate.

The pair of known BRCA genes are two great genetic discoveries. In 1990, BRCA 1 was identified as a caretaker gene on chromosome 17. When expressed in the breast tissue, it’s partially responsible for repairing DNA. More specifically, the associated protein joins others to form the BRCA1-associated genome surveillance complex, which then assists RNA polymerase II in mending double stranded DNA breaks. BRCA 2, on chromosome 13, likewise helps in double stranded break repair. BRCA 1 is more than 100,000 base pairs long; BRCA 2 just over 84,000. There are plenty of opportunities for the building blocks of DNA to be toppled. In the case of the BRCAs, mutations are passed from generation to generation, rather than occurring spontaneously. 

This is amazing from the point of view of a medical student. It’s a beautiful example of the interconnectedness between our genome and our bodies, between our heritage and our health, and between family history and disease risks. This is terrifying from the point of view of a patient. It’s an example of the double edged sword of inheritance; it demonstrates the helplessness implied by the power of our genetics. 

The clinician and I chatted – white coat to blue gown, doctor to student, woman to woman. It was obvious to both of us what should happen. A bulk of the conversation revolved around insurance coverage of genetic testing. Finally she left the room. She returned minutes later with a kit in one hand and a pamphlet in the other. 

The form was white and purple, and I filled it out with a black pen. I signed where I should have printed my name. I checked a box that I shouldn’t have. She said not to worry, it was fine. The phlebotomist arrived. She strangled my bicep with a tourniquet, and we watched a precise stream of blood rush into the collection tube. I do not faint at the sight of blood, mine or anyone else’s. I watched the red meniscus rise, in wonder and in horror at how much information about me can be contained in such a small amount of liquid. The phlebotomist left. I changed into my clothes. Then I made an appointment for October 30th to find out the result, and went to the subway.

That night I had a glass of wine while I wrote a quick note about the experience on my personal blog.

A few days later I received a message from a friend: “Hello Roz!!! I just read your last blog post. Many belated hugs. I’m wondering, if you don’t mind me asking – why you decided to take that blood test – i mean, what will change for you either way? what will you do differently/ feel differently/why do you want to know if there are no preventative measures really – and also, as we are aging and dying more everyday anyway kind of thing? I know – big question – but truly curious.”

Enormous questions. Right now, I don’t know. Things will change when I find out the results, I’m sure. For BRCA positive people there are options for surveillance – earlier and more frequent imaging studies, possible preventative surgeries, those kinds of things. Regardless, neither knowledge nor ignorance will change the turning genome ladder within each of my cells; the molecular blueprint of “who I am”. But aren’t we more than that? And shouldn’t self discovery be pursued, in order to live our lives to their truest extents? Apparently, big questions prompt further questions. Perhaps I’ll get more than one answer on October 30th.

thick skin

October 19, 2012

It was a long week – the kind of week that feels like it’s going by quickly, then on friday you can barely remember what happened tuesday.

I don’t remember what happened tuesday.

My last patient went home today. I picked up 4 more. One woman refuses to eat or drink or talk. She had a kidney removed a month ago, and only speaks spanish. Another patient was just diagnosed with hepatitis C, plus his kidneys are letting protein out of his body when they shouldn’t. He has huge areas on his legs where the skin has come off. A third patient, about my mother’s age, has HIV and breast cancer that has metastasized to her bone (we think). She goes to surgery on Tuesday. And, an 80 year old man from Italy fell off a ladder and has bilateral pelvic fractures.

Outside of the hospital, the residency application process consumes most of my headspace. Meaning, I check my email for program interviews every three minutes. I feel nervous anytime there’s something in my inbox. I need to relax. Two very special shoutouts to two Alexes (CBA and Yevcha) for keeping me calm this week.

When I was a teenager, I assumed people lost sensitivity as they aged. Adults seemed to cry less, and lacked the melodrama of adolescence. I looked forward to the day when I would be so mature. Skin gets thicker with time. I was sure. But, apparently, the thickness of skin doesn’t make it any less sensitive. Maybe tough skin simply contains emotions better, allows us to control our reactions. What do you think, reader?

Doctors on a rainy day

October 10, 2012

I’m tired. No beating around the bush. Just the facts, please. 

My health insurance came through, so I went to three doctors today. (I have one for almost every part of my body).

I asked Dr. #3 about breast cancer. My namesake, a direct relative, passed away from it at 44. Given my Ashkenazi lineage, I wondered if I’d inherited a BRCA gene as well as a name. At 4 pm I gave a tube of blood to find out. Results come in October 30th. 

I received my first Thanks-but-no-thanks response from a residency program. It was a reach school to begin with, so I’m not surprised. Regardless, No’s are discouraging.

Also, it rained all day. 

So…. There’s a lot on my mind. Cancer. My career prospects. The location of my umbrella.

In a way nothing’s been lost (except a tube of blood). I won’t go to a residency program that I never went to in the first place. I’ll find out about my genetics, and that knowledge won’t change the twisted ladder of DNA in every cell that makes up “me”. 

Tonight I just want to focus on being dry, enjoy the glass of wine in front of me, and go to bed early so this day ends soon. I’m ready for a hug if anyone’s offering.

A grateful shout out to Becca and her mom Deb – lovely to talk to you this afternoon, as always. Much Love. 

 

A day of life

October 8, 2012

To the readers who made sacrifices to the medicine sub-I gods on my behalf: thank you! I have a day off for Columbus Day!

Now might be a good time to mention I’m auditing a college course, on the history of the world from 1300 onward. We finished the conquest of the Americas last week, and our first essay was due yesterday. I wrote it in the hospital on my lunch break. Anyway here are a few fun facts about the exchanges between the New World and Afro-Eurasia:

1. Europeans brought 14 epidemics to the New world. The indigenous population decreased by about 80% when all was said and done. In an attempt at revenge, surviving indigenous people kneaded blood into bread that they fed to Europeans, and threw corpses into wells to contaminate the water.

2. Europeans brought back syphilis from the New World.

3. Imported European pigs thrived in the caribbean, so much so that they dominated tons of local fauna. By the 1500s the islands were overrun with wild swine.

4. Pirates who hid out on caribbean islands captured wild pigs, skewered them, and roasted them over an open fire. They ate everything from beard (barb) to the tail (cue)…. (get it? barbecue?)

5. Potato, tomato, corn, and sugar businesses were BOOMING back then – not fair trade, though.

So, on those notes of Columbian exchange, Happy Columbus Day. I plan to celebrate by finishing my nephrology videos, doing more yoga, and possibly painting my nails. Someday I will stop biting them. Maybe.

By the way, if you’re interested in auditing a college course online for free check out http://www.coursera.org Reader, maybe we could be study buddies – whaddya say?

And, if plotzk isn’t enough, check out my latest medscape post: http://boards.medscape.com/.29ef0439/

X

Don’t forget to write

October 6, 2012

Note: I have writer’s block. In lieu of a proper blog post, which is what you really deserve, here’s an unedited rambling few paragraphs (which is what most of my posts amount to anyway… so enjoy as usual)

It was my 1st week of a medicine sub-internship (not a 3rd year, not yet a resident). My patients are lovable, and for the most part fluent in English. One woman was devoted to Jehova, and I had to convince her to get a transthoracic echo via theological debate. Another patient, who I took care of all week for epigastric pain, finally had a bowel movement; I have never met a happier man, and I will never underestimate the importance of a good BM again. A 20 year old had shingles, but we managed to discharge him from the hospital in time for his physics midterm. A  patient in a manic episode let me draw her blood because she thought I was pretty. A man with tongue cancer and chronic pancreatitis is going home with a tube in his throat that hisses when he talks. A woman who’s been unconscious has the room with the best view in the hospital. Another woman who only speaks cantonese had GI bleeding, and we wrestled with the translator phone system to explain it to her.

The patients come and leave quickly in this rotation. Our team manages about 15-20 cases at a time. I want the patients to leave, because it means they are better. I want them to stay because I want to get to know them. Tricky.

My team is great, but they change next week. Can’t get too attached to the nice residents.

On Friday I got a haircut, and today I spent most of the morning and a good part of the afternoon watching videos about nephrology. I have had bizarre, uncharacteristic urges to stretch or do yoga. Today I tried running too. Weird. Must be the weather. In general, I’ve been waving my solitude flag this week, craving alone time, and pursuing a career as a hermit-rockstar… but, I guess you’re never alone as long as you have the internet, right, reader?

So, that’s what’s new – Living the dream as usual.

More to follow, hopefully soon.

Then

September 30, 2012

Well, I got better. I turned in my residency application . Then it was Rosh Hashana.  Jewish New Years Resolutions: Write more, travel more, feel more, work more, sleep more, play piano. I went to Delaware for the holiday, then Philadelphia, then back to New York, and finally landed in the hospital. I rescheduled my boards exam… again… from January up to December. I swear I’ll take it at some point. I saw my amazing friend Anyssa play piano and discovered Couperin.

Then it was Yom Kippur. Back to synagogue, in conjunction with self imposed starvation and caffeine withdrawal. My Vietnamese textbook arrived. The last two days of Gyn Onc came and went. One patient went home. Another patient finally got the operation she needed.

Friday I celebrated by going to a fundraiser for an awesome org Pacific Links, then went to a show for my pal Mike Webster.

As for last night: shout to my friend Elliot, whose friendship has spanned from Vietnam all the way to Brooklyn. Additional shoutouts to Claire, Gill, and Lori — I love coincidences when they mean seeing you.

Now I’m on my way to the Hudson Valley. I’ve got two hours on an Amtrak train – one window is looking out to water, the opposite window is filled with trees showing the early signs of autumn. There’s free wifi. I’m having a work date with my lovely friend. A final important shoutout to Rachel Russel — hanging with you is nothing less than a roller coaster of joy.

Tomorrow starts my medicine sub-internship. Lovely reader, please say a prayer to the medicine gods and goddesses.

Thanks.

 

Overdue post – sick day#2

September 13, 2012

There is no free time to write blog posts anymore. It takes a sick day. Make that two. Yesterday I was a pathetic lump of food poisoning, asleep for 36 hours straight. (Interrupted by occasional miraculous texts from Vietnam. Shout out to Alex – thanks for keeping me company during my delirium). Moral: Beware the fish arepas.

I still love OB/Gyn, and still love my team and my patients. Each day seems to last a week. By the evening I have a list of things to blog about. When I’m home, I manage to turn my computer on just in time to fall asleep in front of my WordPress dashboard, with the mouse hovering over “Add New Post”.

Things on the blog list: I have a patient from Belize who has stage III cancer because they don’t do pap smears regularly in Belize. My attending gave me a lecture on why I shouldn’t say “Thank You” when giving an order as a surgeon. Our robot broke and we had to postpone a procedure.

Sounds grim. But, we’re treating the patient as best we can (better late than never); I still say thank you and always will; they fixed the robot.

This week is also the last minute crunch for residency applications. I need to submit a photo (ugh). Thank god my computer has photobooth. Aside from that, there’s the frenzy of personal statements (is everything spelled right?), letters of recommendation (are they written??), and I need to select programs to apply to (where????)

Maybe a sick day or two isn’t such a bad thing.