I spend a lot of time trying to prove people wrong about me.  Generally when someone tells me I can't do something, it means I will dedicate my life to making them regret doubting me.  I think it's the way my competitive spirit kicked in.  I was too annoyed by high school sports to get into them, so instead I just get even with the nay-sayers of the world.

I am definitely not the smartest person I know.  I didn't graduate number one in my high school class, and I truly didn't do that great in the college realm.  I feel like a lot of my objective results in life have been about average.  However, somehow I got into medical school...I convinced someone somewhere along the line to have enough faith in me to bring me into the fold.  Now, in about 6 weeks, I'll be graduating on time from medical school and will be preparing to start residency.

What blows my mind is that I still struggle regularly with the thought that whatever I do doesn't measure up.  It's a frustration I can't fully express to the entire internet community, but I have never felt like enough in any capacity.

And not because I wasn't surrounded by the most loving and engaged family of all time, because I was.  And I think that may be where the issue began.  It's taken me soooooo long to finally make something of my life that I feel like everyone else passed me up along the way.  I have these brothers and cousins and aunts and uncles and grandparents who are living their lives to the fullest in every capacity.  They are beautiful inside and out and they have pursued their passions from the beginning.

I have struggled with finding meaning in the mundane.  I've been trying to be reminded of the individual gifts and talents that God has blessed each of us with, but I just have such a hard time really focusing in on it.  Maybe I've just let satan have a hold of this part of my heart for so long that it's become much easier to hear the constant ridicule inside my own head.  I missing a peace that should make me feel whole and I'm sure it's because I'm simply not taking it into my own grasp.

I dream of being exceptional...but I worry that I will never see myself as more than an ordinary girl who lucked onto a series of fortunate circumstances.  It's hard to find pride in your work when you don't see it as fruits of your own labor.

I have a lot of soul work to go, it seems.

A change in the plan?

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

Suddenly my results are showing critical care...which is what I've been starting to lean towards.  All this planning for a possible change in plans...

In Memory...

I started off by writing this huge post about my incredible family.  I decided to save it for next time and for today focus on my grandpa.

My grandpa, David Etzel, passed away a year ago.  He was diagnosed with transitional cell carcinoma on his kidney in the fall of 2009.  He underwent a nephrectomy at that time and did really well.  He was never on chemotherapy and never had to receive any radiation.  He did amazingly well and recovered quickly.  By Christmas of 2009, he was back to his old self...mostly.

The entire Etzel clan got together in Wisconsin for Christmas that year.  It will likely go down as one of the greatest Christmas get-togethers of all time for our lovely little family.  I was going through a dark time in my own little life and I spent a lot of that Christmas really struggling with this loneliness that was starting to consume me.  Middle had been recently engaged, Christian was dating "the one" and I had just had a very public fight with a guy I had loved for a long time that ended with me incredibly embarrassed and alone.  Christmas was really rough for me that year.

I remember sitting at the kitchen table looking out at the snow and grandpa came up to me.  He gave me this Iowa Hawkeyes keychain and told me it had been given to him by an old friend when he was going through his surgery.  He said he had kept it with him through his time in the hospital and that it had served its purpose for him.  He gave it to me and told me to keep it with me as my own reminder of how much he loved me.  He said since it had worked so well for him that he hoped it would help me get everything I wanted out of life.

I remember grandma kept telling me grandpa was having back pain and she would ask me if the cancer was coming back.  I told her we couldn't live our lives in fear of his cancer coming back and that his pain may just be from sleeping in a new bed since he hadn't had any before Christmas.

Two months later my mom called me to tell me that grandpa's cancer had, in fact, come back.  He had metastatic disease to his vertebrae and they found it because his back pain had become unbearable.  Things went downhill from there.  I had several gracious attendings in Febuary and March who allowed me to spend a lot of time in Iowa and let me make up the time I missed on the weekends later on.  Grandpa could not withstand the MRI to diagnose the extent of his metastasis, and I can't remember why but we were really struggling with palliative radiation for the larger mets in his mid back.  The last few weeks with grandpa are really a blur now.  We spent a lot of time in the hospital with him and at home with him.  We did everything we could to make him comfortable but our efforts with futile. 

Grandpa passed away March 10, 2010 in this beautiful hospice facility...his children and wife were with him as he took his final breath.  He passed peacefully and we were all grateful that his pain had subsided.  Christian was in Mexico for a missions trip and I remember having to call him to tell him.  I was so glad to know he was with people who would comfort him even while he was so far away.

We've talked about it since then and we think he knew that the cancer had come back over that Christmas.  We're all so grateful to have such a beautiful memory together dancing and singing together.  I'm grateful we didn't know at that time so that we could just enjoy one last perfect moment together.

I still carry that keychain with me everywhere I go.  It has gone with me to multiple board exams.  I have had it in my suit pocket on every residency interview.  It is in whatever purse I have with me at any time.  I still go looking for it anytime I need the reminder of a grandpa who believed in me.

My cousin Megan and I always used to joke about how we are screwed and will likely never find anyone to marry who even remotely measures up to the men in our family.  It's true, though.  They don't make them like Grandpa anymore.  He has been such a beautiful example of strength, leadership, love, faith and family.  I still cannot believe that a year has gone by, but the memories of grandpa will last a lifetime and it is my prayer that his legacy lives on in each of his grandchildren.

You can read more about the life my grandpa lived at his memory page here

Pressing on Toward the Goal...

I have recently successfully completed my cardiology rotation.  It. was. AWESOME!  Not only did I get taught the ins and outs of atrial fibrillation, which was pretty much what I was hoping to learn, but I'm now much better at EKG readings, cardiomyopathies, risk factor stratification, AND looking at echos.

However, I think what this month really taught me was a confidence I have been lacking.  My attending taught me how to stick a needle into someone's femoral artery.  I know it seems silly and is probably something that really anyone could figure out...but as much as I brag about putting tubes in tubes, I have really struggled with finding confidence in my procedures.  I've seen, at this point, about every procedure that could ever be done, but I haven't had many opportunities to actually do them.  This month, that all changed.

And on top of that, I was actually pretty good at finding the artery, sticking a needle in it and then using guidewires and dilators to work my way up to a larger bore so that we could actually do the heart cath.  I mean, that's pretty awesome.

The cardiologist kept teasing me about wanting to do heme/onc because cardiology has better toys.  This is true.  Maybe I'll find some happy medium ultimately, but for now my ears are still perking up at the sound of "unknown etiology of anemia" or "platelet count of 25,000" or "bone lytic lesion of the hip in a 25 year old".  So probably until I can turn that part of my brain off, I'm heading in the right direction.

It's weird, I'm starting to really feel like this is happening.  All of the hard work is about to pay off.  My graduation garb is camping out in my living room, my graduation announcements (for the most part) have been sent out, I'm asking for boxes from random people I work with, I'm working on finding a place to live with my Rascal for at least the next year, and trying to get all of the paperwork done and in.

This is it.  I'm about to be responsible for my medical decision making.  Soon, I can actually write orders that someone will listen to.  I have about a million books sitting here to read between now and July and I'm freaking out about everything I still feel like I don't know.  But every day is a new step towards the goal.

At the end of the day...I still love going to work everyday.  I'm so ding-dang excited for all of the new again.  And as crazy sad as I am to leave this place that has really been the first place that's felt like home for me, I cannot wait for everything that lies ahead.

"Not that I have already obtained all this, or have already arrived at my goal, but I press on to take hold of that for which Christ Jesus took hold of me. Brothers and sisters, I do not consider myself yet to have taken hold of it. But one thing I do: Forgetting what is behind and straining toward what is ahead, I press on toward the goal to win the prize for which God has called me heavenward in Christ Jesus."Phillipians 3:12-14

For all the straining and pressing, there's more to be done.  It's just nice to sit back in the peace of knowing that all of this is for a purpose greater than me.  And to be used in such a way that my heart is full day in and day out is a blessing I could have never dreamed I would have.  I have had a bad habit of getting caught up in the work and losing sight of the goal.  I'm hoping to get better at that soon.

I'M GOING TO BE A DOCTOR!!!!  :)