Match Day: "I NICED myself"

            For those who don't know, Match Day is the day in the U.S. when all the medical students studying medicine find out which hospital they get assigned for their residency (the 3-5 years you spend as a physician under the guidance of more senior physicians).  It's probably the biggest day in any medical students life, thus you can understand the aneurysm inducing week students have leading up to that day.  To make matters even worse, the Monday of Match week you get an email that says "Matched" or "Un-Matched".  If you are one of the lucky students that got the questionable email from the National Residency Matching Program (NRMP) this year you were probably initially puzzled, since somehow they thought it would be a good idea to add to the suspense..... the already 4 years long suspense process by titling the match email with a darn question - "Did I Match?"  Without even opening the email you could already tell if you matched or not.  Sadly if you didn't match, that meant spending the following days doing what I would call the "evil cousin of the former SCRAMBLE", SOAP (Supplemental Offer and Acceptance Program).

            Apparently this was suppose to be a easier process than before but if you went through it or watched anyone else go through it, it's nerve-racking, gut-renching, disorganized torture.  I can't even imagine why anyone would think having medical students scramble for the last available spots, waiting and wishing for their phone to ring for someone to offer them a job is some how better than not matching initially.  This substitute SOAP causes most medical students subjected to the process, to change their chosen specialty within hours of finding out they didn't match in an effort to secure a job at last minute.  Sadly this is the only solution the "Med School Gods" aka NRMP have come up with to help the over-populated residency application process.  Over the last few years medical schools have increased the number of students they admit each year but the amount of residency spots have not increased; so the residency application process has become even more competitive.  So like everything else in medicine, applying to residency is analogous to the Darwinian principle of only the "fittest will survive".  Fittest in our world meaning those who have the better board scores, better answers in interviews, maybe even better names (there is a such a thing as generational doctors, where parents pass on the gift of medicine, look into to it, it's a genetic trait) and probably most important when it comes to the application process is having the better strategy.

          According to some resources, there are about 34,000 applicants applying for an available 19, 000 residency spots, and only 17,000 of these applicants actually come from the U.S.  We are all subjected to take the costly $1,200 U.S dollar Clinical skills exam, which is a required exam of all applicants applying to residency in the U.S. but recently I have come to the conclusion that it is just a tactic to weed out foreign medical graduates who have a difficulty speaking English.

            So after you make it through the expensive application process, interviews, and then make your rank list; you then have to agonize through Match week, which is probably the longest week in any med students life.  The agony occurs either because you are subjected to still "scrambling" or if you're lucky to have matched on Monday you have to wait patiently/anxiously or spastically (per Michelle, a word we made up for when someone just freaks out randomly) waiting for Friday to come to hear where you matched.  Then to make matters worse, the NRMP follows up with a second email in the form of a question, "Where did I match?"  "Will you just tell me already!!!" as you spazz out at the computer after a week long build up to Match Day.

So after you survive the grueling process and finally find out that you matched and have a job and where it is exactly, your intense anxiety turns in to what I like to call "random rachet fun".  You are so elated that all you want to do is jump around, scream, dance, hug people, smile from ear to ear or may even slap someone on the butt like your a pro in the NFL.  Essentially you join the club of medical students who have spent their whole lives dreaming about changing the world ( or making money, no judgments), who then started medical school without realizing just how hard it was going to be, then you couldn't quit because you were either too close to the finish line or too far in debt.  So after a lot of hard word and too much delayed gratification you find your self, the very moment you open your envelope and realized you finally have a job; you find your self dancing around like a happy chicken relieved that everyone around you is a vegetarian..

            I think it would actually be better if they made it one big match day for all the medical students in the U.S. then transport us to a large open field and allow us to run around scream, rip our clothes off and just let the crazy out for about 30 seconds to release all the built up frustration then allow us to dance all night long.  Yup that sounds exactly like what we need, no pictures though, there are just certain ways you don't wanna imagine your doctor.  Being in Kenya didn't make my match day any less exciting, especially since 6 of my classmates (3 of which are my close friends) were also here during the big day.  So we celebrated with the kind of party one Kenyan referred to as "Severe".  The fun was had!  Believe me, I made sure of it, being that I was appointed by my physician team leader in Kenya as "Chair of Match Day Festivities".  Since we are in Kenya, we had to have a nyama choma (roast goat), Ugali, Kachumbari (Kenyan style pico de gallo) and so much more.  The party started a little slow with just about 12 Americans watching the live feed of the match day ceremony occurring at our medical school back in Indiana.  I mixed up a little tropical rum punch and within what seemed like minutes the place was crowded, similar to what happens when zombie's smell fresh blood.  It was about 1 hour later however, that the Kenyans arrived, taking their commitment to never being on time serious.  But they came prepared with great Kenyan music and speakers to blast it through the dining room.  By the time the nyama choma was off the grill, people were in the dining room dancing off beat in the dark and we were popping champagne bottles outside to celebrate this great milestone event. (Thanks Dr. G for the donated bottles).  Hmmm, If this is what delayed gratification feels like, I wouldn't have it any other way.

            I will never forget how difficult my first 2 weeks of medical school was, especially since I had a hard time giving up my habit of watching hours of TV on a daily basis.  I would watch TV for 5 hours then stay up till 3 am studying.  So I guess it was no surprise when the evening before our first ever quiz in medical school, it was in Cell & Molecular biology, I went home to take a nap and woke 12hours later 20 minutes before my quiz.  Needless to say I failed that quiz, but it gave me the much needed kick in the butt I needed.  When I got discouraged I remember my Dad would always tell me to "focus on the end result Dr. Gordon".  So I wrote it on a piece of paper taped it to my door and would read it on the way to school every day (well on the days I actually went to school since it was much better to watch lectures from my bed).  In the midst of it though I was never quite sure when the end would come, but it did.  Now it seems like four years just rushed by, and I don't know how I did it, let's just say it was a little of me and a lot of God.  So now that we are 49 days from graduation, let's celebrate, have some "rachet random fun" shake what your Momma gave, stay up late, dance like there is no tomorrow, and have a severe time doing it.

           It was clear that our Kenyan friends enjoyed the nyama choma and Tusker beer Match day party as much as we did, verified by the text message I woke up to the following morning from one of my Kenyan friends that read, "Thanks for the big party, I niced myself last night".  I leaned over from the top bunk in our room to share the text with my roommate Michelle and needless to say, we burst out into uncontrollable laughter sharing our ideas of the many things that text could have meant.  Kenyans are really creative at using the word nice, but I have to say this one takes the cake.  But if he's using it in the way I think, I "niced" myself last night too.  I think our Nyama Choma Match Day party was quite the success.  So cheers to all the graduating medical school seniors out there!!!  And Match or No Match, celebrate your M.D anyway, Lord knows we worked hard for it.  Remember the formula P = MD!

Till next time,
Kwaherini!
~Sash :)

Soon to come, my experience in the hospital, then we travel to Germany & Prague this week!

My love for Street Kids: One in a hundred success story!

             When I arrived in Kenya six weeks ago, I couldn’t wait to set foot on the grounds of Tumaini Drop in Center for Street Kids again.  Although the center represents a sad reality for a great need to care for children that are orphaned and living on the street; the center for me represents a place of happiness as Tumaini is where I spent a lot of my time during my first visit to Kenya in 2011 .  Many people look at street kids and only see there outward appearance, their dirty torn clothes, barefoot and some with one hand holding on to a bottle containing 10 shillings worth of glue.  As some of the street kids sniff glue in an effort to become euphoric and forget about the daily hunger and hardship that they face.  The almost two months I spent at Tumaini however, taught me so much more than that; that the street kids I met at Tumaini were unexpectedly inspiring, they were resilient, strong, courageous, clever and not to mention quite funny.  I will never forget one girl, called Elizabeth that use to come to the center, one day I said to her, “Elizabeth you really need to attend class so you can learn English”.  In Kiswahili she responded with something I could tell was a clever response.  After the Kenyan teachers at the center, took a breath from laughing, they translated to me that her response was “And Sashana, you need to learn Swahili so if the police arrest you, you can beg for your freedom”.   I couldn’t help but laugh too at her clever but honest response as this was a real issue that these kids faced every day.  The police claiming to be removing the kids from the streets for their own benefit but doing so in a forceful and brutal manner, at times even breaking limbs to get their message across to the street kids.  Each child had a different story but in so many ways the same, ending up on the street from losing their parents to HIV/AIDs, post-election violence or being in a home with too many mouths to feed, leaving to fend for themselves, and becoming responsible for their own well being way to early in life.  On the street there are no rules, no bed time, no "rites of passage" needed to earn privileges in life, it’s a “YOLO” do what you please type of mentality and semi-society constructed the kids that live on the street.  Streets paved with the freedom to eat what you want when you want, even if that means scraping it out of a fly swarmed garbage bin or begging from people on the street.  Boys become men at the age of 10 years old, trained by the older street boys who bully the younger boys into begging and stealing, kids essentially earning their way into a newly constructed family structure, the street gang.  My heart hurts especially for the girls, so vulnerable, so fragile, so easily broken, forced into prostitution or chosen as the easiest way to earn a living on the streets.

You rarely get success stories out of such devastating circumstances, but the goal of Tumaini Drop-in-center is to help street kids transition from street life into a structured society, helping them to go back to school to get an education or to learn a skill if they are pass secondary school level that can help them earn a honest living.  As I sat there with the office of the Director of the center, he showed me pictures and told stories of kids I knew from 3 years ago some were sad, but some were great stories of those that had successfully left the streets.  One such story was of Bill, a charismatic and determined young man I remembered from my time at Tumaini.  He never sniffed glue and rarely engaged in mischievious behavior on the streets.  So when I helped Tumaini start the Brombig/Sizmbig program in 2011, naturally Billie grasped tightly at the opportunity to earn points in this team building program to get the opportunity to be enrolled in school.  I remember Bill especially because he would argue for his points if he thought they weren't calculated properly and really worked hard to be one of the best kids at the center that would follow the rules, stay away from drugs and always be in attendance in the academic classes at Tumaini.  So imagine my excitement when one of the teachers at Tumaini asked me if I would go with her to see Billie at his boarding school.  It was hard maneuvering my schedule at the hospital to take a day off, especially since I have realized as a senior medical student you play a large role in the care of your patients, and if you fail to play an active role in this low resource over populated hospital, it could occasionally mean the difference between life and death.  With all my assigned patients in stable condition, I jumped at the opportunity to go see Bill at his school several hours away.

 As we traveled to Bondo in the morning, another community about 4 hours South of Eldoret, Kenya, my bladder suddenly became heavy.  I guess having Kenya  tea and passion fruit Fanta wasn’t the best thing to do for the morning drive; and going over the multiple-segmented speed bumps in quick succession didn’t help either.  I leaned forward from the backseat of the car to ask our driver Kibet to stop at the nearest toilet (bathroom or restroom are not common words used here).  Since the road miles ahead seemed to be filled with green grass, trees and mountains on both sides of the road, Kibet answered in a gentle voice, “Are you okay using the natural toilet?”  There was a pause, as my eventful mind only took seconds to imagine myself being snatched from the bushes and captured into an unwanted marriage by any Kenyan man who would see the sun reflecting off my well-formed Derrière.  None the less, I followed Carol, the teacher I was accompanying to Bondo, into the bushes.  Immediately I understood what Kibet meant by natural toilet; there was something almost too natural and freeing about using the natural toilet, I giggled as I hid there in the bushes, and began to reminisce on my childhood in Jamaica, memories of the other times I have used the natural toilet.  If you need a stress reliever, I recommend peeing outside, it just brings a certain happiness, that probably explains why drunk people pee in public.  Just don't mistake your neighbors lawn for the location to get this "freeing" experience as that may not go over well.

Seeing Bill 4 hours later was nothing short of worth the drive and the bladder abuse I experienced with my continuously full bladder and the crazy speed bumps.  It was quite interesting clearing security at the school and seeing the extensive barbwire fence that surrounded the all boys secondary school.  This explains why we stopped at the hardware store and loaded the trunk with barbwire in an effort to mend relationship with the school, who were punishing Bill for sneaking out of school over the Christmas Holiday.  Apparently the school thought it was a fair penalty for him to replace the barbwire he must of ruined when he and some other students left the premises without permission.  After Bill collected the barbwire from the trunk and delivered it to the principal we sat and talked for some time.  To my surprise he remembered me just as much as I remembered him.  He told me of his aspirations of wanting to become a neurosurgeon, which reminded me that Bill had won, as a monthly prize in the Brombig/Sizmbig program, the book “Gifted hands” by Ben Carson, when he earned the most points for that month at Tumaini Drop-in-center.  The same book that helped me believe that a little girl from Jamaica could one day become a doctor, seemed to have also inspired a little boy from Kenya that he too could do the same.  Just like Dr. Carson, the world-renown pediatric neurosurgeon, who hailed from a poor community in Michigan.

We drove a total of 8 hours by car, and paid KES$8,000 to spend 30 minutes with Bill on his lunch break, but it was more than worth it.  Sometimes in life we set out to do something small, sometimes pouring ourselves into it, with many hours, days, even weeks spent working at a one particular goal, and you just never know how it will change someone else's life.  Many times we can't see any benefit from the work we do, because we fail the count the one out of maybe a 100 people that will actually benefit from our work.  But we should marvel at the one out of a hundred success stories; I am pretty sure am one of those, since I too was inspired by Dr. Carson and so many others before me who demonstrated that neither poverty, hardship or hard work couldn't keep them from accomplishing their dreams.  “You can be a neurosurgeon Bill, and I will help you, do you know I become a doctor in 3 months?  Me a little girl from Jamaica, that’s how I know you can do it.”  He smiled and responded, “Yes I believe you, let me say congratulations now.”  I hope I never forget Bill, and that he will never forget me.  Now my promise to Bill is to help him with text books, uniforms and a little encouragement on the side.  If you are interested in learning more about the Tumaini center for street kids please visit their website at www.tumainicenter.org

Bill carrying the Barbwire to Principal's office

PHOTOS FROM TUMAINI DROP-IN-CENTER FOR STREET KIDS

" There is no easy walk to freedom anywhere, and many of us will have to pass through the valley of the shadow of death again and again before we reach the mountaintop of our desires" Nelson Mandela 

~Enjoy Sash’s Stash of In My Own Words~

Peace & Love,

Sash