So now I know I can't force myself to blog, I just have to feel like it. Stopped journaling about my interviews after Interview #3, haha. I'm already done with Interview #10, and now I'm done. Now it's time to make a rank list.

Just like my decision between Family Medicine and Psychiatry, I change my mind about what I prioritize and thus which residency programs I want on a daily basis and sometimes even more frequently.

I keep on having epiphanies or keep on learning additional information that shuffles my rank list around in my head. I'm glad for these epiphanies though, they help form my rank list.

But I'm too much in my head. If I let my cerebrum make my decision, that doesn't settle well with me. I need to go with my heart. And my heart is telling me that my top choice is: Long Beach Memorial.

I was with David cooking in the kitchen last night when I decided to just stick with it. No more thinking too much. Just commit and we'll be happy no matter what. And I am so happy.

I put so much pressure on myself forming this rank list. By prioritizing programs, I'm also by extension prioritizing the people in my life, the patient populations of those programs, my values. My overthinking did not let the question be as simple as "Which program feels most right?"

But no more guilt. I am happy.

1. Long Beach Memorial
2. Kaiser Napa-Solano
3. UCSD
4. UCLA
5. UCSF
6. Contra Costa
7. Kaiser WH
8. UCD
9. Kaiser SD

Ok. Here we go.

My interview at UC Davis felt very comfortable and familiar. I knew almost everyone I came into contact with. The one person I didn't know was Dr. Nuovo, who interviewed me, and is a former medical school dean ironically.

My first interview was with a resident I had worked with very briefly. But he said he remembered me, and that even though we only interacted for a short amount of time, he could tell I was a hard worker. That just set up for a relaxed interview. The whole day was really relaxed actually.

The only extra information I got from the interview day (that I didn't already know) was that there is an underserved community rotation. That's better than nothing, but there is a definite disconnect between UC Davis and the Sacramento community.

Ugh, I'm blogging about this late (8 days later), and I don't know what to say anymore. Basically, I am almost positive they will rank me highly. But I've realized about myself that program directors I consider inspirational are those with a passion to serve. And I want to be at a program that inspires me. I really do. And UC Davis does not exude this passion.

Regret.

It's something I don't feel very often. I believe in the Butterfly Effect that any small, tiny change would have taken my life in a different direction. And I'm fortunate to love my life. So I don't regret very much because I don't wish for anything in my life to be different (though I do wish for other people's lives to be different).

Two weeks ago, I did feel a strong sense of regret. I found out that Ron Wilson died. He was a former Vice Chancellor at UC Irvine, and he got me into UC Davis medical school. I hadn't seen or spoken to him in nearly three years. The last time was Thanksgiving of my first year of medical school. And now I'm a fourth-year. Not only had I not seen or spoken to him in so long, I had seriously contemplated visiting him this past summer when I was in southern California. But I didn't follow through. I can't for the life of me remember any specific reason why I didn't follow through. Just a general mis-prioritization. I knew he was old and ill. I missed my chance.

I immediately started sobbing when I read that he died. I believe the source of the sobbing was regret more than grief. This man was a huge reason why my life is so great, and I never told him how wonderful medical school has been. I never told him that I chose Family Medicine. He would have been so proud.

I called his wife to give her my condolences, and she ended up comforting me. I told her about how I wish I kept in touch better, and she told me that he wasn't doing well in the past year. Then she told me that even though he died >1 month ago, the memorial service was the following week! I knew I had to go.

It is quite coincidental that I found out about Ron's death. My sister's friend Lisa told me. She works in the UCI Chancellor office and I had told her about Ron Wilson nearly 2 years ago. She actually had heard about him from other people in the office and Ron's daughter worked there too. I was so lucky to find out from her.

Though a trip to OC was unexpected, David and I managed quite nicely to attend 2 memorial services in OC in the same week. And it was actually a very wonderful trip where we spent quality time with a good amount of people without feeling too spread thin. Including David's childhood friends I've never met before.

Ron's memorial service was attended by ~300 people. They even ran out of programs, and Ron's wife Carol graciously gave me hers. They displayed his beautiful photography of landscapes and portraits. Ron had said he would give me one of his prints, and again I didn't follow through. The quotes from the speakers I purposely remembered were:

"Ron didn't just touch people's lives, he altered their lives in a positive direction." Spoken by a former mentee of his who is now a fellowship-trained doctor. I had to introduce myself to him. Ron had a 100% track record of getting students into medical school, and I'm pretty sure I was the last one. Ron retired from UCI before 2002, so I'm from a totally different generation of students. I had to meet the doctor who spoke. We are both products of Ron Wilson's mentoring. I told him I was a fourth-year medical student and that Ron helped me get into medical school. And he said, "if Ron believed in you, you must be special." He also said that we are supposed to be celebrating his life, but it's hard to celebrate when the guest of honor isn't here.

"He believed in me when I didn't believe in myself." Spoken by his successor, who was hand-picked by Ron to succeed him. This reminded me of when I was driving up for my interview at UC Davis. We were on I-5 and had passed 152, the farthest north on the 5 I had ever been. That's when the nerves of my first medical school interview hit me. I started having palpitations. And then I thought about Ron. I remember he told me to believe in myself. Words that are said all the time, but rang true coming from him. I was able to share this with Ron after my interview. He even bragged about it to his wife Carol. I cherish that.

"Carol was his rock." David hugged me tighter when these words were spoken and whispered in my ear, "thank you for being my rock." I love my man.

I learned that Ron had a heart transplant in 2002. He was days from dying, and they could not find a heart big enough for him. How poetic.

Jodaiko gave a wonderful performance at the beginning of the service. Jodaiko is the taiko Japanese drum group at UCI. I didn't know Ron that well, but I even knew that he always wanted Jodaiko to perform at his funeral. It was a little surreal to watch the performance. Ron had wanted this for many, many years, and there they were.

I no longer feel regret about having not kept in touch better. Attending that memorial service showed me that Ron impacted many, many people's lives. He knew what a great life he lived. He knew how he helped so many people. There is no need for me to dwell on my relationship with him specifically.

He wrote a letter to all of us, and it was in the program. It was a very interesting letter about how he's hanging out with all these cool people in heaven now. And that he wants to hear from us. I find myself back to a naive, younger version of myself wishing that heaven does exist. Wishing that there is more to this life, and that he was able to enjoy the Jodaiko performance too. Wishing that he knows how grateful I am for the impact he's had on me and my life.

If you're listening, Ron. I want you to know that I'm going into Family Medicine to help transform the health of our country. That I will be a kind doctor that makes my patients feel valued. That I will always remember what you did for me.

David’s cousin’s grandmother passed away last week. Her name was Betty also. I met her a handful of times since I started dating David nearly 5 years ago. I even brought egg rolls to her birthday potluck (which were a hit). She always remembered David even though she was very old and nearly blind.

I didn’t know her well, but well enough to know that she was very sweet and kind. I knew she was very Christian. I knew she opened her home to many people to the point of adopting some of them. I knew she was cared for by one of her daughters, who the rest of the family did not think was doing an adequate job.

Her memorial service confirmed all of this. The recurring theme was that she lived for Jesus and lived by His word. I like Jesus’ message of love and generosity and humility. And I do believe Grandma Betty personified Jesus’ message. But that is the extent to which I agree with Christianity. Another recurring theme at the memorial service was to take Jesus’ message a step further, into worship. I guess that the Bible is His message, but the talk about worship and not idolizing false gods does not make sense to me. There were times that the service stopped being about Grandma Betty and started being about the Bible. In my heart, I know that a book does not determine a person's worth. Grandma Betty's belief in Christ allowed her to feel supported while being a good person. But she was a good person independent of Christianity. 

My favorite part of the service was when her son Noonie read a note that Grandma Betty wrote years ago. She described what hardship she had raising 5 young children as a single mother. How she had to walk 8 miles with the children in a wagon to get to work on the farms. Then walk 8 miles back for a nominal amount of money. Food and money were scarce. While the story sounded like acknowledgement of what she's had to overcome, she sadly ended with thoughts of worthlessness. The thoughts were to the effect of, "so what?"

It was written on a single piece of paper, it wasn't even a journal. She must have been in a dark place when she wrote it, even depressed. We will never know why she wrote it down and how she got out of the dark place. But it was very special. I feel privileged to have listened to her words. 

I also loved when several family members played recordings of her singing. They were recorded in her last days. It was very sweet. 

This side of the family is very troubled and complicated. But the one value they all have right is their value of Grandma Betty. She kept this family good even when they made dark choices. As messed up as their lives have gotten, they were always able to look at Grandma Betty to be the good. I don't wonder about how they will get on without her, I honestly imagine that they will get on in a way that I don't want to know about. 

At several points in the past ~14 months, Kaiser Vallejo was my “#1 choice.” I think its biggest selling point is that it’s the first family medicine residency for Kaiser Northern California. This is a selling point for me because I want to be a Kaiser doc, and because I love Nor Cal. Even as recent as the National Conference in Kansas City 2.5 months ago, I wanted to match there so bad.

That feeling has waxed and waned. As I learn in more detail about which programs are highly respected, I see myself more in one of these excellent training programs…and I see myself less in a brand new residency.

I don’t mind the frustrations and growing pains that are anticipated with anything that’s brand new. But I do worry about the quality of the training. It’ll be a huge leap of faith.

The reason I was so excited about this program in Kansas City is because I learned that they have a relationship with Vallejo Unified School District, and that each resident will be assigned to a school to assess its needs and execute an intervention. This idea still excites me very much. I still have a deep passion for education, I still believe that education can solve our world’s problems. I would love to influence the health of a community by targeting its youth.

The work schedule will be relatively light, and that used to be very appealing to me. But again, as I learn about these highly respected programs that are inpatient heavy, a demanding schedule doesn’t seem so bad. I do value free time and sleep and wellness…but a part of me wants to challenge myself. Really pay my dues. Just jump in the pool. I believe I will grow more in a more challenging residency. And I love growth.

I didn’t feel the same enthusiasm that I felt at UCSF. While it’s a great hospital and the program has some great aspects, it’s lacking that excellence UCSF exuded. Obviously, a new program cannot provide examples of excellence. But the attendings were new, and they were lacking the ability to inspire that only experience can provide. 

I still want to be a Kaiser doc, and a Kaiser residency would be the easiest road to take. But I can still be a Kaiser doc even if I did a non-Kaiser residency. 

Today was my first residency interview at UCSF. I was eager to start the interview trail, and today confirmed it. Getting to know programs is fun! The traveling might suck after I go to So Cal for the third time, but I get to visit family and friends when I do so that's not too bad at all.

So today was a very exciting day. I was a bit nervous, but not palpably so. It felt quite liberating to not doubt myself too much. I was asked how I changed throughout medical school, and I responded that I've gained a significant amount of confidence. And today exemplified that. In the bathroom before my first interview (there were 2), I said to myself "you got this, Jenny, you like the person you are, just be yourself." Hahahaha! True words. Hysterical, but true.

I was originally going to separate this blog entry (and every entry I do for each interview) into pros and cons. But I think I'm just going to write from my gut. Just like Dr. Fong would promote (my professor in the Family Medicine department).

My gut says...

San Francisco General Hospital serves the poorest of the poor. They are a true safety net hospital and they serve despite a patient's ability to pay and they mean it. The people there feel the need to serve in their veins. One frightening thing I must admit to myself is that I don't know if I have that same passion that today's residents and faculty exhibited. What's even more frightening thing is that the undergrad me did. Even the first year medical student me did. What happened? The old me said $100K/year is enough to live comfortably on, so go on and serve the poor for that much income, serve the people who need you most, be the giver since you'll have more than enough to give. Then somewhere along the way...I became more greedy, more materialistic. I want Kaiser's $100K sign-on bonus, their $200K starting salary, their pension. At what cost?

Well that's a question I don't want to spend time answering in this entry that is supposed to be about UCSF. But it does take me back to the discomfort I feel about fitting into with those amazing people at UCSF. Discomfort is good, especially for me. Someone who struggles with self-doubt several times a day. Thankfully, my self-doubt continues to improve as I gain life experience, and I know that would be the case at UCSF. I know I would grow there. I do not imagine myself even slightly miserable there because I know that serving that patient population would fill me up everyday, I'd make sure of it. 

UCSF is unique in many ways. Its patient population and the system they work in are two of the ways. They also have a clinical psychologist on faculty who sounds amazing and I would love to learn therapy from. Being able to treat my patients through conversation is something I'll always strive for. 

As a married woman who wants kids soon, as someone who hates difficult parking, and dislikes driving with so many cars and pedestrians...San Francisco might not be the place for me, but the surrounding areas might be?

David and I had a hot date last week. We went to Berkeley to see Fun. and Tegan & Sara in concert at the Greek Theater. It was a BLAST! I had never heard David sing that much, EVER! It was very shocking and very romantic. We haven't had that much fun. together in a long time. And we had never had fun. like that. What made this concert experience unique is that we both knew the songs and thus we both could sing along. We have not been to a concert like that together before, but the problem is we don't listen to the same musicians either. The only other musician whom we both know well is Dashboard Confessional, and who knows if he's touring anymore.

It'll be hard to replicate that night. I felt very in love with him...in a way that's different from my day-to-day love for him. I felt very much aware that he was my husband and I had found my partner for life.

I was reminded of a time when I was ~12-13 years old watching the fireworks at Disney Land and wishing I was being held by a significant other. David held me throughout the concert and I found myself very grateful that I will not have to experience that loneliness again. There is nothing more romantic than dancing with the one you love to a romantic song.

I always say that the MCAT was the most important test of my life. You have no certainty as a pre-med hoping to get into medical school. Your hopes and wishes to be a doctor are just that - hopes and wishes. The decision to accept you into medical school is beyond your control and the numbers are not in your favor.

So as I embark on my next application process for residency, the stakes are much lower. I am in a position where getting my second or third residency option is understandably disappointing. As opposed to my pre-med days when I said I'd go anywhere that accepts me.

I am very excited to start the interview trail. I applied to 20 programs and have no idea where I'll end up. It'll be in California, at least, but where in California will make a huge difference.

Do I want to stay in Sacramento, 1 hour away from my in-laws? Do I want to move to Bay Area, where it's more expensive to live but there's great food? Am I ready to move back to the congestion of LA/OC where my family is? San Diego sounds like fun. Inland Empire is lower on the list. And I did not apply to any central coast or central valley programs.

This feels much better than applying to medical school for the reasons I listed. All I have to be concerned about is choosing a location that will best allow me to have children while simultaneously training me to the best doctor.

Another sleepless night in Las Vegas. Ugh. Without my husband and without herbal assistance, falling asleep is very hard for me in my adolescent-hood home. I was able to do it last night in about one hour, but tonight was painfully unsuccessful. There are several reasons for my failure to sleep tonight. I think the strongest reason is that I couldn't stop thinking.

I am probably going to see a former friend tomorrow who I have not seen in 5 years exactly. I've been invited to a surprise graduation party for our mutual friend Ambika and I can only assume this former friend of mine is invited too. She was a fear-inducing friend and I have let myself succumb to this attribute I remember most strongly of her. I fear seeing her tomorrow (well, today). I do not think she will attack me, and I hope she doesn't give nasty stares. But I fear the awkwardness, which is a silly thing to stay up all night for. I'd be fine without talking to her, but can I really get away with that? If not, who starts the conversation? What would the conversation be about?

I think the anticipation has been built up because though we haven't been friends in 5 years, I have an occasional recurring dream of us meeting up again and calling it out directly, "hey, so we're not friends anymore." I hate these dreams because I think they imply that I want her back in my life and that is not true at all. I don't know why I have these dreams, maybe it's because we were so close before and it never feels good to lose a friend. But with her, it felt okay at least.

I also couldn't stop thinking about how uncomfortable my fucking legs are. I have this new skin rash I've never had before and I'm almost positive it's not infectious in nature. I don't know my skin diseases well, but I worry that it's autoimmune. Autoimmune diseases scare the shit out of me - my own body attacking itself? Fuck. It's caused me quite a bit of distress and I think it continues to worsen. I've recognized many times throughout my 3 years of medical school how fucking lucky I am that I'm healthy. Even shit like ear infections don't happen to me. I have acne and some mild knee pain with running - I'll take it. But with this new skin rash, my image of my health has been shaken and I don't like it. It also doesn't help that part of me is hesitant to schedule a doctor's appointment in fear of upsetting my senior resident or attending on my next Radiology rotation. But I gotta do it, so I'll make an appointment ASAP. I need an answer, I don't know what the fuck this skin rash could be.

What's really ironic and annoying is that I was sleepy when I went to bed. My eyelids were heavy and I felt the sensation of sleepiness. But as soon as I got off the phone with David, it went away. I just hope I don't have bags under my eyes if/when I see this former friend.

Earlier this week, I witnessed dying. There's this phenomenon called "air hunger." Even if a patient is obtunded, you can still see them gasping for air. Their lips curl inward and their tongue sticks out a little while you can see the muscles in their neck working to help them breathe.

The family knew her time was coming based off the glistening of tears in their eyes. But this was the type of family that held onto hope until the very end. They requested that she receive suctioning of her mucous to help her breathe more comfortably. When suctioning didn't improve her breathing, then they actually finally accepted it. The glistening in their eyes became full on sobbing and wailing. They held her head up in grieving and wiped her forehead with a damp towel.

My tear ducts have a physical reflex when I see others crying. I was able to control the tears from running down my face for a few minutes, but the family's full on sobbing eventually got to me and I had to step out of the room. Then when the whole team regrouped afterwards, I had to let my tears flow freely for a little bit. The team was supportive asking me if I was okay. I was okay, I just can't help but cry sometimes.

The family was Mien. And I felt that extra connection to them being Asian. I thought about my very stoic uncle who practically never shed a tear for his wife who committed suicide. He wasn't heartless, he was the eldest male in m Asian family, he just doesn't cry.

And I thought about David's grandma Betty who had to be on a BiPAP machine to help her breathe while she was dying. I didn't notice the air hunger at that time, she had been dying for months, so I didn't notice that she was actively dying the last time I saw her. For my patient, our team said that a BiPAP machine would be unethical/harmful/uncomfortable. It was probably true for Grandma Betty.

I'm going to be dealing with death a lot in my career. And for professionalism sake, I should try to keep my tears under control. But I'm trying to imagine what my reaction would be if I were the patient's family and I saw the doctor shedding a little tear. I don't think it would be so bad. I think shedding a tear is okay. But only a few tears, doctors have to maintain their composure. Have to.