Saturday, August 27, 2011

Achieving at What Price

I wrote this while watching a movie called, "The Doctor" filmed in 1991 for ethics class. I finally had time to stop and think... and here is what I thought...

With all this achieving in medical school, which is amazing... I have one sadness... I forget to see the stars; the moon. I spend all my time inside studying things that are completely enrapturing. Yet I don't see the flowers blooming by the road, the rabbits on the lawn and the trees turning their flaming yellow. I don't see the mountain range I love looming in the morning sky when I drive to school because my mind is focused on von Willebrand and the coagulation cascade.

And that's what's hard to lose. Somehow I'll have to find it and not let 4 wonderful years of my life go by. They say it's a snap and it's gone, they mean that in a positive way. Funny, that's what I fear. Life is too  short anyway.

An interesting dichotomy, I'm in medical school because life is short, too short to not do, be and experience everything I want to and I'm sad because this experience could make it feel shorter.

So on top of all the things I'm learning and the many things I'm adjusting just to survive, I'll have to figure out how to step out of the doorways of my artificial world, breathe in a quiet breath and see again.

Life is not simple.

But that's what makes it worth living.


Saturday, August 6, 2011

Fun Fact: Hedgehogs cause Cyclops

We have a subfamily of pathways that is active during the fetal period called Sonic Hedgehog. If there are mutations in it, it can cause babies to be born as cyclopses. This is common in mt goats & sheep in the west because there is a plant Veratrum californicum/Corn Lily/Cow Cabbage that if eaten around the 14th day gestation and it causes the mutation in the Sonic Hedgehog pathway & the babies can be born as cyclops. And yes, it's named after the game, Sonic the Hedgehog.

Friday, August 5, 2011

Fun Fact: Sun Made Dimers

I'm learning all sorts of fun things so I thought I would start putting up fun facts. Here's the fun fact for today:

For every second of sun exposure 50-100 dimers are created in your exposed skin cells. These are caused by two base pairs or nucleotides (nobs that code for your proteins) on your DNA covalently bonding (sharing electrons) and causes a problem in DNA a big chunk has to be cut out by enzymes, unzipped from the double helix, removed, and then put back together and the DNA backbone taped up with the tape enzyme ligase.

So when those errors become more than can be fixed you can have skin cancer.

Saturday, May 7, 2011

Stories Told: Lessons From a Storm Part 2

Stories were told. I suspect every disaster has its own folklore that races through the battered towns. Little children rescued from coolers citing women with wings as their saviors, adults flung hundreds of feet only to stand and help their neighbor, five people found in a basement in this town, three people rescued from a basement in another. Each day, without the help of a TV or radio we heard more stories of hope. Each day they brought a smile to our faces.

Humanity needs hope. Most of the time these stories whether partially true, true or truly figments of someone's imagination stoke the embers of hope. They are like a sugar pill, they make tomorrow more bearable and if they are true, all the better.

One story was different. Every disaster or human tragedy has this story. The characters and places are different the message is the same. It is a story of brightly colored, candy coated poison.

A man of faith had been away from his home and when he returned the valley around his home, a place of drug dealers, was decimated. Houses were piles of rubble. His home, his pets, his cars were untouched. My friend's face was enraptured. The tornado had spun out at the bottom of his hill and couldn't make it up.

I smiled and nodded. My stomach cramped and my heart bled, grated raw by the lack of compassion in the story for the families in the valley. Families who most certainly suffered and will continue to suffer for their loss of life and homes.

In a few of my photos there were shots, specific ones that were a rebuttal to this innocent story that poured toxic into my heart from that day forward. Photos of the box labelled "Missions" that was flung from the place on the granite counter top where items were put in to donate, the counter top pulverized. Photos of an inner wall that has, "Every good and perfect gift comes from above." The rest of the house crushed like an egg. Ironic.

I wanted to grab my friend and beg for him to see, there are no favorites. There isn't always reason, not always an answer to impose upon this chaos. Everyone suffers together. We crave black and white yet are gifted with a insipid gray haze. In that dreaded pallid haze, is a place of grace.  It is here that I found humanity grabbed hands, rough hewn and straight laced, broken and whole, deserving and undeserving and struggled to rise above the obliteration of their existence.

But in my abraded heart I still hemorrhage anguish for the callousness of the 'favored' who will never understand the gift of the haze.

Thursday, May 5, 2011

We have Our Lives: Lessons From a Storm Part 1

This morning I woke up with black circles around my eyes, a smoker's voice and the energy quota of a snail. Most people felt they understood what was up. But one friend  cheerfully asked, "What's your problem?" I laughed a little and slowly walked away. How do I explain? Maybe I never can. Maybe you just have to be there. Maybe I'll try, as I explore what a few days in the aftermath of a storm taught me.

The reality is that most people thought that searching for bodies would suck me dry, leave me depressed or stressed. This was a nearly forgone conclusion with many. It didn't. While I'd obviously rather rescue a living human I feel honored to bring closure to a family who would otherwise wonder what became of their relative or perhaps stumble upon their husband, wife, or child's mangled or dismembered body. I have the protection of not knowing the person whose shell became a part of the twisted debris tossed aside by an insatiable storm, they do not.

Why do I spend the evenings alone by the lake to silently reflect?

I climbed over acres, if not miles of rubble, most of it was unrecognizable splinters. I'd see a doll, a pair of jeans, video tape, a photograph of children, a motorcycle chain and a jewelry box all a dull, gritty, angry brown. As I walked I realized each of the items represented someone's life, their money and their hopes. I came across a father, a mother, a grandmother as I walked, each one staring blank at the shards that had been their home. Each one forcefully met my eyes with theirs and with a feverish passion of thankfulness named the people in their family that were alive, their neighbors and friends. While they stumbled in light tennis shoes over boards bristling with nails, cement blocks on edge and the dusty splintered trees, they all had the same conclusion, "We have our lives."

We have our lives. The contents of their homes ripped open, gutted like the prey of an angry dog.

We have our lives. Their cars rolled and tossed by the careless hand of an enraged child.

We have our lives. Photographs of their children, healthy, happy and proud buried in the mud, slowly decomposing.

We have our lives. Vulnerable, stripped and bare.

We have our lives. Their hearts full of thankfulness.

We have our lives. Their hands full of supplies for their neighbors; the one who was deaf, the one who lost a loved one or the ones who sat in mute coma at the place where their front door should have been.

We have our lives.

And so tonight I stood beside the lake, throwing a pebble in and watching the ripples move away. The trees around me reached toward heaven in a majestic verdant hymn of grace. On my heart a heavy responsibility laid bare, throbbing, bleeding fire throughout my soul...

I have my life...

The Strength of What Remains

I was privileged to spend four amazing, heart breaking days with Union College - Lincoln, Nebraska International Rescue & Relief team in towns around Burlingham, AL, where an F5 tornado hit just a day before. What a privilege to see these towns at their most vulnerable moments; watching them rise as strong communities working together to survive.

Daily, we grossly underestimate the good of those around us.





More blogs to come... my brain is still sorting through the experience. 

Most of these photos are available on my Facebook page with explanations under them.

Thursday, April 21, 2011

Shutter Island

It is never boring interviewing. There is always some bit of craziness to amuse the astute observer and often craziness that doesn't require any sort of astute'ness on the part of the observer.

The school is on an island in the middle of the old Navy base. Windows are broken out of large warehouses, that allow shafts of sun to penetrate the dust stirred up by the ghosts of sailors or more likely gang members planning wars. Shutter Island is the name given to it by the shuttle driver who takes us from the hotel.

The foyer of an old inn is the headquarters the school and is under construction so the place appears closed with various hand written yellow signs pointing out that these doors are not to be used. The shuttle driver gallantly finds the correct door for his cargo of women and we all enter a storage room with tables and chairs lining the walls. Welcome.

We are settled into the conference room, fluorescent lights flicker menacingly, we've entered the asylum. The Dean of Admissions skips into the conference room in his enthusiasm and proclaims with large smile slashed into a weathered face that they interview "right" as opposed to other schools. Fifteen minutes later we are still listening to how the other schools do it wrong and they do it right. And then the hot shock of pain that comes from a rampaging UTI hits me. I just finished my antibiotics yesterday and its back already. I rock slightly and nearly cry, I forget to keep listening how they do it right while others do it wrong.

When he quiets, with a composed rush I enter into the room with the secretaries and ask if anyone has Tylenol, explaining to a room of women that I've just come down with a UTI. With pity they all reach into purses and desk drawers. The one nearest me pulls out Tylenol 800, anti-inflammatory and some sort of muscle relaxant, her prescription. "I choose you." I chug the pill with a handful of water from the sink, begging the Tylenol gods to give me quick relief.

The Dean of the SOM comes in to tell us about the school and answer questions. He has trouble getting to the point and so I sit in agony while he spends 15 minutes telling us that they are proud that they are focused on getting their students good at the patient history and exam. Hands fold contentedly on a flabby belly, "I am proud that we are focused on the medical history and exam." I start my second water bottle. "I am proud that we are focused on the medical history and exam." I stop listening.

My biggest question is always about the curriculum, is it PBL or lecture based? Is it systems based or structured like undergraduate classes? He says, "it's hard to quantify but we are changing it every year... I am proud that we are focused on the medical history and exam."

Do they use student input in these curriculum changes? "We value student input..." the students and professors are close... they are focused on getting their students good at the patient history/exam. After ten more minutes of hearing about patient history and exam, he pauses for a breath and I try to condense 10 minutes into a sentence, "The student's input is informal based on close relationships with the professors?" No, he says emphatically, it is formal too... "Excellent," I wait to hear what formal procedures they have in place, he doesn't say another thing about it but talks about the patient history and exams. I feel sincerely amazed.

We wander around campus for the tour with a first year student who at 6'7" ducks instinctively at every doorway, even while walking backward and talking. "And here is the exam room...*bob* the lab *bob* the cadavers *bob*. No I wasn't a basketball player *bob*." The hazards of being tall.

The campus is old but has character. I like it. I like old buildings that peel paint into ratty hairdos and sneeze the dust of history.

It's a group interview, three interviewers, five students. It's my first of this most dreaded form of interview. They ask me difficult questions like, "What, besides what you have in your application, brought you here today." I smile calmly, while rushing about in my head like a rat being chased around a bucket with a stick, looking for something interesting to say. I coolly mention, "My application is incredibly thorough." This makes my cohorts laugh for some reason, it wasn't a joke or sarcasm it was just the truth. Then I ask for some time attempt to pull an adult rabbit out of my tiny suit pocket. I find, to my astonishment, I don't have a rabbit in my pocket to produce with trumpets and dancing girls so I recap what my application has already said. They are testing my ability to handle stress. I'm starved, limp from a muscle relaxant and my abdomen still feels on fire; it wasn't slick.

We get lunch and it gets interesting. It starts over a sandwich, tuna or turkey. The slightly pudgy male student insists on my choosing first. I try to let him know it doesn't matter and he states, "I'm afraid you will beat me up if you want the one I choose; you could, you know." I look confused at him and the table spontaneously erupts into everyone talking at once.

"We don't have a chance."
"She's been everywhere in the world."
"She could beat me up."
"I was waiting for her watch alarm to sound, for her to nod at us, pull on a jet pack and crash out a window on some important mission."
"What hasn't she done?"
"If she didn't get into other schools its because she intimidates the interviewers, they felt ignorant and inexperienced!"
and the ultimate,
"she is really intimidating," and "she's incredibly intense." 

I look at the whole table my mouth hanging stupidly open not quite sure how to take what I'm hearing, do they feel they are complimenting me or insulting me. I haven't said anything to the people about my life but somehow the little I've said in the interview, and I REALLY toned it down to keep from being intimidating, and what the interviewers have said has spread like the E bola virus around the room.

I finally shut my mouth and took it with a smile but I realize what the trouble might have been in my other interviews. I don't mean to be intimidating and intense but obviously I can be without trying. I focus on the person talking, razor sharp, perhaps much like a cat looking at its next meal.

I'm confident in my abilities, my support group and my work ethic otherwise I wouldn't have bet my future on a 3% chance. I laugh and joke with the kids around me trying to get everyone to relax and enjoy themselves but taken with the other I now suspect I've come across as cocky. Cocky?!?!

And so I wonder if I had appeared less confident, worn a more feminine shirt, if I had trotted out my frightened side, if I appeared helpless maybe I would have more acceptances and less wait lists. Would it be different if I were male where it seems cocky confidence is encouraged? I don't know, I'll never know, but I wonder. Then again, I am always genuine in the interview and if they don't like it I shouldn't be there... so... Admittedly I've done well, considerably better than average, considerably better than I dared to even hope, ever. To my detriment I want perfection, my own perfection.

Thursday, March 31, 2011

In Closing

While I sat in the Urgent Care room, its chilly pleather aqua blue and mauve chair squeaking beneath my restless twisting and turning, they told me it was the last time. I was given the script for antibiotics that would drain my credit card and destroy my guts. It's been two weeks I've been sick, maybe three, it's hard to remember now.

We'll culture your sample, we're shocked its never been cultured before, with your history.

I don't go to doctors.

Your sample was incredibly dilute.

I drank 96 oz of water since 7am to keep the pain down.

Infections can be resistant to all but the most exotic antibiotic.

Great

They listened to heart and lungs. Peered into ears, eyes, nose and tonsils. Tapped an aching back. The doc was excellent, thorough.

It's the last time. Another, in a month or less, you'll need to go to a Urologist.

I don't go to doctors.

You've likely already damaged your bladder and possibly kidneys.

My face in my hands I stare at blue smears on a composite tile floor, all a fluorescent white, burning my eyes...

...I'm cold.

(another sketch for a short story)

Friday, February 4, 2011

Experiencing YMSB

I'm deaf, although a few minutes ago I wish I were more deaf. The cilia in my ears is flattened and an eternal hum, buzz and ring reverberates in stereo around my frontal cortex. Something like a good pair of headphones stuck on the emergency broadcast system and you can't tune it out, off or to a lower volume.

Never mind my ears. The other day while running down the beach and through the sandy Florida streets early in the morning I saw a sign hung on moldering bleached pinkish, brown bricks that said, "Yonder Mountain String Band (YMSB) - Thursday 8pm".  I went early and was the first one in line. Sad I know, but I've been to YMSB shows in Durango and the line snakes out further than I wanted to stand on a wet, gelid Florida night. A woman and her father came stand with me and chat. She's a lawyer who does medical malpractice lawsuits, he's retired and checking out chics, professionally, it appeared. She and I got into a vigorous and illuminating discussion. We took up standing positions along the upstairs rail, front and center and waited watching the crowd below go on a collective and expensive bender.

YMSB - Dave Johnston, Ben Kaufmann, Jeff Austin & Adam Aijala
When it all started there were a few "hoppers" up front that felt the word dancing meant constantly flinging themselves vertically away from the earth's gravitational pull only to find themselves being rudely yanked back by it's unceasing grip.

There were three men to my right that I called the judges. All were well over the age of veiled peeking and had degenerated into twelve year old males, engaging in the, "punch, nudge, wink, har har," view of females. They pointed and assessed expertly, mouths obtusely agape at the bouncing, lissome females in the crush below.

People behind me waved their arms in the air in erratic patterns, hopped and bowed to the rhythm of the base, mandolin, banjo and guitar. The iniquitous rhythm drove even the most upright person to nod their head like a seizing bird.

I wondered if I took a video with all the sound gone if all of you would think I visited an asylum for fun. Everyone looked like they'd come undone. 

It was a good show for a small venue.
Like molecules moving from different states people's movements changed throughout the night. At first with maximum space the people flowed, jostled and hurled themselves as if molecules in the gaseous state (something is just not right with that sentence). Collisions were infrequent and fully elastic.

As the night became darker, the music louder and the crowd denser their movements were more like that of a liquid. Some formed bonds and bounced around but most could still fling themselves in abandon before hitting the next person.

Finally we hit solid. It was flesh from wall to wall. At this point each molecule's degree of freedom was limited to simply quivering from side to side. Most of the real motion was up and down. Bonds were formed and broken regularly throughout the crowd. People, well sozzled, were kept up right and jumping by their neighbors. It was at this point I decided I'd had enough of the balcony and was going to join the solid on the floor.

It looked like the concerts in Colorado but missing were the distinct little pillars of smoke that shown the way to a pot pipe and a pinch of the good stuff.  But although they were visibly absent the affects were still there. People upstairs were unmistakably chemically loony, whirling in large circles with arms flying out beside them like streamers and eyes inscrutably looking at the tongue and groove ceiling. Girls sat in darkened corners fixated by the bits of dirty torn carpet near their feet.

Down on the ground floor I squeezed my way through bulky fat middles and skinny eyeball jabbing elbows until I was in the middle of the solid. At this point they began to sing one of the songs that always makes me laugh, "Granny Won't You Smoke Some". What a hilarious song.  Up and down the crowd surged. What had taken me so long to join the solid? It was fun dodging elbows and being pummeled by rings of fat as they orbited the twirling bodies to which they were loosely attached. And hearing my shoes schluck off a floor covered in drying beer and mud. It was fun, I know this appears  sarcastic but I enjoyed the experience.

Social lubricant had greased the wheels and one fine young man up front pulled up his shirt showing his scrawny chest to the boys on the stage. Save two members, the band looked bored. They've seen it all and mentally they were off in Tahiti on a beach just like you and I when we're at work from 9am-5pm. Likely they were likely aided by a chemical agent that we'd be fired for having. The two front and center fed on the energy of the crowd and it was hitting feverish.

I was considering coming home early, you know midnight or one, like the pathetic old person I am but decided to stay a little more. I was not disappointed. They pulled out all the volume the speakers had and jammed out "Crazy Train," another favorite of mine and from the reverberating howl everyone else's too. The crowd bounded up and down and up and down hands flying and waving people yelling and singing.
Strobes

Strobes broke us into vignettes of the moment. I was there hopping, singing and crossing my fingers that all the jumping would help build muscle to avoid injury when I ran. The boy behind me with his hoody askew was leaping with two arms in the air while bowing and thrashing around. He fell on me several times not being as much part of the solid as he should have been with that much induced instability. Sweetly, he screamed a sincere mushy drunken apology in my ear each time.

Suddenly a great gap in the crowd appeared in front of me. Three people were on the floor.  A trampling at a YMSB concert? Unthinkable. Then I saw they were kneeling, heads down in the gummed, muddy beer floor. I thought perhaps they had decided they wanted beer so badly and were so high they were licking it off the floor but not wanting to make too many assumptions I decided to ask. They were looking for the glasses. Being the only one that saw one of everything rather than with wobbly, double vision I found the glasses quite quickly. YEY! Everyone around gave me a hugs. Hands soaked in mud and beer stuck lovingly to my back and hair. It made my night. I know what it's like to have lost your glasses.

It was time to go and the solid began to melt and once out the door it nearly instantaneously sublimed back into a gas. Released from their solid state most of the molecules were teetering down the street appearing unable to shoulder the responsibility of holding themselves upright. One helpful teeterer perhaps in his twenties and with frightening brown curls that shot straight out from his head shouted at me in his profound deafness to put on my coat, didn't I know it was cold? The streets barren, had been almost silent, neon lights bouncing off of wet, glimmering asphalt.

It was cold the wind blowing off the crashing waves a few hundred yards to the left but I was warm, sweating. "Thanks Mom," I wanted to yell back to my helpful teeterer in my own state of hearing loss. What a night.

Thursday, February 3, 2011

Grad/Med School Interviewing Tips

This will bore most of you to tears. I just want to put it up in case anyone is trolling the web looking for tips on interviewing for graduate or medical school. It was written originally as an email and was written specifically for a girl applying to psychology graduate school. I've reworked just slightly it for my adviser at NCSU so it is for those going to medical school. But most of it applies to any interview.

Why do I feel qualified to write this. This is a conglomeration of my own experience and a friend of mine. We have both had well above average success in getting accepted into medical school.

The truth is if you're asked to interview you have what the school is looking for in general. You need to present yourself in the best light one more time. Also never forget you may only be interviewing for a wait list position, for those applying to medical school, so don't be depressed if they give you wait list.

---------------------------------

You are about to choose a place that you will spend four years of your life. Life is relatively short and it is worth your time to make sure you get into a place that fits you and your learning style, if at all possible. There are different schools with different perks because each of you is different in what you need.

First and hopefully before you apply look at a school's curriculum. For med schools there are several curriculum styles and I only interviewed at places that I was interested in their curriculum. Each school is predominately one of these styles usually but will mix in other styles. There are:
  • PBL (problem based learning or case based learning)
    • This is where you learn all of the information based around patient cases/stories. The one I interviewed with was all patient cases (except a few that were hard to integrate) and you learned by exploring a patient's story for several hours with a small group and then taking your books and reading for hours on your own about the possible problems that the patient had. The tests are then custom made around what you studied in your group. You are lectures maybe a few hours a week and in your small group session a couple hours a day. The rest of the time is for you to read and study. This one is for a self-motivated individual.
  • Undergraduate Style
    • This is where you have separate classes and separate test for each class every few weeks. Section test along with midterms and finals. This is much like your undergraduate education. You will take in a single semester classes such as Genetics, Ethical Issues, Biochem, Histology, Micro and Immunology, Doctoring and be in class from 8am-5pm and you will study after that.
  • Systems based
    • Where they base the curriculum around body systems, usually starting from the micro and moving to the macro. Different schools do this differently. Some will do normal the first year and then abnormal the second and some mix normal and abnormal together. Currently this is the most popular style.
  • Other
    • One school I interviewed at had “Undergraduate Style” the first year and then went to “Systems” the second year. Almost all do some mixing and matching just to a far less degree than this one.

The next step is to make sure you pay attention during the interview when they describe their curriculum or ask people students/staff about a normal day or what specific semesters are like first and second year. I found the school that was old fashioned the first year and systems the second when I went to interview. It was not made clear on the site or even via the phone when I asked specifically. Once I found this out, because I have no interest in the Undergraduate Style curriculum, I dropped them from my list of possibilities.

I chose to keep interviewing beyond my first acceptance. This is because every school is different. There are tangibles that they don't mention on their websites such as the school that is setting up time during rotations for their students to ride with the local flight for life helicopters and there are the intangibles such as the personality of the school.

You will walk in and after a few hours feel whether the school is a good fit for you. You will be able to tell whether the school and faculty are a little distant and cool, whether they are warm and inviting and how this fits in with your own personality. You will never find this out from a paper or a website and it is important. I found that the school's that accepted me right out I felt fit my personality while I was there. The ones that wait listed me didn't fit my personality quite as perfectly. So when they say they are seeing if you are a good fit, they are and they expect you to be doing the same.

Thus interviews are critical not just for them to find out about you but for you to find out about them! YOU are interviewing THEM to see if you want THEM. Don't forget this or lose focus on this, it puts you in a position of power, in charge of your own destiny and will change your attitude. This will be apparent to the interviewer. If you see interviews as being all about whether they want you, you've just lost that edge, that confidence that you have determination in your own future. This may seem like an academic point but what you think and feel changes how you behave and talk. How you conduct yourself and speak are what they are judging you on.

Preparing for Interviews:

This is the only time I personally recommend visiting studentdoctor.net or other forums. Get on, skim (important!!!) the posts about each school and look at what the interview style of the school is. Also check if there are question lists for the school provided by a student. Another option is to contact the school and see if they will put you in touch with a current student - most will – the student can help you a lot when it comes to knowing how to prepare (type of interview/questions they ask).

1. If you can, do not sweat it too much. This is hard for most people. I did great until the few hours leading up to the interview then I would get jittery. Once I walked into the school I lost the jitters by talking to people interviewing the same day. Mostly I spent it finding out about them, asking about where they applied, where they were from, their goals and dreams and I encouraged them if they were nervous or down.

Keep it friendly and light hearted and stay away from trigger points such as test scores, qualifications for med school, whether they've been accepted or not and controversial topics of all kinds. Doing this forced me to focus outside of myself and on others which made me stop thinking about the interview and becoming fearful. Perhaps this won't work for you so know yourself and what will help you lose those jitters.

2. Don't forget your position of power. It's about you interviewing them as much as it is about them interviewing you. They need to impress you not just you impressing them. This is your money and your life you're making decisions on.

3. Don't worry or think about about the other applicants qualifications or your odds of getting accepted. In fact, don't even look at what those odds are until after you're done interviewing and have been accepted some where. It doesn't matter and looking won't change anything, you are qualified or you wouldn't have been asked to interview. You have things that each of the other students do not have and that makes you uniquely interesting to the school. Your ability to smile, be caring to those around you and as relaxed as possible will put you in the best position to leave a good impression of your confidence and who you are, these are the things that in person will set you apart from the average student.

4. If at all possible give yourself at least a day to arrive, find your hotel, pre-find the school/building/room number, relax and prepare your clothes. Interviewing is a big deal and stress ridden, for me it was not worth adding the stress of not finding a taxi or the rental car or showing up and having your interview suit/clothes need pressed and not having time to do it. I wanted to do the process well the first time and not have to waste more money next year flying all over interviewing again so I took several days off work and made sure I gave myself the best chance of success.

If you can find out online or from a student of the school what kind of interview process your school has it is helpful. There are two styles formal, where they try to be objective about something that is inherently subjective; informal, where it is more of a let's get to know the real you and figure out what makes you tick.

Formal:They would read formal questions and you would answer. Lots of times they would ask the same one several times. They cannot respond to what you say and these are the ones where they ask the strange hypothetical questions you may not have considered. If at all possible get question lists for these and prepare answers for the most difficult questions. From what I could figure out the medical schools, Allopathic and Osteopathic, that are doing this are located in the Northwest of the USA. There may be others but this is what I heard. I do not enjoy these kind but again that is based on my personality, you may enjoy them.

Informal:I LOVED these interviews, especially near the last. This style is where your intuition and reading people comes in handy. I realized, later, that I was most comfortable when I knew something about my interviewer. I would read the info the school gave me on them the day of the interview, if they did, and then ask the interviewers questions about themselves when the opportunity arose and it was appropriate. This put me much more at ease and relaxed the interviewer as well. Some interviewers opened it up so I could do this first, others I did it in the middle or end. Pay attention to the body language of your interviewer and how they begin the interview, it will guide you to when this is appropriate.

For example: One told me about himself a little at first, this allowed me to ask questions and get him talking about his research then we transitioned into the interview. Another at the same school didn't give me the chance and started in on questions, mid way through I was able to find out a little about her. And one I had to ask at the end when they asked me if there was anything I wanted to know. I had done my research on the school so I took that time to get to know my interviewer. Bear in mind this is not the only thing to ask here and you may have other things you want to ask. Do what's best for you. Getting to know my interviewer was what I wanted to do.

If possible avoid the question and answer session which is easy to allow the interview to get into. It is at this point that remembering you are also interviewing them is invaluable. When appropriate, I added stories of my own to expound on points I was making. Read your interviewers and trust me you will get better at this as it goes along, my first interview, although fine, was not the quality of my last.

Give yourself a break not every interview will be perfect and you will have many different emotions about them. The interview day I felt not as positive about was the first school to accept me so don't place a lot of stock in emotions but if you know something went poorly, adjust it for next time, but don't get wrapped up in the feelings.

Often the people you are interviewing with are brilliant and outstanding in their specialty. In different interviews I was given names of authors to read which would help me in my plans for the future, insight into the school, the latest information available in the professor's research and most importantly a smile on both my face and on the face of the interviewer.

Some interviews it will be easier to insert your own stories then others but have a story or two in your mind that aren't in your application and that expound a positive trait in yourself or something you've learned that you want to bring out. Then look for ways to lead into it during your interview.

My story was about a surgery I had after a Dr made a mistake and how that allowed me to learn valuable lessons not only about how a patient feels but how a patient feels when a Dr messes up and how the reaction of the Dr changes how the patient feels. If that all makes sense. This is something a school has a difficult time teaching but is really important that the student know before they leave. I may be an asset to the school because I have this insight and it will make me a better Dr (ie a better reflection of their school)

For you, it will be different. Be creative with this there are many things that brought you to this place in life and made you confident you could handle the stress of being a doctor, draw on that.

I didn't add that story to my interview process until after interviewing at several schools. I sat down and talked with a friend and he is the one that when he heard that story told me I should use it. It was a huge asset. Talk to your friends and look for things together that you can use. It seems so obvious to me now but I didn't think I had anything before that. Don't short change yourself and definitely get the help of your friends.

Give yourself a break, find ways to enjoy the process as much as possible because you are going to spend days doing it and celebrate the fact that you have the courage to do something as difficult as try to get into medical school. In fact, I suggest, whether you get into a school or not, find a constructive way to celebrate that you made it through one more interview. Best of luck!