June 24, 2009

The word “cancer” is a scary word.  I don’t know what you think of when you hear it, but I usually think of it as a terrible thing that is incurable.  It doesn’t seem like something people want to talk about if they have had it.  I would not have associated it with a lot of joy or hope.  Until this last week.

“I’m not going to be working for the next month,” I said, “because I’m volunteering at two different cancer camps.”  “Well that will look good on your med school application,” someone said.  Yes, it probably will.  That remark bothered me though, because I had been trying to convince myself that I was doing it for all the right reasons.  I won’t deny that part of the reason why I have volunteered at these cancer camps or with hospice is so that I can add them to my list of experiences which have prepared me for med school.  Of course there is a part of me that thinks about how what I do will make me look, and I want to be seen as an altruistic person.  But I believe I had some genuinely good motives as well.

I have spent several years volunteering in all sorts of different camping and ministry programs at Camp Bighorn while I was doing my Outdoor Ed degree, and found it to be something that I really enjoyed, something really rewarding.  Most importantly, I learned that when I am working in a team which shares the common goal of serving others, I am the most satisfied with my work and feel the most purpose in my life.  I have also discovered that when I sense that someone has a major need or is hurting deeply, I empathize with that person and want to do whatever I can to help.  It is interesting, because it seems like there is some sort of threshold that must be crossed before that response is triggered within me.  For example, if I feel like someone is just complaining or overreacting, my response is to want to tell them to suck it up or get over it.  When I do empathize though, sometimes it is overwhelming, especially when there is nothing immediate that I can do to relieve the suffering that someone else is experiencing.  For example, when I see images of starving children in Africa, sometimes I am moved deeply, and want to devote my life to helping them.  The problems of the world are so big that it feels hopeless, like I could never actually accomplish any lasting change.  Cynicism or realism tells me any effort would be futile, and that there is not much I could accomplish in the grand scheme of things.

The times when I have experienced the most satisfaction have usually not been when I can look at some big recognizable accomplishment that I have done, but rather occur when I am able to break free from my self-serving existence and do something purely for the sake of someone I care about.

“How was camp?”  I’m still trying to figure out the answer to that question.  Part of the answer is that it was a ton of fun.  And that is true.  I especially enjoyed getting to know the other volunteer staff.  Creative, funny, high-energy, compassionate, smart, smart-alec…  Part of the answer is that it was really tiring.  More emotionally draining than physically.  I’m still trying to learn how to be friends with young children, going along with their games one minute, and then be the authority figure the next when things get way out of control.  Trying to walk with one or two kids on each arm and leg is also difficult.  I did feel like a bit of an outsider coming in at first, because the majority of the staff had been coming to camp for several years beginning as kids with cancer and then returning as counselors.  Half of the families were regulars who knew each other from the previous years.  For several of these families, this was their last year, because their children who had cancer were ten, which was the upper age limit.  It was a small enough group that after a few days I felt like I had known everyone for much longer than I had.  The last night that we were at camp, there was a time of sharing what had been the highlight of the camp, and there were many tears as people shared how this one week was the highlight of every year, and the one thing that the kids looked forward to the most.  One parent noted that after what the families had all been through living with cancer, the cold weather and rain that week didn’t even affect anyone’s ability to have fun.

To me, getting to be a part of the camp was quite inspirational.  Each kid who was there, and each of the families, was quite amazing.  In many ways, the people were just like any other “normal” people.  The kids liked to run and play games, they didn’t always share the toys, and the families had the occasional times of disagreement.  But they looked out for each other and had a strength gained from experiences which I cannot relate to.  It was neat to see attitudes of thankfulness, joy, and hope.  We were on a hike and one of the young boys was scrambling up on some rocks, and another parent told me that his mother wasn’t going to stop him from doing anything, because he wasn’t even supposed to have lived this long.  His treatment had not been working, and the doctors had said there was nothing more that could be done for him, and he wasn’t going to make it to his tenth birthday.  But then they found a clinical trial which he qualified for, and the experimental treatment was working really well.

That was the crucial moment for me.  That is when it all hit home.  This  kid—who had helped me make my nametag the first day, and who had been very active, catching a garter snake among other things, and had shown me a little house he had made in the woods—he was not even supposed to still be alive.  On the one hand, it was incredibly encouraging to hear how well the new treatment was working for him.  On the other hand, I knew that he may not still be alive next year.

During the cancer camp last week I was able to forget myself for a few moments.  In those moments, I was no longer aware of how ridiculous I looked in my superhero costume or how silly the song or game we were doing was, because only one thing mattered:  there was a precious child who needed to be loved, needed to laugh, needed to forget about the next round of chemo they were about to be starting, or just needed someone to pay attention and listen to them.

Getting to interact with specific individuals is what had the most impact on me.  This was a much-needed change of pace for me.  I am in the midst of finishing up my med school application, and have kept myself busy with work and play.  Having to write a personal statement explaining why I want to be a doctor has challenged me to examine my motives and whether it is what I really want to do, and think about whether I would make a good doctor.  I feel the need to be challenged, and to do something significant, something that makes a positive, lasting impact.  Sometimes this need is just to feed my ego, but thankfully there have been times such as during this cancer camp when my perspective on life is briefly adjusted and I realize what does and what doesn’t really matter in the end, and looking good or feeling happy don’t really matter.  Caring for another individual matters.  I’ll be the first to confess that usually even when I am doing something “loving” for someone else, there are selfish motives mixed in.  It is only by God’s grace that we are sometimes able to love another person in a selfless way.

I just finished reading Tracy Kidder’s Mountains Beyond Mountains, about Dr.  Paul Farmer, while on a plane after the camp was over.  Farmer defies conventional wisdom about cost-effectiveness by spending an entire day hiking to a village to see one individual patient.  Farmer views every patient as equally important, and says he won’t stop fighting the “long defeat” because others want to give up on some individuals.

I am thankful for the opportunity to have gotten to learn a little from those who have had cancer, and from those who have lived with family members with cancer.  Having cancer doesn’t mean your life is over.  Many cancers are in fact curable.  I now know people who have been through cancer, and are more beautiful people because of it.  This has helped renew my determination to study medicine so that I can use whatever abilities and the short time I have on this earth for a purpose greater than serving my own needs and wants.

But alas, I so quickly return to being caught up in my own self-absorbed world of to-do lists, books, and back-to-back activities.

“We need to stop the CT and get him out of there right now—his O₂ sats are dropping too low!”  We entered the room, pulled him out, and tried to prop him up higher.  The nurse had warned that he couldn’t be laid flat.  I did not notice what his O₂ sats were at that time, because I was preoccupied with looking for the oxygen tank that we had brought with the patient’s bed.  There was only one oxygen supply tubing in CT, so the patient was on high-flow O₂ via non-rebreather mask, but in ICU he had also had a nasal cannula.  Not finding the oxygen tank, I returned to the patient.  The nurse was obviously very concerned. “He’s going to code on us—call the crash team.”

The nurse had been trying to schedule a CT scan for her patient all morning, and finally a spot opened up.  The patient, an elderly man, was almost completely unresponsive, only responding to painful stimuli, such as when an NG tube was being inserted through his nose.  I had steadied his head and tried to explain what we were doing, but I don’t think he had any idea what was going on except that it hurt when the tube was being shoved down one nostril and then the other after it didn’t go all the way in. During this procedure, his vagus nerve was stimulated, causing his heart rate to drop to 35, and his oxygen saturation to drop to 87 percent.  The other nurses noticed this drop in heart rate, which set off an alarm on the computers.  They suddenly appeared with the crash cart and some atropine, but his heart rate started to rise again so it was not needed.  After a DuoNeb bronchodilator treatment and the addition of a nonrebreather oxygen mask on top of his nasal cannula, his O₂ sats eventually returned to the upper 90s.  He needed a CT scan to get a better view of his lungs, because an X-ray had shown some problems.

While the nurse called for a code, and requested several other people be paged immediately, her voice was raised, and she spoke with a strong sense of urgency, but she remained calm.  “He’s DNR and DNI” she stated.  I understood that DNR meant that there were written orders in which he had agreed beforehand that if he ever went into cardiac or respiratory arrest, he did not want resuscitation efforts done.  I guessed that DNI meant he would not be intubated.  I found the oxygen tank I was looking for, and connected a nasal cannula to it, and brought it to the patient to provide as much oxygen as possible.  Many people started showing up in CT in a short amount of time, and one of the other nurses from ICU arrived.  “Oh, look at him—he’s agonal breathing.”

There were several of us crowded around, but I was pretty oblivious to what the others were doing.  I was intent on monitoring the patient, who was going for longer and longer periods of time between labored gasps for air.  “I don’t think he’s—” I started to say anxiously after a very long pause, but I was interrupted by another gasp.  I tried to palpate a radial pulse, but was not feeling anything.  I felt around, thinking I must be missing it.  I heard a sigh, and I sensed that the people around me had stopped what they were doing.  It hit me then that this man was going to die right there in CT.  I stopped feeling for a pulse, and held his hand instead.  The oxygen mask was taken off of his face, and I was confused momentarily, because he was still gasping occasionally after very long pauses.  The vitals monitor was facing away from me, but I assume his heart had already stopped.  Agonal breathing can continue even after the heart has stopped, but I did not remember this.  Finally, he breathed no more.  Between five and ten minutes total had passed since we had first put him in to get scanned.

After a brief silence, the various medical workers looked at each other, and some laughed softly.  “I’ve been working here over seven years and I’ve never had someone die in CT.”  “Let’s prop up his head more so his eyes will close.”  “Do we need to cover him?”  His monitor was covered with a towel, but his face wasn’t.  “I’m sorry George,*” his nurse said, touching him.  An entourage of us pushed him quickly back through the halls to the ICU.  We got a few looks, and someone whispered “Shhhh…”  It was an odd procession—sad, and yet slightly comical in a way because of the strangeness of the situation.

“That just shows how sick he was,” the nurse told me, commenting on how quickly he died.  “I hope I die like that,” another nurse said.  “At least it was quick and didn’t seem painful,” I agreed.  I was still a little bit stunned, trying to register what had just happened.  “You’re not allowed to help transport patients anymore,” the unit clerk joked.  I laughed.  I felt more sadness when I heard the nurses say they weren’t able to contact his wife, and they were going to request a police officer go to her home to tell her.  I was relieved to hear that at least his wife had come in to see him that day, and had been told that he was not doing well.  Having a patient suddenly die in front of me made me realize that even though I knew better, I was still taking it for granted that patients shouldn’t die while good care is being given to them.

*Name changed

So, how do I feel it went?  Well, I don’t feel terrible about it, and I don’t feel great about it.  Each part of the exam had some very difficult sections.  The physical science section started out easy but then had some tough physics sections dealing with topics I did not know well.  The verbal reasoning section seemed harder than the last few practice ones I did, which was discouraging, because I had been doing fairly well in VR.  I almost ran out of time on the last part, Biological Sciences, but was smart enough to skip the passage which I was getting hung up on, and then come back to it.  I took 4 practice MCAT’s this last week, and had quite a range of scores (from 31-38), so it was difficult to gauge where I was at.  The times that I scored high were times when I happened to know the topics which were covered really well, and there were few questions on the topics I didn’t know well.  I also got lucky on many of the questions I had to guess on.  Basically, I need to get at least a 30 to start being a competitive applicant.  From the way I felt during the actual test, compared to some of the practice exams, I am pretty confident that I got at least a 30.  Possibly somewhere between a 30 and 34.  But’s that’s a very subjective estimate.

Yesterday I drove here with two of my friends, Chris and Zach, who are going to MSU-Bozeman, but live here in Missoula.  I had originally thought I would have to get a hotel, but they decided to go home for the weekend and graciously offered for me to stay with one of them.  I half-heartedly tried to study some more last night, but knew it was too late to try to be adding anything to my already saturated  brain.  I have this big fat MCAT review book, but I only was able to get halfway through it.  I am sure glad that I rescheduled the test, because although I really could have used a few more weeks to study, I felt much better after studying almost 4 weeks rather than the 1 week I had studied by the time I was first planning on taking it.  Scoring better on the practice MCAT’s increased my confidence as well.

After the MCAT my friend Chris treated me to lunch, and then in the afternoon he and Zach and I went and boogie boarded on a wave in the river that goes through Missoula.  The water was cold, but it was a sunny day, and we had a blast.  I got to take a nap in the sun, and was just so happy and content being outside, in the water, after spending the entire summer in class.  Being finished with the MCAT is quite a relief–I feel like a big weight has been lifted off my back, and now I can catch up for the first two weeks of class I’ve had.

And now I have to wait a whole THIRTY DAYS before I find out how I did on the exam!  I think that is ridiculous, considering it was all done on a computer, and it was all multiple choice except for two essays I wrote.  I really, really do not want to have to take this exam a second time.  In this whole process of preparing for the MCAT, which is basically the culmination of the whole last year’s work (48 credits), I have repeatedly felt like God has been asking me, “Do you trust me?”  Do I trust that regardless of my MCAT score or whether I get accepted into medical school that He is in control and that his plan for my life is better than my own?

29 days and counting…

Today I Almost Took the MCAT

It almost would have been easy to pretend like I wasn’t signed up to take the MCAT today.  I slept in this morning, read the news, and then drove into town (Bozeman).  Except that at 11:45 am I got a call from the test center, wondering if I was still planning on taking the Medical College Admissions Test at starting in 15 minutes.

So what happened?  Did I just forget that I was supposed to taking the exam today?  (Those of you who know me well may not be too shocked if that was the case.)  No, I actually just decided not to show up.  So did I chicken out at the last minute?  Actually, not quite.

The MCAT is a pretty big deal.  Not only is it a long exam (5 hrs), covering a minimum of one year’s worth of general chemistry, one year of physics, one year of biology, one year of organic chemistry, an hour-long verbal reasoning section, and two 30-minute essays, but it is also probably the single biggest factor for acceptance into medical school.  Less than 40% of people who apply to medical school get accepted.  For comparison, the GMAT for business school is 3 and ½ hrs long, the LSAT for law school is 3 ¼ hrs, and the GRE for grad school is 2 ½ hrs.  So you really don’t want to have to take it twice.

The plain and simple truth is, I was not ready to take it today.  You are allowed to take the exam 3 times in a year, but medical schools see all of your test scores that you have ever gotten, and take them all into consideration.  I will admit, I am disappointed in myself.  I think what I’m really disappointed in, more than realizing I wasn’t ready to take the test today, is that basically this confirms that I’ll be applying to medical schools next spring, with the hope of starting med school Fall of 2010, since you have to apply a year before you want to start.

I had worked my butt off this entire year, nearly killing myself this summer taking a year of organic chemistry and a year of physics at the same time, completing 16 credits in 12 weeks, while working with the ambulance on the weekends and volunteering with hospice and search and rescue.  All that with the hope that I could send in a really late application to med schools right before the deadline, and then start med school Fall of 2009.  I didn’t realize though that 75% of med schools have rolling admission, and that as competitive as med schools are to begin with, by now almost all of those spots are already taken, so even if I had a really strong application, and somehow managed to get all my ducks in a row with transcripts, personal statement, letters of recommendation etc, my chances of acceptance would be significantly lower than if I were applying in June along with the majority of applicants.

On the other hand, it is a relief.  I decided last week that I wasn’t going to take the MCAT today as scheduled, after taking a second mock MCAT practice test and scoring very poorly.  I had thought that since I completed all my premed requirements in this one year, everything would still be fresh.  As I study though I realize I need a lot more time to review topics which I have forgotten the specifics for.  My brain reached a supersaturation point this summer during O-chem, and not everything made its way into my long-term memory.  I’ve had two other people give me the same advice about not taking it until I feel I’m ready, so that has been encouraging.

I had less than 2 and ½ weeks from the time my second summer session ended till today to study for the MCAT.  I had hoped to study this whole summer but it was literally impossible if I wanted to survive O-chem (God decided to work a miracle and I pulled off a B+ in O-chem both semesters, and A’s in both physics classes.).  Instead of studying every single day, I ended up working with the ambulance 6 of those days, with most of those being 24 hour shifts, because we were really short staffed this month, with not enough people to have two ambulances running at all times like we’re supposed to.  I also managed to work a mountaineering trip in, which was awesome!  (I’m going to post pictures, really I am…)

I find myself coming up with all sorts of reasons to justify not taking the MCAT today as planned.  Some are good reasons, I know.  But of course there is the fact that I have a fear of failure, and that I have an ego and my pride would be hurt if I took the MCAT and got a low score, as I most likely would have today.  I would have been able to make excuses for a low score, but then I would have had to do it all over again.  Right now I’m hoping to take it the last possible date, which is Sept 13.  School start next week though, and I’m moving in to a new place in Bozeman, so I’m afraid I won’t get all that much extra study time in.  If I’m still not doing well on practice exams by then, I’ll consider taking it in January.  I have another heavy course load ahead of me this fall (biochem, neurophysiology, genetics, and more) so I won’t have much time to study, and then I’m afraid I’ll be worse off than now with having forgotten more.

I have to remind myself that God’s timing is a lot better than my own, even though I may not be able to see it until years from now.  It’s really hard for me NOT to lean on my own understanding in all of this and try to make plans based on what I think is the best thing to do.  I keep telling myself, “All I can do is my absolute best, and trust God to take care of the rest.”  Easier said than done.

Alright, well it is officially no longer the same day, and I think it’s time to dream about the Nernst equation, Zaitsev’s rule, Snell’s Law, Henderson-Hasselbach equatio

Triage

Definition: the sorting of and allocation of treatment to patients and especially battle and disaster victims according to a system of priorities designed to maximize the number of survivors (http://medical.merriam-webster.com/medical/triage)

“This is mass casualty disaster,” I said.  “You have to assess each one and determine whether there is a chance of survival.  If there’s no respirations and no pulse, you have to move right on to the next one.  There’s no time to waste on the ones that won’t make it anyway.”

I said this 30 seconds before starting my fourth organic chemistry exam.  Ironically enough, a few hours later I would be doing chest compressions on a man without respirations or a pulse.  But that’s another story.  The last exam had destroyed me.  I had gotten behind in the reading because of doing a swiftwater rescue class with Search & Rescue the weekend before.  I walked out of that exam feeling worse than I had ever felt about a test in my life.  I was certain I had failed it, and didn’t know what it meant.  Did it mean I was going to fail o-chem?  Did it mean I didn’t have what it takes to finish premed, much less get into med school?  I ended up getting a 62% on the exam the week before, and the fact that the class average was 58% was small consolation.  I felt better prepared for this one—I had actually been able to finish the chapter and do quite a few practice problems.

The exams are passed out and we put our names on the cover page.  You can feel the anxiety in the air, and your classmates either have intense looks of concentration, or nervous smiles.  The professor writes the current time on the chalkboard and tells the class they can begin.  One hour and ten minutes to do an amount of problems which takes you 3-4 hours to do at home.  You briefly scan each page to get an idea of what’s ahead, and then you begin the first problem.  When you get to a problem that you don’t know how to do right away you star it with a shaking hand and move on to the next one.  You work on that for 5 minutes and only figure out half of the steps of the mechanism to get to the final product before running into a wall.  When your mind is blank for more than 15 seconds you star it and move on.  You’ve got absolutely nothing for the next one, so you star it and move on.  Finally a kind of problem that is familiar.  The questions get harder on each page and then you get to the end and there is 30 minutes left.  You look back and half of the problems have been starred and skipped, and a lot of the ones that haven’t been starred you know are only half finished.

“Anti-Markovnikov addition? Hofmann elimination?  SN2 substitution or E2 elimination?  Intramolecular epoxide ring formation?  Dimethylsulfoxide solvent?  Diastereoisomers?  How the heck do I make a triple bond and add an aldehyde?….”

You start scribbling down whatever first comes to mind.  If you know it somehow becomes this but don’t know how it gets there, you just draw it in anyway and see if you can figure out what it reacts with to get to the next step.  You start drawing arrows for the electron pushing even if you don’t know if it’s possible for the electrons to go where they are going.

10 minutes left.  Really, even though you have no clue on some of them, you just can’t leave them blank.  “I don’t know why this synthesis pathway is better than the other one exactly, but it must be because the other one could form multiple products because of competing reactions.”  “Time.  Please hand in your exams.”  You let out a big sigh.  If only you had another half hour…  But at least you triaged well.  You answered the ones you knew, and hopefully got a few partial credit points on the ones which you only knew half of the mechanism.  You even made a long shot guess on the last problem of the test, which will probably not give you any points, but at least you didn’t leave it blank.

I felt better about that test than the last one.  And now it’s time to cram for the physics exam.  When that’s done it’s time to start an 18 hour shift with the ambulance.

I’ve been learning a lot about triaging my tasks.  Each hour of the day needs to be assigned to something.  If I’m not doing homework while I’m eating I feel like I’m wasting time.  I’ve lost over 15 pounds in the last year.  Usually only 5 hours or less goes to sleeping.  I figure one cup of coffee equals one hour of sleep anyway.  But I really don’t like to be in a position where I have to be triaging everything!  I am a perfectionist, and the idea of not doing everything completely and to the best of my ability bothers me.  And then I start getting stressed, and sleep deprived, and become irritable.  And then I don’t like who I’ve become.  I know there are a lot of lessons to be learned from this…

July 12, 2008

It turned out that I got a 54% on that exam.  The class average on that exam was 48%.  Lowest test score of my life probably.  That was really discouraging.  The final exam was the day after my birthday, so all I did on my birthday was study till 3 am.  I ended up doing “well” on the final exam, with a 70%.  Never would have thought that a 70% could be good.

Good news: by some MIRACLE, it turns out I got a B+ for that class!  The teacher insisted all along that the class would not be curved, but I think he might have after all.  That was a huge relief, because I was expecting a C, which would mean I would have to retake the class this fall.

I’m realizing that I have not been trusting God and his plans and his timing.  For some reason I got my mind set on finishing all my premed classes in a year and applying to med schools this summer instead of next summer.  I know that my pride gets in the way often, when it comes to taking on more than I can really handle.  You have to apply a year before you start, so if I can pull this off I could start med school Fall 2009.  Problem is, a lot of med schools don’t recognize my degree from prairie, so I have to plan on finishing a second bachelor’s degree in case, which sets me back again.  Even if I can somehow get a B- in this second O-chem class I’m in now, which is harder than the first, I don’t know if I’ll finish my application to med schools in time this summer.  I have a whole lot to do before then, including preparing for the MCAT at the end of August.

Another highlight: Last weekend I got to go to the wedding of one of my good friends from high school.  She married another of my friends from highschool.  I got to see several of my close high school friends, and my dorm parents and their family, who are like a second family to me.  That was a very encouraging time, and definitely a blessing from God.  I wouldn’t have been able to afford the trip if it weren’t for several people donating money for my plane ticket.  Another blessing this summer: there are two other guys in my O-chem class who have become good friends.  Both are interested in medical missions, and are also into doing outdoor activities, so that has also been a huge blessing for the summer.  God is good!

Just got to survive 4 more weeks.  Search and rescue has been real busy lately (4 calls this week, 2 today), but I don’t have a hospice patient I’m visiting at the moment.

Explore Reunion

Finals Week

Hired as an EMT

Rock Climbing

Started Summer School

My second semester at MSU Bozeman finished really well.  I even got to go to the Explore reunion and see a whole bunch of great friends that I went through the Explore program with, and then worked with as interns.  The Explore program was having its 10-year reunion over the weekend right before Finals week for me.  I didn’t want to miss it, but I was concerned about my Microbiology final, which was on that next Monday.  I started studying for that exam a week before, and was able to do my Friday biology lab on Thur.  Thur night at 10:00 I decided I had had enough of studying in the library (I’m usually there till midnight when it closes) and decided I’d drive to Bighorn that night.  I had left by 10:30 pm, and arrived at Bighorn just before 3:00 am Fri.

People from every year since the program started 10 years ago came, and it was a great time!  While everyone else was out rock climbing and rafting etc during the day, I hid away in the office and studied.  I got to hang out during meals and in the evenings, which was still awesome.  Several of us camped out at the Matrix, and we had a great time around the fire each night.  All of the interns from my year: John, Jen, Andrea, and I were there, and we spent some time catching up on what we’d been up to since we finished the internship.  I got to see my senior intern from when I was a student in 03-04, Steph, and a lot of my 04-05 Blue Team: Lindsay (Senior Intern), Jeremiah, Tim, Nathan, Elliot, Elizabeth, and Rachel.  We missed Andrew, who was in Iraq, and Tiffany.  I just got to talk to Andrew though, and he’s back from Iraq!  A few of my 05-06 Brown Team members were there: Hannah (Junior Intern), Josh, Tim, and Kerry.  We missed Sarah, Sam, Amanda, and Jordan.  I was having so much fun I decided I’d stay at Bighorn until Mon morn and then drive the 4 hours back to Bozeman in time to take my microbiology exam Mon afternoon.  It was a hard exam, as I expected, but I felt about as well-prepared as I could have been.  I got a B+ on the exam and a high A in the class, so that was a relief.  I did well on all my other exams, and was able to keep my 4.0 GPA for the year!  I thank God for that, because I know I couldn’t have done it on my own.  God has really been confirming to me that doing premed has been the right thing for me to be doing right now.

I just recently got hired by the Bozeman ambulance service, American Medical Response.  I had applied at the beginning of the year, even though they weren’t hiring at that time.  They had some spots open up and they called me up for an interview.  Afterwards I was told that they didn’t need me, but then a week later they called me and said they wanted me to start working for them.  I am excited because I have wanted to do this for a long time.  My last exam was on a Thur, and then I started training with them Fri and Sat.  Then I did my first shift from that Sun morning till Mon morning.  Then that Mon I spent some time in the emergency dispatch office, seeing how things run there.  On Tue I got to get out rock climbing with two of my friends, Tanner and Luke.  It finally stopped snowing and got really warm that week.  Then I spent a day doing a ride-along with Bozeman Fire Department to meet people there and see how they do things, because both Fire and EMS respond to all 911 calls.  Saturday I got to go out rock climbing with Aaron and two of his friends.  We ended up doing a 4-pitch 5.6 route that was really easy but still really fun.  It was great to finally get out and do a trad climb again!  After that week of “break”, I started summer session number one, taking 4 credits of organic chemistry 1 and 4 credits of physics 1 in 6 weeks, and then I’ll be doing another 4 credits of organic chemistry 2 and 4 of physics 2 in the 6 weeks immediately after that.  Then I’ll be taking the MCAT at the end of August and sending off my applications to med schools!  It’s going to be a crazy busy summer for me.  I started volunteering with Hospice recently, and am visiting with an older man once a week.  I’m also volunteering with Search & Rescue and doing training with them.  I get to do a swiftwater rescue technician training course soon.  The rivers are at flood stage right now, the highest they have been in many years.

This Fri I skipped my physics and organic chemistry classes so I could work with AMR.  The first 8 or more shifts that I do have to be with a field training officer, and there are only certain days when they are working.  Since I have class Mon-Fri, it is difficult to find a time when I can actually work until I am finished being “credentialed”.  After this week I have an O-chem exam every Fri, and a physics exam basically once a week as well.  I have 2-4 hrs of class a day, as well as a 3-4 hour lab every day except Fri.  We’re covering a whole chapter every day or two, which makes it difficult to keep up!  Thankfully, most of the physics so far is a review from high school 7 years ago.  This Fri I did a 24 hour shift with AMR, and then went straight to the hospital ER to do an 12-hour shift there.  Mostly I took patients vitals and visited with them to keep them company.  I only needed to be there until 4 pm, but then an interesting patient was taken in.  He had OD’d and needed to be intubated (tube put into his lungs) and have several other things done to him so I got to watch that and help hold him down because he was violent, even though he was only responsive to pain.  Once they paralyzed and sedated him he was fine.  I got to bag him (breathe for him by squeezing air into his lungs through the ET tube) while he was taken to get a CT scan and then taken to ICU.  So that was a lot more exciting than just taking people’s vitals.  I ended up staying there till 9 pm, so it was about 37 hours straight for me.  We got a decent amount of sleep the night before, with a call around 10 pm, and then one at 4 am.  I still have a ton to learn about working as an EMT, and sometimes it is discouraging when I feel like I really don’t know what I’m doing.  There is a huge difference between getting certified as an EMT and actually working as an EMT.  I really enjoy it, and know I am learning a lot, even though it doesn’t feel like it yet.  I’ve only worked two shifts so far, and the first one was entirely observational.

I applaud you if you actually read this far.  I know I often don’t feel like I have time to read a post this long.  I’m working on learning to leave out the unnecessary details that aren’t important, as well as writing more frequently.  Sometimes I wonder what the purpose of blogs are anyway.  Why would other people want to read the details of what I’m doing with my life?  I feel like I should be writing entertaining anecdotes, or sharing profound thoughts for people to learn from.  Sometimes it seems like people write blogs simply because it is helpful for them to sort through their thoughts and feelings by writing them out and posting them.  I have found that to be true sometimes for me, although I usually just stick to the facts, which is not what people are going to want to spend their time reading.  Hmmm….

This last weekend I skipped 2 classes on Friday and packed up to drive up to Three Hills.  I didn’t end up leaving until almost 6 pm (I’m not what you would call a quick packer).  I drove all the way up to Calgary, arriving at about 2 am on Saturday.  I drove around until I found a Tim Horton’s that was open all night, and slept in the back of my car in the parking lot.  It was really bright, and noisy, with cars going by and planes flying overhead, and I was still wired from the coffee and energy drink I had drank, so I tossed and turned most of the night.  I got out of my car at 8 am and then drove over to the airport to pick up Andrew.  He is being deployed to Iraq in a few weeks, and he wanted to see friends before he left.  He, Tim, Nathan, Elliot, Jeremiah, and I were the Blue Team Guys in Explore 04-05.  We became a close group of friends, and we hadn’t all been back together since Explore.  It was so fun seeing everyone again.  Only a few had heard we would be coming, so we surprised a lot of our friends.  We got to see quite a few other good friends from that same year of Explore, including Dennis, Mandy, Hannah, Jeremy, Aynsley, Emily, and Ashleigh.  We ate meals together, had a bonfire, and basically just stayed up late talking and enjoying each other’s company.  Andrew was staying until Wed morning, but I left Monday morning because I couldn’t skip my chemistry and biology labs on Tue.  My time there was short but sweet.  I wished I could have just stayed there.  There were other friends at Prairie that I didn’t get to see that I would have liked to.  I missed 5 classes on Monday, which put me a little behind, and I had my first exam in 3 of my classes this week.  I had to study a whole lot to catch up, but I did well in them.

Brief Update:

I’m quite enjoying my classes at MSU that I’m taking.  I’m majoring in Cell Biology and Neuroscience.  My degree from Prairie isn’t recognized because Prairie isn’t provincially accredited in Alberta.  It is nationally accredited in the US because it is part of ABHE, but apparently colleges look to see if other colleges are regionally accredited.  I’m hoping to take the MCAT in two years and apply to med schools, and finish my degree in the third year while I’m waiting for med schools to process my application.  I’m taking the 1^st and 3^rd of a sequence of biology classes at the same time because they are only offered one semester and I’m trying to finish in three years, so my one biology class is really challenging not having taken the prereqs yet.  I spend hours every day studying for that class.  My chemistry class is easy because I took AP chem in high school.  My infectious diseases microbiology class is quite interesting and pretty easy.  Statistics is mostly easy so far.  I have to really work hard to keep up in all my classes, but thankfully I actually improved a lot last year in not procrastinating!

This summer I worked construction part time and worked at Camp Bighorn as well during the first half, and then I went to Snoqualmie Pass to take a month-long Wilderness Emergency Medical Technician course.  That class was awesome, and I got to meet a lot of cool people.  We had quite a diverse group of people who came from all over the States and even Hawaii, Israel, and Hong Kong.  It was a very intense course, because we were doing the EMT-Basic certification, Wilderness EMT certification, and US Coast Guard Medical Person in Charge Certification all at once.  We got to do clinicals at the ER at the hospital at UW.  We did some rock climbing at Exit 38 while I was there and explored the river at the pass (Snoqualmie?) and did some hiking.  Then I got to spend a few days with Brian and Beth in Spanaway, WA before flying back.  My car had broken down on me, and it took longer to find a used transmission and get it put in than I was hoping.  My friend Aaron at camp was gracious enough to loan me his car for a week and a half so I could move down to Belgrade (7 mi from Bozeman) and start classes.

This Fall I want to start pre-med classes!  That’s a whole long story in and of itself.  Being a missionary doctor has been a dream of mine for a long time (at least since early highschool), but the journey to get there has been delayed for the last several years.  I do not regret doing the Explore internship at all, even though it was very difficult at times, and it changed my plans a lot.  I feel so much better prepared now for whatever kind of vocation I end up in, even being a medical doctor.  This is something that I am still very much in the process of, and I alternate between being very excited and confident that this is the right thing for me to do, and being very intimidated and thinking there is no way I could do it.  It has been a great exercise in seeking God’s leading and learning to trust in him, as well as evaluating my gifts and examining my motivations.

I am really excited about this WEMT course, as I have been wanting to do the EMT training since I was a sophomore in highschool.  The course that RMI offers was the one that really impressed me when I was looking at different WEMT programs, because of its advanced level of training, and with it teaching each step of the EMT training with the wilderness context in mind, not just doing the standard urban EMT training and then adding on a wilderness upgrade.  I just got the textbook for it today and started reading it.  It is an EMT-Intermediate textbook, and is almost 1,600 pages!

Alright, well that is all I can write for now, but more is on its way!

PS The mountains in the title refers to my family vacation in Canmore as well as a daytrip I did with Tim Andries, and the logs refers to my job, working for a log home construction business.

It’s weird to be writing something addressed to the general world at large, and yet I guess since there are very few people who even know of this website, that isn’t really true. It is my hope that I will be able to use this website as a way of letting people know in general where I am and what I’ve been doing. This year has been a really good year for me. I have been able to slow down a bit and reflect on my last two years of internship. I haven’t felt stressed much at all this year. I often realize how good God has been to me and how much he has blessed me. I have been thinking a lot about what I will be doing after graduating, but I’m excited about discovering what God has in store, and trying to remain open to that, and yet at the same time stepping forward in faith even when I’m not sure yet.
So right now I’m in the middle of the last semester of my four years at Prairie Bible College, in the little town of Three Hills, Alberta. Three Hills is a small town located about an hour and a half north and east of Calgary. I’m finishing a Bachelor of Art’s in Ministry, with a double major in Outdoor Education and Leadership. I’m rooming off-campus with my friends Tim Andries, who was on my Blue Team in the Explore Program when I was a junior intern (first year of internship, second year of college), and Levi Bergen, who who did a two-year intership the same time as me in Discover, the sister program of Explore. This semester I am taking 4 classes, plus finishing my internship class (huge paper), and another class (Wilderness Instructor). I’m working as the Supervisor for our school’s climbing wall. I also work about 12 hours a week in the dining hall. I’m playing on the basketball team, so I have practices and games on the weekends. What! Andy’s playing college basketball! We’re in a small league of smaller schools, so it doesn’t mean I’m very good. I’ve been spraining one ankle often which has been annoying. So between all that I keep myself pretty busy, but a whole heck of a lot less busy than when I was doing the Explore Internship.

I hang out with Tim Andries, Dennis Landon, and Jeremiah Jordan in my free time. We spend a lot of time talking about doing all sorts of cool things, but then I get tired of talking about doing things and plan some sort of trip. Some of the trips haven’t worked out, but Dennis and I got to go backcountry telemark skiing in Kananaskis a few weekends ago. Just yesterday we went driving around the prairies here and found a little hill to ski down. It was big enough to get about a half dozen turns in. That big. Unfortunately, the weather here is very dynamic. There will be times of extreme cold (negative 30 or colder), and then a warm Chinook wind will come through and it will be above freezing for a while. This has been frustrating, because it melts away the little snow we get here. Not that there are a lot of places to ski around here, but you start to get really desperate after living in the prairie lands.

A few weekends ago I got the chance to get a ride with some other friends down to Camp Bighorn. It was great to be able to see all my friends there. I got to hang out with the interns I worked with last year, Hannah Mikul, Nathan Nash, Jeremy Freeman, and Mandy Vargas. My friend Andrea, who did the Explore internship with me, is now married to Luke Underhill, and works on permanent staff at Bighorn. I have a lot of other friends there who are working there now. I got to go to my home church, the Bible Chapel, in Plains, and talk with some of my friends there, such as Luke Dryden, who I worked with building log homes last summer.

I had an amazing Christmas break. I spent 2 days ice climbing near Canmore, Alberta, with Nathan Nash (Explore Intern). Then we drove down to Montana and went skiing. Then we drove to his place in Washington, and we climbed the South Gulley route up Guye Peak, at Snoqualmie Pass. That was a great climb. Short, but quite steep. Then I got to spend 2 nights with my friends Brian and Beth Meaden, whose wedding I was in this last October. Then I flew down to southern California to stay with my two brothers and sister-in-law. We rock climbed at Joshua Tree, and spent Christmas Eve with cousins and grandparents, which was really neat. Then we had Christmas Day with just the 4 of us (Daniel and Katie, Joseph, and myself). My uncle Karl came to visit all the way from BC, which was a lot of fun. We went down to San Diego for a few days to stay with Katie’s family, and I actually relaxed and did nothing for a while! We did go for a hike one day, but otherwise I just lazed around the house and did some reading. It was so refreshing not having a packed schedule for once. I don’t think I could handle not doing much for very long, but it was good for me. I got hang out with Oliver Malabuyo, one of my best friends from all the way back since 5th grade in the Philippines.  It was so good to be able to catch up with him.  Then I was fortunate enough to get a ride back all the way to Alberta with my friend Sara M., who was a Discover intern at the same time as me. We got to stay with my very hospitable Uncle Dale and Aunt Donna in Utah on the way up.