“I am tired of knowing nothing and being reminded of it all the time.” – F. Scott Fitzgerald

Four core rotations down. Three more to go. Today marks my second week of clinical duties on the psychiatric ward. It’d be a lie to say I’m not nervous about this rotation in particular. I mentioned some of my anxiety to one of my colleagues today and he responded: “oh c’mon, Ajibike, you’re always nervous at the start of a new rotation.” To an extent, he is right. There’s an overwhelming sense of I know nothing that accompanies the start of each rotation. It seems as though the moment when I feel comfortable on a new service is exactly when it is time for me to move onto a new team.

Everyone who knows me knows that I love F. Scott Fitzgerald. Many of his works are fixtures in my list of favorite novels. When I stumbled upon this quote, I knew it would serve as an honest introduction for this post. This quote = mood.

MS3 is the year during which you amass a ton of clinical knowledge.

MS3 is the year during which you learn to not “sweat the small stuff.”

A MS4 told me at the start of my MS3 year that I should be prepared for moments when 150% effort will be rewarded with an evaluation that reads: “Good student.” She told me that it’s important to hold learning the art and practice of medicine as my main priority rather than impressing attending and resident physicians. Unsurprisingly, I followed her advice with: “Okay…I hear what you’re saying but what can I do to be a good medical student.”

She gave me three pieces of advice that I still find incredibly valuable:

1. Know your place.

2. Take ownership of responsibilities related to your patient(s).

3. Present well.

What does it mean to present well? Each discipline has their own twist on the history & physical or SOAP note…but at the end of the day, a good presentation is: concise, thorough, and accurate.

The major 🗝 to a good presentation is: organization. On my first couple of clerkships I made my own templates to record information on each of my patients. I also toted around an myriad of documents (physical exam maneuvers listed and described and an extensive review of systems). On each team, I learned what my attending wanted from me and adjusted my presentations accordingly.

I felt a lot of pressure when I started my pediatrics rotation. I came into medical school with an interest in pediatrics and so when the rotation rolled around, I wanted to impress my attendings. At that time, I got my hands on a Perfect H&P notebook.

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This notebook fits in a white coat pocket and is affordable – only $15 guys! The notebook supplanted all of the documents I was carrying around in my pockets. I’ll talk a little bit about how the notebook is constructed in a moment. I will say that this notebook is perfect for wards work. Sure, certain disciplines may require a bit more material on topics not specifically mentioned in the notebook. I’d say that this notebook is a great organizing tool for internal medicine, surgery, family medicine, and pediatrics. I can’t speak to neurology or OB/GYN as I haven’t completed those rotations yet. I will say that I don’t think the notebook is as helpful for psychiatry.

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The template has checkboxes for basically ALL the physical examination findings and symptoms (for review of systems) you could possibly want. I will say that the section for laboratory results is on the small side.

One aspect that I really appreciated is the sect ion for differential diagnosis. On so many rotations, I haven’t been required to present my differential for each aspect of the problem list. That’s honestly been a disservice to my education but I’ve found that  forcing myself to think of a differential (of at least 3) has helped me to present more sound assessments and plans.

I’m hooked on this notebook and I fully intend to pick up another one before I start my sub-I in June!

If you guys have tips and tricks for presenting on the wards, I’d love to see them in the comments below!

Disclosure: Perfect H & P provided this notebook for free to be reviewed on this blog. All opinions are my own. 

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“Here’s to the unknown, the smiles and the tears and the laughs we haven’t had yet.” – O.L.

Happy New Year’s Eve everyone! The quote that serves as the title of this post is an excerpt from a poem I discovered earlier today. Simple in its construction, the poem has great depth. I want to share the poem, “Honest Toasts for the New Year” in its entirety before I dive into the rest of this post.

New Year’s Eve and we are all
holding flutes of cheap champagne,
with people we don’t know
or don’t care for, or we wish we could
just leave behind with this year
and we are all toasting,
glasses raised above crooked halos.

Here’s to the friends we lost,
the friends that left us behind,
the friends we haven’t met yet
and the friends that are bound
to be more than.

Here’s to the knives wedged
between shoulder blades
and blood slick ribs,
grazing our hearts as we breathe.
Here’s to the pain
that made us stronger.

Here’s to the resolutions we didn’t keep,
the ones we will make again
and again and again,
but habits are hard to break.
Here’s to consistency.

Here’s to the lips we kissed,
bruised, bit, lavished
and all the lips we will come
in contact with in the future.
Here’s to love.

Here’s to the scars
and the pieces of ourselves
we had to cut off to make it,
the fractures of glass that we are leaving
in this hellhole of a year.

Here’s to the unknown,
the smiles and the tears and the laughs
we haven’t had yet.
Here’s to next year, the New Year,
hopefully it will be better
and we will learn just as much.

Feel free to read the rest of O.L.’s poetry at this link.

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Lessons from the Wards: Little Bo Peep

I nicknamed my favorite patient Little Bo Peep. I can explain: her earliest memory was of dancing through the streets of New Orleans during Mardi Gras, dressed as Little Bo Peep. She was 3 at the time, perhaps 4. It was hard for her to remember. Her memory had been “hazy,” she admitted cautiously — worried about how I would take that confession. She admitted a lot of things to me. 


Over the course of two weeks, I noticed that we had a lot of shared interests: nail polish (eh, I’ll admit it), German Shepherds, and Russian literature – in particular, Anna Karenina. 


She was dying — I think she knew that but I was blinded by my desire for her to live — and nonetheless she took such interest in my life. Carefully spun sentences stitched us closer together. Patients with terminal cancer have a great need for emotional support; I found myself holding her hand as she cried, painting her nails, cleaning her up after she vomited. 
We spent a lot of time talking – she hated to be alone – and I often told her that she knew me better than anyone else in New Orleans. She didn’t believe me, but it was true.
I was both fascinated and terrified by her disease process.

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