Adventures in Child Neurology

>Today was the big day! First day of medical school. Actually it was just the first day of a pair set aside for registration and orientation. One hundred and seven of us (100 new students and 7 holdovers from last year who are having to repeat first year due to all sorts of reasons) gathered in a large tiered auditorium. We were handed out information packets and a new catalog before being welcomed to the school by Dr. Wallace Conerly, the Dean of the School of Medicine. We spent the morning going over all sorts of mundane things while everyone looked around trying to size up all the people around them. Around 11:30 we broke up into groups of ten or so and met our faculty advisors. Mine is Dr. Davis Manning. He is a research physician and professor doing work on cardio studies.

We ate boxed lunches in a large conference room at the Student Union while listening to a presentation by the Family Practice department. They pitched a program that the State of Mississippi funds with the large tobacco settlement funds our Attorney General sued for a few years back. The deal is that 20 scholarships are funded each year in perpetuity to recruit Family Medicine physicians. $25,000 is given for each of your four years of school, in return for a commitment to practice in a “critical need area” in Mississippi for 10 years upon completion of a three year residency, which can be done in state or out of state. It turns out that there are “critical need areas” in all but seven counties in the state, so it looks like a great deal for student who want to go into that area and wants to stay nearby.
We had several upperclassmen speak to us after lunch about student activities and the like. The director of the Rowland Medical Library then spoke to us about the resources in the library. I was impressed with the amount of information that is accessible via electronic database. After visiting Information Services to get my user ID and password for the school network I was done for the day.
Tonight the second year class threw a barbecue dinner for us at the Ag Museum. It was catered by Red, Hot and Blue, and spouses were invited. All of us first years were paired up with an M2 “buddy” who is supposed to be available to answer our questions, give advice, share old tests, and so on. My buddy is a nice guy named Jason McManus.

Of the most interest today to me was our schedule. We have only Biochemistry and Gross Anatomy for the first 13 weeks. After that we get courses in Histology, Physiology, and Neurobiology. We have five “board exams” that we will take during the year upon the completion of each of those subjects. These are national standardized tests that you must pass to proceed to second year. We also have brief courses Psychiatry and CPR. We received detailed schedules which even show when all exams will be given. The first year ends on May 24th, so it looks like about nine full months of studying. Even the Christmas break will require studying because we have a Biochemistry exam three days after we get back and a board exam the next week.

Another cool thing is the use of a “Virtual Instruction & Distance Learning” site on the web. Our Gross Anatomy class is supplemented by material posted on our class web site. We can go there to get notes from the professors, syllabus information, etc. It appears our grades will be posted as well as class averages and statistics. It looks pretty cool.
Well one more day of prep before we dive in!

>For the first time since I graduated from Millsaps in 1989, I find myself unemployed! This was my last week at Southern Farm Bureau Life Insurance Company. I had a great time there, made many good friends, and kept my family in groceries, clothing, and shelter for 12 plus years. And despite the fact that I’ll miss all the people, it seems incredibly liberating! If the balance sheet doesn’t match the Impromptu reports, Ann can figure it out! If AM Best needs some data on the CMO portfolio, Mr. Polk can mine for it! If Walt can’t get into his e-mail he can call Tech Services!

The last month went by fast. I took my stuff home little by little, and by the time last week got here, my office looked a little crypt-like. When Ann Blakeney started trying to move some of her stuff in, I had to draw the line. You don’t throw dirt on the guy until he’s dead, Ann! Anyway, I’ll miss my cool big desk and those great book shelves! I took a picture to remember it by:

Thanks to everybody for all of the well wishes and parting meals! Bryan Teel bought me a steak finger dinner at the Cherokee (highly recommended), my department took me out to On The Border Wednesday night (Thanks Walt!) and to lunch at Red Lobster on Friday, my last day. And to cap it off, my good friend Dottie Carlisle treated me to a night out at Chili’s Friday night with a bunch of my favorite people from the Farm. I had a great time Dot, you’re the Best! Thanks to all who came and remembered old stories with me. Ken, I’m glad we never had that race … it would have been embarrassing for me to admit that, yes, not only can 300 lb football players outrun me, but so can middle-aged actuaries! And a special thanks to Lorie Keeton who not only gave me a bag of Cinnamon Bears but thoughtfully wrapped them in a Segmented Balance Sheet! (Finally a good use for those things!)

Tomorrow is the first day of what comes next. Orientation starts at 8:00 A.M. Olson doesn’t think I can make it that early, but I will!

>One of my biggest worries about going to medical school is that I will not be able to provide my family with all of the things that they have become accustomed to. Besides the huge time commitment I fear that we won’t be able to enjoy many of the things we do now, due to lack of finances. While we have never lived the lifestyle of the rich and famous, we do love to go to Sonic, for a milkshake or a sundae, on a whim. And we’re forever dropping $20 here for a soccer tournament entrance fee and $10 there for some new books. I worry that my girls might become resentful if we can’t do all the things we used to. However I read an article that gives me hope that I can give them something, that in the long run, will be more valuable than the lack of regular Taco Bell runs.

An actuary named Irwin T. Vanderhoof, (what a great name!) who is now deceased wrote an article entitled “And I’m Not …” in a magazine I get. He told how these words, spoken by a friend of his named “Izzy” had come to symbolize a message that made a difference in Vanderhoof’s life. He writes:

“He mentioned that he’d once wanted to become a lawyer. He’s told all his friends about his ambition to go back to law school at age 45. His friends said, ‘You’re crazy, Izzy. By the time you finish, you’ll be 55. What his friends said sounded sensible enough at the time.

Writers sometimes elegize “the road less traveled.” Robert Frost wrote verses about the choices that can make a difference. (“But I took the one less traveled by…”) And maybe the Rubaiyat is more stylish in its phrasing: “The moving finger writes, and, having writ, moves on…” but it couldn’t have the same impact on me as ‘and I’m not’ from my friend.

I had already been preparing to go to med school a year when I read this article, but it sure did mean a lot to me in thinking about my decision. I am going to be 40 or dead in six years whether I am a doctor or not. I might as well be 40 and a doctor than 40 and not. And I hope when my kids are older, they can more appreciate what I’m doing and find the courage to pursue their own dreams.

>Only one more week until school starts and it seems more real every day! We are beginning with an Orientation on Monday morning, August 20th at 8:00 a.m. At lunch time there will be a program for all 100 incoming med students put on by the Mississippi Association of Family Medicine to tell us about a program the state offers. Apparently if you commit to practicing family medicine in a rural area of Mississippi for ten years upon completion of your residency, the state will provide you with a $25,000 scholarship for each of your four years in med school! In other words they will give you $100,000 for a ten year commitment. It seems awfully tempting, but at this point I am not wanting to do anything that will limit my options later. Hence I am also passing on the military scholarships that are also quite attractive and apparently readily available.

Monday night we are having a cookout to which the spouses are also invited. I understand that there are clubs or organizations for the spouses of medical students to do things together in, and I hope Angie will be able to make some new friends to help her adjust to the changes in our life that are sure to come.

On Tuesday night, we are having a “White Coat Ceremony” where we will be presented with our first lab coat, as a symbol of our new career. This has me really excited though I am afraid it seems a bit assuming. It will really make things seem real though! After all of this fun sounding stuff we jump right into Gross Anatomy and Biochemistry on Wednesday.

>I have been reading John Adams, a new biography by David McCullough this week. Adams was a strong proponent of education and believed that an educated populace was essential to preserve and and prosper the new nation he was helping to establish. He wrote:

I must study politics and war that my sons may have liberty to study mathematics and philosophy. My sons ought to study mathematics and philosophy, geography, natural history, naval architecture, navigation, commerce, and agriculture in order to give their children a right to study paintings, poetry, music, architecture, statuary, tapestry, and porcelain.

Public education tends to take it on the chin in many circles today and to be sure there are problems. But there are also spectacular successes. Adams believed, as do I that it is a noble and wonderful thing for a country to provide education for its people, and an educated populace improves the lot of all citizens. I just read a book, Gifted Hands, about one of the world’s top neurosurgeons, a man named Ben Carson. His story is just one of countless tales of hard working people taking advantage of education to make the world a better place for all of us.

I received in the mail this weekend my financial aid information for medical school. I am amazed at how simple the process was. I filled out online applications on the Internet a few months ago and am now approved for government loans for my schooling. Thanks to all of you taxpayers out there who through your hard work make it possible for me and others to learn, and hopefully give you a return on that investment one day. As my father-in-law is wont to say, “What a Country!”

>After failing to get into school on my first application I signed up to retake the MCAT in the Spring of 2000. I also concentrated on finishing up my remaining coursework with a 4.0 to keep my application looking good. This time I made a 31. I maintained my Verbal Reasoning score and bumped both of my Science section scores up two points. This got me ready to apply again in the summer of 2000.
The application process is interesting. There is a service called AMCAS run by the Association of American Medical Colleges (AAMC) that acts as a sort of clearing house for all of its member medical schools. This allows candidates to fill out one standardized application and have it forwarded to all of the school they are interested in. You can also download software to prepare your application electronically and submit it on diskette. I only applied to one school, the University of Mississippi Medical School. I felt certain that I would be invited to interview, as I had been interviewed the previous year and had only strengthened my application in the interim. I had substantially improved my MCAT and added 20 hours of coursework with a 4.0 average. The two most important objective factors on your application are MCAT scores and college GPA. My undergrad GPA had been a fairly unimpressive 3.2. I had done just enough to get by most of my time at Millsaps (1985-89). Now I had to defend my lower grades by implying that I had not performed to my potential while at the same time convincing the admissions committee that I had learned from my mistakes and was ready to apply myself now. (I always knew those skipped classes and nonchalant study habits would come back to haunt me!)
I did get my interview in November of 2000. UMC interviews approximately 300 candidates for their 100 slots. Dr. Read had retired as the Dean of the Admissions, and was replaced by Dr. Steven Case. I started the day speaking with him and also spent an hour with two other professors. As a last step for the day, I was given a box of Crayola crayons and a blank sheet of paper and asked to draw my image of a doctor. I ended up drawing Superman with the big red “S” on his chest. I had drawn the logo so many times as a kid I knew exactly how it was supposed to look. I then put a lab coat on Superman (red cape tucked in at the shoulders, but flowing loose from the bottom) and a stethoscope around his neck (who needs that with super-hearing, though?) I don’t know if that picture was the deciding factor or not, but I know the secretary I turned it into seemed impressed!
I left the interview feeling like it had gone just as well as the year before but probably not any better. I was confident, but then again I had been confident the year before also. I just hoped that the new facts of my application would make the difference and they did! On a Saturday in March I got an acceptance letter. It was dated two years and two days after my decision to pursue medical school.

>After thinking about what I wrote yesterday, I wanted to clarify something about the October Sky influence on me. I don’t want it to sound like I’m some groupie who had my life turned around by a movie. My decision to quit my job and return to school was like a kid who was daring to jump off the high dive for the first time. I had already climbed up the ladder and made my way out to the edge of the board. A few practice bounces and all that was left was to close my eyes and jump. October Sky was just the last taunt from a kid down below that determined the timing of my final step off the end of the board! By the way, it’s a great movie and I recommend it if you have never seen it!
On the first day of March, 1999, I called the Dean of Admissions, Dr. Virginia Read, at UMC. Though an imposing Ph.D., she was also a grandmotherly type who was very encouraging. We made an appointment to meet a few days later. My main memory of that first meeting was her telling me that the Fall of 2001 would be the earliest I could hope to enter school. I remember being frustrated that she didn’t think I could get in for the 2000 class. I had a few things to get in order first. After reviewing my transcript she found that I needed to pick up 8 hours of Organic Chemistry and 8 hours of Zoology. In my days at Millsaps I had plenty of hard sciences – math and physics – but not much in the way of life sciences. She encouraged me to pick them up at the Junior College level to save money since all my prior course work was at Millsaps. I had to have the hours on my transcript but just as importantly I needed to know these subjects to take the MCAT – the Medical College Admissions Test – a standardized exam that every prospective medical student in the country takes. Dr. Read felt that I would not be ready to do well on this test until I had completed the course work. That meant taking the test in the Spring of 2000 and being ready to apply for 2001. Medical Schools begin taking applications for admission a year in advance!
I immediately got signed up for a summer Intro to Biology class to get my feet wet and then took two semesters of Organic and Zoo in the 1999-2000 school year. However, against Dr. Read’s advice I went ahead and signed up to take the MCAT in the August sitting. She had told me that she feared I would get depressed and frustrated if I took it before I was well prepared. I tried to explain that my decade of taking Actuarial exams had made me immune to the pain of failure, but like most people who are not familiar with the actuarial profession, she did not seem duly impressed with their difficulty.
The MCAT is made up four sections – Verbal Reasoning, Physical Sciences (Physics and Chemistry), Biological Sciences (Biology and Organic Chemistry) and a Writing sample. The first three sections are scored on a 15 point scale and the sum of them is what you typically hear reported as an MCAT score. The Writing sample is actually two short essays in response to given topics. It is graded on some crazy alphabetic scale and the only way to make sense of it is to look at your percentile ranking when you get your test results in. I knew I wasn’t prepared to do as well on the Biological Sciences part and I needed to review the Physical Science section more, but I was confident I could do well on the Verbal Reasoning and Writing sections. I ended up making a 27 – 12 on the Verbal, 8 on the Physical, and 7 on the Biological. I also was in the high 90s percentile on the writing. When I got my scores back, I knew I had a score in the range that would get me some consideration, though I knew I could do better with some more review work. I had a week until the application deadline and rushed one together. When I got invited in for an interview, I was ecstatic. I had visions of beating Dr. Read’s forecast by a year. Despite knowing that it is tough to get in on the first application, (particularly for older students coming back into academia) I let my hopes get up only to see them dashed in April of 2000 when I received my rejection letter. However, that got me all the more determined to get in the next year. More on that in the next installment.

>Today is exactly four weeks before school starts. On August 20th, 100 incoming medical students will report for two days worth of orientation before they throw us into the fire with classes beginning on the 22nd. I can’t believe how fast the time has gone since I first made up my mind that I was going to be a doctor.
I had been considering going to medical school since 1997 when my son Manning began having seizures shortly after birth. We met so many great doctors that I began to think about what it would be like to be one. However, the thought seemed so fanciful. I had three kids, a wife and a mortgage. Not only does medical school cost a lot of money, but you are too busy to make any money while you’re in school. It just didn’t seem feasible.
In 1998, I met a fellow named John Boyles who was around my age. He had two kids and was in his second year of med school here at UMC. Meeting him kind of turned a light on for me that it could be done. However the thought of quitting my job and drastically changing my life still seemed a little too fantastic to consider. I continued to think about it though, and started looking around at Southern Farm Bureau Life, where I worked (and still do!) as an actuary in the investment area. What did I want to do there and who did I want to be when I was 50 years old? I didn’t see anybody there that I wanted to be! Instead of being freaked about thinking of jumping off the cliff into a new career, I began to get freaked out about being trapped in my old career.
On February 27th, 1999, Angie and I went to see the movie, October Sky. In the movie, a young man spurns his father’s notions that he should follow his dad into the coal mines because he wants to be a rocket scientist. He follows his dreams and ends up working for NASA. When I got home, I knew that I was going to be a doctor.
In the next four weeks leading up to the start of school, I’ll write about the process I had to go through to get accepted into medical school. I hope some folks out there will find it interesting enough to keep reading.

>I got the letter today.

I had pulled up to the mailbox along the curb, in the Suburban, with Angie and the kids. We were returning from a leisurely lunch at CiCi’s Pizza in Brandon where we went to get out of the house during a rainy day in a rainy week. I pulled the mail out of the box and right away noticed the bubble envelope of baseball cards I had bought on eBay. I pulled on into the driveway and before getting out thumbed through the good sized stack of mail.

Angie and I saw the return address from UMC at about the same time. I looked at her and she was staring at me wide-eyed. It HAD to be an acceptance letter, didn’t it? After all, they would be accepting candidates through mid April and then let all the poor joes who didn’t get in know then. But what if it was just a bill, or a request for more information? I tore it open and immediately read, “The Admissions Committee of the University of Mississippi Medical School of Medicine has selected you as a member of the medical school class entering in August, 2001. Congratulations …”

This was it! I felt my hands trembling and my stomach knotted as if I might need to puke the buffet pizza I had just eaten. I floated out of the vehicle as I told the girls I had gotten into med school. Leave it to Macey to burst my bubble. She wrinkled her brow and said, “I thought you already went.” She had mistaken the Hinds Community College classes of the prior year that I had taken as pre-requisites as “medical school.”

I thought of Mom first in Alamogordo, but decided to make a local call first. Dad and Beth were thrilled to hear the news and Beth was very pumped for me. I called Mom next who had thought about my application just thirty minutes earlier she claimed. She said that when she realized it was me calling that she guessed what was up. We laughed and exulted for a moment together, with Angie listening in for every word. Calls quickly followed to the Stokes, Cranes, Alison, and Mark Polk. Glenna was not home and it was an hour before I could reach her.

Even now, hours later, it still seems surreal. I have all kinds of thoughts running through my head about how my life will change and the things I need to do. Find a new church treasurer. Get out of my investment club and the responsibilities that go with it. Cancel the quarterly pest control service (too expensive).

The letter says I have 15 days to accept my acceptance. I will hand deliver my signed form and $50 deposit check on Monday. I think I will also go by the bookstore and start scooping anatomy and bio-chem books. May the adventure begin!