My 'last' summer

I survived! First year of medical school - check! It sure does feel good to be on the other side of this year and to be headed into summer. Looking back on it now, the year seems to have breezed by. There is no denying that this year was a bit of a roller coaster and a huge challenge in a multitude of ways, but I am happy to have been through it all. I have emerged largely unscathed and a bit more centered, empowered, and ready for the next phase. The first quarter was all about figuring out Stanford culture and what it means to succeed academically in a very challenging, high-expectation environment. Winter quarter involved juggling numerous classes and exploring whether it is even possible to acquire some academic rhythm amidst a diverse and dense curriculum. I feel like a found my stride in spring quarter. I now have a better understanding of how I need to study to both do well and absorb the information I really need to know. I am able to devote time to the extracurriculars I really enjoy and spend some time with my friends. It is true, medical school is hard on relationships, friends, family, and partners, and I know that it will continue to be hard, if not harder. I have felt that deeply this year and I know all of my classmates have struggled with that at one time or another. Yet, I think I am finding a better way of splitting my time between the medical world and everything else. I know, without a doubt, that I am someone for whom living completely within the medical world would be dissatisfying. I need a life outside of it and I am trying to cultivate good habits, routines, etc. that will help me hold onto all that feeds me outside of the medical profession. Staying true to my values now and into the future will prove to be incredibly important. At Stanford, it is particularly easy to be swept up by the high expectations, the opportunities, the connections, etc. and forget that one has to be quite deliberate about one's path, otherwise the momentum of it all will take over. Spring quarter wrapped up nicely. The last few weeks were full of events honoring student advisors/mentors and faculty, panel discussions led by Stanford medical graduates about to transition to residency, and lots of studying for finals. I had four exams in the last week of school – the last cardiovascular block exam, a practical clinical skills exam, a written exam on differential diagnosis, clinical exam findings, and diagnostics, and then our integrated block exam (respiratory system plus the cardiovascular system). The practical exam was the highlight for me. It consisted of a 25-minute, problem-focused visit where we were supposed to exercise our clinical reasoning skills. Each of us had a patient presenting with uncontrolled high blood pressure and worsening chest pain and our task was to interview them with our differential diagnosis guiding the questions we chose. I love the challenge of having to both interact with the patient and efficiently problem-solve what brought them there. To us first-year med students, a 25-minute visit seems soooo short, so I definitely was pressed for time, but it went very well. I think I asked good questions and I still had time for a lung and heart exam (albeit quite brief). 9 months into medical school, I certainly feel that my interviewing skills have vastly improved and I am feeling much more comfortable with the physical exam. I look forward to next year, as we get to further hone those skills, learn more specific physical exam components, and see more 'real' patients. I will have the added bonus of more immersion with clinical skills material as a TA for the clinical skills and ethics curriculum for first-years. The day of my last final, I celebrated the end of first-year by getting a pedicure with my classmates Liana, Lindsey, and Cassie, then lounged poolside with Alex and Liana until we met up with the rest of my class in downtown Palo Alto. It was a wonderful we to celebrate having made it all this way. The next day, I flew to Seattle for 10 days with family and friends. I spent a few days in Seattle and most of my time on Whidbey. I caught up with friends from high school, college, and lots of family. Whether it was the time spent in the vegetable garden with my mom, playing in the yard with Weston, or catching up with dear friends over coffee, I loved it all! The highlights: dinner at my favorite restaurant on Whidbey (Gordon's), had my first taste of filet mignon and 3 hours of great conversation with my parents a day in the city with my best friend from high school, Ann – spin class, lunch at the Pink Door, tour of Pike Place, dinner at her beautiful home, and Mad Men = perfect! excursion to Port Townsend with my parents, complete with Thai food, ice cream, bookstores, and a movie at the Rose Theatre! family potluck to celebrate my cousin's newly attained American citizenship – aunts, uncles, cousins galore! I returned to the bay area on June 25th for a week of research and catching up with friends. After that, Alex and I jetted to North Carolina on July 2nd for 5 days with his mom's family in the Outer Banks. It was really fun to take part in such a big family reunion. Alex's mom has three sisters – one from Virginia, one from Colorado, and one from Texas. They rented a big house right on the beach and we all got to catch up, sunbathe, swim in the ocean, swim in the pool, eat good food, etc. I felt very welcome and it was some of the most relaxing time I have had this summer. It certainly was hot over there (over 100 most days and humid), but I thoroughly enjoyed it and it was hard to leave. One of the more unique moments I had when I was there was waking up for an early morning ocean swim and paddleboard experience with Alex and having ~8 dolphins swim right past me as I sat quietly on my board. They were so close, I felt like I could reach out and touch them! Amazing! Now, I am back in the bay area for most of the remainder of my summer. My days are spent either working on research, attending meetings, coordinating the outdoor orientation for the incoming medical students, having bbqs with friends, and searching for housing for the coming year. I have to move within the next month, so I am madly trying to find a place closer to campus to call home. Hopefully, I will find something really soon so that I can move slowly, rather than frantically. The housing market is nuts in this area, both in terms of price and in terms of competition, so I will be happy to be over this hurdle. Alex and I went to Salinas, CA yesterday to check out the land of John Steinbeck. We went to the National Steinbeck Center and I reminisced about how much I loved reading East of Eden while we were traveling in Mexico and Guatemala last summer. We explored Salinas a little (ate some humongous fresh blackberries and picked up some okra to make at home – my knew culinary specialty), drove up to Castroville to sample some deep fried giant artichoke hearts, then stopped in Santa Cruz from some happy hour margaritas on the wharf. So much fun! Now, I plan to be deliberate about how I approach my summer. I want to feel like I have more momentum with my research, which means devoting more time to it and focusing a bit more. I want to explore the outdoors – more hiking, camping, etc. Alex will be moving back to the northwest at the end of August to start a year of travel, so we want to soak up every ounce of summer fun we can. I think we are doing pretty well so far! Another goal for summer – more blog posts and reflections, so stay tuned. I fell of the blog-wagon a bit, but I am back and hope to reconnect with this as part of my routine. Happy Sunday to all my family and friends! Stay tuned! :-)

Me and baby Lupe

Here's the pic of me and baby Lupe about 20 minutes after her entry into this world (4/20/12).   What a wonderful moment, I love this stuff!

Emerging from spring quarter

Time for a recap... Since the last time I posted, a lot has happened!

1. I ran the Santa Cruz half marathon with my college friend Larissa on April 1st. It was a beautiful race and we both ran 13.1 miles with more vim and vigor than we ever had. (next race on my calendar, the Nike Women's Marathon in SF - another full 26.2 miles in October!)

2. Four days into spring quarter, I flew home to surprise my parents for Easter. Danielle was in on the secret (so that she could help coordinate and make sure that my parents didn't have too many plans for that time). The plan was executed perfectly! And, despite a few of my family members getting sick while I was there, it was a wonderful trip. So glad I did it!

3. As a compliment to all of the physiology coursework I have right now, I am enrolled in an elective called "Mothers and Newborns"...all of the med students refer to it as "Mommies and Babies." This class includes a weekly seminar about various pregnancy and early childhood-related topics, but what it is known for is the opportunity to be matched with an expectant mother for the remainder of her pregnancy and beyond. I was lucky enough to paired with a vibrant 28-year-old Tongan woman at about 7.5 months into her pregnancy. I followed her to many of her OB, ultrasound, and stress-test visits (she had quite a few because she is profoundly diabetic, independent of pregnancy, has hypertension, and was preeclamptic for both of her previous two pregnancies).

On April 20, I spent the entire day with her and her family in labor and delivery for her scheduled induction. Everything went well, albeit slowly, for the first portion of the day until they gave her a second dose of the hormone that is supposed to trigger contractions. Her contractions came too close together and the baby started to show prolonged signs of distress. Because of these, and the mother's risk factors, the medical team suddenly swarmed into the hospital room, broke her water, put her on oxygen, told her to get on her hands and knees, and wheeled her out to the OR. This was all due to the presumed stress the baby had been under and the team's concern for long-term oxygen deprivation.  Within a matter of a couple of minutes, my 'mommy' was on her way to a possible emergency c-section and the father and their two-year-old son were left in an empty hospital room.  The most distressing part of this...neither the mother, nor father, were told what was going on.

I was shocked by the lack of communication between the medical team and the family.  The mother was visibly traumatized throughout the whole experience.  Fortunately, the baby did stabilize and the emergency c-section was canceled.  After she was returned to her room, I was able to take some time to acknowledge what had happened and convey to the family that they deserved better.  The medical outcome was a good one, but the team failed to respect the family appropriately.

The rest of the labor went smoothly and the mom delivered a beautiful baby girl ('Lupe') at 9pm that evening.  It was a true privilege to be there for the whole experience and I think I am now an honorary member of their family.  I have seen them a couple of times since then and will see the family next week for another follow-up appointment.

Having this opportunity has been one of the highlights of my quarter.  Any chance to connect with patients and have a little more human interaction!

4. I started my new organ-system based curriculum. We kicked this portion of the curriculum off with a study of the respiratory system. Last Monday (4/30), I had my first block exam where we were assessed on respiratory physiology, pathology, neoplasms, as well as on antibiotics and antifungals. Needless to say, we were accountable for a ton of information and I passed. :-) I am glad to be onto the cardiovascular system. Check one thing off the list and take one step closer towards summer.

Now, I am studying the cardiovascular system and, unbelievably, I only have 2 more weeks until another exam, ewwww.

That's a basic recap for me.  Alex remarked the other day that he thinks it is ironic that I came to medical school and then needed to learn how to study less.  :-)  I certainly overcompensated in the fall and I have been purposely striving to be more relaxed about school.  Relaxed, while still taking it seriously...just not too seriously.

I, along with many of my classmates, found winter quarter to be remarkably challenging and I know many of us felt stunned by all that we have ahead of us and the intensity that will entail.  Thus, I am trying to do what I can to tone down my life...just a little.

I am more forgiving of myself.  If I am tired and just want to lay in bed and watch a movie, then that's what I am going to do.  If I decide to go for a run or bake banana bread instead of studying, so be it.  I am soaking up the opportunities, cultivating more meaningful friendships, enjoying the sunshine, and embracing all of the information I am being introduced to.  So much going on, but it is all very rich.

It is not a mystery to me now why medical school is so challenging.  Achieving greater balance is going to be an ever-changing target, but I am up to the task.

Much love to all!

P.S.  Below is a picture from our trip to Napa last weekend.  I almost had a change of heart and had Alex leave me at the Culinary Institute of America.  ;-)

Time to reflect and reset...

I survived winter quarter, yippee!

I have officially emerged from winter quarter largely unscathed. The last two weeks tested my academic endurance, with six finals, including one for the great behemoth of neurobiology. That class was my first final last week (had two finals the week before) and covered material from ~55 lectures and 20 hours of neuroanatomy lab. Yikes! I spent the most time reviewing material for that exam, partially out of necessity (we had more class time for that course than for any other) and partially because of the rumors we all heard about just how difficult that class is compared to all others we will encounter in the first two years of med school.

I made it through that exam and through three more. By Wednesday afternoon last week (post-immunology exam), most of my classmates 'checked out'. We still had our head & neck anatomy exam on Thursday, but since our grades would be cumulative with first quarter, many people were happy to start spring break early and hope they acquired enough points on Thursday's exam to skate by.

A subset of my classmates, me included, did not 'check out.' We dove head first into anatomy for another 24 hours. This subset was particularly dedicated because we are all applying to be anatomy TAs next year. The position entails the most teaching and greatest amount of one-on-one contact with first-year students, plus it is entirely hands on. That combo makes it particularly appealing for people either interested teaching or surgery. I believe my final effort for studying was worth it and now I get to wait until the end of May to find out whether I will be one of the 9 anatomy TAs for the next academic year.

At ~11:15 last Thursday, I was officially on break!! Oh, how glorious that was! We celebrated by completing nutrition modules online and drinking sangria. Alex met up with me at my classmate's apartment for some fun evening festivities and then Friday I left for Tahoe. Alex, Liana, Nicole, Nicko and I (Alex plus 3 classmates) drove up to Tahoe Friday afternoon and just returned yesterday. We had a wonderful time and I felt like I was truly on break once I put my first loaf of homemade bread in the oven!

Nicko's family has a cabin right on the Lake (facing south with an incredible view). We took over the place and spent our days skiing, baking, cooking, playing games, etc. It was so much fun and exactly what all of us needed. Even Alex needed a little break from the Palo Alto grind.

The cherry on top of the entire experience was that it snowed on Sunday night, which meant we had fresh powder to ski in on Monday. Below, you can see the view from Alpine Meadows ski resort in north Lake Tahoe.



Now, I am back in Palo Alto and enjoying the sunshine and spring-like weather. I am sitting at Philz Coffee, where they make delicious coffee by the cup (they do not serve espresso, but offer an array of light, medium, and dark roasts to suit your personality, emotion-of-the-day, the weather, etc.). I spent the morning shadowing Dr. Bachrach (the wife of one of my deans) in the pediatric endocrinology clinic at Lucille-Packard Children's Hospital. I had a great time! I was able to see a couple patients with Turner's syndrome, one with a possible growth hormone abnormality, and another with congenital heart disease combined with hypoparathyroidism. It was a very educational day and gave me a glimpse of what kinds of issues endocrinologists get to deal with. I will definitely go back to get a little more exposure to that field.

The rest of my week will be pretty low key. I have several social commitments in the next couple of days and then on Sunday, I am running the Santa Cruz half marathon with my former college classmate and rowing teammate Larissa.

I know that this break will fly by, but I am trying to savor the change of pace and the opportunity to spend a little more time with Alex. I can feel my brain sighing and I cherish the moments when I can indulge in thinking about absolutely nothing.

The winter quarter was particularly challenging because of the academics, but more than that it was challenging because it was within the last few months that it really hit me that I will be living in California for at least 3 more years. I miss my friends and I miss my family and I need to be patient with how my social network and community is growing and evolving here. It is easy to forget that the friendships I have formed here are very 'young' and that the kind of depth of relationship that I yearn for takes time and experience.

My medical school life is becoming richer and richer, but no matter what the activities are that I find myself engaging with, I keep yearning for more. I want this place to feel more like home than it does right now and I need to try to be a bit more patient!

Spring quarter will be very full - I am helping organize Admit Weekend for the incoming class (this occurs the second full weekend of April), I am co-coordinating the outdoor orientation leaders seminar throughout the quarter (this includes outdoor skills, mentorship and leadership training), I am taking on a leadership role with the medical school committee, and I am helping run the women's clinic at one of the student-run free clinics. Lots to do and lots to be energized by.

In addition to all of that, I get to start the systems-based portion of the medical school curriculum. This is very exciting for all of us, because we feel like we are on the brink of taking classes that well really teach us how to approach clinical reasoning. We are ready for it!

On a different note, I drove through tons of rain yesterday on our way back from Tahoe and I was immediately transported back to the northwest. So...to all my friends and family in that area, know that I think of you often and I hope you are all happy and healthy!

Until next time...

Too much sunshine :-)

Hmmm...what has happened in my life in the past three weeks?

Reflecting upon it, I feel like a lot has happened, although much of it is rooted in med school routine. In clinical skills, I now know how to do a basic neurological exam, the cranial nerve exam, and the head, eyes, ears, nose, and throat (i.e. head & neck) exam. For many of the sessions in the past few weeks, we have practiced on each other, rather than standardized patients, which means that the classes are much more low key (no professional dress required) and the preceptors are more forgiving of mistakes or the instances where our memory of a 20-point checklist falters a bit. :-)

Last Friday, we learned the musculoskeletal exam and we were given instructions to wear 'loose clothing.' I took full advantage of that statement and chose to wear pajama bottoms to school on Friday. I was definitely the only med student to choose such attire (most chose athletic clothing) and I received a range of interesting looks and remarks as a result. Ah well, I loved the chance (perhaps the only one I will get in medical school) to wear such comfy clothing. I'll just have to get used to scrubs as the new pj's.

Everything is going pretty well overall. Alex likes his new job, which is great. Now, between the two of us, we are busy until about 8pm most nights during the week. So, most of our time together on weekdays is spent vegging out, either by watching Scrubs, Top Chef, or Grimm.

The end of the quarter is fast approaching and I am in a great deal of denial about how much I have to study/review before I take on 6 final exams in mid-March (yowza!). Next quarter will be a welcome shift (fewer class hours and a block, 'organ-based' curriculum). Tick-tock, tick-tock.

Alex and I have made several trips up to Tahoe (with friends) over the past few weeks. One time actually included a good round of skiing (despite there being minimal snow in the mountains) and last weekend we got a little snowshoeing in. This upcoming weekend, I finally have a chance to be in the area for the most part, which is a welcome change of pace.

Planning for the outdoor orientation trip this summer is well underway. With that and my involvement in student committees for the wellness initiative at the medical school, I am certainly keeping myself busy, busy, busy. Oh, and I have taken on a commitment to help lead the Women's Clinic at one of the community free clinics run by Stanford students. That commitment will begin next month and carry through the next year.

On a different note, the weather has been gorgeous. The northwest girl in me still fights just how warm it is on any given February day here (stubbornly wearing a vest or fleece when it is in the mid-60s). Today is one of those days. As I write this, I am sitting on the fourth floor balcony of the med school, enjoying the view and the warm breeze after having overheated over lunch at on outdoor cafe nearby. At least there is shade here. It feels like May to me, certainly not a bad thing, but it takes a little to get used to.

I am still very happy to be here, but I continually wish I was closer (geographically) to the people that ground me most. I am establishing good friendships here, but they have known me for only a few months. Up until my move to Stanford, I have had the privilege of being in close proximity to those that know me in a deeper way. Those connections provide a sense of comfort that I miss. I am fortunate and grateful to have Alex here, but it is still a little hard to imagine the roller coaster I will be riding for the next 3+ years. So, I keep strengthening current friendships, going for long runs (most recently, I joined a CrossFit gym), baking/cooking, and finding other ways to keep me grounded, sane, and well overall.

Sending lots of love to family and friends!

To the brainstem and beyond!

Wowee, winter quarter has almost swallowed me whole. Not really, but the material we are learning now makes me roll my eyes in a this-stuff-is-so-crazy-i-just-can't-believe-it kind of way, not a oh-not-this-again kind of way. Immunology is a whole new version of alphabet soup - everything comes in acronyms. Neurobiology involves so many very specific, intricate structures and their specific, intricate functions that I find myself being baffled by the fact that scientists have figured this much out.

Generally, the topics we are covering now are very interesting, despite feeling a bit overwhelmed by the quantity of information. I do feel more settled in my study habits now than I did last quarter. Part of that stems directly from the fact that I just recently looked at my grades from last quarter (a weird, consistent habit of mine) and the grades reflect the quantity and, thankfully, quality of the studying between September and December. I felt like I had never studied that much before and it paid off! Phew! Now, I just need to keep reminding myself of that, especially as I approach finals in March.

The pace of life has sped up a bit. More class time, more meetings, and more activities. We only have anatomy once a week now, which breaks up the week, but makes me miss dissecting. Instead of anatomy on Thursday afternoons, we have neurobiology lab (lecture followed by small group sessions with nervous system specimens). Our Monday and Friday afternoons have turned into a bit of a doctor-to-be's playground. It is during those periods of time that we get to practice the physical exam. We covered cardio, pulmonary, and abdomen in the first few weeks and this past Monday we did part of the neurological exam. Instead of working with standardized patients, we practiced on each other to test for pain sensation, coordination, reflexes, etc. It was actually a lot of fun! I love our clinical skills class! It serves as a reminder that we really are being trained to be clinicians and, hopefully, healers too.

Besides class, I have been gearing up the planning efforts for the outdoor orientation trip that a classmate and I are leading this summer and I have been working on arranging my summer research. That and the time I spend as a member of the wellness committee has added to the overall density of my schedule.

Two weekends ago, my friend Larissa came to visit me and then we celebrated my friend Megan's birthday (I made chocolate ganache cupcakes, go figure). Alex had a 24 hour bout with food poisoning (the culprit was likely some expired deli ham), but recovered in time to go to his aunt and uncle's house in Walnut Creek and watch the SF 49ers lose the championship game. The day after the game, Alex started a new job as a sales sourcer for Box.net. He is working full-time in Palo Alto and he loves the work environment. It is a really big and very good change for him.

This last weekend, Alex's mom, Kim, came into town to help celebrate Alex's grandma's 85th birthday. Kim arrived Friday night and Saturday morning we drove over to Half Moon Bay (on the coast, west of Redwood City) to join in the festivities. There was a great turn out, the weather was gorgeous, we ate good food, and even went on a beach walk with the whole family.

Saturday night, Alex had his brew team over to bottle their last batch of beer (an oatmeal stout) and brew another (an Irish Red). Kim and I made dinner, hung out, watched TV, and relaxed while Alex and two of my classmates (Liana and Nicko) concocted their beer in the kitchen. The next day was half about touring the Stanford campus and half about studying. I introduced Kim to the magic of Stanford and then I immersed myself in it by isolating myself (along with Liana) in one of the student union buildings in the heart of campus.

This week so far has been fairly low-key (relatively speaking). I was even able to take some of today to run errands, which is certainly a rarity. The weather has been quite beautiful. Mostly sunny days, and warm enough that my Chaco sandals have reemerged from my closet. The evenings still have a bit of a chill to them, but one look at the trees around Stanford campus and you can tell that nature thinks that spring is on its way. :-)

What lies ahead? I am going to Pacific Grove with Alex this Saturday to enjoy a crab feast with his other aunt and uncle that live down there (rough, I know). Sunday, I am spending all day in the women's specialty clinic at Arbor Free Clinic. I am excited to actually get in there and work with some patients! Besides those things, my objective is to study-study-study, since I have a midterm next week for the compilation course that includes pharmacology and microbiology.

Ever onward - (i.e. now it's time for me to watch some Scrubs and then hit the hay!)

Entering the ring again

It feels good to have one quarter of medical school behind me! Having 'survived' the strenuousness of finals and realized just how much I have learned in such a short period of time, I feel like I can better navigate my winter quarter.

My winter break was exactly what I wanted it to be - relaxing, rejuvenating, and an opportunity to reconnect with friends and family. I spent the first part of my break in Hood River, Oregon with Alex's family and then made my way back to the Seattle area to spend the Christmas holiday with my family. After a week and a half based on Whidbey and tons of time spent baking, cooking, reading and enjoying being obligation-free, I flew back to the bay area to take advantage of the time and explore the bay area/peninsula a bit.

Immediately after getting back, I had a reunion with my college roommate Rachel who had flown up to visit friends. I had not seen her in a year and a half, so it was wonderful to spend a day in SF eating good food and savoring perfect "winter" weather (a slight edge of crispness in the air to begin the day, but then exquisitely clear and sunny, with temperatures high enough that Rachel was wishing she had shorts - crazy talk for winter, I say). I was able to go on a hike in the Santa Cruz Mountains with Rachel, Alex, and several of my medical school classmates and after bidding farewell to Rachel, Alex and I headed to Tahoe to test out the slopes.

We spent two nights in South Lake Tahoe with 5 of my classmates at a cute little cabin. Tahoe has absolutely no snow right now, which is completely unusual. I had never been to Tahoe until that weekend, so I have no frame of reference. But the ski areas are only offering a few runs at each location, purely based on the amount of manmade snow they have to offer. Nevertheless, we spent a full day skiing at Kirkwood Meadows. It was beautiful and we had fun, but the snow was certainly all but ideal. Our time at Tahoe was a perfect conclusion to my break, but when the first day of class rolled around, I did not feel ready to let go of what had been an incredibly fulfilling/meaningful time of respite.

School has been really good so far, although I am still readjusting to the pace and demands that come along with our day to day schedule. I am taking Immunology, Neurobiology, Head & Neck Anatomy, Neuroanatomy, Intro to Human Health & Disease (includes Pharmacology, Microbiology, etc.), and Practice of Medicine (includes clinical skills and health policy). Winter quarter is the densest in terms of required class time of any quarter at Stanford. There are plenty of rumors going around that it is the toughest also. I think I just need to figure out how to organize everything and keep myself moving forward, especially amidst other things I am trying to be involved, such as planning the outdoor orientation trip and contributing to the school-wide wellness committee.

Last weekend, I joined about 40 of my classmates back at Tahoe for a two-day, med school subsidized escape from school. Most people went skiing, but since Tahoe still doesn't have any snow/only 5% of Kirkwood is open, Alex and I stayed near the rental house and went hiking on the rim trail with some other people who decided to stay off the slopes. The weekend was a ton of fun, although it served as another excuse to be in denial about school being back in full swing.

I am grateful that this week is a short one. Right now, I am having a hard time being ok with missing the snow in Seattle, as I love snow days. Why did I move somewhere where snow days will never happen?! :-) Ah well. I will just have to "ooh" and "awe" at the pictures people are posting on Facebook.

Lots of meetings this week and lots of lecture to bring me to yet another weekend. Hopefully I can catch up on work enough to feel like I can initiate some of my goals for this quarter, mainly to achieve better balance between the time I spend studying and the time I spend doing things that are either meaningful or relaxing or both. I know this is a long journey I have begun, so I am trying to put less pressure on myself than I did last quarter. I'll let you all know how that goes!