It seems that somehow I am a month into my second semester of nursing school and my last entry was a month into my first semester. How does that happen? I sometimes compose entries in my head as I am driving or drifting off to sleep, but they never materialize in cyber form. So, since I am feeling an urge to write here, I will take this moment to breathe, reflect, and purge...and not just because I am procrastinating on finishing the rough draft of my 3010 theory paper.
First semester seems like a whirlwind. It went by so quickly...and yet, it feels like this semester is going even faster. I managed to pull a 3.7 GPA during the first semester. I definitely had some moments of disappointment over it, but in the end I am moderately pleased with it. It has been sometime since I haven't received and A in a course. I try to comfort myself with the thought that the classes I did the poorest in, Pathophysiology (B) and Pharmacology (B+), have the least to do with direct patient care.
Our cohort lost four people due to grades in the first semester, so I should feel a huge sense of accomplishment. Everyone who made it into the program is bright and talented. Sometimes I need to remind myself that its a pretty big deal that I even got into the program on my first try.
This semester I am trying to find more balance. I am working to make sure I get enough sleep, down time, study time, and fun time. Truth is I have been in a progressively growing funk since the semester started. It makes it hard for me to seek out fun time or commit to study time. My first exam of the semester was a big wake up call that I am not focusing enough. Lest anyone get too worried, I am pretty adept at recognizing my patterns of clinical depression and am taking steps accordingly.
One of the things I am finding to be a real challenge is the lack of queer community. Or, perhaps it more the lack of connection to people who know all the layers of me. I have made some really wonderful friends here and yet because of our crazy school schedule there aren't a lot of occasions to get to know people beyond the superficial layers. I am such a processing orientated person that it difficult for me to continue moving forward without opportunities to process some of the challenges I am facing. For instance, last semester, for the first time that I can recall in over a decade, I lied about who I am.
Early on in my clinical rotation, I was taking care of an older woman in her 70s who had just undergone a Whipple procedure for pancreatic cancer. In the course of our time together, she asked me if I had any kids. When I replied that I had a teenager, the inevitable questions about my marital status (I’m single) and where his mother was (I’m his birth parent), were asked. For the first time ever I lied. I did not come out as transgender, or claim my role as AJ’s birth parent and dad. In the moment, my job was to care for that patient and I felt her need to be comfortable with me as her caregiver outweighed my need to be honest about who I really am. I believe I made the right decision, but it doesn’t change the fact that it made me feel horrible and that I didn’t feel like I had someone to process that experience with.
Similar things come up for me all the time in classes. I find it so interesting (and at times exhausting) how so much of our medical knowledge and training involves differentiation based on gender and yet there is so little research or acknowledgement of people who fall outside of the gender binary. Case in point. Right now, I am supposed to be working on a paper about coronary artery disease (CAD). After writing up the pathophysiology of the disease, risk factors, prevention, treatment, etc. I need to analyze my own risk factors and come up with a plan to mitigate at least some of them. For those not familiar with CAD, metabolic syndrome is a significant risk factor. One of the indicators of metabolic syndrome is waist circumference. For males a measurement over 40” is considered a risk factor, while the measurement for women is over 35”. So, as a trans person which measurement do I use as my standard? When I asked my professor, she said analysis should go with a person’s genetic gender. When I mentioned that previous healthcare providers have told me that testosterone use in FTMs, places them in the male risk category for heart disease, she thought that was an interesting point. No clear answers…story of my life. I couldn’t find a single research or journal article that dealt with metabolic syndrome and transgender people.
Now, to be honest, I knew this was going to be an issue coming into the program. One of the main reasons I wanted to go to nursing school was to have an impact on transgender healthcare. However, knowing and living through the challenges are two different things. If my program wasn’t so intense, I could envision participating in a queer health students coalition or something like that and getting some support or at least camaraderie, but given my schedule that’s just not possible. It does make me think more about where I am willing to do my master’s degree if I choose to go that route. I am certain that I will choose a school that is on the cutting edge of LGBTQ health care.
So, on that note, I will return to the land of coronary artery disease.
Peace and compassion…
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