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Wrapping Up ICO: French Fries, Thundersnow and Clinical Pearls


May is here!

I have been looking forward to this month for a very long time. Our last set of exams. Our last lectures. Our last clicker questions–followed by a scurry of movement as everyone tries to unearth their clickers from the depths of their backpacks and click something before the timer runs out. (For the record, my clicker has been covered in jam, glue, ink splatter, and tea leaves, and has perpetually been “low battery.” I will cherish that clicker until the day I die–or until someone offers me a dollar on the ICO Marketplace.)

However as much glee and impending joy that this month represents, it is with a unique sadness that we say goodbye to ICO. As our class embarks on externships, ranging from the shores of Hawaii, the excitement of Spain, the opulence of Dubai, and the Tim Hortons of Toronto, it is the first time in a long time that our class will be apart.

I think it is safe to say that the class of 2014 is awesome.

We started study groups on Facebook when everyone else was still on MySpace.

My first memory of ICO and our class was orientation, in what can only be described as the three most humid days ever, when I tried to allay the fears of terrified Wisconsinites be telling them they could call me Siva instead of Shivakhaami. It’s okay. Aside from one arch nemesis, Wisconsinites are my favorites.

I have vague memories of those first few days. Mostly I remember going out every night and being confused every morning. What is an ophthalmoscope and why are they talking about it? I remember the word “professionalism” being threaded into every sentence, and standing in line to buy a refrigerator in the RC with my suitemate. I remember getting a gargantuan stack of notes, bound with black clips, and to my abject horror, learning they were only for the first quarter. I remember coloring in the vagus nerve and laryngeal nerve and optic nerve. I remember hating the Pentose Phosphate Pathway. I remember learning that the iris sphincter isn’t under voluntary control unless you are the Dalai Lama, in which case, all bets are off.

I remember meeting my best friend Caroline at the “Big House Party” after ICOlympics–and the terrifying experience at the 35th Street McDonalds afterwards that forever solidified our friendship. I guess this is the adult version of spitting on your palms and shaking them, because nothing bonds people together like fear and French fries.

First year is a flurry of emotions and an assault to all your senses. It is learning a new language. It is pushing your mind and body to limits they haven’t been pushed to before. It is crying in the study room in the RC, seeing the sunrise because you are still studying, sleeping during the day like the nocturnal mammal you have become, and eating four cookies during lunch at the cafeteria (because five is glutinous). I remember watching the Thundersnow blizzard of 2011 engulf the school for two days, allowing for an impromptu party, sledding and snowball fights.

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Second year was more comfortable. We knew the shortcuts around the school, the only vending machine that had Sour Skittles, and finally what an ophthalmoscope was. I learned that there is nothing like a quick bike ride to 31st Street Beach to calm my nerves, and that Jimmy John’s can deliver to the library in four minutes. As we replaced our coloring pencils for “Drug of the Day,” we settled into ICO like the cool kids we had become. And as the anxiety waned, we started dressing better. You could always tell who had PCP that day, because no one chooses to wear a tie or tights on their own accord. We pranked Dr. Lesher on April Fool’s Day by all wearing matching blue shirts, and subsequently bought him a pink shirt to spice up his wardrobe.

Which brings us to third year. The summer was marked by the realization that I had gone from 8 a.m. to 8 p.m. without stopping, and that I was operating on such a high level of adrenaline that I was in a constant state of fight or flight. I apologize to anyone I punched in the face during summer quarter–it was my sympathetic nervous system talking. With clinic shifts and CPS and dispensing and Retina (throw in Baby and Contacts and online Evidence Based Health Care quizzes that I managed to fail every time!) it’s a wonder I made it through. I think that was the quarter that glued our class together–there was always someone to commiserate with. In our mutual despondency, our class became one. I’m pretty sure Rihanna’s song “We found Love (In a Hopeless Place)” is written about summer quarter.

Full disclosure: I’m just trying to scare you. It wasn’t that bad.

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I think we can all agree that the best thing about third year is clinic. There is never a dull moment within the four walls of the IEI. It took me three quarters to figure out how to carry my suitcase, trial lenses, and BIO. It took me until last week to find the elevator. It took one ill-fated turn of the wrist to spill all my trial lenses on the ground. However, it was with undeniable relish that I crossed my name off the board after I finished my first shift–and then ran after the poor woman to apologize for what I was certain was the wrong prescription.

Everyone finishes third year with their own “clinical pearls.” Most are not the pearls that will help you in any facet of life, but they are the kind of thing that will still make you laugh years after you have left ICO.

I still laugh when I think about the woman who asked me if her co-worker was giving her the “stank eye” at the end of the day, because the left eye would drift out and point at her while the right eye looked straight ahead. No dear, that’s just a decompensated phoria that’s troping–don’t give her the cut eye back. I made more than one child turn against me when I insisted that Fluress “just tickles” and that if they looked straight ahead at the blue light, they’d see Mickey Mouse. I have reigned in my temper when patient’s bury their lashes because they are clamping their eyes shut but insist they are open during BIO. I just went with it when my little nine-year-old patient reached over and started stroking my hair, and took the opportunity to check her pupils. I choked back my surprise when a voluptuous woman proceeded to undress herself when I asked her to roll up her sweater so I could take her blood pressure. I smiled for days after my 75- year-old patient told me “if he was just 50 years younger,” he would have proposed. I contemplated wearing my PAP polo shirt out in Chicago, seeing as I got more attention in that outfit than any other article of clothing I possessed.

And everyone has their favorite story. The one that makes your heart skip a beat. Mine was a 40-year-old cerebral palsy patient who didn’t speak, but was animated, joyful and full of life despite arriving for her appointment on a gurney. I took off my heels and did retinoscopy on my knees to get her prescription, and despite the challenges her case presented, we laughed with each other. When she pointed to the words “Thank you” after her eye exam, I nearly cried.

So as we embark on our externships and start forcing ourselves to branch out from our ICO cocoon. I would be remiss if I didn’t give shout-outs to some of the most defining events of our three years at school.

Who could forget our massive confusion during retinoscopy and the “at” versus “axis” debate? Who didn’t shed a tear when Dr. Z talked about the importance of family before our Thanksgiving break, or feel a renewed sense of confidence when Dr. Baker talked about his marathon? Who didn’t sheepishly pretend they knew what was going on during dark adaptation, because it was “extremely basic”? Who amongst us didn’t exfoliate our feet prior to Dr. Gabriel’s lab, just in case we got Babinski-ed? And who didn’t feel the vestiges of fear finally wane after Boards, only to be replaced by the terror that we’d be injecting each other in the eyeballs?

And before you know it, not only are you done with ICO–ICO is done with you. All the tests have been taken, all the PP fossas have been demystified, you stopped worrying your prescriptions were wrong, and you figured out where the elevators were. Perhaps it won’t be until well after ICO that we can truly appreciate our class for all its wonder–but remember, some people want to come to ICO so bad, they’ll drive their car right through the courtyard.

Take the time to enjoy your classmates. Yes, we are all annoying. Yes, all we can talk about is school, even when we try not to. But May comes at you like a freight train. These are the people you feel like you’ve known forever. You’ve seen each other at your worst and at your best. They will probably be your bridesmaids or your groomsmen, and let’s face it–they’ve looked deep into your eyes and that’s a bond that can’t be shaken.

Don’t worry too much about grades–you win some, you lose some.

Don’t feel bad that you spent the entire night on Facebook–it happens.

Watch your classmates play in the championship hockey game and sabotage the other team at all costs.

Learn the city and province your Canadian friends are from–they will love you forever.

Enjoy Chicago and all the amazing things it has to offer–and most of all, enjoy it with the people around you. It goes by fast.

And don’t tell a cheeky kid there is a Mickey Mouse on your tonometry probe–you will rue the day.

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