Chapter 69

Excerpt taken from “misc rants”

I awoke to silence. The sky outside my window is still dark. The street light shone past the tree branches and extended an eerie shadow into my room. My eyes weren’t adjusted for the darkness at first but now, they slowly got used to the dimly lit scene. 

The yellow street light was enough for me to see the entire room now. But honestly what was there to see? I stared at the ceiling. I started a small chant to myself. 

“Things are going to be okay. Things are going to be okay. Things are going to be okay…”

I tried all I could to will these words into truth but that was an impossible feat. I knew my consciousness wouldn’t buy it. My body and soul were aching with guilt from what I knew to be true. I was inadequate at my program. 

I turned to my girlfriend who was sleeping next to me. She was deep in a dream. I didn’t want to wake her up though I really wanted to. I needed someone to talk to to ease up some of the dark voices in my head. But I couldn’t do that for her. She’d already taken a week off work to stay with me while I was psychologically fragile and ruining her sleep too is asking for too much.I didn’t want to be a bother. 

Instead of seeking company, I sat up alone and looked at my phone. 

4:13 AM. 

This is too early. I turned to my phone and logged online to my school email. I started to look at the email telling me about my supplementary test. In my mind, again and again I played out how I could have studied a bit more for this or a bit more for that and in the end, it would always land back on the thought of why bother thinking about that? 

But here’s the thing. I don’t know if anyone has been known to have failed a course in my program. Am I the first in a while? Are the staff at school secretly looking at my file and thinking how much of a disgrace I am? Am I the worst one that has come through the program? What about doctors that get sued their first year out? Even though they made it through school fine! Yet here I was, unable to be even at their level. 

I laid back down. This over-thinking isn’t going anywhere. My thoughts were becoming more and more incohesive. I didn’t want to close my eyes. I knew what follows sleep was waking up and lately, it had become my most dreaded part of the day. Waking up and remembering myself as a failure was painful. But what can you do?

End of Entry

It’s pretty easy to see that I felt ashamed of what I was going through. Failing a course was not something I was used to and I definitely didn’t take it well. Writing did help but I quickly came to find out the limitations it had. It didn’t really fix anything, it simply slowed your mind a bit. 

So how do you fix this problem? Well, it’s simple. I had actually mentioned this already in the last chapter too. Just get to work on studying for the supplementary test. I mean that was what was next, the make up test. If I pass it then I pass it and we all get to move on with our lives as if nothing happened. So that’s what I did. I got to work and started cramming for the test I had to retake. 

I had ample time. The supplementary test was in the middle of summer and to be honest, all I really needed to do was just go over all the material from my notes again a few times until I’ve memorized everything better than before. As I got to work, I felt better about my situation. I mean. If you think about it, if I pass this test and then move on with my class, literally no one would know what happened at all! When I came to this realization, I suddenly became very happy that I did not post anything on my class page. I don’t think outing myself would’ve done anything for me nor my psyche. 

By the end of the first week, I had memorized all the material from the course. It was still kind of fresh in my head from when I crammed for the test the first time and I felt a bit of weight lifting from my shoulders. This was easier than I thought.

I mean, besides the obvious fact that I was studying for an exam I had already studied for, I was now spending an entire month studying for one exam. A few weeks ago I was spending a week studying for like 8 exams. This was nothing. But I didn’t let up on the cramming. There was too much running on this.

As for the material of the exam itself, I came to understand it much better and had a gist of what the exam was really going to test me on. Well, sort of. Pharmacology was just a course that taught us about medications. In the manner that the course was taught, I felt like it was just straight up memorization. In fact, that was what I did initially for the exam the first time. I just memorized everything. When the supplementary exam came around, I realized that I had some small fine print details that I missed. While I initially attributed my inability to memorize the small stuff to why I failed the exam, I quickly came to learn more about the course material and found something, kind of unsurprising. 

The content of the course was all over the place. 

That’s not an excuse. Especially when, obviously, the rest of my classmates had passed and I hadn’t. The obvious point there being that if they could do it, why can’t I? But still, I think it’s still a valid thing to point out. There are various ways to interpret how learning in university works and how learning optometry concepts work, however, I thought about it this way. 

Remember breakdancing and hip hop? 

There was the similar concept of top bottom learning vs bottom top learning and for me optometry. Although, it was a bit different in how it played out. I liked to see a well established fact in science that leads into various branches of small independent facts. Then, it becomes easier to learn those small facts when you know the large facts at play. Every small fact falls under some form of previously known large fact.

It’s actually quite simple and in fact, schools do this all the time. They call it foundation. This is no different in healthcare. I realized that we weren’t learning this way however. We didn’t learn one particular physiological fact and then derive from it all the ways to manipulate the metabolism of a structure. We didn’t learn the anatomy of the eye and then learn about how specific medicines affect specific areas. How our class learned most of the material was like so.

We had one class for anatomy, then one class for physiology. After that, a year later, we got to the pharmacology stuff. We got segments of the whole picture instead of the whole picture all at once.

Now, to the school’s credit. This started off with some logic. It seems reasonable to have all the anatomy and physiology leading into pharmacology as I described it. However, in practice. The chain is often filled with small chinks. That is to say, because of all the substitute professors, our class rarely got to learning properly all the material that was needed in the foundational facts prior to learning about the ways we can manipulate certain systems of the body for our benefit. 

This is to say. Essentially, instead of learning foundational facts and then deriving logical reasoning to manipulate those facts, what I was left with was how to manipulate the facts and how to derive the foundations I had known before. 

Furthermore, because there seems to be an absence of instructor to instructor communications. Even under the best circumstances, sometimes the students had to find a way to translate the material from a foundational class to an advanced class. Meaning, there was a disconnect along the way. 

If I’ve lost you, that’s okay. It’s kind of hard to explain specific forms of learning. But let me just save you the trouble by maybe clearing this up with an example. After graduation from classes, optometry students have to take a board exam to get their certification. These are known as “boards” and consist of a written component and a practical component. The written component is a culmination of everything we have ever learned in school. Studying for this would appear as a nightmare, no?

Well…actually. In my case, that was when I really learned how to be an eye doctor. Having all the material of the optometry school curriculum jammed down my throat at once turned out to be the best way for me to understand my field. This is because in the unofficial definitive study guide for the board exams, called KMK (not sponsored), they had jammed all the information I needed to learn from school in a systematic way from the foundations all the way to the small facts. 

In my school, I learned basically learned pharmacology like this (hyperbolized to make a point):

• Here are some prostaglandins. Here are some beta blockers. Here are some steroids. Now learn how they work.
• After extensive memory of all those drugs, I’d occasionally make a connection that some of them share some similar mechanisms of actions because they act on the same systems. 

Here was how KMK (the board guide taught it to me):

• All meds are categorized into two things
  • Parasympathetic affecting drugs and Sympathetic sympathetic affecting drugs
  • These two categories can then each be divided into 2 subcategories of agonists and antagonists. 
  • Those four categories can then be divided into specific medications affecting specific areas. 

The KMK was a flow chart. It taught us a big concept and then went into the roots of the other facts we’re trying to learn. To complete the parallel, let me explain it the way I see it. In breakdancing, you learn small concepts and then add them with each other to form a bigger idea. No one teaches an entire set, they always only teach you moves or combos. You have to form the set on your own. This is like bottom top learning and similar to what my school was teaching. You learn small facts and then after learning a lot of those, you can put them all together into something more useful. This may not have been the intention of the school’s curriculum but it was how it played out. 

While in breakdancing the idea was good, in school it sucks. There’s way more effort needed and in case you miss something, you may not even realize you missed it. It’s much better to do top to bottom learning in school. Someone teaches you the choreo of a hip hop dance and incorporates a bit of everything you need for hip hop to make a full routine. When you learn it, you now have a specific guideline that teaches you all the necessary foundations. Moreso, it flows as a whole entity. One move leads into another. It all flows. This is how KMK taught me optometry. One thing led to another, eventually forming everything into a full picture. 

Okay. Enough ranting. Where does this lead me? Well, simple. Nowhere. Complaining about it gets me nowhere and in the end, it’s all the same. However the school decided to teach things, however inefficient. I still had to play by their rules and keep going. Being conscious of these facts did not help at all. 

So for the rest of the time before my supplementary test, I simply memorized as many more facts as I could. I must’ve put into this one course for which I already studied for a good extra 100+ hours by the time the exam came around. 

But that was still just the content of the exam. There was also the aspect of the mental game. 

Was I mentally prepared to face a test redo? Especially when my optometry career hangs in the balance?