Ten Rules of Engagement

0. Zero tolerance for NYT: News, Youtube, Twitter

1. Wake up at 0500

2. Complete the daily run before 0600

3. UWorld 60 Qs, Screenshots 300, Read 30 Pgs, Kaplan Videos 3 Hrs

4. Break the news before 0800

5. Start at 0700

6. Stick to the plan - 9.5 hours of studying (at least 90% time-wise)

7. Eye exercises, pull-ups, body-weight dips on the break

8. Go on airplane mode 1800 - 0630 & complete silent at 2000 - 0440 

9. Wrap up at 2000 - Bath time, brush teeth, PJs, story time and off to bed 

10. Get 500 minutes of sleep

Day 54 - Step 2CK Prep - NBME 12

 Age is opportunity no less
Than youth itself, though in another dress,
And as the evening twilight fades away
The sky is filled with stars, invisible by day.

~ Henry Wadsworth Longfellow

Day 53 - Step 2CK - Sports Medicine

 Exercise alone provides psychological and physical benefits. However, if you also adopt a strategy that engages your mind while you exercise, you can get a whole host of psychological benefits fairly quickly.

~ James Rippe, M.D.

Day 52 - Step 2CK Prep - Eyes, Ears, Nose & Throat

 When you want to believe in something, you also have to believe in everything that's necessary for believing in it.

~ Ugo Betti

Day 51 - Step 2 CK Prep - NBME Free For All

 Sometimes the questions are complicated and the answers are simple.

~ Dr. Seuss

Day 50 - Step 2CK Prep - Review of the practice exam

 An expert is a person who has made all the mistakes that can be made in a very narrow field.

~ Niels Bohr

Day 49 - Step 2CK Prep - Rheumatology/Orthopedics & Sports 3

 Even God cannot change the past.

~ Agathon

You can impact your future today!

~ Me

Day 48 - Step 2CK Prep - Rheumatology/Orthopedics & Sports 2

 The greatest mistake you can make in life is to be continually fearing you will make one.

~ Elbert Hubbard

Day 47 - Step 2CK Prep - Rheumatology/Orthopedics & Sports 1

 I believe that [everyone] is the keeper of a dream - and by tuning into one another's secret hopes, we can become better friends, better partners, better parents, and better lovers.

~ Oprah Winfrey

Day 46 - Step 2K Prep - Heme 2

 Whenever you find that you are on the side of the majority, it is time to pause and reflect.

~ Mark Twain

Day 45 - Step 2CK Prep - Heme 1

 Nothing great in the world has been accomplished without passion.

~ Georg Wilhelm

Day 44 - Step 2CK Prep - Renal 2

 He who every morning plans the transaction of the day and follows out that plan, carries a thread that will guide him through the maze of the most busy life. But where no plan is laid, where the disposal of time is surrendered merely to the chance of incidence, chaos will soon reign.

~ Victor Hugo

Day 43 - Step 2CK Prep - Renal 1

 No trumpets sound when the important decisions of our life are made. Destiny is made known silently.

~ Agnes de Mille

Day 42 - Step 2CK Prep - Neuro 6

 Eighty percent of success is showing up.

~ Woody Allen

Day 41 - Step 2CK Prep - Neuro 5

 Stay centered by accepting whatever you are doing. This is the ultimate.

~ Chuang-tzu

Day 40 - Step 2CK Prep - Neuro 4

 The sad truth is that excellence makes people nervous.

~ Shana Alexander

Day 39 - Step 2CK Prep - Neuro 3

 Wisdom doesn't automatically come with old age. Nothing does - except wrinkles. It's true, some wines improve with age. But only if the grapes were good in the first place.

~ Abigail Van Buren

Day 38 - Step 2CK Prep - Neuro 2

Learning is not attained by chance, it must be sought for with ardor and attended to with diligence.

~ Abigail Adams

Day 37 - Step 2CK Prep - Neuro 1

Because we do not understand the brain very well we are constantly tempted to use the latest technology as a model for trying to understand it. In my childhood we were always assured that the brain was a telephone switchboard. ('What else could it be?') I was amused to see that Sherrington, the great British neuroscientist, thought that the brain worked like a telegraph system. Freud often compared the brain to hydraulic and electro-magnetic systems. Leibniz compared it to a mill, and I am told some of the ancient Greeks thought the brain functions like a catapult. At present, obviously, the metaphor is the digital computer.

~ John R. Searle

Day 36 - Step 2CK Prep - Endo 5

 Stamina is utterly important. And stamina is only possible if it's managed well. People think all they need to do is endure one crazy, intense, job-free creative burst and their dreams will come true. They are wrong, they are stupidly wrong.

~ Hugh Macleod

Day 35 - Step 2CK Prep - Endo 4

 Memory is not wisdom; idiots can by rote repeat volumes. Yet what is wisdom without memory?

~ Martin Tupper

Day 34 - Step 2 CK - Endo 3

 Time is an essential element of life and as they say, “time is muscle”. An equilibrium and akinesis are equivalent to death. Hyperkinesis, despite its negative connotations, is life. You would be more successful at reaching a normokinetic state if your starting position is hyperkinetic rather than akinetic.

~ Me at 28 Days to Go

Day 33 - Step 2CK Prep - Endo 2

 You must keep sending work out; you must never let a manuscript do nothing but eat its head off in a drawer. You send that work out again and again, while you're working on another one. If you have talent, you will receive some measure of success - but only if you persist.

~ Isaac Asimov

Day 32 - Step 2CK Prep - Endo 1

 You gotta dream? You gotta protect it. People can't do somethin' themselves, they wanna tell you you can't do it. If you want somethin', go get it, period.

~ Steven Conrad

Day 31 - Step 2CK Prep - GI 5

 I don't know a better preparation for life than a love of poetry and a good digestion.

~ Zona Gale

Day 30 - Step 2CK Prep - GI 4

 The truth is that there is nothing noble in being superior to somebody else. The only real nobility is in being superior to your former self.

~ Whitney Young

Day 29 - Step 2CK Prep - GI 3

 Dreams alone aren't enough to make your belly full.

~ Takayuki Ikkaku

Day 28 - Step 2CK Prep - GI 2

 When you can't have what you want, it's time to start wanting what you have.

~ Kathleen A. Sutton

Day 27 - Step 2CK Prep - GI 1

 Real glory springs from the silent conquest of ourselves.

~ Joseph P. Thompson

Day 26 - Step 2 CK Prep - Psych 501

 Nothing contributes so much to tranquilizing the mind as a steady purpose - a point on which the soul may fix its intellectual eye.

~ Mary Wollstonecraft Shelley

Day 25 - Step 2CK Prep - Psych 401

 Man's main task is to give birth to himself.

~ Erich Fromm

Day 24 - Step 2CK Prep - Psych 301

 Self-development is a higher duty than self-sacrifice.

~ Elizabeth Cady Stanton

Day 23 - Step 2CK Prep - Psych 201

 Television has done much for psychiatry by spreading information about it, as well as contributing to the need for it.

~ Alfred Hitchcock

Day 22 - Step 2CK Prep - Psych 101

 The scientists of today think deeply instead of clearly. One must be sane to think clearly, but one can think deeply and be quite insane.

~ Nikola Tesla

Day 21 - Step 2 CK Prep - Peds

 I think when I work 14 hours a day, seven days a week, I get lucky.

~Armand Hammer

Day 20 - Step 2CK Prep - Peds

Clinical scenario based on real life situation:

A patient is vented through ETT #6.5 suddenly drops to SpO2 25% and is showing a consistent good waveform. The patient who was comatose, now opens his eyes and his face is turning grey. Vent shows extremely low TV.

What have you got? What do you do? What do you order?

- Mucous plug

1. Call for help (respiratory, etal.)

2. Attempt to suction. If that does not resolve the issue move to the next step

2. Grab an Abmu to connect to the ETT and ventilate despite resistance

3. Once help arrives, you may connect O2 and crank it up. Use a saline lavage while ventilating and inline suction.

Post intervention: 

STAT ABG and portable Chest Xray

Encourage a frequent tracheobronchial toileting

Consider ordering Mucomyst (Acetylcysteine) and bronchodilators.

P.S. I saved a life on Thanksgiving day and hope that the concept of this scenario will save another.

Day 19 - Step 2CK Prep - Peds

 My philosophy is that not only are you responsible for your life, but doing the best at this moment puts you in the best place for the next moment.

~ Oprah Winfrey

Day 18 - Step 2CK Prep - Peds

 Every goal is achievable when the right amount of diligence, consistency and perseverance is applied.

~ Me at 45 Days to Go

Day 17 - Step 2CK Prep - Peds

Doubt is a virus that attacks our self-esteem, productivity and confidence. 

~ Sean Stephenson

Day 16 - Step 2CK Prep - Peds

 Never believe a prediction that does not empower you.

~ Sean Stephenson

Day 15 - Step 2CK - Peds

 If you have a heartbeat, there's still time for your dreams.

~ Sean Stephenson

Day 14 - Step 2CK - Peds

 You gotta dream? You gotta protect it. People can't do something themselves, they wanna tell you you can't do it. If you want something, go get it, period.

~ Steven Conrad, "Pursuit of Happyness"

Day 13 - Step 2CK Prep - Peds

 Grown-ups never understand anything for themselves, and it is tiresome for children to be always and forever explaining things to them.

~ Antoine de Saint-Exupery, "The Little Prince"

Day 12 - Step 2CK Prep - Surgery Recap

 Nothing is easy to the unwilling.

~ Nikki Giovanni

Day 11 - Step 2CK Prep - Surgery

 Remember! Things in life will not always run smoothly. Sometimes we will be rising toward the heights - then all will seem to reverse itself and start downward. The great fact to remember is that the trend of civilization itself is forever upward, that a line drawn through the middle of the peaks and the valleys of the centuries always has an upward trend.

~ Endicott Peabody

Day 10 - Step 2CK Prep - Surgery

 A strong positive mental attitude will create more miracles than any wonder drug.

~ Patricia Neal

Day 9 - Step 2CK Prep - Surgery

 Never say never, for if you live long enough, chances are you will not be able to abide by its restrictions. Never is a long, undependable time, and life is too full of rich possibilities to have restrictions placed upon it.

~ Gloria Swanson

Day 8 - Step 2CK Prep - Surgery

 The only way of finding the limits of the possible is by going beyond them into the impossible.

~ Arthur C. Clarke

Day 7 - Step 2CK Prep - Surgery

 Study without desire spoils the memory, and it retains nothing that it takes in.

~ Leonardo da Vinci

Day 6 - Step 2CK Prep - Surgery

 Focus on what you can affect - your upcoming score!

That is the only aspect that you have control over right now.

Day 5 - Step 2CK Prep - Surgery

Han Suyin said: "Truth, like surgery, may hurt, but it cures."

It is a sparkling witty remark. Nonetheless, surgery should not hurt if you have a good anesthesiologist and an appropriate pain management. Choose yours right.

Day 4 - Step 2CK Prep - OBGYN

 Just one small positive thought in the morning can change your whole day.

Wake up and think of something positive: an expression of your face when you get a score that was waiting for a long time.

Day 3 - Step 2CK Prep - OBGYN

Where there is a will, there is a way.

~ A quote by... - whoever applies it.

Day 2 - Step 2CK Prep - OBGYN

With the current decline in education, all attention is paid to pumping muscles.

Did you know that the human brain is not inferior to biceps?

It is susceptible to development just as any other bodily organ.

Let us put it to the test.

Day 1 - Step 2CK Prep - OBGYN

House M.D. paraphrasing: 'An industry needs both: those who are tightening the bolts and architects'. 

Me: After tightening a considerable number of bolts, I have decided that it is time for me to advance further and join the "proverbial architects".

P.s. Step 2CK preparation is in progress. 

Per Aspera ad Astra

I don't want to just be tightening bolts and following instructions. 

I want something to be different because of me. 

~ Thirteen 'House M.D.'