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I’m not going to lie. It has been one of the toughest weeks – career-wise. In my head, it has been my career marathon (Read this post). And I feel like I just passed the 18th mile. In a marathon, the 18th mile is notoriously known as the hardest. Some even say that though 13.2 miles is the halfway point, the 18th mile is really the physical body’s halfway point. It’s really when you are not that far but you are bloody tired and losing your form (What am I talking about, I don’t have good form in the first place).

I like checklists. As a preview…

And it really was the most challenging 2 weeks ever. Just like a marathon, this was a mental and physical test of endurance, on top of actually training for an actual marathon. And don’t forget being a mum. But David, as usual really steps up to the plate.

Last set of Nights. During these nights, we were down a junior doctor. So I had to pick up the small tasks throughout one of the Acute Medicine wards. Some memorable moments were looking after 1) a chap with severe electrolyte imbalance (on replacement) and started having an arrhythmia and started becoming breathless and clammy. Still chatting though – continue the infusions, keep an eye. 2) a lady with PR3+ vasculitis who had increasing breathlessness due to partially treated chest infections (pleaaase don’t let it be pulmonary haemorrhage)… oh what she’s started itching on cipro? STOP IT! 3) IVDU, cannula out, need US-guided cannula for antibiotics. No switch his IV clari to PO, he may be able to go home in the morning. 4) Man with BP 210/108, tingling in his face, arms, legs. No bleed on CT head. BP 145/72 after 5mg amlodipine. I think he can be discharged, GP to titrate antihypertensive.

Medical Oncology interview. For this interview, there is a clinical scenario, an ethics station, a research station, and a portfolio/commitment to specialty station – all about 5-6 minutes each. Now although I get really really nervous during interviews, I actually also really enjoy them. In preparation, a couple of Regs helped me by doing a mock interview the week before. I read up on several different Acute Oncology emergencies (with the help of the teaching slides from the Oncology teaching group I set up), I read up on a couple of clinical trials and their design, got re-acquainted with my CV, and ultimately find the answer deep within me… “Why do you want to go into Medical Oncology Specialty Training?” I was happy at the end of this interview. I went on a 4 mile run straight after to run off the adrenaline.

Then got a bit of a break before travelling to Liverpool for PACES. so we went to Manor Farm.

PACES. I was meant to have been done with PACES already but due to the junior doctor strikes, my original date was cancelled and was moved to the 27th of March to Liverpool. As you can imagine, I had already peaked as I was ready 2 weeks ago. This was a really tough adjustment because I was also already getting ready for the interviews. It was very difficult to switch back and forth. At this point, I was probably more focused on Oncology. PACES as I’ve already talked about in the past is my chip, is my crutch, my disability. I could talk about this more later and maybe relate it to marathon running somehow. Liverpool was actually nice though I as too preoccupied to take photos and it was too wet and cold to go for a run so treadmill runs at the Novotel. Anyway, results on the 18th of April. Hang tight.

Okay pause. Take a breather and a sip of water. Part 2 tomorrow.

This week has been a mini roller coaster.

Let’s start with the losses. On the 1st of March, the results of the NYC Marathon lottery were out and unfortunately, I didn’t get a place. Whilst waiting impatiently, there were 2 ways to find out – the official email or my credit card being charged $295. I’m sure I am not the only one who has thought “Please take my money, please take my money, PLEAAASE…” This year has been my second year. Although, this isn’t really a big deal, the mini rejection still hurts a little. But hey ho, better luck next year.

And today, the 5th of March was the Tokyo Marathon – my meant to be first entry to the World Marathon Majors. But thanks to me failing my exams, I couldn’t justify going to Japan and enjoying the trip and the run. I also missed the deadline to defer my entry to next year. So really, back to square 1. But hey ho, better luck next year.

On to the wins. This week, I ran 6 miles in 55 minutes. Although, this was on a treadmill (as it was very cold again), still not a bad effort – got pretty close to my 9:00/mile goal.

Also this week, I ran the longest distance so far for this training plan – 15 miles! This brought the total of miles ran this week to 30 miles. Whoa! The more comforting thing was that I also felt great after 15 miles – not fatigued.

On other minor wins – all but one of my sign offs for my medical portfolio, which due for review on the 14th of March, is now complete. The last one to be done after the exam. Also, had a mock exam yesterday and surprisingly, I passed.

So, I may have missed out on NYC and Tokyo but I am on track for London and also for career progression. Fingers crossed.

The past few weeks and the next few weeks have been rather hectic. But when is it not ever hectic? And I can 100% say that the chaos is all my doing – they are my responsibility and I am the reason why I got tangled into this madness in the first place.

March

1st – NYC Marathon lottery results – The ballot opened in early February. This is my second application, didn’t get in last year. If I get in, that would be 5 out of 6. But of course, I won’t be running Tokyo this year.

4th – Mock PACES – Despite it being a mock exam, it is the same nerves and adrenaline rush.

5th – Tokyo Marathon – Not running.

13th – Junior Doctors 72-hour Strike begin. Still don’t know how this will impact my exams.

14th – Practical Assessment of Clinical Examination Skills (PACES) – For the last year, this has been the #1 thing that is causing the most stress. Exams are not my strong suit. Everyone around me says that these shouldn’t define me as a doctor. The challenge is that what I think about myself is what should really define me as a doctor but at the moment, the results of my previous attempts sitting this exam is really affecting how I think about myself.

14th – Annual Review of Competency Progression (ARCP) – I am now in the last month of this part of medical training (Internal Medical Training). With any training, you need to prove you have achieved your competencies, that you are competent. In medicine, you need to prove through assessments that you are good enough to progress, that you ‘meet expectations for this year of training.’

23rd or 24th – Medical Oncology Interview – I am still awaiting an interview invite. AND I am scheduled to work Nights on both these dates. I have not done any interview prep yet due to PACES and ARCP.

30th or 31st – Clinical Oncology Interview – I am still awaiting an interview invite. Similarly, I have not done any interview prep yet due to PACES and ARCP.

April

2nd – Last shift as an IMT2 – well, if all goes well and I pass ARCP.

6th – PACES Results – High stakes. This will determine if I would be able to take a Specialty Training job, if offered one.

20th – Oncology job offers – well, if all goes well and whether I am suitable or not.

23rd – London Marathon AND 7th year wedding anniversary – First attempt on Reaching the First Star.

Oh I know what I can get you for our anniversary… I’ll let you run the marathon.

David

*24th – Maya’s school – We find out which school Maya will be attending in September.

All in all… it really is a rollercoaster and this is on top of raising a 4 and a 2 year old. And at the end of the day, everything may be happening all at once and it is overwhelming, but everything will fall into place. More importantly, it is the event on the 24th of April that puts everything into perspective. My baby girl is going to start school soon!!!

One day, after a gym session, David said…

“Mon, I noticed that you run very inefficiently.”

On a normal day, I would have been fuming for being criticised. On this particular day, just as I was about to break into a tirade, I actually paused and listened to his observation.

“Your feet are landing behind you. This will slow you down.”

He’s right. But I won’t get into the Physics of it all as it is now 10pm. The next time I went on a run by the seashore, I went on a little mindful exercise and actually paid attention to my posture from head to toe.

• Head and eyes straight ahead.
• Shoulders slightly back.
• Chest slightly out (as if there’s a line pulling you ahead).
• Arms at 90 degrees, keep at the side.
• Hips neutral.
• Land mid-foot (not heel, and I’m not a forefoot runner).

This was all quite difficult to pay attention to all at once so I focused on the top first until I was happy with it, then focused on the next one, then the next one. I’ve been running a certain way for years so who knows how long these little changes will actually become very natural.

At the end of that run, I actually found that I was a lot faster than my projected 9:30/mile. This was encouraging. Now I just really have to be mindful of this and the difference it actually makes.

Towards the end of medical school, I decided I wanted something dramatic – sign up and run a marathon. I chose the Edinburgh Marathon 2017 as it looked beautiful and it claimed to be flat. I also decided to make this task even more dramatic – fundraise. I chose to raise money for Anthony Nolan – a charity that makes a difference in leukaemia and stem cell transplant. I chose this charity because whilst in med school, I matched to be a stem cell donor and actually donated stem cells. Unfortunately, I don’t know the current outcome of the stem cell transplant.

So there I was putting in the miles, pounding the streets of Huntington, West Virginia (part of my med school training was there), trying hard to regulate my breathing and not really knowing what VO2 max is (still don’t know what this is). After finishing my Final Exams, I went back to Long Island, NY (where I used to live in the US) and continued training there for the marathon in May. Running by the ocean during long runs was a dream.

During this time, I was also waiting for my visa to be able to get back to the UK and start working as a doctor. The days started to inch towards the end of April and no word about the visa. As you can imagine, this was very stressful! But I was determined and people had already donated a lot of money! I had to think of a back up plan. Sign up for a marathon around the same time? But where is the closest? There was one in upstate New York on the same day, but I was not ready to drive all the way up and back. So the best solution I thought about was…

“Well, I’ll just run it on my own.”

I thought – well, I’ve already ran 20 miles (alone) in Long Beach, which had a really good stretch of distance, there’s a board walk, what’s another 6 miles? When I ran the 20 miles, the only thing I carried was a bottle of Gatorade and gummy bears wrapped in cling film. The boardwalk had toilets. But now for 26 miles – I thought I needed support. I recruited my mom, then-stepdad, and my one of my best friends, Joe. I stationed them at every 6 miles and make sure they provided me with encouragement and sustenance in what would have been a very tough and lonely endeavour.

So there I was, running around Long Beach, not really bothered by time at that point. I think I completed this over 5 hours. But I just wanted to finish what I’ve started. Like always, I go all in into something, not really foreseeing the difficult and challenging road ahead, just dealing with it as I go along.

I’ve looked back to this moment in time because as I’ve been slightly struggling mentally about the pressures of my job and career progression. There were moments in the past that defines the kind of person I am and reflecting on them is important when also trying to get through other hurdles that come along. My past experiences have only trained me and better equipped me to deal with new challenges. So looking back to 2017, yes I finished med school (which is a difficult challenge in itself) but I also decided to run 26.2 miles on my own. I ran it without the big crowds cheering, just with a handful of people who matter most and also of course, also the people who answered to the call of fundraising. In the end, I completed my first marathon and raised £1592.37.

This past month has been a big mental health exercise for me. Last summer, I was overcoming the despair of failing an exam. After going through the 5 stages of grief, I got back up, worked harder, and practiced more to prepare for the exam. In between, I also had a period of great opportunities and successes at work. So I did the exam again and honestly felt good about it – thinking I did much better this time around. I felt this way until I got the results and found out I failed again. This was more crushing than the first time because I had put in a lot more effort this time around and was more confident. But that might have been it – maybe I was overly confident. And just not know enough.

I had to go through the 5 stages of grief all over again. I talked to my colleagues about it, ran through the scenarios with seniors. I have since dissected and deconstructed both exams and played it over in my head and see how I could make them better. I need to learn how to play the PACES game well – learn more, strategize, perform. More training. Keep going.

It’s not a sprint, it’s a marathon.

Most people working in healthcare have an inherent degree of resilience programmed into their system. I think I am pretty resilient – otherwise, I wouldn’t make it this far. In medicine, the quote “it’s not a sprint, it’s a marathon” is embedded in our heads – from medical school until one day, we will end up saying it to our juniors. Choosing this career, I’m in it for the long run – I wake up everyday and I am still running the race. Some challenges are harder than others and I find that challenges against myself are more difficult to overcome – I can say that I don’t feel 100% better because ultimately, the only way I could really gain my confidence back is by passing the exam.

Another heartbreak and a hard decision to make as a consequence is to not run the Tokyo Marathon AND I missed the deadline for deferring my place to 2024. The next exam is the 14th of March (Tokyo is 5th of March). I had already booked 2 weeks of Annual Leave (now using it as revision time). If I was who I was 10 years ago, I would still go ahead with it, but the more boring and attempting to be sensible me tells me to sit this one out. And I don’t think I’ll fully enjoy being in Tokyo and running a race with a big PACES cloud looming over my head. I’ll try my luck again next time – I’ve signed up for the Tokyo Marathon Foundation Virtual Runs, which are good for training anyway. I have since readjusted my training plan.

So Tokyo is out (for now), London it is.

Happy New Year!

Last year, I ran 644.4 miles. Not as much as the previous 799.6 miles in 2021. However, in the past few months I’ve shaved off about 15 secs from my pace but not confident that this is really the case and whether it will now be consistent.

What I think has helped are the once a week Interval and Surges workouts. Last year, I never did these work outs but I think they’ve made a difference in training. Physically, the legs feel fatigued after the work out but they then feel miraculously a bit more stronger during the next run. The recent Surges work outs have been 4.8 miles with 1.5 miles of relaxed run then 1 minute at 7:10 followed by 1 minute 10:30 (total of 10 intervals) then 1 mile cool down. It happens that 4.8 miles is about the distance from home to the hospital – convenient. So to make things a bit more complicated, add a backpack to doing a Surges work out. Annoyingly, it still then averages to about 10 minute miles. But that is okay, I trust it will be faster without the backpack. So like every training session, make it count.

Like in many across the country, the hospital I work at is overwhelmed. High volume, high acuity. Many patients unwell, many staff also unwell. At home, we already had our winter viral illnesses. I had a lingering cough that one night after work, became dramatic complete with sore throat overnight. Something didn’t feel right – so swabbed myself and sure enough, Covid – back again. Off from work and also too unwell to go out for a run. Just what I needed.

Now negative and asymptomatic, I braved the cold. I raced David to the hospital – me a 4.8 mile Surges workout and David drove the car – to get to the hospital nursery to pick up the kids. Happy to say, I got there first. I did get a 10 minute head start though.

The past 2 weeks have been a challenge resulting to training being compromised but also learning how to adapt.

A very cold spell had come over the UK a couple of weeks ago and that same week, we were also afflicted with a virus or was recovering from one. With a lingering cough, I didn’t think it was a very good idea to go outside in 1 degree Celsius weather and breathe in the cold air. At the same time, I also didn’t want to regress. So… I signed up to a nearby gym just to use a treadmill.

I find running on a treadmill quite challenging because 1) physically, I’m not used to it and I feel like I’m just bouncing in place 2) mentally, I can’t find the groove, don’t trust that my pace matches, and I don’t like looking at all the numbers in front of me. But it was good because I wasn’t coughing due to the cold air.

Once I was brave enough to dare, I went back out again. I completed a Tokyo Marathon Foundation Virtual Challenge. Run a half marathon is however many splits and get a chance to win an entry to the Tokyo Marathon 2024. I ran it in 2 lots – 2hrs 5mins total. The second run included a 1 mile uphill in Surrey on Christmas Eve.

Then I worked 4 Nights starting Boxing Day. That was chaos. The hospital declared Critical Incident status. There were almost no beds anywhere with people getting seen in the ambulances. Almost everyone admitted had the Flu or Covid. Coming home from that, feeling that I too have caught the flu, meant there was no getting up for anything until I had to wake up to go back to work again.

A bit behind on the training and the writing but getting back, especially with these new babies…

Whatever you do, do not skip the long run and the tempo/interval run.

Whilst many runners really adhere to this rule – I have already broken it.

There are so many different marathon training plans catering to all types of runners with all different goals. I like using the marathon plan on the Asics Runkeeper app as it is straightforward enough for me. Enter race distance, date, time goal, how many days and which days of the week you wish to train.

The long runs are always on a Sunday (marathon day), but for me – Sunday is also family day. I can go out for a quick run but not a run longer than an hour (whilst the kids are napping). So I always have to make up the long run on a day off during the week. Additionally, I don’t have a 9-5 job like many people. I am sure that there is an algorithm to the training plan but I always seem to change the weekly long run and tempo/interval run schedule based on which days I’m not working and how much time I have on the day.

This definitely was the case for the past few weeks when there was a big event each week – conference, PACES, laser eye surgery (not me), oral presentation at a conference, job applications, change of rotation. And this week…the flu!

Xave caught a virus and also briefly ended up in A+E. It was my first day in AMU when I got a call that nursery staff was bringing him to A+E, I met him there and felt a bit like a fraud because the paracetamol had kicked in. Because of what was going around these days, his nursery had to make sure it wasn’t Group A Strep. Thankfully, it wasn’t. But whatever it was, we all caught it and we had to stay home. This also meant – too poorly to run.

I hit another milestone this week. 15 miles – the most distance I’ve run during this training plan so far. However, it was also the only run I did this week.

BUT… being home and unwell, we managed to do this…

Side note: Applications for Specialty Registrar jobs in Medical Oncology and Clinical Oncology have now been sent. Now hang tight for invitation to interview – if any.

Please don’t forget to visit my fundraising pages – Cancer Research UK and Home-Start Portsmouth. I know right… two?

Let’s cut to the chase. For this Six Star journey, I decided I will raise funds the whole way through. Not only that, I will also raise funds for 2 special charities – Cancer Research UK and Home-start Portsmouth. Now it’s slightly unconventional to raise money for 2 charities but you know what, like everything else about this challenge, well why not?

Cancer Research UK. As mentioned in a previous post, I intend on pursuing a career in Oncology. So choosing this charity – intended for the Spring Marathons – Tokyo and London. Apart from the obvious, funding for cancer research, what I really like about this charity is it also uses some of the funding for the researchers, the people working hard on breakthroughs against cancer – investing time and taking sometimes years to produce results good and safe enough results that could make a difference in people’s lives.

Home-Start Portsmouth. When I told David, I wanted to raise money and which charity I should raise money for – he said “If you want the money to go a long way, pick a local charity.” And naturally, we decided on a charity that supports children. There are many families, especially with very young children, who maybe having a difficult time. Especially nowadays when the cost of living crisis is very much on the forefront of people’s minds. Home-Start Portsmouth is a local charity that has been around for 30 years supporting young families in getting a good start in life. They have several programmes they run and are also very accessible and easy to get in touch with.

So why fundraise? There are so many different reasons why people support a charity – to remember someone by, it feels good, believe in a cause, to help out, to make a difference. For me, my idea of racing always comes hand in hand with raising money. I raised money for Anthony Nolan for my first marathon and for Children with Cancer UK for my second marathon. Fundraising is a very good way not only to raise awareness but also get people together and hopefully, inspire them too. I always think ‘well, somebody’s got to benefit if I put in all this effort.’ And in my head, I always think that…

If I can make each mile go further (well not physically of course), if I can increase the value of each mile I run, then it’s worth running that mile.

Raising money is also just as challenging as training for a race. With training, I have to prove to myself that I’m good enough for the race, that I could run 26.2 miles without getting injured or even dying. With raising money, I have to convince I others that this cause is good enough to support. And again, amidst the cost of living crisis, it might even be harder to convince people to give up a little bit of their hard-earned money. However, people do rally around those who need help and most of the time, the outcomes are unexpected and incredible. So get donating! Please.

Now here’s my Extra Challenge… I don’t have social media. No Facebook. No Insta. No TikTok. Only this blog, old fashion email, and telling people about it. I’ve not done a great job yet about this as I had to put my energy of other things during the past few weeks. Now, I am 6 weeks in and have now broke a hundred miles AND blogging for 6 week as well – I think it is time to turn the fundraising gear up a notch.

So please, I would like to invite you to join me on my Six Star journey – I’ll do the running OR you can also join me with the running (that would be amazing), and if like me, you think these charities are fighting a good fight, then kindly check out my Fundraising Pages – My Fundraising Page – Cancer Research UK and My Fundraising Page – Home-Start Portsmouth. Thank you from the bottom of my soles!

Side note: This week I had 2 milestones… my schedule finally allowed me to meet my 20 miles/week goal AND I’ve run over 100 miles since I started training in October.