Thursday, November 29, 2007

Tom, Dick, ANd Harry

Do you know what's pretty cool? When you pull on the extensor hallucis longus, the big toe actually moves. Visibly. My entire anatomy group freaked out.

It was probably the highlight of anatomy lab thus far. Aside from the Halloween factor, it was the first moment since we opened the left ventricle that anatomy actually made sense.

Monday, November 26, 2007

Fear not, sweet Reader

I'm still here, albeit swamped with work. I decided to take a real break for Thanksgiving -- studied a bit on the bus ride home but spent four days being a mental vegetable on the sofa -- so I'm now playing catch-up.

I realized the other day that in 3.5 years (give or take a couple months) I'll be finished with my 21 years of continuous schooling ... and earning less per hour than I did the summer I was 17. That's slightly depressing. To quote Scarlett O'Hara, I'll think about that tomorrow.

Wednesday, November 14, 2007

Perspective

I was going to complain about my day-long fast (too busy to grab anything to eat between 8 and 6), but then I checked my email and learned that someone I know -- the most upbeat guy I've ever met -- has cancer. We knew he was sick because he had been away for a few weeks, but then he returned, bald and as jovial as ever, so I assumed that whatever was wrong had been fixed.

I guess you can't fix all the people, all the time.

Sunday, November 11, 2007

This is how we socialize nowadays:

(9:08:14 AM) Rebecca: i need to go shower but i wil talk to you later!!
(9:08:18 AM) Rebecca: where are you studying today?
(9:08:31 AM) Me: probably [the library]
(9:08:37 AM) Me: lower level

I really dislike Monday exams, because it means we don't get weekends. The weekend before is spent cramming (see above) and the weekend after is spent catching up with all the classes you ignored in the pre- and post-exam madness.

Thursday, November 8, 2007

Yesterday, I interviewed two real, live patients all on my own.

And when I say "on my own," I mean of course, with an interpreter. My Spanish, though adequate, is not up to snuff when dealing with illness or numbers, which can make it difficult for all concerned. English-speaking patients are a rarity.

Anyway, I ended up filling out the Social Work Assessment on both these patients, one of whom was pretty stable and ready to be discharged, and the other of whom was in a bad state about her cancer diagnosis. She spoke really fast -- the interpreter had to ask her to slow down -- and she kept jerking her head around like a hunted animal. I felt really terrible for her.

And the worst part was, I couldn't sit down with her and help her feel better. Partially there was the language barrier, but more than that, what does one even say to a person whose chronic back pain turned out to be advanced lymphoma?

After returning from the hospital, I went to a reading on gendered illness and women's experiences with illness. I'm still not convinced that there is a distinctly feminine component to the experience of illness. To be honest, the biggest connection I can see is the loss of power/autonomy/agency that often accompanies illness and the loss of power/autonomy/agency that often accompanies the traditional barriers against women. Pretty weak.

Still, the reading was interesting and moving, and it emphasized the use of narrative as a weapon against isolation and marginalization. And there was food.

Sunday, November 4, 2007

In which our heroine goes to OR

I was in the OR today, shadowing anesthesiology residents. (Cheesy title, I know.) It was really fantastic -- one showed me how to put in an IV and another let me watch him give a thoracic epidural for a double lung transplant (!) and afterwards explained the differences between thoracic and lumbar epidurals -- what to watch out for, etc. That was particularly exciting because we just did the vertebral column and spinal cord in anatomy. Who would have thought that all those spinal ligaments are actually clinically relevant? I can tell you that I remember them a lot better now. After weeks in the classroom, it's always really exciting to see Medicine in Action.

And then I helped the anesthesiologist set up for an operation and stayed until the pt went under. I thought I wouldn't really like the OR, but it's actually a cool place. There is definitely a vibe of Go Go Gadget O2 Sat! Still leaning towards the medicine side of the med-surg division, though. We do 15 weeks of surgery rotations here (5 gen surg, 10 surg subspecialties), so I'm sure I'll get all the exposure I need in 3rd year. But it's nice to get a little flavor early.

Mostly, I was impressed at how willing the residents were to have me and my classmate there. I'm sure they must be exhausted and everything, and we were these two happy, well-rested first-years bouncing in and being all naive. They all had great things to say about the program, too. It's gratifying to know that not all residencies have malignant "beat you and eat you" mindsets.

Thursday, November 1, 2007

Transection

I didn't really have much of an emotional problem in anatomy lab, until today. Today we were told to transect our cadavers just below the rib cage and prop their lower bodies up on goalposts. The rationale for this was so that we could have a good view of the perineal area.

Bullshit.

Gynecologists can get a good view of the perineal area without needing to saw their patients in half. (Yes. We had to use saws to get through the vertebral column.) Ever heard of stirrups? They aren't comfortable, but they are a damn sight better than what we had to do today.

I am extremely upset about this whole situation. Even the first day, when we uncovered the shrouds and looked at our cadaver's face, was not quite so bad. We could say to each other, It's ok -- she donated her body. We'll learn from her." That belief helped us with our first cuts.

If this were the only way to learn, I would rationalize it. But it's not.

Today, there was no pedagogical reason for what we did in the name of "learning." I feel physically dirty for having violated a human body. I feel like a medieval medical student, grave-robbing cadavers, knowing what I am doing goes against every fiber of decency in myself -- and doing it anyway.

Transections seems so innocuous on paper. And yet, looking around the room and seeing red-bagged feet dangling in the air -- it was like something from Dante's Inferno. It was disrespectful, had no academic value, and I am disgusted at myself for having taken part.