I love being on Spring Break. I'm just chilling at my parents' house -- sleeping, reading novels, watching movies. It's absolutely what I needed after March block.
Our grades still aren't up yet, but unlike during Winter Break, I'm not so worried this time. Not to say that this block was any easier (it wasn't), but even if I didn't pass anatomy, I'd just have to retake that exam in May, as opposed to spending the summer retaking the entire course. Also, I am personally satisfied with my level of knowledge of the head, neck, and upper extremity.
A few days ago, a friend from high school asked me for medical advice, for a friend of hers. I've been getting this on and off for a while. It's different when it's family though; I have no qualms telling my parents that I know nothing and that they should go see an Actual Doctor. Which is what I told my friend, too, but I felt bad about it. I did have some ideas, and if this were small group, I'd have been fine discussing them. It's somehow different with a real person, though, especially someone I've never met. (Small group cases are drawn from what our preceptors have seen, but since there is an official diagnosis -- a correct answer -- they might as well be hypothetical.)
But you know what? It's break. I'm not going to think about medicine any more until next Monday.
Wednesday, March 26, 2008
Tuesday, March 18, 2008
Exams continue to dominate my life, but Thursday is Match Day, when fourth-years find out where they are going to be training. Even the Times has taken notice.
Sunday, March 16, 2008
The run-up to the last anatomy exam.
A good family friend, now in his fourth year of med school, was studying for Step 1 some years ago. I was incredulous at what he said his study schedule was: essentially study hardcore for 5 hours, take an hour break for lunch and some TV, and then back to the books for another 5 until dinner. I thought he was exaggerating, counting "study time" when he was actually online.
Now, I'm incredulous at the memory of my own naivete. To recap the weekend: on Friday I took a 3 hour exam on GI and spent the afternoon (from 12:30 PM to 1 AM, with a half-hour dinner break) studying either in the library or in the lab. Saturday, I went hardcore from 10 AM to 1:30 AM. Today, I took a practice practical at 11 AM and went to the study lounge in my dorm directly after. Study breaks limited to trips to the vending machine, water fountain, and bathroom. And all this for one measly exam.
The strange thing is, I don't feel tired at all. In college, this sort of schedule would have left me exhausted and murderous. Now, I don't really mind it so much. Yeah, it sucks, but I don't feel as mentally blank as I would have even a year ago. Maybe I'm building up some of that magical stamina that is supposed to get residents through their 80-hour weeks. (Or third-years through their unregulated work hour weeks.)
Life is going to be weird after anatomy. I expect it will be rather like after I gave my undergrad thesis to the bindery. It's consumed my life since the end of August. I really don't know what I'm going to do with myself.
Now, I'm incredulous at the memory of my own naivete. To recap the weekend: on Friday I took a 3 hour exam on GI and spent the afternoon (from 12:30 PM to 1 AM, with a half-hour dinner break) studying either in the library or in the lab. Saturday, I went hardcore from 10 AM to 1:30 AM. Today, I took a practice practical at 11 AM and went to the study lounge in my dorm directly after. Study breaks limited to trips to the vending machine, water fountain, and bathroom. And all this for one measly exam.
The strange thing is, I don't feel tired at all. In college, this sort of schedule would have left me exhausted and murderous. Now, I don't really mind it so much. Yeah, it sucks, but I don't feel as mentally blank as I would have even a year ago. Maybe I'm building up some of that magical stamina that is supposed to get residents through their 80-hour weeks. (Or third-years through their unregulated work hour weeks.)
Life is going to be weird after anatomy. I expect it will be rather like after I gave my undergrad thesis to the bindery. It's consumed my life since the end of August. I really don't know what I'm going to do with myself.
Tuesday, March 11, 2008
It's that time of the month again
Exams start on Friday and continue through next Thursday. March Block is acknowledged by all to be absolute hell, but I'm trying to stay positive. In less than a week, anatomy will be over forever! And then we have Spring Break. I'm planning to go home and pass out on my parents' couch for at least three days.
I've always thought of our class as very cohesive and cool and not at all competitive. But atlases have started disappearing from the anatomy lab, which puzzled me until I saw some people wrapping them in the red biohazard bags and stashing them in their lockers. Seriously? Maybe I just missed out on all this in college, because I avoided the regular premed classes as much as possible (I took the Chemistry for Chem Majors sequence, AP'ed out of bio and calculus; baby physics was the only "premed" class I took), but I thought we were cooler than that.
This year is P/F, but second year they throw honors into the mix. We are trying to convince the administration to change that.
I've always thought of our class as very cohesive and cool and not at all competitive. But atlases have started disappearing from the anatomy lab, which puzzled me until I saw some people wrapping them in the red biohazard bags and stashing them in their lockers. Seriously? Maybe I just missed out on all this in college, because I avoided the regular premed classes as much as possible (I took the Chemistry for Chem Majors sequence, AP'ed out of bio and calculus; baby physics was the only "premed" class I took), but I thought we were cooler than that.
This year is P/F, but second year they throw honors into the mix. We are trying to convince the administration to change that.
Monday, March 3, 2008
On autism
Parents "shun" inoculation for their children.
This makes me sad, because while you don't have to vaccinate everyone (herd immunity's a wonderful thing), the threshold is always somewhere in the high 80%s. Also, the link between vaccines and autism is completely unsupported by scientific evidence. In fact, we had an entire small group session devoted to debunking it. I should've taken notes on the "miracles" required for the link to be true.
Moreover, after the Wakefield paper was published in the Lancet (and subsequently reported all over the popular press), there was a scare in Britain where parents refused to consent to vaccinating their kids. Result: increased incidence of measles and mumps, with two kids suffering measles encephalitis (read: permanent brain damage). Similar effect in Ireland: 1500 cases and 3 deaths. It's all nicely outlined, with citations, on Wikipedia.
Now, autism is an illness that hits very close to home -- one of my family members has been diagnosed with autism. It's a frightening label to put on your kid, because although there are various therapies, there is no cure. I completely understand why parents would want to avoid anything that might cause it. (Current evidence suggests it's genetic, but obviously very complex and non-Mendelian.) But also frightening: encephalitis. Death. You'd think parents would want to avoid these, too.
On a slightly related note: there are ads in the subway for some medical malpractice firm. In large and glitzy letters, they proclaim that you can win $1.5 million suing for autism. Who do you sue for a complex genetic trait, anyway? The worst part is the testimonial from a "satisfied customer" who notes how pleased she is that her child's incurable neurological condition has netted her some bling. I wish I were kidding.
This makes me sad, because while you don't have to vaccinate everyone (herd immunity's a wonderful thing), the threshold is always somewhere in the high 80%s. Also, the link between vaccines and autism is completely unsupported by scientific evidence. In fact, we had an entire small group session devoted to debunking it. I should've taken notes on the "miracles" required for the link to be true.
Moreover, after the Wakefield paper was published in the Lancet (and subsequently reported all over the popular press), there was a scare in Britain where parents refused to consent to vaccinating their kids. Result: increased incidence of measles and mumps, with two kids suffering measles encephalitis (read: permanent brain damage). Similar effect in Ireland: 1500 cases and 3 deaths. It's all nicely outlined, with citations, on Wikipedia.
Now, autism is an illness that hits very close to home -- one of my family members has been diagnosed with autism. It's a frightening label to put on your kid, because although there are various therapies, there is no cure. I completely understand why parents would want to avoid anything that might cause it. (Current evidence suggests it's genetic, but obviously very complex and non-Mendelian.) But also frightening: encephalitis. Death. You'd think parents would want to avoid these, too.
On a slightly related note: there are ads in the subway for some medical malpractice firm. In large and glitzy letters, they proclaim that you can win $1.5 million suing for autism. Who do you sue for a complex genetic trait, anyway? The worst part is the testimonial from a "satisfied customer" who notes how pleased she is that her child's incurable neurological condition has netted her some bling. I wish I were kidding.
Wednesday, February 27, 2008
Today, in clerkship, my preceptor, a peds gastroenterologist, was running behind, so he threw a chart at me and told me to go in there and talk to the patient. The chart was completely empty except for a photocopy of their insurance card.
So I did my first Real Medical Interview today. For about half an hour. Completely unrealistic to have that kind of time, I know, but I got a ridiculously detailed history involving a rather dramatic family dynamic playing into the medical condition. Really, it was almost novelistic.
It was a little frightening, I admit. With less than a year of medical school under my belt, I have no clue what sorts of questions I need to ask. "So, what brings you here?" was my opening gambit. We rehashed the same topics over and over as I racked my brains for the best thing to say. At one point, the mother asked me, point-blank, for a diagnosis.
"Well," I demurred, "I'm just a medical student, so I can't tell you much."
"Oh." The corners of her mouth turned down. I felt terrible for not having an answer.
So I said, "I just learned about how sometimes, there might be a sort of block between the colon and the brain. Like the nerve cells in your intestine don't work properly, so your brain can't sense when to go to the bathroom. That might be something you could ask the doctor about when he comes in."
Very confident, as you can see.
Then I felt even worse, because I had no clue what I was talking about. All I know about GI, after three weeks in the block, are celiac sprue, Hirschsprung's, and cholera. Oh, and situs inversus. Everyone has situs inversus.
Luckily for me, the doc arrived; I fumbled my way through the presentation (first presentation as well!); and when he went in, his explanation also involved damage to the vagus nerve. So I didn't completely mislead the mother.
In short, my faith and interest in medicine are renewed once again. Thank God for clerkship.
So I did my first Real Medical Interview today. For about half an hour. Completely unrealistic to have that kind of time, I know, but I got a ridiculously detailed history involving a rather dramatic family dynamic playing into the medical condition. Really, it was almost novelistic.
It was a little frightening, I admit. With less than a year of medical school under my belt, I have no clue what sorts of questions I need to ask. "So, what brings you here?" was my opening gambit. We rehashed the same topics over and over as I racked my brains for the best thing to say. At one point, the mother asked me, point-blank, for a diagnosis.
"Well," I demurred, "I'm just a medical student, so I can't tell you much."
"Oh." The corners of her mouth turned down. I felt terrible for not having an answer.
So I said, "I just learned about how sometimes, there might be a sort of block between the colon and the brain. Like the nerve cells in your intestine don't work properly, so your brain can't sense when to go to the bathroom. That might be something you could ask the doctor about when he comes in."
Very confident, as you can see.
Then I felt even worse, because I had no clue what I was talking about. All I know about GI, after three weeks in the block, are celiac sprue, Hirschsprung's, and cholera. Oh, and situs inversus. Everyone has situs inversus.
Luckily for me, the doc arrived; I fumbled my way through the presentation (first presentation as well!); and when he went in, his explanation also involved damage to the vagus nerve. So I didn't completely mislead the mother.
In short, my faith and interest in medicine are renewed once again. Thank God for clerkship.
Friday, February 22, 2008
Overtired and undermotivated.
I feel like I'm in over my head again and kind of want to shut the world out. Or at least the med school part of it. I just want to flit from one social engagement to another -- tonight I'm going to a play, tomorrow to a dance -- instead of being holed up in my room or the library wondering why, exactly, apical ENaC channels are so important. And because my heart isn't really in it, my studying is very unproductive. I stare at the wall a lot.
It snowed today, you see. Snowfall is always beautiful, but in New York the beauty is fleeting. Already, the streets have turned to brownish slush. I really wanted to make it down to Central Park to take pictures, but, like I said. Studying. Death.
Sometimes, I wonder if I'm missing out on life. I am living in the greatest city in the world, and I feel like I can't enjoy it because I have to study. And I know that these demands on my time will only get bigger as I move through the ranks of medicine.
*deep breath*
I am reading Jerome Groopman's How Doctors Think at bedtime, and it's wonderful. I wish that this, rather than The Spirit Catches You, had been our summer reading. The cultural dynamics of Spirit were fascinating and obviously relevant, but Groopman's book is more immediately applicable, I feel. Also better-written. Like Oliver Sacks, he revives the case study as a narrative form. Although it's billed as "how to avoid misdiagnosis," it's really just about listening to the patient and the patient's body. And zebras.
It snowed today, you see. Snowfall is always beautiful, but in New York the beauty is fleeting. Already, the streets have turned to brownish slush. I really wanted to make it down to Central Park to take pictures, but, like I said. Studying. Death.
Sometimes, I wonder if I'm missing out on life. I am living in the greatest city in the world, and I feel like I can't enjoy it because I have to study. And I know that these demands on my time will only get bigger as I move through the ranks of medicine.
*deep breath*
I am reading Jerome Groopman's How Doctors Think at bedtime, and it's wonderful. I wish that this, rather than The Spirit Catches You, had been our summer reading. The cultural dynamics of Spirit were fascinating and obviously relevant, but Groopman's book is more immediately applicable, I feel. Also better-written. Like Oliver Sacks, he revives the case study as a narrative form. Although it's billed as "how to avoid misdiagnosis," it's really just about listening to the patient and the patient's body. And zebras.
Monday, February 18, 2008
It's been a good week or so. The formal and afterparty were a lot of fun, just what I needed after exams. And my mother was visiting this weekend, so she and I had a good time exploring New York. We saw Curtains, a murder mystery musical about a theater troupe, set in the later 1950s. Think Kiss Me, Kate meets Radioland Murders.
Last week I went to a talk on the Science of Meditation, partly because there was food and partly because it seemed an interesting topic. The speaker, an alum of my med school, presented a bunch of data on melatonin as a contributer to tissue regeneration, which was intriguing. But then he started talking about the pineal gland being the "third eye" they talk about in Vedic scriptures (uh, did you ever think that might be a ... metaphor?), and yoga as promoting vagal maneuvers. Something about how standing on your head makes your diaphragm go slack? Didn't make a lot of sense to me, either. I'm cool with herbalism as a potential source of drug development, but this business of chakras and reiki and acupuncture is uncomfortably vague. Not to mention Orientalist. It is "Eastern," therefore it brings wisdom to the spiritually-deficient West. I am very, very tired of East-West Othering.
I know yoga and meditation are now trendy, stress-reducing ways for yuppies to achieve nirvana, but because of my background, they are very much a religious activity for me. And therefore intensely personal. And not scientific at all. Take yoga, for instance. It's not supposed to be about flexibility. It means "union," and it is supposed to be a way of moving past materialism and illusion into a spiritual plane in order to commune with God. I'm glad that people have some way of keeping fit and healthy, but it just seems, well, odd to me.
----------------
Now playing: Adam Pascal / Rosario Dawson - Light My Candle
via FoxyTunes
Last week I went to a talk on the Science of Meditation, partly because there was food and partly because it seemed an interesting topic. The speaker, an alum of my med school, presented a bunch of data on melatonin as a contributer to tissue regeneration, which was intriguing. But then he started talking about the pineal gland being the "third eye" they talk about in Vedic scriptures (uh, did you ever think that might be a ... metaphor?), and yoga as promoting vagal maneuvers. Something about how standing on your head makes your diaphragm go slack? Didn't make a lot of sense to me, either. I'm cool with herbalism as a potential source of drug development, but this business of chakras and reiki and acupuncture is uncomfortably vague. Not to mention Orientalist. It is "Eastern," therefore it brings wisdom to the spiritually-deficient West. I am very, very tired of East-West Othering.
I know yoga and meditation are now trendy, stress-reducing ways for yuppies to achieve nirvana, but because of my background, they are very much a religious activity for me. And therefore intensely personal. And not scientific at all. Take yoga, for instance. It's not supposed to be about flexibility. It means "union," and it is supposed to be a way of moving past materialism and illusion into a spiritual plane in order to commune with God. I'm glad that people have some way of keeping fit and healthy, but it just seems, well, odd to me.
----------------
Now playing: Adam Pascal / Rosario Dawson - Light My Candle
via FoxyTunes
Friday, February 8, 2008
No more exams!
Well, for a month, anyway.
It wasn't such a bad block, since we didn't have anatomy. I can't wait for after Spring Break, when anatomy is Over For Good.
And now we have the med school formal tonight, which will be excellent. I love being all girly and getting dressed up for things -- don't get much chance for that these days.
Proof that med school takes over your life:
(3:40:04 PM) Laura: i was just painting my right hand
(3:40:15 PM) Laura: and im very unsteady with my left holding the brush
(3:40:34 PM) Me: uh oh
(3:40:39 PM) Laura: and the first thought to pop into my head is "gee i wonder if being ambidextrous makes you a better surgeon"
----------------
Now playing: Cast Of Rent - La Vie Boheme
via FoxyTunes
It wasn't such a bad block, since we didn't have anatomy. I can't wait for after Spring Break, when anatomy is Over For Good.
And now we have the med school formal tonight, which will be excellent. I love being all girly and getting dressed up for things -- don't get much chance for that these days.
Proof that med school takes over your life:
(3:40:04 PM) Laura: i was just painting my right hand
(3:40:15 PM) Laura: and im very unsteady with my left holding the brush
(3:40:34 PM) Me: uh oh
(3:40:39 PM) Laura: and the first thought to pop into my head is "gee i wonder if being ambidextrous makes you a better surgeon"
----------------
Now playing: Cast Of Rent - La Vie Boheme
via FoxyTunes
Wednesday, February 6, 2008
Surgeon's Blog has an excellent post on all that health economics/politics stuff that keeps coming up in connection with the election.
I would contribute actual content, but I'm tired, and sick, and studying for exams (just genetics to go!). My headaches have been getting more regular and more severe, which is really no fun. I consulted the wise and wonderful WebMD yesterday, which told me that I might have a subarachnoid hemorrhage. I love the internet.
I would contribute actual content, but I'm tired, and sick, and studying for exams (just genetics to go!). My headaches have been getting more regular and more severe, which is really no fun. I consulted the wise and wonderful WebMD yesterday, which told me that I might have a subarachnoid hemorrhage. I love the internet.
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