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.

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.

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.

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.

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.

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.

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.

New Block Resolutions

Well, exams were fair-to-middling. I passed (at least the ones whose grades have been put up), but only marginally in anatomy.

We started a new block today -- essentially, starting afresh. So here are my Block 3 Resolutions.

I will:

• Spend 1 hour per lecture prereading the night before.
• Spend 1 hour per lecture reviewing, the same afternoon.
• Spend 2 hours in anatomy lab every Sunday, reviewing the structures for the previous week.

I will not:

• Fritter away my study time on YouTube. (Diagnosis Wenckebach can conceivably be a "study aid", but the temptation to watch SEVERAL HOURS of French and Saunders is just too great.)
• Study only in the hellhole that we call a library.

This is what I did first block, and it worked. It also kind of sucked, balance-wise. Second block, I swung too far the other way -- making free time at the expense of my studies. Maybe this time I'll find the happy medium.

(That sounds like a Lifetime Original show, doesn't it? "The Happy Medium." Seances and crystal meth.)

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Now playing: Yo-Yo Ma, Mark O'Connor & Edgar Meyer - Caprice For Three
via FoxyTunes

Balance

For the first time, I feel reasonably prepared for a test in med school. Of course, they haven't provided us with any practice questions for this class, so that might have something to do with it. Heh. Syllabi are incredibly high-yield, though. My school doesn't officially provide syllabi anymore, but there are old ones floating around; they cover exactly what the lecturer emphasized and are much easier to understand than the Powerpoints. I heartily approve.

(For non-med students out there: med school syllabi aren't just a list of topics to be covered. Rather, they are extensive, multi-page lecture notes. The anatomy syllabus, for instance, is 650 pages long, excluding the index, errata, and learning objectives appendices.)

I've been a lot better about balance this exam block. For instance, I take about half an hour every evening before bed to read White Teeth, a novel of Awesome by one Zadie Smith. It helps to pull myself out of STRESS mode and remember the power of literature.

Speaking of which, I got the teaching job I applied for and have been teaching 7th graders every other Saturday for the past few weeks. It's a lot of fun, and coming up with lesson plans is not as terrifying as I thought it would be. (There are two other advisors, who are full-time, so that helps.) I'll be teaching solo in December when I do my elective; I know what I want to teach but am holding off on the actual planning until post-exams.

It's going to be so relaxing to have a real weekend this time. I wonder what I'll do.

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Now playing: Mozart - Elvira Madigan Piano C
via FoxyTunes

365 Days Ago

A year ago today, I got a fat envelope from the med school associated with my undergrad university. I pretty much jumped up and down, right there in the mailroom, called my mom, and went around for the rest of the week grinning like the Cheshire Cat.

The rest of the application cycle brought luck but also heartache. Around November, I had a serious crisis (precipitated by love for my thesis) wherein I was just an email away from withdrawing my applications everywhere and applying to English MA programs.

Crazy, I know.

What was I afraid of? Partly the work (and there's no denying that it's rough; I study about 4 hours a day and more during the week before exams). Mostly the culture of medicine. You know, those people who insist that medicine is supreme, more important than family or sanity or outside interests. It may be heresy, but I applied to medical school because I like stories. And medicine is pretty much the only profession (besides Starving Writer) in which narrative is supreme. I was afraid that "they" would find out that I secretly love stories more than duodenums (duodena?) and that "they" would summarily kick me out of med school, leaving me disgraced and jobless.

In my mind, "they" were pretty much Nazis.

In the end, I decided to stick with medicine because I met a physician who showed me that I was not strange or somehow demented for seeing disease in the framework of a story. That there would be opportunities in medical school to pursue stories. That becoming a physician might actually improve my own stories. I honestly think that that woman is the reason why I am where I am today.

And how do I like it here? Bloody awesome. School is very school-like -- lectures from 10-12 daily, anatomy lab twice a week from 1-5, nightly studying until 9:30 or 10. I'm working much harder than I ever did in undergrad, and failure is a very real possibility (albeit with shadowy, ill-defined consequences).

But I still find time to cook, to read; I even get up an hour early every morning to write. There are many other writers and artists here as well -- we have book clubs and musical performances and writers' workshops -- and I think that's contributed a lot to my rapid adjustment and general joy. It's almost a frightening sort of happiness, as though some Greek god were about to strike me with the plague, just to even things out.

So that's why when Dr. B. asked this morning if med school was all we imagined it to be, I thought, "No ... it's much better."