Xmas Lessons

Drinking a bottle and a half of champagne will not only give you an exciting hangover experience (TM). No, it will also (if you're me) make you excessively paranoid and cause you to hear voices telling you to do weird things.

Lesson? No more excessive champagne for me.

Vacation

I am stuck in the unusual position of having free time. I finished my exams yesterday and don't have any classes until January 5th (I think). As some of my classmates so astutely noted, we're now 1/8th of the way to being doctors. Such a thought hadn't even occurred to me, actually. I'm just happy to be able to tidy up my house (it was gross) and spend time with my cats and husband. It's absolutely freezing outside, literally like eight degrees or something ridiculous like that, and the ground is covered in a thick (to me) layer of snow. I feel pretty good about it, actually. There's really only two things I need to do between now and January 5th. I have to write an application for a grant for summer research (more on this should it come to fruition) and I need to start studying for Head and Neck.

I also need to work on the notion that passing is good enough. My school does pass/fail grading, which sounds pretty nice. It is, I guess. Except some bright person stuck in the option of high passing. Now, if you've ever gone to medical school, you know how ridiculous this is. Heck, if you went to graduate school you get it too. You're taking a massive amount of classes, all of which are covering an epic amount of material in a short amount of time. You can study ten hours a day (and many days I do) and only get a 70% (stupid histology). Since this is passing, it shouldn't bother me. It does though. I want to high pass things. I think I equate doing the best I can in things to intelligence. This is not necessarily the case. I am in medical school with 123 other students who are also used to making top grades. Clearly, we're not all high passing. Most of us aren't, actually. That doesn't make us dumb. It makes us human. And we don't like it. We want to ace everything. We're certain that getting a 70% in histology (sigh) will affect us negatively in the future. It might, but probably not.

The thing is, none of us came to medical school to be mediocre, and that's what we equate 70% with. We don't want to be average. Now, not being average may vary from person to person; luckily for me, being above average does not mean becoming a neurosurgeon. For most, though, getting good grades is part of being above average.

My toes are cold.

Exam Week III

Really? This is the third time around? Seriously? It doesn't feel like I've been here long enough to warrant this. I have learned a few things though.
1) snow is really pretty.
2) snow is also a righteous pain in the ass.
3) there's always the same three to five guys at the Sea Star Market, every morning, just shooting the shit.
4) Irish punk = awesome.
5) pretty much anything can be made better by hanging out with the husband, playing with Matt's babies, or going upstairs and seeing Nancy in the clinic. If she has babies around, she'll let me play with them.
6) In the winter, when you lose power, just stick all of your food out on the porch. It's only 20 degrees out there anyway.

On a roll

This morning, I managed to fall down about twelve icy stairs, not get to the bank, not get my biochem reading done, and not get to the gym, all before 10 am. I am such an overachiever. Luckily the clinic at school was open so I could get checked out, and yelled at for not having put salt/sand on my stairs.

Gym may occur later today. Bank? Probably not.

Ouch.

One of my teachers actually said this...

"Just as an aside, a bit of proselytizing here – most of my research is focused
on the spine, spine pain and the anatomy of the spine as it relates to pain. But we’re also involved in doing this type of thing which is targeted dissections and then researching ways of getting them presented so they facilitate learning. If you’re interested in something like that, I’d be interested in talking to you. Some of the criteria for doing it – it’s greatly facilitated if you’ve got wicked OCD and it’s even better yet if you’re
somewhat bipolar. So, if you meet either of those 2 criteria, the thing to do is go off your medication for about a week, stay up all night and then have one of those cinnamon buns up here and a big cup of coffee. Then come and see me. I can really identify with people in that state."
Dr. W

Winter

Today's high temperature was 22 degrees F. That was the high. It's 8 degrees F right now. You can imagine what this is doing to my asthmatic lungs, even with careful administration of the appropriate medication at the appropriate time.

I'm calling the doctor tomorrow. I'm a bad patient. I haven't set us up with a doctor yet, and we've been here nearly six months...

Public Service Announcement

Don't go to medical school. I hear business school is really awesome. You get to take wine tasting classes. Granted, I like med school in general but right now, I hate it. It's exhausting and loads of work and you never catch up.

Flash Back

This fall, I've been helping out with the application process. That is, I've been showing interviewees the campus, letting potential students follow me around for half a day, answering emails and questions, etc. Most of the time it's fun. Right now, though, we're in the middle of a particularly rigorous block. Something about trying to learn all of the internal organs while still taking six other difficult classes makes for some pretty stressed students. As such, everyone in my class, even the kids who are super smart and have their stuff totally together, are starting to get sort of strange, manic, and loopy. This became most evident when a fellow student and I were giving a tour of the campus and spent five minutes showing the interviewees the fish tank.

Granted, it's a neat fish tank. I stop there at least once a day to look at the gorgeous fish that the marine science majors (undergrads) work with. They are a nice respite in an otherwise hectic experience. This is an experience, though, that I would not have understood a year ago. Had some med student spent five minutes showing me the fish tank, I would have thought they were bonkers. And maybe we are. In a year's time, maybe these same applicants will be doing something similar as a first year med student. They'll suddenly realize that they've spent five minutes at a fish tank or a grove of trees. And then they will understand.

Blues

It's four o clock in the afternoon and it's getting dark. I'm stressed about upcoming exams, and worried that no one likes me. Partially, it's because I don't fit in with the "cool" kids in our class. Granted, they aren't really the "cool" kids. They're really just the kids who are fresh out of college and all live together. It's slightly strange to be around them. They're really nice, but they're in a different place in their lives than I am.

Basically, I have the blues and biochem is kicking my ass. That and histo. And embryo. And everything else.

Holidays take one

Our first attempt at a holiday far away from our families went quite well. Yeah, we missed our families, but we did well for ourselves. We ate too much, but not as much as we would've had we gone home. We played video games, hung out with people, and basically went about life as if I were not in medical school...aside from the random bit of studying, that is. It was strange to go to school and study, which I did (only because Husband had to work) and then come home and not have to study anymore. Instead, we could do, y'know, other things. Like watch a lot of "Doctor Who" or "Psych."

We're gearing up for the third round of exams (holy shit, right?) and I finally bit the bullet and bought another biochemistry book on the grounds that our teacher isn't teaching me biochemistry, so someone sure has to, and it looks like it's going to be me. Right now, I am surrounded by anatomy texts and biochemistry texts.

Have you ever seen a picture of the gall bladder? They always color it green. I thought this was just a color convention, sort of like how carbon is always black in organic chemistry.

It's not.

So I just did the nuttiest thing that I've done in a while. I cut my hair. Like, a lot. Now, it wasn't super long to begin with; chin length has been the standard for about three years now. For the past month or so, I'd been toying with the idea of shorter hair still. So tonight, I went to the salon, sat in the chair, and watched as my hair got progressively shorter.

I have no idea if I like it. I'm not sure that I'll know for a week or so. It's dramatically different from anything that I've ever had before.

Hopefully I don't look too retarded. Back to studying histology and watching The Daily Show.

And how do you like that the nuttiest thing that I've done in a while is cut my hair?

Five months out

I have officially lived on the east coast for five months. This is a strange feeling, because it both feels like it's been less time and more time. It feels like ages since I've seen some of my family although I know I've gone five months without seeing them before. I think the strangeness has to do with the fact that I'm unable to hop in my car and drive home in two hours. I can, however, do that with Bangor. Let me tell you, I'm not driving to and from Bangor in one day again. That was a lot of driving.

Since I've lived here, I've learned some strange things, interesting things. Many have little or nothing to do with medicine (thank God, a break is good).

1. Lobster roll is essentially a tuna sandwich with lobster instead of tuna. I don't get what's so good about it, but the locals go nuts. Maybe they really like mayonnaise.
2. Aroostock county, otherwise known as the Alabama of New England, is generally referred to as "the county." Apparently everyone but me knows what they're talking about.
3. "The City" refers to New York city. Always. No exceptions. Unless you're in Quebec. Then it might refer to Montreal.
4. There are two New Yorks. New York City is a completely different animal than New York State, something that you'll see rather quickly when talking to people from upstate.
5. Boston is south of where I live, yet people inexplicably say that they're "going up" to Boston. I think it has something to do with trade winds.
6. Part of Maine is called "Downeast." This is not the part of Maine that is furthest southeast. It's actually north. Somehow.
7. Being bilingual here is a good thing, but it's helpful to know French rather than Spanish.
8. Moose regularly cross the highway, to the extent that there are actually "Moose Xing" signs. No, really.
9. When talking about New Jersey, people tend to drop the "New."

Addendum

On the plus side, my school is pass/fail (with the option of a high pass that doesn't really matter too much in the end) and I don't think I actually failed anything. Yet. Last time I managed to high pass three classes; I'm pretty sure I didn't pull that off this time. If I did, we better call hell, cause their pipes? Frozen. Fully completely. That's a good Tragically Hip song...

Post Block Two

They can't put all of us on the five year plan, right? Even if we royally tanked physio?

Suffice it to say that the second block didn't go as well as the first block. Last block, I knew that I had passed everything directly after the test. This block, there are four classes that I know I passed. The other three? Well, everyone thought that they would fail biochem. As far as histology and physiology go, they curve the heck out of histo because everyone fails it. Physio though, that's a new one. Apparently we are not meant to be cardiologists. At least 2/3 of the people that I spoke to today believe that they failed physio. This includes me.

This is in sharp contrast to last block, where I passed everything and high passed three things. This time? I'll be lucky if I pass everything.

On the plus side, there is beer and children trick-or-treating and a snuggly husband who believes that I'm awesome no matter what.

Also, I don't want to be something super duper. I just want to work with crazy people, little people, or old people (psych, peds, geriatrics).

Hello in there

Long time, no blog, I know. It's been busy. We're nearing our second block exam, and this time we have seven classes worth of material to manage. It's exciting. That's one word for it. Anyway, one of the classes I am taking right now is a medical humanities class. We learn how to use medical instruments, discuss ethics and philosophy, and generally have a good time. It's taught by a minister who happens to have a medical degree and a wicked sense of humor. All in all, it's an excellent respite from our other six classes. Anyway, tomorrow we have a reflection session. We're all supposed to write (or draw, sing, etc) something that expresses how our medical education has changed us, or how some life event has impacted us. Or something like that. It's all incredibly vague and as such, none of us had started until today. We're lame like that. I kind of liked what I wrote, though. It's a little disjointed, perhaps, but that's how I think and write.
--------------------------------------------
My medical education has been like facing an extremely well functioning fire hose and trying to drink all of the water in at once. It’s not going to work, clearly. My mouth is not big enough, stretchy enough, and even if it was, my body is not willing to accept such a volume of fluid in one sitting. Instead of water, though, I am faced with a seemingly endless stream of information. I am certain that I can never know all of it, but I’m going to try anyway. Every day, I go to class, open wide, and pray that I don’t miss anything too crucial (aorta? What’s an aorta?). In the end, there’s an awful lot of minutiae to sort through, very little of which is actually important. It is unlikely that I will need to remember the various stages of blood cell development. Here I am, though, cramming it into my head as if it were the meaning of life and I the only person who had gotten the message. If only my brain were big enough, stretchy enough. No, instead of being able to remember the types of adrenergic receptors, I am stuck with the theme song from “The Beverly Hillbillies.” At least it’s not the entire musical catalogue of Monty Python…oh wait. It is. Damn.

It is a precarious balance, this learning of information. We are taking seven classes, all of which are tested or graded in some manner. Some of them are easier than others, but in the end we need to pass them all. This is complicated by the fact that some classes are forgotten until the week before exams. I know I did this with Embryology last block. Unfortunately for me, it worked out really, really well. There are only so many times this will work. We’re going to see if it works with Biochemistry this time around. I am hopeful.

We don’t need to know every last little detail, but I would like to. Sometimes I joke that it would be neat to have a USB port in my head. I could simply stick in a little portable hard drive and download all of the applicable information. This isn’t so much a joke, though, as it is an honest to goodness desire. I want this USB port in my head. Until then, though, I’m going to have to face down this water hose.

Excitement

In other news, school is going and my parents are coming to visit for a week. I haven't seen them since June 13th. This is a long time for me.

How Myspace changed my life

At some point a few years ago, I got a MySpace profile. I think I was bored. I probably wanted to see if I could stalk some kids that I went to high school with. Seriously, that's about all the thought I put into it. I found a few people that I knew, and found plenty of others to mock. I never though that getting a MySpace profile would change my life in any appreciable way.

And then it did.

I'm adopted. I've got a biological family floating around out there. They are presumably doing the things that come along with living: eating dinner, making car payments, fighting with one another, and having good times together. Although I probably wasn't supposed to know anything about them, my foster mother slipped up and told my mother a bunch of identifying things about them. Y'know, things like names, occupation, home town. Things that i certainly wasn't supposed to know, given that my adoption was among the last closed adoptions to take place in Oregon. I've even got the amended birth certificate that lists my mom and dad as my birth parents, although they certainly had nothing to do with my actual genesis as a human being. My mom also told me that I could seek out my birth family when I turned 21. Maybe they'd want to see me, maybe they wouldn't. There was no harm in trying; the worst thing they could do was say "no." The age of 21 came and went without me doing anything of the kind. I changed my mind about what I wanted to be when I grew up, and eerily enough, I chose an occupation that many people in my birth family favored. Creepy.

Fast forward to this October. I was bored and poking around on MySpace. There wasn't much interesting to see. Most of the people I know from Ferndale are pretty boring (with the exception of you, Stef). I was so achingly bored that my mind was running around in circles, thinking of things to search for. I looked up one of Chris' ex-girlfriends. She had her profile set to "private." What fun is that? I searched for the girls that I had really hated in high school, only to discover that i still didn't like them. Finally, it dawned on me. I knew that I had a brother out there. I knew his name. Maybe he had a MySpace profile. I typed in his name, pressed "search" and was confronted with a male who could only be one person. Yes, he was my brother. I stared at his profile picture for hours. It was like I had seen him before. After a few days of obsessively looking at his profile picture, I took the plunge. I contacted him. Through MySpace. In the lamest way possible. I told him, via a comment on his comment page, that I liked his hat. Thus, an awkward relationship was born. We exchanged emails and instant messages for two months, getting to know each other better. Apparently, both he and his sister are in medical school. They both went to Ivy League schools. They both claimed to remember me. Creepy.

Finally, it happened. Last night, Chris and I drove down to Portland to have dinner with this guy. There are no words that can fully describe this experience, but it was sort of like a blind date with more baggage. We effectively didn't know each other, and yet we had quite a history. I disappeared from his life when he was seven years old. He remembers me coming home from the hospital as a new born. I have some really vague memories of him as a little boy. It was surreal.

And that is how MySpace changed my life.

Bone Box

The second block is upon us. We're still doing all of the same subjects (histo, embryo, physio, anatomy, OPP, EOM) and now we've added biochem. Clearly, we didn't have enough to do. Clearly. We've moved on from the brachial plexus to its evil stepsister the lumbosacral plexus.

Oh, and I have a femur. In my house. That's not mine. That is all.

Geologic time

Someone informed me that 25 years is the smallest unit of time that geologists will use (i.e. a quarter of a century). I don't know if this is true, and I am far too lazy to look it up. I kind of hope it's true though, just because it's interesting. At any rate, today my age can be measured in geologic time.

Happy Birthday to me. Twenty-five seems really old, but I know it isn't. Maybe it's just that I never thought about actually getting here until now. One thing is for certain. Time goes quickly. It feels like just yesterday that I was doing really silly Shakespearean plays with my friends and watching silly shows like Sabrina the Teenage Witch. My how things change.
I have biochem (ick) and a preceptorship at a substance abuse clinic (yay!).

Nurse Ninjas

Most nurses are ninjas, at least when it comes to respiratory illnesses. I have chronic asthma, which I have had since childhood. As such, I am normally quite skilled at managing it and rarely have symptoms. When I do have symptoms, it's usually due to upper respiratory infections or other illnesses. Currently, I have such an illness. Yesterday, I went to the school clinic to get a refill on my albuterol (I know, I know, I shouldn't have even let it run that low) and to have the nurse practitioner listen to my lungs to make sure I wasn't dying. I walk in and she's talking to a drug rep, but the RN is available. I basically say, "Hi," and before I can get anything else out, the RN has whisked me back to a room and is taking my vitals, listening to my chest, etc. It's like she had a weird nurse spide-y sense when it comes to asthma. It was quite remarkable.

I've had that happen before. Once, the nurse did it over the phone and demanded that I be driven to the clinic within the hour.

I don't know how they do it. Freakin' ninjas, I tells ya.

Post Block One Fortunately/Unfortunately Game

It's time for another game of fortunately/unfortunately.
Fortunately, I seem to have survived the block exam.
Unfortunately, with regards to histology, this seems to be based upon a technicality.
Fortunately, I am willing to accept that technicality as a "pass."
Unfortunately, this means my histo barrier is pretty weak.
Fortunately, I was not in the group in my class that had the upper respiratory infection during exam week.
Unfortunately, I have it now.

Post Exam Weekend

I have officially survived my first exam week. I'm a little thrilled, really. Every day was hard, no doubt, but I feel pretty good about how I did on my exams. I am pretty sure I passed everything, and there is a slight chance that I high passed a few things. That wasn't my goal this first exam cycle. My goal was to get my bearings, figure out what works and what doesn't, and then apply it to future exam cycles to do better and to use my time more effectively.

Also, this weekend has been awesome. I've done nothing school related, except for a memorial service for our body donors. The service was nice and respectful, except for the MSII that was wearing a mini skirt that was just barely longer than her short white coat.

I think I may be getting the upper respiratory thingie that's going around in my class. I am happy to have had it miss exam week, but I feel like crap right now and that's horrible. I wanted to go to church today, for the first time in a month or so. I feel gross though, so I may have to go next weekend. I'm sitting here with a glass of water and seeing if I feel better. Mostly, though, my church has a lot of elderly folks and I don't want to get them sick.

Either way, today I do have to do a little bit of work to prepare for classes tomorrow. I think I'm ready to move forward.

Sleep deprivation

This week has been, and will be, an exercise in sleep deprivation. The goal is to sleep just enough to function properly and learn things but not so much as to lose a lot of time to it. Time spent sleeping is valuable and could be used to study. Granted, I have been sleeping about six hours a night, which isn't horrible. It's also not good. I'm a gal that likes massive amounts of sleep, usually like eight or ten hours.

Oh, next week is exam week. That may help explain things. I have a block exam on Friday, Sept. 12th. Prior to that, I have an OPP practical exam on Tuesday, a Histology lab exam on Wednesday, and an Anatomy lab exam on Thursday. It sounds like a lot, and it is. There's a lot to know, although I feel pretty ok about OPP. OPP is a very active class. You are doing things to patients, like soft tissue manipulation and range of motion exams. As such, it's a little easier to learn this stuff. Anatomy is less active, but you can kind of multi-task in the lab by studying for the practical portion and then making sure you think about stuff that might come up in the written. This can be done in Histology too, so as far as those classes go, I feel ok.

Physiology is just a more in-depth version of the physio and cell bio classes I took in undergrad. I can spend some time with the notes, internet, and book and get it.

Embryology is horrible. I mean, it's interesting. It's just so complicated. Once you get to like day nine or ten, it's completely obtuse and you have to have a really good sense of what happens visually, since there's so much folding around that occurs.

Tomorrow, we welcome tropical storm Hannah to the northeast.

Forgetting school

Every now and then, it's necessary to take a day and forget that you're in medical school. Yesterday was one such day. I woke up leisurely, had a lovely brunch with my husband, went to an art show on the coast, and had a wonderful dinner with friends.

So it wasn't a complete success. I kept trying to remember the muscles in the extensor compartment of the forearm, as well as the muscles of the thenar and hypothenar eminences of the hand. Also, I kept finding bony landmarks on my husband. It was weird. Even on play days, you're never really away from it.

The downside, of course, is that yesterday is gone, and now even though my husband has today off and I theoretically have no classes, I am going to go study at school. All day.

Oh yeah, and we're less than two weeks away from our first block exam. Not that I'm stressed or anything.

Strange things

I've started saying "thank you" to the cadavers after I have finished body surfing/studying in the the anatomy lab. I'm not sure why. Maybe it's my way to remind myself that they are, or were, once humans. I don't know. It's not like they can hear me. Maybe they can, I don't know.

The time crunch and information crit continues. There is no real way to explain it, unless you have actually gone to medical school. Just when you think you might have a handle on the information, you find more somehow.

It's time for sleep. Then, I get up at 5:30 am and do it all over again.

Information Crit

I'm still in some sort of time vortex. I knew that it would be like this, but I can hardly believe the sheer amount of material that there is to learn. It's been barely two weeks and it feels like it's been years. The relationships in our class show it too. We're already joking with each other like we've known each other for years. Only problem is that we forget names periodically. So y'know, my anatomy crew is pretty awesome and we've done a lot of bonding over our cadaver, but half the time I forget their names. I know what they look like though, which is a plus.

A pretty common theme here is information overload, but it comes in waves. During the first wave, you're completely astounded that there could be so much. It's like running into a brick wall, over and over again. Then, you slow down a bit and take a gander at just a portion of the wall. Suddenly, it seems somewhat more manageable. You pick away at it for a week or two, gradually adding to your understanding of the wall. Then, just when you think you've finally got a hold on the massive amount of information in that wall, you see a tidal wave of even more. Rinse and repeat. Most recently, this happened with the upper limb. I learned all of the muscles in the shoulder/back area, as well as most of their attachments enervation, and blood supply. I could, and can, draw the brachial plexus. I felt like I had a tenuous grasp on the upper limb.

Of course, then we started in on the arm and forearm region. And let's not talk about the hand. Seriously.

And who names this stuff? Why is everything so similar? It makes it easy to get mixed up, whereas if we named things like Bob or Jerry, there'd be less to mix up. Bob sounds nothing like Jerry, whereas anterior circumflex artery of the humerus sounds strangely like posterior circumflex artery of the humerus, as well as circumflex artery of the scapula (not anterior or posterior though, just to piss me off).

The other day in anatomy lab, My forehead was itchy. I couldn't scratch it though, because my gloved hands were...gross. Really gross. My lab partner's first reaction was to say, "My elbow's clean! Use my elbow." And I did. I have no shame.

I need to go learn about various polygynal shaped spaces and intervals in the upper limb. Who decided to have the triangular space, triangular interval, quadrangular space, etc? Who's dumbass idea was that? There must be a really special place in hell for those bastards. And you know what's best? the triangular space is near both the quadrangular space and the triangular interval. Just for shits and giggles. Really.

Time Vortex

I have fallen into a time vortex. I basically sleep, exercise, study, eat, rinse and repeat every day. So far, most days look about the same, except some leave me smelling like anatomy lab. I got dead people in my hair last week. Seriously. How is this part of anyone's reality? On the up side, I seem to have found a groove wherein I don't feel like I'm going completely insane and yet I am only slightly behind. I think it's sort of common to be, or at least feel, like you're about two or three days behind. We were learning about muscles in anatomy today, but I haven't gotten to that in my studying. Yeah, I did the reading, but reading is different than studying, y'know? Maybe you don't. I kind of hope you don't. There is a difference.

I realized the other day that I have no clue as to what's going on in the world. I try to keep abreast of things, but I'm failing. Has Obama picked a running mate? Have the Olympics started? Who is Michael Phelps, and why is he such a big deal? I have no idea. I saw a headline today that stated something like, "Utah to close Friday" and all I thought was, "Gee, is it like the Hotel California?" Oh, and apparently Russia is blowing up Georgia (not the state. My gut reaction was to wonder how they got tanks to Atlanta), the air in Beijing still sucks, and John Edwards had an affair, only no one believed it for a few weeks because only the tabloids would report on it.

It's like time has stopped and yet I am still getting older. This doesn't seem fair.

Brachial Plexus

I've just spent the last day and a half memorizing the image to the left. With the exception of a few of the nerves that branch off of the cords, I can draw it, too.

I have no life. Don't get me started on the bones in the upper limb. It's not enough to know that the humerus is the upper bone in the arm. Nope, there's landmarks on it. Ten of them, I think. I'm not really sure. Sort of like maps. Which I can't read. Nice.

I'm going to go spend a huge chunk of my day in the anatomy lab now.

(Hi, Mom! Hi, Dad! At least I think they read this...)

My Cadaver

Dear Madam,
I want to take a moment to thank you for your gift. By the end of this academic year, I will know your body more intimately than you did. You have given me an amazing opportunity to learn the intricacies of the human form. I promise to learn all that I can from you, to take full advantage of the time I have to learn from you, and to never come to the laboratory unprepared.

I will never forget you.

The way it is

There is only one way that this whole med school thing is going to work (aside from me waking up with a 500 GB hard drive in my head). I need to have a schedule that I stick to most days. If I don't do that, I'll probably go nuts trying to do everything at once. This is what I'm thinking for the time being.

Weekdays
5:45-6:00 am Get up and exercise (if I don't do it in the morning I probably won't)
8:oo-12:00 pm Class of some sort or another
12:00-1:00 pm Lunch (yay!)
1:00-5 or 6 pm More class
6:00-7:00 pm Dinner with the boy (a must; if I don't get to sit down and talk to my husband, I will go nuts)
7:00-10:00 pm Study time
10:00-10:45 pm Guitar time
11:00 pm Bed time

Weekends will probably be sorta similar, except without class and the possibility of sleeping in a little bit. Oh, and I'm going to try to give myself one weekend day off a week, and use the other one as a sort of full day study session.

This might just work, assuming I can do this...

First Day

Do you remember your first day of kindergarten, and how you felt leading up to that first walk into the elementary school, plastic lunch box in hand? A lot of children are at least a little scared. They aren't certain about being away from their parents for that amount of time, they may worry that the other children won't like them, and they have no idea what it'll be like to learn the curriculum.

That's kind of like how I feel tonight, on the eve of my first day of medical school. Except that I'm thousands of dollars in debt, thousands of miles away from my family and friends, and I have to pack my own lunch. Yes, I admit it. I'm scared. Terrified, in fact. I am about to start school with 120 of my new best friends, only one of whom I've had an actual conversation with. I know it'll get easier, and I am looking forward to meeting new people and (hopefully) making at least a few friends. My school doesn't seem like the kind of school that would admit a bunch of douchebags, but it's possible that I will get a surprise.

I remember on the night before my first day of kindergarten, I spent a while picking out what outfit I would wear. I wound up wearing a jean skirt (I went through an epic phase with these. My poor mother had to wash it every few days so that I could wear it every day), a pair of sandals, a white t-shirt with some kind of design on it, and my glasses. I had a pink back pack. Tomorrow, I don't know what I'll wear, but it'll probably be pretty snazzy for my standards. It might actually have sleeves! It might not involve a comic book reference! Maybe it'll involve khakis.

All I know is that I'm terrified, more terrified of this than just about anything else.

Strangest Date I've Ever Had

In a week, I have a date, of sorts. I will meet a person who will be very important to me for the next few months. We've never met before; in fact, that's generally the way you want it. On our first meeting, they will be naked, although I may not see all of them at once. This person, who I have never met before, is giving me a gift.

They are my cadaver. At some point during their life, they decided that donating their body to my school after their death was the right thing for them. They didn't have to do it, no one forced them to (this does supposedly happen in other countries). They have no assurance that I will treat their gift with respect (I will).

It is very humbling to receive such an intimate gift from a complete stranger. My aunt, who went to medical school at age 30, still remembers her cadaver. She says that she loved him, that she thinks of him every day. I don't know if I'll think of them every day for the rest of my life, but I do think I will develop a deep appreciation for the gift they're giving me.

I wonder if this person will be watching, from wherever they are now. I think that bodies are just containers, albeit containers that we get very attached to for about eighty years, plus or minus.

The Great Hearafter

I'm afraid. It's the kind of person I am. If I were to be another creature, it would be a prey animal with an anxiety disorder. Instead, I'm a human with an anxiety disorder. Being afraid or worried is in my nature. Generally, there's something I can do about it. Talking to husband helps, as does seeing a psychiatrist. Other times, I can go on a walk or do one of my kick boxing videos (today, I've done both, even though it's 85 degrees with 60% humidity). Recently, though, I've found something that I can't do much about. I've been thinking about the nature of living and dying. Not so much the "how" part; that's going to be different for everyone, and I'm hoping for either passing while sleeping or while on the toilet. Rather, I've been thinking about the after part. What happens after we die? Anything? Nothing? Do we just decay?

Bodily, I sort of assume that we decay. I mean, our bodies don't merely disintegrate into nothingness (I will become very aware of this next week, during my first anatomy lab). There's something else, though, something "other" about all creatures. It's pretty difficult to look at my husband, who I love dearly, and think that his quirky personality is only due to chemical reactions taking place deep within his skull. Similarly, my cats are just completely ridiculous, but they clearly have some sort of character that makes them who they are. So what happens to that essence of being, that spark of personality, the sense of consciousness, the soul? Calvin and Hobbes have the following exchange to offer.

Calvin: Hobbes, what do you think happens to us when we die?
Hobbes: I think we play saxophone for an all-girl cabaret in New Orleans.
Calvin: So you believe in heaven?
Hobbes: Call it what you like.

I...am not sure what I believe. I only know that I have this deep certainty that there is something else after this world. My problem is that I desire proof, beyond a doubt, of what comes next. It's pretty hard to scientifically prove whether or not there is an afterlife, especially since bodies decay so willingly when left unattended. I am currently reading Spook by Mary Roach. She goes out looking for evidence to prove or debunk the notion of an afterlife. She says, in the beginning, that she very much wants there to be a place for the soul to hang out in after we're done here. She then quips, "will there be a place to plug in my laptop?" It should be an interesting read. Maybe it'll help my worrying.

All I know is that I watched The Bucket List the other night and bawled my eyes out (I know, not the best movie choice for an existential crisis).

Miscellaneous

Husband and I are now officially broke. Until my loans come in, that is. Then, we're living off of future money. That actually freaks me out more than being broke. Maybe it shouldn't. All I know is that when husband sat down to pay the bills, there wasn't a whole lot left. We're used to there being an "oh shit" buffer and it's just not there. We can rebuild it, but it's scary.

Orientation and classes start next week. I'm apprehensive and excited. It should be quite a journey. My main concern, though, isn't the material (yet). It's that orientation apparently comes along with a dress code of business casual. I've worked in the non profit world for a year and a half, and prior to that, I was in college. I have no idea what business casual means, but it sure better involve khaki pants and maybe some sort of blouse thing or else I'm screwed. I don't even know if I still have the blouse thing. I'd really like to be able to show up in a tank top and my capris, but both my capris and tank tops are borderline...gross looking. Most of my tee-shirts are those cheap knit things from Old Navy or involve comic book characters or jokes (and in one rare instance, both!). Clearly, in a few years, I will be an excellent candidate for What Not to Wear on TLC. Pretty much the only dressy things I own are the suit I wore for med school interviews (hot, right?) and the bridesmaid dress I wore for my sister-in-law's wedding this past May. Admittedly, the dress is actually wearable and the suit makes me look a little like K.D. Lang, so it's not a complete wash. Unless, of course, you don't like K.D. Lang.

I know that I'll have to, eventually, get used to dressing in a non-schleppy manner, but I was hoping to put it off for a few years, so I could pick a specialty wherein I could wear scrubs all of the time. Also, I was hoping not to have to acquire decent clothes as we're, y'know, broke.

Dog Days of Summer

Generally, the end of August is referred to as being the "dog days of summer." I think this is because the end of August is seen as the last hurrah of summer, the time that you have to squeeze in all of your extra fun before it's too late.

My dog days of summer are occurring now. Why? Well, school starts the first week of August, and may I say that it is really strange to start school so early. During grade school, I never started school before the last week in August; often, I didn't start until after Labor Day. High school was pretty similar. The college I went to didn't start classes til the third week of September.

This past week, we had a friend from Jersey visit us. We've known her for quite a while; I met her in 1996 in seventh grade algebra and my husband met her in 1998 in 9th grade German. She's the kind of friend who actually knew you when you had a retainer and went through your poser/grunger/punk rock/backstreet boys/other phase. The kind of friend who has not only met your parents but has possibly done work for your parents. The kind of friend who has way too much dirt on you for you to ever consider running for public office. The kind of friend who has cheated off of your math homework, but you've returned the favor. It was a fun week. We didn't do a whole lot, but we enjoyed ourselves nevertheless. She was entertained by our new home (it's like "Gilmore Girls" sometimes, I swear) and we were regaled by her tales of being a nanny. Luckily, she now works for a lovely family, but she went through some real lemons a few years ago. Some families, it seems, don't want a nanny so much as they want a slave.

There was a foray into NH to see The Dark Knight, which was excellent. I wasn't expecting to like it as much as I did. This has been happening a lot lately. Husband wants to go see a movie based upon a comic he read in his youth and I go along, feeling pretty much neutral. Then, I see the movie and really like it. This means that it's probably good that I didn't read comic books as a kid; I clearly would have gotten even less done at school. I would have been the kid that stared out of the window all of the time as opposed to only about half of the time.

Whoa

In a little over two months, I will be 25 years old. This is strange to me. Not necessarily because it's old, per se (although I am a year or two older than about half of my classmates), but because my life as it is now is nothing like the life I envisioned for myself ten or twelve years ago. Med school? No way. Living 3000+ miles away from my entire family? Not a chance. About the only thing that I accurately predicted was that I would be married and have cats. Yessir, life at nearly a quarter century old is nothing like what I expected. If you'd have told me that I would go to medical school even five years ago, I would have laughed. I didn't even get the idea of medical school until I was 21. It was an accident (literally; my mom's car rolled over and she had excellent health care within minutes). Getting here has been a pain. It took two years of classes, several cracks at the MCAT, and two application cycles. This is probably because the first cycle, I didn't really know what I was doing. I pretty much looked up the top twenty medical schools and applied to those. I didn't look at much information outside of their ranking, so these were research heavy schools. Second time around, I was smarter about it. I read up on all the schools I applied to, looked at their programs, and picked ones that I knew I would be happy attending. Actually, I found my school on accident; I saw its name mentioned in passing on a pre-med message board and looked it up. Funny, how things happen.

So life at 25? It's really weird and completely unexpected. And that's a good thing, I think, as this life is quite a bit more interesting than that which I could dream up on my own.

Reason 101 to wear sunscreen

Apparently, you can get sunburned on your eyelids. This seems like it would be the most excruciating pain ever.

Also, downtown Portland (Maine) is awesome, in much the same way that downtown Portland (Oregon) is awesome. We went and saw some live music and went exploring. It was a much needed excursion from the apartment, which is really, really, hot right now.

I lack intelligent statements.

She's got balls

Part of me has always wondered what it would be like to be super morbidly obese (yes, that is the medical term). I'm not sure why, exactly. I don't want to be overweight or unhealthy. It is a rare person indeed who does wish themselves ill health. I suppose I've always wondered if being obese would be as frustrating as I imagine it to be. Everyone assumes you eat poorly, are lazy and don't care about your health. It is difficult to find stylish clothing in your size. The summer's heat is perhaps even more unbearable. I've also often wondered what happens to people when they get so large. Are they able to clean themselves? Walk? Play? This blogger has something to say about all of this. She's chronicled her journey to the decision to have weight loss surgery and written very well about the surgery and aftermath.

Damn, that girl's got serious cojones. Damn.

To my neighbors

Dear Neighbors with a pool (i.e. not the neighbors who seem to hate cats for some reason),

I have noticed that you have a pool. I have also noticed that it is 90 degrees with 75% humidity. Now, I am a bit shy, but I would like to suggest myself as an excellent partner in pool shenanigans. I cite the following reasons.

• I have a huge collection of sunscreen since I am terrified of UVA and UVB rays.
• I can do really awesome things with seltzer water and a little juice (vodka/gin optional).
• I'm pretty funny most of the time.
• I have double jointed thumbs and elbows. While this is of little use to you, it is entertaining.
• I have all the Harry Potter books, as well as a fairly large collection of comic books that I would be willing to share.
• I'm new in town, and thus have not been poisoned against anyone (except the cat-hating neighbors), so you could mold me as you see fit.
• I'm a med student, so after August 1st, you might not see me again. Minimal effort on your part for a pretty awesome friend.

Won't you invite me over to your pool? I promise to bring tasty cherries.

CRNA vs. Anesthesiologist

Recently, in the medical blogging world, there's been a lot of chatter about Nurse Practitioners, Certified Registered Nurse Anesthetists, and "Doctor" Nurses versus actual MDs or DOs. I do not really know what I think about all of this. I have received care from NPs on multiple occasions and never had any problem with it. Additionally, a close family friend of ours is a CRNA, and she certainly seems competent, like she takes her job very seriously. That said, there's a lot of concern that to the common healthcare consumer, NPs are starting to look more and more like MDs or DOs. Indeed, there are a lot of nurses who are working very hard in the fields of primary care, who are taking on more and more of the responsibilities previously held by doctors. It's happening with PAs too. This is due to the fact that most med students look at their massive amount of debt and think, "There's no way I can pay this off and go into primary care." Also, anyone who gets into medicine for patient contact may find that lacking in family practice, where Medicare reimburses the physician for 15 minutes of his/her time. Yikes.

I am too inexperienced to provide much insight in this whole nurse practictioner versus doctor thing. I do know that I would prefer to be put under by an anesthesiologist, but can't quite identify why. The fellow at The Chloroform Rag (a first year anesthesiology resident) provides some interesting thoughts on this. He is understandably perplexed by the fact that some CRNAs see themselves as being just as competent as a doctor. What I find interesting, though, is that he is just now grappling with an issue that has plauged family practitioners for quite a while. This is not a new issue, unique to anesthesiologists. Frankly, it is one issue that I'd like to avoid. As such, I'll probably be eschewing fields such as family practice in favor of ones like psychiatry, pediatrics, internal meds. In the meantime, I've been being both entertained and horrified by the hubris of some of the posters in the message board for this article. The article by itself is interesting, if somewhat insubstantial. The comments are where the real entertainment is.

On that note, it is far too hot here. I am going to go drink seltzer water and think about all the things that I ought to be doing.

Doctor Who

This is completely non-science, non-medicine related. Well, it might be related, if you count the title "Doctor." Anyway, in recent years, I have fallen in love with "Doctor Who." So has husband. We have fallen so hard that we briefly toyed with the idea of painting our car blue so that we could name it "The TARDIS." Then we found out that it would cost $2ooo or more. We named the car "The Debt-mobile." That works too.

Anyway, we just watched the episode, "The Stolen Earth," and may I say that it was quite good. I loved how they incorporated Davros, who first appeared in "Genesis of the Daleks" in the 1970s. That was brilliant. The look of shock when David Tennant saw Davros was nothing short of brilliant. It had even more impact if you had, like us, actually watched the 1970s mini-series.

What I find most interesting about "Doctor Who" is not the plot, the twists and turns, or the illusions to other historical events being orchestrated by the Doctor. It's that the latest incarnation is intended to be a children's program. Either Americans are wusses or the Brits really like to mess with their children, because some of these episodes would have really scared me silly as a child. I mean, I'm still frighted when I hear the all too familiar and eerie exclamation of "EXTERMINATE." The episode "Blink" from a few seasons back effectively gave me a fear of garden statuary. It really makes me wonder about what, exactly, constitutes a children's show. When I was little, they were fairly obvious. Pretty much any cartoon was a children's show. Then, of course, "The Simpsons" came along and blurred the line a little. But that was on during prime time. It was a fairly hard and fast rule that anything on after the 6 o'clock news was going to be adult programming. That's all changed now. The Cartoon Network actually premieres new cartoons in the early evening, cartoons that my husband and I watch. Now, too, there are more cartoons intended for adults. They play directly after the cartoons for children. Sure, they're grouped under the title "Adult Swim," indicating that they're not for children, but the line is blurred. When I worked in social services, I often had pre-teen clients who wanted to talk about the latest episode of "Family Guy" or "South Park." It always gave me pause, as I don't believe in censorship, but the content of these shows tends toward the more mature.

I have the same questions about young adult fiction too. When I was a kid, this genre barely existed. It was made up of, principally, "Goosebumps" books by R. L. Stein. I read a few of them on a camping trip. They were entertaining enough, but I wanted to read other things too, and so moved right along to adult fiction. Now, a scant twelve years later, the young adult genre is exploding with books that I would, and have, read. Books like "Little Brother" by Cory Doctorow and the "Uglies" series by Scott Westerfeld are all fairly sophisticated stuff for kids. I would have loved these books as a kid, and my mom wouldn't have had the control of them the way she did tv. I distinctly remember, for instance, when she fast forwarded through the racy scene betwen Forrest and Jenny in "Forrest Gump." At that same age, I was reading adult fiction, studying Shakespeare. It struck me as hilarious then. I couldn't watch it on tv, but I could read about it at great length. It's still funny, actually.

Basically, what designates something as being for young adults versus actual adults?

The No S Diet

Husband and I have decided that it is high time that we embark on healthier lives. I already exercise a fair amount, and it sure seemed like we ate healthy. His job, however, keeps him tethered to a desk chair for hours upon hours every week day. Between that and the fact that we both have sweet tooths, we've managed to become somewhat...chubby.

Anyway, husband found a diet on the internet that is actually quite reasonable. The creator of the diet sums it up in fourteen words. "No snacks, no sweets, no seconds, except (sometimes) on days that start with S." It's just that simple. Every meal, you get one plate. You don't have to eat everything on your plate, but you can't fill it up again. That's all you get until the next mealtime. Sweets are defined as, well, sweets. Any food item that is eaten purely because it's sweet. Sugar in coffee is ok; a frappucino is not. Sugar in tea is ok; a milkshake is not. Seltzer water (the zero calorie kind) is ok; pepsi or coke are not. A snack is anything eaten between meals. This does not mean that you can't eat chips or pretzels; they simply need to go on your plate during a mealtime.

So far, this is the most realistic diet I've ever been on, primarily because you can still eat just about anything. Want a hamburger for dinner? Fine, you can have it, but you can't have any snacks or sweets. Want spagetti? Go for it. There's no diet food to buy, no forbidden foods a la Atkins or South Beach, and no punishing yourself if you mess up. If you mess up, so what? Don't do it again. Learn from it.

Granted, husband and I are trying to eat healthy foods, lots of fruits and veggies, simply because they are better for you. And we're attempting exercise. The creator of the diet also has an exercise program that he developed. It's got to be the most bizzare exercise program that I've ever attempted, or seen attempted. It requires no gym membership and minimal equipment. Namely, it requires a sledgehammer. You really have to see it to believe it, I think. Husband is going for it; I've tried it for three days now, and while I'll probably do it again, I am very anxious to get back to my kickboxing videos.

Fortunately/Unfortunately

We feel, sometimes, like we're living in a fortunately/unfortunately book. You know, the ones that say things like, "Fortunately, Suzy got ice cream. Unfortunately, she dropped it." Ours would be different though.

Fortunately, we got the cats through airport security. Unfortunately, one of them used my chest as a spring board to try to get away and now I have a righteous cut.
Fortunately, we didn't miss our flight. Unfortunately, it was a red-eye and neither of us got any sleep.
Fortunately, we arrived in Boston with little incident. Unfortunately, we then had to drive in Boston.
Fortunately, we were able to find our way to the interstate with little incident. Unfortunately, we discovered the toll road.
Fortunately, we had change for the toll road. Unfortunately, we then arrived in New Hampshire and had to pay another toll.
Fortunately, we acclimated to New Hampshire. Unfortunately, New Hampshire lasted about ten minutes.
Fortunately, we had several leads on apartments. Unfortunately, some of these places seemed to be approaching crack den level skeezy.
Fortunately, we found an amazing house with beach front property. Unfortunately, there was no way that we could afford it.
Fortunately, we found an awesome townhouse up for rent. Unfortunately, it wasn't available until July 16th.

And so on. We're doing ok now, as we've got an apartment and have a car. However, it sure took a while to get here. And now, one of the cats is hiding under the floor somewhere. No, we don't know why. No, we can't get her to come out.

The East Coast

So husband and I are experiencing culture shock. The first bit of this involved toll roads. Washington State just got a toll bridge recently. It was a very big deal, lots of angry people, etc. Good times. Well here, just about every time you go on the interstate, you pay a toll. Sometimes twice, if you cross from one state to another. This really confused us while we were driving north on Monday, because we'd already paid a toll to get onto the interstate in Boston. Then we realized that Massachusetts had ended, and we'd entered New Hampshire. Just when we got used to that, we left New Hampshire. It lasted ten minutes. I'd like to see some of these folks go out west where you can drive in Montana for eight hours and still be in Montana two days later. That'd break their little brains. We saw a house that was a little ways out of town (like two miles) and the landlord actually said that it wasn't "that long" of a drive. Like two miles was a real hardship.

Also, everything is older, and the apartments look funny. Almost all of the buildings are converted from something else; most are old manors or boarding houses. Nearly all are at least fifty years old, although one building we looked at was nearly one hundred years old. As such, everything, even the nice places, is cobbled together in a funny fashion. Takes some getting used to. These places would not work on the west coast; no one would want to rent them. I've really had to work on the whole not judging a book by its cover. We found two really nice apartments that are quite lovely on the inside but less than ideal on the outside. I suppose it's a common cliche for people of all sorts, but when I come from a state where apartment buildings are pretty awesome looking, it's difficult.

Homeless

We are currently homeless. It's fine in our case, since we're crashing up north at husband's childhood home. It's been nice to hang out with friends and families that we've been close to for years. The bittersweetness of it all is quite poignant. There are moments of absolute beauty and utter sadness. Quite often, one follows the other. We were at a dinner party with some of our lovely friends (essentially adopted family) and we were laughing and watching the water birds dive and the humming birds flit. This is something that I'm leaving because...why, exactly?

Homeless girl out. Will give word when we reach our destination.

Moving far, far away...

There are so many little things that need to be done to move across the country. Stuff needs to be packed and shipped or given to St. Vincent de Paul. There are plane tickets to be bought, hotels to be booked, cars to be rented. We aren't even on the plane yet and we've already booked appointments to look at apartments in a town that I've been to once. The whole process is so daunting that something will inevitably be forgotten. I made a list of things to do today and I'm sure that I've already forgotten something.

One thing that complicates this whole process is that we have cats. These cats are going to be following us across the country to the great northeast. Obviously, flying with a cat is only slightly less insane than driving with one. There is still a cat carrier involved; only to go through airport security, you have to take the cat out of the carrier and walk through the metal detector. This is after you've somehow handed the TSA agent your ticket, your I.D. and the cat's health certificate. Then, you somehow get the cat back into the carrier and proceed to stick them under the seat in front of you for the duration of the flight. Hopefully, after your cat scratches heal, your cat will have forgiven you. I'm not counting on it, because we don't have an apartment to take the cats to.

Nope, we're going to be hotel camping. This is a proud tradition in my family, since we did move thirteen times in twelve months. I'm very afraid of this particular portion of the journey, because we'll have cats. In a hotel. That's crazier than flying with cats. There are so many things that can go horribly, horribly wrong. What if the housekeepers let the cats out? What if the cats decide to hide under the bed and not come out? What if, what if, what if?

Hopefully, in two weeks, we'll have a place to live and the cats will be getting over their anger and acclimating to our electoral vote splitting home.

We know where we're going!

The title should be self explanatory. There is no doubt about where we're headed. We're going to the east coast, to a state that has lovely autumns and a rampant wild turkey problem. The state's name has one syllable and is one of only two states in the union to split their electoral college votes.

Leaving

On Friday the 13th, my husband and I shall begin our frightening journey. Phase one of this journey shall involve us spending the weekend up north, in the strange little town that we grew up in. Phase two will involve us flying somewhere on Monday the 16th. Then, we scramble to find a place to live and a car to drive, all while living in a hotel/motel with cats.

The shortest version of the story is this: starting the evening of Friday the 13th, my husband and I will be homeless.

Pure, concentrated, crazy

So Hillary Clinton is actually suggesting that she'll suspend her presidential campaign on Saturday. She wants her supporters to support Obama. That'd be swell, and some of them might actually do it. Not these crazies, though. Sure, Obama has crazy supporters too, they just don't have a website that I can easily access. This website is pure, unadulterated crazy. Be sure to read some of the comments; several Fark.com memes have resulted from this one website. It's madness.

Let's all move on to the craziness that will be the Veepstakes. I realistically want an Obama/Clark ticket, but would settle for Obama/The Doctor. Hillary has already managed to inject herself into this mess, saying that she'd be willing to serve as Obama's VP for the good of the party. I am only glad that it will occur before school starts so that I can observe the madness. Sadly, I'll be feverishly studying during the conventions, but I'll make time for that too.

Your Mama?

For something completely different, this right here is why I love The Stranger. Nothing is sacred and they have Dan Savage.

I'm going to miss it here.

Exams

Most Americans have some experience with standardized tests. Throughout primary and secondary schooling, students take a variety of tests to determine if they're making the grade. Tests such as the Iowa Test of Basic Skills (ITBS) are pervasive and used all over the country. The results are more of a diagnostic tool than anything else though. It's not until high school that standardized tests in America are able to determine more about your future. A high score on the SAT will make your application to elite schools more likely to succeed, whereas an average score, not unlike mine, generally relegates students to state universities. Even then, though, the tests aren't the be all, end all in a student's future.

Graduate school exams are similar to the SAT, but narrower in their scope. On the MCAT, for example, it is not necessary to complete any analogies (thank God). I had a hard enough time getting a reasonable score in the physics section; if there'd been analogies I would've been totally screwed. Your score helps make your application more or less competitive; notice that I did not apply to Harvard or Yale. It does not necessarily exclude you from medical education, however.

Standardized tests in China, however, are quite a bit scarier, in my opinion. High school students take a single, two day marathon exam called the gaokao. This exam can and does channel students to specific tiers of colleges, not unlike America. The gaokao is the only factor that universities in China consider in selecting students, which makes it far more powerful than the SAT can ever be. A high score can send a student to MIT, whereas a low score can send the student to a community college. The disparity in the perceived status of these colleges can and will affect the student for the rest of their lives. There is only one analog that I can think of in America.

That exam is the medical licensing exam, either the USMLE or the COMLEX. A student's score can and does determine what specialties they are able to go into after they complete medical school. A student scoring about 240 on the USMLE is eligible for prestigious residencies like plastics and opthalmology, whereas a student scoring around the national average is eligible for residencies in pediatrics, family practice, and other primary care specialties. This can be quite upsetting for a student who is gearing for something like opthalmology. Imagine working through the first two years of medical school, only to get your Step 1 scores back and realize that you cannot get into that residency. That is really the only American analog to the gaokao in China. And maybe that's a good thing.

Political Junkie

So presidential election years are like my Christmas. I don't know why, exactly. I love the speculation, the fact that the whole thing resembles "Survivor." I've always been this way.

I come from a very left leaning family. We're the ones who caucus for Kucinich, vote for Stevenson, etc. We're the ones that initially liked Ralph Nader. May we express our sincerest apologies for that, by the way. Essentially, my family and I are very rarely on the winning side of the democratic nomination process, much less the general election.

That's why tonight is so cool. I actually picked the winning democrat. What's that about?

I wish I was in Minneapolis tonight. I think it would be a great place to be. Instead, I'm out west, preparing to go east.

Moving Day

Moving day is officially Monday, June 16th. We aren't sure where we're moving to, but that's our day. We're actually leaving our apartment somewhere between Thursday, June 12th and Friday June 13th. We'll be crashing up north with our families through the weekend, after which said families will drive us to the airport.

Oh, and did I mention that we have cats? Two of them. Next Wednesday, we get to go to the doctor (me) and the vet(them) and get shots (both of us) and official paperwork (both of us).

Crap. We're at two weeks from departure. Wasn't it just October?

Gettin' Ink Done

Prior to moving to ______, I am going to get a tattoo. Of course, it's going to be a highly nerdy tattoo of serotonin. This will be my first tattoo, and I am both excited and apprehensive. It seems like a good time to do it though, because I'm getting ready to move to start medical school, and ending this non-academic phase of my life.

Everyone ought to watch Doctor Who.

FLDS

Unless you're living under a bridge somewhere, you've probably heard of the FLDS polygamist group in Texas. You know, the group where 400 children were forcibly removed from their parents and are now involved in the biggest custody battle in American history. This is one of those cases that causes people to really examine large enclaves of people with scrutiny. If they group together and are isolated from other people, they must be up to something, right? The whole debacle just breaks my brain a little.

Anyway, I was at a family shindig recently, talking to my cousins, when the FLDS people came up. Specifically, they came up because one of the younger cousins had previously lived with her mother in a very cloistered, conservative enclave. My cousin was trying to think of a way to describe them and stumbled on his words, saying that they were kind of like the FLDS, but not as extreme. Then, he succinctly said, "You know, skirt people."

Such an apt analogy.

Empty Nest

Just getting a few more things packed. Our apartment looks creepy with fewer and fewer items in it. It's messy and yet empty. Soon, most of our kitchen stuff will be gone.

Anxiety thought dump

I am currently having second thoughts while attempting to kill brain cells while watching "What Not to Wear" on TLC. I know that my second thoughts are unfounded, but they exist. I am anxious, for example, about my age. I graduated college in 2006 and proceeded to take two years off. While I really needed the time off ( see www.caseaidediaries.net for more), I am becoming more and more alarmed that I will finish med school at the ripe old age of 28, only to turn 29 shortly thereafter. That's if I don't do an OMM fellowship, which I am seriously considering because of the teaching experience. Then, it's residency for 3 to 5 years (most likely 3). And what if I want to do a fellowship? Clearly, that's insane when paired with the stuff I want to do. Where do I have a life? I'm married, I want children. There are so many things that I want to do that have nothing to do with medicine.

It stings to think that I could just ditch this whole crazy adventure and live in a pretty place with sweet people and get my little family life started. My sister in law? She's just gotten married and is already talking about kids. For me, kids are far, far away. My biological clock is ticking. I know people have children during med school/residency/loan repayment programs, but how realistic is that?

At the same time, I know that I have a husband who loves and supports me, as well as in-laws who are amazing. I know that my husband would be a stay at home dad in a heartbeat, and that my in-laws and parents would be thrilled to have a grand baby to play with. I also know that if I don't at least try to make this work after all the effort I've gone to, I'll be seriously angry at myself for the rest of my life.

Why Osteopathy?

Why not? No, really. Why not? Osteopathic medical schools teach the same basic science curriculum as allopathic medical schools. They are accredited, their students are eligible for the same NIH research grants, their students are able to participate in all AMA and AOA accredited residencies, and they learn additional material that allopathic students do not.

Yes, I am referring to Osteopathic Manipulative Medicine, or OMM. This practice includes soft and rigid tissue manipulation, similar to both massage and chiropractic medicine. Note that I did not say the same as. This is important, because most physicians will use massage and/or chiropractic treatment in concert with medical or surgical treatment. Osteopathic physicians, however, often elect to use OMM as a diagnostic tool, or as sole treatment for minor injuries.

As a diagnostic tool, OMM is very powerful. For one, it increases the amount of time a physician's hands spend touching the patient. All too often, doctors examine with their eyes alone, leaving whatever lies beneath the surface untouched. Instead of simply writing a script for some sort of neck pain, a doctor may discover a lump or a dislocation and be able to treat that instead. OMM has the potential to help all doctors treat not just the symptoms, but the cause of disease. This should be the ultimate goal, I think. Perhaps allopathic medical schools should teach some osteopathic methods as well; it certainly couldn't hurt a future physician to have more skills with which to help patients.

Interestingly, allopathic does not show up in Firefox's spell checker, but osteopathic does. This pleases me somehow.

'Allo, world

I am:
moving across the country in 20 days
going to medical school, starting in August
a member of a minority in the medical community, i.e. osteopathic medical student
the proud owner of double jointed elbows and thumbs

I am not:
single
aware of where, exactly I am moving to, which makes the process all the scarier
a fan of mushrooms
an excellent speller