Medical Student Musings

What's in my white coat?

2010-10-28T16:02:00.000-07:00

So rotations have officially taken my life; I've completed family medicine and surgery and just started in patient internal medicine. I'm learning lots and have little time, but today I was curious what, exactly, was in my white coat.

*Pocket Medicine
*Motorola Droid
*stethoscope
*two tuning forks
*lollipop
*pager
*list of important phone and pager numbers
*25 cents
*call room keys
*pocket handbook for the Maine Dartmouth family medicine residency for some reason
*three highlighters, only one of which works
*four pens, none of which I can find when I need them
*patient census form
*half completed progress notes
*yesterday's patient census form
*nametag
*Maxwell's
*Pharmacopia 2010

entertainment value

2010-08-24T12:52:00.001-07:00

Me: Have you had any surgeries?

Elderly lady: I had a complete hysterectomy. They took everything, but they left the playpen.

new chapter

2010-08-01T17:57:00.001-07:00

I just got used to the idea that I passed my boards (both of them) with scores that are probably good enough but not as good as I would have liked, and now tomorrow I start rotations. Hmm. Not sure I'm ready for this...but I think it may involve an early morning run. I almost think that I need rotations to recover from my excellent but exhausting week long journey to the west coast. I traversed over much of Washington State, experiencing highs of 100 degrees (with no humidity) and lows of 53 with pea soup fog. It's a great state, one which I intend to live in, one day.

Revealing

2010-07-14T09:26:00.001-07:00

No matter what I do or how much I accomplish, part of me still feels like the world sees me as the little girl with coke bottle glasses and asthma that no one wanted to play with.

Summer

2010-07-02T18:34:00.000-07:00

Boards - took 'em. Might have passed. I was initially going for getting at least the average on them (beating it would have been nice). At this point, I just hope I pass, and I only want to pass because I don't want to have to take them again.

All I know is that I felt pretty ok leaving both of them and that around 4 pm this afternoon, I temporarily lost the ability to form a coherent sentence.

Residencies look at things besides boards, right? Like...research, Step 2, clinical grades, other grades, letters of recommendation...right?

Approaching the end

2010-06-30T13:57:00.000-07:00

I am, at long last, approaching the end of my board studying. Today was my last official day studying, although the past week has really just been me watching the world cup, reading First Aid and Goljan and doing question sets and flash cards. I took the COMLEX on the 22nd, and I probably passed. I take the USMLE on Friday, and I will probably pass...
I will basically stare at First Aid/Goljan a little more tonight, hang out with my husband, go get a 1.5 hour massage tomorrow, do things that have nothing to do with studying, and then go take my test on Friday. Then it will be summer for me, although one could argue that what I've done this past week can't really be called studying. I like to think that it's like training for a marathon. You work really hard for a long time and then back off a week or two before.

Acheivement unlocked

2010-06-27T05:59:00.001-07:00

* sunrise hot air balloon ride
* five mile run
* survived first board exam (COMLEX)
* four days until USMLE (eek!) and then SUMMER FOR ME!

T-minus two weeks/three and a half weeks

2010-06-07T09:57:00.000-07:00

Two weeks til COMLEX. Three and a half weeks til USMLE. I'm hanging in there. Barely. I think I've narrowed down what I want to be when I grow up to a few options...
*Physiatrist (PM&R, probably with some sort of pain management tacked on)
*Pediatrician
*Psychiatrist (probably with kids/teenagers)
*Palliative care physician (this necessitates an internal medicine/family medicine residency)
*Neurology (Ok, I just actually kind of enjoyed reviewing it today/yesterday, hence it is on the list).

Palliative care can also be integrated into any of the above, which is cool.

Median USMLE Step 1 Scores for Matched Seniors
*Psychiatry 208
*PM&R 208
*Family Medicine 209
*Pediatrics 217
*Neurology 218
*Internal Medicine 222
*Transitional year 233 (some residencies need you to do a transitional year prior to beginning them)

Art project?

2010-05-23T13:56:00.000-07:00

So I'm up to my eyeballs in board studying, having now entered "it's 29 days until COMLEX" territory. I'm to the point where I'm now studying for 8-12 hours a day except (generally) on one weekend day. I am actually starting to think that I'll pull this whole thing off somehow, which is am amazing feeling. I've got a crapload of work to do, sure, but something about gradually studying since oh, January, seems to have helped. I "forgot" a lot, but it's coming back, which is nice.

Anyway, I mention this because part of my studying strategy is to pick a section in First Aid and sit with it and another book and go through and annotate EVERY ENTRY. THIS TAKES FOREVER, but it means I get to use pretty, colored pens. I've also been taking notes on pretty, colored paper, which keeps me happy. Anyway, I've become fascinated with the difference in how students utilize First Aid. Some students draw all over it (me), some students have elaborate color coding systems (not me) and others do absolutely no marking. This fascinates me. So I thought what would be a cool art project is to pick a page in First Aid and ask as many medical students as I can to take a picture of it. I could then compile it and see the different ways in which people use the book.

This is the kind of crap that keeps me up at night.

ugh

2010-05-21T13:27:00.000-07:00

24 hour-ish stomach/gi bug is a hell of a way to lose five pounds. Also a good way to miss the super awesome end of year party at M and L's house and to get a day behind in studying for the boards.

Dammit.

"Swimming"

2010-05-13T05:51:00.000-07:00

So I'm in Florida for a conference until Sunday early in the morning. I'm at Disney World, to be exact. A few of my classmates are here; we're all presenting posters at some point. The strange bit is that, although my classmates are super nice, I don't know them that well and so I'm effectively in Disney World by myself. It's very weird. Husband was going to come, but it was financially too much for us. Of course, now I wish he'd come, because I'm essentially in the happiest place on earth by myself.

It's kind of depressing.

I woke up early (I don't really need to be at the conference until noon today) to go running outside while it was still "cool." Now, if you've never been to Florida, you'll have no way of knowing this, but there is no "cool." There's hot, more hot, and "oh my god I'm melting" hot. Why is this? Humidity. It was 72 degrees out when I was running, a reasonable temperature if you're wearing a tank top (I was) and shorts (ditto). It was also like 85% humidity. It wasn't so much a run as it was a swim.

Overheard in a dressing room

2010-05-08T15:26:00.000-07:00

Today, my husband and I ventured out into the world to acquire some professional attire. I'm going to present a poster at a conference next week and I needed polo shirts that weren't transparent. Anyway, we wound up at Target (I'm cheap, ok? I liked the shirts at The Gap better, but they just weren't worth $25-50. Similarly, Macy's was too confusing and costly). I grabbed a few and went into the dressing room and overheard the following:

Gal 1: I mean, I don't know if I really need it, y'know?
Gal 2: Why?
Gal 1: Well, I just don't have the money.
Gal 2: Neither do I. I'm getting these pants instead of food this week. I'm not nursing; it's not child abuse.

There. Are. No. Words.
And with that, I'm going to go re-learn all of the pharmacology I've theoretically learned this year.

Boards

2010-04-29T05:06:00.000-07:00

If I take one set of boards on June 14 and the next set of boards on June 22nd, I have enough time to study, right? RIGHT? Like, if I've already started studying, and doing questions and such...right? RIGHT?

OMG. I will not panic.
*panics*

Hope my head cold feels better this afternoon so I can go on a short jog or something. I'm in need of endorphins.

'ello again

2010-04-28T07:42:00.001-07:00

Long time, no post. I'm sorry.

Ok, I'm not really sorry. I'm stressed. Very stressed. Second year courses are drawing to a close (yay!), but before they do, I have two exams to take; one tomorrow and one next Monday. Then, my school, like many other schools out there, does another course that is meant to transition us all from our pre-clinical years wherein we sat on our asses for like 8+ hours a day to working as a member of a medical team in a hospital. Oh, did I mention that we get to take this course while studying for boards?

I'm taking two boards, USMLE and COMLEX. This is basically because I am uncertain about what I want to do, and think that I should hedge my bets. Some programs are totally down w/ COMLEX scores, others are a little confused by them. I'll save them the time spent being confused by giving them something that they understand.

Hopefully.

Husband and I got some awesome shoes. The goal is to strengthen our foot/lower leg muscles. They're fun, if nothing else.

Question: is biochem relevant in practice? I don't mean like acid/base stuff; that's clearly relevant, as is blood glucose and metabolism. But when will I ever need to know how many ATP are generated by a specific pathway? That seems a wee bit excessive to me. Not that I hate biochem. I actually really like it...

Boards

2010-03-01T12:34:00.000-08:00

So I won't lie; I'm starting to freak out about boards. Mine are a little over three months away and I've been studying a bit for them...nothing hardcore...some biochem review here, a little microbiology there, using first aid as a study guide for my courses, etc etc.

I'm not sure how, exactly, to study for boards though, especially since we have classwork until May sometime.

I feel like I'm too new to this to have forgotten so much...

babies, babies everywhere

2010-02-20T18:47:00.000-08:00

So this sounds like it's going to be a post about how my maternal clock is ticking away and every time I see a cute baby I can feel my ovaries scream. It's not, although those things are sometimes true.

Many people around me are having babies or actively trying to have babies. And they're my age. I am not old. In fact, it strikes me as odd that anyone I know would be having babies without the requisite freak out about school/life/keeping it/etc. Basically, I still feel like my friends, peers and I are in high school, and that we ought to be, I don't know, avoiding pregnancy like it's the plague. Sure, we've gone on to college, joined the army, started businesses, gotten married, and so forth, but we can't possibly be old enough to have babies responsibly. (There's a bumper sticker I used to want that said, "We are the people our parents warned us about." Now, I would add to that, "and we're suddenly in charge.")

Except we are. And that terrifies me. Because my friends/peers are mostly good parents, responsible parents who attempt to do everything right. It's a strange time when friends you used to hang out with while wearing diapers now have children.

Also, our radio stations are sneakily morphing into the "new" oldies stations. I heard Nirvana referred to as being "Classic Alternative" the other day.

patients

2010-02-11T17:19:00.001-08:00

Our school has a several opportunities for students to work with and interact with patients. One of them is a free manipulative medicine (OMM) clinic that second years can rotate through. Another is a local free clinic for low income patients. In both circumstances, students are precepted by physicians, but there is an awful lot of autonomy given to us in our little tasks. I have had the great fortune of working in both situations; sadly there are not enough spots for every student to participate. In my time in the clinics, I have seem a lot of patient overlap, to the point where I saw a patient regularly in the OMM clinic only to see her the other day in the free clinic in town. I really enjoy this patient; she's a feisty lady. Anyway, when I went out to call her in for her appointment, we had the following exchange.

Pt: It's you again.
Me: I hope that's a good thing...?
Pt: Don't you ever sleep? You need to sleep.

I think she's just great.

Rotations

2010-02-10T05:53:00.000-08:00

So we've had our rotations lottery. I got *undisclosed location*, which allows my husband and I to stay in our current apartment. This brings us great happiness, as we really like our apartment. It does mean that I'm going to be completing a 45-50 min commute most days, but I've done that before and it really doesn't seem that bad to me.

Now I'm just excited to get out of the classroom and into the hospitals. Yeah, the hours will suck, but I won't be sitting for 8-12 hours a day.

I can now run a 10 min 54 sec mile.

Winter, pt II

2010-01-25T06:30:00.000-08:00

Dear New England,
It's winter. Less rain, more snow. Seriously. I love rain and all, but it's winter.

Also it smells like corn dogs in here. What's the deal with that?

Winter

2010-01-18T14:36:00.000-08:00

So between about 10pm last night and 1pm today, we managed to get at least a foot of snow. I didn't measure it because I was too busy cursing as it came up to my knees when I walked out to meet Cathy today. We live in a city that has epic plows of doom. They circulate not infrequently and clear our streets so that they are passable. However, the snow that they move has to go somewhere, generally along the periphery of the street. This means that it gets pushed into driveways. Yup, we had a veritable 2.5 foot tall jersey barrier of snow in our driveway today. I spent about 30 minutes hacking away at a portion of it with a snow shovel from Wal*Mart, dutifully piling up hunks of snow and ice on the snow covered lawn. I had triumphantly (pathetically?) cleared about a quarter of the entire thing when our neighbor with the industrial strength snow blower showed up to clear the entire jersey barrier and our driveway in 25 minutes. I am torn between feeling depressed by the futility of my actions and impressed by the relative ease that the snow blower did its job. Either way, I think I owe that man a good bottle of wine or cookies.

New Year's Ramblings

2010-01-16T13:38:00.000-08:00

So I won't lie. The Haiti thing is really getting to me. I mean, it's just so completely ridiculous. Haiti was already one of the most unstable, impoverished nations in the world and now they have to deal with the fact that most, if not all, of their infrastructure is destroyed.

That and I saw Sanjay Gupta treating a 15 day old infant with a skull laceration yesterday. On CNN. I started to cry, at the gym, while running on the treadmill. I then gave all of the money in my wallet to Doctors Without Borders (MSF).

I still don't know what I want to be when I grow up, but it might be a good idea to avoid growing up for the foreseeable future.

I'm learning to read EKGs. It's essentially like trying to comprehend the scribbles of your best friend's child; they mean something to them, but to you, they're gibberish. It's one of those skills, however, that I think every doctor should have, even if all they can do is think, "huh, this is not good. I better call a cardiologist/the ER."

Today is atypical; let me give you an example of typical

2009-12-10T08:05:00.000-08:00

Today I am sick. This means that I'm doing school work at home, in my jammies. Some of my classmates do this every day. I like going to school, though, because classes can be helpful. Something about actually seeing the professors is good. Needless to say, though, that today is atypical. I slept until 10 and am already considering a nap. My head is full of cobwebs and my brain is trying to exit through my nose. Gross, I know.

But what is a typical day for me?
4:30am - cat starts batting at my face; he thinks it's food time. I ignore him.
5:00am - alarm goes off. I hit the snooze and lie there for five more minutes. Then, I get up and gather everything together. Books, clothes, food.
5:45am - feed the cats and leave for the gym.
6:00am - arrive at gym. Somehow convince myself that it is a good idea that I do this most mornings. Claim an elliptical/treadmill.
7:10am - realize that it's 7:10am and run to the locker room. Shower.
7:45am - go to car, swap gym bag for school bag and breakfast.
8:00am - arrive in class, eat breakfast, and sit in same seat for four hours.
12:00pm - lunchtime! sometimes I actually get to eat with friends. Other times, there are meetings.
1:00pm - 5:00pm - class.
5:00pm - on most days, I am able to head home and study until husband gets off work at 6pm.
6:00pm - husband gets off work, cats demand food, we make dinner and feed cats. We talk about our days and eat together. Sometimes we watch something funny.
7:30pm - study for a bit, or until bedtime.
9:30-10:00pm - we head to bed and/or play card games for a bit and/or read.
11:00pm - we actually fall asleep.

2009-11-20T10:11:00.001-08:00

I've been called a gunner a few times this week. "Gunner" for those not in the know, is a word used in medical schools to describe very driven students, often in a negative light. In my mind, at least, "gunner" connotes a negative sentiment.

I also feel like I'm the least gunner like person I know. Yeah, I'm trying to do my best in medical school, but I would never sabotage my classmates. I also pretty much don't care how I do in my classes anymore, so long as I pass the courses. I've also started casually studying for boards, which is apparently quite weird. I think it makes sense to study as we go through the courses; I've purchased a few books and I'm working through them along with my courses. We'll see what happens with this.

I just don't feel like a gunner. My classmates probably meant this in more of a complimentary way than I'm thinking...at least I hope so...

Nature

2009-11-02T15:00:00.000-08:00

Today, one of my professors, who also happens to be a physician (shocker, I know) gave me an assignment. She told me to go take a walk outside for at least 20 minutes.

Best homework ever.

Halloween

2009-10-31T16:02:00.000-07:00

A little boy came to our door dressed up as a compact fluorescent light bulb, complete with a band that listed his wattage and amps used. Best costume ever.

October

2009-10-12T05:09:00.001-07:00

It's currently my favorite time of year. It's the time of year that (at least in New England) wild turkeys run rampant and wild along the highways, that frost lingers in the air, and that everything is pumpkin flavored. I love fall, and it is 100% more awesome here than it was in Washington State. People here get really into fall. They go on hay rides, make really elaborate corn mazes and open them up to the public, float pumpkin boats down rivers, and attempt to make anything and everything pumpkin flavored. It is a pretty awesome season.

Yesterday, my husband and I went to the most massive corn maze ever with another couple. The theme was "Under the Sea," and supposedly if you looked at the maze from a helicopter, it actually formed the image of a lobster and other sea life. It also encompassed 5 acres of maze goodness. There's something really neat about running around in corn fields. After we finished the maze, we went on a hay ride to look for pumpkins. That was fun too, although we left without pumpkins. You have to find just the right one, y'know? It has to speak to you. This same farm also had a corn cannon, where you could shoot ears of corn across a field to hit wooden cut outs. Although we didn't try it, we got a big kick out of watching little kids attempt to hit a blue cow made out of old oil drums.

Anyway, I'm on day four of a four day weekend, which means (predictably) that I've had a lot of fun and gotten plenty of sleep but I haven't accomplished much in the way of school work. That's today. It's time to learn about psychiatry.

Neuro drawing to a close

2009-09-30T15:28:00.000-07:00

Our last neuro exam is on Friday. It will emphasize diseases, radiology, and pharmacology. This is great, because most of us totally forgot about the pharmacology part due to being overwhelmed by the neurology part. As such, due to our fear of failing neuro, we're all going to fail pharm. We clearly planned this well.

I wrote a haiku.
"Primary brain lymphoma / ring enhancing pics / periventricular spread."
Clearly, I've lost my mind. But I remember things about primary brain lymphoma now...

You know you live in a small town when...

2009-09-24T15:28:00.000-07:00

Your bank calls you to wish you a happy birthday, and it's not an automated call.
Dogs sleep in the middle of the road and cars drive around them (this happens when I drive to school periodically).

In other news, neuro is grinding to a finish; our last exam is on October 2nd. I think it's safe to say that we're all pretty much ready for it to be over, although there are certainly a few budding neurologists in our crew who have emerged triumphant and glorious over the material. I, however, am not likely one of those people.

2009-09-13T18:55:00.000-07:00

Tomorrow I have the second of three tests for our Neuroscience class. This one is purported to be the most difficult; as such, my classmates and I are finding ourselves both panicking about the amount of material and lacking in motivation to study the material. Case in point - I'm writing this right now.

So I posted a note on facebook, asking people what was one memory they had of me. My brother (who I didn't grow up with past the age of about 2) replied, saying that I "wore a tiny little football helmet and didn't make eye contact."

I think it's interesting what his 7 year old self noticed about me before I vanished from his life.

When I grow up...

2009-09-11T17:15:00.000-07:00

Here are (in no particular order) the things that I am thinking of being when I grow up.

*General pediatrician - I like kids. They are fun to care for.
*Pediatric palliative care doctor - I like kids, families, comfort care, and counseling. Also, I have an "in" at one of the fellowship sites.
*Palliative care doc - this is the non-pediatric form. I like it for pretty much the same reasons as the pediatric form.
*Physical medicine and rehab - helping people regain function is awesome.
*Child psychiatry - this is actually the thing that set me on this long, circuitous path in the first place; I took general psych when I was 16 years old, loved it, wanted to do more and go to medical school, and very shortly thereafter convinced myself that I wasn't smart enough to do so. Then, five years later, I took a neuroscience course that made me realize that although I might not be smart enough, I am determined enough.
*Neurology - I like brains. They're fun. I like puzzles. They're fun.

Basically, I like the notion of comfort in medicine. This is what I get from this. With the exception of just being a general pediatrician, all of these options would require either a 3 year residency and a fellowship (usually 1-2 years) or a 4 year residency (PM&R, combined peds-psych, combined peds-internal meds) or both.

Yikes.

2009-09-03T15:52:00.001-07:00

I haven't written in a while; there are a number of reasons for this. The most compelling is that I am in the midst of learning everything humanly possible about neuroanatomy and neurology in six weeks. Additionally, I'm lazy. Also, there are some strange things occurring around me. Suffice it to say that medical school is keeping on keeping on, and there is minimal drama (ok, so the lack of drama is a lie).

Another year, another $60,000

2009-08-20T05:26:00.000-07:00

Second year is started; we're going full swing at this point. If you live in New England, you'll know that summer just now started. This past week, it's been high 80's-mid 90's with 75% humidity. It's great times, studying instead of being out on the beach.

Also, if you live in New England, you know that the mosquitoes are pure, unfettered evil. You go outside and get bit immediately.

Med school is expensive. I'm weighing financing options that include but are not limited to joining the army, national health service corps loan repayment plans, public health service corps, just paying off the quarter million, working in under served areas or public service for ten years while making income based payments and then having the remaining debt forgiven, and getting a wealthy benefactor. As of this point, the two top options are joining the army and doing the ten year public service/loan forgiveness program. I'm honestly torn between the two, because they both honestly have some benefits and negative points. I've been talking to loads of people about both options. There are quite a few military scholars at my school, all of whom have had different experiences. We'll see what's in store, I suppose.

2009-07-31T22:20:00.000-07:00

One of the things that some folks struggle with while in medical school, or grad school, or any kind of school, really, is putting off starting a family. I know that I want kids, but I also know that while I could have them in medical school and/or residency, I wouldn't be able to be the kind of parent I want to be if I do that. Thus we wait. It's hard, though. I love children and both enjoy and hate watching my friends have children. I am so pleased for them; so far, they have all proven to be good parents. I get great joy out of seeing their children, playing with them. I know logically that we will be able to be better parents in a few years, but that hasn't stopped some of my peers from having children and being good parents. A gal entering third year is expecting and is thrilled. An acquaintance of mine is going into fourth year and his wife is pregnant. Not perfect, perhaps, but not the end of the world either.

Partially, I am afraid that when it is time for me to try to have a baby that I won't be able to. I didn't really make plans for my life, but part of me always thought I'd have kids by the time I was 30. At this point, that might not be entirely likely. When the time comes, though, will I be able to have a baby, or will I struggle to conceive? Will we be eligible for adoption? My parents were nearly too old when they adopted me; apparently Oregon had strict adoption laws in the eighties. Now they simply can't afford road signs. Oregon is a weird state. What if I am "too old" to have a baby?

Maybe I'm just frustrated because while I am doing this school thing, my friends are doing other things and leaving me behind. At the same time, I really enjoy my schooling. Gah.

The most ridiculous thing ever

2009-07-23T04:00:00.000-07:00

I've done a lot of nutty things this summer. There was the time that I walked into the Charleston Naval Shipyard and asked if it was Massachusetts General Hospital. That was funny, wasn't it? Then there's the whole hanging out with people while they die thing. This is less funny, but it's not something that most people do during the summer time. I also convinced my husband (not to mention myself) to scale a rock face at Acadia National Park. This particular hike is called "The Beehive" and although it's purportedly only 0.8 miles long, it's pretty ridiculous.

Today, though, I think I may have outdone myself.

Every Thursday for the past month or so, I've been attending the didactic sessions that the palliative care fellows go to, sort of to get an idea of what it's like to be a palliative medicine fellow. They're fun and I understand about 5-10% of everything that is said. All in all, they're an excellent use of a Thursday morning. Today is the last one that I'll be able to attend, and I'm stuck in Wakefield. This is because I've lost my keys somewhere in this house, and I CAN'T FIND THEM. It's beyond the point of even looking at this point, because I've already missed my bus by about a half an hour, and even if I could find them, I couldn't get all the way from Wakefield to Dana Farber by eight o'clock. It's just not feasible. Even if I could, I can't leave the house because, well, this isn't MAINE or Lummi Island, where you can leave your house unlocked and your keys in your car with the windows rolled down and not worry about anything. Wakefield is a nice area, to be sure, but it's not that nice. And I'm not leaving my friend's house completely unlocked.

Oh well. One of the things they were gonna talk about today is delirium, and there were like four MSTAR presentations on that on Tuesday.

The pictures were taken by one of my classmates as he hiked the Beehive at Acadia.

2009-07-17T07:56:00.000-07:00

I brushed the cats and got enough fur off of them to build another cat.

I am also officially overweight. I didn't go to the doctor, but pretty much every good source that I can find on the internet says that I'm at least ten pounds overweight. This is a huge deal for me, because although ten pounds isn't that much, it's the notion that I'm overweight at all that gets to me. I try to exercise and am fairly successful; I generally exercise between three and five days a week, for about an hour at a time. I feel like I eat ok, but that is clearly not the case. I think the main issue is that while I eat healthy overall, I eat too much of those healthy foods. I think it's the portion size that is the problem. I mean, I don't live on donuts, cupcakes, or macaroni and cheese. Sometimes that sounds awesome though.

I think I'm going to start up the No-S Diet again. It's a good diet and isn't really a diet.

Harry Potter today! But for now, back to work.

AFAR MSTAR - the end is near

2009-07-13T17:08:00.000-07:00

I (probably) have my presentation mostly done. I'm going to start practicing it either tomorrow evening or Wednesday. It's not exactly the worst presentation in the world; I basically have to talk in an organized fashion for ten minutes, and then allow five minutes for questions from the peanut gallery. I have a few good case studies that I can share, as well as a framework for end of life communication that I can present.

The other slightly more stressful aspect of this is that I'm attempting to write a review of the literature that is appropriate for publishing. The problem that I'm running into isn't the literature search; if there's an article out there about family meetings in the ICU or in end-of-life care or in pediatric palliative care or in palliative care or whatever, I've read it (that is if it was written after about 1990). I've even been fairly successful in keeping track of my search criteria, search terms, and how I culled down the articles. I'm at this point now where I have my big stack of paper print outs and I don't know what to write about. I think I actually have enough for two reviews, one which would present the current view points and frameworks for family meetings in end of life care and one that would deals with prognostication in family meetings. A lot of the articles could even be used to make a third review about family satisfaction with end of life care and family meetings. I just don't know how to write this. They haven't taught us this in our didactic sessions because most people are doing more data analysis stuff. Basically, my thoughts are scattered.

Computers, not casinos. I like it.

Crunch time

2009-07-06T14:20:00.001-07:00

So I have two weeks before I have to give some sort of presentation on the work I've been doing this summer. It's interesting, because I know I've done a lot, learned a lot, but I'm not sure how to best share that with people. I've learned quite a lot about the current opinions concerning family meetings in palliative care; I could probably summarize for you the best accepted format for said meeting. I've begun to develop what I think is a good way for someone, not me (hopefully), to start researching how family meetings in the ICU affect the family's understanding of prognosis. There are papers out there about how best to talk about prognosis with the family. Sure, there's like five, and they all say the same thing, which is "it depends on the family." Clear as mud, right? For the short term, I'm attempting to do a literature review, which I've never done, in such a way as to make it acceptable for publishing, which I've never done either. I also have some nice data for case studies of family meetings; there have been quite a few this summer, but understandably, not many of these families are keen to be the subject of research of a medical student, even if she does have IRB approval (yes) and even if she is nice (yes). Basically, I bit off way more than I can chew.

I have two weeks to figure out what to present; the paper can come later, although it'd be nice to have it done before school starts (not likely).

On the entertaining side, though, hearing half a million people sing "Sweet Caroline" along with Neil Diamond is really scary.

What can brown do for you?

2009-07-01T17:39:00.000-07:00

I just had a phone date with a friend from college. We email, chat on instant messenger, and text each other fairly regularly. He's one of the very interesting people I know from undergrad, not in the least because he started out as a computer science type guy. He then evolved into a scientist of sorts, then became an EMT, started going to Burning Man, and applied to medical school. When I first met him, I didn't imagine that he would be a doctor, but now I think it suits him quite well. We're med school buddies now. We go to different medical schools together. Quite a departure from taking a photography class and eating moochi together during undergrad.

Hmm...now I want moochi. And sleep.

One of the rules of surgery

2009-06-30T19:31:00.000-07:00

"Eat when you can, sleep when you can, never fuck with the pancreas."
~ Dr. Rudolph

In other news, I have eczema and one of the patients on our service has diagnosed themselves based upon the hit television series "House, M.D." I wish that was a joke.

2009-06-29T15:40:00.001-07:00

(M. Jagger/K. Richards)

I saw her today at the reception
A glass of wine in her hand
I knew she would meet her connection
At her feet was her footloose man

No, you can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometime you find
You get what you need

We went down to the demonstration
To get your fair share of abuse
Singing, "We're gonna vent our frustration
If we don't we're gonna blow a 50-amp fuse"

You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes well you just might find
You get what you need

I went down to the Chelsea drugstore
To get your prescription filled
I was standing in line with Mr. Jimmy
And man, did he look pretty ill
We decided that we would have a soda
My favorite flavor, cherry red
I sung my song to Mr. Jimmy
Yeah, and he said one word to me, and that was "dead"
I said to him

You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes you just might find
You get what you need

You get what you need--yeah, oh baby

I saw her today at the reception
In her glass was a bleeding man
She was practiced at the art of deception
Well I could tell by her blood-stained hands

You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes you just might find
You just might find
You get what you need

You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes you just might find
You just might find
You get what you need

Bunny

2009-06-24T17:01:00.001-07:00

Also, Tina's bunny is hopping around on the floor and may have just pooed on the floor. He likes to be free.

oy vey

2009-06-24T15:26:00.000-07:00

So can I just say outright that I have the up most respect for people who do research. Y'know, the people who really enjoy mulling through their hypotheses and figuring out how best to test them, people who like to mess with statistics to figure out relationships and the proper way to interpret data. These people are great and necessary for the future of pretty much every scientific discipline out there.

That said, screw it. I'm good at the idea part. I can even formulate a hypothesis. I get hung up, however, when I try to figure out how best to test my hypothesis. There is something hypnotic and enjoyable about data entry; it's meditative. Writing I can do; words are pliable. I don't even mind the revision process, because I still feel like I'm doing something. Similarly, data collection is good, if it involves talking to people. People fascinate me. Basically, what I need is a research project where I can either share ideas, do the literature review and writing (did I mention that I like doing searches for things? I should have been a research librarian), or enter data. Don't make me design the protocol for the study; I'll manage to confound it somehow. I could probably analyze data a little bit if someone gave me a crash course in statistics. Unfortunately, this program I'm in seems to want me to do all of these things. This doesn't seem realistic; a simple search on PubMed for anything will show that most journal articles have multiple authors. Certainly all of the authors didn't design the study, do the data analysis, enter the data, collect the data, or come up with the idea. That would be highly inefficient.

I think what I was hoping for from this program was to be a part of a research TEAM. Instead, it's just me. And my mentor, who is good and available, but is confusing. I think he teaches by giving me cryptic hints and then watching me flail for a few days and then dropping more cryptic hints. If I do research in the future, I want to do it as part of a team. I don't need to be first author. It doesn't need to be solely my idea. I certainly don't need to design the damn thing. Just let me write it and be obsessive compulsive about grammar, spelling and split infinitives.

On a somewhat unrelated note, if you're ever in Boston, you should go to the Countway Medical Library. They have a skeleton of conjoined twins on the fifth floor, in addition to other sundry and macabre items.

2009-06-19T14:00:00.000-07:00

I had one of those weeks where everything I did seemed to go wrong, except when I was working with the PM&R resident on a patient's chart and got her pimping questions right. I like her, I've decided. Other than that, though, everything seemed to go wrong. My mentor didn't realize that I was actually enrolled in the MSTAR program, and thus didn't realize that I actually had to do some kind of research project. This would, I guess, explain why he was so confused when I kept mentioning figuring out how we would collect data. I think it's better now, as we've had a brainstorming session, Maybe. Either that or I'll somehow manage to get kicked out of the MSTAR program, which would suck. I just have to keep reminding myself that the goals of this program are to:

1. learn about how to do research.
2. do a research project, obviously a small one, as program is just during summer.
3. learn about the research process, e.g. hypothesis forming (got it), literature review (totally got it), methods (um...workin' on it), data collection (um...yeah workin' on it), results (so not there yet), and discussion (I'm pretty verbose so this should be easy).

Also, I'm writing this on the train to Maine (yes, that's actually Amtrak's slogan; cheesy ain't it). The future is NOW!.

2009-06-18T15:24:00.000-07:00

I'm not sure what it is about the east coast, namely New York City and Boston, but the majority of the people I interact with seem to be quite image conscious. This is probably confounded by the fact that I interact with a lot of well-paid nurses, nurse practioners, and doctors, but it's definitely there. Some of the ladies on our service have positively massive diamond engagement rings, only one of which I could potentially see myself liking even remotely. People carry handbags as a statement, not as a means to cart around stuff. Here I was, foolishly assuming that handbags were to cart around books for the subway, chapstick for the lips, the wallet, the keys, and various other sundry items. This is not the case; in fact, one of my co-workers has a large Coach bag in which she keeps a smaller bag. The smaller bag is for all of her things; the Coach bag is for...something. I have a really nice purse that I like. It's a decent size, it's black, classic looking, practical. And it was on sale at Macy's. Compared to my coworker's bags, it's a non-event. I'm fine with this, although recently I've started carting around my purple backpack from undergrad just to see the looks on their faces.

The handbags aren't the only sign of this image consciousness. I am not used to seeing people look so well put together all of the time. I don't necessarily mean within the hospital; there's a professional aspect to that mode of dress. I mean when I'm wandering around Boston in a daze. Precisely ripped jeans paired with an Abercrombie t shirt and a little jacket slung just so. Women who have their hair perfectly styled to go to the grocery store. People who refuse to wear things that aren't some name brand. Everyone has an image in mind that they're trying to project.

This extends beyond the realm of clothing and accessories. On Tuesdays, I meet with a group of medical students from around the country, all of whom are participating in this "learning research while doing research" thing. The first day, the lecturer told us that simply by being in this room, we were setting ourselves apart from our classmates, making ourselves more competitive for residencies. This is probably true but it still struck me as odd. He seemed to focus on the program as a method to boost our CVs as opposed to an opportunity to learn some cool things while visiting a strange place. He spent a decent amount of time sharing with us that he thinks he got where he is today solely because way back when, he participated in this program and got an awesome letter of recommendation. While that might be true, I hate that he insinuated that our classmates who chose to travel, life guard, or sleep on the beach were dumb.

I am enjoying my time on the east coast, but I would be lying if I said that I wanted to stay here.

Research

2009-06-16T19:08:00.000-07:00

What have I gotten myself into? I have until the end of the summer to create some sort of original research project.

Oh god. How am I going to pull this off?
Starting tomorrow, I'm kicking my work ethic up to 11. I will pull this off. I figure if I can get around on the Boston public transit system, I can survive this.

Sometimes you can't go home again...

2009-06-12T11:09:00.000-07:00

Literally. We have a patient on our service who will probably never go home again. It's complicated, but it is in large part due to the fact that his daughters and long term partner don't want him at home because they don't think that they can give him the kind of care he needs. Now, his insurance has a hospice benefit, so it would be plausible to send him home with hospice and have visiting nurses. The patient doesn't know this though, and I'm under the impression that we're not supposed to tell him. Really, I think his family just doesn't want him at home because he stresses them out.

I wonder what his last days will be like, where he will spend them.

bah-ston

2009-06-09T16:59:00.000-07:00

We had a patient the other day who suffered a stroke and then abruptly began to hemorrhage, creating a subdural hemorrhage. Those are bad and will generally kill you unless it is caught in time. This patient's case was complicated, though, and they quickly took a turn for the worst. The family was called in, the patient given a morphine drip to keep pain at bay, and spiritual counselors called in. Her surname was stereotypically eastern European, perhaps Jewish, perhaps not. We all thought she was Jewish. Anyway, we're standing at the nurse's station talking over her pain regimen when two rabbis and a priest walk onto the floor looking for our patient. It was really all we could do to keep ourselves from laughing hysterically. I said to a nurse, "two rabbis and a priest walk onto the neuro-oncology floor and here I am without a punchline."

It was a good day.

(By the way, 2/3 of the time spent at hospitals is spent at the nurse's station. True story. 1/6 of the time is spent walking and 1/6 of the time is spent in patient rooms.)

2009-06-04T19:31:00.000-07:00

It's strange to be excited about learning about death. I mean, I obviously don't want patients to die, don't want families to have to learn to cope with loss. However, something about helping the process go smoothly for everyone involved is fascinating for me. Helping to keep the patients comfortable and the families feeling supported, informed, and free to grieve appropriately is really fun. Not like going on a roller coaster fun, mind you. More of a peaceful fun. The reading I did today was different than any I'd done recently. It wasn't science really (thank goodness). No kinases, no interleukins, no prostaglandins.

I am damn sick of that hand sanitizer though. I swear it just makes my hands more of a breeding ground for little bacteria.

We actually had an incident the other day where two rabbis and a priest walked onto the neurology/oncology floor looking for a patient. There I was without a damn punchline.

"Just a small town girl, livin' in a lonely world..."

2009-06-02T03:10:00.000-07:00

Oy. Yesterday was my first day in Boston and at MGH. Ugh. I'll have to write about it later as I need to brush my teeth and such so I can achieve my goals for today, which are quite a bit LESS lofty than yesterday's.

goals for today - don't wind up at the naval shipyard and think it's MGH; don't fall and skin knee (again); get to work in time to get a cup of coffee; get to work on time today, not nearly an hour late; don't be intimidated by the harvard medical students as i was accepted to this program and am allowed to be here too; don't lose my badge (again).

Year One - check

2009-05-22T19:56:00.000-07:00

With a little luck and a ton of work, I am done with the first year.

Dear med school,
You made me gain weight. I'd like for you to take it back now. Maybe that's what summer is for, though? Losing weight and doing research? Food for thought.

2009-05-20T12:06:00.001-07:00

I am not sure that I've ever felt this burned out, this distractable in my entire life. I do a few pharm flashcards and then see a kitty. I look at some pathology slides and then have an urgent need to find one of my classmates (this was mostly yesterday; i've sequestered myself in my apartment today). I look at bacteriology and freak out about how there's no conceivable way that I can pass it and the other four classes that will be on the written exam on Friday. Oh, and it's eight hours. Which is, y'know, totally awesome. There are a few classes, at least, where I can kind of just show up and look pretty for. Or I can try to do really well.

Bet you can't guess which one I'm trying to do. Oh and it's really stupid of me. Pharm, yeah, I have an 88% (or something near there). I could break into the high pass zone. OPP I have something similar...I actually might already be in the high pass zone...I actually don't know my average. BacT is one where I just need to get 70% to match my 70% on the previous exam. Nutrition is a "one and done" as we call them. Final exam is only worth 35% of our grade, but we have to pass it. Pathology is a "one and done" too.

At this point, I just want it to be Friday evening and know that I've passed everything.

2009-05-12T06:08:00.001-07:00

The end is near. And I'm not talking about the apocalypse. I'm going to be studying for the rest of the week...after I see "Star Trek" tonight, of course. I shall emerge Friday, May 22, at around four pm. Hopefully I will be triumphant.

Then, I get a week off. Yay!

Why only one week, you may ask? Well, that's because I am doing research at a Large Prominent American Hospital for eight weeks. I got some grants and a research training fellowship from the American Foundation for Aging Research. I applied, thinking that there was no way I'd get it. My advisor even got me to apply to the program at Prominent Ivy League Med School. I did so, pretty much assuming that there was no way I'd get it.

And then I did. Huh.

Winding down

2009-05-02T19:12:00.000-07:00

The first year is drawing to a close, although I'm really trying not to think about this too much. I still have quite a bit to do; drug names to be learned, bacteria to understand, pathology to be...stared at, I guess. Lots to do.

But I bet when it's over with, it'll feel awesome.

Then comes summer. I'm going to be staying in Boston during the weeks, doing research at a large, well known hospital and university. I'm scared, because I've only ever been to the Boston airport and I have no where to sleep during the weeks. A commute is technically possible but insane and impractical. I'm excited because I get to do things at places that I've never thought I'd be at.

I should learn some bacteria now.

The truth about medical school

2009-04-22T04:17:00.001-07:00

Today, I had a guest student with me. He is planning on applying for admission in the next application cycle. Like most perspective students, he asked a lot of questions that I know I had when I was applying. They're questions that now seem completely ridiculous. I think the one good question he asked was about affordable housing. Everything else was bupkes. This is a selection of things that I wanted to tell him, but I doubt he'd have believed me. Either that or he would get scared.

You will study. You will study until your eyes feel like they will fall out of your head, until you are dreaming about the life cycle of the malaria causing parasite P. vivax and its evil twin P. falciparum. This effort will maybe allow you to pass your classes.

You will take a test that appears to be written in some foreign language, filled with concepts that you have never seen.

You will fail something. If you are lucky, you will fail something that you can fix. I failed immunology, and I am fortunate enough to get to retake the exam. I had better not fail it this time, though. I am lucky, though. One person in my class failed everything and has to go before some board to determine if they get to stay or not. And this person is wicked smart.

You will get sick. Even if you are reasonably healthy, you will get sick. Why? You're in a confined space with 120 other people for large amounts of time.

You will be sleep-deprived. This is because you're trying to take in loads of information, all at once.

You will need support. In this regard, I feel fortunate because I have an awesome husband who is totally ok with me doing this crazy little thing called medical school.

You will ignore the kids who get 90% or better on exams, but only after you too attempt to get 90% on things and fail to do so. This will be for your own good, your sanity. As a corollary, if you are able to get 90% or higher on something, you will keep it on the down low as a courtesy.

You will never look at turkey basters the same way ever again.

Your concept of fun will be forever warped. Studying in a group can now pass for fun.

Bodily functions no longer seem as gross or socially unacceptable.

Your idea of acceptable dinner time conversation will change dramatically. I mean, once you've dissected an entire human being and seen...well...everything, you have a much higher threshold for gross things.

You will make some awesome friends.

Only some of the friends will be dead.

Still Alive

2009-04-15T02:19:00.000-07:00

I'm still here. Some things are going well; I get to work in the free clinic next year. Not everyone who wanted to got to. Other things not so well. The last test was indeed a microbiology block of doom, although we haven't gotten all of our results back. It looks like I'll be using one "mulligan". I'm hoping to only have to use one though. I guess we'll see. Having to even use one of my mulligans (we get two) is not doing much in the way of helping my self esteem. Luckily, I'm not alone. Well, lucky for me, I guess. I am in good company, and we're all gonna shout "mulligan!" together.

Seriously, I have the best husband and friends ever. I walked out after getting some of the results and burst into tears on the first available person. Luckily, that was Gil, who has two small children and is thus used to copious amounts of snot,and Nick, who just is. We have a little study group to help each other (Nick, Eve, John, and I) and hopefully we'll pull this off. I'm still not sure how this happened; I felt fairly good about this test. Not "high pass" good, but certainly, "yeah, I passed" good.

Microbiology block of doom

2009-04-07T16:56:00.000-07:00

Oh. My. God.
So many bugs, so little time. I'm really hoping that I can pass bacteriology. It's looking borderline right now, especially since the test isn't multiple choice. I can't believe I'm actually desiring a multiple choice test.

Did you know that there are parasites that basically "shed" genitalia? They lose them and then the infected host defecates them. Can you imagine being able to essentially shit your genitals whenever you wanted, just to grow another set?

2009-03-31T09:29:00.001-07:00

Summer time plans seem to be falling into place.

2009-03-20T02:19:00.000-07:00

Medical school is actually quite a lot like high school. The only real differences are that the stakes are higher and there are more dead bodies. Other than that, though, it's pretty much the same. There's the group of "cool" kids, who do things like run for class president and post pictures on facebook where they are seen drinking. A group of jocks can still be found, though they're a bit disorganized due to the lack of any real sports teams to join. The honors students are there too, and they are pretty much like the honors students in high school. There are a few of them who can do everything well and look good at the same time, there's the couple of quiet nerdy ones, and then there's the one that flies under the radar. We haven't found them yet, shockingly. The final group is sort of a composite group, because we have no band, no orchestra, no drama club, no av club. The composite group is actually the biggest.

Hell, there's even rumor of a spring fling. You've got to be kidding me. The parallels are a little creepy. Maybe more traditional colleges are like this; my college certainly wasn't. We were all drama/orchestra/av club/chess club types and we were all socially awkward together.

2009-03-17T06:09:00.000-07:00

Still working on getting over the desire to high pass everything (anything). At this point, I'm high passing nothing (I think).

Realization

2009-03-11T08:19:00.000-07:00

"Axilla" is just a fancy word for "armpit." We have two words for armpit (three if you count Aberdeen, Wa) and only one word for love?

Spring class haiku

2009-03-11T06:14:00.000-07:00

Too many classes.
Bugs, bugs, bugs, bugs, bugs, laws, drugs.
I have gained ten pounds.

It's exam week; do you know where your child is?

2009-02-25T03:09:00.000-08:00

Little things that make me happy
1. Yesterday, Chris made me an egg and cheese quesadilla. It was fantastic.
2. Chris is getting up early especially so I can practice physical examination skills on him.
3. I thought I needed new underwear, but then Chris and I found like four packages of underwear that mom sent me in August.
4. After my objective clinical skills examination, I think I'll go to the gym for a little while.
5. On Friday at 5 pm, I get to burn my scrubs.
6. It's (near) impossible for me to fail biochem; in theory, I can go to the biochem exam drunk. I won't though.
7. Monday means new classes.

2009-02-22T15:46:00.000-08:00

Too much to learn, too little time. Today I forgot the word "nose." Seriously. Yesterday, I forgot the word "pen." Med school makes you dumber. I also occasionally forget how to conjugate verbs in ENGLISH, a language I have spoken since I decided to speak at age 2.

You have a pterygopalatine fossa. Does it make you think of dinosaurs?

We've started making "Silence of the Lambs" jokes in anatomy lab. Does this mean we're nuts?

I've had a disembodied hand in my hair.

2009-02-20T11:42:00.000-08:00

1. It's weird to study a condition that you actually have.
2. It's frustrating to figure out how to study for a class just as it's ending. At least I'm passing everything.
3. I wish that it wasn't so difficult to get used to the idea of passing being good enough.
4. I wish I could high pass stuff.

A day in the life...

2009-02-17T02:27:00.001-08:00

5:00 am - alarm goes off. I glare at it.
5:03 am - crawl out of bed.
5:03-5:30 am - stare at the internet in an attempt to wake up.
5:30-6:00 am - gather all of my stuff together, wish I had started this earlier. Trip over the cats. Hug Chris, who is still in bed.
6:00 am - leave for school.
6:15-7:30 am - gym time.
7:30-8:00 am - regroup and get ready for class. Breakfast of some sort.
8:00-12:00 - class of some sort. Breaks given every fifty minutes so I can run up and down the stairs.
12:00-1:00 - lunch time, maybe go to a club meeting if I feel ambitious. Usually eat lunch with Matt, Gil, Cathy.
1:00-5:00 pm - classes again. This varies somewhat; sometimes we only have class til three. One day a week, we finish at noon because we have clinical experiences in the afternoon.
5:00-6:00 pm - study, then home time. Unless it's Wednesday, which means I stay at school until 8:00 or 9:00 pm.
6:00-7:00 pm - food with Chris.
7:00-9:00 pm - sometimes studying fits here; other days, Chris and I hang out.
9:00 pm - fully intend upon going to sleep. Watch some tv program with Chris and snuggle.
10:00 pm - really considering sleep at this point. Maybe even brush teeth. Wind up talking to Chris, studying, or watching more tv.
11:00 pm - we both crawl into bed, snuggle, and pass out, thinking that we're going to try to get to sleep earlier tomorrow.

Med school tidbits

2009-02-15T08:19:00.000-08:00

In lab, we use the expression "pimp" when someone is pointing to structures on a cadaver and quizzing us relentlessly. Only recently did we learn that, at least according to someone, "pimp" is an acronym for "put me in my place." It's pretty accurate, at any rate.

The other night, we were in lab, studying the pharynx. I have been really working my tail off in anatomy, and so when D pointed to the pharyngeal tonsils, I excitedly named them and mentioned that an inflamed pharyngeal tonsil is called an adenoid. He looked at me like I was insane.
D: That's ridiculous. Don't ever let a clinician hear you say that.
Me: Ok, but Dr. H mentioned this...
D: Well he's wrong.
Me: But it's his class...
D: and as long as you're in it, when he says something you say, "please sir, may I have another." Just remember that he's wrong.

2009-02-10T14:36:00.000-08:00

In the next two and a half weeks, I have to:
Take an anatomy practical exam
Take a histology practical exam
Take a clinical skills practical exam
Take an OPP practical exam
Write up a take home exam for medical humanities
Take the epic written block exam of doom
Write up an H&P

...at this very moment, I hate med school.

Random

2009-02-10T05:37:00.000-08:00

Chris: so I'm thinking of putting any tax return into an IRA.
Katie: sounds good.
*confused pause*
Katie: what's an IRA?
Chris: it's a retirement fund.

Also, I think I may have accidentally signed up to help run an event. And I found out that I was on a committee yesterday...because one of the committee members came and found me and said, "Yeah, so I wasn't sure if you knew you were on this committee cause you're kind of a free spirit."

Status = too much to do, too little time

2009-02-06T11:36:00.000-08:00

This block has been surreal, primarily because I am exhausted about 75% of the time. I have bronchitis; granted, it's better than it was, but I'm still coughing a lot at night, even with cough syrup, and my chest is still tight and icky. Today in particular was weird, though.
1. We found a Netter with a Hanson sticker on it in the anatomy lab. Our class has a few older students in it, students who were not in middle school when Hanson was popular. For those of us who were familiar with them, though, it was pretty strange. One of the omm/anatomy fellows started singing one of the songs. We threatened to throw a brain at her (yes, we have them.) and she stopped.
2. There's a portion of tissue on the back of the pharynx called the pharyngeal raphe. A large part of lab was spent trying to figure out how to say it. Do you say "wraith," or "rape" or "raffi," or what? No one seemed to know, but when someone said "raffi," one of the fellows and I immediately thought of Raffi the singer, who children love and adults hate. He sang a song called "Baby Beluga" that most parents heard and then despised. Well, the fellow and I started to sing it, thus incurring the wrath of our peers.

Harry Potter

2009-02-05T06:08:00.000-08:00

I really enjoy the "Harry Potter" series of books. Yeah, they're written for children, but I figure I'm at least partially a child. Anyway, when I was reading them over and over and over again, I sort of imagined which character I would be. Throughout high school and college, I was the most like Hermione. Spent too much time with my nose in a book, knew really weird, obscure things. I kind of hoped this would continue to medical school, that I would somehow be able to balance my relationship with Chris and maintain my Hermione-esque bookworm nature.

I forgot that I'd be going to medical school with lots of other Herminones. There's enough of them that I am no longer a Hermione. I'm Ron. Even on days when I feel like I'm balancing Chris and school fairly well, even on days when I'm doing ok in classes, I'm still Ron. I can't pull down the "Outstanding" grades Hermione did in the books. Heck, I can barely make the "Acceptable" grades that Ron and Harry made. I'm almost Neville.

Damn.

2009-02-03T02:40:00.000-08:00

So it's official. Having a panic attack before, during, and after a quiz will most certainly affect your ability to high pass a course. It's great to prove the obvious to myself by accident. Let's never do that again, shall we?

Snow Drift of Doom

2009-01-29T05:51:00.000-08:00

Dear City of Saco,
I appreciate that you plow the streets. Heck, you plowing the streets is one of the main reasons that we moved to the apartment that we did. I love watching it snow, primarily because I know that within a half hour or so, I will hear the reassuring rumble of your plowing monstrosities clearing my street. That said, I have a bone to pick with you. Last night, husband and I went down to clear our driveway, which was a non-trivial task. There was significant snow but we prevailed, reassured that, because we'd cleared our driveway last night, that we would have no problems. This is where you come in.

Your rumbling creatures plowed our road, yes. In the process, however, they managed to push a massive drift of sludge, snow, and ice into our drive way. It was big; big enough that to drive over it would destroy the underside of my not trivially sized SUV. What's more, this two-feet thing of snow had managed to freeze, leaving me to ponder how, without any metal snow shovels, I was to get to class. Yes, I know, we should have metal snow shovels, but when you buy your snow gear at Reny's you pretty much get whatever they happen to have that day. Luckily, I was not alone. I have an awesome husband, and good neighbors with metal tools. It took four of us a half an hour to clear this...thing in such a way that I could drive to school. I would appreciate it if you could somehow keep the massive barricade of snow and ice out of my driveway, as well as the driveways of my neighbors.

At least I don't have to go to the gym today, which is good. I no longer have time due to the snow barricade of doom.

Love,
Me

End of January? What?!

2009-01-27T10:53:00.000-08:00

1. I have officially finished my first course, Embryology. While I did not high pass it (unless some sort of bizarre miracle occurs), I did pass it, possibly above the class average.
2. I am nearly done with the application for my secret plan for summer.
3. The other day, I felt sort of warm. Then I realized it was 37 degrees. It hasn't gotten that warm since.
4. The real proof that I live somewhere that has winter is compliments of www.weather.com. "WINTER STORM WARNING REMAINS IN EFFECT FROM 6 AM WEDNESDAY TO 3 AM EST THURSDAY...A WINTER STORM WARNING REMAINS IN EFFECT FROM 6 AM WEDNESDAY TO 3 AM EST THURSDAY.TOTAL SNOWFALL AMOUNTS IN THE WARNING AREA WILL RANGE FROM 10 TO 15 INCHES." Apparently they have to yell across the internet.
5. Cranial Nerve quiz on Friday. Biochem quiz on Thursday.
...I'm almost done with my first set of classes...new classes to commence at the end of February...

Busy, busy, busy

2009-01-24T15:27:00.001-08:00

There are no words for how much I have to do.

New beginnings

2009-01-19T15:22:00.000-08:00

I'm sitting here in my living room, watching my boy play a game on the Wii Fit, and I can't help but think that I would give anything to whisk Chris and I away to the inauguration tomorrow. Instead, we're doing what countless Americans are doing tomorrow. We're going to work. Missing this historic day is made more difficult by the fact that my mother, father, two aunts, four cousins and one of their husbands have descended upon our nation's capitol like a whirling dervish. They've been there for a few days and I can't help but think that perhaps our nation's capitol wasn't ready for them.

But I wouldn't take their places. For one, two of my cousins are under the age of sixteen. Being able to witness history will be amazing for them. They'll never forget it. More importantly, though, I would never take my father's place.

My father grew up in the south prior to the civil rights movement. His childhood was one of segregation; he didn't share bathrooms, schools, water fountains, or bus seats with non-whites. Although he might not have thought about it much as a child, as an adult the injustice haunted him. He knew that that environment had been unfair, that he had gotten advantages simply due to the color of his skin.

The last time my father went to D.C., he found the name of his dear friend on the Vietnam wall and cried. This time, he goes to celebrate. If he cries, they will be tears of joy.

2009-01-19T12:58:00.000-08:00

It's weird to have snow stay on the ground long enough to get gross, grey, wet, and then freeze again, in globular, heinous shapes. Then, another layer of snow will fall on top of these shapes, making the dirt disappear and the shape slightly enlarged. It's not really pretty or poetic. It's more like the Pillsbury dough boy took a massive dump on the lawn.

In other news, I wish I was in D.C. this week and I am starting to grow fond of the east coast. Not fond enough to stay forever, mind you. I'm a west coast girl. I like drizzle and cloud cover and wind storms and mountains that are actually worth noticing.

I also want to high pass my classes. This is not going to happen as I'm having a really hard time motivating myself.

2009-01-13T17:54:00.001-08:00

i may be the worst wife in the world. at least i feel like it right now.

Boy, kitty, beer

2009-01-12T09:43:00.001-08:00

Last night, husband and I were watching "Chuck" which is a good, good show. We were sitting on the couch, me with a cat on one side, a boy on the other, and a beer in hand. I actually said, "This is pretty good. I've got boy, beer, and kitty."

Then the boy moved.
Then the kitty moved.
I was down to beer.

Water, water, everywhere

2009-01-09T12:59:00.000-08:00

Floods are attacking my home state. There was an unprecedented amount of snow in December, and now the snow is melting and it's continuing to rain, causing massive flooding. The local paper has photos showing just how much water has accumulated. These are places I've driven, lived, visited. It's hard to watch from so far away.

H&N

2009-01-05T17:46:00.001-08:00

Human...skull...in...apartment...
Peace out.

New Years' Resolution

2009-01-05T03:16:00.000-08:00

Now, people are notoriously bad at making New Years' Resolutions. This is because we are either way too ambitious, i.e. let's lose fifty pounds by June, or we simply don't keep them. I generally find it better to not make resolutions at all. I think I'll break that rule this year. I think my resolutions are achievable though.

1. tell husband that I love him every day (already do this).
2. exercise a reasonable amount (taking a week off makes it hard to get back to it).
3. set self up with a psychiatrist/counselor to work on some issues.
4. call my best friend more often (sorry A).
5. do reasonably well in school (i.e. pass everything and get used to it being enough).
6. hug kitties.
7. attempt to actually do the biochem reading this block. doing it right before/during class doesn't count.

Xmas Lessons

2008-12-26T11:27:00.000-08:00

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

2008-12-20T15:00:00.000-08:00

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

2008-12-18T04:06:00.000-08:00

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

2008-12-11T06:23:00.001-08:00

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...

2008-12-10T19:50:00.000-08:00

"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

2008-12-08T18:12:00.000-08:00

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

2008-12-08T12:50:00.000-08:00

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

2008-12-07T19:30:00.000-08:00

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

2008-12-04T12:56:00.000-08:00

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

2008-11-30T15:13:00.000-08:00

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.

2008-11-18T18:18:00.000-08:00

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

2008-11-16T07:02:00.000-08:00

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

2008-10-31T14:48:00.000-07:00

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

2008-10-31T12:34:00.000-07:00

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

2008-10-21T17:27:00.001-07:00

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

2008-10-06T18:20:00.000-07:00

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

2008-10-06T18:17:00.001-07:00

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

2008-09-30T14:56:00.000-07:00

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

2008-09-25T02:33:00.000-07:00

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!).