Thursday, September 27, 2007

Blog of Events That Occurred During JMP Late Night Lit Review

I can't take credit for this....

9/26-9/27/07


11:09 – David has Coca-Cola poisoning. Will has decided to watch family guy and eat Top Dawg. Andie seems to be progressing nicely now that she has a picture of Barry Bonds in front of her. I am very . . . very . . . . upset about this lit review.

11:10 – David is laughing at me. Looks like I’ll be the only one to be contributing to this blog.

11:24 – I saw David put his head in his hands.

11:25 – Will is living in a state of ignorant bliss, still watching Family Guy without an inkling of consequences.

11:26 – David hit his funny bone – it wasn’t very funny. Group seems to be turning on Andie – she has too many resources.

11:28 – David: “I have no idea how to do this. What am I doing.” Will tells Matt that he is spending more time on the blog than on the lit review.

11:41 – Matt considers buying another cup of coffee for the second time in a half hour.

11:48 – Guy Micco shows up and said, “This is sick.” He asks us what we are doing here. We ask him the same. e gives us figs.

11:49 – Discussion of the movie “The Ring.”

11:54 – Discussion of getting McDonald’s breakfast in a few hours. Good discussion.
MIDNIGHT
12:11 – Will is asleep on the couch. Will thinks he’s better than us – he is wrong.

12:20 – Will has reverted to referring to himself in the third person like Bob Dole.

12:33 – Andie denies just hitting her funny bone.

12:34 – Realizations all around about how hepatitis, a disease of the liver, is aptly prefaced with the prefix “hepat”.

12:46 – Fantasies about large fans being installed in the Fun Room commence.

1:05 – Will is missing.

1:11 – Will is still missing. David states time, followed by Matt making a rule that there is no more mentioning of time.

1:14 – Will is back.

1:55 – Group decides to address the problem of the Fun Room having a hell-like temperature by putting the fan in front of the open refrigerator temporarily.

1:56 – David is hungry, and proceeds to have moral dilemma over whether or not to steal yogurt from the Fun Room fridge. He ends up taking it.

1:59 – Discussion of erections – strangely not awkward.

2:37 – Jason is discussed as character in a martial arts movie – he would be a wise and uniting influence.

2:39 – We discuss the highlights of JMPers zoning out; focus on Nicole.

3:06 – Matt loses it – lashes out at Will.

3:07 – Will loses it – barricades himself with pieces of paper.

3:08 – Nicole loses it – yells “I can’t take it!” bangs her hands on the table, and then makes an odd screeching noise.

3:25 – Group discovers levers on left side of chair – great fun!

3:36 – Another unjustified lashing against Will. Matt feels bad, but will not tell Will. Will retaliates by threatening to shave half of Matt’s head.

4:38 – Discussion topic: is the word “sequalae” in vogue? If so, why?

4:51 – Nicole is taking a nap on the couch.

4:59 – David is done.

5:09 – Will is taking a nap on the couch.

5:28 – Will is up.

5:52 – Matt leaves.

Sunday, September 23, 2007

Coffee Shop Sociology

I'm extremely unfocused when I'm at home. Too many distractions are too tempting: a kitchen full of food, an internet connection to play around on, a room that always needs straightening. So I often pick up and go to a coffee shop, where $1.50 for a small coffee also buys me a few hours of relatively focused study time.


And usually at some point during the coffee shop outing, I'll have to make a bathroom run. Who wants to pack up all those papers, books, pencils, and sometimes computer, only to lay them all back out again a couple minutes later (and feel guilty about sitting down without having bought anything new)? Not me. So I usually turn to the person next to me and ask, "Will you watch my stuff for a minute?" And every once in awhile, the same will be asked of me; I'll always comply.


So I got to musing: this is a weird phenomenon. I don't know the person sitting next to me any more than I know the prospective thief of my stuff. Why would I trust him or her with my stuff? I guess there's the factor of sameness -- because that person is a coffee shop-goer just like me, I feel a kinship with him/her. But probably not trust. Moreover, why do people agree to watch others' stuff, and comply while those people are away from their seats? They can't have built a friendship while sitting nearby sufficient to really care if that person's stuff is stolen or not. The best I can come up with is that people avoid conflict whenever possible. They don't want to make a scene out of refusing to watch someone's things for just a few minutes, nor do they want to deal with the resulting scene if a person returns to find his/her stuff missing. Hm.

I tried googling "watch my stuff", really the only permutation of this request, and got this video made god-knows-why by some Columbia business students. It's not really that funny, but it is appropriate.

Thursday, September 20, 2007

Bike accident, one week later

Most of the injuries are healing just fine, and I'm back on my bike, very cautiously this time around. One interesting aspect, though, is that I now have two red bruises on my arm that just appeared there yesterday. As in, eight days after the accident. And I don't even think there was direct impact to the site where one of these has shown up. Is this weird? Anyone out there have experience with delayed bruising? According to my classmates, I either have leukemia or hemophilia. Thanks, guys.

What situations like this make me realize, though, is how happy I am to be in a problem-based learning curriculum. It's not just that I have two funky bruises on my arm; it's "huh, I have two funky bruises on my arm. I wonder if I can find more information on that which could tell me how weird that really is." It's a sometimes tortuous process that means you're always looking for more information, but it has the excitement of a detective chase. I'll try to post more on PBL in the future, which probably won't be hard, as it dominates my life these days.

Wednesday, September 12, 2007

Doctor, heal thyself

I'm really going to kick myself for taking that title so early in the blog's life; I'm sure I'll need it later.

But it is appropriate here. The story goes:

Yesterday was our first day of preceptorships, a sort of guided clinical rotation series, in which we're paired with real live physicians who give us an introduction to patient interviews and exams. We know nothing. We're all nervous. I manage to run a little late as I leave the house and get on my bike, speeding down streets I don't know so well.

At an intersection, with typical "biker's arrogance" (I just made that up, but you know what I mean, don't you?), I edge under a red light -- and am hit from the side by a car in the far right turning lane, who hadn't seen me coming and is taking off as the light turns green. My bike and I are knocked down, and I land on my side, my helmet the last thing to hit the pavement.

And, I'm fine. I'm a bit scraped up, and am paying $90 for a new back wheel and for fixing the front inner tube, but mostly I'm thankful that I got off so easy. I even made it to the preceptorship in time for a really fascinating morning. It could easily have been much worse: according to the Harborview Injury Prevention and Research Center at the University of Washington, over 500,000 people in the U.S. end up the ER every year because of bicycle accidents. The lesson here for doctors, doctors-in-training, and everyone else: nothing is so important that you should speed through a red light. Have some perspective, and think about your health and safety.

And, tonight is the first night of Rosh Hashana. Happy New Year, and remember to wear a helmet.

Sunday, September 9, 2007

Anatomy backblog #2

There's always something funny about struggling through a new situation. It's the teetering on the edge of panic that, if you have enough perspective, can be hilarious. This feeling is magnified if you're a first-year medical student trying to get a grasp on your first experience with a human body.

Don't get me wrong -- there are plenty of sobering, reflective moments too, when you're working with cadavers. But there's a certain humor in the oh-my-god-why-did-they-let-me-do-this-when-clearly-I'm-a-bumbling-idiot feeling of being handed the responsibility of cutting into the body of what was once a living, breathing, human being.

"Stay calm," I would try to tell myself, scissors in hand, not sure whether to laugh or burst into tears, but pretty sure neither of those would be useful, "she's already dead. There really isn't much you can do now to change that." It probably helped a little. But I still managed to cut off a few arteries that should have been kept on, create a knotted mess of the small intestines, and put the liver in backwards in front of my instructor. Not my crowning achievement.

Or, during a pre-exam study session, when we were all a little more on edge than usual. We were grouped around the thigh, trying to find the sartorius muscle, which, because the deep dissection was already done, had been cut and pulled back to who-knew-where. We picked up candidate muscles: "hm. No -- rectus femoris." One of my classmates picked up a testicle. Looked at it for a second, hopefully. A voice from behind her: "Uh, that is not sartorius."

We eventually found it, I think. And we did eventually get our bearings on the cadavers, at least enough to lessen the panic a little.

I don't mean to be callous, here. All of us were entirely grateful to be given the opportunity to explore on our own the complex, wondrous bodies we worked with in anatomy lab. Excitement, anxiety, fear, humor: all part of the experience.

Anatomy backblog #1

We took anatomy over the summer, in a very sink-or-swim start to med school. Fine, they threw us a lot of life jackets. But the water was still cold. Anyway, here are some posts from the summer.

Anatomy is all about mnemonics. There’s so much to remember that without them, you’re lost in a sea of nerves and muscles. A few are actually found in the textbooks: SCALP, for the layers of the (yes) scalp, Randy Travis Drinks Cold Beer, for the brachial plexus, or Some Lovers Try Positions That They Can’t Handle for the names of the carpals. These are generally useful, and sometimes surprisingly dirty. I guess every mnemonic needs something to make it memorable.

Then there are the mnemonics that we make up ourselves. Some have already taken their places in history among my classmates. For the pronunciation of the acetabulum, many of us – probably due to those agonizing years of studying chemistry – wanted to pronounce it with an accent on the second syllable, when really the accent goes on the third. How to remember this? Said one of my classmates: “I just remember that Tab tastes like ass.” Or, how to remember that the visceral layer is always deep to the parietal layer? Another classmate: “I think about VIPs: they’re never on the outside. They’re always on the inside, coming out. But never on the outside trying to get in.” Or, to remember that the Great Vein and the Left Anterior Descending artery of the heart run together? In a Scottish accent: “The Great LAD.”

Often, though, mnemonics take on a personal slant. They work for whoever made them up, because they fit within the organizational wiring of that person’s mind. I’ve had classmates try to describe to me their own brilliant mnemonics, in explanations that are more complicated than the anatomy itself. No wonder that each of our presentations usually includes a tip on how to remember things – if it works for you. We all learn differently, and each person knows his or her mind best. Well enough to know if he’s looking at lovers or just lunates.

Sunday, September 2, 2007

Med School Blog, take I

I threatened to create a med school blog awhile back, but a few things kept me back. There were finals, yes, but mostly it was lack of the perfect blog title. Finally, I found one. The home of my electronic ramblings will heretofore be named for the late Dr. Louis Lasagna, author of the revision of the Hippocratic Oath that I am to take this Friday. The oath is full of compassion and wisdom -- characteristics that any medical student must aspire to.

Well, it's either that or the delicious, layered Italian pasta dish of the same name. Take your pick.