Final Countdown

A little while ago, SR-F emailed me the following YouTube vid:

Final Countdown - cellos and orchestra

The 3 cellists look ridiculous, but don't let them fool you - it takes a lot of skill to do what they're doing. The cello is an instrument meant to be played seated, so to play it standing and still be in tune and achieve the technical skills in the upper register is something I can't do. So while they look a bit ridiculous doing their headbanging and standing solos, it's quite a feat.

Now on to the "real" stuff while you let that vid play. Block 3 exams coming up this week. It shouldn't be as bad as last block. I've discovered that I suck at nerves and the nervous system compared to other organs. Identifying nerves gives me the most trouble unless they're super-obvious nerves. Blah. :-/
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Yesterday I spent 6-7 hours with 2 of my labmates studying lung and heart development. Omg, heart development is so complex; it took us several hours just to get through 23 pages of notes!! But I think we've got it down now, finally. I think we were starting to lose our sanity partway through as parts of heart development began to look . . . phallic. That was Leslie's doing, not mine, lol. I was able to approximate development drawings more accurately. :-P

In anatomy lab we've had this odd tendency this block to ascribe animal characteristics to body parts. For example, we call our cadaver's right lung "tiger lung" because it has black stripes across it. Presumably this is "normal" for anyone who lives in/near a city - so for all of us living said area, our lungs will apparently become striped.

The lab table across from us has an excellent heart dissection. But it looks like a snail, so we call it "snail heart." It's their coveted body part because it's such a good specimen (for the most part). We've actually opened their humidor when they weren't around, reached into their cadaver's body, took out the heart, and brought it back to our table for examining. Once Leslie tried to give them our tiger lung as collateral as well as "transplant" snail heart in our body. That didn't go over so well.

And just yesterday morning, we came across "T-rex heart" from the other cadaver in lab who died of congestive heart failure. They cut the heart across its entire length, so if you held the heart sideways and opened and closed it where it's cut, it looks like a T-rex opening/closing its mouth.

So this is what becomes of us in anatomy lab . . .
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Anyway, I've a theory about academic physician lecturers (pseudo-tangent, I know).

The pediatrics department provide our classes with great guest lecturers. They're so engaging, know how to communicate, are able to grab one's attention, and even instill enthusiasm about the subject. By contrast, surgeons and radiologists suck at explaining anything (but radiologists are the worst).

Yesterday I sat in a radiology lecture for anatomy. The radiologist just clicked through slide after slide after slide after slide without pausing long enough for anyone to really process what they were seeing. AND he was talking to the screen the whole time - didn't look at us or really even address us. I HATE that. I mean, if you're going to show me an ultrasound of the aorta and have it zoomed all the way in so that I don't even recognize it as an aorta, at least give me 10 more seconds to figure out for myself what's wrong on the slide. I seriously sat through the entire lecture and the only thought I had was how bad it was and how I could so do a better job.

This kind of reinforces my psuedo-stereotypes of the different specialties, or rather the kinds of people who go into them. As Leslie said, "You don't choose to go work in a dark room if you want to interact with people."

---TANGENT---
I (finally) got a haircut today. I hate getting haircuts. I hate my hair, I can never get it to do what I want or make it look good.

So I went to a place nearby to get my hair cut. The only Asian woman there "singled" me out to cut my hair, haha. She's Vietnamese and even I had some trouble understanding her thick accent, though her talking in a quiet voice didn't help any. At one point she randomly busted out Spanish because she had taken some Spanish courses. I just kind of sat there and was like, "Seriously?" She was skilled with cutting Asian hair (or so she says), because mine turned out decent. A tad shorter than I wanted it but that's okay, it'll grow out. She also gave me the name and address of a good Thai place. :-D

Lastly, it seems that I've gotten some new Followers lately! I don't know who you all are, but thanks for liking my blog enough to follow. ^_^
---END TANGENT---

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Happy Birthday Landyn!

Hey Landyn,

Happy Birthday!! One year older but still plenty young, and plenty of time to work and play (but please emphasize the play on this day). I hope you're going to enjoy your day, relax with friends, go out and have a nice dinner (and have all of them treat you to it, lol).

And when you have time, visit this blog we made just for you!

We're here for ya, and you should know that by now. *Hugs* Best wishes with everything!! :-)

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The Spirit Catches You and You Fall Down

In my medical anthropology course in undergrad, I read the book The Spirit Catches You and You Fall Down by Anne Fadiman. It's a story about an epileptic Hmong girl and the narration of her story from worldviews of her parents and of her doctors.

Imagine my excitement when I learned she was giving a guest lecture at my med school earlier tonight! Of course I had RSVP'd like a month ago in advance. How could I miss the opportunity to meet the author of a book that captured the beginning of a shift within the medical profession? How could I miss an opportunity to hear what pearls of wisdom I may gain from this lecture, especially as I'm involved in the Hmong Health Education Program (HHEP) committee here? How could I, as a med student, not sit in on a lecture so relevant to cultural competency to aid me in better caring for a diverse patient population in the future (especially since cultural issues largely aren't discussed at length throughout medical training)?

It was a great lecture. She was more down-to-earth than I had envisioned. She discussed the conflict that could occur between two cultures due to mis-communication. Indeed, there is a medical culture that contains within it almost everything you'd expect of a culture - it has its own hierarchy, it's own rules, it's own language, it's own special clothes, it's own rituals, and it's own worldview. One thing she said that will stick in my mind is the idea of a Venn diagram of patient-physician communication. There is always overlap, however small. Sometimes the patient, sometimes the doctor, often both, must venture to the periphery of their circles into the area where the two circles overlap - to where there is common ground between patient and doctor. This overlap is (apparently) called the "lune," and we must seek it as both patients and doctors to promote maximal outcome.

Afterwards, I had the luck (and patience) to have her sign my book! Okay, I actually left my original copy back home in another state. But an M4 (incidentally the M4 who started the HHEP) gave me a free copy of her book for the signing, so now I have 2 books and one of them has her autograph!! She drew that Venn diagram in my book, reminding me to find the lune. I also got to take a picture with her. This must be the first time I was so close to a celebrity, lol.

Her work is well-known in medical anthropology and in the medical community. To think that a journalist would have such a profound effect on the way physicians, bioethicists, anthropologists, would view cultural differences and how those differences impact healthcare (Mirrorboy, if you read this take note, maybe one day you'll produce some work that'll be the beginning of a paradigm shift). Unfortunately, formal training in medicine concerning cultural differences is severely lagging, even today.
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Now, for the other randomness in my life.

1. Apparently I'm no longer fit (I was never that in shape, but I was way more in shape 2-3 years ago). I judge my fitness by my cardio endurance, and right now I'm at under a mile on the treadmill. This won't do as I used to be able to run 2.5-3 mi. Then again I hate the treadmill as I usually can't run as long on treadmills as on ground (oddly enough). Anyway, exercising has now been bumped up into my top 5 priorities.

2. I participated in the disembowelment of the dead today. After 2 of my labmates left early, leaving just Jon and me in the lab, we decided to disembowel our cadaver so we could expose the posterior (back) abdominal cavity. We stumbled upon a whole new world! After we ripped, tore, and cleaned away the fascia (which one of my labmates describes as being "incredibly satisfying" - it is), we were able to expose the abdominal inferior vena cava (main vein going into the heart), the renal veins leading from the kidneys, and the kidneys themselves. There was definitely something satisfying and exciting as a result of this disembowelment (which, might not be a "true" disembowelment as we just moved all the intestines upward until they sat in the upper chest cavity).

3. It's creepily humorous in lab these days. In order to get at certain things to dissect, one must remove organs and place them all over the place. We had the left lung on our cadaver's face, his massive heart on his groin, his right lung next to his head, and his ribcage and calvaria (skullcap) near his ankles. Yeah . . . organs everywhere. The more one dissects, the less human the body becomes.

Okay, that's all for this episode of anatomy lab. My eyes can't seem to focus tonight, blah.

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Long Week is Long

Wow, it's been a hideously long week, and it's not even over yet! o_O

On Monday I went to a potluck at a labmate's condo. My anatomy lab group - the best group in the West lab I must say - decided to have a potluck dinner and just relax and talk. So we met at a labmate's condo about 20 minutes away from school - I'll call him Jon. He has a cat named Stewie (the baby from the show Family Guy). I think his cat really liked me, lol. When the other lab members showed up, all they wanted to talk about was Jon's proposal to his fiance, how they met, and their eventual wedding. Women, I swear. It was actually a bit depressing for me since I've never had a relationship and marriage is sooo far away for me, if ever (depending on what happens and what state I'm in). I feel so alone. But I didn't show it and just toughed it out. I think Jon liked having another guy to just be around who's not all into talking about proposing and wedding stuff, haha. Overall the food was really good we were stuffed, and there were TONS of leftovers.

Yesterday I was at school from 8:20am until almost 9pm. o_O Classes, lab, dinner thing, and devo tutoring. The devo tutor was honestly much better than the professor for the course. She was clear and easy to understand, she was dynamic, and most importantly, she was enthusiastic. At least 2/3 of my class was at the devo tutoring session. The professor for the course is just old and slow . . . really nice guy in person though.

Tuesday through tonight (Thursday) there were a series of dinners put on by various student groups. It was nice interacting with M2s, M3s, and M4s, and getting a sense about Step 1 of the boards as well as rotations. It was also nice talking to various pediatricians and subspecialists to get a sense of what their lives are like. There may hopefully be an opportunity to shadow a couple of them in the near future, if I ever get on that. It seems every pediatrician I talk to pushes me a bit further towards wanting to be a pediatrician, which I suppose is good.

This was also "supported" (at least in my mind) by my medical interviewing course earlier this afternoon. I had to interview a standardized patient (SP) who was an elderly woman with depression. That was A LOT more difficult than I'd imagine it to be. I knew I was not at my best when I said something like, "I ask about the stairs and walking around because we're concerned about falls, which could be very bad in the elderly," and the SP responded with, "Oh, I never really thought about myself as being elderly, I guess I am . . ." Shit. For crying out loud, she was supposed to be 75!! There were 1-2 more other instances where I kind of froze up in my mind as I paused to think how to best phrase my next question - it didn't help though. Apparently I came across as being "more clinical" compared to the other M1 who interviewed her just prior, who instead came across as "more empathetic." Blah!! I don't know. I guess I can't quite connect with older patients as I can with younger patients. It somehow feels "weird" to me, like I have to be extra respectful and/or extra cautious about what I say around older patients. I guess I'll figure out how this pans out during rotations.

And speaking of different medical specialties, I've noticed some distinct trends. Psychiatrists keep stressing how it's okay to see them and how all other specialties will come across patients with mental issues (which is true), but it almost seems as if they're "preemptively" fighting the stigma attached to psychiatry and trying to legitimizing their field in medicine. Family physicians keep trying to defend themselves as a legitimate specialty and deserving of recognition, and how they're not slackers and actually really important. Pediatricians keep emphasizing how understanding they are about having families, placing families above work, and how woman-friendly the field is, but also how they (for some reason) earn in the lowest income bracket right next to family physicians. Surgeons keep going on about how great surgery is . . . but fail to mention how little of a life they have otherwise. Primary care physicians (internal med, peds, family med) keep trying to defend themselves against surgeons. It's all quite interesting.

One of the things that (right now) draws me to peds is some of the things I keep hearing said. How in peds you can watch kids grow up - sometimes from when they're a baby until they go off to college, how you become a part of their families, and how the kids consider you "their doctor." When kids think of the doctor they immediately think of their pediatricians, and you're the first impact on young people concerning medicine. There's a special honor in that, I think. The pediatricians I've talked to all seem really happy and really laid back, even the ones who do surgeries.

Lastly, my class is more gunner-ish than I thought. People have already lined up mentors for summer research and I haven't even started yet! People have already begun shadowing physicians left and right. I'm starting to feel like I constantly have to step up my game, but I just want some time to unwind and relax - like, REALLY relax. I really really need to catch up on studying this weekend - I'm more than a week behind in practically all my classes. So much for Halloween weekend, lol.

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Visiting Friend

Saturday morning I drove to Chicago starting at around 8am. I avoided traffic and rush hour for the most part, only hitting the very tail end for about 15-20 minutes. I got there around 10am or so. My friend from out-of-town (SR-F) was staying downtown with a mutual friend (SN-F) who's an M2 at Northwestern's med school in downtown Chicago.

I arrive and was fortuitous enough to find street parking, as the parking structures were really expensive. Heck, the street parking was expensive at $2/hour! Because my GPS is stupid sometimes, I walked a block down looking for the apartment on the right side of the street. When I walked back to my car I found out that I literally parked in front of the front door to the apartment. *facepalms*

SN-F was on rounds with the dermatologists (she's gunning for dermatology) so we waited in her apartment for her to finish. Her apartment had 45 floors, I had never seen so many buttons in an elevator! SR-F took a picture of them because she hadn't seen so many either. SN-F was running behind schedule so she told us to go eat brunch without her. She recommended a great local place called West Egg that serves breakfast and lunch. It was really good! When we finished eating, SN-F still hadn't finished rounds. We waited for a few minutes before deciding to head back to her apartment. She had finished by the time we returned, so she was there to greet us.

We chatted for a bit, catching up, then SN-F took us on a quick 30-minute tour of the Northwestern med campus. All I have to say is, wow. All the hospitals looked and felt like fancy hotels. The lobbies were huge with receptionists and all! There were escalators up to second and third floors and it was all just so pretty - I couldn't believe this was a hospital system. Also, all the buildings are connected on the 2nd floor via glass skywalks. We didn't even see doctors in white coats or scrubs. SN-F responded that you'd only see them in the higher floors. It was a great campus situated in a nice downtown area.

SR-F and I left Chicago around 3pm and thankfully didn't hit much traffic on our way out of the city. When we returned to my place, I gave her a quick tour of my med school - the anatomy labs, the library, and the route we take to hospital cafeteria (because it goes through 2 hospitals). We then chilled at my apartment for maybe half an hour then walked to a local pub/restaurant for dinner. The rest of the night was rather uneventful, just catching up mostly.

The next morning we made pancakes. :-D Then with my roommate we went to see Where the Wild Things Are. I thought it was a great movie and a pretty psychological one, as the monsters (or whatever they are) paralleled Max's imagination and how the progression showed how Max's mind worked out some of the problems in his life and how it gave him a perspective other than his own. It was a surprisingly and refreshingly intellectual movie, if one chose to watch it as such. I think the critics who were talking smack about the movie were talking out of their asses.

After the movie my roommate left to go eat somewhere on his own while SR-F and I got a quick lunch before I drove her back. I drove her to a Metra train station that went directly to Union Station rather than driving all the way into downtown Chicago again. Good thing she made it to Union Station on time and that her MegaBus out of Chicago was also more or less on time.

All in all it was a pretty relaxed and fun weekend. LOTS of driving on my part, way more than I'd like. I rather dislike long-distance driving - it exhausts me. At least the weather was really nice for most of the weekend. But now it's all gray, cloudy, and rainy again. Ugh.

---TANGENT---
I was talking to my brother who just had his first (I think) med school interview on Friday back at my alma mater. He said it went pretty well, which is cool. I'd just like to share one thing.

He had 3 interviews with 3 physicians, 2 of them faculty physicians I think. One of them was a radiation oncologist. My brother mentioned in some form that he likes origami. The radiation oncologist asked him to make something for her. So my brother made an origami strawberry as he asked her why she decided to go into radiation oncology. By the time she finished he had also finished making the origami strawberry.

I wish I made origami during my med school interviews, lol.
---END TANGENT---

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Died of a Heavy Heart

On Wednesday we took the heart out of our cadaver. He died at the ripe old age of 92 due to congestive heart failure, so his heart was about twice the size of a normal heart. It was quite heavy for a heart. He also had a triple bypass surgery, as he had "fake" arteries going all around his heart. That said, he looked REALLY good for a 92-year-old; we thought he was in his late-70s or early-80s.

For some reason there's something oddly symbolic about taking out a heart. It's almost like, "NOW we're doctors." We passed the heart around our table, taking turns holding it and examining the valves, the aorta, the superior and inferior vena cava, the pulmonary arteries and veins, etc. As one of my lab-mates said, "It's not every day that you get to hold a human heart." The lab table across from us had a heart that looked like a snail, because they took out the aorta higher up whereas we removed it right where it met the heart. I must admit, it was kind of cute . . . for a heart.

Today we dissected further into the heart. The left ventricle (that pumps blood to the body via the aorta) was massive. It had hypertrophied (got bigger) to the point where there wasn't much of a cavity for blood to go - that space had become mostly cardiac muscle. But we could still see all the structures inside the heart really clearly, so that was cool.

Then a few of us at a time were called into the inner lab by the oldest anatomy professor there. Once the 8 or so of us had assembled, he ordered me to take off my top scrub and shirt. O_O How embarrassing. Then he had me sit with my back turned to everyone so he could demonstrate an exam on my back (basically he man-handled me, lol). I'm really ticklish so that wasn't very fun. Then he turned me around and had everyone take turns listening to the 4 heart sounds (it's a consensus, my heart's just fine and healthy). Still, that was embarrassing and just a bit creepy as I was being touched (ungloved) by the oldest professor there. I still think he's older than our cadaver - at least, he looks older. Oh well, all for the pursuit of medicine I guess . . .

Tomorrow I have to drive to Chicago to pick up a friend who's visiting. That's not going to be fun because it's been raining in this part of the Midwest for about a week. Also, with construction, traffic, and the fact that I've never driven in downtown Chicago, I'm quite a bit anxious. Hopefully I'll miss rush hour and the rain keeps the people at bay, lol.

---TANGENT---
If you read Landyn's blog at Stuck In The Middle, he's having a really rough time right now. Working practically full-time and being a full-time student is really taking its toll on him (as it would on anyone). He's being a real trooper and it's amazing that he's held up as well as he has thus far.

But he's at his limits. Anyone would be overwhelmed in his situation. So at the very least go visit his blog and give him a comforting comment and an e-hug. If anyone has any ideas how we as the blogosphere community can help him, please let everyone know.

Thanks all.
---END TANGENT---

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Regression in the Service of Sanity

The title comes from something else that the psychiatrist who teaches our "Foundations of Human Behavior" class called "regression in the service of the ego." I liked it and thought it was fitting.

Anyway, when I study I often like to listen to classical music because lyrics distract me. Music helps me pace myself and limit how I sometimes read the same things over and over again without it going in. Last week while studying hardcore for exams I listened to quite a bit of classical music. I came across the following:

Beethoven - Symphony No. 7, Movement 2 - Allegretto.


This was the best recording I found on YouTube. The beginning is a bit too legato and it's a tad faster than my recording.

The moment I heard the opening to this piece I had a flashback moment to high school (I think sophomore year) when I played it. I was 6th chair then. I missed playing pieces like this - I missed the feeling of the strings under my fingers and the vibrations of the cello body against my legs. I missed how the subtle layers of the piece build on top of themselves, ever-gradually crescendo-ing. I missed the focus, the concentration, the intensity that music brings. It's what people would call "being in the zone," and it's been a long time since I've felt in the zone.

Hearing and smell are powerful triggers. Even though sight dominates our senses, it betrays memory the easiest in my opinion. Things visually change - houses, plants, people - all things subject to age. But smells and sounds can remain fresh. The sense of smell has the more direct tract into the brain via cranial nerve I (olfactory). There are smells that will bring back memories of when I was 3 or 4. And for me, hearing is the second most powerful memory trigger. I'll hear a song or piece and either associate it with something or be transported back to when I played it. There are very few things I truly missed about high school, but orchestra was something I dearly miss.
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For a total change of subject, a friend linked the following on Facebook:

Scrubin'


Lyrics found here.

I totally lol'd at this when I saw it. I found it hilarious!! There are subtle inside jokes there, hehe. This will be in my head when we start dissecting the thorax . . . tomorrow. Note: Rollin's and Netter's are anatomy textbooks. And my anatomy lab doesn't look anything like the anatomy lab in there.

And the following was created by med students somewhere in Canada:

Piss in my Scrubs


Oh Canadians. :-P

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