Thursday, December 31, 2009

2009 in Summary, 2010 Resolutions

end of the line by *Blepharopsis on deviantART

It's now the close of 2009 and the just before the beginning of 2010. Let's take a look at my 2009 Resolutions. Hmm, seems that I was quite successful on some points but woefully failed at others. Such is to be expected I suppose. Let's see how 2009 went (using the 2008 in Summary template):
2009 in summary (and this is by no means an exhaustive list):

Winter Semester (January - April):
- Got a new roommate (or apartment-mate, I suppose). He was alright, except when he cooked, then the apartment reeked of kimchi.
- Was a GSI for the undergrad Intro to Genetics course. Was totally kick-ass at it! :-P Read about some of it here.
- Got over 10,000 views on my blog! Not particularly exciting, just being amused.
- Went to China over Spring Break with other public health students and faculty. It rocked!! Read parts I, II, III, and IV.
- Was performing poorly in research, but was able to get a second chance to redeem myself. I hope I actually did redeem myself . . .
- Worked on an epic final project with my friend, AG-F, for a class. Read about the genius here!
- Got straight A's (somehow) in all my grad school courses. Grad school wasn't so hard . . .
- Said my farewells to the city of my undergrad. :-( Pictures here.

Summer (May - August)
- Was going to travel around in China! Then the swine flu scare, and my trip got canceled. T.T
- Saw the Star Trek movie twice, lol; the first time with a friend (YY-F), the second time with another friend (SR-F) and my brothers.
- Saw Up with my brothers.
- Went to my old roommate's, AW-M's, wedding in July.

Fall Semester (Late August - December)
- Started med school.
- Volunteered at a free clinic (with pretty much all the other M1s, lol).
- Gave an obesity presentation at a nearby high school.
- Joined the LGBTPM (LGBT Persons in Medicine) student group.
- Came out to my labmate, Leslie.
- Visited SN-F in Chicago when SR-F came to visit. :-D
-> Saw Where the Wild Things Are with SR-F and the roommate.
- Got a pediatrics externship for summer 2010!!
- Finished first semester of med school. :-O
- Saw Avatar in 3D with SR-F and my brother. Good movie!
- Saw Sherlock Holmes with both my brothers. Good movie!
- Met an old friend, JR-M, for a late lunch. Caught up a bit. JR-M had been my next-door neighbor for 7-8 years of my life.
- Met an old friend, JS-M, for a late lunch. Caught up a bit. I had known JS-M since elementary school.

- Met many great (new) bloggers and have had the wonderful opportunity to chat with several of you online. You make my days and I'm so thankful for getting to know you. :-)
2010 Resolutions

I'm going to take it easy on the resolutions this year. I'll try not to make "benchmarks" for myself.

1. Be healthier. Eat healthier, exercise at least 3-4 days/week. De-stress more. Hopefully the rest will follow.

2. Take more pictures, record more memories.

3. Keep in contact with friends. Solidify new friendships.

4. Keep up in med school. Do a bit better academically, take more advantages of certain things.

5. Pursue what may be (I hope) the beginnings of a relationship. It's a secret. Well, I guess it isn't so much now that I've mentioned it here . . . but no details for you till later. ;-)
Now to plug some new blogs that I've recently began Following. I'm still catching up in reading all their posts, but all in due time.

A Beautifool Chaos
Frozen with a Heart on Fire
Rock James Bottom

If you haven't visited them, definitely stop by and say hi in 2010!!

Thursday, December 24, 2009

Geeked Out

use the force by *Blepharopsis on deviantART

Not much has transpired since I finished up with exams (and I rather like it this way, for now).

After I went to Michelle's birthday celebration, we went to her house for cake and wine. There I met Alice, a fellow M1. Somehow it came to the topic of how horrible our genetics course was way back in August, and how frustrated we all were with it. I find out her undergrad major was basically in genetics, so we commiserated and felt an instant bond. We probably spent a good hour or two talking about genetics, how it was taught, how it should've been taught, its ethical ramifications, its growing utilization in health care, etc. At one point she was on the edge of her seat as we both bemoaned our dislike for the lab technique called "maxi-prep" (where you take a ton of cells, break them up, and extract the DNA).

Totally geeked out.

Around 7:30pm or so, we decided to hit up the bar crawl that Leslie was organizing. We went to the first place to find that no one in our class was there. o_O We saw 2 guys, so all of decided to go to the second bar early. The second bar was rather . . . avant-garde. Again, no one from our class was there. What gives?! We hang around there for a bit . . . there weren't many people at the bar except for some people in their 30s to 50s that looked like they had went there right after work. At one point several of them started to line dance to something . . . wtf. Well, at least their mango mojito was really really good. :-P

At around 9pm or so, after we had been there for well over an hour, people from our class finally started to show up. Leslie showed up a bit later, all dressed up and rather tipsy already. She bought me a shot of tequila, lol. Then several of us spotted this really really tall guy at the bar. He must've been at least 6'6" if not more. Several times people would whisper (insofar as much as one could whisper in a bar) how they wanted to go up to him and ask him if he had Marfan's syndrome . . .

Totally geeked out.

Lastly, I was chatting online with my friend JW-M (I'll call him . . . Jake) from undergrad. For about 3 years now, Jake has been trying to get me to sign up for Steam, an online gaming vendor of sorts. He bought me 2 games on Steam, Torchlight and Jade Empire. He knew I'd never play these games or get Steam unless he did something like getting it for me, lol. Truthfully, I haven't really played any PC games since starting med school - maybe a little bit here or there right after an exam. :-/

Anyway, now I'm pretty much addicted to Torchlight. It's a "dungeon crawler" very similar to Diablo II except that it's easier to play and level. My brother is also kind of hooked on it too, as I let him play a character on my account. I haven't tried out Jade Empire yet! Alas all good things will come to an end once med school starts up again.

And yes, we've totally geeked out (much to our parents' dismay).

Thursday, December 17, 2009

1/8th of a Doctor!

Finished my last couple exams about 2 hours ago. I think I did alright. It's been a long week and I'm glad I'm done.

Biochem exam. That was absolutely brutal. I barely passed though, thankfully. Enough said. For future reference, I'm asking a pharmacist - it's their job to know more than me in this arena.

I also shadowed my mentor, a pediatrician. Speaking of which, I got a position for a pediatric externship for the summer! It's actually a really cool program: 8 weeks, $2500, shadow a primary care pediatrician for 2-4 weeks, shadow 1-2 pediatric subspecialists for 2-4 weeks, and maybe some clinical research. The coordinator really works with each extern (there are 8) and tailors their experience to their interests, so I'm really excited for that! Anyway, back to the mentor shadowing. It's was alright, pretty much "bread-and-butter" pediatrics (strep throat season it seems). Learned some interesting things, but to protect patient info (not that I know them anyhow) I'll just mention some of the things I've learned:

- Be careful when diagnosing strep throat. Using antibiotics when it's viral won't help and may make things worse. Not using antibiotics when it is strep throat (bacterial) is dangerous - kids can develop rheumatic fever (which affects the heart) as a result of a strep infection.
- A lot of kids have innocent heart murmurs that go away spontaneously as they get older. No idea why that is . . . I should ask the next time I go in.
- Kids can be born with a cataract. And sometimes these cataracts don't impact vision at all.
- Kids can be born with 20/20 vision in one eye and 20/200 vision in the other. They have to wear an eye patch over the good eye to force the brain to "fix" the bad eye - they way they probably won't need glasses at an early age.
- A strep infection can lead to PANDAS, where they develop sudden-onset OCD (or other mental health issues). Treating the strep infection promptly can remedy the mental health symptoms. Who knew that mental health issues may sometimes have an infection as the root cause?

Mock lab practical. So after the biochem exam, and after mentor shadowing, I still had to go into the anatomy lab with about 100 other med students and identify stuff on the cadavers in practice for our exam on Wednesday. By this time in the semester we aren't really phased by the dead anymore.

But I'll say one thing: there was this body with the largest penis I've ever seen. Seriously, the head (more properly - the glans) was the size of like a jumbo-sized chicken egg. o_O Way to make all the living guys in the room feel inadequate, lol. In all actuality, we don't envy his . . . penile prowess. It looked way too large to be comfortable for his partner. The 2 girls next to me were like, "If I saw that on a guy, even if he was totally hot, I'd take one look and be like 'Alright, peace. See ya.' And run away."

I went to lab early to raise the body, only to find all the bodies already raised and arranged for the exam later that afternoon. Well, that just cut an hour's worth of sleep I could've gotten instead. :-/ It's very cold in the mornings here now. I'm talking single digit or below zero Fahrenheit. Brrr . . .

I did pretty well on the lab practical, only got 2 out of 46 wrong. Mildly annoyed I wasn't able to identify the pudendal artery, but whatever. One of the structures tagged was the vagina, and we had a discussion about it afterwards . . .

My labmates and I were discussing the lab exam. And one girl was like, "I know this is really really embarrassing, but was that structure the vagina? I've just never bothered looking at one in the hemi-section." We agreed. We thought it was too easy for it to "just" be vagina. We were all looking on our structures list to see if they were different parts of the vagina on there (yes, there are different parts like vagina vestibule or anterior vagina). But no, it was just vagina. And that made it easy. :-)

And this brings me to today. :-)

I set my alarm for 6:30am, so I could get up and study a bit more before my last 2 exams: anatomy written and human development (devo). I didn't get up until 6:50am or so, at which point I heard this NPR story on correcting lower limb defects (e.g. clubfoot, congenital displacement of the hip, etc) in Honduras. Seeing as part of the devo exam is on limb development and defects, I saw this as a divine sign to get up.

So yeah, the exams came and went. Weren't too bad, I hope I did better than I thought. I'm usually a pretty good judge of how well/poorly I do on exams, so I have high-ish expectations for these exams.

Alright, have to leave in a little bit to celebrate Michelle's birthday. Going out to lunch with her and other friends, then to her place for cake and wine. And later tonight, there's apparently a triple birthday bash somewhere in the city. I don't know the city at all, so we'll see about that. Could/should be fun though, and my labmate Leslie is planning it (as she's one of the 3 birthdays coming up). Maybe there'll be some interesting development(s) between now and when I go home Sunday morning, but don't bank on it. :-P

Sunday, December 13, 2009

I Kinda Hate Myself . . .

. . . for procrastinating half of Saturday away, especially since my biochem exam is on Monday. o_O

My motivation to study is at an all-time low. I did 2 lectures on Friday, 4 on Saturday, and that means there are 5-6 left to do all on Sunday (today, I guess). *Sigh* Truthfully, I loathe studying biochem. I enjoy learning, I appreciate what I learn, I just hate trying to memorize it all because there's just so much.
That's a biochem "map" of most/all of the biochem pathways. Now, of course we don't need to know all of it (especially for this exam), but we do need to know a good chunk. For a more detailed look at that picture, go to the ExPASy site here.

On my Facebook status, I have: "[Aek] kinda wishes biochem had a physical form so he could stab it with cadaver-blunted scalpels. o_O"

From that, a friend linked me to the follow YouTube vid:

U of Pitt Med School: Lord of the Rings parody 1

When I watched it, I couldn't help but laugh. It was soooo bad, but so hilarious. Particularly apt was where "Gandalf" declares "You shall not pass!" to a med student who accosts him. Here's an excerpt:
"It began with the forging of the great bling-blings. 3 were given to the anesthesiologists, fairest, most rested of all physicians. 7 to the renal lords, great managers of electrolytes and craftsmen of the Foley. And 9, 9 were gifted to the administration, who above all else desired power and research . . ."

U of Pitt Med School, Lord of the Rings parody 2 (the sequel)

Short excerpt from it here:
". . . There is a union now, between the two biomedical science towers. BST1, fortress of UPMC research; and BST2, stronghold of cheap foreign labor. And now a third tower rises, a third BST constructed solely to hoard NIH funding . . ."
And I'll end this post with a song linked to those parodies:

'On Call' - Med School's That Way

Thursday, December 10, 2009

Tripartite Post


First of all, I'd like to thank those who commented on my last post and/or emailed me, it meant a lot to me. To those of you who wrote emails to me, I will (eventually) reply to them. I have final exams next week . . . and I just wasted all of today procrastinating. *sighs* Well there just went 5-6 hours of potential studying today. :-/

Alas, whatever my issues, I must suspend them for now. How typical - always postponing the issues at hand, always with a "good" excuse, always well-intentioned. I think this is something med students are particularly good at doing.

Though, I must admit, there was a blip of deus ex machina that showed that the universe at least acknowledges my loneliness. An old friend from elementary school (and we ended up going to the same place for undergrad) messaged me on Facebook. He wanted to let me know that he got into dental school and because it had been forever since we last chatted, he suggested that the next time I'm home, we should grab lunch and catch up. He was one of my best friends growing up, so I'll definitely take him up on his offer.

Lastly here, I seem to have a bunch of new Followers. I don't know who you all are (yet), but thanks for Following!! :-D

The blogger of MSTP Bound asked me several days ago to write a eulogy for his now deceased blog.

MSTP Bound is the blog of a gay Asian (gaysian) MD/PhD student. His blog had been running and well-established before I even began reading blogs. I think it might've been one of the handful of blogs that inspired me to blog in the first place.

MSTP Bound chronicled his first 2 years of med school, and all the adventures, intrigues, politics, and relationships therein. Truly, his experiences were far more intense and far more interesting to read about than mine. At times, it was almost as if it was out of a Korean drama (though I've never watched K-dramas; he'd probably bitch slap me for this).

Alas, MSTP Bound met its natural end. It makes me wonder if blogs have a lifespan of their own, and I sometimes wonder how much life is left in mine. Thankfully, MSTP Bound has transcended this cycle of blog death and has been reincarnated as a new blog (somewhere).

Last week, Jay (formerly known as Randy) of Sun on my Face posed 12 questions on his blog in this post. He recently answered his questions here. They are certainly thought-provoking questions, and my own answers are as follows:

1. Whose the last person you've helped, but didn't have to?
The last people I helped were people in my med school class. You see, some of us were lucky enough to have inherit old exams from the M2 class. There's a set of old exams that have been handed down throughout the ages. Anyway, I decided to undergo the laborious task of scanning and uploading these exams online (this usually take hours, mind you). I then distributed these exams to several of my med school friends to help them along in studying. I could've been a gunner, I could've hoarded these exams to give me an "edge" in getting a better grade in class, but that's against my nature. And yes, several of my friends will do better than me - whether it's due to these practice exams, I don't know.

2. Whose the last person you loved but didn't want to?
A difficult question for me to answer, as I'm not sure I've ever really felt love (or am able to recognize it when it's right in front of me). But to answer the question, it's definitely someone I've been chatting with online for at least several months now. Is this guy a blogger? Maybe. If so, he definitely reads this blog - I'm almost certain he doesn't know who he is, and I intend to keep it this way. It's simpler if I don't formally admit my love, as the distances and situations separating us would probably crush me emotionally.

3. Whose the last person you hated, but couldn't help it?
Probably myself. As if you couldn't have gathered that much from my last post. It extends further, but I'd rather not elaborate on it here.

4. What means most to you, but could do without?
Systems and routines. I like my systems and my routines - it helps keep me focused and on task. However, I wouldn't mind if something came along and disturbed this monotony and introduced a bit of spontaneity in my life. It's so difficult for me to break out of it myself, much easier if it's from some external source.

5. At the end of the day what can you do better, and will you try to?
I can do a lot of things better. I could study harder, be more social, be more active, be more vocal. All these things are important and probably things I should really do, but will I? Probably not because I only have a finite amount of motivation and energy - and right now I'm pretty low in both.

6. Can you ignore want and acknowledge necessity?
Is this not the definition of med school? Delayed gratification is almost an art - a torturous one - that med school teaches. I want many things, but I need surprisingly little. There are perhaps things that I need that I don't currently have, but such is life.

7. What is fucked up in your LIFE that you CAN change but never will?
I'm not sure how to answer this. I suppose, I constantly put other things and other people before my own needs. As long as someone else is worse off, I can't complain. As long as people need to vent, I won't (much). It would be difficult for me to say "Screw you, I need to look out for myself" to someone who needed me. I'm not sure I even want to change this.

8. What is fucked up in the WORLD that you CAN'T change but will try?
Apathy. I've seen so much apathy in this world, and I admit I'm guilty of it too sometimes. But I'll do my best to help make people care - care about their health, their education, and their actions. I've seen kids, teens, and undergrads I've taught go from apathy to caring. Everyone has that spark, it just needs to be ignited. But as a whole, I can only do so much when there's so much apathy in this world.

9. Would you denounce your convictions to save the life of one person/millions?
Hmm, that would depend on which of my convictions is in question. How could I denounce a conviction to help others when that conviction is meant to save lives? No, I wouldn't denounce my convictions because I can't foresee a (realistic) situation where I would have to.

10. Would you follow your convictions if it lead to the injustice of one person/millions?
Perhaps. If we were talking about my conviction to help others above, and if one of the people I help ends up killing another person (or millions), would I denounce my conviction to help that person? I might, so long as I didn't have to participate (directly or indirectly) in the death of that person. But now this philosophical musing is getting too complex for me.

11. Is your life about giving or taking?
My life is usually more about giving than taking. But I'm by no means a saint.

12. If you died tomorrow, what footprints have you left?
I feel like, despite everything I may have done and the people I may have impacted, that I would'nt leave a significant footprint on this Earth. Perhaps if I'm lucky, I'll be blessed with the butterfly effect and someone I've interacted with will rise to greatness - perhaps a student of mine or a good friend. But at best those footprints would only be indirectly mine. I feel like I haven't achieved much yet, and all I see are footprints to potential in the future.

Friday, December 4, 2009

Face of Broken Solitude

I think it's time that I show one of my faces behind the masks. You may have seen the eyes peering from behind, but now I'll let you see the raw flesh. For all intents and purposes my masks have covered and hidden this face of mine to my satisfaction.

You see, my masks are my defenses. They allow me to transform insecurity into confidence, exhaustion into energy, unease into comfort, vulnerability into strength, and sadness into apparent happiness. My masks are as much a part of me as anything else. Perhaps they are more of me than I realized. Perhaps I can no longer tell apart my masks from my faces, as that distinction is blurred. Indeed, this may not even be a face but yet another mask; but if it is, it's not a mask I let others see.

I've learned from a young age to put up walls of emotional defense. If I must, I can attain an almost Vulcan-like clinical mind. As such I've created masks to show you what I feel (and want to feel) and what I want you to see. You may have noticed that the bulk of my posts since August have centered almost exclusively on my life as a med student, under the all-encompassing Mask of Medicine. You may have felt me delve into issues that no one else cares much about, dedicating my Mask of Caring to some purpose that may or may not be greater than myself. And perhaps my posts read like a documentary, as I'm not the most emotional writer, even without my Mask of Stoicism. What's left to hide, I hide under my Mask of Silence. It was all for some purpose, but so that you now see, here is me defenseless, here is me vulnerable. This post may be longer than my usually long novelette posts, but realize my difficulty in articulating that which I can't even stand to see.

To reiterate, you may first want to read this post on Straight as the Arrow Flies. Deep down, beneath the masks and the walls, is a fragile insecurity that's always on the edge of breaking. As true as it was since I started this blog, I am alone in every romantic/sexual sense possible. Though I may have moved on to the next stage in my life and career, that part of me has not matured since perhaps the 7th grade. Dating and seeking a relationship, quite frankly, unsettles me to the point of emotional paralysis. Even thinking about it makes me feel exhausted and heavy. I'm being held back . . . by myself.

It truly is all my own damn fault. I don't make much of an effort to get out and explore. I generally dislike going to clubs or bars, and I certainly will not go alone. But even if I did, I don't know how to approach someone and I'm too shy to express interest. It's so easy to make excuses; after all, the Mask of Medicine pretty much dictates the majority of my life right now.

I am scared that I've become numb to my own feelings, that I wouldn't recognize love even if it were in front of me. What does it feel like? How do I know? How do I act on it? I'm not sure I'm able to separate out love from infatuation from lust. I've spent too long brushing aside such feelings in pursuit of other achievements.

And I am tired. Lately, every now and then, I laugh in the shower. I laugh at my own pathetic-ness and how nice it feels to have water flow over my body, to pretend to have something wash away my unease and hide my tears (in case I have any). And the nights I crawl into bed cold (because it's getting cold here), and alone, and wonder what it must feel like to get into bed with another person and wake up next to him/her.

For the most part I guess I'm too good at hiding this face. I wish just once someone would call me out on it. I wish every now and then someone would hug me, long and sincere, and tell me that things will be okay. I wish I could hug back and not feel awkward. I wish someone would call bullshit on my excuses and drag me out somewhere I've never been (and probably somewhere I'd never be able to find on my own). I wish I were invited to more social events and activities. And I wish I didn't have to initiate and feel pathetic doing so.

Today in anatomy lab, we were having our usual conversations and gossip. But then somewhere along the line it hit a nerve, I felt a crack and felt my face showing. Our conversation drifts, as it often does, towards relationships. And every time I feel alone, left out, unable to contribute - for I have no experience, I've had no relationships. Virginal in all aspects to this subject that my peers were well-versed in.

Perhaps you think I'm silly, or pathetic, or perhaps you haven't even read this far. But this is how it is. And even now, I feel that invisible hand grasping my heart and the dense gravity in my legs. I'm no saint, I'm not some confident med student, I'm not even always on steady ground. But this much you can count on - so long as someone else needs me, so long as others suffer, so long as you have a complaint that I'm willing to hear - I won't tell you my own issues. Because it's my duty to put aside my problems for you, an aspect of medicine that I find relief in. It's my job to care but not yours to reciprocate. My masks and I are for you, even if no one's there for me. There are other people and bloggers who write more emotionally than I, who expose more of their problems than I, and who receive the love and praise of the world. I don't ask for it and I don't expect it because I don't bring it up, but you know what? It does make me sad, and I suppose envious.

I guess med students and doctors are human after all. Time to go to bed, alone and heavy with this broken solitude.

Tuesday, December 1, 2009

It Has a Seizure Button?!

Earlier tonight, I went to a pediatrics skills workshop for M1s and M2s. There were about 30-40 students there total, and we were divided into smaller groups to rotate through several stations.

My first station was a well-child physical check-up. Two pediatricians brought in their kids for us to learn/practice check-ups on. They were such good sports about it. One kid was 4-years-old and he was seriously the cutest and most adorable thing ever! When his mom was demonstrating the physical on him, she asked, "What's that spot on your neck?" And he said, "It's my special spot," referring to a dime-sized birthmark on his neck. He was precious; he reminds me of my baby cousin.

Alas, I didn't get a chance to play with the 4-year-old. The kid I worked with was 7-years-old. It's all good. After the pediatrician finished demonstrating on him, she asked him to pick who got to go first to examine him. And he chose me! ^_^ So in general, you go from head to toe. So I kinda massaged his head and neck to make sure everything was fine, no weird bumps or massive lymph nodes, then I listened to heart and lung sounds. I'm not sure exactly what I'm listening to because we haven't formally learned yet, but it's all good. Then I got to listen to bowel sounds and then my favorite, the liver scratch test. So with the liver scratch test, you put your stethoscope where you know the liver is. Then you lightly scratch the stomach closer and closer towards the liver until you can hear the scratching sound. Once you hear the scratching sound, you've found the inferior (lower) border of the liver. Pretty cool! I took someone's hammer and did the knee reflex on myself - that was fun.

After that, we went to the immunization session where we learned how to give injections into muscle and subcutaneously. Ugh, I had issues getting rid of bubbles in the syringe - they just wouldn't float and go away!! It was pretty bad when the pediatrician at that station laughed at my incompetence with needles, lol. I think this is a sign that I shouldn't be giving injections to anyone.

Then the last station was the airways station. Personally this was my favorite one. We were shown how to use a laryngoscope to intubate (stick a breathing tube down the trachea) the airways on a child dummy. When I first put on the air mask, the pediatrician noticed how I was holding it wrong and remarked how I must've played the piano. o_O She said she used to play piano for many years, and that I was the first person to have held the air mask the way I did. Now, all laryngoscopes are left-handed tools, so I was excited since I'm left-handed. So was the pediatrician, so we were both quite excited. ^_^ It was also funny watching the right-handed people use the scope wrong before being corrected.

Lastly, some of us returned to the first station that we had missed. It was doing a well-baby check on a SimBaby (a fake simulation baby). The SimBaby is really cool in that it can simulate different heart sounds, lung sounds, cries, pulses, can turn cyanotic (blue), and can even seizure. When we heard that, Karen - from the anatomy lab table across from me - and I exclaimed at once, "Omg, it has a seizure button?!" Let me say, seeing a seizing fake baby is kind of funny. But, if you mentally transpose that seizing onto a real baby, I think that'd be scary as hell. We thought it'd be really mean if someone pushed the seizure button while you were working on the SimBaby, because then it becomes an "Oh shit!" moment.

All in all, this was totally the highlight of my day. Karen and I spent some time just staring at the kids because they were so cute!!

Wednesday, November 25, 2009

Among the Clouds

On my flight home for Thanksgiving break, I wondered, what if our consciousness persists beyond and our souls dispersed among the clouds such that our spirit breaks free of a single physical anchor.

What if our souls merged and became one with the clouds, each droplet a particle our former being - each droplet it's own contained consciousness with a kind of spiritual sight, hearing, smell, touch, and taste. What would it be like to lazily drift across the skies of earth and observe the world below? What would it be like to have only the sun or the moon and stars above you, and the glittering lights of cities under you? What would it be like to travel to places you were never able to see in life?

And when we wanted to inspect the world more closely, we coalesce with nearby droplets of our souls and rain down upon our destination. To experience free fall, attracted to the earth by gravity, to watch the world zoom closer, to land on buildings, on trees, on umbrellas. And then when we've experienced enough, to let our droplets warm to the sun's light and rise back into the clouds, rejoining other free floating souls.

Perhaps if we were adventurous, we could rain down over the ocean and let our soul droplets sink to the deepest abyss, to see and explore that which is still undiscovered to science. Or perhaps we will let ourselves fall along the geography of mountains, canyons, and crevices into the darkest caves and underground wells, and float along to an outlet where we once again rise to the warmth of the sun.

And once we've tasted enough of freedom, once we've grown weary of our vagabond travels, once we grow restless of peaceful "nonexistence," we let ourselves condense into rain again to be drank by someone. And perhaps under the right conditions, we let our souls attach to a new growing being - to a new anchor. In the process, we learn to let go of freedom, let go of our travels, and to re-experience life anew. And perhaps in life it's this remnant of our former deaths that moves us to learn, to explore, to travel, to yearn for freedoms and transcendence . . .

Just a thought. I admit it's rather romantic, but perhaps that would be a kind of heaven on earth. It's also kind of an oddly Taoist/Buddhist notion.

Saturday, November 21, 2009

Mask of Medicine

It's curious that I've been talking about my adventures in med school a lot recently (most of my posts since August), and yet I've failed to explicitly discuss the Mask of Medicine that practically all med students, residents, and doctors wear. Unlike my other Masks, this Mask has some physical manifestations as a white coat, scrubs, and/or stethoscope.

This is a Mask that trumps all other Masks. When it's worn, next to nothing else matters. Time melts away, personal dramas are set aside, and you push through drowsiness and exhaustion - all that matters is that person in front of you. To say, "How can I help you?" or "What brings you in today?" and have a total stranger tell you some of his most intimate details of his life, to place his trust in you, how can you even dare think about anything else but that person in that very moment? All you care about, all you should care about, is helping that person the best you can. And when you do your best and you know that, you feel a distinct sense of achievement.

I'll be the first to admit I'm not the best med student in the class, book-wise. Heck, even with a 95% on one of my last exams I was still below average (or that my 82% on another exam is below the average of 89%)!! Nothing stings more than knowing that, though you've passed and actually did quite well, many many more students did better yet. But medicine is so much more than book smarts, so much more than memorizing pathways and facts. And so far I've taken consolation in that.

There are students who fail so badly at medical interviewing that you pray they decide to go into radiology or pathology, where they never have to see patients face-to-face (or at least, not much). There are students who desire to do the least amount of work possible and aim for the "lowest tier" of medicine. And there are many who scoff at evidence-based medicine (EBM) - who scoff at epidemiological study designs, biostatistics, and valuable critical thinking and analytical skills. I have a friend who feels he'll be too busy to read medical literature when he becomes a practicing doctor, saying he'll only read the abstract and the conclusions of the studies and base his judgments on that; I worry for his future patients.

And then I realize that at the heart of the Mask of Medicine is an extension and amplification of the Mask of Caring. My roommate accuses me of "thinking too much" about medicine, about the issues that we may face in the future in clinical care (then again, he's just a bum). That I think about how I can better improve how I interact with patients; about how the ability to read, interpret, and critically evaluate medical literature is more important than any amount of biochem learned throughout a single semester; about how important cultural awareness is when dealing with a population as diverse as the US; about how "unfriendly" most medical practices are to LGBT persons (mostly unintentional); and about how we can all personally improve how we conduct care - perhaps I do think too much . . . perhaps I do care too much. I'm not saying I'm the best med student to grace the clinics - far from it. If there's anything this Masks shows me, it's that I've a long long way to improve in all respects.

The Mask of Medicine is all-consuming, it often dominates the majority of my days. Medicine, as preached to me by every physician I've spoken to candidly, is more than a job. The doctors who treat medicine as "just a job" are not good doctors and are rarely happy being doctors. This Mask is an exhausting one, but often also a rewarding one.

Last night I watched a gay-themed movie called Eating Out 3. It's a rather silly film - a bit over-the-top, but also hilarious and had some pretty hot scenes. Interestingly, all 6 of the main male characters are gay, and read an interview with them here. One of the main characters, played by Chris Salvatore, is simply gorgeous:

He's also a singer/songwriter with his own myspace and YouTube pages. I listened to some of the songs at those 2 sites, and actually liked some of them. So head over and listen to some tunes. And watch the movie if you're feeling up for a laugh and maybe a couple "awww" moments.

Wednesday, November 18, 2009

So Gross

Wednesdays are always rough - 8:15am until 9pm. Yuck. Anyway, the title says it all. Today was so high yield in terms of material to blog about! You thought the last post was bad, but today's anatomy lab was one of those we've been dreading. Proceed with caution, this stuff is NOT for the faint of heart. There's stuff at the end too, so if you want to skip the explicit dissecting details, don't feel like a wimp for jumping past it. BUT please read the first paragraph blurb so you know what the details are all about.

Abandon all hope ye who enter here . . .

Today's anatomy lab involved the dissection of the perineum region. For my lab group this involved 2 things: removing the sigmoid colon and rectum (this part's unrelated to the perineum), and cutting off the scrotum and penis (because our cadaver's a guy).

1. On Monday the lab professors bisected everyone's cadavers axially (horizontally) such that the lower half of the body was disassembled from the upper half. The small intestines and colon were also cut. But they left part of our descending colon, our sigmoid colon, and rectum in. Unfortunately . . . it was full of poop.

So we have to remove as much of the colon and rectum as possible. I tied up the free end of the descending colon, but I must've missed some poop because as I was tightening the string, poop oozed out of the open end of the colon like gross brown toothpaste. I grabbed more string and tied it further down and we lopped off a good chunk of colon filled with poop.

Later a lab professor came by and told us that we still needed to remove more, as much as we possibly can. So I got more string, but we had to tie it now so close to the rectum/anus that it was hard to get the string down there. My labmate (future surgeon guy) deftly used 2 tweezers/foreceps and tied knots around the lower rectum, just like a surgeon would tie a knot or suture. We then had some difficulty cutting between the 2 strings we tied to ensure poop didn't leak out of either end. Unfortunately . . . we accidentally cut our last string. Thankfully his rectum and anus were mostly clean of fecal matter. I quickly threw away the second poop-stuffed colon "pouch."

2. The perineum region is the area (on a guy) below the penis and above the anus. Basically, the "taint." Future surgeon guy and I took a side and began cutting off his scrotal skin, all the while wincing. One of the girls had to leave early so we quickly "recruited" the only girl left in our group, Leslie, to "help" us. See, we had to cut around and under the penis, and it was just sticking in the way. So we had her lift the penis straight up as we cut away the scrotum under it.

The moment she held the penis up, several guys came by and commented on that, lol. It was quite amusing. I had remarked something like, "I wish we could induce an erection in death, because his penis is just in the way." That somehow became the quote of the semester in our lab group, lol.

So after we cut away the skin of his scrotum (of which he had lots - his balls were rather large), we cut deeper into the fascia until we could pull out the testicles. Again his testicles were pretty big. o_O We then tried to cut away and find the small thin muscles at the base of the penis. But the penis was in the way. So . . . future surgeon guy decided to bisect the penis at mid-shaft. I protested vigorously, but to no avail. So now we had a disembodied penis tucked somewhere elsewhere in the body. The look on both our faces must've been priceless, because this is just not something any guy would want to do.

Later we also bisected the penis ventral-dorsally (top to bottom), so now the stub of penis left connected to the body is bisected in half. We "had" to do that because sometime soon the lab professors are going to bisect the pelvises of practically every body down the midline.

P.S. If I ever discover that the above is against HIPAA or something, I'll of course have to delete it. I don't think it is because there aren't any identifiers, just the "procedures" we did on this cadaver.

Now I have two convos I'd like to share briefly. The first I found interesting, the second I found hilarious.

1. Background: our cadaver guy is uncircumcised. This is (mostly) the convo between the 2 girls (the 3rd girl was home sick . . .) in my group about it. Girl #2 is Jewish.

Girl #2: Why does his penis look bent like that?
Girl #1: I think it's because he's uncircumcised.
Me: Of course he's uncircumcised, that's obvious.
Girl #1: Well, I've never seen an uncircumcised penis before.
Girl #2: Really?! Wow, really? Never?!
Girl #1: Yeah. I mean, I've seen my fair share of penises, but none of them were uncircumcised.
Girl #2: I can't believe you've never seen an uncircumcised penis.
Girl #1: Well, my sample size is pretty limited to just [insert Midwest state here].
Girl #2: My first bf for 5 years is uncircumcised.
Me: Wasn't that the guy you would've married?
Girl #2: Yeah. I probably still would.

2. Background: I went to a patient care panel in oncology dinner thing tonight. One of the guys had pretty aggressive prostate cancer (he's in his late-40s to mid-50s). He's obviously alive and well, surgery and chemo went fine and all.

Him: "The surgeon gave me this little blue pill [Viagra]. And I told him it just wasn't working. He then referred me to this other doctor."

*goes to see this other doctor*

Doctor: "You need penile rehabilitation."
Him: ". . . What does that mean?"
Doctor: "You need to masturbate every day."
Him: "o_O Where were you during high school?!"

There are a couple blogs that have closed recently, and a few more that haven't updated in a while so I going to assume they're abandoned/closed, at least for now. I still follow all the blogs, but I follow anonymously if they're not currently active.

So farewell to:
Just me
MSTP Bound

And I hope to see the following blog again soon:
A Popular Dude's Secret Life

Lastly, I'd like to welcome a new blog on my blogroll by a blogger who's no stranger here. Head over to Welcome to Inglewood to see what that's all about.

Monday, November 16, 2009

Up The Ass

It's not every day that you can say you had your hands shoved up someone's ass (muscles).

Yes, Block 4 has begun - perineum and lower extremities. First things first, the professors bisected all the bodies at around the level of the kidneys (bellybutton area-ish) so now everyone's cadavers are in 2 pieces. o_O Then we had to flip over the lower half and dissect the butt to get to the pelvis.

Proceed not for those with weak stomachs beyond this point . . . you've been warned.

After removing the skin from the butt, we had to clean off the fat and fascia over the gluteus maximus. That was gross. Fat is just so . . . yellow, and squishy, and greasy, and gross. Our guy has been generous to us - the lab table across from us has a woman bordering on obesity and she had inches of fat. Once we found the border of the gluteus maximus, we had to shove our fingers under there and find the ligaments, hence shoving my fingers up under his butt muscles. Those were some tough ass ligaments (pun intended)!!

And of course, the highlight of the lab. We had to insert a tampon into the anus, to "provide support" to the soft structures bordering the anus. We think it was just to plug up the hole so poop doesn't leak out while we dissect. The other guy in my group and I were quick to say "Not me" with regards to that.

So I gave Leslie the tampon which she so skillfully put in. Then she removed the applicator and had this look on her face, exclaiming "Was I supposed to take it out!!" The applicator had poop all over it. We all then kind of proceeded to "freak" at the grossness of this lab. Minutes later, we hear a lab group in the near distance freak at something. We concluded they also inserted a tampon into their cadaver's butt.

You know, it's good to know that despite cutting up the bodies and supposedly getting desensitized to it all, we're all still able to become utterly grossed out. Anatomy lab is also a great motivator to get one to at least consider losing weight.

I started watching this new TV show, V. It's about aliens, the Visitors, who come to Earth. It's a remake of a show way back when (that I've never even heard about until now). It looks like a good show, so I'm excited to see what happens next.

Also, it doesn't hurt that some of the main characters are hot. ;-)

Saturday, November 14, 2009

Push On Through

It's been a long week. But then again, I'm kind of used to this - in fact, it's a recurrent theme.

This week was Block 3 exams - thorax and abdomen. Anatomy and human development (devo) were both quite easy and I did really well in both of them. Then again, Block 3 was supposed to be the easiest block of exams and everyone's expected to do really well. However, biochem is as difficult as always. It seems that no matter how much or how hard I study, I just can't get the grade I want in that class. Grrr. I've determined that I suck at neuro and biochem. Block 4 is on the pelvis and lower extremities. Joy.
Soon after my last exam (biochem), which was on Friday the 13th (how apt), I went to my mentor's office to shadow him. All M1s are assigned a mentor who we visit in their clinics. Mine's a pediatrician - he's a really nice old guy. I got to his office a bit before lunch and there was lunch provided for everyone in the clinic. It was a really nice clinic! His son actually joined his practice soon after finishing residency; I found that interesting (I don't think I'd ever be able to work for/with my dad).

After lunch he had some charts and patient notes to finish writing up, as well as phone calls to make. He gave me some things of his to read and look through - to "inspire" me about pediatrics I guess. Before we began he had talked to me about his philosophy of medicine, and I could see that played out in practice. He gave me some great advice which I'm sure will be of use to me later. He's a super-organized guy, which is of course a great quality for a doctor to possess. He's also close to retiring and doesn't really know how to use computers, and so laments the EMR (electronic medical records) system Obama advocates. I held my tongue, lol. Generation gap - typing is second nature to me whereas it isn't for him.

Starting at 1pm, we saw patients. In the span of just under 3 hours, we probably saw 10-12 patients (rough guestimate) - that's a lot, btw. He was almost sprinting (or as close as a 63-year-old gets to sprinting) from exam room to exam room. His poor nurse couldn't quite keep up with him, lol. There were a lot of well-child physical check-ups. I saw this really cute baby girl. She didn't like the tongue depressor and so bawled when the doctor tried to look in her mouth. The office visits were pretty typical and routine - "bread and butter pediatrics" as he called it.

He counseled a lot of parents to get the seasonal flu and the H1N1 flu vaccinations for their kids. It was quite interesting seeing the parents' different reactions to it - some were for it, some were against it, most were on the fence. At times it almost seemed like he was pushing a bit too hard to get kids vaccinated, though I understand his viewpoint - he's had several young patients hospitalized within the last 2 months due to H1N1. He doesn't agree with the way the government is handling the vaccination distribution (that is, they're doing all of it), and I'm inclined to agree.

Two of his patients were from "second generation" families, meaning that the pediatrician used to treat the parents way back in the day. I thought that was really cool - that you would love and trust your pediatrician so much that when you had kids of your own you'd take them to see the pediatrician you used to see. That in and of itself speaks volumes about him. He even has one or two "third generation" families, where he once treated the grandma/grandpa!

All in all it was a great experience. Though this first visit was pretty much exclusively shadowing, he said in the next 5 (mandatory) visits he'll show me how to use some of the typical equipment - otoscope, stethoscope, etc - so I can actually do something and do some things on my own. I look forward to that! I was exhausted when I got back to my apartment, and then I went with my roommate to join up with some friends to play poker. I lost, but I got damn close to winning this time!
This morning (Saturday) I went to volunteer again at the free clinic for the uninsured. Unlike the first time I was there, I didn't have an M2 with me. So I saw patients and took their medical histories all by myself. I also took the first guy's blood pressure manually (because electronic blood pressure cuffs SUCK). I was somewhat off from the number the M3 got when she entered in with me later. Oh well, at least my measurement was still WAY more accurate than the machine's.

As an M1, I feel woefully ill-equipped to do much beyond just talking to the patients. The M3s kept asking me if I did a physical on the patients and I was like, "No, I haven't learned that yet - won't learn that until next year." I was pulling the "ignorance card" left and right, lol. I did get a little better at presenting the patients to the attending compared to last time (at least they didn't look annoyed at me), and I took more thorough histories than last time as well (I think).
Okay, I'm exhausted now for reals. I think I'm just going to crash for the remainder of this weekend, lol. Thanksgiving does not come soon enough - I'm excited to go home. :-)

Saturday, November 7, 2009

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. :-/
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 . . .
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."

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. ^_^

Wednesday, November 4, 2009

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!! :-)

Monday, November 2, 2009

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.
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.

Thursday, October 29, 2009

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.

Monday, October 26, 2009

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.

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.

Friday, October 23, 2009

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.

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.

Sunday, October 18, 2009

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.
For a total change of subject, a friend linked the following on Facebook:


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

Friday, October 16, 2009

Well, I Passed . . .

It's been a long and rough week. And I'm finally glad it's (almost) over.

5 exams this week. It's been a long time since I've had to study so hardcore for exams; usually, my exams have been spaced just far enough to have at least half a day to breathe in between exams. But this week, this week was a constant onslaught. Compound that on top of the fact that this is the hardest block in all subjects ("head and neck" for human development (devo) and anatomy, and a TON of info in biochem).

I didn't sleep much before my exams on Wednesday, maybe 5 hours. I also didn't sleep much last night; I spontaneously woke up after maybe about 5 hours of sleep with biochem racing in my head. It was still dark outside. Ugh. At least I passed all my exams . . . barely. If I had gotten one more question wrong here or there, the scary "Low Pass" lady may have had to hunt me down and that wouldn't be pleasant.

I won't bore you with the minutia (because that's what I was tested on), but for the life of me I could not remember the pterygopalantine fossa and what went through it. It's seriously the "black box" of head and neck anatomy for me - I was more or less fine on everything else. And despite being able to recall all the biochemical pathways and having what I felt was a decent understanding of it, I apparently did worse than I'd like. 3 more weeks until the next block exams. At least it's rumored to be the easiest block - so hopefully I'll do A LOT better.

I had a moment while studying this week - a moment where I wished I had just finished my MPH and gone on with a career in public health, a moment where I wished I was still in undergrad or even grad school. Still toying with finishing my MPH though (in addition to my MD), but I'll have to figure that out in due time.

Now I have to go tidy up the apartment a bit before people arrive - it's a mess. My roommate convinced friends to come over to our apartment to play some poker. I keep forgetting how to play that game. :-/

And tomorrow, I have to wake up early-ish to go volunteer at the free clinic as a "patient educator." That should be interesting but I really wanted to sleep in. And I kind of look like an Asian hobo right now. As they say, "C'est la vie."

Friday, October 9, 2009


Hmm, no one got or seemed to have noticed my reference in the title of my last post. I'm not too surprised; you'd have to be pretty geeky to figure it out. :-P

Anyway, I'm feeling somewhat better today. The cold, gray, cloudy, rainy weather isn't helping any though. Apparently we're supposed to get a frost warning for Sunday morning as the temperature dips to about 28F. Wtf, I hate the Midwest. Must . . . get . . . into . . . residency . . . elsewhere . . .

This morning I went into the anatomy lab with my lab group around 11:30am. We were there until about 3pm. Medicine is an all-consuming field, and is rightly called the "jealous mistress." At the moment, in my current state, that's sort of a good thing. See, the all-consuming nature puts me into a kind of trance. While I'm focused, all that exists are my peers, me, and the body (or patient) before us. While I'm in the anatomy labs life outside is put on hold. I am where no cell phone can reach me, no internet can distract me, no personal emotions/woes can waver me. We all become dedicated with one goal: to identify as many structures as possible and to learn from each other (and other groups' cadavers). We found the elusive torus tubarius (which I still think would make an excellent sci-fi name for a planet) right above the Eustachian tubes, we located the hidden levator veli palatini, and saw the internal thoracic artery (which was easy to find once you know where to look). On one body we saw the glossopharyngeal nerve (cranial nerve IX), which hadn't been successfully dissected out on any other body. While we moved from body to body, our purpose was solitary and almost nothing disturbed our trance-like focus.

This doesn't mean, however, that we didn't have some fun while poking around inside bisected skulls that look no longer human - indeed, some look like zombie aliens that would readily maul your own living face off. We would often encounter some structure whose name would evade our memory. One person with the probe would poke at it, another with the anatomy book would look up the possibilities, and the rest of us would concur (literally saying, "I concur") or not.

The trance is almost absolute. The "outside" world doesn't rush back until I change out of my scrubs. But when it rushes back, it redoubles its force, and I am exhausted. It's an . . . unnerving sensation.
I got a ride back to my apartment from a lab mate, Leslie, because I didn't feel like walking 15 minutes in the drizzling cold. She asked me how the LGBTPM talk went, because she wasn't able to go though she wanted to. Apparently she's super-liberal and is hoping to transfer med schools (you can do that?!) to where her boyfriend is. She knows the dean of admissions at that other med school - who happens to be gay - because she worked for his partner at Planned Parenthood for a couple years.

She was shocked at how conservative our class and our med school was. As far as she could tell, there wasn't a single "out" person in our class. In the car ride back, she asked me if I knew anyone in the class who might be LGBT. *insert hesitant pause here* I responded, "Umm, yeah, me."

Did I just come out to her? Yes. Though I didn't use the words "bi" or "gay" (at the time), simply "I don't know what I am." It seems she has pretty good gaydar and thought I had been out back in undergrad but not here; she was mistaken with that, lol. While in PA, her best friend was so-called "King of the Gays" and she knew many many gay guys - hence her apparently really sensitive gaydar (if only I had that).

At this point we had arrived at my apartment. Upon stepping into my apartment, a sinking feeling overcame me. It was like confessing to a crime - how it gripped my chest. I laid on the couch for a while, napping lethargically. I then sent her an email asking her to keep what we talked about confidential between us - almost as if to absolve myself.

Her response later amused me. If only she were single, perhaps I'd consider my slight crush on her. But alas, the curse meant she of course had a boyfriend. I digressed, in there she assured me that my trust wasn't misplaced and that I should always feel comfortable confiding in her. Also, she offered to be my "wing-woman" should we ever go out to a gay bar/club or something. Fleetingly I felt like Ted Mosby with her as a female version of Barney Stinson (though she's more like Lily Aldrin in personality) from the show How I Met Your Mother, lol.

Oh yeah, the one remaining member of our lab group didn't come in to anatomy lab because she was busy shadowing the chief of surgery - scrubbing in and even assisting in a mastectomy (at least insofar as holding the retractors). Gunner. -_- Pfft, she doesn't even know the cranial nerves yet. Now I've got to get my game on.

It may be a while until I post again. Block 2 exams all next week. Joy. So not ready. T.T