I Have Return from Death

Okay, so I took my USMLE Step 1 exam last Thursday. It was a beast. 15-minute tutorial followed by 7 one-hour blocks of 46 questions and a 45-minute break that can be divided up however one wants. It was going alright until I encountered a heart sound question that required audio and . . . the audio on my computer didn't work. T.T That threw me for a loop. Good thing there was only 2 questions that required audio.

Overall I think I did alright. Hopefully, with some luck, I met my target of getting a score of 225+ (national average is usually between 220 and 223). There was a moment in the middle of the exam that I wondered whether or not I'd pass it, but apparently that's pretty much how most people feel coming out of that exam.

And with that, walking out of the exam dazed, I have returned from Death!
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On Saturday I met up with Drew for coffee. I had promised that I'd get him coffee for his birthday that was about a week earlier. We chatted for a few hours before heading back to his house. His mom and dad were home, which was just a tad awkward for me. We went down into his basement where he proceeded to show me all the music compositions he had written (most of them fragments of would-be melodies).

Then we listened to some classical music on YouTube while I gave him a back rub. For almost an hour. I didn't know that a person could get such knots in their back (I could clearly feel that his muscles had knotted up in ways it shouldn't)! This guy has clearly been under some stress and his boyfriend terribly sucks at giving back rubs.

Man, it sucks that I still like him in a way that's potentially more than just friends. And he's quite happy with his boyfriend, crappy back rubs notwithstanding, lol.
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I've been a bum for most of this week and it's great, haha. I had intended to do a bunch of things but I simply haven't gotten to them. Not sure if I will or not. Tomorrow I'm on my way to a friend's wedding in St. Louis. Going to drive down there with another friend. Hopefully everything goes smoothly!

Gender-free?

A person's sex is biological, primarily determined by XX or XY. A person's gender is largely a social construct, or what being of one sex or the other "means."

This may be old news, but it's interesting nonetheless. A couple in Canada decided to withhold their newborn's gender from the world and him/herself. The idea is to let the child discover his/her own gender and decide for him/herself. It's an interesting "experiment," to say the least, and one that has drawn a lot of controversy.

Personally, I think the child will be all right. S/he will figure out gender, as it's been shown that a child's concept of gender is innate and becomes cemented by the time they're 4 or so. A child "knows" if they're a girl or boy. But what does it "mean?" That can be challenged.

I'm not sure I agree with the way the parents are withholding the child's gender from the child and the world. I think they'd be better off treating the child in such away to avoid gendered stereotypes. Because, honestly, gender stereotypes (to me) seem to be getting less distinct and less important. But maybe that's just me. There's a related article on masculinity that's an interesting read.

---TANGENT---
On a completely different note, I came across this recently:


Oh to have a body half as good as that, lol. Yeah, it's totally unrealistic for the vast majority of us to ever have a body remotely like that. And I can accept that. Doesn't mean I/we can't try to get halfway there (which, honestly, is more than good enough). :-P

Btw, Chris Fawcett is HOT. It's mostly his eyes to me, and less his body.
---END TANGENT---

Homunculus of Touch

Argh. Been feeling kind of defeated lately with these frustrating qbank questions. Overall I'm improving somewhat, but my scores are erratic - they spike up and then plummet and then spike again. Anyway, after studying neurology for the better part of a day, I managed to pull off a 71% on a block of neuro questions! Not sure how that happened, as I generally consider neuro to be one of my weaker areas.

Somewhat related, one of the most interesting things I remembered learning while going through neuro was the somatosensory homunculus. You see, sensation is unevenly distributed throughout our bodies and our brains form a somatosensory homunculus of it on the pre-frontal cortex. It's rather interesting. So think, what are the most sensitive parts of your body? Now look at the distribution of the somatosensory cortex:

Does it match what you thought? You'll notice that the face and hands are far over-represented. The fingers, lips, and face are more sensitive than pretty much any other part of the body. Do you notice the genitals? Hint: it's by the feet. Interesting that it comprises such a small part of the homunculus. A drawing of the somatosensory homunculus would be like this:

So I find it kind of funny how we put so much focus and attention on the penis and genitals. Yeah, sure, it's pretty sensitive given its body surface area (more so than, say, the legs), but it pales in comparison to the hands, lips, and face. One would probably expected the homunculus to be more like this:

Lol, right? Well, apparently, some recent-ish studies kind of hint that the homunculus actually is a bit more like this last version (the things you find on Google, lol). In 2005, Kell et al. attempted to update the somatosensory homunculus for males - chiefly that genital sensation is not near the feet in the somatosensory cortex, but closer to where it'd be on the body. In 2007, Sorrells et al. reported that 5 of the most sensitive parts of the penis is removed during circumcision (so it's curious, and incorrect, that the homunculus above is circumcised).

Of course, one has to wonder, what about women? It's been presumed that the number of genital nerve endings in men and women are about equal; however, there just aren't that many such studies out there done on women. There are numbers floating around in the internet (with no source that I can pin down) stating that the glans clitoris (basically the entire clitoris) has about 8000 nerve endings, whereas the glans penis (head of the penis) has about 4000; presumably, the other 4000 nerve endings are distributed along the shaft. Furthermore, the foreskin has about 10,000 to 20,000 nerve endings (and the clitoral hood somewhere around there but perhaps a little less).

What does all this mean? Who knows. Everyone experiences sensation different anyhow. Sure, there are objective ways to test sensation: 2-point discrimination, temperature, fine touch, coarse touch, vibration, etc. And there are different nerves that sense different things (apparently the foreskin has a bunch of the kind that detect fine touch and vibration). But what it all "means" is another thing entirely. I mean, though the hands are sensitive, they're not particularly sensual, am I right?

Anywho, I'm rambling. I hope you were entertained and curiosity piqued. :-P

Like a Fiend

So . . . how're you all doing? It's been almost a month since I last blogged. o_O

Been a brutal month, of sorts. Finished finals (passed all my classes, phew!), took the weekend off (mostly), then began studying like a fiend for the behemoth known as Step 1 of the USMLE Board Exam.

I've been slowly pushing past the burnt out phase - that lasted about 4 days longer than I could really afford. As is, I study probably about 6-8 hours a day, on average. That's not enough. I need to get upwards of about 12 hours a day. The exam itself is 8 hours long. Ugh. Only 2.5 weeks away, eep! I must resist the urge to reschedule my exam for a later date.

Other than that, nothing special. Took a couple hours off from studying to celebrate my b-day with a few friends a couple days ago. Had teppanyaki for dinner at a Japanese restaurant. It was good. :-) Now, what do you think 9 med students talk about when they're all studying for the same beastly exam? The exam, of course. That dominated our conversations. Yeah.

---TANGENT---
On a completely unrelated note, I saw the following commercial on TV today:


I thought it was pretty sweet.
---END TANGENT---

You're Better Than Me

About a week ago, I had the following conversation with Michelle on gchat (slightly edited):

Michelle: Hey, I try to be open. But when I'm not good enough to talk to someone . . . I get really irritated.
Me: Awww. I never got that sense from her. Maybe I'm just oblivious, idk.
Michelle: No, you fit into a different class of people than me. This is most certainly not the first person I've experienced this response from in our class.
Me: Lol, what do you mean by that?
Michelle: You're better than me. I'm overweight, and I don't look like I have money . . . so I get relegated to a lower class. Plus a myriad of other factors. But I'm judged on the first two sooooo quickly.
Me: How am I better than you? And how do I not meet those criteria too?
Michelle: You're more peppy than me. More positive. People like you. I don't know anyone who doesn't like you.

I was rather taken aback by her statement. While it's true that I don't know of anyone who overtly dislikes me, I'm not exactly best buds and close friends with most people in our class either. I tend to hover outside near the fringes of most social circles. It's a rather weird place to be, tbh.

Maybe I am peppy, though I don't really feel it. I try to be positive, but sometimes that's difficult. In any case, I certainly feel no better than anyone else (and very much the opposite compared to some people I know). If only personality is everything, hehe.

---TANGENT---
1. I got an iPod Touch a few days ago. We need one for use in the hospitals and clinics (apparently). I had the option of getting an iPad but I turned it down. Before you shriek, here's why: it's bigger and less practical to carry around in the hospitals. True, it fits in my white coat, but it's just this big bulky thing that I don't want to have on me at all times (and we'd be required to use it and have it with us at more or less all times). So yeah, I've been fiddling around with this iPod for the past few days. I resisted for a while before getting the Grindr app. I still don't see what the big deal is about it . . . Anyway, any "must get" apps?

2. Landyn's back (sorta)! Go read his update on his blog, Stuck In The Middle.
---END TANGENT---

Will This Work?

So if you recall from like a year ago, things with Jay didn't work. In retrospect, that was probably for the best.

And while I met Drew a couple weeks ago, it looks like things won't work out with him either. Apparently he had gotten back together with his ex-bf - the same guy who brings him such great highs and such great lows (it's a rather bipolar relationship). Things were rocky and last week they've broken up, again. And within the last week, he's been dating this guy he seems to really like. They go to the same undergrad, so it's much easier for them to meet up than, say, with me. Oh well, I saw this coming. I'm not disappointed, per se, I'm happy for him. But man, I still can't quite get over him (which is odd, since we never really got it on to begin with). I think he's one of those people who can connect with almost anyone really easily.
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At the same time, a new guy started messaging me online a couple weeks ago. I'll call him Mel. He seems like a nice guy. Anywho, a few days ago we actually met up for a "date." I say "date" because he considered it a date, but it didn't quite feel like one to me (not that I'd really know).

While he goes to school about 45 minutes away, he had to stop by my area because there's an art store near here that he needed to get supplies from (he's a graphic design and animation student). So we met at a Barnes & Noble at the mall near me. He was wearing a black fedora and a black trench coat; eh, must not judge (but really, a trench coat?). We walked around the mall a bit, making small chat. He seemed nervous and shy. He had this habit of talking in small quick bursts in a low tone, kind of how my youngest brother talks sometimes.

After a few minutes, we went to a sushi place not too far away. It was pretty good, it had been a while since I'd had sushi. The place was pretty empty since it was still a bit early for dinner. We chatted some more. I felt like I had to initiate a few times and be more upbeat, because he seemed somewhat monotone. Once we finished, we went back to the mall to mill about for a bit before saying goodbye.

I don't know. I just didn't feel like we really connected. I mean, we could be good friends but I'm not sure if it'll go any further. There was an odd disconnect in person that I didn't quite feel when chatting online.
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What am I looking for in a person? What am I looking for in myself? Will this work?

I suppose I have more important things to attend to; that is, working out (I've been pretty slack on P90X and it's showing, ugh) and studying for finals and my Step 1 exam in June (I'm less than 60 days away, eep!!). Tick tick tick . . .

Leave Your Mark

Afterburn by `creativ82 on deviantART

It always amazes me how some people can have such an impact on others.

A couple weeks ago I attended a dinner event to which I invited Dr. H and his team to be some of the speakers. He's just as inspiring to me as always. I asked (innocently) the panel about how we as medical providers may help patients adhere to various treatment regimens. At that, the neurosurgeon present called me naive, how we can't change people's behaviors, and how we have to meet patients where they are. Instantly Dr. H took over and agreed that we needed to meet patients where they are. Some patients aren't ready to adhere to a treatment regimen, but what we must do is to help them prepare for the day that they are ready. It's more important that they see us and stay "plugged in" to the health system than to demand them to take their drugs.

I also attended a lunch talk by an MD/MBA about his journey in getting a dual-degree. I love hearing docs with dual-degrees speak because it usually tends to reinvigorate my desire to finish my MPH (which I still fully intend on doing).
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A few days ago I attended the state medical society's annual meeting in the state capital. At this meeting, resolutions are debated, recommendations are made, and then resolutions are voted on. We, the medical students, have made some great changes to the state medical society's policies on a variety of things.

One student put forth an anti-bullying policy that explicitly states the position to oppose bullying in all its forms (including against LGBTQ individuals), and to encourage and support school anti-bullying training programs for students, parents, teachers, counselors, coaches, etc. The specific inclusion of the LGBTQ wording caught some controversy from a few physicians, as they felt it detracted from the "oppose bullying in all its forms." On the floor of the House of Delegates, there were some amazing testimonies from students and physicians in support of keeping the language. One physician (a plastic surgeon) stated that LGBTQ must be included in the resolution as is because, unfortunately, many people still don't see bullying against that population as a legitimate issue. And a med student said that, while LGBTQ students are bullied about as much as any other student, the severity of the bullying may be worse. In the end, the resolution was adopted.

My resolution was adopted without opposition (which is rather rare). I "merely" reworded the hospital non-discrimination policy to include: sex, gender identity, sexual orientation, race, ethnicity, religious beliefs, and disability. The original wording only included class, means, age, and gender. While this resolution may seem like a minor thing, it's really quite significant. With this, it means that every hospital in the state must be that much more inclusive in their non-discrimination policy.

There were other resolutions that we fought for. In retrospect, words can't quite convey the importance of what we were able to accomplish. To be able to, as a med student, change the state medical society's policy and stance on things is pretty impressive.

Change is possible. We are leaving our mark.