super_blaze sent me this one & it's too good not to share (although, to be honest, it has little to do with medical school!). apparently an artist in sao paulo decided to make a statement against the city's extreme pollution by "erasing" the dirt and grime in city tunnels to create his art. the full story can be found here. but the video which follows sums it up best. enjoy!
there's only one way to describe what the last few days before a pbl exam are like. this site sums it up nicely:
mwms is one of several "new" branch campus medical schools that are popping up around the country. basically, this means that a medical school (usually in another state), builds a campus in another location. the branch campuses pretty much run themselves (i.e. have a separate faculty, student body, admissions process, etc.). so why do these campuses exist? because it's easier to open a branch of an existing school than it is to create a new school from scratch, thanks to the complexity of licensing and accreditation laws. basically, this means that mwms's "campus" is really only consists of a shiny new building. for now, the clinics, hospitals, & affiliated stuff are all located elsewhere.
this also means that the community in which mwms is located has no idea that it has a medical school in its midst. or, at least, they didn't know at the beginning, when the school opened. apparently, that lady they pay the big bucks to come into our classes and take pictures of us is supposed to have gotten the word out that we exist and are here to help the community. (r-i-g-h-t....) mwms should be known by everyone around here, given that the area is not yet very large and that the school has been placing all sorts of ads everywhere, right?
ah, but then we have experiences like these:
recently, a classmate of mine was talking to one of his neighbors.
the neighbor asked "where do you go to medical school? i didn't know there were any medical schools around here."
"oh, i go to mwms," my classmate replied, "you know, in the building next door to the ymca?" "you mean you go to school in the fbi building?!?!?!"
*headdesk*
This post makes me want to go out shirtless, just to see what would happen. Would I get arrested in this country (i.e. the U.S.) if I went out without a shirt? How come women in Europe and other parts of the world don't have to cover their breasts in public, but we do? Why is a breast, in any form, perceived as obscene? Does "the public" not realize that the difference between a man's breasts and a woman's amounts to some adipose (i.e. fat) tissue and developed ducts and glands? Or that breast milk is technically classified as a kind of mucus secretion?
It's just a breast people! Yes, i said it: breast. Maybe I should shout it: B-R-E-A-S-T.
And now for the point: to all those who have issues with seeing breasts, whether on a billboard, a magazine cover, a nursing mom, or on the street, or wherever, I say: GET OVER IT!
Seriously!
But I'm guessing that the people who have a problem with it are probably not reading my blog. *sigh* So what are we to do? How do we educate/liberate people? How do we get the advertisements and messages portraying women as mere sex objects to stop? Why do we buy products that are advertised like this? How come the conservative rhetoric seems to overpower the liberal voice these days?
my mom forwarded an email to me about the recent appointment of Susan Orr, PhD, to head the Federal Family Planning programs at the Department of Health and Human Services. the message was rather tantalizingly incendiary, and while my personal beliefs meshed with their assertions, i was curious to know whether the piece was slanted. so, thanks to Google, i did a little research.
the liberal slant on this appointment is that it's yet another huge step backwards for women's reproductive rights because Dr. Orr proposed elimination of contraception coverage for federal workers' insurance plans. the conservative slant is that it's a positive movement toward affording a greater amount of choice to individuals, particularly in the form of what components of health insurance coverage they choose to elect.
but what does this office of Federal Family Planning do, exactly? i wondered. so i looked them up. after a bit of digging, i discovered that title x is the main "to do" of this governmental unit. given this, theoretically, their mission is the following:
Program Priorities
1. Assuring ongoing high quality family planning and related preventive health services that will improve the overall health of individuals;
2. Assuring access to a broad range of acceptable and effective family planning methods and related preventive health services that include natural family planning methods, infertility services, and services for adolescents; highly effective contraceptive methods; breast and cervical cancer screening and prevention that corresponds with nationally recognized standards of care; STD and HIV prevention education, counseling, and testing; extramarital abstinence education and counseling; and other preventive health services. The broad range of services does not include abortion as a method of family planning;
3. Encouraging participation of families, parents, and/or other adults acting in the role of parents in the decision of minors to seek family planning services, including activities that promote positive family relationships;
4. Improving the health of individuals and communities by partnering with community-based organizations (CBOs), faith-based organizations (FBOs), and other public health providers that work with vulnerable or at-risk populations;
5. Promoting individual and community health by emphasizing family planning andrelated preventive health services for hard-to-reach populations, such as uninsured or under-insured individuals, males, persons with limited English proficiency, adolescents, and other vulnerable or at-risk populations.
None of the funds appropriated in this Act may be made available to any entity under title X of the Public Health Service Act unless the applicant for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides counseling to minors on how to resist attempts to coerce minors into engaging in sexual activitiesUm, is it just me, or does that sound like any applicable program has to teach abstinence and take away the rights of minors in order to be funded? *sigh*
i interrupt this day of testing to bring you the latest news from mwms. <--yup, it's that interesting that i feel the need to share now, even though i should be memorizing more "road-kill" slides for my practical at 1pm.* mwms is relatively new, and one of the things it's known for is its plethora of security cameras. seriously--there are security cameras everywhere, except the cadaver lab (for hippa reasons) and the restrooms. we also have to badge-swipe in and out of the building. this would all be par for the course if the school were located in the heart of some major metropolis like most schools. but, i kid you not, the only thing near the school is a field of cows. that, and the ymca & red cross. but i don't think any of those entities are dangerous enough to warrant the levels of security present. sure, it's nice to be able to leave my laptop in a study room for a while and not have to worry about it being stolen. but i think it would be that way even if we didn't have cameras everywhere. the school is just not that big. so....the secretary had emailed us on friday to remind us of the time our test was to begin (as if we'd forget...) and told us that cell phones would not be allowed in the lecture hall during the exam (duh). we had the written portion of our exam this morning. in the beginning, things went as usual...they let us into the room, we all found seats, we began bubbling those damn scantrons (someone should create a stamp or a barcode sticker or something so that i don't have to keep bubbling in my name, dammit!), etc. in the midst of this, the head anatomy instructor gave general instructions; you know, the usual: there are this many pages, don't forget to erase completely if you change an answer, use a #2 pencil or the world will come to an end, etc. but here was the kicker: he then announced that only one person at a time would be allowed to use the restroom during the exam. fair enough, right? oh, but it gets better.... everyone who needed to use the restroom during the exam had to be *chaperoned.* the chaperone would stand by the sinks in the restroom and give each person a total of 2 minutes max to do their business. i'm not kidding. i couldn't make this stuff up if i tried. now, i don't know about you, but i'm the kind of person that likes to use the bathroom in private. i have nothing against bodily processes--they don't bother me one bit and i'm not ashamed of them--but my sphincters have a different attitude. there are times in the past where i've had to take a drug test for a new job and it's taken me like 15 minutes to pee because i was being "watched." my sphincters don't like to be watched. they don't like to be heard, either, for that matter. so i'm really grateful that i didn't have to use the restroom during the exam because i think it would've been a huge problem. i'm surprised they didn't say we'd have to leave the stall doors open! and i feel for the guys--i've never understood how men manage to pee at urinals given how public they are--but can you imagine trying to pee knowing that your anatomy professor is staring at your parts? couldn't that be construed as sexual harassment or something? it just seems...ridiculous. as you can see, just about the time i start to feel like i'm not giving mwms enough credit for the things they do well, they pull stunts like this. i'm not in medical school, i'm in prison. and the guards are paranoid.
*gulp*
----
* I call our practical slides of gross dissections road-kill because that's what they look like to me--road-kill. some of them, particularly in this section (head/neck), are downright indecipherable unless we're given some point of orientation. which we're often not....
i'm happy to report that, thanks in no small part to many of you, the mwms group raised over $1400 for breast cancer today! :-) the photos tell all....
the multitude of walkers
mwms students making strides!
the group pose
i want to give a big public thank you to the world's best realtor for sponsoring mwms's breast cancer walk! her donation not only helped us reach our goal, it put us over the top! i continue to be stunned by her generosity--who knew that in buying a home, you could also gain a wonderful, supportive friend? :-)
i have much to add to my blog this month about breast cancer--particularly about a new screening device that's just come on the market that's sure to help our efforts at early detection--but i really ought to go study now. i have to keep reminding myself that i won't be able to help anyone with any medical problems unless i get through medical school.
in the meantime, use the internet for good & educate yourself about breast cancer. and don't forget: guys, you're at risk, too!
...is a death trap for medical students.
i signed up to participate in mwms's breast cancer walk this weekend (see sidebar) & sent an email to some friends to ask if they'd help support us, as we were only 13% from our goal last night. one of my friends sent a message back to me, asking me to join her "facebook community." i'd heard about facebook, but never really looked at it.
that is, until today.
all i can say is: holy time-sucking vortex!
i've decided i like the internet a little too much. maybe more than too much. it fascinates me. i'm always finding new things here--new people, new places, new news, new stuff.... and it all keeps getting in the way of what i'm supposed to be doing, which is *studying medicine,* not studying the links to long-lost friend of a long-lost friend and oohing over pictures of their babies/cats/dogs/houses/etc. just when i thought i'd beaten the urge-to-check-email-every-5-seconds beast and had turned off all the chat features on my computer, what happens? i find something else to distract me!
so, it's official and i need to say it: hello, my name is student doctor blaze, and i'm an internetaholic. need i say more?
i'm now 6 days away from my anatomy final and have realized that every moment up to the exam will be excruciating no matter what i do.
i have so much that i want to say here--so many things to write about--but, with the impending exam & all it entails, i can't take the time right now to post about any of it. i promise you, though, there will be some interesting posts making their appearance after the 15th.
in the meantime, i'll leave you with a photo i took this morning (using my macbook pro, which, unfortunately, doesn't have a flash) during our osteopathic principles & practices lecture. we had a guest lecturer and even our regular professor fell asleep! (<--too bad i didn't catch a shot of him sleeping!)
the day was redeemed by an excellent lecture given my mrs_dr_do this afternoon on taking a social & sexual history--so at least i've learned something useful during all my hours of sitting in the lecture hall. overall, though, this picture nicely sums up the energy level/morale on campus....
well, i've made it through part one of the exam. it took me 3 hours to complete the written exam of 150 questions. i probably would've stayed longer and re-checked everything (the professors, i kid you not, misnumbered the exam, causing mass panic among the students. we had two #4s and no #71. fun!), but we've got the practical this afternoon, so i figured that rather than perseverate, i'd come home and review my labs.
the written was actually not as bad as i feared. it would've been as bad as the rest of the exams, except i finally got a bit of advice before this test that seemed to really help. i met with one of my pbl-mates from last year on wednesday, and he explained to me how he studies for one of these exams. he said that it's all about relationships--that i need to be able to take the 2D slide and translate it into 3D, because they'd be asking questions that are relational. maybe it sounds obvious to everyone else, but it dawned on me, in talking to him, that this business of "memorizing the lecture slides" doesn't help if i can't picture, in 3D, how the structures go together.
(aside: i guess i should mention that we're working on prosected cadavers. i'm beginning to think that perhaps this isn't such a good way to learn. staring at a cadaver isn't a heck of a lot different than staring at rohen's, you know?)
so this weekend i spent a considerable amount of time going through the cross sections in netter's atlas. i tried to view each picture and really *see* where things were. not only was it more fun to study it that way, but i started to feel like i had some direction to my study for a change.
i'll probably miss all the minutiae questions on the exam, because i didn't spend time memorizing little facts this time, but i'm hoping it doesn't matter too much. an overall understanding of the big picture will help me more in the long run...i think....
at any rate, it'll be interesting to see if my study changes made any difference.
as for the exercise some of you mentioned, i've been feeling a bit stymied lately. we're in our late summer weather pattern where i live, which means that the days are brutally hot and the evenings consist of a deluge of thunderstorms. it hasn't let up long enough for me to get on my bike, and it is starting to bug me. i need some exercise and some time outdoors. i snuck away last weekend to study in a quiet place with no interruptions--fortunately this place is on the beach, so i did get to swim in between my study sessions. <--that was really nice. i guess this is all to say that i'm waiting for a break in the weather. i'd ordinarily ride during a rainstorm (i don't melt when i get wet), but i currently live in one of those areas that's known as lightning capital of the world. seriously. so i figure i'll leave the golfers to get struck and keep my butt indoors. at least, for now. but i may go join the ymca. i'm not as into gym exercise, but something is better than nothing....
speaking of exercise--another side note--my brother completed another triathlon yesterday! he came in 5th overall in his age/gender bracket (39th overall out of a total of nearly 1,000 participants!)--for someone who has only been doing this for about 10 months, his abilities are incredible. he acts like it's nothing, but--damn--he's not far behind the times of the professional racers! it's amazing!
alas, i best get back to my mental triathlon. onward!
my. brain. is. full.
seriously--i'm at that point in my studies where all i want to do is shake stuff out of my head like a dog shakes water off its back. i've been studying at home, alone, all day. haven't showered or eaten much, although i did manage to do some chores, just because i can only sit still for so long before my body starts screaming for movement. it's day two of non-stop studying and i'm exhausted. so exhausted, in fact, that i slept through two alarms, the telephone, and my roommate leaving this morning. agh! it really is insane, this process, on so many levels....
so what, you might ask, have i been stuffing into my head?
20 lectures at an average of 60 slides per lecture; 18 labs at an average of 40 slides per lab...so that's about 2,000 slides for the exam.
the material covers about 2/3rds of the anatomy textbook (Gray's) and 1/3rd of the histology text.
it was all covered in three weeks.
the whole thorax, abdomen, pelvis, & perineum, plus their histological components.
i may have mentioned this already. i think i keep repeating it so that i don't forget and answer some question with, well, innervation of the little toe by accident (gotta love digiti minimi!).
my brain is particularly fried at the moment, i think, because i've been reviewing cross-sectional anatomy. on the advice of a tutor, i'm attempting to get myself more grounded in what is where and answer questions based upon logic off of that rather than memorizing. i don't know if it will work--i usually leave these tests wishing i could have memorized every last word on every page of every slide. but it's impossible. it does make more sense to truly learn it--to get a sense of being able to see the anatomy in one's mind--but it's more difficult to do than i ever imagined. those diagrams we see everywhere of the human body? yeah, not so accurate. i feel like i have to erase all my prior knowledge and start over. <--i'm still cleaning! ;-)
anyway...i'm sitting here thinking that this is sort of a pointless post...but again, i want to capture this experience of medical school with as much truth & honesty as i can.
the truth of the moment: i'm exhausted & my brain is full.
*thunk*
'nuff said.
i do exist. i know this because of the amount of angst i'm currently experiencing re: my upcoming anatomy exam. no one else knows i exist because this anatomy exam keeps me from doing everything else. seriously. i went to the grocery store tonite for the first time in weeks and everything had been rearranged. i mean, whole isles. clearly, i'm not getting out much. nor have i been able to reply to emails, much to the dismay of many people.
i'd blame my lack of communication on myself, as i usually do, but i'm at the point where i'm so fed up with mwms that i've decided it's their turn to get the blame. so, yeah, i haven't returned phone calls, emails, snail mail, answered the door, or, on occassion, even a question posed directly to me. scary, i know. but this is what happens when you find yourself in a medical school that decides it's "special" and wants to do things differently from every other school.
evidence of this difference? our anatomy class. one of my pbl group mates reported today that he'd recently spoken to a friend who is a first year student at another medical school. the student asked him how many questions were going to be on our upcoming exam. "225," he replied. "wtf?!?!?" was reportedly his friend's response. apparently at other medical schools, they have a test every other week with about 50 questions per test. it's unheard of to wait 4 weeks to slap students with an exam, such that it covers all of the thorax, abdomen, pelvis, & perineum. and not just gross anatomy, oh no--we also have to know all the microanatomy (i.e. histology) of these structures, too. not to mention that our professors seem to be a bit confused. they keep adding in details that i could swear belong to the genre of physiology, not anatomy. but do they care? nope. still have to know the whole hormonal cycle in women for this exam. fun.
i guess this is all to say that i'm feeling a tad unmoored. i'm doing wonderfully in my other classes, but this one...it's kicking my ass, again. i fear i may be banging my head against a brick wall. <--so, truly, i'm still alive. wouldn't go so far as to say well (roommie gave me the stomach bug on top of everything else this week), but i'm surviving.
since i can't say much more (i'm already past my time limit for puttering on the computer), i'll leave you with an interesting clip. one of my classmates somehow recorded the power point presentation given by one of our professors last week. during this presentation, this professor--i've spoken of him before; he's dean_honey--starts flipping through slides and sort of murmuring to himself. then it happens. the it? well, you'll just have to watch/listen to the movie to find out. i couldn't make this stuff up if i tried.... enjoy! (btw--it's nsfw, just so you know....)
i'd heard the audio for this before, but the video is even better. a little humor about anatomy lab. enjoy!
practical exams are par for the course in medical school. in any given semester, between opp class and ce class, we have at least a half dozen of such exams. they involve being tested, live, in the presence of a professor, on one technique or another.
today we had our first opp practical exam. it wasn't a big deal--the information at the beginning is basic (e.g. identify these landmarks) and the techniques (basically massage-type) are also relatively straightforward (aside from their names, of course).
i wasn't particularly concerned about this practical--i've been through them before, and i happen to know for a fact that this will be, by far, the easiest one in medical school. i'd also planned to pair up with one of the guys in my advising group, who happens to be laid-back and kind.
aside from having a little difficulty at first understanding the question posed to me at the first station, i got through the techniques part without incident. then i went to the second station, where we were supposed to point out "landmarks" on one another.
one such landmark i was asked to identify on my classmate was the pubic symphysis:
No problem, right? it's an easy enough bone to find...but when someone is lying down on a table & you have to find it, you have to find a way to slide your hand down the abdomen and onto the bone without, well, staring at their crotch. when i'm trying to palpate something, i often look elsewhere or close my eyes, simply so that i can focus on what i'm feeling rather than what i'm seeing.
only, yeah...it kind of backfired on me today, as i veered a little too far left. oops. it's a good thing my lab partner was a good sport about it, but my goodness, did i feel like a goofball! i guess it's better to risk having someone think that you're staring at their crotch rather than accidentally grabbing it..... *cringe*
never a dull moment!
Tonight I went to meet one of my former classmates (in the '10 bunch) for tutoring at a local St@rbucks. I got there early, so I decided to indulge in my favorite shaken-iced-tea-lemonade drink, since it was almost 7pm and I was in dire need of some caffeine (nope, i'm not a coffee drinker--strange, i know).
I went to the register, where some lady took my order. While she was getting it, one of those little pimply high school guys in training behind the counter commented on my t-shirt. I've been having a rough time in my anatomy class lately, so after school today, I changed into one of my most-loved-for-bad-days t-shirts from think geek. :-)
Said guy, since I had his acknowledged his presence by saying thank you, decided it was time to engage in some small talk. Looking down at the bag parked beside me, he said, "oh are you going somewhere?" I looked at him, puzzled. "Where are you going on your trip," he asked me. I must have raised my eyebrow at this point, because he pointed at my bag and remarked, "the luggage?"
Uh, yeah... That bag on wheels? That's not luggage. It's my bookbag! All 50 lbs of it!!!!
Note to self: what looks ordinary on campus appears downright nerdy off-campus.
Trip...I wish! ;-)
i interrupt my study time this morning to share a positively frightening story brought to us directly from the NYT. i think i mentioned previously that i haven't been following politics lately--i can't really remember the last time i watched the news or read a newspaper--but when i read this article and clicked on the links to the "videos," i was drop-jaw speechless. has politics come to this? have we deteriorated to rap debates between "obama girl" and "guliani girl"? is this the only way the media thinks it can capture the attention of the american people? and, my goodness, after all the chatter about conservativism over the past several years, should i consider it a good thing that this stuff hasn't been pulled off the net? when i wished for a more liberal discourse and debate in this country, i was thinking west wing, not mtv music video. i guess next time i wish for something, i should be more specific!
interested in sharing my shock? (for full effect, make sure to click the links to the two prior articles & videos contained therein.) here's the link:
Net Watch: Obama Girls New Crush - The Caucus - Politics - New York Times Blog
click away. but don't say i didn't warn you....
it's a fact: 99.9% of medical students depend upon federal funding from the U.S. government in order to pay for medical school and its associated costs (i.e. FOOD), while in school. the funding is not guaranteed--there are many, many hoops to jump through (read: 10,000 or so forms to fill out and sign) before a student can get such funding. if we do get student loans, we're considered "lucky." our interest rate on our student loans from the government is currently capped at 8%, as opposed to the uncapped rates, some upwards of 22%, on private loans. nevertheless, it goes without saying that if the government lends an average of $200,000.00 at 8% interest to almost every medical student (~4,000 nationwide?) in the country during his or her tenure in medical school, they end up earning quite a lot of money off of us. add to this the amount the government discounts our services once we do go into practice and one starts to wonder: is the government screwing over its healthcare providers? i'll leave you to chew on the answer to that one....
(aside: too bad michael moore left the education part out of "sicko"...it's another way that the U.S. is lagging behind the rest of the world with respect to health care.)
in the meantime, i'm here to report that the hoops have just become more numerous. why? because some idiot, somewhere in Washington D.C., decided that all institutions receiving federal funding must celebrate--are you ready for this?--CONSTITUTION DAY. [have any of you even heard of constitution day? did you know that it's tomorrow? sorry, no, you don't get the day off from work. not even if you're the postman.] as such, schools that funnel federal funding to their students--including medical schools--must hold activities to celebrate constitution day. i kid you not. we're talking lectures, people. videos. presentations by politicians. and attendance, as i've been informed, is MANDATORY.
apparently, this is simply one of the latest actions taken by the department of education, which is now diving wholeheartedly into its misdirected "no child left behind" and "american competitiveness initiative" programs. what i want to know is: how do they think they're helping medical students by forcing them to take time out of their studies to attend lectures on the constitution? (is it not bad enough that we only have, oh, a week to cover the anatomy of the abdomen? how about cutting that down to an hour? it's not like we need to know about the abdomen or anything....) do they not realize that the majority of medical students likely have better knowledge of the constitution than most politicians serving in government? (i'd dare them to test our knowledge versus W's, but it'd take them too long to decide on a color scheme for the scantron to actually give us the test before he's out of office....) do they actually think that we want to celebrate constitution day when we realize that (among other things) it does nothing to ensure healthcare for all citizens?
we'd be better off having lectures on how to understand medicare or medicaid or governmental policies on healthcare. but that would mean that the government would have to produce clear directives on such matters and be honest about them. not to mention, they'd have to acknowledge that many of the government's policies on healthcare go against one of the primary tenets of the constitution: to promote the general welfare of its citizens.
yes, let's celebrate the constitution--but, shh, don't let anyone point out what that really means.
time spent...
studying outside of class: 39.5 h
taking an exam: 4 h
getting "ripped a new one" by the deans: 15 minutes
felt like...
studying: 23 h/d
taking exam: endless
meeting with the deans: an hellish eternity
overall?
moments when i temporarily forgot where i was: priceless.
for everything else, there was xanax....
one of super_blaze's photos, via the AP, was published on the front page of the NYT sports section this week. how cool is that?!?!? check it out!
the head anatomy instructor came in before the thoracic lecture this morning and mentioned that there had been a lot of coughing during the practical exam yesterday. this coughing, he said, corresponded to the answers on the test. Morse code coughing, he called it. he said that if he caught anybody cheating he'd ensure that that person never practiced medicine.
i feel a bit dumbfounded by this news. i didn't hear any coughing. then again, we were split into two groups--one group in each lecture hall. so perhaps whatever he noticed was happening in the other room. but more to the point: what kind of idiot cheats in medical school?
then again, this class is a lot younger than last year's. [<--one of the downsides to a school getting older/becoming recognized is that the applicant pool shifts; more and more of those straight-A right out of college 21 year-olds end up in these seats versus those of us who were "old pre-meds" struggling to do things like work or raise children while taking classes and might not look as good on paper as a result.] the class is academically/paper smarter, but socially? well...the group is a bit lacking. i'm not saying these students are undeserving of being here. they've worked hard, too. but many of them still have that work hard party hard attitude that they've carried over from undergrad. they haven't had the immaturity beaten out of them by a job, family, grad school, etc. they still think it's cool to go out and get drunk after an exam.
[interior monologue: *ugh* get over it already!]
so i guess, given this sometimes immature attitude, i shouldn't be shocked at the notion that there are students who are cheating--but, goodness, you'd think they'd know better. it's not merely an incredibly bad idea. it's also something that took them time to cook up. time they could've spent learning the material straight up.
stupid students.
Heard in the lecture on the thoracic wall & lungs this morning:
“Breast cancer doesn’t kill people. So you lose your breast, so what? It’s metastasis to [other areas] that proves fatal. [….] What’s the matter? Why is everyone looking at me like I’m crazy?”
Oh. My. G-d.
I wish I had the balls to respond with: “What if you get penile cancer? So you lose your penis, so what?” Maybe then he would get the point.
Maybe.
We’re not looking at you like this because you’re crazy, Professor. We’re looking at you like this because we cannot believe you’re that ignorant. All those years of cadavers & formaldehyde have clearly affected your ability to remember that anatomy is about people.
*headdesk*
my father has spent many, many years trying to get me to join the family business. needless to say, i've stubbornly continued to pursue this whole medical school thing rather than taking up his offer to become "president of the eastern seaboard," as he likes to say. ;-)
while looking for a few good jpgs to throw in amongst my weekly milage, i found the following. this one's for you, dad!
time spent...
in class or lab (no dumb orientation presentations this week! yea!): 18 h
studying anatomy: 41 h
studying opp or ce: 0 h
buying organic veggies i haven't had time to cook: 2 h
taking biddle to the vet: 1 hr
experiencing anxiety about the upcoming anatomy exam: 24-7
one more moment of distraction before i dive back in to Gray's: my blog has reached 1,000 hits! wow! i'm stunned that people have come to read what i have to say that many times. i haven't even had time to post about the interesting stuff yet!!!! ;-)
thank you for reading! more 411 to come soon....
i'm nauseated. and not in that physical i-can-go-take-my-zofran-to-fix-it way. i'm psychologically nauseated.
the second anatomy exam is on monday. <--this is the main reason for my present distress. while the first exam covered 2 weeks of material and was worth 10% of our grade (the anatomy professors dubbed it the "welcome to medical school" exam), the second exam covers everything we've learned over the past 4 weeks (i.e. all the way back to day 1) and is worth 30% of our grade. needless to say, i'm anxious! (as are the other 160+ people in my class...but maybe that goes without saying!)
i'm having an exceptionally difficult time focusing. it's amazing what can capture my attention when i'm supposed to be focused on anatomy. i knew i was getting truly neurotic on thursday when i found myself cleaning out the litterbox. i *hate* cleaning the litterbox. yet, there i was, hosing it down in the front yard. <--yeah, i wasn't just replacing the litter...i was *scrubbing* the damn thing. in the meantime, my roommate was upstairs scrubbing the dishes. i guess this kind of anxious neurosis is contagious. although, when i said that to her, she said, "dead tissue is contagious?" oh boy. that's neurosis, not necrosis! (<--thank god!)
anyway...i shouldn't be spending time posting right now. rather, i should be learning everything about the back, arms, & legs. but i couldn't help but take a moment to share the little discussed nasty underbelly of medical school: psychological nausea. i ought to come up with an icd-9 code for that one...after the test, that is. ;-)
by now, i'm sure you're aware that i love animals, particularly cats. my mom (thanks mom!) sent me an article last week that summarized a publication in the new england journal of medicine. i felt i should share. enjoy!
--
Oscar the Cat awakens from his nap, opening a single eye to survey his kingdom. From atop the desk in the doctor's charting area, the cat peers down the two wings of the nursing home's advanced dementia unit. All quiet on the western and eastern fronts. Slowly, he rises and extravagantly stretches his 2-year-old frame, first backward and then forward. He sits up and considers his next move.
In the distance, a resident approaches. It is Mrs. P., who has been living on the dementia unit's third floor for 3 years now. She has long forgotten her family, even though they visit her almost daily. Moderately disheveled after eating her lunch, half of which she now wears on her shirt, Mrs. P. is taking one of her many aimless strolls to nowhere. She glides toward Oscar, pushing her walker and muttering to herself with complete disregard for her surroundings. Perturbed, Oscar watches her carefully and, as she walks by, lets out a gentle hiss, a rattlesnake-like warning that says "leave me alone." She passes him without a glance and continues down the hallway. Oscar is relieved. It is not yet Mrs. P.'s time, and he wants nothing to do with her.
Oscar jumps down off the desk, relieved to be once more alone and in control of his domain. He takes a few moments to drink from his water bowl and grab a quick bite. Satisfied, he enjoys another stretch and sets out on his rounds. Oscar decides to head down the west wing first, along the way sidestepping Mr. S., who is slumped over on a couch in the hallway. With lips slightly pursed, he snores peacefully — perhaps blissfully unaware of where he is now living. Oscar continues down the hallway until he reaches its end and Room 310. The door is closed, so Oscar sits and waits. He has important business here.
Twenty-five minutes later, the door finally opens, and out walks a nurse's aide carrying dirty linens. "Hello, Oscar," she says. "Are you going inside?" Oscar lets her pass, then makes his way into the room, where there are two people. Lying in a corner bed and facing the wall, Mrs. T. is asleep in a fetal position. Her body is thin and wasted from the breast cancer that has been eating away at her organs. She is mildly jaundiced and has not spoken in several days. Sitting next to her is her daughter, who glances up from her novel to warmly greet the visitor. "Hello, Oscar. How are you today?"
Oscar takes no notice of the woman and leaps up onto the bed. He surveys Mrs. T. She is clearly in the terminal phase of illness, and her breathing is labored. Oscar's examination is interrupted by a nurse, who walks in to ask the daughter whether Mrs. T. is uncomfortable and needs more morphine. The daughter shakes her head, and the nurse retreats. Oscar returns to his work. He sniffs the air, gives Mrs. T. one final look, then jumps off the bed and quickly leaves the room. Not today.
Making his way back up the hallway, Oscar arrives at Room 313. The door is open, and he proceeds inside. Mrs. K. is resting peacefully in her bed, her breathing steady but shallow. She is surrounded by photographs of her grandchildren and one from her wedding day. Despite these keepsakes, she is alone. Oscar jumps onto her bed and again sniffs the air. He pauses to consider the situation, and then turns around twice before curling up beside Mrs. K.
One hour passes. Oscar waits. A nurse walks into the room to check on her patient. She pauses to note Oscar's presence. Concerned, she hurriedly leaves the room and returns to her desk. She grabs Mrs. K.'s chart off the medical-records rack and begins to make phone calls.
Within a half hour the family starts to arrive. Chairs are brought into the room, where the relatives begin their vigil. The priest is called to deliver last rites. And still, Oscar has not budged, instead purring and gently nuzzling Mrs. K. A young grandson asks his mother, "What is the cat doing here?" The mother, fighting back tears, tells him, "He is here to help Grandma get to heaven." Thirty minutes later, Mrs. K. takes her last earthly breath. With this, Oscar sits up, looks around, then departs the room so quietly that the grieving family barely notices.
On his way back to the charting area, Oscar passes a plaque mounted on the wall. On it is engraved a commendation from a local hospice agency: "For his compassionate hospice care, this plaque is awarded to Oscar the Cat." Oscar takes a quick drink of water and returns to his desk to curl up for a long rest. His day's work is done. There will be no more deaths today, not in Room 310 or in any other room for that matter. After all, no one dies on the third floor unless Oscar pays a visit and stays awhile.
Note: Since he was adopted by staff members as a kitten, Oscar the Cat has had an uncanny ability to predict when residents are about to die. Thus far, he has presided over the deaths of more than 25 residents on the third floor of Steere House Nursing and Rehabilitation Center in Providence, Rhode Island. His mere presence at the bedside is viewed by physicians and nursing home staff as an almost absolute indicator of impending death, allowing staff members to adequately notify families. Oscar has also provided companionship to those who would otherwise have died alone. For his work, he is highly regarded by the physicians and staff at Steere House and by the families of the residents whom he serves.
Source Information
Dr. Dosa is a geriatrician at Rhode Island Hospital and an assistant professor of medicine at the Warren Alpert Medical School of Brown University — both in Providence.
time spent...
classes, labs, lectures, & dumb presentations: 25 h
ce: 0.5 h
opp: 0 h
anatomy: 37.5 h
medical appointments: 5 h
exercise: does carrying my book bag up the stairs count?
crying & whining: >2 h
as i believe i mentioned in an earlier post, i've been making an effort to pay attention to material i come across during my studies that piques my curiosity or interest. i'm calling these little nuggets "factoids," for lack of a better term.
this week's factoid proved more difficult to study than i'd anticipated. it all began while i was studying the dreaded brachial plexus in lab on wednesday. our group went to look at this meshwork of nerves in one of the cadavers. it was the first time we'd seen one of the cadavers face up this year. for whatever reason, it's more difficult to see the ventral side of these bodies than the dorsal side. our group took it in stride, though, and began to make sense of the mass of nerves in the cadaver.
it's hard to tell what's what in a cadaver. the preservation process they undergo leaves the tissues looking rather like thanksgiving turkey meat--for the most part, all the tissues are the same color, and they're dehydrated, so they're not always in the same position as one would expect them to be. it takes quite a while to learn how to appreciate the difference between an artery and a nerve, as you can imagine--both look like beige string.
as we were reviewing the nerves and arteries in the brachial plexus, though, we noticed a large, brownish-red mass on one of the nerves. 'strange.' i thought. 'that shouldn't be there.' then as we were digging around in the cervical area, we found more of these masses. as we went through our studies, i wandered around to view the rest of the body, and then it hit me: this was the cadaver that had died of cancer. skin cancer, to be precise. the masses we saw were metastases. and they were spread *everywhere.*
friday, as i was sitting through yet another exceptionally droll administrative lecture, i went to a blog i'd heard mentioned on dr_couz's blog (gotta love the blog chain effect!) written by a woman with melanoma. in it, sarah, a woman who was born the same year i was, describes her battle with cancer. her blog is stunning. i highly recommend you read it, from beginning to end. now.
sarah's blog sent me to another, living with melanoma. between the two, i gained a whole new perspective on what it must be like to be a cancer patient, particularly a young one. some of what they experienced overlaps with my experience, and likely the experiences of anyone who has faced a chronic disorder that requires careful and consistent management; but their experiences run deeper than i could've ever imagined. i never really thought about what it must be like to live with a disease that you can literally watch eating you alive. i also had no idea it could spread so fast....
and that's what brings me to post about what i've seen and read: it's clear to me now that the signs of disease can be extremely subtle and that we need, more than ever, to pay attention to our bodies. i don't mean to suggest that we all become hypochondriacs--that would be counterproductive. but rather that we take time to really look at our bodies, to check in with them, to observe change over time, etc.
i read a post back in july by kevin_m.d. that, well, frankly pissed me off. it basically suggested that breast self-examination is a worthless tool for the detection of cancer. the post and linked article angered me not because i doubt the stated statistics, but rather because it implies that women should ignore their breasts. the trouble with this is that society tells us--particularly those of us who are women (and i say this not to be sexist, but i noticed that nobody's done a study on the efficacy of testicular self-exam in men*)--that we're not supposed to be in touch with our bodies.
doing breast self exams may or may not allow women to detect possible malignancies earlier than they would be detected by other screening measures. but they do give women permission to pay attention to their breasts. (you'd be surprised at how many people are afraid to look at their bodies--this concept of it being okay to look at oneself wasn't fixed with hand mirror parties in the late 60s, believe me.) and one bright physician, dr. christiane northrup, extends the concept further. in her book, women's bodies, women's wisdom, she recommends what she calls a "monthly self-care ritual." the concept is that a woman take time, once per month, to examine her whole body. the idea is not to look for tumors or cancer--the concept is to appreciate one's body and learn how it feels when it's well. When we're informed about our bodies--their anatomy, physiology, and their innate unique personal quirks--we're more in tune with them, and we're more likely to notice changes, good or bad!
i assert, as well, that such a monthly screening ritual is not just for women. men would benefit from doing this, too. again, not to seek out disease--but to know wellness.
my factoid for the week was melanoma. my message(s) for the week? wear sunscreen. learn from the experiences of others. get to know your body. touch yourself! i promise you won't be sorry.
as one of my professors said this week: the lecture is over. now go learn something! :-)
* yes, i did look it up on PubMed, in case you're wondering.
at present, i'm breaking about 10 rules by logging on to blogger from school, but it's 8am and they've dragged our butts here for a presentation by the president of a medical association (i.e. pr bullsh!t talk) and now they're telling us it's going to start at 8:30am instead of 8:00am, and i'm feeling just a tad bitter about missing out on that extra 30 minutes of sleep. <--yes, that was a run-on sentence. this is the kind of verbiage i produce after one very long, stressful day yesterday and not nearly enough sleep last night. but the point of my post is not to whine about my fatigue and the multiple unnecessary events i'm required to attend on a regular basis...rather it's to relate my experience of medical school exams.
i actually wrote a post about medical school exams yesterday, as i was sitting in one of the afternoon lectures. we have a new professor here who is from the former USSR. he's an interesting guy--exuberant and hyper educated (an md/phd breed) and has a wealth of information to share with us. alas, between his accent and his utter inability to create a useful powerpoint presentation, we're not quite benefiting as much as we could be under the circumstances. it's a shame, really.
so during lecture, i pulled up word, changed my font to some crazy small unlegible from (so as to prevent the faculty in the two rows behind me from reading my ramblings) and pretended to be taking notes while i was really going on a very long venting rant about how much i hate medical school exams. i'm not going to post that particular rant here. it contained one too many expletives, even for my taste. ;-)
the whole medical school experience is difficult to describe. i think that's one of the reasons i'm so interested in attempting to capture this process--how do i explain what i'm going through to others? i think it's important, to somehow articulate this so-called life, not just for my family and friends (so that they don't assume i've just fallen off the planet!), but also for those of you out there who may be contemplating this path. i sure wish i'd had a blog or two to read before jumping into the thick of this. then again, can a pre-medical student really hear what a medical student is saying? it's hard to know. as open-minded as i'd like to think i am, i'm not sure i could've heard what i have to say now before i began.
yet, i digress. again. (i seem to be getting better and better at rambling. it's a function of how much i'm studying and how little social interaction i'm getting!) what are medical school exams like? what makes them difficult? why do they trip up students who have been consistently successful in every other academic endeavor they've ever undertaken?
i can only speak from my experience--i doubt it's the same for everyone--but i know there are some common threads, so here's my attempt at a description: i'll use the exam we took on monday as an example. the faculty dubbed it the "welcome to medical school" exam. it was "only" worth 10% of our grade. i say only because most exams in medical school are worth, at a minimum, 30% of a student's grade for the semester. most are worth more than that. in some courses last year, our grades depended upon one examination. in other words--if you had a bad day on test day, it sucked to be you, because there was no room for improvement or remediation. harsh? hell, yes.
comparatively, then, monday's exam was one of the easier ones, simply because there was less performance pressure. however, just because the exam was worth less, doesn't mean that there wasn't less material on the exam. the test on monday comprised the following:
this year, in an ingenious fit of inspiration, mwms decided to give all the incoming first-year students a survey to complete during the first four weeks of school. the concept is to calculate "the number of hours spent in studying the following subjects for the next four weeks" and then submit the form "anonymously" so that the administration can get a sense of how much students are studying. the first week of school they technically dubbed "week 0," so we began calculating this week (who starts counting from 0, i don't know...how can a week be 0?!?!?). for those readers interested in knowing what the life of a medical student is like, prepare to be amazed....
week 1 mileage:
time spent in class, labs and lectures: 25 hours
independent study (i.e. study time outside of class) for clinical exam (ce) course: 0.5 hours
independent study for osteopathic principles & practices (opp) course: 1 hour
independent study for anatomy: 35.5 hours
medical appointments/sessions: 5 hours
legitimate exercise: 1 hour
time spent reassuring classmates: endless
the big question: did i study enough to pass tomorrow's anatomy exam? who knows?
:-)
i've been tagged! this means that, for an actual, oh, 20 minutes or so, i get to stop thinking about anatomy! hooray!
okay, perhaps it seems a little strange for a medical student to want to be distracted from her studies, but you have to understand: i've just been through two weeks of anatomy, punctuated only by very droll orientation lectures and one too many doctors' appointments. it is a tad easier this time around--i've been able to stuff my own anxiety just long enough to look around and notice that when you take 160 overachieving type-A students and put them under a crazy amount of pressure, life gets rather comical. being on campus is akin to being put in a blender of self-doubt--i swear, i can hear the voices in other people's heads asking the same questions that mine does:
am i studying enough? am i smart enough to do this? how come everyone knows this material better than i do? what am i not doing? why can't i learn faster? did they make a mistake with my acceptance? did i do something to piss off the anatomy professors? is that why they ignore me? what if i fail? what if i get kicked out of school? what if i kill someone because i didn't learn the innervation of this muscle? who was that dead person? why do i have to study dead people? what was this person thinking when they put on that coat of nail polish for the last time? omg, i just wasted 5 minutes thinking about nothing! will i fail the exam on monday because i wasted 5 minutes?i could go on for hours. but i'll spare you. but in case that wasn't quite enough of a description to give you a glimpse into this world, check this out--the following is the list of topics that will be on tomorrow's exam:
i'm amazed that one year after writing this post, i've just relived the first day of medical school again. today was like one gigantic deja-vue dream. the slides were the same. the lecturers were the same. the message was the same (aka: they own my ass. still.). the only difference? this time, they decided to begin anatomy on day one. so in addition to hours of talks on policies and procedures, we had two hours of anatomy lecture. that shocked most of the incoming students, i could tell. it's one thing to hear described how much information will be thrown at us; it's an entirely different thing to experience it. by the end of the day, it seemed like the class was rather sobered.
i feel like being a brat and saying 'i told you so,' particularly to my roommate, who was eyeing me suspiciously all weekend as i studied anatomy. "classes haven't even started yet!" she exclaimed. my response? "it doesn't matter." i kept studying.
when i mention to my new set of peers that i'm a returning student, i get some pretty odd looks. many people prickle a bit, on the assumption that i've got some kind of academic advantage. sure, i've heard these anatomy lectures before--but i'm not certain that makes up for the loss of confidence that comes from having done poorly in the course the first time around.
the days leading up to today were riddled with anxiety for me. can i do this? am i well enough? should i do this? am i making the right decision? is it worth it? what if i fail? <--these were just a few of the questions rattling around in my head. i still don't have answers to the questions. but i did come up with one crazy idea: to find one thing, each day, that i learned that interested me. i'm sure on many days there will be more than one thing that piques my curiosity--but it's not always easy to remember to be curious in the midst of such a pressured environment. since i'm here because i love to learn, though, i need to remind myself why i'm doing this. and i need to remind myself as often as possible. so...i'm off to a new start again. here's to hoping the road will be less bumpy this time around....
"during early embryonic development cilia containing a 9 + 0 pattern of microtubules establish the left-right asymmetry of internal organs"*this quotation refers to the fact that there are these itty bitty hairlike processes (cilia) that extend from cells that help cells to move (think of high school biology class and seeing weird critters move around under the microscope via what look like little caterpillar legs.). apparently, recent research studies have shown that the location of the internal organs in the body (i.e. that our heart is on the left & the liver on the right, etc.) comes from the movement of these little cilia found on cells really early in embryonic development. the significance? people who lack these little cilia end up with situs inversus, a condition in which the internal organs are reversed in their position, such that what is usually on the right ends up on the left and vice versa.
Have we reverted to the Victorian Age? Based upon the following email I received from NOW, one would think so.
Breaking News: Cleavage on Displaymy reaction to all of this?
"There was cleavage on display Wednesday afternoon on C-SPAN2. It belonged to Sen. Hillary Clinton... There wasn't an unseemly amount of cleavage showing, but there it was. Undeniable," the Washington Post reported.
NEWSFLASH: Hillary Clinton has breasts.
And apparently that "news" merits coverage in the Washington Post.
In a Style section cover story on Friday, fashion "reporter" Robin Givhan notes that Hillary Clinton has taken a brazen step for a woman politician by wearing a low neckline. "Showing cleavage," says Givhan, "is a request to be engaged in a particular way. It doesn't necessarily mean that a woman is asking to be objectified, but it does suggest a certain confidence and physical ease."
Shock! Horror! A prominent woman showing confidence and physical ease!
Givhan goes on with her psychobabble: "It means that a woman is content being perceived as a sexual person in addition to being seen as someone who is intelligent, authoritative, witty and whatever else might define her personality. It also means that she feels that all those other characteristics are so apparent and undeniable, that they will not be overshadowed."
This article about the frontrunning candidate for U.S. president caused quite a stir in the NOW office this morning, eliciting reactions ranging from "You've got to be kidding!" to "What century is this?" The piece is definitely outrageous, but it's also hilarious. Absurdly hilarious. And it's an indictment of our society's lingering archaic notions of femininity, assumptions about breasts and sexuality, and fears about powerful women.What do you think? Share with us your take on this story -- whether analysis or satire. We'll post the best ones on the web site. Send your submissions to cleavage@now.org.
Read more on media treatment of politicians including Hillary Clinton. Sign our petition to major media outlets. Send this story to your friends.
