Tag Archives: Life Updates

Back at It

It’s been quite a while since I last posted anything. I will admit that there were multiple times I seriously considered sitting down and writing again, I just never got around to doing it. So what have I been doing lately?

First of all, I finished the Neuroscience Module. I wouldn’t exactly say I passed it, even though I did technically pass. My final grade did not equal a pass based on the way the course was introduced to us in March, but because fully 1/3 of the class was in the same situation as I was, they (our overlords) moved that passing percentage a little lower. Why was that class so incredibly terrible? I guess it’s always been bad, it’s just been 10 weeks long for the last two decades. Because my class is going through a new curriculum, the course was supposed to be shortened and streamlined to 7 weeks. My belief is that the course directors just did the shortening and forgot about the streamlining, giving us 10 weeks of hard material in 7 weeks. And so we all just about died during those two months, barely passing.

I certainly liked the subject matter. I remain fascinated with the workings of our brain and the ways that defects can manifest in people’s ability to understand and interpret the world. Despite my terrible performance in the class, I won’t rule Neurology out just quite yet. To get a sense of some of the cool stuff we learned about in Neuro, I’d recommend “The Man Who Mistook His Wife for a Hat” by Oliver Sacks.

So we finished Neurology two weeks ago, and moved into a course called Behavioral Medicine (or something). I attended a few hours of lecture the first day, and then pretty much didn’t go to class for the next two weeks (except for a few required activities, which I mention below). Much of it was basic psychology, which I was familiar with from courses in undergrad, and the rest was easy to learn from the syllabus and online recordings. So those two weeks were more like a vacation than school, even if I did have to cram a little the night before the test (had to learn a bunch of medications), only to show up and take a test so easy I could have passed it without studying. Compared to the previous neuro stuff we were doing, this psych stuff was like taking a nap.

We did have very helpful sessions where we practiced interviewing standardized patients and working through some possible diagnoses. One session stands out because I had to do the history and questions, and I suddenly was not worried about the process of history taking. Instead, I had a list of possibilities in my head, and I had a plan on how I would get a full story and cover my bases on what I thought it could be. That must be how actual doctors feel all the time. It was encouraging, I have to admit.

Now I am writing this post called “Back at It”, but there are really only three weeks of “it” left. After I complete a short course in hematology/oncology, I will be free for the summer. I’ve mentioned before that it is my last summer ever, so I plan to enjoy it as much as I can. I also am less than a year away from taking Step 1, so I ordered a review book from amazon. It’s called “Crush Step 1” (which is my plan), and it’s really heavy for being such an average sized book.

I also hope to write more frequently here, because it’s very relaxing.

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I Don’t Know Anything About Brains

The newest unit in my adventure called medical school is Neurosciences. After just three days, I have come to a couple of conclusions.

First, neuroscience is really hard. The content of the class itself is just very challenging. There are many anatomical structures to learn, pathways to memorize, and some fairly abstract concepts that need to be applied in order to really understand what’s going on. The class itself is going to be hard because we don’t take an exam until April, meaning we cover 5 weeks worth of material before taking any sort of evaluation. There is huge potential to fall behind before the test, and there will be too much material to catch back up.

Next, I have started to second guess my speaking skills. I have always thought that the neuron, the fundamental cell of the nervous system, was pronounced “nur-on”. In fact, I have never heard it pronounced any other way until Monday, when 4 separate neurologists called it a “nur-own”. Is this some sort of professional neuroscience thing to mark the pros from the outsiders? What’s going on? We need to ask the teaching staff to address this ASAP. Every time they confidently talk about nurrowns, i feel a little bit like a morrown.

Finally, I have realized that nobody really understands the brain. I don’t mean that we know nothing about it, just that we don’t understand it. Yes, we understand the areas of the brain that process certain information. We know tracts of the spinal cord and the types of sensations they relay. We even know the functions of the brainstem and midbrain. What no one really understands is how all of this happens. Even in “smaller” nuclei in the brain, there are something like a million neurons synapsing together. There is a huge body of scientific knowledge on what a neuron does and how it functions, but a complete lack of explanation as to how a billion neurons together create conscious thought. The brain is the most complex organ in the body, home to all of our higher orders of reasoning, memory, emotion, and thought. It’s amazing, but we still don’t actually understand it.

This is the first cool brain image Google brought me.

I was talking about this with my family last weekend. Have you ever seen a 30 second commercial for an antidepressant drug, followed by a full minute of side effects and warnings? It’s because we still don’t get the brain. Compare that drug to, say, an antibiotic. We know exactly how that antibiotic is metabolized, the effect it has on bacteria, side effects on the patient, and certain kinds of infections that can be more easily treated with that drug. An antidepressant is far more complicated. For an SSRI, for instance, we know what it is supposed to do, but this action causes a huge amount of side effects due to its action on the brain and neurotransmitter levels. Why would this drug cause suicidal tendencies in younger patients? Good question.

I really like studying neuroscience because I think humans have awesome brains. We have enormous brains, by the way. Why are babies born so young and relatively helpless? Because otherwise their enormous brains would be too big to squeeze through the birth canal. Our skeleton is designed to support a large skull full of brains, and our metabolism is geared to continually supply our brains with the energy it so desperately demands. The most spectacular part of our brains is the interconnections, or synapses. This is where the magic happens. This is why humans are so fundamentally different than any other animal. The interconnected nature of the brain is the reason we make music, paint pictures, write stories, love, hate, and want things. It’s the reason certain smells can evoke such vivid memories, and it’s the reason we can even undertake an effort to learn about our own amazing cognitive ability.

The best analogy for the enormous complexity of our brain is outer space. Even the word we use to describe it fails miserably to convey the entirety of what it actually is. Calling the universe space is like calling the ocean wet. Astronomers are still discovering more planets and stars in our very own galaxy, which is sort of like finding more furniture in your living room when set to the scale of the universe. Small wonder we don’t fully understand our own brains. I wonder if we even can. Even with the elaborate supercomputer sitting in my head (ok, more like an iPhone. Or a fax machine), I will never be able to actually understand how big the Earth is, and I will definitely fall far short of grasping the size of the solar system or galaxy. I don’t think it can be done, but that doesn’t mean we shouldn’t try. Who knows, it could be my generation of neurologists that discovers ways of treating and curing Alzheimer’s disease. What’s the saying about effort? Shoot for the moon, and even if you miss, you’ll land among the stars.

Time for me to wrap this up for the night. Thanks for reading! If you have read this far, you may be interested to know I will have a guest post featured on the Student Doctor Network next week. I am very appreciative of this opportunity to reach a wider audience. Also, their forums are incredibly helpful for any pre-meds who haven’t found their way over there yet. Just saying.

sortadrwordpress@gmail.com

Floating Along

Welcome back to my blog! In reality, I was the one who took a brief hiatus over the holidays, and I don’t regret it at all. I would love to say that I spent my two weeks off deep in thought, drafting blog posts, and learning all of the things I forgot immediately after taking my final exam on December 20th, but that would be a lie. Instead, I spent most of my break at home with family and friends, and the rest of it being as lazy as humanly possible. On the plus side, I am refreshed and ready to tackle another semester of medical school.

Just kidding…I actually laughed after typing that last sentence. Let me do a little catching up on what medical school has done to me recently. In late November we started Pharmacology and Microbiology. I prefer to call it “Bugs and Drugs”. The courses are taught simultaneously, which is actually helpful because we get to learn the organisms that cause disease around the time that we learn the drugs that can treat said disease. I use the word “learn” very loosely here, because really they just throw hundreds of drugs at us and we get to sort out what they do for a few days before the exam. In the week before Christmas we covered around 220 antibiotics, antifungals, cancer therapies, and other drugs in about 4 days before taking an exam on Friday before break. That was my hardest week of medical school yet. While attempting to learn all of those drugs, we also had to learn information on bacteria, viruses, their associated structures and pathology, some information about other organisms (mycobacteria), and take an exam on that the same day as pharmacology. Have you seen Christmas with the Kranks? Remember the scene where Luther is leaving the shop in the beginning and the water canopy breaks, drenching him in water even as he stands in the pouring rain? That was a pretty accurate description of me during this course.

This is not an area of strength for me, either. I had great undergrad anatomy experience to support me during med school anatomy. I did take immunology and pharmacology as well, but both courses were incredibly easy. Most of what I remember from immunology was “viruses are scary”, and I don’t think I remember anything at all from pharmacology. So learning information at the insane pace set by the course directors required long, long days of studying at home. In the winter. In the cold. By myself. Very depressing. But hey, I have passed everything so far, and am 1/8 of the way toward completing my MD.

While talking to an actual doctor, I learned the dirty secret of pharmacology. None of us will remember all of these drugs after this year (I already knew that part). We will really learn them again during third year and beyond, when we begin to prescribe and work with drugs in a practical setting. The goal of this class is to make sure we have heard of these drugs at least once.

In other news, I have now interviewed and presented my own patients. The dermatologist I have been shadowing is letting me see patients (with a resident keeping a close watch). This allows me to demonstrate my complete ignorance of dermatology for both the patients and the residents, but has helped me start to develop my all important “bedside manner”. I have a feeling I will be much better at interviewing and taking histories when I know roughly what I am hoping to find.

Of course, this is kind of what I expected from medical school. I’m busy and I’m challenged, and I like it. At this point in undergrad I was already bored (and still on winter break). The pace is grinding, but is also what keeps school interesting. It’s like sightseeing from a bullet train. While it’s impossible to see everything that flashes by, there are so many interesting things to see that the view is still captivating. Some semesters of undergrad felt like sightseeing from a snowplow.

I have been sending Facebook messages back and forth with a friend who is considering medical school. Most of his questions centered around the difficulty of the classes and exams, the pace, the hours, etc. I understand the worry from potential students, but I don’t understand the doubt. I have never once, even for a second, thought I would fail/drop out/give up during medical school. I would say that trend is strong among my friends as well. Despite the deluge of information and massive investments of time and money, I don’t think anyone is legitimately worried about dropping out. It’s fine to ask “how”, but counterproductive to ask “what if”.  To be honest, most of my classmates are generally happy people. Maybe this is because of our pass/fail system. Maybe our class is different. This is just an honest opinion from what I see on the days I go to class (instead of watching lectures online from home). If you think you can do it, you probably can. Just my opinion. Of course, it wouldn’t hurt to read up on this before you go applying, just in case 🙂

I have other topics I want to write about (vaccinations, antibiotic resistance, books and movies, and a stunning realization I had ordering dinner over break), but I really need to wrap up this little update of a post and call it day.

Thanks for reading!

sortadrwordpress@gmail.com

Brains, Blogging, and My Favorite Month of the Year

It’s Friday, the sun is shining, the leaves are brilliant shades of red and yellow, and November is just getting started! So many great things happen in November each year that it always makes for a great month. Allow me to walk you through some of these things by first backing up to yesterday.

It was fitting that our dissection of the skull and into the brain would be scheduled for October 31st. I spent the majority of the morning and afternoon carefully sawing, chiseling, and hammering my way through our cadaver’s skull. Eventually we were separated the brain itself from its protective covering (called dura mater) and removed it from the head as well. I think an appropriate amount of Frankenstein/Halloween jokes were made throughout the day. Personally, I thought this dissection was great. Not only did we get to use power tools, we also got to hold and examine the brain, the most intricate and beautiful organ in the body. One partner in my group was a little disturbed by the whole process, and I’m not actually sure where she was most of the time. The skull is quite thick, and the sawing process created lots of dust and a terrible smell (I thought it smelled like burnt hair and cheddar Sun Chips) that grossed many people out. The sawing part was tricky, since we didn’t want to cut too deep and turn our nice brain into a brain smoothie, but we also had to cut far enough to lift off the skull. I didn’t love the smell, but I thought the work was pretty cool. Side note: Chipotle was selling burritos for $3 if you wore a Halloween costume yesterday. I had a pair of scrubs in the car, which I realized doubled as a costume, and since I dissected straight through lunch my burrito for dinner was extra delicious. Yes, I just transitioned from brain smoothie to burritos in two sentences.

Another reason I love November is that my birthday is each year in November. I get less excited about presents every year (yet I also look forward to that….let’s be honest) and more excited about spending time with my family. Since I live farther from home now that I’m in medical school, I’m really looking forward to having my family come stay with me for part of the weekend to celebrate my birthday.

November is a bit of a sad month, because baseball is over, but also a happy month, because a whole new season kicks off. Yup. Gaming season. This pre-Christmas period is launch time for big budget video games that I enjoy playing, like Assassin’s Creed, Battlefield, and Call of Duty. Ever wonder why work/school is a little less crowded on the first Tuesday of November? Call of Duty came out, that’s why. Add in some time off for Thanksgiving, a few premature Christmas carols, and you’ve got a great month ahead of you.

There’s some other things going on this month that I would like to mention as well. You may or may not have heard of NaNoWriMo, which stands for National Novel Writing Month. Each November, several hundred thousand authors attempt to write a full length novel (50,000 words) in one month. They register online and could potentially win prizes when they submit their finished story by midnight on November 30th. All genres are fair game. I don’t think I can honestly commit to writing 1,667 words a day while in medical school (I’m not sure I say that many words a day), but someday I’d like to try. The beauty of NaNoWriMo is that the rush and pace help spark creativity. You essentially forget about editing and revisions and just dive in and write. That sounds like fun to me.

A more realistic goal is NaBloPoMo, AKA National Blog Posting Month. The challenge is to post once a day on your blog. The posts don’t have to be long or complicated. I’m pretty sure anything goes. I’m a firm believer in setting low expectations and then surprising yourself (just kidding) and this challenge is much more manageable than writing a novel this month. It takes just a quick glance to realize that despite blogging for nearly six months, I have only accumulated 29ish posts. Attempting to double that in a month will be challenging, to say the least.

I’ll wrap this up for today. I’m worried about my dog, who has chased her tail consistently for the last five minutes and looks a little bit dizzy. Thanks for reading. As always, feel free to leave a comment below or send it straight to my face at sortadrwordpress@gmail.com

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Tales from Anatomy Part 2

As you may have noticed, it’s been awhile. There are lots of good reasons for not writing posts while in anatomy, and I am here to share them. Actually, I think I am doing pretty good at maintaining a normal lifestyle during the first half of this block. I have several classmates that live in the lab, study constantly, know everything, and are thoroughly miserable. I have studied a little, read a book for fun, and enjoyed myself for the last three weeks or so. My grades for the first exam have yet to be posted, so I don’t know how well this strategy has paid off.

Speaking of tests, we took a whopper of a test on Monday. It was the first half (AKA the top half) of anatomy in a giant afternoon of testing. Not only did we take a standard multiple choice test, we also took a practical test in the lab (identifying tagged structures on cadavers and organs) and a slide exam in a lecture hall (identifying structures from images projected on the front of the room). The written test was par for the course, since we have all taken a bazillion of those. The other formats were more difficult for me. First of all, they weren’t multiple choice. We had to think of the answer all by ourselves (and spelling also counted). Second, they moved at an amazingly slow pace. Ninety seconds per question is way more than enough time to either figure out the answer or realize that you don’t know the answer. I take tests quickly, and being forced to wait 82 seconds before I can go to the next question just drives me crazy.

As far as the course itself, I actually like it a lot. Dissecting is difficult and tedious and lots of work, but at the end of the day it is infinitely cooler than sitting in a lecture hall listening to metabolism lectures all day. The coolest part is being able to see all of the anatomy in three dimensions, oriented in an actual body, and begin to put all of the pieces together mentally. Anatomy can’t be learned by listening to a PowerPoint lecture of a muscle group, it has to be learned directly, seeing the muscles, tendons, and nerves together.

Dissecting takes a lot of time out of your day, and I think it makes us students confront our own humanity in a certain way. While we cut through organs, vessels, muscle, and tissue, the thought is constantly in the back of your mind that these same muscles and nerves were part of a person who loved, dreamed, hoped, and lived a full life. This person left behind a family and friends, but they thought ahead and left part of the stuff that made them human behind for us to take apart and look at first hand. That makes anatomy class a privilege, and it encourages me to make the most of my time in lab, so that I can take the most of this opportunity to learn.

The pace can be overwhelming. Most of the time we have no idea where we are supposed to be or what we are supposed to be doing (the “remodeling” of our course has left it a little short on directions). All things considered, it’s a pretty good time. It is interesting the division of labor among group members. With only three members per group, there is much to do and often too many hands. When we dissected the heart, for instance, only one person could work on it at a time. I have one lab partner who was an anatomy TA at his undergrad, so he is knowledgeable and talented in dissection. My other partner has never taken anatomy, and usually asks very basic questions like “Which one is the spleen?” I’m somewhere in between those two extremes. I can almost always tell when I’m looking at a spleen. So me and my awesome lab partner do most of the dissecting, while the not so helpful partner does the accounting to make sure we find everything and makes tags to place on the structures we identify. Most of us aren’t squeamish, but there are two kinds of people in anatomy lab. On chest day, we got to use a saw to cut through the ribs and get into the thorax. One kind of med student wants to use the saw, the other kind of med student plugs it in and hands it to me (or whoever wants to use it).

That’s all for tonight! Thanks for reading. As always, feel free to comment below or email me at sortadrwordpress@gmail.com

Tales from Anatomy Part 1

What a week! I write this on my first Saturday after my first week of anatomy, and I am still alive to tell the tale. This Clinical Anatomy course is seven weeks long, which means we will be immersed in anatomy until Thanksgiving or so. I’ll likely write just once each week as I suffer through the course. There is a pretty significant time commitment involved between attending lectures, doing the dissections, and then learning the material.

Yes, the material. The fire hose analogy is definitely beginning to apply (med school is like drinking from a fire hose). The first block of Cell Biology was like a high pressure garden hose (enough to drown you, probably) but just the first week of anatomy was upgraded to full-size fire hose. I have a relatively good background in anatomy, having taken a difficult course in undergrad that included cadaver work, but this is pretty intense. 

The course is organized like this. Every morning we have lectures on pertinent structures and organs (muscles of the back, etc) as well as clinical problems associated with those structures (spinal trauma, paralysis, etc for spinal cord). This can take anywhere from a quick hour of lecture up to 5 hours of lecture. After that’s finished we go the cadaver lab. Three students are assigned per body for each day of dissection, but we switch off with another group of 3 about every other day. That means I do dissections with two others on Monday, Wednesday, and Friday while three other students dissect Tuesday and Thursday. Once we finish our dissection, we present all of the muscles and structures we found to the other half of the group. 

The pace is pretty frantic, because I believe that when the faculty shortened the course from 10 to 7 weeks they kept the same amount of dissection and cut out other activities like cross sections. My experience with dissection in the past has been very meticulous and careful, with lots of effort taken to make sure the maximum amount of material can be gleaned from each body. This is more like “do as best as you can but make sure you do it really fast”. In the first week we have done the back, neck, thorax, heart, lungs, and associated nerves, glands, and muscles. Then we took a quiz on it yesterday. That’s a pretty quick pace.

There is good news. First, the course only has six weeks left, and I can probably do anything for six weeks. Second, I do actually enjoy dissection work. While tedious and time consuming and smells bad and sometimes burns my eyes, it’s actually pretty cool to be able to learn anatomy so directly. Very few people have the privilege to ever look inside of a body like this, and I think it’s cool that I can see the heart, lungs, and vessels that once kept someone alive. 

So after one week I’m still in good shape. I have had a great Saturday around the house with my wife and the puppy. I have a great book to read (non-class material). There has been some absolutely FANTASTIC baseball played the last few days. The Cardinals took game 1 into the 13th inning, keeping me awake until 12:30 last night. I’m also excited to see the Red Sox play the Tigers tonight, since I think the Sox could clean house against the Tigers. On a different note, the incredibly terrible Jacksonville Jaguars travel to Denver to play the amazingly talented Peyton Manning and the Denver Broncos this weekend. I bet Denver wins by 40. Lastly, the greatest race on earth is being held today in Hawaii, as the Ironman World Championship is going on today. It’s been a beautiful fall weekend and a fulfilling week, and to make sure I’m ready for the next week I’m going to stop blogging for now and continue on later. 

Thanks for Reading!

Wrapping It Up

This week concludes Cell Biology, Metabolism, and Genetics. We will take the last exam on Friday. Despite my abysmal performance on the last quiz (and passing Epidemiology and Research by the skin of my teeth), I need to score just a 36% on this final test in order to pass the block and never see any of these subjects again (until Step 1). Tomorrow is given entirely for self study in preparation for the exam, which will be followed by a glorious weekend with NOTHING to study before anatomy begins next Monday.

I’m actually a little bit worried about that. I am comfortable with brute memorization and have fairly good visual skills, so the material isn’t too unsettling. What worries me is this new format. A 10 week course in the past has been re-packaged into 7 weeks. Apparently the amount of dissection has remained unchanged, which is potentially bad news. They reduced the amount of histology and cross section lab work, while adding more clinical applications and emphasizing radiology reading (something we will have to actually use). A few second years told me that it will be much better than their schedule. We start dissection on the back, then switch to the front and work from the head down. Some second years told me that they had passed the course by acing exams until they hit the waist, at which point they slacked off. One girl mentioned she knew almost nothing about the lower legs and feet, since she didn’t really go to class for that part. That’s hilarious, if true, and reminds me of this.

I may fall into that same trap, because Week 5 or 6 of anatomy coincides with the release of about 3 of my favorite video games, as well as my birthday. I plan to do well and study hard, but my scores may decrease slightly after November begins 🙂

Ready for a big reason why I may fail this next exam? Here it is.

This is little Zoe, the newest addition to our family. I had a post in draft describing all of the reasons I wanted a dog, and finally convinced my wife to go to an adoption event last weekend because we saw that cute little pup on Craigslist. Now she is ours. She is part Rottweiler/Doberman, but is pretty small. Her mom is only 35 pounds, and she shouldn’t get bigger than that. She is recovering from pneumonia right now, so her endurance for romping in the yard is about 10 minutes. Let me tell you, there is NOTHING in the world sadder than a 4.5lb puppy with pneumonia. NOTHING.

She’s doing pretty good on housetraining and basic stuff, and is pretty chill for a puppy. In high school and college our family dog was a big yellow lab, 90lbs of love and spastic crazy tail. Our house and yard aren’t great for a dog of that…..girth. I like big dogs, and Zoe is a good compromise.

Despite my prolonged periods of non-posting, I have noticed continued views on posts in my absence. How cool is that? And if you are reading my blog from Australia please email me and tell me how you found it. If you Google “basically useless”, am I on the front page? Should I be excited about that?

In all seriousness, I have a theory I call the Blogger’s Paradox: those with the least time to write blogs often have incredible material to work with, should they decide to write. I have read blogs in the past where posts were frequent and the authors time was obviously plentiful, but the quality just wasn’t there. People who have different experiences on a daily basis can pull from that and write strong blogs, if they have the time. One benefit of medical is taking a daily swim in the pool of weird stuff, whether it’s diseases, classmates, or the strange things professors do and say. I try to make writing a daily habit, and I largely succeed, but the result is not always ready to be published, so I often have drafts and scraps floating around for days on end. Any time a big test looms in the future, however, you can count on posts while I do my best to not study 🙂

Thanks for reading! As always, feel free to comment below or send an email directly to my face at sortadrwordpress@gmail.com