Tag Archives: Medical Students

Step 1… Closer to Being a Doctor

It’s been quite a while since I’ve written anything on this blog, and I’m sorry about that. I had to make a decision back in January, and it was really tough. Do I…..

1) Study really hard all day and every day for Step 1 so that I can become a doctor.

or

2) Continue to blog, increasing my status as an internet celebrity and cementing the love that both of my readers have for my writing (and one of them is still my mom).

I obviously went with the first option. I studied long, hard, cold days for that stupid test, and I’m here on the other side of it with a majority of my sanity intact. If you are here to read a little about the test, skip on down a few paragraphs for my take on the exam and studying. Sadly, studying for days and days on end does not lend itself well for blog posts. Frankly, nothing interesting really happened. My wife did a bunch of fun stuff, and I made sure to get out and do things in the world on a weekly basis, but the vast majority of my time (even weekends and evenings) was spent in the library or at my desk.

I received my score a few weeks ago, so I am past the nervous period of waiting for those 3 digits (hopefully 3 digits, I’d hate to be the first guy to score less than 100!). I did ok, but I feel like I was capable of scoring higher, which is a little frustrating. I would straight up just tell you guys what I got….but you know, it’s the internet, Obama, NSA, etc. I’ll just say I scored a little bit below average, which is kind of my place in the world of medical school. Not really dumb, but also not smart. It’s a good enough score for most of the specialties I am interested in, but it makes some of the competitive specialties more of a reach (orthopedics, for example). Thankfully, I’m not a super gunner (see below for explanations of new words) and I’m not trying to become a plastic surgeon at the Mayo Clinic, so my score should be just fine. To compensate for my subpar score in the dating scene that is residency applications, I plan to make sure programs know that I also have a terrific personality.

So how specifically did I study for this test? First Aid, UWorld, SketchyMicro, and Doctors in Training. Before you copy those down as bullet points, you need to read the next sentence. Figure out how YOU learn as a student, and tailor your studying to that. For example, if you don’t learn well from videos, don’t buy Doctors in Training, because you’ll just be wasting your time. I’ll run through these resources in order of importance:

1) Uworld – this is a giant question bank (2200+) that closely resembles the questions on the actual test. You simply must do the entire bank of questions. Don’t procrastinate doing these, either. Start early, take notes, and review your answers. This is as close as you can get to the actual exam, so spend a lot of time here.

2) First Aid – The Step 1 Bible, everything important can be found here once you learn where to look. Definitely have this open often. Definitely add information to the margins. Definitely never just sit and read this book. It’s not meant to be read. Because everything is in outline form, you won’t learn much from reading the words. It is useful to browse through sections to remind yourself of concepts you have already learned, but not very useful as a way to learn complex concepts.

3) Sketchy Micro- this is a series of cartoons drawn by some genius (who is also now rich). Each of the cartoons give you little memory aids for bacteria, viruses, etc. This is stupidly helpful, especially because I didn’t learn anything from out Microbiology course. It’s fairly cheap, quick and easy to watch, and I guarantee that it will add points to your exam. I hear they are also coming out with Sketchy Pharm for future tests, which should also be very helpful.

4) Doctors in Training – this is the least mandatory of all study options. First off, it’s pretty expensive. Secondly, it’s fairly time consuming. Last but not least, it’s pretty expensive. There are some advantages to it though. Let’s say you have your heart set on a specialty that is not competitive, so you just want to pass the test and have a score that starts with a 2. If you buy DIT, watch the videos, and fill in the workbook, you are going to pass the test. They do a good job covering material efficiently, and they have spaced recall built in to the workbook to help drill in some of the details. It seems like their motto is “If you don’t remember it the first time, you’ll remember it the 8th time”.

My last few thoughts on Step 1 are especially pertinent to students who didn’t do well (like me….just kidding). After just a month or so of clinical exposure, I’m beginning to realize how little anyone cares about Step 1. I think it gets overhyped to second year students (at least it was to us). The material tested on Step 1 has very little clinical significance or correlation. Attendings and residents have been very emphatic that we are just now beginning to learn actual medicine. Finally, there’s a lot more that goes in to your residency app than your Step 1 score. If you want to be a plastic surgeon or dermatologist, you may want to work crazy hard and score well, but don’t freak out because you scored 5 points under the average for your specialty.

To close out this post, I need to include a little dictionary (for people like Mom) who may not be familiar with some of the “buzzwords” of clinical medicine. I will use these words frequently in future posts. This will be on the test.

Attending – this is an actual, fully licensed physician. They lead treatment teams and represent the light at the end of a long tunnel. The attitude of the attending often determines your fate as a med student. Good ones will teach well, have a good attitude, let you do cool stuff, and let you leave to go study. Bad attendings pimp you mercilessly, make you stay tediously long hours, are cynical and jaded, or just aren’t involved with anything going on.

Pimping – this is what happens when a senior team member asks questions to a junior member, usually in a pressured setting. It’s kind of like teaching, just scarier and with a lot more crying. Pimping can be aggressive, like an attending asking rapid fire questions to a medical student in front of everyone at rounds. It can also be helpful, like a resident asking you which structures you can identify during a surgery, then helping identify ones that you have missed.

Resident – these people do most of the actual work. Residents have graduated medical school but not finished the required residency. They are doctors, but don’t have the freedom (or responsibility) of an attending. Residents come in several flavors. Interns are fresh out of med school and are highly supervised. Each successive year past intern year, residents are given more responsibility until their final year, where they transform into the chief resident, who does everything. Residents work long hours, are not appreciated by anyone, and can be the best/worst part of your rotation on the service as a medical student.

Rounds – the sacred ritual of medicine. This happens once (or more) daily, and comes in a few flavors. Walking rounds are exactly what they sound like. The team walks from room to room. First they talk about a patient in the hallway, then they go and see that patient. Sometimes they just talk, then people see patients later, but you get the idea. Sometimes everyone sits down at a table and just talks about the patients. Sometimes rounds only take 30 minutes. Sometimes it takes hours and hours and hours. Students often present their patient(s) during rounds, giving an attending or resident a chance to pimp the student on that disease/treatment.

Tune in next time for ER stories, featuring the lady you got drunk, passed out while smoking, lit her mattress on fire, and had to be admitted for simultaneous burns AND being super drunk (at 10am on a Monday). Or, tales from OB-GYN, featuring the legendary lady with a BMI of 92. I’m more motivated to write when I see stuff like that on a daily basis.

Thanks for reading!

The Hardest Day

Second year has started off with a bang. If you are paying attention, you’ll see some crazy stuff in any medical school. Whether it’s an official lesson, or people watching, or patient encounters, or something you learn on accident while researching something else, there will surely be something to learn. Recently we had a deep lesson that I wanted to share, but first I need to set the stage.

All of the MS2 students are packed into our lecture hall. This isn’t the nice, new lecture with comfortable chairs that we used last year. This is the older lecture hall that doesn’t have enough seats for the whole class, the one with the terrible chairs, and the one with not enough room for your laptop and anything else on the desk. There are students standing in the back, and everyone looks sharp because we all are wearing our white coats and professional clothes.

On stage are six people. Standing at the podium is a Pediatric Hematologist who is running the event. She has a very serene demeanor, but seems to radiate strength from her small stature. Sitting at the table on stage are 5 others. There is a couple in their 40’s. He is lean and tan, with the muscle tone and hands of a construction worker. She sits next to him, well dressed and confident, if somewhat anxious. Another lady sits next to them. She is African American, somewhat heavyset, with a joyful face, floral blouse, and somewhat excessive afro. Next to her is an elderly little lady with thin gray hair and a stooped posture, and she is in deep conversation with the woman beside her, who is wearing scrubs and has two phones and a pager.

This is a lecture panel on handling the death of patients, specifically children. The couple on the end lost twin boys, their 5th and 6th children. The first died before being born. The second lived for 10 months, but had a debilitating matrix of health problems and lacked any ability to develop. The lady next to them had a daughter who developed bone cancer at age 11, which metastasized to her brain and took her life when she was 13. The older was a chaplain, and the last lady was a NICU nurse. Everyone was there to talk to us about handling death.

Most learning in medical school is very clinical and sterile. We learn about our bodies from distinguished looking old professors who wear white coats and use technical language to describe anatomy and physiology of organs and diseases, of which they are experts. That approach is obviously not practical when talking about handling death, so we learned from “experts” in their own way, people who had gone through this and were willing to talk to us about their experience.

I don’t like thinking about death, and I don’t think many of my fellow students do either. We are all young and vigorous, filled with the energy and optimism of youth. In my mind, death is something far off. It’s not that I’m scared of it, I just prefer not to think about it. I have been very fortunate to have made it this far in my life with living parents and grandparents.

This forum was not the first time that I had focused my heart and mind on this idea of death, and current events will tell you why. On Saturday evening the violence in Ferguson, MO erupted after a young man was shot and killed by police. Even as I write this tensions remain high, with protests and heavy police presence keeping the conflict in the national spotlight. It was only a few days ago that the world was shocked to discover that Robin Williams had ended his own life. Violence in Iraq and the Middle East have created a summer that will go down in history as a violent, restless summer.

I don’t want to talk specifically about any of those subjects listed above, at least not in this post. Instead, I want to talk about dying. The way someone reacts to death will tell me a lot about the way they view the world.

Death is a part of life, just like birth. Everyone is born, and everyone will die. What we do in between is what makes the difference. Death is also a great equalizer. I learned this lesson at a young age helping my dad clean our boat after a day on the lake. He always said that the boat ramp was the great equalizer. At the end of the day, everyone comes back to the ramp and goes home after a fun day of boating. It doesn’t matter how big your boat was, how big the truck you used to tow it, or how many fun inflatable things you could pull behind your boat. At the end of the day everyone comes back to the ramp sunburned and tired, and everybody had fun.

So when we die, as we know we will, we are all equalized again. Your influence, your money, and your responsibilities are all lost and left behind. What happens to you after you die? What or where do you think you will be after you die? Some believe that death causes you to cease to exist, but I find that hard to accept and impossible to believe.

The hardest part of the last few weeks has been actually organizing my thoughts on this matter. It’s not easy to do, when my cell phone keeps ringing, emails keep arriving, and the world flies by on my laptop screen. It’s easy to ride the wave of now, caught up in an endless progression of thinking about what happens next. Thankfully, I found the time to take my dog to a local state park and hike. So it was there that I hiked miles from any road, on trails not commonly traveled, and sat down for a water break. The sun was high in the sky, coming through the trees to turn the world green. Except for my trampling feet, the world was perfectly still. So I sat there for a long while, and I’m glad I did, because that’s how I was finally able to write this.

Lastly, I wanted to leave with the words to a poem. It was written in the 1600’s, but people then died at the same rate as they do now, and the words speak to people today just like they did 400 years ago.

Death, be not proud, though some have called thee
Mighty and dreadful, for thou art not so;
For those whom thou think’st thou dost overthrow
Die not, poor Death, nor yet canst thou kill me.
From rest and sleep, which but thy pictures be,
Much pleasure; then from thee much more must flow,
And soonest our best men with thee do go,
Rest of their bones, and soul’s delivery.
Thou art slave to fate, chance, kings, and desperate men,
And dost with poison, war, and sickness dwell,
And poppy or charms can make us sleep as well
And better than thy stroke; why swell’st thou then?
One short sleep past, we wake eternally
And death shall be no more; Death, thou shalt die.
Thanks for reading!

Winning The Lottery

A few weeks ago, my wife and I were at a trivia night, a fundraiser for a local church. Our group lost the overall competition pretty handily, but we managed to score a 4-way tie for first in one of the other mini games. It was decided that each group would send a representative to the front of the room and draw a card from a deck, highest card wins. I was chosen from my group, walked up to the front, and promptly drew the ace of spades, winning gift cards for everyone in my team.

The best part of this is that I never win anything. When it comes to raffles, drawings, or anything that has an element of luck to it, I generally don’t win. That’s also why I hate playing Yahtzee and poker. Full disclosure: I should point out some amazing luck I’ve had lately:

– I passed my first neurology exam by 1.3% I’m happy with that 🙂

– While running last week, my phone fell out of my pocket and landed on the only six inches of grass in a park that was otherwise mud puddles or soggy gravel (it’s been raining a lot).

None of this compares to the luckiest moment of my life: when I was born. The moment I was born I effectively won the lottery. By being born in a middle class family, I became statistically more likely to achieve higher levels of education and income. By being born in America, I became a citizen of a country that values freedom and expression. By being born in the 20th century, I am able to enjoy modern luxuries like air conditioning, automobiles, indoor plumbing, and the internet. My life at this instant is more comfortable than the lives of kings and rulers from history.

No AC, way too many clothes.

Several weeks ago we had a required lecture, which I diligently attended. It wasn’t so much of a lecture as it was a “in-class exercise” where we played a game called Oppression Monopoly, invented by someone at Harvard. It’s Monopoly with four players, each with the following rules

Player 1: Plays normal monopoly

Player 2: Starts with half the normal money. Moves half the distance rolled. Starts with a railroad, but can’t buy any property valued at more than $100. Must pay double any time he lands on another players property. If he rolls more than a seven, he must go to jail.

Player 3: Starts with the cheap properties (the brown ones) and half the normal amount of money. Most of the rules above applied to him as well.

Player 4: Starts with double the normal amount of money and all of the green properties. Moves double the roll, collects double when passing go. Must pay double taxes, and has 4 get out jail free cards at the start.

To further emphasize the direction this game was going, our instructor asked to make sure any people of ethnicity or women didn’t end up as players 2 or 3. Awkward.

I was Player 2. Because I had no money and the board was a dangerous place, I played along with the game and purposefully spent the first 30 minutes mostly in jail. After 30 minutes the rules above were lifted and normal rules applied for everyone. Since it was now significantly harder to stay in jail, I promptly landed on park place and went bankrupt.

We then had a “group discussion” to talk about what we learned. Because my class is full of medical students, when she asked for any impressions from the group, she got an immediate “I felt crushed and marginalized by the combined weight of society attempting to repress me” from the back row.

The obvious point here is to demonstrate a simple fact. There is disparity in this country and in our city. I live in one of the most racially polarized cities in the country, and it’s a problem. A serious gap in income, healthcare, and quality of life exists, and I appreciate the effort they have taken to make us aware of it (although we are getting tired of hearing it).

I don’t appreciate the victimization that occurs in this process. Many are often quick to point out that men make more than women, or that whites tend to make more than blacks, and that somehow that is something to be ashamed of. Years from now I will be a practicing physician, hopefully making a comfortable salary and taking care of my family and community. Maybe my birth or family’s status gave me opportunities others wouldn’t have had, but I put in the work to make those opportunities a reality, in an attempt to create a better life for my family and those in my community that weren’t born with that opportunity available. That’s the way it should be.

There will always be income gaps. That’s the way our country is built. People who work hard and have great ideas will go make a gazillion dollars. My favorite headline is “the rich get richer”, as if this is bad. I like to add to it. “The rich get richer….and good for them.” As long as rich people can get richer, that opportunity still exists for everyone else, including me.

The ironic part of this is we get this talk every other week at medical school. Despite my schools best attempts at creating a diverse student body, many of us come from “privileged” backgrounds, and not all of us are white males. Most of us are at this junction of opportunity, privilege, and attempting to do our part to make those opportunities reality. That’s exactly what you do with opportunity.

The differences in these lectures comes down to motivation. If the theme of the book/lecture is informative and neutral, then we are engaged in the kind of productive conversation I would like to have. If there is intent to victimize, slander, or make accusation against some specific group, you’re just wasting everyone’s time. This isn’t a zero sum world.

I need to wrap this up and study now.

Thanks for reading.

sortadrwordpress@gmail.com

 

 

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

Standardize Me

I didn’t post at all last weekend, even though I really wanted to do so. There are a few good reasons why. Besides unsuccessfully fighting off a cold and studying for three exams this week, I am also incredibly lazy and didn’t have the time or motivation to sit down and write the post that has been on my mind for several weeks. It’s only fitting that I find this motivation shortly before my pathology final, most likely using a blog post as another reason to avoid studying  for this test. As one classmate posted on Facebook so accurately: “I find that I Netflix better with study going on in the background”.

I don’t even have to study all that hard for this exam. Because of our grading system (pass/fail) and the assignments and tests I have already completed give me all but six points I need to pass the class. To put in another way, I need to get just 6/100 questions correct to pass this class. I could do that in my sleep. Don’t worry, I will study hard and do fine. (Edit: I actually did pretty well on it).

Our Pathology overlords are doing us a bit of a favor, they tell us. All of their exam questions are “board style”, similar to the format we can expect when we take Step 1 next year. This means that we take the exams on our computers through secure browsers, and that some of the multiple choice questions have options a-h instead of a-e.

Our questions are slightly harder than this, by the way.

Another way we are being prepared for Step 1 is that we are doing everything way faster than previous classes have ever done anything. As I write this in the first week of March, we have already completed all of the Year 1 curriculum. Next week we will begin Year 2 curriculum. The benefits to us include more time to study for Step 1, and more time in rotations before having to make important residency decisions. This all seems like a good idea to me, but we are the guinea pigs in this little experiment, so only time (and our board scores) will tell how it worked out.

This got me thinking about all of the standardization we are receiving. The main goal of the first two years of medical education is to perform well on Step 1. My understanding is that this test makes sure new medical students have an appropriate amount of basic medical knowledge before entering the wards and practicing on real patients. This actually works out very well for me, as I have a long history of crushing standardized tests (including NBME pathology most recently).

Recently my brother-in-law graduated from the police academy. Police officers have a very important and challenging job not unlike a doctor. They have a huge body of knowledge to learn, including the geography of their city, procedures of their department, legality issues, physical ability to drive, arrest, restrain, and I know many cops that have a highly developed “sixth sense” that gets them out of dangerous situations. Even my limited EMS experience has shown me the value of this sixth sense, but I doubt it could be taught.

Now if the police academy worked like medical school, they would spend 2 years in a classroom watching powerpoint presentations on street layouts, with the dangerous areas highlighted. They would take multiple choice exams on how to handle interactions with dangerous suspects, maybe watch videos on driving skills. Thankfully, my brother’s academy didn’t work like this at all. He rode with cops, listened to their advice, and saw firsthand dangerous areas of town. He went to an abandoned runway and spent an afternoon learning defensive driving techniques.

Medical school isn’t taught like that, and I’m not even sure it should be. All I know is that medical school has been taught the same way for a very long time, which is why it is so standardized. There is a well defined process to becoming a doctor, steeped in tradition and learning. If improving the quality of medical education came at the cost of leaving behind those traditions, would anyone attempt it? Will there be a series of huge sweeping changes in the coming years, or will innovation come in small steps, creeping along over the years?

I’ll have to think more about this, but it’s something that will be on my mind as I work my way through medical school.

This post is now very late, but thank you for reading!

 

Tales from Anatomy – The Long Post

I just finished anatomy. The last eight weeks have been a complete blur, but last Friday I took the final exam and most likely identified enough body parts to pass the class. I needed to get 38% on this final test in order to pass anatomy. Because of how hard the test was, I am not completely sure I got 38%, just reasonably sure. The test was hard. My score will likely be the lowest score I have every received in my life. Ever. On anything. To sum up my experience this final week of anatomy, I have to share this screencap someone posted on our Facebook page before the test. This should go on our class T-shirts.

I spent this last week studying hard, spending extra time in the lab, and cramming “high-yield” study tips. I studied with my dissection group, with random people, with lab TA’s, and anyone else who would help me. My wife quizzed me on insertions and innervations of muscles, and my little puppy was intent on helping however she could. Admittedly, she has a tiny brain and no thumbs, so she wasn’t much use. She’s mostly a ten inch tall Roomba (with a slightly lower chance of tumbling down the stairs to her death), trotting around the house and eating anything she finds on the floor. Even after all that studying, I still felt really dumb at the exam. Anatomy has a way of doing that to me. I would study all week on assigned materials, then drive in to take the practice exam on Sunday. Number 1 would say “What is this thing?” and I would have absolutely no idea. Was that even assigned to us?

I also realize I was fortunate during this class. First of all, I took a tough anatomy course in undergrad, so I was roughly familiar with most subjects. Second, I have a quick memory and uncanny ability to remember pointless details from lectures several weeks ago. We seem to get tested on pointless details all of the time, so I get those questions during the exam (most of the time). I also learned anatomy the hard way. I did the dissections, pored through atlases, and did the leg work required to learn relationships and functions. Compare that to a certain member of my lab group, who we will call Leo. Leo doesn’t dissect. Leo doesn’t even help his group during dissection. Instead, he drifts around the lab like a knowledge mosquito, stopping briefly at each groups table and learning a few factoids from each group. Then, during exam week, he becomes the king of mnemonics (more on those below). He has mnemonics for everything. He has primary, secondary, and tertiary mnemonics to remember his mnemonics. He confuses his mnemonics with others, and ultimately forget it all and have to relearn it. Also, he probably can’t problem solve as well when he mostly knows mnemonics.

There are two kinds of anatomy geniuses. The first kind was my dissection partner. He could study a picture and a cadaver, then somehow reconstruct everything into a mental, 3-dimensional structure that he could then picture anytime, from any angle. He was always oriented, and always knew where structures came from and where they were going. It must have been awesome to be him. The second kind of anatomy genius (and the kind I actually understand) are the ones who understand relationships. There is no intricate mental picture stored in their super-brains. Instead, they know where a structure is based on the structures that surround it. They can use the context to identify what a specific structure is, much like confirming the location of your house by locating your hoarder neighbors house. Yes I used to live next to a hoarder.

I also used mnemonics, which are tools to help you remember something. For example, there are 13 cranial nerves that every medical student must memorize. Here they are, in order: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear (auditory), Glossopharyngeal, Vagus, (Spinal) Accessory, and Hypoglossal.

Here they are demonstrated on a cartoon brain.

That’s quite a list to remember. Instead, we first memorized “On Old Olympus’ Towering Top, A Finn and German Viewed Some Hops”. We then knew the first letter for each nerve in order (OOOTTAFAGVSH). Any sentence works, really, as long as the letters fit that pattern. There are incredibly dirty mnemonics I won’t post here, and some creative ones involving Harry Potter, the Hunger Games, and certain faculty members at the school. Everyone uses these to some extent, but I think students like Leo (not his actual name) ended up getting buried in mnemonics, so they are only somewhat helpful.

So what were my “takeaway lessons” from anatomy? I definitely liked it, enough that my interest in surgery has been validated. I enjoyed working with my hands and learning how knowledge of anatomy is applied to procedures and therapies. I also gained an appreciation for all of the material I still don’t know. We learned a vast amount of information in just eight weeks, and no one learned everything that was assigned to us. That amount of material isn’t necessarily unknowable, but it is probably unlearnable over the course of two months. I know that I will need to go back and re-learn critical areas during rotations, and should I decide to become a shoulder surgeon I will learn that anatomy at an even more detailed level. Lastly, I am even more amazed at the intricate design and daily function of our bodies. Even studying a single organ, like the kidney, is absolutely fascinating, totally reinforcing my decision to attend medical school.

Of course the good news of anatomy being done is that I can spend more time on my favorite activities, one of which is blogging! I have this entire week of Thanksgiving off, which will be completely glorious. There is nothing for me to study. Nothing at all. I will likely pick up the pace at which I post here, because I have a lot I want to discuss. I read some blogs that are easily categorized. There are “mommy blogs”, “medical school blogs”, “tech blogs”, “political blogs”, etc. While the general theme here will always be medical school, I can and will branch out write about whatever is on my mind. I’ve gotten a lot of support lately, despite my complete lack of regular posting, and I really appreciate it.

Two weeks ago I made the unfortunate decision to start reading Game of Thrones when my friend (so he calls himself) lent me the first book, which I promptly read in one week. Now I’m hooked, on book 2, and have thousands of pages left to read (and probably hundreds on main characters yet to die, if the next books are like the first). I am also doing a lot of outside reading on religion, so expect posts as I finish reading other religious texts. I realized that despite my college education and multiple classes on world religion, I had done little firsthand reading of any religious text besides the Bible, which I have read cover to cover multiple times. I am now working my way through the Qur’an, the Bhagavad Gita, and the Pearl of Great Price, with more to come afterwards. That was a good decision, since even my early readings were very interesting.

Of course I will also spend time playing Call of Duty, training my puppy, and eating at the new Chick-fil-a that opened RIGHT BY MY HOUSE. I may or may not have camped out and received 52 combo meals, which I am eager to claim for delicious free chicken. Finally, as I get ready to publish this post, I can see that all of the recommended posts from WordPress are posts that I wrote myself. Weird. I’ll leave you with another picture of my cute puppy.

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Thanks for reading! sortadrwordpress@gmail.com

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Tales from Anatomy Part 3

As I near the final week of anatomy, several questions come to mind? First, where did October go? Where was I for that month? Oh right, the anatomy lab. Second, will I pass anatomy? As long as I am alive on the day of the final, I should do just fine. Third, what could I have done better in the beginning of the class to improve my study habits? This was me at the beginning of anatomy:

I was thinking about this a few nights ago as I sat in my backyard recycling (burning) all of the leaves and grass that are piled everywhere. The previous owners of our house left us many of these silly bushes:

As you may or may not know, these need to be trimmed down before winter each year. This left me with a pile of grass roughly the size of my SUV, which I set on the curb in the misguided hope that the trash guys would have mercy on me and take it all (along with our weekly ONE BAG of house trash). Of course they didn’t. They probably just laughed at me and drove off. So now I have a metric ton of freaking bush grass, plus my yard’s monopoly on all of the fallen leaves in my zip code. That’s why I was “recycling” the other night. I have lived in the country long enough that I’m perfectly fine with pushing it all in a big pile, dumping some gas on it, and burning it all at once. Since I now live in a metropolitan area, I have to “use a fire pit” and “have a hose ready” and “extinguish the neighbors tree”. Gosh. City people.

So I’m sitting outside recycling, and I am thinking about anatomy. Here is a typical day for me during the first few weeks of anatomy. I go in to campus and up to the anatomy lab around 8. I then attempt to learn something from Group B regarding the previous day’s dissection (if they didn’t destroy everything) or teach Group B what we learned (so that they can destroy it later that day). We all walk down for a few hours of lecture by professors that I don’t understand, and I spend most of the lectures surfing the internet on my phone or reading Game of Thrones under my desk (don’t judge me). I then troop back up to the lab, where I fumble around attempting to “dissect” the structures I “learned about” in lecture, and I have no idea what’s going on. Finally, late in the afternoon or early evening, I wearily return home, only to realize that I didn’t learn anything, so I have to start all over on that unit.

Here’s my NEW, IMPROVED plan! I wake up and don’t go to class. During the morning, I look at the unit we are going to cover for the day. I google stuff, look in my atlas, and familiarize myself with what the goal for the day is. Then I drive in to lab later in the morning, and I actually know where things are! I see a nerve and think “that must be the _______, since it’s immediately lateral to the ______”. That’s actually learning something. Previously, I would announce that I had most definitely found a “thing” and wait for a TA to come and ID it for me. After leaving dissection, I hop on the interweb and watch the lecture from that morning on double speed, but since I am familiar with the structures from dissection, it just helps me tie everything together, learn the innervations and blood supply, etc. It’s far more effective that the previous method

I’ll continue this for another week, after which I will have an incredibly glorious full week of Thanksgiving with no class at all. I expect to put together a few more anatomy posts over the next week or so, as well as some posts regarding some fun stuff that came up in the past few weeks. I’ll leave you with this cute picture of my dog eating a stick.

As always, thanks for reading!

sortadrwordpress@gmail.com

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