Tag Archives: Writing

Surgery, Metaphors, and the Story of Your Life

Most of us have a very limited understanding of the world in general. It’s not really our fault. Our perspective is pretty well limited to our immediate circle of family and friends, and of course you have only your direct sensory perception of the world to actually create the framework of your consciousness. There’s a big world out there, surrounded by an incomprehensibly huge universe, and we’re pretty much blips. Because our own experience through our lives is very limited, humans have traditionally told stories about their lives and the experiences of others. So many ancient texts and myths have been passed down to us today as oral tradition, or essentially campfire stories that were told for generations before we finally started writing stuff down, which turned out to be a pretty big deal. Nowadays we have the entirety of the internet to connect and share (and in some cases overshare) our life stories. We have even managed to make obscure stories from long ago available widely online, expanding our collective knowledge an incredible amount in a relatively short amount of time. My story on this blog is technically contributing to that collection of knowledge, though it is admittedly drastically limited by my unwillingness to proofread and the limited sphere of influence of both of my readers (hi Mom!).

I think stories are important. I should mention here that I have read an incredible number of books over the years, mostly because I am a huge nerd. I continue to read (at a much slower pace) even during surgical residency. I love the structure of a story, the ebbs and flows, climaxes, and suspense. I like to view my life as a story, as it gives me a framework to look at my family, friends, and goals in a larger setting that may be difficult for me to grasp otherwise.

Stories work especially well when discussing shared experiences. Laughter, fear, embarrassment, stress, relief, and grief are all common across mankind, and sharing stories about how those feelings have affected our lives draw us closer to each other. People generally like to tell stories because they usually like to talk about themselves, but listening to stories is almost as good. I like telling stories so much that I take time to write them down to people on the internet.

Some stories are difficult to share effectively if the experience is relatively unique to you personally. You can communicate the facts and the sequence of events, but you won’t be able to really convey the meaning of the story unless the person listening has had a similar enough experience. I have found this particularly true when it comes to incredibly stressful events such as natural disasters, traumatic events, and surgical residency.

It’s hard to tell stories about residency to people that aren’t residents. Most people don’t have any similar experiences to relate with, and so it’s tough to get that understanding across. This is why many residents only hang out with other residents (also no money, shockingly little spare time, and poor social skills). I recently had the opportunity to catch up with some old friends and this was made very clear as we shared about our lives. I worked more than double the amount that my friends (who have full time jobs) work each week, with far less compensation, WAY fewer benefits, and a much more hostile work environment. It was actually a little depressing as I realized how sad my life was. I found myself saying things like “I can usually do my laundry” and “I’ve been sleeping in until 5am or so lately”. I can still tell funny stories about crazy people, or gross stories about traumas, but it’s tough to actually relate with how I get through my life. I don’t get off at 5, take a lunch break, or even have my own chair. I do have a small locker all to myself, which I think is pretty great.

I really like metaphors. I think they are useful both for teaching and for communicating with others who may have some things in common with you, but not necessarily the experience you are discussing. I have an attending surgeon who overuses metaphors. He will start teaching with a sports metaphor, switch to fishing, then make a pop culture reference from 30 years ago to end it, and I can’t keep up with all that. Medical students definitely don’t, but they will laugh at his jokes, which are terrible. His metaphors are even worse, there needs to be some similarities in your metaphors for them to work.

I like to compare anatomy to cities. Surgeons love anatomy. Every little thing in the body has a name, a function, and variants to know. Then add in the insertions, origins, innervation, vascular supply….it really adds up. Anatomy is often the first traumatic experience medical students have in their schooling. Though it may cause PTSD in medicine residents, it’s a working language and constant learning challenge in surgery residents.

Learning surgical anatomy is like learning to drive around a new city. You can look at maps and get a good idea of the layout of the city, but once you get there you need to start driving and see signs to confirm that Main Street is actually Main Street. Experienced surgeons are essentially the cabbies of the city, having spent years making their living driving on every single block, watching accidents happen (and causing a few), taking alternate routes for traffic, and knowing how time of day affects traffic flow. Medical students don’t know simple things because they are still getting their bearings, they still need to drive down Main Street and see the big attractions.

 

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This is Hong Kong, by the way.

Surgery residency is a strange beast, but I think it has a lot of similarities with baseball. Both are long seasons or careers that require endurance and daily performance. In baseball you can strike out with the bases loaded in one inning, then hit a game winning home run the next at bat. You can play extremely well and the team will lose, then vice versa the next day. No matter how well or poorly you are playing, there is always your next at bat, the next inning, the next game, and you have to continually prepare yourself to perform at your best when that time comes.

Baseball Infield Chalk Line

In the same way, surgery is tough business. Patients live and patients die. The hours are long, and the stress is real. The stress comes in different intensities, like a fire. Each morning there is the distant, soft, constant burn on the way to work. “I don’t want to hurt anyone today. I hope I can help at least one of my patients. How can I be my best?” Then there’s the anxiety when you aren’t at the hospital, but you know have a huge case the next day, or a sick patient back in the ICU. There’s the intense heat and focus in critical situations, when everything is beeping and you are the first to respond to a code, or have the MAC blade in hand to intubate a patient. Everything is on the line, and you’re up to bat. No games to win or lose, but the lives of others are at stake. Finally, there’s the huge weight of fatigue when you walk into the hospital for your 18th shift in a row, or walking out late at night knowing you’ll be back early the next morning.  Batter up.

The story of general surgery is not good. 20% attrition in residency. Huge egos competing for operating room time and influence, each person convinced in their own skill and decision making. A long, antiquated tradition of training surgeons by breaking down medical school graduates and molding the pieces into surgeons. That story is changing very, very slowly, but is still the reality for surgery residents all over the country today, tomorrow, and the next day for the remainder of our training.

If our lives are stories, each of our stories is made up of layers. Starting broadly, there are the events of our lives, or the circumstances that we either create of find ourselves in without our doing. Next, there is our conscious interpretation of those events and their effect on our lives. Separate from that are the actions we take and the decisions we make.

Finally, and most importantly, there is the internal story that you tell yourself about what is happening in your life and how you are going to respond to it. We all have inner voices, or an inner dialogue, and I think that voice is the single most important factor that drives who you are as a person. That inner voice is you, or at least as close as anything can be to you as a person. Whatever you are doing, or whoever you want to be, that voice is going to get you there. It’s remarkable how much I can affect my own day and my own well being despite the circumstances of the day, and that is the single most important thing I have learned in residency.

Intern year has been ROUGH, and there have been life circumstances that have made it more difficult as well, but it hasn’t changed who I am.  The challenge will be to maintain this for the next few years of training without burning out. I’ll probably write about that if it happens, but I hope to just keep telling you all funny stories and letting you know what’s on my mind instead.

Thanks for reading!

 

 

 

 

 

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My Life is Very Glamorous Now

For anyone keeping score, I have not written a single blog post in almost two years. In that amount of time I have passed a whole bunch of tests, finished medical school, moved partway around the country, and become a for real, honest-to-God surgical resident. Impressive, I know. I return now to divulge all the juicy secrets about doctors and describe all the ways that my life is exactly like Grey’s Anatomy.

glamor

Actually, I’m back because I got an email that someone might have hacked my page and been posting malicious content. The security threat was neutralized (unknown source, but it could have been either of my regular readers) and once I remembered my password I realized what a gold mine of ridiculous stories I am sitting on and how much I miss writing. Shockingly, this blog is visited routinely despite not logging in for over two years. There are comments from 2014 that will still be awaiting moderation when the world ends. If I had monetized this thing two years ago I could probably get a York peppermint patty at the gas station, but as I mentioned, I have been busy living a very glamorous life, which I will detail below.

The main perk of being a surgical intern is that you get do everything. Actually, mostly everything. All of the cool stuff gets done by people above you, BUT you get to do everything else, so pretty much lots of pushing buttons of the computer, taking papers from one place in the hospital to another, and keeping tabs on dozens of patients doing their best to leave the hospital to overdose on drugs or make poor decisions as soon as they can. Also, everything is your fault unless you have proof of being in a different location, being on a different service, or an iPhone video of the attending surgeon telling you explicitly to do that specific thing. The basic procedures that are “intern level” are bestowed on you as though they were gifted from God himself, but really it’s just a chief resident with a healthy opinion of himself “letting” you do a gallbladder. But trust me, you are very busy and definitely not with busy work.

Perfect resident

A second perk of being a surgical resident is the ease of managing your life outside of work. See, a “resident” describes someone who lives at a certain place. To “intern” someone also means to confine them to a certain location. The ACGME had to create new rules specifically so that we worked less than 80 hours a week. Simply put, your life outside of the hospital becomes pretty well simplified into brief periods of lucidity shortly before or after going to sleep. Starting residency, I was shocked at how little cleaning I needed to do, since I was never actually in my apartment long enough to make a mess. I have since managed to surreptitiously move into and live in an upstairs call room at the hospital, and I use the neighboring anesthesia call room to store all of my boxes.

A third perk of surgical residency, which I consider to be a defining perk of surgery in general, is the ability to wear scrubs every day of your life. I love my scrubs. My sweatpants at home aren’t as comfortable as my scrubs. I can change them whenever I want, add or subtract layers above or below them, and they are so comfortable I could wear them as pajamas. Acceptable all days of the week, on the floor, most of the time in clinic, they simplify your life and wardrobe into a nice dull shade of green. Gain a few pounds and no one will ever know. They are impossible to wear inside out once the logo and tag get washed off in the scalding hot bleachy hospital wash water. Depending on the situation it is possible to layer your scrubs for maximum efficiency, allowing you to remove and dispose of the top layer on the go (while seeing isolation patients, for example).

Finally, one of the key factors that made me choose to be a surgeon in the first place, I actually feel like I help people. Surgery, as an act, can directly fix problems. Gallbladders come out, mesh goes in, wounds are repaired, infections drained….whatever that individual needs, we can often help them in a tangible way. Of course some people have chronic issues no surgery can fix, but that’s a common theme in all areas of medicine now and a bigger problem than choosing your specialty.

Honestly, surgical residency is nothing like Grey’s Anatomy. The one episode my wife showed me started with the surgeons going to the hospital after the sun had risen, which immediately tipped me off that it was going to be incredibly wrong. Ironically, surgery residency is more similar to Scrubs than to any other show. The ridiculous “cast” of hospital staff you work with every day, the unbelievable patients and family members under your care, and the combined drama of having all of your patients experiencing their worst day ever weave together to form a story so impossible to communicate effectively that you end up just seeing the pieces.

I wish I could tell you about the stress, the anxiety, the soul crushing nights of trauma, delivering bad news to cancer patients, and grasping for ways to explain to families how their loved one has died. I wish I could share the combined experience of every sleepless night, running around the hospital while three pagers ring incessantly, worried that my action or inaction would cause harm to a patient. Conversely, I wish I could tell you about the bond I have with my co-residents, the thrill of mastering difficult technical skills, of doing work well, and the peaceful content after a job well done. There is a deep satisfaction to working as a surgeon so impossible to convey that it’s easier to just show the “skits”, the short stories that are relatable and funny, easy to tell at dinner on the weekend.

On this blog, however, I can do something different. My writing over the years builds on itself. My story, my perspective, and my experience can create a narrative that is greater than the sum of its parts. The lessons and experience I am currently gaining are coming at a dear personal cost and are worth sharing. It’s worth it to me personally to take the time to sort out my thoughts and articulate them here, and I hope that over the years this story has a meaningful impact on someone else in the world too, wherever or whenever that may be.

That’s why I’m back writing here.

Thanks for reading.

 

 

 

 

 

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.

So You Still Have a Blog?

Do you have a Facebook? Of course you do. How about a blog? Even if you don’t have a blog, you are reading one right now, so I guess you’re familiar with the concept. How often do you see people post links to other blogs on your Facebook? I’m guessing it happens quite often. Here’s an example of the type of post I see often:

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That’s from a blog written by James Michael Sama. I don’t know all that much about him, except that his posts appear on my Facebook about twice a week. Even a quick look at his blog shows that he has slightly less than ten million hits on his blog. I can also tell by his archives that he started blogging in June 2013. Take a look at my archives over to the right. When did I start blogging? June 2013. How many views do I have on my blog? Not ten million. Not even close!

I suppose I need to give him the credit for that. He has been in feature films and mainstream media far more than I have (which is never, by the way). He also posts far more frequently than I do, and often on topics that are easily readable. Let’s face it, more people want to read about dating, relationships, and current events than they want to read about science, medicine, religion, or whatever else I’m thinking about. His posts are also well written and creative. So I’m not trying to compare authors or blogs here, I’m just telling you about this guy to set up a point I want to make about blogging.

The strangest thing about blogging is how lopsided our interactions are. I get to write things, post them on the internet, and let them stand for all time and eternity. I covered that briefly here. To write a blog, one must believe at a certain level that “I can write something that others will want to read”. This is the opposite of Twitter, where people just assume that everyone wants to hear about what they had for lunch. To write a blog, you have to be able to string together a line of reasoning, assembling your thoughts and shaping it into a post that is interesting enough that people want to click on it and read it. The best (and worst) part of blogging is that anyone can do it.

I have this theory that 42% of all blogs have one post called “I have a blog”. Because starting a blog requires an internet connection and two thumbs, nearly anyone can jump online and make a blog. Historically, this is unprecedented. I can sit in my office and write a post in about an hour. Let’s say a few people put it on their Facebook pages, and it goes viral. Suddenly hundreds of thousands of people have read my post and I get tons of traffic. 100 years ago, there was no way to reach hundreds of thousands of people that easily. Radio, perhaps, but that was harder to access. Newspapers, maybe, but only certain groups of people could actually write in a paper. Anyone can write a blog, and who knows if that post is the next one to go viral?

The downside to the accessibility of blogging, of course, is that anyone can do it. I’ve read some blogs and wondered whether they had ever graduated high school, or even attended one. I followed a blogger for a while who posted once every three weeks, and his/her only content was “I’m sorry I haven’t been posting lately….I’ve been like super busy”.

Blogging is great, especially when authors like Sama go out and reach a huge audience, but I don’t see it lasting. I understand that my little post here is just one tab on your browser, and I have to compete with everything on the internet for your attention. Blog posts take time to read, and require much more effort from you than, say, a YouTube video. It can be difficult to find your way to a blog you really enjoy consistently, while YouTube gives you a recommended playlist based off your preferences, so after you watch a cat video there are 12 more cat videos to watch. My favorite blogs have been those that people referred to me. When I search for blogs, on Google I have much worse success.

I’m not upset that I don’t have ten million views on this blog, since that was never my goal. My goal is to write, and enjoy writing, and talk about what I learn and see during medical school and life. That’s not a good recipe for generating ten million views in six months (unless somehow I was already famous). At the same time, I like it when people enjoy what I write. That’s the whole point of blogging, right? If no one reads your blog, that’s just a diary. While I enjoy Sama, Matt Walsh, and Fat Cyclist, I know that I will never be that kind of blogger. Why? Probably due to my sporadic writing schedule and “no proofreading ever” policy, among other things (like medical school, for instance). If I wanted a million views in the next six months, I am confident I could get them. I just know I wouldn’t have as much fun as I am now, and I’m having lots of fun 🙂

Thanks for reading!

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The Anatomy of a Story

I  love stories. Ultimately, life is best expressed as a story. As long as people have gathered together, we have related to each other by telling stories. Our stories make us unique and form part of our personality and worldview.

But have you ever tried to create a story? I mean a real story, like a book or movie, even a short story written for a composition class in school. Have you ever created individual characters and let them live out their own little stories inside of your fictional world?

That’s one of the things I have been trying to do lately, specifically hoping to one day finish a novel of my own. I missed out completely on NaNoWriMo, thanks to medical school anatomy during November. I still wrote and brainstormed and thought about my book, even if only a little bit of it got written down.

So how is a story made? In my mind, I want to frame the whole story from beginning to end, then go in and fill in the details as a write. I want to “construct” the story, and then build it methodically. NaNoWriMo gave me a different idea, however. If I had completed NaNoWriMo, my story would be nurtured. I would start writing with a vague outline and ideas, then watch the story grow as I wrote it. To stick with the growth analogy, the story could then be trimmed and revised after it was fully grown in order to reach its final shape.

However it’s written, I have gained a lot of respect for great storytellers over the last few months as I labor on my silly little book. It took Tolkien something like two decades to finish The Lord of the Rings and have it completely published, but in that time he created a complete universe (including languages and cultures for multiple races) and set his story in his world. I have always enjoyed reading Tom Clancy’s thrillers, which were well known for being meticulously researched and technical, which made the stories more believable and enjoyable. I am slowly reading my way through the Game of Thrones books right now, and I can’t imagine how long it would take to create a sound plot that involves a huge cast of characters and multiple kingdoms (even though his main plot twist is to kill main characters every other chapter).

We each get to write our own story for our life, as well. I had a unique opportunity when I moved halfway across the country in the middle of high school. Because I had gone to school with the same people since kindergarten, I feel like I had acquired enough “labels” in my early high school years. You know how high school students can be. Halfway through high school I moved 1500 miles away and started at a completely different school. It was during that summer I realized that I could be whoever I wanted to be, as no one in this new city knew me at all. While I could have been anybody, I did some growing and maturing and just became myself (which is an entirely different story).

This brings me to my last point about stories, specifically our own stories about our pasts. I’m not convinced it’s the contents of our stories that matter, but the way we see and interpret them. I had a psychology professor tell me once that after every disaster, there are victims and there are survivors. After a hurricane (I’m pretty sure it was a hurricane), some people will have their lives shattered and never be the same. Others treat it like a setback and press on. I’m not sure what her point was after that, but I’m using that story to illustrate my point. There are people who are products of their environment, and there are people who overcome their circumstances and rise to greatness. I think the difference is in the way they told the story of their life.

Thanks for reading.

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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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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