Winter Break!

Ah the sweet bliss that is break. Translation: opportunity to sleep. This is important. I had no idea what sleep deprivation really felt like. An all-nighter here, a few hours of sleep there - no big deal. In medical school we don't sleep, we take naps. My naps were getting shorter and shorter with the impending doom that is physiology. Last night (morning?) around 2:00AM I thought I felt a bug in my ear (literally). Then I felt something crawling in my shirt. I thought I saw a bug on the wall. I became quite paranoid - hating bugs and all. I removed my shirt to see if there was in fact a bug in there. Negative. Then it all rushed back at me in the silence of the night - I was hallucinating. I took a deep breath, inspected my garments and the walls, and realized there were no bugs. Problem averted. However, that ain't good. It's a very tenuous balance - do I get some sleep, or do I learn a few more tidbits in hopes of a few more points? Unfortunately, our tests are small and every point counts. So, usually we choose bugs in our clothes over sleep.

So why don't we all run away screaming? Because it's awesome. This week we learned how to perform an abdominal exam. I felt the aorta with my hands! I could feel my partner's kidney! I could hear what the bowels were doing. I could hear the clear pulses of a healthy person. It's amazing what goes on inside. It's amazing how beautiful is the human body. We worry about a little flesh here or a small this or that - missing what is to me, much more exquisite. Sometimes people don't understand how I can mean sincerely that everyone is beautiful. That sounds like cheap poetry, but it's true. The older individual that was my "simulated patient" - the body just looked and sounded like wisdom - its sounds are like, "Yes, I've been there and I've done that." It's physical history; living and breathing knowledge and experience. To have the opportunity to listen to and touch that person is quite a gift and one that requires an immense amount of trust. Trust that is bestowed upon me. That's worth some bugs in my shirt!

Post-Finals Quarter One

Today marked the passage of quarter one. With complete exhaustion and utter humility I can say, I did well - despite it all. At 4:00AM this morning I was still begging my brain to remember countless dirty mnemonics to remember what all each of the 20 amino acids does/becomes. I was trying to remember every step and enzyme and enzymatic subunit of DNA replication, transcription, and translation. I was trying to remember what happens from the moment you eat your dinner to the moment what's left comes out. It seemed like billions of enzymes all starting with either gluco- or phospho- and ending in -ase. And the pathways! The pathways and their enzymes and things that can go wrong and what happens when things do go wrong, and what to do about it. . .and on and on and on. 500 pages of this!

If you are a pre-med student, do not tear-up your application. It's hard as Hell to get in. It's hard as Hell to succeed. However, it's great to be here. My friends and I discussed how it's similar to being in an abusive relationship - "It was my fault; I'll try harder next time." "If medical school didn't love me and want me to succeed, it wouldn't push me so hard." All right, that's a terrible analogy, but there's some truth to it. It's horrible, and yet, it's awesome. I bet you didn't know tonsils are also on your tongue and your palate. See - pretty damn cool.

It's worth it, even when I feel like I can't possibly take another day of this or another bad grade it all evens out, and by tomorrow, I will have had more than 3 hours of sleep, and that's truly wonderful.

What an honor - to learn so much about the secrets in every crevice and cell. It certainly isn't easy, but I'm glad I'm here.

Finals - Quarter One

I can now understand, with a great degree of clarity, why medical students become hardened and uncaring. Unless you've been there, or are here, you can't possibly understand the enormity of the task and the feeling of utter hopelessness. It's just school, how can it be that bad? It is.

I'm not sure if it's the countless numbers of mind-numbing, "I'll never use this again," details, or the lack of time for anything else, or the bi-polar grades. Probably it is the combination of it all. The material is interesting; I wouldn't be here is I didn't think it was. The frustration of never being well-prepared is extremely taxing. There is not enough time. There is never enough time.

So what do we do? I think probably learn new coping skills. Take time when there isn't any. Understand that mediocrity doesn't equal bad doctor. In fact, some of the smartest people in my class are going to be awful doctors. It's too bad, really, that in the US we base success on the ability to memorize.

I can't see a better way to do it. You don't want a manual-dexterity genius taking out your gallbladder if they don't know exactly where it is and how to stop bleeding. You don't want a pediatrician for your baby with a cleft palate that doesn't understand where neural crest cells go. However, for those of us who struggle with memorization, we are suffering, and we will probably not have the option of a competitive residency. You're loss.

For now, I will be happy that I'm doing well-enough. I will play my cello and go on dates with my husband. I will play with my critters, and I will try to enjoy medical school without becoming a business-woman. "Next, please. . ." I will do my best to look you in the eye and give a damn.

Wellness

Today is our once-a-semester wellness day. Though I need to study, I am listening to their advice and taking some much needed time off. I will study and work later today, but not right now.

Did I need a break? Yes! In fact, I slept for 11 hours today. It felt great. I feel so much healthier, especially mentally. I was getting depressed and overwhelmed, not because medical school isn't the greatest thing on Earth, but because it's so exhausting. The responsibilities are huge, and the amount of material is even more vast.

We are still learning about the upper extremities. I had no idea there were that many parts and connections. I still say - may you never need to memorize the brachial plexus. Also, I had no idea there were so many different muscle groups in the forearm and hand. Yesterday we dissected the hand on our cadaver, and I didn't expect to like it as much as I did. Everything was so neat and tidy - this small space of little muscles, nerves, and vessels. I don't know that I want to do such detailed work as hand surgery, but I certainly enjoyed learning the anatomy.

Other things that are humerous only from afar - carbohydrate metabolism. So, many people have heard of glycolysis or the Kreb's Cycle (currently called The Citric Acid Cycle - TCA Cycle). When everything starts with gly- or phospho- the brain starts getting mightily confused. I have over 60 pages of these words and diagrams to put into my brain by next Friday. Good times. It's really cool to see how that slice of bread becomes fuel, but it isn't straightforward or instinctive. However, I did learn why we fart. That was amusing. Unfortunately, it's not something I could explain without a fair bit of background information. If you want to know, ask, and I'll try to explain.

Send prayers to my little Francesca (one of my new mice). She has "wet tail," and although she is strong and determined, she is getting weak. I'm doing my best as "Student Doctor Anne," but I'm no veterinarian.

And now - off to study. Perhaps I will go get another piece of honey cake.

Rats

I am trying to study anatomy. We are learning about the upper extremities. Though it is interesting, I have trouble focusing when reading Greek and Latin - neither of which I know to any usable extent. May you never need to memorize the brachial plexus. At first I thought our professor was making a joke. When I realized that he really does expect us to be able to draw it I wanted some Valium, a comfort blanket, and a little vodka.

My little rattie - Emmett has sustained neurological damage. Emmett got gravely sick about 11 days ago. He was fine and playful in the morning, and by evening I thought he had acute failure of something vital. He was barely breathing, immobile, and his face was crusted with porphyrin. I couldn't find a vet, so we had to wait until morning. By this time my little one was honestly starting to get stiff and cold. He was breathing a tiny bit. He had nothing to eat or drink for almost 24 hours. The vet was a jerk. He picked up my dying baby by the scruff and pronounced him "pneumonia." He injected him with Baytril and I requested some subcutaneous fluids. We took him home and waited for him to die.

Emmett didn't die. He did teach us that one can get really creative with baby food in order to hydrate and get nutrients into a sick rat. He got better, but he didn't. He was breathing fine and eating fine, but he couldn't follow my voice, and he was acting like he couldn't see. His pupils didn't respond to light. He is very sweet, but not playful anymore. I do believe my little rattie has come out a bit retarded from this experience.

Anyone who doesn't believe that all living creatures have a soul - I put him back in the cage with his brother (Martin). Martin is a very playful and instinctive little beast. I thought perhaps he might eat Emmett - thinking he was going to get them killed. In the wild, a disabled rat is like bait. Instead he started cleaning him and then cuddled up with him. This has been the pattern ever sense. He knows. He's being so gentle.

Another rat story - Martin decided that his fluffy "couch" should be in his purple house/nest. He dragged it into the house, and the next day, Georges (one cage over) did the same thing. He's almost three! It's not like he decided to do this all of the sudden. I do believe he learned from the other rat. And we think indiscriminate animal testing is okay. Stupid unfeeling rabbits and guinea pigs and rats. They are practically considered compost. Don't even get me started on mice. I hate it. I hate they way we do animal testing. There are so many things we can learn from tissue testing. We can keep growing tissues and cells in culture. Once that's well defined, then kill a critter. I wish we never had to do that.

And now - I go to the store to get foods for my Georges rat who is on antibiotics and hates them.

G'nite.

Mercury and Vaccines

Today was a very mixed day. I failed my first exam - totally my own doing. I didn't study. So, I will be mending my ways. I'm not too upset. I just need to remember in the future that no medical school class is a blow-off class.

Also, today I participated in giving free health screenings to the under served. I was part of the blood pressure crew. I learned how to do it, and then I did several. It was just so gratifying to do something clinical - to work with people instead of sitting at my desk and studying. The participants were all very nice. I can see why a physician would choose to help the under served - it's a much different population. They were all very grateful and really seemed to want to take ownership of their health. Nobody came in with "yuppie disease." You know - "I'm allergic to soy, and my son has ADHD and Asperger's." Did you read in the news - people are pissed about chelating treatment for Autism being cancelled. That's where a chelating (tight binding) agent is administered into the bloodstream, in this case to sequester (grab) mercury molecules, because these people are convinced that vaccines containing mercury (more about that in a moment) "gave" their kids Autism. More likely - it's caused by excess opioids in the brain due to something vital missing - probably from a genetic mutation. This is similar, in my opinion, to Adrenoleukodystrophy - where one can't process certain long chain fatty acids correctly, and it causes all kinds of problems.

Some vaccines contain a mercury (thiomersal) compound. This is okay, because it is broken down in the body and eliminated in a maximum of 120 days. Small doses of mercury aren't going to harm a person. Remember when you played with an old broken mercury thermometer? You're okay, right? However, a fungal infection from the vaccine would kill a person. Additionally, you wouldn't think twice about using this compound if bitten by certain spiders or snakes. There are dying people who would love to have had these vaccines. People are ridiculous.

Anyway, I need to get back to biochemistry. You know, I'm sure glad not to have diphtheria (see photo - get your kid vaccinated!)

One Down. . .

Today was the first exam of the quarter - it was beloved biochemistry. I was quite apprehensive - being that it was the first exam. I went in there quite prepared, and I'm very proud of the score I received.

Tomorrow is another day, and histology and anatomy are nipping at me for some attention. I better not get too confident, because the pile is getting higher and deeper, but this was a good way to get started.

I'm tired. I will have to write more at a later date. Is it bad to drink coffee, because I like it, and then have an alcoholic beverage so I can sleep? Hmmm, probably not something I should do too often.

Want Some Mo'? Gimme Some Mo'!

All right - that was supposed to be funny. You know what's not funny? Studying all the freakin' time. When I take a break I feel guilty, because I know I need to be studying. When I'm studying and my brain turns into static in-between-stations fuzz, I feel guilty, because I am not the smartiest pants. My pants are going to get bigger if I don't get off my bum and start working out more!

So we were lectured on "balance." I understand that I need to close the books and forget about it sometimes, but it's so hard when I know the tests are creeping up, and the assignments are piling up. . .I've heard that shrugging the shoulders, saying something obscene, and walking away gets easier as the quarters go on, and on, and on. . .

However, despite my lack of focus and my heightened sense of dread at the impending exams, etc., I am having a wonderful time learning. The greatest word so far? Syncytiotrophoblast. Isn't that pretty. Say it again. Oh yeah!

Our first day of dissection was last Friday. I loved it times 10. It was extremely fascinating and absolutely exhausting. We, like several others, have an obese cadaver, and though I am endlessly grateful to this person for giving me an irreplaceable gift, it's a lot of work to get down to muscle. No doubt, it's a much better learning experience to go layer by layer, cut by cut, to learn anatomy. I hate the idea of prosection (where it's already done). Yes, dissection takes a huge amount of time, but I think it's absolutely necessary. Each body is different, and actually seeing it and discovering it is the best way to learn - in my not-so-humble opinion.

And now - tis time to spend some precious time with my husband. I think a little wine and relaxation will do a body good.

New Space

I decided this new path deserved a new blog. Today was much better than yesterday. I was forced to use Excel yesterday, and that was a problem, since I have very diligently avoided learning how to use it. I honestly believe one could get a degree in Excel. Anyway, after three frustrating hours I found someone to help me. Voila! All I had to do was some algebra - that I can do.

I love medical school - so far. I've watched the second year students this week; they have finals. They are a tired and ratty-looking bunch of people right now.

Next week is my first exam - biochemistry. I'm nervous, because biochemistry was a disaster for me during undergrad, and it seems far too easy right now. Well, my first biochemistry teacher was a roaring drunk. Unfortunately I am being completely honest. His tests rarely matched what was taught. However, that lousy training made me ever-so-grateful for my current wonderful professors. I have one professor who could explain the derivation of the Michalis-Menten equation to a six year old.

After class today I worked out. I'm trying to get my fighter body back. We'll see how that goes when things get tough.

And now I bask in the glory that is medical school. For right now it is manageable and quite enjoyable. Today we started learning about the anatomy of the back. That, my friends, is some seriously cool stuff.

B'shalom