Medical Students are Crazy

There must be an anatomy test in 2 days, because I've found time to blog. I'm not going to lie - the intimate details of the nasopharynx do not interest me one bit. Learning the material for this test is like trying to convince a teenager to practice the cello for 2-1/2 hours everyday. Considering that I used to attempt this feat on a daily basis I know it is impossible. Since I am not currently passing anatomy, this is a problem. Step one - I've admitted I have a problem. Step two - continue with blog and ignore problem.

We had a tornado this week which not only uprooted several locals and students, but uprooted our schedule as well. The dreaded microbiology case presentations were cancelled. I felt guilty for being so grateful, but there you have it, I was ecstatic - especially since I've chosen sleep over study recently. I spent Thursday helping clean up felled trees and brush from a local town. It was great. I became a doctor to work with and help people. Reality - medical school has nothing to do with that goal. I take every opportunity that presents itself to work with people in the community so I don't lose sight of my goals and forget that I really do like people. Okay, most people.

A room full of medical students - it sounds like the start to a joke - in a way, it is. I enjoy watching us, myself included, in groups like this. It's like having 172 type-A bosses all standing around and trying to be polite. It's downright hilarious. We enjoy each other, because we understand the pain and joys of medical school, but we can barely stand each other, because we're all so similar. Some take charge no matter what, and others stand back and talk about them behind their backs. Some ace test after test and they're idiots. Some fail constantly, and they're going to be amazing doctors. I have no idea how the world works. I'm not going to lie - it's fun to watch.

So there you have it - medical students are nuts. We know this, we're just trying not to have that fact documented on paper. Whatever you do, don't let them know you're bipolar! Good luck boys and girls. Now get back to studying.

Medical School with a Baby

It has been quite awhile since my last post. Shame on me. Things really got interesting in second quarter, and third quarter is unrelenting. And then I found out, back in February that I'm pregnant. Mini-me was certainly planned, but not probable. I was not intended to have children, according to my doctors. Here I am, almost 17 weeks pregnant and at least so far, no signs of any problems.

I was waiting for some real inspiration for a post. Something uplifting and wholesome for future doctors. Something that will make the pre-meds very excited. Unfortunately I have had no such luck. It's not that I'm miserable, I'm not, but it's absolutely grueling, and sometimes that takes a toll on my usually positive self.

Balance. It's such a simple word, really. However, if one adds medical school and pregnancy to the equation the calculus becomes much more interesting. My pregnancy hasn't been too bad. I've been exhausted and quite sick, but nothing too major to report. Medicine of course does not care. It's not that my professors are callused and uncaring; they have been great. However, were I to put off a test on account of morning sickness, then I'd have to double-up studying for the next day's tests. Not an option. I dragged my sick and nauseated self to an anatomy final. I was sweating bullets trying not to hurl (chunder, vomit. . .). I managed and I even did all right on the exam, but it was pretty awful.

Balance. I cannot and will not spend all day and all night of everyday studying. The people who do that are machines, and not in a good way. People are not machines and algorithms do not always work. Creative thinking does have its place. I refuse to see people as merely a set of numbers. Those numbers are important, but if the doctor can't think beyond that - well then, you're going to have a problem.

Balance. What if I forget to listen? What if I'm so busy that I cannot really look? What am I then? I am that doctor that everyone complains about. The one who walks in the room and says without introduction to a cancer patient, "We're going to have to remove that finger." True story. It's unfortunate that every medical student (myself included) thinks that we're never going to get anywhere if we can't intelligently define LaPlace's Law. It's simply not true.

Balance. What does student Dr. Anne recommend? That you lay in bed for a few extra minutes every morning to take in the sounds. Look around at the trees. Have a good cry. Try to do better. We must do better.

The Physical Realm (not a medical musing)

Today I went shopping. I hate shopping, and especially for clothes. Partly it's the guilt that overwhelms me. Guilt that because I have poor control of my food choices and my drive to exercise is weak, I am somehow not a good person. Okay, gross overstatement, but every heavy woman knows about what I write. It is so hard to be a fit American. We have french fries available to us every 20 meters or so, mochas at every corner, and fantastically comfortable furniture begging to be sat upon, layed in, or lounged across. I do love exercising. I used to be a weightlifter. So what's the problem? As with all medical students - I hate doing anything halfway. So - why exercise for only an hour? I want a three-hour-a-day body-busting routine. 60 pounds ago and a lot more free time - I had that. It's depressing to go run for 30 minutes and lift a few weights.

I need to get over it. Being a fat doctor just doesn't look too good. Be honest - you'd trust a fit doctor over a fat one. I could never look a patient in the eye when I had to tell them to lose weight. It's awful! I need accountability! I need time!

Fear not - I will not make this a New Year's resolution. That's just bad luck. Mope. That is what I will do. Then maybe I'll find the strength to take the cliched bull by the horns and treadmill by the rails. . .

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.