3 Down

It's kind of scary to think that we've been back at school for three weeks and it already feels like we never left. I've fallen pretty much right back into the routine of studying, although I have to admit that this semester, it feels a bit easier to balance my time between study and the other important stuff.  Maybe it's because we don't have gross lab taking up immense amounts of time, maybe it's because I've gotten more efficient.  Maybe it's because I'm not studying nearly as hard as I should be...who knows.  Either way I don't really care...it's nice to just not feel like I'm doing nothing but study all the time. 

Went and saw "Defiance" last night w/ my family.  It was excellent and I highly recommend it.  I love true life stories, and honestly it wasn't nearly as violent as I was expecting, all things considered.  My list of movies that I want to see in the new year, however, continues to grow every time I see the list of trailers.  Currently on the list are: The Reader, Revolutionary Road, Duplicity (Julia Roberts and Clive Owen--yum), Doubt, Watchmen, He's Just Not That Into You, and probably several others that I've forgotten to mention.  Too bad movie tickets are outrageously expensive and I probably won't get to see many of them til they're out on DVD.  

D closes at work tonight (which sucks) but he did just get promoted on Wednesday--which means not much change in job duties but a decent bump in his salary, which is exciting for both of us.  He's hoping to be able to apply for another job opening within the company within a month or two, depending on how things fall.  

Goals for Today:

• Go Grocery Shopping--we quite literally have zero food in this house.  It's kind of pathetic.
• Study physio, biochem, and force my way through neuro.  With any luck, do some physio practice problems and a practice test.
• Vacuum this dog fur-ridden house. 
• Call the Nintendo people, as our Wii has suddenly and to everyone's dismay decided it doesn't like playing games any more.  As this is one of our sole means of entertainment on a daily basis that doesn't require money, it will have to be remedied ASAP.

Power of a White Coat

My ER preceptorship was this morning.  I was incredibly nervous at first, getting dressed in my brand new scrubs (didn't want to smell like a cadaver), putting on my white coat--I felt like an imposter.  Surely, I thought, someone will see through this.  Someone will look at me and realize that I am nowhere near qualified enough to wear this garb and will point out my inadequacy.  I do not feel like a doctor yet.  I don't even feel like a medical student.  

Yet there is some strange, inherent power to the white coat.  It's only hip-length, which signifies to those in the know that I am junior, inexperienced, unqualified...but to those not in the know the coat means power, authority, knowledge--the ability to end suffering and mediate treatment and maybe even hand out a free drug score if you really know how to work the system.  I walked into the elevator from the parking garage on my way in today, and the two ladies riding with me looked up to me and asked where the pedway was.  It was such a simple question, but from the way they looked at me, you could tell that they would have accepted just about anything I said as gospel truth--because I was the one in the coat.  I sheepishly admitted that I did not know, I hadn't been in the hospital much. 

When I actually got to the ER where I was spending the day and met up with the doctors I would be shadowing, we had a really fun time.  It was much different than the experiences I had had previously, when I was in high school or undergrad.  Then, I was clearly a nuisance, someone getting in the way.  Now, I have the coat--doctors called for me, nurses gave up their chairs, patients accepted my presence without question and even encouraged me to ask questions or congratulated me on being simply what I was--the "student doctor."  Truth be known I know about as little about their disease or how to diagnose and treat it as they do.  But that's why I'm there.  To watch, and listen, and learn about their disease and treatment and so much more.  It was fascinating to see how quickly the physicians I shadowed could run through a history, making sure to ask the questions that were most pertinent to the problem at hand and coming up with answers so quickly that I had not even processed the little applicable information I knew by the time they were on their way back with a prescription.  I saw a sinus infection (five minutes from the time we walked in to the time the person was discharged), a man with a large boil (possibly from a MRSA infection) that had to be lanced and packed with gauze, and a woman with such trouble breathing that I just wanted to force air into her myself.  I left before she was well--she probably had to be intubated and kept overnight.  One woman was diagnosed just last night with an inoperable brain tumor and had to be brought back in because she was having more seizures.  She refused to stay and be treated.  And at least three people that came in while I was present were "repeat offenders," in and out of the department with so-called chronic pain, looking for drugs.  If nothing else, it was fascinating to see the patient-doctor dynamic in those situations, to see how all involved handled it when the doctor refused to give a patient narcotics.  

I was worried when I arrived today that I would be bored, like I used to be when I shadowed in an ER as an undergrad.  In reality, time flew by pretty quickly (and probably would've gone faster had I been filling out all the paperwork that the doctors were doing).  The nice thing was to see what the actual doctors do all day long, rather than nurses or techs or orderlies or a combination thereof.  The even nicer thing was that it is definitely something I can see myself doing every day. 

Playing Doctor

The thing I love about this semester is how applicable everything is beginning to become.  I took about four weeks of biochem in undergrad and dropped it because it was boring and the professor was horrible.  Now, we're taking biochem and I love it because we don't just talk about compounds and how they react but about why they are important to you as a doctor.  When discussing enzymes, we didn't just talk about the difference between competitive and non-competitive inhibition, but had examples given to us of different HIV drugs that utilize both strategies.  When we talked this week about isoenzymes, we discussed how cardiologists use creatinine kinase isoenzymes in the blood to diagnose a heart attack.  SO cool.  It keeps me interested and reaffirms what I love about this field.  

On Thursday, we had what's called an ICC group--basically, a small group setting led by a couple of physicians where we discuss diseases that make our material more clinically relevant.  This particular case was what's called a "pimping session," which is where the doctors came in and were supposed to just ask us lots of questions about a certain disease we had been told to look up.  Pimping is one of those things that med students and residents generally hate, because a lot of times when you're actually on the wards, attendings will get malignant with it and just ask you impossible questions until you cry.  Our group's session was completely the opposite--we were relatively well-prepared for the questions they asked, and I feel like I learned a lot about biochem but more about how things actually work in a real-life hospital diagnosis setting.  This is why I came to medical school, and it makes even getting up to be at class at 8 every day so much fun.  

Last night me, my husband, two of our old friends and one of my new med school friends went out to dinner and spent the evening chilling out and playing the most evil game of Monopoly of all time.  At one point I was in debt to a loan shark.  It was crazy, ridiculous, and the most fun I've ever had playing that particular game.  Nice to just have a relaxing evening with good friends, new and old. 

Tomorrow we have a day off of classes for Martin Luther King Day, so I'm using the time to do my required ER preceptorship.  Basically I'll be spending 8 hours following an ER doc around and hopefully getting to see some cool stuff.  I get to wear my scrubs and white coat and stethoscope and feel like this is actually real, as it eventually will be.  I couldn't be more excited...hopefully I'll have some good stories tomorrow. 

Dinner and Emergencies

I went out to dinner tonight with several friends from school.  It was nice to get away for a while and talk about things not related to biochemistry or the makeup of cerebrospinal fluid, to joke about the quirks of our professors from last semester and ponder the relative merits of not having lab vs. marathon lecture sessions.  It was nice to meet and get to know some of my friends' spouses, who kept the conversation from getting too medical.  It was nice to realize that I have finally found a bit of a niche at school where once I wasn't sure if I really would.  It was nice to leave the restaurant already setting up times to meet over the weekend and study, but also times to get all the girls together for wine night.  It was nice to have a night of balance, even if it means doing some double-time this weekend to catch up on material I missed tonight. 

Yesterday, I had an orientation for a research project I'm joining, which I'm really excited about.  From what I gather, the gist of things is that we are "employed" to sit in a conference room and study while keeping an eye on the check-ins in the pediatric emergency room.  When someone new checks in, we see if their chief complaint falls in line with one of the studies that are going on currently--one, for example, is comparing ultrasounds and x-rays in kids with broken arms to see if ultrasounds could be just as effective as a diagnostic tool (advantageous, since they involve no radiation).  We basically look to see if anyone is coming in with a suspected break, and when they do, we alert the physicians doing the study and get the ball rolling with the patients.  In the downtime, we are essentially free to do homework, but also to tag along on cool cases that come into the ER.  I'm pretty excited about it.  I'm also excited about working in the ER next Monday for my required preceptorship time, which I have been trying to set up for months now.  Hopefully I'll come back with all kinds of cool stories about getting to stitch people up and whatnot.  

Back at it

I have officially survived the first week of the new semester relatively unscathed and am beginning to get back into the stride of studying.  We're doing biochem, physiology, and neuro this semester, and while the four hour marathons of lectures every morning are a bit much, it's kind of a nice change of pace to not have to worry about a) changing for gross lab almost every day and b) the absolute rote kind of memorization that was required in anatomy.  I really did enjoy gross, but it's nice to have classes where you're telling a story rather than reciting random facts.  The studying certainly goes much more quickly this way, and I feel like I get a better grasp on the material the first time around.  

Last night I got to go out to dinner at one of those Japanese places with the big grills where they cook everything in front of you with some of my old gymnastics teammates.  We always try to get together a couple times a year at least, and it was nice to catch up with everyone.  If only we did it more often.  Today, I have been uber productive with the studying, and I'm hoping it will pay off by giving D and I some time to actually go out to dinner or something.  We got a couple of gift cards to restaurants for Christmas, since we have so little time and money to actually go places any more, so I've been really looking forward to getting out and actually doing something rather than our usual routine of sitting at home.  

Speaking of doing something other than sitting...one of my goals for the new year (I hate to say "resolutions," because I always find new year's resolutions to be so easily forgotten and pointless) is to actually get off my butt and start working out more.  I had gotten in the habit of going to the gym at school for a while back in the fall, but it's so difficult to stay motivated when I get out of class around 4:00 every day, it's getting dark and cold, and all I want to do is go home and get warm rather than changing into shorts and back into normal clothes.  What I'd really like is a Wii fit, so that I can start doing some things at home (like yoga!  I've always wanted to try yoga).  Unfortunately the $80+, combined with the impossibility of actually finding a Wii fit in stores are probably going to mean hoofing it to the gym a couple of times a week.  Come on, tax refund!!  Maybe then I can afford to be lazy in my work out habits.  

First day back

Today was our first day back to classes, and in a lovely surprise they sort of took it easy on us today.  We didn't start physiology lectures yet, biochem was essentially a review of some basics from undergrad chemistry, and neuro was...well, neuro but nothing crazy.  I have a feeling things will get crazy soon enough but for now it's nice to not feel overwhelmed after one day. 

The most awesome part of the day came later, though, when I was doing some research into tax stuff and realized that, since we were first time home-buyers this year, we qualify for the government's first time home buyer tax credit--essentially, we're going to get about $7500 EXTRA added to our tax refund for the year!!  I, of course, immediately started mentally remodeling my kitchen, but my all-too-practical husband unfortunately wants to put the money in savings so that we have a rainy day account and maybe use it as savings toward another European trip in a few years.  I can't say I would mind going to Europe...or anywhere else for that matter...but I still want to try to convince him to spend at least a *little* of it on some stuff for the house.  I mean, I would really like a new sofa...or even a chair, or something so that we could fit more than four people in our living room without pulling out the folding chairs.  But we'll see.  Who knows how he'll feel when the money actually gets here.  

I swear I'm still alive

I know, I haven't written in over a month.  Depressing stuff.  Honestly I just got to the point at the end of last semester that I couldn't think of anything to write other than "WOW med school sucks.  ALL I do is study ALL the time."  And who wants to read that?  Not even me, hence, I did not write it.  In the meantime, however, things have cleared up and I've found that there are generally lots of things to write about...as my friend A pointed out (quite a while ago...sorry for not following up on it sooner), the blog does not *have* to be about just what goes on while I'm at school each day.  It can also deal with my (gasp!) real life outside of school.  So I'm going to give that a shot and see if it's slightly more tolerable to write that way.  

So...a recap of the last month.  After Thanksgiving (which was lovely), my entire class was basically thrown into double-time torture mode with anatomy labs nearly every day so that we could cram every tiny iota of information about the arm and leg into our rapidly overflowing brains prior to exam week.  I spent far, far too much time smelling like formaldehyde, and there were a few days where I literally didn't leave the school until six or seven at night.  Leaving school without seeing the sun all day is not a good time, fyi.  But even that wasn't the real trouble.  The burnout didn't truly set in until you realized that on top of all of the insane amount of new material being thrown at us in a two week span, we all had to start reviewing everything from the past 3 months as well.  Luckily for me, this wasn't insanely hard because I tend to use flashcards for everything, so I didn't have to crank through an entire book or set of notes or anything like that, but still...the workload was pretty intense.  And the intensity combined with the fact that we had not had a break since after our second test (two months previous) led to a dangerous state of mind by the week the exams actually rolled around.  Luckily, with friends, family, my awesome dog, and the ridiculously addictive Twilight books to keep me relatively balanced, I did not go insane.  In fact, I managed to get through all of the exams in relative mental health and ended up with honors in all of my classes.  

After all of that insanity, we were lucky enough to get a full 17 days off, which has been outright blissful.  The first couple of days were rough--mainly because I kept waking up with a residual panicked feeling, wondering what I had to get done that day--but we have enjoyed a lovely holiday break, complete with family galore at Christmas and a couple of parties and meetings with friends.  I have played far too many video games and watched an entire season of Scrubs.  All in all, I have done just about nothing that require intellectual input, and it's been great.  School starts back up on Monday, so I'm trying to get in as much brainless stupor as possible before launching myself at what I think will probably end up being my new worst enemy--biochem.  I'm sure that will provide some fabulous stories.  For now, though, it's back to Mario and Guitar Hero and tv and sleep, while I still can.