Friday, August 14, 2009

One Week

If anything, this experience has been about the emotional ups and downs that accompany being a new student in a med-school program. One day I'm thrilled and really positive that I'll succeed; the next day I'm pretty convinced that I'm going to fail everything and be asked to leave the program. So far, it's been a study in control and stress management. I worked with a guy who would describe it like a duck. "A duck?," you might think. Yep. A duck: on the surface it might look calm but underneath, it's paddling like hell.

So, I'm like a duck. Except I might not look as calm.

The Honeymoon Is Over
After the glorious "ease-in" of the first day, I've definitely been freaked out about everything. The volume of information is, as they put it, intense. If I've heard the phrase "it's like trying to take a drink of water from a fire hose" one time, I've heard it a thousand. It is, however, a pretty good way of looking at everything.

Here's a quick rundown of my classes with the official descriptions:
  • Clinical Skills - This course is designed to teach the students how to perform a proper history and physical examination. He/she will be assessed not only on the knowledge related to this activity, but also the practical skills related to (1) interviewing and history taking, (2) performing the physical examination, and (3) making clinical judgments. The course will teach the various systems and how to understand the importance of the history and physical examination for detecting pathophysiology. The student will learn to make a differential diagnosis, leading to the selection of "definitive" laboratory studies and then ultimately to diagnosis and treatment.
  • Community and Behavioral Medicine - This combination lecture, small group and problem-based learning course will focus on topics ranging from the behavioral sciences to health care systems management and public health. The emphasis will be to develop the student's process of clinical decision-making. PNWU curriculum goals regarding lifelong learning, self-care, ethics, and social and community contexts of care will be addressed. Other topics include biological correlates of behavior, personality, learning and behavioral change, life-span development, communication and interaction, group processes, family and community socio-cultural patterns of behavior, behavioral risk factors and disease, study design and biostatistics, and medical jurisprudence.
  • Physiology - This combination lecture and laboratory course is a comprehensive study of normal human physiology and neurophysiology. It will focus on properties and functions of living cells, tissues, organs, and organ systems with special emphasis on integration, control, and pathophysiology. The course includes an overview of normal and pathological physiology of the human nervous system as it relates to perception, behavior, and the control of bodily functions.
  • Biochemistry - Students will learn the structure and function of the human body's most basic constituents and the role of these components in normal body function and pathological processes. Major elements of the course include key concepts in biochemistry, nutrition, molecular biology, immunology and genetics.
  • Gross Anatomy - This combined lecture and laboratory course introduces the student to the macroscopic structure of the human body using a regional approach. Emphasis is placed on the correlation between anatomical structure and function, embryonic development, clinical application, radiologic interpretation, and usage of correct anatomical terminology. Study of the emergence of human form is oriented towards its relation to gross anatomy, on the one hand, and to the pathological conditions that have a developmental basis on the other. Resources used during the laboratory portion include cadaver dissection, radiographs, MRIs, CT scans, OPP, and orthopedic clinical correlation.
  • Pathology - This combined lecture and laboratory course explores functional anatomy principally at the light and electron microscope levels. Study of basic cell structure, the functions of cellular organelles, and the relationship between ultrastructure and cellular function will be emphasized. This course further highlights the intimate relationship between structure and function through the study of functional morphology of diverse cell types, their organization into tissues, and the properties of these tissues. In addition, this course examines contributions made by coherent organization of tissues into organs to human form (gross anatomy) and function (physiology) and provides a foundation for how its distortion correlates with disease.
  • Osteopathic Principles and Practice - Osteopathic Principles and Practice I is a combined lecture and laboratory course comprised of formal didactic lectures ("cognitive component") in an amphitheater setting, small group "problem based learning" (PBL) sessions ("cognitive component"), and clinical skills training (CST, "psychomotor" component) conducted in a large teaching laboratory setting. The skills and knowledge that will be taught and examined are done in a cumulative and comprehensive manner. The course will familiarize the students with the history of osteopathy, the research contribution, the future projections for the profession, and the anatomical and physiological basis of osteopathic medicine. The students will also understand the biomechanics of the various joints of the musculoskeletal system and how to manage them. The student will understand how to integrate osteopathic principles with clinical medicine, surgery, pediatrics, and gynecology/obstetrics.
  • Microbiology - This combination lecture and laboratory course presents virology, bacteriology, mycology, and parasitology from a medical standpoint and will emphasize microbe morphology, physiology, life history, pathogenicity, epidemiology, diagnosis, therapy, and prevention. A case history / problem-solving approach to infectious diseases will be incorporated throughout the course and will emphasize such clinical aspects as etiology, patient management, specimen collection, laboratory tests, pathologic findings, and prognosis. Most basic science concepts will be discussed via analysis of clinical case studies.
  • Current Issues - In this lecture course, osteopathic primary care physicians and other professionals will present lectures on specifics topics related to the present day practice of primary care medicine, especially in rural or underserved areas of the country.
So, as you can imagine, I'm a little busy with stuff. So far, I've had about a gajillion pages to read. I've literally gone to bed at around midnight or later and gotten up at about 5:30a.m. to begin the day with a little coffee and "light reading." Wow. This stuff is intense. And, they took it easy on us this week. Yippee.

I Met Walter, Our Cadaver
On Thursday of this week, we had our first official Gross Anatomy lab. During the course of the year, we'll be dissecting a human body. We've been reminded to think of the cadaver as our first patient, the one who will teach us so much more about medicine and about the body than we'll ever learn.

I'll admit that I was pretty anxious about going in there on the first day. Hell, with my luck, I would be the one to pass out or drop the body or set something on fire or throw up or something. Various scenarios ran through my head, you know. Anywho, we met in the lab to "unpack" our bodies. Our group of four cautiously opened the hood on the stainless steel table and looked inside. There, in two giant, plastic bags was our cadaver. Our task for the day was to remove the plastic bags, drain the preservative from the body, and put a body bag on it. Really, there was nothing to do but to dive right into it. I cut through the first bag and the smell of the formyl got really intense. If you've ever dissected a fetal pig or anything, magnify the scent by about 100. Then, we cut the second bag away to reveal the naked, preserved body of an older (maybe 70s) male.

So, a minute later, I'm there with a lab partner, wrestling with a preserved human body, trying to slide a body bag under it, occasionally glancing at the vacant eyes that keep staring at the ceiling, looking at the stubble on his face, and trying not to get the fluid all over me. Had the setting and circumstances been different, we could've been acting out a scene from a Scorsese film. Instead, I was surrounded by 74 other students trying to do the same thing to 19 other bodies. It was one of the most amazing things that I've done and I've not even started a dissection...this was just unpacking day.

I couldn't help thinking that this person had been someone's friend, somebody's husband, a father, a grandaddy. I thought about what we'd be doing to this body, how we'd be getting to know the most minute secrets it held and I couldn't help but be amazed by the beauty of the person's gift to us medical students. Dissection, after all, is not easy; it is a highly organized destruction of a body. To know what occurs during dissection and to still make the ultimate gift of yourself is nothing short of amazing. I've decided to call the cadaver Walter. (I don't know, he just seems like a Walter to me.) Anywho, thanks Walter. Look forward to spending more time with you.

The General Freak-Out
So, everyone is pretty much freaking out. We're right to do it, too. Already we're feeling behind in class and feeling that there is no way in hell that we'll be able to survive any of the testing. It's pretty funny (or not) to put 75 mostly Type A personalities in a room and watch their anxieties about grades manifest. The funniest are the youngest people who are fresh out of school and are terribly stressed. That being said, I need to quit writing and get some more studying done. I'll try to post as frequently as possible.

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