Put a Fork in 2009

Boy, this one got out of here fast, didn't it?

I finished finals on the 19th, cracked open a bottle of Blue Label and had a celebratory toast.  Let's just say those damned things were pretty tough.  I focused most of my efforts on Physiology and BioChem.  As a result, I pulled up those grades at the expense of my Anatomy grade which fell.  All told, though, I passed everything so I'm thrilled.  For a while, it seemed doubtful.  After the dust settled, I packed my stuff and got my ass back to Georgia for the holidays and have been doing as little as possible.  Seriously, my goal has been to stay in my pajamas as long as possible each day and watch the worst television possible (reality programming excluded).

What I Learned During My First Semester in Medical School

• Nobody can truly prepare you for the shitstorm that you are entering.  Seriously, people told me that it would be tough but that I could succeed at it.  After I'd started, it seemed like all of my doctor friends changed their tune to "Yeah, it's pretty tough but you've got to gut it out and get through it."  Today, I really think that I can make it.  For the first few weeks, however, I was waiting for my bus ticket back home.
• Your closest friends and family really have no idea what you are battling through on a daily basis.  People can empathize and sympathize but, unless someone has done it, people don't truly understand.  At times, this is great because having a conversation with someone who is "in the real world" is awesome.  The outside is a balance to the all-consuming world of being a student; it's beneficial.  At other times, it can be pretty lonely when you are trying to recount an anecdote who's primary audience are med-school dorks like you.
• Sometimes, a class member can yell out "Anal Sex" in class and be courteously dismissed by the professor and thanked for a good guess but an incorrect answer.
• When strangers find out you're a med student, they will tell you things that they don't confide to others; it's the blessing and the curse of the profession.  For example, the guy who cuts what's left of my hair dropped some heavy personal medical information on me during a visit.  The best I could do was listen, remind him that I was seven weeks into my first semester of school, offer to track down some information for him and try to give him some resources.  I was flattered and frightened by his confidence in me.
• I can do this; I will be a doctor.  Early in the semester, I wrote a few notecards for myself and posted them around my apartment where I'd see them each day.  "Kick Ass Today" on the back door.  "You Can Do This" on the bathroom mirror.  The one that gets me going the most: "Do This For Bamba and Granddaddy." Sure do wish that those family and friends who have passed on could be here to experience this with me.  
• Friends, old and new, get you through it.  I'm now in a fraternity with my classmates.  We've been through the hell of the semester together and have seen each other at our best and worst.  They're the day to day crew that help you get over the peaks and valleys of the coursework.  Of course, my wife, family, and friends back home helped me more than I can articulate.  Cards, voice messages, quick emails or texts give me so much motivation to keep studying for another ten minutes, another half hour, another hour, another day.
• You will be isolated by what you know.  Lots of acquaintances will glaze over when you get into the second sentence of your description of med school.  Others will laud you with "fact" that are absolutely untrue.  Seriously, people will repeat things that one would think are too absurd to pass along as fact.  People just don't think about what they're saying.  I was walking my dog with a guy at the park who told me about a lady who "cured" her cancer simply by thinking positive thoughts.  After listening to as much as I could, I sort of unloaded on the error of his thinking and of the tremendous gaps in the retelling of his story.  Without a doubt, a positive attitude and strong support network is beneficial when fighting illness but I'm not sure that it's the only thing.  After spending most of every day thinking critically and doing your best to rationalize through things, it's a little more difficult to suffer fools and foolish comments. At a minimum, people should research things; snopes.com is a great start.
• Classmates will drunk-dial you over the holidays to remind you of that one time when a microphone fell into your ass in front of the entire class.
• Some classmates might get a little uneasy at jokes involving hobo hunting (for sport, of course) and jokes involving Bea Arthur's sexual magnetism.

Here's looking forward to next semester.

Staying Positive

One class final (Histology) and one practical exam down.

One practical exam, one presentation, and exams in Community and Behavioral Medicine, Medical Microbiology, Clinical Skills, Medical Physiology, Osteopathic Principles and Practice, Gross Anatomy, and Biochemistry to go. 

You've Got Mono!

I just got out of an essay exam in Microbiology.  Essentially, we were given an infectious condition and expected to identify the causative agent, describe the etiology of the causative agent, discuss the pathology of the condition, identify transmission methods, describe hallmark symptoms, describe any pertinent incidence/fatality rates, and discuss treatment options.  All of this in a pseudo-cohesive essay per condition, within an hour.

Our prof had given us a list of five possibilities:  bacterial pneumonia, bacterial diarrhea, burn wound infections, infectious mononucleosis, and urinary tract infections.  Of these five, two would be drawn from a hat at test time. We'd write a third essay on a condition of our choice that was not included in the original five.

So, as the week has drawn on, everyone has been busy trying to learn everything for all the conditions, some of which have what seems like a gajillion causative agents.  (Google some of the causes of bacterial diarrhea; there are seven serotypes of Escherichia coli alone.)  A few days ago, I started asking people what their wish list would be for the exam.  Most everyone, would say either bacterial pneumonia or diarrhea and infectious mononucleosis.  Mono is caused by the Epstein-Barr virus and, compared to the others, is easier to quickly understand and memorize key points.  As the rigors of the week continued to mount (we have two tests tomorrow and finals next week), people became more hopeful that we'd all get mono.

"I don't know ... I really hope we get mono!," someone would tell me.

"Yeah, that'd be pretty sweet," I'd concur.

Today, everyone made the final push on studying for it.  Like most exams, the room was buzzing with nervous tension in the minutes before the test.  One of our classmates picked the topics from a jar.  We were on pins an needles as our prof, unfolded the first one and announced that one of the topics would be bacterial pneumonia.  Everyone sighed.  In my gut, I knew that we'd be getting Urinary Tract Infections.

His hand rattled around in the jar for what seemed an eternity before he drew out a folded yellow slip and handed it to the prof.

"Your.  Next. Topic. Is. Infectious Mononucleosis!"

No shit, the room erupted with yells and applause.  All 75 of us were cheering and carrying on like we'd just won the lottery. It was ridiculous.  Hell, I personally was pumping my fist and screaming "Mono!!! Yeahhhhh!!!" without being at all sarcastic or ironic.  For five minutes after the cacophony settled, I sat there with my eyes closed laughing silently.  I smiled and chuckled during the entire thing.  Afterward, I headed to a conference room and laughed about it with a classmate until I cried.  Instead of studying for Histology and Anatomy, I'm writing this because it still kills me.  Damn, I wish I had it on video.  Classic.  Absolute classic.

That's what it's like to be a medical student:  the absolute effing highlight of my day involved cheering with joyful abandon for mono.  Honestly, it felt like my team won the big game on the final play with no time left.

Microphone Check, One, Two, One, Two...

In one of my classes, students are regularly used by instructors to demonstrate certain techniques and practical skills to the class.  Typically, the student, playing the role of the patient, will be examined by the instructor on an exam table on a small stage in the front of the class.  Overhead video cameras are used to ensure that everyone gets a great view of the treatment technique being addressed.

So, my lucky day was last week.  I was to be used to demonstrate how to identify and treat certain tender points on the posterior lumbar and sacral areas.  Normally, male students are shirtless and wear only a pair of running short.  The room was cold, however, and I got away with a pair of running shorts and a t-shirt.  During demonstration of the technique, the attending doctor had me slide to one side of the table so that he could manipulate my leg in order to demonstrate the treatment technique.  The following image shows how I was splayed on the table in front of my peers.

For the record, I wasn't wearing a sports bra. Also, my shorts were much shorter. 

While the professor was lecturing, he leaned over to move my leg.  His microphone fell off and dropped right into my ass-crack.  My shorts served as a thin, nylon barrier but, for all practical purposes, it was a direct hit.  Hell, I probably couldn't have placed it so precisely myself.

Precision and accuracy.

On feeling the impact and hearing the broadcast, muffled sounds of a microphone rumbling around in my ass, I quickly raised my head and flashed a confused expression to my classmates.  I was greeted with laughter, some stifled, most raucous.  Although I couldn't see him, it seemed as though it took the professor about an hour to gingerly pluck the microphone from my crevasse.

Never in my life had I been so happy to not have farted into a microphone placed in my butt.  (Not that this scenario has presented itself before, mind you.)  Had I done so, I would've immediately thanked everyone in the room, gather my things, and left, never to return. As it stands, I'm not sure that I'll be volunteering much more.

Down

Last night as I headed back to campus for a Physiology recitation, the moon perched in the sky, peeking through the clouds, winking at me, whispering "There is more.  There is more."  I had dressed in too light a jacket for the cold foggy day and wore the same into the night.  Sometimes, I like to feel the stinging cold air rip through my shirt and chill me to the core.  Sometimes, it's what I need to remind me that life exists outside the walls of this building, away from the formalin that leaps from an old, gray body to bury itself in my skin, apart from the pages and pages of text that I hunch over.  It heightens my senses, puts a snap in my step, pushes me urgently into these halls toward the tasks at hand.

I thought that Thanksgiving break would replenish me.  I thought that I could go home and be fully recharged.  Instead, I feel the pain of transition anew: parting is such sweet sorrow (again).  On my return, I discovered that those tending the fire had busied themselves splitting kindling and, on seeing me, dumped armloads onto the flame.  The heat is too much, is suffocating.  I want to wade out into the river and let the cooling waters pull me down, pull me down.