Saturday, August 28, 2010

Well ..

Cardiovascular system exam is over.  Based on my previous pharm scores, I was thinking that I'd be able to prescribe Skittles.  Today, I am certain that if I tried to do that, someone would swat the damned things out of my hand and give me a stern look.  So, I'll be limited to making poultices, probably with mustard or eucalyptus. 

Tuesday, August 24, 2010

"That Sonofabitch Just Might Make It"

It's the week leading up to our second exam and everyone around me is equally haggard.  Last night, I got four hours of sleep and (actually overslept until 5:45).  Tonight, it'll probably be the same.  As I've intimated previously, I think the pace is pretty ridiculous and that the amount of info that's washing over us at any given hour is incomprehensible.  That being said (again), it's effing amazing what actually makes it into your brain, what you can actually learn when pushed.  It has, of course, been a week of peaks and valleys but, thus far, the peaks have been pretty cool.

Epiphany
Last night around midnight, my buddy and I were on campus almost ready to wrap up for the day.  We were reflecting back on a case study exercise that we'd done earlier.  (As a group, you and your peers are given info about a patient and must interview the patient for relevant info to complete a history, determine what lab values and physical exam findings are pertinent, identify areas for further assessment or diagnostic exams, and formulate a plan of action.  Then, you have between 60 and 120 seconds to provide an oral presentation of this information to the attending physician.)  Essentially, these studies are an integration of academic material, clinical scenarios, and the skills of speaking aloud to your peers aka preparation for 3rd year rotations.

So, last night we start talking the day's case.  A while later, we realized that, without any provocation, we'd been thinking and speaking like practicing physicians.  It was pretty cool; a step along the path to reforming my self-image into that of a doctor.

Go Suck It, Digoxin-Induced Hypokalemia.
Two interactive sessions today, both on Heart Failure.  This afternoon, I seemed to do much better on the questions: my rationale seemed to be based on some sort of reality and grasp of key concepts instead of how a third-grader might approach pharmacology.  When I was called on, I stood and correctly answered a question regarding hypokalemia as induced by a drug-regimen.  I went with my gut, stuck to my guns, and didn't look like as much of a clueless dick in front of my peers.
The Scholar: 1, Pharmacology: 248K.
I'm hoping this was my Dave Roberts moment. The crowd goes wild.  (By "crowd," I mean me.)

Tuesday, August 17, 2010

On To The Next One

" ... Don't be mad 'cause it's all about progression.
Loiterers should be arrested."
'On to the Next One' from Jay-Z's "The Blueprint 3"

Another week, another trove of insurmountable tasks to complete.  I wouldn't quite call them Sisyphean but it definitely feels vaguely similar.  After the last week of doing nothing more than studying, it should come as no surprise that this week is yielding more of the same.  As will next week.  And the week after.  For the foreseeable future.  [Sigh.]  It is, however, pretty damned cool.

Brush That Dirt Off Your Shoulder
One of the major learning experiences of second year, thus far, has been the attempt to become comfortable with standing before your peers and attempting to respond to questions.  You know, a whole "stand and deliver" routine.  In addition to learning the course content, we're being given the opportunity to become more comfortable with failing spectacularly in front of our peers.  This is a task for which I just might earn honors.  What can I say?  Everyone excels at something, right?

We've been given little remote controls called iClickers (the hottest technology of 1999) that we use to respond to questions during class for real-time tallying.  Prior to seeing how your peers respond, though, a student is randomly called to answer the question and, if you're really, really lucky, some follow-ups in front of your peers.  Luckily, I was called on during a Pharmacology session to answer a question involving the selectivity of a Beta-antagonist.  Being the exemplary pharmacology whiz that I am, I punted and guessed something that stuck in my head.  Wrong.  I looked to my peers who whispered the correct answer and called it out.  Wrong again.  I looked to other peers for more choices and tried to follow the prof's coaching. Wrong again.  After what seemed like an hour, I stumbled on the designated response and was allowed to return, licking my wounds to the anonymity of being a less-active participant in the lecture.

I am never going to earn a prescription pad.  Mark my words, I will be forced to "prescribe" Skittles to my patients.  If those don't work, we'll move to either M&Ms or Reese's Pieces.  The options are pretty much unlimited.

Thursday, August 12, 2010

This Is War

Not that I'm finished collecting my thoughts about my first year or anything, mind you, but it's day 4 of the 2nd year and I'm feeling like I've been in the trenches for months.  All that bullshit "pie-in-the-sky" thinking that I'd be able to sneak off to see Winning Run in Seattle are teetering on the edge of the sinkhole that is being a med student. 

Seriously.  Day 4.  Monday.  Tuesday.  Wednesday.  Today.

In other news, I feel like I've learned a bunch in these four days.  It is stunning what you can learn when terrified / trying / overwhelmed / sleep-deprived / enjoying it.

More from the front lines, soon.  I promise.