Sometimes they let us do real medical things!

So I’ve spent a lot of time explaining (complaining) about all of the science classes and tests and studying I’ve been doing for the last three months, but I haven’t spent much time talking about the more medically-related things I’ve gotten to do. In many ways, these are the things that keep me going as they sneak into my schedule just frequently enough to remind me what all of this is about and why I’m ultimately there. Here’s a little summary of three that have been the most notable for me.

Standardized patients: In the last post I talked about our Clinical Decision Making class that tries to encompass all of the non-science parts of being a doctor. One part of this has been learning to interact with patients. I should qualify this by explaining that they aren’t dumb enough to let completely untrained students see real patients. Instead it’s like they let us play doctor. This includes a Clinical Skills Center that looks just like a regular doctor’s office complete with waiting and exam rooms, and “standardized patients” who are actors given various ailments to present to us. (Yes, like that “Seinfeld” where Kramer pretends to have gonorrhea.) So far we haven’t actually been allowed to touch the patients, but that starts in a couple weeks. For now, we’ve been working on techniques for interviewing patients and eliciting a complete medical history. I’m sure this sounds boring, but I’ve been quite excited. Plus, they let us dress up in our white coats and everything, so we feel super official. (I told you it was like playing doctor…)

Anatomy lab: Last week we started Block 2, which includes Gross Anatomy Lab (appropriately called “gross lab”). This means we started work with the cadavers we’ll be dissecting and studying for the next few months. I can’t do this experience justice in the paragraph I’m planning to write right now, but suffice to say that it’s incredible and incredibly overwhelming all at once. We are lucky to work in groups of just 4 students per cadaver, which allows each of us to really appreciate each structure and take part in dissections. As a learning tool, this is invaluable, and lab follows right with our lectures of the different body sections / systems. So far we have dissected the back, shoulder, and axilla (armpit – believe it or not there is a crazy network of nerves and vasculature in there!). Next up: upper arm, forearm, and hand. It can be a little strange to spend so much time with dead bodies (and the smell permeates you and isn’t great), but we have adjusted pretty quickly. I’m sure I’ll have lots of stories to share as we go along, but for now I would be completely remiss if I didn’t recognize the amazing gift these people gave by donating their bodies to our program. We’re all so thankful to them and their families – even if it does result in me spending hours in our basement gross lab.

Suturing workshops: This is the closest I’ve gotten to doing “real doctor things” since I got here, and it’s made me really excited (as evidenced by the fact that many people have probably already heard about this ad nauseum). The first was a basic suturing workshop in which we learned four different stitches (interrupted, vertical mattress, horizontal mattress, and running – you can see them all in the pictures!) on straight, smooth-edged incisions. We learned proper instrument usage and knot tying. There were a number of physicians that came to help us all practice and to give us tips. My friend Lara was there with me, and we judged the night a huge success as we were not told by a doctor, as one of our classmates was, “Hmmm… maybe you should just consider psychiatry.” We were able to continue to hone our skills a few weeks later when we attended an advanced suturing workshop. This one assumed mastery of the basic skills (which we clearly had) and taught more specialized techniques. We learned all sorts of cool stitches and how to work with non-ideal wounds (those that aren’t straight, don’t close evenly, etc.). I received the biggest compliment of my nascent career when the physician looked at a particularly tricky closure I had completed and declared, “Looks like you’ll have a career in Plastics if you want it!” While I have no interest in Plastic Surgery and he was likely just being nice, I was (and still am) thrilled by the comment. I guess I should acknowledge (as is evident in the pictures) that our unwilling experimental patients were pigs’ feet. However, I really want a live, human patient to practice on… and as a result I’ve taken to encouraging my friends to do reckless things and then assuring them I’ll take care of it if they need some stitches! Unfortunately, I don’t think they appreciate my skills as much as the indulgent doctors do.

Med school is consuming my life

So it’s officially happened – med school has consumed my life. And as a result, my blog (among other things) has clearly been neglected. Here’s a quick attempt at bringing everyone up to speed.
First, a little about the organization of my school curriculum. Year 1 is divided into three “blocks” with different focuses. Part of the reason that last week was so crazy was that it marked the end of Block 1, which was “Cellular and Molecular Biology.” The title is deceivingly simple, but the material was not. I have quickly learned that med school requires way more studying than I’ve ever had to do before. The sheer volume of material is daunting. Last week I had an exam for the fourth and final unit of Block 1 on Monday and then a cumulative final covering all four units (over 2500 pages of notes) on Wednesday. In addition to the different blocks, there is a year long course we take called Clinical Decision Making. I also had an exam on the first 10 week so of this course on Wednesday – wasn’t that a nice way to schedule it? That course includes ethics, clinical skills, contemporary healthcare issues, etc. We have two associated small groups: an ethics discussion group that meets every other week and a problem-based learning group. With the problem-based learning group we are presented a hypothetical patient and we need to approach the case by asking appropriate questions, doing research, ordering lab tests, and going through the differential diagnosis process. It’s been interesting, but a bit frustrating since we still have a whole lot to learn. I’m sure it’ll get easier as the year goes on and we actually understand the tests we order and the words we come across in our research…
One of the most depressing things about having three exams last Monday and Wednesday (besides the fact that studying kept me at school studying way more than half of the hours in the week prior) was that Election Day fell right in the midst of it all! I’ve been really excited about this election, especially since I’m actually in a state where my vote and efforts could really make a difference. I spent as many hours as I could out registering voters, canvassing neighborhoods, talking to voters, and generally “campaigning for change.” However, I was really frustrated that the weekend before the election and Election Day itself were consumed by school for me. I was completely torn because I knew my time had to be put toward studying, but I also felt like this election was bigger and more important in many ways. In the end, I put as much time as I could toward the election, and thankfully it all worked out! Ohio was, as it often is, pivotal in the election and was called for Obama by 9:30 pm! I’m especially thankful for people like my sister, who are giving me full credit for Ohio going blue. I’m more than happy to take credit. Plus, it took over 2 hours for me to vote on Saturday before the election (Ohio has early voting). Good thing I brought my flashcards so I could study while I waited… It just worries me because many people don’t have the time or aren’t willing to wait that long – our election process has some major problems, but that’s a discussion for another time.
I think some of my friends here might be a little happy that the election’s done. Between persistently reminding my water polo teammates to register and vote, constantly discussing the most recent debate or Palin slip-up, and compulsively reading NY Times and CNN articles, political blogs, and Op Eds I have become a bit obsessed with this election, to say the least. Some other people are a little worried about me. They think I might be lost and wonder what I’ll spend my time doing now. My answer? Studying. Lots and lots of studying. And maybe a little pleasure reading. That would be really nice. I think the novels I naïvely brought from California are starting to feel a bit neglected. But I also don’t see myself getting to them anytime soon. Block 2 has just started (of course, at 8 am the day after our last exams) and it is “Human Structure and Development,” which most notably includes Anatomy. This means that starting this week I’ll be in the anatomy lab dissecting a cadaver – stay tuned for more frequent updates, because I’m sure I’ll have lots to say about that. Plus, I can’t read about Sarah Palin anymore, so maybe I’ll make more time for my blog!

Crazy things happen when I drive around here

Disclaimer: This post will have very little to do with med school. The next one (which I previously intended to write tonight) will have everything to do with med school.

To start, one very exciting development in my life (besides starting med school, moving to Toledo, etc.) is that I found a water polo team to play with here! I realized very quickly that my schedule and volume of material were going to necessitate some sort of totally non-med school-related activity. It is easy to spend all of your time with your classmates and to also have your extracurriculars revolve around medicine, which I was afraid would make me feel a bit claustrophobic. I mean, I love medicine as much as the next person here, but I just can’t have it totally consume my life. For that reason, I went in search of a water polo team, which isn’t particularly easy to come by in Ohio. However, I found one at neighboring Bowling Green State University (about 20 minutes from my apartment) and the guys in charge of the team there are thrilled to come have me practice with them (possibly because an extra body means there may be enough people to scrimmage more often…). I’m very excited about this because it’s a chance to break out of my med school bubble, to expend some of my energy pent up from hours of studying, and to do something I love while I’m at it.

Ok, so I promise this all relates to the title of my post: In the torrential downpour brought on by the remnants of Hurricane Ike (more on that later) I was driving home from polo practice this afternoon and talking to my mom on the phone. As I’m driving through campus I see a large animal run along the grass and stop at the edge of the road and realized it was a beaver! I say excitedly to my mom, “Mom, it’s a beaver! A real live beaver!” (Caryn – unfortunately I didn’t get to continue “Look at it swim!” as Colin’s mom famously did since wasn’t near the water.) I couldn’t really believe that there was a beaver just hanging out on a college campus and wandering along the grass. I was pretty excited for the rest of my drive home, but then something much more exciting (not sure if that’s really the right word…) happened. As I got off the freeway about 2 miles from my apartment I saw a huge streetlight fall across the road, hitting the car next to me in the process. At this point, I was on the phone with Andy (maybe I shouldn’t talk on the phone so much while driving?) and he got to deal with me freaking out and abruptly ending the conversation. I hurriedly parked, called 911, and ran over to make sure everyone was ok. Amazingly, I was the only person to stop, but the family in the car was fine. This was quite a relief because, contrary to what my little sister believes, being in med school gives me no real qualifications to deal with triaging an accident scene! The pole just hit the front of their hood, but I don’t want to imagine if they had been a few feet ahead and it had crashed through the windshield… Needless to say, I drove home carefully (after talking to the police, etc.) and changed into some warm, dry clothes. As an aside for those of you who know me well, the most impressive part may be that I knew exactly where I was to describe the location to the 911 operator! A bit too much excitement for one day – but I’ve made up for that by spending the rest of the night studying.

Ohio is not a foreign country

So I figure I should say a bit about the fact that I now live in Toledo, Ohio. I know that I spent 4 years in Hanover, but that seems different for some reason. I never really thought I’d be living in the Midwest and Toledo just seems so random. I mean, who lives in Toledo?! That being said, I have absolutely not lost sight of the fact that Toledo has something huge to offer me – namely, med school.
I really like UTCOM (University of Toledo College of Medicine) and know that it will give me just what I need to eventually return to California a great doctor! The atmosphere within my med school class is very laid back and cooperative. Of course, there are a few crazy people that I’m sure plan to help no one on their scramble to the top of the class, but I just don’t talk to those kids. The majority of people want to study together and share tips and resources (like study guides, lists of relevant clinical examples, and materials passed from previous classes). And even outside of the people and school (and I know I may get flak for saying this), Toledo isn’t all that bad. It has a few really good things going for it – things are ridiculously cheap (except my medical education), it’s a true battleground state and therefore a great place to be during an election year, there’s not really such thing as “rush hour”, there’s a great art museum and zoo, I have found a water polo team to play with a couple times a week, and it’s Eastern time which makes keeping in touch with everyone much easier. My mom was also relieved to find out that they even have some of the same stores here as we have in California – what a surprise. During my first week, one of our conversations went about like this:
Me: “Today was good – I went to Bed, Bath & Beyond to buy new sheets.”
Mom: “Oh good, they have Bed, Bath & Beyond there? Do they have other stores you’re familiar with?”
Me: “Yes, Mom, it’s Ohio, not a foreign country.”

Welcome to my blog!

First of all, welcome to my blog! I figure this is an easy way to share some of my med school experiences, keep you all up to date with what I’m doing, and spend a bit of time reflecting on my time here. While 4 years sounds like a long time right now, I’m sure it will fly by and I will later enjoy having a chronicle of my experiences. I don’t know exactly what form this will take, but I’m sure some entries will be directly related to medicine, some will be tangentially related, and some will just be random.

I had intended to start this before orientation, but the last three weeks have managed to escape me. To catch you all up, here’s a (not so) brief summary of my time so far in Toledo, Ohio:

Saturday, Aug. 16^th I arrived in Detroit (about 50 minutes away from Toledo) after a red-eye flight. I met my roommate Elizabeth, who graduated from UCLA and grew up in Southern California. In retrospect, it probably would have been smart for each of us to live with someone from a bit closer to Ohio as we both showed up without much more than clothes and a small handful of other things to contribute to our apartment. As a result, we dedicated the whole first weekend to craigslist and garage sales and the effort was totally worth it, as by the time orientation rolled around we were set up with two couches, a dining room table and chairs, a coffee table, two end tables, a bed for each of us, and furniture for each of our bedrooms. Needless to say, we were very lucky to have Elizabeth’s parents’ pickup truck and an apartment only 7 steps up from the front door. I was especially lucky because my friend Andy and his brother left a whole bunch of stuff at their dad’s house in Toledo when they moved to Berkeley this summer, so I got to do some apartment “shopping” there as well. Our apartment is now fully set up and I really like it! It was completely renovated over the summer, which meant new cabinets, appliances, carpet, and paint. It has a few idiosyncrasies (such as carpet in the kitchen and an 8 foot sliding glass door that goes from my bedroom into the living room… we’ve since covered that with curtains!), but we enjoy it. It is a short 10 minute drive from school and the majority of my friends live and hang out within a 15 minute radius.

Monday, Aug. 18^th we started our orientation! The days were a bit long (Monday – Thursday from 9 am – 5 pm each day), but it was nice to have time to settle in, meet people, and prepare for the start of classes. I would have had a lot more to say about orientation if I were writing this during that week, but at this point it seems like a bit of a blur and has been eclipsed by the events that followed it. Orientation week culminated in our “White Coat Ceremony” which was a 2 ½ hour long ceremony that mostly consisted of the tedious presentation of 53 (I counted!) different scholarships and awards to mostly 2^nd, 3^rd, and 4^th year med students. However, the last 15 minutes was very exciting as we were each called up from our seats on stage and given our white coats that (almost) make us look like real doctors! The other notable (albeit sobering) event from the end of orientation was the distribution of our notes packet for our first unit. It was 490 pages long and we were all a bit overwhelmed by this, and then totally shocked to see the dates that these notes would be covered: Aug. 25^th – Sept. 5^th. Yes, just two weeks.

Monday, Aug. 25^th we started our classes! Our schedule is pretty consistent week-to-week and classes generally run 8-10, 10-noon, and 1-3. Each 2 hour block we have a different topic and a different professor. At some point I’ll go into more detail on the way our academic blocks are set up. Right now I don’t want to think much more about it.

Monday, Sept. 8^th we took our first test! I’ve never spent so much time studying (I realized that in the weekend before I spent almost three times as many hours studying as I did sleeping…) but the sheer volume of material makes it so that you don’t have another option. Everyone basically commits to spending a good chunk of the afternoon and evening each day reviewing the material that was covered in that day’s lectures and then reviewing the whole week for a second time over the weekend. I’m already discovering ways to make my studying more efficient for me and learning what each professor expects from us. The relief of finishing that first exam yesterday, turning it in, and knowing I didn’t fail was huge! However, it was slightly tempered by the fact that before we left, they handed us our new note packet for lectures that started back up today. It seems that this is indicative of life as a med student, and eventually life as a doctor. The work doesn’t seem to stop, but rather just seems to steadily gather momentum through the years of med school. I think many of us may have had this idealized vision of med school being the “hard part” of it all, but of course then you move on to residency where you need to have an exponential learning curve with 80+ hour work weeks and even in practice you need to stay on top of all of the basics in addition to new developments in the field to be able to best serve your patients. It’s a good thing that there’s no doubt in my mind (despite all of this) that this is what I want to do with my life.