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!