P=MD

Once again, lots to update yall on. Lets go in order of most interesting this time instead of chronologically (just to be different)

So.... school just got a lot harder. We had quiz 2 today, and it was significantly more difficult than quiz 1. Histology (cell bio) wasn't bad, probably because I've sent quite a bit of time looking at blood cells through a microscope (thank you summer internship). Doctoring and Anatomy were ok, but not great (if you didn't see my colorful brachial plexus on FB, you should. For those who don't know, the brachial plexus is a big tangle of nerves in your in that little triangle below your collar bone/between your shoulder and your arm pit. It was really interesting to dissect on Stanley last week because his had a "variation" where some of his nerves joined back together, mixed their fibers up and then split apart again.) Biochem and Physiology pretty much kicked my butt, hopefully I passed them. Can I just say, there are these molecules called "glycoaminoglycans" (or GAGs) and I hate them. First of all, why is "amino" in your name if you DONT CONTAIN NITROGEN? wtf. I hope all GAGS die a slow and tedious death (just like we all would if we didnt have any GAGs).

Today we finished dissecting the flexor forearm, and then dissected the hand. The had was a little weird, for whatever reasons the fingernails kind of creeped me out. Our hands are a really human part of us. It's easy to ignore the fact that Stanley's an actual person when his head is all wrapped up and we're just digging around in a shoulder or something. But it's a lot harder to ignore his human-ness when you're literally holding his hand open so someone can cut the skin off the palm. The had was also really cool. There are two main muscles in the forearm (the flexor digitorum superficialis and flexor digitorum profundus if you wanted to know their names) which flex our finger joints (the metacarpopharangeal joint, proximal pharageal joint and distal pharangeal joint). The muscles are in the forearm, and their tendons run through the carpel tunnel (with the median nerve which, fun fact is what gets compressed and causes pain in "carpel tunnel syndrome"), then the tendons spread out and one runs to each finger (except the thumb, which has its own little party). So the highlight of lab today was dissecting out each tendon and then pulling on it to make his fingers bend. like little one fingered waves. 

One last thing, I worked at a clinic on Saturday that specializes in serving IV drug users. Saw a really interesting patient who came in with full body tremors. Her father has parkinsons so she was really concerned that she could be showing early signs of the disease as well. She was an interesting case because, while she needed some physical treatment, she mostly wanted to be reassured that she didn't have early onset parkinsons. It was a really good reminder of the human side of medicine, that we're ultimately treating people, not fixing machines :) Which is a REALLY nice reminder as I crammed for an exam. Unfortunately this clinic runs in the afternoons, which kind of kills my saturday study time so I probably won't volunteer there very often. I'll stick with the morning clinics.

So, TLDR; Schools a little overwhelming at the moment, but its still amazing :) I got a dead guys fingers to wiggle. And I'm counting down the days (3 more!) until I can go hang out with trees in the mountains :)

PS- the title of my post, P=MD is our saying, reminding ourselves that to become doctors (MDs) all we need to do is pass!

OPQRST

So, things got a little busy :) but I'll try and back up and tell yall everything important that happened since last week.
Last Saturday I worked in another of our student run clinics. This one took appointments so I liked the flow a lot better (you also get better patient continuity with appointments as opposed to walk ins, and you turn away less people). Highlight of the day: I got to do a patient interview! A patient came in with the usual chronic conditions (diabetes, high blood pressure, high cholesterol) and complaining of knee pain. So, right before we walk in, the second year student I'm with goes "so there's a mnemonic for pain..." and I go "OPQRST!!!!!" and he's like "oh, you know it already?" and I said "I've volunteered as a first responder"... shout out to Ski Patrol! :-D (for those who don't know its: Onset, Provocation/Palliation, Quality, Radiating, Severity/Scale of 1-10, Time, all ways to describe pain). So basically clinic was awesome. This Saturday I'll be at a third clinic, and this one focuses on serving IV drug users and sex workers (its a "harm reduction" program) so it should be really interesting!

Last week was really really lecture intensive so the volume of information was really overwhelming. This week there's been less lecture but the labs have been overwhelming. This week we've had 8 hrs of anatomy lab, 4 hours of physiology lab and 2 of histology lab. Anatomy has been frustrating, we're working through the shoulder and arm now. There are an obscene number of nerves, veins, arteries and muscles in our arms. And they all have long names. I did however learn that your funny bone is the ulnar nerve and the "rotator cuff" is actually a group of four muscles around the shoulder blade (in case you wanted to know, they're called the supraspinatus, infraspinatus, teres minor and subscapularis... but you probably didnt want to know that).

Our next quiz is on Tuesday next week so this weekend should be full of studying... but then NEXT weekend, I get to go to the mountains (and I'm totally counting down the days...). For my mountain friends: my desk top background is a picture of pinecrest at sunset (I'd shout out a photo credit but im trying not to use names...). At least once a day someone in lecture goes "oh my god thats BEAUTIFUL, where is that?". I wish I could live in the mountains and teleport to school.

Thats all :)

Clinic, Quiz and Stanley's Arm

Ok, major events in chronological order (because I like things to be organized):

1. On Saturday I volunteered in a free clinic that's run by my school. The clinic is staffed by doctors, med students and PA students. Undergrad students do all the office work. Everyone is a volunteer, no one gets paid for their time. The clinic I was at last week is located in a neighborhood that's primarily African American (this weekend I'm volunteering in one in a Philipino neighborhood and next weekend I'm volunteering in one that focuses on harm reduction for IV drug users). So Saturday was my favorite day of med school so far. I like seeing patients, I like helping people. I didn't do any patient interviews or physicals. Mostly I was just shadowing to get the feel for how a clinic runs. Although I did get to take some blood pressures, heard a really distinct heart murmur, and palpated a mass. Basically, I really liked clinic and want to get more involved as I learn more and am able to do more (I really want to do a blood draw!)

2. We had our first quiz on Monday, which means I didn't go outside all weekend which was somewhat distressing but it was also excessively hot outside so I wasn't toooo distressed. Let's just say I rocked my first quiz (can we say 100% on the multiple choice? :) Does that make me a gunner?) My school has one big quiz every two weeks that covers material from all five classes. But the first quiz covered only one week to sort of ease everyone into the testing format/question types etc. So we'll see how well the next one goes...

3. Today was cadaver day two. Our task was to reflect (or fold back) the chest wall (skin and the fascia underneath) to expose the muscles for later work. We also had to remove all the skin from the arms. One arm we did a superficial dissection to find veins and nerves that run just under the skin (for example: flip your arm over and look at your elbow pit. See the vein that they use to draw blood? We dissected that out so you can follow its path all the way up into Stanley's shoulder). The other side we were supposed to go deeper and expose the muscles that are under the fat and nerves and such. It turns out Stanley has really nice big veins but he also has a lot of subcutaneous fat, which made his nerves hard to find so we didn't get very deep on either side. But thats fine, just more to do next week.

[skip this paragraph if you don't like squeamish details] Part of what I was tasked with was to remove the skin from the middle of the upper arm to the wrist in one big sheet (apparently I was dubbed the most precise with a scalpel in my group). Once I got the skin completely separated from the tissues underneath, it was really surreal. Rigor mortis prevented us from completely straightening Stanley's arms, so when I took the skin off, it held the shape of the bent elbow, which was just a really weird feeling. Holding human skin that maintained the shape of a joint in my hand... was even more bizarre than I expected.

Anyhow, the rest of this week is jam packed with lectures and next week is really lab heavy, then we'll have quiz #2 and then the week after is Labor day and I'm already looking forward to 3 days in the mountains :)

Meet Stanley

So today was my first ever human dissection. I spent quite a bit of time yesterday and this morning worrying that I might puke, faint or tear up. I was afraid that I'd freak out when we made the first incision through the -skin. But I didn't. :) In fact, right after lab I texted one of my friends (who oh-so-thoughtfully sent me a note this morning to wish me luck!) and said "That might have been the coolest thing I've ever done". That dissection was absolutely incredible.

So if you'd like to nerd out (and maybe gross out) for a second... we dissected Stanley's back today (Stanley's not his real name, its the name we gave him at the beginning of the lab). Cutting through the skin was a little weird, but once the skin was pulled back and the fat cut away... musculature is breath taking. I honestly can't put into words how awe inspiring it was to actually FEEL and SEE what its like inside a person (and this is just the back! Just wait till we get to internal organs!) There was also something really satisfying about cutting away the subcutaneous fat and fascia (which just looks like a bunch of yellow gunk) and finding perfectly ordered muscle striations underneath (someone more philosophical than I am can find some sort of Jesus analogy in there I'm sure...). Finally, there's something also satisfying about stepping back and admiring your handy work. Looking at the dissected back (we dissected deep on one side- to find underlying muscles and superficially on the other side to show big muscles like the trapezius and latissimus dorsi) and knowing that our hands did all that... that felt good, it felt like we really accomplished something. Which was a nice change because for the most part the first week of med school has felt more like this:
http://whatshouldwecallmedschool.tumblr.com/post/28985228486/trying-to-keep-up-the-first-week-in-medical-school

So overall, today was pretty fabulous. I can't WAIT to do the heart, lungs and brain (Stanley's cause of death and medical conditions should make these really interesting...).Who knows, maybe I will end up being a surgeon, since apparently I really like cutting things open to see whats inside :)
Only negatives for today (and the first two negatives are really more like fun facts):
1. My scrubs are too big (no surprise there...) had to roll them up so they don't drag in cadaver juice
2. I have to wear my glasses in lab because apparently prolonged exposure to formalin with soft contacts in can make them fuse to your eyes.
3. I spent 3 hrs on biochem tonight. Chem nerds, take a moment with me here: conceptually, enzyme kinetics makes perfect sense. I understand conceptually what happens when you vary enzyme, substrate and inhibitor concentrations. I understand the effects of altering environmental conditions. So why the hell do I need the Michealson-M...whatever equation? and that horrible graph where everything is an inverse (I think the y axis is 1/Vi and the x axis is 1/Km... or something like that). Math and graphs make life so confusing. If anyone can explain to me why I need to know these (other than "because its on the test") it'd be much appreciated.

I have a skeleton in my closet... literally

Ok, I'll get to the skeleton in a second, but can I just start by saying I am a happy camper. :) I'm sitting on my bed with six shiny new binders (each a different color) which I just filled with all my materials for block one. I just spent way too much money ordering awesome books with fabulous pictures. I have five pretty new highlighters (thanks to my big sib) with which to attack the contents of my pretty new binders.

Oh... and I also have a box of bones. So me and my roommies went to pick up our bone boxes today (yep, its exactly what it sounds like... a box that looks like a musical instrument case full of bones). Some bone boxes have plastic (fake) bones and some have real. By the time we got there, there were only real ones left (why anyone would pick fake over real beats me, but one of my roommates is a little creeped out by the idea of a dead dude's bones sitting in her room). Anyways, I guess my skeleton's not technically in my closet (yet) but thats because the box is still open in the middle of my floor because I can't get over how freaking awesome it is. I can't tell the gender (yet) so I'm taking suggestions for androgynous names. I'm leaning towards thinking its male though, the long bones (particularly the femur and tibia) are really long... this person was definitely taller than me.

So just for reference, this block I'm taking:
1. Gross anatomy- lectures + cadaver lab
2. Physiology
3. Cell and Tissue biology (aka histology)
4. Molecular medicine/Genetics
5. Doctoring
Doctoring is the class that first of all catches all the loose ends (bioethics, biostatistics, epidemiology etc) and its the class where we learn a lot of our practical skills. On the agenda for this block are the physical exams (general, neurological, pelvic, urogenital, and a list of others...). Anyhow, that list is just for context.

Thanks for reading, and don't forget suggestions to name my new friend :)

TLDR; I'm taking cool classes and got a box of bones!!! (and I'm really really excited about it!). lol, sorry it was too tempting.

PS- whoever's reading my blog in the United Arab Emirates... get lost creeper, go live vicariously through someone else.

Disclaimers

Hello my friends. I've been debating whether or not to start a blog to log my journey over the next four years. I finally decided in favor of blogging mostly so I can have a place to process. Currently the blog is public, so anyone can technically read it, but I'm not giving the link to anyone from my med school or my family. I want a place I can process uncensored. (If creepers start reading/commenting, I'll make it private). So my disclaimers are:
1. I don't plan to censor myself
2. It's med school, there's a certain gross-out factor involved. I'm sure things like bisecting a cadaver's face will require some processing so be forewarned.
3. Everyone says med school's a bitch. I might run out of time to blog, but as I said, this is for me (not for you) ultimately so I apologize now if I don't keep this up.
4. Please don't pass my link off to others without letting me know. I know its public so other people could find it on their own, but I just like to have an idea of who's creeping on me :D
5. For now, lets keep this name free. Thanks.

So, orientation's over and real life starts on Monday. Ready go!