When I was in Surgery I would see the kids in internal medicine rotation and think “Weenies.”
They were laughing, happy, so young and free. At least, that’s how it seemed through my eyes, burning from weeks of waking up at 4:30am to stay at the hospital until 6pm.
Now I’m in medicine myself and I don’t feel bad at all. I like IM.
Day one of clerkship tomorrow. Surgery. I feel ill but that may be my flying and little eating today. Excited, open, tired, unprepared, bit nervous. I say 5:30am start isn’t so bad. At least I won’t be jumping into a frigid pool. Good luck to me and all the other new 3rd years.
Whelp, that’s that.
Finished the Pharm exam, headed to Charter for a slide show and champagne. Then a jump off the cliff behind the library.
Now my mom and brother are coming to visit, landing in just a few hours! Frond’s parents are coming in too – on the same flight. Yowzas.
Leah and I went up to visit another roommate from first year before heading home, and as we exited the elevator, on the other side was the Pathophys prof and a tutor! The tutor with the bump on his head, the tutor who i felt was giving me such a hard time, and at the time it shook my confidence up. I thought it was because I was the only girl in my small group. It was the start of a term that wasn’t as academically challenging as last term, but somehow it was one of the more challenging, emotionally, mentally. I had moments where I felt so full of anxiety and stretched-too-thin, that I felt something in my chest was going to burst. There were moments I felt so jaded about this career path, asking: why do I care?
Now it’s finished and there’s a new feeling settling in. Something about reaching the end. Days can seem so similar, and trudging along, it’s hard to see where things are going. But moments like these are a chance to breathe and soak it in. It’s a turning point, people!
When I saw the tutor during Pathophys quizzes, he always gave me a smile, which I thought at first was a smirk. But the more sessions I had with him, the more I saw he was really teaching me something new I hadn’t learned yet in school. Out to get me? I think he was out to push me to be a better student, clinician, and better me. He lit up when he saw us leaving the elevator and asked us how the last exam went. Good! we told him. Best of luck on the step and in your careers! he told us, genuinely.
It’s Psychiatry week in Pathophysiology.
In honour of this week of self-analysis and labeling everyone you know with a psychiatric condition, here is nice gem from my prof:
It’s SPEAK. It’s what he counsels his patients with depression to do.
S – Schedule daily (this is important)
P – Pleasant activities (we really don’t get enough)
E – Exercise (get that blood flowin’!)
A – Assertiveness (express those emotions and feelings!)
K – Kind thoughts (kindness starts with being kind to yourself).
He said that med students especially need to look after themselves. I’m not sure about especially, but looking around at students, there is a definite tend to letting yourself go – physically, emotionally, creatively, and socially (myself included). On the one hand I feel one-dimensional if I spend my days only studying. On the other hand if I don’t spend all my time studying I feel behind and like I am not living up to my potential.
In the end, it’s this: we are living now, not just working and preparing for the future – future career, future location, future life. We keep ourselves going by focusing on our goals but it’s still worth living a good life now. Besides, it’s only going to get harder to figure this balance out; may as well figure it out now.
P.S. I’m cyclothymic.
It’s been tough to concentrate these days. The material doesn’t seem as exciting as it did in first year and, just to be dramatic, I’m finding myself forgetting why I’m doing this. It’s normal and happens to all second years, especially in the lead-up to the step 1. But it does make me appreciate reading things like this post, reblogged from a 3rd year medical student:
“This” being medicine.”This” being a chance to be a medical student. Which if you really think about it, is a pretty awesome job. I get to spend my days learning about things I find interesting. I’m on my feet, talking to patients and practicing skills I hope to spend the rest of my life doing. I am not really responsible for anything. Nothing is expected of me beyond being interested and showing up.”This” being a part of patients’ lives when they are at their most vulnerable. As a medical student I have time so I can spend an hour talking to and educating my patient about whatever disease and treatment is relevant. I have time so I can talk about life or anything really… and I like this time.I can spend half the day in the library reading. Or I can spend it in the cath lab, or GI suite or wherever else my patient may need to go. I get to see medicine from the perspective of someone who knows a little but has the time to absorb it all.I’m only 10 days in but so far I’ve see the textbook come to life.
Ascites with a fluid wave. Gout with tophus nodules. Stephenson-Johnson Syndrome. Hypertensive retinopathy complete with arteriovenous nicking, cotton-wool spots and flame-shaped hemorrhages.This is medicine and this me getting to do it.
I love this time in medical school. Third year is nearly over and I’m just happy to be here. This is good.
I have female patients who try to convince me that they don’t pass gas. I tell them, “Well I know you pass gas every day, and I know how much you pass every day!”
– GI Pathophysiology prof
For the record: 7-8 times a day. Males do it twice as much.
The school Healthy Grenada is working with had a PTA meeting tonight, so Frond and I went to introduce the program to the parents. As we were sitting waiting for the meeting to start, the principal pulled us aside into another classroom and asked who was going to be presenting. Frond said both of us. But she replied that I wouldn’t be able to do it because of my shorts. I don’t have many shorts, and the one pair that I wear a lot while here are pretty short I suppose. Not by North American standards, but for a Roman Catholic Elementary school, I could see what the principal was talking about. She said that I could hand out the fliers we had made, but I couldn’t be presenting. In the end, I went home to change and we presented together.
I appreciated the principal pointing this out to me, as it’s important. But I felt bad because I had worn these shorts to the school before, while doing activities with the kids. It really hit me that for all my trying to make Healthy Grenada a culturally competent program, I had overlooked many basic things.
We stayed for the entire PTA meeting, where parents shared some things they had learned about food, artifacts, and songs that their “forefathers” used. Grenada’s independence day is coming up in February, and judging by the efforts going in to it around town, it’s a pretty big deal. The principal and vice went on to talk about programs they are running for the students, including Sports Days (with an “Infant Cross Country Race” where the kindergarteners run a cross country course — incredible! People were saying how it was such a short course, but to me it sounded like quite a length), Spelling Contests, Reading Contests, and an ongoing school-wide Physical Activity competition. I was thinking the whole time about how I had came in to the school with so many assumptions about what the school had to offer their students. It had me wondering what exactly Healthy Grenada had to bring that would benefit the school. Was the school doing us more of a favour, by giving us a chance to volunteer with their kids? During their school time? I felt like a silly tourist.
After the meeting, we went to thank the Principal for inviting us to the meeting. She asked where we were from, and when we told her she said how we’re three different cultures. We agreed, adding that we’ve got a lot to learn from them, and she said, “Yes a lot to learn from each other” and gestured her hand back and forth between the 3 of us.
It’s back to school and that means back to more awkward clinical examinations.
Last week, we had our last practice session with a simulated patient. From here on out we’ll be going to the General Hospital with only real patients.
Our simulated patient was a 70 year old man, who worked as a gardener. We decided to practice going over the examination for the central nervous system. We started with the mini-mental state exam, which is what it sounds like. One of the questions to test higher functioning is to ask to hear “world” spelled backwards. Our patient hesitated for a long while but couldn’t do it. We tried the other test, which is to count down from 100 by 7. He said “100.. 97…”, he had memorized the answer to the other version of the test, which was to count down by 3. Some of the people in my group felt uncomfortable and laughed to cover it up, which stirred something in the patient. To his credit, my group member who was actually doing the test didn’t laugh and just waited patiently for his answer. The patient had been sitting quietly during the entire exam, but spoke up to say, “Let me tell you something. My mother abandoned me when I was three weeks old. I was raised by an adoptive family. So they didn’t teach me to spell such words.” The room was quieter after that.
We moved on to testing the sensory system, and the tutor reminded us to test dermatomes T4 and T10, which are at the level of the nipple and umbilicus, respectively. My group member doing the test opened up the gown and picked up the opened up paperclip that we use to test the pain and crude touch sensations. He told the patient to let him know if he felt a sharp touch (end of the paperclip) or a dull touch (the bent end of the paperclip) and went ahead and poked the patient with the sharp end right on the patient’s areola. “Sharp or dull?” He went on to poke the other nipple with the bent end. Our tutor told us that we should try to avoid the nipple. This poor 70 year old man. My group member went on to test for fine touch, which is done with a cotton wisp. Again, he went right for the nipple and brushed it with the cotton wisp. “Do you feel anything?” My tutor said, “Again, please try to avoid the nipple.”
Sometimes when you’re doing an exam it’s hard to keep things straight. You’re taught to do things that you’d think would hurt (sticking your fingers way into someone’s neck to feel their thyroid, tugging hard at someone’s knee to test their cruciate ligaments), and common sense easily goes out the window for things you clearly shouldn’t be doing (tickling someone’s nipple with a piece of cotton).
Kinda Cliché 
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