I've been laying in bed for the past few hours in the grips of insomnia. I haven't really been thinking about anything in particular, but I haven't been not thinking either.
I cannot believe that I am almost finished with the first two years of medical school. It has not been at all what I expected it to be. I came in with delusions of grandeur, ready to save the world and be passionate about everything that I learned. I was excited to escape the hum-drum rhythm of the working world, but I realize now that I miss having that rhythm in my life. I do not, however, miss sitting on the Mass Pike in traffic. I especially miss the sense of purpose that having a place to be in the morning gives me. I've been really bad about going to class this semester, not having anywhere that I absolutely had to be made me feel somewhat useless and didn't really give me the incentive to get out of bed in the morning raring to go.
I am looking forward to third year and all of the ridiculous new requirements it will bring. I think that I'll finally have a sense of my life moving forward again, that I'm ticking off the boxes that I need to get out of NY and into a career. Second year was an absolute slog for me, partially because I have made it so in my mind and partially because of the drawn out nature of our schedule. I think that having a new service to work on every few weeks, seeing new people every day, having someone tell me what to do and where to be will at least give me a reason to get out of bed in the morning, if nothing else. I'm also looking forward to the subjective grading scheme, where how hard I work has a bearing on how I perform. It seemed no matter how hard I worked this year that I always ended up in the same spot on the curve.
I think the greatest sense of accomplishment from second year comes when I look at the tattered, over-highlighted pages of my copy of Robbins. I read that damned book cover to cover, and while how much I retained is another story, I knew enough of all of it at some point to pass the course. That's a pretty cool feeling, that passes as soon as I realize the number of hours I spent hunched over a desk in the library.
Anyway, 2 more exams and then it's onto board studying. For anyone that's interested, I passed the in-house path exam and I'll be waiting with baited breath for the shelf results in 2 weeks. I'm off to try to sleep now...hopefully I'll get some shut-eye.
5.09.2008
5.07.2008
PATH
Pathology ends tomorrow after two exams (in house mid-term and an NBME shelf)...I'm counting down the minutes (approximately 960 as of midnight).
It's been a struggle and I have some issues with how the course was run. Overall, I feel like I have a fairly solid basis for taking on the boards successfully in about 46 days...but that's another issue...I still have to make it out of this semester in one academic piece.
Catch ya on the flip side.
It's been a struggle and I have some issues with how the course was run. Overall, I feel like I have a fairly solid basis for taking on the boards successfully in about 46 days...but that's another issue...I still have to make it out of this semester in one academic piece.
Catch ya on the flip side.
5.05.2008
Apologies
Increasingly, I find myself apologizing for being a medical student. It has gotten to the point where my reflex is to give a detailed schedule out through September and an account of what I'll be doing so people don't think that I'm blowing them off...I really am that busy and not going to be in town or free until September! It could be Mother's Day (Sorry Mom!) or my brother moving into his new house (Sorry Bro), or my friends marriage that falls in the middle of my surgery rotation (Sorry Guys! Enjoy my gift!) or my girlfriend's graduation ball (Sorry Hun), but it's always the same story...I have school, I cant get away. Yes, I have to study for a straight week before my exams, no I'm not stupid. Yes I have to study for 6 weeks straight for the boards, it determines a big chunk of my career. No I can't go to Vegas with you because I have to work 60 hours that week, I'm probably staying late most nights and I'm probably on overnight call that Saturday too...yeah, I'll see you at Christmas too.
One of my friends has been in town for work on and off for the past few months and I've turned down his invites for drinks a few times now. He's VERY understanding of the whole thing, but I'm just wondering when understanding runs out like it has with so many others...
What other career can you rack up $260k of debt and lose your personal life all before your first sub-minimal wage paycheck?
One of my friends has been in town for work on and off for the past few months and I've turned down his invites for drinks a few times now. He's VERY understanding of the whole thing, but I'm just wondering when understanding runs out like it has with so many others...
What other career can you rack up $260k of debt and lose your personal life all before your first sub-minimal wage paycheck?
4.29.2008
100th post...
100 posts...I'll dedicate this post to the fact that I've pretty much finished my pre-clinical medical education. Thanks for reading.
Looking back on the past 15,454 hours (or 21 months, 4 days...not that I'm counting) of my life, I'm not all that impressed by what I've seen. I've done a lot of sitting infront of books, I've run through 70+ highlighters, I've done a lot of memorizing but not a lot of learning. Every time that I think that I've mastered a subject, I go back and the foundation has fallen out from it. I try to look at the forest, but all I see are the individual pine needles. At this point, my exams test for ability to regurgitate random minutiae from Robbins, not for understanding of the material. Understanding material and being able to regurgitate sentences from Robbins on demand are very different. For one, I don't see the utility of being able to recite the translocations responsible for 15 different hematologic malignancies, or the cell of origin of one of the 25 difference neoplasms of the ovaries in the education of someone who will be a family physician, psychiatrist or emergency physician.
There has been a lot of wasted effort in my education, on both my behalf as well on the behalf of the AAMC/LCME who have an asininely archaic idea of what medical education should be. After June 23rd about 70% of what I've been forced to learn over the past 2 years will be vaporized from my short term memory. All those little interconnected neurons in my holding medical knowledge in my hippocampus will simply rearrange some microtubules and the hours I spent slaving over the pages of Robbins will spill out of my the distance reaches of my consciousness. Two years of my life be reduced nothing more than a few distant memories of sitting my ass in front of that same crappy carrel in the dingy basement of the library with the humming of the furnace and the fluorescent lights in my ears.
You would think that I would be sad that I'm about to reduce the intimate memories of approximately 1/12th of my life down to one simple experience that I like to refer to as "The Suck." But I'm not. You see, the past 21 months have been little more than a requisite right of passage into what I've been waiting to experience: LEARNING MEDICINE! Isn't that what I've paid for thus far? Didn't I go to medical school and not "memgurgitate lots of information that you probably will never see in the course of your career for the fun of it" school?
The ironic thing is that I'll probably look back on all of this in the middle of one of my over-night call shifts on surgery or OB and long for the days where I could sleep for 8 solid hours and control my own schedule instead of being abused on the floors. But for now, I'm hopeful that seeing and experiencing the management of patients and their various disease will re-ignite my failing passion for medicine.
Looking back on the past 15,454 hours (or 21 months, 4 days...not that I'm counting) of my life, I'm not all that impressed by what I've seen. I've done a lot of sitting infront of books, I've run through 70+ highlighters, I've done a lot of memorizing but not a lot of learning. Every time that I think that I've mastered a subject, I go back and the foundation has fallen out from it. I try to look at the forest, but all I see are the individual pine needles. At this point, my exams test for ability to regurgitate random minutiae from Robbins, not for understanding of the material. Understanding material and being able to regurgitate sentences from Robbins on demand are very different. For one, I don't see the utility of being able to recite the translocations responsible for 15 different hematologic malignancies, or the cell of origin of one of the 25 difference neoplasms of the ovaries in the education of someone who will be a family physician, psychiatrist or emergency physician.
There has been a lot of wasted effort in my education, on both my behalf as well on the behalf of the AAMC/LCME who have an asininely archaic idea of what medical education should be. After June 23rd about 70% of what I've been forced to learn over the past 2 years will be vaporized from my short term memory. All those little interconnected neurons in my holding medical knowledge in my hippocampus will simply rearrange some microtubules and the hours I spent slaving over the pages of Robbins will spill out of my the distance reaches of my consciousness. Two years of my life be reduced nothing more than a few distant memories of sitting my ass in front of that same crappy carrel in the dingy basement of the library with the humming of the furnace and the fluorescent lights in my ears.
You would think that I would be sad that I'm about to reduce the intimate memories of approximately 1/12th of my life down to one simple experience that I like to refer to as "The Suck." But I'm not. You see, the past 21 months have been little more than a requisite right of passage into what I've been waiting to experience: LEARNING MEDICINE! Isn't that what I've paid for thus far? Didn't I go to medical school and not "memgurgitate lots of information that you probably will never see in the course of your career for the fun of it" school?
The ironic thing is that I'll probably look back on all of this in the middle of one of my over-night call shifts on surgery or OB and long for the days where I could sleep for 8 solid hours and control my own schedule instead of being abused on the floors. But for now, I'm hopeful that seeing and experiencing the management of patients and their various disease will re-ignite my failing passion for medicine.
4.27.2008
What it's all about
If you've read this blog with any frequency, you know that I have an soft spot in my heart for cancer stories and patients who have been through the medical ringer with their diagnosis and treatment. My heart absolutely goes out to those abandoned souls who are left hanging without a physician who will advocate for them.
We had a patient presentation session this past week from breast cancer survivors treated by one of our faculty physicians. The stories of these women were sad and at the same time absolutely appalling. Between all of the mis-diagnoses, the poor attention paid to their needs, the lack of communication and the delays between procedures, it's a wonder that these women are alive at all. It reminded me why I wanted to get into this field in the first place and brought together a lot of what doctoring is all about.
-First patient: Hypodensity in one breast was missed over a fibroadenoma in the other breast. She was cleared for hormone replacement therapy. A year later, and she had full blown carcinoma that was being fed by her estrogen replacement...though that mechanism was not completely lucid at the time. Found the doc on campus and had everything taken care of and is still here to tell the story.
-Second patient: She made me extremely sad. She felt a lump, and had a mammogram done. She was diagnosed clinically with breast cancer on that mammogram. She requested a second opinion, and was sent to another oncologist at a prestigious ivory tower institution on the East Coast with another patient's films. The oncologist picked up on it right away, and repeat films were clean. Two years later, her films were not clean and so she returned to that same ivory tower practice to find that the physician had retired and left the practice in the hands of another doc. This guy was all about fitting in as many patients as possible. He drained the patient's cystic adenomas monthly for 8 months without biopsy, until one visit he stopped getting fluid. He looked at the patient and said "I think I made a mistake. Go see the receptionist, and we'll get you in for a biopsy." He didn't have an opening until 4 months later...so she left and came to our institution and found this doc who made everything all right, after a year of weekly chemo.
-Third patient: Basically got told by a doc at a NYC Cancer Mecca that she had breast cancer, and was not presented with the full amount of information that she requested. Great doctor, crappy care. The doctor gave her info and treatment options on a need to know basis and basically told her what she was going to do. She left out of frustration and found the doc at our institution who presented the entire picture of how they were going to get through it.
---------------------
The take home message that I got out of this session was that communication is 95% of being good physician. If you're not able to communicate what is going on with the patient, how you're going to fix it and what they need to do, the patient is going to lose faith in you from the get go. Your work lies in finding and correcting the errors in physiology and anatomy of another human being!!! This is not some computer simulation or lab animal or entry in Robbins that you're dealing with, it's a person and their life and their family. You can be the most technically knowledgeable and capable individual in the field, but what takes you that extra step ahead of the rest is the simple ability to explain the situation to a very scared person, who may not be thinking rationally, and to make them understand what you're about to do.
I see so many of my colleagues lacking in this regard, and I worry for their future patients and the future of medicine.
We had a patient presentation session this past week from breast cancer survivors treated by one of our faculty physicians. The stories of these women were sad and at the same time absolutely appalling. Between all of the mis-diagnoses, the poor attention paid to their needs, the lack of communication and the delays between procedures, it's a wonder that these women are alive at all. It reminded me why I wanted to get into this field in the first place and brought together a lot of what doctoring is all about.
-First patient: Hypodensity in one breast was missed over a fibroadenoma in the other breast. She was cleared for hormone replacement therapy. A year later, and she had full blown carcinoma that was being fed by her estrogen replacement...though that mechanism was not completely lucid at the time. Found the doc on campus and had everything taken care of and is still here to tell the story.
-Second patient: She made me extremely sad. She felt a lump, and had a mammogram done. She was diagnosed clinically with breast cancer on that mammogram. She requested a second opinion, and was sent to another oncologist at a prestigious ivory tower institution on the East Coast with another patient's films. The oncologist picked up on it right away, and repeat films were clean. Two years later, her films were not clean and so she returned to that same ivory tower practice to find that the physician had retired and left the practice in the hands of another doc. This guy was all about fitting in as many patients as possible. He drained the patient's cystic adenomas monthly for 8 months without biopsy, until one visit he stopped getting fluid. He looked at the patient and said "I think I made a mistake. Go see the receptionist, and we'll get you in for a biopsy." He didn't have an opening until 4 months later...so she left and came to our institution and found this doc who made everything all right, after a year of weekly chemo.
-Third patient: Basically got told by a doc at a NYC Cancer Mecca that she had breast cancer, and was not presented with the full amount of information that she requested. Great doctor, crappy care. The doctor gave her info and treatment options on a need to know basis and basically told her what she was going to do. She left out of frustration and found the doc at our institution who presented the entire picture of how they were going to get through it.
---------------------
The take home message that I got out of this session was that communication is 95% of being good physician. If you're not able to communicate what is going on with the patient, how you're going to fix it and what they need to do, the patient is going to lose faith in you from the get go. Your work lies in finding and correcting the errors in physiology and anatomy of another human being!!! This is not some computer simulation or lab animal or entry in Robbins that you're dealing with, it's a person and their life and their family. You can be the most technically knowledgeable and capable individual in the field, but what takes you that extra step ahead of the rest is the simple ability to explain the situation to a very scared person, who may not be thinking rationally, and to make them understand what you're about to do.
I see so many of my colleagues lacking in this regard, and I worry for their future patients and the future of medicine.
4.22.2008
Progress...
Part of the reason that I've been writing less is that I've been running a bit more and doing other outside funtime activities. That has provided me with a whole bunch of good feeling endorphins, incremental gains in fitness and a dose of sanity that nothing else has been able to provide to this point. I feel better, I've cut back on coffee consumption, I'm sleeping a bit better and I have a good excuse not to study. And the dress slacks fit better now too...which is always a plus.
I took my longest run in a while this weekend -5.3 miles- which felt great and I put in my first structured speed work since high school. I think the hardest part about getting back into running is that I'm still getting used to the fact that I'm a beginner again. I can't expect my body to pound out a decent pace like I used to, and it takes a bit of mental work to realign my perceived effort level with the paces/times that I'm putting up. So far the heart rate monitor is helping out with that aspect, I know where my lactate threshold is and where I need to put my heart rate to match my perceived effort, my feet just fall in line with the rest...kind of a cool quasi-physiological way to approach things. I'm also taking time to rest, which is helping out alot with the aches that plagued me for a lot of my earlier self-directed running.
I cobbled together a half-marathon training schedule that takes me up to the race in October. I'm almost sticking to it, except when exam weeks get in the way. I just hope that Surgery doesn't completely kill my hopes of finishing the race...but we'll see!
******************
I'm getting into the home stretch with classes, and starting to get all wound up for the boards in June. The nice weather is making it increasingly difficult to lock myself in the library with my good ol' pal Robbins, but I've been fairly good thus far.
Looking back on the first two years of medical school, it's been rough. It's not that the material is difficult to understand. It's the frame of reference that's been killing me all along. I'm an active learner. I learn by doing and seeing, not by staring at piles of notes and pages of readings. There is no way to actively learn pathology or biochem or any of the pre-clinical material, really. Seeing patients with their diseases makes the material stick more than the books do. It's just been the pure grunt work of slogging through the material until enough of it sticks, and that's led to some disappointing performances for me...like all of them. I've never felt less confident about what I'm doing in my life, and to have to live with that lack of confidence is draining.
Two weeks of torture left though, then a week of reading period/exams and then it's time for me to study for the boards. I'm looking foward to board studying, because I have a schedule that I'm going to stick to and it should be plenty to get a decent score on the step 1's. I'll probably continue to sneak in a post or two a week, updating about running/studying/life in general.
I took my longest run in a while this weekend -5.3 miles- which felt great and I put in my first structured speed work since high school. I think the hardest part about getting back into running is that I'm still getting used to the fact that I'm a beginner again. I can't expect my body to pound out a decent pace like I used to, and it takes a bit of mental work to realign my perceived effort level with the paces/times that I'm putting up. So far the heart rate monitor is helping out with that aspect, I know where my lactate threshold is and where I need to put my heart rate to match my perceived effort, my feet just fall in line with the rest...kind of a cool quasi-physiological way to approach things. I'm also taking time to rest, which is helping out alot with the aches that plagued me for a lot of my earlier self-directed running.
I cobbled together a half-marathon training schedule that takes me up to the race in October. I'm almost sticking to it, except when exam weeks get in the way. I just hope that Surgery doesn't completely kill my hopes of finishing the race...but we'll see!
******************
I'm getting into the home stretch with classes, and starting to get all wound up for the boards in June. The nice weather is making it increasingly difficult to lock myself in the library with my good ol' pal Robbins, but I've been fairly good thus far.
Looking back on the first two years of medical school, it's been rough. It's not that the material is difficult to understand. It's the frame of reference that's been killing me all along. I'm an active learner. I learn by doing and seeing, not by staring at piles of notes and pages of readings. There is no way to actively learn pathology or biochem or any of the pre-clinical material, really. Seeing patients with their diseases makes the material stick more than the books do. It's just been the pure grunt work of slogging through the material until enough of it sticks, and that's led to some disappointing performances for me...like all of them. I've never felt less confident about what I'm doing in my life, and to have to live with that lack of confidence is draining.
Two weeks of torture left though, then a week of reading period/exams and then it's time for me to study for the boards. I'm looking foward to board studying, because I have a schedule that I'm going to stick to and it should be plenty to get a decent score on the step 1's. I'll probably continue to sneak in a post or two a week, updating about running/studying/life in general.
4.21.2008
Yankee Stadium Revisited
Every time I head down to the Bronx to watch a ball game I get a few too many beers into me and awesomeness ensues:
I'm generally not a well liked person within the walls of Yankee Stadium, and I'm OK with that for the most part. I understand that two of the best teams in baseball play each other 18 times a year. I know that it's going to be a 4 hour game with plenty of action. I know that I'm going to be screamed at for the entirety of those 4 hours and every portion of my life will be insulted. I usually have a few drinks so that I can appreciate the atmosphere and lower my inhibitions about yelling insults at perfect strangers and their mothers. So here's how the night went:
shouting matches with the entire train car that lead to me being escorted to another car"spirited conversations" the whole way home.
EDIT: One of my friends that was at the game sent me the following link saying that this could have easily been me. I'm not a violent person by nature so I think he was a little bit off, but check it out anyway!
I'm generally not a well liked person within the walls of Yankee Stadium, and I'm OK with that for the most part. I understand that two of the best teams in baseball play each other 18 times a year. I know that it's going to be a 4 hour game with plenty of action. I know that I'm going to be screamed at for the entirety of those 4 hours and every portion of my life will be insulted. I usually have a few drinks so that I can appreciate the atmosphere and lower my inhibitions about yelling insults at perfect strangers and their mothers. So here's how the night went:
- Within about 30 seconds of opening the car doors in the parking garage, my friend and I are booed mercilessly. So we tailgated for a while because $10.50 for a Hineken is obscene.
- On the way up to our 3rd tier seats, I stop to buy a beer for the walk up to our alcohol free seating. The beer lady looks at me and says with the thickest accent she can muster "NO, I don't serve any Red Sox fans". The other beer lady came over and poured me a beer...and she got a tip too!
- We exit the concourse onto the third tier seating. My friend and I remained standing to finish our beers, and we were greeted by an intoxicated fan's "Hey, go F--- yourself and your mother". Officer Del Reye of the NYPD had a nice chat with him and I felt a little bit safer.
- Later on, I'm waiting in line for the Men's room (only place on earth I've ever experienced this) and I get my favorite insult of the night. "Hey! You in the Sox jersey! Your penis is attached to you vagina!" I looked at the guy for a second, marveling at his stupidity, and said "I don't even know what that means." He shrugged and left...by far the best insult I've ever received because it was hilarious for everyone
EDIT: One of my friends that was at the game sent me the following link saying that this could have easily been me. I'm not a violent person by nature so I think he was a little bit off, but check it out anyway!
4.12.2008
Quotes from the rectum
Ok so I have to share this one with everyone, despite how disturbing it is to me. So I had my standard male genitourinary and rectal exam a few weeks ago, and I just keep relaying one quote to everyone that asks how it went.
So we finished up the awkward exam of the male genitals (junk or twig and two berries if you will) and perenium (the taint or grundle for the anatomically disinclined). I've plucked this guys spermatic cords about 5 times and have had my finger up into his inguinal canal to feel his hernia...crossing all sorts of boundaries that I've never crossed with another man's junk, with minimal public display of discomfort. The patient/actor/educator turns around to the three of us males in the room and says:
"Hold up your hands."
We oblige. Pointing to the large-handed former football player, he deadpan says "Ok, you've got the biggest fingers, you're going to go first and open me up."
Great way to make things comfortable and welcoming for all with that visual aid...whilst I insert my fingers into your rectum...ugh.
Thanks for that again. I'll definitely be rushing to do my requisite 10 observed rectals on my surgery rotation in July after that experience.
So we finished up the awkward exam of the male genitals (junk or twig and two berries if you will) and perenium (the taint or grundle for the anatomically disinclined). I've plucked this guys spermatic cords about 5 times and have had my finger up into his inguinal canal to feel his hernia...crossing all sorts of boundaries that I've never crossed with another man's junk, with minimal public display of discomfort. The patient/actor/educator turns around to the three of us males in the room and says:
"Hold up your hands."
We oblige. Pointing to the large-handed former football player, he deadpan says "Ok, you've got the biggest fingers, you're going to go first and open me up."
Great way to make things comfortable and welcoming for all with that visual aid...whilst I insert my fingers into your rectum...ugh.
Thanks for that again. I'll definitely be rushing to do my requisite 10 observed rectals on my surgery rotation in July after that experience.
Lack of blogging motivation
So I've kind of been out of ideas for writing lately, and for that I apologize to anyone who still regularly checks in. I've been running away from school for the past two weekends since my renal path exam and the rest of my free time is being eaten up by a stupid group project.
I'm not quite sure why as a 24 year old medical student I'm still assigned group work. Honestly, I am quite capable of working with a group to complete an assignment as well as doing it independently. I think that group science report that I did in elementary school proved that skill set. But here I am again, trying to coordinate 7 other classmates to create a paper that will live up to the nit-picky expectations of the course director. I've realized that I naturally gravitate to these types of positions where I take on the burden of getting a group of people to pull in the same direction, and usually I do ok with them. Hopefully, we can get a decent grade out of this project for all of us, I've certainly done my share. Especially with rewriting the sections assigned to the the one member of the group that struggles to write a coherent paragraph. I figured the 5 non-native english speakers would be the dead weight in the writing department, but they actually write quite well...it was one of the two native speakers that gave me trouble...figures.
******************
So I got out to my favorite spot on earth this afternoon again: Fenway Park.
There's just something about the hustle and bustle around the ball park that makes me feel invigorated. Once I'm through the ticket gates, I like to immediately descend from the overly comercialized and family friendly Yawkey Way into the dimly bowels of the stadium that has stood there, almost unchanged since 1912. It almost feels like I'm traveling back in time amidst the smokey aroma of sausage on the grill and the white noise of 37,000 people vibrating through the concrete structure. Each descent brings back floods of memories of dozens of visits before, all rushing back at once. It's similar to what I imagine seeing your life flash before your eyes is like, but you can do it whenever you like for the price of admission. There's the usual, comfortable ritual of procuring the correct overpriced mass produced American lager for my dad in appreciation for the tickets he preennially provides, of walking down the ramp past the same souvenir vendor that's always there with the same old overpriced stuff, past the nacho/pretzel and hot dog/sausage, Papa Gino's, Beer/Peanut and Ice cream stands (yes, in that exact order). Waving to the same beer guy that's always there with some clever remark while he happily pours his brews in the corner by the entrance up to our section. It's a ritual that always feels familiar and yet always exciting and new...like nothing else I've ever experienced. If you've been to Fenway and sat on the third base side of the stadium, you probably know what I mean...it's the least renovated portion of the ball park and instead of feeling like a dump, which is what I'm sure many people would think, it feels like I'm walking back into an earlier time where nothing else matters except for enjoying the home team playing the classic american game.
For me, the real magic begins as soon as I emerge from the musty underbelly of the beast into the light and fresh air and echoing sounds of the park. I like to look up at the skyline over the right field wall and scan the outfield and just take a few seconds to absorb the atmosphere, and it instantly takes me back to the first few times that I visited the stadium back in the 80's and sat on my dad's lap and ate cotton candy and watched Wade Boggs (one of my favorite childhood players) play his heart out at third base and be the RBI machine that he was. It's a great feeling. The world could be collapsing around me (as it indeed it often seems to be these days), but I wouldn't really care if I had my butt in one of those cramped old seats. It really is a special place for me and holds hundreds of amazing memories that make me feel at peace and at home.
It's quite a stark and welcome contrast to my other life in New York, where I constantly feel out of place and like something is looming over me waiting to rend my soul to it's very roots. I wish I could better express what it is that I feel in words, but it's one of those intangibles that just nags at the periphery of my consciousness. Like when you walk into a room and absolutely know that something is out of place but you're not even sure what it is or why you have that feeling, but it's there nonetheless. I guess that I just don't feel at home there in NY and it adversely affects everything I do and weighs me down. I guess that strikes at the heart of the reason that I started writing this blog in the first place...to get over that feeling of living in a place that I will never be comfortable enough to call home.
I've come to realize over the past two years that discomfort is the place where I have to learn to be comfortable through many experiences (see "Notes from the Vagina"). However, making that leap from conceptualization to actualization is more difficult than it appears on the surface.
So that's a little bit about where I'm coming from in my life at this point, and it only took 3 overpriced, mass produced American lagers at my favorite place on earth to bring it out...hopefully I'll have something less touchy-feely to write about next time, but here's where my flow of consciousness went tonight.
Peace out girl scout...
I'm not quite sure why as a 24 year old medical student I'm still assigned group work. Honestly, I am quite capable of working with a group to complete an assignment as well as doing it independently. I think that group science report that I did in elementary school proved that skill set. But here I am again, trying to coordinate 7 other classmates to create a paper that will live up to the nit-picky expectations of the course director. I've realized that I naturally gravitate to these types of positions where I take on the burden of getting a group of people to pull in the same direction, and usually I do ok with them. Hopefully, we can get a decent grade out of this project for all of us, I've certainly done my share. Especially with rewriting the sections assigned to the the one member of the group that struggles to write a coherent paragraph. I figured the 5 non-native english speakers would be the dead weight in the writing department, but they actually write quite well...it was one of the two native speakers that gave me trouble...figures.
******************
So I got out to my favorite spot on earth this afternoon again: Fenway Park.
There's just something about the hustle and bustle around the ball park that makes me feel invigorated. Once I'm through the ticket gates, I like to immediately descend from the overly comercialized and family friendly Yawkey Way into the dimly bowels of the stadium that has stood there, almost unchanged since 1912. It almost feels like I'm traveling back in time amidst the smokey aroma of sausage on the grill and the white noise of 37,000 people vibrating through the concrete structure. Each descent brings back floods of memories of dozens of visits before, all rushing back at once. It's similar to what I imagine seeing your life flash before your eyes is like, but you can do it whenever you like for the price of admission. There's the usual, comfortable ritual of procuring the correct overpriced mass produced American lager for my dad in appreciation for the tickets he preennially provides, of walking down the ramp past the same souvenir vendor that's always there with the same old overpriced stuff, past the nacho/pretzel and hot dog/sausage, Papa Gino's, Beer/Peanut and Ice cream stands (yes, in that exact order). Waving to the same beer guy that's always there with some clever remark while he happily pours his brews in the corner by the entrance up to our section. It's a ritual that always feels familiar and yet always exciting and new...like nothing else I've ever experienced. If you've been to Fenway and sat on the third base side of the stadium, you probably know what I mean...it's the least renovated portion of the ball park and instead of feeling like a dump, which is what I'm sure many people would think, it feels like I'm walking back into an earlier time where nothing else matters except for enjoying the home team playing the classic american game.
For me, the real magic begins as soon as I emerge from the musty underbelly of the beast into the light and fresh air and echoing sounds of the park. I like to look up at the skyline over the right field wall and scan the outfield and just take a few seconds to absorb the atmosphere, and it instantly takes me back to the first few times that I visited the stadium back in the 80's and sat on my dad's lap and ate cotton candy and watched Wade Boggs (one of my favorite childhood players) play his heart out at third base and be the RBI machine that he was. It's a great feeling. The world could be collapsing around me (as it indeed it often seems to be these days), but I wouldn't really care if I had my butt in one of those cramped old seats. It really is a special place for me and holds hundreds of amazing memories that make me feel at peace and at home.
It's quite a stark and welcome contrast to my other life in New York, where I constantly feel out of place and like something is looming over me waiting to rend my soul to it's very roots. I wish I could better express what it is that I feel in words, but it's one of those intangibles that just nags at the periphery of my consciousness. Like when you walk into a room and absolutely know that something is out of place but you're not even sure what it is or why you have that feeling, but it's there nonetheless. I guess that I just don't feel at home there in NY and it adversely affects everything I do and weighs me down. I guess that strikes at the heart of the reason that I started writing this blog in the first place...to get over that feeling of living in a place that I will never be comfortable enough to call home.
I've come to realize over the past two years that discomfort is the place where I have to learn to be comfortable through many experiences (see "Notes from the Vagina"). However, making that leap from conceptualization to actualization is more difficult than it appears on the surface.
So that's a little bit about where I'm coming from in my life at this point, and it only took 3 overpriced, mass produced American lagers at my favorite place on earth to bring it out...hopefully I'll have something less touchy-feely to write about next time, but here's where my flow of consciousness went tonight.
Peace out girl scout...
4.04.2008
Renal Failure...
I'm having a little trouble walking after that exam.
The combination of being flustered and under prepared for the depth of material was infuriating. I felt completely lost for about half the questions, which should get me into the "I should still be able to pass the course" range. It was renal, hepatobiliary and GI with clinical correlations and lab correlations. I could have had Robbins and Cecil open on my desk with a boarded pathologist, a nephrologist and a gastroenterologist sitting next to me for the exam whispering answers into my ear and I probably still would have struggled.
Good job course director, you have crushed my will to continue on in medicine yet again...off to to nice and easy pharm exam and then to crawl into a bottle of something alcoholic until Monday.
The combination of being flustered and under prepared for the depth of material was infuriating. I felt completely lost for about half the questions, which should get me into the "I should still be able to pass the course" range. It was renal, hepatobiliary and GI with clinical correlations and lab correlations. I could have had Robbins and Cecil open on my desk with a boarded pathologist, a nephrologist and a gastroenterologist sitting next to me for the exam whispering answers into my ear and I probably still would have struggled.
Good job course director, you have crushed my will to continue on in medicine yet again...off to to nice and easy pharm exam and then to crawl into a bottle of something alcoholic until Monday.
Ode to a Kidney...
Oh Kidney, you rend the joy within my soul.You do so much, so elegantly, without complaint.
Yet I cannot fathom the depths of your pathology.
Your glomeruli confound me.
Your tubules vex my very soul.
Your electrolytes confuse the living shit out of me.
In short kidney, you make me want to curl up into the fetal position...
I suffer from neophrogenic anxiety and acute interstitial glomerulo-I-FREAKING-HATE THE-KIDNEY-itis.
3.28.2008
New Side Bar Items
I'm going to add a few new side bar items:
-A count down until I take the boards
-A link to my Runner's world workout log for anyone that might want to follow along with that progress.
-A count down until I take the boards
-A link to my Runner's world workout log for anyone that might want to follow along with that progress.
Goals and Expectations
Most people think of their new year's resolutions in December/January and break them by February. Since I'm an amazing procrastinator, I've set a few new goals for myself over the next few months:
- Finish out the year on a strong note (ie stop slacking off!!!)
- Carry that momentum through studying for the boards (June 23rd...yikes)
- Do above average on the boards (220-230 range)
- Keep running a couple times a week to maintain sanity/health
- Go into 3rd year with a positive attitude, especially with our school's "academic mecca" surgical clerkship in July as my first rotation
- Come out with a decent grade and something positive from the experience to set the tone for familyvacation medicine and the rest of the year
- Finish a half marathon with girlfriend in October
- Help my brother do some work on his new house this summer and stay in better touch with him
- Overcome the relentless beer potomania that arises with every path study session
I'll let you know how they go.
- Finish out the year on a strong note (ie stop slacking off!!!)
- Carry that momentum through studying for the boards (June 23rd...yikes)
- Do above average on the boards (220-230 range)
- Keep running a couple times a week to maintain sanity/health
- Go into 3rd year with a positive attitude, especially with our school's "academic mecca" surgical clerkship in July as my first rotation
- Come out with a decent grade and something positive from the experience to set the tone for family
- Finish a half marathon with girlfriend in October
- Help my brother do some work on his new house this summer and stay in better touch with him
- Overcome the relentless beer potomania that arises with every path study session
I'll let you know how they go.
3.26.2008
Post Match
With all of this Post-Match hoopla, I'm feeling pretty good about things. My school matched a bunch to MA based EM residencies, so I'm pretty pumped about my prospects of getting back up to the Boston area.
The downside of being a second year is that everything seems so far away when you have the rest of path, step 1, a year of mandatory clerkships, Step 2, aways, ERAS, and interviews to get through. Looking behind me though, I'm almost done with Pre-clinical. I just have a few more pre-clinical requisites to get through include my Male GU exam this weekend/the second time I have to put a finger into someone's rectum for a check mark.
I'll probably be away from the blog for another 2 weeks since we have exams coming up and I'm behind as usual...
The downside of being a second year is that everything seems so far away when you have the rest of path, step 1, a year of mandatory clerkships, Step 2, aways, ERAS, and interviews to get through. Looking behind me though, I'm almost done with Pre-clinical. I just have a few more pre-clinical requisites to get through include my Male GU exam this weekend/the second time I have to put a finger into someone's rectum for a check mark.
I'll probably be away from the blog for another 2 weeks since we have exams coming up and I'm behind as usual...
3.23.2008
Spring break
Carrying my clothes back into my building from my car, I ran into a couple of my classmates.
Bostonian: Hey guys, what's happening?
Guy: Back to hell
My thoughts exactly...
Bostonian: Hey guys, what's happening?
Guy: Back to hell
My thoughts exactly...
3.09.2008
Clinical Competence
We arrived at the Morchand Center For Clinical Competence at about 11 am and had a nice little introduction of how the exam will run. The basic rules are that you get an hour to elicit a full H&P from an actor in 1 hour. Every move and every word are recorded on videotape for your school and you have 15 minutes of review/critique at the end. Three sections on the grading- History, Physical and Patient Interaction. The administrator kept calling it "an experience". Oh and was it ever.
There is a big cloud of mystery that hangs over the Morchand center at my school. Mostly it is talked about with a tone anxiety and whispered rumor. I've heard stories of people failing for pretending to give immunizations, I've heard of people failing for not taking it serious enough, I've heard of people completely freezing and forgetting large chunks of the history...there's a lot of rumors. My roomate got reamed for being "excessively happy and not respecting the patient" the day before I went. Not exactly the comforting aura of puppy dogs and rainbows like you'd expect.
Having done one full H&P on my own, and briefly practicing over the past few days, I was somewhat worried about the physical. I knew that I was solid on the history and patient interaction, but I haven't quite gotten the complete physical synthesized to the point where it flows. I had planned to spend about 2o minutes with the complete medical history and then move to the physical for the remainder, and I hit around 25 minutes...not too bad. What killed me was the neuro exam. It's so long, and my oncologist preceptor kept telling us that we didn't need to know the complete neuro exam no matter how much we asked to go over/practice it. Guess what Doc...we needed it. So I didn't finish my neuro exam or get a chance to wrap up the session...but the rest of everything went fine.
My patient was actually quite friendly and cooperative with me, and even managed to joke around with me despite having unstable angina. I was somewhat unsettled when I went over to the sink to wash my hands ended up staring directly into a camera mounted on the wall. I made sure to give the camera guy a little wink, so maybe that will show up on my eval. The most interesting part of the feedback came from the patient who told me what it was like to be my patient...and it was all pretty positive. I guess those empathy classes worked.
Overall I think it boosted my confidence in communication and showed me what I have to work on in the physical: PRACTICING!
There is a big cloud of mystery that hangs over the Morchand center at my school. Mostly it is talked about with a tone anxiety and whispered rumor. I've heard stories of people failing for pretending to give immunizations, I've heard of people failing for not taking it serious enough, I've heard of people completely freezing and forgetting large chunks of the history...there's a lot of rumors. My roomate got reamed for being "excessively happy and not respecting the patient" the day before I went. Not exactly the comforting aura of puppy dogs and rainbows like you'd expect.
Having done one full H&P on my own, and briefly practicing over the past few days, I was somewhat worried about the physical. I knew that I was solid on the history and patient interaction, but I haven't quite gotten the complete physical synthesized to the point where it flows. I had planned to spend about 2o minutes with the complete medical history and then move to the physical for the remainder, and I hit around 25 minutes...not too bad. What killed me was the neuro exam. It's so long, and my oncologist preceptor kept telling us that we didn't need to know the complete neuro exam no matter how much we asked to go over/practice it. Guess what Doc...we needed it. So I didn't finish my neuro exam or get a chance to wrap up the session...but the rest of everything went fine.
My patient was actually quite friendly and cooperative with me, and even managed to joke around with me despite having unstable angina. I was somewhat unsettled when I went over to the sink to wash my hands ended up staring directly into a camera mounted on the wall. I made sure to give the camera guy a little wink, so maybe that will show up on my eval. The most interesting part of the feedback came from the patient who told me what it was like to be my patient...and it was all pretty positive. I guess those empathy classes worked.
Overall I think it boosted my confidence in communication and showed me what I have to work on in the physical: PRACTICING!
3.07.2008
Notes from the vagina
As I've written in the not so distant past, my pelvic exam experience was not as traumatizing as I had predicted it would be...irreparably scared for life, yes, but I have gained a lot of respect for the vagina and female pelvic exam models. I'll also say that I cannot conjure a more awkward than three guys sitting around a woman in the lithotomy position in a small exam room while another woman explains the finer points of her...ahem...anatomy. Completely in role play.
Here's some of the more interesting feedback points that I received from my lovely teacher Fay (who liked to be called Faymous...and had a pretty sweet tat across the left side of her abdomen) and my silent mental responses:
-Please put your thumb down-
"Sorry! Apparently when I'm nervously prodding around a woman's privates for the first time with 4 people observing me I lose track of where my digits are..."
-You don't have to press quite that hard-
"Sorry! I'll be more gentle...I don't know that you were so sensitive down there, I barely moved my finger. I guess the wince of pain was my first clue"
-Push harder-
"But didn't you just say softer? I'm so confused"
-Pull down from your shoulder, not your arm-
"I don't know what that means!!! This is my first time using this medieval torture implement"
-Stop being so polite, look down there not up here-
"Sorry, you're the one that keeps talking to me. My mother taught me to look at people when they're talking, not to stare at their vagina!"
-You had good technique with that walking motion, you might need use that on a woman with a larger clitoris-
"I just had a vagina instructor compliment me on technique...I am the most awesome clitoral inspector ever! I have reached a new low in my life, I shall tell no one"
-You'll notice that there's some cervical mucous and some red pigmentation, that's normal since I'm pretty much mid-cycle-
"Don't gag, poker face, poker face...it kind of looks like someone sneezed on your cervix...don't gag, don't laugh...poker face. "
-What would you say to a woman who is sitting something like this? (knees close together)-
"How do I say spread your legs without saying spread your legs? Uh, uh...I have to ask."
-Make your sweeps bigger-
"size does matter...poker face"
-Faster!-
"hehe...not the first time I've heard that...PROFESSIONALISM!!!"
-You were very gentle and it wasn't entirely an uncomfortable experience once you made your movements smaller-
"Thank you??? My confidence has increased at least 0.5% because of your backhanded near-compliment."
-You did a good job of making words into plain English, not too dumbed down, not too complex-
"Sweet, that's what I go for...can I leave now instead of watching the other guys violate your womanhood? No? Ok...I'll just watch sweaty guy and overly confident guy who did this last year, but failed pathology violate you. I feel dirty being here. Maybe if I stare at the poster on the wall behind her it will look like I'm paying attention. Stop calling my attention to your vagina...No I was just all up in there, I don't need to see your cervix again I don't think it has changed in the past 7 minutes...fine I'll feign interest"
Here's some of the more interesting feedback points that I received from my lovely teacher Fay (who liked to be called Faymous...and had a pretty sweet tat across the left side of her abdomen) and my silent mental responses:
-Please put your thumb down-
"Sorry! Apparently when I'm nervously prodding around a woman's privates for the first time with 4 people observing me I lose track of where my digits are..."
-You don't have to press quite that hard-
"Sorry! I'll be more gentle...I don't know that you were so sensitive down there, I barely moved my finger. I guess the wince of pain was my first clue"
-Push harder-
"But didn't you just say softer? I'm so confused"
-Pull down from your shoulder, not your arm-
"I don't know what that means!!! This is my first time using this medieval torture implement"
-Stop being so polite, look down there not up here-
"Sorry, you're the one that keeps talking to me. My mother taught me to look at people when they're talking, not to stare at their vagina!"
-You had good technique with that walking motion, you might need use that on a woman with a larger clitoris-
"I just had a vagina instructor compliment me on technique...I am the most awesome clitoral inspector ever! I have reached a new low in my life, I shall tell no one"
-You'll notice that there's some cervical mucous and some red pigmentation, that's normal since I'm pretty much mid-cycle-
"Don't gag, poker face, poker face...it kind of looks like someone sneezed on your cervix...don't gag, don't laugh...poker face. "
-What would you say to a woman who is sitting something like this? (knees close together)-
"How do I say spread your legs without saying spread your legs? Uh, uh...I have to ask."
-Make your sweeps bigger-
"size does matter...poker face"
-Faster!-
"hehe...not the first time I've heard that...PROFESSIONALISM!!!"
-You were very gentle and it wasn't entirely an uncomfortable experience once you made your movements smaller-
"Thank you??? My confidence has increased at least 0.5% because of your backhanded near-compliment."
-You did a good job of making words into plain English, not too dumbed down, not too complex-
"Sweet, that's what I go for...can I leave now instead of watching the other guys violate your womanhood? No? Ok...I'll just watch sweaty guy and overly confident guy who did this last year, but failed pathology violate you. I feel dirty being here. Maybe if I stare at the poster on the wall behind her it will look like I'm paying attention. Stop calling my attention to your vagina...No I was just all up in there, I don't need to see your cervix again I don't think it has changed in the past 7 minutes...fine I'll feign interest"
3.05.2008
Work out wagon
The combination of my pathology class, every patient that I've seen with diabetes thus far and a few of the MI's I saw over the summer have prompted me to get back on the workout wagon. Oh yeah, and the indignity of pannus retraction that I've seen on a few occasions. I fell off that wagon about 6 weeks into first year with the advent of "oh-crap-I-have-to-study" as one of the dominant emotions in my life. I've done some on and off running since then, but I've been feeling increasingly like crap, not had the energy to get out of bed, put on some apple shaped weight and generally become less than the healthy person that I once was. Seeing fatty streaks, atherosclerosis and ruptured plaques was pretty much like when I watched "Scared Straight" 20 years later back in the day...3 months later and I'm finally getting off my arse to do something about it.
The last time I self-coached myself through a half-marathon, I ended up needing 3 months of PT and a year of rest before I could run without pain. So, I bought myself a nifty heart rate monitor (Suunto t4) that has an interesting physiologically based training effect measurement that it uses to schedule in workouts and emphasizes not over training. Anyway, I'll occasionally be posting about running/working out with this infernal machine strapped to me as catharsis from time to time, so bear with my lameness. I'll probably put it away come time for my surgery rotation (I mean lose the majority of my rights as a human being) anyway.
The last time I self-coached myself through a half-marathon, I ended up needing 3 months of PT and a year of rest before I could run without pain. So, I bought myself a nifty heart rate monitor (Suunto t4) that has an interesting physiologically based training effect measurement that it uses to schedule in workouts and emphasizes not over training. Anyway, I'll occasionally be posting about running/working out with this infernal machine strapped to me as catharsis from time to time, so bear with my lameness. I'll probably put it away come time for my surgery rotation (I mean lose the majority of my rights as a human being) anyway.
Gonorrhea!!!!
Gonorrhea!!!
I have my clinical skills exam this weekend, which should be fairly interesting. It's being held at the Morchand center, made famous by an episode of Seinfeld, you all know the one
Student #1: And are you experiencing any discomfort? Kramer: Just a little burning during urination. Student #1: Okay, any other pain? Kramer: The haunting memories of lost love. May I? (signals to Mickey) Lights? (Mickey turns down the lights and Kramer lights a cigar) Our eyes met across the crowded hat store. I, a customer, and she a coquettish haberdasher. Oh, I pursued and she withdrew, then she pursued and I withdrew, and so we danced. I burned for her, much like the burning during urination that I would experience soon afterwards.
Student 1: GONORRHEA!!!
Anyway, there's a a 100% chance that it will be nothing like that scene, but it should still be interesting...I'll make sure to report back. I survived my GYN exam with minimal emotional trauma. The ladies that ran the session were great and even though I was forced to desexualize the vagina, which was not an easy feat for me, they made it a very professional and educational experience. I am still afraid of the cervix though...it's one of the scariest organs that I've encountered.
***********************
Failure to Communicate
I've written a string of posts relating to my adventures through my oncologist preceptor's practice, and I think my experience came to an apex today. My classmate and I were telling our preceptor about what we thought we needed in terms of getting ready for our clinical skills practical and how we would both like to run through a H&P today to make sure we have everything down before the exam. So our first two patients were follow up visits, the first a schitzophrenic who was so gorked out on anti-psychotics that he cannot communicate and the second was a patient that we had already dealt with in the past who needed some theraputic phlebotomy.
Patients 3 and 4 didn't show, so we went out to the floor to do a consultation. We get to the patient's bedside, and my preceptor tells me to go ahead and do the H&P. Slight problem, the patient HAS NO LARYNX and has a GAPING TRACHEOSTOMY FISTULA without one of the tubes that you usually see. (PS-Don't smoke.) Ok...how to communicate with a man who cannot speak...
Bostonian: How long have you been hospitalized?
Patient: Gurgle gurgle gurgle... (mouths November)
(this is going to be easy)
I took about as complete of a history as I could have, got a general idea of what was going on in terms of what needed to be done and did as painless a physical as I could, because they poor guy was wasting away and had several exquisitely tender points on his body. I've never seen such a pitiful site. The skin was just hanging off of his leg bones, he had no muscle mass left just bones with some skin hung on them. Pretty sad. It was also my first physical on someone in bed...not my ideal way to practice, but a good experience none-the-less.
To make things even more happy, it turns out that he was MRSA positive and the only notation was in his chart, the nurses didn't mention it, there was no warning about contact precautions...nothing. So if I disappear from the interweb, it's because I'm hospitalized with MRSA pneumonia
I have my clinical skills exam this weekend, which should be fairly interesting. It's being held at the Morchand center, made famous by an episode of Seinfeld, you all know the one
Student #1: And are you experiencing any discomfort? Kramer: Just a little burning during urination. Student #1: Okay, any other pain? Kramer: The haunting memories of lost love. May I? (signals to Mickey) Lights? (Mickey turns down the lights and Kramer lights a cigar) Our eyes met across the crowded hat store. I, a customer, and she a coquettish haberdasher. Oh, I pursued and she withdrew, then she pursued and I withdrew, and so we danced. I burned for her, much like the burning during urination that I would experience soon afterwards.
Student 1: GONORRHEA!!!
Anyway, there's a a 100% chance that it will be nothing like that scene, but it should still be interesting...I'll make sure to report back. I survived my GYN exam with minimal emotional trauma. The ladies that ran the session were great and even though I was forced to desexualize the vagina, which was not an easy feat for me, they made it a very professional and educational experience. I am still afraid of the cervix though...it's one of the scariest organs that I've encountered.
***********************
Failure to Communicate
I've written a string of posts relating to my adventures through my oncologist preceptor's practice, and I think my experience came to an apex today. My classmate and I were telling our preceptor about what we thought we needed in terms of getting ready for our clinical skills practical and how we would both like to run through a H&P today to make sure we have everything down before the exam. So our first two patients were follow up visits, the first a schitzophrenic who was so gorked out on anti-psychotics that he cannot communicate and the second was a patient that we had already dealt with in the past who needed some theraputic phlebotomy.
Patients 3 and 4 didn't show, so we went out to the floor to do a consultation. We get to the patient's bedside, and my preceptor tells me to go ahead and do the H&P. Slight problem, the patient HAS NO LARYNX and has a GAPING TRACHEOSTOMY FISTULA without one of the tubes that you usually see. (PS-Don't smoke.) Ok...how to communicate with a man who cannot speak...
Bostonian: How long have you been hospitalized?
Patient: Gurgle gurgle gurgle... (mouths November)
(this is going to be easy)
I took about as complete of a history as I could have, got a general idea of what was going on in terms of what needed to be done and did as painless a physical as I could, because they poor guy was wasting away and had several exquisitely tender points on his body. I've never seen such a pitiful site. The skin was just hanging off of his leg bones, he had no muscle mass left just bones with some skin hung on them. Pretty sad. It was also my first physical on someone in bed...not my ideal way to practice, but a good experience none-the-less.
To make things even more happy, it turns out that he was MRSA positive and the only notation was in his chart, the nurses didn't mention it, there was no warning about contact precautions...nothing. So if I disappear from the interweb, it's because I'm hospitalized with MRSA pneumonia
3.01.2008
GYN/Breast and GU/Rectal exams
So I've got one of the aspects of medical school that I have dreaded to this point coming up in a few days: The GYN exam. I've seen a few pelvic exams and even with the most experienced hands, it's an unpleasant prospect for the patient as well as the examiner. Appropriate to nothing, our chapter of AMWA just put on their performance of the Vagina monologues, which only adds to the comedic fodder/anxiety that I'm going to experience.
It's not so much the vagina that creeps me out, it's the fact that I have to insert portions of my body into portions of someone else's body that have until this point in my life only been broached from an extracurricular/recreational angle. Not only that, but I'm probably going to have to have my face far too close for comfort fairly close to a complete stranger's vagina, inflicting the torture that is the duck-billed speculum and cervical swab. And then this poor lady has to endure the entire line of medical students serially going through the same horrible exam. I feel really bad for the patient having to go through the discomfort of us clumsy students clumsily poking about in her nether regions. At the same time, I find the cervix is one of the most repulsive and horrifying places that I have ever visited in the human anatomy (although that opinion is heavily influenced by ED patients and you can only imagine the state of hygine of someone who presents to the ED with "purulent discharge" for 3+ days).
To be fair, I'm equally put off about having to poke around some dude's wedding tackle and then place my finger into his rectum. The poop chute is meant as an exit physiologically, and anyone that's willing to get paid a couple hundred dollars to have a bunch of strangers insert their gloved fingers into his chocolate starfish is suspect in my book. I think the most painful aspect will come from the referred pain of having to check for inguinal hernias by following the path of spermatic cord up through the inguinal canal with my finger, a maneuver the requires inverting the patient's scrotum up to the level the inguinal canal and having him cough...ouchie I'm getting shivers just thinking about it.
All kidding aside, I have to thank these people for their willingness to volunteer their bodies and the opportunity to learn from them because they save us from having to train on each other. I personally don't want any of my classmates going near my anus with their knobby little fingers. So thank you, and to show my appreciation, everyone gets two packets of surgilube on whatever is being inserted into their bodily orifices!
It's not so much the vagina that creeps me out, it's the fact that I have to insert portions of my body into portions of someone else's body that have until this point in my life only been broached from an extracurricular/recreational angle. Not only that, but I'm probably going to have to have my face far too close for comfort fairly close to a complete stranger's vagina, inflicting the torture that is the duck-billed speculum and cervical swab. And then this poor lady has to endure the entire line of medical students serially going through the same horrible exam. I feel really bad for the patient having to go through the discomfort of us clumsy students clumsily poking about in her nether regions. At the same time, I find the cervix is one of the most repulsive and horrifying places that I have ever visited in the human anatomy (although that opinion is heavily influenced by ED patients and you can only imagine the state of hygine of someone who presents to the ED with "purulent discharge" for 3+ days).
To be fair, I'm equally put off about having to poke around some dude's wedding tackle and then place my finger into his rectum. The poop chute is meant as an exit physiologically, and anyone that's willing to get paid a couple hundred dollars to have a bunch of strangers insert their gloved fingers into his chocolate starfish is suspect in my book. I think the most painful aspect will come from the referred pain of having to check for inguinal hernias by following the path of spermatic cord up through the inguinal canal with my finger, a maneuver the requires inverting the patient's scrotum up to the level the inguinal canal and having him cough...ouchie I'm getting shivers just thinking about it.
All kidding aside, I have to thank these people for their willingness to volunteer their bodies and the opportunity to learn from them because they save us from having to train on each other. I personally don't want any of my classmates going near my anus with their knobby little fingers. So thank you, and to show my appreciation, everyone gets two packets of surgilube on whatever is being inserted into their bodily orifices!
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