Tuesday, April 30, 2013

One. More. Test.

This was me ten minutes ago.
It's very rare that I get to say this during med school - One More Test. And it's not really TRULY true even now... Come to think of it, the actual end of my education is so foggy, I'm not sure if there really will be a "last exam..." Shudders and steers mind away from such thoughts.

The end of this semester is almost here! Today I took my last Microbiology exam - this time on Virology - and it went great enough that I indulged myself and took an almost two-hour nap this afternoon. I feel more rested right now than I have in weeks! I can't be a complete slug though - no matter how much I'd like to just play Fun Run and eat chips on the porch for the rest of the day - because Thursday I have One. More. Test.

Thursday's ringer will be Pathology, which has sadly not risen to its potential. You know you're in for a wild time when that day's Path prof (who also happens to be the course director) steps up to the lectern and says (and I'm paraphrasing here), "Well, we sure have been getting some dry lectures lately, haven't we? I'm sorry, but that's not really going to get any better today, as this lecture may be the driest one yet. Just stay with me and we'll get through it."

I think I fell asleep twice during that day.

If you can't tell, I like it when things are just a bit more up-beat... So no, I'm not quite relishing the thought of spending 8-9 hours this afternoon / evening (and ~12 hours tomorrow) memorizing the details and terminology of amyloid bodies, edema, and neoplasia. The plus-side is that I will be rewarding myself with some food this evening for getting through this morning's exam. Not sure where from quite yet, but it's going to happen.

Before I know it, Thursday will have come and gone, and then the next big event on the horizon will be this weekend when Wife FINALLY Moves to Grand Rapids!! We've been waiting for this day for months, and I sort of can't believe it's finally going to happen. All of the plans have been laid, and it's almost here...

After that, I'll have a week of nothing. And I mean nothing but blissful sleep, relaxation, as well as possibly some exercise and/or gardening. That's right - I'm going to start a garden while I actually have enough time to do the digging and planting. We should be past the last frost of the year (*crosses fingers*), and though I haven't had a garden since I was a wee little 'un, I thought this summer might be a fun time to reattach the green thumb that got severed by my education. All right, time to hit the books digital coursepacks!

Wednesday, April 24, 2013

Locked-In Syndrome


Locked-In Syndrome is officially the most terrifying condition I have learned about so far. In my opinion, it is worse than any form of cancer. It is worse than leprosy. It is worse than flesh-eating bacteria, or Huntington's Chorea, or Broca's Aphasia. It is worse than having all of your limbs surgically amputated. It is worse than being paralyzed from the neck down. Locked-In Syndrome results from strokes to the ventral pons - the shaded region labeled 11 in the diagram above. For clarification, the pons is part of your brainstem - see Region 5 in the midsagittal cross-section below:


When blood supply to the ventral pons is cut off long enough for the cells there to die, you lose all motor function except a select few movements. While there is some variability in severity of conditions, this often means no unassisted breathing, no swallowing, no facial expressions, no eye movements - NOTHING. From what I have read, eye movements are the most commonly retained ability, but even with that, sometimes the only movement retained is of both (in some cases only one) eyelid.

The worst part is that people with this condition can still feel everything. If their eye is dry because they haven't blinked, it will itch and burn like it would for you or me. If they have some saliva trickling down their throat into their lungs, they will feel the need to cough but won't be able to. If they contract pneumonia from not having their lungs get sufficient ventilation (or from never being able to cough up bacteria), the pain and discomfort will be every bit as real and constant for them as it would be for anyone else with pneumonia, but they won't be able to do anything. And unless someone notices that they are able to move their eyelid in a non-random manner and works out a method of communication so that they can speak one excruciatingly slow letter at a time, they will have no way to tell anyone about their pain or discomfort.

It is reading about conditions like this in class (and then searching about real people who have them) that makes me feel horribly ashamed for the minor complaints to which I so regularly give voice. Who am I to complain about feeling tired because I stayed up too late studying, or because I feel sore the day after moving furniture? Sometimes perspective like that which is provided by Locked-In Syndrome is like a slap to the face. I have nothing to complain about, and vast mountains for which I should be eternally grateful. We all do. No matter what our situation is, it can't possibly be as bad as being stuck in a bed, unable to communicate with the world around us, while still feeling like you did the day before - remembering what it is like to move and laugh and talk and hold hands and swim and drive and run and kiss, all the while knowing that you will never do any of that again. Knowing that you will just lie there every day for the rest of your life. Until some bacterial infection gets overlooked, you contract pneumonia and can't fight it off, and you die drowning in your own pulmonary pus. I can't imagine a worse form of torture than that...

So remember - it could almost always be worse. All too often, I think we are afraid of acknowledging what we have - abilities and talents both intellectual and physical - and asking ourselves, "So what am I doing with what I have?" So ask yourself, and be honest:

What am I doing with what I have?

Tuesday, April 23, 2013

2013 MSU CHM Med Folly - Medical Rhapsody



Great vid by Brittney Benjamin.
Interesting note: I'm in this one... :)
Also: 1:25 features my friend Alex at his finest...

One Year Ago Today

It's crazy to think that one year ago today, I was still working in Human Resources. I knew I was going to med school, but it still felt a long way off. I had just gotten a present in the mail, and all I could think about was starting med school. Time has absolutely flown since then, and at the same time it is very easy to concentrate on exactly how exacting the last two semesters have been.

Right now, we're in the final push of the spring semester. We have a few more classes and a couple exams this week, and then next week just two exams before a week-long break leading up to the six-week summer semester. Today is pretty packed. I've been studying at the med school since 6:00am, though our first lecture is a two-hour required Integrated Clinical Correlation lecture at 10:00am. At 1:00pm I have my hour-long Core Physical Exam assessment, two-hour mentor meeting at 4:00pm, then my final written and practical exams for Medical Spanish Interviewing from 6:00pm - 8:30pm. And then I'll start the evening's studying for the upcoming Neuroscience (Friday), Virology (next Tuesday), and Pathology (next Thursday) final exams.

The nice thing is, these last few exams aren't going to be so bad because we aren't getting new classes throughout this whole time. In med school, and especially this semester, it can feel like one constant exam week that lasts the whole semester, except you're consistently getting new lectures and material that you won't be tested on until the next exam. That's probably the toughest part of first year - the seemingly impossible mountain of exams and lectures that you see on your schedule at the beginning of each semester. I remember looking at February and thinking, "Is this really possible? If so, HOW?" But we got through it, and though it was every bit as difficult as I thought it would be, it was possible.

And now, my first year is almost over. Yes, we still have summer semester, and it won't be like picking dandelions, but we'll get through it. And then comes second year - just one test for each ~1-month-long unit. Talk about "do or die..." We'll see which form of academic assessment I find more/less enjoyable. Something tells me I will enjoy next year a bit more. While I like the finite aspect of first year ("This is exactly what you need to know, and while it's a LOT of information, you know that is EVERYTHING you need to know for this test.") I think I will like the self-guided nature of next year, as well as how everything we learn is based in a clinical case scenario. The concept that we will be responsible for everything in the assigned textbook chapters is a little daunting. First year has been all about learning the information in printed coursepacks, which are basically just condensed textbooks.

All right, enough of distraction in blog form. I'd love to write more, but the thalamic nuclei (and the incessant practice of my core exam) are calling to me...

Sunday, April 21, 2013

MSU CHM Medball 2013 and A Med Folly Video


Last night was the 2013 MSU CHM Medball, and it was a blast. The theme was Bond - Dr. Bond, and everything went off without a hitch. The night was the product of weeks of planning by the student council (of which I am a member), as well as many faculty and staff, and would not have been possible without the generosity of MANY donors. For those that don't know, the event is basically a big banquet to celebrate the year, as well as an opportunity to recognize outstanding faculty and staff with awards. Awardees were voted for by the student body, and were presented with special glass Green Apple awards for their contributions and dedication to students.

The night also serves as an opportunity to unwind by hanging out with friends, dancing, and watching the student- and faculty-made Med Folly videos. Once the Grand Rapids vids get posted, you may see your's-truly in a couple of them - but I'll make sure to post each video as it gets uploaded. They do a good job of showing up much fun we can have - even though we're med students, haha. Without further ado, here's one from the East Lansing campus:



Below is a panorama of the ballroom at the Radisson in East Lansing, Michigan. Though you may not be able to tell very much, each table is decked out with all the Bond-themed decorations - wine bottles, posters, playing cards, fake cash, candles, and 007 signs. All told, it was a great night.




UPDATE:
Just after posting this, another med folly was released:

Friday, April 19, 2013

MSU CHM Secchia Center - Awesome View

This photo really doesn't do that sunset justice...
This was my view from the med school last night.
Even amidst all of the flooding that has been happening in Grand Rapids lately,
we sure have been getting some awesome sunsets.

Glad I chose Grand Rapids?
You bet.

Wednesday, April 17, 2013

Work Faster... After.

So today I took my very last Anatomy Lab exam. My very last.
It felt weird.

And now, I just want to slack off. So, I'm going to watch some Breakout Kings and hang with friends for an evening.

If only real life worked like this:

Wednesday, April 10, 2013

75% Off Jintus Study MCAT Flashcards for iPad


In honor of the springtime "gearing up" of MCAT studying worldwide, I've decided to try something out - an eight-day discount of 75% off all Jintus Study flashcard sales!! 

Two Rules:

1. Minimum $5.00 pre-discount order total.
         - Note: this comes out to only $1.25 after the discount... So it's not much :)

2. Use coupon code JINTUS75 at checkout (must be all capital letters).

Note: you should really read the installation instructions BEFORE purchasing. You must have some version of the free or paid Mental Case app on your Apple device to use these cards.


For the next seven days it will only cost $5.00 for all 3,499 flashcards in the four Jintus Study MCAT Flashcard bundles for Mental Case on the iPad.

This normally costs $20 for each $5 bundle sold separately, or $17 at the discounted rate for all four bundles. So for the next week, you can get all four bundles for the price of one. Just add all four bundles to your cart, enter the coupon code JINTUS75, and hit "update coupon."


That's only $0.0014/card.
That's cheap.

But hurry - sale ends on 4/18/2013 at 9:30pm EST.

Monday, April 8, 2013

Saying Goodbye


This past weekend, my family and I traveled to the east side of Michigan to bury my grandfather's remains. Everything went as he would have wished it, right down to the hymns, eulogy, and military ceremony, which included an American flag draping his casket, being folded, and presented to his eldest son by a representative of the Air Force. My grandfather was a mechanic in the Air Force during World War II, and he was probably the most patriotic person I have ever met.

It was good to have been able to attend the funeral, both to say goodbye one last time to my grandpa, as well as to see some family that I haven't seen in several years. Funerals are an unusual experience - both happy and sad as you rejoice in retellings of the loved one's life, and mourn their loss at the same time. He had a long life, and he made it count in many ways. It was definitely worth the sacrifice in time that it took to attend - despite the Micro exam that I took this morning, it was worth it. After all - when I die someday, would I want my grandson to not come or skip out early just because he wants to add an extra 7% to his Micro grade? No. There's more to honoring my ancestor than that.

And so, this weekend is passed, and my grandfather lies beside his wife of 54 years. It was sad. It was good. And now I move on, plugging away at med school, hoping to make him proud with how I live my life.

Saturday, April 6, 2013

The MSU CHM Class of 2017



The 2017 Class of MSU CHM is almost a cohesive, defined group at this point. Most of them have received that awesome phone call, and their Facebook page is up and running. My class also had a solid presence on Facebook from way before day 1 of this year, and it has been a great source of collaboration, mutual encouragement, and camaraderie.

When I mentioned this to a friend the other day (and the fact that I snooped on their group a bit), the conversation went like this:

Friend - "Are they all just bubbly with excitement and naiveté?"

Me - "Yeah, actually. It's pretty cool - definitely takes me back a bit."

Friend - "Back to before you knew how insane med school really is?"

Me - "Sort of... But more like, back to before everyone talked about how insane med school really is and nothing else."

It was refreshing to see unbridled excitement, not hindered by any sense of loathing/foreboding of the next exam. That's a sentiment that can very quickly and easily get squashed out of the med student population, because school is more stressful and demanding than even the most prepared student anticipates. That's why newly-accepted students want to pre-study over their last summer. They know it's going to be hard, so they think they should prepare. What they don't know is that the biggest effect their preparation will have on their med school career will be to waste some of the last true free time they'll have before it starts. So to the future students - do not pre-study to prepare for M1. Just enjoy your time and don't even look at a book.

Anyway, you see how easy it is to get caught up in talking about the 'difficulty of med school?' I tried to talk about how I don't want to talk about it and ended up talking about it. Very few people at this point in the year are talking about how cool it is that we get to be in med school, on the path to becoming doctors. We don't talk about the interesting clinical presentations that result from the mycoses that we're studying in Micro - we just talk about how annoying it is to have to rote-memorize a million foreign names and symptoms.

So I like hearing about the new students, because it does take me back - and it inspires me to be more optimistic. To bring back some of the magic, the snap-and-fire of optimism and forward-thinking to the average, everyday med student conversations. Because our blessings/good fortune of being in med school are no less true and real now than they were when we had just recently received our acceptances - they're just harder to see beneath the dross of fact regurgitation and exam performance.The positives and the promise of med school are still there. We just have remember them and act accordingly.

Now, being exposed to the MSU CHM Class of 2017 for the first time also had another, unanticipated effect on me. It involved seeing that number - 2017 - and thinking, "Huh. 2017 = 1 + 2016. This means that... Holy CRAP I'm almost a second-year med student." Yeah, we still have about four weeks left (three weeks now? AH!) in this semester, followed by a six-week summer semester, but let's face it - summer semester might as well be next year, since I've never had one before. This year is largely over and PBL (Problem Based Learning) and the more advanced clinical skills are just around the corner. We're going to start to actually learn the stuff we need to know to pass Step 1, to diagnose - to BE DOCTORS. Crazy how fast this is all moving...

Thursday, April 4, 2013

Stung in the Pacific Ocean

The girls from our group in Costa Rica, doing some yoga on the very same beach where this story takes place.
A couple weeks ago when I got back from Costa Rica, I mentioned that some crazy stuff went down during our 1.5 days of down-time at the ocean before we came back to the states. Enter said craziness:

So I was walking toward the beach from the resort in Tamarindo, Costa Rica, having finally gotten my stuff settled and picked up my towel from the towel hut. I was eager to get out and do some swimming in the last couple hours of sunlight left in the day. The rest of the group was already on the beach, but I had needed to do something (I can't for the life of me remember what) that required I get there about 45 minutes after everyone else.

As I walked down the path to the beach past some patio tables and chairs, I noticed some resort employees tending to someone sitting in one of the chairs. It looked like a girl had cut her foot or something - nothing very serious. There were two other girls, her friends probably, standing around nearby looking a little worried. I didn't look at any of their faces, just kind of registered their existence and was about to keep walking when I noticed that one of the friends was looking straight at me, and not looking away. I noticed her with my peripheral vision, and it felt so awkward (kind of like when a strange child looks you in the face and just will not stop looking directly at your face) that I couldn't help but return her gaze. And I realized that it was the other student leader from my trip!

I walked over and realized that all three girls were from the trip, and one had been stung by something in the ocean! There were two hotel workers rinsing off her foot with water from a water bottle, saying that it would be fine, nothing to worry about, but she said the pain was getting worse. She didn't know what had stung her, and her toe was pretty swollen. She held her composure really well, but soon began to feel dizzy and started to get scared. The pain began to radiate up her leg and into her thigh, and she started to feel a tightness growing in her throat. I remember thinking, "Oh crap, she might be going into anaphylactic shock." I remember people around me asking if anyone had an epi pen, but I also remembered hearing somewhere that it's not a good idea to use other peoples' epi pens except as an absolute last resort. Something about prescriptions, or expiration dates - something like that.

At this point, she started to get more worried, a frantic note entering her voice. She had passed out before from unknown causes, she said, and she felt like she had in those instances. I squeezed her hand and looked her firmly in the eyes and said (WAY more calmly than I felt) "Just hold on for a couple more minutes - it's going to be ok. I just called Daniel [the doctor] and he is on his way down. You're going to be just fine."

The problem was, I realized, the doctor didn't know where we were in the resort. I quickly called him again on his cell, told him to RUN and meet us in the lobby, then scooped her up in my arms and ran past the swimming pools full of wide-eyed tourists, ignoring cries of, "What happened!?" and "Is she all right?" as I charged into the main resort building.

Almost as soon as we found the doctor, she passed out. And I mean OUT. Cold. Eyes incredibly wide-open and staring, no response whatsoever, face the whitest white. Once we laid her down and got her legs up a bit she woke back up, only being unconscious for about ten seconds or so, but it was very definitely freaky. Later on she said she had the longest, most vivid dream ever while she was out. Strange.

After about 45 minutes of consultation with the doctor and a very poorly-equipped paramedic, it was determined that her reaction was most likely a combination of some benadryl that she had taken earlier in the day, her low but "normal-for-her" blood pressure, and the anxiety produced by the situation and pain from whatever had stung her. As the doctor examined her, I helped by taking her heart rate regularly. It was only about 45 bpm the first time I took it - 45! - but soon rose back above 60. The doctor mentioned to me later that since she had woken up right away after laying her down and elevating her legs and did not have any trouble maintaining consciousness thereafter, she had most likely fainted from causes other than an anaphylactic shock-type reaction. When I asked him if we should have considered an Epi pen, he told me that it was always better to try to rule other things out first, since her airway wasn't in any immediate danger.

It was a crazy situation, and I felt bad that it had to happen to her on our first afternoon at the beach. However, I felt that everyone involved had done an incredible job handling the situation. I didn't even realize until afterward that I had stepped in and taken charge. I've known from other situations that I function well under stress, and though it had seemed natural and felt right, I was still woefully aware of exactly how ignorant I still am about all things medical. It's going to take a LOT more preparation before I will feel truly confident in such a situation - and having people completely rely on me for their healthcare. Luckily, that's what the next six years are for.

The following day was much more fun for everyone involved. It was full of surfing, eating, shopping, relaxing and posing for pictures like this:


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