Friday, February 28, 2014

Spring Break = Spring Blitz


Last year during Spring Break, I led a group of med students on an elective class to Costa Rica where we learned about their health care system. While very informative and a lot of fun, it wasn't the most relaxing Spring Break. This year, things are going to be quite different, though there won't be much more relaxing, unfortunately.

I'll be missing the sun and staying indoors this year; it was -12 degrees Farenheit this morning, apparently a record low for Feb. 28th in Grand Rapids, and our pipes actually froze solid. It was the third time this year that's happened, so the landlord came by to work on insulating the attic where the pipes run a bit better. Anyway, this week I've planned to devote most of my time to working on Step 1 preparation. I'm hoping to average about 8-10 hours per day on UWorld QBank questions from the domains we covered last semester, with a little Cardio studying sprinkled in here and there. Is 60-80 questions per day too much to hope for? Hopefully not, or I'll end up disappointed in myself.

It won't be fun, but it won't be stressful, either. Actually, it should serve to decrease my stress load, since I'll finally feel like I'm covering/reviewing the material that I really need to cover. I'm taking a bit of a break this weekend, with the true blitz starting on Monday. Tonight, Wife and I will be going out to dinner and spending the evening with Hobbes. If you're reading this and are doing something fun for Spring Break, tell me about it! It's fun to live a little vicariously through others, so please feel free to share.

Wednesday, February 26, 2014

MSU CHM in the News - Doctor Shortage Could Affect Care - Wood TV 8


So, this story played on the local news this morning, and it featured my school and our dean, Dr. Marsha Rappley, MD. You can't tell (because they cut out some of the more disheveled-looking students) but part of this was filmed during my morning PBL session... SO CLOSE to being on TV :/

Even more unfortunately: this MAY be a slight problem for me in a couple of years.

:/

Monday, February 24, 2014

Step 1 Woes

I hardly ever feel like I'm doing enough practice questions for Step 1. For those that don't know, all M2s buy a subscription to the USMLE Step 1 Qbank. This is roughly 2,300 detailed practice questions that you gain access to for several months, with the goal being to make it through every question (and the 1-2 pages of detailed explanations telling why the right answer is right, and why the wrong answer is wrong) TWICE. Along the way, most students annotate First Aid for the USMLE Step 1 book, highlighting and underlining and writing in the most important topics.

Anyway, when I'm doing questions, I just want to keep doing questions. I don't want to stop to work on other, necessary school work, like going to lectures, or re-reading my notes. The last thing I want to do is volunteer, or go to committee meetings, or read my ethics articles for the week, or eat or sleep or do anything other than more questions.

Conversely, when I'm doing other, necessary school work, all I want to do is stop so that I can do more questions, or read from First Aid. Everything else starts to feel like a waste of my time. Curse the person who designed the Countdown app I have on my phone. Curse me for creating countdowns to both the start of my intensive study period and my Step 1 date...

Sometimes, the last thing I want to do is study for Step 1 because doing so reminds me how unprepared I still am. Other times, that's all I want to do because I'm afraid that I'll wake up, and the test will be tomorrow.

In still other times, I just want to rage against residency programs for how much stock they put in this one, 8-hour exam. Gah. Angst.

Angst.

Angst.

Angst.

I spent so much time today on stuff unrelated to Step 1, I didn't do ANY questions. More angst.

If you can't tell from this rambling, these are going to be a doozy of a few months. No promises on posting regularity / coherency.

Thoughts and well-wishes are welcome.

Saturday, February 15, 2014

Wife = RN, Hobbes in Therapy, and The Glitch Mob

I must say, today appears to be the day for passing exams. I'm proud to announce that Wife is now a Registered Nurse in the state of Michigan, having officially passed the NCLEX! I couldn't be prouder of her for all of the hard work that she has put into reaching this point. She has already accepted a position at a local institution, but I'll leave it up to her to fill you in on the details. That is, if she allows herself to finally stop studying so much and start blogging again...

Exam success #2 came in the form of Hobbes passing his performance screening examination and getting accepted into the training program for West Michigan Therapy Dogs (WMTD). It's basically a program where awesome dogs bring happiness to sick and stressed-out people. It's amazing. He is eight months and two days old right now, which (unofficially) makes him the youngest dog to be accepted to the program. Dogs are not eligible to take the screening exam until they have been with their "handler" for at least six months. Since most dogs do not go home with their owner until 8 weeks of age (though we got Hobbes at ~5 weeks old...), simple math means he's pretty much as young as a pup can possibly be in the WMTD program. Click here or, better yet, here for a glimpse of what WMTD does. Interacting with those incredible dogs last year as a stressed-out, lonely (recall: Wife and I were living in separate cities for the bulk of the time) M1 inspired me to see if Hobbes could bring similar happiness to others.

And with that, I just realized that this means that I, Wife, AND our dog Hobbes are now all pursuing careers in healthcare. That's awesome. Now we just need a couple of kids to become a PA and maybe an NP and we can open our own clinic...

Alas, I must return to my studying. Today feels like a wash with only seven hours of studying under my belt, thanks to all of the hullabaloo with Hobbes' testing (and trying to tire him out before going so he wouldn't be too hyper...) and such. I laugh even as I say that, but the reality is I still have a couple more hours to do before I'll feel okay leaving the rest for tomorrow. I have the Pulmonary Domain exam on Monday, you see, and Pulmo is... a lot of information.

I leave you with my newest study-music obsession:

The Glitch Mob featuring Aja Volkman in Our Demons

Saturday, February 8, 2014

My Brain and Body: A Snapshot of Distracted Studying

Neuraminidase

So, I'm studying away, learning about drugs designed to fight the Influenza A and B viruses - Oseltamivir and Zanamivir, better known as Tamiflu and Relenza. I learn that they work by inhibiting a specific protein that the flu viruses use when infecting our cells: Neuraminidase.

My brain and my body then do this:

Brain: Oh crap, I don't remember what neuraminidase does.

Body: [types into google "neuraminidase," shuns first entry on wikipedia, clicks the second search result (an article called Influenza Neuraminidase by David Goodsell from the Research Collaboratory for Structural Bioinformatics when it apparently won "Molecule of the Month" in May 2009)

Brain: Oh yeah, I remember from last year when we learned about H1N1. The N stands for Neuraminidase, and the H stands for Hemaglutinin... What does Hemaglutinin do? 

Body: [slides fingers over trackpad, rapidly twitches ocular muscles to shift pupils back and forth, adjusts lens focus and pupillary dilation reflexively]

Brain: Oh, there... It says Hemaglutinin is a protein that grabs onto some sugar molecules on the surface of our cells, anchoring the virus so it can inject its viral DNA into the cell. And there - it tells what Neuraminidase does, exactly... Looks like Neuraminidase works to let the virus leave the cell. Ahh, I remember - once the virus has hijacked the cell's DNA replication machinery to duplicate itself and it's ready to leave the cell by exiting back through the cell's membrane, Neuraminidase snips the sugar molecules on the surface of the human cell so they don't get grabbed by Hemaglutinin, trapping the virus to the surface of the cell.

Body: [scratches chin with fingertips, unconsciously tugs beard in an unfortunately habitual manner always acted out when Brain is lost in thought, contracts diaphragm and intercostal muscles to create a net negative intrathoracic pressure, expanding the lungs and inflating alveoli before relaxing while slightly tightening the vocal cords to produce a satisfying sigh]

Brain: Okay, so Oseltamivir and Zanamivir make it so the virus gets stuck to the cells it infects, rather than letting the replicated viruses leave the cell to go infect other cells. This must give the cytotoxic T cells a chance to come kill the virus-infected cells before the viruses can spread very much. Cool.

Body: [flicks eyes randomly around page, seeking something to intrigue Brain]

Brain: Hey, check out the structure of Neuraminidase, pretty cool. Looks like it's a tetramer. Wow, that's crazy complex. I wonder how many amino acids are in each monomer...

Body: [types Cmd+N, "Neuraminidase Structure Amino Acids," taps fifth search result in Google (an article called Influenza Virus Neuraminidase: Structure and Function), eyes scan, scan, scan]

Brain: Ah, there it is! Looks like Neuraminidase has 470 amino acids split up between the 4 tetramers. Weird though - that's not an even division. 470 / 4 = 117.5. I would have expected it to be evenly divisible. There must be linking regions on each tetramer of an odd number of amino acids.

Body: [flicks fingers and eyes to scan second page of online document, raises levator palpebrae muscles to produce humanoid expression of surprise]

Brain: Whoa, each virus has 50 neuraminidase tetramers. Crazy. Whoa, look at the time. I've spent too much time on this. Gotta get back to studying. Wait, though, this was too cool to not share. Our world is SO COMPLEX! I can't just tuck this information away, keeping it for myself... Hmm, I haven't written in the blog in a while... What the heck, it's a Saturday.

Body: [types "jintus.blogspot.com", taps "New Post"]

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