Not Actually a "Full" Post

Genetics was supposed to be unstressful. My three weeks of November/December were supposed to be like summer vacation.

Well, I won't go so far as difficult, but I feel like this term has been very fast-paced. Having an exam every week still kind of looms over me. I spent last week studying very little; its picked up significantly, but isn't quite at pre-Thanksgiving levels.

Oh, and I'm going to class alot now. With so little time between the class and exam - less time to forget material - and so many required attendance classes, I might as well just attend. But "ugh" for 8 am classes. I mean seriously, I chose further education this year to avoid being awake before 10 am. Its like I'm employed I have to get up so early!

(Those last couple comments are to get all the real adults in the room riled up!)

Sweet Victory

We won.

For those of you who are not involved in the Ohio State Michigan rivalry, I may have been more obnoxious than usual last week (sorry Grouse) about football. I mean, this was (to me) the event of the century: Ohio State, ranked #1 in college football. Michigan ranked #2. Already greatest rivalry of college football, this game got inflated to "Judgement Day" status. No really, ESPN was using that very title for the game all during the preceding week.

So, Saturday came. Ohio State beat Michigan 42-39 in one of the best games I've ever witnessed. And we won. Oh, and we're going to the National Champ Game!

And that's all...Oh, you want to know what's going on in my life? Well, Katie and I have been splitting time between each other's parents which is fun. Just doing the standard Thanksgiving thing really. Ah, but the game.......

What?! Another Post?

I'm binging. I don't want to study for CTS (my last exam), and I feel it's my duty to blog while wasting time. I mean, you know, to make up for all the not-blogging I've done.

There are two kinds of people in the world (okay, there are many more, but let the analogy do its job):

1. Those who enjoy metering out their gratification over a long time...savoring each little piece. We'll call these the "Steves" of the world.
   
2. The boom and busters, who enjoy their gratifaction as it comes to them...savoring the feeling of eating way too much candy on halloween. We'll call these the "Mark and Laras" of the world.

If there was, let's just imagine, a container of cookies in a household, the Steves might have a cookie (as in 1 cookie) a couple times a week; however, the Mark and Laras may just demolish the whole bag in two days (Lara wouldn't, I definitely would).

Why the long-winded analogy? As those of you who know I used to live with Steve and Lara probably guessed, it was just an excuse to relive a fond memory from last year. But I'm also making a point (sort of)!

I am a boombuster, and I am blog-booming.*

All the Steves (putteroffers) in the room have probably resorted to reading one of my posts every four days, to delay the gratification and make it last. Hopefully the boombusters are all just enjoying that I post again. But all of you - putteroffers and boombusters alike - are probably wondering what even compelled me to write this rambling post...have I seriously begun blogging about blogging now (meta-blogging)?

I originally started this post to show you all my really good dinner tonight. Originally performed by my girlfriend Katie, duplicated with variation by yours truly. I give you Peas and Shells, Alfredo.Notice the steam coming off it. Looks pretty tasty doesn't it? Don't you wish your girlfriend was sweet enough to come up with a dish this good that takes like 5 minutes to make? Okay, I'm getting obnoxious so I should go study the CTS.

Two more days!

*honestly, you can't say that aloud without smiling

Part 2: Bring on the Biochem!

I got up ridiculously late again, but really why not? It's not like I have a job or anything...

Yesterday's anatomy exam was very similar to the previous one, and I feel the same as I did for the first one. But now anatomy is done forever. I got kind of nostalgic about the whole thing last night (thus the sappy haiku writing), and starting running through my mind all of the stuff I will never see or do again.

Anatomy lab was surreal. It flies in the face of social taboos, mostly those related to "don't ever ______ to a dead body". Why are we punk kids so special that society is willing to overlook these offenses? Because we're responsible for the lives of your kids, parents, and loved ones (no pressure).

The lab was in many ways a museum. Not in the way that museums have boring exhibits and smell weird. Rather, the things they hold are irreplaceable. You can't just go out and buy what we were privy to - both the dissecting experience, and all of the skeletons, skulls, and organ models - and in some cases, nobody can.

For instance, our institution owns a human head dissection that is so old it is preserved in motor oil (no embalming back then). "They" removed the brain without damaging any of the inner skull - its hard to explain why this is an important learning tool, but it is. Because of its age and difficulty of dissection, there is probably no other dissection of it's kind, and now that I'm out of anatomy I'll never see it again. That's exactly what I was thinking during my anatomy practical when I was looking into this skull trying to identify what "tag A" was attached to.

I sound like a museum tour guide. Anyway, I was feeling nostalgic about anatomy yesterday. Today is all about biochemistry though. Well that and blogging. Really, this is all I'm doing this week!

Note about the sleeping: I am working on getting up earlier by Friday. CTS exam is at 9am, so I definitely need to be awake before 10 that day!

Anatomy Haiku

Haikus seem to be all the rage here at school. So, I was moved by the spirit to put my feelings about anatomy into 5-7-5.

Cadavers farewell
We will wash away your smell,
but never your gift.

Okay....I'm a big dork.

Part 1: The Beginning of the End (of the Beginning)

I got up at 10:30 am today... for the fourth day in a row. My significant ventures outside the house have been

1. Drive to an ATM to deposit a check
2. Drive to Staples (new pencils & eraser) and get my oil changed

I am - by my count at least - the laziest person I know. And I love it. In all honesty, I have been very busy studying for exams. The first one - anatomy - is in an hour. The next two are on Wed and Fri. The nice thing about studying for exams though is that I never have to actually change out of my pajamas!

I feel a small force trying to compel me to freak out about exams, but I just can't do it. I've been trying to reason it out: I'm an anxious person, I'm quite concerned about school performance, I have a history of freaking out about school (see all things quiz-like), now shouldn't I be a horrible mess right now??

My calm is not because of confidence that I'll do really really well on any of the exams. My performance will probably be average, as usual. I think I feel good, because I actually feel proficient in the subjects being taught to me. Its a really good feeling to flip through Netters (anatomy atlas) and say "Hey, I know the human body with all its tuberosities, foramina, and whathaveyou's*" To all the first years who read this (both of you), as we close this chapter of our med school experience, isn't kind of facinating to think we know anatomy now? I mean, we're not experts ... but we pretty much know it now.

* This of course refers to the inferior scaphonavicular whathaveyou, the integral bone of the nervous system. Ironically, it is found at the tip of your nose (rhino-distally).

This is the Quiet Life

"It's been a quiet week in Lake Wobegon, my hometown..."

The overture to Garrison Keillor's monologue in every Prairie Home Companion show, those words always make me so nostalgic. I often stumble upon the show when I've been driving for a long time, and the words themselves bring up memories of weekends as a child, many of which are foggy and unclear, but all accompanied with a feeling of being home. As I get closer and closer to adulthood - I'm not ready to admit I'm a full fledged grownup just yet - I feel home less and less. Therefore those words and the feelings I get from them grow stronger and stronger with time.

Back to the point, it's been a quiet "week" in Charlottesville, not my hometown... my life has become extremely un-blog-worthy. For instance, my last post about being sick; that was much less about drumming up sympathy and more the only interesting thing that's happened to me in weeks (PS I'm feeling much better now). Everything has just been more of the same: Class, Studying, Quizzes, and Weekends.

Class: I'll admit it to everyone right now. I am not attending class much anymore. Now don't freak out! I still attend all required small groups sessions, labs, and selected lectures that really help my understanding (ie anatomy). But I found that going to the lecture really isn't helping me; it's studying the lecture material that makes the difference. After a long day at class I just couldn't find the motivation to study anything! Thus I would lose a whole day by attending instead of studying.

Studying: This is the battle of my every day. If I'm not studying, I'm feeling guilty about not studying. If I'm studying, I'm trying hard to keep on task and not check my gmail, or the weather, or what's new on facebook, or all the blogs I monitor...anything but biochem!

Quizzes: Still the standard freak-out for me. I don't know why. They're worth a tiny percentage of my grade, yet they are my biggest source of anxiety (take home point on Anxiety: "Logic has nothing to do with it").

Weekends: My time away from school, mentally and often physically. This is often Katie-Mark time, so it's worth its weight in gold. This weekend she was here. We saw my anatomy professor play bass in a band (we 1st years took up the whole restaurant!), and went to the med school's Halloween Party dressed as Peter Pan and Tinkerbell (pictures to come). Honestly, that is about all we did this weekend. Other than that, we studied together alot, finished a 1,000 piece puzzle, and tried to find the only donut place in charlottesville (unsuccessful after 2+ hours). The beauty is that it doesn't matter what we do or don't do ... time with Katie = happy time.

So, this is why my blogging has faltered as of late, I guess. My life is currently not particularly interesting on paper. I mean, I could totally wow you with my understanding of cranial nerves and amino acid metabolism...but you don't want to hear that, I don't want to write that, and I'll probably get beat up at school just for mentioning it in my blog. One thing worth mentioning though...

Nov 17, 1pm = end of 1st semester and beginning of glorious 1 week thanksgiving break!!

Until then, it'll probably be more of the same as I struggle to find something interesting to talk about on "the online"

Home ... Sick

The thermometer kept climbing, one point at a time, until I got my number: 101.4. I am officially out of commission and I'm really not sure how long it'll be like this.

I'm been feeling like crap for the past week, but I have also been self-treating with water, sleep, nyquill (helps with the sleep too) and ibuprofen. This arsenal has been my defense for years, all through college and beyond. I was even starting to feel better this weekend.

Then Monday came around. Between an anatomy lab snaffoo - the schedule said 3p lab, but it started at 2p! - the looming online quizzes this week, and the inevitability of an oral quiz during lab, I was beyond stressed out. Everybody kept telling me I looked ragged, I couldn't concentrate, and I again felt absolutely awful. I was convinced I only had a cold, and that my temperature spikes were related to the anxiety, so I pushed on, still self-medicating and doing my best to get my fluids and my sleep. My mom - a wonderful nurse - taught me those two cardinal rules.

Instead of waking up early for class on Tuesday, I slept in and went to study in the library. I drank 5 gatorade bottles of water at least, and peed almost on the hour. I was beating my "cold" - which now had mild lymph node swelling, feeling warm, and mucus running down my throat - and by the end of the day I felt quite well.

Today I felt worse than ever. My "nodes" were huge, and it burned like fire when I swallowed. During anatomy lab, we finally got oral quizzed, and I did okay. But about 2 hours into lab I was fading fast. I felt sicker and sicker, and since Megan told me during lab about people who were getting strep I was convinced that I had it. I left lab early to go to student health.

The people there were pleasant, and although the whole ordeal took hours, I walked out having received a thorough physical exam, lab tests for strep and mono (both negative), penicillin...just in case...and a bill for $10. Good thing I paid an arm and a leg for Student Health's preferred insrance.

So I'm sick. For real sick. I feel like I should study, but can't concentrate due to my ears ringing. I feel like I should sleep, but I'm not sleepy. So, I'm chilling out on the couch which a box of Wheat Thins and water bottle #3, or #4, since I got home 3 hours ago. I'm watching Family Guy DVDs, and almost having a good time being sick.

Anyway, I should wrap this up and...get back to my tv and wheat thins I guess. More postings later.

The Post I've Been Wanting to Write

I read in bed almost every night...not for my intelligence, rather because I have to give my mind something to do until I actually fall asleep. Otherwise, I just lay there thinking about the past day or about the upcoming day, or who-knows-what.

I picked up this book from my bookcase - a gift from the med school to all the entering first years - in the hopes that it would satisfy the criteria of a nighttime read, namely 1) be interesting enough to follow for two to ten pages before I get to sleep 2) be boring enough I will actually fall asleep instead of reading it until 5am (curse you, Harry Potter!!).

The book is On Doctoring, (3rd edition) edited by Richard Reynolds and John Stone (link to Amazon look-up). Note that used editions are very cheap. It is a collection of poems and short stories about what it actually meant and means to be a doctor. I say it like that because the stories and poems go way back to the 19th century. I was immediately struck by the book when I randomly opened it to a poem:

CARNAL KNOWLEDGE by Dannie Abse (1923- )
"...you, student, whistling those elusive bits
of Schubert when [...] you climbed the stone-murky steps
to the high and brilliant Dissecting Room
where nameless others, naked on the slabs,
reclined in disgraceful silences - twenty
amazing sculptures waiting to be vandalized.

You, corpse, I pried into your bloodless meat [...]
Your neck exposed, muscles, nerves, vessels,
a mere coloured plate in some anatomy book;
your right hand, too, dissected, never belonged,
it seemed, to somebody once shockingly alive,
never held, surely, another hand in greeting
or tenderness, never took up a pen to sign an authentic name..."

- I edited and slaughtered that poem (sorry Dr. Abse) to give a glimpse of what I was reading. It was written during WWII but I felt like had been written about my experience everyday in anatomy.

It's crazy how hard it is to remember that what you're dissecting was, just months earlier, walking around talking, thinking. I wonder sometimes whether the future cadavers really knew that I would be dissecting their anus (yes...I really did. We all did.) when they signed on. I mean one would naturally assume that being a cadaver means being explored inside and out, but the things we've done and will do in the name of science...

Anyway, to return to the topic, this is a great collections of works. I particularly latch on to the short stories - the poems are to artsy I think - about doctors making housecalls in the early 1900's, delivering babies, healing little kids' coughs, and holding people's hand as they die. They were the hardcore renaissance men, before specialization and pre-mixed medicines. Admittedly, they did about as much harm as good, but still I respect them for even doing what they could.

If you do decide to get this book, try out a couple passages I particularly like:
Introduction - cuz you're supposed to read them
The Girl with the Pimply Face - William Carlos William
The Old Gray Couple (II) - Archibald MacLeish
Carnal Knowledge - Dannie Abse
Imelda - Richard Selzer
A Day in the Life of an Internist - Richard C. Reynolds (editor snuck in one of his own)
The House Officer's Changing World - Joseph Hardison
Mistakes - David Hilfiker (docs actually make mistakes...)
Invasions - Perri Klass (med student perspective...very good)

Anyway, that's my commerical for the book I'm reading right now. It's pretty fantastic.

MWAHAHAHA!

A little fun Eric and I had with the digital camera (doubles as a video camera). Overlook the poor sound quality, and editing....oh and the fact that Eric is not wearing a shirt....to see the beautiful mess that is pharmacological naming.

http://www.youtube.com/watch?v=CogoEo5v9EQ

I Remember Having a Blog....

I have been a bad blogger. I keep feeling guilty about not posting, but I just haven't found time to get my thoughts on "paper". I"m afraid there won't be much to read until October though, because exams are looming ahead.

In the meantime, Anatomy Katie posted a spot-on and hilarious piece about our most recent dissection. (follow the hyperlink)

A quick run-down of what's been happening:

1. My Katie visited last weekend (~8 days ago) and we had a great time making dinner together, etc. It was really nice to be "away" from med school for the weekend.
2. Last week was my second set of quizzes. Even though I spent most of the previous weeekend NOT studying, I was golden for the anatomy quiz - in contrast to the first set, I knew to study ahead so that I wasn't scrambling to get everything in my brain by Monday.
   
3. By the end of the week, my mind was fried. I was emotionally wrought, which - apologies to my anatomy group - was pretty evident during Friday's lab.
   
4. Immediately after lab, I took my online biochem quiz, got in the car and drove directly to Ohio.
   
5. This past weekend, I went to the OSU game and helped my Katie and her roomates move into their new house. I studied very little, and felt very good about it.
6. Now it's time to get down to business. Anatomy, Biochem, and Histology are next Mon, Wed, and Fri.

PS The list was unnecessary, but it was fun for me.

Clinical Correlation: Rare Genetic Disorder

1) The patient presents with severe hemolytic anemia, causing painful facial edema and a particularly dark jaundice - this symptom grouping is often referred to as craniofacial Solanum tuberosum - and swelling of the mouth, lips, and tongue.

2) Further analysis shows a peculiar developmental condition involving anatomical mismatch, involving the same gene that causes ottis dorsum (which you've seen here before). This was particularly visible as a pronounced optic armitis.

3) Many of the 'accessory' appendages of the body were missing on inital physical examination. However a rectal examination revealed many of the organs had migrated posteriorly.

You don't believe me? My brother posted a picture of this disorder on his blog!

Yes I am so much of a dork that I thought this post was hilarious! I'm not sorry. Also, what's the deal with Mr. Potato-head having a butt cabinet? Does anybody really put stuff back there?

Delayed Entry: The Good Side of "Last Week"

The whole point of my Aug 29 Posting Title "The Bad Side of Last Week" was lost due to the fact that I got lazy. The original idea was to quickly follow up with "The Good Side of Last Week" in a charming little juxtaposition. I made the mistake of telling myself I'd wait until the next day. So, now it's been a week and I'm writing tangents about spices! It's time to re-center...

--cue harp music and wavy horizontal lines, ala "having a flashback"--

There were alot of GOOD aspects of "last week", but I thought it would be too confusing and long winded to mention both the good and the bad at once. On Saturday, I was part of a beautiful thing called a study group. As a rule, I avoided study groups as an undergrad. They always disintegrated into nonesense because someone got bored, or two people had a personality conflict, or everybody just wanted to talk about their day. It was just inefficient and boring for me.

But this was different. Everyone in our anatomy group who was in town met at the library during Saturday afternoon ready to go. We chatted a little while, then all gathered around a skeleton and started grilling each other. The questions were uncompromising, and you really had to know your stuff...but everyone was so supportive! If you don't know that muscle's innervation, now you know to study it. "Let's keep moving on." I was surrounded by intelligent, well-prepared, and collegial peers! It was a great feeling, and I honestly learned more during that time than I would have learned studying alone.

The second good aspect of last week was that my Katie* came down to visit for the first time since I moved from back home to school (~7 hours away). Having her around was the best part of the weekend. I could mentally walk away from all of my med student baggage and spend quality time with her instead of fretting about some meaningless quiz in a couple of days.

This brings me to a mini-rant. Everybody tries to say you shouldn't be involved with someone during med school. The doctor I previously mentioned (Dr. Johnson) gave me a long speech about how he was so glad that he waited to have a significant other until after residency...you're much better off giving med school your full attention and finding a nice woman once you're all done. Well, I think that's a bunch of crap.

While the weekend I mentioned is not necessarily indicative of all of med school, one thing that stands out about it is that contrary to Dr. Johnson's claim I was better off (ie more sane) since Katie was there. Yes, of course there was compromise - I studied alot more during the week in order to have more time for her during the weekend, and she had to entertain herself for hours when I actually did have to study alone - but that's the nature of life. I'm sorry to say though that the medical profession is brimming with very intelligent people who refuse to compromise in their daily lives.

I think they're worse off for it.




*You may have to doublecheck your playbills, because this is the introduction of a new character on the blog. I call her My Katie only to distinguish her from Katie-from-anatomy-group. She's in school back home, and for those friends and family members who are dying to know more about her, just email me.

So what's all this business about Cinnamon

Eric is worried that our carton of eggs will become culinary hand grenades on Septmber 9 (exp date), so I've been trying to eat them at every opportunity recently. I was looking for something new to put on my eggs this morning - to make them taste a little less like plastic and a little more like...well, food - when in a snap decision I grabbed the cinnamon shaker and *BAM*-ed the eggs, Emeril stlye.

"Cinnamon?" you might say, "What's this guy's problem?" I don't know what came over me either! I don't usually put cicnnamon on anything.

It's just that people keep talking about cinnamon in their diet, and how it decreases heart disease risk, cures cancer...and might even mow your lawn if you ask nicely. I have no idea of the bona fide health benefits and/or risks of a heavy dose of cinnamon on your cereal, but an exhaustive literature review (googled it) leads me to believe there might be something to this one. Link!

Are you getting enough cinnamon in your diet?? This seems the new high point in absurd dietary recommendations. Next thing you know, we're asking "How about my allspice intake? You know, I don't think I'm getting my recommended daily allowance of Mrs. Dash either..."

So, open question: Of the people who read this blog (yes, both of you), has anybody heard this business about cinnamon in the diet? Have you added it to your diet, and/or did your physician recommend doing so?

Maybe it's good for you. Maybe it causes ears to grow out of your back. All I know is that cinnamon on the eggs is REALLY tasty!

The Bad Side of the past week

Yesterday was the opening of our first online quiz - all of our quizzes are online and have a "time window" when you can take them on a library computer - and everybody was in a hazy mix of panic and sleep loss. I felt it most during anatomy lab when senses of humor were a little more sarcastic and harsh than normal, nobody could concentrate on their work, and everybody had a slightly stricken look on their face (or maybe it was just me). But anatomy lab was really just the climax of a pretty hectic few days.

The whole thing started building last week when the specifics of the anatomy quiz were announced - what would be covered, etc. The collective blood pressure of the lecture hall raised 20 points apiece. When I tried that night to study, I had to repeatedly focus and re-focus my attention on what I was studying right then. Left to my own devices I would stumble off on a tangent about some random muscle factoid, rare neurologic condition, or anatomical space, all the while convincing myself that this would surely be on the quiz!

Back to reality for a second, I should explain that the significance of the quiz had nothing to do with its grade weight. I could have refused to take it, and still done fine in anatomy...heck, if I aced our two exams this semester I could pass without ever taking a quiz. On the other hand 1) acing both anatomy exams is guaranteed not to happen and 2) it's not about the weight; its about knowing where you stand!

We judge ourselves by looking at others. We constantly ask ourselves if we know as much as the other guy. Did I know more structures than anybody else in lab today? That guy just rattled of every nerve in the back and shoulder...can I do that? Some hold this behavior up as evidence that med students are intensely competitive, but I disagree with that. Competitiveness involves me beating you...somebody wins, and somebody loses. What we have here is slightly different. We're just all really freaked out about our own failure.

This brings me to keeping up. The one mantra that was drilled into our heads the first week of med school was Don't Get Left Behind. You can't forget your studies, because the material will keep coming just as fast, if not faster. But how do you know if you're keeping up? There aren't any sirens or alarms that go off when you're lagging. How then do you know whether you're studying as much as you should; whether you'll excel at school, be loved and respected as a doctor, and find the cure to AIDS, or whether you're...*gasp*...falling behind?

You know by freaking out about insignificant anatomy quizzes, and by trying to read every little twitch and glitch in the med students around you. You know by studying until you dream about muscle innervations at night. You know by blowing your first online quiz completely out of the water, and seeing "15/15 correct, 100%". That's how this stupid little quiz came to mean so much. And that's why by Sunday night I had convinced myself that this single quiz would be the crystal ball that would determine my fate (AIDS cure vs. street bum).

So, its not competitiveness that drives the med student, its something called "cognitive distortion". Just for fun, follow that link and use it as a tally-sheet for how many cognitive distortions I comitted in this single posting.

First Anatomy Lab

As I walked into the anatomy lab, the smell of formaldehyde immediately turned my stomach. Thirty corpses, each laying on a cold metal gurney, were lined up in front of me. Our professors had counseled us that the first day would be an unusual experience, but I couldn’t shake the idea that this looked like a bad horror movie. As I approached my cadaver, I realized that this person – likely someone’s sweet little grandmother – had donated her body to me. She would be my anatomy teacher for the next semester, and would likely become permanently lodged in my memory. This no longer looked like horror, but rather like the greatest gift one could ever give a med student. Of course, I should thank my parents for the second greatest gift you could give, my new stethoscope (thanks mom!).

My four lab mates and I had read and re-read the instructions in preparation for today. Our first step was to clean and prepare the body. Everyone was putting on their stoic face, and doing the assigned steps with remarkable efficiency, but our bright red faces revealed how truly freaked out we all were. I noticed that I kept touching her arm, almost trying to comfort her through the transition from corpse – deceased person – to cadaver – tool of scientific learning. I kept wondering who she was before she died. Was she happy and fulfilled, or had she lived a hard life? Did she die peacefully one night, or had she succumbed to her illness after a long struggle? Her surgical scars pointed to the possibility of breast cancer, but we won’t find out her cause of death until the end of the semester.

Once the dissection commenced, I became wrapped up in the anatomy of the human body, and wondered less often about her life and death. She had donated her body to me in order for me to learn about and appreciate the human body, so I got right to work. Our group worked remarkably well, everyone sharing “scalpel time” and “book time”. One good thing about being surrounded by other intense over-achieving type A personalities is that communication and cooperation occur very efficiently and with few words.

The human body is beautiful. A drawing does not do justice to the perfect symmetry of the trapezius muscle, and the gleaming tendons intricately interwoven through the back. On a many occasions, a member of the group would just blurt out “whoa, that’s so cool”, and we would all gather around to marvel at a certain structure. There was also plenty of “Are we too shallow, or too deep? I think we cut through the muscle we’re supposed to be looking at…”, but overall everyone proved to have a pretty good hand at dissection.

As we zipped up the body bag on our first day’s dissection, I was again hit with the gift that had been provided us. At one point during the dissection, a member of our group pointed out that if we weren’t med students we would go to jail for cutting up a corpse. Even in our first week, we have been given such a privileged place in society. To everyone who plans on donating their body to science…thank you. To everyone who didn’t, that’s cool. Just remember not to get too angry at that jerk who cut you off in traffic; he may be the greatest learning tool a med student could have.

Remember that this post is a fictionalized account. Details about the "patient" were changed and/or just made up. I can do that, you know.

Big Boy School, Week One

My first day of med school (previously referred to as “real” med school, heretoafterforthwith just med school) was uncannily similar to the first day of kindergarten.

I woke up all nervous and excited, with no clue what the day would bring. I had never been to Big Boy School before. I packed my lunch and set off for the University, a little part of me wanting to turn around and stay home…maybe sip a juicebox and watch cartoons. But when I got there, everyone else was milling around (20mins early like the overachievers we are) and I got quickly caught up in the din of school…trying to figure out who I would sit with (the kid with the he-man lunchbox, obviously), where my anatomy group (playgroup) friends were, etc.

Once the professors started teaching about sedimentation coefficients and energetic coupling, the feelings of kindergarten faded quickly. I had seen this all before in undergrad biochemistry and…my goodness…I remembered it! Granted I couldn’t spit out s = MW(1-vp)/Nf on cue, but I felt a long atrophied intellectual machinery start creaking into motion. It felt really good!

My studies surround three courses that describe how the body works at varying levels of detail: Biochemistry (very tiny), Cell / Tissue Structure (medium, but still invisible), and Anatomy (the mouth bone’s connected to the face bone…). I feel most comfortable with biochemistry, and least comfortable with anatomy, mainly because I ate/slept/breathed biochem in college and the last time I studied anatomy was in high school.

Things revved up very quickly this week, and – by modeling my 2^nd year roomate’s study habits – I have so far stayed ahead of the game. While I am still attending every lecture, I have been assured by many that most students end up attending less and less class and studying more and more on their own. This statement may seem shocking and horrifying to you, and that’s okay. But the truth of the matter (as conveyed to me) is that lecture introduces the topic and allows you to chew on it for an hour, but studying is required to make the material your own (to digest it, perhaps), and to really understand it. The pace of information in med school is so fast, that there’s no time to chew your food. You have to just get it in and make it your own.

My Summer up to last Sunday

While my medical school experience officially started last month, "real" medical school started this week. I set out to describe in this post the past week's events, but I kept running against roadblocks as I realized that many people don't know the events that led up to this week. So I really have to start by describing what happened before my first week of school.

I started in July as part of the Generalist Scholars Program (GSP), which selects about 6 accepted matriculants who have a special interest in Generalist medicine (ie Family Practice, Pediatrics, Internal Medicine). While I admittedly don't know what specialty I want to go into, I am drawn to Generalist medicine and to Internal Medicine in particular. It seemed fitting to join the program, given my interests...and also the scholarship monies they offered (I am human... and poor).

During July I spent two weeks at the University receiving a healthy dose of How to be a Great Physician from about 10 physician faculty members. These docs are good at what they do, and they love teaching us about it. While these 2 weeks weren't particularly difficult, the classes reignited my fire for medical school and doctoring.

During the third week of the program, I went out to the boondocks and shadowed an Internist in a city of about 5,000. Shadowed, as it turns out, was a very appropriate verb. I wisked in the door 1 step behind Dr. Johnson(fictionalized), stood behind him while he performed a thorough history, put my stethoscope where he did...paused...looked thoughtful...nodded even if i didn't hear whatever he was pointing out (I'm such a fraud), then returned to my position behind Dr. Johnson.

The real fun of shadowing Dr. Johnson was that I could ask any question I could think of once the patient was gone. I learned alot about the practice of medicine during the visit (quiet time), but I got really passionate about the beauty of medicine between visits (recess). Now, if only medical school would start already...

August rolled around, and I got ready for my first day at "big boy school". But the first week of school was, well, not really school. On Monday, I performed with 3 other students what amounted to a scavenger hunt: Item one, find badge office; Item two find Mulholland lounge and sign lots of forms (yay, forms!), etc, etc for the rest of the day.

Tuesday through Friday everyone participated in Cells to Society. We studied diabetes all the way down to the cellular level (how insulin receptors work), all the way up to the societal level (obesity trends in the US...they're up), and we participated in group interviews of patients who have type 2 diabetes, which is always interesting…but, this wasn't really med school yet! To make it worse, our teachers kept playing up the importance of “keeping up”, basically equating “falling behind” with “you’re a goner”.

By the Sunday evening before "real" medical school, I was a nervous wreck. I was driving back from a wedding in Ohio, obsessing about starting medical school. What if I’m not ready? What if I fail? What if *shudder* I fall behind? I could barely concentrate on my driving, I was so "keyed up"...a term I stole from my mom (thanks mom!).

Needless to say, I didn’t sleep well Sunday night. But things changed quickly the following day.

Big, Bad Post #1

I did it. I have created a blog. While I feel obliged to fill this post with the necessary first-post nonsense, I promise that my next post will concern an event in my life that is actually significant: my first week at med school.

Obligatory Stuff:

The opinions I express on this blog are my own, are quite subject to the winds of change, and in no way represent the opinions of any organizations or educational institutions with which I am associated.

On occasion I may feel led to tell a story about clinical experiences...the operative word here is Story, and it will be fictional. Another blogger's disclaimer writes "Any and all names in my writings have been changed. The ... clinical stories have been altered substantially to the point of fictionalization in order to protect both my colleagues' and my own privacy, and most importantly the confidentiality of my patients. Characters, events, and stories depicted here are composites of many occurrences, patients, and conversations..." (drcharles), and I can't really improve on that. While I will do my best to make these stories as emotionally accurate as possible, I'm still writing fiction (lies).

Lastly, everyone always feels the need to explain why they started the blog. I have been kicking around the idea for a couple of months because a) I find myself checking blogs of friends and family members every time I get on the internet, and it has been a really good way to keep in touch, and b) it turns out I am terrible at sending email updates to those who are dear to me, mostly because I get frustrated with saying the same thing twice (ie how my 1st week was). The punchline to why I didn't just fire up a new blog 2 months ago is that I couldn't think of a snappy name!


Every blogger must have a smart, pithy blog name. Your blog name is to blogging as your lunchbox is to the first day of kindergarten. If you had the brand new He-Man lunchbox that day, you were the most popular kid in school for the next 6 years. Remember that kid who brought his lunch in a paper bag the first day?? Of course you don't, and that's my point exactly.

So, in the interest of my blog name being somewhat honest while also working in that oh-so-satisfying pun, I chose the one you see. Medically, the phrase Visceral Articulations is absurd. It means nothing. I warmed to it immediately though, because I believe that many of the ideas I express here and elsewhere are much less cerebral (logical, well thought out) and much more visceral (impulsive, total crap).

This is my blog. I hope it helps all of my friends and family stay abreast of my life. I'm sorry I'm not better about emailing, but hopefully I'll be able to escape the class-study-sleep-study routine often enough to write about the experience.