November 25, 2007

What Would You Do If I Didn't Have A Scanner?

I've discovered a funny little quirk in my studying habits.

I draw a lot. See Exhibit A, a page of the notes I made while studying for this last exam.

I can't simply look at a picture and memorize the information but if I sketch out said picture in my own lame rendition for some reason it sticks. Besides this being the source of endless ridicule by my friends in class ("where are your cute little drawings!?") it's also given me a great opportunity to look back at my growth as an artist over these past four months. Here are some of the highlights:

Lonely Platelet.

A social examination of the under appreciated existence of clotting factors.


It's true that smiling utilizes more muscles and burns more calories than frowning.

The Knee

A Football Player's Worst Enemy

The Indifferent Gonad

Because at one point of development, we all had the same private parts!


An examination of color and the anterior triangles of the neck.


I went through an impressionistic stage during our study of the genitalia. I think it was a coping mechanism.

Your Pelvic Girdle

Because without it, you'd poop out your insides!


Nothing better to spur reflection on life and death than a lateral diagramatic view of the skull!

I am sure as I continue to find myself in medical school my artistic style will continue to evolve in turn.

Not much else to say right now - the last month was constant tests (and thus hell). When you spend all day and night every day studying for almost a month straight it leaves little time for things like "reflection" or "personal growth." Thanksgiving break has been a much needed break and now three weeks to push through to Christmas. The year has been flying by. I think that's a good sign - must mean I'm enjoying myself. So really, in the spirit of this post, I think there's only one real way to explain what I've been up to the past month. If you recall in an earlier post - I have a little something called The Place My Medical Knowledge Goes To Die (which has subsequently been renamed The Place My Medical Knowledge Goes To Die Until I Need To Resurrect Every Last Drop Of It Before The Boards Next Year).

My brain on October 2nd, 2007:

My brain on November 25th, 2007:


November 11, 2007

I Enjoy VH1 Celebreality TV.

There's different types of tired. There's just-had-a-crazy-intense-workout tired (which I actually enjoy). There's running-on-too-little-sleep tired (which I definitely don't enjoy). There's an emotionally drained tired. There's a been-running-around-all-day tired.

Right now I'm feeling a wholly different kind of tired. My brain is tired.

I am currently about to start the second week of a three week gauntlet where we have an exam each week. As I have already covered, preparing for a medical school exam is like preparing for 4 college exams in the same day - it's a week long process that requires a great deal of time and energy investment.

My previous strategy for surviving these draining cram-and-purge periods was by mailing in the week of school after the test. Not studying much (ok, at all). Maybe catching up on study objectives for a couple hours max on saturday. It worked well, gave my brain a nice break, gave me a chance to hit the gym, and when it came time to get back to work I was more than happy to jump right in. I really liked mailing it in.

I took my final GIE exam last week, a grueling exam on 3 weeks of material that was easily our most difficult challenge yet. This week I have a cumulative exam for our Principles of Clinical Medicine class. Next week is our first exam for our new Cell Structure and Function curriculum. Basically this requires me to be in full balls-to-the-wall study mode for 4 weeks straight. I can now understand why Pheidippides fell over dead after his sprint from Marathon to Athens.

So what's it like to be brain tired? Pretty easy to describe actually. Motivation? You lack any of it. Sense of humor? Well lets just say I have no problem perpetuating my blonde hair stereotype at the moment. A little slow on the uptake. Energy? Good luck, even on the back end of halloween and its copious amounts of candy lying about - no sugar high can touch my fatigue. Quad venti caramel low fat peppermint mocha latte extra hot? Please, I'm not even sure a line of coke could move my flatline.

Thankfully, at the end of the tunnel is a four day break for thanksgiving where I get to mail it in and not feel guilty about it. I think someone on our med school curriculum board has a soul. And if there's one undeniable truth, its that I will eat my weight in stuffing, park my butt on the couch, and have the most amazing nap of my life. Just got to get there first. Anyone got any coke?

November 5, 2007

Practice makes good enough.

“I had never done this surgery before,” my preceptor said as he pointed to the MRI on the screen. “I read about it in a journal. Didn’t turn out quite as well as I hoped. But next time I’ll read up on it some more and hope for better.”

As all things in life, practice makes perfect. Medicine uniquely requires one to practice on people. To further complicate things, medicine is always changing. Always improving. Of course, nothing in medicine is ever introduced without extensive testing to guarantee the safety of the people we treat. But eventually, every doctor has to make the jump and attempt that new treatment or new procedure. What happens to those first patients? Their results may be “not quite as well as we hoped.” Our patients unfortunately have to be the guinea pigs.

Even though I was not present for the conversation between my preceptor and his patient prior to the surgery, I can imagine somewhat how it may have transpired. He would have sat the patient down - explained all options. That a current surgery may exist which can help them. That he does not have experience with that surgery. Of course, many people put a great deal of trust in their physicians. When my preceptor explained “I have never done this surgery before,” many would likely hear “but I have done many surgeries like this before” as an unspoken affirmation. How close is that to the truth? How much does previous experience translate to future success?

Ultimately, I believe it is simply a matter of trust in the checks and balances in a system designed for change. As medical students, we bumble around learning the foundations of medicine that will help us function as the physicians of the future. In residency, we learn the skills and instincts that will help us succeed in the field we have chosen. New drugs and techniques are put through extensive trials. Surgeons travel to observe new procedures and read about them in journals. And ultimately it is all overseen by “experience.” Medical students are aided and corrected by the residents they work under. Residents are taught and covered by the attendings of their program. Surgeons learn from their peers who have pioneered and practiced new procedures. Drugs are tested and scrutinized by those involved and educated in their design and effects.

It may not be the best system, but it seems to be one that works. But with all things new, there are guinea pigs. Unfortunately in medicine, the guinea pigs are people, with the physician possessing only an instruction manual and trust in his or her skills and instincts to go on. This means people with "not quite good enough" results (which in reality in some cases means difficulties they will have to live with the rest of their lives). The best we can do is educate and hope for the best. Because it is ultimately about change, and change, as history has taught, is good for medicine. And good for the patient.