Can't Focus.

It's March Madness.

Brains.

Today marks the 56th day in a row that I have been studying "Neuroscience & Behavior."

Yes, I attend medical school at one of those places with that fancy pants "integrated curriculum" that's all the rage with the youngins these days. Which means that instead of having individual "classes," we have "one class," with a loose association of various subjects all tied together under one common umbrella. Kinda like a family reunion where everyone shows up, including Uncle Frank with his 5th wife he met last month in Tijuana.

So I am on my 56th day of studying "Neuroscience & Behavior." 56 days of neuroanatomy, CNS pharmacology, CNS pathology, CNS trauma, neurology, psychiatry (definitely the Uncle Frank of the group), and everything else about the brain. The integrated curriculum is nice is some respects. Studying for one class is much easier than juggling multiple. Having to prepare for one test instead of a test week is nice. The integrated subjects of the integrated curriculum can sometimes be pretty integrated, which allows you to make some interesting and useful connections between material (or so called... integration of knowledge).

But there is one dramatic drawback to integrated curriculum... the debilitating and inevitable subject burnout that comes at the end of each class.

I have been reading about the brain for damn near two straight months. Imagine doing anything every single day for 2 months. Eating plain spaghetti without meat sauce. Every day. Coming home from work to watch the same episode of Family Guy. Every day. Wearing the same black t-shirt. Every day.

As such, I am 3 days removed from kissing NSB's sweet ass goodbye, but instead of being motivated to boot its neuropil-filled derriere out the rear screen door I am instead motivated to do absolutely. no. studying. It sounds like a recipe for success to me.

The next class? Simply titled: Blood. Who knows who is going to show up to THAT family reunion?

You know you're in med school when... (V)

Your notes sometimes look like this:

And other times look like this:

Scrambled Eggs.

I have come to realize medical school is like juggling a bunch of eggs.

In the beginning you start with a couple eggs. Like any beginning juggler, you kind of fumble around a bit. Maybe you break some eggs, but eventually you start to get the hang of it. Before you know it, you're juggling those couple of eggs and thinking "This is NIIIICCCEEE!!!"

But med school doesn't applaud your newfound juggling skillz. Med school gives you a snarky face and adds another egg. You get the hang of 4 eggs? Try 5. 5 becoming a breeze? Try 6. As you progress through your training, the eggs may change. The "biochem exam" egg becomes the "OB/Gyn shelf" egg. The "research for residency" egg may become a "giving a talk to colleagues at regional conference" egg. The "I just failed that test" egg becomes a "I just lost that patient" egg. But the more skilled you become, the more eggs there are, until you become a proficient and masterful physician/juggler. Then you retire.

Why juggling? Because it requires constant attention. Why eggs? Eggs are fragile. One of the all too familiar feelings as a medical student are those moments when your concentration lapses and you break an egg. Could be not getting enough sleep. Stress getting to you. Failing an exam. Getting out of shape. The analogy applies to many if not all walks of life. But man, med school sometimes sure feels like a lot of eggs sometime.

Of course, its not all doom and gloom. When you're on a roll juggling those eggs, then hell, it can be damn fun. Makes you kinda feel like this guy:

I guess that's why I haven't been posting as much lately. Second year threw a bunch of new eggs at me and I had to ditch one to make things more manageable. But things are back on the up and up and I'm back to cruisin' down the highway with the top down and the wind in my hair. So I'm adding another egg back in.

And hey, if I break one, I can always make scrambled eggs.

Dear kidney, I love you.

The following words were uttered from my mouth this past Thursday:

"I hate this so much it makes me miss 'renal'."

Yes, neuroscience, neuroanatomy, neuropilates, all that neuro- junk has officially crawled itself to the top of the Super Aggro Crag that is my 'Most Hated' list. Maybe that's because I've spent the past 3 days straight cramming for an exam I spent the previous week and a half being a piece of crap preparing for. But I'd rather pawn off my irresponsibility on the subject matter. I was at Macaroni Grill last night and all I could think to draw on my paper tablecloth with my Roasted Pepper Red crayon was a f#@cking diagram of the cerebral cortex (complete with labels!). I am so much better then that.

Exam tomorrow. I will feel so much better when I purge myself of this information all over that scantron sheet.

Until then, I defer to Bobby Boucher.
Mama says that alligators are ornery 'cause they got all them teeth but no toothbrush.
...
Somethin's wrong with his medulla oblongata.

The day that will never happen again.

Every once and a while you have an afternoon where everything feels right. Got dressed for clinic and found a $10 bill in my pocket (yes, a $20 would have been just way too cliche). Clinic was efficient, with straightforward visits, even the narcotic patients (I swear to f'in god this is not made up). Traffic on the drive home didn't matter because I was catching up on the phone with an old friend I haven't talked to in 8 months. Got home to watch the alma mater win a classic college ballgame in overtime. Cracked a beer to celebrate and it was the perfect combination of "chilled" and "icy."

If only days like that could come more often, I'd probably be a little (ok, a lot) more sane.

Speaking of clinic, today marked the first time I have seen a patient in 35 days. Between my final and winter break, I had damn near forgotten what I was supposed to even do with one. But today was a nice lukewarm wading pool for me to get my feet wet in again. Saw a cellulitis patient whose entire right arm was much larger, redder, and hotter than his left one. Drained the wound to give him relief, gave him a boost of IM antibiotics, a scrip, and his arm should be feeling immensely better within 48 hours. Saw a patient with textbook bacterial sinusitis. A patient with a URI who simply needed reassurance about his new-onset hearing problems. Yup, your tympanic membranes are full of serous fluid and bulging sir, start popping those decongestants. Saw a 2 year old with a 6 month history of constipation. Natural methods had proven ineffective so far and it was time to actually see what we could get going with laxatives. You could tangibly feel the relief from the parents when we handed them the prescription, as if they now had a tool they could use to fight their kid's suffering. And yeah, even the narc patient, a pleasant 70 year old woman with a history of loading up a bit too much on her oxy. She was in a nursing home now, and the pyoderma gangrenosum on her leg was causing her a great deal of pain, oh doctor please, can't you give me more to help this go away? Turns out the nursing home... wasn't giving her any oxy period on a clerical error. Well that was an easy fix. Between histories and physicals, I didn't even have to think and ponder about "what to do next?" - it was all so straightforward it came naturally. This after 35 days. Unreal.

Dare I say, I actually enjoyed myself for an entire afternoon in family practice?

Hahaha. That's silly.

And yes, I chose the fruitiest picture possible for this post on purpose.

Christmas... Break?

Turns out the winter storm referenced in my previous post was simply a little foreplay from Mother Nature until she unleashed the full-on kama sutra of arctic chill on my little niche of the world (see right). As a result, I abandoned Siberia, I mean, my apartment, and have been sleeping on various couches of various houses I have broken into over the past 10 days. Having no internet access for nearly 2 weeks, being sans car, sans bed, and sans normalcy has been equal parts entertaining and maddening. The Great Thaw has finally come, and with it my migration home, just in time for me to hop on a plane tomorrow for Vegas and New Years. I don't really know what the point of this post is except to justify my hiatus. I was hoping to post some thoughts over break but that will have to come after my return from Sin City and the hangover subsides.

Until then - Vegas, baby. Vegas!