1/8 MD!

As of last Friday, I have completed 1/8 of medical school! After lots of preparation and a fair bit of worrying, my finals went well. In fact, yesterday I got kind of an early Christmas present in that my biochemistry grade was posted and I was very happy! I'm still waiting on my final anatomy score, but I know approximately what it will be, and I'm totally satisfied.

It's really amazing how much can change in a few short months. I know this from past experience, and had tried to remind myself earlier in the semester, whenever I got worried and agitated, that eventually I would get used to this whole med school thing and it would seem like old hat. I realized I had reached that point about 2 weeks ago. I had the day off from class, but needed to go to my ICM (Intro to Clinical Medicine) site, where I work with an internal medicine doctor about once or twice a month, learning to do basic patient interviews and exams. I stopped by school to pick up my white coat and stethoscope from my locker, and as I hurried through the halls, I realized that the only thing on my mind at the moment was driving carefully through the rain to get to the site on time - a perfectly normal thing to think about. This was in stark contrast to earlier days when, in addition to normal worries, I had to think about finding my way around the halls of the Health Sciences Center where I go to school. (On the first day of class, after I finally figured out how to get from my car to the right entrance of the building, I had to follow other classmates because I didn't know which way to wind through the seemingly-labyrinthine halls to get to class!) School alone provides enough to worry about, so imagine how much was on my mind when I was still adapting to my new setting! It was like a full-bodied sigh of "Aaaaahh, I'm ok now," to realize that, without knowing when exactly, I had passed through that initial phase. Now my full concentration can be given to school rather than being spread thin between school, navigation, meeting new people, etc.

After finals, I slept past noon for the first two days. I'm starting to feel like a normal person again, re-entering the rest of life and taking care of things like laundry and buying stamps. I'm also starting to work out how I will spend next summer - my last free summer! I'm hoping to do some clinical oncology research (surprise, surprise), but I'm not sure where that will happen yet. I have already applied to one program, and will investigate several others as well.

And now the holidays are in full swing. Tay and I spent Sunday evening with his mom and her boyfriend, Monday evening with his father, stepmother, and little brother who just turned 7, and last night with my parents. We actually had my family's "official" Christmas last night, including a scrumptious meal and many thoughtful gifts, because we are heading up to Vermont today for four days of skiing. (We did save some presents to bring up there; I'm still a little kid and insisted we have something to open on the real Christmas Day.)

With that, I will end and continue cleaning the apartment and packing. I wish everyone happy and healthy holidays!!

Cadaver Dreams

Last night, with only six sessions of dissection to go, I had my first dream about anatomy. In it, Harvey was whole again - organs back in place, skin intact, face no longer marred. I was gathering clothing in order to dress him before he was sent away. I remember feeling very sad that it was time for him to go. At the end, I patted him on the chest and said, "Thank you, Harvey. I will be a better doctor because of you."

Just a quick post to celebrate the election outcome and share some pictures from Halloween. Hoping that Sarah Palin would henceforth disappear from the US political arena and such a costume would never again be relevant, I decided to dress up as her for Halloween, complete with folksy accent and incessant winking. (My pin says "I love Real America.") I admit I was probably channeling Tina Fey as much as the real Palin, but it made for a very entertaining evening and "also too" earned a ton of laughs. Maverick!

Change of Perspective

In the movie "21," which chronicles the adventures of a bunch of MIT students counting blackjack cards in Vegas, the instigating professor presents a probability problem to his class. It goes something like this:

Professor: I have 3 doors. A car is behind one of them. Pick one.
Student: I pick Door 1.
Professor: OK, what if I tell you that the car is not behind Door 3? Do you want to keep Door 1 or switch your answer to Door 2?
Student: I'll switch to Door 2.
Professor (clearly impressed): Why?
Student: When I first picked, I had a 33% chance of being right. Once you took away one option, the odds changed....

My understanding of the math gets fuzzy right around there, but I've been thinking about that scene lately and how getting a piece of new information can change how you think or feel about something. Two recent situations have illustrated this.

A week and a half ago, I took my Biochemistry and Anatomy midterms. I was somewhat terrified going in, convinced that no amount of studying would make me feel fully prepared, and aware that, given my proclivity for sleeping, eating, and exercising on a fairly regular basis, I didn't have time for unending cram sessions anyway. I entered the tests feeling that I had prepared to the best of my ability and reminding myself that all I really needed to do was pass.

Last week as I walked to my mailbox to get my graded anatomy exam, I repeated my mantra: "All I need is a 65; I'll be happy with that" over and over. I took one look at my grade (safely above a 65) and thought, "Crap! I want to do better than that!" Once I had that assurance that I was passing, my goals changed. In the end, I scored above average on both tests. That knowledge has made me enjoy my subsequent studying even more; some of the fear of failure has been replaced by fascination with the information I'm studying, which I think is a healthy switch.

The second instance of a change in perspective occurred last Friday in Anatomy lecture. As we study the branches of the facial nerve, we learn about Bell's Palsy, in which a nerve injury leads to symptoms such as a drooping of one corner of the eye and mouth. We also saw pictures of people who have just one nerve injured, and saw that an injury to the marginal mandibular nerve results in the bottom lip being paralyzed on one side, making it look like the other side droops. This injury can occur when a person has surgery on their submandibular glands for cancer, and indeed, the person in the picture has sort of an indentation right under his jaw.

Suddenly my mind flashed to my 9th grade Earth Science teacher, Mr. Pearlmutter, with his asymmetrically drooping lip and what looked like a strange indentation in his upper neck. This man who we ignorant teenagers had made fun of had most likely suffered a nerve injury during a surgery (possibly for cancer)! I felt really terrible and want to apologize to him, wherever is he is now. I'm so sorry Mr. Pearlmutter!

Loving the Jewish Holidays

I haven't set foot in anatomy lab for 3 whole days, which is a new record. I also slept until almost 9:30 this morning (gasp!). These luxuries are thanks to the fact that Stony Brook shuts down in observance of Rosh Hashanah. This extra time has let me [start to] catch up in my studies and begin preparing for midterms, which are only 2 weeks away.

Here's a quick (maybe) synopsis of the goings-on since my last post:

We had a fantastic guest lecture last week delivered by a gynecologic oncologist - in other words, someone who does exactly what I hope to someday! It was so much fun to hear her describe the surgeries that she does, and when she started using terminology that I've been learning, it was sort of a lightbulb-going-on-over-my-head moment, as in, "Hey wait! I know that! I'm learning some of the EXACT things that I will need someday when I practice medicine for real!"

I've been ruminating quite a bit lately about how different medical school is compared to college in that everything I'm learning is directly related to, and vital for, what I will be doing later. Even after I declared my French major, I didn't look at what I learned in my classes in terms of its application to my future studies - there were no thoughts of, "Hmm, I'll definitely use this verb tense or cite this piece of literature in my senior thesis!" Here, however, it's a different story. There's a lot of pressure that comes the knowledge that this actual information may be important for my career, but it's also a great source of motivation when there seems to be no end in sight to the amount of information to cover.

Back to the guest lecturer, though. I had actually met this doctor years ago when I was doing an internship at Stony Brook with one of her colleagues (who no longer practices here, unfortunately), so I introduced myself to her afterwards and told her of my interest in gyn onc. In inquired as to how I might get involved in the department's research, and she told me whom to contact. Yay!

Some classmates and I spent almost 8 hours in lab on Saturday "pinning" several bodies. One aspect of our exmas will involve identifying different organs/nerves/blood vessels that are marked in the bodies using pins, so we decided it would be good review to pin everything we have studied so far - about 175 structures - and then test ourselves. It was very helpful and fun, especially with our break for pizza. Long hours in lab never fail to make me hungry.

Finally, I had a personal training session at my new gym on Sunday, and the girl worked me so hard I've been hobbling around for a few days with extremely tight muscles. At least I have some new moves to do at the gym once I recover!

Looks like I've been verbose once again. There's just one more thought that I want to share, as well as to document it so I will remember it in the future. I was talking to the medical school's learning specialist (who offered some really great tips as to how I can study even more efficiently), and she told me that, although everyone will tell you something different regarding how much grades, board scores, and where you do your residency matter, it's important never to forget that it's a privilege to even have the opportunity to study medicine.

Missing the Big Green

I just read that Dartmouth's convocation was today, officially beginning the new school year. I know that the point of going there was to learn things that would prepare me to go out into the big, wide world, but sometimes I really miss being safely nestled up there in the mountains and trees.

White Coat, Breakdowns, and Amusing Anatomy Anecdotes

On Sunday, September 7, I went through one of the rites of passage of medical students: the white coat ceremony. My parents and Tay came to watch me go up on stage and have one of the deans put my white coat on me, welcoming me into the medical profession. Here are some pictures from the ceremony:




(On a side note, several other parents who were sitting in the audience turned to my mother and said, "I can tell which one is your daughter!" Yes, we now sport even more-similar haircuts. I'll take it as a compliment!)

The ceremony was an exciting occasion even though I can't actually do anything medical yet; my coat is a short one, which indicates that I'm a student. I wear it whenever I have any clinical interactions. So far, this entails practicing interviewing standardized patients (trained actors) in our Clinical Skills Center. The patients are given a certain complaint and medical history which we need to elicit while sitting in an actual exam room, being observed remotely by a fellow student who then provides feedback. It's a nice break from lectures and a great reminder of why I'm doing this!

By "this," I mean, of course, ridiculous amounts of work. I don't mean to complain; I got myself into this mess! It's just that the amount of information thrown at me each week has become somewhat overwhelming and I am currently upset with myself for (already!) having falling behind. That's exactly what I promised myself I wouldn't do! Perhaps I was too confident coming in, thinking that I was a mature, seasoned student who has figured out over the years what study techniques and time management techniques work for me. However, due to my earnest studying for the first anatomy quiz (which went very well!), I let the more current work for anatomy and biochemistry lapse. As a result, the second quiz did not go as well.

My "big sib" (a second-year student who was assigned to me as sort of a mentor) has assured me that she didn't really feel settled until at least mid-October of her first year. She also maintains that everyone will have at least one breakdown/freak-out within the first month. Well, I'm right on schedule! I woke up this morning with a cold, took the aforementioned not-so-good quiz (we take them electronically), and promptly burst into tears, convinced there was no way I could catch up and handle all of this work.

Mom and Dad, if you are reading this before having talked to me, don't worry; Tay took great care of me and I'm feeling much better now. I spent the afternoon studying in bed and then did an overhaul of all of my course materials, finally getting fully organized. I've realized that I need to focus my studies a bit differently, now that I can see what types of things my professor focuses on in exam questions.

On a happier note, I ran a 10K race yesterday with some of my new friends, and have joined a weekly "mindful meditation" group led by a psychologist at the medical center. It's supposed to help you relax and clear your mind so that you feel calmer and aren't as affected by worries and negative thoughts. I'm trying hard to maintain a few aspects of my life outside of my studies that will keep me happy and healthy.

Finally, I'll end with a recent amusing scene from the anatomy lab. (It's not for the faint of heart.) Our cadavers lie in bags on top of a steel table, in which there is a hole that drains into a funnel into a big bucket underneath. We have been warned never to move these buckets, as they collect all the "juice." Well, our bag was getting rather full of fluid, and we were strategizing how best to empty it without having it pour onto the floor. A friend from a nearby table said, "Just cut a hole in the bag right over the table's hole so the juice can flow through right into the bucket. Here - I'll do it." He did. And because, unbeknownst to us, the funnel leading into our bucket was clogged, the fluid poured all over our lab bench under the table (holding our tools, dissction books, etc) and all over the floor around us. All I could do was laugh and be thankful that this hadn't happened on the first day!