Thursday, August 31, 2006

Day 18: U-pass

Today i found out that they're finally selling the U-pass. It'll be available Tuesday morning, at 8:00am. Why is this important? Because they're selling U-passes for only $52. A U-pass is a year long bus pass that allows unlimited rides for one year on the Harris County Metro system. Typically, these things go for mucho denaro, ala $400 bucks or so. $52 is one buck a week, for unlimited rides. Can't beat it. You can bet I'll be first in line.

Wednesday, August 30, 2006

Day 17: More bus news

Today we did the Gross lab on the posterior triangle of the neck. For those of you who have no clue what that is, relish in your ignorance. It truly is bliss. Mainly that's because the platysma muscle should just freaking die. All it does it stretch your neck. Heck, I'll take a cool palmaris longus muscle over platysma any day. At least then I get claws.

But yesterday, I didn't write about my bus experience, so although this is day 17, the experience happened on day 16. Sue me.

I got on the bus late, because I was dead tired after doing condo-hunting junk all night, and started transfering phone numbers from my old cell phone to my new one (I just jumped ship from Sprint to T-mobile and got a Motorola Razor ... although I think my wife's Samsung T509 is much better) when I saw a young Vietnamese girl hop on the bus at the last second. Since I was catching the later bus, it was already "standing room only" since everyone seems to like to ride it at 7:00am. I thought "man, she looks familiar" but I couldn't place her.

Of course, I've lived in 'Nam, and I've seen so many Viet faces that lots of people start to look familiar. We used to call it the "Cannon Center face" at BYU because you have no clue who the person is, never talked to them, but you see them every day because you eat at the same location (or work, etc.) so you nod at each other in recognition of your mutual existence as you pass each other wordlessly yet again. I know you all know what I'm talking about.

As I near my stop, the Viet girl turns to me and says, "Excuse me, but you look familiar. Have I met you before?" Smiling, I replied "Well, I was just thinking the same thing. My name's Minh Triet."

"Spencer!" she screams. It turned out to be my friend Anh, who I last saw a year and a half ago. She and I had gotten to know each other briefly two years ago, but after a couple months I headed out to school. Last I heard, she was studying at HCC and thinking of accounting.

It turns out she's at the med center studying nursing at TWU. We chatted up a storm in Vietnamese until my stop came, everyone around us staring in shock that some white guy was ripping off fluent Vietnamese on a bus, swapped numbers and headed to our respective schools.

See all the cool experiences you can have on the bus? Busses rock.

Tuesday, August 29, 2006

Day 16: Gross Anatomy Practice Practical

Today, from 4:00-5:00pm, Gross Anatomy had a practice practical. It was set up by the second year pedagogues because we MS1s have no clue what a practical will be like, and we're now half-way through the five-week first block. The scary part is that for everything we've learned (or were supposed to have learned) up until now, it's only half of what's on the first-block exams, and one-sixth of what's required in the course.

The practical was 27 questions. Well, it was 27 body parts tagged with pins and arrows, asking, "What the heck is this? Oh, you don't know? Well, sucks to be you. Actually it's just your finger, but it's put in a position that makes you think it's your appendix."

The practical was really helpful and I'm greatful I got one. I learned two things:
  • There's a lot I don't know
  • There's a lot I do know, but can't translate from Netter or my cadaver to other cadavers in not-so-perfect positions
That's heartening and disheartening in one fell swoop. I got 9 ouf 27 correct; a full 33%. It's disheartening because 33% sucks badly and I've put so much time into Gross, but it's heartening because I know I haven't put in as much time as I could have (family stuff) and I know much more than 33%, I just need to spend more time looking at other bodies on Saturday.

Alright, no rest for the weary. Tomorrow starts the neck, taught by the amazing Dr. Zhang.

Monday, August 28, 2006

Day 15: Mondays

Mondays suck. Today was the first good monday I've had in a while. Why? Because some sweet soul decided to schedule no classes until 10:00am. Soooo nice. What that really means is no pressure to get up freaking early to get on a bus to sit through a class I don't want to be in. Nobody likes Mondays. They should just get rid of them.

Except that would make Tuesday the new Monday, and the vicious cycle would start over again.

Saturday, August 26, 2006

Day 13: The Zhang Train

Every Saturday, the MS1s do an interesting little dance called the Zhang Train. I did it today. It basically entails cramming around the professor-prosected cadaver while Dr. Zhang reviews the disections of the past week. Then, after he's done numerous rounds of that, he moves from cadaver to cadaver answering questions and curious students form a train following him everywhere he goes.

The man is amazing. He grew up and went to school in China. He studied western medicine, but he says every doctor is required to study 400 hours of chinese medicine too. Back then, medical school was five years, and the first two years were horrible--deadly. Now, things have eased up. China is starting to follow an American path. Students go to undergraduate institutions for four years and medical school for four years.

Since he first graduated medical school and started work as a general surgeon he has taught Gross Anatomy. He says it is the best way for a surgeon to become good and proficient. Teaching Gross Anatomy for two or three years makes you memorize everything in the body, and makes you a much better surgeon.

Example: You need to do an appendectomy. Many surgeons will open up the abdomen and will not be able to find the appendix because it can turn on itself and hide in the intestinal wall. However, with a supreme knowledge of Gross Anatomy, Dr. Zhang has put many pompous young surgeons in their place as he deftly pointed out where the invisible structure was hiding.

The man is amazing. He was an accomplished surgeon in China, but came here for his children. However, he cannot practice medicine in America. America requires that he take all the licensing exams (like I will do) and go through residency again.

"The licensing exams I can handle," he said, "but residency ... so many nights on call ... (laughing) I'm too old for that."

His skills are peerless. He can find any structure, nerve, artery, etc. in under 30 seconds. He cleans up the most MS1-messed-up area so fast and well that it looks like an MS1 never touched it.

Mixing western and eastern skill, he told us today of how Chinese surgeons, when working on the thyroid, would not use anesthesia. Instead, they would insert one accupuncture needle laterally and medially in the neck, into a cutaneous nerve. Why would it numb the whole neck? He doesn't know, but it works. They do it all the time. That way, when they are working in the neck, they can talk to the patient. There are many nerves running through it, and as they work, they monitor the patient's voice. If it changes up or down, they know they are near a nerve, but still have time to move around it and not sever it. Conversely, western doctors give the patient gas and knock him or her out. They perform the surgery and cannot tell if a nerve is accidentally nicked until after the patient wakes up.

His heart is gold. He doesn't have to come in on Saturdays. Every other professor goes home. But Zhang, every fall, spends four or five hours a Saturday in the Gross Lab reviewing and teaching hungry, eager students because he loves it. He loves teaching and he loves medicine. He loves passing along thirty years of teaching Gross Anatomy to those wet-behind-the-ears.

That is the one and only Amazing Dr. Zhang.

Friday, August 25, 2006

Day 12: Moroccan Generosity

Friday. Gross lab. Five hours disecting the anterior forearm and palm ... and I was in a fast group. Some people took 6 and a half, some are coming back tomorrow. There are so many nerves and arteries and muscles in the forearm and hand, not to mention the axillary space with the brachial plexus (which was two days ago), that my head hurts, and I am TIRED.

So, after lab I ran to the LRC, checked the bus times, and rounded up my stuff. I had to hurry to make the 298 at 5:45pm. Walking quickly to the corner, I met a short, wavy haired woman also walking briskly towards the bus stop on the other side of the street.

"I missed my bus," she said. "I always take the 5:30 but I'm late. I hope I didn't miss the next one."

I smiled politely at her.

"I was so busy today," she continued of her own accord. "I'm going on vacation and had to finish up and now I'm late."

"Well," I finally replied, "I think you're ok. There should be another bus."

"Yes. I saw that one just pass by. I'm just hoping that wasn't it."

"Me too," I concurred.

The light turned green and the little white figure of a walking man appeared. Crossing the street, I looked right and saw two busses making their way towards our stop.

"Well, one of those should be ours ... I can't see the numbers ... ah, yep! That first one is the 298," I said.

As we merged into the fast forming line, she turned to me quickly and said "Do you have any money?" I flashed her my blue pass that my father gave me the week before. It has a stored amount of cash on it which is depleted a little every time I ride a bus.

"How much is the bus?" she queried.

"Three dollars a time," was my response.

We boarded the bus, I got my transfer, and moved down the aisle. The bus was nearly empty. The talkative woman sat by the window on a row, but I, smelling like Gross Lab, chose to sit in the aisle seat of the open row behind her so as to spare her a stench-filled ride.

Within seconds she turned to me and said,

"So I'm going on vacation. I'm going for a whole month. Take this." And with that she gave me her red bus card. "It's good until September 2nd," she continued. "I'm going on vacation for a whole month so I won't need it."

Flabbergasted, I asked "Well, don't you need it when you get back?"

"No," she replied. "It's only good for one month. I'll buy a new one when I get back. But it's only good until September 2nd."

Still in shock, I said thank you and humbly leaned back in my chair to inspect my newly received prize. It was a red zone 4 card, worth $110 a month, which gives the bearer unlimited rides on busses during the month.

After a minute or so, I struck up a conversation with the lady. She's from Morocco, heading back for a month-long vacation to see family. She works as a lab manager for Baylor College of Medicine. She's a very nice lady.

It's amazing all the types of people in this world. I love riding busses because you get to meet many of them. More than if you shut yourself up in your car. Almost all my experiences on busses have been more than favorable. People that want to be alone sit quietly, but often, there's a very nice person on the bus who wants to chat, and for a second you're like a passerby, given the chance to look into the window of a house whose curtains are usually drawn, and glimpse the story unfolding within. The bus ride ends, the drapes close, and you walk away enriched by what you experienced. And maybe you'll get a red card too.

Thursday, August 24, 2006

Day 11: I Missed the Bus

Yes, it's true. I missed the bus. This is a big deal. Currently, I live out at Hwy 6 and Interstate 290--about 45 minutes away NOT during rush hour--so I hop the bus at the local park & ride, make a change at the p&r at the I-10 and 610 intersection, and get to the medical center in about 45 minutes to an hour. That sure beats driving, which would cost me at least one and a half hours in rush hour. Plus, I get to read while riding the bus.

However, coming home is different. If I don't catch the last bus by 6:59pm, I have to take the MetroRAIL up to downtown, walk three blocks, and then catch the bus from there back to my original park & ride. Sounds complicated? Yep, it is. You see, sometimes I'm not even out of class/lab until 5:30pm, and I want to study on campus where everything is so close. There's no way I'll be done by 6:45pm so I can make the 7:00pm bus. However, if not, I'm stuck. metrorails come every 12 minutes or so, and then I gotta walk to the stop. And the bus? Yeah, it comes every hour. So, to make the 7:41pm bus, I have to leave by 7:00pm, because the rail could come anywhere between then and 7:12, it takes 18 minutes to get to downtown, making it possibly 7:30, and then it takes about 7-8minutes to get to the station, for a grand total of 7:38pm.

Yesterday I missed the bus by 4 minutes and had to wait downtown studying notecards at the busstop for an hour. This isn't the first time. Grrr...

Wednesday, August 23, 2006

Day 10: Videos

Heaven is streaming videos. The undergraduate experience was decent, mostly because I chose hard classes but ones that had great professors. Here, I don't really get to choose to take anything. I either do and go to med school or don't and do something else...whatever that may be.

Some professors are knowledgeable, but not very good lecturers. However, we have streaming videos!! Someone gets paid $5 an hour (unfortunately not me) to sit in the back and press record and stop. Those videos are uploaded by 4pm that same day, to be watched by all those students who want to see it again, or missed lecture.

This is heaven in Biochem. First, I was a microbiology and history double major in college, hence I've had a lot of biochemistry. Second, the current lecturer likes to stutter, and go on tangents. Therefore, I doze a lot. When I watch the video of lecture, however, I can use Windows media player 10 to speed it up to 1.4x speed. This makes everything go faster, without making words unintelligible. Most every student watches them this way.

Verdict? I get a 45 minute lecture in about 30 minutes, plus the ability to pause, rewind, and review. What a great use of time. Now, what should I do with the hours I was in biochemistry?

Tuesday, August 22, 2006

Day 9: Condos

Medical school is hard, really hard. What makes it crazy is what it isn't--life. Today I skipped lunch and histology lecture/lab (i.e. all afternoon) to go condo hunting with my folks. They wanted to see what my wife and I had found while they were traversing Europe.

Needless to say, things are never done. After taking a closer look at the condo we wanted to make an offer on (well, did, but didn't have a loan so it wasn't finalized) we noticed tons of foundation problems, air duct problems, water leaks, etc.

So...we're retracting our offer that wasn't accepted anyway, and the search continues. Meanwhile, I'm trying to study for school, and wondering where people find the time to do it all. Noticed these are short entries?? Yep. No time to write long ones. Maybe the hectic feeling will wear off by second block, but I doubt it ever ends.

On the up-side, I got Taco Cabana for lunch. Yummy.

Monday, August 21, 2006

Day 8: Week 2

Beginning the second week. I didn't post on the weekend and decided to count those days, that way my day count reflects a real 365/366 days a year.

I skipped developmental anatomy and gross anatomy today and went to the doctor. I've been having huge headaches for about a month now and have a large knot in the back of my neck. The doc said simply that they're tension headaches, not migraines, nothing else serious. All the stress of looking for a condo (still looking) and starting school has lead to serious tightening of my shoulders (now I know the trapezius, levatores scapulae, etc.) and neck. Got a prescription for ibuprofen (says you need antinflammatory drugs for tension headaches, not tylenol), a muscle relaxant to take at night, and massage.

Yes, that's right, I got a prescription for a massage. Doctors rock.

Friday, August 18, 2006

Day 5: My Cultural ID

Today we had a seminar on cultural humility. Studies have shown that patients get amazingly better healthcare when they are treated by someone of the same race, ethnic background, religion, etc. This may be shocking at first, but it really isn't that groundbreaking. Look at the people you associate with--they all have significant things in common with you.

A physician is no different. Obviously, a doctor that hails from the south will understand my love for brisket or biscuits and gravy more than someone from New York. Neither might be a bad doctor, but the connection will make me feel at ease and probably open up a little more. That extra info I share can often be crucial in diagnosing a disease.

This situation is even more pronounced in ethnic and racial differences. I have many African-American friends, but I can't say I empathize with them. I don't know what it's like to live my life with a skin color that changes how people view me, affects my ability to get a job, etc. I experienced it for awhile in Vietnam, but 6 months is far different from 26 years. I can sympathize, but never empathize.

That empathetic connection can be crucial in some patients, and sympathetic people are always crucial. That's why we get cultural humility training from week one now. It's important, and it's worth it. I'm thankful for it.

Thursday, August 17, 2006

Day 4: Water cooler talk

I took the park & ride into school today for the first time. Got to school about an hour and a half early, so I could study, since I got no studying done last night (long story).

Sat down, opened Biochem, and overheard a couple 4th year students running the OBGYN club table talking. One said this:

"So I have the worst patient. The other day, four cousins came to see him and they got in a fist-fight in the hall outside his room. We had to call security. When security arrived, they found crack in the pockets of two of them, but that's not the end of it. Scared because of the crack they were trying to hide, they admitted that the car the took to get here and was parked in the hospital garage was stolen."
Gotta love medicine.

Wednesday, August 16, 2006

Day 3: Gross Anatomy

Today was the first day in Gross Anatomy and the first time I actually cut into a human body. I can't express the emotions. It's weird to cut into the flesh of another human, even if he or she is already dead. Cultural prohibitions, you know??

Out of it all, here's the tidbit of info I learned:

Humans have red, striated muscle like the beef you buy at the grocery store.

However, we have yellow fat like chickens (beef and pork have white fat).

Tuesday, August 15, 2006

Day 2: Revolving Feelings

Here I am, sitting in Histology, and wondering to myself,

"Can I do it?"

My feelings fly back and forth, like a pendulum...no an old grandfather clock, where the pendulum swings left and right and left and right and...

...and with each swing the tick of the clock echoes, reverberates in the back of my mind.

You see, I sit in Histo, or Biochem, or Devo, and I think to myself

"I have done this before. This isn't new. It's got some new parts, but it's not wholly new. More importantly, the concepts aren't hard. I can do this."

Then I look at the amount of material and pace of my courses and I think to myself

"I am dead. There is so much material to cover. The classes move incredibly fast. I can't do this."

Which brings the pendulum back to vertical, and sounds another tick in the back of my head. Time is running short.

"Can I do it?"

"Yes, I can."

Monday, August 14, 2006

Day 1: First Impressions

Chirp ... chirp ... chirp ... DA NA NA DA NA NA NA NA nuh NA! Startled, I awoke as my first alarm gave way to the blaring of the star spangled banner that is my second alarm. Rising out of bed, I showered and ate a quick bowl of Life, and headed out the door.

Traffic was heavy, but not stand-still. Nevertheless, I was tired by the time I got to school. What was I doing? Should I be a student? Again? It's been so long....

I stood in line and paid $117.26 for syllabi. What are syllabi?? They're paperback books, textbooks, thick ones, ones that every med student dreads and loves, because with them come hours of pain, yet knowledge that will let you care for your patients later.

Class was as great as stale bread dipped in muddy water. I sat on the third row. My classmates were friendly--all of them. I do have a great class. I predict I will have some great professors too. Unfortunately, even in medical school the first day of classes is filled with necessary but inane banter about procedures, syllabi, reading materials, how to not fail, who's hot and who's not, etc.

Ultimately, the clock hit 3:30pm and I stood up dazed.

"All done? Nah... couldn't be. But it is!?"

And then the realization of the amount of homework I had--even on the first day--hit me.

"I guess it's never done."

Nope. Never. I have started on the journey to become a physician. I entered the doors of medical school today, swearing a life of moral uprightness, long hours, hard work, and determination. I will be a good student so I can be a good doctor so I can be an instrument for comfort and health and happiness to those who trust me with their care. I will be a doctor.