Friday, September 29, 2006

Day 46: Baby

The word of the day is BABY.

Today we had a good Devo lecture about the Branchial (Pharyngeal) apparatus. Our lecturer ended with some pictures of babies, and the rhetorical question, "isn't it all about babies?"

Then I met my friend Jamie and his coworker Will for lunch and I took the rail to get there. I sit down behind a young white man and his hispanic girlfriend, and nearly laugh while studying my Anatomy flash cards as I overhear his pleading.

"Baby, I just wanna make us like the way it was."

"..."

"Yes, I know, baby, but we can try to get as close to that as possible, baby."

"You know I love you, baby. Why don't we just **** this and go to Cancun, baby. We'll rob a bar and get naked on the beach. Come on, baby."


Then, as I'm leaving the rail, a tall black man gets off right in front of me, and stops at the door, turns to a white woman sitting by the door, and says,

"Baby, you got pretty eyes, baby."


Then he got off the rail, and I met my friends for lunch.

So, that's the word of the day: BABY

Thursday, September 28, 2006

Day 45: ICM sucks

I don't understand why such a great idea can be put into practice so inefficiently. As a first-semester MS1, I take Biochemistry (Biochem), Developmental Anatomy (Devo), Gross Anatomy (Gross), Histology (Histo), and Introduction to Clinical Medicine (ICM). Each class is hard, quirky, and requires lots of practice to succeed. Also, each class is coordinated well.

Every summer, the class leader works with lecturers to put together a syllabus and set up a course outline. Upon starting school, I received (bought) my syllabi for each class, and received a calendar/schedule.

How come every class except ICM did this? Gross made minor changes to the schedule, but announced all semester changes at one time a couple weeks ago. In contrast, ICM cannot seem to do anything by the book. Every week an email is received adding some online assignment, or cancelling some class. All of this change requires a lot from already hugely busy medical students.

We just finished Block 1 exams, so my fellow student Richard bought a ticket out of the state to visit his girlfriend. This was predicated on a couple assumptions: 1. There's nothing to study because its the first weekend of Block 2. 2. He was scheduled for the last day of ICM every week in Block 1. However, two days before he is to leave, he is told via email that he's been changed to the first day, causing him to jump through hoops to find someone to switch timeslots with so he doesn't miss his flight.

Now Yom Kippur. ICM is cancelled for Yom Kippur. I like having the class canceled, but this isn't someone getting sick at the last minute--it's Yom Kippur. You kinda know a year in advance when this holiday is, and can plan ahead for it.

Is it too much to ask from professionals to efficiently organize this class?

Wednesday, September 27, 2006

Day 44: Losing Face

Today we disected the face in Gross. It was a tedious, tedious lab. The skin on the eyelid is the thinnest skin in your body, and the rest of the face isn't far behind. Also, nerves in the face are about as thick as floss, branch every which way, and sometimes just pop out of the bone, literally.

Either way, it sucked going back in the lab for the first time after tests, but it was good that I got to disect this lab, because it is so intricate. Do you know that your smiling muscle is Zygomaticus major?? Well, now you do. I wish they'd let us take pics of the cadavers so you could see the progression of the disection, but for obvious reasons they do not, and I whole-heartedly agree with those reasons. I'm very thankful that these men and women donated their bodies so my classmates and I can learn medicine, and I wouldn't want to disrespect that.

You hear about stories of med students doing stupid things in Gross, such as storing flasks of whisky in bodies, or chopping off penises and playing catch. Those stories always disgusted me when I heard them, and I'm happy to say that nothing like that has happened in my class. Nothing even remotely close. The staff did a great job of educating the students at the beginning of the semester about the proper ettiquete around bodies and my classmates have been very mature about it. That doesn't mean there isn't the occasional joviality in lab, it just means its never done at the expense of or disrespect to the cadaver. Life's got too many other funny things to laugh about than to be immature around cadavers.

Tuesday, September 26, 2006

Day 43: Plumbing Problems

The subplot to my med school melodrama is the thriller of trying to buy a condo. My wife and I have been looking for a place since July. We've been staying with my folks, about an hour away, and I've been riding the bus into town and back since. We finally found a place, had the bid accepted, and are now running around like chickens with our heads cut off, making sure everything is ok so we can close in a couple weeks.

Oh, it will be nice to close and have a place CLOSE to school.

So, the wife went to transfer the title of my father's old Honda Accord to us yesterday, but they wouldn't let her because we didn't have insurance on the thing. We bought it from my parents for cheap, because we're really poor. So, today, my wife and I went to State Farm and got insurance on the bad boy so tomorrow she can get the title transfered.

In the morning we took the bus and mapped her route from home to her new job. She gets to practice her Public Health degree with the city. It should be good for her, and they seem to like her. Plus, she won't need to drive, which is a big plus because she doesn't have a lot of experience driving in big cities.

However, we also needed a plumber and electrician to look at the place we're buying, because the inspector suggested it. So, I met our realtor at the place and the plumber looked things over. About $1000 to fix the toilet, shower, and kitchen faucet. I left to go back to school and the electrician came. My wife said he wanted $1225 to replace the breaker box which is obsolete, but not broken.

Man, the money's flying and I'm not even making anything yet. We'll probably wait on the breaker box and I'll do most of the plumbing myself. It pays to have a dad who's a handiman and I've learned a little by his side.

Either way, I missed this new Clinical Applications class. I don't even know what it's about. It just showed up on my schedule, and they sent out some email a day or two ago. Whatever.

Monday, September 25, 2006

Day 42: Back to the Grind

Today the joys of vacation ended and I hit the books again. Well, sorta. It sucked royally to get up today and know I had to go back to school. The weekend was basically spent veging. I watched lots of football, and slept, and generally basked in the glory that was no tests. It was great.

Most of my classmates went to The Lounge (a club) Friday night and got plastered. That's what most med students do--study and binge drink. Not healthy at all. You can translate it into hypertension and cirrhosis of the liver. And they're the one's that'll be telling you to get rid of some stress and stop downing the vodka...

Anyway, I don't drink, never have, and my wife isn't a big dancer, so my Friday was spent blissfully sleeping (in my bed this time, not the LRC). I hear the Lounge was fun, but I KNOW it was fun waking up after 20 hours of sleep. Great fun.

Today the Saints killed the Falcons 23-3 on Monday Night Football. It was the first homegame in the newly renovated Superdome. I watched the whole thing. I figured, what better reason to get behind immediately than to support the rebuilding of New Orleans...through football. People do need to get their acts together and finish it, because it's been a year and little's been accomplished. Someone would be fired if it wasn't the government.

Friday, September 22, 2006

Day 39: It's Over!!

Devo's Done! That test was so short--only 40 questions. Yes, that means I can't miss much, but it also means I was done quickly. The best part about the exam was how straightforward it was. It didn't try to trick you. You either knew the material or you didn't.

Compare that with Biochem, which was a horribly written test. All it did was test your ability to understand obtuse language, not Biochem. I don't understand how some of the smartest professors in the world can write some of the stupidest tests. I think there needs to be education classes for professors. I know my undergraduate, BYU, had them, and those professors that went ALWAYS taught better than those who didn't.

Tonight I'm gonna sleep. Sleep, Sleep, Sleep, in MY bed...ah that sounds good.

Thursday, September 21, 2006

Day 38: Biochem Blues

Three practice tests. I took the old exams from 2003, 2004, 2005 and then walked the Green Mile. Failed. Oh it sucked.

Well, maybe not failed, but I missed at least 10 of 50. That's really my goal anyway--just pass. I haven't endured the rigor of a week like this in over a year and a half, and its killing me. Today's Biochem test was harder than the last three years. I just hope I pass.

My wife has been great. She's truly supportive and patient as I slept here last night and haven't really seen her for two weeks since I've left for school before she wakes up and get home after she's asleep.

Tomorrow's Devo and then it's all over. Now, if I can just cram enough into my head in 22 hours to pass...oh I wish the weekend were here already.

Wednesday, September 20, 2006

Day 37: LRC campout

Things have gotten tough. School is killer. The Biochemistry final is tomorrow, and nobody's ready for it. I've studied non-stop since Histo got out, and what do I have to show for it? Pure caffeine coursing through my veins.

What has test week done to me?

I feel guilty going to the bathroom without taking notecards.

I fell guilty eating without a book in front of me.

I feel guilty driving home because I can't watch a videotape of a lecture.

I feel guilty sleeping because I'm not studying.

Tonight I'm not going home. Not pulling an all-nighter--I'm far too tired to do that, and I have Developmental Anatomy the day after Biochem. I don't wanna crash. Nope, I'm just sleeping in the LRC. My lovely wife brought me dinner, breakfast, a pillow, and a blanket. I'm studying until two, sleeping until six, and back to studying until the biochem test.

Tuesday, September 19, 2006

Day 36: Histology Horror

Well, Histology is over. Done. I'm miserable. This week has been rotten. One of the worst weeks of my life. I have almost never felt as depressed as I do right now. It's this general feeling of sadness, like Eeyore from Winnie the Pooh.

"Oh, Bother..."

Sometimes, in my fleeting moments of resilience, I steel my mind, pull up my britches, and tell myself I can persevere. I am good enough to be a doctor. Then I get back to studying and I feel as if the world is collapsing all around me. I've never felt so alone, so tired, so sad, so angry, so frustrated.

I have such great friends around me, trying to pump me up. They keep saying "don't worry! Everyone's in the same boat." Or, "hey, this is the first exam. Now you'll know how to study. You've still got 75% of your grade to go." I'm so thankful that they're here to help me along, but the reality is, I still suck.

Sometimes I wonder if I have a learning disability. Then, in my next thought, I tell myself that would be a cop-out, since I am having trouble focusing, and I feel like I must reread things a billion times before they stick. It shouldn't be a cop-out, because learning disabilities are real things that real people struggle with and, if anything, those people should be lauded for dealing with and overcoming their trials. But I still have that thought, and I get depressed. Some psychiatrist lady here told everyone at orientation that many people in medical school get diagnosed with learning disorders. They were always so smart that they just covered it up. Nobody noticed because their grades were high. But once you get here, everything gets manifest.

Regardless, I haven't been blogging because I've spent so much time studying, and I'm realizing as I write this how therapeutic blogging is to me. I'm gonna have to go back and fill in what's gone on between now and 5 September 2006.

Monday, September 18, 2006

Day 35: First Block Exams

Today sucked. I've never felt so overwhelmed in my life. I now realize what I've been going through--finals. At BYU, I had to study. I was not the smartest kid, although if you ask my mom, there's nobody smarter. But that's a good mom talking. Especially my freshman and senior years. I took hard classes. I was a glutton for punishment because I wanted the good professors even if my grades were lower ... and they were. Plus, it was tough doing school while getting married. But that's no excuse.

I studied hard, but rarely did I feel overwhelmed, especially because BYU has a testing center. Example: a biochemistry test would be put in the testing center from monday through thursday. Then, based on how prepared I felt, and what was going on in my other classes, I could take the exam any day I wanted morning or night (well, until 10pm). Such flexibility was a blessing I do not have anymore.

Studying for these first tests has truly been like finals. Finals at BYU were not flexible, and with all my hard classes, made me miss a lot of sleep and subsist on caffeine. The pressure, hours, and material here in this first round of tests is equivalent to a finals week. That makes me fear what finals week here will be like.

*shudder*

it doesn't help the fact that I bombed my anatomy test. It was so tough. I knew the practical, knew it, but drew blanks. Ugh. Alright, just 18 hours until Histology...

Sunday, September 17, 2006

Day 34: Sunday School

I typically don't write on days that aren't involved with school, but since finals (I mean first round of exams) are tomorrow, today is applicable. Applicable because of what I couldn't do--study.

I am a church-going guy. My wife and I currently help out in the Vietnamese branch (congregation) downtown. We don't technically belong to that area, but we know most of the members, and we both speak Vietnamese, that we felt we could help out a small branch.

Anyway, I got asked two Sundays ago to teach Sunday School today and next Sunday. I said yes, not realizing what finals were going to be like. So, here I am, teaching about Paul's second missionary journey, preparing for it, going to church, home from church, etc...you get the picture. Study time on Sunday? All of about 4 hours--from 7pm to 11pm. By then I was shot, having spent my morning preparing my lesson and being in church from 2pm to 6:30pm (counting driving time). Two of those hours were histology and two were gross anatomy.

I'm scared.

Saturday, September 16, 2006

Day 33: Gross Day

The marathon studying continues. I got up to school today by 8am, and was one of only five or so people in the gross lab. I left at 4:30pm, after reviewing five or six cadavers by myself, a couple with two classmates, Veronica and Adrianna, and hearing the amazing Dr. Zhang do his thing (a full review). My head hurts so I think I'm gonna switch to Histology for a bit.

I'll go home from the LRC (learning resource center) about midnight, because I have to teach Sunday School tomorrow at church. That'll be a good 16 hours studying. You truly can't understand medical school until you go. People have no idea the stress you endure or how hard it is.

Wednesday, September 13, 2006

Day 30: Gay Doctors

I've been thinking about this some more. What about gay doctors? This was my question that i asked Dr. Bockmon directly. You see, when a male doctor examines the genitalia of a female patient, a third person accompanies him into the exam room (usually a female nurse). This is smart, because it can put the patient at ease and protect the doc from sexual harrassment litigation. But in medicine, there is a BIG double standard. Female doctors often do not have to take a third person in the exam room when examining male patients' genitalia. More than that, sexual persuasion is never asked (of the doctor) in the hospital/clinic, so a gay doctor could be examining a male patient without a third person in the room. Do I think that gay doctors are going to molest patients? Heck no. They're not any more likely to do it than straight doctors. My point is, for those women who feel awkward having a male doctor give them a pelvic exam, there are doubtless people who would feel just as awkward having a homosexual doctor of their same gender giving them an exam. There is a simple, fair, equitable, and respectable answer to this. Give everyone their privacy by requiring a third person in the exam room every time a physician gives a genital exam regardless of the gender of physician or patient. Then people can keep their personal lives personal, and hospitals/physicians can be better covered against sexual harrasment litigation.

Tuesday, September 12, 2006

Day 29: Treating Gay Patients

Today, I took time out from the studying to attend the "Cultural Humility Series" lecture on "Treating Gay, Lesbian, Bisexual and Transgender Patients." I love this cultural humility class thing. We get "blue book" credit for going to a certain percentage of them, but even without that, I'd still go. Why? Because it gets me to constantly reevaluate and assess my existence.

Last week's topic on Southeast Asian patients was interesting because I am so intimately involved with the Vietnamese population here and in Vietnam. Today was a different kind of interesting.

Honestly, I've never thought about homosexual patients, or doctors for that matter. It's never crossed my mind. I just lived my life, day after day, not thinking that there could be issues regarding sexuality, besides your doc asking "are you sexually active?"

Dr. Bockmon gave a good seminar on the issues that GLBT patients deal with and what physicians who treat them deal with. I did not care for the loads of time he spent trying to tell us why people are gay.

You see, I'm a Mormon. I come from a pretty conservative christian church. I have personal religious beliefs that deal with sexuality of all forms. Naturally, as we've all seen in the public forum debates today, people's beliefs run head-on into each other when discussing homosexuality, specifically homosexual marriage.

How should I feel about this issue, as a person? As a doctor? Religiously, I believe that there is a God, who is our spiritual father, and he's given us commandments. If we follow them, we are worthy to return and live with him forever. Most of these commandments deal with controlling the natural body -- putting the spirit in charge -- and ordering society. "Thou shalt have no other god before me..." etc. One of God's big commandments, is "Thou shalt not commit adultery." It's obviously elaborated further in the scriptures, but I believe that a person should abstain from sexual activities (not just intercourse, but felatio, etc.) until marriage, and should be monogamous after. Marriage is defined in the scriptures as a man and a woman. So I have a deep religious belief that homosexuals are breaking this commandment. It's a religious belief, and I do not feel any need to change it or apologize because the prevaling social norms are different.

Nevertheless, I live in a country where nobody is allowed to impose their beliefs on others. So I cannot stand on my horse and judge or meet out judgement on homosexuals because I feel they are breaking God's law. God, Himself, says that we should treat everyone with love and be subject to the laws of the land. As a doctor, I am required (and would feel awkward doing otherwise) to put aside my personal feelings about anyone, whether it be race, sexuality, religion, creed, gender, etc. and make sure that patient gets the best possible heathcare. I feel extremely strong on this point. No matter what my personal beliefs are on homosexuality and eternal salvation, there is no question about homosexuality and temporal healthcare. Everyone gets the same healthcare. I do my best for all.

I liked that about the talk. It was very eye opening. But then the question was asked, should physicians be required to treat LGBT patients (or any patient for that matter)? This gave me fits for quite awhile, but I think I've decided NO. The physician-patient relationship is special, because it is so contractual, yet the employee is the boss of the employer. Technically, the patient walking into my office is the boss. He or she decides to spend his or her hard-earned money on me, to achieve the outcome (better health, bigger boobs, etc.). However, part of that contract is that the patient basically relinquishes power to the doctor because the doctor has the knowledge and expertise. You let a lawyer draw up merger plans for your company because you have no clue how to do so. Same thing with a doctor, only the outcome of this "merger" really is life or death.

So, being a contractual relationship, I think the doctor has the right to say, no, I don't want to treat such and such patient, no reason necessary. On the other hand, a patient has the right to choose whatever doctor he or she thinks is best for him or her, even mid-treatment. Now, caveats. Today's HMO/PPO junk has limited the number of doctors people can see, true, but there are still many doctors out there so I don't think this is a valid argument against my point. The other caveat is that a doctor is oath-bound to save lives, and if there is not a reasonable alternative, I don't think any doctor can ethically turn away any patient.

Example: if you're the only doctor in a small town, you can't turn away townsfolk who have nobody else to go to. Or, if you come across a motor vehicle accident, you cannot ethically excuse yourself from giving aid to hurt passengers. But for standard, walk in patients with cuts, bruises, viruses, or chronic diseases, where there are other alternatives available, I think a physician is well within his or her right to refuse services just as a patient can stop services that he or she deems unneccesary or ineffective.

Tuesday, September 05, 2006

Day 23: U-pass Trauma

Today was a horrible day. I awoke early, drove fast, and arrived at school at 6:33am to get my U-pass. Remember, the place doesn't start selling them until 8:00am. I was the third person in line, behind a nursing student and a dental hygienist student who brought CHAIRS. Yes, chairs.

It didn't matter though. I looked down for my badge and my heart sunk into my jejunum when I realized I left it on the night stand by my bed. I live a freaking 45 minutes away in NO TRAFFIC. Rush hour? Forget it.

So I called my loving wife, and then my best friend Jamie. He hadn't left for work yet, so she ran it over to him. However, then my mom awoke (remember, still staying with the folks, bidding on condos) and she and Thi decided to run it down to me (faster). So they got ahold of Jamie, and the three of them plus another guy from the park and ride flew down the HOV lane towards downtown.

I gave up my place in line and watched vainly as person after person got their U-pass. They had 1107 passes, and I mentally ticked them all down. At 8:30am, 2 hours after I realized my bone-headed mistake, Thi walked in holding my badge.

Could I get my U-pass now? No. I have to go upstairs to the 22nd floor and get a dumb little sticker that says I paid tuition. Why they couldn't have sent it to me when I paid my tuition, or given it to me at orientation, I dunno. Red Tape is my least favorite color of tape.

So I got that, went back down to the first floor, paid my $52, and walked out with my little, blue U-pass. My mom and Thi raced home so she could change for a job interview (she made it on time) and I went to class late and eternally grateful to everyone.

And I'm supposed to be smart enough to be a doctor? I can't even remember my badge.

Monday, September 04, 2006

Day 22: Labor Day

How was everyone's Labor Day? Anything amazing or fun? I spent all day studying at Barnes & Noble. Yep, studied Devo (Developmental Anatomy). I hate that class. I will never be an OB/GYN.

I've consigned myself to the reality that I will never get a real holiday. When people are playing, I will be studying. The day after exams, I will play, and everyone else will work.

Yea.

Saturday, September 02, 2006

Day 20: Gross Saturday

I've decided that six-day study weeks are mandatory for passing in medical school. Not to get ahead, but to stay afloat. Today I had a great Gross Anatomy study day with Dung studying the neck. Man, that boy's got a memory. I wish I had a mind like his.

Also, we're bidding on a condo. Maybe, just maybe, by the second block, I'll be in my own place down close to school.

Friday, September 01, 2006

Day 19: Practicing Skillz

Today was my first Introduction to Clinical Medicine (ICM) practice day. There's this section of the school that was built to look like doctors' offices, and my class is split into groups of 20 or so who go on a specified day to practice our skills ... or lack thereof.

Today I got paired with a very beautiful and nice girl named Megan. One of the best attributes a doctor can have is a warm, heartfelt smile, and she has an award-winning one. In my opinion, this is very important because often a patient has no relationship with his or her doctor, but is supposed to open up and share what's wrong. A warm smile can help bridge that unfamiliarity gap quickly, which will allow the patient to be more expressive and help the doctor make a quicker, more accurate diagnosis.

Our patient was a girl named Jenny. A good looking nursing student who runs a lot. This was wonderful because we walked in and didn't know what to do. Well, Megan was on the ball, but I was a fool. I knew what to do, but not how to do it ... and that's ok. That's what the practice session is for. Jenny helped walk us through how to feel radial, brachial, and ulnar pulses, take blood pressure, and count respiratory rates.

The first time I did it, I got a good bp, something like 110/70 (ish) and thought I was doing good (except I wasn't sure if I was hearing the right stuff). The second time I got something like 100/60 and thought that was low, but Jenny just laughed and said it's high, because she's a runner.

So all y'all watch out!! I'll overestimate your blood pressure!!

Let's just wait for next time--it's heart and lung stuff.