Well, I'm closer to the Caribbean...

Being in Florida and all...

Apparently, one of the side effects to being a med student is that instead of spending my summers lazing around watching television, contemplating my navel, or succumbing to a secondhand headhunter job as a technical writer all of which I've done in times past, I actually make the most out of my summer because I not only feel like I did enough work to earn it, but it's only going to get worse from here, and graduation, rather than being a license to relax, is only the initiation ceremony to an onslaught of the-worse, which hopefully medical school will have taught me to handle, not in knowing everything (or anything), but simply in being used to being overwhelmed.

Now that, ladies and gentlemen, was the longest run on sentence in history. Even Dean Koontz couldn't have done better, and I read enough of him in my formative years (which probably explains a lot) to shape my entire adult string of verbiage.

But to expand, this summer I have gotten counseling for being an insomniac idiot, shadowed three orthopods including getting to play doctor by doing the preliminaries on a patient with a sprained wrist who didn't know I had no idea what I was doing (even got to palpate the area to deliberately induce pain!), studied endless biochem, and toured New Hampshire (including the White Mountains and hiking a number of the trails), Boston, Cape Cod, Maine, Montreal, Vermont, and now Florida, which added Pennsylvania, New York, Maryland, North Carolina, South Carolina, and Georgia to the itinerary (we drove) all in a fell swoop.

I'm not doing as well as Lori (part of the original team bravo and supporter of my left side during the sprained ankle fiasco), who has been doing a tour of Europe that causes me to go sick with envy, but I'm still chalking up the summer as a win. It still seems odd that it's coming to a close though.

To expand on the earlier biochem, I've been trying to rebuild my confidence after the crap at finals by learning this stuff so well that I aim to teach it. Since I've been visiting with my parents, doing this while not being completely antisocial involves a system of flashcards, where they get to feel (and are) helpful by reading my flash cards to me, I get to learn all my material, and they get to learn far more about biochem than they ever wanted to.

I'm embarrassed that it's gotten to an extent that this is how I'm spending time spent in line at Disneyworld, causing me to get the absolute *strangest* looks from fellow ride-waiters who now know WAY more about unconjugated bilirubin than they expected when boarding the Finding Nemo ride, which, for the record, is identical to the Haunted Mansion but without the dead people.

To backtrack, I spent the day at Epcot Center, being my first Disney destination because I'm an ubergeek. To compound my ubergeekness since I never grew out of my childhood love of aminals (up to and including ponies and puppies), tomorrow is Animal Kingdom.

Does this seem like an emotionally-stunted vacation for a 26 year old? Don't care. Disney rocks. Well... not Disney cartoons (except the Pixar stuff) because there isn't the wanton violence celebrated in the Warner Brothers tradition, but it is still a place that constructs an entirely artificial but temporarily convincing reality where one can forget that she is going back to medical school in two and a half weeks. Yargh. If I regress to 8 year old mentality, that gives me another 18 years before I have to take the biochem final, and in the meantime I can worry about which New Kids on the Block snap bracelet makes me look the most fly. I think I just dated myself.

In other news, I've gotten to learn to be junior phlebotomist (not at Disneyworld; Epcot hasn't expanded that much yet) on my dad while he was visiting since he has good veins, and I'm getting a more secure stick now. It's a strange thing to do that's hard to describe. Due to anatomy class relations on tests (you are aiming for the median cubital vein to draw blood when suddenly the patient screams and complains of pain and fingering in his first three fingertips. What nerve have you hit and what will your malpractice settlement be?), I'm actually more skittish about hitting major structures that I would have expected with my experience since I KNOW that nothing vital is that superficial and I'm not going to screw up that badly, but yeek.

Speaking of blood draws, I had to get stuck again (though it was the cleanest blood draw I've ever had; apparently my phlebotomist's dad had been patient too) and I'm immune to Hep B, which is pretty cool. Now if I could only get the rubella titers to show up, which they never do, thus I'll have to get the MMR shot... again.. like always, until the next time I have my titers drawn and rinse repeat. I think it's rubella.

To attract back the few prospective students that are getting tired of reading about my east coast adventures, which have absolutely no relevance whatsoever to getting into, starting, or attending medical school, there's a medical form you have to fill out, get approved by your doctor and all that, so if you have good health insurance, use it as soon as possible so you don't have to worry about it arranging it later on the school's insurance or in that scary time if you quit your job with some time left before you leave.

There doesn't seem to be a yellow fever risk on Grenada, and the last cases in Trinidad were, I believe, in the early 70s, so I opted out of that vaccine (it's not required nor necessarily recommended, but the combination of going to a tropical country AND entering the medical profession tend to bring with it a host of involuntary and voluntary vaccines), since the side effects of it tend to be grossly unpleasant. MMRV or titers are required, as is Hep B, and a TB test. I believe you can register for first term without at least some of them, but don't quote me on it. I know you can register if you have started, but not completed, a shot series, like for hep B, so don't panic if you get your health instructions right before school starts and don't have time to do the full series.

Meningitis is recommended, but not required. I went with it because though it's not a common condition, people with meningitis are going to go to the hospital, which is where you're going to be. I also went for it early (as in, before basic sciences) because I had good insurance at the time (thank you, temp job!) and without it, that is one pricey shot. It's also a viscous and uncomfortable shot, so go with the nondominant arm.

I got typhoid vaccine largely because I could and it doesn't have significant side effects (though anything can), but it's hardly a common condition (if ever) on Grenada.

Basically, the island of Grenada is relatively free of evil nasty bugs by virtue of being, well, an island. I believe Hep A is a risk, but not a big one, and a much bigger risk elsewhere. It doesn't have malaria, though in the rainforest, it does have rare cases of Dengue, so spray yourself down with mosquito repellent. I've never met anyone whose gotten it (though I've heard rumors that half the students with general flu think they have it), but it's out there. You're probably more likely to pick up exotic nasties on the plane ride down.

Well, I'm off to bed to hit the DisneyZoo tomorrow, but figured I'd update to let people know that the rushing approach of the new semester hasn't put me in catatonic withdrawal... yet.