Down to the wire...

Yup, path exam in 6 hours now, so what am I thinking primarily as I'm doing slide reviews?

I'm thinking... I'm becoming a doctor.

I'm thinking... I'm a mature adult.

I'm thinking... this means I will NOT laugh at the name of the Coxsackie virus. I will NOT laugh at the name of the Coxsackie virus. I will NOT laugh at the name of the Coxsackie virus.

Monday monday

Can't help that day... or something.

Yes yes, I've been gone, but after doing bupkiss for half the weekend, I've needed some serious study-on groove for my path exam Monday.

So far I feel cautiously optimistic. That optimism may prove fatal, but... well, what can you do? Just study more!

Micro's on Friday and has a significant chance of kicking my ass for neglecting it in favor of path. And I know it's a rookie mistake; I do, and yet, it is so easy to make.

The weirdest part is most of path seems easier, though more volumetastic, than micro. Path is a lot of this leads to this reviewing stuff from biochem and weirdly, stuff I remember from histo. Micro is a TON of properties, scattered letters that don't seem to relate to anything, and gram positive this PAS stain that. It also makes path more fun to study than micro.

So what's that mean? More fun + more units + daily labs = SEVERE MICRO NEGLECT

Addendum: I'm finally getting med student syndrome. Right now the scariest part of path is stuff like "50% of patients with deep vein thrombosis are asymptomatic. The first sign in many of them is a pulmonary embolism."

Ahhh! Is that an ache in my calf? Is that one? Is that one? Does my ankle swell because I sprained it a year ago, ignored orders to put it in a cast, and it never healed properly, or because ANY SECOND A GIANT THROMBUS IS GOING TO BREAK OFF, SHOOT TO MY LUNGS AND KILL ME???

The weirdest part is that all I can think about when I think about death (which you think about a lot when you stare at cross sections of hearts and lungs all day and the tutor gets mad at you for wanting to diagnose everything with an autopsy) is that I'll leave the loan companies losing a hundred g's on my decomposing brain. That comforts me somehow...

And speaking of death (to keep things cheerful), I was looking at the pretty pictures on webpath and got sucked into the forensic path section even though we're not due to study it for like another two months... I keep running from it, but it keeps calling me back. I LIKE diagnosing patients, dammit! Why do I keep looking at gunshot exit wounds going "I wonder if I could determine the caliber of that weapo... no! Must help the living!" And I blame UCD's Donated Body Program for this, where I first learned how UTTERLY cool criminalistics is. And that's without ever watching an episode of CSI, babies!

There was the play, then the work...

Easter Weekend, so Thursday and Saturday were my "enjoy the last fun you'll ever have" days, and now, with a week to go until my first path exam, the heat's on.

Saturday was Sandblast. Or more accurately, Sandblast, rejection of Karma for the Snooty Principle, Creole Shack, and Banana's. Hardcore, eh?

Sandblast was fun, though I got there late because I'm too lazy to even party on time.





But there were a ton of people all having fun, so that was great. Lost at a little beer pong, took some pictures, crawled into the opening to the security dog cages so I could get a picture on my hands and knees barking... You know, the usual stuff...



BUNCH of cruise ships out too. I was thinking of the poor people on board and how they probably just wanted to relax on a relatively secluded beach, only to stumble into the middle of Spring Break at a medical school they probably didn't even know was here.

Waves were crazy high too, almost up to the edge of the ladies, and a friend said there was a bunch of coral and rock debris thrown up the next day. Wonder what was up with the tides.

There was an afterparty at Club Karma, but I was with my friend Jay. We'd thought there was no dress code that night because everyone said there wasn't, but instead this one was very pointedly looked at him, said he couldn't go in and that by "Dressing down", it meant he didn't have to wear a nice shirt like the guy was wearing (wasn't that nice, dude), but no long shorts or whatever, and THEN there were student ID issues, and altogether, way too much "We're a New York nightclub" image-obsessed feeling, so wasn't worth it, and was glad to save the 20 bucks.

It's some people's thing, but I'm rarely dressed up anywhere, so I don't like clubs where the goal is to "be seen". So not a fan of Karma, I'm afraid. I'll take Victory Bar anyday.

Headed down to Creole Shack instead, because I wanted to stay on the Carenage for a while, since I really like it. Great place! I've been meaning to go there for about a year, but the people were really nice, they had some karaoke going on and the food was great and cheap. We started to walk back, and saw a youth basketball game going on where everyone was having a lot of fun and getting rowdy, and cheering their teams. We got invested, and even though they lost, GO BLACK AND YELLOW! Southern Pros!!

Afterparty, as always, at Banana's, but they'd converted their new awesome game room back into the "Club Banana's", which sucked because I really wanted to play darts. Ahh well. Still found good company and a good time, and everyone was out.



But now, path and micro own me for the foreseeable future. On the plus side, I like the classes. On the minus side, there's SO much studying. I know it sounds like all I do is go out, but honestly, the rest of the time it's just STUDY. Study for group, do the quizzes, do my slide presentations, do my concept maps, do the lectures, review the slides, review the staining techniques, check the book, go running with the Goljan lectures so that no time is wasted. Exhausting!!!

Let's just hope it pays off.

Life Lesson No. 14

Never say "surprise me" to a bartender.

Also, never say "I want a LOTTA vodka and a LITTLE Ting to guy doin' it for charity because you will get would you ask for.

In other news, I think I'm gonna die...,

They're onto me...

or at least like me...

Some brilliant med students have expanded the Bud Light's Men of Genius to extend to medical students, and they found me, but in dude form.



You may also know me as my alter-ego, "Always late for small group guy (girl)".

Cheap Humor

The best kind, well, next to bathroom humor, which Family Guy has covered.

I was studying at my desk and saw a bat-sized mosquito hanging out on the wall. Being practiced by this point, I grabbed the nearest object that I could to swat it...

thus grinding a mosquito corpse and a pretty significant blood spatter that I presume came from me, directly into the cover of the "Pathologic Basis for Disease".

I swear, I'm just going to rip the cover off and turn it in as my next concept map.

Er, Micro Dept?

I know you guys are having administrative difficulties and such, but muttering stuff that's not in the notes, saying we've been taught stuff that isn't covered in lecture OR notes, or instructing us to read the notes when the info isn't in the notes and saying "Know this, I ask questions on this" is completely uncool.

Not in lecture + not expanded in notes + not in lab + unclear slides + heading misspelled in lecture notes making even googling it difficult = SHOULDN'T BE TESTABLE!

Penicillin is pretty

Sorry, not feeling too creative tonight; I've gotta lazy brain, made lazier by micro...

But! Had my last wet lab in micro today (awwww), but penicillin under a microscope is quite pretty, versus Candida (think yeast infections), which is blah. Guess that's why penicillin is the good guy. Also, from cultures last week, discovered that my throat, though covered in stuff that grows disgusting looking stuff on blood agar (though not half as disgusting as the stuff isolated from black sand beach), doesn't have anything too destructive in it, which considering that I'm a slob, is amazing.

In other micro news, Dr. Cool-Guest-Lecturer-from-Immuno is back! Bringing in the pain with a cool story about the founder of microbiology...

Apparently, the revered Dr. Koch, in an effort to demonstrate that cholera causes... well, cholera, attempted to showmanship this idea in front of his rival, whose hypothesis was that cholera came from "bad air". Dr. Koch had a jug of isolated cholera, which his rival, to prove him wrong, drank.

And didn't get cholera. Oh schnap.

This was supposed to be a demonstration of how the host's immune system always plays a role in infectious disease, and we should keep that in mind when we study it. I, naturally, took the more selfish lesson that considering I've been disgusting since infancy, I have an immune system that by now has probably made me impervious to fungi, bacteria, and bullets, and can continue eating street meat in Grenada, tacos from beaten up shacks in Ensenada, and fish cheeks in the Philippines with impunity.

Though the fact that Dr. McP from parasit got malaria not once or twice, but five times, might be sufficient to give me pause. Or not... Maybe it just means I have to be careful of mosquitoes, but not feces-infused drinking water.

Another notable microbio fact is that 80% of SGU students as of a couple years ago, show antibodies for dengue. I haven't learned yet whether this means my immune system is stronger or if it means that if I get bitten by a mosquito carrying a different strain of dengue, I'll start bleeding out of my eyes. We haven't gotten to that lecture yet.

It was also a relief not to hear about Jenner for the fifteenth time. Jenner, for those who don't know, discovered the smallpox vaccine... by injecting it and smallpox into a small child. Whatta hero. I think I like Salk and Fleming better.

Happy Birthday Dad!

Okay, okay, it's not a very traditional cake, but it is drooltastic, I think anyone could agree, particularly when one has no access to such a thing. And 'baking it myself' isn't an option, because honestly, I'm a person that's challenged by Betty Crocker premix. Add that to a gas stove, and you have a disaster.

So what's new over at Casa de Rock? Path, path, path, and more path (and micro). Path has this odd combination of being both 13 units and, to date, extremely interesting, plus has the whole large group of people meeting nearly daily aspect to keep me from descending into my usual lazy slugism that keeps me perpetually behind. Not sufficient to make me go to lecture, though. It takes direct and persistent professor-pressure to do that.

What does that all mean? Ishie gonna fail micro. Yes, micro, the "little" five unit class that's difficult, has notoriously nasty exams, yet ends up getting back-burnered by so very many people because 5 seems so much smaller than 13.

And on that realization, what am I going to do now? Study more pathology, of course. Last night I was so buried in tuberculosis (mmmm... caseating necrosis), that when the power and internet went out in a fell swoop, I barely noticed.

As far as power outages in Grenada go, by the way, I believe this makes two, possibly three in total I've experienced since I got here. On the plus side, I got to use my new "emergency flashlight". On the minus side, Grenada still hasn't even come close to sucking at power provision the way California-under-Gray-Davis did. Though you pay for the privilege!

I am queen dork

Something the brighter of you will have figured out by now, and if not, the lego monkey dancing in the last entry should probably clear it right up.

I'm in the much reviled, much despised, much feared fourth term right now...

And was faced with a dilemma. I must study to keep my study on, my grades up, and my loan companies happy, but I must also exercise to keep my mind sharp and my ass from looking like my sofa. In addition to all this, I must, despite my chronic insomnia, sleep.

In fourth term, this leaves you with a significant hours-deficit. Even in the early days. What to do...

A friend of mine hooked me up with a macdaddy (collections of potentially useful files collected and compiled over the terms by upper termers and passed down, usually in exchange for good will, or in some of the clubs cases, 60 EC and a t-shirt) that contains over a gig of board review path lectures on MP3 format.

Oh, dilemma solved! So now, since jogging in a Caribbean country doesn't make me look like enough of a tool, I now do it hooked into my ipod listening to patterns of cell injury in the brain. It's finally the perfect mind/body workout! And as I sat on a rock point staring out at the water as the sun slid down (or the earth slid up; damn heliocentric view of the solar system), I thought "Liquefactive necrosis." And then I thought "Med school is weird". Then I walked home with a strange rotweiller following me until it got distracted by a stray goat. I didn't see the end result of that.

So path lab is going well. I like my group; they seem to rock the house and all, and put me in a position where I feel peer pressured to accomplish what I'm supposed to accomplish but we have designated go getters that ensure I don't have to arrange anything, which is absolutely freaking perfect. Control me, babies. Make me like it.

Path group is kind of a game of 'beat the tutor'. In that, if you know your shit well enough, and you talk fast enough, you can *probably* make it through your presentation without getting your ego shredded, IF you're lucky, and if you were not so unlucky as to have the preliminary slide to something someone else is presenting.

This keeps me on my game of course, because I do hate the blank fish-eyed stare I get when people ask me questions that I not only don't know, but have never heard the words involved before. This hopefully allows to blossom into the other subtype of group member... the bastard. The one that has always cross checked 17 other sources and knits them into a presentation that even the tutor can't find flaw in. And as you smirk and point out the "nontestable but still really important stuff", your group starts surreptiously arranging alibis for when your mangled body is discovered, no doubt with its head beaten in by the "oil lamps" in micro that we're using as bunsen burners. Who knew I'd been camping with a bunsen burner? My food should have been way better.

BUT, by the end of the class, I should know how many things I'm gonna die off after doing :THIS: in Venezuela:



So it's to bed, earlier than usual.

Intermission

Important med school tips

Brought to you by the microbiology department.

This week's subject: Black Sand Beach

Micro lab is ridiculously fun. This is largely because IT'S ACTUALLY A LAB. Most "labs" in med school constitute of sitting around a table with other people and either panicking each other with the minutia they don't know, or discussing the previous night's episode of House, Grey's Anatomy, or Lost, depending on your preference, until the clinical tutor yells at you. Sometimes, like in physio, it consists of arguing with your clinical tutor over type 1 diabetes because your professor has given you conflicting (ie: correct) information that the tutor is insisting isn't true (not you, neuro dude. You still rock). So they're not so much labs, which implies that you're getting to manipulate stuff you don't want on your clothes (at least to me), as "group study sessions", which is all well and good unless, like me, when you study you're so solitary and territorial that you not only get a single apartment largely for that reason, but consider peeing in the corners of it to keep out wolves.

But I was talking about micro lab.

In micro lab, it consists of donning scrubs and/or a lab coat and finding just how disgusting the world around you is.

First of all, the lab air. I'm going to really hope our agar plate was that nasty because a fly landed in it last week and not because I'm actually regularly breathing that shit in because otherwise my lungs are going to look like rotting hamburger meat and I'm going to bring some gnarly pathogens back to the US if I live that long.

Second of all, last week, since I've been wondering about the level of nasty at Black Sand Beach since I got to this school, I sprinted down the hill and raced BACK up the stairs to the lab solely to get a good solid sample of black sand beach funkiness.

This week, the results were in. Ewwwwww... It's telling when after sampling one of your colonies, you call over one of the circulating professor/tutors to ask what on earth you're seeing, follow up with "Would you swim here?" and they look through the microscope and go "nooooo".

It's also telling that after my run to and fro last week, I was quite literally dripping with sweat so suggested one of my other group members take her swab from my armpit, to which she replied "Ewww!" before promptly shoving the swab up her nose. Details.

Most annoying disorders...

Submit your nominations. Right now I'm going with "paronychia", which I now know what to call thanks to pathology. That's an infection around the side and base of your fingernail.

Now, in path, inflammation seems to largely be divided into duration of problem, morphology of exudate (that's the stuff that oozes out of your particular problem), and location/special forms. "Paronychia" is appropriately considered a location/special form, but I think there should be a new category of disorders in "things that hurt disproportionately to the area they occupy, and should get you a lot more sympathy than they actually do."

I'm guessing the top of that list would be a three way tie between "paronychia", "stubbing your baby toe" (characterized clinically by a patient's increasing volume and complexity of profanity over time), and "swollen taste bud".

Farewell Fun...

And I'd like to just take this moment to reflect on all the good times I had over third term and the first week of fourth term... the days without studying; the lounging around doing nothing, the multiple beach trips, the "catching up" 6 lectures in a weekend and still having time to do a grocery shopping, a hash, a winebar dinner, and 8 Skype conversations without breaking a sweat.

Those days are gone as of 10 am tomorrow morning, replaced by a looming 13 unit beast known to mere mortals as "pathology", and known to SGU students as "the reason why fourth term will take 17 years off your life and make you rue the day you ever decided to don the stethoscope".

Adding to the suffering will be microbiology, which, for the last week, has been our only class, which at 5 units, still makes it the equal to physio or neuro (but not both), but by itself, hasn't been too bad, and featured a lab that was not only fun but at a time of day where I was awake enough to not spill Gram's iodine and infectious Black Sand Beach nasties all over myself.

And adding to the suffering will be fourth term Clinical Skills, which in practice, is cool because you get to play doctor, and in reality may be grueling because, well, it's one more class in addition to path and micro.

And adding to the suffering will be nutrition, which is only 2 units thrown in after micro ends, but it's one more class in addition to path and micro and clinical skills.

Holy crap, right? That's a lot of units!

Path lab will be, I believe, a daily affair, where we split up into groups, present slides, and while the path tutors aren't looking, I'm guessing, hold group therapy sessions. Path lab also inexplicably includes a dress code despite the fact that we aren't working with any materials (unlike micro lab) and we all live in the Caribbean where even the professors wear sandals to class. No visible tattoos, no wacky hair or piercings, no shorts, no tank tops, no no no no. Ostensibly, this is to treat us as "doctors". The fact that the dress code is far more similar to a 1950s Catholic Junior High school than a hospital should probably be overlooked. Having carefully reviewed the dress code, I've determined that if they don't allow scrubs and trail runners, then I'm screwed, because beyond that, the next "nicest" is boot cut jeans and ventilated sneakers I use for hiking in mud.

For the time being, I'm trying to stay positive. It seems like fourth term will consist of stuff I like, and be real medicine, diagnosing and proper House type stuff rather than simply knowing the nitty gritty of how the human body works, since it is FAR more interesting when it doesn't.

I celebrated the send off by a nice romantic dinner/movie Friday night, a study sleep day on Saturday complete with a jog that ran me into Dr. Bob and his niece (Hi guys!), and a beach trip with a swim today.

Friday marked my first Grenadian movie theater experience, so I can comment on that...

Why are the seats so close together? There were 6 people in the theater, but the seats in front of you are so close that it's like being in coach class on an island hopper.

Earth to projectionist: Please put the movie in the correct aspect ratio, because otherwise you see the top and bottom parts of the movie that were supposed to be cut out, but the wide screen aspects are chopped off, thus while watching American Gangster, rather than seeing whatever it was Denzel Washington was looking at that was off screen, I figured he was looking at the boom mic that was following him around. That thing got more face time than Ruby Dee did. It was in no less than 20 scenes, so as Dave and are watching it, and unfamiliar with the "this is a projectionist screw up, not a directing screw up" rule, we're whispering to each other "This movie is directed by Ridley Scott, and has at least five really big name actors in it. There is no WAY it could have been edited this badly."

But it was still a good time, got back to Dave's place and he cooked incredibly good fish for me, which I matched with Bordeaux since it was the only thing I had around the house. Mmm... Bordeaux.

Today, I mixed up my exercise regiment, or so I told myself, by snorkeling sans snorkel but found a healthy section of reef off Grand Anse and spent a good bit of time chasing lobsters (no, not trying to catch them, tres illegal and all), bristleworms, flying gernards, and in the swim back, a snake eel whose tail I was able to touch (not grab), a fact he wasn't too happy about.

He also wasn't that fast though, so I didn't get a cool "snake eel" bite to tell all my friends about. D'oh.

Have I mentioned that you get progressively stupider as you go through medical school? Ah well, that's probably self-evident.

Here's another hash picture before bed: